tag:theconversation.com,2011:/nz/topics/fibre-529/articlesFibre – The Conversation2024-03-18T13:44:34Ztag:theconversation.com,2011:article/2255902024-03-18T13:44:34Z2024-03-18T13:44:34ZOats and oatmeal aren’t bad for you, as some claim – in fact, they probably have more health benefits than you realise<figure><img src="https://images.theconversation.com/files/581925/original/file-20240314-24-ysaqlb.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C3494%2C1964&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Oats are a great source of fibre, which can help you stay full after eating.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/oatmeal-porridge-berries-honey-healthy-breakfast-1721472361">Vladislav Noseek/ Shutterstock</a></span></figcaption></figure><p>Oats have long had a reputation for being one of the healthier foods you can choose for breakfast. But some people on social media have been calling this claim into question, suggesting that rather than being a healthy staple, oatmeal (and porridge, which is often made using oats) might in fact have <a href="https://www.dailymail.co.uk/health/article-12509825/cardiologist-SHOULDNT-eat-oatmeal.html">no nutritional value</a> whatsoever.</p>
<p>However, while these claims have garnered plenty of media attention, there’s little evidence to back them up. Rather, the science overwhelmingly shows that oats can be beneficial for your health in many ways. </p>
<p>One line of reasoning used to argue oats aren’t healthy is that eating them can lead to spikes in blood sugar (glucose). This seems to be linked to the <a href="https://www.mdpi.com/1424-8220/22/5/2030">rising use of glucose monitors</a> by people who don’t have diabetes. These monitors may depict normal changes in blood glucose, which happen after we eat, as a “<a href="https://wchh.onlinelibrary.wiley.com/doi/full/10.1002/pdi.2475">spike</a>” in blood sugar. </p>
<p>Foods that contain carbohydrates (including starchy foods such as oats and other cereals) are broken down during digestion into sugar (mainly glucose but also fructose and galactose). As the foods are broken down, the levels of sugar in the bloodstream begin to rise. This is a normal but important process – the sugar provides us with immediate energy or is stored by the muscles and liver cells for energy later. </p>
<p>Some foods take longer to digest, which means they spend more time in the stomach before reaching the intestines. As such, they will cause a smaller but more sustained rise in blood sugar. This can be better understood by looking at the glycaemic index, which rates foods based on how quickly they affect blood sugar levels.</p>
<p>The glycaemic index shows that the <a href="https://glycemicindex.com/gi-search/?food_name=oatmeal&product_category=&country=&gi=&gi_filter=&serving_size_(g)=&serving_size_(g)_filter=&carbs_per_serve_(g)=&carbs_per_serve_(g)_filter=&gl=&gl_filter=">sugars in oatmeal and porridge</a> are absorbed at about two-thirds the rate of sugar from white bread. This means oats are considered a <a href="https://www.nhs.uk/common-health-questions/food-and-diet/what-is-the-glycaemic-index-gi/">medium glycaemic index</a> food, similar to pasta but absorbed more slowly than many other breakfast cereals. </p>
<p>Generally, it is a good thing for food to be absorbed more slowly, as it is thought this helps with appetite control. So, while your blood sugar may rise after eating oats, this rise is a normal part of the digestive process.</p>
<p>But while the glycaemic index tells us how quickly sugars are absorbed by the body, it doesn’t really look at the portion size of the food. The <a href="https://www.nhs.uk/common-health-questions/food-and-diet/what-is-the-glycaemic-index-gi/">more carbs you eat</a> in one go, the more it will increase your blood glucose levels <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/glycemic-load#:%7E:text=Glycemic%20load%20refers%20to%20the,the%20bloodstream%20(glycemic%20index).">after a meal</a> – even if they are normal overall.</p>
<h2>Cholesterol-lowering benefits</h2>
<p>Oats are also a great <a href="https://www.nhs.uk/live-well/eat-well/digestive-health/how-to-get-more-fibre-into-your-diet/">source of fibre</a>, which not only helps us stay full after eating but also keeps our bowel movements <a href="https://academic.oup.com/nutritionreviews/article/78/5/343/5602346">regular and healthy</a>.</p>
<p>Oatmeal contains specific types of fibre called <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3236515/">beta-glucans</a>. These have been linked to lower risk of insulin resistance (associated with type 2 diabetes), weight gain, high blood pressure and high <a href="https://efsa.onlinelibrary.wiley.com/doi/abs/10.2903/j.efsa.2010.1885#:%7E:text=The%20following%20wording%20reflects%20the,oat%20beta%2Dglucan%20per%20day.">cholesterol</a>. Beta-glucans are also linked with a <a href="https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=101.81#:%7E:text=Daily%20dietary%20intake%20levels%20of,of%20whole%20oats%20and%20barley.">lower risk of heart disease</a>.</p>
<figure class="align-center ">
<img alt="A bowl of uncooked rolled oats." src="https://images.theconversation.com/files/581928/original/file-20240314-24-4nh1zr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/581928/original/file-20240314-24-4nh1zr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/581928/original/file-20240314-24-4nh1zr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/581928/original/file-20240314-24-4nh1zr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/581928/original/file-20240314-24-4nh1zr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=565&fit=crop&dpr=1 754w, https://images.theconversation.com/files/581928/original/file-20240314-24-4nh1zr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=565&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/581928/original/file-20240314-24-4nh1zr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=565&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">Beta-glucans are a beneficial type of fibre.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/oats-spoon-plate-on-table-scattered-417963298">Timmary/ Shutterstock</a></span>
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<p>This cholesterol-lowering effect is the result of the way the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6892284/#:%7E:text=Viscous%20%CE%B2%2Dglucan%20is%20hypothesized,systemic%20LDL%20cholesterol%20(59).">beta-glucan bind to bile</a>, a fluid that helps with digestion, in our intestines. This process reduces the amount of bile that can be re-absorbed into the body as cholesterol.</p>
<p>But in order to get these benefits from beta-glucans, you need to consume at least 3g of them daily. Given an average <a href="https://www.heartuk.org.uk/ultimate-cholesterol-lowering-plan/uclp-step-3">30g serving of oats contains 1g</a> of beta-glucans, pairing a bowl of porridge with other foods that are rich in beta-glucans (such as oat cakes and pearled barley) can help you get enough of these important fibres in your diet each day.</p>
<h2>Oatmeal and gut health</h2>
<p>Oatmeal is a source of soluble fibre, which means it can be fermented by the bacteria in our digestive tract. This has led to suggestions that oats might be beneficial for our gut microbiome. </p>
<p>Emerging evidence suggests that as well as increasing numbers of bacteria linked to a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10459712/#:%7E:text=Oat%20fiber%20increased%20expression%20of,not%20all%20indices%20(Shannon)">healthy bowel</a>, oatmeal may also help with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10459712/#:%7E:text=Oat%20fiber%20increased%20expression%20of,not%20all%20indices%20(Shannon).">short-chain fatty acid production</a>. </p>
<p>These are produced by bacteria and help nourish the cells in the colon. They may even help us to <a href="https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/control-of-appetite-and-energy-intake-by-scfa-what-are-the-potential-underlying-mechanisms/A1EFBE12AD6F9838EBE3D7314D1EE1B4">regulate our appetite</a> and control <a href="https://link.springer.com/article/10.1007/s13668-018-0248-8">blood fats and glucose</a>, which may help reduce risk of type 2 diabetes and heart disease.</p>
<h2>Is all oatmeal healthy?</h2>
<p>Although all oatmeal will contain fibre, how it’s milled can affect how quickly it’s digested. Instant oats are digested more quickly compared with rolled oats due to the way they’re milled.</p>
<p>Unlike other cereals, oats need steaming and heating before they can be cut or rolled. This is to <a href="https://www.sciencedirect.com/science/article/abs/pii/S0733521007000689#:%7E:text=Steaming%20is%20routinely%20used%20during,process%20also%20improves%20the%20flavour.">stop enzymes</a> breaking down the fats in the oats, which would cause rapid spoilage. </p>
<p><a href="https://library.dpird.wa.gov.au/cgi/viewcontent.cgi?article=1161&context=bulletins">Oats can be rolled</a> to make larger oat flakes, or cut first before rolling to make quick or instant oats. Larger (rolled) oats are digested more slowly than cut oats. </p>
<p>Making oatmeal with milk can add additional nutrients such as calcium, vitamin B12 and protein. But even if your porridge is made with water, oats are a good source of manganese, phosphorous and zinc, as it is. These are <a href="https://www.fao.org/3/ab470e/ab470e06.htm">essential</a> for hormone production, bone health and wound healing. So, although oats may not be fortified in the same way as other cereals, they contain <a href="https://fdc.nal.usda.gov/fdc-app.html#/food-details/173905/nutrients">valuable nutrients</a> and fibre, and are far from nutrient-free.</p>
<p>Oats clearly have benefits. But what this debate highlights is that no food is perfect – or completely useless – for our health. We need to look beyond the positives and negatives of individual foods, even oatmeal, and look instead at how all the foods in our diet work together when it comes to our health.</p><img src="https://counter.theconversation.com/content/225590/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Duane Mellor is a member of the British Dietetic Association</span></em></p>Oats have many health benefits – including keeping our bowels regular and healthy.Duane Mellor, Lead for Evidence-Based Medicine and Nutrition, Aston Medical School, Aston UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2248852024-03-04T16:19:45Z2024-03-04T16:19:45ZDaily fibre supplement improves older adults’ brain function in just three months – new study<p>In just 12 weeks, a daily fibre supplement improved brain function in <a href="https://www.nature.com/articles/s41467-024-46116-y#Tab2">twins over the age of 65</a>. Could the microbes in our gut hold the key to preventing cognitive decline in our ageing population?</p>
<p>The study my colleagues and I conducted showed that this simple and cheap food supplement can improve performance in memory tests – tests that are used to spot early signs of Alzheimer’s disease.</p>
<p>As populations age globally, the prevalence of age-related conditions such as declining brain and muscle function is on the rise, so we need innovative ways to slow and prevent this. </p>
<p>The number of gut microbiome studies has <a href="https://gut.bmj.com/content/67/9/1716">increased exponentially</a> over the past 15 years. Researchers are recognising the huge potential of this under-explored facet of human health. We know that the gut microbiome can be influenced and changed from the outside, for example, using a prebiotic supplement. </p>
<p>Prebiotics are simple fibres that encourage healthy bacteria to flourish in the gut. They are already widely available to buy.</p>
<p>With this new study, we sought to understand how targeting the microbiota, the diverse community of microorganisms residing in our guts, using two cheap, commercially available plant fibre supplements, inulin and FOS, could affect both brain function and muscle health. </p>
<p>The study comprised 36 twin pairs, with one twin randomly allocated to receive a placebo and the other randomly allocated to receive a prebiotic fibre supplement. The treatments (prebiotic or placebo) were taken every day for three months and none of the participants knew which they were receiving – in other words, the study was “blinded”.</p>
<p>To improve muscle function, all the participants also did resistance exercises and took a daily protein supplement.</p>
<p>We monitored participants remotely via video calls, online questionnaires, and online tests of memory and thinking. </p>
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Read more:
<a href="https://theconversation.com/gut-microbiome-meet-lactobacillus-brevis-a-fermentation-superstar-213323">Gut microbiome: meet Lactobacillus brevis – a fermentation superstar</a>
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<h2>Beneficial bacteria</h2>
<p>When we tested participants’ stool samples, we found the fibre supplement led to significant changes in the participants’ gut microbiome composition. In particular, there was an increase in beneficial bacteria, such as <em>Bifidobacterium</em>. </p>
<p>While there was no significant difference in muscle strength between the groups, the group receiving the fibre supplement performed better in tests assessing memory and thinking, including the Paired Associates Learning Test. This test is <a href="https://pubmed.ncbi.nlm.nih.gov/11351138/">able to detect early signs of</a> Alzheimer’s disease. Those who received the prebiotic had half the number of errors on this test compared with the group that received a placebo. </p>
<p>Seeing this positive result in just 12 weeks holds huge promise for enhancing brain health and memory in our ageing population. </p>
<p>We hope that further understanding of the gut-brain connections may unlock new approaches for helping people live more healthily for longer. For example, preventing or delaying frailty and ultimately keeping our ageing population independent and well for as long as possible. </p>
<h2>Innovative trial</h2>
<p>Another novel aspect of the study was its remote design, which showed the feasibility of conducting trials in older adults without the need for extensive travel or hospital visits, which could be delivered in many settings globally. </p>
<p>Such trial designs aim to improve the representation of older people in research. We acknowledge that challenges to this type of study design exist, including access to the internet and computers, and we aim to address these in future large-scale projects. Ultimately, the aim is to enhance the quality of life for ageing populations worldwide.</p>
<p>We estimate the cost of taking this kind of supplement at 15p a day. They are safe and easy to take. They could benefit a large group of people and the research team plan to go on and test whether these results are sustained over longer periods and in larger groups of people.</p>
<p>Our findings show that targeting the gut bacteria with simple interventions can have significant effects on human function. So how else can we target these microbes to enhance wellbeing as the population gets older? We are planning to carry out further trials, exploring the huge potential of this important question.</p>
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Read more:
<a href="https://theconversation.com/gut-microbiome-meet-bifidobacterium-breve-keeping-babies-healthy-208340">Gut microbiome: meet Bifidobacterium breve, keeping babies healthy</a>
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<img src="https://counter.theconversation.com/content/224885/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Mary Ni Lochlainn receives funding from the National Institute of Health Research. This study was supported by King’s Centre for Ageing Resilience in a Changing Environment (CARICE) and by grants from the National Institute of Health Research and Wellcome Trust.</span></em></p>A daily fibre supplement improved brain function in twins over 65s in just 12 weeks.Mary Ni Lochlainn, Specialist Registrar in Geriatric and General Internal Medicine, and Post Doctoral Research Fellow, King's College LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2213842024-01-21T12:59:06Z2024-01-21T12:59:06ZDietary fibre affects more than your colon: How the immune system, brain and overall health benefit too<figure><img src="https://images.theconversation.com/files/570412/original/file-20240119-19-bkynf2.jpg?ixlib=rb-1.1.0&rect=66%2C6%2C3923%2C2249&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Most people only consume about half of the recommended amount of dietary fibre, and it can negatively affect overall health.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/dietary-fibre-affects-more-than-your-colon-how-the-immune-system-brain-and-overall-health-benefit-too" width="100%" height="400"></iframe>
<p>There’s no shortage of advice about what to eat, including hype about the latest <a href="https://www.hsph.harvard.edu/nutritionsource/superfoods/">superfoods</a> that will help you <a href="https://www.npr.org/sections/thesalt/2015/04/11/398325030/eating-to-break-100-longevity-diet-tips-from-the-blue-zones">live to 100</a>, or about the newest <a href="https://food-guide.canada.ca/en/tips-for-healthy-eating/diets-food-trends/#section-2">restrictive diets</a> that claim to help you lose weight and look beautiful. As a researcher from the <a href="https://farncombe.mcmaster.ca/">Farncombe Family Digestive Health Research Institute</a>, I’m well aware that there is no universal “healthy diet” that will work for everyone. </p>
<p>However, most professionals would agree that a diet should be well balanced between the food groups, and it’s better to include more things like vegetables and <a href="https://doi.org/10.3390%2Fnu11081806">fermented foods</a> in your diet than restrict yourself unnecessarily. Eating foods that promote gut health improves your overall health too.</p>
<h2>Why is everyone so concerned about fibre?</h2>
<p>The importance of fibre has been known for decades. The late great surgeon and fibre researcher <a href="https://doi.org/10.1017/S0954422417000117">Denis Burkitt</a> once said, “If you pass small stools, you have to have large hospitals.” But dietary fibre does more than just help move your bowels. Fibre can be considered a <a href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/probiotics/faq-20058065">prebiotic nutrient</a>. </p>
<p>Prebiotics aren’t actively digested and absorbed, rather they are selectively used to promote the growth of a beneficial species of microbes in our gut. <a href="https://doi.org/10.3390%2Ffoods8030092">These microbes then help digest foods</a> for us so we can obtain more nutrients, promote gut barrier integrity and prevent the growth of harmful bacteria. </p>
<figure class="align-center ">
<img alt="High-fibre foods against the outline of intestines" src="https://images.theconversation.com/files/570413/original/file-20240119-17-wpd6x9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/570413/original/file-20240119-17-wpd6x9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/570413/original/file-20240119-17-wpd6x9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/570413/original/file-20240119-17-wpd6x9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/570413/original/file-20240119-17-wpd6x9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/570413/original/file-20240119-17-wpd6x9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/570413/original/file-20240119-17-wpd6x9.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">Prebiotics aren’t actively digested and absorbed, rather they are selectively used to promote the growth of a beneficial species of microbes in our gut.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
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<p>Fibres can also have microbe-independent effects on our immune system when they <a href="https://doi.org/10.1111/bph.14871">interact directly with receptors expressed by our cells</a>. These beneficial effects may even help teach the immune system to be more tolerant and reduce inflammation.</p>
<h2>Getting enough dietary fibre?</h2>
<p>Probably not. The so-called <a href="https://doi.org/10.3390%2Fnu15122749">western diet</a> is low in fibre and filled with ultra-processed foods. The <a href="https://www.canada.ca/en/health-canada/services/nutrients/fibre.html">recommendation for daily fibre</a> is between <a href="https://doi.org/10.1038/s41575-020-00375-4">25-38 grams depending on factors like age, sex and activity level</a>. Most people consume about half of the recommendation, and it can negatively affect overall health. </p>
<p>Good sources of dietary fibre include whole grains, fruits and vegetables, beans and legumes, and nuts and seeds. There is a lot of emphasis on soluble fibres and less on insoluble fibres, but in reality, most foods will contain a mixture of both, and they each <a href="https://www.healthline.com/health/soluble-vs-insoluble-fiber%23risks">have their merits</a>. </p>
<p>High fibre snacks are also gaining popularity. With an estimated global value of US$7 billion in 2022, the <a href="https://www.precedenceresearch.com/prebiotic-ingredients-market#:%7E:text=The%2520global%2520prebiotic%2520ingredients%2520market,13.25%2525%2520from%25202022%2520to%25202030">value of the prebiotic ingredient market</a> is expected to triple by 2032.</p>
<h2>The benefits of dietary fibre</h2>
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<img alt="Diagram of a human with arrows linking brain and intestines" src="https://images.theconversation.com/files/570414/original/file-20240119-17-fwfmrl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/570414/original/file-20240119-17-fwfmrl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/570414/original/file-20240119-17-fwfmrl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/570414/original/file-20240119-17-fwfmrl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/570414/original/file-20240119-17-fwfmrl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/570414/original/file-20240119-17-fwfmrl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/570414/original/file-20240119-17-fwfmrl.jpg?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">
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<span class="caption">Fibre is associated with overall health and brain health through the gut-brain axis.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
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<p>There’s plenty of evidence supporting the benefits of dietary fibre. Fibre isn’t just associated with colon health; it’s associated with overall health and brain health through the <a href="https://my.clevelandclinic.org/health/body/the-gut-brain-connection">gut-brain axis</a>. Diets low in fibre have been associated with gastrointestinal disorders such as irritable bowel syndrome or inflammatory bowel disease. </p>
<p>On the other hand, consuming adequate fibre also <a href="https://doi.org/10.1038/s41575-020-00375-4">reduces the risk and mortality associated with cardiovascular diseases and obesity</a>. There are studies that show <a href="https://doi.org/10.3390/nu13072159">improvements of cognitive function with certain types of fibre</a>. </p>
<p>There are some gastrointestinal diseases, like Celiac disease, which are not typically associated with the benefits of dietary fibre. However, <a href="https://doi.org/10.1038/s41575-020-00375-4">there isn’t a consensus</a> to the specific type of fibre and dose that would be beneficial in treating most diseases.</p>
<h2>Not all fibre is good fibre</h2>
<p>Shockingly, not all fibre is good for you. Fibre is used as an umbrella term for indigestible plant polysaccharides, so there are many different types with varying fermentability, solubility and viscosity in the gut. </p>
<p>To make things more complex, <a href="https://doi.org/10.3389/fped.2020.620189">the source matters too</a>. Fibre from one plant isn’t the same as fibre from another plant. Additionally, the old proverb, “too much good is not good” rings true, where overconsumption of fibre supplements can cause symptoms such as constipation, bloating and gas. This is partly due to the differences in gut microbiomes that affect the ability to metabolize fibre to produce beneficial molecules like short-chain fatty acids. </p>
<p>In some cases, such as inflammatory bowel disease patients, lack of microbes with the capacity to digest fibre may allow intact fibres to <a href="https://doi.org/10.1053/j.gastro.2022.09.034">interact with intestinal cells directly and exert pro-inflammatory effects</a>. Recent evidence has even shown that excessively high consumption of soluble fibres, such as inulin, a common supplement, <a href="https://doi.org/10.1053/j.gastro.2023.10.012">can increase the risk of colon cancer development in an experimental animal model</a>.</p>
<h2>Part of a healthy diet</h2>
<p>Dietary fibre is an important part of a healthy diet that can promote both gut and overall health. Fibre helps you feel more satisfied after meals and helps to regulate your blood sugar and cholesterol. Do your best to consume fibre as part of your diet, and when needed, take only the dose of supplements as recommended. </p>
<p>Prebiotics promote the growth of gut microbes that can affect gut health and immunity in the context of many different diseases, although not all fibres are created equal. While fibre won’t cure illness, diet is a great addition to medicines and treatment strategies that can improve their efficacy.</p><img src="https://counter.theconversation.com/content/221384/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Mark Wulczynski 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>Fibre isn’t just associated with colon health; it’s associated with overall health and brain health through the gut-brain axis. But not all fibres are created equal.Mark Wulczynski, Medical Sciences PhD Candidate, McMaster UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2117482023-09-15T00:56:34Z2023-09-15T00:56:34ZHow can I lower my cholesterol? Do supplements work? How about psyllium or probiotics?<figure><img src="https://images.theconversation.com/files/545897/original/file-20230901-17-zovk4b.jpg?ixlib=rb-1.1.0&rect=2%2C0%2C1908%2C1279&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.pexels.com/photo/white-ceramic-bowls-with-supplements-7615572/">Nataliya Vaitkevich/Pexels</a></span></figcaption></figure><p>Your GP says you have high cholesterol. You’ve six months to work on your diet to see if that’ll bring down your levels, then you’ll review your options. </p>
<p>Could taking supplements over this time help?</p>
<p>You can’t rely on supplements alone to control your cholesterol. But there’s some good evidence that taking particular supplements, while also eating a healthy diet, can make a difference.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/got-high-cholesterol-here-are-five-foods-to-eat-and-avoid-63941">Got high cholesterol? Here are five foods to eat and avoid</a>
</strong>
</em>
</p>
<hr>
<h2>Why are we so worried about cholesterol?</h2>
<p>There are two main types of cholesterol, both affecting your risk of heart disease and stroke. Both types are carried in the bloodstream inside molecules called lipoproteins.</p>
<p><strong>Low-density lipoprotein or LDL cholesterol</strong></p>
<p>This is often called “bad” cholesterol. This lipoprotein carries cholesterol from the liver to cells throughout the body. High levels of LDL cholesterol in the blood can lead to the <a href="https://www.ahajournals.org/doi/full/10.1161/JAHA.118.011433">build-up of plaque</a> in arteries, which leads to an <em>increased</em> risk of heart disease and stroke. </p>
<p><strong>High-density lipoprotein or HDL cholesterol</strong></p>
<p>This is often called “good” cholesterol. This lipoprotein helps remove excess cholesterol from the bloodstream and transports it back to the liver for processing and excretion. Higher levels of HDL cholesterol are <a href="https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.119.312617">linked to</a> a <em>reduced</em> risk of heart disease and stroke. </p>
<p>Diet can play a key role in reducing blood cholesterol levels, especially LDL (“bad”) cholesterol. Healthy dietary choices are <a href="https://theconversation.com/got-high-cholesterol-here-are-five-foods-to-eat-and-avoid-63941">well recognised</a>. These include a focus on eating more unsaturated (“healthy”) fat (such as from olive oil or avocado), and eating less saturated (“unhealthy”) fat (such as animal fats) and trans fats (found in some shop-bought biscuits, pies and pizza bases).</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/546536/original/file-20230905-26-5plf10.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Cut avocado, glass of olive oil, green herbs and cut lemon on timber background" src="https://images.theconversation.com/files/546536/original/file-20230905-26-5plf10.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/546536/original/file-20230905-26-5plf10.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/546536/original/file-20230905-26-5plf10.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/546536/original/file-20230905-26-5plf10.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/546536/original/file-20230905-26-5plf10.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/546536/original/file-20230905-26-5plf10.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/546536/original/file-20230905-26-5plf10.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 find unsaturated fat in foods such as olive oil and avocado.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/food-background-fresh-organic-avocado-lime-253287091">Shutterstock</a></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-whats-healthier-butter-or-margarine-19777">Health Check: what's healthier, butter or margarine?</a>
