tag:theconversation.com,2011:/au/topics/mediterranean-diet-6780/articlesMediterranean diet – The Conversation2024-03-05T13:29:22Ztag:theconversation.com,2011:article/2236672024-03-05T13:29:22Z2024-03-05T13:29:22ZThe Atlantic diet: how it compares to its Mediterranean counterpart – and what benefits it might have<figure><img src="https://images.theconversation.com/files/579168/original/file-20240301-22-1qoqvf.jpg?ixlib=rb-1.1.0&rect=0%2C7%2C4822%2C3203&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The Atlantic diet also places an emphasis on fresh, minimally-processed foods.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/cod-fish-potato-tomato-cherry-on-562428598">Natalia Mylova/ Shutterstock</a></span></figcaption></figure><p>The Mediterranean diet has long been seen as one of the most beneficial diets out there. It’s been associated with many health benefits, including lower risk of <a href="https://cdt.amegroups.org/article/view/14269/14736">cardiovascular disease</a> and other <a href="https://pubmed.ncbi.nlm.nih.gov/34204683/">chronic diseases</a> (including <a href="https://pubmed.ncbi.nlm.nih.gov/31480794/">cancer</a>), better <a href="https://pubmed.ncbi.nlm.nih.gov/35889954/">sleep</a> and even <a href="https://gut.bmj.com/content/69/7/1218">good gut health</a>.</p>
<p>But a recent study suggests that a slightly modified version of this diet – named the “<a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2814624">Atlantic diet</a>” – may also be beneficial for your health. </p>
<p>The Atlantic diet draws inspiration from the traditional eating habits of people living in northwestern Spain and Portugal. Like the Mediterranean diet, it’s characterised by eating local, fresh and minimally processed seasonal foods – such as vegetables, fruits, fish, wholegrain, nuts, beans and olive oil. But unlike the Mediterranean diet, the Atlantic diet also includes moderate amounts of meat and pork products, as well as starchy vegetables such as potatoes.</p>
<p>According to this latest study, the Atlantic diet may reduce the risk of <a href="https://www.heartuk.org.uk/genetic-conditions/metabolic-syndrome">metabolic syndrome</a>. This is the combination of high blood pressure, high blood fat levels, obesity and high blood sugar – all of which can lead to heart disease, stroke and type 2 diabetes.</p>
<p>The researchers conducted what’s known as a secondary analysis. This meant they analysed data from a previous study on the Atlantic diet, the <a href="https://pubmed.ncbi.nlm.nih.gov/27539113/">GALIAT Atlantic Diet study</a>, in order to better understand its effects. This was a six-month randomised clinical trial, which included more than 500 participants who were grouped together by family.</p>
<p>As part of the GALIAT trial, families were placed into two groups. One group followed the Atlantic diet. They were also taught about the diet and given cooking classes to help adhere to it. The second group, who acted as the control group, followed their usual diet and lifestyle. </p>
<p>The study lasted for six months. At the beginning of the study and after six months, researchers collected information on participants’ food intake using a three-day food diary, as well as their physical activity levels, any medications they took and other variables such as weight if they smoked.</p>
<p>In the <a href="https://www.mdpi.com/2072-6643/13/4/1211">initial GALIAT diet study</a>, the researchers found that the Atlantic diet group lost weight – whereas those in the control group gained weight. The Atlantic diet group also saw improvements in their levels of one type of cholesterol – though other types of cholesterol still remained the same. There were also no changes in their blood pressure and blood sugar.</p>
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<img alt="A plate of food with cooked fish and slices of pork or chorizo." src="https://images.theconversation.com/files/579170/original/file-20240301-28-ls360c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/579170/original/file-20240301-28-ls360c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/579170/original/file-20240301-28-ls360c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/579170/original/file-20240301-28-ls360c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/579170/original/file-20240301-28-ls360c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/579170/original/file-20240301-28-ls360c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/579170/original/file-20240301-28-ls360c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">The Atlantic diet may also include pork and other types of meat.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/prawn-rice-closeup-traditionnal-spanish-food-106809581">ilolab/ Shutterstock</a></span>
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<p>In the recent secondary analysis of this study, the researchers found that overall, participants who had followed the Atlantic diet had significantly lower risk of developing metabolic syndrome compared to the control group. They also found that following the Atlantic diet lowered risk of obesity, improved waist circumference and levels of cholesterol (specifically high-density lipoprotein).</p>
<p>But though the Atlantic diet had an overall effect on lowering risk of metabolic syndrome, it wasn’t shown to have much effect on specific aspects of metabolic syndrome. Specifically, the researchers did not see any benefit from the Atlantic diet on blood pressure, blood sugar and blood fat levels.</p>
<p>Overall, the study shows that consuming the Atlantic diet may be helpful for managing weight – which may in turn lower risk of some long-term chronic conditions (such as cardiovascular disease). </p>
<h2>Balanced diet</h2>
<p>This is not the first time the effects of the Atlantic diet have been researched. </p>
<p><a href="https://www.atherosclerosis-journal.com/article/S0021-9150(12)00830-1/abstract">Previous studies</a> have shown that the Atlantic diet is associated with lower levels of inflammation, blood fat levels and blood pressure among adults living in Spain. <a href="https://www.mdpi.com/2072-6643/11/4/742">Another study</a> also found that Spanish people who paired the Atlantic diet with regular physical activity had a lower risk of cardiovascular disease, lower cholesterol and lower rates of obesity.</p>
<p>But while research does show some potential benefits in adhering to the Atlantic diet, these results may not hold true for everyone. </p>
<p>First, most studies on the Atlantic diet – including this latest one – only included participants of Spanish or white European descent. This means we don’t know whether the Atlantic diet will be equally beneficial for ethnic groups who are at <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/0470025131.ch2">greater risk of metabolic syndrome</a> – such as people of south Asian, Black African and Caribbean descent.</p>
<p>It’s well established that regularly consuming fruits, vegetables, wholegrains, nuts and fish provides a wide range of essential vitamins, minerals, fibre and antioxidants that are <a href="https://www.who.int/news-room/fact-sheets/detail/healthy-diet">vital for good health</a>. While the Atlantic diet is said to contain plenty of these foods, there’s no clear information from this latest study on portion sizes or what quantity of certain foods participants consumed in order to reduce their risk of metabolic syndrome.</p>
<p>Another thing worth mentioning is that the <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3441-y">GALIAT study gained a lot of media attention at the time</a>. This may have influenced the particpants’ eating and lifestyle habits as a result, making them adhere more strictly to it – making it appear the diet had a greater affect than it actually might in reality.</p>
<p>And, even though participants in both groups had similar characteristics at the start of the study (such as how physically active they were on average, or if they smoked), the researchers were unable to adjust their findings to fully account for all the factors that might influence a person’s risk of developing metabolic syndrome.</p>
<p>The participants in the Atlantic diet group were also provided with the food they needed in order to stick with their diet. But in a real world setting, not everyone can regularly access or afford the kinds of foods the Atlantic diet consists of. This makes it difficult to know whether the findings will still stand outside of a controlled environment. </p>
<p>At the end of the day, the ideal diet to follow for improving metabolic health is one that includes a wide range of foods from each of the main food groups: fruits and vegetables, starchy carbohydrates (opting for wholegrain alternatives where possible), protein, dairy or dairy alternatives and healthy fats that you find accessible, affordable, enjoyable, as well as nourishing.</p><img src="https://counter.theconversation.com/content/223667/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Taibat (Tai) Ibitoye does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The Atlantic diet draws inspiration from the traditional eating habits of people living in Spain and Portugal.Taibat (Tai) Ibitoye, Senior Lecturer in Public Health and Registered Dietitian, University of HertfordshireLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2199552024-01-17T13:37:48Z2024-01-17T13:37:48ZWhat’s the best diet for healthy sleep? A nutritional epidemiologist explains what food choices will help you get more restful z’s<figure><img src="https://images.theconversation.com/files/569476/original/file-20240116-23-j8753f.jpg?ixlib=rb-1.1.0&rect=12%2C0%2C2105%2C1409&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A balanced diet is one key factor in getting a restful night's sleep. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/freshly-woken-up-young-woman-enjoying-the-morning-royalty-free-image/1413633179?phrase=person+sleeping&searchscope=image%2Cfilm&adppopup=true">SimpleImages/Moment via Getty Images</a></span></figcaption></figure><p>You probably already know that how you eat before bed affects your sleep. Maybe you’ve found yourself still lying awake at 2 a.m. after enjoying a cup of coffee with dessert. But did you know that your eating choices throughout the day may also affect your sleep at night? </p>
<p>In fact, more and more evidence shows that <a href="https://doi.org/10.3390/nu12092830">overall dietary patterns</a> can <a href="https://doi.org/10.3390/nu14142998">affect sleep quality and contribute to insomnia</a>.</p>
<p>I am a <a href="https://sph.umich.edu/faculty-profiles/jansen-erica.html">nutritional epidemiologist</a>, and I’m <a href="https://scholar.google.com/citations?user=NwgRhPYAAAAJ&hl=en">trained to look at diets at the population level</a> and how they affect health. </p>
<p>In the U.S., a large percentage of the population suffers from <a href="https://www.gallup.com/analytics/390536/sleep-in-america-2022.aspx">poor sleep quality</a> and sleep disorders like <a href="https://www.nhlbi.nih.gov/health/insomnia#">insomnia</a> and <a href="https://www.ncbi.nlm.nih.gov/books/NBK459252/#">obstructive sleep apnea</a>, a condition in which the upper airway becomes blocked and breathing stops during sleep. At the same time, most Americans eat far too much <a href="https://fns-prod.azureedge.us/sites/default/files/media/file/AverageHealthyEatingIndex-2020ScoresfortheUSPopulation.pdf">fatty and processed food, too little fiber and too few fruits and vegetables</a>. </p>
<p>Although it is difficult to determine whether these two trends are causally linked to one another, more and more <a href="https://doi.org/10.1146%2Fannurev-nutr-120420-021719">research points to linkages between sleep and diet</a> and offers hints at the biological underpinnings of these relationships.</p>
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<a href="https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Overhead view of colorful foods with high dietary fiber content arranged side by side on a countertop." src="https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=337&fit=crop&dpr=1 600w, https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=337&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=337&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Most Americans consume far too little fiber and too few fresh fruits and vegetables.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/group-of-food-with-high-content-of-dietary-fiber-royalty-free-image/1457889029?phrase=high+fiber+diet&searchscope=image%2Cfilm&adppopup=true">fcafotodigital/E+ via Getty Images</a></span>
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<h2>How diet and sleep quality can be intertwined</h2>
<p>My colleagues and I wanted to get a deeper understanding of the possible link between sleep and diet in Americans who are 18 and older. So we analyzed whether people who follow <a href="https://health.gov/our-work/nutrition-physical-activity/dietary-guidelines">the government’s Dietary Guidelines for Americans</a> get more hours of sleep.</p>
<p>Using a nationally representative dataset of surveys collected from 2011 to 2016, we found that people who did not adhere to dietary recommendations such as consuming enough servings of fruits, vegetables, legumes and whole grains <a href="https://doi.org/10.1016/j.appet.2020.104748">had shorter sleep duration</a>.</p>
<p>In a separate study, we followed more than 1,000 young adults ages 21 to 30 who were enrolled in a web-based dietary intervention study designed to help them increase their daily servings of fruits and vegetables. We found that those who increased their fruit and vegetable consumption over a three-month period reported better sleep quality and <a href="https://doi.org/10.1016/j.sleh.2021.02.005">reductions in insomnia symptoms</a>. </p>
<p>Research conducted outside the U.S. by my group and others also shows that healthier overall dietary patterns are associated with better sleep quality and fewer insomnia symptoms. These include the <a href="https://doi.org/10.3390/nu12092830">Mediterranean diet</a> – a diet rich in plant foods, olive oil and seafood, and low in red meat and added sugar – and <a href="https://doi.org/10.3390/nu15020419">anti-inflammatory diets</a>. These are <a href="https://doi.org/10.1016/j.appet.2021.105881">similar to the Mediterranean diet</a> but include additional emphasis on <a href="https://doi.org/10.1093/sleep/zsy158">certain components in the diet</a> like <a href="https://doi.org/10.3390%2Fmolecules25225243">flavonoids</a>, a group of compounds found in plants, which are shown to lower inflammatory biomakers in the blood.</p>
<h2>Parsing the foods and nutrients</h2>
<p>Within overall healthy diet patterns, there are numerous individual foods and nutrients that may be linked to quality of sleep, with varying degrees of evidence. </p>
<p>For example, studies have linked consumption of <a href="https://doi.org/10.5664/jcsm.3714">fatty fish</a>, <a href="https://doi.org/10.1016/j.advnut.2023.01.004">dairy</a>, <a href="https://doi.org/10.3389/fnut.2023.1079609">kiwi fruit</a>, <a href="https://doi.org/10.1097/mjt.0000000000000584">tart cherries</a> and <a href="https://doi.org/10.3390/nu15245115">other berries</a> such as strawberries and blueberries with better sleep. One of the common pathways through which these foods may affect sleep is by <a href="https://www.nccih.nih.gov/health/melatonin-what-you-need-to-know">providing melatonin</a>, an important modulator of sleep and wake cycles in the brain.</p>
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<figcaption><span class="caption">Walnuts and almonds, as well as fruits like kiwis and bananas, provide natural sources of melatonin.</span></figcaption>
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<p><a href="https://theconversation.com/fiber-is-your-bodys-natural-guide-to-weight-management-rather-than-cutting-carbs-out-of-your-diet-eat-them-in-their-original-fiber-packaging-instead-205159">Fiber-rich foods</a> like beans and oatmeal and certain protein sources – especially those that are high in the amino acid tryptophan, such as poultry – are also associated with <a href="https://doi.org/10.1016/j.jand.2022.01.007">higher-quality sleep</a>. Individual nutrients that may be beneficial include <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703169/">magnesium</a>, <a href="https://doi.org/10.1016/j.tjnut.2023.11.030">vitamin D</a>, <a href="https://doi.org/10.1016/j.tjnut.2023.11.030">iron</a>, <a href="https://doi.org/10.1093/jn/nxz286">omega-3 fatty acids</a> and <a href="https://doi.org/10.1016/j.tjnut.2023.11.012">manganese</a>. Some foods like salmon are sources of multiple nutrients. </p>
<h2>Untangling the complexity</h2>
<p>One important caveat with a lot of the research on individual foods, as well as diet patterns, is that most studies cannot easily disentangle the direction of the relationships.</p>
<p>In other words, it’s hard to know whether the association is a result of diet affecting sleep, or sleep affecting diet. The reality is that it is likely a cyclical relationship, where a healthy diet promotes good sleep quality, which in turn helps to <a href="https://doi.org/10.1146/annurev-nutr-120420-021719">reinforce good dietary habits</a>. </p>
<p>With observational studies, there are also possible confounding factors, such as age and economic status, that may have important correlations with both sleep and diet.</p>
<h2>Foods to avoid for sleep health</h2>
<p>Aiming for higher intake of sleep-promoting foods isn’t necessarily enough to get better sleep. It’s also important to avoid certain foods that could be bad for sleep. Here are some of the main culprits:</p>
<ul>
<li><p>Saturated fats, such as that in burgers and fries and processed foods, could <a href="https://doi.org/10.5664/jcsm.5384">lead to less slow-wave sleep</a>, which is <a href="https://pubmed.ncbi.nlm.nih.gov/19998869/">considered the most restorative sleep</a>. </p></li>
<li><p>Refined carbohydrates, such as those in white bread and pasta, are metabolized quickly. If you eat these foods for dinner, they can result in <a href="https://doi.org/10.3389/fpubh.2022.931781">waking up from hunger</a>. </p></li>
<li><p><a href="https://doi.org/10.1016/j.alcohol.2014.07.019">Alcohol disrupts sleep quality</a>. Although the sedative effects of alcohol can initially make it easier to fall asleep, it disrupts sleep patterns by shortening the amount of <a href="https://www.webmd.com/sleep-disorders/sleep-101">REM, or rapid eye movement</a>, sleep in the first part of the night and leads to more night awakenings.</p></li>
<li><p>Caffeine consumed even six hours before bed can <a href="https://doi.org/10.5664/jcsm.3170">make it difficult to fall asleep</a> because it blocks the hormone adenosine, which promotes sleepiness. </p></li>
<li><p>The consistent overconsumption of calories can lead to weight gain, one of the <a href="https://doi.org/10.1016/j.smrv.2023.101838">strongest predictors of obstructive sleep apnea</a>. Having excess weight is a factor because it can put additional pressure on the diaphragm and lungs, and can also lead to a narrower airway if fat accumulates around the neck and throat.</p></li>
</ul>
<p>Interestingly, our group has recently shown that toxicants in food or food packaging, <a href="https://doi.org/10.1186/s12889-021-12014-x">like pesticides</a>, <a href="https://doi.org/10.1016/j.envres.2020.110216">mercury</a> and <a href="https://doi.org/10.1007/s11356-023-26833-5">phthalates</a> – chemicals used to manufacture plastics – can affect sleep. Since toxicants can be found in both healthy and unhealthy foods, this research suggests that some foods can contain a mix of components that are both beneficial and harmful for sleep.</p>
<h2>Timing of meals and gender considerations</h2>
<p>The timing and consistency of eating, known as “chrononutrition” in the sleep research field, also very likely help to explain associations between healthy diets and good sleep. </p>
<p>In the U.S., eating at conventional meal times as opposed to random snacking <a href="https://doi.org/10.1017/S136898001000296X">has been associated with better sleep</a>. In addition, late-night eating is typically associated with unhealthier food intake – such as processed snacks – and could <a href="https://doi.org/10.1017/s0007114521003597">cause more fragmented sleep</a>.</p>
<p>A final and very interesting piece of this puzzle is that associations between diet and sleep often differ by gender. For example, it appears that the associations between healthy diet patterns and insomnia symptoms <a href="https://doi.org/10.1016/j.sleh.2021.02.005">could be stronger among women</a>. One reason for this could be gender differences in sleep. In particular, <a href="https://doi.org/10.3389%2Ffpsyt.2020.577429">women are more likely than men to suffer from insomnia</a>.</p>
<h2>Keys to a good night’s sleep</h2>
<p>Overall, there is not one magic food or drink that will improve your sleep. It’s better to focus on overall healthy dietary patterns throughout the day, with a higher proportion of calories consumed earlier in the day. </p>
<p>And, in addition to avoiding caffeine, alcohol and heavy meals in the two to three hours before bed, the last few hours of the day should include other <a href="https://sleepeducation.org/healthy-sleep/healthy-sleep-habits/">good sleep hygiene practices</a>. </p>
<p>These include disengaging from technology, reducing light exposure and creating a comfortable and relaxing environment for sleep. Moreover, allowing enough time to sleep and maintaining a consistent bedtime and wake time is essential.</p><img src="https://counter.theconversation.com/content/219955/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Erica Jansen receives funding from the National Heart Lung Blood Institute (NHBLI) through a K01 award (K01HL151673). </span></em></p>A growing body of research is finding a robust link between diet and sleep quality. But it’s not just the usual suspects like caffeine and alcohol that can get in the way of restful sleep.Erica Jansen, Assistant Professor of Nutritional Sciences, University of MichiganLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2145802023-12-26T20:30:36Z2023-12-26T20:30:36ZYou can’t reverse the ageing process but these 5 things can help you live longer<figure><img src="https://images.theconversation.com/files/565071/original/file-20231212-19-m904rz.jpg?ixlib=rb-1.1.0&rect=0%2C437%2C6500%2C3746&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/seniors-enjoying-breakfast-1105683980">Rawpixel.com/Shutterstock</a></span></figcaption></figure><p>At this time of year many of us resolve to prioritise our health. So it is no surprise there’s a <a href="https://digiday.com/marketing/health-food-brands-ramp-up-marketing-efforts-around-consumers-new-years-resolutions/">roaring trade</a> of products purporting to guarantee you live longer, be healthier and look more youthful. </p>
<p>While an <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4822264/">estimated</a> 25% of longevity is determined by our genes, the rest is determined by what we do, day to day. </p>
<p>There are no quick fixes or short cuts to living longer and healthier lives, but the science is clear on the key principles. Here are five things you can do to extend your lifespan and improve your health.</p>
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Read more:
<a href="https://theconversation.com/no-you-cant-reverse-ageing-by-injecting-young-blood-and-fasting-but-that-doesnt-stop-people-trying-207038">No, you can't reverse ageing by injecting 'young blood' and fasting. But that doesn't stop people trying</a>
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<h2>1. Eat a predominantly plant-based diet</h2>
<p>What you eat has a huge impact on your health. The evidence overwhelmingly <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8210981/#:%7E:text=According%20to%20an%20expansive%20review,13%20Given%20that%20so%20many">shows</a> eating a diet high in plant-based foods is associated with health and longevity. </p>
<p>If you eat more plant-based foods and less meat, processed foods, sugar and salt, you reduce your risk of a range of illnesses that shorten our lives, including heart disease and cancer. </p>
<figure class="align-center ">
<img alt="Delicious Mediterranean serving platter." src="https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=371&fit=crop&dpr=1 600w, https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=371&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=371&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=466&fit=crop&dpr=1 754w, https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=466&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/565062/original/file-20231212-19-nxaeys.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=466&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The Mediterranean diet is one of the healthiest and most studied eating patterns.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/tray-of-food-on-white-surface-K47107aP8UU">Louis Hansel/Unsplash</a></span>
</figcaption>
</figure>
<p>Plant-based foods <a href="https://www.nature.com/articles/s41398-019-0552-0">are rich</a> in nutrients, phytochemicals, antioxidants and fibre. They’re also anti-inflammatory. All of this protects against damage to our cells as we age, which helps prevent disease. </p>
<p>No particular diet is right for everyone but one of the most studied and <a href="https://www.hsph.harvard.edu/nutritionsource/healthy-weight/diet-reviews/mediterranean-diet/#:%7E:text=%5B6%5D%20Those%20who%20had%20the,who%20had%20the%20lowest%20adherence.">healthiest</a> is the <a href="https://www.eatingwell.com/article/291120/mediterranean-diet-for-beginners-everything-you-need-to-get-started/">Mediterranean diet</a>. It’s based on the eating patterns of people who live in countries around the Mediterranean Sea and emphases vegetables, fruits, wholegrains, legumes, nuts and seeds, fish and seafood, and olive oil.</p>
<h2>2. Aim for a healthy weight</h2>
<p>Another important way you can be healthier is to try and achieve a healthy weight, as obesity <a href="https://www.healthline.com/health/obesity/how-obesity-affects-body">increases the risk</a> of a number of health problems that shorten our lives.</p>
<p>Obesity puts strain on all of our body systems and has a whole myriad of physiological effects including causing inflammation and hormonal disturbances. These <a href="https://www.ncbi.nlm.nih.gov/books/NBK572076/">increase your chances</a> of a number of diseases, including heart disease, stroke, high blood pressure, diabetes and a number of cancers.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-body-mass-index-cant-tell-us-if-were-healthy-heres-what-we-should-use-instead-211190">The body mass index can't tell us if we're healthy. Here's what we should use instead</a>
</strong>
</em>
</p>
<hr>
<p>In addition to affecting us physically, obesity is also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6052856/">associated with</a> poorer psychological health. It’s linked to depression, low self-esteem and stress.</p>
<p>One of the biggest challenges we face in the developed world is that we live in an <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6817492/">environment</a> that promotes obesity. The ubiquitous marketing and the easy availability of high-calorie foods our bodies are hard-wired to crave mean it’s easy to consume too many calories.</p>
<h2>3. Exercise regularly</h2>
<p>We all know that exercise is good for us – the <a href="https://www.insurancebusinessmag.com/au/news/breaking-news/hcf-reveals-australias-most-popular-new-years-resolutions-for-2023-431665.aspx">most common resolution</a> we make this time of year is to do more exercise and to get fitter. Regular exercise <a href="https://www.who.int/news-room/fact-sheets/detail/physical-activity">protects</a> against chronic illness, lowers your stress and improves your mental health. </p>
<p>While one of the ways exercising helps you is by supporting you to control your weight and lowering your body fat levels, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1402378/#:%7E:text=For%20instance%2C%20routine%20physical%20activity,HDL%5D%20cholesterol%20levels%20and%20decreased">effects</a> are broader and include improving your glucose (blood sugar) use, lowering your blood pressure, reducing inflammation and improving blood flow and heart function.</p>
<figure class="align-center ">
<img alt="Woman with grey hair does yoga outside" src="https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/565049/original/file-20231212-27-u1vhzr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Do the types of exercise you enjoy.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/woman-in-black-tank-top-and-gray-denim-jeans-sitting-on-green-grass-field-during-daytime-FGQQho5XXn4">Kelly Newton/Unsplash</a></span>
</figcaption>
</figure>
<p>While it’s easy to get caught up in all of the hype about different exercise strategies, the evidence <a href="https://www.medicalnewstoday.com/articles/320760">suggests</a> that any way you can include physical activity in your day has health benefits. You don’t have to run marathons or go to the gym for hours every day. Build movement into your day in any way that you can and do things that you enjoy.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/cant-afford-a-gym-membership-or-fitness-class-3-things-to-include-in-a-diy-exercise-program-206204">Can't afford a gym membership or fitness class? 3 things to include in a DIY exercise program</a>
</strong>
</em>
</p>
<hr>
<h2>4. Don’t smoke</h2>
<p>If you want to be healthier and live longer then don’t smoke or vape. </p>
<p>Smoking cigarettes affects almost every organ in the body and is associated with both a shorter and lower quality of life. There is no safe level of smoking – every cigarette increases your <a href="https://theconthatkills.org.au/?utm_source=googlesearch&utm_medium=search&utm_campaign=theconthatkills23&utm_content=RSA&gclid=Cj0KCQjwqP2pBhDMARIsAJQ0Czrlep6EQHC-8_9xUhpz0h9v2ZglMF-6-k7_65awq8FxVaIL5HRoivwaAqJwEALw_wcB&gclsrc=aw.ds">chances of developing</a> a range of cancers, heart disease and diabetes. </p>
<p>Even if you have been smoking for years, by giving up smoking at any age you can experience <a href="https://www.cdc.gov/tobacco/quit_smoking/how_to_quit/benefits/index.htm">health benefits</a> almost immediately, and you can reverse many of the harmful effects of smoking.</p>
<p>If you’re thinking of switching to vapes as a healthy long term option, <a href="https://theconversation.com/can-vaping-help-people-quit-smoking-its-unlikely-204812">think again</a>. The long term health effects of vaping are not fully understood and they come with their own <a href="https://theconversation.com/no-vapes-arent-95-less-harmful-than-cigarettes-heres-how-this-decade-old-myth-took-off-203039">health risks</a>.</p>
<h2>5. Prioritise social connection</h2>
<figure class="align-center ">
<img alt="Older men play chess outdoors." src="https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/565064/original/file-20231212-21-u1vhzr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Don’t forget about friendship and socialising.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/two-men-playing-chess-ItphH2lGzuI">Vlad Sargu/Unsplash</a></span>
</figcaption>
</figure>
<p>When we talk about living healthier and longer, we tend to focus on what we do to our physical bodies. But one of the most important discoveries over the past decade has been the recognition of the importance of spiritual and psychological health. </p>
<p>People who are lonely and socially isolated have a much higher risk of dying early and are <a href="https://healthnews.com/longevity/healthspan/social-connection-and-longevity/#:%7E:text=One%20of%20the%20biggest%20benefits,the%20following%20factors%20and%20influences.">more likely</a> to suffer from heart disease, stroke, dementia as well as anxiety and depression. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/are-you-part-of-a-social-group-making-sure-you-are-will-improve-your-health-81996">Are you part of a social group? Making sure you are will improve your health</a>
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</em>
</p>
<hr>
<p>Although we don’t fully understand the mechanisms, it’s likely due to both behavioural and biological factors. While people who are more socially connected are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150158/">more likely</a> to engage in healthy behaviours, there also seems to be a more direct physiological effect of loneliness on the body. </p>
