‘Western society is chronically sleep deprived’: the importance of the body’s clock

The 2017 Nobel prize for medicine was awarded for the discovery of how our circadian rhythms are controlled. But what light does it shed on the cycle of life?

The cycle of day and night on our planet is age-old and inescapable, so the idea of an internal body clock might not sound that radical. In science, though, asking the questions why? and how? about the most day-to-day occurrences can require the greatest leaps of ingenuity and produce the most interesting answers.

This was the case for three American biologists, Jeffrey Hall, Michael Rosbash and Michael Young, who earlier this week were awarded the Nobel in medicine or physiology, for their discovery of the master genes controlling the bodys circadian rhythms.

The first hints of an internal clock came as early as the 18th century when the French scientist Jean-Jacques dOrtous de Mairan noticed that plants kept at a steady temperature in a dark cupboard unexpectedly maintained their daily rhythm of opening and closing their leaves. However, De Mairan himself concluded this was because they could sense the sun without ever seeing it.

It was only when Hall, Rosbash and Young used fruit flies to isolate a gene that controls the rhythm of a living organisms daily life that scientists got the first real glimpse at our time-keeping machinery that explains how plants, animals and humans adapt their biological rhythm so that it is synchronised with the Earths revolutions, the Nobel prize committee said.

Using fruit flies, the team identified a period gene, which encodes a protein within the cell during the night which then degrades during the day, in an endless feedback cycle.

Prof Robash, 73, a faculty member at Brandeis University in Waltham, Massachussetts, said that when his paper was published in the 1980s he had no grandiose thoughts about the importance of the discovery. During the intervening years, the picture has changed.

Its [now] pretty clear that it has its fingers in all kinds of basic processes by influencing an enormous fraction of the genome, he said.

Scientists discovered the same gene exists in mammals and that it is expressed in a tiny brain area called the suprachiasmatic nucleus, or SCN. On one side, it is linked to the retina in the eye, and on the other side it connects to the brains pineal gland, which pumps out the sleep hormone melatonin.

Modern lifestyles may no longer be constrained by sunrise and sunset, but light remains one of the most powerful influences on our behaviour and wellbeing. This realisation has fuelled a sleep hygiene movement, whose proponents point out that bright lights before bedtime and spending the whole day in a dimly lit office can dampen the natural circadian cycle, leaving people in a continual mental twilight dozy in the morning, and too alert to fall asleep promptly at night.

Rosbash welcomes this new awareness. Its been overlooked for a long time as a real public health problem, he said. All of western society is a little bit sleep deprived and, when I say a little bit, I mean chronically.

There is growing evidence that this decoupling from the natural circadian cycle can have long-term health consequences much more far-reaching than tiredness.

At first, it was assumed that the brains master clock was the bodys only internal timekeeper. In the past decade, though, scientists have shown that clock genes are active in almost every cell type in the body. The activity of blood, liver, kidney and lung cells in a petri dish all rise and fall on a roughly 24-hour cycle. Scientists have also found that the activity of around half our genes appear to be under circadian control, following undulating on-off cycles.

In effect, tiny clocks are ticking inside almost every cell type in our body, anticipating our daily needs. This network of clocks not only maintains order with respect to the outside world, but it keeps things together internally.

Virtually everything in our body, from the secretion of hormones, to the preparation of digestive enzymes in the gut, to changes in blood pressure, are influenced in major ways by knowing what time of day these things will be needed, said Clifford Saper, a professor of neuroscience at Harvard Medical School. The most common misconception is that people think that they do not have to follow the rules of biology, and can just eat, drink, sleep, play, or work whenever they want.

This discovery explains why jet lag feels so grim: the master clock adapts quickly to changing light levels, but the the rest of your body is far slower to catch up and does so at different speeds.

Jet lag is so awful because youre not simply shifted, but the whole circadian network is not aligned to each other, said Prof Russell Foster, chair of circadian neuroscience at the University of Oxford. If you were completely aligned but just five hours shifted you wouldnt feel so crappy.

It is also helps explain the extensive range of health risks experienced by shift workers, who are more likely to suffer from heart disease, dementia, diabetes and some cancers. Theyre having to override their entire biology, said Foster.

Obesity is also more common among those with irregular sleep patterns. Sapers team has found that animals that dont get enough sleep, but keep their circadian pattern, do not gain weight. But when they are placed on a 20-hour light-dark cycle, they eat more impulsively and develop glucose intolerance.

I would suggest that for humans, staying up late, watching video screens with high levels of blue light and eating high fat foods, is potentially a major cause of obesity and diabetes, said Saper.

Evidence is also emerging that our risk of acute illness rises and falls with a predictable regularity. People are 49% more likely to suffer a stroke between 6am and 12 noon than at any other time of the day and a similar pattern is true for heart attacks. This is linked to a circadian rise in blood pressure in the early morning, which happens even if youre lying in bed not doing anything.

As a result, it makes sense to take certain blood pressure medications first thing, before getting out of bed. By contrast, cholesterol is made more rapidly by the liver at night. So, statins, which lower cholesterol, work best if taken before going to bed.

Foster said that a failure to consider the circadian influence in past animal experiments may even have led to promising drug candidates being shelved. Toxicity can change from 20% to 80% depending on the time of the day you test a drug, he said.

As the impact of scientific advance slowly trickles down, the medical profession and society at large are waking up to the power of the biological clock.

A paper last year showing that jet lag impairs baseball performance, prompted some professional sports teams to take on circadian biologists as consultants on schedules for training and travel. The US Navy has altered its shift system to align it with the 24-hour clock, rather than the 18-hour day used in the old British system. Schools are experimenting with later school days, better aligned with the teenage body clock, which runs several hours later than that of adults.

As circadian rhythms have journeyed from obscure corner of science to part of the zeitgeist, companies are launching an increasing number of products on the back of a new anxiety around sleep and natural cycles. This is the western world; if somebody can make a buck theyre going to try to do it, said Rosbash.

The 73-year-old, who describes his own relationship with sleep as borderline problematic, prefers low- tech remedies, however.

I havent quite figured out how to do better, he said. I try not to take sleep medication. I dont drink alcohol too late in the evening, I read a good book. The common sense things, I think they help.

Read more: https://www.theguardian.com/science/2017/oct/06/western-society-is-chronically-sleep-deprived-the-importance-of-the-bodys-clock

Disturbed sleep patterns may be key to ADHD, study finds

Research links disruption of body clock to number of chronic conditions

Struggling to concentrate, having too much energy and being unable to control behaviour the main manifestations of attention deficit hyperactivity disorder (ADHD) have been linked to disruptions in sleep, researchers will reveal on Sunday.

The findings underline a growing awareness among doctors that disturbed sleep is associated with many major health hazards. Other ailments linked to the problem include obesity, diabetes and heart disease. The work opens up the possibility of developing treatments for ADHD without drugs, the researchers say.

Speaking at a pharmacology conference in Paris, Professor Sandra Kooij, of VU University Medical Centre in Amsterdam, will outline research which shows poor sleep is a sign that the timings of many physiological processes are not properly synchronised.

The onset of ADHD is one of the clear signs that this is taking place. Our research is making clear that sleep disruption and ADHD are intertwined. Essentially, they are two sides of the same physiological and mental coin, said Kooij, speaking before her presentation.

Symptoms of ADHD, which also include mood swings and impulsiveness, are generally noticed at a fairly early age, often when a child is being sent to school for the first time, although cases are sometimes not recognised until adulthood. It is estimated that between 2% and 5% of people are affected by ADHD at some time. According to Kooij, the condition is very often inherited and usually has a pronounced neurological background.

In addition, about 80% of cases are associated with profound sleep disturbances. This is most frequently manifested as delays in the onset of sleep, Kooij will tell delegates at the annual congress of the European College of Neuropsychopharmacology in Paris.

People simply cannot go to bed and fall sleep at the end of the day like others, she said. And that has consequences. Affected individuals sometimes cannot get to sleep until around 3am but they still have to get up to go to work or school. The result is a drastic loss of sleep.

This problem is linked, in turn, to disturbances in levels of the neurological transmitters dopamine and melatonin in the brain, she said. These chemicals control when we fall asleep and when we wake up by directing the brains circadian system, the internal biological clock which keeps us in sync with the 24-hour day.

