Wednesday, 24 May 2017
As CAM therapies are generally multi-modality, and are likely to have a strong psycho-social basis born out of the therapist-patient relationship as well as a biomedical one, evidence should not be limited to measurements of outcomes based on comparing treatments with controls in randomised controlled trials (‘RCTs’). We strongly feel that the route employed to establish the efficacy for pharmaceutical medicine is almost entirely unsuited to CAM.
There are several reasons for this, but the most prominent is that using the peer-reviewed literature will, in many or even most instances, lead to dismissing a therapy due to insufficient research of the type judged to be the ‘gold standard’ for pharmaceutical medicines. The key reason for a far lower level of research is profitability. The huge investment made in drug research is with a view to generating huge profits. The ‘bar’ for medical evidence is now set so high (and by this we are referring to cost, not quality) as to effectively rule out low-cost interventions of any type. Tragically, this fact is resulting in spiraling medical costs and lack of research into cheaper effective options.
The territory of CAM is a very different one to that of orthodox medicine, in that most CAM interventions are ‘natural’ ones, often based on foods, or they are ‘bodywork’ interventions such as massage, or work in the psychological/emotional arena. In contrast, practically all orthodox medicines are synthetic toxins and all have side-effects which are well documented. With orthodox medicines there is a fine balancing act between benefits and unwanted side effects. Hence it is critically important to ascertain that the balance is towards the beneficial side and that the side effects are not, in fact, worse than the condition being treated. Relatively speaking, CAM interventions are exceptionally safe and have few undesirable side effects. *When it comes to efficacy, the evidence for CAM interventions is undoubtedly ‘variable’. However, we feel this should not be the concern of the Charity Commission. In order to ensure that a given charity is providing benefit to the public and advancing health for the public benefit, it is sufficient for the Charity Commission to know that the public are not being put at risk by a charity providing a dangerous therapy. In our view, the beneficiaries are the only people qualified to judge whether a therapy is providing them with benefit - so it’s just a matter of asking them. A further role of the Commissioners is to ensure that money given to a charity is used for the purposes declared by the charity - ‘does what it says on the tin’. Hence if a charity advertises that it supports cancer patients with a type of complementary medicine and donations are received on that basis, then donors are particularly choosing to support the offering of such therapy to people with cancer because they have reason to believe it will be of benefit to them.
Evidence-based medicine (EBM), in the arena of CAM at least, is in many ways in direct conflict with a central policy of successive governments for the past 40 years or thereabouts - that of promoting patient choice and patient-centred care. EBM has had a stranglehold over choice to such a degree that it has required policy decisions such as the mandatory introduction of Personal Health Budgets(‘PHBs’) in the face of the resistance of the medical services, in order to even begin to introduce an element of patient choice, and some personal control over healthcare. Meanwhile, charities have been one of the very few channels through which choice has been introduced over this period.
We are very supportive of the work now being undertaken by Clinical Commissioning Groups and GP’s who are delivering PHB’s to their patients. Their use of patient experience is one of the key evaluation measures to determine outcomes. Patients frequently ask their doctor how their health might be improved by interventions that are not usually available on the NHS, and can be provided by charities. For example, acupuncture for pain relief. Whilst being positive on the efficacy of such interventions, GP’s have been limited in the past to offering NHS services. PHB’s have allowed a more flexible approach so that an individual personal care plan can be designed by the patient and the GP to best suit their needs. The NHS’s recently published ‘Five Year Forward View’ adopts a more patient-centred approach. Dismissing the use of patient experience as a means for evaluation would therefore be at odds with the government’s own policy.
It should also be noted that a substantial number of cancer centres now have a CAM unit offering patients a choice of CAM therapies to relieve the enormous stresses of cancer and of going through orthodox treatments. It is our understanding that in every case it has been a charitable initiative to introduce these choices and, without continued charitable input, these would quickly disappear. With EBM as the sole guiding principle, no such development would have occurred.
The consistently rising market for CAM is evidence enough of the public’s faith in its benefits. Despite our ‘free’ healthcare service, more and more people are putting their hands in their pockets in order to escape the paternalistic style of the NHS and its narrow views on what can be described as medicine. This situation is so desperate that Macmillan (a charity which now offers CAM) is running a campaign to elevate patient experience to the same level of importance as clinical outcome. This demonstrates how patients are being excluded from the picture. EBM can prescribe a course of treatment and then also judge the outcome by its own standards, without consulting the patient at any point, or in any way.