</strong>
</em>
</p>
<hr>
<h2>Fibre is your friend</h2>
<p>An additional way to significantly reduce your total cholesterol and LDL cholesterol levels through diet is by eating more <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">soluble fibre</a>.</p>
<p>This is a type of fibre that dissolves in water to form a gel-like substance in your gut. The gel can bind to cholesterol molecules preventing them from being absorbed into the bloodstream and allows them to be eliminated from the body through your faeces. </p>
<p>You can find soluble fibre in whole foods such as fruits, vegetables, oats, barley, beans and lentils.</p>
<hr>
<p>
<em>
<strong>
Read more:
<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 is your body's natural guide to weight management – rather than cutting carbs out of your diet, eat them in their original fiber packaging instead</a>
</strong>
</em>
</p>
<hr>
<h2>Fibre supplements, such as psyllium</h2>
<p>There are also many fibre supplements and food-based products on the market that may help lower cholesterol. These include:</p>
<ul>
<li><p><strong>natural soluble fibres</strong>, such as inulin (for example, Benefiber) or psyllium (for example, Metamucil) or beta-glucan (for example, in ground oats)</p></li>
<li><p><strong>synthetic soluble fibres</strong>, such as polydextrose (for example, STA-LITE), wheat dextrin (also found in Benefiber) or methylcellulose (such as Citrucel)</p></li>
<li><p><strong>natural insoluble fibres</strong>, which bulk out your faeces, such as flax seeds.</p></li>
</ul>
<p>Most of these supplements come as fibres you add to food or dissolve in water or drinks. </p>
<p>Psyllium is the fibre supplement with the strongest evidence to support its use in improving cholesterol levels. It’s been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413815/">studied</a> in at least 24 high-quality randomised controlled trials.</p>
<p>These trials show consuming about 10g of psyllium a day (1 tablespoon), as part of a healthy diet, <a href="https://www.sciencedirect.com/science/article/pii/S0002916523070107#:%7E:text=Conclusions%3A,mild%2Dto%2Dmoderate%20hypercholesterolemia.">can significantly lower</a> total cholesterol levels by 4% and LDL cholesterol levels by 7%.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/545910/original/file-20230901-20-orbx53.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Person stirring in psyllium into glass of water, bowl of psyllium next to glass" src="https://images.theconversation.com/files/545910/original/file-20230901-20-orbx53.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/545910/original/file-20230901-20-orbx53.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/545910/original/file-20230901-20-orbx53.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/545910/original/file-20230901-20-orbx53.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/545910/original/file-20230901-20-orbx53.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/545910/original/file-20230901-20-orbx53.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/545910/original/file-20230901-20-orbx53.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 mix psyllium fibre into a drink or add it to your food.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-adds-spoon-psyllium-fiber-mix-2031428417">Shutterstock</a></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-are-you-eating-the-right-sorts-of-fibre-20089">Health Check: are you eating the right sorts of fibre?</a>
</strong>
</em>
</p>
<hr>
<h2>Probiotics</h2>
<p>Other cholesterol-lowering supplements, such as probiotics, are not based on fibre. Probiotics are thought to help lower cholesterol levels via a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3352670/">number of mechanisms</a>. These include helping to incorporate cholesterol into cells, and adjusting the microbiome of the gut to favour elimination of cholesterol via the faeces.</p>
<p>Using probiotics to reduce cholesterol is an upcoming area of interest and the <a href="https://www.sciencedirect.com/science/article/abs/pii/S089990071500461X">research</a> is promising. </p>
<p>In a <a href="https://pubmed.ncbi.nlm.nih.gov/29384846/">2018 study</a>, researchers pooled results from 32 studies and analysed them altogether in a type of study known as a meta-analysis. The people who took probiotics reduced their total cholesterol level by 13%.</p>
<p><a href="https://www.tandfonline.com/doi/full/10.3109/07853890.2015.1071872">Other</a> <a href="https://link.springer.com/article/10.1007/s11906-020-01080-y">systematic reviews</a> support these findings.</p>
<p>Most of these studies use probiotics containing <em>Lactobacillus acidophilus</em> and <em>Bifidobacterium lactis</em>, which come in capsules or powders and are consumed daily.</p>
<p>Ultimately, probiotics could be worth a try. However, the effects will likely vary according to the probiotic strains used, whether you take the probiotic each day as indicated, as well as your health status and your diet.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-should-healthy-people-take-probiotic-supplements-95861">Health Check: should healthy people take probiotic supplements?</a>
</strong>
</em>
</p>
<hr>
<h2>Red yeast rice</h2>
<p><a href="https://www.nccih.nih.gov/health/red-yeast-rice">Red yeast rice</a> is another non-fibre supplement that has gained attention for lowering cholesterol. It is often used in Asia and some European countries as a complementary therapy. It comes in capsule form and is thought to mimic the role of the cholesterol-lowering medications known as statins.</p>
<p>A <a href="https://www.frontiersin.org/articles/10.3389/fphar.2021.819482/full">2022 systematic review</a> analysed data from 15 randomised controlled trials. It found taking red yeast rice supplements (200-4,800mg a day) was more effective for lowering blood fats known as triglycerides but less effective at lowering total cholesterol compared with statins.</p>
<p>However, these trials don’t tell us if red yeast rice works and is safe in the long term. The authors also said only one study in the review was registered in a major <a href="https://www.clinicaltrials.gov">database</a> of clinical trials. So we don’t know if the evidence base was complete or biased to only publish studies with positive results.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/546589/original/file-20230906-23-a4o8yh.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Red yeast rice capsules" src="https://images.theconversation.com/files/546589/original/file-20230906-23-a4o8yh.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/546589/original/file-20230906-23-a4o8yh.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=274&fit=crop&dpr=1 600w, https://images.theconversation.com/files/546589/original/file-20230906-23-a4o8yh.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=274&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/546589/original/file-20230906-23-a4o8yh.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=274&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/546589/original/file-20230906-23-a4o8yh.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=344&fit=crop&dpr=1 754w, https://images.theconversation.com/files/546589/original/file-20230906-23-a4o8yh.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=344&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/546589/original/file-20230906-23-a4o8yh.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=344&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Red yeast rice is often used in Asia and some European countries to lower cholesterol.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/red-yeast-rice-supplement-capsules-on-1625852824">Shutterstock</a></span>
</figcaption>
</figure>
<h2>Diet and supplements may not be enough</h2>
<p>Always speak to your GP and dietitian about your plan to take supplements to lower your cholesterol.</p>
<p>But remember, dietary changes alone – with or without supplements – might not be enough to lower your cholesterol levels sufficiently. You still need to quit smoking, reduce stress, exercise regularly and get enough sleep. Genetics can also play a role.</p>
<p>Even then, depending on your cholesterol levels and other risk factors, you may still be recommended cholesterol-lowering medications, such as <a href="https://jamanetwork.com/journals/jama/fullarticle/2795522">statins</a>. Your GP will discuss your options at your six-month review.</p><img src="https://counter.theconversation.com/content/211748/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, Mater Misericordia and the Royal Australian College of General Practitioners. 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>If you try supplements, you still need to eat a healthy diet, exercise, reduce your stress, quit smoking and get enough sleep. Even then, they may still not be enough.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/2064022023-07-25T01:26:05Z2023-07-25T01:26:05ZHow burgers and chips for lunch can worsen your asthma that afternoon<figure><img src="https://images.theconversation.com/files/534504/original/file-20230628-15-3dpvk3.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C998%2C663&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/delicious-burger-chips-handmade-house-on-243618775">Shutterstock</a></span></figcaption></figure><p>Certain foods or dietary patterns are linked with better control of your asthma. Others may make it worse. Depending on what you’ve eaten, you can see the effects in hours.</p>
<p>Food can affect how well your lungs function, how often you have asthma attacks and how well your puffer works.</p>
<p>Here’s what we know about which foods to eat more of, and which are best to eat in smaller amounts, if you have asthma.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/what-causes-asthma-what-we-know-dont-know-and-suspect-96409">What causes asthma? What we know, don't know and suspect</a>
</strong>
</em>
</p>
<hr>
<h2>Asthma and inflammation</h2>
<p>About <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/asthma/latest-release">one in ten</a> Australians (2.7 million people) have asthma. This makes it the <a href="https://www.health.gov.au/topics/chronic-conditions/chronic-conditions-in-australia">fourth</a> most common chronic (persisting) disease in Australia. </p>
<p><a href="https://www.nationalasthma.org.au/understanding-asthma/what-is-asthma">Asthma</a> is an inflammatory disease. When someone is exposed to certain triggers (such as respiratory viruses, dust or exercise), the airways leading to the lungs become inflamed and narrow. This makes it difficult for them to breathe during what’s commonly known as an asthma attack (or exacerbation).</p>
<p>Researchers are becoming increasingly aware of how someone’s diet can affect their asthma symptoms, including how often they have one of these attacks.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/passive-smoking-synthetic-bedding-and-gas-heating-in-homes-show-the-strongest-links-to-asthma-176677">Passive smoking, synthetic bedding and gas heating in homes show the strongest links to asthma</a>
</strong>
</em>
</p>
<hr>
<h2>Thumbs up for fruit and veg</h2>
<p>The Mediterranean diet – a diet high in fruit, vegetables and oily fish – is linked with <a href="https://pubmed.ncbi.nlm.nih.gov/30997754/">less wheezing</a> in children, whether or not they have been diagnosed with asthma. Some, but not all, of the studies found this was regardless of the children’s body-mass index (BMI) or socioeconomic status.</p>
<p>Eating a diet high in fruits and vegetables is also important for adults with asthma. Two studies found adults who were instructed to eat a diet with few fruits and vegetables (two or fewer servings of vegetables, and one serving of fruit daily) had <a href="https://pubmed.ncbi.nlm.nih.gov/18324527/">worse lung function</a> and were twice as likely to have an <a href="https://pubmed.ncbi.nlm.nih.gov/22854412/">asthma attack</a> compared to those eating a diet high in fruits and vegetables. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/534507/original/file-20230628-23-j6h1ll.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Mediterranean diet pyramid" src="https://images.theconversation.com/files/534507/original/file-20230628-23-j6h1ll.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/534507/original/file-20230628-23-j6h1ll.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=514&fit=crop&dpr=1 600w, https://images.theconversation.com/files/534507/original/file-20230628-23-j6h1ll.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=514&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/534507/original/file-20230628-23-j6h1ll.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=514&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/534507/original/file-20230628-23-j6h1ll.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=646&fit=crop&dpr=1 754w, https://images.theconversation.com/files/534507/original/file-20230628-23-j6h1ll.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=646&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/534507/original/file-20230628-23-j6h1ll.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=646&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The Mediterranean diet is rich in antioxidants and soluble fibre.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/illustration-mediterranean-diet-meal-shape-food-1640001031">Shutterstock</a></span>
</figcaption>
</figure>
<p>Why might the Mediterranean diet, or one rich in fruit and vegetables, help? Researchers think it’s because people are eating more antioxidants and soluble fibre, both of which have anti-inflammatory action: </p>
<ul>
<li><p><strong>antioxidants</strong> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5075620/">neutralise free radicals</a>. These are the damaging molecules produced as a result of inflammation, which can ultimately cause more inflammation</p></li>
<li><p><strong>soluble fibre</strong> is fermented by gut bacteria to produce short-chain fatty acids such as acetate, propionate and butyrate, which <a href="https://www.sciencedirect.com/science/article/pii/S2352385919300246">reduce inflammation</a>. </p></li>
</ul>
<p>The Mediterranean diet is also high in omega-3 fatty acids (from oily fish, such as salmon, mackerel and tuna). However a <a href="https://www.mdpi.com/2072-6643/12/12/3839">review</a> looked at five studies that investigated omega-3 intake (through the diet or with a supplement) in adults with asthma. None of the studies showed any benefit associated with omega-3 for asthma.</p>
<p>Of course there is no harm in eating foods high in omega-3 – such as oily fish, flaxseeds, chia seeds and walnuts. This has numerous other benefits, such as <a href="https://pubmed.ncbi.nlm.nih.gov/29350557/">lowering the risk</a> of heart disease. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/food-as-medicine-how-what-you-eat-shapes-the-health-of-your-lungs-73450">Food as medicine: how what you eat shapes the health of your lungs</a>
</strong>
</em>
</p>
<hr>
<h2>Thumbs down for saturated fat, sugar, red meat</h2>
<p>Saturated fats are found in highly processed foods such as biscuits, sausages, pastries and chocolate, and in fast foods. </p>
<p>Diets high in saturated fats, plus sugar and red meat, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4888803/">can worsen</a> someone’s asthma symptoms.</p>
<p>For instance, one study found a diet high in these foods increased the number of <a href="https://pubmed.ncbi.nlm.nih.gov/18829673/">asthma attacks</a> in adults.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/534506/original/file-20230628-21-6oihd1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Woman clutching throat reaching for asthma inhaler on table" src="https://images.theconversation.com/files/534506/original/file-20230628-21-6oihd1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/534506/original/file-20230628-21-6oihd1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=380&fit=crop&dpr=1 600w, https://images.theconversation.com/files/534506/original/file-20230628-21-6oihd1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=380&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/534506/original/file-20230628-21-6oihd1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=380&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/534506/original/file-20230628-21-6oihd1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=477&fit=crop&dpr=1 754w, https://images.theconversation.com/files/534506/original/file-20230628-21-6oihd1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=477&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/534506/original/file-20230628-21-6oihd1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=477&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">What you eat can affect how well your asthma puffer works.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/asthma-attack-young-woman-reaching-inhaler-1554476906">Shutterstock</a></span>
</figcaption>
</figure>
<p>Foods high in saturated fat can have an impact in as little as <a href="https://pubmed.ncbi.nlm.nih.gov/21377715/">four hours</a>. </p>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/21377715/">One study</a> looked at what happened when adults with asthma ate a meal high in saturated fat (consisting of two hash browns, a sausage and egg muffin, and a sausage muffin) compared with a meal with similar calories but low in saturated fat.</p>
<p>People who ate the meal high in saturated fat had reduced lung function within four hours. Within four hours, their puffer was also less effective.</p>
<p>These worsening symptoms were likely driven by an increase in inflammation. Around the four hour mark, researchers found an increase in the number of the immune cells known as neutrophils, which play a role in inflammation.</p>
<p>It’s still OK to eat a sneaky burger or some hot chips occasionally if you have asthma. But knowing that eating too many of these foods can affect your asthma can help you make choices that might improve your quality of life.</p>
<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>What about dairy?</h2>
<p>One food type you don’t have to avoid, though, is <a href="https://theconversation.com/mondays-medical-myth-dairy-products-exacerbate-asthma-10641">dairy products</a>. </p>
<p>Although many people with asthma report eating dairy worsens their asthma, evidence shows this to be untrue. In fact, one study in adults with asthma found drinking milk was linked to <a href="https://pubmed.ncbi.nlm.nih.gov/33918391/">better</a> lung function.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/mondays-medical-myth-dairy-products-exacerbate-asthma-10641">Monday's medical myth: dairy products exacerbate asthma</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/206402/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Evan Williams receives funding from The John Hunter Charitable Trust Foundation. </span></em></p>Some foods can affect how well your lungs function, how often you have asthma attacks and how well your puffer works. Here’s what to eat if you have asthma.Evan Williams, Postdoctoral Researcher in Respiratory and Nutritional Biochemistry, University of NewcastleLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1997122023-02-14T21:54:25Z2023-02-14T21:54:25ZUK laundry releases microfibres weighing the equivalent of 1,500 buses each year<p>Around 35% of the microplastics contaminating the world’s oceans <a href="https://portals.iucn.org/library/sites/library/files/documents/2017-002-En.pdf">come from washing our clothes</a>. When washed, synthetic clothing sheds tiny plastic fragments (typically shorter than 5mm). Known as microfibres, these fragments are a common type of microplastic, and when released pose a serious threat to marine environments.</p>
<p>Due to their small size, microfibres can be easily ingested by marine animals. <a href="https://www.sciencedirect.com/science/article/pii/S0269749119340552?via%3Dihub">Research</a> finds that exposure to microfibres can inhibit growth, disrupt reproduction and feeding and even cause death.</p>
<p>But the scale of microfibre pollution from laundry is poorly understood. The factors affecting microfibre discharge are complex, while these plastic fragments alone are not the only issue. Natural microfibres, such as cotton, are released from fabrics during washing and may also carry an environmental threat.</p>
<p>Yet current methods for measuring microfibre release are unreliable. A large number of studies have estimated the scale of microfibre pollution from domestic laundry. But they have obtained <a href="https://link.springer.com/article/10.1007/s11356-023-25246-8/tables/1">widely varying results</a>. Each person in the UK, for example, could release anywhere between 5g and 2.14kg of microfibres each year. </p>
<p>But these estimates do not reflect the <a href="https://www.tandfonline.com/doi/full/10.1080/00405000.2021.1892305">complex mechanisms</a> through which microfibres are released during washing. Clothes are made from thousands of different fabrics and we all use different washing machines and cycles to clean them. </p>
<p>Using a gyrowash (a device that replicates a domestic washing machine in lab conditions), we <a href="https://link.springer.com/article/10.1007/s11356-023-25246-8?">studied</a> the effect of different washing conditions on the microfibre footprint of domestic laundry. We found that UK laundry generates up to 17,847 tonnes of microfibres each year (243g per person), weighing the equivalent of around 1,500 double-decker buses.</p>
<h2>Washing conditions</h2>
<p>We found that increasing the wash temperature from 40°C to 90°C reduced microfibre release by 26%. At this temperature, the fibres become less brittle making them less susceptible to fragmentation.</p>
<p>Wash duration, however, had only a minor effect on microfibre release. We found no significant difference in the amount of microfibres released after 30 minutes and after an hour. This is likely to be because the majority of microfibres are held loosely in the fabric and are released early on in the washing cycle.</p>
<p>What had the most significant impact on microfibre release were the ratio of water to the size of the wash load and the level of abrasion between fabrics in the washing machine drum. </p>
<p>As clothes are tossed around in the wash, they collide with each other and the sides of the drum. Called agitation, this dislodges and breaks fibres in the fabric, allowing particles to wash out of the fabric structure. When we reduced the level of agitation but kept all other wash conditions constant, the release of microfibres reduced by over 50%. </p>
<p>We also found that more microfibres were released when the water to wash load ratio was higher. More than twice as much material was released from the fabric when this ratio was doubled. Increasing the flow of liquid through the fabric likely causes more fragments to be washed out of the fabric. </p>
<p>But these results were based on just one type of fabric – a polyester fleece. So we then tested more than 40 other types of fabric, all of which are used for clothing. These included <a href="https://www.britannica.com/topic/cotton-fibre-and-plant">cotton</a>, <a href="https://en.wikipedia.org/wiki/Rayon">viscose</a>, <a href="https://sewport.com/fabrics-directory/polyester-fabric#:%7E:text=Polyester%20is%20a%20synthetic%20fabric,within%20the%20ester%20functional%20group.">polyester</a> and several different blends. </p>
<figure class="align-center ">
<img alt="Clothes inside a washing machine." src="https://images.theconversation.com/files/510074/original/file-20230214-26-rxr3cq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/510074/original/file-20230214-26-rxr3cq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/510074/original/file-20230214-26-rxr3cq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/510074/original/file-20230214-26-rxr3cq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/510074/original/file-20230214-26-rxr3cq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/510074/original/file-20230214-26-rxr3cq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/510074/original/file-20230214-26-rxr3cq.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">More microfibres were released when the water to wash load ratio was higher.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/clothes-washing-machine-close-542200810">Africa Studio/Shutterstock</a></span>
</figcaption>
</figure>
<h2>Variation between fabrics</h2>
<p>We found an exceptionally large variation in microfibre release between different fabrics. A polyester elastane mix, for example, released just 96g per person annually. By contrast, 100% polyester released 1.29 kg per person every year. </p>
<p>How tightly the yarn is twisted and whether the fabric was knitted or woven both influence microfibre release. More compact yarns and fabrics, such as those used in woven shirts, help to retain fibres and reduce the likelihood that microfibres are released. But yarns and fabrics that have an open structure, such as knitwear, are more likely to allow the release of microfibres from the fabric. </p>
<p>Fabrics that include a blend of natural fibres and other synthetic non-plastic fibres, such as viscose, also released significant amounts of microfibres when washed. This is important, as cotton fibres may take years (and often hundreds of years) to biodegrade. In 1990, intact cotton garments were <a href="https://www.tandfonline.com/doi/abs/10.1179/019713601806113076">retrieved</a> from a shipwreck near the coast of North Carolina after 133 years underwater. </p>
<p>Natural microfibres may carry a threat to marine organisms, particularly in early life stages. <a href="https://en.wikipedia.org/wiki/Mysida#:%7E:text=Mysids%20have%20a%20cosmopolitan%20distribution,percent%20are%20found%20in%20freshwater.">Mysid shrimps</a> and <a href="https://en.wikipedia.org/wiki/Inland_silverside">inland silverside</a> fish are indicator species that live in river estuaries. Declining water quality can be monitored through changes in the behaviour or population of such species. <a href="https://www.frontiersin.org/articles/10.3389/fmars.2022.991650/full?&utm_source=Email_to_authors_&utm_medium=Email&utm_content=T1_11.5e1_author&utm_campaign=Email_publication&field=&journalName=Frontiers_in_Marine_Science&id=991650">Research</a> reveals that exposure to cotton microfibres in salty water can cause reduced growth in mysid shrimps and can change the swimming behaviour of inland silversides.</p>
<h2>Doing your laundry responsibly</h2>
<p>Any quantity of microfibres can be harmful to living organisms and their release should be avoided. But this is just one of a number of problems facing the fashion industry. For example, around <a href="https://wrap.org.uk/sites/default/files/2021-03/WRAP-textiles-market-situation-report-2019.pdf">350,000 tonnes</a> of clothing ends up in landfill in the UK each year. This is the same as every person in the UK throwing more than 5kg of their clothing in the bin.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/fast-fashion-why-your-online-returns-may-end-up-in-landfill-and-what-can-be-done-about-it-188090">Fast fashion: why your online returns may end up in landfill – and what can be done about it</a>
</strong>
</em>
</p>
<hr>
<p>But reducing the environmental impact of your laundry is relatively simple. </p>
<p>Only washing your clothes when they are dirty is a great start. But when you do your laundry, load your washing machine to two-thirds of the drum’s capacity. This will clean your clothes but will reduce the release of microfibres. However, you should bear in mind that overfilling a washing machine can reduce the quality of the wash.</p>
<p>We now have a reliable method for measuring microfibre pollution and a better understanding of the types of fabric and washing conditions that determine laundry’s environmental impact. But the problem is not purely about synthetic fibres. Some natural microfibres are equally hazardous and their impact is becoming increasingly apparent.</p><img src="https://counter.theconversation.com/content/199712/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The University of Leeds receives funding from the Microfibre Consortium to support the research project on microfibres </span></em></p><p class="fine-print"><em><span>The University of Leeds receives funding from the Microfibre Consortium to support the research project on microfibres</span></em></p><p class="fine-print"><em><span>The University of Leeds receives funding from the Microfibre Consortium to support the research project on microfibres. Mark Taylor has also received funding from UKRI as part of a research consortium with University West of England to investigate microfibres in the home (<a href="https://homesunderthemicroscope.co.uk/">https://homesunderthemicroscope.co.uk/</a>).
