Should I Use Creatine? A Science-Based Review

Should I Use Creatine?

Sportspeople often inherently have a competitive nature, so many look for other ways, including dietary supplements like creatine, to gain an advantage over their competitors. In this science-based review, we’ll look at the evidence behind creatine use, with particular attention to plant-based, vegan and vegetarian athletes, to help you decide if creatine might be helpful for you.

Supplements can certainly be a legitimate part of an athlete’s preparation, when used appropriately and responsibly. There are countless examples in sporting history where the difference between first and second place comes down to hundredths of a second, or where the slightest extra bit of power can help a rugby player tip the balance and move a ruck or maul forwards. It’s instances like these where anything that can give you a slight edge could make all the difference.

However, as with any topic around nutrition - especially with plant-based / vegan / vegetarian nutrition - there are a lot of conflicting messages and confusion around creatine use. So I want to cut through all the noise and show you what the body of evidence tells us about creatine’s safety, efficiency, and any potential drawbacks.

What is creatine?

Creatine’s a natural organic compound, made in the body, primarily by the liver and kidneys. It’s mostly found in the skeletal muscles, where it exists in the forms of free creatine and creatine phosphate, which act as important storage forms of energy - it facilitates the recycling of ATP, which can be thought of as the energy currency of our cells.

The body produces creatine using the amino acids glycine, arginine, and methionine. So, as long as you’re getting enough of these amino acids in your diet (which, as long as you’re eating a balanced vegan or vegetarian diet, you will be) you’ll be making sufficient amounts of creatine for healthy functioning yourself. Still, meat-eaters get some additional creatine through the diet - an average of around 2g per day (1). This makes sense, given that creatine is found primarily in muscle tissue, including those of other animals. By comparison, the dietary intake of creatine in those following a vegan or vegetarian diet is negligible. This is why lower concentrations of creatine are often found in the blood and skeletal muscle of those on a plant-based diet (2).

Is Creatine Effective?

There’s been considerable amounts of research conducted on creatine supplementation over the last two decades. Meta-analyses show that taken in supplement form, creatine can provide benefits in two ways: firstly, by significantly increasing muscle creatine stores, it can improve performance in high intensity, short-duration exercises (such as weight training and the interval-style anaerobic power required in many team sports) (3). Secondly, supplementation has also been shown to improve adaptations to training, leading to greater gains in lean muscle mass, strength, and power over time (4). This is likely through several specific mechanisms that favour an anabolic (muscle building) environment, as well as due to the higher metabolic demand created by the more intensely performed training sessions (5).

Is Creatine Beneficial When Following a Vegan or Vegetarian Diet?

Because vegans and vegetarians tend to have lower baseline muscle creatine levels, evidence shows that those on a plant-based diet can respond even better to creatine supplementation than omnivores. For instance, a study looking at vegetarian and non-vegetarian responses to creatine supplementation while training showed that, as expected, all participants taking creatine had greater increases in creatine stores, muscle strength, and whole-body muscle mass than those in the placebo groups. But, interestingly, the vegetarian subgroup supplementing with creatine had a significantly greater increase in creatine stores, whole-body muscle mass, and total work performance than the non-vegetarians who also took creatine (6). So, it’s often suggested that plant-based athletes taking part in strength training or sports with explosive movements can benefit the most from regular or periodic creatine supplementation.

What are the Best Dosage and Timings for Creatine?

A commonly used protocol is to follow a high intake (20-30g a day) during ‘loading’ phase for about a week, followed by a lower ongoing ‘maintenance’ dose of 3-5g a day. The loading phase is designed to quickly saturate creatine stores in skeletal muscle, and once saturated, the lower 3-5g daily intake can maintain these levels. The loading phase can be omitted, and a daily intake of 3-5g a day will also lead to the same increases in muscle creatine levels over time, but it may just take a little longer (3-4 weeks) to maximise your stores (7).

Timings-wise, it doesn’t seem too important. Some research shows that consuming it shortly after resistance training is slightly more beneficial for increasing muscle mass compared to supplementation immediately before training (8). Probably of greater importance would be consuming creatine at the same time as carbohydrate and/or protein sources, as this seems to promote uptake into skeletal muscle by around 25% (9). So adding it to a carbohydrate- and protein-rich smoothie after your workout could be a great option.

Is Creatine Safe?

Most statements about the health or performance enhancing effects on the labels of many products are not backed by clear scientific evidence. Because of this, institutions such as the American College of Sports Medicine and the Australian Institute of Sport have created systems to classify supplements according to their effects on performance based on confirmed scientific evidence (10). And creatine makes it into the highest category, because there’s now so much scientific evidence that it’s both safe and effective (when taken in the appropriate amounts and in the right setting).

Creatine’s not screened for or banned by the World Doping Agency, International Olympic Committee, or the NCAA. It’s now widely used among recreational, amateur, and professional athletes, for example an estimated 37% of English professional footballers say they use creatine (11).

In fact, the International Society of Sports Nutrition (ISSN) released their official position stating that on the mass of evidence, creatine supplementation is not only safe, but has been reported to have a number of therapeutic effects (12). For instance, in a study specifically designed to assess its safety, American football players supplemented with creatine for 21 months and were assessed using 69 health markers, including kidney function, muscle and liver enzymes, metabolic markers, electrolytes, and blood lipids. Those supplementing had no difference in risk factors for any of the health markers (13). In fact, creatine users experienced fewer incidences of cramping, heat illness/dehydration, muscle strains, and total injuries than those not taking creatine (14).

Still, I would only recommend using creating if you are a.) taking your training seriously (it won’t provide any benefit if you’re not strength training at least a few times a week); b.) are already consuming a well-balanced and performance enhancing diet; c.) are knowledgeable about appropriate use of creatine; and d.) do not exceed recommended dosages. Also, if you’re an endurance athlete, taking creatine will not provide any beneficial effects on aerobic performance (15). In fact the opposite may be true – it can be detrimental in events where body mass must be moved against gravity (such as jumping athletic events) or when a specific body mass needs to be reached (16).

IS CREATINE VEGAN?

The short answer? Yes, creatine is vegan. In its supplement form, creatine is made in a lab using two key ingredients: sodium sarcosinate (like salt but slightly sweet in taste) and cyanamide (an organic compound).

These two ingredients are heated and pressurised in a large reaction vessel. This creates a liquid which is then cooled and purified by centrifuge, which spins out any impurities, before being vacuum dried to become crystalline creatine, then milled into a fine powder to make it easier to dissolve in water. So, both of these ingredients are vegan, and the processes used to transform them into creatine powder involves no animal products.

What Form of Creatine Should I Use?

Creatine monohydrate is the most extensively studied and clinically effective form of creatine, so if you do choose to try creatine, this would be the safest option. Look for this in its pure form, rather than mixed with a variety of other ingredients as is sometimes found in commercial sports products. There are several brands certified as vegan by The Vegan Society and some that are third party tested for quality and purity which is advised.

