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Coeliac Awareness Week 2023

What is Coeliac Disease?

Coeliac Disease is an immune response to the protein gluten which is contained in certain grains and ends up damaging the lining of the small intestines, flattening down the villi so that it is harder for your body to absorb nutrients from food. It is not an allergy to gluten or wheat but an autoimmune disease where the gluten in the grain (wheat, barley and rye) triggers the immune system to produce antibodies that over time damage the lining of the small intestines.

Symptoms of Coeliac disease can include diarrhoea, abdominal pain, mouth ulcers, anaemia, skin problems like psoriasis and weight loss, but not everyone gets the same symptoms.

Non-Coeliac Gluten Sensitivity

Over the last few years there has been recognition that a person can be sensitive to gluten but not have full-blown Coeliac disease. So you might have symptoms that are similar to those experienced in Coeliac disease but antibodies in the blood are negative and it does not cause damage to the small intestines.

When this is the case, you might still benefit greatly from a gluten-free diet, seeing dramatic improvements in your symptoms and your sense of health and wellbeing in general. (Volta U, De Giorgio R, 2012, New understanding of gluten sensitivity, Nat Rev Gasstroenterol Hepatol, 9, 5, 295-9).

Symptoms of non-coeliac gluten sensitivity can include not only gastrointestinal ones like bloating, abdominal pain or discomfort, diarrhoea, constipation but also tiredness, lethargy, migraines, headaches and joint pains.

Research is suggesting that gluten sensitivity is extremely common and could affect up to 10% of people compared to 1% for Coeliac disease (Hogg-Kollars S et al, 2011, Gluten sensitivity a new condition in the spectrum of gluten-related disorders, Complete Nutrition, 11, 4, July/August).

It is thought that the toxic peptides of gluten may actually trigger auto-immune conditions in different parts of the body e.g. Hashimoto’s thyroiditis, Lupus etc.

Research shows that non-coeliac gluten sensitivity can upset the balance of bacteria in the gut, cause inflammation in the brain, increase cognitive dysfunction and increase a person’s vulnerability to Alzheimer’s. (Daulatzai MA, 2015, Non-celiac gluten sensitivity triggers gut dysbiosis, neuroinflammation, gut-brain axis dysfunction, and vulnerability for dementia. CNS Neurol Disord Drug Targets, 14, 1, 110-31)

Wheat Allergy

I will mention wheat allergy briefly just to make clear the difference between a wheat allergy, Coeliac disease and gluten sensitivity.

A wheat allergy is the type of allergy where you would have an IgE antibody reaction to one of the proteins in wheat as measured on a blood test. Symptoms can include nausea, bloating, hives and also breathing difficulties. And like other IgE reactions to other foods, such as peanuts and shellfish, it can cause a life-threatening anaphylactic allergic response.

When a person has a wheat allergy they only have to eliminate wheat from their diet, not other grains such as rye and barley (which a Coeliac would have to eliminate).

Gluten

Gluten is a protein found naturally in grains. Over the years the gluten content of wheat has been altered to be increasingly high so that the grain does not fall apart as it goes through commercial bakery machines. Obviously, commercial bread is not made by hand and so the grain has to be robust enough to endure the factory process.

Gluten acts like glue, it is stretchy and sticky (think of how a mixture of flour and water is often used as a paste for gluing papier-mâché). The problem is that it has the same effect inside your body, making it hard to digest and also absorb nutrients. You may also suffer from symptoms such as abdominal pain, bloating and diarrhoea as well as other non-digestive related symptoms such as tiredness, headaches and joint pains.

Grains like rye and barley also contain some gluten, but in much smaller amounts than wheat. Oats don’t naturally contain gluten but they can often become contaminated with gluten during growing because the oats can be next to the wheat fields and can also be contaminated during the milling process.

There are now gluten-free oats available but some people who react to gluten can also react to a protein in the oats called avenin which is similar to gluten.

Spelt is another grain that contains gluten and is often called ‘ancient wheat’ because it is one of the original strains of wheat. The gluten in spelt is different from the gluten in wheat in that it is much easier to digest and a number of people who find wheat a problem can tolerate spelt.

Get used to reading the ingredients of foods like condiments. For example, lots of soya sauces contain wheat so it is often better to look for wheat-free tamari. I know you can buy gluten-free breads and other baked foods but the ingredients have, in general, appalled me. The aim seems to be to make the food ‘gluten-free’ and disregard the health aspects of the food, so other ingredients like sugar, artificial colours and flavours are often added. If you have Coeliac disease you have to avoid gluten but still to eat healthily. Again, read labels carefully.

If you would like to explore whether a consultation with an expert nutritionist at the Glenville Nutrition Clinic could help you, please contact us on 01892 515 905 or send us an email at reception@glenvillenutrition.com

The Beat Hay Fever Diet

If you’re a hay fever sufferer you’ll know how the unpleasant symptoms of a runny nose, sore scratchy eyes and sneezing can make the summer months a misery. But interesting research has found that the food you eat may be increasing your risk of these unpleasant symptoms.