<p>So if you want to be healthier and live longer, build and maintain your connections to others.</p><img src="https://counter.theconversation.com/content/214580/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Hassan Vally does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Don’t believe the hype about products claiming they can help you live longer. Here are five lifestyle changes to prioritise instead.Hassan Vally, Associate Professor, Epidemiology, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2104682023-08-15T01:42:43Z2023-08-15T01:42:43Z9 signs you have inflammation in your body. Could an anti-inflammatory diet help?<figure><img src="https://images.theconversation.com/files/540707/original/file-20230802-29-iod8xt.jpg?ixlib=rb-1.1.0&rect=54%2C100%2C5121%2C3274&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-suffering-pms-menstruation-pain-bedroom-1357975919">Shutterstock</a></span></figcaption></figure><p>There is a lot of health buzz around the term “inflammation” right now. From new scientific <a href="https://medicalxpress.com/news/2023-07-inflammation-discovery-aging-age-related-diseases.html">discoveries</a> to <a href="https://people.com/health/gwyneth-paltrow-addresses-backlash-anti-inflammatory-diet/">celebrities</a> and social media influencers, it seems like everyone is talking about this important bodily process and its potential impact on our health.</p>
<p>“<a href="https://www.nature.com/articles/s41574-018-0059-4">Inflammaging</a>” is a specific term you may also have seen. It’s an age-related increase in persistent, low-grade inflammation in blood and tissue, which is a strong risk factor for many conditions and diseases. </p>
<p>So, can an anti-inflammatory diet help reduce inflammation? Let’s take a look.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/dont-listen-to-gwyneth-paltrow-ivs-are-not-a-shortcut-to-good-health-202621">Don't listen to Gwyneth Paltrow – IVs are not a shortcut to good health</a>
</strong>
</em>
</p>
<hr>
<h2>What is inflammation?</h2>
<p>When our body becomes injured or encounters an infection, it activates defence mechanisms to protect itself. It does this by instructing our cells to fight off the invader. This fighting process <a href="https://www.nature.com/articles/s41591-019-0675-0#citeas">causes inflammation</a>, which often presents as swelling, redness and pain. </p>
<p>In the short-term, inflammation is a sign your body is healing, whether from a grazed knee or a cold. </p>
<p>If inflammation persists for a longer time it’s called “chronic”. That can indicate a <a href="https://www.nature.com/articles/s41467-018-05800-6">health problem</a> such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3638313/">arthritis</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719998/#B2-ijms-20-03879">heart disease</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6523054/">diabetes</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390758/">dementia</a> or other autoimmune disorders. </p>
<p>The <a href="https://www.ncbi.nlm.nih.gov/books/NBK493173/">signs and symptoms</a> of chronic inflammation may be present from several months to years and include:</p>
<ol>
<li>persistent pain<br></li>
<li>chronic fatigue or insomnia </li>
<li>joint stiffness </li>
<li>skin problems </li>
<li>elevated blood markers (such as <a href="https://www.healthdirect.gov.au/c-reactive-protein-CRP-blood-test">C-reactive protein</a>)</li>
<li>gastrointestinal issues (constipation, diarrhoea, acid reflux)</li>
<li>depression, anxiety and mood disorders </li>
<li>unintended weight gain or loss</li>
<li>frequent colds or flu.</li>
</ol>
<h2>What role does diet play?</h2>
<p>The relationship between food and inflammation is <a href="https://www.sciencedirect.com/science/article/pii/S0735109706013350">well recognised</a>. Overall, some food components may activate the immune system by producing pro-inflammatory cytokines (small proteins important in cell signaling) or reducing the production of anti-inflammatory cytokines.</p>
<p>A “<a href="https://theconversation.com/clear-evidence-for-a-link-between-pro-inflammatory-diets-and-27-chronic-diseases-heres-how-you-can-eat-better-158451">pro-inflammatory diet</a>” may increase inflammation in the body over the long term. Such diets are usually low in fresh produce like fruits, vegetables and wholegrains, and high in commercially baked goods, fried foods, added sugars and red and processed meats.</p>
<p>In contrast, an “<a href="https://academic.oup.com/ajcn/article/80/4/1029/4690355">anti-inflammatory</a>” diet is associated with less inflammation in the body. There is no single anti-inflammatory diet. Two well-recognised, evidence-backed examples are the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet.</p>
<p>Anti-inflammatory diets typically include the following elements: </p>
<p><strong>1. high in antioxidants.</strong> These compounds help the body fight free radicals or unstable atoms, that in high quantities are linked to illnesses such as cancer and heart disease. The best way to consume antioxidants is by eating lots of fruits and vegetables. Research shows frozen, dried and canned fruits and vegetables can be <a href="https://theconversation.com/frozen-and-tinned-foods-can-be-just-as-nutritious-as-fresh-produce-heres-how-201740">just as good as fresh</a></p>
<p><strong>2. high in “healthy”, unsaturated fatty acids.</strong> Monounsaturated fats and omega-3-fatty acids are found in fish (sardines, mackerel, salmon and tuna), seeds, nuts, and plant-based oils (olive oil and flaxseed oil) </p>
<p><strong>3. high in fibre and prebiotics.</strong> Carrots, cauliflower, broccoli and leafy greens are good sources of fibre. Prebiotics promote the growth of beneficial microorganisms in our intestines and can come from onions, leeks, asparagus, garlic, bananas, lentils and legumes</p>
<p><strong>4. low in processed foods.</strong> These contain refined carbohydrates (pastries, pies, sugar-sweetened beverages, deep-fried foods and processed meats). </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/540704/original/file-20230802-25-1w4mlv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Woman cuts tomato at bench" src="https://images.theconversation.com/files/540704/original/file-20230802-25-1w4mlv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/540704/original/file-20230802-25-1w4mlv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/540704/original/file-20230802-25-1w4mlv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/540704/original/file-20230802-25-1w4mlv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/540704/original/file-20230802-25-1w4mlv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/540704/original/file-20230802-25-1w4mlv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/540704/original/file-20230802-25-1w4mlv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">You can’t really go wrong by including more fruit and vegetables in your diet.</span>
<span class="attribution"><a class="source" href="https://www.pexels.com/photo/woman-cooking-cutting-vegetables-for-sandwiches-5424595/">Pexels</a></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/clear-evidence-for-a-link-between-pro-inflammatory-diets-and-27-chronic-diseases-heres-how-you-can-eat-better-158451">Clear evidence for a link between pro-inflammatory diets and 27 chronic diseases. Here’s how you can eat better</a>
</strong>
</em>
</p>
<hr>
<h2>Rheumatoid arthritis, dementia, depression</h2>
<p>There is mixed evidence for the role of anti-inflammatory diets in rheumatoid arthritis pain management. A recent <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8706441/">2021 systematic review</a> (where researchers carefully group and examine the available evidence on a topic) found eating an anti-inflammatory diet likely leads to significantly lower pain in people with rheumatoid arthritis when compared with other diets. </p>
<p>However, the 12 studies included in the review had a high risk of bias – likely because people knew they were eating healthy foods – so the confidence in the evidence was low. </p>
<p>Inflammation is strongly implicated in the development of neurodegenerative diseases like <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6486891/">Alzheimer’s disease and related dementia</a> and evidence suggests anti-inflammatory diets might help to protect the brain. </p>
<p>A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015034/">2016 review</a> showed an anti-inflammatory diet may be protective against cognitive impairment and dementia, but that further large randomised controlled trials are needed. A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8673721/">2021 study</a> followed 1,059 people for three years and observed their diet. They reported those with a greater pro-inflammatory diet had an increased risk of developing dementia.</p>
<p>Inflammation has also been linked with mental health, with people eating a pro-inflammatory diet reporting more symptoms of <a href="https://pubmed.ncbi.nlm.nih.gov/31152670/">depression</a>. Diet is the fundamental element of <a href="https://www1.racgp.org.au/ajgp/2019/october/lifestyle-interventions-for-mental-health">lifestyle approaches</a> to managing anxiety and mental health. </p>
<p>More broadly, a <a href="https://www.mdpi.com/2227-9059/9/8/922">2021 review paper</a> examined recent research related to anti-inflammatory diets and their effect on reducing inflammation associated with ageing. It found compounds commonly found in anti-inflammatory diets could help alleviate the inflammatory process derived from diseases and unhealthy diets. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/netflix-psychiatrist-phil-stutz-says-85-of-early-therapy-gains-are-down-to-lifestyle-changes-is-he-right-195567">Netflix psychiatrist Phil Stutz says 85% of early therapy gains are down to lifestyle changes. Is he right?</a>
</strong>
</em>
</p>
<hr>
<h2>What about turmeric?</h2>
<p>A favourite on social media and vitamin shelves, turmeric is promoted as having anti-inflammatory benefits. These are linked to a specific compound called <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5388087/#:%7E:text=Curcuminoids%20are%20phenolic%20compounds%20commonly,several%20important%20functions%20of%20curcuminoids.">curcumin</a>, which gives turmeric its distinctive yellow colour. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/540708/original/file-20230802-17-nrwsv2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Bowl of yellow turmeric spice and roots on bench" src="https://images.theconversation.com/files/540708/original/file-20230802-17-nrwsv2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/540708/original/file-20230802-17-nrwsv2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=429&fit=crop&dpr=1 600w, https://images.theconversation.com/files/540708/original/file-20230802-17-nrwsv2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=429&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/540708/original/file-20230802-17-nrwsv2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=429&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/540708/original/file-20230802-17-nrwsv2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=539&fit=crop&dpr=1 754w, https://images.theconversation.com/files/540708/original/file-20230802-17-nrwsv2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=539&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/540708/original/file-20230802-17-nrwsv2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=539&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Turmeric – and the curcumin it contains – is often touted as anti-inflammatory.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/turmeric-powder-fresh-roots-on-wooden-402590536">Shutterstock</a></span>
</figcaption>
</figure>
<p>Research suggests curcumin might act as an anti-inflammatory agent in the body but high-quality clinical trials in humans are <a href="https://www.mdpi.com/1420-3049/16/6/4567">lacking</a>. Most of the <a href="https://www.mdpi.com/1420-3049/16/6/4567">existing studies</a> have been conducted in <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/jcp.27360">lab settings</a> using cells or in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608712/">animals</a>. So it’s unclear how much curcumin is needed to see anti-inflammatory benefits or how well <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5664031/">we absorb it</a>. </p>
<p>Overall, adding turmeric to your food may provide your body with some health benefits, but don’t rely on it to prevent or treat disease on its own.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-burgers-and-chips-for-lunch-can-worsen-your-asthma-that-afternoon-206402">How burgers and chips for lunch can worsen your asthma that afternoon</a>
</strong>
</em>
</p>
<hr>
<h2>Safe eating</h2>
<p>Inflammation is a major factor in the link between diet and many health conditions. </p>
<p>Eating an anti-inflammatory diet is considered safe, likely to support health and to prevent future chronic conditions. If you are looking for tailored dietary advice or an anti-inflammatory meal plan, it’s best to speak with an <a href="https://member.dietitiansaustralia.org.au/Portal/Portal/Search-Directories/Find-a-Dietitian.aspx">accredited practising dietitian</a>.</p><img src="https://counter.theconversation.com/content/210468/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lauren Ball works for The University of Queensland and receives funding from the National Health and Medical Research Council, Queensland Health and Mater Misericordia. She is a Director of Dietitians Australia, a Director of the Darling Downs and West Moreton Primary Health Network and an Associate Member of the Australian Academy of Health and Medical Sciences.</span></em></p><p class="fine-print"><em><span>Emily Burch works for Southern Cross University.</span></em></p>In the short-term, inflammation is a sign your body is healing. But persistent levels of inflammation in blood and tissue, called ‘inflammaging’, is linked to disease. Diet might help.Lauren Ball, Professor of Community Health and Wellbeing, The University of QueenslandEmily Burch, Dietitian, Researcher & Lecturer, Southern Cross UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2002282023-03-19T11:51:51Z2023-03-19T11:51:51Z3 ways to unlock the power of food to promote heart health<figure><img src="https://images.theconversation.com/files/515920/original/file-20230316-2393-gn90tf.jpg?ixlib=rb-1.1.0&rect=172%2C111%2C5146%2C3700&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Heart-healthy approaches to eating include the Mediterranean diet, the DASH diet and the Portfolio diet.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Your diet — the foods and drinks you eat, not short-term restrictive programs — can impact your heart disease risk. Evidence-based approaches to eating are used by dietitians and physicians to prevent and treat cardiovascular (heart) disease. </p>
<p>National Nutrition Month, with its 2023 theme of <a href="https://www.dietitians.ca/Advocacy/Nutrition-Month/Nutrition-Month-2023?lang=en-CA">Unlock the Potential of Food</a>, is an ideal opportunity to learn more about these approaches and adopt more heart-friendly behaviours.</p>
<p>The <a href="https://doi.org/10.1016/j.cjca.2016.07.510">Canadian Cardiovascular Society (CCS) Clinical Practice Guidelines</a> recommend three main dietary patterns for lowering heart disease risk: the Mediterranean Diet, Dietary Approaches to Stop Hypertension (DASH) and the Portfolio Diet.</p>
<ol>
<li><p><strong>The Mediterranean Diet</strong> is rich in colourful vegetables and fruits, whole grains, legumes, nuts, olive oil and seafood. Research studies have shown that this diet <a href="https://doi.org/10.1056/nejmoa1800389">reduces risk of having a heart attack or stroke</a>, even <a href="https://doi.org/10.1016/s0140-6736(22)00122-2">if you already have heart disease</a>, and provides several other health benefits. <a href="https://www.dietitians.ca/DietitiansOfCanada/media/Documents/Mediterranean%20Diet%20Toolkit/Mediterranean-Diet-Toolkit-A-Guide-to-Healthy-Eating-(handout).pdf">Dietitians of Canada has created a resource</a> that summarizes the details of this approach to eating. </p></li>
<li><p><strong>The DASH Diet</strong> focuses on eating plenty of vegetables, fruit, low-fat dairy, whole grains and nuts, while limiting red and processed meats, foods with added sugar, and sodium. <a href="https://doi.org/10.3390/nu11020338">Originally developed to treat high blood pressure</a>, this diet can also lower low-density lipoprotein cholesterol (LDL-C — the unhealthy type of cholesterol) and provides several other health benefits. <a href="https://www.heartandstroke.ca/healthy-living/healthy-eating/dash-diet">Heart & Stroke has several resources</a> on this approach to eating. </p></li>
<li><p><strong>The Portfolio Diet</strong> was originally developed in Canada to treat high cholesterol. It emphasises plant proteins (for example, soy and other legumes); nuts; viscous (or “sticky”) fibre sources such as oats, barley and psyllium; plant sterols; and healthy oils like olive oil, canola oil and avocado. <a href="https://doi.org/10.1016/j.pcad.2018.05.004">Many research studies</a> have shown that this diet can lower LDL-C, and provides several other health benefits. Research shows that <a href="https://doi.org/10.1161/jaha.121.021515">even small additions of Portfolio Diet heart-healthy foods</a> can make a difference; the more you consume of these recommended foods, the greater your reductions in LDL-C and heart disease risk. The <a href="https://ccs.ca/app/uploads/2020/11/Portfolio_Diet_Scroll_editable_eng.pdf">Canadian Cardiovascular Society has an infographic</a> on how to follow the Portfolio Diet. </p></li>
</ol>
<p>A common theme among these three approaches to eating is that they are all considered plant-based, and small changes can make a difference in your overall heart disease risk. “Plant based” does not necessarily mean you have to be 100 per cent vegan or vegetarian to get their benefits. Plant-based diets can range from entirely vegan to diets that include small to moderate amounts of animal products.</p>
<p>Knowledge of healthy eating approaches is key, but behaviours unlock the power of food. Below are three strategies to use to apply the potential of food to promote heart health. They show that by combining the power of nutrition and psychology, you can <a href="https://www.newharbinger.com/9781684033331/healthy-habits-suck/">improve your chances of making long-term changes</a>.</p>
<p>You don’t need to do this alone. We recommend requesting a referral from your physician (this helps with getting the appointment covered by your insurance) to work with a registered dietitian and/or psychologist (behaviourist) to co-create your own ways to unlock the potential of food. </p>
<h2>3 ways to unlock the power of food</h2>
<figure class="align-center ">
<img alt="A woman in a white coat holding an apple, with a bowl of fresh produce on her desk, consulting with a woman who has her back to the camera" src="https://images.theconversation.com/files/516092/original/file-20230317-4846-oh3wlb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/516092/original/file-20230317-4846-oh3wlb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/516092/original/file-20230317-4846-oh3wlb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/516092/original/file-20230317-4846-oh3wlb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/516092/original/file-20230317-4846-oh3wlb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/516092/original/file-20230317-4846-oh3wlb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/516092/original/file-20230317-4846-oh3wlb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Working with a registered dietitian or psychologist (behaviourist) can help you create a personalized plan to unlock the potential of food. A physician’s referral can help with getting the appointment covered by insurance.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<h2>1. Master and conquer the 90 per cent goal</h2>
<p>Pick a goal you’re 90 per cent sure you can succeed at, while creating a plan to meet larger and harder goals in the future. This approach will help you build confidence in your skills and give you valuable information about what does and does not work for you.</p>
<p><a href="https://www.newharbinger.com/9781608824342/the-abcs-of-human-behavior/">Research shows</a> starting with 90 per cent goals makes it more likely we meet future goals. A 90 per cent goal could be swapping out animal protein for plant protein — such as tofu or beans — at lunch on Mondays (<a href="https://www.mondaycampaigns.org/meatless-monday">Meatless Mondays</a>). Another example: use a meal delivery service that provides measured ingredients with plant-based recipes on Monday, Wednesday and Friday, so you can get some new ideas about how to incorporate more plants into your meals.</p>
<h2>2. Why eliminate and restrict, when you can substitute?</h2>
<p>Pick a “do instead” goal or work with a registered dietitian to substitute healthier choices for your current foods and drinks. Avoid setting goals that may <a href="https://doi.org/10.1016/j.eatbeh.2010.03.001">make you focus MORE on the foods you’re trying to avoid</a> (for example, “stop eating sugar”).</p>
<p>Instead, the substitution approach can include things like choosing lower-sodium soup or purchasing pre-cut vegetables with the aim of reducing your starch portion at meals by half. <a href="https://food-guide.canada.ca/en/tips-for-healthy-eating/make-healthy-meals-with-the-eat-well-plate/">Canada’s Food Guide</a>, <a href="https://www.diabetes.ca/resources/tools---resources/basic-meal-planning">Diabetes Canada</a> and <a href="https://www.heartandstroke.ca/-/media/pdf-files/what-we-do/publications/living-well-with-heart-disease/chapter-3.ashx?rev=bae93023086643e8873730f4bd29b946">Heart & Stroke</a> recommend that half your plate be vegetables.</p>
<h2>3. Set value-based goals</h2>
<p>Connect your goal to something that deeply matters to you. While long-term outcomes (such as heart disease) may be the impetus for change, <a href="https://doi.org/10.1093/oxfordhb/9780197550076.013.18">research shows that things that matter to us right now motivate us most</a>. Picking personal and meaningful reasons for change will help with sustained change.</p>
<p>For example, choose to cook one meal that incorporates a vegetable with a close friend or family member, so you can share the experience and spend time together. This example may be rooted in the following values: kindness, relational values, cultural values, empathy, courage.</p>
<h2>Unlock the power of food</h2>
<p><a href="https://obesitycanada.ca/wp-content/uploads/2021/07/10-Psych-Interventions-2-v7-with-links-1.pdf">Research shows</a> a key to changing diet is focusing on changing eating habits and food behaviours, one at a time. The support of a nutrition professional, such as a registered dietitian and/or a psychologist, can help you make informed choices and plans, tailored to your unique needs, situation, preferences, traditions, abilities and capacity.</p><img src="https://counter.theconversation.com/content/200228/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Shannan M. Grant has received funding from Diabetes Canada, Dietitians of Canada and currently holds funding from Medavie, Tri-Council Funding Programs, Canadian Foundation for Dietetic Research, IWK Health, Mount Saint Vincent University. She is affiliated with Mount Saint Vincent University, IWK Health, Dalhousie University, Dietitians of Canada, Diabetes Canada, People in Pain (PIPN), and Dr. Dayna Lee-Baggley and Associates.</span></em></p><p class="fine-print"><em><span>Andrea J. Glenn receives postdoctoral research funding from the Canadian Institutes of Health Research (CIHR). She has received honoraria from the Soy Nutrition Institute (2020) and the Academy of Nutrition and Dietetics (2022). </span></em></p><p class="fine-print"><em><span>Dayna Lee-Baggley, Ph.D, Registered Psychologist owns shares in Dr. Lee-Baggley and Associates. She has received funding in the past from the Kidney Foundation of Canada (research grant), QEII Foundation (research grant), CIHR (research grant), SSHRC (research grant) and honoraria/speaking fees from Tobacco Free Nova Scotia, Bausch Health, and Novo Nordisk. She receives royalties from New Harbinger. </span></em></p>Research shows the key to changing your diet is focusing on changing eating habits and food behaviours, one at a time.Shannan M. Grant, Associate Professor, Registered Dietitian, Department of Applied Human Nutrition, Mount Saint Vincent UniversityAndrea J. Glenn, Postdoctoral research fellow, Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard UniversityDayna Lee-Baggley, Adjunct professor, Department of Family Medicine & Department of Psychology and Neuroscience, Dalhousie UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1978212023-01-31T17:15:10Z2023-01-31T17:15:10ZLong COVID: a range of diets are said to help manage symptoms – here’s what the evidence tells us<figure><img src="https://images.theconversation.com/files/505844/original/file-20230123-13-gznfp8.jpg?ixlib=rb-1.1.0&rect=53%2C0%2C6000%2C3997&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/healthy-eating-plate-vegan-vegetarian-food-2214062919">Creative Cat Studio/Shutterstock</a></span></figcaption></figure><p>Most people who contract COVID recover within a few weeks. But for some people, symptoms can develop later, or persist for a long time after the initial infection. A recent <a href="https://www.nature.com/articles/s41579-022-00846-2">review of the evidence</a> on long COVID suggests the condition affects at least 65 million people around the world, occurring after at least 10% of COVID infections, and affecting all age groups.</p>
<p>Common <a href="https://www.nice.org.uk/guidance/ng188/resources/covid19-rapid-guideline-managing-the-longterm-effects-of-covid19-pdf-51035515742">long COVID symptoms</a> include fatigue, shortness of breath, and difficulties with memory and concentration (“brain fog”). Symptoms can worsen with physical or mental exertion. We’re still learning about long COVID, and treatment options are very limited.</p>
<p>Recently, some people, for example <a href="https://www.tiktok.com/@anakaciamarie/video/7084306065348889902?is_from_webapp=v1">on social media</a>, have been talking about a variety of diets as ways to manage long COVID symptoms. But what are these diets, and what does the evidence say?</p>
<hr>
<figure class="align-right ">
<img alt="Quarter life, a series by The Conversation" src="https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
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</figure>
<p><em><strong><a href="https://theconversation.com/uk/topics/quarter-life-117947?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">This article is part of Quarter Life</a></strong>, a series about issues affecting those of us in our twenties and thirties. From the challenges of beginning a career and taking care of our mental health, to the excitement of starting a family, adopting a pet or just making friends as an adult. The articles in this series explore the questions and bring answers as we navigate this turbulent period of life.</em></p>
<p><em>You may be interested in:</em></p>
<p><em><a href="https://theconversation.com/whats-it-like-being-a-young-person-with-long-covid-you-might-feel-like-a-failure-but-youre-not-192060?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">What’s it like being a young person with long COVID? You might feel like a failure (but you’re not)</a></em></p>
<p><em><a href="https://theconversation.com/binge-eating-disorder-is-more-common-than-many-realise-yet-its-rarely-discussed-heres-what-you-need-to-know-190587?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">Binge-eating disorder is more common than many realise, yet it’s rarely discussed – here’s what you need to know</a></em></p>
<p><em><a href="https://theconversation.com/smartwatches-could-help-detect-and-track-covid-heres-what-the-research-shows-181479?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">Smartwatches could help detect and track COVID – here’s what the research shows</a></em></p>
<hr>
<h2>The anti-inflammatory diet</h2>
<p>The process by which the immune system protects us from harmful pathogens is called inflammation. But too much inflammation can be a bad thing. Scientists believe that many of the symptoms associated with long COVID arise from <a href="https://www.nih.gov/news-events/nih-research-matters/long-covid-symptoms-linked-inflammation">chronic inflammation</a>.</p>
<p>We know that some foods <a href="https://academic.oup.com/advances/article/12/5/1681/6238545?login=false">can promote inflammation</a>, while studies have shown that components of certain foods may have anti-inflammatory effects.</p>
<p>So <a href="https://aspenjournals.onlinelibrary.wiley.com/doi/abs/10.1177/0884533617700353">an anti-inflammatory</a> diet involves avoiding foods that <a href="https://pubmed.ncbi.nlm.nih.gov/15447916/">elicit inflammation</a>, such as fried foods, refined carbohydrates, sugar, red and processed meats, and lard.</p>
<p>Instead it focuses on foods that reduce inflammation, such as tomatoes, olive oil, green leafy vegetables, nuts, fatty fish and fruits such as strawberries and blueberries. These foods are high in antioxidants and compounds which help <a href="https://pubmed.ncbi.nlm.nih.gov/15234425/">protect against inflammation</a>. </p>
<p>If you’re looking for a diet that closely follows the tenets of anti-inflammatory eating, consider <a href="https://theconversation.com/what-is-the-mediterranean-diet-and-why-is-it-good-for-you-12656">the Mediterranean diet</a>. Following a Mediterranean diet means eating lots of fruit, vegetables, nuts, whole grains, fish and healthy oils. This diet is rich in vitamins, minerals and dietary fibre, and has <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359750/">an anti-inflammatory effect</a> in the gut.</p>
<p>Researchers have suggested <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7833284/">the Mediterranean diet</a> may have benefits in reducing the severity of a COVID infection in the short term, as well as in addressing longer-term symptoms.</p>
<h2>The low histamine diet</h2>
<p>Histamine is a compound released by cells, often in response to an injury or an allergic reaction. If we have hay fever or are stung by a bee, we might take an antihistamine.</p>
<p>Histamine can lead to inflammation and can be a problem when we can’t break it down properly, and levels get <a href="https://www.mdpi.com/1081186">too high</a>. Symptoms when this happens can include headaches, diarrhoea, wheezing and fatigue.</p>
<p>Many of these symptoms are similar to those reported with long COVID. Some scientists have proposed that the increased inflammatory responses <a href="https://link.springer.com/article/10.1007/s00011-022-01589-9">seen with long COVID</a> could be caused by increased histamine release by dysfunctional immune cells, which we’ve seen before with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8308327/">other conditions</a>.</p>
<p>A <a href="https://www.mdpi.com/1081186">low histamine diet</a> involves restricting the intake of food and drinks considered high in histamine for several weeks, before gradually reintroducing them to test tolerance. These include alcohol, fermented foods, dairy products, shellfish, processed meats and aged cheese, as well as wheat germ and a range of <a href="https://www.webmd.com/diet/foods-high-in-histamine">fruit and vegetables</a>. </p>
<figure class="align-center ">
<img alt="A young man eats a bowl of cereal." src="https://images.theconversation.com/files/505853/original/file-20230123-19-fo8huf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/505853/original/file-20230123-19-fo8huf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/505853/original/file-20230123-19-fo8huf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/505853/original/file-20230123-19-fo8huf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/505853/original/file-20230123-19-fo8huf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/505853/original/file-20230123-19-fo8huf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/505853/original/file-20230123-19-fo8huf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Could a certain diet help to manage the symptoms of long COVID?</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/handsome-man-having-breakfast-eating-cereals-1453256840">Shift Drive/Shutterstock</a></span>