In summary, when dealing with CAM, we strongly believe that the term ’evidence of efficacy’ should be replaced with ‘no evidence of harm’.
Our major concern is for patient choice, and therefore we feel that a ‘hands off’ approach to choice of therapy, regardless of whether they might be described as ‘complementary’ or ‘alternative’ is essential. The same safety concerns should apply to both categories, but otherwise a limiting of choice when it comes to patients deciding what is best for their own healthcare is an infringement of their human rights.
It is worth noting:
a) There is no firm dividing line between complementary and alternative. A single therapy could be used in either way. Again this is a matter of patient choice.
b) CAM is very quickly being replaced as a ‘category’ of medicine. We talk about Integrative Medicine (IM), which does include all aspects of CAM, but also includes all aspects of conventional medicine. IM can be described as ‘the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all the appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health’.
c) The same limiting of choice described above also applies to charitable donors. If the Commissioners were to limit the range of complementary therapies that charities are allowed to offer, based on EBM principles, this also limits the rights of charitable donors to support safe non-conventional ways of helping people in the most difficult circumstances.
The Commission is providing an essential service to the public in registering CAM providers as charities. The example given above of CAM units attached to cancer centres, shows clearly the role of these charities in bringing choice to patients and in filling some of the enormous and well-documented gaps in care in our NHS. It should also be noted that generally practitioners operating within such organisations often provide their services free or at very low costs. Hospices are another excellent example of charities with a heavy reliance on CAM that are providing a level of care that is widely acknowledged to be unavailable within the NHS.
If the Commissioners decide to move under the same philosophical umbrella as our health services, then clearly charities will only be able to offer the same narrow choices prescribed by the EBM system, with all its well-documented shortcomings. In short, one of the key roles of our UK charities - that of addressing some of the gaps in care of the NHS - will be diminished unacceptably, and patients will effectively be taken back several decades in terms of the care they receive. As the UK is already languishing well down the European league tables for diseases such as cancer,** it is both irrational and inhuman to consider degrading our healthcare still further by preventing charities from broadening the services available to patients in an effort to improve their situations.
The entire foundation of charitable giving comes under question when an outside body, subject to forces beyond the control of the public, dictates what a donor is allowed to support and what a beneficiary is allowed to receive, based on a questionable and unsuitable system of ‘evidence’. The reasons for the shortcomings of EBM are now well-documented***, and we are all paying the price for the lack of choice and expensive, ineffective results it often produces. As explained above, CAM doesn’t even have the same requirement for such a system. Evidence is, of course, always welcome as a guide to effectiveness for patients and practitioners, but ‘no evidence of harm’ is really the only requirement that the Commissioners need be concerned with in order to establish that the therapy or therapies are beneficial. A non-patriarchal and democratic approach by the Commissioners will ensure that donors and beneficiaries are free to judge for themselves the benefits of safe therapies.
Antioxidants are everywhere – all you have to do is pick up some real food (i.e. something natural and unprocessed) and you’ll literally be staring a wealth of these health-enhancing, wellness-promoting, disease-preventing nutrients in the face and yet, somehow, we are living in a pandemic of oxidative stress-related diseases and health complications.
Antioxidants have long been promoted as the panacea of health, with their potential to protect against a range of illnesses and aliments, but, as with so many things, too much of a good thing is, often, no longer a good thing. Despite their seemingly infallible health-enhancing potential, antioxidants have a dark side and can, when intake is too high, have negative consequences on our health. To understand which antioxidants might be safe and beneficial to you, and at what doses you should consume them, we need to consider the environment to which they are being added (i.e. your body and biology) and the systems that need support (i.e. what health concerns or risks you have), the benefits you are hoping for by taking them (e.g. improved energy, reduced ageing, less muscle soreness) and whether you are taking a form that can actually be absorbed (i.e. is it effective). So over this two part series we are going to unpick the pieces of this puzzle so you can decide if and which extra antioxidant support you might need.
