Archive: Aug 2010

  1. Vitamin supplements

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    I’m responding to the above article in the DM today regarding the dangers of vitamin supplements. This is another bad piece of journalism that takes the writers problem and one other man that died and suddenly denounces vitamins as toxic. The trials on glucosamine are sound – trust me I’ve looked over hundreds of them and it is safe to take so please do not worry. We do not know why the man mentioned died – it could be for a number of factors, not just glucosamine and he could have been at risk of other diseases anyway.

    Taking the average person with the average diet, we are mostly left as a nation with deficiencies in many vitamins and minerals. This can be easily proved with blood tests. Ok so you cant test for glucosamine deficiency (because it doesnt exist!) but you can test for: Vit B1, B2, B3, B5, B6, B12 and folate, iron, Vit C, Vit E, Selenium, Vit A, Vit D, Calcium, magnesium, zinc, CoQ10, potassium, sodium, essential fatty acids etc. Some of these cannot be tested for on the NHS, but the point I’m making is nearly everyone I see has some deficiency. I need B12 injections and that’s with a good diet.

    What is important is that too many people are self prescribing and become dependant on supplements. Some patients I see will bring with them for example ginko biloba because a friend told them “it helped the brain” or ginseng because another friend said it was great. This does not mean that you need them. Supplements should be given only if there is a deficiency – that is proved either by clinical symptoms or a blood test. If you are taking more than four or five a day then get someone to sort them out for you – you may be taking too many or wasting your money.

    Herbs do have side effects and should be taken with advice and the fat soluable vitamins, A,D and E should not be taken in high doses. Water soluble vitamins are excreted through the urine so can be taken in higher doses more safely

    I dip in and out of taking supplements. At the moment I’m taking Lamberts Premtis and extra magesium – that’s two supplements a day. Often I go for months and take none and when under stress take Vitamin B100mg.

    So certainly be cautious but do not worry about this article.

  2. Free from breads and cakes

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    Trying to look for gluten free, wheat free, egg free, diary free, yeast free or vegan cakes, breads and biscuits can be hard. The supermarkets are now offering a reasonable range of free from foods but by and large these are not great products- do still look at the ingredients. Free from in some cases seems to mean let’s add ingredients that people won’t recognise.

    That’s why I love The Village Bakery. Stocked in Waitrose, Sainsburys and Tescos and your local health food shop they have got this free from range completely tied up. They have a great website, are based up in Cumbria and have the organic seal of the Soil Association which is always reassuring.

    They make gluten free, wheat free, dairy free, vegan, egg free loaves, cakes and biscuits and the difference is – they taste delicious. Their Rossisky rye loaf ingredients are : Rye flour, water and sea salt and its bouncy and soft and tastes great. I particularly recommend their gluten free ginger biscuits and lemon cake and the chocolate brownies are pretty good as well.

    If you can’t source them ask Waitrose, Sainsburys or your local health food shop if they can order them in. You could buy in bulk and freeze, particularly the bread, or you could buy over the website. Again I would buy in bulk. They also do a great range of christmas stollens, mince pies, cake and pudding.

    If you are stuck with what to buy I’d look for simple ingredients, ie not too many or invest in a bread maker and get some good quality flour and make your own bread. That is the only way to really make sure you now what is going into your baking.

  3. Information overload (cont)

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    Have had a fascinating few weeks with my patients. It’s great to see so many people opening their eyes and really desiring change – not only in the way they eat but also in what they absorb and read in the media.

    People are not stupid and they understand that to eat healthy food, they need to ignore pretty much all product advertising. I can’t name brands but there are several on TV at the moment that are beamed into millions of homes in the hope that people will believe what they are selling. Well I tell you now they are not, and that’s great. Just take a look at some of the ingredients in these so called healthy breakfast foods (I’m being vague here for a reason) and you will soon see that as per usual they are selling you sugar which for all the reasons that you already know – well you just don’t need first thing in the morning. So start the day with foods that are not advertised/rarely advertised – what about an egg or some beans or some grilled bacon, or nuts and plain yoghurt and fruit? – whatever it is start your day with some kind of protein.

    Great stuff – go people!! Get reading labels!

  4. Fibromyalgia – extracts from August newsletter

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    Several of my patients have asked me to write about Fibromyalgia this month, whilst not a particular seasonal topic it is one of the top five conditions I see in my clinic. We all get aches and pains every now and then but fibromyalgia is more than that – another strange collection of symptoms caused by so many different things that makes it difficult to treat… a little like IBS I guess. Nearly everyone I have spoken to knows someone who is suffering. In the UK, fibromyalgia in the general population has a prevalence ranging from 1.3 to 7.3 percent, costing the NHS billions each year. However because it is difficult to diagnose, those figures could be even higher.

    What is fibromyalgia syndrome (FMS)?