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<p>However, there appears to be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7463562/">lack of consensus</a> on which foods are truly high in histamine. And as the foods are wide ranging, this can be a tricky diet to implement without potentially causing nutritional deficiencies. </p>
<p>Although some people have reported <a href="https://twitter.com/drpeterbagshaw/status/1313546908321886208">an improvement</a> in their symptoms by following a low histamine diet, there have been no studies published in this area. Given the <a href="https://www.bda.uk.com/resource/caution-advised-with-low-histamine-diets-for-long-covid.html">lack of evidence</a> and the associated challenges, elimination of dietary histamine is not currently recommended for long COVID.</p>
<h2>The plant-based diet</h2>
<p>Plant-based eating refers to diets where the majority of energy is derived from plant foods, such as vegan and vegetarian diets. Plant-based diets are <a href="https://www.mdpi.com/2072-6643/13/7/2308">beneficial</a> to markers of inflammation and may favourably alter immune function.</p>
<p>More specifically, a well-balanced <a href="https://www.mdpi.com/1660-4601/18/5/2455">plant-based diet</a> is high in fibre, antioxidants, good fatty acids and a range of vitamins and minerals, which positively affect several types of cells implicated in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8429479/">immune function</a> and may exhibit direct antiviral properties. </p>
<p>For example, compounds called polyphenols found in fruits and vegetables may improve the functionality and activity of <a href="https://www.immunology.org/public-information/bitesized-immunology/cells/natural-killer-cells">natural killer cells</a>, an immune cell that patrols the body recognising abnormal cells. </p>
<p>Though some long COVID sufferers have touted the benefits of a plant-based diet, its usefulness to alleviate long COVID symptoms has not yet been examined <a href="https://link.springer.com/article/10.1007/s13668-021-00369-x">in clinical trials</a>. </p>
<p>Nevertheless, evidence from studies done before the pandemic suggests a plant-based diet may benefit <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8429479/">some conditions</a> that can also affect people with long COVID – including fatigue, headaches, anxiety, depression and muscle pain.</p>
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Read more:
<a href="https://theconversation.com/covid-and-your-gut-how-a-healthy-microbiome-can-reduce-the-severity-of-infection-and-vice-versa-195132">COVID and your gut: how a healthy microbiome can reduce the severity of infection – and vice versa</a>
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<h2>Take-home message</h2>
<p>Some diets, such as a low histamine diet, are not currently backed up by enough data when it comes to the management of long COVID. </p>
<p>But a varied Mediterranean diet or well managed plant-based diet can provide <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/jmv.25707">certain nutrients</a> which have positive effects on immune function and may protect against chronic inflammation. That said, more research is still needed as to how these diets may affect long COVID.</p>
<p>If you’re considering changing your diet to manage long COVID symptoms, it’s best to consult your GP first to ensure you can do so safely.</p><img src="https://counter.theconversation.com/content/197821/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>From low histamine to anti-inflammatory diets, people on social media have been touting a variety of eating patterns to help manage long COVID.Samuel J. White, Senior Lecturer in Genetic Immunology, Nottingham Trent UniversityPhilippe B. Wilson, Professor of One Health, Nottingham Trent UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1965602023-01-31T13:48:24Z2023-01-31T13:48:24ZUltraprocessed foods – like cookies, chips, frozen meals and fast food – may contribute to cognitive decline<figure><img src="https://images.theconversation.com/files/507225/original/file-20230130-14099-bxhu8i.jpg?ixlib=rb-1.1.0&rect=20%2C104%2C4608%2C3588&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Surprisingly, even packaged foods that contain healthy components can qualify as ultra-processed.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/new-jersey-jersey-city-close-up-of-tv-dinner-on-royalty-free-image/114849031?phrase=processed%20foods&adppopup=true">Jamie Grill Photography/Tetra Images via Getty Images</a></span></figcaption></figure><p>Scientists have known for years that unhealthy diets – particularly those that are high in fat and sugar – may cause <a href="https://doi.org/10.1002/hipo.20470">detrimental changes to the brain</a> and <a href="https://doi.org/10.1111/j.1471-4159.2010.06865.x">lead to cognitive impairment</a>. </p>
<p>Many factors that contribute to cognitive decline are out of a person’s control, such as <a href="https://doi.org/10.1038/s41593-022-01042-4">genetics</a> and <a href="https://doi.org/10.1080/13607863.2022.2046694">socioeconomic factors</a>. But ongoing research increasingly indicates that a <a href="https://doi.org/10.1016/j.arr.2021.101395">poor diet is a risk factor</a> for memory impairments during normal aging and increases the risk of <a href="https://doi.org/10.1016/j.arr.2021.101397">developing Alzheimer’s disease</a>. </p>
<p>But when evaluating how some diets may erode brain health as we age, research on the effects of consuming minimally processed versus ultraprocessed foods has been scant – that is, until now. </p>
<p>Two recent large-scale studies suggest that eating ultraprocessed foods <a href="https://doi.org/10.1001/jamaneurol.2022.4397">may exacerbate age-related cognitive decline</a> and increase the <a href="https://doi.org/10.1212/WNL.0000000000200871">risk of developing dementia</a>. In contrast, another recent study reported that ultraprocessed food consumption was not associated <a href="https://doi.org/10.1007/s00394-022-02911-1">with worse cognition in people over 60</a>. </p>
<p>Although more research is needed, as a <a href="https://neuroscience.ufl.edu/profile/burke-sara/">neuroscientist</a> who researches how <a href="https://scholar.google.com/citations?user=EYPe4zQAAAAJ&hl=en">diet can influence cognition</a> later in life, I find that these early studies add a new layer for considering how fundamental nutrition is to brain health. </p>
<h2>Lots of ingredients, minimal nutrition</h2>
<p>Ultraprocessed foods tend to be lower in nutrients and fiber and higher in sugar, fat and salt compared to unprocessed or minimally processed foods. Some <a href="https://doi.org/10.1093/cdn/nzy077">examples of ultraprocessed foods</a> include soda, packaged cookies, chips, frozen meals, flavored nuts, flavored yogurt, distilled alcoholic beverages and fast foods. Even packaged breads, including those high in nutritious whole grains, qualify as ultraprocessed in many cases because of the additives and preservatives they contain. </p>
<p>Another way to look at it: You are not likely to find the ingredients that make up most of these foods in your home kitchen.</p>
<p>But don’t confuse ultraprocessed with processed foods, which still retain most of their natural characteristics, although they’ve undergone some form of processing – like canned vegetables, dried pasta or frozen fruit. </p>
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<figcaption><span class="caption">A look at three categories of foods.</span></figcaption>
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<h2>Parsing the research</h2>
<p>In a December 2022 study, researchers compared the rate of cognitive decline over approximately eight years between groups of people that <a href="https://doi.org/10.1001/jamaneurol.2022.4397">consumed different amounts of ultraprocessed foods</a>. </p>
<p>At the beginning of the study, over 10,000 participants living in Brazil reported their dietary habits from the previous 12 months. Then, for the ensuing years, the researchers evaluated the cognitive performance of the participants with standard tests of memory and executive function. </p>
<p>Those who ate a diet containing more ultraprocessed foods at the start of the study showed slightly more cognitive decline compared with those that ate little to no ultraprocessed foods. This was a relatively modest difference in the rate of cognitive decline between experimental groups. It is not yet clear if the small difference in cognitive decline associated with higher consumption of ultraprocessed foods will have a meaningful effect at the level of an individual person. </p>
<p>The second study, with about 72,000 participants in the U.K., measured the association between <a href="https://doi.org/10.1212/WNL.0000000000200871">eating ultraprocessed foods and dementia</a>. For the group eating the highest amounts of ultraprocessed foods, approximately 1 out of 120 people were diagnosed with dementia over a 10-year period. For the group that consumed little to no ultraprocessed foods, this number was 1 out of 170. </p>
<p>Research examining the relationship between health and ultraprocessed foods uses the <a href="https://regulatory.mxns.com/en/ultra-processed-foods-nova-classification">NOVA classification</a>, which is a categorization system based on the type and extent of industrial food processing. Some nutritionists have <a href="https://doi.org/10.1093/ajcn/nqac123">criticized the NOVA classification</a> for not having clear definitions of food processing, which could <a href="https://doi.org/10.1038/s41430-022-01099-1">lead to misclassification</a>. They also argue that the potential health risks from consuming ultraprocessed foods could be explained by low levels of fiber and nutrients and high levels of fat, sugar and salt in the diet rather than the amount of processing. </p>
<p>Many ultraprocessed foods are high in additives, preservatives or coloring agents, while also having other features of an unhealthy diet, such as being low in fiber and nutrients. Thus, it is unclear if eating food that has undergone more processing has an additional negative impact on <a href="https://doi.org/10.1093/ajcn/nqac122">health beyond low diet quality</a>.</p>
<p>For example, you could eat a burger and fries from a fast food chain, which would be high in fat, sugar and salt as well as being ultraprocessed. You could make that same meal at home, which could also be high in fat, sugar and salt but would not be ultraprocessed. More research is needed to determine whether one is worse than the other. </p>
<h2>Brain-healthy diets</h2>
<p>Even when the processes that lead to dementia are not occurring, the aging brain undergoes biochemical and structural changes that are <a href="https://doi.org/10.1038/nrn1809">associated with worsening cognition</a>.</p>
<p>But for adults over the age of 55, a healthier diet could increase the likelihood of maintaining better brain function. In particular, <a href="https://doi.org/10.3390/nu13062067">the Mediterranean diet</a> and <a href="https://doi.org/10.1016/j.cmet.2017.08.004">ketogenic diet</a> are associated with better cognition in advanced age. </p>
<p>The Mediterranean diet emphasizes the consumption of plant-based foods and healthy fats, like olive oil, seeds and nuts. The ketogenic diet is high in fat and low in carbohydrates, with the primary fiber source being from vegetables. Both diets minimize or eliminate the consumption of sugar. </p>
<p>Our research and the work of others show that both diets can <a href="https://doi.org/10.1093/gerona/glx193">reverse some of these changes</a> and <a href="https://doi.org/10.3109/13697137.2015.1078106">improve cognitive function</a> – possibly by <a href="https://theconversation.com/what-is-inflammation-two-immunologists-explain-how-the-body-responds-to-everything-from-stings-to-vaccination-and-why-it-sometimes-goes-wrong-193503">reducing harmful inflammation</a>. </p>
<p>Although inflammation is a normal immune response to injury or infection, chronic inflammation can be detrimental to the brain. Studies have shown that excess sugar and fat <a href="https://doi.org/10.1096/fj.201700984RR">can contribute to chronic inflammation</a>, <a href="https://doi.org/10.3390/nu14163309">and ultraprocessed foods might</a> also exacerbate harmful inflammation.</p>
<p>Another way that diet and ultraprocessed foods may influence brain health is <a href="https://doi.org/10.1016/bs.irn.2022.07.006">through the gut-brain axis</a>, which is the communication that occurs between the brain and <a href="https://theconversation.com/which-microbes-live-in-your-gut-a-microbiologist-tries-at-home-test-kits-to-see-what-they-reveal-about-the-microbiome-181392">the gut microbiome</a>, or the community of microorganisms that live in the digestive tract.</p>
<p>Not only does the gut microbiome help with digestion, but it also influences the immune system, while producing hormones and <a href="https://doi.org/10.1038/mp.2016.50">neurotransmitters that are critical for brain function</a>.</p>
<p>Studies have shown that the <a href="https://doi.org/10.3390/nu14091758">ketogenic</a> and <a href="https://doi.org/10.1136/gutjnl-2019-319654">Mediterranean diets</a> change the composition of microorganisms in the gut in ways that benefit the person. Ultraprocessed food consumption is also associated with <a href="https://doi.org/10.3390/nu13082710">alterations in the type and abundance</a> of gut microorganisms that have more harmful effects.</p>
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<figcaption><span class="caption">There’s a war going on in your gut: good bacteria versus bad bacteria.</span></figcaption>
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<h2>The uncertainties</h2>
<p>Disentangling the specific effects of individual foods on the human body is difficult, in part because maintaining strict control over people’s diets to study them over long periods of time is problematic. Moreover, <a href="https://doi.org/10.1016/j.cmet.2019.05.008">randomized controlled trials</a>, the most reliable type of study for establishing causality, <a href="https://doi.org/10.3945/ajcn.116.136085">are expensive</a> to carry out. </p>
<p>So far, most nutritional studies, including these two, have only shown correlations between ultraprocessed food consumption and health. But they cannot rule out <a href="https://doi.org/10.1136/bmj.f6698">other lifestyle factors</a> such as exercise, education, socioeconomic status, social connections, stress and many more variables that may influence cognitive function. </p>
<p>This is where lab-based studies using animals are incredibly useful. Rats show <a href="https://doi.org/10.1111/ejn.12183">cognitive decline in old age that parallels humans</a>. It’s easy to control rodent diets and activity levels in a laboratory. And rats go from middle to old age within months, which shortens study times. </p>
<p>Lab-based studies in animals will make it possible to determine if ultraprocessed foods are playing a key role in the development of cognitive impairments and dementia in people. As the world’s population ages and the number of <a href="https://www.who.int/news-room/fact-sheets/detail/dementia#">older adults with dementia increases</a>, this knowledge cannot come soon enough.</p><img src="https://counter.theconversation.com/content/196560/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sara N. Burke does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Researchers are trying to understand whether ultraprocessed foods erode brain health in the aging process.Sara N. Burke, Associate Professor of Neurobiology and Cognitive Aging, University of FloridaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1971512023-01-09T11:12:07Z2023-01-09T11:12:07ZColds, flu and COVID: how diet and lifestyle can boost your immune system<figure><img src="https://images.theconversation.com/files/503417/original/file-20230106-9921-bqlyvc.jpg?ixlib=rb-1.1.0&rect=44%2C11%2C7425%2C4973&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Most of us are eager to avoid getting sick this time of year.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-sick-woman-sitting-on-sofa-667211476">baranq/ Shutterstock</a></span></figcaption></figure><p>Every day we are exposed to a wide array of potentially harmful microorganisms – such as colds, the flu and even COVID. But our <a href="https://www.niaid.nih.gov/research/immune-system-overview">immune system</a> – a network of intricate pathways within our body – helps protect us against these microorganisms and other potential diseases. Essentially, it recognises foreign invaders, such as viruses and bacteria, and takes immediate action to defend us.</p>
<p>Humans have two types of immunity: innate and adaptive. <a href="https://www.niaid.nih.gov/research/immune-system-overview">Innate immunity</a> is the body’s first-line of defence, primarily consisting of physical barriers (such as skin), and secretions – including mucus, stomach acid and enzymes in saliva and sweat which prevent microorganisms getting inside the body. It also consists of cells that attack all foreign invaders entering the body.</p>
<p><a href="https://www.niaid.nih.gov/research/immune-system-overview">Adaptive immunity</a> is a system that learns to recognise a pathogen. It’s regulated by cells and organs in our body such as the spleen, thymus, bone marrow and lymph nodes. When a foreign substance enters the body, these cells and organs create antibodies and <em>multiply</em> the immune cells specific to that harmful substance in order to attack and destroy it. They also remember the pathogen for future reference.</p>
<p>There are many things we can do to support our immune system and even improve its function. Simple changes to your diet and lifestyle can all play a big role in helping you avoid getting sick.</p>
<h2>We are what we eat</h2>
<p>The nutrients we get from the foods in our diet play key roles in both building and maintaining our immune system.</p>
<p>Take for example the amino acid <a href="https://academic.oup.com/jn/article/137/6/1681S/4664953?login=false">arginine</a>. This is essential for generating nitric oxide within immune cells, which is an important defence molecule against organisms. <a href="https://pubmed.ncbi.nlm.nih.gov/33377367/">Vitamin A and zinc</a> are crucial in the rapid reproduction of immune cells. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707683/">Vitamin C</a> contributes to immune defence by supporting the cell functions of both immune systems. Similarly, <a href="https://www.mdpi.com/2072-6643/10/11/1614">vitamin E</a> has been shown to enhance immune responses in animals and humans and to provide protection against several infectious diseases, such as flu, COVID and the common cold. </p>
<p>A varied diet including fruits and vegetables, wholegrains, nuts, seeds, dairy products, as well as fish, meat, or plant protein alternatives, will all contain these key nutrients which support our immune health.</p>
<p>The vast combination of microorganisms that live in our gut – <a href="https://ep.bmj.com/content/102/5/257">known as our microbiome</a> – also have significant effects on our health and wellbeing, despite their tiny size. In fact, the microbiome is often referred to as the “<a href="https://www.sciencefocus.com/the-human-body/a-gut-feeling-meet-your-second-brain/">second brain</a>” due to the extensive relationship it has with the body’s organs and systems. </p>
<p>One particular role the microbes in our gut play is supporting <a href="https://www.nature.com/articles/s41422-020-0332-7">immune function</a>. They help to control inflammation, the process the immune system uses to protect us from harmful pathogens. Ensuring the microbiome is healthy can improve immune function.</p>
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<img alt="A bowl of greens with a two pieces of grilled salmon on top." src="https://images.theconversation.com/files/503419/original/file-20230106-21-oixeb2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/503419/original/file-20230106-21-oixeb2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/503419/original/file-20230106-21-oixeb2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/503419/original/file-20230106-21-oixeb2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/503419/original/file-20230106-21-oixeb2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/503419/original/file-20230106-21-oixeb2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/503419/original/file-20230106-21-oixeb2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">The Mediterranean diet can help support the microbiome.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/grilled-salmon-fillet-fresh-vegetable-salad-1934626109">Sea Wave/ Shutterstock</a></span>
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<p>There are many ways we can support our microbiome through the foods we eat. For example, research has shown <a href="https://www.mdpi.com/1422-0067/19/12/3720">a Mediterranean diet</a>, which is rich in vitamins, minerals and dietary fibre, has an anti-inflammatory effect in the gut, which can help boost the body’s immune function. </p>
<p>This effect may be explained by a strain of bacteria known as <em>Faecalibacterium prausnitzii</em> which is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359750/">key to immune regulation</a>. This bacteria tends to be low in the western diet but abundant in the Mediterranean diet. You should also avoid too many refined cereals, sugars and animal fats, which can all <a href="https://www.nature.com/articles/nm.3444">heighten inflammation</a> in the body which weakens the immune response.</p>
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Read more:
<a href="https://theconversation.com/mediterranean-diet-increases-gut-bacteria-linked-to-healthy-ageing-in-older-adults-131928">Mediterranean diet increases gut bacteria linked to healthy ageing in older adults</a>
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<p>Probiotics (supplementary blends of live bacteria) may also have benefits. Research has even shown a probiotic blend of bacterial strains <em>Lactiplantibacillus plantarumand</em> and <em>Pediococcus acidilactici</em> <a href="https://www.tandfonline.com/doi/full/10.1080/19490976.2021.2018899">reduced the amount of virus</a> detected in the nose and lungs, as well as the duration of symptoms, in COVID patients.</p>
<h2>Living a healthy lifestyle</h2>
<p>Your lifestyle can also have a big affect on immune function.</p>
<p>For example, smoking <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5352117/">affects both innate and adaptive immunity</a>, causing it to both overreact to pathogens and lower it’s immunity defences. Alcohol has also been shown to increase susceptibility to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590612/">both bacterial and viral infections</a>. It does this by altering the way our immune system defends against infections. Even moderate drinkers may have lower immunity. </p>
<p>Sleep is also crucial for maintaining immune function. Studies show that frequent, poor sleep causes inflammation in the body. This may worsen immune response, <a href="https://www.nature.com/articles/s42003-021-02825-4">increasing infection risk</a> and worsening infections. Adolescents who only get around six hours of sleep are also more likely to suffer from common illnesses, such as <a href="https://onlinelibrary.wiley.com/doi/10.1111/jsr.12096">cold, flu and gastroenteritis</a>.</p>
<p>Stress is another factor known to have a large impact on the immune system. It isn’t just chronic stress that suppresses the immune system either – even <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/">brief periods of stress</a> (such as an exam) can worsen immune function. Fortunately, mindfulness meditation (which can help manage stress) may be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940234/">beneficial for the immune system</a> – though it isn’t entirely clear yet why.</p>
<p>Exercise has also been shown to affect immune function, with research showing <a href="https://journals.physiology.org/doi/full/10.1152/physrev.2000.80.3.1055?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org">moderate-intensity physical activity</a> in particular (such as a brisk walk or ballroom dancing) can improve immune response. However, it’s important to strike the right balance as long, intense exercise without sufficient rest between workouts can actually worsen immune function and make you more likely to catch an infection. And according to some data, this decrease can happen after only <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387807">90 minutes</a> of moderate- to high-intensity physical activity. </p>
<p>Of course, <a href="https://www.who.int/news-room/questions-and-answers/item/vaccines-and-immunization-what-is-vaccination">vaccination</a> remains the best way to prevent infection from many common diseases, such as the flu. But a good diet and lifestyle – alongside other <a href="https://www.gov.uk/government/publications/health-protection-in-schools-and-other-childcare-facilities/preventing-and-controlling-infections">preventative measures</a>, such as washing your hands or wearing a face mask – help support your immune system and the effectiveness of vaccines.</p><img src="https://counter.theconversation.com/content/197151/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Philippe B. Wilson is Chief Scientific Officer of NHS Willows Health.</span></em></p><p class="fine-print"><em><span>Samuel J. White does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Here are some simple things you can do everyday to help your immune system fight off infections.Samuel J. White, Senior Lecturer in Genetic Immunology, Nottingham Trent UniversityPhilippe B. Wilson, Professor of One Health, Nottingham Trent UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1872032022-07-28T15:59:05Z2022-07-28T15:59:05ZThe Nordic diet: fans claim it rivals its Mediterranean counterpart for health benefits – here’s what we know<figure><img src="https://images.theconversation.com/files/475602/original/file-20220722-16-um9btd.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C6720%2C4466&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Fatty fish, such as salmon, are a staple of the Nordic diet.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/gravlax-raw-marinated-graved-salmon-dill-1953646186">Christin Klose/ Shutterstock</a></span></figcaption></figure><p>Every month there seems to be a new diet doing the rounds online. One of the latest is the Nordic diet, which <a href="https://www.express.co.uk/life-style/diets/1642801/How-to-lose-weight-body-fat-8lbs-Nordic-diet-foods-Mediterranean-diet-plan">some claim</a> could be <a href="https://www.dailymail.co.uk/femail/article-10990715/Berries-cabbage-canned-fish-embracing-Nordic-diet.html">better for your health</a> than the Mediterranean diet. And research is starting to suggest it could at least have some similar benefits.</p>
<p>The Nordic diet is based on the traditional foods available in Nordic countries. The core foods it comprises are whole grains (particularly rye, barley and oats), fruits (especially berries), root vegetables (such as beets, carrots and turnips), fatty fish (including salmon, tuna and mackerel), legumes and low-fat dairy. </p>
<p>But unlike the Mediterranean diet which has a <a href="https://ich.unesco.org/en/RL/mediterranean-diet-00884">long heritage</a> and the <a href="https://cdt.amegroups.com/article/view/14269/14736">health benefits</a> of which have been consistently observed in <a href="https://academic.oup.com/nutritionreviews/article/55/11/383/1831631?login=true">population studies</a> and investigations, the Nordic diet was actually <a href="https://www.cambridge.org/core/journals/public-health-nutrition/article/guidelines-for-the-new-nordic-diet/B495738BC44965E3968004DCD5EDD294">developed by a committee</a> of nutrition and food experts, alongside chefs, food historians and environmentalists. The motivation for creating it was to <a href="https://www.norden.org/en/nordic-food-policy-lab">improve dietary guidelines</a> in Nordic countries in a sustainable way, while also seeking to create a local identity linked to food and culture. </p>
<p>Still, the <a href="https://www.cambridge.org/core/journals/public-health-nutrition/article/guidelines-for-the-new-nordic-diet/B495738BC44965E3968004DCD5EDD294">Nordic Diet</a> shares a number of similarities with the <a href="https://www.sciencedirect.com/science/article/pii/B9780128186497000060?via%3Dihub">Mediterranean Diet</a>, in that it consists of more wholefoods and less or no highly processed foods. It also encourages eating more plant foods and less meat. </p>
<p>Perhaps the key feature of the Nordic diet is that it encourages people to include a diverse range of locally available foods like mosses, seeds, vegetables, and herbs (including those growing wild). This is why berries such as <a href="https://www.sciencedirect.com/science/article/abs/pii/S0308814618300621">lingonberries</a> are a core element of the Nordic diet, while citrus and tropical fruits aren’t.</p>
<p>Although the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270004/">bulk of both</a> the Nordic diet and Mediterranean diet are made up of plants, the type of plants are very different. For example, people following the Nordic diet will be encouraged to eat foods like seaweeds and kelp (which are rich in nutrients such as iodine, omega-3 fatty acids and even vitamin D), as well as other locally available vegetables and fruits. For the Mediterranean diet, people would include leafy vegetables such as spinach, as well as onions, courgettes, tomatoes, and peppers, which are all local to the region.</p>
<h2>What does the evidence say?</h2>
<p>The Nordic diet is still relatively new, being <a href="http://www.hungryplanet.dk/pdf/plancher/07_ny_nordisk_hverdagsmad.pdf">first published in 2010</a>. This means it’s probably too early to tell if it reduces the risk of chronic diseases. </p>
<p>The Mediterranean diet, on the other hand, has been studied by researchers since the <a href="https://www.sevencountriesstudy.com/mediterranean-dietary-patterns/">1950s and 60s</a> – meaning we have a much better understanding of its links to lower risk of <a href="https://www.google.com/search?client=safari&rls=en&q=mediterranean+diet+heart+disease+georgoupolou&ie=UTF-8&oe=UTF-8">heart disease</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/28278309/">type 2 diabetes</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/27014505/">some cancers</a>.</p>
<p>But some studies which have looked retrospectively at peoples’ eating habits have found that people who ate diets similar to what is now known as the Nordic diet tended to be healthier. These studies found that Nordic eating patterns were associated with a lower risk of <a href="https://link.springer.com/article/10.1007/s00394-020-02188-2">heart disease</a> and <a href="https://www.sciencedirect.com/science/article/pii/S0168822714003799">type 2 diabetes</a> in people from Nordic countries. However, the relationship between lower risk of disease and Nordic diets is less strong in people from <a href="https://link.springer.com/article/10.1186/s12916-018-1082-y">other countries</a>. The reason for this currently is unclear. </p>
<p>The difficulty with these population studies is that they looked at a dietary pattern that technically did not exist – as it had not been defined until after they took part in these studies. This means that the participants may not have followed the Nordic diet deliberately – making it hard to truly know if the health benefits they say were due to the Nordic diet itself. </p>
<figure class="align-center ">
<img alt="A bowl full of lingonberries." src="https://images.theconversation.com/files/475603/original/file-20220722-12-u705t0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/475603/original/file-20220722-12-u705t0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/475603/original/file-20220722-12-u705t0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/475603/original/file-20220722-12-u705t0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/475603/original/file-20220722-12-u705t0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/475603/original/file-20220722-12-u705t0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/475603/original/file-20220722-12-u705t0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Lingonberries, which are local to the region, are also included in the Nordic diet.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/ripe-fresh-cowberry-lingonberry-partridgeberry-foxberry-701444872">Julia Sudnitskaya/ Shutterstock</a></span>