For many years research has shown that fruit and vegetables contain remarkable substances called antioxidants that can help fight infection and disease. But now it seems that the health and immune boosting benefits of five fruit and vegetables a day can also extend to allergies like hay fever too.

A few years ago, a study asked parents of 690 children aged one to eighteen to fill in detailed questionnaires about their children’s eating habits. The children were tested for the 10 most common allergies and those who ate the most fruit and vegetables had up to 60 percent lower risk of developing hay fever. Top of the menu were tomatoes, oranges, apples and grapes. More research needs to be done but another study carried out on 334 people, suggested that EPA (an omega-3 fatty acid found in oily fish like mackerel and sardines, as well as nuts, seeds and legumes) can reduce risk of hay fever.

In addition, certain foods have been found to cross react with pollens, making symptoms worse. For example, if you’re allergic to birch pollen, your hay fever may be made worse by apples. The key is knowing exactly which pollens you’re allergic to so you can tailor your diet. You can have a blood test for inhalant allergens to check what you are allergic to.

If you are interested in having this done, it can be the clinic so call 01892 515905 and ask to do the Inhalant Panel. This comprehensive blood panel tests for tree pollens including walnut, birch, elm, maple, oak; grass pollens including orchard, timothy, rye, meadows; weed pollens including ragweed, plantain, lamb quarters, Russian thistle; moulds and dog dander, cat dander, cockroach and dust mites.

Here are some typical pollen and food combinations that may make your symptoms worse:

Birch – March to May
- Triggers: Celery, curry spices, raw tomato, raw carrot, apples, pears, kiwi
Grasses – May to August
- Triggers: Oats, rye, wheat, kiwi, raw tomato
Weed – May to August
- Triggers: Raw carrots, curry spices
Mould – September to October
- Triggers: Yeast

Once you establish exactly what kind of pollen you are reacting to, remove the foods known to cross-react with it from your diet for a week to ten days and take note of your symptoms. Then gradually reintroduce one food at time to see what the effect is. This is important because a number of foods associated with pollens are full of good nutrients, so you want to cut out as few of them as possible.

If you notice that your symptoms return after reintroducing a certain food eliminate that food for the season, then go back to eating it once the pollen season is over. Do bear in mind that this is not a cure-all and not everyone with hay fever is affected by foods. The good news, however, is that the great majority of pollens are only around for up to three months maximum, so you don’t need to give up these foods forever. And in some cases, such as tomatoes and apples, cooking will destroy the substance that is triggering the reaction.

Send pollen packing:

In addition to the dietary advice above, if you’re allergic to a pollen and have a problem with hay fever, try the following suggestions:

Use a tumble dryer: Try not to hang your laundry out on a line to dry because it will pick up pollen. Using the dryer may not be energy efficient, but it can help cut down on hay fever symptoms during the months that you are most prone to them. If you must put it outside, do so between 10am and 3pm when the count is lowest. After your pollen season is over you can go back to using the washing line.

Shut it out: Keep pollen out of your bedroom by getting undressed in the bathroom and showering before bed. Keep windows closed at peak pollen times, from late afternoon to early morning, and check local pollen-count forecasts.

Change your exercise routine: Regular exercise boosts your immunity to hay fever, so be sure to work out at least 30 minutes a day. Sadly, outdoor activity increases your risk of symptoms. In general, pollen counts are highest in the early morning and decline through the day so consider planning your outdoor walk, run or bike for late morning or late afternoon. If pollen counts are really high consider exercising indoors that day.

Wear sunglasses: If you have to be outdoors when pollen counts are high, make sure you wear sunglasses. They will act as a barrier to prevent pollen getting into your eyes.

Hoover up: Vacuum the carpet every couple of days and dust with a damp cloth. Pollen can survive indoors for up to three months.

Say yes to nutrients: Studies have shown that vitamin C and quercetin have both been found to significantly reduce symptoms.

Visit the seaside: Many people find symptoms disappear on the coast because sea air is less polluted and onshore breezes blow pollen inland.

Don’t let smoke get in your eyes: Not surprisingly, smoking aggravates symptoms; plus children exposed to more than 20 cigarettes a day are three times more likely to develop allergies like hay fever than those who are exposed to none.

Dementia Awareness Week

Did you know that Dementia is an umbrella term that includes up to 100 different types of diseases?

Most common type is Alzheimer’s disease, which occurs in 50 to 75 per cent of cases – caused by plaque and tangles developing in the brain. Plaque are clumpy spheres that float between the neurons and prevent the transmission of messages to each other and the tangles actually choke the neurons from inside.

Next most common is vascular dementia at approximately 20 to 30 per cent – problem of supply of blood to the brain.

Alzheimer’s is the leading killer of women, three times more deaths than breast cancer, third biggest killer for men.

There are 850,000 people with dementia in the UK and it is estimated over 1 million people in the UK will be diagnosed with a form of dementia by 2025.