Other conditions linked to disturbed dopamine and melatonin levels include restless leg syndrome an irresistible urge to move your legs and sleep apnoea, in which breathing is disturbed during sleep. These disorders are also linked to ADHD, said Kooij.

This claim is backed by Professor Andreas Reif, of University Hospital, Frankfurt. A disturbance of the circadian system may indeed be a core mechanism in ADHD but beyond these considerations, sleep abnormalities are a huge problem for many patients, heavily impacting on their social life. More research is very relevant to improve patients lives. The crucial point is that a cascade of health disorders, including ADHD, appear to be triggered by disruptions to circadian rhythms, offering some routes to counter these conditions by attempting to restore a patients body clock. Kooij said her team was now looking for biomarkers, such as vitaminD levels, blood glucose, cortisol levels, 24-hour blood pressure, and heart-rate variability that are associated with sleeplessness.

Once we can do that, we may be able to treat some ADHD by non-pharmacological methods, such as changing light or sleep patterns. We may also be able to prevent the negative impact of chronic sleep loss on health in general.

Read more: https://www.theguardian.com/society/2017/sep/02/disturbed-sleep-patterns-may-be-key-to-adhd

I live a healthier life now Im free of the trappings of modernity | Mark Boyle

Being healthy is not about doctors, ambulances and technology. I use natural methods to keep my body in balance, writes Mark Boyle, the Guardians Life Without Technology columnist

When people learn of my decision to reject modern complex technology in favour of older, slower, forgotten ways, their first line of inquiry usually involves healthcare. Considering its importance to our lives, this is hardly surprising. Yet because of its emotive nature which of us, after all, doesnt have friends or family needing glasses, hearing aids, stents or prescription drugs? it seems difficult to have a calm, objective discussion on the subject.

The more concerned and curious inquirers often ask me what I would do if I got seriously ill. While the long answer is complicated and nuanced, honestly, I dont know. Its easy to live by your values when times are good, much harder when youre having a stroke or dying of cancer.

One thing I can say with more confidence is this: if we continue pursuing this political ideology of mass industrialism which has given us ambulances, dialysis machines, wheelchairs and antidepressants not only will we continue to harm our physical, emotional and mental health (leading to even more people needing such things) well also wipe out much of life on Earth.

Industrial civilisation, itself only 200 years old, is already causing the sixth mass extinction of species of the last half billion years. Whats that got to do with an ambulance? Well, both nothing and everything. The ambulance itself undoubtedly saves lives (including my dads). Yet deconstruct a single ambulance with its plastics, oils, fluids, copper, acids, glass, rubber, PVC, minerals and steel and Ill show you how to lay waste to the very thing all our lives depend upon: the planet.

Big picture aside, most of what afflicts us today cancer, obesity, mental illness, diabetes, stress, auto-immune disorders, heart disease, along with those slow killers: meaninglessness, clock-watching and loneliness are industrial ailments. We create stressful, toxic, unhealthy lifestyles fuelled by sugar, caffeine, tobacco, antidepressants, adrenaline, discontent, energy drinks and fast food, and then defend the political ideology that got us hooked on these things in the first place. Our sedentary jobs further deplete our physical, emotional and mental wellbeing, but instead of honestly addressing the root cause of the illness we exert ever more effort, energy, genius and money trying to treat the symptoms and contain the epidemics.

Weve developed Stockholm syndrome, sympathising with the very system that has economically held us hostage since the 18th century. Industrialism, along with its partner in crime, capitalism, has even persuaded us that, in order to save ourselves and loved ones from the horrors of disease we should spray every surface with chemicals, keep childrens hands out of the dirt and muck, and try to sterilise our entire world. With our immune systems compromised as a result, multi-billion-dollar pharmaceutical companies then sell us products to fend off what our bodies should be able to fight off naturally.

In their cleverness they have even persuaded us to pop painkillers for things that hardier generations would balk at. My own approach to healthcare wont satisfy the critics, the advocates of this strange thing called progress that seems to have us all more stressed and less content. And thats OK; Im not trying to tell people what to do, and Ive got no product to sell. I share it only because my editor tells me its the most common online inquiry.

In doing so Im very aware that Ive been blessed to be born without any serious long-term health issues, and that at 38 Im relatively young. That said, Im not convinced that its necessary to fall into such poor physical shape, as civilised peoples tend to do. My dad is almost 73 and he can still cycle 150km before dinner, simply because he has never stopped looking after his health.

The philosophy underlying my approach is that of any herbalist: keep the vitality in your body strong, and be mindful to do it every day. When it goes out of ease and into disease, use the appropriate plants the original source of many industrial medicines to bring your body and mind back into balance, and to restore optimal functioning. Your body is always aiming for balance and health, and listening to it is one of the best things you can do. Illness is feedback the sooner you heed it and restore your vitality, the less likely it is youll develop more serious problems.

I find it impossible to describe my approach to health without describing my approach to life. I wouldnt dream of suggesting that this is a prescriptive solution for anyone else; but with the exception of a voluntary vasectomy, I havent seen a doctor or nurse for 20 years.

I pick my own fruit and vegetables from the garden and hedgerows, and eat them as fresh, raw and unwashed as is optimal. I cycle 120km each week to lakes and rivers, where I then spend three evenings of that week relaxing and catching the following days dinner. I work outdoors, getting sweaty and dirty doing things I enjoy. I made the tough decision to live in the natural world so that I could breathe clean air, drink pure water and create life that allows others the same. I wash with water, and water only. I use no chemicals inside or outside the house. I wear as few clothes as I need, I use nothing electrical no fridge, no screens, no phone. I avoid sugar, caffeine and stress like the plague.

Sleep comes and goes with the light I find six hours of peaceful rest sufficient. If and when I do feel ill or out of balance, my girlfriend Kirsty (who illustrates these articles and is teaching herself herbalism) recommends a plant from our herb patch and I slowly feel vital again. Shes currently drying yarrow, horsetail, silverweed, self-heal, calendula and chamomile for the winter months.

Ive suffered from hay fever something becoming more common as CO2 levels in the atmosphere increase since I was a child. These days I eat a handful of plantain leaves a natural antihistamine three or four times a day, and that sorts it. Plantain comes out just before hay fever season and goes to seed shortly afterwards, and is a common in the cracks of city pavements and lawns as it is in the countryside.

I appreciate that this may sound unrealistic to many. When I was working 60 hours a week in a low-paid job in the City, 10 years ago, it did to me too. I only managed to do it by stripping away modernitys bullshit, learning to live with the land, and reducing my bills down to zero. Simplicity in these times is hard won, but Ive found that its worth it.

I can only speak for myself, and I support everyones decision to care for their own health as they see fit. Ultimately, were all going to die and I wish to go out like the American writer and conservationist Edward Abbey: by taking off to the wilderness, where wildlife can feed on my dead body just as I have done on theirs. It seems only fair.

Two things, in this respect, I find important. One is that like Henry David Thoreau once remarked, I do not safely reach death and discover that I had not lived. Second, that I dont cling to my own fading light so desperately that I extinguish it for all else. Like all good guests, its wise not to overstay your welcome.

This article was written by hand and posted to an editor at the Guardian, who typed it up to go online. Get in touch with Mark Boyle, the Guardians Living Without Technology columnist, here or in the comments below, a selection of which will be posted to him

Read more: https://www.theguardian.com/commentisfree/2017/sep/21/healthier-life-free-modernity-doctors-technology-exercise-herbs

Poor diet is a factor in one in five deaths, global disease study reveals

Study compiling data from every country finds people are living longer but millions are eating wrong foods for their health

Poor diet is a factor in one in five deaths around the world, according to the most comprehensive study ever carried out on the subject.

Millions of people are eating the wrong sorts of food for good health. Eating a diet that is low in whole grains, fruit, nuts and seeds and fish oils and high in salt raises the risk of an early death, according to the huge and ongoing study Global Burden of Disease.

The study, based at the Institute of Health Metrics and Evaluation at the University of Washington, compiles data from every country in the world and makes informed estimates where there are gaps. Five papers on life expectancy and the causes and risk factors of death and ill health have been published by the Lancet medical journal.