The Take Home Message

Creatine isn’t for everyone - endurance-based athletes don’t need to consider it, nor does anyone who’s not frequently strength training and looking to build muscle strength and size. Also, please remember that creatine and other ergogenic aids should be considered as the ‘icing on the cake’ - i.e. by far the most powerful performance enhancer is to get the fundamentals of good nutrition and your basic training principles right. Too many people I speak with obsess over the small details but neglect what’s going to impact them most, which is what they’re eating from day to day.

But, if you’re already eating a balanced and performance-enhancing diet, you’re regularly strength training, and feel like you’re ready to give yourself that extra boost, then creatine is a viable option that’s proven to be safe and effective, especially for anyone on a vegan, vegetarian, or plant-based diet.

References:

1. Balsom, P. D., Söderlund, K., & Ekblom, B. (1994). Creatine in humans with special reference to creatine supplementation. Sports medicine (Auckland, N.Z.), 18(4), 268–280.

2. Kreider RB, Jung YP. Creatine supplementation in exercise, sport, and medicine. J Exerc Nutr Biochem. 2011;15(2):53–69.

3. Lanhers, C; Pereira, B; Naughton, G; Trousselard, M; Lesage, F; Dutheil, F. (2016). Creatine Supplementation and Upper Limb Strength Performance: A Systematic Review and Meta-Analysis. Sports medicine, 47.

4. Chilibeck, PD., Kaviani, M., Candow, DG., and Zello GA. Effect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: a meta-analysis. J Sports Med, 2017;8(213-226)

5. Burke DG, Candow DG, Chilibeck PD, MacNeil LG, Roy BD, Tarnopolsky MA, Ziegenfuss T. Effect of creatine supplementation and resistance-exercise training on muscle insulin-like growth factor in young adults. Int J Sport Nutr Exerc Metab. 2008;18:389–398.

6. Burke, D; Chilibeck, P; Parise, G; Candow, D; Mahoney, D; Tarnopolsky, M. (2003). Effect of Creatine and Weight Training on Muscle Creatine and Performance in Vegetarians. Medicine and science in sports and exercise. 35. 1946-55.

7. Buford, T; Kreider, R; Stout, J; Greenwood, M; Campbell, B; Spano, M; Antonio, J. (2007). International Society of Sports Nutrition position stand: Creatine supplementation and exercise. Journal of the International Society of Sports Nutrition, 4, 6.

8. Antonio, J., & Ciccone, V. (2013). The effects of pre versus post workout supplementation of creatine monohydrate on body composition and strength. Journal of the International Society of Sports Nutrition, 10, 36.

9. Cooper, R., Naclerio, F., Allgrove, J., & Jimenez, A. (2012). Creatine supplementation with specific view to exercise/sports performance: an update. Journal of the International Society of Sports Nutrition, 9(1), 33.

10. Travis, T. et al. (2016). Nutrition and Athletic Performance, Medicine & Science in Sports & Exercise: 2016, 48(3), 543-568

11. Waddington, I., Malcolm, D., Roderick, M., Naik, R., & Spitzer, G. (2005). Drug use in English professional football. British Journal of Sports Medicine, 39(4).

12. Kreider, R.B., Kalman, D.S., Antonio, J. et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr 14, 18 (2017).

13. Kreider RB, et al. Long-term creatine supplementation does not significantly affect clinical markers of health in athletes. Mol Cell Biochem. 2003;244(1–2):95–104.

14. Greenwood M, et al. Creatine supplementation during college football training does not increase the incidence of cramping or injury. Mol Cell Biochem. 2003;244(1–2):83–8.

15. Mielgo-Ayuso, J; Calleja-Gonzalez, J; Marqués-Jiménez, D; Caballero-García, A; Córdova, A; & Fernández-Lázaro, D. (2019). Effects of Creatine Supplementation on Athletic Performance in Soccer Players: A Systematic Review and Meta-Analysis. Nutrients, 11(4), 757.

16. Maughan, R. (2018). Dietary Supplements and the High-Performance Athlete. International Journal of Sport Nutrition and Exercise Metabolism, 28(2), 101.

Can you Build Muscle on a Vegan Diet?

Can you Build Muscle on a Vegan Diet?

The number of people adopting a vegan diet has skyrocketed in recent years, and shows no signs of slowing down.

Everyone’s got their own motives for switching to a plant-based diet, including ethical reasons like helping to prevent animal cruelty and dramatically reducing their environmental impact, as well as the proven health benefits I cover in this article.

But, as a registered sports nutritionist specialising in plant-based nutrition, I’ve found one of the main concerns from strength and fitness enthusiasts is this: they want to tread a little lighter in this world, but assume it’ll come at a cost to their strength and fitness.

Yet you only have to look at the growing number of world-class vegan athletes who are demonstrating that the complete opposite is in fact true: many are discovering it could give them a competitive edge.

Still, the misconceptions surrounding veganism from a fitness perspective continue. My mission, therefore, is to knock these myths on the head once and for all, as ever using a scientific, evidence-based approach to do so. In this article I’ll answer some of the most common questions I’m asked about building muscle of a vegan diet.

Can vegans get enough protein to build muscle?

You certainly don’t need meat, fish, or animal products to get your protein fix. What’s more, protein requirements are very often over-estimated in the bodybuilding / fitness worlds. It’s true that increasing protein intake can help to promote muscle synthesis when combined with strength training.

Historically, this notion has led trainers to recommended up to 3g of protein per kg of bodyweight each day for building muscle (i.e. 240g of protein a day for an 80kg man). But a recent review combining results from 49 controlled studies showed that protein intakes above 1.6g per kg of bodyweight per day made no further difference to gains in muscle mass or strength (1).

For an 80kg man this equates to a maximum beneficial intake of 128g protein per day, which is very easily achievable on a vegan diet. And remember this is for strength training athletes: for endurance athletes and recreational exercisers, the optimal intake is likely to be much closer to the average recommended intake for adults in the UK of 50g a day (the level used on food nutrition labels).

Is it difficult to get the full range of amino acids on a vegan diet?

This vegan Bolognese recipe is very high in protein and the combination of grains and pulses means it contains all the amino acids in abundance!

Proteins are made up of 20 amino acids, nine of which are ‘essential’ because our bodies cannot produce them on their own, so they need to be provided by the foods we eat. Animal foods contain all the essential amino acids, whereas plant foods are usually low in at least one amino acid.

However, a varied and balanced vegan diet consisting of a variety of whole plant foods will contain all the amino acids necessary for muscle growth. For example, beans are high in the amino acid lysine but are low in another called methionine, whereas many grains are high in methionine and low in lysine. Similar complementary combinations are found in various pulses, vegetables, nuts, seeds and grains. So in the context of an overall diet consisting of a variety of whole plant foods, you can rest assured knowing you’ll be getting plenty of each individual amino acid to optimise your results.