The total annual cost of dementia in the UK is £26.3 billion

The Alzheimer’s Society charity estimates delaying the onset of dementia by just five years would reduce deaths directly attributable to dementia by a staggering 30,000 a year!

Preventing memory loss is important whether you are a young person, middle aged or older as we know that it can take up to 30 years for symptoms of dementia to present themselves.

Did you know?

1 in 3 people over the age of 60 has problems with recall
Dementia is now the leading killer of women, causing three times more deaths than breast cancer
Changes in memory and concentration are major symptoms in women leading up and after the menopause
It is the third biggest killer for men
The financial cost of dementia to the UK is £26 billion per annum

Research shows that diet and lifestyle have more to offer the ageing brain than the drugs that are promoted to manage it. Physical activity is also important for healthy brain function.

One study tracked a group of people over eight years. The researchers found that those people who were the most active had a 30% lower risk of cognitive decline. What was interesting was that it was not the intensity of the exercise that made the difference but the amount.

So, with walking, the distance the people walked was more important than how fast they walked.

There are plenty of lifestyle changes you can make to boost your brain power and getting enough sleep is one of them.

Just as your body needs regular exercise, your brain needs regular exercise too.

Keep it fit by playing cards and chess games, reading books, doing crosswords, learning an instrument or new language or by pursuing a new hobby.

Supplements of omega 3 fish oils can be helpful as DHA one of the major omega 3 fatty acid in the brain has most protective effect against Alzheimer’s.

The DHA in Omega 3 fatty acids helps to prevent the plaque forming in the brain which is present in Alzheimer’s, and they help improve cerebral blood flow and reduce inflammation, making them important in the fight against not only Alzheimer’s but also vascular dementia.

Other nutrients which can be helpful include anamino acid called acetyl-L-carnitine as it increases the brain receptors that would normally deteriorate with age so are helpful for memory loss and dementia.

People with Alzheimer’s have been found to have a shortage of the neurotransmitter acetylcholine and it is critical for memory and brain function.

Choline is a starting block for acetylcholine and is contained in high amounts in egg yolks and is also found in soya and nuts. So these are good foods for boosting memory and brain function.

Acetyl-L-carnitine works with coenzyme Q10 and alpha lipoic acid to maintain the function of the mitochondria. The mitochondria are the power houses of your cells, they provide the energy for your cells to function and survive.

In one study, people taking vitamins, B6, B12 and folic acid (vitamin B6 20mg, vitamin B12 500mcg, folic acid 800mcg) had 90% less brain shrinkage compared to those using a placebo.

How What You Eat Can Protect You Against Alzheimer’s and Dementia

Feed Your Brain

What you eat can have an enormous impact on your brain function as a study of over 1,000 people followed over 5 years showed that eating a Mediterranean diet is linked to less of a risk of memory loss and problems with concentration. The advice is to increase the consumption of fresh fruit and vegetables, olive oil and eat more oily fish and cut out processed, fast and convenience foods.

Making sure you keep your blood sugar in balance is also important as poor blood sugar control has been so closely linked with an increased risk of Alzheimer’s that it has been suggested that Alzheimer’s should be called type 3 diabetes.

Almost three quarters of people – a staggering 70 per cent – with type 2 diabetes are now known to develop Alzheimer’s, compared with only 10 per cent of people without diabetes.

Tips for balancing your blood sugar.

Try andeliminate added sugar as much as possible and also refined carbohydrates like white bread, white rice as they are turned to sugar (glucose) quickly in your body and your pancreas has to produce more insulin in order to deal with them. Eat little and often, leaving no longer than three hours without eating, so breakfast, mid-morning snack, lunch, mid-afternoon snack and dinner.

Make sure you have breakfast otherwise you are more likely to reach for a coffee and a cake at 11am because your blood sugar will have plummeted. You may feel moody, irritable, tense and not able to concentrate. Always eat breakfast and make it a mixture of protein and carbohydrate – avoiding sugar-laden breakfast cereals at all times.

Include protein with every meal as it slows down the blood sugar rise from the carbohydrates. So, whenever you eat an oat cake or brown rice, include some fish or eggs, or a vegetable protein such as quinoa, legumes (in the form of, say, chickpea hummus), nuts (nut butters, such as almond butter, are good) or seeds. The body takes longer to process proteins than other foods, so adding protein effectively slows down the absorption of the carbohydrate.

Be booze aware

Alcohol has an effect on your blood sugar, so look for drinks with a lower sugar content. Spirits do not contain sugar, but their mixers usually do. White wine is more sugary than red, but on the other hand a white wine spritzer (made with sparkling mineral water) will be better for you than a full glass of red wine.

Nurture your nutrients

Certain nutrients can also be helpful in keeping your brain healthy and can be thought of as being supplementary to your diet.