It finds that people are living longer. Life expectancy in 2016 worldwide was 75.3 years for women and 69.8 for men. Japan has the highest life expectancy at 84 years and the Central African Republic has the lowest at just over 50. In the UK, life expectancy for a man born in 2016 is 79, and for a woman 82.9.

Diet is the second highest risk factor for early death after smoking. Other high risks are high blood glucose which can lead to diabetes, high blood pressure, high body mass index (BMI) which is a measure of obesity, and high total cholesterol. All of these can be related to eating the wrong foods, although there are also other causes.

causes of death graphic

This is really large, Dr Christopher Murray, IHMEs director, told the Guardian. It is amongst the really big problems in the world. It is a cluster that is getting worse. While obesity gets attention, he was not sure policymakers were as focused on the area of diet and health as they needed to be. That constellation is a really, really big challenge for health and health systems, he said.

The problem is often seen as the spread of western diets, taking over from traditional foods in the developing world. But it is not that simple, says Murray. Take fruit. It has lots of health benefits but only very wealthy people eat a lot of fruit, with some exceptions.

Sugary drinks are harmful to health but eating a lot of red meat, the study finds, is not as big a risk to health as failing to eat whole grains. We need to look really carefully at what are the healthy compounds in diets that provide protection, he said.

undernourishment graphic

Prof John Newton, director of health improvement at Public Health England, said the studies show how quickly diet and obesity-related disease is spreading around the world. I dont think people realise how quickly the focus is shifting towards non-communicable disease [such as cancer, heart disease and stroke] and diseases that come with development, in particular related to poor diet. The numbers are quite shocking in my view, he said.

The UK tracks childhood obesity through the school measurement programme and has brought in measures to try to tackle it. But no country in the world has been able to solve the problem and it is a concern that we really need to think about tackling globally, he said.

Today, 72% of deaths are from non-communicable diseases for which obesity and diet are among the risk factors, with ischaemic heart disease as the leading cause worldwide of early deaths, including in the UK. Lung cancer, stroke, lung disease (chronic obstructive pulmonary disorder) and Alzheimers are the other main causes in the UK.

The success story is children under five. In 2016, for the first time in modern history, fewer than 5 million children under five died in one year a significant fall compared with 1990, when 11 million died. Increased education for women, less poverty, having fewer children, vaccinations, anti-malaria bed-nets, improved water and sanitation are among the changes in low-income countries that have brought the death rate down, thanks to development aid.

People are living longer but spending more years in ill health. Obesity is one of the major reasons. More than a billion people worldwide are living with mental health and substance misuse disorders. Depression features in the top 10 causes of ill health in all but four countries.

Our findings indicate people are living longer and, over the past decade, we identified substantial progress in driving down death rates from some of the worlds most pernicious diseases and conditions, such as under age-five mortality and malaria, said Murray Yet, despite this progress, we are facing a triad of trouble holding back many nations and communities obesity, conflict, and mental illness, including substance use disorders.

In the UK, the concern is particularly about the increase in ill-health that prevents people from working or having a fulfilling life, said Newton. A man in the UK born in 2016 can expect only 69 years in good health and a woman 71 years.

This is yet another reminder that while were living longer, much of that extra time is spent in ill-health. It underlines the importance of preventing the conditions that keep people out of work and put their long term health in jeopardy, like musculoskeletal problems, poor hearing and mental ill health. Our priority is to help people, including during the crucial early years of life and in middle age, to give them the best chance of a long and healthy later life, he said.

Read more: https://www.theguardian.com/society/2017/sep/14/poor-diet-is-a-factor-in-one-in-five-deaths-global-disease-study-reveals

The truth about superfoods

How hipster is seaweed? Are avocados actually a disaster for the environment? Do goji berries really make you live for ever? We examine the evidence

Few lies can be told in one word, but superfood manages it. It is such an appealing idea: that some foods are healthy, some unhealthy and some superhealthy. Why change your habits, when you can correct them by adding goji berries? Why settle for boring old good health, when chia seeds on your cereal can make you superhealthy? Little wonder that 61% of British people reported buying foods because they were supposed superfoods, according to a 2014 survey conducted by YouGov for Bupa.

Of course, there is always science talk, of omega-3s and glucosinolates and anthocyanins. Many of us may feel we understand the value of antioxidants that mop up the free radicals that damage our cells, causing ageing and cancer. Yet in 2011, the European Food Safety Authority (Efsa) reviewed the evidence and found no actual benefit to health. Indeed, as Ben Goldacre pointed out in his book Bad Science, the body actually uses free radicals to kill bacteria. Does that mean a surfeit of antioxidants might weaken your immune system? The point comes when you have to give up and ask a doctor. (A real one, not Gillian McKeith.)

The truth so unappealing is that nutrition is fabulously complex, different for everybody and mostly mysterious. We know that if you eat a balanced diet with plenty of fruit and vegetables and do regular exercise, nothing is a superfood. And if you dont, no superfood will save you.

Kale

Kale
Kale chips a superfood upgrade on crisps? Photograph: Redphotographer/Getty Images/iStockphoto

Currently one of the coolest superfoods around, kale is also one of the most perplexing. Isnt it just one of the greens people have been told to eat for about as long as they have had a choice? Certainly, you would struggle to find a less exotic vegetable. Kale has grown in northern Europe, and plenty of other places, for thousands of years. In wartime, it was one of the stolid, practical crops that people were advised to grow in their gardens. Along with cavolo nero and red Russian kale, it is one of many cultivars of the magnificent Brassica oleracea species, which also gives us cabbage, broccoli, cauliflower, kohlrabi and brussels sprouts, and is closely related to turnips, bok choy and Chinese cabbage.

Kale
Kale. Photograph: jenifoto/Getty Images/iStockphoto

Health benefits Well, we know that it is healthy to eat a diet containing plenty of vegetables, so really the question ought to be: is kale significantly better than the rest of them? And that is easy. No, it isnt. Fans of superfoods like to list the things that kale contains a lot of (iron, vitamins, fibre, antioxidants) and point out what those things do (make red blood cells; miscellaneous; help you poo; mop up free radicals/dont know), but that doesnt mean your body gets superpowers if you eat more than you need, especially if youre already getting enough from other sources. Its like trying to make your car go faster by putting in more petrol. All vegetables contain different amounts of vitamins and minerals, which also vary depending on the soil they are grown in, so there is not much point making them compete in a nutrient competition. Sure, by weight, typical kale contains more calcium, vitamin B6 and indeed calories than typical cabbage, broccoli, brussels sprouts, spinach or carrots, but eating more of them will get you to the same place. Typical kale also contains less vitamin A than carrots, less iron, magnesium or potassium than spinach and less fibre than brussels sprouts. Big deal. No good evidence shows that eating plenty of fruit and vegetables with kale is any better than eating plenty of them without.

Eco rating Close to perfect you can grow it easily yourself (under a net to keep off the cabbage white butterflies).

Hipster rating Sky-high.

Stars in Crispy chips, colcannon, not-very-nice salads.

Avocado

Avocado
Avocado toast: an ecological disaster. Photograph: Vladislav Nosick/Getty Images/iStockphoto

A true delicacy, when just ripe, and now one of the most popular fruits in the US. (It is technically a fruit rather than a vegetable. Very technically, its a large berry.) So high is the demand for avocados, in fact, that the crop has recently caught the attention of Mexicos criminal gangs. To look at, use, and taste and, indeed, in its nutritional content avocado is certainly unusual. Whether it has superpowers is another matter.

Avocado:
Avocado. Photograph: FotografiaBasica/Getty Images

Health benefits The high fat content stands out immediately. It is monounsaturated fat, which helps to protect your cardiovascular system, but you can also get that from oily fish, nuts, uncooked olive oil, sunflower oil loads of things. And you should. As result, despite seeming so light and barely filling you up at all, avocados are hugely calorific. A whole one provides about 240 calories. (A Mars Bar provides 228.) An excellent way of getting fat by mistake is to go on a misguided avocado binge. A review of eight preliminary studies in 2013 found that eating hass avocados may benefit the cardiovascular system. However, this is far from established and, more importantly, the review was paid for by who else? the Hass Avocado Board. Currently, there are no good-quality independent systematic reviews of the effects of avocados on health. There have been reports that an extract of avocados might treat leukaemia, but the extract in question avocatin B comes from the seed in the middle, so youll get none from eating it.