</figcaption>
</figure>
<p>However, a recent (but small) review looking at studies on the Nordic diet found that it can lower some risk factors for disease – including body weight and <a href="https://link.springer.com/article/10.1007/s00394-018-1804-0">LDL cholesterol</a> (often termed the “bad” cholesterol). But no significant improvements were seen in blood pressure or total cholesterol. </p>
<p>At the moment, it’s probably too early to say whether following the Nordic diet has long-term benefits for health – and whether it’s more beneficial for our health than the Mediterranean diet. But based on the research out there, it does appear the Nordic diet is promising for health.</p>
<p>Research also shows that some of the main staples of the Nordic diet (including <a href="https://academic.oup.com/jn/article/142/7/1304/4743493">wholegrains</a> and <a href="https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000000574">oily fish</a>) are on their own linked to better health – including reducing risk of heart disease. This suggests that combining these foods together when following the Nordic diet could lead to similar health benefits. </p>
<h2>Eat local</h2>
<p>The Nordic diet is not just about health. It was also developed to help the planet by using local and sustainable foods to make a healthier diet.</p>
<p>At the moment, some of the main barriers preventing people from adopting the Nordic diet are <a href="https://www.sciencedirect.com/science/article/pii/S0195666313003073">taste preferences</a> and <a href="https://www.mdpi.com/1660-4601/12/7/7370">cost</a>. But if these barriers are overcome, the Nordic diet could very well be a more <a href="https://www.mdpi.com/2072-6643/11/9/2248">more sustainable way of eating</a> for those in Nordic countries as might a locally derived diet for others. </p>
<p>While it’s perhaps too early to say if the Nordic diet is healthier than other well-known diets out there – such as the <a href="https://linkinghub.elsevier.com/retrieve/pii/B9780128186497000060">Mediterranean diet</a> – it might help inspire us to look at how we can adapt diets to focus more on consuming whole foods available and grown locally. </p>
<p>However, eating more of the foods common to both Mediterranean and Nordic diets – such as vegetables, seeds, legumes, wholegrains and fish – alongside consuming less red and processed meat, is likely to be the basis of a healthy diet. This, alongside eating a <a href="https://www.sciencedirect.com/science/article/abs/pii/S0261561421000984">variety of foods</a> and trying to be primarily <a href="https://link.springer.com/article/10.1007/s00394-022-02831-0">plant-based</a> is more important for health than following a <a href="https://theconversation.com/low-carb-paleo-or-fasting-which-diet-is-best-89685">particular named diet</a>.</p><img src="https://counter.theconversation.com/content/187203/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Duane Mellor is a media spokesperson for the British Dietetic Association.</span></em></p><p class="fine-print"><em><span>Ekavi Georgousopoulou has received research funding and PhD scholarships in the past from the Hellenic Atherosclerosis Society, the Coca-Cola SA and the Hellenic Cardiology Society; she is also the vice-convener for the ACT Engagement and Leadership Committee for Dietitians Australia. </span></em></p>The Nordic diet places a greater emphasis on eating wholefoods and less (if any) processed foods.Duane Mellor, Lead for Evidence-Based Medicine and Nutrition, Aston Medical School, Aston UniversityEkavi Georgousopoulou, Assistant Professor in Nutrition & Dietetics, University of CanberraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1854932022-07-18T03:29:06Z2022-07-18T03:29:06ZVegetarian diets may be better for the planet – but the Mediterranean diet is the one omnivores will actually adopt<figure><img src="https://images.theconversation.com/files/474237/original/file-20220715-12-zmx8jk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">shutterstock</span> </figcaption></figure><p>What we eat and how we produce food matters. Food systems are responsible for <a href="https://www.science.org/doi/10.1126/science.aaq0216">more than a quarter</a> of the world’s greenhouse gas emissions. </p>
<p>We cannot fully tackle the climate crisis without reducing the greenhouse footprint of our food. The issue is only becoming more urgent, as world population climbs alongside hunger stemming from war disruption of food exports. As people get richer and more urbanised, global consumption of meat and dairy products also grows. </p>
<p>Livestock are the main source of our food emissions and the <a href="https://www.ipcc.ch/site/assets/uploads/2018/02/ipcc_wg3_ar5_summary-for-policymakers.pdf">third highest global source</a> of emissions at 14.5%, after energy (35%) and transport (23%). </p>
<p>To cut these emissions, many advocate switching to plant-rich or plant-only diets. But will people who have a longstanding attachment to meat actually choose to switch? Our <a href="https://www.sciencedirect.com/science/article/pii/S2352550922001282">new research</a> suggests the sweet spot is the Mediterranean diet, which includes some meat while remaining plant rich and healthy. </p>
<h2>What’s the problem?</h2>
<p>Rearing livestock requires large areas of land, as well as inputs of water and feed. More intensive livestock production is linked to biodiversity loss, land degradation, pollution of waterways, increased risk of <a href="https://www.nature.com/articles/s41467-017-00923-8">zoonotic diseases</a> such as COVID-19, and <a href="https://www.sciencedirect.com/science/article/pii/S0269749117342562?via%3Dihub">antibiotic resistance</a>. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/474239/original/file-20220715-26-vda9cd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Chicken farm intensive" src="https://images.theconversation.com/files/474239/original/file-20220715-26-vda9cd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/474239/original/file-20220715-26-vda9cd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/474239/original/file-20220715-26-vda9cd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/474239/original/file-20220715-26-vda9cd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/474239/original/file-20220715-26-vda9cd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/474239/original/file-20220715-26-vda9cd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/474239/original/file-20220715-26-vda9cd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Intensive livestock production often entails worse animal welfare.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>While methods of <a href="https://theconversation.com/feeding-cows-a-few-ounces-of-seaweed-daily-could-sharply-reduce-their-contribution-to-climate-change-157192">cutting livestock emissions</a> are <a href="https://www.dpi.nsw.gov.au/dpi/climate/Carbon-and-emissions/emissions-reduction-pathways/livestock-industries/methane_emissions">undergoing development</a>, production is only half the story. To have a real impact, we also need to consider the demand side. </p>
<p>Without reducing the overall demand for meat and dairy, it’s unlikely livestock emissions will fall fast enough and far enough. In wealthy countries like Australia, we consume meat and dairy at high rates. Reducing these consumption rates could cut greenhouse emissions and reduce other environmental damage. </p>
<p>So which diet should we eat? Clearly, any acceptable diet needs to be nutritionally adequate. While meat provides essential nutrients, too much of it is linked to diseases <a href="https://www.tandfonline.com/doi/full/10.1080/10408398.2013.873886">like cancer</a>. It’s important to consider both environmental and health credentials of a diet. We can add animal welfare to this as well, which tends to be worse in <a href="https://www.sciencedirect.com/science/article/pii/S016815911830100X?via%3Dihub">intensive livestock production</a>. </p>
<p>We hope by identifying healthy, environmentally sustainable diets with better animal welfare, we can help people make sustainable dietary choices.</p>
<h2>What did we find?</h2>
<p>We looked at five common plant-rich diets and assessed their impacts on the environment (carbon footprint, land, and water use), human health, and animal welfare. We focused on food production in high-income countries.</p>
<p>The diets we examined were: </p>
<ul>
<li><em>Mediterranean</em> (plant-heavy with small amounts of red meat, moderate amounts of poultry and fish)</li>
<li><em>Flexitarian/semi-vegetarian</em> (meat reduction)</li>
<li><em>Pescatarian</em> (fish, no other meat)</li>
<li><em>Vegetarian</em> (no meat but dairy and eggs OK) </li>
<li><em>Vegan</em> (no animal products) </li>
</ul>
<p>All five of these plant-rich diets had less environmental impact than the omnivore diet, with no-meat diets (vegan and vegetarian) having the least impact. </p>
<p>We have to add the caveat, however, that environmental footprint measures used to compare diets are simplistic and <a href="https://theconversation.com/environmental-footprint-calculators-have-one-big-flaw-we-need-to-talk-about-166897">overlook</a> important indirect effects of shifting diets. </p>
<p>Overall, the Mediterranean diet was deemed the healthiest for humans, while the vegan and vegetarian diets had the best outcomes for animal welfare. When we combined all three measures, vegan and vegetarian diets were found to be the most ‘sustainable’ diets based on reducing our food footprint, staying healthy, and reducing negative impacts on farm animals.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/474238/original/file-20220715-12-hvzp5p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Vegetarian diet" src="https://images.theconversation.com/files/474238/original/file-20220715-12-hvzp5p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/474238/original/file-20220715-12-hvzp5p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/474238/original/file-20220715-12-hvzp5p.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/474238/original/file-20220715-12-hvzp5p.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/474238/original/file-20220715-12-hvzp5p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/474238/original/file-20220715-12-hvzp5p.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/474238/original/file-20220715-12-hvzp5p.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Vegetarian diets are better for the planet but are less popular.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<h2>We know which diets are best. But what diet will people actually choose?</h2>
<p>There is often a gulf between what we should do in an ideal world and what we actually do. To tackle this, we examined what people are actually willing to eat. Is promoting a vegan or vegetarian diet the most effective way to reduce demand for meat and dairy? </p>
<p>To find out, we asked 253 Australians what they currently eat and which of the five plant-rich diets they were willing to eat. </p>
<p>Australia is a high meat-eating country, so it’s not surprising that most of our respondents (71%) identified as omnivores. </p>
<p>It’s also no surprise that the diets least likely to be adopted were the vegan and vegetarian diets, as these diets represented a major shift in most people’s eating habits. </p>
<p>As a result, it was the Mediterranean diet – which entails a small reduction in meat consumption – which had the highest likelihood of adoption. Combined with its high health benefits and moderate environmental and animal welfare impacts, we identified it as the best diet to promote.</p>
<p>While some of these results may seem intuitive, we believe by combining social, environmental, human health, and animal welfare elements of food consumption, we gain a more complete picture to spot pitfalls as well as realistic solutions. </p>
<p>For instance, it’s likely a waste of precious time and resources to promote diets like the vegan diet which, realistically, most people are not willing to eat. Yet despite the evident lack of enthusiasm from people, <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0165797">most research</a> assessing the environmental impact of different diets has favoured vegan and vegetarian diets. </p>
<p>That’s why taking a wider view is important. If we actually want to reduce meat and dairy consumption, we must use approaches that have the best chance of working. </p>
<p>In high-income countries like Australia, that means we should promote the Mediterranean diet as the best diet to begin to tackle the demand for emissions-intensive meat and dairy. We need to start at a realistic point to begin to create a more sustainable global food system.</p><img src="https://counter.theconversation.com/content/185493/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Annette Cowie is a Senior Principal Research Scientist in the Climate Branch at the NSW Department of Primary Industries, and Adjunct Professor in the School of Environmental and Rural Science at the University of New England. She receives research funding from NSW and Commonwealth government programs and rural research and development corporations. She is a member of Soil Science Australia and an adviser to the Australia New Zealand Biochar Industry Group and the Land Degradation Neutrality Fund.</span></em></p><p class="fine-print"><em><span>Amy Lykins and Nicole Allenden do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Vegetarian and vegan diets are the best for the planet. But most omnivores simply won’t switch to them. It’s realistic to promote the Mediterranean diet instead.Nicole Allenden, PhD Candidate, School of Psychology, University of New EnglandAmy Lykins, Associate Professor in Clinical Psychology, University of New EnglandAnnette Cowie, Principal Research Scientist, Climate, NSW DPILicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1810022022-04-14T15:45:04Z2022-04-14T15:45:04ZHeart disease risk and depression: a new study explores whether the two may be linked<figure><img src="https://images.theconversation.com/files/458181/original/file-20220414-12-z0vibq.jpg?ixlib=rb-1.1.0&rect=35%2C0%2C7904%2C5304&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/middleaged-mature-happy-family-couple-wife-1995321275">Inside Creative House/Shutterstock</a></span></figcaption></figure><p>For generations, people have been fascinated by the links between mind and body. For example, do people really die of a broken heart? Does a healthy mind indicate a healthy body?</p>
<p>Scientists have been studying the associations between mental and physical health for some time. One such association is between depression and heart disease. Research has shown that <a href="https://www.nature.com/articles/nrcardio.2016.181">depression is more common</a> among people with heart disease compared to the general population. </p>
<p>Further, in people who are physically healthy, when followed over many years, those with elevated depressive symptoms are <a href="https://www.nature.com/articles/nrcardio.2016.181">more likely</a> to develop heart disease than those who don’t have depression.</p>
<p>We also know that in people with acute heart disease (for example, they’ve had a heart attack), having depression is associated with <a href="https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/adjusted-prognostic-association-of-depression-following-myocardial-infarction-with-mortality-and-cardiovascular-events-individual-patient-data-metaanalysis/D18583CC65474874781249C87519771D">increased risk</a> of further heart attacks and death, not only from heart disease, but from any cause.</p>
<p>However, fewer studies have investigated whether these trends exist in reverse – that is, whether cardiovascular risk factors are associated with a higher likelihood of developing depression. But now, a <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0265079">new study</a> published in the journal PLOS ONE has sought to explore this. </p>
<h2>What the researchers did</h2>
<p>Sandra Martín-Peláez from the University of Granada in Spain and her colleagues focused on people with metabolic syndrome to explore the link between cardiovascular risk factors and depression in people aged between 55 and 75. </p>
<p>Metabolic syndrome is a <a href="https://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/symptoms-causes/syc-20351916">group of conditions</a> that occur together – including high blood pressure, high blood sugar, excess body fat around the waist, and elevated cholesterol – and which increase a person’s risk of heart disease, stroke, and type 2 diabetes. Some researchers have suggested that metabolic syndrome may <a href="https://diabetesjournals.org/care/article/34/4/904/38821/Metabolic-Syndrome-and-Onset-of-Depressive">play a role</a> in depression, too. </p>
<p>The participants in this study were drawn from a <a href="https://www.predimedplus.com/en/project/">broader trial</a> analysing the effects of a Mediterranean diet on people who are overweight or obese, and who have metabolic syndrome. The ongoing randomised trial consists of one group following a calorie-restricted Mediterranean diet and a physical activity programme, and another group following an unrestricted Mediterranean diet without a physical activity programme.</p>
<p>More than 6,500 participants were included in the baseline analysis for the PLOS ONE study, with over 4,500 followed up two years later. The researchers used the well-established <a href="https://framinghamheartstudy.org/fhs-about/">Framingham risk score</a>, which was developed by following healthy people over time to determine the major risk factors for heart disease. They categorised people as low-, medium-, or high-risk for having a heart attack or dying from heart disease within ten years. </p>
<p>Participants were asked about their depressive symptoms using questionnaires at baseline (when they began following the diets and physical activity programmes) and then two years later.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/depression-anxiety-and-heart-disease-risk-all-linked-to-single-brain-region-149213">Depression, anxiety and heart disease risk all linked to single brain region</a>
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<p>Surprisingly, no significant association was found between cardiovascular risk and depression at baseline or follow-up. So, overall, participants with a higher risk of heart disease were not more likely to have or develop depression.</p>
<p>When the authors analysed the data by gender, they found that at baseline, women with higher cardiovascular risk were more likely to exhibit symptoms of depression. But this was not the case in men, and not in either men or women at follow up. </p>
<p>On average, all participants’ depression scores reduced at two years. Depression scores dropped more for those who had low cardiovascular risk, and for those in the intervention group (participants who were following the restricted diet and the physical activity programme). </p>
<figure class="align-center ">
<img alt="A middle-aged man exercising at the beach." src="https://images.theconversation.com/files/458149/original/file-20220414-26-gbe2cc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/458149/original/file-20220414-26-gbe2cc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/458149/original/file-20220414-26-gbe2cc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/458149/original/file-20220414-26-gbe2cc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/458149/original/file-20220414-26-gbe2cc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/458149/original/file-20220414-26-gbe2cc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/458149/original/file-20220414-26-gbe2cc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A healthy lifestyle is associated with a lower risk of both depression and heart disease.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/fit-senior-man-exercising-beach-morning-138177053">michaeljung/Shutterstock</a></span>
</figcaption>
</figure>
<p>It’s difficult to clearly interpret the findings of this study. The data has been analysed in several different ways, and there are some mixed results. For example, the authors analysed the data by different metabolic syndrome factors, finding that diabetes and certain cholesterol levels resulted in lower depression scores at follow-up. </p>
<p>But we do know from other research that women with heart disease have <a href="https://journals.lww.com/psychosomaticmedicine/Abstract/2015/05000/Systematic_Review_and_Individual_Patient_Data.9.aspx">higher levels</a> of depression than men with heart disease. It’s also well-established that in the general population, women experience <a href="https://journals.lww.com/hrpjournal/Abstract/2020/01000/Gender_Differences_in_Depression__Biological,.2.aspx">higher rates of depression</a> than men. So the finding that there may be a link between heart disease risk and depression in women seems to align with these trends.</p>
<h2>Why are depression and heart disease linked?</h2>
<p>Although we can’t conclude from this study that heart disease risk is associated with a higher risk of developing depression, it does add to an already strong body of evidence suggesting heart disease and depression are linked. </p>
<p>A number of factors, behavioural and biological, may explain this relationship. Some of the <a href="https://www.nature.com/articles/nrcardio.2016.181">biological factors</a> common to both depression and heart disease risk include:</p>
<ul>
<li>increased inflammation</li>
<li>endothelial dysfunction (constriction of blood vessels in the heart)</li>
<li>altered autonomic nervous system activity (the autonomic nervous system controls muscles, including the heart)</li>
<li>blood platelet dysfunction (where blood platelets are more likely to stick together and form clots). </li>
</ul>
<p>Also, we know that <a href="https://www.nature.com/articles/nrcardio.2016.181">healthy lifestyle factors</a>, such as doing physical activity, not smoking and maintaining a healthy diet, are protective against both heart disease and depression. The opposite is also true – unhealthy lifestyle factors are associated with increased risk of heart disease and depression.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/exercise-as-therapy-its-surprising-potential-to-treat-people-with-multiple-chronic-conditions-145413">Exercise as therapy: its surprising potential to treat people with multiple chronic conditions</a>
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<p>Unfortunately, people with depression find it more difficult to change these sorts of habits, for example, <a href="https://journals.lww.com/psychosomaticmedicine/Abstract/2014/01000/Systematic_Review_and_Meta_Analysis_of_the_Impact.7.aspx">to quit smoking</a>. So probably the most interesting finding of this study is that depression scores were reduced in the group who were encouraged and supported to adopt a healthier lifestyle, including a more restrictive diet and increased physical activity. </p>
<p>While there’s good evidence to suggest that exercise is a very <a href="https://journals.lww.com/psychosomaticmedicine/Abstract/2021/06000/Hybrid_Systematic_Review_and_Network_Meta_Analysis.5.aspx">effective</a> treatment for depression in people with heart disease, the role of diet as an intervention for depression is less clear. This study provides a promising impetus for more investigation of diet and lifestyle as potential depression treatments in those with and at risk of heart disease.</p><img src="https://counter.theconversation.com/content/181002/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Frank Doyle receives research grant funding from the Irish Research Council, the Health Research Board and the EU H2020 Research and Innovation Action and the Irish Network of Healthcare Educators. </span></em></p>A new study has explored whether cardiovascular risk factors are associated with a higher likelihood of depression.Frank Doyle, Senior Lecturer, Department of Health Psychology, RCSI University of Medicine and Health SciencesLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1766372022-02-14T13:36:58Z2022-02-14T13:36:58ZExtra virgin olive oil: why it’s healthier than other cooking oils<figure><img src="https://images.theconversation.com/files/446280/original/file-20220214-25-1p2kbo4.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C4288%2C2848&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The benefits of extra virgin olive oil might just make it worth the extra cost.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/typical-extra-virgin-olive-oil-sicilian-163003097">Bruno D Andrea/ Shutterstock</a></span></figcaption></figure><p>It’s common advice for people watching their waistlines or looking to eat healthier to beware of the amount of oil they use while cooking. But that doesn’t mean we should cut oil entirely from our diet. This is because extra virgin olive oil in particular can have many benefits for our health. </p>
<p>Numerous studies have shown that consuming olive oil – in particular extra virgin olive oil (EVOO) – can have many different benefits for our health. For example, the Spanish Predimed study (the largest randomised control trial ever conducted on the Mediterranean diet) showed that women who ate a Mediterranean diet supplemented with extra virgin olive oil had a <a href="https://pubmed.ncbi.nlm.nih.gov/26365989/">62% lower risk</a> of breast cancer compared to women who were advised to eat a low fat diet. </p>
<p>Experts who have since examined multiple scientific studies looking at the Mediterranean diet and its effect on chronic diseases conclude that a primary reason the diet protects against breast cancer is <a href="https://pubmed.ncbi.nlm.nih.gov/29804831/">because of EVOO</a>. There’s also evidence that EVOO may protect against <a href="https://pubmed.ncbi.nlm.nih.gov/28394365/">type 2 diabetes</a> and possibly even <a href="https://pubmed.ncbi.nlm.nih.gov/34895363/">Alzheimer’s disease</a>. </p>
<p>So what makes extra virgin olive oil better for us than other types of cooking oil? The answer lies in its composition.</p>
<p>Alongside its fat, EVOO also contains many natural substances, such as polyphenols. Polyphenols occur naturally in plants, and have been linked to many health benefits, such as reducing the risk of <a href="https://pubmed.ncbi.nlm.nih.gov/23953879/">cardiovascular disease</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/22475317/">cognitive disorders</a>. Studies also seem to show that a major reason why EVOO is beneficial to our health is because of the polyphenols it contains. Polyphenols are thought to have <a href="https://pubmed.ncbi.nlm.nih.gov/34577008/">many benefits</a> in the body, such as improving the gut microbiome. </p>
<p>Research shows that the polyphenols in extra virgin olive oil are linked with lower risk of cardiovascular disease. In fact, when researchers stripped EVOO of its polyphenols, they found it <a href="https://pubmed.ncbi.nlm.nih.gov/16954359/">didn’t protect</a> the heart from disease as well. It’s believed that one of the benefits of EVOO on heart health is because its polyphenols prevent <a href="https://efsa.onlinelibrary.wiley.com/doi/pdf/10.2903/j.efsa.2011.2033">cholesterol becoming oxidised</a>. It’s when cholesterol reacts with oxygen and is oxidised that it damages blood vessels. </p>
<figure class="align-center ">
<img alt="Freshly pressed olive oil pours out of a spigot into a large metal container." src="https://images.theconversation.com/files/446272/original/file-20220214-23-e6hudj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/446272/original/file-20220214-23-e6hudj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/446272/original/file-20220214-23-e6hudj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/446272/original/file-20220214-23-e6hudj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/446272/original/file-20220214-23-e6hudj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/446272/original/file-20220214-23-e6hudj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/446272/original/file-20220214-23-e6hudj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The simple production method helps EVOO retain polyphenols.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/extraction-oil-olives-modern-farm-1050735893">pointbreak/ Shutterstock</a></span>
</figcaption>
</figure>
<p>The reason EVOO contains such high levels of polyphenols is because it’s produced by simply crushing olives. More processed versions of olive oil – such as light olive oil or spreads – don’t contain as many of these polyphenols. This is because to create these requires more processing, resulting in most of the polyphenols being lost.</p>
<h2>Other cooking oils</h2>
<p>Most other cooking oils, such as sunflower oil or rapeseed oil, are made from seeds. Seeds are very difficult to extract oil from, so they need to be heated and the oil extracted with solvents. This means that most of the polyphenols in seeds are lost during production.</p>
<p>It’s sometimes claimed that <a href="https://pubmed.ncbi.nlm.nih.gov/25322908/">rapeseed oil</a> (also known as canola oil or vegetable oil) is a healthy alternative to EVOO. While there is some evidence that <a href="https://pubmed.ncbi.nlm.nih.gov/25322908/">raw rapeseed oil</a> (meaning it hasn’t been heated during cooking) can temporarily lower cholesterol levels, there’s currently no evidence it can lower risk of developing diseases associated with high cholesterol – such as heart disease. </p>
<p>Of course, most of us use oils for cooking. But when an oil is heated at too high a temperature it reacts with the oxygen in the air, causing the fat in the oil to break down. This can lead to the formation of harmful substances that <a href="https://link.springer.com/article/10.1007/s11746-013-2242-z">irritate the eyes</a> and even <a href="https://pubmed.ncbi.nlm.nih.gov/15291498/">carcinogens</a>. Rapeseed oil is particularly prone to this process - called oxidation - especially when used repeatedly for deep fat frying. </p>
<p>Polyphenols help prevent fats from oxidising and so EVOO <a href="https://pubmed.ncbi.nlm.nih.gov/25322908/">remains stable</a> even when used at the temperatures needed to shallow fry foods. Because rapeseed oil and other oils such as sunflower oil contain lower levels of polyphenols, the fats aren’t so well protected from breaking down during cooking. </p>
<p>Another important reason for EVOO’s stability is that its main type of fat is monounsaturated fat. This is both a healthy fat and quite resistant to oxidation. Monounsaturated fat is also the main type of fat in rapeseed oil. But unlike EVOO, rapeseed oil also contains quite high levels of a polyunsaturated fat called alpha-linolenic acid. This is not very stable and is another reason why heating rapeseed oil too much is not a good idea. </p>
<p>Coconut oil is often advocated as a healthy oil to use. But coconut oil contains high levels of saturated fats, which can <a href="https://pubmed.ncbi.nlm.nih.gov/31928080/">significantly increase</a> low-density lipoprotein (or LDL) cholesterol levels (sometimes know as the “bad” cholesterol). Elevated LDL-cholesterol is linked to cardiovascular disease, and there’s evidence that the saturated fat in coconut oil <a href="https://pubmed.ncbi.nlm.nih.gov/27881409/">increases the risk of heart disease</a>.</p>