    FMS is a rheumatic disorder characterised by chronic, achey, muscular pain that has no obvious physical cause. It most commonly affects the lower back, neck, shoulders, back of the head, upper chest and the thighs, although any areas of the body may be involved. The pain is described as burning, throbbing, shooting and stabbing. The pain and stiffness is often greatest in the morning than at other times of the day and it may be accompanied by headaches, strange sensations in the skin, insomnia, irritable bowel syndrome, and TMJ (sore jaw joint). Other symptoms often experienced by people with FMS include:

    PMS, painful periods, anxiety, palpitations, memory impairment, irritable bladder, skin sensitivities, dry eyes and mouth, a need for frequent changes in eyeglass prescriptions, dizziness and impaired coordination.

    Such activities as lifting and climbing stairs are often very difficult and painful. Depression often accompanies this disorder. Because the immune system is typically compromised, opportunists like viral and bacterial infections are common as well. The most distinctive feature of FMS, one that differentiates it from similar conditions, is the existence of certain tender points – there are eighteen specific spots where the muscles are abnormally tender to the touch. These points tend to cluster around the neck, shoulders, chest, knees, elbows, and hips and can include the following: around the lower vertebra of the neck, in the upper and outer muscles of the buttocks, on the side of the elbow, in the mid back muscles, in muscles connected to the base of the skull, in the middle of the knee joint and around the upper part of the thigh bone.

    There are 5-6 million people suffering from FMS in the US, and between 1.5 – 7% of the population in the UK. However, the real number of cases is probably much higher as this condition is often misdiagnosed. FMS manifests itself in a similar way to chronic fatigue sydrome (CFS) and rheumatoid arthritis and as a result it can take a long time for a proper diagnosis to be made. In the past FMS was known as fibrositis or fibromyositis but these terms are now considered inappropriate because they imply inflammation of some sort.

    Most people with FMS also have an associated sleep disorder known as alpha EEG anomaly. In this disorder the individuals deep sleep periods are interrupted by bouts of waking type brain activity, resulting in poor sleep. Some people with FMS are plagued by other sleep disorders as well, such as sleep apnoea, restless leg syndrome and bruxism. Not surprisingly given all these sleep difficulties people with FMS offer suffer from CFS. Other disorders that can be found along side are:

    Chemical or food allergies
    Dizziness and loss of balance
    Extreme fatigue
    Jaw pain
    Memory loss and difficulty in concentrating
    Menstrual pain
    Sensitivity to bright lights or loud noises
    Sensitivity to dairy products
    Skin sensitivities
    Stiffness in the morning and often on waking

    What causes FMS?

    FMS is more common in females than in males and most often begins in young adulthood. In most cases, symptoms come on gradually and slowly increase in intensity. They can be triggered by a number of different factors, including overexertion, stress, lack of exercise, anxiety, depression, lack of sleep, grief, trauma, extremes of temperature and or humidity and infectious illness. In the majority of cases symptoms are severe enough to interfere with normal daily activities. The course of the disorder is unpredictable. Some cases clear up on their own, some become chronic, and some go through cycles of flare-ups with periods of remission.

    The causes of FMS are unknown and there are no tests that can diagnose FMS with complete certainty. Some evidence points to a problem with the immune system. Also a disturbance in brain chemistry may be involved or sometimes depression. Other possible causes are the Epstein Barr Virus, systemic Candida albicans, anaemia, parasites and hypothyroidism. When a patient comes to me with fibromyalgia, the above is usually looked at plus an extensive food diary to distinguish if any foods are making the condition worse. There is a huge link between inflammation in the gut and FMS and this is usually where I start the investigation process.

    Tips for FMS

    Drink plenty of fluids.

    Include pomegranate juice in the diet – it contains anti inflammatory and antioxidant properties.

    Limit consumption of green peppers, tomatoes, white potatoes and aubergine. These foods contain solanine which interferes with enzymes in the muscles and can cause pain and discomfort in some. (This won’t help everyone though).

    Try to avoid red meat and foods high in saturated fat – they can promote the inflammatory response and increase pain.

    Try to avoid caffeine, alcohol and sugar.

    Avoid wheat and brewers yeast until symptoms improve.

    Maintain a regular programme of moderate exercise. A daily walk followed by stretching exercises would be good. If you have been sedentary before, start slowly and be careful not to over exert yourself.

    Be sure to give your body sufficient rest. Set aside eight hours of sleep each night. Sometimes a hot shower on waking can stimulate circulation and help relieve morning stiffness. Or for some alternate between hot and cold. Cold showers seem to be better for pain whereas hot baths help relax muscles.

    Have your doctor check your thyroid function. Symptoms of hypothyroidism can mimic those of FMS

    Considerations with FMS

    Chronic pain sufferers especially those with CFS or FMS tend to be low in magnesium.

    Do get checked for other underlying conditions that could be causing your symptoms e.g. Lymes disease, depression etc.