Eco rating Not good, Im afraid. Deforestation to make way for avocado trees is now a problem in Mexico. Even those trees that already exist need a very large amount of water perhaps as much as 272 litres for every half-kilo of fruit (two or three avocados). In California, where there is a long-term water shortage, this is an even more serious problem. On top of all this, avocados are heavy, have to be shipped from the tropics and kept cool en route.

Hipster rating Low. So predictable.

Stars in Guacamole, avocado toast, milkshakes, ice-cream, prawn cocktail (dont knock it).

Pomegranates

Pomegranate
Pomegranate syrup with pomegranate seeds and prosecco. Photograph: Westend61/Getty Images

Pink, sweet, tasty and a little bit exotic, pomegranates are an easy fruit to like especially when someone has already juiced them for you and removed the seeds (which contain all the fibre, by the way). Grenadine, the red syrup you last saw at the bottom of a tequila sunrise in 1992, was traditionally made from sweetened pomegranate juice. It is often replaced with less expensive fruit these days, since no one really notices.

Pomegranates:
Pomegranates. Photograph: Sarah Lee for the Guardian

Health benefits In 2012, a US judge ordered POM Wonderful to stop making bold health claims for its products. As things stand, studies only hint at benefits for people with existing health problems. It has been suggested that drinking lots of pomegranate juice might help to reduce the artery damage caused by cholesterol and improve blood flow to damaged hearts, but the evidence is neither decisive nor well understood. There is also a very faint suggestion that it may slow the progress of prostate cancer. You will not be surprised to hear that there are lots of antioxidants in pomegranates (especially in the peel, which you cant eat), but that means exactly nothing until large doses of antioxidants, per se, are shown to improve peoples health.

Eco rating Pomegranate trees grow easily in hot places and manage well with limited water. Even so, the rush to get into the pomegranate business has left many central Indian farmers in trouble after years of inadequate rain.

Hipster rating Low, now that you can get it in washing-up liquid. Pomegranate molasses, which is basically sugar, is very cool.

Stars in Juice, couscous, and Persian, Indian and Pakistani stews.

Goji berries

Granola
Granola with goji berries: no healthier than any other fruit. Photograph: Elenathewise/Getty Images/iStockphoto

Once known as wolfberries, this fruit of the boxthorn has become highly prized, and fairly expensive, under its sort-of Chinese name. When fresh, the fruits look like pink, elongated grapes. When dried, they look like pink raisins. As such, they are very easy to snack on and mix into things. The Chinese herbalist Li Ching-Yuen was said to have lived for 197 (or even 256 years) on a diet high in goji berries, but didnt.

Goji
Goji berries. Photograph: Alamy

Health benefits Goji berries have played a big part in traditional Chinese medicine for thousands of years, but dont take that as an endorsement. The best evidence suggests that traditional Chinese medicine, like traditional European medicine, was and is mostly a reassuring waste of time or actually harmful. Eating goji berries, or drinking the juice, almost certainly isnt bad for you, but there is simply no evidence that they do anything more useful than any other fruit. Studies claiming they treat cancer, heart disease and various other things have been tiny, badly run and generally based on large doses of goji extract that you couldnt possibly get by eating them normally.

Eco rating Fine. You can even grow your own, although most are shipped from China.

Hipster rating Good, especially if you can talk about how you grew them.

Stars in Juice, granola.

Chia seeds

Chia
Chia pudding: gloopy but good for you? Photograph: Westend61/Getty Images/Westend61

An obscure Central and South American seed with an ancient history and a weirdly high omega-3 content: chia seeds were destined to become a superfood long before anyone knew what, if any, good they did. They also behave quite excitingly in the kitchen, forming a gloopy kind of gel when mixed with liquids, which means you can use them to thicken drinks or even make strange jellies. Otherwise, you can scatter them on almost anything or grind them into a flour to bake with. They dont taste of very much.

Chia
Chia seeds. Photograph: Marek Uliasz/Alamy

Health benefits Chia seeds are all about the small print. Omega-3 fatty acids, in case you hadnt heard, are found in oily fish, and a broadly Mediterranean diet including oily fish seems to be a very healthy way to eat. One hundred grams of chia seeds contain about 17g of omega-3s, which is enormous about eight times as much as salmon. However the omega-3s in chia are different from the ones in fish, and your body turns the chia kind into the fish kind very inefficiently, meaning that you will actually absorb less, by weight about 1.8g per 100g, compared with 2.3g. Nor is it easy to eat a full 100g of chia seeds, which, by the way, also contain 486 calories, almost as much as a Big Mac. And however part two: why do you want to eat lots of omega-3s? Fish is definitely good for you, helping to protect against cardiovascular disease. (The government recommends two portions, one oily, a week.) But the evidence for omega-3s from other sources is vague, and there is little evidence to suggest health benefits for chia in particular.

Eco rating Certainly an ecological improvement on fish, if youre determined to get omega-3s from somewhere.

Hipster rating Getting a bit pass now.

Stars in Bread, granola bars, smoothies, weird jelly.

Beetroot

Beetroot
Beetroot salad: dont eat more than two beets a day. Photograph: MarynaVoronova/Getty Images/iStockphoto

Not long ago, beetroot was a relic. You would see mushy spheres of it sealed in plastic, maybe soaked in vinegar. Only old people still had a taste for beetroot, like condensed milk or tongue. Now, like so many relics, it is cool again, and deserves to be. Freshly roasted, or grated, or pickled (carefully), or juiced, it is one of the great vegetables. You can eat the leaves, which are basically chard, and the classic purple beetroot has the jolly side-effect of dyeing you, your plate, your kitchen and your excreta red for the rest of the day.

Beetroot:
Beetroot. Photograph: Melanie Major/Getty Images/Flickr RF

Health benefits As vegetables go, beetroot is a fairly unspectacular source of vitamins and minerals. (Not that this matters. See kale.) Yet, like many vegetables, it is rich in nitrates, which somehow manage to make it a superfood, a sports supplement and a health scare, all at the same time. The good part is that beetroot juice does seem to lower blood pressure, a little, probably because of the nitric oxides that your body converts nitrates into. In practice, this is is not much use, however. If your blood pressure needs to be lowered, you are much better off doing exercise, eating less salt and taking the drugs your doctor gives you. Other research suggests that drinking beetroot juice before exercise improves the endurance of casual athletes by allowing more oxygen to be delivered around the body (but has little effect on serious ones). When added to red meat, however, nitrates worry people, as they form nitrosamines, and do lead to an increased risk of bowel cancer (from about a 5.6% lifetime risk in people who eat almost none, up to about 6.6% in people who eat lots). It is possible that the nitrates in beetroot could also form nitrosamines in your body, so Efsa recommends eating no more than about two beetroots a day.

Eco rating Excellent. Grow it yourself.

Hipster rating High, given its traditional unpopularity.

Stars in Everything. Salt-baked slabs with cheese, pickled in a jar, julienned in a salad, juiced for breakfast You can even make beetroot cakes, or turn puddings pink with the dye.

Seaweed

Seaweed-wrapped
Seaweed-wrapped maki sushi: rich in vitamin B12. Photograph: Glow Cuisine/Getty Images

Seaweed is definitely having a moment right now. It plays a big part in east Asian food, especially in Japan, and also crops up in the Philippines and in Welsh laverbread which, in case youve never tried it, is very unlike bread. Given its weirdness to those not used to eating algae, it is surprising that seaweed hasnt had its moment sooner. It comes in many edible forms laver or nori (they are similar), kelp, sea grapes, dulse and plenty more. All are different, and some have special claims attached to them, but it is possible to generalise a bit.

Forget five a day, eat 10 portions of fruit and veg to cut risk of early death

Scientists say even just 2.5 portions daily can lower chance of heart disease, stroke, cancer and premature death

Five portions of fruit and veg a day is good for you, but 10 is much better and could prevent up to 7.8 million premature deaths worldwide every year, say scientists.

The findings of the study led by Imperial College London may dismay the two in three adults who struggle to manage three or four portions perhaps some tomatoes in a sandwich at lunchtime, an apple and a few spoonfuls of peas at dinner.