He is affiliated with the Microfibre Consortium as a member of the organisations technical committee.</span></em></p>By washing our clothes, we release microfibres into the environment which are then ingested by marine animals.Mark Sumner, Lecturer in Sustainablity, Fashion and Retail, University of LeedsAlice Hazlehurst, Postgraduate Researcher, University of LeedsMark Taylor, Research Officer, University of LeedsLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1932382022-10-27T15:28:22Z2022-10-27T15:28:22ZFermented foods and fibre may lower stress levels – new study<figure><img src="https://images.theconversation.com/files/492088/original/file-20221027-18659-el39uc.jpg?ixlib=rb-1.1.0&rect=0%2C9%2C6016%2C3998&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Foods such as kimchi are great to include in a psychobiotic diet.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/kimchi-cabbage-cucumber-radish-jar-korean-1543686266">Nungning20/ Shutterstock</a></span></figcaption></figure><p>When it comes to dealing with stress, we’re often told the best things we can do are exercise, make time for our favourite activities or try meditation or mindfulness. </p>
<p>But the kinds of foods we eat may also be an effective way of dealing with stress, according to research published by me and other members of <a href="https://www.ucc.ie/en/apc/">APC Microbiome Ireland</a>. Our latest study has shown that eating more fermented foods and fibre daily for just four weeks had a significant effect on lowering <a href="https://www.nature.com/articles/s41380-022-01817-y">perceived stress levels</a>. </p>
<p><a href="https://www.nature.com/articles/s41579-019-0256-8">Over the last decade</a>, a growing body of research has shown that diet can have a <a href="https://www.nature.com/articles/s41380-021-01360-2">huge impact on our mental health</a>. In fact, a healthy diet may even reduce the risk of <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0791-y">many common mental illnesses</a>. </p>
<p>The mechanisms underpinning the effect of diet on mental health are still not fully understood. But one explanation for this link could be via the relationship between our brain and our microbiome (the trillions of bacteria that live in our gut). Known as the <a href="https://psychscenehub.com/psychinsights/the-simplified-guide-to-the-gut-brain-axis/">gut-brain axis</a>, this allows the brain and gut to be in constant communication with each other, allowing essential body functions such as digestion and appetite to happen. It also means that the emotional and cognitive centres in our brain are closely connected to our gut.</p>
<p>While previous research has shown stress and behaviour are also <a href="https://www.sciencedirect.com/science/article/pii/S2352289516300509">linked to our microbiome</a>, it has been unclear until now whether changing diet (and therefore our microbiome) could have a distinct effect on stress levels. </p>
<p>This is what our study set out to do. To test this, we recruited 45 healthy people with relatively low-fibre diets, aged 18–59 years. More than half were women. The participants were split into two groups and randomly assigned a diet to follow for the four-week duration of the study.</p>
<figure class="align-center ">
<img alt="A bowl of slices apples." src="https://images.theconversation.com/files/492089/original/file-20221027-20344-nhnm85.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/492089/original/file-20221027-20344-nhnm85.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/492089/original/file-20221027-20344-nhnm85.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/492089/original/file-20221027-20344-nhnm85.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/492089/original/file-20221027-20344-nhnm85.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/492089/original/file-20221027-20344-nhnm85.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/492089/original/file-20221027-20344-nhnm85.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">Participants were told to eat foods high in prebiotic fibres, such as apples.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/fresh-red-apples-sliced-bowl-on-1366904762">gowithstock/ Shutterstock</a></span>
</figcaption>
</figure>
<p>Around half were assigned a diet designed by nutritionist Dr Kirsten Berding, which would increase the amount of prebiotic and fermented foods they ate. This is known as a <a href="https://www.ucc.ie/en/research/spotlight/thepsychobioticrevolution/">“psychobiotic” diet</a>, as it included foods that have been linked to better mental health.</p>
<p>This group was given a one-on-one education session with a dietitian at both the start and halfway through the study. They were told they should aim to include 6-8 servings daily of fruits and vegetables high in prebiotic fibres (such as onions, leeks, cabbage, apples, bananas and oats), 5-8 servings of grains per day, and 3-4 servings of legumes per week. They were also told to include 2-3 servings of fermented foods daily (such as sauerkraut, kefir and kombucha). Participants on the control diet only received general dietary advice, based on the healthy eating <a href="https://www.hse.ie/eng/about/who/healthwellbeing/our-priority-programmes/heal/healthy-eating-guidelines/">food pyramid</a>. </p>
<h2>Less stress</h2>
<p>Intriguingly, those who followed the psychobiotic diet reported they felt less stressed compared with those who followed the control diet. There was also a direct correlation between how strictly participants followed the diet and their perceived stress levels, with those who ate more psychobiotic foods during the four-week period reporting the greatest reduction in perceived stress levels.</p>
<p>Interestingly, the quality of sleep improved in both groups – though those on the psychobiotic diet reported greater improvements in sleep. Other studies have also shown that gut microbes are implicated in <a href="https://www.sciencedirect.com/science/article/pii/S1471491421001854">sleep processes</a>, which may explain this link. </p>
<p>The psychobiotic diet only caused subtle changes in the composition and function of microbes in the gut. However, we observed significant changes in the level of certain key chemicals produced by these gut microbes. Some of these chemicals have been <a href="https://www.sciencedirect.com/science/article/pii/S0149763421001032">linked to mental health</a>, which could potentially explain why participants on the diet reported feeling less stressed.</p>
<p>Our results suggest specific diets can be used to reduce perceived stress levels. This kind of diet may also help to <a href="https://academic.oup.com/advances/article/12/4/1239/6164875?login=true">protect mental health</a> in the long run as it targets the microbes in the gut.</p>
<p>While these results are encouraging, our study is not without its limitations. First, the sample size is small due to the pandemic restricting recruitment. Second, the short duration of the study could have limited the changes we observed – and it’s unclear how long they would last. As such, long-term studies will be needed. </p>
<p>Third, while participants recorded their daily diet, this form of measurement can be susceptible to error and bias, especially when estimating food intake. And while we did our best to ensure participants didn’t know what group they’d been assigned to, they may have been able to guess based on the nutrition advice they were given. This may have affected the responses they gave at the end of the study. Finally, our study only looked at people who were already healthy. This means we don’t understand what effect this diet could have on someone who may not be as healthy. </p>
<p>Still, our study offers exciting evidence that an effective way to reduce stress may be through diet. It will be interesting to know if these results can also be replicated in people suffering from stress-related disorders, such as anxiety and depression. It also adds further evidence to this <a href="https://www.sciencedirect.com/science/article/pii/S0924977X19317237">field of research</a>, showing evidence of an association between diet, our microbiome and our mental health. </p>
<p>So the next time you’re feeling particularly stressed, perhaps you’ll want to think more carefully about what you plan on eating for lunch or dinner. Including more fibre and fermented foods for a few weeks may just help you feel a little less stressed out.</p><img src="https://counter.theconversation.com/content/193238/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>John Cryan receives funding from Science Foundation Ireland (SFI), Irish Research Council and the Health Research Board. He also receives funding from the Saks-Kavanaugh Foundation. The author receives research funding, has been a consultant and been on the Speakers Bureau of food and pharmaceutical companies in the microbiome, food and neuroscience arena.
</span></em></p>Our latest study adds further evidence that diet and mental health are closely connected.John Cryan, Vice President for Research & Innovation, University College CorkLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1887442022-08-26T01:29:15Z2022-08-26T01:29:15ZDoes TikTok’s chia-lemon ‘internal shower’ really beat constipation? Here’s what science says<figure><img src="https://images.theconversation.com/files/480764/original/file-20220824-20-zngofk.jpg?ixlib=rb-1.1.0&rect=147%2C542%2C6209%2C3834&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/composition-glass-water-chia-seeds-lemon-1379681924">Shutterstock</a></span></figcaption></figure><p>Heard about the chia seed-lemon juice “internal shower” drink? It’s going viral on TikTok and is being hailed as a digestion booster, constipation and bloating buster (particularly after travelling), detox drink and hangover cure. </p>
<p>Advocates recommend you mix two tablespoons of chia seeds in a cup of water, add lemon juice, wait till the seeds start to absorb the water and form a gel, drink it on an empty stomach, and wait.</p>
<p><iframe id="tc-infographic-730" class="tc-infographic" height="400px" src="https://cdn.theconversation.com/infographics/730/0814a4ed8c2b8e3d7a498fbb676f71593f896f1d/site/index.html" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>Chia seeds are edible seeds from a <a href="https://pubmed.ncbi.nlm.nih.gov/35208997/">flowering plant</a> of the mint and sage families. These tiny seeds (1,000 seeds weigh about 1.3 grams), pack a nutritional punch and are <a href="https://pubmed.ncbi.nlm.nih.gov/31086922/">rich in dietary fibre, polyunsaturated fat and protein</a>. They also contain B vitamins (thiamin, riboflavin, niacin and folic acid) and minerals (calcium, potassium, magnesium and phosphorus). </p>
<p>Before you rush out to get some chia seeds, be wary. The <a href="https://www.poison.org/articles/internal-shower">National Capital Poison Center</a> in the United States urged caution, following the case of a person needing surgery after the gelled chia seeds became stuck and blocked his oesophagus. </p>
<h2>Let’s break down the ‘internal shower’ claims</h2>
<p><strong>1) Digestion booster</strong></p>
<p>Chia seeds can’t “boost” digestion. For most people, digestive processes run automatically, just like breathing and blood flow. So you can’t speed up the enzymatic processes that help with food breakdown, digestion and absorption.</p>
<p>This claim is likely to be mixed up with constipation, which affects the time in takes for undigested food to travel though your gut and to your large bowel where it gets processed and turned into poo.</p>
<p>There are medical conditions, such as <a href="https://www.cysticfibrosis.org.au/">cystic fibrosis</a>, where digestive enzymes can’t mix with food adequately and medicinal enzymes have to be taken orally. But this is very rare.</p>
<p><strong>2) Constipation buster</strong></p>
<p>This claim is likely to be true, due to the very high fibre content of chia seeds. </p>
<p>Dietary fibre content of chia seeds varies from 23% to 41%, depending on the variety. Of that, 85% is insoluble fibre that adds bulk to stools and helps increase the transit time of bowel motions through your intestines. The other 15% is soluble fibre, meaning that it dissolves in water and remains intact until it gets to the large bowel. There, it is fermented by the gut microbes. This produces water that helps to keep your bowel motions soft. </p>
<p>Two tablespoons of chia seeds weigh about 20-25 grams, providing 9-10 grams of fibre, which is a lot compared to adult daily intake targets of <a href="https://www.nrv.gov.au/nutrients/dietary-fibre">25-30 grams per day</a>. </p>
<p>But chia seeds aren’t the only fibre-rich food. </p>
<p>So what are the signs you need to have a closer look at your diet?</p>
<p>If, over the past few months, you have experienced symptoms including lumpy or hard stools, incomplete emptying of bowels, straining to pass a bowel motion or having fewer than three bowel motions per week, you could be constipated.</p>
<hr>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/141158/original/image-20161011-3909-p1j1kp.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/141158/original/image-20161011-3909-p1j1kp.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=764&fit=crop&dpr=1 600w, https://images.theconversation.com/files/141158/original/image-20161011-3909-p1j1kp.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=764&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/141158/original/image-20161011-3909-p1j1kp.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=764&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/141158/original/image-20161011-3909-p1j1kp.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=960&fit=crop&dpr=1 754w, https://images.theconversation.com/files/141158/original/image-20161011-3909-p1j1kp.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=960&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/141158/original/image-20161011-3909-p1j1kp.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=960&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">The Conversation</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<hr>
<p>To address this, drink enough water so your urine is the colour of straw. </p>
<p>Next, boost you intake of foods high in fibre such as psyllium, wholemeal and wholegrain breads and legumes (chickpeas, lentils, four-bean mix, red kidney beans, baked beans), as well as foods such as prunes, kiwi fruit, leek, onion, beetroot, Brussel sprouts, peaches, watermelon and honeydew melon, and of course chia seeds. These high-fibre foods have all been shown to manage constipation.</p>
<p>If your bowel habits don’t improve, or have changed, see your GP.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/had-constipation-here-are-4-things-to-help-treat-it-123364">Had constipation? Here are 4 things to help treat it</a>
</strong>
</em>
</p>
<hr>
<p><strong>3) Beating bloat</strong></p>
<p>Bloating is the feeling your abdomen is under pressure due to gas retention. </p>
<p>Recent <a href="https://pubmed.ncbi.nlm.nih.gov/27746233/">research has shown</a> both people with a healthy gut and people with irritable bowel syndrome (IBS) had similar responses following consumption of a test meal, in terms of gas production and retention of contents in the stomach. </p>
<p>However, the researchers found people with IBS reported more symptoms related to the gas production, meaning their guts were more hypersensitive. </p>
<p>This suggests people with IBS may find gas production due to a chia “internal shower” uncomfortable or even painful. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-what-causes-bloating-and-gassiness-107605">Health Check: what causes bloating and gassiness?</a>
</strong>
</em>
</p>
<hr>
<p><strong>4) Hangover cure</strong></p>
<p>There is no evidence chia or lemon juice, vitamins or other remedies can cure a hangover. </p>
<p>Chia seeds contain thiamin and <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/vitamin-b#thiamin-b1">alcohol reduces thiamin absorption</a> from the gut. However, a hangover occurs after you have had too much alcohol and so thiamin from chia seeds arrives too late to be used during alcohol digestion. </p>
<p>The best “cure” for a hangover is prevention.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/science-or-snake-oil-do-hangover-cures-actually-work-101033">Science or Snake Oil: do hangover cures actually work?</a>
</strong>
</em>
</p>
<hr>
<h2>A final word</h2>
<p>Chia seeds are high in fibre. You can use them in recipes that taste better than the “internal shower” drink, such as <a href="https://nomoneynotime.com.au/healthy-easy-recipes/easy-chia-pudding-with-banana-almonds">chia banana pudding</a> or a <a href="https://nomoneynotime.com.au/healthy-easy-recipes/emmas-blunana-smoothie">berry chia smoothie</a> and that don’t pose a choking risk.</p>
<p>Just drink your water separately. There’s no special benefit in combining the two.</p><img src="https://counter.theconversation.com/content/188744/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Clare Collins is a Laureate Professor in Nutrition and Dietetics at the University of Newcastle, NSW and a Hunter Medical Research Institute (HMRI) affiliated researcher. She is a National Health and Medical Research Council (NHMRC) Leadership Fellow and has received research grants from NHMRC, ARC, MRFF, HMRI, Diabetes Australia, Heart Foundation, Bill and Melinda Gates Foundation, nib foundation, Rijk Zwaan Australia, WA Dept. Health, Meat and Livestock Australia, and Greater Charitable Foundation. She has consulted to SHINE Australia, Novo Nordisk, Quality Bakers, the Sax Institute, Dietitians Australia and the ABC. She was a team member conducting systematic reviews to inform the 2013 Australian Dietary Guidelines update and the Heart Foundation evidence reviews on meat and dietary patterns.</span></em></p>The ‘internal shower’ drink is being hailed as everything from a digestion booster, to a treatment for constipation and bloating, to a detox drink and hangover cure.Clare Collins, Laureate Professor in Nutrition and Dietetics, University of NewcastleLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1787832022-04-13T20:33:36Z2022-04-13T20:33:36ZCurious Kids: how is fabric made?<figure><img src="https://images.theconversation.com/files/456533/original/file-20220406-22-i84cbj.jpg?ixlib=rb-1.1.0&rect=0%2C6%2C4056%2C2817&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/craftsman-using-old-spinning-wheel-turn-1479103070">Shuttershock</a></span></figcaption></figure><blockquote>
<p><strong>How is fabric made? – Saskia, age 5, Sydney</strong></p>
</blockquote>
<p><a href="https://theconversation.com/au/topics/curious-kids-36782"><img src="https://images.theconversation.com/files/291898/original/file-20190911-190031-enlxbk.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=90&fit=crop&dpr=1" width="100%"></a></p>
<p>Hi Saskia, that’s a great question! </p>
<p>From clothes to curtains, towels and sheets, fabrics are everywhere in our daily lives. You might also hear people call them “textiles”. </p>
<p>People have been making fabric, or textiles, for a very long time. In fact, they’ve been doing it for almost 35,000 years!</p>
<p>Let’s first think about what a fabric is. The dictionary says fabric is a cloth made by knitting or weaving together <em>fibres</em>. </p>
<h2>What is a fibre?</h2>
<p>A fibre is like a strand of hair. It’s very long and thin.</p>
<p>Fibres can come from nature. Some common natural fibres are cotton, silk and wool. </p>
<figure class="align-center ">
<img alt="A branch of cotton laid across a wooden table." src="https://images.theconversation.com/files/456529/original/file-20220406-20-chr9z5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/456529/original/file-20220406-20-chr9z5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/456529/original/file-20220406-20-chr9z5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/456529/original/file-20220406-20-chr9z5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/456529/original/file-20220406-20-chr9z5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/456529/original/file-20220406-20-chr9z5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/456529/original/file-20220406-20-chr9z5.jpg?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">Raw cotton as it is found on the branch.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/cotton-plant-buds-over-wooden-background-290823218">Shutterstock</a></span>
</figcaption>
</figure>
<p>Humans have also found ways to make fibres ourselves in the past 150 years. We can use technology to turn oil into fibres. We can even make special fibres to make your raincoat waterproof, or make a soldier’s vest bullet-proof. </p>
<p>But how can these thin, hair-like fibres be made into something we can wear?</p>
<h2>From fibre to yarn</h2>
<p>First, we need to put the fibres together to make long strings of yarn. This can be tricky because many fibres are quite short, especially natural ones. </p>
<p>A cotton fibre is usually only around 3cm long. That’s shorter than a paper clip. Wool is usually cut from a sheep when it is 7.5cm long – about the length of a crayon. </p>
<p>We twist these shorter fibres together to make a longer yarn. The twisting makes the fibres rub together and grip to each other. This is called <em>yarn spinning</em>. </p>
<h2>Yarn spinning</h2>
<p>The first step of yarn spinning involves taking bundle of fibres, lining them up, them combing them like you comb your hair … or how you might comb a long beard! In fact, when we’ve combed them into a sheet, we call it a “beard”.</p>
<figure class="align-center ">
<img alt="Hand holding raw wool spinning it into yarn." src="https://images.theconversation.com/files/456524/original/file-20220406-22-19224l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/456524/original/file-20220406-22-19224l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/456524/original/file-20220406-22-19224l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/456524/original/file-20220406-22-19224l.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/456524/original/file-20220406-22-19224l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/456524/original/file-20220406-22-19224l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/456524/original/file-20220406-22-19224l.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">Before we can make wool into fabric, it needs to be spun into yarn.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/close-hands-woman-demonstrating-traditional-wool-150051644">Shutterstock</a></span>
</figcaption>
</figure>
<p>Next, the sheet is stretched into a long tube. As it stretches, it becomes thinner and thinner. Then we twist it to form a yarn. This delicate sheet of fibres may have been metres wide to begin with, but we twist it into a thin thread. </p>
<p>There are all types of yarn threads. They can be thin, thick, hard, soft, stretchy, or even ones you can’t cut! It all depends on the starting fibre and the machine settings. </p>
<h2>Turning yarn into fabric</h2>
<p>Once we have our yarn, we’re ready to make fabric. There are many ways do this, such as weaving, knitting or felting. </p>
<p><em>Weaving</em> crosses the yarns over and under in a chessboard pattern. <em>Knitting</em> makes loops that pass through each other. </p>
<figure class="align-center ">
<img alt="A woman weaves pink and yellow yarns into frabric using wooden poles." src="https://images.theconversation.com/files/456530/original/file-20220406-18-icfn7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/456530/original/file-20220406-18-icfn7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/456530/original/file-20220406-18-icfn7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/456530/original/file-20220406-18-icfn7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/456530/original/file-20220406-18-icfn7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/456530/original/file-20220406-18-icfn7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/456530/original/file-20220406-18-icfn7.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">Weaving yarn into fabric can be done by hand, or by machine.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-typical-guatemalan-dress-weaving-colored-1897092847">Shutterstock</a></span>
</figcaption>
</figure>
<p><em>Felting</em> is when we get wool fibres wet and soapy. We rub the fibres together until they are all tangled up. Then we press the fibres into a flat sheet called felt.</p>
<p>Weaving, knitting and felting can be very slow if you do them by hand! These days we often use machines to speed things up.</p>
<h2>How fabric is made</h2>
<p>So we start with the fibre. Then we spin it into long strings of yarn. Next we weave, knit or felt the yarn into fabric. And that, Saskia, is how we make fabric. </p>
<hr>
<p><em>Hello, curious kids! Have you got a question you’d like an expert to answer? Ask an adult to send your question to curiouskids@theconversation.edu.au</em></p><img src="https://counter.theconversation.com/content/178783/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ken Aldren S. Usman receives funding from Deakin University's Post-graduate Research (DUPR) Scholarship Grant.</span></em></p><p class="fine-print"><em><span>Dylan Hegh receives funding from Australian National Fabrication Facility, IMCRC and Sustainability Victoria</span></em></p>From fibre to fabric. The process of making textiles has been important to humans for almost 35,000 years.Ken Aldren S. Usman, PhD Candidate, Deakin UniversityDylan Hegh, Manager - Circular Economy Initatives and ANFF-Deakin Hub, Deakin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1763682022-02-17T05:37:18Z2022-02-17T05:37:18ZDo low-carb diets help you lose weight? Here’s what the science says<figure><img src="https://images.theconversation.com/files/446925/original/file-20220217-17-qolnhs.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/image-photo/young-woman-on-gluten-free-diet-486745783">Shutterstock</a></span></figcaption></figure><p>In the 1970s, low-carb diets were all the rage. The <a href="https://en.wikipedia.org/wiki/Atkins_diet">Dr Atkin’s Diet Revolution book</a> claimed carbohydrate restriction was a “<a href="https://www.amazon.com/Dr-Atkins-Diet-Revolution-Calorie/dp/B0006C4BC0">high calorie way to stay thin forever</a>”.</p>
<p>Carbohydrates are found in breads, cereals and other grains, fruit, vegetables and milk. They’re also in <a href="https://www.fao.org/publications/card/en/c/CA5644EN/">ultra-processed</a> fast foods, cakes, chips and soft drinks. </p>
<p>These days, low-carb diets are promoted as a weight-loss solution, to beat heart disease and as better for diabetes. But how do these claims match up with the latest research?</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>A new <a href="https://pubmed.ncbi.nlm.nih.gov/35088407/">review of the evidence</a> found long-term low-carb dieters lost just under a kilo more weight than other dieters. However the review concluded there was no evidence low-carb diets have any additional health benefits. </p>
<p>In fact, if you’re on a low-carb diet, you’ll need to pay closer attention to what you eat to make sure you get enough essential vitamins, minerals, dietary fibre and other <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</a>.</p>