<p>One of the important messages about EVOO is that it seems to be far more effective when eaten as part of a Mediterranean diet – which is typically high in vegetables, fruits, legumes, grains, fish and olive oil. This is probably because extra virgin olive oil and its beneficial polyphenols <a href="https://pubmed.ncbi.nlm.nih.gov/30487558/">interact with other foods</a> incuding the vegetables eaten as part of this diet. The Mediterranean diet is linked with lower risk of <a href="https://pubmed.ncbi.nlm.nih.gov/34423871/">many chronic diseases</a> including cancer, cardiovascular disease and Alzheimer’s disease. This might just make the extra price of EVOO worth paying for.</p><img src="https://counter.theconversation.com/content/176637/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Richard Hoffman is the author of two books on the Mediterranean diet: The Mediterranean Diet: Health and Science (2011) and More Healthy Years - Why a Mediterranean Diet is best for you and for the planet (2020).</span></em></p>Extra virgin olive oil contains polyphenols, which studies have linked to a range of different health benefits.Richard Hoffman, Associate lecturer, Nutritional Biochemistry, University of HertfordshireLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1752882022-02-01T21:21:23Z2022-02-01T21:21:23ZThe baffling case of metabolically healthy obese people: Are they protected from chronic diseases?<figure><img src="https://images.theconversation.com/files/443086/original/file-20220127-9640-1k7cbpu.jpeg?ixlib=rb-1.1.0&rect=0%2C276%2C1211%2C783&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Some studies have demonstrated that a significant number of obese people are metabolically healthy, leading to the contention that one could be healthy at any size.</span> <span class="attribution"><a class="source" href="https://www.instagram.com/juliakubow/">(Julia Kubow)</a>, <span class="license">Author provided</span></span></figcaption></figure><iframe style="width: 100%; height: 175px; border: none; position: relative; z-index: 1;" allowtransparency="" src="https://narrations.ad-auris.com/widget/the-conversation-canada/the-baffling-case-of-metabolically-healthy-obese-people--are-they-protected-from-chronic-diseases" width="100%" height="400"></iframe>
<p>There is a growing global body positivity movement to combat the <a href="https://www.euro.who.int/__data/assets/pdf_file/0017/351026/WeightBias.pdf">stigma and prejudice that overweight and obese individuals face</a>. Some of this stigma arises from the perception that obese individuals are unhealthy. </p>
<p>However, weight is only one of the metrics that medical professionals use to assess overall health. In fact, some studies have demonstrated that a significant number of obese people are metabolically healthy, leading to the contention that one could be <a href="https://dx.doi.org/10.2105%2FAJPH.2015.302552">healthy at any size</a>. This phenomenon is referred to as <a href="https://www.mdpi.com/2218-1989/10/2/48">metabolically healthy obesity</a> (MHO). Research is now starting to explore what this means. </p>
<p>A person who is MHO has healthy blood pressure, normal levels of blood lipids (cholesterol and triglycerides) and normal blood sugar. Having high values of one or more of these measures significantly increases one’s risk for cardiovascular disease. </p>
<figure class="align-right ">
<img alt="Illustration of foods representative of the Mediterranean diet: olive oil, seafood, nuts, grains" src="https://images.theconversation.com/files/443864/original/file-20220201-21-obngem.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/443864/original/file-20220201-21-obngem.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=465&fit=crop&dpr=1 600w, https://images.theconversation.com/files/443864/original/file-20220201-21-obngem.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=465&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/443864/original/file-20220201-21-obngem.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=465&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/443864/original/file-20220201-21-obngem.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=584&fit=crop&dpr=1 754w, https://images.theconversation.com/files/443864/original/file-20220201-21-obngem.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=584&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/443864/original/file-20220201-21-obngem.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=584&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Healthy diets provide anti-inflammatory and antioxidant benefits that help achieve a healthy metabolic profile.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>It has been proposed that metabolically healthy obese individuals might be protected against obesity-related diseases. The extent of this protection has been controversial within the scientific community, and this is partly because we still <a href="https://www.karger.com/Article/Fulltext/495852">don’t have a standardized definition of MHO</a>. </p>
<p>So, over the past few years, researchers have gone to work to find out who can be defined as MHO, and to what extent people with MHO are protected from chronic disease. </p>
<h2>Emerging consensus</h2>
<p>Several large population studies have been initiated towards this end. So far, results show that, indeed, more rigorous definitions of MHO are needed. This can be achieved by <a href="https://doi.org/10.1172/JCI129186">including other measures of health</a> such as insulin resistance and blood markers of inflammation. Insulin resistance is when the body does not respond well to the insulin hormone that helps to take up sugar from the bloodstream for use as a fuel for energy. This leads to elevated blood sugar and the consequent health complications.</p>
<p>An emerging consensus has been that although MHO individuals show some protection from chronic disease, they still seem to be significantly less protected than those who are metabolically healthy and lean.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/443629/original/file-20220201-21-t6nwbh.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Infographic showing different combinations of health status and obesity" src="https://images.theconversation.com/files/443629/original/file-20220201-21-t6nwbh.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/443629/original/file-20220201-21-t6nwbh.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=390&fit=crop&dpr=1 600w, https://images.theconversation.com/files/443629/original/file-20220201-21-t6nwbh.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=390&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/443629/original/file-20220201-21-t6nwbh.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=390&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/443629/original/file-20220201-21-t6nwbh.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=490&fit=crop&dpr=1 754w, https://images.theconversation.com/files/443629/original/file-20220201-21-t6nwbh.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=490&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/443629/original/file-20220201-21-t6nwbh.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=490&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Individuals with metabolically healthy obesity have lower risk of disease than those with metabolically unhealthy obesity, but still higher risk than non-obese, metabolically healthy individuals.</span>
<span class="attribution"><span class="source">(Kubow/Iskandar)</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>The fact that people with MHO still have a relatively higher disease risk led some researchers to suggest that the term “metabolically healthy obesity” could be a misnomer. Moreover, <a href="https://doi.org/10.1172/JCI129186">a majority of the MHO population tends to progress towards “metabolically unhealthy obesity” or MUO over a number of years</a>, leading to enhanced risk of diabetes, cardiovascular disease and other disorders linked with obesity. </p>
<p>This leads to another question: is MHO truly protective over an entire lifetime, or is it just a question of time before MUO sets in, making MHO a transient state? </p>
<h2>Protective factors</h2>
<p>One factor to consider that might differentiate metabolically healthy versus unhealthy obesity is how fat is distributed in the body. A <a href="https://doi.org/10.3390/ijms20153690">genetic predisposition for depositing fat under the skin</a>, called subcutaneous fat, seems to play a protective role. </p>
<p>People with this predisposition are mostly premenopausal women who accumulate subcutaneous body fat in the hips rather than the waist (pear-shaped). They are <a href="https://doi.org/10.1016/S2213-8587(19)30084-1">better protected against diabetes and cardiovascular disease</a> compared to people whose body fat is located more in the abdomen (apple-shaped). </p>
<p>In contrast, obese individuals with a high waist circumference show excessive fat deposition in the abdomen and a <a href="https://nutrition.org/inflammation-what-is-it-and-how-can-my-diet-and-behavior-affect-it/">pro-inflammatory</a> state that leads to insulin resistance, which can be a precursor to Type 2 diabetes.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/443863/original/file-20220201-14-4iu6yf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Series of illustrations of a woman in exercise clothes" src="https://images.theconversation.com/files/443863/original/file-20220201-14-4iu6yf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/443863/original/file-20220201-14-4iu6yf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=269&fit=crop&dpr=1 600w, https://images.theconversation.com/files/443863/original/file-20220201-14-4iu6yf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=269&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/443863/original/file-20220201-14-4iu6yf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=269&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/443863/original/file-20220201-14-4iu6yf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=338&fit=crop&dpr=1 754w, https://images.theconversation.com/files/443863/original/file-20220201-14-4iu6yf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=338&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/443863/original/file-20220201-14-4iu6yf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=338&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">People with metabolically healthy obesity are involved in regular physical activity to a greater extent than those with metabolically unhealthy obesity.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Researchers have also looked at the lifestyle habits that differentiate MHO from MUO individuals to see if development of metabolically unhealthy obesity can be prevented. </p>
<p>One factor is exercise. People with MHO are involved in <a href="https://doi.org/10.1016/j.pcad.2018.07.008">regular physical activity to a greater extent than MUO individuals</a>. The other is diet. Although <a href="https://doi.org/10.1172/JCI129186">dietary studies show mixed results</a>, it seems that <a href="https://doi.org/10.3390/nu13113925">MHO people consume healthier diets</a> such as the Mediterranean diet, which is rich in fish, fruits, vegetables, whole-grain products, legumes, extra virgin olive oil and nuts. </p>
<p>Healthy diets provide <a href="https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation">anti-inflammatory and antioxidant</a> benefits that help achieve a healthy metabolic profile. Indeed, of the MHO population, those who <a href="https://doi.org/10.1038/ijo.2016.114">follow the Mediterranean diet seem to have lower mortality rates</a>. Adopting these healthy lifestyle habits could help prevent the trajectory of metabolically healthy obesity moving towards metabolically unhealthy obesity over the course of a lifetime. </p>
<h2>Is metabolically healthy obesity real?</h2>
<p>So is MHO real and does it protect against disease? There isn’t a yes or no answer yet. The more we learn about it, the more nuance is injected into the concept that one can be perfectly healthy at any size. Based on the information we have so far, <a href="https://doi.org/10.1038/s41574-021-00619-6">only a narrow segment of obese individuals are without risk</a> of developing obesity-related chronic diseases. </p>
<p>We also know a lot more about their characteristics. They have less abdominal fat and more subcutaneous fat. They have less insulin resistance, less inflammation and a metabolically healthy cardiovascular profile. They also have healthy lifestyle habits such as regular exercise and a healthy diet. It seems that genetics play a role as well. </p>
<p>We can expect more insight from major international population studies and clinical trials that are currently underway. But in the meantime, the age-old advice holds truer than ever: regular physical activity and a healthy diet are crucial to maintain health and longevity.</p><img src="https://counter.theconversation.com/content/175288/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Some obese people lack the classic metabolic risk factors of high blood pressure, high cholesterol and high blood sugar linked with obesity. But are they still at risk for heart disease and diabetes?Stan Kubow, Associate Professor, School of Human Nutrition, McGill UniversityMichele Iskandar, Research Associate and Lecturer, School of Human Nutrition, McGill UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1708632021-12-08T18:46:43Z2021-12-08T18:46:43ZJunk food and the brain: How modern diets lacking in micronutrients may contribute to angry rhetoric<figure><img src="https://images.theconversation.com/files/431386/original/file-20211110-25-1wi438n.jpg?ixlib=rb-1.1.0&rect=0%2C268%2C5190%2C3718&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Research reveals links between the irritability, explosive rage and unstable moods that have grown more common in recent years, and a lack of micronutrients that are important for brain function.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Emotional, non-rational, even explosive remarks in public discourse have escalated in recent years. Politicians endure insults during <a href="https://calgaryherald.com/news/politics/braid-jansen-stuns-legislature-by-reading-out-explicit-anti-female-slurs">legislative discussions</a>; scientists receive emails and tweets containing <a href="https://doi.org/10.1126/science.acx9488">verbal abuse and threats</a>.</p>
<p>What’s going on? This escalation in angry rhetoric is <a href="https://www.sciencefocus.com/the-human-body/why-social-media-makes-us-so-angry-and-what-you-can-do-about-it/">sometimes attributed to social media</a>. But are there other influences altering communication styles?</p>
<p>As researchers in the field of nutrition and mental health, and authors of <a href="https://thebetterbrainbook.com"><em>The Better Brain</em></a>, we recognize that many in our society experience brain hunger, impairing their cognitive function and emotion regulation. </p>
<h2>Ultra-processed products</h2>
<p>Obviously, we are not deficient in macronutrients: North Americans tend to get sufficient protein, fats (though usually not the best fats) and carbohydrates (usually not the good complex carbs). But we are being cheated of micronutrients (minerals and vitamins), particularly in those whose food choices are dominated by ultra-processed products. </p>
<p>Ultra-processed products include things like soft drinks, packaged snacks, sweetened breakfast cereal and chicken nuggets. They generally contain only trivial amounts of a few micronutrients unless they are fortified, but even then, only a few at higher amounts. </p>
<figure class="align-center ">
<img alt="A plate of chicken nuggets and fries" src="https://images.theconversation.com/files/431460/original/file-20211111-17-7h2spi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/431460/original/file-20211111-17-7h2spi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/431460/original/file-20211111-17-7h2spi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/431460/original/file-20211111-17-7h2spi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/431460/original/file-20211111-17-7h2spi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/431460/original/file-20211111-17-7h2spi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/431460/original/file-20211111-17-7h2spi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Ultra-processed products contain only trivial amounts of vitamins and minerals.</span>
<span class="attribution"><span class="source">(Pixabay)</span></span>
</figcaption>
</figure>
<p>Three published analyses from the 2004 Canadian Community Health Survey and the 2018 U.S. National Health and Nutrition Examination Survey revealed these sobering statistics: in Canada, in 2004, <a href="https://doi.org/10.1016/j.appet.2016.11.006">48 per cent of the caloric intake across all ages</a> came from ultra-processed products; in the United States <a href="https://doi.org/10.1001/jama.2021.10238">67 per cent of what children aged two to 19 years</a> consumed and <a href="https://doi.org/10.1093/ajcn/nqab305">57 per cent of what adults consumed</a> in 2018 were ultra-processed products.</p>
<p>Most of us are aware that dietary intake is a huge issue in physical health because diet quality is associated with chronic health conditions such as <a href="https://doi.org/10.1111/obr.13349">obesity, diabetes and cardiovascular disease</a>. The public is less aware of the impact of nutrition on brain health. </p>
<h2>Micronutrients and mental health symptoms</h2>
<p>Given that our society’s food choices have moved so strongly toward ultra-processed products, we need to learn about the substantial scientific evidence proving that micronutrient intake influences mental health symptoms, especially irritability, explosive rage and unstable mood.</p>
<p>The scientific evidence base for this statement is now vast, though it is so rarely mentioned in the media that few in the public are familiar with it. A dozen studies from countries <a href="https://doi.org/10.17269/cjph.104.3845">like Canada</a>, <a href="https://doi.org/10.1017/s1368980011001856">Spain</a>, <a href="https://doi.org/10.1017/s1368980020001548">Japan</a> <a href="https://doi.org/10.1176/appi.ajp.2009.09060881">and Australia</a> have shown that people who eat a healthy, whole foods diet have fewer symptoms of depression and anxiety than people who eat a poor diet (mostly ultra-processed products).</p>
<p>Correlational studies cannot prove that nutritional choices are the cause of mental health problems: for that we turn to some compelling prospective longitudinal studies in which people with no apparent mental health problems enter the study, are evaluated for their health and dietary patterns, and are then followed over time. Some of the results have been astonishing. </p>
<p>In a study of about <a href="https://doi.org/10.1192/bjp.bp.112.114793">89,000 people in Japan</a> with 10-15 years of followup, the suicide rate in those consuming a whole foods diet was half that of those eating less healthy diets, highlighting an important new direction not yet covered in current suicide prevention programs. </p>
<p><a href="https://doi.org/10.1542/peds.2018-3307">Here in Canada</a>, similarly powerful findings show how children’s dietary patterns, as well as following other health guidelines on exercise and screen time, predicted which children aged 10 to 11 years would be referred for diagnosis of a mental disorder in the subsequent two years. It follows that nutrition education ought to be one of the first lines of treatment for children in this situation.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/431461/original/file-20211111-6783-wkr3qx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Foods typical of Mediterranean style diet, including fish, grains, fruits, vegetables and beans" src="https://images.theconversation.com/files/431461/original/file-20211111-6783-wkr3qx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/431461/original/file-20211111-6783-wkr3qx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=770&fit=crop&dpr=1 600w, https://images.theconversation.com/files/431461/original/file-20211111-6783-wkr3qx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=770&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/431461/original/file-20211111-6783-wkr3qx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=770&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/431461/original/file-20211111-6783-wkr3qx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=968&fit=crop&dpr=1 754w, https://images.theconversation.com/files/431461/original/file-20211111-6783-wkr3qx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=968&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/431461/original/file-20211111-6783-wkr3qx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=968&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A Mediterranean-style diet is typically high in whole grains, fruits, vegetables, nuts, legumes, seafood and unsaturated fats such as olive oil.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Irritability and unstable mood often characterize depression, so it’s relevant that multiple independent studies have found that teaching people with depression, who were consuming relatively poor diets, how to change to a whole foods Mediterranean-style diet resulted in significant improvements. A <a href="https://theconversation.com/what-is-the-mediterranean-diet-and-why-is-it-good-for-you-12656">Mediterranean-style diet</a> is typically high in whole grains, fruits, vegetables, nuts, legumes, seafood and unsaturated fats such as olive oil. </p>
<p>In <a href="https://doi.org/10.1186/s12916-017-0791-y">one such study</a>, about one-third of the people who changed to a whole foods diet in addition to their regular treatment found their depression to be in remission after 12 weeks. </p>
<p>The remission rate in the control group using regular treatment but no diet changes was fewer than one in 10. The whole foods diet group also reported a cost savings of about 20 per cent in their weekly food budget. This final point helps to dispel the myth that eating a diet of ultra-processed products is a way to save money. </p>
<p>Important evidence that irritability, explosive rage and unstable mood can be resolved with improved micronutrient intake comes from studies evaluating micronutrient supplements to treat <a href="https://doi.org/10.3390/nu12113394">mental health problems</a>. Most public awareness is restricted to the ill-fated search for magic bullets: <a href="https://doi.org/10.1037/0033-2909.133.5.747">studies of a single nutrient at a time</a>. That is a common way to think about causality (for problem X, you need medication Y), but that is not how our brains work. </p>
<p>To support brain metabolism, <a href="https://www.helpguide.org/harvard/vitamins-and-minerals.htm">our brains require at least 30 micronutrients</a> to ensure the production of neurotransmitters such as serotonin and dopamine, as well as breaking down and removing metabolic byproducts. Many studies of multi-nutrient treatments have found improved mood regulation and reduced irritability and explosive rage, including in placebo-controlled randomized trials of children with <a href="https://doi.org/10.1111/jcpp.12817">attention deficit hyperactivity disorder</a> and <a href="https://doi.org/10.1016/j.jaac.2021.07.005">mood dysregulation</a>.</p>
<p>The evidence is clear: a well-nourished population is better able to withstand stress. Hidden brain hunger is one modifiable factor contributing to emotional outbursts, aggression and even the loss of civility in public discourse.</p><img src="https://counter.theconversation.com/content/170863/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Bonnie Kaplan receives funding from no organization currently, because she is retired. But during her career she received many grants from private foundations (donor funds) and from provincial funding competitions. Her only current affiliation is as a member of the Scientific Advisory Board of the John W. Brick Foundation.</span></em></p><p class="fine-print"><em><span>Julia J Rucklidge receives or has received research funding from Health Research Council (NZ), Waterloo Foundation, Vic Davis Memorial Trust, University of Canterbury Foundation, Canterbury Medical Research Foundation, GAMA Foundation, and the Foundation for Excellence in Mental Health Care.</span></em></p>Ultra-processed foods high in sugar, fat and empty carbs are bad for the mind as well as the body. Lack of micronutrients affects brain function and influences mood and mental health symptoms.Bonnie Kaplan, Professor Emerita, Cumming School of Medicine, University of CalgaryJulia J Rucklidge, Professor of Psychology, University of CanterburyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1584512021-04-22T07:17:49Z2021-04-22T07:17:49ZClear evidence for a link between pro-inflammatory diets and 27 chronic diseases. Here’s how you can eat better<figure><img src="https://images.theconversation.com/files/396420/original/file-20210421-13-o33a3w.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C1000%2C667&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p><a href="https://www.aihw.gov.au/reports/australias-health/chronic-conditions-and-multimorbidity">Almost half of all Australians</a> live with a chronic disease, which contribute to some <a href="https://www.aihw.gov.au/getmedia/8f7bd3d6-9e69-40c1-b7a8-40dca09a13bf/4_2-chronic-disease.pdf.aspx">90% of deaths</a>.</p>
<p>It’s no secret our diet can have a major impact on our health. But our new umbrella review, published <a href="https://academic.oup.com/advances/advance-article-abstract/doi/10.1093/advances/nmab037/6238545?redirectedFrom=fulltext">this week in Advances in Nutrition</a>, provides compelling evidence that pro-inflammatory diets increase the risk of 27 chronic diseases and premature death. An umbrella review is a review of multiple reviews, and is among the highest levels of evidence.</p>
<p>What’s more, reducing inflammation by eating better could cut our risk of developing certain chronic diseases. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-rise-of-ultra-processed-foods-and-why-theyre-really-bad-for-our-health-140537">The rise of ultra-processed foods and why they're really bad for our health</a>
</strong>
</em>
</p>
<hr>
<h2>Clear evidence</h2>
<p>A pro-inflammatory diet is one that, over the long-term, may lead to increased inflammation in the body. Such a diet often includes high amounts of commercially baked goods, fried foods and fatty meats, and at the same time is low in fruits, vegetables and other healthy foods. </p>
<p>We reviewed and pooled data from 15 meta-analyses, which is a type of study that summarises data from lots of individual studies. All up, we looked at 38 health outcomes from four million people from across the world. </p>
<p>We found strong evidence for a link between pro-inflammatory diets and heart attacks, premature death and certain cancers including bowel cancer, pancreatic cancer, respiratory cancers and oral cancers. There was also evidence pro-inflammatory diets were linked with depression.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/plant-rich-diets-may-help-prevent-depression-new-evidence-103898">Plant-rich diets may help prevent depression – new evidence</a>
</strong>
</em>
</p>
<hr>
<p>By bringing together data from populations all over the world, we were able to provide a comprehensive and reliable overview of the research to date. We also looked at the strength of the evidence of studies and found that for most outcomes, evidence was limited, highlighting the need for more research. </p>
<p>Because of the type of study we did, we were unable to determine cause and effect, so we can’t conclusively say pro-inflammatory diets <em>cause</em> these chronic diseases yet. But we found clear evidence a pro-inflammatory diet is linked with <em>an increased risk</em> of developing certain chronic diseases and premature death.</p>
<figure class="align-center ">
<img alt="Fried crumbed veal with chips" src="https://images.theconversation.com/files/396422/original/file-20210421-15-17uz7s9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/396422/original/file-20210421-15-17uz7s9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/396422/original/file-20210421-15-17uz7s9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/396422/original/file-20210421-15-17uz7s9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/396422/original/file-20210421-15-17uz7s9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/396422/original/file-20210421-15-17uz7s9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/396422/original/file-20210421-15-17uz7s9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Dietary patterns that contain lots of calorie-dense, ultra-processed foods can contribute to inflammation and increase your risk of certain chronic diseases.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<h2>But what is inflammation, and what role does our diet play?</h2>
<p>Inflammation is part of our body’s natural defence processes. It’s our immune system’s response to an irritant, be that an infection or injury, and is often a welcome sign our body is working to protect us. For example, swelling when you roll your ankle delivers resources to help repair the damage. </p>
<p>But when inflammation can’t be turned off, this process may start to work against us. </p>
<p>Persistent low levels of inflammation (known as chronic inflammation) can be problematic and is linked to premature death and conditions including coronary heart disease and <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-11-200">depression</a>, to name a few. </p>
<p>We can detect whether chronic inflammation exists by a simple blood test that looks at levels of inflammatory markers in the blood. Our diet is one factor that influences levels of these inflammatory markers, among many.</p>
<p>Take the “Western diet”, for example, which consists of calorie-dense, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/obr.13146">ultra-processed foods</a> and is low in fruits, vegetables and other plant-foods. This type of dietary pattern has been linked to <a href="https://pubmed.ncbi.nlm.nih.gov/15447916/">higher levels of inflammation</a>.</p>
<p>Conversely, healthy dietary patterns have been linked to <a href="https://pubmed.ncbi.nlm.nih.gov/15234425/">lower inflammatory markers</a>. This includes the <a href="https://theconversation.com/what-is-the-mediterranean-diet-and-why-is-it-good-for-you-12656">Mediterranean diet</a>, which is high in fruits, vegetables, legumes, olive oil and oily fish, and low in ultra-processed, refined foods. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/mediterranean-diet-increases-gut-bacteria-linked-to-healthy-ageing-in-older-adults-131928">Mediterranean diet increases gut bacteria linked to healthy ageing in older adults</a>
</strong>
</em>
</p>
<hr>
<p>The potential for diets to be pro- or anti-inflammatory can be measured using a tool known as the Dietary Inflammatory Index. </p>
<p>The index takes into account a number of nutrients, compounds, and foods that have been identified in research as having either anti- or pro-inflammatory properties.</p>
<h2>Using foods to fight inflammation</h2>
<p>Despite promising marketing claims you might see online, there’s no magic supplement or superfood to combat all our inflammation woes.</p>
<p>Instead, you should focus on improving your overall diet quality, rather than on a single food or nutrient. This is because many nutrients and foods interact with one another and can work together to improve inflammation.</p>
<figure class="align-center ">
<img alt="Two pieces of salmon with lemon wedge" src="https://images.theconversation.com/files/396421/original/file-20210421-19-nk461d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/396421/original/file-20210421-19-nk461d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=397&fit=crop&dpr=1 600w, https://images.theconversation.com/files/396421/original/file-20210421-19-nk461d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=397&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/396421/original/file-20210421-19-nk461d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=397&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/396421/original/file-20210421-19-nk461d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=499&fit=crop&dpr=1 754w, https://images.theconversation.com/files/396421/original/file-20210421-19-nk461d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=499&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/396421/original/file-20210421-19-nk461d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=499&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A Mediterranean diet full of oily fish, fruit, vegetables and legumes has been linked with lower levels of inflammation.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
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</figure>
<p>As for what to eat?</p>
<ol>