What is an antioxidant and what do they do in the body?
Exactly as the name suggests, anti-oxidants inhibit oxidation (a chemical reaction that produces highly reactive compounds, called free radicals, which have the potential to cause damage to our cells, DNA and functional proteins, if left unmanaged). Antioxidants act to stabilise free radicals usually by donating an electron, hydrogen or other chemical group that, essentially, calms the free radical down and stops it going on the rampage.
Antioxidants can also act to stop the production of free radicals in the first place, by increasing our natural oxidative-stress coping capacity (e.g. upregulating super oxide dismutase transcription), or by running around after free radicals cleaning up the mess they’ve made.
Free radicals are produced by a range of internal and external factors including:
- Cellular respiration (yes that’s right – breathing & using oxygen!)
- Cigarette smoke
- Environmental pollutants
- Certain drugs
- Industrial solvents
- The ozone layer
As the above list shows, we are exposed to
free radicals all day, every day, so you would not be judged harshly for thinking that ingesting ample antioxidants to appease these otherwise volatile and aggressive molecules would be a good idea. Unfortunately, to date, research is pretty lacking in terms of proving the benefits of antioxidants to health, above and beyond showing that a diet rich in them is health positive. When we look at the consensus science, the use of antioxidants for disease management, or to treat specific conditions, suggests that in most cases they are quite unhelpful. ‘How can this be?!’ I hear you cry. Looking at the role of oxidation, free radicals and antioxidants in the body, it all starts to become clear.
Understanding free radicals and reactive oxygen species
Oxygen is vital to sustain life, and yet it is this very life-giving molecule that causes oxidative stress. Oxygen is used to generate energy in our cells, by the mitochondria, and this process generates free radicals, including reactive oxygen species (ROS). In order to prevent this from being a problem, our bodies, as well as almost all organisms on earth, have developed complex endogenous antioxidant systems to cope with this and make sure it does not pose a significant threat.
Plant foods that are rich in antioxidants contain these for the very same reasons we do, to protect them from free radical damage, caused by various stresses they face during their lifespan, including heat, light and, more recently, agricultural chemicals. By adapting these highly effective internal processes, all forms of life can maintain the delicate balance between carrying out essential, albeit ROS-generating, processes and preventing any resultant damage to cells and DNA.
Antioxidants protect us against harmful free radical – or do they?
Whilst it may seem like avoiding sources of oxidative stress and eating lots of antioxidant-rich foods would be a good idea, in many cases free radical production is actually a beneficial process that triggers a positive adaptation process that allows us to grow and thrive in harsh environments, under stressful situations and in times of increased demand on the body. Human beings, being the clever creatures we are, have also begun to manipulate the benefits of free radical damage for medical purposes, such as cancer treatments. It is because of the need for ROS in adaptation that it is not always a good idea to flood the body with excessive amounts of a few specific antioxidants, unless you have a recognised need for them.
For example, exercise is a process that, on the whole, is considered a very healthy thing; as a result of needing to quickly and significantly increase the rate of energy produced and subsequently supplied to the muscles, however, a large additional free radical load is also generated. These free radicals then cause damage to the surrounding tissues, which subsequently require repair (this is why we get sore, aching muscles when we train hard). The process of repairing the damage allows us to adapt to the stress that was placed on the muscles, and come back stronger (improved strength and fitness). Whilst we do need adequate antioxidant levels to prevent the generated free radicals from getting too enthusiastic or wandering off and causing problems elsewhere in the body, having too much antioxidants could suppress the natural adaptation process and therefore reduce the benefits you see from your training. Indeed, studies have shown that chronic supplementation of vitamin C (1000mg) and vitamin E (400IU) can blunt the beneficial adaptation process otherwise triggered in response to exercise, thus negating the positive effects of exercise.
Scientific research shows that those exposed to UV radiation in small but consistent doses do not experience the same level of skin damage as those exposed infrequently and in high doses. This is because, over time, the body’s defence mechanisms can adapt to help protect against any damage being caused, as long as it remains manageable. In short sharp bursts (such as a week’s holiday in sunny southern Spain) UV radiation causes excessive free radical damage and this can lead to genetic mutation in skin cells, and subsequently cancer.