Supplements of omega 3 fish oils are particularly helpful as DHA, one of the major omega 3 fatty acid in the brain, seems to have the most protective effect against Alzheimer’s. The DHA in Omega 3 fatty acids helps to prevent the plaque forming in the brain which is present in Alzheimer’s, and they help improve cerebral blood flow and reduce inflammation, making them important in the fight against not only Alzheimer’s but also vascular dementia.

Other nutrients which can be helpful include anamino acid called acetyl-L-carnitine as it increases the brain receptors that would normally deteriorate with age so helpful for memory loss and dementia.

People with Alzheimer’s have been found to have a shortage of the neurotransmitter acetylcholine and it is critical for memory and brain function. Choline is a starting block for acetylcholine and is contained in high amounts in egg yolks and is also found in soya and nuts. So, these are good foods for boosting memory and brain function.

In one study, people taking vitamins, B6, B12 and folic acid (vitamin B6 20mg, vitamin B12 500mcg, folic acid 800mcg) had 90% less brain shrinkage compared to those using a placebo.

The research suggests that there is a 20- to 30-year interval between first development of amyloid plaque and onset of dementia. So, no matter what age you are it is never too late to change your diet to help protect your brain health.

How Does Stress And Poor Sleep Increase Your Risk Of Alzheimer’s and Dementia

There are plenty of lifestyle changes you can make to reduce your risk of Alzheimer’s and dementia and getting enough sleep and reducing stress are two of them.

Get enough shut-eye

Too little sleep increases your risk for Alzheimer’s because amyloid plaque, which is one of the structural changes seen in Alzheimer’s is cleared away during sleep, when your cerebrospinal fluid washes out toxins from your body. This cerebrospinal detoxification only happens during sleep. Brain cells shrink, making space for the fluid to flow freely through and around them clearing out the waste. And the best position for clearing out this plaque is to sleep on your side.

Sleep is so important for your memory as it consolidates the effects of your waking experience by converting those memories into more permanent and enhanced forms. This also makes it easier to retrieve those memories when you need them.

Aim for six to eight hours. If you are not already sleeping well, you should look at your bedtime routine. Poor ‘sleep hygiene’ is the most common cause of insomnia and disturbed sleep. Your busy, active brain needs to be treated like a dimmer switch and allowed to wind down slowly. Ideally, you should allow about 40 minutes to switch off with whatever relaxing routine you find most helpful – for example, having a bath, reading, or listening to an audio book.

But before you do any of that, you need to switch off your TV, phone and tablet – at least an hour before you intend to go to bed. This is not just about bombarding your brain with information just before you try to sleep, there are physical factors at work: backlit screens, such as those of a tablet or smartphone, emit blue light that interferes with your body’s production of melatonin – the hormone that regulates your body’s circadian rhythm, the 24-hour rhythm of day and night.

Exposure to bright light of any colour before bed will suppress your melatonin production – it’s just that blue light is worst of all. Studies show that sitting in bright light compared to a dim light delays melatonin onset and shortens melatonin exposure by up to 90 minutes – that is, it takes a full hour and a half for the effects of bright-light exposure to wear off and melatonin to kick in and make you feel sleepy. If the room light is left on during sleep, melatonin secretion is suppressed by greater than 50 per cent.

Top tips for a good night’s sleep

As well as putting away screens one to two hours before you go to bed and creating a relaxing bedtime routine, try adopting the following as part of your good sleep hygiene:

Use blackout curtains or blinds, which can stop morning light waking you too early, and will help to mask the light of bright streetlights, if you have it, outside your bedroom window.
Don’t have an alarm clock or night light that emits a light during the night.
If you need a night light (for example, to light your way to the loo), then use a dim, red light, as this bypasses your optic nerves in such a way as not to interfere with your body’s production of melatonin.
Get lots of bright light during the day and early evening, as this will help improve your sleep and melatonin levels. It could also help prevent sundowning (an increased state of confusion towards the end of the day) in people with Alzheimer’s.
Keep your bedroom cooler rather than warmer, then layer on blankets that you can add or remove during the night if you get too cold or hot.
Use cotton bedding, which will enable your body to regulate your temperature more effectively during the night, improving your ability to sleep through.
Get a comfortable mattress – the best and most comfortable you can afford!

When you want to get to sleep quickly and sleep well throughout the night then a good combination of natural ingredients including magnesium can help. Valerian reduces the amount of time it takes to fall asleep and also improves the quality of that sleep. Hops have a natural sedative effect and a long history in helping to improve sleep. Research has shown that both valerian and hops can reduce restlessness and anxiety. L- theanine is important to help your brain ‘switch off’ when going to sleep. Other herbs such as chamomile, passionflower, skullcap and lemon balm are known for their sleep-inducing effects. And tart cherries have been shown to increase sleep time in people with insomnia by up to 84 minutes.

Reduce Stress

Research has shown that that experiencing stress in midlife can increase your risk of Alzheimer’s and dementia later on.