All of that is good because a daily intake of even 200g, or two and a half standard 80g portions, is associated with a 16% reduced risk of heart disease, an 18% reduced risk of stroke, a 13% reduced risk of cardiovascular disease, 4% reduced risk of cancer and a 15% reduction in the risk of premature death.

But the study suggests we should be piling up platefuls of vegetables and raiding the fruit bowl every day if we want the best chance of avoiding chronic diseases or an early death.

We wanted to investigate how much fruit and vegetables you need to eat to gain the maximum protection against disease, and premature death. Our results suggest that although five portions of fruit and vegetables is good, 10 a day is even better, said Dr Dagfinn Aune, lead author of the research from the School of Public Health at Imperial.

Eating up to 800g of fruit and vegetables equivalent to 10 portions and double the recommended amount in the UK was associated with a 24% reduced risk of heart disease, a 33% reduced risk of stroke, a 28% reduced risk of cardiovascular disease, a 13% reduced risk of total cancer, and a 31% reduction in premature deaths.

What does 800g look like?

And not all fruit and veg are created equal. Apples and pears, citrus fruits, salads and green leafy vegetables such as spinach, lettuce and chicory, and cruciferous vegetables such as broccoli, cabbage and cauliflower were found to be best at preventing heart disease and stroke.

To reduce the risk of cancer, however, the menu should include green vegetables, such as green beans; yellow and orange vegetables such as peppers and carrots; and cruciferous vegetables.

The researchers did not find any difference between the protective effects of cooked and raw fruit and vegetables.

Fruit and vegetables have been shown to reduce cholesterol levels, blood pressure, and to boost the health of our blood vessels and immune system, said Aune. This may be due to the complex network of nutrients they hold. For instance they contain many antioxidants, which may reduce DNA damage, and lead to a reduction in cancer risk.

Compounds called glucosinolates in cruciferous vegetables, such as broccoli, activate enzymes that may help prevent cancer. Fruit and vegetables may also have a beneficial effect on the naturally occurring bacteria in our gut, he said.

Toddler
Most people struggle to eat three or four portions a day, the study shows. Photograph: Simon Masters/Getty Images/Vetta

And it will not be possible to bottle the effects of fruit and vegetables or put them in a pill, he said. Forget the supplements. Most likely it is the whole package of beneficial nutrients you obtain by eating fruits and vegetables that is crucial to health, he said. This is why it is important to eat whole plant foods to get the benefit, instead of taking antioxidant or vitamin supplements (which have not been shown to reduce disease risk).

The analysis in the International Journal of Epidemiology pooled the results from 95 different studies involving a total of approximately 2 million people. They assessed up to 43,000 cases of heart disease, 47,000 cases of stroke, 81,000 cases of cardiovascular disease, 112,000 cancer cases and 94,000 deaths.

Aune said more research was needed, but it is clear from this work that a high intake of fruit and vegetables hold tremendous health benefits, and we should try to increase their intake in our diet.

Sarah Toule, from the World Cancer Research Fund, said: This interesting research shows just how incredibly important vegetables and fruit are as part of a healthy diet. In fact, theyre essential for maintaining a healthy weight, which our own evidence has shown reduces the risk of 11 common cancers.

People should aim to eat at least five portions of vegetables and fruit a day but the more the better. If people find this hard, why not start by adding an extra portion of fruit or veg a day to your lunch or try swapping one of your naughty snacks for a piece of fruit?

Read more: https://www.theguardian.com/society/2017/feb/23/five-day-10-portions-fruit-veg-cut-early-death

A danger to public health? Uproar as scientist urges us to eat more salt

Exclusive: In a new book a US scientist claims eating more salt will make us healthier. But UK experts have condemned the advice as potentially dangerous

Public health experts in the UK have spoken out against a new book that claims many of us should be eating more salt, not less claiming the advice could endanger peoples health.

New York scientist James DiNicolantonio says in his book The Salt Fix that the World Health Organisation and the US and UK advisory bodies on diet have got it wrong with their advice to cut down on salt.

Salt is necessary and good for us, he says. Eating more salt will reduce the amount of sugar in our diet and help us lose weight, he says. Indeed low-salt diets may be causing brittle bones and memory loss and more salt could fix diabetes, he claims.

Instead of ignoring your salt cravings, you should give in to them they are guiding you to better health, he argues in his book, which has won attention for his ideas in the UK media. Most of us dont need to eat low-salt diets. In fact, for most of us, more salt would be better for our health rather than less.

Meanwhile, the white crystal weve demonized all these years has been taking the fall for another, one so sweet that we refused to believe it wasnt benign. A white crystal that, consumed in excess, can lead to high blood pressure, cardiovascular disease, and chronic kidney disease: not salt, but sugar.

But Public Health England (PHE), speaking out as promotion of DiNicolantonios book gathered pace in the UK, said his advice was not only wrong but dangerous. Prof Louis Levy, head of nutrition science at PHE, said: Diet is now the leading cause of ill health. By advocating a high-salt diet this book is putting the health of many at risk and it undermines internationally recognised evidence that shows a diet high in salt is linked to high blood pressure, a known risk for heart disease.

Our work with the food industry to cut the salt in food has already seen consumption in the UK reduce by 11% and is seen as the model to aspire to globally.

The row follows other diet controversies, such as the renewed debate over saturated fat and cholesterol. But the evidence on salt is incontrovertible, according to Graham MacGregor, a professor of cardiovascular medicine, who led the campaign for action on salt and health (CASH). That succeeded in persuading the government to take action by putting pressure on fast food companies to reduce the salt levels in their ready-meals, the biggest source of salt in our diets.

He is entitled to his views but it is all based on a few studies and they are misplaced, said MacGregor. It you look at the totality of the evidence on salt, it is much stronger than for sugar or saturated fat or fruit and vegetables in a positive way. Its overwhelming because weve got all the epidemiology, migration studies [where people have gone to live in another country and changed their diet], treatment trials, mortality trials and now outcome trials in countries.

Finland has reduced salt. The UK has and there have been big drops in heart deaths. You cant really argue against the importance of salt but you always get one or two people who deny it.

MacGregor, who now also runs Action on Sugar, says DiNicolantonio is probably quite well-meaning but is one of those who think every death on the world is because of sugar.

But DiNicolantonio, who is an associate editor of the journal BMJ Open Heart and a cardiovascular research scientist at Saint Lukes Mid America Heart Institute, says the evidence does not stack up, whatever bodies such as PHE and the American Heart Association (AHA) say. The AHA recommends no more than a teaspoon of salt a day equating to 2,300 milligrams of sodium and says most Americans should cut down to not much more than half of that.

Because the average Americans sodium intake is so excessive, even cutting back to no more than 2,400 milligrams a day will significantly improve blood pressure and heart health, it says, noting that 75% of intake comes from processed, packaged or restaurant food.

DiNicolantonio says there is no evidence that a low-salt diet will reduce blood pressure in the majority of people. Evidence in the medical literature suggests that approximately 80% of people with normal blood pressure (less than 120/80 mmHg) are not sensitive to the blood-pressure-raising effects of salt at all. Among those with prehypertension (a precursor to high blood pressure), roughly 75% are not sensitive to salt. And even among those with full-blown hypertension, about 55% are totally immune to salts effects on blood pressure, he writes.

The governments scientific advisory committee on nutrition (SACN), which backed a reduction to 6g of salt a day in the UK diet from around 9g, lists a large number of trials in animals and humans that suggest high salt levels do lead to higher blood pressure in its 2003 report. However, it could not come to conclusions on the numbers of cases of heart disease and deaths that might be caused, because the data was hard to collect.

But the National Institute for Health and Care Excellence, which looked at the impact of salt reduction for the population in 2013, said the governments strategy could lead to 20,000 fewer heart deaths each year.

DiNicolantonio also claims that we lose too much salt when we exercise or sweat in heatwaves. MacGregor says that is not so. There was a very good experiment with the SAS, parachuted into a desert, which found they needed quite a low salt intake. If you have a higher salt intake it is more dangerous. They had to carry more water with them because of thirst, he said.

Speaking to the Guardian, DiNicolantonio rejected the criticism from PHE that his book would make people risk their health, saying he was advocating for a normal salt intake, which he claims is between 3,000 and 6,000 mg of sodium per day. As sodium accounts for 40% of salt, that would equate to 7.5g to 15g of salt a day. But he says that is not a high salt diet. Moreover, if a high salt diet really put peoples health at risk then why are the highest salt-eating populations (Japan, South Korea, and France) living the longest with the lowest rates of coronary heart disease in the world? he said.