<h2>What did the reviewers investigate?</h2>
<p>The Cochrane <a href="https://www.cochranelibrary.com/about/about-cochrane-reviews">review</a> included 61 randomised controlled trials (the highest level of evidence) with almost 7,000 adults with excess body weight. About 1,800 had type 2 diabetes. People in the <a href="https://www.heartfoundation.org.au/bmi-calculator">healthy weight range</a> were not included.</p>
<p>The reviewers compared weight-loss diets that varied in carbohydrate content:</p>
<ol>
<li><p>lower carbohydrate diets. This included very low-carb or ketogenic diets (less than 50g of carbs a day or less than 10% of your total energy from carbs) and low-carb diets (50-150g of carbs per a day, or less than 45% of total energy from carbs)</p></li>
<li><p>“balanced” carbohydrate diets (150+ grams of carbs a day, or 45-65% of your total energy from carbs). </p></li>
</ol>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/446445/original/file-20220215-19-1npe202.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/446445/original/file-20220215-19-1npe202.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/446445/original/file-20220215-19-1npe202.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=346&fit=crop&dpr=1 600w, https://images.theconversation.com/files/446445/original/file-20220215-19-1npe202.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=346&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/446445/original/file-20220215-19-1npe202.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=346&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/446445/original/file-20220215-19-1npe202.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=435&fit=crop&dpr=1 754w, https://images.theconversation.com/files/446445/original/file-20220215-19-1npe202.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=435&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/446445/original/file-20220215-19-1npe202.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=435&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Here’s an example comparing how a very low-carb, low-carb and balanced carb one-day meal plan might look. The portion sizes differ between the meals to keep the total kilojoules about the same. Note, the reviewers grouped the first two low carb diet categories together.</span>
<span class="attribution"><span class="license">Author provided</span></span>
</figcaption>
</figure>
<h2>What did they find?</h2>
<p>The reviewers found that among adults with excess body weight (but who didn’t have type 2 diabetes), those following lower-carb diets for 3-8.5 months lost, on average, one kilogram more weight than those on balanced carb diets.</p>
<p>However, when they ensured restrictions in energy intake were the same in both groups, by providing the food or meal plans, the difference was about half a kilogram. </p>
<p>In longer-term weight-loss interventions lasting one to two years, the average difference in weight-loss between those on low-carb versus balanced carb diets was just under one kilogram.</p>
<figure class="align-center ">
<img alt="Person steps onto bathroom scales." src="https://images.theconversation.com/files/446928/original/file-20220217-27-169hlkc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/446928/original/file-20220217-27-169hlkc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/446928/original/file-20220217-27-169hlkc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/446928/original/file-20220217-27-169hlkc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/446928/original/file-20220217-27-169hlkc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/446928/original/file-20220217-27-169hlkc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/446928/original/file-20220217-27-169hlkc.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 isn’t a great different in weight-loss outcomes between those on low-carb diets and those on balanced carb diets.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/female-bare-feet-weight-scale-bathroom-785794792">Shutterstock</a></span>
</figcaption>
</figure>
<p>The average weight lost by groups on any weight-reducing diet varied greatly across the trials from less than one kilogram in some, up to about 13kg in others. </p>
<p>The studies in adults with type 2 diabetes found greater initial weight loss on low-carb diets compared to balanced carb diets: 1.3kg over three to six months. However, in longer interventions that lasted between one to two years, there was no difference. </p>
<p>In the small group of studies that included a maintenance period at the end of the weight-loss intervention, there were no differences in weight-loss in adults either with or without type 2 diabetes.</p>
<p>There were no significant differences in other health measures, including blood pressure, cholesterol, blood sugar control or risk of constipation. And they found no important clinical differences in results based on the extent of participants’ carb restriction.</p>
<p>Overall, the review shows that whether you prefer a lower carb or a balanced carb eating pattern, both can work for weight loss. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/do-ketogenic-diets-help-you-lose-weight-81810">Do ketogenic diets help you lose weight?</a>
</strong>
</em>
</p>
<hr>
<h2>Nutrients to monitor on a low-carb diet</h2>
<p>Carbohydrate is a macronutrient. Your body uses it to produce energy to fuel your muscles, brain, lungs and other vital processes. </p>
<p>Healthy foods with carbs – breads, cereals and other grains, fruit, vegetables and milk – are packed with other important nutrients, especially dietary fibre, thiamine, calcium and folate. </p>
<p>Without careful planning, a low-carb diet could also be lower in these nutrients. So how can you ensure you’re consuming enough? Here’s what to look out for – and some lower- and higher-carb options.</p>
<p><strong><a href="https://www.nrv.gov.au/nutrients/dietary-fibre">Dietary fibre</a></strong> is needed to keep your bowel function regular and promote growth of healthy bacteria in your colon. </p>
<p><em>Lower carb sources:</em> spinach, fresh and frozen mixed berries, almonds, cauliflower</p>
<p><em>Higher carb sources:</em> wholegrain bread, apples, chick peas, sweet potato. </p>
<figure class="align-center ">
<img alt="Chick pea and spinach salad." src="https://images.theconversation.com/files/446930/original/file-20220217-23-1v5l00m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/446930/original/file-20220217-23-1v5l00m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/446930/original/file-20220217-23-1v5l00m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/446930/original/file-20220217-23-1v5l00m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/446930/original/file-20220217-23-1v5l00m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/446930/original/file-20220217-23-1v5l00m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/446930/original/file-20220217-23-1v5l00m.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">Chick peas are high in fibre.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/fresh-salad-chick-pea-food-closeup-691008247">Shutterstock</a></span>
</figcaption>
</figure>
<p><strong><a href="https://www.nrv.gov.au/nutrients/thiamin">Thiamin</a></strong> or vitamin B1 is needed to supply energy to your body’s tissues and is used to metabolise carbohydrates. </p>
<p><em>Lower carb sources:</em> trout, tuna, sunflower seeds, beef, yeast extracts </p>
<p><em>Higher carb sources:</em> brown rice, black beans, wholemeal bread, yoghurt.</p>
<hr>
<p>
<em>
<strong>
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>
</strong>
</em>
</p>
<hr>
<p><strong><a href="https://www.nrv.gov.au/nutrients/calcium">Calcium</a></strong> is needed for strong bones. </p>
<p><em>Lower cab sources:</em> hard cheese, canned salmon with small bones, almonds, firm tofu</p>
<p><em>Higher carb sources:</em> yoghurt, milk, soft cheese. </p>
<p><strong><a href="https://www.nrv.gov.au/nutrients/folate">Folate</a></strong> is essential for growth and is used to manufacture DNA, your genetic code. <a href="https://theconversation.com/six-common-questions-about-eating-carbs-during-pregnancy-answered-84595">Adequate intakes are especially important for women</a>, as folate is needed to prevent neural tube defects in infants during pregnancy.</p>
<p><em>Lower carb sources:</em> green leafy vegetables, avocado, broccoli, peanuts</p>
<p><em>Higher carb sources:</em> wholemeal bread (Australian bread-making flour is fortified with folic acid), fortified wholegrain cereals, brown rice, oranges. </p>
<p>Ultimately, if you love carbs and want to lose weight, you can. Plan to lower your kilojoule and carb intake by not eating ultra-processed, energy-dense, nutrient-poor (junk) foods, while still eating carbohydrates from <a href="https://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating">healthy foods</a>. </p>
<p><em>If you’d like to learn more about weight loss, you can enroll in our free online course <a href="https://www.edx.org/course/the-science-of-weight-loss-dispelling-diet-myths">The Science of Weight Loss – Dispelling Diet Myths</a> which begins on February 23.</em></p><img src="https://counter.theconversation.com/content/176368/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Clare Collins is a Laureate Professor in Nutrition and Dietetics at the University of Newcastle, NSW and a Hunter Medical Research Institute (HMRI) affiliated researcher . She is a National Health and Medical Research Council (NHMRC) Leadership Fellow and has received research grants from NHMRC, ARC, MRFF, HMRI, Diabetes Australia, Heart Foundation, Bill and Melinda Gates Foundation, nib foundation, Rijk Zwaan Australia, WA Dept. Health, Meat and Livestock Australia, and Greater Charitable Foundation. She has consulted to SHINE Australia, Novo Nordisk, Quality Bakers, the Sax Institute, Dietitians Australia and the ABC. She was a team member conducting systematic reviews to inform the 2013 Australian Dietary Guidelines update and the Heart Foundation evidence reviews on meat and dietary patterns.</span></em></p><p class="fine-print"><em><span>Erin Clarke is affiliated with the School of Health Sciences, College of Health, Medicine and Wellbeing, The University of Newcastle, NSW, Australia.</span></em></p><p class="fine-print"><em><span>Rebecca Williams is affiliated with the School of Health Sciences, College of Health, Medicine and Wellbeing, at the University of Newcastle, NSW, Australia.</span></em></p>A new review of the evidence found long-term low-carb dieters lost just under a kilo more weight than other dieters. But they could be missing out on some important nutrients.Clare Collins, Laureate Professor in Nutrition and Dietetics, University of NewcastleErin Clarke, Postdoctoral Researcher , University of NewcastleRebecca Williams, Postdoctoral Researcher, University of NewcastleLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1522332021-01-27T01:10:59Z2021-01-27T01:10:59ZDo men really take longer to poo?<figure><img src="https://images.theconversation.com/files/377953/original/file-20210111-15-ruzndd.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"><a class="source" href="https://www.shutterstock.com/image-photo/close-man-toilet-using-phone-619346291">from www.shutterstock.com</a></span></figcaption></figure><p>There’s a common assumption men take longer than women to poo. People say so on <a href="https://twitter.com/trenduso/status/1100968885203931136">Twitter</a>, in <a href="https://www.sammichespsychmeds.com/men-bathroom-memes/">memes</a>, and <a href="https://www.youtube.com/watch?v=nLcEU6ahlOI">elsewhere</a> <a href="https://www.livescience.com/why-men-take-longer-to-poop.html">online</a>. But is that right? What could explain it? And if some people are really taking longer, is that a problem?</p>
<p>As we sift through the evidence, it’s important to remember pooing may involve time spent sitting on the toilet and the defaecation process itself.</p>
<p>And there may be differences between men and women in these separate aspects of going to the toilet. But the evidence for these differences isn’t always as strong as we’d like.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/do-we-have-to-poo-every-day-we-asked-five-experts-98701">Do we have to poo every day? We asked five experts</a>
</strong>
</em>
</p>
<hr>
<h2>Men may spend longer sitting on the toilet</h2>
<p>Men do appear to spend more time sitting on the toilet. An <a href="https://www.dailymail.co.uk/femail/article-2641550/Britons-favourite-loo-terature-revealed-Sports-biographies-erotic-magazines-bathroom-reading-material-poll.html">online survey</a> by a bathroom retailer suggested men spend up to 14 minutes a day compared with women, who spend almost eight minutes a day. But this survey doesn’t have the rigour of a well-designed scientific study.</p>
<p>Would there be any physiological reason to explain why men spend longer on the toilet? Well, the evidence actually suggests the opposite.</p>
<p>We know it <a href="https://www.tandfonline.com/doi/abs/10.1080/00365520310000410">takes longer</a> for food to travel through the intestines in women than in men. Women are also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175559/">more likely to suffer</a> from constipation related to irritable bowel syndrome than men. So, you’d expect women to take longer to defaecate, from the start of the bowel motion to expulsion.</p>
<p>But this is <a href="https://pubmed.ncbi.nlm.nih.gov/12870773/">not the case</a> even if you take into account differences in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986479/">fibre intake</a> between men and women.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-what-is-irritable-bowel-syndrome-and-what-can-i-do-about-it-102579">Explainer: what is irritable bowel syndrome and what can I do about it?</a>
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</em>
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<p>Instead, how long it takes someone to poo (the defaecation time) is <a href="https://pubmed.ncbi.nlm.nih.gov/28470247/">heavily influenced</a> by the mucus lining the large bowel. This mucus makes the bowel slippery and easier for the stools to be expelled. But there’s no evidence this mucus lining is different in men and women. </p>
<p>One thing we do know, however, is mammals from elephants to mice have a similar defaecation time, <a href="https://pubs.rsc.org/en/content/articlelanding/2017/sm/c6sm02795d#!divAbstract">around 12 seconds</a>. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1100968885203931136"}"></div></p>
<p>For humans, it’s slightly longer, but still quick. In <a href="https://pubmed.ncbi.nlm.nih.gov/12870773/">one study</a> it took healthy adults an average two minutes when sitting, but only 51 seconds when squatting. Again, there were no differences in defaecation time between men and women, whether sitting or squatting. </p>
<p>If there’s no strong evidence one way or the other to explain any gender differences in how long it takes to poo, what’s going on? For that, we need to look at the total time spent on the toilet.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/whats-the-best-way-to-go-to-the-toilet-squatting-or-sitting-63991">What's the best way to go to the toilet – squatting or sitting?</a>
</strong>
</em>
</p>
<hr>
<h2>Why do people spend so long on the toilet?</h2>
<p>What I call the “toilet sitting time” is the time of defaecation itself and the time allocated to other activities sitting on the toilet. For most people, the time spent just sitting, aside from defaecating, accounts for most of their time there.</p>
<p>So what are people doing? Mainly reading. And it seems men are <a href="http://news.bbc.co.uk/2/hi/health/1230115.stm">more likely</a> to read on the toilet than women.</p>
<p>For instance, a <a href="https://pubmed.ncbi.nlm.nih.gov/19019015/">study</a> of almost 500 adults in Israel found almost two-thirds (64%) of men regularly read on the toilet compared with 41% of women. The longer people spent on the toilet, the more likely they were to be reading. However, in the decade or more since this study was conducted, you’d expect adults would be more likely to be reading or playing games on their mobile phones rather than reading paper books.</p>
<p>People might also be sitting longer on the toilet for some temporary relief from the stresses of life.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Meme about men avoiding parenting responsibilities by sitting on the toilet for longer" src="https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=417&fit=crop&dpr=1 600w, https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=417&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=417&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=524&fit=crop&dpr=1 754w, https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=524&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/380091/original/file-20210121-19-q4weg1.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=524&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Sometimes, people just need time to themselves.</span>
<span class="attribution"><a class="source" href="https://www.sammichespsychmeds.com/men-bathroom-memes/">Ramblin Mama</a></span>
</figcaption>
</figure>
<p>One <a href="https://www.dailymail.co.uk/femail/article-2641550/Britons-favourite-loo-terature-revealed-Sports-biographies-erotic-magazines-bathroom-reading-material-poll.html">poll</a> found 56% of people find sitting on the toilet relaxing, and 39% a good opportunity to have “some time alone”. Another <a href="https://www.independent.co.uk/life-style/bathrooms-shower-washing-habits-poll-a8988626.html">online survey</a> revealed one in six people reported going to the toilet for “peace and quiet”. Although these are not scientific studies, they offer useful insights into a social phenomenon.</p>
<p>Then there can be medical reasons for a prolonged defaecation time, and consequently a lengthier time sitting on the toilet. </p>
<p>An anal fissure (a tear or crack in the lining of the anus) can make defaecation a painful and lengthy process. These fissures are <a href="http://eknygos.lsmuni.lt/springer/526/178-191.pdf">just as common</a> in men as in women. </p>
<p>And <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306148/">obstructive defaecation</a>, where people cannot empty the rectum properly, is a common cause of chronic constipation. This is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3030249/">more common</a> in middle-aged women. </p>
<h2>Are there any harms from spending too long on the loo?</h2>
<p>In a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236649/">Turkish study</a>, spending more than five minutes on the toilet was associated with haemorrhoids and anal fissures. Another study from <a href="https://pubmed.ncbi.nlm.nih.gov/31996480/">Italy</a> noted the longer the time people spent on the toilet, the more severe their haemorrhoids.</p>
<p><a href="http://www.annalsgastro.gr/files/journals/1/earlyview/2019/ev-01-2019-19-AG4360-0355.pdf">One theory</a> behind this is prolonged sitting increases pressure inside the abdomen. This leads to less blood flow into the veins of the rectum when passing a bowel motion, and ultimately to blood pooling in the vascular cushions of the anus. This makes haemorrhoids more likely to develop. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-why-do-people-get-haemorrhoids-and-how-do-you-get-rid-of-them-94820">Explainer: why do people get haemorrhoids and how do you get rid of them?</a>
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<hr>
<h2>What can we do about this?</h2>
<p>In addition to the usual advice about increasing the amount of fibre in your diet and ensuring you drink enough water, it would be sensible to limit the amount of time spent on the toilet.</p>
<p>Different researchers recommend a <a href="https://pubmed.ncbi.nlm.nih.gov/28150480/">different</a> <a href="https://pubmed.ncbi.nlm.nih.gov/27723447/">upper limit</a>. But I <a href="https://pubmed.ncbi.nlm.nih.gov/30346317/">and others</a> recommend the SEN approach:</p>
<ul>
<li><p><strong>S</strong>ix minute toilet sitting time maximum</p></li>
<li><p><strong>E</strong>nough fibre (eating more fruit and vegetables, and eating wholegrains)</p></li>
<li><p><strong>N</strong>o straining during defaecation. </p></li>
</ul>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-what-causes-constipation-114290">Health Check: what causes constipation?</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/152233/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Vincent Ho 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>If you believe the memes, men spend ages in the toilet. But they’re not always pooing. Here’s what they’re really doing.Vincent Ho, Senior Lecturer and clinical academic gastroenterologist, Western Sydney UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1248092019-10-10T09:04:54Z2019-10-10T09:04:54ZGut microbes can be picky eaters – here’s why it matters<figure><img src="https://images.theconversation.com/files/295980/original/file-20191008-128686-1qmesj5.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/384682516?src=H308wgbrl6ERz7KJ-Osa8Q-1-0&size=medium_jpg">TL Furrer/Shutterstock</a></span></figcaption></figure><p>We choose our food for a variety of reasons, including personal preference, availability, cost and healthiness. But we should also take our gut microbes’ preferences into account, a <a href="https://doi.org/10.1016/j.cell.2019.08.011">new study</a> published in Cell suggests.</p>
<p>The bacteria in our guts, collectively known as the microbiota or microbiome, live on the fibre and other chemicals that come their way from the foods we eat. “Fibre” is an umbrella term that covers a wide range of sugar-based molecules (polysaccharides). It’s not clear how individual plant polysaccharides affect the growth of different species of beneficial gut bacteria.</p>
<p>While we know that people who eat a greater number of different plant-based foods <a href="https://www.sciencedirect.com/science/article/pii/S2212877816000387">have more diverse, healthier microbiomes</a>, less is known about exactly which bacteria prefer which foods. </p>
<p>To find out about the foods that each type of bacteria prefers, the authors of the aforementioned study published in Cell, raised mice in sterile conditions and gave them a set of 20 different species of human gut bacteria. At the start of the experiment, the mice all had a similar set of gut microbes. They then fed the animals a high-fat, low-fibre diet that’s typical in the US. This was supplemented with 34 purified fibre preparations made from fruit and vegetables.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-the-victorians-help-explain-our-obsession-with-the-microbiome-86270">How the Victorians help explain our obsession with the microbiome</a>
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<p>The researchers observed how the animals’ microbiomes changed as a result of their diets. They found that certain bacteria prefer different fibre supplements, and when their favourite food is available, the proportion of those microbes in the gut increases. For example, mice that ate a lot of pea fibre had a much higher proportion of a bacteria called <em>Bacteroides thetaiotaomicron</em> at the end of the experiment.</p>
<p>But food fibres aren’t made up of just one compound. They often contain a variety of long-chain polysaccharides that we can’t break down without the help of gut bacteria. To find out exactly which polysaccharide molecules increased the numbers of specific microbes, additional experiments looked at various bacterial species. For the <em>Bacteroides thetaiotaomicron</em>, for example, the increase in abundance is driven by a molecule in pea fibre called arabinan.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/295981/original/file-20191008-128695-16q4q5u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/295981/original/file-20191008-128695-16q4q5u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/295981/original/file-20191008-128695-16q4q5u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/295981/original/file-20191008-128695-16q4q5u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/295981/original/file-20191008-128695-16q4q5u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/295981/original/file-20191008-128695-16q4q5u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/295981/original/file-20191008-128695-16q4q5u.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">Bacteroides thetaiotaomicron liked to feast on pea fibre.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/434170963?src=YazMLI1Gut8WwIBuqr0ekA-1-1&size=medium_jpg">SherSor/Shutterstock</a></span>
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<h2>Manipulating your microbiome is not so simple</h2>
<p>The microbiome is a complex community made up of billions of bacteria. It is important to understand how the food we eat affects our microbiome as a whole and not just individual bacterial species. Simply supplying a particular type of fibre is no guarantee that specific bacteria will show up to eat it. And if the same food is preferred by two competing species of bacteria, one beneficial and one potentially harmful, how do you ensure that the healthier species gets the lion’s share and thrives?</p>
<p>To understand which microbes get first pick of the nutrients, the researchers set up competitions for food between different bacterial species. They used magnetic beads coated with fluorescent fibre molecules to see which bacteria metabolised each fibre type and how the presence of other bacteria influenced their choices. </p>
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<strong>
Read more:
<a href="https://theconversation.com/you-are-what-you-eat-why-the-future-of-nutrition-is-personal-119477">You are what you eat – why the future of nutrition is personal</a>
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<p>As might be expected when there are plenty of bacteria and a limited supply of favourite foods, bacteria competed for certain fibres. Importantly, the researchers found that the bacteria adapt to changes in circumstances. Some species were able to adapt to the presence of others who preferred the same fibre, switching to a different food source. Other microbes remained determined to have their favourite meals.</p>
<p>What does that mean for our microbiomes? It suggests that certain strains can adapt more easily to changes in diet and these may be the best for building a resilient gut community.</p>
<h2>Still a lot to learn</h2>
<p>It’s becoming increasingly clear that what we <a href="https://theconversation.com/i-spent-three-days-as-a-hunter-gatherer-to-see-if-it-would-improve-my-gut-health-78773">eat</a> and <a href="https://theconversation.com/why-a-glass-of-red-wine-is-good-for-your-gut-122072">drink</a> has a profound impact on the makeup of the gut microbiome, and therefore a huge impact on nutrition and health. But we have a lot of work to do before we really understand the effects of real food on our real-life microbiomes and how our gut bacteria affect our health.</p>