<li><p>Load up your plate with a wide variety of plant foods such as fruits, vegetables, wholegrains and legumes, like chickpeas and lentils. These foods are high in anti-inflammatory nutrients, such as fibre and a range of vitamins. They also contain unique “phytochemicals”, such as polyphenols which are plant compounds that have potential antioxidant and <a href="https://pubmed.ncbi.nlm.nih.gov/31583990/">anti-inflammatory effects</a></p></li>
<li><p>Flavour your food liberally with herbs and spices, and sip on tea and coffee regularly. These are also great sources of polyphenols </p></li>
<li><p>Enjoy oily fish regularly, such as salmon, sardines and mackerel, which are rich in anti-inflammatory omega-3 fatty acids</p></li>
<li><p>Reduce your intake of foods that may fuel inflammation. These include foods high in trans and saturated fats, found in commercially baked goods, fried foods and fatty meats.</p></li>
</ol>
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<em>
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Read more:
<a href="https://theconversation.com/phytonutrients-can-boost-your-health-here-are-4-and-where-to-find-them-including-in-your-next-cup-of-coffee-132100">Phytonutrients can boost your health. Here are 4 and where to find them (including in your next cup of coffee)</a>
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<p>Given almost half of us live with a chronic disease, and many more are likely at risk, adopting an anti-inflammatory diet could be very beneficial for your health, and may help you live longer too.</p><img src="https://counter.theconversation.com/content/158451/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Meghan Hockey receives funding from Rotary Health Australia and Deakin University. </span></em></p><p class="fine-print"><em><span>Wolfgang Marx is currently funded by an Alfred Deakin Postdoctoral Research Fellowship and a Multiple Sclerosis Research Australia early-career fellowship. Wolfgang has previously received funding from the NHMRC, Clifford Craig Foundation, Cancer Council Queensland and university grants/fellowships from La Trobe University, Deakin University, University of Queensland, and Bond University, received industry funding and has attended events funded by Cobram Estate Pty. Ltd, received travel funding from Nutrition Society of Australia, received consultancy funding from Nutrition Research Australia, and has received speakers honoraria from The Cancer Council Queensland and the Princess Alexandra Research Foundation. The Food & Mood Centre has received Grant/Research support from Fernwood Foundation, Wilson Foundation, the A2 Milk Company, and Be Fit Foods</span></em></p>Our research provides clear evidence pro-inflammatory diets are linked to poor health, including heart attacks, bowel cancer and depression.Meghan Hockey, PhD Candidate, Accredited Practising Dietitian, Deakin UniversityWolfgang Marx, Postdoctoral research fellow, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1383532020-06-02T14:10:24Z2020-06-02T14:10:24ZBelonging through food: lockdown thoughts from Britain’s renowned food writer Elizabeth David<figure><img src="https://images.theconversation.com/files/338893/original/file-20200601-95013-z7tv82.jpg?ixlib=rb-1.1.0&rect=6%2C0%2C4147%2C3120&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Elizabeth David's book, published in 1950, revolutionised the way British people thought about food.</span> <span class="attribution"><span class="source">Illustration by John Minton, photograph by author</span>, <span class="license">Author provided</span></span></figcaption></figure><p>If the lockdown has caused me to rethink anything, it’s what it means to belong somewhere. For many of us, life before lockdown was varied: we went out to work, saw friends and family and an annual holiday abroad was a real possibility. But the lockdown has presented a significant challenge to those of us whose worlds have suddenly shrunk to the four walls we call home. What can we do? How can we reconsider what it means to belong at home? I think one approach is through what we eat. </p>
<p>I’ve been finding some comfort from the books of <a href="https://www.theguardian.com/lifeandstyle/2013/dec/08/elizabeth-david-first-lady-of-food">Elizabeth David</a> (1913-1992) – one of Britain’s most revered food writers of the 20th century. David’s difficult experiences during the second world war and its immediate aftermath find their way into her books, in which she uses food as a key ingredient in meditating on what it means to belong, sometimes in very challenging circumstances.</p>
<p>In 1939, David left the UK to sail around the Mediterranean with her lover, Charles Gibson Cowan. The goal was to sail to the Greek isles, and on this journey David took with her some culinary travelling companions such as Hilda Leyel’s The Gentle Art of Cookery (1925) and Edward Bunyan’s The Epicure’s Companion (1937) to fire her imagination. </p>
<p>These books helped David experiment with Mediterranean cookery in southern France before the war caught up with them and she and Cowan fled, sailing to Messina in Italy where they were thought to be spies and detained under horrible conditions, losing their boat and all their possessions. Eventually they settled in Syros in Greece, where David learnt to “keep house” – something immortalised in biographical entries to her books which proudly tell us that: “Mrs David has lived and kept house in France, Italy, Greece, Egypt and India, as well as England.” </p>
<p>While Cowan taught English, David pared back their lifestyle to the basics: the preparation of what she called in her classic French Country Cooking (1951) food that was “honest, sincere, and simple”, made with what she had to hand. This formula was then carried to Cairo, where David spent the remainder of the war working for the ministry of information as a reference librarian, learning traditional Levantine food ways from her cook, Kyriacou.</p>
<h2>Warmth in a cold climate</h2>
<p>In the volume of recipes she published in 1950 as <a href="https://www.theguardian.com/books/2016/aug/22/100-best-nonfiction-books-no-30-book-of-mediterranean-food-elizabeth-david">A Book of Mediterranean Food</a> David set down what she had learnt while keeping house in times of difficulty. The recipes were usually either “given” to her by other people or created from David’s understanding of regional customs and practices. Her basic method was to record the essentials of a dish and then adapt it, in the process helping her to be flexible in straitened circumstances.</p>
<p>This process of cultural inheritance, of preparing and eating food in traditional ways and then adding to the basics according to her circumstances, enabled David to belong anywhere (preferably somewhere which valued lemons, garlic and olive oil) at precisely the moment she was forced by events to belong somewhere very restrictive – in 1947, this was the England of the <a href="https://blog.metoffice.gov.uk/2017/01/26/winter-1947-brought-a-freeze-to-post-war-britain/">coldest February on record</a>, plummeting to -21°C.</p>
<p>But it was more than just recipes that preoccupied David: it was a way of thinking about and living with food in the specific contexts in which we find ourselves, as she wrote in French Country Cooking:</p>
<blockquote>
<p>Some sensible person once remarked that you spend the whole of your life either in your bed or your shoes. Having done the best you can by shoes and bed, devote all the time and resources at your disposal to the building up of a fine kitchen. It will be, as it should be, the most comforting and comfortable room in the house.</p>
</blockquote>
<p>Many of us I’m sure have resorted to DIY projects of various kinds during the lockdown, and our kitchens-cum-offices are no exception. We have been searching for the “comforting and comfortable” in these difficult times, chucking the clutter, but focusing on building up as we’re newly confronted with belonging in our homes.</p>
<h2>Belonging in a lockdown</h2>
<p>The lockdown has prompted us to rethink where we belong. How do we avoid becoming resentful at being immured in our homes and gardens (if we have them)? One way we can pare down to the essentials in a moderately conciliatory rather than resentful way is to work out what already “lives in us” of the world beyond in our approach to food and the design of the spaces in which we prepare and eat it. </p>
<p>When Elizabeth David was confronted with the confinements of war and post-war Britain, she turned to food: writing about it, experimenting with ingredients to hand, and by building up a comforting and comfortable kitchen in which she could freely belong. Kitchens needn’t remain restrictive places: they can become avenues through which we break the confines of lockdown, letting us travel as far as our imaginations can take us.</p><img src="https://counter.theconversation.com/content/138353/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Richard Vytniorgu receives funding from the Wellcome Trust. </span></em></p>Food can be a great way of breaking out of the confines of lockdown.Richard Vytniorgu, Impact and Postdoctoral Research Fellow, School of Cultures, Languages, and Area Studies, University of NottinghamLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1317712020-02-24T20:02:23Z2020-02-24T20:02:23ZHow the Mediterranean diet became No. 1 — and why that’s a problem<figure><img src="https://images.theconversation.com/files/316502/original/file-20200220-92507-dz1up2.jpg?ixlib=rb-1.1.0&rect=87%2C67%2C4237%2C2863&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Considered one of the healthiest ways to eat, the Mediterranean diet has evolved over hundreds of years, but ignoring other diets is a form of cultural superiority. </span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>The Mediterranean diet was voted by a panel of 25 health and nutrition professionals as <a href="https://www.cnn.com/2020/01/02/health/best-diet-worst-diet-2020-wellness/index.html">the best diet for 2020</a>. Characterized by plant-based meals, the diet emphasizes eating less red meat and dairy, and more fish and unsaturated fatty acids like olive oil. Red wine can be enjoyed in moderation.</p>
<p>Even if you are familiar with the Mediterranean diet, you may not know that it “involves a set of skills, knowledge, rituals, symbols and traditions concerning crops, harvesting, fishing, animal husbandry, conservation, processing, cooking and particularly the sharing and consumption of food,” as described by the United Nations Educational, Scientific and Cultural Organization (UNESCO). In 2013, UNESCO added the diet to its <a href="https://ich.unesco.org/en/RL/mediterranean-diet-00884">list of the intangible cultural heritage of humanity</a>. </p>
<p><div data-react-class="InstagramEmbed" data-react-props="{"url":"https://www.instagram.com/p/B8zAy8HHD4_","accessToken":"127105130696839|b4b75090c9688d81dfd245afe6052f20"}"></div></p>
<h2>The Mediterranean region and its <strong>food traditions</strong></h2>
<p>The Mediterranean area covers portions of Europe, Asia and Africa around the Mediterranean Sea. While many nations share that bio-geography and elements of the diet, only the nations of Cyprus, Croatia, Greece, Italy, Morocco, Portugal and Spain sponsored the diet’s addition to UNESCO’s list.</p>
<p>Mediterranean food traditions have deep history, but different ingredients arrived at different times. Olives were first <a href="https://doi.org/10.1371/journal.pone.0218001">pressed for olive oil</a> sometime before 2,500 years ago. Grapes were likely first enjoyed as wild harvests, but by 6,000 years ago <a href="https://www.theguardian.com/science/2017/aug/30/traces-of-6000-year-old-wine-discovered-in-sicilian-cave">full wine production was underway</a>. <a href="https://dx.doi.org/10.1073%2Fpnas.1009363108">Domesticated grains and legumes</a> like wheat and lentils appeared between 9,000 and 10,000 years ago. Fish would have been one of the earliest resources, <a href="https://www.nationalgeographic.com/history/magazine/2018/01-02/what-is-garum-rome-fish-sauce/">traded even into non-coastal areas</a>. </p>
<p>In spite of the diet’s guidelines, various red meats and dairy products also enjoy a long history in the region. <a href="https://dx.doi.org/10.1073%2Fpnas.0801317105">Domesticated herd animals</a> such as sheep, goats, cattle and camels arrived on the scene at least 10,000 years ago, and <a href="https://www.heritagedaily.com/2016/11/early-evidence-of-dairying-discovered/113234">dairying goes back at least 9,000 years</a> in Europe. The prominence of red meat and dairy foods in daily meals may have varied regionally, but both are deeply rooted in Mediterranean history. </p>
<p>But these are just the ingredients. Defining a single Mediterranean diet is tricky business. The Mediterranean region encompasses hundreds of languages and cultures, culinary techniques and styles. The ancient past was equally diverse, with millennia of migration and trade across the region bringing new ingredients and culinary innovations. Ask someone in Lebanon if their food is the same as Spain’s, or someone in Morocco if their food traditions are identical to those in Greece. </p>
<p>And no one in the Mediterranean would agree that their diet is identical to that of their ancestors. The multinational group that nominated Mediterranean food traditions to UNESCO might agree on the broadest framework, but culturally each region in the Mediterranean is distinct. </p>
<h2>What’s wrong with the Mediterranean diet?</h2>
<p>We are anthropologists who study biological and cultural aspects of nutrition and past foodways as part of human gastro-heritage. And we are simultaneously excited and concerned about the Mediterranean diet in public health messaging. </p>
<p>Health professionals should focus on food traditions rather than just nutrients, but it worries us when one cultural food tradition is held up as superior to others — especially one that has been associated with a history of Western political and cultural imperialism. </p>
<p>Historian <a href="https://experts.mcmaster.ca/display/levenst">Harvey Levenstein</a> writes that <a href="https://press.uchicago.edu/ucp/books/book/chicago/F/bo12778615.html">the Mediterranean diet was created</a> by physiologist Ancel Keys and his biochemist wife, Margaret Keys. In 1952, the Keys travelled to Italy and Spain and conducted some quasi-experimental surveys of blood pressure, blood cholesterol and diet.</p>
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<figcaption><span class="caption">A brief history of Ancel Keys, the physiologist who, along with his wife, popularized the Mediterranean diet.</span></figcaption>
</figure>
<p>Many epidemiological studies later, the couple promoted the Mediterranean diet in <a href="https://www.nytimes.com/2004/11/23/obituaries/dr-ancel-keys-100-promoter-of-mediterranean-diet-dies.html">their popular diet book <em>How to Eat Well</em></a>, later repackaged as <em>How to Eat Well and Stay Well the Mediterranean Way</em>. </p>
<p>In the 1990s, <a href="https://www.internationaloliveoil.org/olive-world/olive-oil-health/">the International Olive Oil Council</a> promoted olive oil as a key ingredient in the diet, and the Harvard School of Public Health built <a href="https://memory.ucsf.edu/sites/memory.ucsf.edu/files/MediterraneanDietHandout.pdf">the Mediterranean Diet Pyramid</a>.</p>
<h2>Promoting the value of all food heritage</h2>
<p>The promotion of the Mediterranean diet is an example of what anthropologist Andrea Wiley calls bio-ethnocentrism. Wiley’s <a href="https://www.routledge.com/Re-imagining-Milk-Cultural-and-Biological-Perspectives-2nd-Edition/Wiley/p/book/9781138927612">study of milk</a> argues that although milk has been promoted as a healthy and nutritious food for all, only a segment of the human species — predominantly those whose ancestry comes from Europe, where there is a long history of dairying — are able to digest the primary sugar in milk (lactose). </p>
<p>Bolstering one region’s diet as universally ideal ignores the long evolution of social, biological and environmental human food traditions through the development and conservation of regional and local cuisines. This includes, as found in <a href="https://ich.unesco.org/en/RL/mediterranean-diet-00884">UNESCO’s description of the Mediterranean diet</a>, the production, preparation and consumption of food through human skills, knowledge, and social and cultural practices.</p>
<p>In a globalized world with increasing migration, retaining traditional cuisines may seem meaningless. But in fact, it may be more important than ever. Anthropological research shows that <a href="https://doi.org/10.17730/0018-7259.76.1.15">migrants work hard to maintain their traditional cuisines as part of their ethnic identity</a> and to support their health and well-being. When a health-care provider suggests to their patient that they adopt a Mediterranean diet, there are several things that can go wrong. Unless the diet is explained in detail, a patient may have a very different idea of what constitutes the Mediterranean diet. More harmfully, if a patient believes that their own cultural food traditions are bad for their health, they may give those up to adopt a diet seen as medically approved.</p>
<p>A survey of global food shows that the core principles of the Mediterranean diet can be found in the traditional cuisines and food traditions of many people. In Mexico, for example, the combination of corn tortillas and beans — accompanied by foods like squash and tomato salsas — has yielded complete plant-based proteins that provide <a href="http://www.fao.org/3/T0395E/T0395E0c.htm">a nutritious and sustainable diet</a>. Research on soy-derived and fermented foods found in traditional Chinese cuisines shows they are <a href="https://doi.org/10.1016/j.foodres.2016.08.009">high in bioactive peptides that can provide protection against disease</a>. </p>
<p>In a world where we are rapidly losing diverse biological and cultural heritage, we should be celebrating the plurality and unique qualities of traditional foods rather than attempting to promote and universalize one regional diet over another. Diverse traditional diets can and should be promoted through public health messaging that is culturally sensitive and inclusive.</p><img src="https://counter.theconversation.com/content/131771/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tina Moffat received funding from SSHRC. </span></em></p><p class="fine-print"><em><span>Shanti Morell-Hart receives funding from SSHRC and CFI-ORF. </span></em></p>Olive oil, grapes and fish. There’s a lot to love about the Mediterranean diet but focusing on it might be a way to exclude other healthy and global diets.Tina Moffat, Associate Professor, Department of Anthropology, McMaster UniversityShanti Morell-Hart, Assistant Professor of Anthropology, McMaster UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1319282020-02-18T11:38:07Z2020-02-18T11:38:07ZMediterranean diet increases gut bacteria linked to healthy ageing in older adults<figure><img src="https://images.theconversation.com/files/315907/original/file-20200218-10980-1xipsm5.jpg?ixlib=rb-1.1.0&rect=0%2C38%2C6402%2C3105&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Half the participants were asked to eat more vegetables, legumes, fruits, nuts, olive oil, and fish -- and less red meat and dairy.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/panoramic-banner-fresh-healthy-food-heart-622969142">stockcreations/ Shutterstock</a></span></figcaption></figure><p>As our global population is <a href="https://www.un.org/en/sections/issues-depth/ageing/">projected to live longer</a> than ever before, it’s important that we find ways of helping people live healthier for longer. <a href="https://theconversation.com/keeping-fit-how-to-do-the-right-exercise-for-your-age-108851">Exercise</a> and <a href="https://theconversation.com/mediterranean-diet-may-protect-your-brain-in-old-age-new-finding-suggests-70909">diet</a> are often cited as the best ways of maintaining good health well into our twilight years. But recently, research has also started to look at the role our gut – specifically our microbiome – plays in how we age. </p>
<p>Our latest study has found that <a href="https://gut.bmj.com/content/early/2020/01/31/gutjnl-2019-319654">eating a Mediterranean diet</a> causes microbiome changes linked to improvements in cognitive function and memory, immunity and bone strength.</p>
<p>The <a href="https://theconversation.com/your-gut-bacteria-dont-like-junk-food-even-if-you-do-41564">gut microbiome</a> is a complex community of trillions of microbes that live semi-permanently in the intestines. These microbes have co-evolved with humans and other animals to break down dietary ingredients such as <a href="https://www.sciencealert.com/inulin-is-being-added-to-many-foods-but-it-could-be-causing-stomach-problems">inulin</a>, <a href="https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/arabinoxylan">arabinoxylan</a> and <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/nbu.12244">resistant starch</a>, that the person can’t digest. They also <a href="https://www.ncbi.nlm.nih.gov/pubmed/28588016">help prevent disease-causing bacteria</a> from growing.</p>
<p>However, the gut microbiome is extremely sensitive, and many things including diet, the medications you take, your genetics, and even conditions like <a href="https://www.ncbi.nlm.nih.gov/pubmed/26323629">inflammatory bowel disease</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039952/">irritable bowel syndrome</a>, can all <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483960/">change the gut microbiota community</a>. The gut microbiota plays a such a huge role in our body, it’s even linked to behavioural changes, including <a href="https://www.ncbi.nlm.nih.gov/pubmed/31144383">anxiety and depression</a>. But as for other microbiome-related diseases such as <a href="https://www.ncbi.nlm.nih.gov/pubmed/30366260">type 2 diabetes</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5933040/">obesity</a>, changes in the microbiome are only part of the issue – the person’s genetics and bad lifestyle are major contributing factors.</p>
<p>Since our everyday diets have such a big affect on the gut microbiome, our team was curious to see if it can be used to promote healthy ageing. We looked at a total of 612 people aged 65-79, from the UK, France, the Netherlands, Italy and Poland. We asked half of them to change their normal diet to a <a href="https://www.everydayhealth.com/mediterranean-diet/guide/#prosandcons">Mediterranean diet</a> for a full year. This involved eating more vegetables, legumes, fruits, nuts, olive oil and fish, and eating less red meat, dairy products and saturated fats. The other half of participants stuck to their usual diet.</p>
<h2>Mediterranean microbiome</h2>
<p>We initially found that those who followed the Mediterranean diet had better cognitive function and memory, less inflammation, and better bone strength. However, what we really wanted to know was whether or not the microbiome was involved in these changes. </p>
<p>Interestingly, but not surprisingly, a person’s baseline microbiome (the species and number of microbes they had living in their gut before the study started) varied by country. This baseline microbiome is likely a reflection of the diet they usually ate, alongside where they lived. We found that participants who followed the Mediterranean diet had a small but insignificant change in their microbiome diversity – meaning there was only a slight increase in the overall number and variety of species present.</p>
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<strong>
Read more:
<a href="https://theconversation.com/mediterranean-diet-may-protect-your-brain-in-old-age-new-finding-suggests-70909">Mediterranean diet may protect your brain in old age, new finding suggests</a>
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<p>However, when we compared how strictly a person followed the diet with their baseline microbiome data and their microbiome after following the diet, we were able to identify two different gut microbe groups: diet-positive microbes that increased on the Mediterranean diet, and diet-negative microbes whose abundance was reduced while following the diet.</p>
<p>Diet-positive microbes are microbes that flourished in the Mediterranean diet. Diet-negative microbes either couldn’t metabolise the diet, or they were were unable to compete with diet-positive microbes. These diet-positive microbes were linked with less frailty and inflammation in the body, and higher levels of cognitive function. Losing the diet-negative microbes was also associated with the same health improvements. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/315912/original/file-20200218-10976-1vg62vc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/315912/original/file-20200218-10976-1vg62vc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=337&fit=crop&dpr=1 600w, https://images.theconversation.com/files/315912/original/file-20200218-10976-1vg62vc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=337&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/315912/original/file-20200218-10976-1vg62vc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=337&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/315912/original/file-20200218-10976-1vg62vc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/315912/original/file-20200218-10976-1vg62vc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/315912/original/file-20200218-10976-1vg62vc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Those who followed the Mediterranean diet had more healthy microbes in their gut.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-illustration/human-microbiome-intestine-1220371276">Alpha Tauri 3D Graphics/ Shutterstock</a></span>
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<p>When we compared the changes in the number of these microbes in the treatment group (those on the Mediterranean diet) and the control group (those following their regular diet), we saw that the people who strictly followed the Mediterranean diet increased these diet-positive microbes. Although the changes were small, these finding were consistent across all five countries – and small changes in one year can make for big effects in the longer term.</p>
<p>Many of the participants were also pre-frail (meaning their <a href="https://www.england.nhs.uk/blog/frailty/">bone strength and density would start decreasing</a>) at the beginning of the study. We found the group who followed their regular diet became frailer over the course of the one-year study. However, those that followed the Mediterranean diet were less frail.</p>
<p>The link between frailty, inflammation, and cognitive function, to changes in the microbiome was stronger than the link between these measures and dietary changes. This suggests that the diet alone wasn’t enough to improve these three markers. Rather, the microbiome had to change too – and the diet caused these changes to the microbiome.</p>
<p>These types of studies are challenging and expensive, and the microbiome dataset is often difficult to analyse because there are many more data-points to study than there are people in the study. Our findings here were possible because of the large group sizes, and the length of the intervention. </p>
<p>However, we recognise that following a Mediterranean diet isn’t necessarily doable for everybody who starts thinking about ageing, usually around the age of 50. Future studies will need to focus on what key ingredients in a Mediterranean diet were responsible for these positive microbiome changes. But in the meantime, it’s clear that the more you can stick to a Mediterranean diet, the higher your levels of good bacteria linked to healthy ageing will be.</p>
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<img alt="" src="https://images.theconversation.com/files/315932/original/file-20200218-11040-p9wweg.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/315932/original/file-20200218-11040-p9wweg.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=112&fit=crop&dpr=1 600w, https://images.theconversation.com/files/315932/original/file-20200218-11040-p9wweg.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=112&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/315932/original/file-20200218-11040-p9wweg.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=112&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/315932/original/file-20200218-11040-p9wweg.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=140&fit=crop&dpr=1 754w, https://images.theconversation.com/files/315932/original/file-20200218-11040-p9wweg.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=140&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/315932/original/file-20200218-11040-p9wweg.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=140&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em>This article is part of a series tied to Medicine made for you, a series by The Anthill podcast on the future of healthcare and how it could soon get a lot more personal. <a href="https://theconversation.com/uk/topics/medicine-made-for-you-82269">Read more here</a>.</em></p><img src="https://counter.theconversation.com/content/131928/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Paul O'Toole is a founder of 4D Pharma Cork Ltd., a company developing microbiome-based diagnostics and therapeutics for IBS and cancer, which has had no material influence on this article.</span></em></p>Our research found that following a Mediterranean diet was linked with less frailty, inflammation, and maintaining better cognitive function.Paul O'Toole, Professor of Microbial Genomics, School of Microbiology and APC Microbiome Institute, University College CorkLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1220722019-08-28T11:45:48Z2019-08-28T11:45:48ZWhy a glass of red wine is good for your gut<figure><img src="https://images.theconversation.com/files/288696/original/file-20190820-170956-1ubedl0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">'To gut microbes.'</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/happy-friends-having-fun-outdoor-young-486675022?src=8N-mDdqI3XzeMhmXh-bzTQ-1-2">View Apart/Shutterstock</a></span></figcaption></figure><p>Alcohol consumption guidelines <a href="https://www.theguardian.com/news/datablog/2016/jan/08/how-do-the-uks-new-alcohol-guidelines-compare-with-the-rest-of-the-worlds">vary widely between countries</a>. In the UK and Netherlands, <a href="https://www.theguardian.com/news/datablog/2016/jan/08/how-do-the-uks-new-alcohol-guidelines-compare-with-the-rest-of-the-worlds">no more than one glass</a> of wine or a pint of beer a day is recommended. In the US it is <a href="https://health.gov/dietaryguidelines/2015/guidelines/appendix-9/">double these levels</a>, and <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/add.13341">in Mediterranean countries and Chile</a> it’s even more relaxed when it comes to drinking wine. </p>
<p>Though there is generally a consensus that everyone should drink less and levels of alcohol use are reducing in most countries, <a href="https://theconversation.com/baby-boomers-are-keeping-booze-britain-afloat-but-the-young-are-drinking-less-121659">especially in young adults</a>, more than 3m (or one in 20) deaths globally are attributed to alcohol consumption – making it <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4311234/">100 times more harmful than cannabis, cocaine and heroin</a>. </p>
<p>Drinking any amount of alcohol is said to increase the <a href="https://theconversation.com/drinking-a-pint-of-beer-may-lower-your-life-expectancy-by-the-same-amount-as-smoking-a-cigarette-new-research-90346">risk of many diseases</a>, including cancers, and liver disease. Yet a number of <a href="https://www.ncbi.nlm.nih.gov/pubmed/86728">studies</a> also seem to suggest there might be <a href="https://www.ncbi.nlm.nih.gov/pubmed/9949793">health benefits to a low intake of red wine</a>. </p>
<h2>Red wine and the gut</h2>
<p><a href="https://www.gastrojournal.org/article/S0016-5085(19)41244-4/fulltext">Our new research</a> also adds support to the idea that a small glass of red wine a day might actually be beneficial to your health – specifically to your <a href="https://theconversation.com/gut-microbes-are-tiny-sensors-of-your-general-health-99098">gut bacteria</a>. </p>