As well as this, your body can draw from it’s ‘free amino acid pool’ which is available because there is a constant turnover of protein in the body. So, if for any reason a certain meal you eat is low in a particular amino acid, your body can draw from this pool to balance things out. That’s why there’s no need to combine protein sources at each meal, as long as a variety of plant protein sources are eaten throughout the day.

Will a vegan diet affect my recovery?

This is in fact true, but perhaps not in the way you might expect – a whole foods vegan diet actually improves recovery time, because of the high level of phytonutrients and antioxidants in plants which, on average, have 64x the antioxidant properties of animal foods (2). This helps to reduce exercise-induced inflammation and resulting muscle soreness – so for competitive athletes, the quicker recovery from consuming a plant-based diet can get them back training harder, sooner. Taken over the course of a whole season or a year, the cumulative results can be significant.

This effect has been shown in numerous studies assessing real-life performance of athletes in both endurance and strength settings. But you can’t cut corners by just taking antioxidant supplements – research has shown that taken in pill form, antioxidants can in fact impair performance and recovery. The nutrition of whole plant foods is far more complex than just taking single nutrients in isolation.

Do vegan athletes perform as well?

There are a large (and fast-growing) number of vegan athletes, from a wide variety of sports / disciplines, who are surpassing their competitors. From ultra-distance endurance athletes to competitive bodybuilders, and everything in-between, world-class athletes are adopting a plant-based diet to give them the edge.

The Tennessee Titans NFL team are a prime example – half the team have gone plant based to help aid recovery and increase energy levels. Some of these athletes are 18+ stone and they’re at the top of their game. The same goes for a growing number of NBA players. Then there’s world-record holding strongmen, powerlifters and bodybuilders all proving that a vegan diet doesn’t hold you back and can in fact give you a competitive advantage. Of course citing these examples is anecdotal in nature, but it at least shows that a well-planned vegan diet can support world-class performance.                                   

Are vegans unhealthy or malnourished?

It’s all very well looking at world-class athletes, but what about the rest of us? Well, on average, vegans and vegetarians live longer, and grow old with fewer health conditions (3,4). For example, those eating a plant-based diet tend to have lower risk of heart disease and cancer (our two biggest killers in the west) as well as lower risk of diabetes, healthier gut profiles, and lower blood pressure.

This is due to a plethora of reasons. Partly because plant foods are incredible nutritional packages, filled with phytonutrients, antioxidants, vitamins, minerals and fibre. But also because cutting out meat and animal products means a lower intake of saturated fat and other potentially detrimental compounds found in them.

Conclusion

As you can see, the latest science and research might just make you think twice about traditional teachings in the world of sports nutrition. Just because things may have worked well for some people historically, doesn’t necessarily mean it’s the optimal way today for those willing to challenge the status quo and base their actions on the best information and facts we have available now.

Want to know how to boost your performance in your sport or training? My book, The Plant-Based Power Plan, shows you how to increase your strength, power and fitness so you can preform at your best - using the exact same strategies I use with elite-level plant-based athletes.

References

1. Morton, R., Murphy, K., Mckellar, S., Schoenfeld, B., Henselmans, M., Helms, E., Phillips, S. (2018). A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults. British Journal of Sports Medicine, 52(6), 376-384.

2. Carlsen, M., Halvorsen, B., Holte, K., Bøhn, S., Dragland, S., Senoo, H., Jacobs, D. (2010). The total antioxidant content of more than 3100 foods, beverages, spices, herbs and supplements used worldwide. Nutrition Journal, 9(1), 3.

3. Song, M., Fung, T., Hu, F., Willett, W., Longo, V., Chan, A., & Giovannucci, E. (2016). Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality. JAMA Internal Medicine, 176(10), 1453-1463.

4. Dinu, M., Abbate, R., Gensini, G., Casini, A., & Sofi, F. (2017). Vegetarian, vegan diets and multiple health outcomes: A systematic review with meta-analysis of observational studies. Critical Reviews in Food Science and Nutrition, 57(17), 3640-3649.

Beetroot - your secret weapon for performance?

Beetroot - health benefits

Beetroot’s long been the centre of attention for its health-promoting properties, particularly because of the pigments that provide its bright red colour – betalains – which have powerful antioxidant properties. Reduced oxidative stress and inflammation, lower blood pressure, and lower risk of type-2 diabetes and dementia are among some of the documented health benefits that can be enjoyed, courtesy of this wonder food (1).

Performance-enhancing effects of beetroot

But often forgotten are the significant performance-enhancing properties of beetroot too. A review of 23 individual studies showed that supplementing with beetroot juice can significantly enhance cardiorespiratory endurance in athletes by increasing exercise efficiency, which improves performance at various distances and increase time to exhaustion (2). Another review showed that beetroot juice can also improve performance during intermittent high-intensity exercise, which is the basis for most team sports (3).

These performance-enhancing properties are all thanks to the high nitrate content of beets – once consumed, they’re converted to nitrous oxide, an important signalling molecule which can help improve blood flow to the muscles during exercise and lower the oxygen cost of exercise through several mechanisms.

The evidence behind the performance-enhancing effects of beetroot juice is so compelling that institutions like the American College of Sports Medicine and the Australian Institute for Sport have documented beetroot juice with the highest ranking in systems they use to classify supplements, accounting for the level of scientific evidence backing up their effects on performance (4).

How to benefit from beetroot yourself

To reap these benefits yourself, try adding raw beetroot to smoothies or have some roasted beetroot alongside a pre-event meal. Alternatively, try a cup or two of beetroot juice 2-3 hours before exercise, or find concentrated beetroot juice ‘shots’ which may be more convenient.

As well taking prior to exercise, habitual intake of nitrate-rich plant foods can accrue performance-enhancing effects over time (5). So, regularly include beetroot in your diet alongside other nitrate-rich plant foods such as spinach, rocket (arugula), lettuce and cress. Try these amazing vegan beetroot and quinoa burgers combined with nitrate-rich greens for a brilliant pre-event meal!

Found this useful? Find loads of proven advice, including the same science-based strategies I use with elite-level sportspeople, in my book The Plant-Based Power Plan. Available from Amazon, Waterstones, The Book Depository (free worldwide shipping) and all good independent book stores.

References:

1.     Clifford, T., Howatson, G., West, D. J., & Stevenson, E. J. (2015). The potential benefits of red beetroot supplementation in health and disease. Nutrients, 7(4), 2801–2822.

2.     Domínguez, R., Cuenca, E., Maté-Muñoz, J. L., García-Fernández, P., Serra-Paya, N., Estevan, M. C., Herreros, P. V., & Garnacho-Castaño, M. V. (2017). Effects of Beetroot Juice Supplementation on Cardiorespiratory Endurance in Athletes. A Systematic Review. Nutrients, 9 (1), 43.

3.     Domínguez, R., Maté-Muñoz, J.L., Cuenca, E. et al. Effects of beetroot juice supplementation on intermittent high-intensity exercise efforts. J Int Soc Sports Nutr 15, 2 (2018).