When is an antioxidant not an antioxidant?
Another factor we have to consider when looking at the protective role of antioxidants is that they can also become pro-oxidants in certain situations, such as when they are found at high levels without the backup and support of other antioxidants. Once an antioxidant has worked its calming magic on a free radical it has now made itself unstable. The antioxidant systems in the body have, however, adapted to ensure these are also dealt with and many antioxidants work together to consistently recycle one another and ensure they are also quickly stabilised. When there is not enough ‘backup’ available, this can lead to the accumulation of unstable pro-oxidants being formed from the antioxidants, adding to the very oxidative stress load they are meant to help reduce.
Maximising the health benefits of antioxidants
In light of the above, we have to consider that artificially altering the delicate balance and coping strategies, which we have adapted over millennia, can have grave consequences and if given at the wrong time to the wrong person, certain antioxidants can make things worse.
Now whilst this all sounds very scary there are a range of benefits to be had from optimising antioxidant status, predominantly through dietary intake. Epidemiological studies show that plant food consumption (fruit and veg) directly correlates with long-term health and much of this benefit is attributed to the antioxidants and phytonutrients contained in these foods.
Since most of us do not eat enough plant foods (recent research suggests less than 60% of the UK population eats the modest 5-a-day) and we are all subject to far more oxidative stress on a day to day basis than is ideal, ensuring your diet is rich in a broad range of natural food-derived antioxidants is a really big step in the right direction. We can run into trouble, however, when we start to look to optimise health via high intake of specifically one or two foods or nutrients. When we eat food (rather than nutrients) we are in fact eating a broad range of chemicals and plant components that work together to provide complementary, synergistic support to the overall health of our cells and body. Recent research shows that when we consume nutrients as whole foods within a healthy and varied diet (rather than isolated supplements) our body processes and absorbs them differently, allowing us to pick and choose what it does and doesn’t need at any one time. This helps to naturally regulate the nutrient levels in our body to ensure optimal balance at any one time; eating a diet rich in health-supportive nutrients will therefore ensure that you are exposed to a wide range of nutrients throughout the day and your body can extract what it needs.
When we focus on the consumption of any one specific food or nutrient, we can overwhelm the mechanisms in the body by which they would otherwise elicit their health benefits, leading to potential imbalance and subsequent problems (as mentioned above). As such, most of the research currently points to antioxidants as only consistently offering benefits when consumed via the diet and, ideally, natural plant foods. Therefore, in an ideal world, eating a rainbow of different vegetables plus some fruit, aiming to exceed your 5-a-day where possible, without relying on high doses of individual antioxidant nutrients, is the safest and most beneficial way to optimise your antioxidant status and overall health.
Targeted antioxidant support can be a good thing
Aside from the overwhelming need for us all to eat more vegetables (ideally local, seasonal, organic ones) there is a growing body of evidence to show that in certain conditions, at specific times, in some genetic backgrounds and when a malabsorption issue is present, the use of targeted and specific nutritional interventions can be beneficial.
In part two of this article we’ll be covering how to identify whether your antioxidant status might be sub optimal and which nutrients, if any, might be of benefit for your specific health concerns.
Devasagayam, T. P. A., Tilak, J. C., Boloor, K. K., Sane, K. S., Ghaskadbi, S. S., & Lele, R. D. (2004). Free radicals and antioxidants in human health: current status and future prospects. Japi, 52(10), 794-804.
Kanti Bhooshan Pandey and Syed Ibrahim Rizvi, Plant Polyphenols as Dietary Antioxidants in Human Health and Disease. Oxidative Medicine and Cellular Longevity. 2009, vol. 2, no. 5, pp. 270-278.
Sies H. Hydrogen peroxide as a central redox signaling molecule in physiological oxidative stress: Oxidative eustress. Redox Biology. 2017;11:613-619.
Lobo V, Patil A, Phatak A, Chandra N. Free radicals, antioxidants and functional foods: Impact on human health. Pharmacognosy Reviews. 2010;4(8):118-126.
Pacholczyk M1, Czernicki J2, Ferenc T3. The effect of solar ultraviolet radiation (UVR) on induction of skin cancers. Med Pr. 2016;67(2):255-66.