<p>Together with my colleagues at King’s College London, Massachusetts General Hospital, Stanford University and ZOE, we’re running the world’s largest study (PREDICT) investigating how individuals and their unique microbiomes respond to different foods. So far, the results show large and consistent differences between people to the same foods. Even identical twins, who share 100% of their genes and much of their upbringing and environment, can have <a href="https://academic.oup.com/cdn/article/3/Supplement_1/nzz037.OR31-01-19/5517817">very different responses to the same foods</a>. </p>
<p>More surprising still, the identical twins in our study only shared slightly more microbe species than unrelated people, which may help explain the difference in nutritional responses. By the end of our studies, with the help of citizen scientists we hope to be able to shed light on the complicated relationship between what we eat, our microbiome, our personal responses <a href="https://theconversation.com/you-are-what-you-eat-why-the-future-of-nutrition-is-personal-119477">to food and our health</a>.</p>
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Read more:
<a href="https://theconversation.com/postbiotics-and-smart-toilets-new-era-of-harnessing-our-microbial-chemicals-to-keep-us-slim-and-healthy-96861">Postbiotics and smart toilets: new era of harnessing our microbial chemicals to keep us slim and healthy</a>
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<p>Scientists are interested in finding ways to manipulate our responses to food and improve our health by intentionally changing the inhabitants of our gut. Uncovering the connections between different types of fibre and bacteria suggests that the molecules identified by the researchers in the Cell study could eventually be used in so-called microbiota-directed foods to increase the numbers of particular beneficial bacteria in the gut and boost microbiome diversity. </p>
<p>Many of the fibre supplements tested in their experiments were made from fruit and vegetable peels left over from making products such as soups and smoothies. These products could provide sustainable, cheap fibre that could easily be incorporated into food products. But before we start tinkering with our gut inhabitants in this way, we need to know how to do it safely – encouraging the “good” bacteria and controlling the “bad” ones – to create the right bacterial balance for everyone.</p><img src="https://counter.theconversation.com/content/124809/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tim Spector receives grants from multiple sources including MRC, Wellcome Trust, EU, CDRF, Danone, NIHR and is co-founder of Zoe Global LTD a precision nutrition company. He is author of "The Diet Myth: the real science behind what we eat (Orion 2016)"
</span></em></p>Scientists are beginning to understand the food preferences of our gut microbes.Tim Spector, Professor of Genetic Epidemiology, King's College LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1218372019-10-08T11:39:06Z2019-10-08T11:39:06ZFood labels too complicated for most shoppers to understand – new research<figure><img src="https://images.theconversation.com/files/296001/original/file-20191008-128655-ti8194.jpg?ixlib=rb-1.1.0&rect=35%2C35%2C5955%2C3736&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/london-june-14-shopper-browses-aisle-199217036?src=Q8LUehjsUHqDIikWT_YcNQ-1-9">shutterstock/1000 Words</a></span></figcaption></figure><p>Think back to the last time you went food shopping, did you check the labels for nutritional information? If you did, chances are it still felt tricky to know exactly what was in your food: how do you decide between a can of soup that has “reduced sodium” and one that’s labelled “low sodium” – and what’s the difference?</p>
<p>Indeed, <a href="https://www.sciencedirect.com/science/article/pii/S0950329319300849?via%3Dihub">our latest research</a> shows that many shoppers find food labels confusing and this is actually leading to a lot of people not really understanding what they’re eating. So while most people are aware a healthy diet involves <a href="https://www.nhs.uk/live-well/eat-well/">eating a variety of nutrients in differing quantities</a>, it’s less well known what these nutrients should be, and how much a person should be consuming. </p>
<p><a href="https://www.cambridge.org/core/journals/public-health-nutrition/article/household-availability-of-ultraprocessed-foods-and-obesity-in-nineteen-european-countries/D63EF7095E8EFE72BD825AFC2F331149">Research from 2018</a> shows that half of all the food bought by families in the UK is now “ultra-processed”. So rather than fresh home-cooked meals, a lot of us are eating food made in factories with industrial ingredients and additives – that bear little resemblance to food in its natural state.</p>
<p>Empowering people to make good decisions at mealtimes starts with shoppers knowing what’s in the food they’re buying. And food labels play a role in this – but manufacturers need to present this information in <a href="https://www.gov.uk/food-labelling-and-packaging">clear and easy to understand formats</a> to be useful – as most people don’t have hours to mull over the ingredients of a ready meal.</p>
<p>In the UK, the Food Standards Agency <a href="https://www.food.gov.uk/business-guidance/packaging-and-labelling#the-legislation">regulates the use of food wording and claims</a> – such as “high in fibre” or “low in salt”. For a cereal to be classed as high in fibre, for example, it needs to have about 30% of the recommended daily fibre intake.</p>
<p>Food manufactures and supermarkets have made attempts to <a href="https://doi.org/10.1017/S1368980010003290">simplify complex nutritional information</a>. But as our research shows, many people still find food labels confusing – and tend to overestimate how much fibre a “high fibre” <a href="https://doi.org/10.1016/j.foodqual.2019.103739">food actually provides</a>. People in our study also overestimated how much fat a label like “low fat” might refer to – though to a lesser extent. </p>
<h2>Lack of consistency</h2>
<p>This confusion around what labels actually mean may stem from the fact that <a href="https://www.gov.uk/government/publications/technical-guidance-on-nutrition-labelling">categorisation guidelines</a> differ from nutrient to nutrient – demonstrating the complexities of nutrition science. </p>
<p>Some guidance is available on how <a href="https://www.nhs.uk/live-well/eat-well/how-to-read-food-labels/">label categories should be understood</a>, but the rules are complicated and hard to remember. Combine this with the <a href="https://www.telegraph.co.uk/food-and-drink/features/help-theres-too-much-choice-in-the-supermarket/">multitude of choices that confront shoppers in supermarkets</a>, and it’s easy to see why so many people struggle to fully grasp what the labels are saying. </p>
<p>Another issue is that there isn’t a consistent system for food labelling in the UK. Shoppers have to compare across words and numbers to make a food choice – how do you quickly choose between a “low fat” cereal and one with “5% of your recommended daily allowance of fat”? Comparing between different nutrients on the same box is also a problem.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/296000/original/file-20191008-128695-1y09o01.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/296000/original/file-20191008-128695-1y09o01.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/296000/original/file-20191008-128695-1y09o01.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/296000/original/file-20191008-128695-1y09o01.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/296000/original/file-20191008-128695-1y09o01.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/296000/original/file-20191008-128695-1y09o01.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/296000/original/file-20191008-128695-1y09o01.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">Food labelling can help shoppers make an informed decision, but understanding the labels can feel difficult.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-woman-shopping-grocery-store-mature-675852160?src=9GJrmVONTgMAmCDjNAezNA-1-9">Shutterstock/Rido</a></span>
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<p>Healthy eating is not just about reducing consumption, but also getting <a href="https://www.who.int/news-room/fact-sheets/detail/healthy-diet">sufficient nutrition</a>. It’s already known that <a href="https://www.nhs.uk/live-well/eat-well/how-to-get-more-fibre-into-your-diet/">most people in the UK do not get enough fibre in their diet</a> – and believing foods offer more fibre than they actually do could be a contributing factor. </p>
<p>And although overestimating quantities of fat may seem like a good thing if it reduces consumption, research shows that a “low fat” label can, for some people, seem like a <a href="http://dx.doi.org/10.1509/jmkr.43.4.605">license to eat more</a>. Ultimately, there are many ways food labels can lead shoppers astray. </p>
<h2>Food for thought</h2>
<p>Standardising the way nutrition is communicated across all packaged foods would help. And <a href="https://www.theguardian.com/society/2018/jun/20/uk-urged-to-make-traffic-light-food-labelling-mandatory">mandating a “traffic light” format</a> on all products would eliminate the need to compare one item with words and another with numbers.</p>
<p>The other challenge is what numbers should be attached to words like “low”, “medium”, and “high”. The current traffic light labelling system <a href="https://www.gov.uk/government/publications/technical-guidance-on-nutrition-labelling">counts how many grams of nutrients are in the food</a>, but claims like “high protein”, <a href="https://ec.europa.eu/food/safety/labelling_nutrition/claims/nutrition_claims_en">counts the percentage of protein</a>. A better system would be to translate words into a food’s percentage contribution to their recommended daily allowance (RDA). This could help to reduce confusion since RDA percentages are consistent for different nutrients, and <a href="https://doi.org/10.1007/s10389-009-0307-0">people understand percentage of RDA more easily than absolute amounts</a>.</p>
<p>Effective legislation for food labels is a challenge because it needs to balance the <a href="http://dx.doi.org/10.1136/bmjnph-2018-000001">complexity of nutrition science</a> with the psychology of communicating information. Current guidelines have made great strides in simplifying and distilling this information. And the next step is to harness the psychology of how people interpret information – so that what’s on food packets actually make sense to shoppers in the supermarket.</p><img src="https://counter.theconversation.com/content/121837/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dawn Liu 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>Shoppers struggle to make sense of food labels – and aren’t always sure what they’re eating.Dawn Liu, Lecturer in the Department of Psychology, University of EssexLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1200842019-09-10T03:29:13Z2019-09-10T03:29:13ZHere’s what you can eat and avoid to reduce your risk of bowel cancer<figure><img src="https://images.theconversation.com/files/290039/original/file-20190829-106494-1end206.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">It's not certain why, but fibre has protective effects against bowel cancer. </span> <span class="attribution"><span class="source">www.shutterstock.com</span></span></figcaption></figure><p>Australia has one of the <a href="http://gco.iarc.fr/today/data/factsheets/cancers/10_8_9-Colorectum-fact-sheet.pdf">highest rates of bowel cancer in the world</a>. In 2017, bowel cancer was the <a href="https://canceraustralia.gov.au/about-us/news/cancer-australia-2017">second most common cancer in Australia</a> and <a href="https://theconversation.com/whats-behind-the-increase-in-bowel-cancer-among-younger-australians-105484">rates are increasing</a> in people under 50. </p>
<p>Up to <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)67725-2/fulltext">35% of cancers worldwide</a> might be caused by lifestyle factors such as diet and smoking. So how can we go about reducing our risk of bowel cancer?</p>
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Read more:
<a href="https://theconversation.com/whats-behind-the-increase-in-bowel-cancer-among-younger-australians-105484">What's behind the increase in bowel cancer among younger Australians?</a>
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<h2>What to eat</h2>
<p>Based on <a href="https://www.wcrf.org/sites/default/files/Colorectal-Cancer-2017-Report.pdf">current evidence</a>, a high fibre diet is important to reduce bowel cancer risk. Fibre can be divided into 2 types: insoluble fibre, which creates a bulky stool that can be easily passed along the bowel; and soluble fibre, which draws in water to keep the stool soft.</p>
<p>Fibre from cereal and wholegrains is an <a href="https://www.ncbi.nlm.nih.gov/pubmed/22074852">ideal fibre source</a>. Australian guidelines suggest aiming for 30g of fibre per day for adults, but <a href="https://www.ncbi.nlm.nih.gov/pubmed/29751656">fewer than 20%</a> of Australian adults meet that target. </p>
<p>Wheat bran is one of the richest sources of fibre, and in an <a href="https://www.ncbi.nlm.nih.gov/pubmed/8537982">Australian trial</a> in people at high risk of bowel cancer, 25g of wheat bran reduced precancerous growths. Wheat bran can be added to cooking, smoothies and your usual cereal.</p>
<p>It’s not clear how fibre may reduce bowel cancer risk but <a href="https://www.ncbi.nlm.nih.gov/pubmed/29333111">possible mechanisms</a> include reducing the time it takes food to pass through the gut (and therefore exposure to potential carcinogens), or through a beneficial effect on gut bacteria. </p>
<p>Once bowel cancer is diagnosed, a high fibre diet has also been <a href="https://www.ncbi.nlm.nih.gov/pubmed/29098294">associated with improved survival</a>.</p>
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<a href="https://images.theconversation.com/files/290467/original/file-20190902-175668-4tk10h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/290467/original/file-20190902-175668-4tk10h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/290467/original/file-20190902-175668-4tk10h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=410&fit=crop&dpr=1 600w, https://images.theconversation.com/files/290467/original/file-20190902-175668-4tk10h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=410&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/290467/original/file-20190902-175668-4tk10h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=410&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/290467/original/file-20190902-175668-4tk10h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=516&fit=crop&dpr=1 754w, https://images.theconversation.com/files/290467/original/file-20190902-175668-4tk10h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=516&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/290467/original/file-20190902-175668-4tk10h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=516&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">Dairy is ‘probably’ protective against bowel cancer.</span>
<span class="attribution"><span class="source">from www.shutterstock.com</span></span>
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<a href="https://theconversation.com/interactive-body-map-what-really-gives-you-cancer-52427">Interactive body map: what really gives you cancer?</a>
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<p>Milk and dairy products are <a href="https://www.ncbi.nlm.nih.gov/pubmed/24023767">also thought</a> to <a href="https://www.ncbi.nlm.nih.gov/pubmed/21617020">reduce bowel cancer risk</a>. The evidence for milk is graded as “probably protective” in <a href="https://wiki.cancer.org.au/australia/Guidelines:Colorectal_cancer/Primary_prevention_dietary_and_lifestyle#Dietary_fibre">current Australian bowel cancer guidelines</a>, with the benefit increasing with higher amounts.</p>
<p>Oily fish may also have some protective elements. In people with hereditary conditions that make them prone to developing lots of precancerous growths (polyps) in the bowel, a <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=20348368">trial</a> where one group received a daily supplement of an omega 3 polyunsaturated fatty acid (found in fish oil) and one group received a placebo, found that this supplement was associated with reduced polyp growth. Whether this is also true for people at average risk of bowel cancer, which is most of the population, is unknown. </p>
<p>And while only an observational study (meaning it only shows a correlation, and not that one <em>caused</em> the other), <a href="https://www.ncbi.nlm.nih.gov/pubmed/29158191">a study of bowel cancer patients</a> showed improved survival was associated with daily consumption of coffee.</p>
<h2>What to avoid</h2>
<p>It’s best to avoid large quantities of meat. International cancer authorities affirm there is <a href="https://www.wcrf.org/sites/default/files/english.pdf">convincing evidence</a> for a relationship between high meat intake and bowel cancer. This includes red meat, derived from mammalian muscle such as beef, veal, lamb, pork and goat, and processed meat such as ham, bacon and sausages. </p>
<p>Processed meats have undergone a preservation technique such as smoking, salting or the addition of chemical preservatives which are associated with the production of compounds that <a href="https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(15)00444-1/fulltext">may be carcinogenic</a>. </p>
<p>Evidence also suggests a “dose-response” relationship, with cancer risk rising with increasing meat intake, particularly processed meats. <a href="https://wiki.cancer.org.au/australia/Guidelines:Colorectal_cancer/Primary_prevention_dietary_and_lifestyle#Dietary_fibre">Current Australian guidelines</a> suggest minimising intake of processed meats as much as possible, and eating only moderate amounts of red meat (up to 100g per day). </p>
<h2>What else can I do to reduce the risk of bowel cancer?</h2>
<p>The key to reducing cancer risk is leading an overall healthy lifestyle. Adequate physical activity and avoiding excess fat around the tummy area is important. Other unhealthy lifestyle behaviours such as eating lots of processed foods have been <a href="https://www.bmj.com/content/360/bmj.k322">associated with</a> increased cancer risk.</p>
<p>And for Australians over 50, participating in the National Bowel Cancer Screening program is one of the most effective, and evidence-based ways, to reduce your risk. </p>
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Read more:
<a href="https://theconversation.com/interactive-we-mapped-cancer-rates-across-australia-search-for-your-postcode-here-102256">INTERACTIVE: We mapped cancer rates across Australia – search for your postcode here</a>
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<img src="https://counter.theconversation.com/content/120084/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Suzanne Mahady 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>Bowel cancer is one of the most common forms of cancer in Australia, and some cases could potentially be avoided. Here’s how.Suzanne Mahady, Gastroenterologist & Clinical Epidemiologist, Senior Lecturer, Monash UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1107472019-02-01T11:53:48Z2019-02-01T11:53:48ZSo you went vegan in January – now what?<figure><img src="https://images.theconversation.com/files/256866/original/file-20190201-75085-15u5zn.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/604314275?src=YumHIBhoddB-Oj18pMcuag-1-49&size=medium_jpg">Anna Shepulova/Shutterstock</a></span></figcaption></figure><p>Many people will have had their fill of cheese, chocolate and meat over Christmas and have felt much more energised after going vegan in January (an event known as <a href="https://veganuary.com/">Veganuary</a>). This invigorating feeling is largely due to the increase in fruit, vegetables, nuts and pulses as opposed to the cutting out of meat and dairy, but it’s still a big win.</p>
<p>One of the main benefits of a more plant-based diet is the increase in fibre. Fibre has been in the press recently after a <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31809-9/fulltext">major review</a> in The Lancet reported that getting more than 25g of fibre per day significantly reduces the risk of heart attacks, strokes and type 2 diabetes.</p>
<p>A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3967195/pdf/nutrients-06-01318.pdf">2015 study</a> of different dietary patterns showed that vegans had an average daily fibre intake of 41g, compared with vegetarians, flexitarians and pescatarians at 34g. Omnivores get a mere 27g of fibre a day, on average.</p>
<p>Keeping up the habits you adopted in Veganuary that keeps your fibre intake high is likely to be of great benefit to your long-term health.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/256645/original/file-20190131-127151-62prsn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/256645/original/file-20190131-127151-62prsn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/256645/original/file-20190131-127151-62prsn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/256645/original/file-20190131-127151-62prsn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/256645/original/file-20190131-127151-62prsn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/256645/original/file-20190131-127151-62prsn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/256645/original/file-20190131-127151-62prsn.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">Dietary fibre reduces the risk of cardiovascular disease and type 2 diabetes.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/1037908300?src=Lc-v2CCHcz7IadcOGZiZoQ-1-6&size=medium_jpg">marilyn barbone/Shutterstock</a></span>
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<h2>What to take forward from Veganuary</h2>
<p>While the jury is still out on whether a vegan diet is healthier than a well-balanced omnivorous diet in the long run, you may well have picked up some new recipes and ideas for eating more plants. And we know that increasing fruit and veg intake is great for your body and may even help <a href="https://www.ncbi.nlm.nih.gov/pubmed/29759102">prevent depression</a>.</p>
<p>Eating a rainbow of fruit and vegetables has been a message we’ve been hearing for a while, but with the progressing research into polyphenols, which are the compounds that dictate the colour of the plant, getting the benefit of the full range of polyphenols on offer is likely to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5465813/">optimise your health in many ways</a>.</p>
<p>Maybe you’ve experimented with a few new fruits or vegetables, so keep up with the increased variety.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/256647/original/file-20190131-110834-8e5sg5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/256647/original/file-20190131-110834-8e5sg5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/256647/original/file-20190131-110834-8e5sg5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/256647/original/file-20190131-110834-8e5sg5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/256647/original/file-20190131-110834-8e5sg5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/256647/original/file-20190131-110834-8e5sg5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/256647/original/file-20190131-110834-8e5sg5.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">Keep your diet colourful.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/1096384175?src=lTl-gdlTS1j8PiVmmlKZcQ-1-16&size=medium_jpg">Peangdao/Shutterstock</a></span>
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<h2>Reintroduce meat or animal products?</h2>
<p>The latest publication from <a href="https://www.thelancet.com/commissions/EAT">EAT-Lancet</a> suggests that the best diet for your health and for the planet includes around 45g of meat per day (or one small portion on alternate days) and 28g of fish per day, which is about the amount you might have in a sandwich. They also recommend 250g of dairy per day, which could be a glass of milk.</p>
<p>This diet has come under fire for being <a href="https://www.fwi.co.uk/livestock/the-eat-lancet-diet-is-nutritionally-deficient-says-obesity-expert">nutritionally inadequate</a>, but most experts agree that reducing meat consumption to one portion per day and having more plants instead protects your health.</p>
<p>So, if you’ve been managing on a vegan diet but just can’t wait for your first bacon sandwich, burger or mac ‘n’ cheese, remember that there are no rules to following a plant-based diet. While having meat or fish a few times per week and including yogurts and cheese might not make you a vegan, you are still benefiting from being more of a planty person.</p>
<h2>How best to reintroduce excluded foods</h2>
<p>Most people won’t have any problem reintroducing meat and dairy into their diet. Some people might notice that they have slight changes in their bowel habit. Others might notice that they feel a bit less tired or sleep a bit better with the extra iron, B vitamins and amino acids coming back into their diet. Humans are supposed to be omnivorous, so we are well designed to handle changes in our diet.</p>
<p>If you do choose to stay on a completely vegan diet, make sure you are supplementing your diet with B12, calcium, algae (for essential fatty acids not available from other sources) and iron, or make sure you are having plenty of fortified foods and check your intake of micronutrients every day. And please remember to only take dietary advice from regulated healthcare professionals.</p><img src="https://counter.theconversation.com/content/110747/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sophie Medlin 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 lose the benefits of a more plant-based diet as you head into February.Sophie Medlin, Lecturer in Nutrition and Dietetics, King's College LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1076052019-01-29T08:06:16Z2019-01-29T08:06:16ZHealth Check: what causes bloating and gassiness?<figure><img src="https://images.theconversation.com/files/256029/original/file-20190129-127151-jj2o3o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">One in six healthy people report problems with bloating.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/95720971?src=0shmPAu3WYTp1m41U5daMw-1-22&size=huge_jpg">Alice Day/Shutterstock</a></span></figcaption></figure><p>Your trousers fit when you put them on in the morning. But come mid-afternoon, they’re uncomfortably tight – and you didn’t even overdo it at lunchtime. Sound familiar?</p>
<p>Around <a href="https://www.ncbi.nlm.nih.gov/pubmed/9772037">one in six people</a> without a health problem and <a href="https://www.ncbi.nlm.nih.gov/pubmed/11774947">three in four people</a> with irritable bowel syndrome (IBS) report problems with bloating. In fact, for people with IBS and constipation, bloating is their <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4893246/">most troublesome</a> symptom.</p>
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Read more:
<a href="https://theconversation.com/explainer-what-is-irritable-bowel-syndrome-and-what-can-i-do-about-it-102579">Explainer: what is irritable bowel syndrome and what can I do about it?</a>