4.     Australian Institute of Sport. ABCD classification system. https://ais.gov.au/nutrition/supplements

5.     Jonvik, Kristin & Nyakayiru, Jean & van Dijk, Jan-Willem & Wardenaar, Floris & Loon, Luc & Verdijk, Lex. (2016). Habitual Dietary Nitrate Intake in Highly Trained Athletes. International Journal of Sport Nutrition and Exercise Metabolism. 27. 1-25.

Should We Eat Organic Foods?

Should We Eat Organic Foods?

Organic foods are undeniably brilliant – it’s always great to know we’re growing and eating closer to the way that nature intended. But they do come at a premium, because organic foods are more labour intensive to grow (for example, instead of using chemical herbicides, organic farmers control weeds using methods like crop rotation, hand weeding, and mulching).

So is organically grown produce worth the extra money? Well, as with most nutrition topics, a quick Google search produces very conflicting messages – some sources argue strongly that eating anything other than organic is toxic for our health and the planet, while other voices dismiss organic food as a trendy lifestyle choice reserved just for the rich and privileged.

This makes it confusing and difficult to know whether we should try to eat organic foods all the time, or if it’s OK to buy produce that’s been grown more intensively.

Well, as ever, I wanted to cut through the noise and present to you the evidence – based on the best available science and research – so you can make your own decisions based on the facts.

There are three main reasons why people buy and eat organic foods, so I thought it would be most useful to address each one individually:

Organic foods contain more nutrients

People often cite the higher nutritional content of organic foods as a main reason for choosing them over conventionally grown produce.

But the difference between the two may be more subtle than we thought. Several meta-analyses, reviewing hundreds of studies that examined the macro- and micronutrient content of organic and conventionally grown foods, show either no difference, or only a very slight difference, in levels of vitamins, minerals and carbohydrates (ref). (if you want to learn more about what evidence to believe, check out my article that teaches you how here)

Where there is a nutritional advantage to organic foods is regarding the polyphenol content – these are not essential nutrients for humans, but they do have antioxidant properties and can reduce our risk of several non-communicable diseases such as cardiovascular disease and cancer. Meta-analyses report between 14-26% higher polyphenol content in organic than conventional produce (ref).

However, buying organic foods can cost anywhere between 10-50% more than non-organic. So for the same money you could buy one more portion of conventionally grown produce and end up taking in the same polyphenol content. Of course, this is the case if your budget is the limiting factor – if money’s not an issue and you’re going to eat the same amount of fruit and vegetables regardless of the cost, then you’d take in more polyphenols by choosing organic produce.

Organic foods contain fewer pesticide and herbicide residues

The science is pretty conclusive on this one – organic foods do contain significantly fewer pesticide residues than conventionally grown produce (ref).  

In fact, controlled studies measuring pesticide breakdown products in the urine show that eating organic produce significantly (and immediately) decreases exposure to pesticides by up to nearly 90% (ref 1, ref 2).

But does the lower pesticide exposure actually result in protection against disease? Well, there are a number of cross-sectional studies that show an association between eating organic foods and a reduced risk of several chronic diseases such as cardiovascular disease, diabetes, and cancer.

But, it’s important to bear in mind that cross-sectional studies aren’t controlled, and there are likely to be other factors at play. For example, people eating organic foods are more likely to exercise, eat more fruit and vegetables, they drink less alcohol and are less likely to smoke (ref 1, ref 2). All these factors have been shown to decrease our risk of chronic diseases too, so we can’t say whether it’s the organic foods themselves, or just the lifestyle of people who buy organic foods.

What we ideally need to see are controlled clinical studies, but as yet there are relatively few. The ones that do exist actually show no difference in health or nutrition status between organic and conventional diets, although these studies were conducted over short durations, which limit the ability to find long-term effects (ref).

There have also been studies conducted showing that farmers and their families exposed to very high levels of pesticides are at greater risk of several chronic diseases, which sound very alarming (ref 1, ref 2). However, the pesticide residues on fruit and vegetables are a tiny fraction of the levels that the farmers actually spraying the stuff are exposed to, so we can’t assume the same effects for the average consumer.

In fact, a recent study actually calculated that the risk to our health of pesticide residues is equivalent to that of drinking one glass of wine every seven years (ref)! This study has its limitations, but does help to put things into perspective – most of us would benefit far more from reducing our alcohol intake than choosing organic foods.

So, until more controlled studies are done, we can’t say for sure whether organic food provides greater protection from disease. But we do know that eating organic food does lower our exposure to pesticide and herbicide residues, so in the meantime, eating organic foods would be a logical precautionary approach.

One last important note on this point – studies have shown that many people overestimate the health risks of pesticide residues. It’s been shown that organic food buyers estimate the risk to health of non-organic food to be almost as high as smoking a pack of cigarettes a day (ref). That kind of thinking is potentially dangerous, because it could lead to a decrease in overall fruit and vegetable consumption, especially for those who struggle to afford organic food.

And the benefits of eating more fruit and vegetables are enormous; they’ve been shown to decrease risk of cardiovascular disease, several cancers, and type 2 diabetes (ref). In fact, increased fruit and vegetable consumption has been shown to reduce overall mortality risk (ref) – that means dying by any cause! So, what’s the take away message regarding pesticide residues? It’s probably a good idea to aim for organic foods when possible, but definitely don’t stress if it’s not affordable or accessible because the benefits of eating more fruit and vegetables, regardless of how they’re produced, far outweigh the risks of the pesticide residues on conventionally grown produce.

Organic foods are better for the environment

Protecting our environment is so incredibly important for countless reasons, including our health. That’s because droughts, flooding, and other natural disasters leading to food shortages are strongly linked with climate change. Then there’s contamination, antibiotic resistance, and the decline of bee and other pollinator populations. All these things will eventually take a toll on food security and therefore public health. So, anything we can do to help protect the environment will also protect our health, and the health of our children and grandchildren.

The benefits to the environment of organic farming include:

• Limiting the pollution of groundwater courses with synthetic pesticides and fertilisers – which can end up contaminating nearby rivers and lakes

• Increasing biodiversity on farmed land by an average of 30%, including birds, rodents, bees and other pollinators (ref)

• Lower energy requirements and carbon emissions (ref) mainly because manufacturing the synthetic fertilisers and pesticides produces greenhouse gas emissions

• Healthier soil, thanks to their greater diversity of life and avoiding herbicides

There are other benefits too. However, organic farming isn’t perfect. Consider this: because organic farming doesn’t use synthetic fertilisers and pesticides, the productivity and yields tend to be lower than conventional farming (ref). In other words, you need more land to grow the same amount of food. And what are the environmental consequences of using more land? More deforestation? Does it mean more water needs to be used? Are the benefits to biodiversity offset by the extra land required to produce the same amount of food? Scientists don’t know – the research is inconclusive (ref).

The truth is the answer is much more complex and nuanced than simply labelling organic farming as ‘good’ and conventional as ‘bad’ for the environment. There are so many benefits and trade-offs at play (ref), and results vary depending on factors such as the location of farms, the soil quality, climate, and which crops are being grown.