Low-salt diets are putting the population at risk as there are literally millions of people who are at risk of salt deficiency, with over six million people in the US alone diagnosed with low sodium levels in the blood every year.

Read more: https://www.theguardian.com/science/2017/aug/08/a-danger-to-public-health-uproar-as-scientist-urges-us-to-eat-more-salt

HRT and vaginal moisturisers? Here’s what really helps menopausal women

Products claiming to fix the menopause are now a multibillion-dollar global industry. We asked the experts for their advice on what works and what doesnt

Even though 80% of women going through the menopause will get symptoms, such as hot flushes and night sweats (and in 25% of cases they will be severe enough to affect quality of life), few are confident talking about it. A global industry worth about US$4bn (3.4bn) flogs books and products, but reliable information is hard to come by. So how can women distinguish fact from marketing hype and what helps?

Managing the symptoms

Kathy Abernethy, chair of the British Menopause Society, says: Hormone replacement therapy (HRT) is absolutely the best treatment for hot flushes and sweats that affect daily life. It can also help sleep disturbance caused by night sweats and is one of several strategies to keep bones strong. Dr Mark Vanderpump, an endocrinologist (hormone specialist), agrees: If men got hot flushes, theyd be screaming for HRT, he says. Other options include the non-hormonal drugs clonidine, venlafaxine and gabapentin, or lifestyle measures such as avoiding spicy foods, alcohol and hot places.

HRT and cancer risks

The risk of cancer from HRT is overstated, says Vanderpump. Cancer Research UK puts it in perspective; if 1,000 women start HRT at the age of 50 and take it for five years, there will be two extra cases of breast cancer and one extra case of ovarian cancer compared with among non-HRT users. There will also be some extra cases of heart attack and stroke, but the overall negative effects are small. Avoiding HRT could prevent 1,700 cancer cases a year, but staying a healthy weight could prevent 18,000 cancer cases and not smoking would prevent 64,500 in a year. Women need to be given information and choices, says Vanderpump. Abernethy recommends the Womens Health Concern factsheets and the website Manage My Menopause, which offers tailored advice.

Natural supplements

Campaigner and author Maryon Stewart advocates a diet rich in plants such as soy that contain oestrogen-like chemicals called phytoestrogens. But Abernethy says we dont know how much soy you need to eat to get the same effect as HRT. And if phytoestrogens have similar benefits to synthetic oestrogens in HRT, they may share the risks: an increased chance of blood clots and a possible increase in breast cancer.

Dietary supplements containing isoflavones (the active chemicals in phytoestrogens), herbal remedies such as black cohosh and vitamin E are all available over the counter, but there is little evidence about their effectiveness or otherwise, according to the North American Menopause Society.

Eating a varied, Mediterranean-style diet, avoiding obesity, and doing regular weight-bearing exercise will help to minimise the risk of osteoporosis, heart disease, depression and osteoarthritis. Most women dont need calcium supplements, but those at particular risk of osteoporosis should get specialist advice.

Preventing heart disease and strokes

June Davison of the British Heart Foundation says women need to be aware that their risk of heart disease and stroke increases dramatically after the menopause. Oestrogen, which has a protective effect on artery linings, falls and other factors, such as high blood pressure, raised cholesterol and the ageing process kick in. Davison says: Heart disease kills three times as many women as breast cancer does; its common and certainly not a male disease. The best approach is to get a health check at your GP, optimise blood pressure, cholesterol and weight, dont smoke, eat well and exercise. We dont advise HRT to protect against heart disease; it may increase the risk of thrombosis (blood clots) if you are at increased risk and there is some evidence that heart disease is increased in the first year of HRT use. Women who want to take HRT for other reasons, such as hot flushes, and are at low risk of heart disease, can be reassured that the increased risk will be very low.

Sex drive and dry vagina

Loss of sex drive is common around the time of the menopause. Low mood, tiredness, hormonal changes and relationship problems may all play a part. It doesnt help that sex can be painful as the fall in oestrogen levels makes the vagina dry and sore. Non-hormonal vaginal moisturisers such as Replens, lubricants, and oestrogen pessaries (on prescription only) can restore vaginal moistness; the other factors may be more complex to fix.

Supplements for skin and hair

Vanderpump says women and men in midlife often experience thinning hair, rougher skin and various other age-related changes to their looks. But these are more likely to be due to genetics and environmental factors, such as sun exposure and smoking. If you eat a normal, varied diet, there is no reason to think that nutritional supplements will help hair, nails or skin. HRT doesnt turn the clock back and isnt recommended for these factors.

How can my employer help?

A government review examined 104 studies and found that the years around the menopause can have a big, usually negative, impact on womens working lives. Study co-author Professor Jo Brewis of the University of Leicester school of business says: We need to talk about the nitty gritty of menopause without embarrassment or fear being judged. Brewis says the analogy is with pregnancy 20 years ago when women feared telling employers that they were pregnant and needed certain reasonable adjustments in the workplace. For menopausal symptoms such as hot flushes, that might include fans, open windows, adjustable air conditioning, non-synthetic uniforms and flexible working hours.

We need to normalise the menopause, understand that it affects women differently and that many of the problems are relatively short-lived, says Brewis.

What are bioidentical hormones?

This form of HRT marketed in the private sector claims to offer hormones derived from plants that are chemically closer to the ones that occur naturally in the body. But the US Food and Drug Administration (FDA) is clear that they are no safer or more effective than standard HRT. Vanderpump says that if you find HRT helps symptoms, the exact preparation can be tailored to your specific needs; adding low-dose testosterone (Testim) gel, for instance, may help libido even though it is only licensed for men.

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Read more: https://www.theguardian.com/lifeandstyle/2017/aug/07/hrt-and-vaginal-moisturisers-heres-what-really-helps-menopausal-women

A brief guide to eternal youth get a dog, avoid tax and inject teenage blood

Recent studies suggest that being neurotic and drinking coffee could help you live longer. But theres no shortage of other theories about how to stay young

You know what never gets old? Nothing. We are all slowly decaying and eventually we will all die. With any luck, this reminder of your mortality has prompted you to anxiously down an espresso and triple-check how many steps you took today. You see, according to a recent study, which analysed data from more than 500,000 people in the UK, neurotic tendencies can help you live longer. This news comes shortly after another study found regularly drinking coffee might add years to your life.

If youre not lucky enough to have been born aneurotic caffeine-addict, dont worry, theres still hope. Ive put together a brief guide that outlines some quick and easy ways to extend your life, should that be something you wish to do, given the imminent possibility of nuclear war and the present popularity ofmale rompers.

Get a transfusion of teenage blood

Nobody is entirely sure what goes on in the minds of teenagers but, apparently, the elixir of youth is swirling around in their blood. Studies have found that injecting elderly mice with plasma (the liquid part of blood) from 18-year-old humans is ridiculously rejuvenating: the mice suddenly have more of a spring in their step and increased cognitive abilities. Scientists and speculators have now moved from mice to men, and are injecting young blood into old people to see if it can help reverse Alzheimers or other serious medical conditions, such as wrinkles. Last year, a California startup called Ambrosia launched adubious private clinical trial to inject blood from 16 to 25-year-olds into any over-35s who wanted to shell out $8,000 (6,120) for the privilege. According to Jesse Karmazin, the founder of Ambrosia, the trial worked wonders. Whatever is in young blood is causing changes that appear to make the ageing process reverse, Karmazin told New Scientist. I dont want to say the word panacea, but theres something about teenagers. Honestly, I dont want to say the word creepy, but theres something about Karmazin.

Evade death by avoiding taxes

Its a truth universally repeated that nothing is certain in life except for death and taxes. However, it turns out avoiding your taxes might help you dodge death a little longer. According to the CIA World Factbook, Monaco has the highest life expectancy in the world at 89.5 years. This might be down to the temperate climate or it might be due to the fact that Monaco is almost exclusively populated by the mega-wealthy because it is a notorious tax haven. Funnily enough, tax havens appear to have some of the highest life expectancies in the world. Residents of Macau can expect to live to 84.5; in Andorra the average is 82.8; in Guernsey its 82.5. Avoiding taxes may well be the financial equivalent of teenage blood transfusions: an elderly elite greedily sucking sustenance from the young.