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<p>Bloating is, of course, a feeling of increased abdominal pressure, usually related to gas. It may or may not be accompanied by visible enlargement of the waist (known as abdominal distension).</p>
<p>But contrary to popular belief, bloating and abdominal distention isn’t caused by an excessive production of gas in the intestines.</p>
<h2>What causes intestinal gas?</h2>
<p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3264926/">Gas in the upper gut</a> can come from swallowed air, chemical reactions (from neutralising acids and alkali) triggered by food, and dissolved gas moving from the bloodstream into the gut. </p>
<p>Food products that are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966170/">poorly absorbed</a> in the small intestine can travel lower down to the large intestine where they’re fermented by bacteria. This process can produce carbon dioxide, hydrogen or methane gas.</p>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/16143143">Gas from the gut</a> can come out through belching or passing wind, or by being absorbed into the blood or consumed by bacteria. </p>
<h2>How much wind is normal?</h2>
<p>Back in 1991, researchers in the UK <a href="https://www.ncbi.nlm.nih.gov/pubmed/1648028">tracked the farts</a> of ten healthy volunteers. The volume of gas they expelled in a day varied from 214 mls (on a low-fibre diet) to 705 mls (on a high fibre diet). </p>
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Read more:
<a href="https://theconversation.com/health-check-what-happens-when-you-hold-in-a-fart-98310">Health Check: what happens when you hold in a fart?</a>
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<p>The participants passed wind an average of 14 to 18 times per day, and it was comprised mainly of carbon dioxide and hydrogen.</p>
<p>In the fasting state, the healthy gastrointestinal tract contains around 100 mls of gas which is <a href="https://www.ncbi.nlm.nih.gov/pubmed/17397409">distributed almost equally</a> among six segments of the gut: the stomach, small intestine, ascending colon, transverse colon, descending colon and lower (pelvic) colon. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/256022/original/file-20190129-108370-6vq3gn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/256022/original/file-20190129-108370-6vq3gn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=496&fit=crop&dpr=1 600w, https://images.theconversation.com/files/256022/original/file-20190129-108370-6vq3gn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=496&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/256022/original/file-20190129-108370-6vq3gn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=496&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/256022/original/file-20190129-108370-6vq3gn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=623&fit=crop&dpr=1 754w, https://images.theconversation.com/files/256022/original/file-20190129-108370-6vq3gn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=623&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/256022/original/file-20190129-108370-6vq3gn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=623&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="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/gastrointestinal-tract-stomach-small-intestine-colon-420418585?src=aH0t0KIDbMRxxQQvETeXig-1-5">Tefi/Shutterstock</a></span>
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<p>After eating, the volume of gas in the gut can <a href="https://www.ncbi.nlm.nih.gov/pubmed/17397409">increase by about 65%</a> and tends to be located around the pelvic colon. </p>
<p>As the <a href="https://www.ncbi.nlm.nih.gov/pubmed/12358237">stomach stretches and small bowel is stimulated</a>, the passage of gas accelerates and you might feel the urge to fart. </p>
<p>But for people with a high-fat diet, <a href="https://www.ncbi.nlm.nih.gov/pubmed/12198695">fats inside the small bowel</a> can delay this passage and make you retain the gas.</p>
<h2>Bloaters don’t produce more gas</h2>
<p>A <a href="https://www.ncbi.nlm.nih.gov/pubmed/1152877">1975 study</a> compared the amount of intestinal gas between people who reported being bloated and those who said they were not.</p>
<p>The researchers pumped (inert) gas through a tube directly into the participants’ intestines at a relatively high flow of 45 mls per minute. Then they recovered the gas via a plastic tube from their rectum. </p>
<p>The researchers found no difference in the levels of gas collected between the bloating and healthy subjects. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/256053/original/file-20190129-39344-1x7t8a0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/256053/original/file-20190129-39344-1x7t8a0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/256053/original/file-20190129-39344-1x7t8a0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/256053/original/file-20190129-39344-1x7t8a0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/256053/original/file-20190129-39344-1x7t8a0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/256053/original/file-20190129-39344-1x7t8a0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/256053/original/file-20190129-39344-1x7t8a0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&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">Not everyone who feels bloated will have a distended stomach.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-woman-having-painful-stomachache-chronic-713425027?src=sx1GhzjfmfAgy9N1_yqxeg-1-66">siam.pukkato/Shutterstock</a></span>
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<p>More <a href="https://www.ncbi.nlm.nih.gov/pubmed/18802999">recent research</a> using abdominal CT scans has shown that people with bloating have similar volumes of intestinal gas as those who don’t feel bloated. </p>
<p>Likewise, although people with IBS experience more abdominal distention, they <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3264926/">do not produce</a> more intestinal gas than other people. </p>
<p>This leads us to believe the volume of gas in the gut itself isn’t the main mechanism for bloating. </p>
<h2>When gas gets trapped</h2>
<p>Most people tolerate intestinal gas really well because they can propel and evacuate gas very efficiently. As a result, only a <a href="https://www.ncbi.nlm.nih.gov/pubmed/9721151">relatively small amount</a> of gas remains inside the gut at a given time. </p>
<p>In <a href="https://www.ncbi.nlm.nih.gov/pubmed/12055580">one study</a>, researchers pumped just over 1.4 litres of gas in two hours into the mid-small bowel of healthy volunteers. This led to only a very small change in waist circumference: no more than 4mm. </p>
<p>On the other hand, people with abdominal conditions such as IBS or functional dyspepsia (indigestion), <a href="https://www.ncbi.nlm.nih.gov/pubmed/28508867">show impaired gas transit</a> – in other words, the gas ends up being trapped in different parts of the bowel rather than moving along easily. </p>
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Read more:
<a href="https://theconversation.com/whats-the-best-way-to-go-to-the-toilet-squatting-or-sitting-63991">What's the best way to go to the toilet – squatting or sitting?</a>
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<p>Studies show people with abdominal conditions tend to retain a relatively large proportion of gas pumped into the mid small bowel. They may even have notable increases in waist circumference without any gas being pumped in. </p>
<p>This impairment was confirmed in <a href="https://www.ncbi.nlm.nih.gov/pubmed/11115817">a study</a> comparing 20 participants with IBS to a control group of 20 healthy participants. All received gas pumped directly into the mid-small bowel. </p>
<p>Some 90% of IBS participants retained the gas in their intestines compared to only 20% of control subjects. The researchers found abdominal distension was directly correlated with gas retention.</p>
<p>Some people also have problems evacuating this gas, or farting. People with IBS and chronic constipation, for instance, may have difficulty relaxing and opening their anal sphincter to release farts. </p>
<p>This can lead to <a href="https://www.ncbi.nlm.nih.gov/pubmed/11408265">intestinal gas retention</a> and symptoms of bloating, abdominal pain and <a href="https://www.ncbi.nlm.nih.gov/pubmed/20179695">distension</a>. </p>
<h2>Pain without looking bloated</h2>
<p>Despite feeling extremely bloated, some people have minimal or no distension of their stomach. </p>
<p>Research among people with IBS suggests this pain and discomfort may be due to a <a href="https://www.ncbi.nlm.nih.gov/pubmed/12055583">heightened sensitivity</a> in the gut when a section of the abdomen stretches.</p>
<p>In fact, <a href="https://www.ncbi.nlm.nih.gov/pubmed/18455167">one study found</a> those with bloating alone had more abdominal pain than those who had symptoms of bloating and abdominal distension.</p>
<p>If you’re <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3264926/">sensitive to this stretching</a>, are unable to move gas throughout your gut, and can’t get rid of it, you’re likely to have bloating and pain, whether or not there’s any visual sign. </p>
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Read more:
<a href="https://theconversation.com/nervous-tummy-why-you-might-get-the-runs-before-a-first-date-106925">Nervous tummy: why you might get the runs before a first date</a>
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<img src="https://counter.theconversation.com/content/107605/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Vincent Ho 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>People who bloat don’t produce more abdominal gas than others but they might have problems getting rid of it.Vincent Ho, Senior Lecturer and clinical academic gastroenterologist, Western Sydney UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/883002018-01-08T02:42:00Z2018-01-08T02:42:00ZIf you don’t have coeliac disease, avoiding gluten isn’t healthy<figure><img src="https://images.theconversation.com/files/198925/original/file-20171213-31706-198x1s8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Of the many food fads, "gluten free" is one that can be unhealthy. </span> <span class="attribution"><span class="source">from www.shutterstock.com</span></span></figcaption></figure><p>Coeliac disease, an allergy to gluten that causes damage to the intestine, affects <a href="http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.184.679&rep=rep1&type=pdf">1% of Australians</a>. But <a href="https://www.cambridge.org/core/journals/public-health-nutrition/article/motivations-for-avoiding-wheat-consumption-in-australia-results-from-a-population-survey/25FD610AA022221398C214691AB705DC">more than ten times this number</a>, or around 11% of the population, follows a gluten-free diet by choice, and up to 30% of people in the United States <a href="https://www.npd.com/wps/portal/npd/us/news/press-releases/percentage-of-us-adults-trying-to-cut-down-or-avoid-gluten-in-their-diets-reaches-new-high-in-2013-reports-npd/">try to reduce their gluten intake</a>. </p>
<p>Gluten-free foods are frequently perceived as a healthier alternative, because of a alignment with a “wellness lifestyle”. But is there scientific evidence to support this? </p>
<h2>Are gluten-free diets healthier?</h2>
<p>Recent large studies have not found health benefits for a gluten-free diet, and in fact the opposite may be true. </p>
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Read more:
<a href="https://theconversation.com/health-check-should-i-choose-a-gluten-free-diet-30305">Health Check: should I choose a gluten-free diet?</a>
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<p><a href="http://www.bmj.com/content/357/bmj.j1892">Researchers followed a group</a> of more than 100,000 people in the US for nearly 30 years and found a gluten-free diet was not associated with a healthier heart. It’s not clear whether this was due to something in the gluten-free foods, or the avoidance of wholegrains, which are considered protective against heart disease. </p>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/10204832">One study suggests gluten may be beneficial</a> because it lowers levels of triglycerides in the blood. These are “bad” fats that increase the risk of heart disease.</p>
<p><a href="http://circ.ahajournals.org/content/135/Suppl_1/A11">Another large study</a> has found an inverse association between gluten intake and type 2 diabetes. People with a lower gluten intake had higher rates of type 2 diabetes. The researchers found this group also had lower fibre intake, and wondered whether low fibre was the culprit. But even after accounting for the lower fibre intake, an association remained, suggesting avoiding gluten is not protective against developing type 2 diabetes.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/198929/original/file-20171213-31716-o48s7w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/198929/original/file-20171213-31716-o48s7w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/198929/original/file-20171213-31716-o48s7w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=397&fit=crop&dpr=1 600w, https://images.theconversation.com/files/198929/original/file-20171213-31716-o48s7w.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=397&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/198929/original/file-20171213-31716-o48s7w.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=397&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/198929/original/file-20171213-31716-o48s7w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=499&fit=crop&dpr=1 754w, https://images.theconversation.com/files/198929/original/file-20171213-31716-o48s7w.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=499&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/198929/original/file-20171213-31716-o48s7w.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"></a>
<figcaption>
<span class="caption">Not eating enough gluten could increase the risk of diabetes.</span>
<span class="attribution"><span class="source">from www.shutterstock.com</span></span>
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</figure>
<h2>Gluten free and diabetes</h2>
<p>Wholegrain products are made using the three parts of the grain – the bran (outside, which is rich in fibre), the germ (the seed) and the endosperm (the starchy, carbohydrate-rich centre). Together they form a bundle of fibre, carbohydrate, vitamins and minerals. Packaged gluten-free products such as bread frequently use only the carbohydrate component using refined flours from rice, corn or potato. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/everything-you-need-to-know-about-coeliac-disease-and-whether-you-really-have-it-4928">Everything you need to know about coeliac disease (and whether you really have it)</a>
</strong>
</em>
</p>
<hr>
<p>These high carbohydrate foods may cause a sharp rise in blood sugar levels and may predispose to diabetes in the long term. Packaged gluten-free products often have added sugars to enhance flavour, and add emulsifiers and thickeners to improve the texture and make it similar to bread.</p>
<p>Gluten-free markets have risen exponentially in the last decade due to consumer demand, even extending to the production of <a href="https://search.mypetwarehouse.com.au/mypetwarehouse/Gluten-Free-Dog-Food?gclid=EAIaIQobChMIgMaLnZaI2AIVwTUrCh2YKgjmEAAYAyAAEgLV1_D_BwE">gluten-free food for dogs</a>. Whether the market will expand or diminish with time is unknown, but food fashions are not new.</p>
<p>Consider the popularity of low-fat diets in the 1980s, when butter was a villain. Now butter is now back in vogue, with sales increasing. Similarly, red wine used to be considered protective for cardiac health, but <a href="https://www.nhmrc.gov.au/health-topics/alcohol-guidelines">guidelines for safe alcohol consumption</a> now recommend reduced intake.</p>
<p>Of course, naturally gluten-free products such as plant-based foods, ancient grains and dairy are all part of a healthy and balanced diet, but there does not seem to be a health benefit for the processed and packaged gluten-free replacements over wheat-based versions.</p>
<h2>Why are gluten-free diets so popular?</h2>
<p>Non-coeliac gluten sensitivity is <a href="https://www.coeliac.org.uk/coeliac-disease/about-coeliac-disease-and-dermatitis-herpetiformis/gluten-sensitivity/">different from coeliac disease</a>. In coeliac disease, gluten intake causes damage to the intestine’s lining, which reverses with a gluten-free diet. In non-coeliac gluten sensitivity (also called “gluten intolerance”), symptoms like bloating and wind are common, but no intestinal damage or long-term health effects occur. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-do-people-decide-to-go-gluten-or-wheat-free-50452">Why do people decide to go gluten- or wheat-free?</a>
</strong>
</em>
</p>
<hr>
<p>To better understand this condition, researchers set out to determine whether it was gluten intake or the perception of gluten intake that may be contributing. <a href="https://www.ncbi.nlm.nih.gov/pubmed/23648697">They designed a study</a> in which self-identified gluten-sensitive people were fed gluten-free, low gluten and high gluten foods, but didn’t know which they were eating.</p>
<p>All diets were also low in <a href="https://daa.asn.au/smart-eating-for-you/smart-eating-fast-facts/medical/fodmaps-and-ibs-whats-the-deal/">wind-causing sugars, called FODMAPs</a>, which can cause similar symptoms. They found most of the group improved regardless of whether they were on a high gluten, low gluten or gluten-free diet. They concluded there was no evidence for gluten alone being responsible, but the reduction in FODMAPs could explain the symptom improvement.</p>
<p>Another reason people may report improvement when commencing a gluten-free diet is the exclusion of many other foods that are known not to be healthy, such as cakes, biscuits, crackers and beer. These dietary changes may also contribute to overall wellbeing. </p>
<h2>So where to from here?</h2>
<p>For people without coeliac disease, there’s no evidence to support claims a strict gluten-free diet is beneficial for health. It’s even possible the opposite is true, and the avoidance of dietary whole grains resulting in a low fibre intake may be detrimental. </p>
<p>Given gluten-free foods <a href="http://onlinelibrary.wiley.com/doi/10.1111/1747-0080.12171/abstract">cost around 17% more</a>, perhaps it’s time to reconsider a strict gluten-free diet chosen for health benefits alone, and instead include a diversity of gluten and gluten-free foods, with dietary variety as the key.</p><img src="https://counter.theconversation.com/content/88300/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Suzanne Mahady 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>Avoiding gluten may actually be doing more harm than good.Suzanne Mahady, Gastroenterologist & Clinical Epidemiologist, Senior Lecturer, Monash UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/744962017-03-15T10:07:41Z2017-03-15T10:07:41ZGut bacteria play a role in long-term weight gain<figure><img src="https://images.theconversation.com/files/160697/original/image-20170314-10720-1g3bqgp.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/531323893?size=medium_jpg">Sharomka/Shutterstock.com</a></span></figcaption></figure><p>Weight gain happens when we consume more food than we can burn, and weight loss happens when we burn more energy than we consume. But why do some people seem to eat whatever they want and not gain weight, and others appear to gain weight even if they eat reasonable amounts of food? The answer, at least in part, may be found in the bacteria that live in our guts. </p>
<p>Our latest research, published in the <a href="http://www.nature.com/ijo/journal/vaop/naam/abs/ijo201766a.html">International Journal of Obesity</a>, shows that people who have a stable weight over nine years or lose weight, have a larger number of different types of microbes in their guts, eat more fibre and have a higher abundance of certain types of gut microbes.</p>
<p>In the past decade, researchers have found that the microbes in our gut have a strong effect on various aspects of our health. Studies in mice have demonstrated that how the body converts food into energy depends in large part on the different types of microbes a person has in their gut and also on the kind of microbes they carry.</p>
<p>In a <a href="http://theconversation.com/why-frequent-dieting-makes-you-put-on-weight-and-what-to-do-about-it-69329">recent study</a>, scientists in Israel found that mice who were put on a yo-yo diet slowly gained weight compared with mice on a steady diet – despite the fact that both groups received the same amount of calories overall. </p>
<p>One of the effects seen in the mice that were put on the yo-yo diet was a decrease in their gut microbiome diversity. Also, when they transplanted the microbes from the yo-yo dieters into the guts of non-yo-yo dieters, the mice on steady diets gained weight – showing that the altered microbes were the cause of the weight gain. But is this relevant to humans?</p>
<p>In humans, comparing microbes in the gut in obese and thin individuals, scientists have already shown that lean people have many more species of intestinal bacteria than obese people.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/160739/original/image-20170314-10720-1e5u042.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/160739/original/image-20170314-10720-1e5u042.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/160739/original/image-20170314-10720-1e5u042.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/160739/original/image-20170314-10720-1e5u042.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/160739/original/image-20170314-10720-1e5u042.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/160739/original/image-20170314-10720-1e5u042.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/160739/original/image-20170314-10720-1e5u042.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">I’ve been on a yo-yo diet.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/406573012?src=230e2_hfgEaJo1Sf4S3W7A-1-2&size=medium_jpg">Janson George/Shutterstock.com</a></span>
</figcaption>
</figure>
<h2>What twins taught us</h2>
<p>Until now, however, there were no experiments tying the gut microbes to changes in weight over several years. For this reason, we decided to do an <a href="http://www.nature.com/ijo/journal/vaop/naam/abs/ijo201766a.html">investigation</a> into 1,632 women from the UK, all of them twins (about half of them identical). The participants had their body weight measured several years ago and, back then, they answered questions about the amounts and types of foods that they ate. We called them again nine years later and, in addition to measuring their weight, we asked them to give us a poo sample so we could analyse the bacteria in their gut.</p>
<p>We found that most of the women gained weight over the nine years, but this was not fully explained by the number of calories in their diet when the study began. Because they are twins, it was also possible to calculate (using the differences between identical and non-identical twins) how much of the weight gain can be explained by genes. Only 41% of the change in weight was explained by genes. That meant that there were other factors, in addition to genes and calories. </p>
<p>We discovered that women who ate high amounts of dietary fibre (found in fruit, vegetables and whole grains) were less likely to gain weight than those who ate little fibre, even if they consumed roughly the same amount of calories. Women who lost weight or had stable weight also had more diverse microbes in their guts. We were able to pinpoint some of the microbes that are different between women who had gained weight and those who had lost weight. Most of these microbes had already been discovered in mice to be involved in better energy metabolism.</p>
<p>These results show that the exciting studies in mice about how microbes affect weight gain are also relevant in humans. They are also important because they will allow our group, and other scientists, to investigate how to influence a person’s gut microbes – using probiotics and fibre – so they are at a lower risk of developing obesity.</p><img src="https://counter.theconversation.com/content/74496/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ana Valdes 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 make-up of your gut bacteria will determine whether or not you put on weight.Ana Valdes, Associate Professor and Reader, University of NottinghamLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/691262016-11-22T12:32:52Z2016-11-22T12:32:52ZEat your fibre or face the flesh-eating microbe cannibals<figure><img src="https://images.theconversation.com/files/146677/original/image-20161120-19356-ck9i2j.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/371849248?src=MYEnBWBcO7yNXNjCpvEbsg-1-14&id=371849248&size=medium_jpg">Moving Moment/Shutterstock.com</a></span></figcaption></figure><p>“Eat your bran even if it tastes horrible – its good for you!” Many of us remember this advice from decades ago. While fibre has been a good cure as a bulking agent for exciting disorders like constipation, it has a dull image and has faded into the background behind trendier (and more commercial) food messages like gluten, cholesterol, saturated fat and sugar. Often it can be the hardest item to find on the food label. </p>
<p>But fibre’s fortunes may now be on the turn. New research in the journal <a href="http://www.cell.com/cell/abstract/S0092-8674(16)31464-7?_returnURL=http%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867416314647%3Fshowall%3Dtrue">Cell</a> sheds light on how fibre works to protect the gut.</p>
<p>An international team used special mice born and raised in sterile conditions with no gut microbes of their own. Normally, all animals from birth have a massive microbe community living mainly in the lower intestine (colon). In humans, this reaches 100 trillion microbes – outnumbering our own cells. </p>
<p>These microbes (mainly bacteria but also viruses and fungi) have co-evolved with us and produce many of our vitamins, hormones and chemicals. They are also key to regulating our immune systems, weight and mood. Abnormalities have been linked to many disorders. Humans have around 17 digestive enzymes and microbes have thousands – the primary role of microbes is digesting high fibre foods (that we can’t) to extract the key nutrients.</p>