Another bit of perspective here – did you know that one third of all agricultural land in the world is used to grow crops to feed livestock? (ref). When you combine that with the vast amount of land used for grazing and housing animals, it’s easy to see that our desire to eat meat and animal products is by far the biggest driver of climate change, deforestation, and loss of biodiversity of all. Agriculture alone is responsible for 80% of deforestation – throwing entire ecosystems, as well as our planet, off balance.

So by limiting, or ideally eliminating, meat and animal products from your diet, you’ve already made the most significant change possible to your environmental impact. When you put that into perspective, you may realise that you shouldn’t put too much pressure on yourself about whether your produce is organic or not.

The Take Away Message

As you can see, the science behind the health and environmental advantages of organic production is not as clear cut as many of us might think. There are complexities, nuances, and gaps in the research that need to be taken into account.

The reason there are such strongly conflicting views is perhaps because food, health, and sustainability are all such emotive topics. It’s understandable why people feel so strongly - they’re trying to do the right thing for their bodies and the planet. But to make informed decisions, we need to be aware of the facts, which I hope you now are.

Perhaps, like me, you’ll find a middle ground:

• Buy organic produce a lot of the time, but also buy conventional produce when organic options aren’t available or are too expensive

• Eat a whole foods, plant-based diet for the most significant benefits to health and the environment

• It’s probably a good idea to wash your fruit and veggies too, not just to remove pesticide residues, but to also wash away soil which could contain bacteria like E. coli (ref)

• Buy seasonal and local produce where possible and try to opt for un-packaged produce to reduce transport emissions and plastic use

• I’m also lucky enough to have a garden where I can grow some of my own fruit and veg - even if you have a small space, you’d be surprised at what you could grow yourself.!

But please remember, by reducing or eliminating meat and animal products from your diet and eating a variety of whole plant foods, you’ve already made the most important choice for your health and for the planet. And please, PLEASE, don’t ever pick up a pack of non-organic kale and think “could this harm me or my family?” The benefits of getting all the vitamins, minerals, fibre, antioxidants and phyto-nutrients far outweigh the risks of any traces of pesticide residues.

Do Vegans Get Enough Protein?

Do vegans get enough protein?

If you’re reading this and you’re vegan, it’s probably a question you get asked… all the time. Or if you’re thinking of trying a vegan diet, it could be a question that’s playing on your mind. And that would be understandable (it was a concern I had myself before I went vegan and studied nutrition) because modern society would certainly have us believe that meat, eggs and dairy must be eaten in order to get sufficient amounts of protein.

But, as ever, I wanted to show you what the scientific literature and best evidence says to provide you with the most trustworthy, unbiased information possible, in order to help you make your own decision based on the facts.

What is protein?

Proteins are large molecules made up of long chains of amino acids (they’re the ‘building blocks’ of protein). There are 20 different amino acids, and proteins have such a varied role in the body because the amino acid combination, structure, size and shape of the protein all influence it’s biochemical activity.  

Why is protein important?

Every cell and tissue in your body contains protein - they’re fundamental structural and functional elements in every cell. Your body also uses proteins to make enzymes and hormones so they’re also involved in a vast range of important metabolic interactions. So protein is essential for growth, repair, and maintenance of general good health.

UK protein guidelines

The UK government recommend a protein intake of 0.75g of protein per kg of bodyweight per day. This equates to around 45g per day for adult women, and 56g per day for adult men. As protein is required for growth, children and pregnant or breastfeeding mothers need a little more, while overweight or obese adults require less (than the 0.75g of protein per kg of bodyweight per day).

Protein deficiency

Severe protein deficiency is a condition known as kwashiorkor and it’s only ever really associated with starvation and famine, usually in developing countries. The main characteristic is oedema, where fluid accumulates in tissues, often causing a swollen belly, because of insufficient protein in the blood that helps to draw fluid from the tissues into the blood circulation. It can also cause fatty liver disease and problems with hair, skin and nails.

However, kwashiorkor is practically unheard of in the West. The current average intake of protein in the UK is 88g for men and 64g for women, which actually far exceeds the reference nutrient intake for protein.

Let’s consider a simple meal of baked beans on toast – it contains 29g of protein which is around 60% of your daily recommended intake (19g of protein in a can of beans, and 5g protein in each slice of bread). It also contains all of the essential amino acids (the ones our bodies can’t make themselves) making it a complete protein source. Having said that, you don’t actually need to worry about combining foods to make sure you get all the amino acids, as a varied balanced diet will contain all of them.

In fact, even if you got all your daily calories from cucumber (this is purely hypothetical as you’d need to eat around 50 cucumbers, which would NOT be fun) you’d be getting around 100g protein (approx. 2g of protein per cucumber).

So you can see just how easy it is to reach these targets on a vegan diet. In fact, it’s difficult not to reach those targets, as long as you’re eating a balanced and varied diet.

So why all the hype?

Well, there are two reasons why eating more protein can be useful:

1.      Higher protein intake (up to a point) can help with short-term weight loss

It has been shown that increasing protein intake can help with weight loss in the short-term. This is for two reasons: Firstly, higher protein foods tend to be more satiating, keeping you fuller for longer – in studies, those eating higher protein diets tended to feel fuller and consume fewer calories (1). Secondly, a higher protein intake during weight loss can help minimise or even prevent associated muscle loss (2). Since lean body mass (muscle) uses lots of energy, retaining as much muscle as possible during weight loss maintains a higher energy expenditure, so metabolism is improved, making weight loss easier and more sustainable.

However, although it’s widely accepted that high protein diets can help with weight loss in the short-term, high quality meta-analysis studies looking at the long-term effects (1-2 years) show no difference in weight between high and low protein diets (4). In fact, some long-term studies, including a large cohort study with 89,432 subjects, found those eating more protein were more likely to gain weight (5,6). However, this difference was only seen with high consumption of animal protein; higher intakes of plant protein does not seem to have the same effect.

Eating too much protein can even cause weight gain in the short-term too. Every gram of protein contains four calories, which is exactly the same calorie content as carbohydrates. So eating an excessive amount of protein will result in the protein being used for energy, with surplus amino acids simply being excreted, and can therefore lead to weight gain.

2.      High protein diets (again, up to a point) can help to promote muscle growth

Studies show that for strength training athletes, almost doubling the recommended intake of protein can increase muscle protein synthesis (MPS – building muscle). However, increasing the protein intake further, to nearly triple the recommended intake, makes no further difference (7). So, just as with weight loss, the effects are only seen up to a point, after which it makes no difference. It’s also important to point out these studies are looking at strength training athletes, who are weight training quite vigorously and frequently. If you’re not regularly strength training, increasing your protein intake won’t promote MPS.

As well as making no further difference to MPS, excessive protein intake – especially from animal sources – can affect our health negatively in a number of ways (8,9). So not only is consuming too much protein just a waste of money, it can even damage our health.