Brenner, M., & Hearing, V. J. (2008). The Protective Role of Melanin Against UV Damage in Human Skin. Photochemistry and Photobiology, 84(3), 539–549.
Paulsen G, Cumming KT, Holden G, et al. Vitamin C and E supplementation hampers cellular adaptation to endurance training in humans: a double-blind, randomised, controlled trial. The Journal of Physiology. 2014;592(Pt 8):1887-1901.
Bouayed J, Bohn T. Exogenous antioxidants—Double-edged swords in cellular redox state: Health beneficial effects at physiologic doses versus deleterious effects at high doses. Oxidative Medicine and Cellular Longevity. 2010;3(4):228-237.
Sies H. Hydrogen peroxide as a central redox signaling molecule in physiological oxidative stress: Oxidative eustress. Redox Biology. 2017;11:613-619.
Forman HJ1. Redox signaling: An evolution from free radicals to aging. Free Radic Biol Med. 2016 Aug;97:398-407.
Rui Hai Liu Health benefits of fruit and vegetables are from additive and synergistic combinations of phytochemicals Am J Clin Nutr. 2003; 78(3):517S-520S.
Monday, 22 May 2017
Today's post is written by Jenny Phillips who specialises in supporting cancer patients with diet and lifestyle interventions. She herself recovered from breast cancer over 10 years ago.
Jenny has kindly shared a recipe with us which is perfect for the summer season...
Here’s a tasty treat which is good for you too! This delicious recipe is easy to make, gluten free and packed with protein from ground almonds and eggs. There is natural sweetness from the banana and this is supplemented with xylitol, a sugar alcohol that doesn’t affect blood glucose levels. And because it’s so satisfying you’ll be less likely to over indulge too. A little bit of what you fancy can indeed do you good. Enjoy!
150g coconut oil or butter
125g 70% chocolate
2 ripe bananas
2 tsp vanilla extract
2 tsp baking powder
30g cocoa powder
150g ground almonds
200g walnuts, chopped
One 9 inch square cake tin, lined.
- Pre heat the oven to 180 degrees
- Cream the oil and xylitol together using a wooden spoon or mixer
- Break the chocolate into a bowl and melt by placing it over a pan of boiling water or place it in a steamer for a few minutes
- Mash the bananas with the vanilla extract. Beat the eggs in a bowl
- Mix the dry ingredients in a large bowl- almonds, baking powder, cocoa and walnuts
- Add each of the wet to the dry ingredients, stir to combine well
- Pour into the lined cake tin and bake for 20-25 mins or until spongy to the touch
- Cool and cut into squares before serving
To find out more about Jenny and the work she does at Inspired Nutrition, please visit the website.
Find more of Jenny's creations on the recipes page.
Tuesday, 9 May 2017
As the sun creeps closer and we start to think about the holiday season why not take your taste buds abroad with this Japanese inspired dish.
This delicious recipe works beautifully as a hearty side dish. Or, double the amount and make it your main.
SERVES: 2-3 as a side
TIME: 35-45 mins (15 mins prep, 20-30 mins in the oven)
DIFFICULTY: Easy - Medium
1 pack/box brown cup mushrooms
1 bunch of spring onions
1 heaped tbsp brown rice miso paste
1 tsp cider vinegar
1 tbsp coconut oil (melted)
1 tsp sesame oil
juice of ¼ lemon
2x tbsp Japanese Tamari Superseeds
STEP 1. Set the oven to 200°C. Chop the mushrooms into halves and the spring onions into inch long chunks, keeping the leafy bits for later.
STEP 2. Mix all the dressing ingredients in a bowl. Add the mushrooms and spring onions and mix using your hands before transferring to a baking tray.
STEP 3. Roast for 20 - 30 mins. To get them nice and crispy you may want to drain some of the liquid 15 mins in and switch to a grill setting for the last 5 mins.
STEP 4. Remove and transfer to a plate. Finish with a sprinkle of the finely chopped spring onion leaves and Japanese Tamari Superseeds.
Top tips for eating to beat inflammation – a key driver of cancer
Unhealthy eating habits coupled with sedentary and stressful lifestyles are known to contribute to poor health. What might be surprising to learn is that inflammation is not only a core contributor to poor health, but one that can also be either exacerbated or elevated by our diet and lifestyle choices. Most importantly, inflammation is considered to be a silent epidemic that contributes to the majority of chronic diseases, slowly progressing over a period of years.