<p>In the experiment, the sterile mice received a transplant of 14 well-known bacteria that normally grow in the human gut. They were then starved of fibre, which led the microbes to change their normal eating habits and instead feed on the natural layer of mucus (made up of tasty carbs) that lines the gut. This would be fine for short periods of time, when the body has time to regenerate the layer, but when it is prolonged – as in people on long-term junk food diets – the mucus layer becomes dangerously thin.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/146957/original/image-20161122-24543-edhvfn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/146957/original/image-20161122-24543-edhvfn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=392&fit=crop&dpr=1 600w, https://images.theconversation.com/files/146957/original/image-20161122-24543-edhvfn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=392&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/146957/original/image-20161122-24543-edhvfn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=392&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/146957/original/image-20161122-24543-edhvfn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=493&fit=crop&dpr=1 754w, https://images.theconversation.com/files/146957/original/image-20161122-24543-edhvfn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=493&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/146957/original/image-20161122-24543-edhvfn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=493&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 permanent junk-food diet can be extremely harmful.</span>
<span class="attribution"><span class="source">Dmitri Ma</span></span>
</figcaption>
</figure>
<p>The new study showed that when the mucus layer is thinner because of a lack of fibre the gut is much more susceptible to infections. Microbes more easily cross the gut wall into the blood stream. As well as infections this also causes irritation and inflammation of the colon – called colitis. This is believed to be the basis of many common modern gut problems. The team tried to rectify the problem by feeding the mice with prebiotics. They found that while real unprocessed fibre did the trick, when the mice were fed processed, supplement fibre, like <a href="http://health.usnews.com/health-news/blogs/eat-run/2015/05/05/what-is-inulin-chicory-root-fiber">inulin powder</a>, it didn’t work nearly as well.</p>
<h2>What about humans?</h2>
<p>What are the lessons we can learn for our own diets? It underlines first how crucial fibre is to our health. Our own TwinsUK study has recently shown that low fibre eaters gain weight more quickly and have less microbial diversity. Most of us are eating far below the <a href="https://theconversation.com/health-check-are-you-eating-the-right-sorts-of-fibre-20089">minimum recommendation of 25-30g per day</a> causing a deficiency which could <a href="https://theconversation.com/explainer-what-is-irritable-bowel-syndrome-34039">explain modern epidemics like food allergies and irritable bowel syndrome</a>, which have been related to the ill defined and hard to measure problem of “leaky gut”. </p>
<p>If we ate more fibre and increased the diversity and health of our microbes this could prevent many diseases. It also suggests that real plant food as a source of fibre is better than processed or refined fibre produced industrially. This has implications for the food industry – and as with vitamin supplements reinforces the view that (although we don’t yet know why) natural is best.</p>
<p>The new study also helps us understand why people on permanent junk food diets do so badly. As I reported previously, ten days of an intensive burger and fries diet can decimate the number (and diversity) of healthy microbes by <a href="https://theconversation.com/your-gut-bacteria-dont-like-junk-food-even-if-you-do-41564">up to 40%</a>. </p>
<p>This new work confirms that fibre starvation is the major factor affecting the microbes – not just fat and sugar overload. The clear message is that we need to eat regular real plant fibre to keep our microbes happy and prevent them devouring our guts from the inside. Food for thought indeed.</p><img src="https://counter.theconversation.com/content/69126/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tim Spector is a co-founder of British Gut and MapmyGut Ltd and receives funding from many sources including NIHR, EU, Wellcome Trust and MRC. He is author of "The Diet Myth"- the real science behind what we eat - Orion 2016 </span></em></p>Low fibre eaters gain weight more quickly and may be more susceptible to certain illnesses.Tim Spector, Professor of Genetic Epidemiology, King's College LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/639402016-10-06T19:09:21Z2016-10-06T19:09:21ZSeven things to eat or avoid to lower your blood pressure<figure><img src="https://images.theconversation.com/files/140682/original/image-20161006-14721-1oivgdv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">To improve your blood pressure, eat rolled oats or oat bran for breakfast.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-471049649/stock-photo-young-girl-eating-a-oatmeal-with-berries-after-a-workout-fitness-and-healthy-lifestyle-concept.html?src=ACF9SbwVzuy8VKp0NFBtsw-1-17">Rasulov/Shutterstock</a></span></figcaption></figure><p>High blood pressure is called the <em>silent killer</em>. That’s because it has <a href="http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/SymptomsDiagnosisMonitoringofHighBloodPressure/What-are-the-Symptoms-of-High-Blood-Pressure_UCM_301871_Article.jsp#.V7OWWI9OI2w">no symptoms</a>. Having high blood pressure (hypertension) increases your risk of heart disease, stroke, heart failure and kidney disease. </p>
<p>Six million Australian adults (34%) have high blood pressure – 140/90 millimetres of mercury (mmHg) or more – or take medications for it. Of those, <a href="https://heartfoundation.org.au/images/uploads/publications/PRO-167_Hypertension-guideline-2016_WEB.pdf">four million have high blood pressure that isn’t treated or under control</a>.</p>
<p>No wonder heart disease and stroke directly cost the Australian economy <a href="http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129546379">A$7.7 billion a year</a>. </p>
<p>There is some good news. High blood pressure can be treated or prevented. Eating oats, fruit and vegetables – and beetroot, in particular – helps. So does avoiding salt, liquorice, caffeine and alcohol.</p>
<p>Optimal blood pressure is <a href="https://theconversation.com/blood-pressure-targets-what-does-the-new-guideline-say-and-how-low-should-you-go-62684">120 mmHg or less</a> over 80 mmHg or less. Lowering it by 1-2 mmHg can have a big impact on reducing your risk of heart disease and stroke, and the nation’s health care costs. </p>
<h2>What to eat to lower your blood pressure</h2>
<p><strong>Rolled oats</strong> </p>
<p>A <a href="http://www.ncbi.nlm.nih.gov/pubmed/25668347">review with five research trials included</a> tested the impact of oats on systolic blood pressure (the first blood pressure number, which is the pressure at which the heart pumps blood) and diastolic blood pressure (the second number, which is when the heart relaxes) in about 400 healthy adults. </p>
<hr>
<blockquote>
<p><strong>Further reading:</strong> <a href="https://theconversation.com/health-check-what-do-my-blood-pressure-numbers-mean-29212">What do my blood pressure numbers mean?</a></p>
</blockquote>
<hr>
<p>The researchers found that systolic blood pressure was 2.7 mmHg lower and diastolic blood pressure was 1.5 mmHg lower when participants ate around 60 grams of rolled oats (a packed half-cup raw oats) or 25 grams of oat bran per day.</p>
<p>This quantity of oats or oat bran contains around four grams of a type of fibre called <a href="http://www.healthline.com/health/beta-glucan-heart-healthy">beta-glucan</a>.</p>
<p>For each extra one gram of total daily fibre, there was an extra 0.11 mmHg reduction in diastolic blood pressure. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/140683/original/image-20161006-14706-p77sl0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/140683/original/image-20161006-14706-p77sl0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/140683/original/image-20161006-14706-p77sl0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/140683/original/image-20161006-14706-p77sl0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/140683/original/image-20161006-14706-p77sl0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/140683/original/image-20161006-14706-p77sl0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/140683/original/image-20161006-14706-p77sl0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Half a cut of oats a day is enough.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-445165693/stock-photo-rolled-oats-or-oat-flakes-in-jar-healthy-lifestyle-concept-top-view-closeup.html?src=H2RPyGhwLE2Fx44GC5Py4A-1-92">Julia Pajumae/Shutterstock</a></span>
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</figure>
<p>Recommended <a href="https://www.nrv.gov.au/nutrients/dietary-fibre">minimum daily adult fibre intakes</a> are 30 grams for men and 25 grams for women. </p>
<p>While some of fibre’s effect is due to weight loss, soluble fibres produce bioactive products when they’re fermented in the large bowel. These work directly to lower blood pressure. </p>
<p>To improve your blood pressure, eat rolled oats or oat bran for breakfast, add to meat patties, or mix with breadcrumbs in recipes that call for crumbing.</p>
<p><strong>Beetroot</strong></p>
<p>Beetroot is extremely rich in a compound called inorganic nitrate. During digestion, this gets converted into nitric oxide, which causes arteries to dilate. This directly lowers the pressure in them. </p>
<p>A <a href="http://www.ncbi.nlm.nih.gov/pubmed/23596162">review of 16 trials</a> of mostly healthy young men found drinking beetroot juice was associated with a 4.4 mmHg reduction in systolic blood pressure. But it found no change in diastolic blood pressure. </p>
<p>However a recent <a href="http://www.ncbi.nlm.nih.gov/pubmed/25421976">trial in 68 adults</a> who already had high blood pressure found beetroot juice reduced systolic and diastolic blood pressure. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/140684/original/image-20161006-14713-tpoai3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/140684/original/image-20161006-14713-tpoai3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=415&fit=crop&dpr=1 600w, https://images.theconversation.com/files/140684/original/image-20161006-14713-tpoai3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=415&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/140684/original/image-20161006-14713-tpoai3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=415&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/140684/original/image-20161006-14713-tpoai3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=521&fit=crop&dpr=1 754w, https://images.theconversation.com/files/140684/original/image-20161006-14713-tpoai3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=521&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/140684/original/image-20161006-14713-tpoai3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=521&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Drinking beetroot juice can lower blood pressure.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-141709798/stock-photo-beetroot.html?src=20BL8p45gc8PhVlJcfQ7xQ-1-23">Yevgeniya Shal/Shutterstock</a></span>
</figcaption>
</figure>
<p>The men were randomly assigned to drink 250ml (one cup) of beetroot juice daily for four weeks or a non-active placebo. </p>
<p>Blood pressure in the men who drank the beetroot juice reduced over 24 hours, with systolic blood pressure 7.7 mmHg lower and diastolic blood pressure 5.2 mmHg lower. </p>
<p>Try wrapping whole fresh beetroot in foil and baking in the oven until soft, or grate beetroot and stir-fry with red onion and curry paste and eat as a relish. </p>
<p><strong>Vitamin C</strong></p>
<p>Vitamin C, or <a href="https://en.wikipedia.org/wiki/Vitamin_C">ascorbic acid</a>, is found in fresh vegetables and fruit. An average serve contains 10-40mg of vitamin C. </p>
<p>In a review of 29 short-term <a href="http://www.ncbi.nlm.nih.gov/pubmed/22492364">trials of vitamin C supplements</a>, people were given 500 mg of vitamin C per day for about eight weeks. </p>
<p>Blood pressure significantly improved, with an average reduction in systolic blood pressure of 3.84 mmHg and 1.48 mmHg for diastolic blood pressure. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/140685/original/image-20161006-14713-1e2i1o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/140685/original/image-20161006-14713-1e2i1o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=397&fit=crop&dpr=1 600w, https://images.theconversation.com/files/140685/original/image-20161006-14713-1e2i1o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=397&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/140685/original/image-20161006-14713-1e2i1o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=397&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/140685/original/image-20161006-14713-1e2i1o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=499&fit=crop&dpr=1 754w, https://images.theconversation.com/files/140685/original/image-20161006-14713-1e2i1o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=499&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/140685/original/image-20161006-14713-1e2i1o.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">Good news for fruit-lovers.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-263051609/stock-photo-citrus-juice-and-slices-of-orange-grapefruit-lemon-vitamin-c-black-background.html?src=kTABgrBPopNt-jCf5NnazQ-1-1">saschanti17/Shutterstock</a></span>
</figcaption>
</figure>
<p>When only those with existing high blood pressure were considered, the drop in systolic blood pressure was 4.85 mmHg. </p>
<p>However, those <a href="http://www.ncbi.nlm.nih.gov/pubmed/26463139">at risk of kidney stones</a> need to be cautious about taking vitamin C supplements. Excess vitamin C is excreted via the kidneys and can contribute to the formation of kidney stones. </p>
<p>One advantage of getting more vitamin C from eating more vegetables and fruit is that you boost your potassium intake, which helps <a href="http://www.bloodpressureuk.org/microsites/salt/Home/Whypotassiumhelps">counter the effects of sodium</a> from salt. </p>
<h2>What to avoid to lower your blood pressure</h2>
<p><strong>Salt</strong></p>
<p>Salt or <a href="https://en.wikipedia.org/wiki/Salt">sodium chloride</a> has been used to preserve foods and as a flavour enhancer for centuries. </p>
<p>High salt intakes are <a href="http://www.bmj.com/content/312/7041/1249?ijkey=cd4b7840cc559055a2997d90100361217218f6e8&keytype2=tf_ipsecsha">associated with higher blood pressure</a>. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/140686/original/image-20161006-14706-ddrtye.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/140686/original/image-20161006-14706-ddrtye.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/140686/original/image-20161006-14706-ddrtye.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/140686/original/image-20161006-14706-ddrtye.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/140686/original/image-20161006-14706-ddrtye.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/140686/original/image-20161006-14706-ddrtye.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/140686/original/image-20161006-14706-ddrtye.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">Most Australians eat way too much salt.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-402073258/stock-photo-old-wooden-table-with-a-salt-shaker-close-up-shot-selective-focus.html?src=4WqYbxqDDZt24yBR5bMZXA-1-3">HandmadePictures/Shutterstock</a></span>
</figcaption>
</figure>
<p>Adults <a href="https://www.nrv.gov.au/nutrients/sodium">need between 1.2 to 2.4g of salt each day</a> (one-quarter to a half teaspoon), which is equivalent to 460 to 920mg of sodium. </p>
<p>But in Australia seven out of ten men and three in ten women eat way more than that – and much more than the upper recommended limit of 5.9 grams of salt (about one teaspoon) or <a href="http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.008%7E2011-12%7EMain%20Features%7ESodium%7E403">2,300 mg of sodium per day</a>. </p>
<hr>
<blockquote>
<p><strong>Further reading:</strong> <a href="https://theconversation.com/health-check-how-much-salt-is-ok-to-eat-58594">How much salt is it OK to eat?</a></p>
</blockquote>
<hr>
<p>If you add salt to food yourself this pushes your sodium intake even higher. </p>
<p>A <a href="http://www.ncbi.nlm.nih.gov/pubmed/23558162">review of studies</a> involving 3,230 people showed that reducing salt intakes by 4.4 grams a day could reduce systolic blood pressure by about 4.2 mmHg and diastolic by 2.1 mmHg. </p>
<p>In those who had high blood pressure there were even bigger reductions of 5.4 mmHg (systolic) and 2.8 mmHg (diastolic). </p>
<p>Avoid foods high in sodium. Don’t add salt and try to choose lower-salt versions of processed foods.</p>
<p><strong>Alcohol</strong></p>
<p>Consuming one or more alcoholic drink a day is <a href="http://www.ncbi.nlm.nih.gov/pubmed/15752957">associated with systolic blood pressure</a> that is about 2.7 mmHg and diastolic blood pressure 1.4 mmHg higher than non-drinkers. </p>
<p>Interestingly, when you first drink an alcoholic beverage, blood pressure goes down, only to rise later. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/140687/original/image-20161006-14716-w3b4fm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/140687/original/image-20161006-14716-w3b4fm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/140687/original/image-20161006-14716-w3b4fm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/140687/original/image-20161006-14716-w3b4fm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/140687/original/image-20161006-14716-w3b4fm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/140687/original/image-20161006-14716-w3b4fm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/140687/original/image-20161006-14716-w3b4fm.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">
<figcaption>
<span class="caption">Drinkers have higher blood pressure than non-drinkers.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-193454063/stock-photo-drinks-with-glasses-of-wine-white-and-friends-filter-vintage.html?src=otdLGGb0w-J4r3OzlIRB2w-1-24">serenarossi/Shutterstock</a></span>
</figcaption>
</figure>
<p>A rise in blood pressure after drinking alcohol is <a href="http://www.ncbi.nlm.nih.gov/pubmed/26123682">more likely to happen when you’re awake</a>, rather during sleep. </p>
<p>The bad news is that larger amounts of alcohol increase your risk of high blood pressure, <a href="http://www.ncbi.nlm.nih.gov/pubmed/23126352">especially in men</a>, but also to a lesser extent <a href="http://www.ncbi.nlm.nih.gov/pubmed/19804464">in women</a>. </p>
<p><strong>Liquorice</strong></p>
<p>High blood pressure due to eating black liquorice is rare, but <a href="http://www.ncbi.nlm.nih.gov/pubmed/26380428">case reports have occurred</a>. </p>
<p>Most liquorice candy sold currently contains very little true liquorice root and therefore, little <a href="https://en.wikipedia.org/wiki/Glycyrrhizin">glycyrrhizic acid</a> (GZA), the active ingredient. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/140688/original/image-20161006-14748-6ws04u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/140688/original/image-20161006-14748-6ws04u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/140688/original/image-20161006-14748-6ws04u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/140688/original/image-20161006-14748-6ws04u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/140688/original/image-20161006-14748-6ws04u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/140688/original/image-20161006-14748-6ws04u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/140688/original/image-20161006-14748-6ws04u.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">Most liquorice contains very little liquorice root.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-399432979/stock-photo-licorice-root-on-white-background.html?src=l-hm31fthr8Iky1766kYqQ-1-0">Siegi/Shutterstock</a></span>
</figcaption>
</figure>
<p>Occasionally, liquorice candy does contain GZA in large amounts. <a href="http://www.ncbi.nlm.nih.gov/pubmed/10944880">GZA causes sodium retention and potassium loss</a>, which contributes to high blood pressure. </p>
<p>So check liquorice food labels. Take care <em>if</em> it contains liquorice root. </p>
<p><strong>Caffeine</strong></p>
<p>Caffeine is most commonly consumed in coffee, tea, cola and energy drinks. </p>
<p>High intakes of caffeine from coffee <a href="http://www.ncbi.nlm.nih.gov/pubmed/21880846">increase blood pressure</a> in the short term. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/140689/original/image-20161006-14701-18l35gz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/140689/original/image-20161006-14701-18l35gz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/140689/original/image-20161006-14701-18l35gz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/140689/original/image-20161006-14701-18l35gz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/140689/original/image-20161006-14701-18l35gz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/140689/original/image-20161006-14701-18l35gz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/140689/original/image-20161006-14701-18l35gz.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">You need to monitor your individual response to caffeine.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-295812896/stock-photo-coffee-cup-coffee-cup.html?src=iPEQXtgO7KH-71qogk7nOw-1-53">Billion Photos/Shutterstock</a></span>
</figcaption>
</figure>
<p>In a <a href="https://www.ncbi.nlm.nih.gov/pubmed/21880846">review of five trials</a>, people given one to two cups of strong coffee had an increase in their systolic blood pressure of 8.1 mmHg and 5.7 mmHg for diastolic blood pressure, up to about three hours after drinking it. </p>
<p>But three studies that lasted two weeks found drinking coffee did not increase blood pressure compared with decaffeinated coffee or avoiding caffeine. So you need to monitor your individual response to caffeine.</p><img src="https://counter.theconversation.com/content/63940/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Clare Collins is affiliated with the Priority Research Centre in Physical Activity and Nutrition, the University of Newcastle, NSW. She is an NHMRC Senior Research fellow. She created the online Healthy Eating Quiz and the Australian Eating Survey. She has received funding from a range of research grants including NHMRC, ARC, Hunter Medical Research Institute, Meat and Livestock Australia. She has consulted to SHINE Australia and Novo Nordisk. Clare Collins is a spokesperson for the Dietitians Association of Australia on specific nutrition issues, including Australia's Healthy Weight Week. </span></em></p><p class="fine-print"><em><span>Tracy Burrows is affiliated with The Priority Research Centre of Physical Activity and Nutrition and Faculty of Medicine and Public Health, University of Newcastle. She has received funding from the NHMRC, ARC, Hunter Medical Research Institute, Meat and Livestock. She is currently a Senior Lecturer and an Advanced Accredited Practising Dietitian.</span></em></p><p class="fine-print"><em><span>Tracy Schumacher is affiliated with the Priority Research Centre in Physical Activity and Nutrition and the Faculty of Health and Medicine at University of Newcastle, NSW. She has received funding from the Hunter Medical Research Institute. She is the current chair of the professional development committee for the NSW/ACT Cardiac Rehabilitation Association and member of the Nutrition Society of Australia.</span></em></p>High blood pressure can be treated or prevented. Eating oats, fruit and vegetables – and beetroot, in particular – helps. So does avoiding salt, liquorice, caffeine and alcohol.Clare Collins, Professor in Nutrition and Dietetics, University of NewcastleTracy Burrows, Senior Lecturer Nutrition and Dietetics, University of NewcastleTracy Schumacher, Research Associate, University of NewcastleLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/331942014-11-24T04:41:50Z2014-11-24T04:41:50ZHealth Check: five food tips that could save your life after a heart attack<figure><img src="https://images.theconversation.com/files/65337/original/image-20141124-19627-1cqkdbi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Any improvements you can make to what you eat and drink will help stack the odds in your favour.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-174191435/stock-photo-man-with-heart-attack.html?src=R1-1l3QSjryQ0uyMyRQJJA-1-0">Image Point Fr/Shutterstock</a></span></figcaption></figure><p>Every ten minutes in Australia <a href="http://www.heartfoundation.org.au/information-for-professionals/data-and-statistics/Pages/default.aspxhttp://example.com/">someone has</a> a heart attack. For 17% this will be fatal; the rest get a second chance. If you have had a close call, these five food tips will help get your health back on track. </p>
<h2>1. Eat more wholegrain cereals</h2>
<p>There are heart health benefits from <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3708330/">eating a range</a> of wholegrain fibres. These <a href="http://wholegrainscouncil.org/whole-grains-101/definition-of-whole-grains">include</a> barley, buckwheat, bulgur wheat, corn and popcorn, millet, oats, quinoa, brown rice, wild rice, rye, triticale (a wheat-rye hybrid) and spelt wheat. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/65300/original/image-20141124-19636-u8azap.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/65300/original/image-20141124-19636-u8azap.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/65300/original/image-20141124-19636-u8azap.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/65300/original/image-20141124-19636-u8azap.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/65300/original/image-20141124-19636-u8azap.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/65300/original/image-20141124-19636-u8azap.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/65300/original/image-20141124-19636-u8azap.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">Buckwheat is a fibrous wholegrain cereal loaded with heart health benefits.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/ervins_strauhmanis/9548721480/in/photolist-cqJPPE-ePJo3b-8BpWRq-fBd6ms-6X8k4B-oXx4jb-3h5ny8-eMZh1e-6XpdKX-4j69X-o7jbCT-fxMGdY-fxxugg-8BpWFE-pgpYYt-4kbee-nMPswg-ePwXSx-32Kce1-8y2DVX/">Ervins Strauhmanis/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>The health benefits of some fibres have been studied more extensively than others. <a href="http://www.uofmhealth.org/health-library/hn-2805007#hn-2805007-uses">Beta-glucan</a>, for instance, is a soluble fibre found in oats and barley. It helps to lower total and LDL (bad) cholesterol. </p>
<p><a href="http://ajcn.nutrition.org/content/71/5/1123.full">Arabinoxylan</a> is a wheat fibre that improves blood sugar levels and insulin sensitivity. </p>
<p><a href="http://umm.edu/health/medical/altmed/supplement/psyllium">Psyllium</a>, which comes from the the seed coat of the Plantago plant, can add an extra fibre boost. You buy it at the supermarket as a dry ingredient and it forms a gel when mixed with liquid. It works to reduce the absorption of bile acids in the small intestine, which helps lower blood fat levels, including total and LDL cholesterol and <a href="http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Triglycerides?open">triglycerides</a>. </p>