    Recent research points to the possible involvement of chemicals/food sensitivities in FMS. This is not surprising as humans have been exposed to more chemicals in the last fifty years than in all the rest of our history combined.

    Studies are being conducted on the possible role of a genetic defect that interferes with the formation of ATP (the source of cellular energy).

    Some doctors prescribe low dose antidepressants for FMS and these drugs can be beneficial but of course may cause other unwanted side effects.

    Physical therapy, relaxation techniques, exercise therapy, massage therapies and biofeedback are all helpful in some cases.

    FMS appears to be a complex syndrome (and certainly can be). When patients come to see me they bring a comprehensive food diary and more often than not will be suffering from some sort of IBS as well. The link between the two is complex but in much the same way as gluten can make you “ill all over” looking at inflammation in the gut, digestion and if foods are making you ill is paramount. Whatever the cause, each person needs to be treated individually as the causes will be different from person to person.

    If you know anyone who is struggling with FMS and would like some help, please contact me on 01323 737814.

  5. One to one shopping

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    Following on from my information overload blog, if you’d like a really fun hour with me shopping here’s what you can expect:

    Understanding food labels
    Trying to reduce your weekly shopping bills
    Learn as you shop what is good/bad to eat
    Learn about alternatives to foods you are avoiding
    Try new produce/cooking tips
    …and also you might have a good giggle

    I usually only do this service in Eastbourne’s Tesco, Sainsburys, Asda and Watirose shops and usually when its quieter so early evenings can be a good time. The earliest I’ve done is 6am and the latest is 10pm so there is loads of flexibility! Contact me on 01323 737814.

  6. Information overload

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    In many ways we are fortunate to have at the click of a button more information than we could ever absorb in a lifetime. However this information overload has its drawbacks especially when it comes to diet, health and nutrition. The daily onslaught of conflicting information is one of the main topics that I discuss with my patients – who should they believe? I’m a nutritionist so shopping and filtering my reading material is easier. However it makes me really mad that it’s so complicated. It doesnt have to be. A few thoughts for you:

    Trust your gut instinct as to what is good and bad to eat – don’t get sucked in by marketing and advertising. In fact the foods that are pushed harder are possibly the ones you need to avoid.

    Look at ingredients not labelling. The labelling on packets is ludicrous and only means something to nutritionists and dieticians. If the packet has ingredients that you don’t recognise put it back. If you’ve picked up bought mashed potato and it has twenty ingredients in it – put it back.

    Try to buy food one item at a time, then you know what you are buying.

    Use your common sense when you read articles in the papers. If a trial or study is backed by a bias source then the outcome may well be bias. If it’s funded by a pharmaceutical company – why would the outcome be weighed in favour of vitamins for example. Another example, if The British Coffee Association is telling you coffee is good for you, and has very little effect on your health – would you except them to say anything else?

    Common sense is what can cut through most of this nonsense. You know that living simply and organically is the way forward using real food, cooked from scratch (if you have the time). I would filter your information closely and trust your instincts.

  7. The placebo effect

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    I have been reading another flawed piece of journalism in the Daily Mail on the placebo effect of antidepressants. I have to say I’m getting tired of this newspaper putting out their daily scare stories and conflicting advice which people like me have to sort out. Please people stop reading and believing the health pages of the Daily Mail.

    To say anti-depressants are nothing more than placebo is actually quite dangerous. Pretty much anything we take could be said to have a placebo effect. Who’s to say chemotherapy, painkillers etc don’t have an element of this? If someone tells you it will help, your mind is already half way there. Homeopathy has recently come in for a bashing regarding this very subject.

    To assess if something is placebo it needs to be tested on babies or animals which of course is impossible for most drugs, however Homeopathy has excellent results in both.

    Sugar pills throughout the ages have also proved to work. This is mind/body medicine and complicated stuff it is to, but for those out there whose lives have/are improving on anti-depressants please do not take this article seriously.

  8. Calcium tablets and increase heart attack risk

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    I’ve had loads of emails in the last week regarding the latest news on calcium supplementation raising the risk of heart attacks by 30% in women. Firstly don’t panic. If you have osteoporosis and are taking high level calcium supplementation like AdCal then speak to your GP. It is still important to get calcium AND magnesium, vitamin D and boron in your diet and not just calcium alone for bone health.

    According to this new study, calcium in the diet is different from the calcium in tablets (nothing new there) and raises levels in the blood that could increase your chances of having a heart attack. As with all new studies that come out unless you look at it in detail there can still be many variables as to how they came to this outcome. If you are worried I would discuss the pros and cons with your GP.

    In the meantime calcium sources in your diet are important and you don’t have to depend on loads of diary food which many people avoid. Here are some other sources:

    Whitebait, sardines, tofu, spring greens, molasses, raw spinach, prawns, baked beans, canned salmon, almonds.

    Tinned fish is a really good source of calcium and if you are avoiding dairy foods and eating soya, do buy calcium enriched soya milk.