What about protein supplements? While they’re by no means absolutely necessary, they can still come in quite handy. That’s because they offer a convenient and quick way to consume a high amount of protein, which can be useful before and after exercise to prevent muscle breakdown and to promote MPS (10). Using vegan protein shakes is no reflection on the ability to consume sufficient amounts of protein on a vegan diet, it’s just a matter of convenience – the same reason that protein shakes are so popular among meat eating gym-goers too. If you do choose to try a vegan protein shake, my favourite brand is Vivo: they have the best tasting and smooth protein powders, they use fermented proteins so they’re easier on the digestion, and they independently test for heavy metals. You an use the discount code ‘TJ10’ for a 10% discount on your first order! Click here to see Vivo’s range of products.

The take home message

So as you can see, increasing protein intake may help in the short-term for those looking to lose weight, and can help with muscle protein synthesis in weight training athletes. But bear in mind that too much of a good thing is not always healthy, and the kind of levels of intake required to see these benefits are very easy to get from a vegan diet.

As with most topics around nutrition, the advice boils down to a very simple message – just make sure you’re eating a balanced, varied, and ideally colourful diet consisting primarily of loads of legumes, pulses, fruit, vegetables, whole-grains, nuts and seeds. Follow this and the rest usually falls into place!  

References

1.      Weigle DS, Breen PA, Matthys CC, et al.  A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin andghrelin concentrations. Am J Clin Nutr  2005;82:41–8.

2.      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4892287/

3.      Schwingshackl, L., & Hoffmann, G. (2014). Comparison of High vs. Normal/Low Protein Diets on Renal Function in Subjects without Chronic Kidney Disease: A Systematic Review and Meta-Analysis. Plos One, 9(5), E97656.

4.      Schwingshackl, L., & Hoffmann, G. (2013). Long-term effects of low-fat diets either low or high in protein on cardiovascular and metabolic risk factors: A systematic review and meta-analysis. Nutrition Journal,12, Nutrition Journal, 2013 Apr 15, Vol.12.

5.      J Halkjær, A Olsen, K Overvad, M U Jakobsen, H Boeing, B Buijsse, . . . A Tjønneland. (2010). Intake of total, animal and plant protein and subsequent changes in weight or waist circumference in European men and women: The Diogenes project. International Journal of Obesity, 35(8), 1104-1113.

6.      Bujnowski, Xun, Daviglus, Van Horn, He, & Stamler. (2011). Longitudinal Association between Animal and Vegetable Protein Intake and Obesity among Men in the United States: The Chicago Western Electric Study. Journal of the American Dietetic Association,111(8), 1150-1155.e1.

7.      Tarnopolsky, M., Atkinson, S., Macdougall, J., Chesley, A., Phillips, S., & Schwarcz, H. (1992). Evaluation of protein requirements for trained strength athletes. Journal of Applied Physiology (Bethesda, Md. : 1985),73(5), 1986-95

8.      Tipton, K. (2011). Efficacy and consequences of very-high-protein diets for athletes and exercisers. Proceedings of the Nutrition Society,70(2), 205-214.

9.      https://www.health.harvard.edu/diet-and-weight-loss/when-it-comes-to-protein-how-much-is-too-much

10. Areta, J., Burke, L., Ross, M., Camera, D., West, D., Broad, E., Coffey, V. (2013). Timing and distribution of protein ingestion during prolonged recovery from resistance exercise alters myofibrillar protein synthesis. Journal of Physiology, 591(9), 2319-2331.

Can You Boost Your Immune System?

Can you ‘boost’ your immune system?

The UK supplement industry is worth a whopping £414 million, with 30 million adults now taking food supplements every week (and nearly half of these are on a daily basis). 

It’s not surprising – the health claims on some of these supplements are extremely enticing: ‘reduce tiredness and fatigue’, ‘maintain health and vitality’ and the one I see all the time: ‘boost your immune system’.

But is it possible to actually ‘boost’ your immune system? Well, scientifically, the concept of boosting your immunity makes very little sense. If a product claims to boost your immune system, which cells in particular are they claiming to boost numbers of, and how? Your immune system is truly astonishing, with countless different types of cells involved – phagocytes (like macrophages and neutrophils), lymphoid cells, mast cells, eosinophils, basophils and natural killer cells, to name just a few. Each of these types of cell has multiple sub-groups too. Then there are all the proteins involved in cell signalling and the inflammatory response like the numerous types of eicosanoids and cytokines. What’s more, the immune system acts intimately with other systems such as the endocrine and nervous systems.

So if we want to boost our immune system, which of these cells do we want to boost, and to what number? What is the best ratio of cells the immune system needs to function optimally? Scientists simply don’t know the answer.

Just some of the known signalling pathways in the innate immune system

Can you boost your immune system with supplements?

Let’s take a look at some of the evidence around specific examples.

Vitamin C is probably the first vitamin people think of when asked about immunity. But, does taking it in supplement form actually prevent us from getting ill? Recent meta-analysis results (the ‘gold standard’ of scientific research, more on what research to believe here) showed that in fact it doesn’t make any difference to the chance of catching a cold (1). It did show that taking vitamin C during a cold can reduce its duration, but only on average by 7.7% - just a matter of hours rather than days.

What about antioxidants? Beta-carotene and vitamin E are important micronutrients necessary for antioxidant functions and a healthy immune system. But when taken in supplement form, do they actually help? Well, recent meta-analysis results (remember, these are the best forms of research we can ask for) show that supplementing with beta-carotene and vitamin E can in fact increase our risk of death (2)! The same goes for higher doses of vitamin A. Not exactly the health benefits you might expect.

This might sound quite bizarre, because we know that we need all of these vitamins in our diet – the very definition of a vitamin is “an organic compound essential for our health that’s required in small quantities in our diet because they cannot be synthesised by the body”.

Well, the reason is that when we get these nutrients naturally through our diet, we’re eating so much more than specific, singular nutrients in isolation, like we do when we take vitamin supplements. For example, fruit and vegetables contain thousands of protective bioactive compounds, including vitamins and minerals but also antioxidants, polyphenols, proteins, fibre, and fats. These compounds interact with each other through numerous, complex mechanisms within the body, to provide some incredible health benefits. Taking vitamins and minerals in supplement form simply can’t replicate the complexity of whole plant foods.

So what can affect our immune system?

Deficiencies

It’s true that malnutrition and deficiencies can negatively affect our immune system. For example, it’s been shown that nearly one on five adults in the UK have low vitamin D status (3) and this is associated with increased susceptibility to infection (4). This could be why vitamin D is one of the cases where supplementation has in fact been shown to reduce our chance of infection (5,6). But seeing as such a large proportion of the population are deficient in the UK, this effect is most likely because supplementing helps to reduce the number of people with a deficiency to ensure immune systems are working normally, rather than ‘boosting’ it to some level beyond the body’s natural functions.