Inflammation is both a natural and necessary part of the body’s immune system, functioning to protect us from infection and allowing us heal and repair. The products generated during a natural inflammatory response, however, are highly destructive, and the body must ensure that the inflammation is tightly orchestrated so that inflammation doesn’t get out of hand. Without this control, inflammation can continue unregulated and a myriad of health issues, including cancer may ensue.
The classic example of how diet and lifestyle can lower our risk of poor health is what is known as the Mediterranean diet. Obviously, this is not a ‘diet’ per se, but rather the traditional eating habits of people living in and around the Mediterranean and includes countries such as Spain, Italy, France and Greece. The benefits of the Mediterranean diet have been recognised from as far back as the 1940s, when the dietary practices involved the consumption of large amounts of olive oil, unrefined cereals, legumes, vegetables and fruit. In addition, consumption of fish was high but consumption of meat products was low. This was coupled with moderate consumption of both dairy products and wine. Foods were locally sourced and therefore fresh and often organic. Lifestyles were generally relaxed in nature, people were more active and stress levels were generally low. So good was this method of diet and lifestyle, that a meta-analysis of studies published in 2008 suggested that following a Mediterranean way of life is likely associated with a significant improvement in health status, as seen by a significant reduction in overall mortality (9%), mortality from cardiovascular diseases (9%), incidence of or mortality from cancer (6%), and incidence of Parkinson's disease and Alzheimer's disease (13%). 
Sadly, the impact of ‘progress’ or ‘westernisation’ in terms of food processing and refining methods means that the ‘original’ Mediterranean diet in its true sense has changed significantly over the years, but by understanding and adopting key principles of the Mediterranean diet (whilst incorporating a more active and less stressful lifestyle) it is relatively easy to benefit from this anti-inflammatory diet, both to reduce the risk of developing inflammatory issues later in life, and to manage already existing inflammatory issues.
Below are our top tips for recreating a healthy, anti-inflammatory, Mediterranean style diet.
1 – Feast on healthy fats
Olive oil is a wonderful fat. Rich in mono-unsaturated fatty acids (MUFA) likeoleic acid and palmitoleic acid that help in lower LDL or ’bad’ cholesterol and increase HDL - 'good' cholesterol, extra-virgin, cold-pressed olive oil, is rich in polyphenols and is also an excellent source of vitamin E. These powerful nutrients act as antioxidants and contribute to the anti-inflammatory health benefits of olive oil. As olive oil is not particularly heat stable (though more so than many typically used oils), it is best to use it as a dressing on salads rather than for cooking; when cooking it’s best to use coconut oil, which can be heated quite safely, and offers the additional benefit of containing high levels of beneficial fats (such as lauric acid) that can help kill harmful pathogens like bacteria and viruses.
2 – Balance your omegas
The high intake of oily fish associated with the Mediterranean diet ensures that the balance of omega-6 (which can exacerbate inflammation) to omega-3 fatty acids (which are anti-inflammatory) are kept in check. Oily fish such as anchovies, sardines and mackerel are particularly rich in EPA and DHA, which can help regulate inflammation and are associated with improved cognitive function, heart health and reduced cancer incidence. If you are not a fan of oily fish, it’s worth topping up your omega-3 levels with a good quality fish oil. Pharmepa MAINTAIN not only provides highly bioavailable EPA and DHA, but also includes the omega-6 fatty acid GLA. Not all omega-6s are pro-inflammatory and it’s important to get a good balance of anti-inflammatory omega-6 as well as omega-3! The organic cold-pressed evening primrose oil (which we use as our source of GLA) is also rich in polyphenols (specifically triterpenes) which are powerful anti-inflammatory and antioxidant compounds.