Try to devise strategies to reduce the amount of stress you are under – asking for help, delegating, and learning to say no are all good ways to start. If your job is stressing you a lot, can you change it – if not completely, then in small but significant ways (reduce your hours, move department)? If friends are overloading you, can you take a step back?

Balancing your blood sugar is essential in lowering stress because the crashes in sugar levels which happen through the day (due to going long periods without food and not eating the right foods) stimulates the stress hormones, adrenaline and cortisol to be released. This is because these stress hormones, apart from helping you to run away from danger, can also mobilise your glucose (which has been stored as glycogen in the liver) back into the blood stream. This is why you can feel more jittery, irritable etc when your blood sugar plummets!

So, ensure you have a small meal every 2-3 hours that contains protein (eat breakfast, lunch and dinner plus a snack mid-morning and one mid-afternoon). For example, a hard-boiled egg, 10-12 almonds, a small can of tuna and brown rice. This will stop those roller-coaster highs and cravings for sweet foods. Because your blood sugar isn’t allowed to drop, your body will no longer have to ask you for a quick fix. As your blood sugar steadies, you will feel less stressed even though you might not be able to control the stress going on around you.

Certain nutrients can be very helpful in reducing stress levels, such as B vitamins, especially B5 for stress relief and energy, magnesium (known as nature’s tranquiliser) for relaxation and sleep, chromium for blood sugar balance, L-theanine for reducing anxiety and finally Siberian Ginseng, which acts as a tonic to the adrenal glands.

What Are The Top 7 Risk Factors For Alzheimer’s And What You Can Do About Them?

From poor nutrition to lack of exercise, there are several factors which can increase the likelihood of you developing Alzheimer’s.

An Unhealthy Diet

It is extremely important that you eat well, as your mind and body are very much connected. We know from research that eating a Mediterranean diet leads to less memory loss and/or problems with concentration. We also know that the Mediterranean diet is important for helping to keep your heart healthy, and this is just as important for your brain. The risks for Alzheimer’s are increased by many of the same conditions that damage your heart and blood vessels e.g., heart disease, stroke, type 2 diabetes, high blood pressure and high cholesterol, so it is important that you do your best to follow a balanced, healthy diet, to reduce the risk.

Lack of Exercise For Your Mind and Body

Physical activity is very important for healthy brain function. One study tracked a group of people over eight years. The researchers found that those who were the most active had a 30% lower risk of cognitive decline, and the amount of exercise made a bigger difference than the intensity. So, with walking, the distance walked was more important than the pace. Some experts have even linked strength training with a lower risk of cognitive decline because parts of the brain grow as your muscles do!

Researchers suggest that the positive effects of exercise on cognitive function occur because exercise can increase hippocampal volume, reversing age-related loss in volume by one to two years. (The hippocampus is the part of your brain that shrinks as a symptom of Alzheimer’s.)

As your body needs regular exercise, your brain needs regular exercise too. Keep it fit by playing cards and chess games, reading books, doing crosswords, learning an instrument or new language or by pursuing a new hobby.

Not Getting Enough Sleep

Too little sleep increases your risk for Alzheimer’s because beta-amyloid protein is cleared away during sleep when your cerebrospinal fluid washes out toxins from your body. You should try to aim for 6 to 8 hours of sleep most nights.

Certain Medications

Proton pump inhibitors (PPIs) are a medication to help reduce acid reflux, and they are now thought to increase the risk of developing dementia by 44 per cent because they increase the level of beta-amyloid in the brain.

In addition, there are several other over-the-counter medicines which include anticholinergics – found in treatments for colds, flu, heartburn, sleep problems – that block the chemical acetylcholine that your body needs to transmit electrical impulses between nerve cells. Recent research shows that those people taking these drugs have reduced brain volume (known as brain shrinkage) and they performed less well on memory tests.

Try not to only use over-the-counter medicine unless you really need them and if you are on a prescription medicine, ask your doctor if there are any other alternatives.

Family History

You may have a strong family history risk of Alzheimer’s, so it is important to think about dietary and lifestyle changes you can make to reduce your chances of developing the condition yourself.

You may worry that Alzheimer’s is in your genes. Some genes do directly cause early onset Alzheimer’s affecting those people aged between 30 and 60. However, genetics are responsible for less than 5 per cent of all Alzheimer’s cases.

It’s important to remember that if you have a strong family history of Alzheimer’s, it is not inevitable that you are going to develop the problem, so it is important to work on prevention and it’s never too early to start.

Vitamin D Deficiency

We have known for many years that vitamin D is important for bone health and in the prevention of osteoporosis. However, it is only in recent years that we have realised how important this nutrient is for general health, particularly for brain health. We get most of our vitamin D quota from sunlight because natural food sources are few. Research has shown that if you are moderately deficient in vitamin D, you have a 69-per-cent increased risk of Alzheimer’s and the risk increases to 122 per cent in those who are severely deficient.

Choose vitamin D in the form of D3, also called cholecalciferol. There is a cheaper form, called D2 (ergocalciferol), but research suggests that vitamin D3 is 87 per cent more effective at raising and maintaining your vitamin D levels than vitamin D2.