Ask your doctor to prescribe a puppy

Numerous studies have linked pet ownership to better physical and mental health. But not all pets are created equal and, as any right-thinking person knows, the best sort of pet to get if youre looking for a longer, happier life is a dog. Dogs need to be walked and walking is good for you; dog-ownership has been associated with areduced risk of heart disease. Cats, on the other hand, have an innate evil that has never been domesticated out of them. If they get achance, theyll kill you, and then theyll eat you. Granted, Idont have an actual scientific study to back that up, but Im fairly certain its true.

Avoid the US unless yourerich

At 78.8, US life expectancy is among the lowest in the wealthy world. This is largely thanks to its abysmal healthcare system, which, if Donald Trump and the GOP were to get their way, could soon become even more abysmal. And if youre poor in the US, you cant expect very much at all: the life-expectancy gap between Americas rich and poor is more than 20 years. A study published last month by the University of Washington found residents of affluent areas of central Colorado have the highest life expectancy, at 87 years, while people in poorer regions particularly Native American reservations in North and South Dakota have a life expectancy of just 66. Thats on a par with Yemen. But, hey, lets remember that dying early from inadequate health care is a small price to pay for the benefits afforded by the free market.

Work yourself to a later grave

According to a recent study from Oregon State University, youre likely to live longer if you retire after 65. The researchers found that when people retired at 66 instead of 65, their mortality rates dropped by 11%. So the fact the Tories are now planning to raise the state pension age doesnt mean the government doesnt care about young people. On the contrary: they are benevolently looking out for everyones best interests!

Approach advice from centenarians with caution

When you turn 100, you get a message from the Queen and a licence to mercilessly troll the media. Whenever super-old people are interviewed by the press they always seem to say the secret to their long life is something extremely dubious. For example, according to 110-year-old Grace Jones, the key to a long life is drinking whisky. A107-year-old Spanish man who died last year credited his advanced age to drinking four bottles of wine a day and never drinking water. And before she died at age 109, Scotlands oldest woman, Jessie Gallan, said her secret to a long life was eating porridge and staying away from men. Actually, you know what, she might have a point.

Read more: https://www.theguardian.com/commentisfree/2017/jul/30/a-brief-guide-to-eternal-youth-get-a-dog-avoid-tax-and-inject-teenage-blood

Coconut oil: are the health benefits a big fat lie?

Its the latest superfood, endorsed by wellness bloggers and celebrities, yet contains more saturated fat than lard

It wasnt that long ago that the closest most Britons got to a coconut was at the fairground or on the inside of a Bounty bar. Yet in the past three years, this hard, hairy drupe (thats the official term) of the coconut palm tree has emerged as the latest superfood extolled by celebrities and health food shops for its nutritional, healing and mind-enhancing powers.

Aisles of health food shops are packed with bags of flour, snacks, milk, sugar and drinks made from its meat and milk. And leading the way is coconut oil, a sweet smelling, greasy fat used for frying, baking, spreading on toast, adding to coffee or simply rubbing into your skin.

Its hard to exaggerate how much hype surrounds coconut oil on health food websites, blogs and YouTube channels. Wellness Mama lists 101 uses including as a mental stimulant, hair conditioner and treatment for insomnia, heartburn, cuts, acne, haemorrhoids, mosquito bites and sunburn. Everdine recommends using coconut oil to cook with at every meal due, while Holland & Barrett claims coconut oil is very healthy, adding: Coconut oil is the little black dress of wellbeing everyone should have some!

Sites such as these, along with celebrity endorsements from the likes of Gwyneth Paltrow and Kourtney Kardashian, have helped UK sales of coconut oil rise over the past four years from around 1m to 16.4m last year, according to consumer research group Kantar.

When it comes to superfoods, coconut oil presses all the buttons: its natural, its enticingly exotic, its surrounded by health claims and at up to 8 for a 500ml pot at Tesco, its suitably pricey. But where this latest superfood differs from benign rivals such as blueberries, goji berries, kale and avocado is that a diet rich in coconut oil may actually be bad for us.

Earlier this month, the American Heart Association (AHA) warned that coconut oil contains the same level of saturated fat as beef dripping. In fact, its so oozing with artery-clogging saturated fat that lard is a healthieroption.

The AHA alert, which has followed similar observations from scientists over the years, has triggered an online battle between those who claim the science of coconut oil is more complex and more sophisticated than food scientists acknowledge and those who say food faddists have been duped by clever marketing.

So who is right? Even if coconut oil really is full of saturated fats, are all saturated fats bad? And why do we get such conflicting messages about the fat in our diet?

Coconut oil is pressed from the meat of a coconut. It has been used in Africa, Asia and South America for centuries and was routinely used in American processed food in the middle part of the 20th century. In the 1940s, it was the main source of non-dairy fat in the US diet until it was replaced by vegetable oils, particularly soya bean oil. Concerns about its high saturated fat content emerged in the middle of the last century and are rife today, even as the oil makes a revival among health foodlovers.

Priya Tew, spokesperson for the British Dietetic Association, says: Coconut oil is a high saturated fat. Its about 92% saturated fat so more than lard or butter. If a woman has two tablespoons, she is eating 20g of saturated fat, her recommended dailyamount.

In the long-established pecking order of fats laid down over many years by public health officials, trans fats are classed as the least healthy. The chemical transformation makes them hard for our bodies to process. They raise levels of bad (LDL) cholesterol and lower good (HDL) cholesterol, increasing the risk of developing heart disease and strokes; they are also linked to type 2 diabetes. In contrast, unsaturated fats are pretty universally accepted as beneficial because they raise levels of good HDL cholesterol. That leaves saturated fats somewhere in the middle.

Since the 1970s, the message from public health bodies has been that they raise bad cholesterol, fur up arteries and increase the risk of strokes, heart disease and heart attacks. Thats the view of the UK government, the World Health Organisation and virtually every other public health body in the world. So where does the idea of coconut oil, one of the richest sources of saturated fat available, being a health food come from?

One branch of evidence often cited by the pro-coconut oil lobby is work done by Dr Marie-Pierre St-Onge, associate professor of nutritional medicine at Cornell University Medical School, in the early 2000s. Her team was looking at the impact on health of medium-chain triglycerides (MCTs), a form of fat molecule that has shorter chains of fatty acid than most and which is found in coconut oil in higher concentrations than any other natural food.

In 2003, her team published research comparing the effects of diets rich in MCTs or long-chain triglycerides (LCTs) on 24 overweight men. She found that eating more MCTs over the month-long study led to losing an extra pound in weight compared with those eating a similar amount of LCTs. Further studies had similar findings. In 2008, she showed that a diet containing MCTs led to more weight loss than a similar diet containing olive oil.

It was a fascinating result and a reminder that not all saturated fats are the same. And it was leapt upon by coconut oil supporters. Holland & Barretts website, for instance, claims that the majority of fat in coconut oil is made up of MCTs. But the link from these studies to coconut oil was arguably a leap too far. Recent studies suggest that coconut oil actually comprises just 13-15% MCTs. The rest are traditional LCTs.

From what I can tell, my research is being used to say that coconut oil is healthy, but this is a very liberal extrapolation of what weve actually studied, says Dr St-Onge.

In her tests, volunteers were given a concoction made from 100% MCTs.

We dont know if the amount in coconut oil is sufficient to have similareffects as pure MCT oil in releasing energy expenditure and improving satiety and weight management. From recent studies, it seems that it is not.

Coconut
Coconut flesh, to be made into oil, drying in Papeete, French Polynesia. Photograph: Gregory Boissy/AFP/Getty Images

If theres little evidence that coconut oil is less fattening than other saturated fats, what about another often made claim that it lowers levels of harmful cholesterol? Some studies appear to show that people who eat more coconut in their diets have higher levels of HDL cholesterol the healthy version linked to lower rates of strokes and heart disease. One reason for this cholesterol boost is likely to be the high level of a substance called lauric acid in coconut oil. A meta-analysis of 60 trials in 2003 found lauric acid increased good HDLcholesterol.