<p>This community of trillions of microbe inhabiting our lower intestines is known as the gut microbiota. Research shows that our gut microbiota <a href="https://www.bmj.com/content/361/bmj.k2179">can affect multiple aspects of our general health</a> and play a role in many illnesses but also dictate how <a href="https://theconversation.com/belly-fat-gut-bacteria-checks-could-lead-to-personalised-diets-120035">the food we eat</a> or the drugs we take affect us. This is partly due to the fact that gut microbes are responsible for producing thousands of chemical metabolites, that have <a href="https://theconversation.com/how-gut-bacteria-ensure-a-healthy-brain-and-could-play-a-role-in-treating-depression-33041">effects on our brain</a>, metabolism and immune systems.</p>
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Read more:
<a href="https://theconversation.com/moving-to-another-country-could-mess-with-your-gut-bacteria-106095">Moving to another country could mess with your gut bacteria</a>
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<p>Previous research in small studies <a href="https://academic.oup.com/ajcn/article/95/6/1323/4568378">in humans</a> and in <a href="https://www.sciencedirect.com/science/article/pii/S0963996913000616">artificial gut models</a> has suggested that red wine could impact our gut bacteria. And in our recent study we investigated this relationship on a large population scale in different countries to understand how drinking red wine may impact gut health compared to other alcoholic drinks.</p>
<p>We looked at food and drink questionnaire responses and gut bacteria diversity (that is recognised as <a href="https://theconversation.com/i-spent-three-days-as-a-hunter-gatherer-to-see-if-it-would-improve-my-gut-health-78773">a marker of gut health</a>) in almost a thousand female twins in the UK, and then checked our results against two other studies of similar size in the US (<a href="http://humanfoodproject.com/americangut/">the American Gut project</a>) and the Belgium (<a href="http://www.vib.be/en/research/Pages/The%20Flemisch%20Gut%20Flora%20project.aspx">Flemish Gut Project</a>). </p>
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<img alt="" src="https://images.theconversation.com/files/289627/original/file-20190827-184234-1nu7r3c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/289627/original/file-20190827-184234-1nu7r3c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/289627/original/file-20190827-184234-1nu7r3c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/289627/original/file-20190827-184234-1nu7r3c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/289627/original/file-20190827-184234-1nu7r3c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/289627/original/file-20190827-184234-1nu7r3c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/289627/original/file-20190827-184234-1nu7r3c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Looks moderate to me.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/portrait-senior-vintner-young-winemaker-tasting-327865286?src=-1-7">Kinga</a></span>
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<p>We found that drinking red wine (even if combined with other alcohols) is linked with an increase in gut bacteria diversity in all three countries. And as a check on other possible genetic or family biases, we also found that twins who drank more red wine than their co-twin also had more diverse gut bacteria. White wine drinkers who should be socially and culturally similar, had no significant differences in diversity, as did drinkers of other types of alcohol, like beer and spirits.</p>
<p>There were other associated benefits of drinking red wine too. Twins who drank red wine had lower levels of obesity and “bad” cholesterol, which we also think is partly because of the associated changes in the gut bacteria.</p>
<h2>Precious polyphenols</h2>
<p>Our study adds to the growing body of evidence that <a href="https://theconversation.com/the-compound-behind-all-those-stories-about-red-wine-being-good-for-you-35291">red wine</a> can, when drunk in moderation, have positive effects on health. The benefits of red wine likely boil down to one key agent: <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835915/">polyphenols</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/289626/original/file-20190827-184222-1nllcvq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/289626/original/file-20190827-184222-1nllcvq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/289626/original/file-20190827-184222-1nllcvq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/289626/original/file-20190827-184222-1nllcvq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/289626/original/file-20190827-184222-1nllcvq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/289626/original/file-20190827-184222-1nllcvq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/289626/original/file-20190827-184222-1nllcvq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/289626/original/file-20190827-184222-1nllcvq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Guts love the polyphenols.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/bunch-grapes-on-vine-sunshine-winegrowers-346371485?src=-1-17">Marako85</a></span>
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<p>These molecules are natural defence chemicals found in nuts and seeds as well as many brightly coloured vegetables and fruits, including grapes. In grape, polyphenols are mostly found in the skins that are in much longer contact in the making of red wine than white. They include the tannins that have a drying effect on your tongue or <a href="https://theconversation.com/the-compound-behind-all-those-stories-about-red-wine-being-good-for-you-35291">resveratrol</a> that promotes good health in people, and they also act as a fuel for our gut bacteria. This probably explains why red wine has a much stronger effect on gut bacteria than white wine. Although non-alcoholic grape juice also contains polyphenols, the fermented version contains more. </p>
<p>While our results are very consistent, as an observational study – where we see if factors are associated more than by chance – we cannot prove causality. To show this we’d ideally need some form of intervention study to test whether red wine directly causes an increase in gut microbiota diversity that leads to improved health. This may be popular, but difficult in practice, however. So for now, all the evidence suggests that if you have to choose an alcoholic drink today, it should definitely be a small glass of red wine.</p><img src="https://counter.theconversation.com/content/122072/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Caroline Le Roy receives funding from the CDRF. </span></em></p><p class="fine-print"><em><span>Tim Spector receives grants from multiple organisations including MRC, Wellcome Trust, NIHR, NIH, CDRF, Danone. He is a scientific founder of ZOE (global) ltd and receives royalties from a book on diet and microbiome "The Diet Myth: the real science behind what we eat" Orion 2016. He also drinks red wine.</span></em></p>We found that drinking red wine is linked with an increase in gut bacteria diversity.Caroline Le Roy, Research Associate in Human Gut Microbiome, King's College LondonTim Spector, Professor of Genetic Epidemiology, King's College LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1135512019-03-25T06:57:55Z2019-03-25T06:57:55ZHealth Check: can eating certain foods make you smarter?<figure><img src="https://images.theconversation.com/files/265493/original/file-20190325-36273-au864m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Green vegetables, nuts and berries are among the foods that could improve our brain function.</span> <span class="attribution"><span class="source">From shutterstock.com</span></span></figcaption></figure><p>Trying to keep up with what constitutes a “healthy” diet can be exhausting. With unending options at the supermarket, and diet advice coming from all directions, filling your shopping trolley with the right things can seem an overwhelming task.</p>
<p>For a long time we’ve known diet is key to maintaining <a href="https://www.sciencedirect.com/science/article/pii/S0140673618322256">physical health</a>.</p>
<p>But <a href="https://www.sciencedirect.com/science/article/pii/S2215036614000510">emerging evidence</a> indicates diet quality also plays a critical role in our cognitive function.</p>
<p>We’re learning some of the best things to eat in this regard include vegetables, nuts and berries, foods containing “good fats” and, possibly, fermented foods.</p>
<p>As well as potentially improving our brain function, eating these sorts of foods could improve our mental well-being – and could even help the planet, too.</p>
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Read more:
<a href="https://theconversation.com/research-check-does-eating-chocolate-improve-your-brain-function-55229">Research Check: does eating chocolate improve your brain function?</a>
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<h2>Diet and brain function</h2>
<p>In the face of <a href="https://www.aihw.gov.au/reports/burden-of-disease/impact-of-overweight-and-obesity-as-a-risk-factor-for-chronic-conditions/contents/table-of-contents">rising obesity rates</a>, over the past couple of decades, researchers have questioned whether increased weight, or poor diet, could influence cognition. They have since looked at what sorts of diets might impair or improve the function of our brains.</p>
<p>Long term follow-up studies show obesity is associated with <a href="https://www.ncbi.nlm.nih.gov/pubmed/28504110">mild impairments</a> in several domains of cognitive function, including short-term memory, attention and decision-making. </p>
<p>Research has also shown <a href="https://www.ncbi.nlm.nih.gov/pubmed/22023100">short-term memory is poorer</a> in people who report eating more saturated fat and sugar.</p>
<p>Conversely, the Mediterranean diet has been associated with <a href="http://europepmc.org/abstract/med/28011241">better brain health</a> and maintenance of cognitive abilities into older age. A Mediterranean diet is based on vegetables, whole grains, legumes and nuts, with healthy fats such as olive oil. Intake of red meat, saturated fats and sugar is limited.</p>
<p>A healthy diet has many elements, so let’s look at what particular foods might explain these benefits.</p>
<h2>Vegetables, nuts and berries</h2>
<p>Evidence indicates eating more vegetables <a href="https://www.sciencedirect.com/science/article/pii/S0531556516306064">slows the gradual decline</a> in cognitive abilities that occurs naturally as we age.</p>
<p>While all veggies are likely to contribute, those in the cruciferous (Brassicaceae) family <a href="https://www.ncbi.nlm.nih.gov/pubmed/15852398">may confer particular benefits</a> through their high fibre, folate, potassium and vitamin content. Vegetables in this family include broccoli, cauliflower, brussels sprouts, and fad favourites kale and rocket.</p>
<p>Interestingly, while there’s good evidence for the protective role of vegetables, there’s less evidence when it comes to fruit.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/265496/original/file-20190325-36248-1by8quw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/265496/original/file-20190325-36248-1by8quw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/265496/original/file-20190325-36248-1by8quw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/265496/original/file-20190325-36248-1by8quw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/265496/original/file-20190325-36248-1by8quw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/265496/original/file-20190325-36248-1by8quw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/265496/original/file-20190325-36248-1by8quw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Research has shown a healthy diet can improve cognitive functions such as learning and memory.</span>
<span class="attribution"><span class="source">From shutterstock.com</span></span>
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<p>Berries, though, contain high levels of antioxidants. These compounds protect the body by scavenging harmful free radicals and reducing inflammation. Together these functions are likely to protect our cognitive ability.</p>
<p>Studies in rats, and in older people with mild cognitive impairment, indicate supplementing diets with berries <a href="https://pubs.acs.org/doi/abs/10.1021/jf2036033">improves performance in various memory tasks</a>.</p>
<p>Nuts, meanwhile, are excellent sources of monounsaturated and polyunsaturated fats, minerals and vitamins. <a href="https://academic.oup.com/ajcn/article/100/suppl_1/347S/4576446">Studies in animals</a> have shown the addition of nuts improves learning and memory. <a href="https://academic.oup.com/ajcn/article/100/suppl_1/347S/4576446">Emerging evidence in humans</a> suggests consuming nuts within a Mediterranean-style diet improves measures of cognition, such as the capacity for verbal reasoning.</p>
<h2>Healthy fats</h2>
<p>Healthy diets such as the Mediterranean diet are also characterised by foods such as oily fish, avocados, olive oil and small amounts of animal-derived fats (such as from red meat).</p>
<p>One of <a href="https://www.ncbi.nlm.nih.gov/pubmed/27448745">our experiments</a> in rats showed diets high in saturated fat from lard or high in sugar led to memory impairments, whereas an oil-based diet high in polyunsaturated fats didn’t.</p>
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Read more:
<a href="https://theconversation.com/food-as-medicine-your-brain-really-does-want-you-to-eat-more-veggies-74685">Food as medicine: your brain really does want you to eat more veggies</a>
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<p>Importantly, rats fed these different diets <a href="https://www.ncbi.nlm.nih.gov/pubmed/27448745">did not differ</a> in their total energy intake – only the type of fat and sugar varied.</p>
<p>While we can’t comment directly on the effects in humans, these findings suggest eating excess sugar, or animal-based fats, may negatively impact cognition.</p>
<h2>Fermented foods</h2>
<p>For thousands of years humans have prolonged the life of foods through fermentation, which increases the proportion of <em>Lactobacillus</em> and other healthy gut bacteria.</p>
<p>Kombucha and kefir are trendy right now, but other popular fermented foods include kimchi, miso, yoghurt and sauerkraut. Intake of these foods is thought to maintain the diversity of the gut microbiome.</p>
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Read more:
<a href="https://theconversation.com/health-check-will-eating-nuts-make-you-gain-weight-108491">Health check: will eating nuts make you gain weight?</a>
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<p>Interest in the potential cognitive effects of fermented foods stems from <a href="https://www.sciencedirect.com/science/article/pii/S1364661318300974">emerging evidence</a> for the importance of the gut microbiota in cognition and health.</p>
<p>It’s well known that a poor diet can <a href="https://theconversation.com/fat-or-thin-can-the-bacteria-in-our-gut-affect-our-eating-habits-and-weight-65103">reduce the diversity</a> of the gut microbiome. Our work in rats has shown the cognitive impairments produced by exposure to an <a href="https://www.ncbi.nlm.nih.gov/pubmed/28289278">unhealthy “cafeteria” diet</a> – a Western-style diet high in saturated fat and sugar – are linked to changes in the gut microbiome. </p>
<h2>Beyond cognition</h2>
<p>It’s not possible to attribute “miracle” properties to one food group alone. We suggest a balanced, varied diet is the best approach to sustain not only brain health, but heart health too.</p>
<p>And there may be other reasons to seek out these foods. A <a href="https://www.sciencedirect.com/science/article/pii/S0277953618306907">newly published study</a> showed eating fruit and vegetables improved mental well-being. Subjects tended to feel happier, less worried, and reported higher levels of overall life satisfaction.</p>
<p>The link between diet quality and better mental health is <a href="https://www.ncbi.nlm.nih.gov/pubmed/26359904">now well-established</a>.</p>
<p>The recently published <a href="https://eatforum.org/eat-lancet-commission/">EAT-Lancet report</a> adds a further compelling reason to eat healthily: the environment. This commission argued for a <a href="https://www.ncbi.nlm.nih.gov/pubmed/30660336">“planetary health” diet</a> – akin to the Mediterranean diet – consisting of whole grains, vegetables, fruits, nuts and dairy, healthy fats, with low animal protein and few processed foods.</p>
<p>It is thought that shifting to such a diet, together with reducing food waste and adopting more sustainable food production systems, will minimise environmental damage and safeguard individual health. </p>
<p>The central message is the health of individuals and of the planet are inextricably linked, and this requires a rethink of global food systems.</p>
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Read more:
<a href="https://theconversation.com/want-to-improve-your-mood-its-time-to-ditch-the-junk-food-107358">Want to improve your mood? It's time to ditch the junk food</a>
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<p>Overhauling food systems – and individual food habits – will not be simple while foods high in fat and sugar are so readily available and relatively cheap.</p>
<p>Nonetheless, recognising that eating well might benefit the planet, as well as the body and brain, might motivate people to change their dietary habits.</p><img src="https://counter.theconversation.com/content/113551/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Margaret Morris receives funding from the National Health and Medical Research Council, Australia and Australian Research Council and she is affiliated with Nutrition Australia. </span></em></p><p class="fine-print"><em><span>Michael Kendig has received funding from the Ian Potter Foundation.</span></em></p>We pick healthy foods to look after our bodies, but research shows certain healthy choices can also benefit our brains.Margaret Morris, Professor of Pharmacology, Head of Pharmacology, UNSW SydneyMichael Kendig, Postdoctoral Research Fellow, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1100522019-02-07T10:23:08Z2019-02-07T10:23:08ZVegan or Mediterranean diet – which is better for heart health?<figure><img src="https://images.theconversation.com/files/257247/original/file-20190205-86217-1ch2xu2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A healthy diet can help to reduce your risk of heart disease.</span> <span class="attribution"><span class="source">shutterstock</span></span></figcaption></figure><p>Cardiovascular disease is responsible for <a href="https://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)">more than 30% of the total number of deaths worldwide</a>, and every year more people are being diagnosed with the condition. In 2015, more than 85m people in Europe were living with <a href="http://www.ehnheart.org/cvd-statistics/cvd-statistics-2017.html">cardiovascular diseases</a>. </p>
<p>But although the total number of people who suffer with cardiovascular disease increases, the number of those who die from heart and circulatory diseases <a href="https://www.gov.uk/government/publications/health-profile-for-england/chapter-2-major-causes-of-death-and-how-they-have-changed">is in steady decline</a>. This is because treatment options, quality of care and access to healthcare have improved considerably since the middle of the previous century. </p>
<p>Even though this is definitely a positive sign, it means that more and more people are living with cardiovascular disease – which can seriously impact quality of life and puts people at risk of sudden death. </p>
<p>In the UK alone, healthcare costs relating to heart and circulatory diseases are estimated at £9 billion each year – while overall, the cost to the EU economy is close to <a href="http://www.ehnheart.org/cvd-statistics/cvd-statistics-2017.html">£200 billion a year</a>.
It makes sense then that cardiovascular disease prevention is considered to be the number one target for many national healthcare services around the globe. </p>
<p>Prevention includes encouraging people to <a href="https://www.nhs.uk/live-well/eat-well/">eat a healthier diet</a>, <a href="https://www.nutrition.org.uk/healthyliving/an-active-lifestyle/how-much-physical-activity-do-i-need.html">become more physically active</a> and <a href="https://ecig2017.wordpress.com">stop smoking</a>. All three can provide multiple benefits – reducing risk for a range of diseases and conditions and improving quality of life. </p>
<h2>Diets for a healthy heart</h2>
<p>For many people facing a diagnosis of cardiovascular disease, diet is probably one of the first things they might look to tackle. There are a number of healthy diets around – many of them associated with regions or countries, such as the <a href="http://www.berkeleywellness.com/healthy-eating/diet-weight-loss/article/new-nordic-diet">New Nordic</a> – which promotes eating root vegetables, cabbage, apples, berries, fish and game among other things – the <a href="https://www.bbcgoodfood.com/howto/guide/why-japanese-diet-so-healthy">Japanese</a> – which advocates the consumption of rice, cooked and pickled vegetables, fish, meat and soy beans – and the <a href="https://theconversation.com/uk/topics/mediterranean-diet-6780">Mediterranean diet</a>.</p>
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Read more:
<a href="https://theconversation.com/mediterranean-diet-may-protect-your-brain-in-old-age-new-finding-suggests-70909">Mediterranean diet may protect your brain in old age, new finding suggests</a>
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<p>The Mediterranean diet is a <a href="https://www.everydayhealth.com/mediterranean-diet/guide/#prosandcons">balanced diet</a>, promoting the consumption of vegetables and fruits in addition to oily fish, olive oil, red wine, lean meats, nuts, and low-fat dairy products. It <a href="https://www.sevencountriesstudy.com/about-the-study/">has been known since the late 1950s</a> that it does offer cardioprotective benefits and several <a href="https://www.sciencedirect.com/science/article/pii/S0033062015000286?via%3Dihub">large</a> and not <a href="https://www.sciencedirect.com/science/article/abs/pii/S0026286214001198?via%3Dihub">so large</a> studies have confirmed these findings since. </p>
<p>Then there is the <a href="https://www.nhs.uk/live-well/eat-well/the-vegan-diet/">vegan diet</a> – a plant-based, meat-free diet, which does require abstaining from eggs, dairy, and honey too. In regards to cardiovascular disease protection, the available evidence is limited. However, what we know suggests that long-term vegans have lower <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3916209/">total cholesterol</a> than <a href="https://theconversation.com/vegan-diet-how-your-body-changes-from-day-one-100413">non-vegans</a>.</p>
<h2>What works best?</h2>
<p>Our team recently explored the benefits of several regional and novel diets – including the <a href="https://www.sciencedirect.com/science/article/pii/S0899900717302411?via%3Dihub">New Nordic diet</a>, <a href="http://www.clinsci.org/content/124/9/579.long">the Mediterranean diet</a>, the vegan diet and nitrate-rich ones – which are said to directly improve heart health. We looked into their cardiovascular effects both in the short and longer-term. </p>
<p>In a recent study we compared the <a href="https://www.mdpi.com/2072-6643/10/12/1897">short-term effects of the Mediterranean and the vegan diet</a>. Our findings suggest that, at least in the short-term, the Mediterranean diet improves significantly the availability of nitric oxide in our veins and arteries – which is important to maintain the good health of our vascular system. Nitric oxide is severely affected by the ageing process and is strongly related to the development of cardiometabolic diseases. So, the observed greater nitric oxide availability is very positive news.</p>
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<img alt="" src="https://images.theconversation.com/files/257248/original/file-20190205-86233-1pesci4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/257248/original/file-20190205-86233-1pesci4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/257248/original/file-20190205-86233-1pesci4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/257248/original/file-20190205-86233-1pesci4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/257248/original/file-20190205-86233-1pesci4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/257248/original/file-20190205-86233-1pesci4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/257248/original/file-20190205-86233-1pesci4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">A balanced diet will help regulate blood pressure and cholesterol levels.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
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<p>Our study also found that the vegan diet offers benefits in the reduction of cholesterol levels. On the other hand, we did find that participants who followed the vegan diet appeared to also have a reduction in a number of important <a href="https://www.who.int/nutrition/topics/micronutrients/en/">micro-nutrients</a> – such as B12 vitamin and iodine. This is despite us providing B12 supplements to participants. </p>
<p>This is a serious finding: micro-nutrients are vitamins and minerals that our body needs in small quantities to function properly, while both <a href="https://www.healthline.com/nutrition/iodine-deficiency-symptoms">iodine</a> and <a href="https://www.nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/symptoms/">B12</a> deficiency pose an important health risk.</p>
<h2>Our recommendation</h2>
<p>Research has showed repeatedly that balanced diets are often more beneficial in the longer term – and our work strongly points to the same direction. In any case, it is probably best to avoid adopting diets that follow popular trends – and make a choice based on your individual needs. </p>
<p>It is also important to be well informed before making any dietary changes. This is because in some cases, a change in diet does lead to deficits of micronutrients and vitamins. This can create a health risk, which surpasses the benefits. </p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/drink-a-glass-of-olive-oil-every-day-the-mediterranean-way-to-a-long-life-48837">Drink a glass of olive oil every day – the Mediterranean way to a long life</a>
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<p>So as far as reducing cardiovascular disease risk, our work suggests that it is probably better to look for a solution in the <a href="https://www.eufic.org/en/healthy-living/article/the-mediterranean-diet?gclid=EAIaIQobChMIv6b51LWk4AIVbrHtCh0WGQzvEAAYAyAAEgKlUvD_BwE">Mediterranean diet</a>. </p>
<p>This means eating more plant-based foods – such as fruits and vegetables, whole grains, legumes and nuts. You should also look to replace butter with healthy fats such as olive oil, as well as using herbs and spices instead of salt to flavour foods. Red meat should be limited to a few times a month, but you can eat fish and poultry at least twice a week. Enjoying meals with family and friends is also a big part of the Mediterranean diet and culture – as is <a href="https://theconversation.com/compound-found-in-berries-and-red-wine-can-rejuvenate-cells-suggests-new-study-86945">drinking red wine</a> <a href="https://theconversation.com/if-youre-going-to-drink-make-it-part-of-your-mediterranean-diet-53406">in moderation</a> (though this part is optional).</p><img src="https://counter.theconversation.com/content/110052/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Markos Klonizakis does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Both diets can help to lower cholesterol, but which is better?Markos Klonizakis, Reader (Clinical Physiology), Sheffield Hallam UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1071202018-11-23T12:06:47Z2018-11-23T12:06:47ZIs alcohol bad for you? It depends on the drink and how you drink it<figure><img src="https://images.theconversation.com/files/246999/original/file-20181123-149326-xwjm5a.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">shutterstock</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/235000729?size=medium_jpg">Sergey Ryzhov/Shutterstock</a></span></figcaption></figure><p>Recent headlines claim that a glass of wine or a pint of beer a day <a href="https://news.sky.com/story/exceeding-recommended-alcohol-limits-cuts-years-off-your-life-11328249">shortens your life</a>. It’s enough to dampen any thoughts of a celebratory drink or two at Christmas. But those conclusions are based on a partial view of the alcohol debate. </p>
<p>No one disputes the fact that many people drink too much alcohol. The controversy centres on whether even low levels of consumption are safe. There is now good evidence that the risks versus benefits of alcohol are strongly influenced by the type of alcohol and the way it is drunk. Yet many studies have not included these factors when making recommendations about safe levels of alcohol consumption. So can you drink alcohol in a way that is safe or even beneficial?</p>
<p>The data seems to say “yes”. When drinking is spread out over the week, death from any cause is lower than when the same amount of alcohol is drunk on only <a href="https://www.ncbi.nlm.nih.gov/pubmed/29676281">one or two days of the week</a>. The way alcohol is consumed matters because spikes in blood alcohol concentrations are <a href="https://www.ncbi.nlm.nih.gov/pubmed/22151744">far higher from binge drinking</a>. Above a certain blood alcohol concentration, the body breaks down alcohol in ways that produce harmful molecules called <a href="https://www.ncbi.nlm.nih.gov/pubmed/23101976">free radicals</a> that can damage the liver and are associated with an increased risk of cancer. But, unfortunately, many alcohol studies are based on the overall amount consumed in a week – they don’t distinguish between different drinking patterns.</p>
<p>Drinking with a meal also has a big influence on the health effects of alcohol because food slows the emptying of the stomach, which lowers the blood alcohol concentration. And when alcohol is consumed as part of a <a href="https://theconversation.com/if-youre-going-to-drink-make-it-part-of-your-mediterranean-diet-53406">Mediterranean diet</a>, it seems to carry far <a href="https://www.ncbi.nlm.nih.gov/pubmed/24937666">less cancer risk</a> than most other ways of consuming alcohol. </p>
<p>This can be explained, at least in part, by nutrients that are present at high levels in the Mediterranean diet, such as <a href="https://www.ncbi.nlm.nih.gov/pubmed/25505228">folates</a>, which reduce the carcinogenic effects of alcohol. It is now widely accepted that the health effects of an individual food or nutrient can only be evaluated within the context of the <a href="https://www.ncbi.nlm.nih.gov/pubmed/11790957">overall diet</a>. But that understanding is sometimes lost when drawing up guidelines for alcohol consumption. </p>
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<img alt="" src="https://images.theconversation.com/files/247012/original/file-20181123-149320-17yr2gk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/247012/original/file-20181123-149320-17yr2gk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/247012/original/file-20181123-149320-17yr2gk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/247012/original/file-20181123-149320-17yr2gk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/247012/original/file-20181123-149320-17yr2gk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/247012/original/file-20181123-149320-17yr2gk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/247012/original/file-20181123-149320-17yr2gk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">The Mediterranean diet and moderate amounts of wine are a good match.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/291753935?src=SlWgsUCcGO79_oVkFDLNQw-1-4&size=medium_jpg">Marian Weyo/Shutterstock</a></span>
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<p>Drinking low amounts of wine is usually found to <a href="https://www.ncbi.nlm.nih.gov/pubmed/24480368">reduce the risk of an early death more</a> than not drinking or drinking other forms of alcohol. A unit of alcohol in wine drunk slowly with a meal results in <a href="https://www.ncbi.nlm.nih.gov/pubmed/23101976">lower blood alcohol concentrations</a> than a unit of alcohol taken as a single swig of spirit on an empty stomach. It is not yet understood whether the benefits of drinking wine – and especially red wine – are due to this more leisurely way of drinking or to wine’s many antioxidants (substances believed to protect cells from damage).</p>