Stress

Unfortunately, stress increases your risk of Alzheimer’s. You may think that you can’t control stress – but you can control how it affects you physically, and you can make sure you are not exacerbating it. There is a chance that your pattern of eating is subconsciously telling your body that it is under even more stress. The reason is that if your blood-sugar levels fluctuate, your body releases adrenaline and cortisol, which are the same hormones it releases when you are under stress.

Try to keep your blood-sugar levels stable by eating something every three hours and be careful if you are drinking a lot of coffee. Eat breakfast, lunch and dinner, plus a snack mid-morning and one mid-afternoon, with no longer than three hours between. This will stop those roller-coaster highs and lows and cravings for sweet foods.

Vegetarian Awareness Week 2023

Make sure you are getting enough protein in your diet. You could make the change gradually and still include fish but stop eating meat and poultry. And then over time stop the fish once you have got used to not having meat and poultry. Most vegetarians will still eat eggs and dairy foods.

What do I need to consider when changing to a vegetarian diet after eating meat?

Are there nutrients I might be missing out on, and how should I supplement this with other types of food?

None for a vegetarian diet if you are still eating a good variety of foods with some animal protein like eggs and dairy.

Likewise, what do I need to consider when changing to a vegan diet after a vegetarian diet?

I do not advocate a solely vegan diet and I think some animal protein such as eggs are important for your health. If you become vegan there can be issues with not enough vitamin B12, calcium and iron. You would need to make sure you are getting enough vegetable protein in the form of quinoa, nuts, seeds and beans.

Also make sure you are getting enough iron. Non haem iron is found in plant based food and haem iron is found in animal foods. Good non haem sources of iron are beans, nuts, sprouted beans, cereals and green leafy vegetables. Vitamin C helps to increase the absorption of iron.

Because vitamin B12 is found in animal foods then, as a vegan, it can be more you to get enough B12. It will be in fortified foods and yeast extracts but you may need to take a vitamin B12 supplement.

Aa a vegan you also need to make sure you are getting enough omega 3 fats which would come from oily fish or egg yolks. So you will need to include vegetable sources of omega 3 such as flaxseeds and chia seeds.

For both vegetarians and vegan it is important to think about eating healthily and not just cutting out meat. Unfortunately you can have unhealthy plant based diets because you are not eating any animal foods but may be living on white bread and lots of cakes and biscuits with added sugar.

I also don’t agree with meat substitutes which are often made with unhealthy ingredients.

What are the main benefits of cutting back on meat?

The meat issue is that certain carcinogenic chemicals are formed when the meat is cooked. These are called heterocyclic amines (HCAs) and are formed when amino acids and creatine (a chemical found in muscle) react at high temperatures. They are found in cooked muscle meat (which includes not only meat but also chicken and fish but would not be found in other animal proteins like eggs) and the higher the temperature of the cooking the more of them are formed so frying, grilling and barbecuing produces the largest amounts of HCAs. Stewing, boiling and poaching are done at much lower temperatures and produce insignificant amounts of HCAs. The research suggest that eating more than one and a half servings (4.5 ounces) of red meat can double the risk of breast cancer compare to 0.75 servings a week (Cho E et al, 2006, Arch Intern Med, 166: 2253-9).

These HCAs are also linked to colon cancer for both men and women and prostate cancer for men. The World Cancer Research Fund suggests avoiding processed meats like ham and bacon completely because of the cancer risk.

Is there strong evidence to suggest eating a more plant-based diet is healthier?

Yes reducing the cancer risk, more regular bowel motions because of the increase in fibre and more antioxidants coming into the diet. Also, we know that women who have a diet rich in phytoestrogens have few menopause symptoms and a reduced risk of breast cancer.

A report has shown that eating seven or more portions of fruit and vegetables a day is healthier that the minimum five currently recommended and will prolong our lives.

A study of 65,226 men and women indicated, in fact, that the more fruit and vegetables people ate, the less likely they were to die. And eating seven a day cut the risk of dying from cancer and heart disease.

Researchers from University College London used the Health Survey for England, which collects data from people in England each year through questionnaires and nurse visits, to look at diet and lifestyle.

They analysed data between 2001 and 2008, which provided a snapshot rather than people’s continuing dietary habits.

The study looked at general mortality as well as death from cancer, heart disease and stroke, and found the risk of premature death from any cause decreased as fruit and veg consumption increased.

Further, the risk of death by any cause over the course of the study was reduced by 42% for those who ate around 10 portions a day.

Fresh vegetables were found to have the strongest protective effect – followed by salad and then fruit.

The findings of this new research are incontrovertible: it is fresh, unadorned produce that produces the benefit. There’s little merit in drinking fruit juice, the study found, as it is so high in sugar content (sugar as fructose).

But the more fruit and veg you eat, the better your chances of living a long and healthy life. So even those who did not manage seven or more helpings, reaped benefits.