<p>A <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4004785/">study of fibre intake</a> in adults who survived an initial heart attack found those in the top 20% of cereal fibre intake had a 27% lower risk of death compared to the bottom 20%. </p>
<p>Those who increased their fibre intake after their heart attack had a 31% lower risk of death and a 35% lower risk of dying from heart disease compared to those who had the least improvement in fibre intake. </p>
<p>Higher-fibre intakes also fill you up, meaning you eat less.</p>
<h2>2. Eat more fruit and vegetables</h2>
<p>Australian <a href="https://www.eatforhealth.gov.au/">Dietary Guidelines</a> recommend we eat two serves of fruit and five serves of vegetables a day. While over <a href="http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4364.0.55.007main+features12011-12">50% of adults meet the fruit target</a>, less than 7% of people do so for vegetables. </p>
<p>A <a href="http://www.bmj.com/content/349/bmj.g4490">2014 review</a> of six studies covering more than 670,000 people found that for each extra serve of fruit or vegetables eaten each day, the risk of dying from heart disease was reduced by an additional 4%. </p>
<p>Higher intakes of <a href="http://www.ars.usda.gov/aboutus/docs.htm?docid=4142">phytonutrients</a> contained in fruits and vegetables, such as polyphenols, vitamin C, carotenoids and flavonoids, are thought to help slow hardening of arteries and blood clotting. </p>
<p>Eating more fruit and vegetables also increases your potassium intake, which helps reduce blood pressure by <a href="http://www.bloodpressureuk.org/microsites/salt/Home/Whypotassiumhelps">cancelling</a> some of the harmful effect of salt. </p>
<h2>3. Focus on healthy fats</h2>
<p>For optimal heart health, it’s important get the right balance of <a href="https://theconversation.com/health-check-cooking-oils-to-eat-and-avoid-31346">healthy fats</a> versus unhealthy fats. This means avoiding fatty meats, commercial pastries, cakes and biscuits, fried, take-away and processed foods and commercial fats such as palm and coconut oil. </p>
<p>Instead, choose mono-unsaturated fats, long-chain polyunsaturated fats (including omega-3 fats), nuts and seeds, avocados, olives, oily fish, mono-unsaturated and polyunsaturated oils and margarine, including olive oil and canola. This helps to reduce total and LDL cholesterol and optimise HDL (good) cholesterol. </p>
<p>A recent <a href="http://www.ncbi.nlm.nih.gov/pubmed/25246449">American Heart Foundation study</a> of more than 4,000 people who had survived a heart attack found that among those following low-carbohydrate diets, high intakes of animal fats and protein were harmful compared to fat and protein from plant-based diets. </p>
<p>Those with the highest intakes of protein and fat from animal sources had a 51% greater risk of death from heart disease compared to the lowest. Factoring in the change in diet following a heart attack, the excess risk of dying from heart disease was still 53%.</p>
<h2>4. If you drink alcohol, have a moderate intake</h2>
<p>While no alcohol is safest to reduce your risk of developing some cancers, there is a <a href="http://www.ncbi.nlm.nih.gov/pubmed/23641990">J-shaped relationship</a> between alcohol consumption and death rates among people with heart disease: moderate intake is associated with the best survival rates. </p>
<p>In a <a href="http://www.ncbi.nlm.nih.gov/pubmed/21737162">2013 study</a> of more than 11,000 Italians who had recently had a heart attack, those who drank wine in moderation (up to 500 millilitres per day) had a 12-13% lower risk of heart attack, stroke or dying from heart disease over the next 3.5 years compared to non-drinkers. </p>
<figure class="align-left ">
<img alt="" src="https://images.theconversation.com/files/65307/original/image-20141124-19612-1p76kow.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/65307/original/image-20141124-19612-1p76kow.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/65307/original/image-20141124-19612-1p76kow.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/65307/original/image-20141124-19612-1p76kow.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/65307/original/image-20141124-19612-1p76kow.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/65307/original/image-20141124-19612-1p76kow.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/65307/original/image-20141124-19612-1p76kow.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">If you’re a heavy drinker, it’s wise to cut back.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/wayneandwax/14450756495/in/set-72157630415212866">Wayne Marshall/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
</figcaption>
</figure>
<p>Over seven years of follow-up, both moderate and heavy (more than 500 ml per day) wine drinkers had a 15-20% lower risk of dying compared to non-drinkers. </p>
<p>Some of the protective mechanisms include higher levels of HDL (good) cholesterol, better insulin sensitivity, less inflammation and lower tendency to blood clots. Wine, especially red wine, contains phytonutrients including flavonoids, tannin and other phenolic compounds.</p>
<p>However, for those who are non-drinkers, taking it up after a heart attack is not necessarily recommended, so check with your doctor. For those who are heavy drinkers, drinking less is wise. </p>
<h2>5. Cut down on salt</h2>
<p>Reducing salt lowers your <a href="http://www.ncbi.nlm.nih.gov/pubmed/23558162">blood pressure</a> and this reduces your risk of heart disease and stroke. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/65308/original/image-20141124-19608-1lsfk6x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/65308/original/image-20141124-19608-1lsfk6x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/65308/original/image-20141124-19608-1lsfk6x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/65308/original/image-20141124-19608-1lsfk6x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/65308/original/image-20141124-19608-1lsfk6x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/65308/original/image-20141124-19608-1lsfk6x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/65308/original/image-20141124-19608-1lsfk6x.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">Lowering sodium intake can help protect against heart disease.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/mtsofan/6716315605/in/photolist-beuSCV-vzQm4-wBC98-wXcWy-busLWE-5kgyM2-dRqDT-HJA5-6FFosg-38dj98-9b1ojM-h52dgK-6fkbq3-3az3bP-58Maox-3gWYCh-koFkb-e2tPM-77iwgm-dRqDU-cZDrRE-dWBjDo-6CCDvD-8UoRCn-8TKtom-8Tbjta-84eph9-84ep7S-84epqq-84epdh-84ep3w-84bkrn-cZ36JL-2cUAz2-84epPG-84epJs-84bkVp-6N4s99-tkr8k-jBSk9-p9XUXs-pbXYAo-buXUar-buXTWD-buXU68-4pSNT7-yJkRj-84bk3z-9oLMNC-9kCrH3">MTSOfan/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
</figcaption>
</figure>
<p>About <a href="http://www.heartfoundation.org.au/healthy-eating/food-and-nutrition-facts/Pages/salt.aspx">75% of the salt we eat</a> comes from processed foods such as potato crisps, salted nuts, packet soups and sauces, canned foods, pies, sausage rolls, hot chips and pizza. Cutting down processed foods and take-away will help reduce your salt intake from an average of nine grams a day to the recommended maximum of six grams (2300 mg sodium). </p>
<p>Choose foods that have less than 120 mg sodium per 100 grams of food on the nutrition information panel. Also avoid adding salt during cooking or at the table. </p>
<h2>Putting it all together</h2>
<p>Here’s how you might put this information into practice: </p>
<ul>
<li><p>Start your day with a wholegrain breakfast cereal or rolled oats with psyllium sprinkled on top </p></li>
<li><p>Munch on fruit, nuts or popcorn for snacks </p></li>
<li><p>Make a salad sandwich on wholegrain bread with canned tuna or salmon for lunch </p></li>
<li><p>At dinner, cover a quarter of your plate with a lean protein, legumes or a mix of both, cover half your plate with five or more brightly coloured vegetables and make the last quarter a grain like quinoa or wild rice.</p></li>
</ul>
<h2>Is it worth the effort?</h2>
<p>It’s not always easy changing dietary patterns established over a lifetime. Some might wonder whether eating more healthily after a heart attack is worth the effort. </p>
<p>It is. Consider the results of the <a href="http://www.channing.harvard.edu/nhs/">Nurses’ Health Study</a> and <a href="http://www.hsph.harvard.edu/hpfs/">Health Professional Follow-up Study</a>, which tracked more than 4,000 adult men and women who had survived an initial heart attack over nine years. Those who improved their eating habits the <em>most</em> after the heart attack had a 29% lower risk of dying from anything and a 40% lower risk of dying from heart disease compared to those who did not improve their eating habits or ate worse. </p>
<p>The researchers also compared people’s eating habits from baseline to after a heart attack. The biggest improvements made by men were for eating more wholegrains, omega-3 fats, fruits, vegetables and for reducing red/processed meat, trans fats and salt. For women it was increasing wholegrains and reducing trans fats, red/processed meat and salt. </p>
<p>If you have survived a heart attack, your doctor will prescribe medications to manage your risk factors. They might provide dietary advice, or you can see an <a href="http://daa.asn.au/for-the-public/find-an-apd/">accredited practising dietitian</a> for a personalised plan. </p>
<p>Use your second chance to eat better as well. Any improvements you can make to what you eat and drink will help stack the odds in your favour.</p><img src="https://counter.theconversation.com/content/33194/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Clare Collins receives funding from the NHMRC, ARC, National Heart Foundtion of Australia, Meat and Livestock Australia Human Nutrition Research Program, Hunter Medical Research Institute, Campbell Arnotts, Horticulture Australia Limited. </span></em></p>Every ten minutes in Australia someone has a heart attack. For 17% this will be fatal; the rest get a second chance. If you have had a close call, these five food tips will help get your health back on…Clare Collins, Professor in Nutrition and Dietetics, University of NewcastleLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/186852013-11-04T03:43:49Z2013-11-04T03:43:49ZHealth Check: should we aim for daily bowel movements?<figure><img src="https://images.theconversation.com/files/34268/original/66ygbyjs-1383443198.jpg?ixlib=rb-1.1.0&rect=0%2C10%2C1000%2C456&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">When it comes to passing stools, 'normal' ranges from three times a week, to three times a day.</span> <span class="attribution"><span class="source">Image from shutterstock.com</span></span></figcaption></figure><p>When I was in my teens, I watched the comedy <a href="http://www.imdb.com/title/tt0099316/">Crazy People</a>, starring Dudley Moore and Daryl Hannah. Moore plays a burnt-out advertising executive who creates (hilarious) “honest” ads. One of the ads is for the fibre supplement <a href="http://en.wikipedia.org/wiki/Metamucil">Metamucil</a> which claims:</p>
<blockquote>
<p>It helps you go to the toilet. If you don’t use it, you’ll get cancer and die. </p>
</blockquote>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/SYtd7huRJJA?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Don’t worry, constipation doesn’t cause bowel cancer.</span></figcaption>
</figure>
<p>Perhaps this is a testament to the power of advertising, but this fake advertisement, inside a movie, had a long lasting effect on me. In fact, <a href="http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Constipation">constipation</a> is <em>not</em> associated with the <a href="http://dx.doi.org/10.1038/ajg.2013.52">development of bowel cancer</a>. But I didn’t learn this until well into my medical studies!</p>
<h2>What is constipation?</h2>
<p>Constipation is the passing of hard, dry bowel motions (stools), which can cause straining and pain. Other common symptoms include passing stools less often, a sense of incomplete emptying after going to the toilet, and abdominal bloating and cramps.</p>
<p>The <a href="http://www.continence.org.au/pages/bristol-stool-chart.html">Bristol stool chart</a> is used to classify faeces, and types one and two can indicate constipation. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/34267/original/q3rfp57g-1383441527.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/34267/original/q3rfp57g-1383441527.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/34267/original/q3rfp57g-1383441527.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=781&fit=crop&dpr=1 600w, https://images.theconversation.com/files/34267/original/q3rfp57g-1383441527.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=781&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/34267/original/q3rfp57g-1383441527.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=781&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/34267/original/q3rfp57g-1383441527.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=982&fit=crop&dpr=1 754w, https://images.theconversation.com/files/34267/original/q3rfp57g-1383441527.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=982&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/34267/original/q3rfp57g-1383441527.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=982&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption"></span>
<span class="attribution"><span class="source">Kyle Thompson</span></span>
</figcaption>
</figure>
<p>From a medical perspective, the <a href="http://www.romecriteria.org/">Rome Foundation</a> publishes the diagnostic criteria for chronic constipation. I’m fond of <a href="http://www.lifehugger.com/moc/1410/Chronic_constipation_Rome_II_criteria">this particularly apt mnemonic</a> to remember:</p>
<blockquote>
<p><strong>S</strong>training for at least 25% of the times </p>
<p><strong>H</strong>ard stools at least 25% of the times </p>
<p><strong>I</strong>ncomplete evacuation sensation at least 25% of the times</p>
<p><strong>T</strong>wo times or less bowel movements a week. </p>
</blockquote>
<p>Constipation is common. [Around](http://www.biomedcentral.com/1471-230X/8/5](http://www.biomedcentral.com/1471-230X/8/5) one in six to one in eight adults suffer from it, so most of us have probably experienced constipation at some stage in our lives.</p>
<p>Although there are many medical diseases that can lead to constipation, such as <a href="http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Parkinson's_disease_explained">Parkinson’s disease</a>, <a href="http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Thyroid_disorders_hypothyroidism">hypothyroidism</a>, and <a href="http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Hernias_explained">hernias</a>, these “organic” causes are by far the minority.</p>
<p>Most episodes of constipation are without structural underlying causes. More commonly, lifestyle and constitutional factors, often in combination, <a href="http://www.biomedcentral.com/1471-230X/8/5">increase the risk</a> of constipation:</p>
<ul>
<li>Dietary habits – particularly a change in diet, reduction in water intake, or a diet low in fibre</li>
</ul>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/34270/original/v8pr894y-1383447917.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/34270/original/v8pr894y-1383447917.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/34270/original/v8pr894y-1383447917.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/34270/original/v8pr894y-1383447917.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/34270/original/v8pr894y-1383447917.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/34270/original/v8pr894y-1383447917.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/34270/original/v8pr894y-1383447917.jpg?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">Older people are more likely to suffer from constipation.</span>
<span class="attribution"><span class="source">Image from shutterstock.com</span></span>
</figcaption>
</figure>
<ul>
<li><p>Physical inactivity – for instance, a reduction in regular exercise, or a sedentary lifestyle</p></li>
<li><p>Mood – anxiety and depression are associated with a number of <a href="http://informahealthcare.com/doi/abs/10.1080/003655202317284192">gastrointestinal symptoms</a>, including constipation</p></li>
<li><p>Drugs – many medications are known to increase the likelihood of constipation (such as opioid analgesics, antidepressants, iron supplements, some blood pressure medicines)</p></li>
<li><p>Age – older people are more likely to suffer from constipation, though mostly from the above factors.</p></li>
</ul>
<h2>So, how often should I go?</h2>
<p>When my patients use the term “regular bowel movement”, they typically interpret it as meaning opening one’s bowels at approximately the same time, on a daily basis. Interestingly, only about <a href="http://gut.bmj.com/content/33/6/818">one third of adults</a> pass stools in such a pattern, making the conventional “normal bowel habit” not terribly “normal”!</p>
<p>There is considerable variation between individuals. The claim that stool frequency in well people ranges from three times a week, to three times a day, is quite old – it comes from a <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1846921/">British study</a> from 50 years ago. Nevertheless, it remains a relatively useful rule of thumb.</p>
<h2>When should I be worried?</h2>
<p>Simple constipation will generally resolve by addressing the aforementioned lifestyle factors. Your local community pharmacist will be able to give advice on the use of fibre supplements and over-the-counter laxatives if they are required.</p>
<p>Longer-term use of laxatives can be safe – but it depends on the medication and the clinical situation. This shouldn’t be a decision made without medical advice.</p>
<p>Although more serious causes of constipation are uncommon, they do occur. Should you experience any of the following, you should seek the advice of your regular general practitioner:</p>
<ul>
<li>having to use laxatives regularly to open bowels</li>
<li>rectal bleeding</li>
<li>mucous (slimy material) in the stool</li>
<li>a change in bowel habit for no obvious reason</li>
<li>alternating diarrhoea and constipation</li>
<li>persistent pain with passing motions.</li>
</ul>
<p>There is no pressing health need to aim for once-daily bowel motions for its own sake, if that isn’t “normal” for the individual. That being said, there are unambiguous health benefits from having sufficient fibre and water in the diet, and being physically active.</p>
<p>An obvious reason to manage constipation well, and aim to avoid it altogether, is – quite simply – that it’s unpleasant. </p><img src="https://counter.theconversation.com/content/18685/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michael Tam is a community general practitioner and consults with patients who suffer from constipation. He otherwise does not work for, consult to, own shares in or receive funding from any company or organisation that would benefit from this article, and has no relevant affiliations.</span></em></p>When I was in my teens, I watched the comedy Crazy People, starring Dudley Moore and Daryl Hannah. Moore plays a burnt-out advertising executive who creates (hilarious) “honest” ads. One of the ads is…Michael Tam, Lecturer in Primary Care and General Practitioner, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/15672011-06-02T20:49:44Z2011-06-02T20:49:44ZIt’s no secret, the NBN’s been left to tender mercies<figure><img src="https://images.theconversation.com/files/1493/original/NBN.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">NBN Co chief Mike Quigley and Stephen Conroy still face many tough tasks.</span> <span class="attribution"><span class="source">AAP</span></span></figcaption></figure><p>The news that NBN Co has found a way to move forward from the crucial cost-of-construction issue must have surely lifted the Gillard Government’s spirits.</p>
<p>NBN Co, the government-owned corporation in charge of the National Broadband Network rollout, announced the <a href="http://www.theaustralian.com.au/business/industry-sectors/contractors-race-for-broadband-leftovers-after-big-win-by-silcar/story-e6frg9hx-1226067501021">appointment of Silcar</a>, a Leighton Thiess-Siemens joint venture, to lead a $1.1 billion build of the project through Queensland, New South Wales, and the ACT. </p>
<p>It also <a href="http://www.theaustralian.com.au/business/ericsson-wins-11bn-nbn-wireless-contract/story-e6frg8zx-1226067487697">appointed Ericsson</a> to take charge of 4G wireless broadband connections in rural areas. NBN is apparently deep in negotiations with a select group of other companies in a controlled bidding process for the remainder of the work, aiming to seal the deal by the end of August.</p>
<p>These deals will steady the government’s nerve on the project in the short term, especially on the threat of a labour-cost blowout. But too many questions around the $43 billion project remain unresolved.</p>
<p>Ever since NBN Co unexpectedly suspended its tender process on April Fool’s Day this year, the once-in-a-lifetime infrastructure project has been embroiled in deepening criticism and controversy. </p>
<p>NBN Co said at the time that judged the cost of contractor bids as being far too high. </p>
<p>The controversy intensified when the NBN’s construction chief, Patrick Flannigan, suddenly resigned a few days after the tender suspension. </p>
<p>Since then, the Federal Opposition and other critics have not missed an opportunity to raise these concerns about cost blowouts. </p>
<p>Not to mention muddying the water with other issues, like the controversy around NBN Co chief Mike Quigley’s disclosure of bribery allegations against Alcatel-Lucent America – a company he used to run (although there was never any suggestion of impropriety on Quigley’s part).</p>
<p>Ever since it was dreamt up on the back on an envelope by then-opposition leader Kevin Rudd and aspirant shadow communications minister Stephen Conroy, the NBN has been something of a grand illusion. </p>
<p>The NBN has had the rare distinction, in these jaded political times, of being twice-endorsed by an electorate still keen on big ideas – even if they never had many of them to choose from. </p>
<p>The NBN was the shining star in the lowly firmament of Gillard’s shaky 2010 victory, remarkable for the endorsement it attracted, rather spontaneously avowed, by so many dubious citizens. </p>
<p>So what’s the hold-up? When is the NBN coming to a plug in the wall, or wireless device, near you?</p>
<p>Well, that’s the problem with big ideas, especially when we are talking technology, and next-generation networks in particular. Unlike the shiny, super-modern, chic design we might associate with an Apple store or an off-the-shelf widget from the electronic entertainment megastore of your choice, building networks across a country as large as Australia is a messy affair.</p>
<p>It’s not just the curse of our geography that makes it messy. It’s also because the path of technology infrastructure is messy at the best of times, especially when it’s a network as big, wide, and complex as the NBN. </p>
<p>As we discovered with the rollout of pay television infrastructure by Telstra and Optus, and partners, in the mid-1990s, the “stuff” of broadband internet might be merrily uploaded and downloaded by users — but someone has to get down and dirty, and actually dig the holes, lay the cables, and put the kit together. </p>
<p>The crucial construction element of the NBN is a whopping part of the cost, as the <a href="http://www.dbcde.gov.au/broadband/national_broadband_network/national_broadband_network_implementation_study">McKinsey feasibility study</a> clearly showed two years ago. </p>
<p>The government is vulnerable to attacks on the inflation of the NBN’s costs. It faces a classic problem of getting the best value for money, while ensuring speedy rollout of the infrastructure. </p>
<p>In a strong economy running at near capacity, skilled workers come at a premium. A colossal project such as the NBN requires an unprecedented scale of expertise. </p>
<p>However, this is a practical problem that can be solved with a different approach, such as direct negotiation with contractors and unions. </p>
<p>While revelling in NBN’s discomfiture, the Coalition’s most convincing line of attack lies in opposition communications spokesman Malcolm Turnbull’s cogent arguments that the project’s $43 billion is better spent on technology-agnostic enhancements. </p>
<p>Turnbull competently argues that we should not tie ourselves ourselves to a predominantly fibre-based network. </p>
<p>There is a direct line to be drawn from the policies of the Coalition when in government to its recipe for government involvement in broadband today. </p>
<p>The Coalition specialised in piecemeal additions and fixes to address market failure in telecommunications. That approach, taken as a whole, had merit, but were often poorly integrated, and often came in response to the parliamentary balance of power at the time (when the Democrats and Tasmanian Senator Brian Harradine were in the ascendancy). </p>
<p>The result was not entirely of their making, but by the time they left office, there was a widespread dissatisfaction with Australian broadband availability. </p>
<p>Burnishing its nation-building credentials, Labor promised to lay the foundations for the digital economy of the 21st century, with fibre to the home. It had two demons to slay. </p>
<p>The ghost of Telstra’s dominance, still very much haunting future internet in Australia, has been exorcised with a heady amalgam of structural separation (latest drafts of which have been just released) and the prospective agreement on migration of Telstra’s customers to the NBN. </p>
<p>The other ghost in the machine has been the immense cost of the NBN, once Labor decided to build it (after their first tender failed). </p>
<p>Here Labor fashioned a public-private partnership, in the arms-length form of NBN. NBN is a vehicle to build the wholesale networks, carry and recoup the costs, until it could be privatised. This left the taxpayer as the guarantor of first, and last, resort. Hence this latest agreement to sustain NBN’s momentum, this time with a ‘value-for-money’ fibre rollout. </p>
<p>Again, the problem is that wedging between the government’s desire to oversell the NBN — now the quest of 20 hand-picked network ‘champions’, and the opposition’s lack of a genuine alternative for an assured national digital platform, is the hapless taxpayer and ultimate user of the service. </p>
<p>Citizens are underwriting the build, and not really being consulted on what they’ll get. Little wonder that users are flocking to available mobile media and wireless technologies, where the broadband action is here today.</p><img src="https://counter.theconversation.com/content/1567/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gerard Goggin 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 news that NBN Co has found a way to move forward from the crucial cost-of-construction issue must have surely lifted the Gillard Government’s spirits. NBN Co, the government-owned corporation in charge…Gerard Goggin, Professor of Media and Communications , University of SydneyLicensed as Creative Commons – attribution, no derivatives.