<h2>Wine as medicine</h2>
<p>Some public health experts strongly believe that to prevent harm from misuse, alcohol should be declared <a href="https://www.bmj.com/content/362/bmj.k3944">a drug of abuse</a>. But, when taken in moderation, alcohol <a href="https://www.bmj.com/content/342/bmj.d671">reduces cardiovascular disease</a>, and <a href="https://doi.org/10.1136/bmj.k3164">possibly dementia</a>. So it may be more appropriate to view alcohol as if it were a pharmaceutical drug. </p>
<p>It would be rather odd to be prescribed a course of medicine without it being made clear that only a few tablets should be taken each day – not all of them on a Friday night, which would turn a beneficial drug into an extremely harmful one. Similar precautions also need to be employed to benefit from alcohol.</p>
<p>Most nutrients, from saturated fats to many vitamins, have safe upper limits, and exceeding those limits can be harmful. These limits reflect the body’s capacity to safely metabolise the nutrient. The <a href="https://en.wikipedia.org/wiki/The_dose_makes_the_poison">dose makes the poison</a>. </p>
<p>Of course, some people, such as pregnant women and people who produce high levels of the cancer-causing substance <a href="https://www.ncbi.nlm.nih.gov/pubmed/19320537">acetaldehyde</a> when they metabolise alcohol, should avoid alcohol altogether. Binge drinking is also rightly condemned as harmful. But the current evidence suggests that for those who choose to drink, the benefits from moderate meal-time drinking (wine with a Mediterranean-style meal, preferably) outweigh the risks. Making a clear distinction between binge drinking and moderate meal-time drinking can help clear up the confusion and allow alcohol its appropriate place in a healthy lifestyle.</p><img src="https://counter.theconversation.com/content/107120/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>
</span></em></p>In moderate doses, alcohol is more of a medicine than a poison.Richard Hoffman, Lecturer in Nutritional Biochemistry, University of HertfordshireLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1061522018-11-13T23:23:21Z2018-11-13T23:23:21ZWhy natural depression therapies are better than pills<figure><img src="https://images.theconversation.com/files/245382/original/file-20181113-194503-k1hmra.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Antidepressants bring in almost $17 billion a year for the pharmaceutical industry, and yet science shows their benefit to be small. Natural therapies such as diet, exercise, light therapy and cognitive behavioural therapy are just as effective. </span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Winter is upon us. And with it comes the annual <a href="https://doi.org/10.1016/j.comppsych.2014.07.021">worsening of depressive symptoms</a>. Sadly, in the United States, suicide continues to claim more lives than firearms, and suicide rates are <a href="https://www.cdc.gov/media/releases/2018/p0607-suicide-prevention.html">increasing in nearly all states</a>. The U.S. Centers for Disease Control and Prevention reports that death by suicide has increased by 30 per cent since 1999 and <a href="https://globalnews.ca/news/4274136/suicide-rates-women-men-canada/">a similar trend is observed in Canada</a>. </p>
<p>I was distressed but not surprised to learn that these increases occurred over a period of time in which use of antidepressants <a href="https://www.cbsnews.com/news/antidepressant-use-soars-65-percent-in-15-years/?fbclid=IwAR1bVoojcdVJ25ekS9pJC3Lvv8fqYSqGfANqm6A7NWXKBrFmsFyN2fGc7s4">skyrocketed by 65 per cent</a>. By 2014, around one in eight Americans over the age of 12 reported recent antidepressant use.</p>
<p>I practice critical-care medicine in Guelph, Ontario. Sadly, 10 to 15 per cent of my practice is the resuscitation and life support of suicide and overdose patients. </p>
<p>It is not uncommon for these patients to have overdosed on the very antidepressants they were prescribed to prevent such a desperate act. The failures of antidepressants are a clear and present part of my clinical experience. </p>
<h2>Wedded to drugs that barely work</h2>
<p>Ten years ago, when finishing medical school, I carefully considered going into psychiatry. Ultimately, I was turned off by my impression that thought leaders in psychiatry were mistakenly wedded to a drug treatment that barely works. </p>
<p>A 2004 review by the Cochrane Foundation found that when compared against an “active” placebo (one that causes side effects similar to antidepressants), antidepressants were statistically of <a href="https://www.ncbi.nlm.nih.gov/pubmed/14974002">almost undetectable benefit</a>. </p>
<p>Studies that <a href="https://www.ncbi.nlm.nih.gov/pubmed/22393205">compared antidepressants to “dummy” placebos</a> showed larger but still underwhelming results. On the 52-point Hamilton Depression Rating Scale (HDRS), patients who took the antidepressants fluoxetine (Prozac) or venlafaxine (Effexor) experienced an average decrease of 11.8 points, whereas those taking the placebo experienced an average decrease of 9.6 points. </p>
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<img alt="" src="https://images.theconversation.com/files/245395/original/file-20181113-194516-13tt28r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/245395/original/file-20181113-194516-13tt28r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=391&fit=crop&dpr=1 600w, https://images.theconversation.com/files/245395/original/file-20181113-194516-13tt28r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=391&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/245395/original/file-20181113-194516-13tt28r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=391&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/245395/original/file-20181113-194516-13tt28r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=491&fit=crop&dpr=1 754w, https://images.theconversation.com/files/245395/original/file-20181113-194516-13tt28r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=491&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/245395/original/file-20181113-194516-13tt28r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=491&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Symptoms of depression can peak over the winter months.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
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<p>I am not suggesting that antidepressants do not work. I am suggesting that they are given a precedence in our thinking about mental health that they do not deserve. </p>
<p>I leave it to readers to look at the <a href="https://www.psychcongress.com/saundras-corner/scales-screeners/depression/hamilton-depression-rating-scale-ham-d">Hamilton Depression Rating Scale</a> and decide for themselves whether a drop of 2.5 points is worth taking a pill with myriad potential side effects including <a href="https://www.ncbi.nlm.nih.gov/pubmed?term=9065681">weight gain</a>, <a href="https://www.ncbi.nlm.nih.gov/pubmed?term=19295509">erectile dysfunction</a> and <a href="https://doi.org/10.1016/j.cgh.2014.06.021">internal bleeding</a>. </p>
<p>It might be, but do note that taking an antidepressant does not seem to <a href="https://doi.org/10.1176/appi.ajp.160.4.790">decrease the risk of suicide</a>. </p>
<h2>Natural therapies that work</h2>
<p>The far more exciting and underplayed point, to me, is that multiple non-drug treatments have been shown to be as effective. As a staunch critic of alternative medical regimes such as chiropractic, acupuncture and homeopathy, it surprises me to note that the following “natural” therapies have rigorous, peer-reviewed scientific studies to support their use:</p>
<h2><em>1. Exercise</em></h2>
<p>In 2007, researchers at Duke University Medical Center in North Carolina randomly assigned patients to 30 minutes of walking or jogging three times a week, a commonly prescribed antidepressant (Zoloft), or placebo. Their results? <a href="https://www.researchgate.net/publication/5994774_Exercise_and_Pharmacotherapy_in_the_Treatment_of_Major_Depressive_Disorder">Exercise was more effective than pills!</a></p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/245390/original/file-20181113-194503-1nakmlh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/245390/original/file-20181113-194503-1nakmlh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/245390/original/file-20181113-194503-1nakmlh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/245390/original/file-20181113-194503-1nakmlh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/245390/original/file-20181113-194503-1nakmlh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/245390/original/file-20181113-194503-1nakmlh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/245390/original/file-20181113-194503-1nakmlh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Taking an antidepressant is not associated with a decreased risk of suicide.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>A 2016 <a href="https://doi.org/10.1016/j.jad.2016.03.063">review of all the available studies of exercise for depression </a> confirms it: Exercise is an effective therapy. And it’s free!</p>
<h2><em>2. Bright light therapy</em></h2>
<p>You know how you just feel better after an hour out in the sun? There probably is something to it. Bright light therapy is an effort to duplicate the sun’s cheering effects in a controlled fashion. Typically, patients are asked to sit in front of a “light box” generating 10,000 Lux from 30 to 60 minutes first thing in the morning. </p>
<p>A <a href="https://doi.org/10.1016/j.jad.2016.03.016">review of studies using this therapy</a> showed significant effect. The <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0447.2005.00574.x">largest study</a> showed a 2.5 point drop on the HDRS, roughly equal to that seen from antidepressants.</p>
<p>The sun gives 100,000 lux on a clear day and I can’t think of a reason why sunlight itself wouldn’t work, weather permitting. </p>
<h2><em>3. Mediterranean diet</em></h2>
<p>This one surprised me when it came out last year. <a href="https://doi.org/10.1186/s12916-017-0791-y">Researchers in Australia</a> randomly assigned depressed patients to receive either nutritional counselling or placebo social support. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/245393/original/file-20181113-194488-lgwenz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/245393/original/file-20181113-194488-lgwenz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=436&fit=crop&dpr=1 600w, https://images.theconversation.com/files/245393/original/file-20181113-194488-lgwenz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=436&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/245393/original/file-20181113-194488-lgwenz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=436&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/245393/original/file-20181113-194488-lgwenz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=548&fit=crop&dpr=1 754w, https://images.theconversation.com/files/245393/original/file-20181113-194488-lgwenz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=548&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/245393/original/file-20181113-194488-lgwenz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=548&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Physicians have a responsibility to talk about options such as diet before writing a prescription.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>The nutritionists recommended a Mediterranean diet, modified to include local unprocessed foods. </p>
<p>Thirty-two per cent of the depressed dieters experienced remission versus eight per cent of those who only received social support, a far larger effect than seen in antidepressant trials. </p>
<h2><em>4. Cognitive Behavioural Therapy (CBT)</em></h2>
<p>This is the best recognized of the “natural” treatments for depression and the <a href="https://doi.org/10.1177/070674371305800702">evidence is indisputable</a>. </p>
<p>CBT is as effective as antidepressants but more expensive in the short term. However, antidepressants stop working when you stop taking them, whereas the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2748674/">benefits of CBT seem to last</a>. </p>
<p>And as an aside, it is very difficult to overdose fatally on a bottle of therapy. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/245392/original/file-20181113-194513-1s0ym12.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/245392/original/file-20181113-194513-1s0ym12.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/245392/original/file-20181113-194513-1s0ym12.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/245392/original/file-20181113-194513-1s0ym12.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/245392/original/file-20181113-194513-1s0ym12.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/245392/original/file-20181113-194513-1s0ym12.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/245392/original/file-20181113-194513-1s0ym12.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Evidence shows cognitive behavioural therapy to be effective in the long term.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>I freely admit that the trials I have mentioned are smaller than the major antidepressant trials. But whereas <a href="http://time.com/4900248/antidepressants-depression-more-common/">antidepressants are projected to bring in almost $17 billion a year for the pharmaceutical industry globally by 2020</a>, the jogging and sunlight industries will never have the resources to fund massive international trials. With this in mind, I am convinced that they are at least as worthwhile as the pills. </p>
<p>Physicians have a responsibility to at least talk to their patients about these options before reaching for the prescription pad.</p>
<p><em>Dr. Strauss does not recommend changing one’s medication or course of treatment for depression without consulting a physician. If you are feeling suicidal or are concerned about a friend, family member or work colleague, visit www.suicideprevention.ca to find a crisis centre near you.</em></p><img src="https://counter.theconversation.com/content/106152/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Matt Strauss does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>These four “natural” therapies for depression have rigorous, peer-reviewed scientific studies to support their use.Matt Strauss, Fellow in Global Journalism, University of Toronto and Assistant Clinical Professor, General Internal Medicine, McMaster UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1048672018-10-22T19:56:57Z2018-10-22T19:56:57ZBlood type, Pioppi, gluten-free and Mediterranean – which popular diets are fads?<figure><img src="https://images.theconversation.com/files/241564/original/file-20181022-105761-1j2fo9i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">You might lose weight in the short term but fad diets are impossible to sustain.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-looking-little-salad-tired-about-209306980?src=EcV_PSTALm2ag4aPd3zxKw-2-101">saltodemata/shutterstock</a></span></figcaption></figure><p>Each year, new weight loss diets appear that promise to reveal the ultimate secret of success – if only you buy the book, pills or potions.</p>
<p>Fad diets might achieve short-term results but they are <a href="https://daa.asn.au/smart-eating-for-you/smart-eating-fast-facts/weight-management/how-to-spot-a-dodgy-weight-loss-diet/">difficult to sustain</a> in the long term. </p>
<p><a href="https://daa.asn.au/smart-eating-for-you/smart-eating-fast-facts/weight-management/how-to-spot-a-dodgy-weight-loss-diet/">They often eliminate entire food groups</a>, which means they’re unlikely to provide adequate amounts of key nutrients that are essential for our health and well-being. </p>
<p>Fad diets and rapid weight loss can also increase the risk of serious health problems such as gall bladder disease and <a href="https://theconversation.com/got-gallstones-heres-what-to-eat-and-avoid-53229">gallstones</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-six-tips-for-losing-weight-without-fad-diets-52496">Health Check: six tips for losing weight without fad diets</a>
</strong>
</em>
</p>
<hr>
<p>When <a href="http://healthyweightweek.com.au/fad-free-diet/">assessing whether a diet is a fad, ask yourself</a>, does the diet: </p>
<ol>
<li>contradict advice from qualified health professionals?</li>
<li>promote or ban specific foods or whole food groups?</li>
<li>promote a one-size-fits-all strategy?</li>
<li>promise quick, dramatic or miraculous results with minimal effort?</li>
<li>focus only on short-term results?</li>
<li>promote “miracle” pills, <a href="https://theconversation.com/five-supplements-that-claim-to-speed-up-weight-loss-and-what-the-science-says-89856">supplements</a> or products touted to “burn fat”? </li>
<li>make claims based on personal testimonials or one random study?</li>
</ol>
<p>If the answer to two or more of these questions is “yes”, it’s probably a fad. </p>
<p>So, how do today’s popular diets measure up? Here we road-test the blood type, Pioppi, gluten-free, and Mediterranean diets.</p>
<h2>Blood type diet</h2>
<p>The blood type diet has been around for some time. It’s based on the idea that your blood type is a key factor in predicting your body weight, nutritional requirements, risk of chronic disease, and overall well-being. </p>
<p>According to this diet, those with blood type A should follow what resembles a vegetarian diet. Type Os are supposed to limit carbohydrates and increase their protein intake. Type Bs should avoid chicken, corn, wheat, lentils, tomatoes, peanuts, and sesame seeds; while type ABs should avoid caffeine, alcohol, and cured meats. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/241581/original/file-20181022-105751-dnwlp7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/241581/original/file-20181022-105751-dnwlp7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/241581/original/file-20181022-105751-dnwlp7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/241581/original/file-20181022-105751-dnwlp7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/241581/original/file-20181022-105751-dnwlp7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/241581/original/file-20181022-105751-dnwlp7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/241581/original/file-20181022-105751-dnwlp7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">People with type B blood can still eat chicken and corn.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/489408907?src=cn5IILxUcaQlAG_t-Fjbcg-1-9&size=huge_jpg">Shutterstock</a></span>
</figcaption>
</figure>
<p>But a comprehensive <a href="http://ajcn.nutrition.org/content/early/2013/05/22/ajcn.113.058693">review of 16 studies</a> found there is no scientific literature to back up this list of dos and don'ts. </p>
<p><strong>Verdict:</strong> Fad diet. It’s highly restrictive and may increase the risk of nutrient deficiencies. </p>
<h2>Pioppi diet</h2>
<p>The Pioppi diet is promoted as resembling the food patterns of people living in the small village of Pioppi, southern Italy, who live long, healthy lives. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/low-carb-paleo-or-fasting-which-diet-is-best-89685">Low carb, Paleo or fasting – which diet is best?</a>
</strong>
</em>
</p>
<hr>
<p>The traditional eating habits of the people of Pioppi are in line with the Mediterranean diet, and include lots of vegetables, legumes, grains, fruit, fish, olive oil and nuts, as well as modest amounts of cheese, yoghurt, coffee and red wine, small amounts of meat, and very little sugar or highly processed foods. </p>
<p>But the 21-day Pioppi plan is very different to this. It forbids bread and other grains typically consumed in the Mediterranean. It <a href="https://health.spectator.co.uk/the-pioppi-diet-is-a-superficial-lifestyle-guide-based-on-distorted-evidence/">promotes foods</a> not usually consumed by the people of Pioppi, such as coconut fat.</p>
<p>People who follow the Pioppi diet might lose weight because they’re consuming less energy, having eliminated entire food groups. But <a href="https://www.ncbi.nlm.nih.gov/pubmed/26185980">consuming saturated fats</a> (polyunsaturated fat) and <a href="https://www.ncbi.nlm.nih.gov/pubmed/26429077">cutting out grains</a> goes against the current evidence for good heart health.</p>
<p><strong>Verdict:</strong> Fad diet.</p>
<h2>Gluten-free diet</h2>
<p>Gluten is a protein naturally found in wheat, rye and barley, plus some food additives. </p>
<p>People with diagnosed coeliac disease must eliminate gluten from their diet to avoid serious damage to their gut, but many people choose to avoid gluten as a weight-loss strategy. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/if-you-dont-have-coeliac-disease-avoiding-gluten-isnt-healthy-88300">If you don't have coeliac disease, avoiding gluten isn't healthy</a>
</strong>
</em>
</p>
<hr>
<p>Eliminating gluten does not automatically reduce your kilojoule intake or induce weight loss. But some gluten-containing foods such as pizza, bread, pasta and cakes are energy-dense, so removing them completely will reduce your total energy intake, which may lead to weight loss. </p>
<p>Gluten-free alternatives can be just as high in kilojoules as the gluten containing version, and sometimes can be higher in kilojoules. </p>
<p>Removing gluten-containing without considering what foods will replace them can also reduce your intake of important nutrients such as fibre, folic acid and other B vitamins.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/241582/original/file-20181022-105761-3ecdu7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/241582/original/file-20181022-105761-3ecdu7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/241582/original/file-20181022-105761-3ecdu7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/241582/original/file-20181022-105761-3ecdu7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/241582/original/file-20181022-105761-3ecdu7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/241582/original/file-20181022-105761-3ecdu7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/241582/original/file-20181022-105761-3ecdu7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">There’s no need to forgo whole grains unless you have coeliac disease.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-cut-whole-grain-bread-on-586453910?src=NcG_v_HfCAh7lznyEGD1Yw-1-9">Shutterstock/wideonet</a></span>
</figcaption>
</figure>
<p>Recent studies <a href="https://www.ncbi.nlm.nih.gov/pubmed/28465308">discourage unnecessary gluten-free diets</a> due to the reduced intake of beneficial whole grains, which are key to a <a href="https://www.eatforhealth.gov.au/guidelines/australian-dietary-guidelines-1-5">healthy diet</a> and are <a href="https://www.ncbi.nlm.nih.gov/pubmed/29091078">associated with lower heart disease and cancer risk</a>. </p>
<p><strong>Verdict:</strong> Fad diet when used for weight loss in people who don’t have coeliac disease.</p>
<h2>Mediterranean diet</h2>
<p>The Mediterranean diet has a strong focus on intake of core foods in addition to olive oil, coffee and wine, and low intake of meat, sugar and highly processed foods. </p>
<p>While the main focus of the Mediterranean diet is not weight loss, when combined with a kilojoule restriction, <a href="https://www.ncbi.nlm.nih.gov/pubmed/20973675">it can be effective for weight loss</a>. </p>
<p>Among studies that did not prescribe an energy restriction, following the Mediterranean diet was not associated with gaining weight. The Mediterranean diet has also been shown to improve <a href="https://www.ncbi.nlm.nih.gov/pubmed/21392646">components of metabolic syndrome</a>, <a href="https://www.ncbi.nlm.nih.gov/pubmed/23505168">even without weight loss</a>. </p>
<p><strong>Verdict:</strong> The Mediterranean diet isn’t a fad but it doesn’t guarantee weight loss unless you also restrict your total kilojoule intake.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">Health Check: what's the best diet for weight loss?</a>
</strong>
</em>
</p>
<hr>
<p>The best approach to weight loss is to follow a <a href="https://theconversation.com/what-is-a-balanced-diet-anyway-72432">healthy, balanced eating plan</a> and to be physically active. Try to make small changes to your usual eating habits that you can live with. </p>
<p>If you need help or to check whether you are meeting your nutrient needs, consult your GP or a <a href="https://daa.asn.au/find-an-apd/">dietitian</a>. </p>
<p><em>If you would like to learn more about weight loss, you can enrol in our free online course <a href="https://www.edx.org/course/the-science-of-weight-loss-dispelling-diet-myths-0">The Science of Weight Loss – Dispelling Diet Myths</a>.</em></p><img src="https://counter.theconversation.com/content/104867/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Clare Collins is affiliated with the Priority Research Centre for Physical Activity and Nutrition, the University of Newcastle, NSW. She is an NHMRC Senior Research and Gladys M Brawn Research Fellow. She has received research grants from NHMRC, ARC, Hunter Medical Research Institute, Meat and Livestock Australia, Diabetes Australia, Heart Foundation, Bill and Melinda Gates Foundation, nib foundation and Greater Charitable Foundation. She has consulted to SHINE Australia, Novo Nordisk, Quality Bakers, the Sax Institute and the ABC. She was a team member conducting systematic reviews to inform the Australian Dietary Guidelines update and 2017 evidence review on dietary patterns for the Heart Foundation. </span></em></p><p class="fine-print"><em><span>Lee Ashton is affiliated with the Priority Research Centre for Physical Activity and Nutrition at the University of Newcastle.</span></em></p><p class="fine-print"><em><span>Rebecca Williams is affiliated with the Priority Research Centre for Physical Activity and Nutrition at the University of Newcastle. </span></em></p>Diets that promise drastic results with minimal effort, or that ban whole food groups, should ring alarm bells.Clare Collins, Laureate Professor in Nutrition and Dietetics, University of NewcastleLee Ashton, Postdoctoral research fellow, University of NewcastleRebecca Williams, Postdoctoral Researcher, University of NewcastleLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1038982018-09-26T12:40:54Z2018-09-26T12:40:54ZPlant-rich diets may help prevent depression – new evidence<figure><img src="https://images.theconversation.com/files/238080/original/file-20180926-48656-1ygow6e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/326073980?src=ODsI2wP9A33YxCFifXcJiA-1-26&size=medium_jpg">DronG/Shutterstock.com</a></span></figcaption></figure><p>Being depressed can negatively affect your appetite and what you eat, but can bad eating habits bring your mood down? Our latest study, a <a href="https://www.nature.com/articles/s41380-018-0237-8">systematic review of the best available evidence</a>, found a clear link between the quality of a person’s diet and their risk of depression. And it goes beyond the effect of diet on body size or other aspects of health that can affect mental health. </p>
<p>We took extra care in including only studies that took age, sex, income, body size, general health, smoking and physical activity into account in their analyses. That way we could be sure that the associations between diet and the risk of depression are independent of these factors.</p>
<p>We aggregated the results of several studies and found a clear pattern that following a healthier, plant-rich, anti-inflammatory diet can help prevent depression. Of the 41 studies in our review, four specifically looked at the link between a traditional Mediterranean diet and depression over time on 36,556 adults. We found that people with a more Mediterranean-like diet had a 33% lower risk of developing depression than people whose diet least resembled a Mediterranean diet.</p>
<p>Following a traditional Mediterranean diet, that is avoiding processed foods and foods that are high in saturated fat and sugar (pro-inflammatory foods) and favouring foods rich in omega-3, fibre, vitamins, magnesium and polyphenols, can reduce the risk of depression.</p>
<h2>Biological explanation</h2>
<p>Diet can influence mental health by causing damage to the brain. This can be due to oxidative stress (a harmful chemical process), insulin resistance, changes in blood flow and inflammation. A diet rich in anti-inflammatory and anti-oxidant components, commonly found in fruit, vegetables, nuts and wine (which should be drunk in moderation), can directly affect the brain by protecting it from oxidative stress and inflammation. Inflammation can also affect the neurotransmitters (the brain’s messenger molecules) responsible for regulating emotion. </p>
<p><a href="https://www.sciencedirect.com/science/article/pii/S0002934318306430?via%3Dihub">Recent research in humans</a> also suggests that diet can affect the formation of brain cells (neurons), particularly in a part of the brain called the hippocampus, which is associated with mood regulation. </p>
<p>There is also new evidence regarding the microbes in your gut, known as the <a href="https://www.ncbi.nlm.nih.gov/pubmed/25415497">gut microbiota</a>. These microbes can break down the nutrients we eat and create molecules that may be inflammatory or that stimulate neural activity. They communicate with the gut and brain neurons and can therefore <a href="https://www.nature.com/articles/nrn3346">influence behaviour</a>. </p>
<p>Diet is a key modulator of gut microbiota. In animal studies, eating plant-based foods improves the microbial composition in the gut, whereas high-fat diets appear to disrupt the microbial balance. When there is an imbalance in the microbes in your gut, it can cause the intestines to become permeable, letting big molecules pass into the bloodstream, and these molecules can interact with brain function.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/238086/original/file-20180926-48653-95586.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/238086/original/file-20180926-48653-95586.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/238086/original/file-20180926-48653-95586.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/238086/original/file-20180926-48653-95586.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/238086/original/file-20180926-48653-95586.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/238086/original/file-20180926-48653-95586.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/238086/original/file-20180926-48653-95586.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">In the future, prescribing may be more than just pills.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/415240006?src=zMHLJ98ImvIFsJhW8OOePw-1-14&size=medium_jpg">FocusStocker/Shutterstock.com</a></span>
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</figure>
<h2>Nutritional psychiatry</h2>
<p>The field of <a href="https://www.sciencedirect.com/science/article/pii/S2352396417300798?via%3Dihub">nutritional psychiatry</a> has emerged recently – around a decade ago – and it is growing rapidly. But results from observational studies, despite giving us an indication on the direction of the association, can’t tell us if the link is causal – only a randomised controlled trial can do this. </p>
<p>The recent <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0791-y">SMILES trial</a> was the first study to provide evidence that diet can affect depression. People allocated to the Mediterranean diet group improved their depressive symptoms after 12 weeks, compared with the control group who received social support. </p>
<p>The growing evidence for nutritional psychiatry suggests that GPs and mental health professionals should now seriously consider including dietary counselling for patients who are at risk of depression.</p><img src="https://counter.theconversation.com/content/103898/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Camille Lassale does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The Mediterranean diet is not only good for your heart. It could protect your mental health, too.Camille Lassale, Research Associate, UCLLicensed as Creative Commons – attribution, no derivatives.