Those eating five to seven a day had a 36 per cent cut in risk of death, while three to five portions reduced it by 29 per cent. Even eating one to three helpings of fruit and vegetables was linked to a 14 per cent reduced risk of death.

A report published by JAMA Internal Medicine has found that vegetarians live longer because of their diet. They found a reduction in death rates for people eating vegetarian diets compared with non-vegetarians in a study of more than 70,000 people. Over a six-year period, vegetarians were 12 per cent less likely to die from any cause.

It is thought the benefits come from lower blood pressure and improved cholesterol levels in people eating ‘good’ fat diets based on vegetables, whole grains and fruit. A vegetarian diet is associated with a higher intake of fibre, folic acid, vitamins C and E, magnesium, healthy fats and phytochemicals which have a positive influence on reducing the risk of some cancers and heart disease.

It is important to remember to get enough protein with a vegetarian diet and it is very easy to do if you know what to look for. My recommendation is to have some good quality protein like eggs, quinoa, tofu and nuts and seeds and pulses. Making sure you have a good serving of protein with each meal is what you’re aiming for. It can be more challenging to get enough omega 3 fat in your diet because it’s predominantly in fish so a vegetarian diet needs to be rich in walnuts, chia seeds, flaxseeds and hemp.

Are you aware of more people becoming vegetarian, vegan and part-time vegetarian?

In my clinic more of my patients are becoming semi-vegetarian and still eating some oily fish because of the benefits and also eggs because they are a first-class protein but cutting out meat and poultry.

What nutrients might you be deficient in if you eat a plant-based diet (if any)?

None, if you eat a good variety with some animal protein included like yogurt. If someone becomes vegan then there can be issues with B12, calcium and iron.

What nutrients will you have in abundance by eating a plant-based diet?

Definitely the antioxidants which are found in all the brightly coloured fruit and vegetables. We used to be told to ‘eat our greens’ but it is better to ‘eat a rainbow of fruits and vegetables’ because different antioxidants are found in differently coloured foods. For example, green leafy vegetables, berries, carrots, beetroot and so on, all contain different antioxidants.

When avoiding animal-based products what are the best sources of protein?

Go for quinoa, nuts, seeds and beans.

And of iron? Non haem iron is found in plant-based food and haem iron is found in animal foods. Good non haem sources of iron are beans, nuts, sprouted beans, cereals and green leafy vegetables. Vitamin C helps to increase the absorption of iron.

And vitamin B12?

Because vitamin B12 is found in animal foods then it can be more difficult for a vegetarian who does not eat eggs or dairy foods or for vegans who don’t eat any animal foods for them to get enough B12. It will be in fortified foods and yeast extracts but people may need to take a vitamin B12 supplement.

Do you have concerns about the rise of plant-based eating in the UK?

No I think it is only a good thing as only about a third of adults eat the recommended 5 a day fruit and vegetables so any increase is going to be good.

Do you feel people now (as opposed to 20 years ago, say) have many more products available to help them eat a healthy animal-free diet?

Yes absolutely as 20 years ago we would not have access to vegetable proteins like quinoa or even the choice of plant-based foods we have e.g hummus, and the enormous choice of fruit and vegetables because they are shipped from all around the world.

If someone is considering eating a diet focused on plant-based foods, what’s the healthiest way to do this?

I would say to still include eggs and even fish if possible but put the emphasis on increasing plant-based foods but they also need to be whole foods especially with grains such as brown rice, porridge. And people can have unhealthy plant-based diets because they are thinking of no animal foods and yet are living on white bread and lots of cakes and biscuits with added sugar.

Read Katy’s story on how improved nutrition helped with painful periods

I started having my periods at the age of 12 and I have suffered with severe pain ever since. My mum took me to the doctor when I was about 15 and he put me on the Pill. At the time it was great because I went from being totally incapacitated for 2 days every month to being ‘normal’. I came off the Pill in my late twenties because I knew it was not good to be on long term. The pain seemed to be even worse having come off it. Each month I would be in so much pain that I would often be sick, and faint. Although my work colleagues were very supportive, it was difficult if I was in an unfamiliar situation.

I went back to my doctor and he suggested I try a different type of Pill, so I said I wanted to explore other options. He sent me away with a prescription for a very strong painkiller. I was reluctant to take it but went off to get a supply as an emergency. I searched for ‘painful periods’ on the internet and came across a really interesting site by Dr Marilyn Glenville. The site explained how nutrition can be helpful for the treatment of painful periods. I downloaded an ‘e-book’ on ‘Understanding Painful Periods’, which I read and found very useful.

I phoned the Glenville Nutrition Clinic because I decided that I needed more support from an expert rather than trying to help myself and struggle on my own. I spoke to a very helpful receptionist who talked me through the consultation process and what I would get out of my initial appointment. She sent me a questionnaire to complete and return for the nutritionist to review before meeting me. I had to fill in a two-day diet diary, which was interesting because it made me write down everything I was eating and drinking – it was quite an eye opener. I thought it best to be honest rather than write down what the nutritionist wanted to hear!