We get 80-90% of our vitamin D from the sun but modern lifestyles mean we get less sun than we used to

There may be specific nutrients that you’re aware of that may be lacking in your diet (like vitamin B12 in vegan diets) in which case it is a good idea to use supplements or eat foods that are fortified in that specific nutrient. Or for those who don’t eat a healthy diet (e.g. lacking in fruit and vegetables) a multivitamin may act as a kind of micro-nutrient ‘insurance policy’.  But in general, multivitamins have been shown to have either no effect (7) or even increase mortality – that’s right, multivitamins can actually increase risk of death in some populations (8). So supplements often just act a distraction, taking people’s attention away from by far the most important things that will influence your immune system – healthy lifestyle habits:

Healthy Diet

In general, the best way to prevent deficiencies is simply to ensure you’re eating a balanced, varied diet every day, containing lots of fruit, vegetables, whole grains, pulses (like beans, lentils and chickpeas) nuts, seeds, herbs and spices. For example, increasing our fruit and vegetable consumption has been shown (again, in meta-analyses) to not only reduce our chance of infection (9), but can even protect against asthma (10), cardiovascular disease, some cancers (11) and diabetes (12). In fact, increased fruit and vegetable consumption has been shown to decrease our overall mortality risk – that means dying by any cause (11). Equally as impressive health benefits have been shown for increased consumption of whole-grains, legumes, nuts and seeds (probably one of the reasons why vegans tend to live longer).

If there were a supplement that could boast results like this, it would sell out in record time. In fact, I imagine the government would insist on everyone taking it. That’s why the Meat Free Fitness nutrition guides recommend saving your money on unnecessary supplements and getting most of your nutrition from the best multivitamins known to man – whole plant foods!

Exercise

Regular exercise has countless, significant health benefits, ranging from physiological effects like improved cardiovascular health, to mental benefits such as reduced stress and anxiety. So exercise contributes to general good health and therefore to a healthy immune system. More specifically, it can improve circulation, which allows the cells and other components of the immune system to move through the body more freely and do their job more effectively. There’s even an exercise-induced surge in immune cells. These effects could help explain why regular exercise decreases our number of sick days with the common cold or other upper respiratory tract infections by 25-50% (13). So don’t forget to move your body (in whichever way you enjoy the most) every day.

Stress

The science behind the effects of stress on immune function is a little more difficult to understand, because it’s a difficult topic to study. Stress is subjective and can be difficult to define. Nonetheless, research shows that stress can influence health in a number of ways, such as raising blood pressure, causing gut issues like irritable bowel syndrome, heart disease, and reduced immune function. There are many ways in which long-term stress can affect our immunity, for example the higher levels of pro-inflammatory cytokines associated with stress. In the short-term, this inflammation is a useful response for eliminating pathogens and initiating healing. But long-term, systemic inflammation associated with prolonged stress can impact our immune system and increase risk of chronic diseases (14). It’s not always easy to avoid stress, but you can manage it by taking time out, moving your body, getting out in nature, or practising some mindfulness.

Sleep

Scientists are discovering just how important sleep is for a huge number of health issues. And among these are immune function. In controlled studies, those who slept less than five hours a night were more than twice as likely to develop a cold than those who slept seven or more hours (15). So if you can develop healthy sleeping habits and get to bed a little earlier than usual, you may be much less likely to get ill.

Gut microbiome

Did you know that the number of bacteria, viruses, and fungi that our bodies host in our gut (as well as on our skin, mouth, lungs, fingernails etc) outnumber our bodies’ own cells by ten to one? This is another area of research where scientists have been making big discoveries in recent years. For example, it’s been shown that eating lots of fibre-rich foods like fruits, vegetables, whole grains and legumes, feeds bacteria in our colon that produce short chain fatty acids (SCFA) during fermentation. These SCFAs regulate the function of the regulatory T-cell network that may contribute to the systemic control of immune responses (16).

On the other hand, the antibiotic residues found in meat and dairy (more than half of antibiotics sold in the world are used for livestock (17)) can impact negatively on our gut microbiome (18). So cutting out animal products and replacing these with lots of whole plant foods can really improve our gut bacteria profile and in turn help our immune system. Probably another reason why vegans tend to live longer.

Smoking and alcohol

We all know that drinking too much and smoking are bad for our health. But did you know they can even effect our immunity? Numerous studies have shown the negative effects of smoking on both our adaptive and innate immune responses (19). And excessive alcohol consumption has been associated with greater likelihood of sepsis, alcoholic liver disease, certain cancers, and even slower and less complete recovery from infections (20). So try cutting back on the booze and if you’re a smoker then take advantage of all the help that’s available to help you quit.

The Take Away Message

Your immune system really is incredible. Most people who are in general good health already have a perfectly well-functioning immune system, and taking supplements or superfoods won’t ‘boost’ it to some level above its normal function. The best measure we can take to keep it working properly is to move our attention away from supplements and instead focus on creating healthy lifestyle habits, like eating a balanced whole foods plant based diet, moving our bodies every day, taking steps to avoid stress, creating healthy sleep habits, quitting smoking and cutting back on the booze.

Oh, and the side effects of all of these lifestyle habits - as well as keeping your immune system healthy - include many significant, long-term physical and mental health benefits, improved energy, and longevity. These are the kind of side effects I like to see!

References:

1.     Hemilä, H., & Chalker, E. (2013). Vitamin C for preventing and treating the common cold. The Cochrane Database of Systematic Reviews,2013(1), CD000980.

2.     Goran Bjelakovic, Dimitrinka Nikolova, Lise Lotte Gluud, Rosa G. Simonetti, & Christian Gluud. (2015). Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. São Paulo Medical Journal,133(2), 164-165.

3.     https://www.nutrition.org.uk/nutritioninthenews/new-reports/ndnsyears7and8.html

4.     Aranow, C. (2011). Vitamin D and the Immune System. Journal of Investigative Medicine, 59(6), 881-886

5.     Charan, J., Goyal, J., Saxena, D., & Yadav, P. (2012). Vitamin D for prevention of respiratory tract infections: A systematic review and meta-analysis. Journal of Pharmacology and Pharmacotherapeutics,3(4), 300-303

6.     Peter Bergman, Asa U Lindh, Linda Björkhem-Bergman, & Jonatan D Lindh. (2013). Vitamin D and Respiratory Tract Infections: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLoS ONE, 8(6), E65835.

7.     Macpherson, H., Pipingas, A., & Pase, M. (2013). Multivitamin-multimineral supplementation and mortality: A meta-analysis of randomized controlled trials. The American Journal of Clinical Nutrition, 97(2), 437-44.

8.     Punnoose, A. (2011). Dietary Supplements and Mortality Rate in Older Women: The Iowa Women's Health Study. JAMA, 306(21), 2309.

9.     Li, L., & Werler, M. (2010). Fruit and vegetable intake and risk of upper respiratory tract infection in pregnant women. Public Health Nutrition,13(2), 276-282.