3 – Unleash the power of protein
The protein obtained from the diet is broken down into numerous building blocks called amino acids. These sit patiently in an amino acid ‘pool’ until they are required to make new proteins, such as enzymes, hormones and other molecules required by the immune system (as well as for general growth and repair). Some amino acids are considered to be essential and must be obtained in the diet. If they are not added to our amino acid ‘pool’ then the body is unable to create important proteins required to support daily functions. Both fish and grass-fed meat, unlike processed refined meats (like basic ‘value’ range sausages, battered fish fingers and so on) will offer quality protein (that is, protein that provides all the essential amino acids). Avoiding (or minimising) processed meat and including quality meat and fish is therefore essential, not just for regulating inflammation but also for numerous other biological processes.
4 – Choose carbohydrates wisely
One of the key features of the Mediterranean diet is the lack of refined and processed carbohydrate; this is a diet that is rich in whole grains (these provide complex carbohydrates) as well as fruit and vegetables and it’s important to have a minimum of 5 portions of fruit and vegetables each day (although the ideal ratio of vegetables to fruit should be around 4 vegetable portions to 1 fruit portion). Fruit contains natural fruit sugars, which are metabolised directly by the liver; if eaten in high quantities, this can put unnecessary strain on the health of the liver, which needs to stay in tip top shape to ensure that it is able to perform its job of detoxifying the body. Choosing fruits like berries that are naturally low in sugar content can be healthier than sugary fruits such as tropical fruits like mango and pineapple. Choosing complex carbohydrates that are broken down slowly is excellent for helping to manage healthy blood sugar levels, unlike refined white sugar which is added to a lot of processed refined food products; the high sugar intake associated with western diets is now widely known to directly contribute to numerous inflammatory conditions. Vegetables provide an essential nutrient profile, including cofactors (required for many biological processes), antioxidants and essential vitamins and minerals. In addition to providing an excellent source of protein and similar to other vegetables, legumes (foods such as beans, lentils and peas) are also rich in fibre and complex carbohydrates (healthier carbohydrates that not only help regulate blood sugar levels but also have the added benefits of keeping the gut functioning well); they are also rich in healthy fats, and essential minerals and vitamins. As the nutrient profile differs between types of legumes, with each kind offering a unique nutritional profile, eating a variety of types can also make a tasty alternative to meat and fish.
5 – Deconstruction dairy
Another key feature of the Mediterranean diet was the moderate consumption of dairy products, mainly in the form of cheese and yogurt. These would have been locally sourced and from cows, sheep and goats that were fed on natural diets. Whilst dairy can be quite high in saturated fat, the
nutrient profile from local animals would be similar to that of organic grass-fed meat, i.e. rich in good fats such as omega-3 and rich in other essential nutrients. In addition, organic eggs from free range birds will offer additional nutrients including quality protein (providing the full spectrum of essential amino acids) and omega-3 fats. If you can tolerate dairy, and it’s not contraindicated for you then a little could be of benefit.
6 –Say hello to whole foods
When we step thought the doors of our local supermarket we are confronted with aisle upon aisle of tins, packets, tubs, bottles and boxes of ‘food’ products. Some need no preparation, some need heating, some need mixing. Our demand for convenience has overshadowed our understanding of the importance of consuming food in its whole, natural and unadulterated form. Depending on where you shop (let’s face it, some supermarkets are significantly guiltier than others) you may come across aisles of fruit and vegetables where, sadly, most of the offerings will have been transported miles (if not continents) to appear on those shelves. The nutrients offered can often be insignificant and of poor quality and we merely feed and fill our bellies rather than supply our bodies with the many hundreds (and more) individual nutrients required to fuel the similar amount of metabolic processes that keep us functioning on a daily basis.
Shopping locally and visiting your local butcher, organic farm or market will take you closer to obtaining the quality of nutrients supplied by a typical Mediterranean diet than any of your local supermarkets. If you are fortunate enough to have use of a small amount of land, or access to an allotment you can grown you own vegetables and fruit (and possibly also keep free-range chickens), offering you even more control over the type of food you choose to eat. Consider the benefits of an anti-inflammatory diet, one that excludes processed foods and focuses on oily fish (preferably non-farmed), whole foods and organic products from free-range animals: it provides the best combination of nutrients to control, reduce or dampen inflammatory processes for optimal long-term health.
 Adherence to Mediterranean diet and health status: meta-analysis. Sofi F, Cesari F, Abbate R, Gensini GF, Casini A. BMJ. 2008 Sep 11;337:a1344.