But before you are tempted to celebrate by smearing some coconut oil on toast, theres a caveat. The same analysis found it also raised harmful LDL cholesterol. And theres little evidence that the rise in good cholesterol from eating coconut oil outweighs the rise in the bad stuff.

There is nothing unusual about coconut oil in this respect all saturated fats raise both good HDL and bad LDL cholesterol levels. What seems to matter is the ratio of these two types of cholesterol in our blood. So while Lauric acid may raise good cholesterol, the increase could be offset by a rise in the bad stuff.

Theres an added complexity. Tew points out that not all HDL cholesterol is necessarily good. As the science of cholesterol is explored in more detail, researchers are discovering that some types of HDL are protective, while others are non-functional and do nothing for the heart. She suspects that some of the rise in good HDL associated with lauric acid may be an increase in the non-functional type of cholesterol, which, while looking good on paper, wont protect us from heart attack or stroke.

The presence of this non-functioning HDL cholesterol and the rise in bad cholesterol when we consume lauric acid could help to explain other studies that show lauric acid in our diets as being associated with an increased risk of heart disease.

Its not just the claims about weight loss and cholesterol that dont stack up. A paper in the British Nutrition Foundations Nutrition Bulletin last year concluded that there is simply not enough evidence for any health claim based on coconut oil.

Dr Stacey Lockyer and Dr Sara Stanner of the BNF wrote: Claims relating to potential health benefits ofcoconut oil are often based solely on animal or in vitro studies or humanstudies feeding one componentof coconut oil rather than the whole food.

There is, for instance, no good evidence that it helps boost mental performance or prevent Alzheimers disease, they say.

The theory is that the fat in coconut oil metabolises more quickly than other fats because of the high MCT content. The argument goes that the brain cells of people with Alzheimers disease are unable to use glucose properly and so starve. Coconut oil is an easier to use source of energy and so keeps brain cells going. Its an interesting idea, but not one based on evidence, according to the Alzheimers Society. A clinical trial into the potential impact was discontinued because there were not enough people taking part.

Coconut oil is also said to be a good source of antioxidants. Although this is true, its nowhere near as good as fruit and vegetables. Tom Sanders, emeritus professor of nutrition and dietetics at Kings College London, says: It is a poor source of vitamin E compared with other vegetable oils. Coconut oil is also deficient in the essential fatty acids, which makes it much worse than lard or palm oil.

As for its much touted antimicrobial qualities that help restore gut bacteria, theres virtually no evidence either way. For Tew, the coconut oil issue is another example of the perils of classifying some foods as superfoods. She, like most dietitians, believes its an unhelpful concept, used by marketers. Labelling products as superfoods can fool people into thinking they are eating well when they are not. Munching a handful of goji berries after fried steak and chips wont make the meal healthy.

The obsession with expensive, exotic superfoods also means we forget the easy, cheap foods that are more likely to keep us healthy apples, oranges, broccoli and milk. But if canonising foods is unhelpful, then perhaps so is demonising them. And here, public health officials may have been guilty of oversimplification and an unfair assessment of fats. In the past few years, the debate over whether fats have been wrongly turned into villains has become intense and polarised.

At one extreme are cardiologists such as Dr Aseem Malhotra, who last year told the media, during the launch of a controversial National Obesity Forum report into fat: Eat fat to get slim. Dont fear fat. Fat is yourfriend.

But even more moderate voices acknowledge that the low-fat diet health message is too crude and not always supported by the evidence. One of the best studies into saturated fats and heart disease was a Cochrane review of 15 clinical trials covering 59,000 people, which found that cutting out saturated fat and replacing it with carbs and proteins made no difference to cardiovascular disease. Yet when the saturated fats were replaced with unsaturated fats, there was a 27% drop in heart disease.

It seemed to be showing that saturated fats are no worse for us than carbs but that the real benefits come when we swap them for olive oils, nut oils and the fats in avocado.

Sanders believes not all saturated fats are the same. It is nuanced and it depends where they come from, he says. A high intake of processed and red meat is associated with an increased risk of heart disease, but dairy seems to be quite neutral. Dairy provides other things magnesium, calcium and nutrients that may counteract the effects of saturated fat.

But while not all fats are equal, Sanders, like most food scientists, remains unconvinced by the health claims for coconut oil or the suggestion that the saturated fat in coconut oil is less harmful than other saturated fats. There is, he says, insufficient evidence for such claims.

There is an incredible amount of hype around the coconut that is driven by marketing, not science, he adds.

Christine Williams, professor of human nutrition at the University of Reading, agrees.

There is very limited evidence of beneficial health effects of this oil and marketing has won out over science again, she says.

Coconut oil may be no superfood, but equally, it is no villain. What it is is a reasonable tasty if overpriced occasional alternative to other equally unhealthy saturated fats and one that, unusually, you can rub into your face without smelling like a butchers shop or cheese counter. But if youre after a miracle cure for obesity, insomnia or piles youll probably have just as much success with a Bounty bar.

David Derbyshire is a former Daily Mail and Daily Telegraph science correspondent. He has written for the Observer on acupuncture, mindfulness and the science of wine-tasting

Coconut claims debunked

According to health food websites, coconut oil can be used to treat everything from thyroid disorders to thrush, via brittle bones and dementia. But in a recent report, the British Nutrition Foundation said: There is no strong scientific evidence to support health benefits from eating coconut oil. So where has this idea come from? Coconut oil advocates believe that it has powerful antibacterial and anti-inflammatory properties because it contains lauric acid, a fatty acid also found in breast milk. It is true that lauric acid derived from coconut oil acts as an antibiotic, but this has only been seen in vitro and at super-concentrated doses. So while lauric acid can kill bacteria, it seems coconut oil cant. In studies where the two have been directly compared, coconut oil was shown to be as useful as water at killing bacteria. Here are three more of the most commonly cited, scientifically dubious health uses for coconut oil to be wary of. Agnes Donnelly

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Photograph: Alamy

Skin
While it is true that coconut oil is found in many sunscreens, coconut oil on its own has an SPF of around 1. The NHS recommends that when you are in the sun you should be using a sunscreen with SPF 15 at the very least. Therefore coconut oil alone is notgoing to be enoughto protect your skin from the suns UV rays, a major cause of skin cancer.

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Photograph: Alamy

Hair
Coconut oil is believed to moisturise, provide nutrients, kill bacteria and improve circulation of blood in the scalp. Some websites even promote it as a way to slow hair loss. In truth, coconut oil contains tiny amounts of nutrients and its antibacterial properties are unproved. Any effect it has on your hair is purely cosmetic.

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Photograph: Alamy

Health
Pulling is a practice where people swill liquid oil around their mouths for up to 30 minutes because they believe it draws harmful bacteria and toxins out of their mouth. There is no evidence that this works. However, there have been cases of lipoid pneumonia, when the oil is accidentally inhaled into the lungs and causes disease.

Know your fats

Dietary fat can be divided into two camps the solid, mostly animal-derived saturated fats such as lard, dripping and butter and the liquid, unsaturated fats such as olive oil and nut oil, mostly derived from plants.

We are so used to bandying around words such as saturated and trans fat that many of us (or at least those of us without a chemistry A-level) rarely consider what the words mean.

Whether a fat is saturated or unsaturated depends on the way that carbon atoms in the long chains of fatty acids found in fat molecules are connected to one another.

In an unsaturated fat molecule, one or more carbon atoms are linked by double bonds. If the circumstances are right, one of these bonds can loosen and connect to a passing hydrogen atom, adding another hydrogen atom to the molecule. However, in a saturated fat such as lard, all the carbon atoms are held together with single bonds. There is no spare capacity for the fat molecule to take on any more hydrogen atoms and so the fatty acid is said to be saturated with hydrogen.

The ability of unsaturated fats to take on hydrogen atoms is exploited when vegetable oils are hydrogenated converted into solid trans fats by exposing them to hydrogen gas and a catalyst. Trans fats are cheaper than normal saturated fats, more suitable for industrial scale baking and have a longer shelf life.

A fat is monounsaturated if it contains just one double bond among its carbon atoms. If it has many double bonds, it is polyunsaturated.

Read more: https://www.theguardian.com/lifeandstyle/2017/jul/09/coconut-oil-debunked-health-benefits-big-fat-lie-superfood-saturated-fats-lard