Before my first consultation it was recommended that I perform a Hair Mineral Analysis to identify any mineral deficiencies. This was really straightforward because all it involved was taking a sample of my hair and sending it off to the laboratory for analysis and the results would be back in time for my consultation.

The nutritionist went through my questionnaire with me and asked about my painful periods – how long they had been painful, what medical investigations had I had and any drugs I was taking. It felt very thorough, and she was really taking time to understand my symptoms (rather than having a rushed 10 minutes with my GP).

She explained that pain is usually a warning signal from your body, so it is important that the pain is investigated. She asked whether my doctor had referred me to a gynaecologist. I explained that he had never mentioned this, even when I had shown concern that I may have a condition like endometriosis. The nutritionist suggested that I follow her recommended programme for 3-6 months and if there was no improvement, I should ask my doctor to refer me for further investigation.

The nutritionist did say, however, that period pains can be unusual in that there may actually be nothing medically wrong – they can simply be an abnormal functioning of your body around the time of your period. This is pretty good news because it means that if you can get things back into balance, you’ll not only get rid of the pain but you’ll prevent it from returning. The natural approach aims to treat the condition, not simply mask the pain or ‘turn off’ your cycle. Furthermore, if you work to put your body back into balance all aspects of your health and well-being will be improved.

The results of my Hair Mineral Analysis identified low levels of zinc and magnesium. The nutritionist explained that magnesium acts as a muscle relaxant and it has been shown to have a beneficial effect on painful periods and lower back pain. Magnesium also has the ability to lower the ‘bad’ prostaglandins (hormone-type substances that can cause inflammation) that may be causing the womb to over-contract. Zinc is important for eliminating pain because it is needed for the proper conversion of essential fatty acids into ‘good’ (anti-inflammatory) prostaglandins.

The nutritionist went through my diet in depth with me. She was concerned that I didn’t eat enough fresh vegetables and fish and relied too heavily on processed meals and sugar! I had never really enjoyed cooking and I suppose I used this as an excuse. She said that I didn’t need to always cook from scratch and spend time in the kitchen – there are always short cuts! She explained that some foods like red meat, dairy and sugar can actually be pro-inflammatory (cause inflammation) which triggers the painful periods, and some foods can be anti-inflammatory (calm inflammation) like oily fish, nuts, seeds and dark green leafy vegetables. Luckily, I do enjoy these foods – I just never really ate them! She said that I could eat tinned fish to make my life easier, and sardines and mackerel in particular are rich in the anti-inflammatory omega 3 oils. Dark green vegetables, including salad leaves (watercress and rocket) are rich in magnesium, which is a natural muscle relaxant so helps with the cramps I was experiencing.

The nutritionist explained that when your body is out of balance, and has been for some time, diet alone is not always sufficient. She recommended that I give my body extra support with nutritional supplements. She put together a tailor-made plan that incorporated a good multi vitamin and mineral as a ‘foundation’, then added to this extra vitamin B complex, magnesium, high strength fish oil and zinc. She explained that the B Vitamins are needed to help produce ‘good’ prostaglandins, which help to relax and widen blood vessels (as opposed to ‘bad’ prostaglandins, which increase the womb contractions and increase the pain). The B vitamins have been shown to significantly reduce the intensity and duration of period pains.

The nutritionist told me that taking EFAs (essential fatty acids) in supplement form is extremely important in the treatment of painful periods. Research has shown that women with low intakes of omega 3 fatty acids have more painful periods than women who have a good intake.

I booked a follow up consultation for 8 weeks later so the nutritionist could assess me after two menstrual cycles. The first period my pain was definitely less intense and on my second cycle there was a remarkable difference. The intensity and frequency of pain was much less. I didn’t need to take any time off work – which was amazing – and I felt normal the whole cycle! I didn’t have to take any painkillers at all, which was brilliant.

I am now 6 months on from seeing the nutritionist and I have kept up with eating well and taking the supplements. I can’t thank the Glenville Nutrition Clinic enough for their support and encouragement in getting me to better health. My life is transformed and I am now in control of my period rather than the other way around! The best thing about it is that I no longer have to plan my life around my period!

Dr. Marilyn’s Comment

Katy’s story is a great example of how powerful nutrition can be in actually addressing the underlying cause, rather than just treating the symptoms. With a change of diet and taking specific, good quality, nutritional supplements Katy has not needed to take strong painkillers and she can lead a normal life – whereas before she was losing at least 2 days each month to her painful periods.

As the nutritionist stressed in the consultation, sometimes pain can be due to an underlying medical condition, so it is always important to be vigilant and further medical investigation is sometimes needed. Although Katy noticed improvement within one menstrual cycle, it can take up to 6 months to correct the balance. Nutrition can take longer to take effect and change hormone balance compared to conventional drugs but the benefit is longer lasting.

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