10.  Hosseini, B., Berthon, B., Wark, P., & Wood, L. (2017). Effects of Fruit and Vegetable Consumption on Risk of Asthma, Wheezing and Immune Responses: A Systematic Review and Meta-Analysis. Nutrients, 9(4)

11.  Wang, X., Ouyang, Y., Liu, J., Zhu, M., Zhao, G., Bao, W., & Hu, F. (2014). Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: Systematic review and dose-response meta-analysis of prospective cohort studies. British Medical Journal, 349(7969), 9.

12.  A J Cooper, N G Forouhi, Z Ye, B Buijsse, L Arriola, B Balkau, N J Wareham. (2012). Fruit and vegetable intake and type 2 diabetes: EPIC-InterAct prospective study and meta-analysis. European Journal of Clinical Nutrition, 66(10), 1082-92.

13.  Nieman, D. (2011). Moderate Exercise Improves Immunity and Decreases Illness Rates. American Journal of Lifestyle Medicine, 5(4), 338-345.

14.  Morey, Boggero, Scott, & Segerstrom. (2015). Current directions in stress and human immune function. Current Opinion in Psychology, 5, 13-17.

15.  Prather, A., Janicki-Deverts, D., Hall, M., & Cohen, S. (2015). Behaviorally Assessed Sleep and Susceptibility to the Common Cold. Sleep, 38(9), 1353-9.

16.  Belkaid, & Hand. (2014). Role of the Microbiota in Immunity and Inflammation. Cell, 157(1), 121-141.

17.  https://amr-review.org/sites/default/files/Antimicrobials%20in%20agriculture%20and%20the%20environment%20-%20Reducing%20unnecessary%20use%20and%20waste.pdf

18.  Jeong, Sang-Hee, Kang, Daejin, Lim, Myung-Woon, Kang, Chang Soo, & Sung, Ha Jung. (2010). Risk assessment of growth hormones and antimicrobial residues in meat. Toxicological Research, 26(4), 301-13.

19.  Qiu, F., Liang, C., Liu, H., Zeng, Y., Hou, S., Huang, S., Dai, Z. (2016). Impacts of cigarette smoking on immune responsiveness: Up and down or upside down? Oncotarget, 8(1), 268-284.

20.  Molina, P., Happel, K., Zhang, P., Kolls, J., & Nelson, S. (2010). Focus on: Alcohol and the immune system. Alcohol Research & Health : The Journal of the National Institute on Alcohol Abuse and Alcoholism, 33(1-2), 97-108.

Sweet Potato Fries Vs. Regular Fries

Sweet potato fries are everywhere nowadays. Just visit almost any burger joint and you can bet your bottom dollar that you’ll find sweet potato fries on the sides menu. Or a quick scroll through some foodie pages on social media and it won’t be long before a stack of those vibrant orange fries or wedges jumps out at you.  

And this is great, because there’s a growing number of us who are health-conscious and would rather opt for a healthier alternative to the old-fashioned potato fries. Many of us have been there: “no, I’m being good at the moment, I’ll order the sweet potato fries instead please”.

But what really are the health benefits of sweet potato fries over normal fries?  Let’s firstly take a look at some of the most noticeable nutritional differences between the two tubers.

Sweet Potato Fries Vs. Regular Potato Fries

Sweet potatoes are much higher in beta carotene, the pigment that gives the red / orange colour in many fresh fruits and vegetables. Beta carotene is an antioxidant and is converted in the body to vitamin A, so it’s an important nutrient necessary for maintaining healthy skin, eyes, and immune systems, and can help protect against cancer. Sweet potatoes are also higher in fibre, something most of us are lacking in our western diet (1) which is really important for digestion and keeping our guts healthy.

However, regular potatoes contain much more vitamin C, which as we all know is important for our immune systems, but is also an antioxidant, and is involved in the synthesis of collagen which is required for the normal structure and function of connective tissues such as skin, cartilage and bones. Regular potatoes are also much higher in potassium, essential for water and electrolyte balance and the normal functioning of cells, including nerves. In fact, many of us don’t meet the suggested intake of potassium and instead we eat too much sodium (salt), and this high sodium-to-potassium ratio is putting us at higher risk of cardiovascular disease (2,3).

Sweet potatoes and regular potatoes are roughly on a par for most other nutrients. Both provide a little bit of protein, some B-vitamins, and small amounts of some minerals such as copper, manganese and iron. It’s important to remember however that most of the nutrients are found in the skin of both varieties, so whether we’re ordering out or making some at home, it’s best to go for the skin-on options where possible.

What about the calories? Many of us choose to order sweet potato fries because we’re watching our waistline, but sweet potatoes are in fact slightly more calorific than regular potatoes due to their higher sugar content!

Now, it’s all very well nit-picking about the nutritional content of sweet potatoes and regular potatoes. Both contain some important nutrients. But there’s one aspect which is probably the most significant point of all with regards to our health… how the fries are cooked. When we order either type at a restaurant, the chances are they’re deep fried. So let’s take a look at some important nutritional points to consider when we order anything that’s deep fried:

Omega-6 Oils used for deep-frying (like vegetable and sunflower oils) are high in omega-6. While this is an essential fatty acid, in the western world we tend to eat far too much of it, while typically consuming too little omega-3 (found in leafy vegetables, walnuts, flaxseeds and chia seeds). A high intake of omega-6 relative to omega-3 leads to a pro-inflammatory state within our bodies, which is linked with many chronic inflammatory diseases (4). Therefore, we should try to reduce our intake of anything deep fried and up our intakes of those healthy omega-3 sources, which incidentally come with an array of other nutrients and health benefits.

Acrylamides and Aldehydes The combination of high temperatures, and the oils used in deep frying, can lead to the formation of acrylamides in starchy foods like potatoes and sweet potatoes, a chemical that has the potential to increase risk of cancer (5,6). The lipids in common cooking oils, such as sunflower oil, also degrade over time at high temperatures, forming various oxidative products known as aldehydes, some of which are also known to be carcinogenic (7,8).

Calories Frying either type of potato significantly increases its calorific density because of the extra fat content that’s absorbed by the fries. Both sweet potato and regular fries typically come in at well over 400 calories per regular-sized serving. That’s 20% of your recommended daily caloric intake in just a side order.

The verdict?

If you’re trying to be healthy, ordering sweet potato fries probably isn’t the answer. While they’re higher in some nutrients, regular potato fries are in fact higher in others, and they’re just as calorific. Plus they’re still deep-fried, and probably covered in salt, which pretty much offsets any of the health benefits anyway. So the boring answer would be: don’t order either – go for a side of veggies or salad instead.

However, the practical answer, and the mantra I live by, would be to keep things in moderation. Go for the fries (just not too often). Include them every now and again as part of a healthy balanced diet that contains plenty of fruit, vegetables, whole grains, pulses, nuts and seeds. And if you are going to order fries, just order whichever you prefer the taste of! It’s easy to get bogged down by focusing too much on the macro- or micro-nutrient content of our foods, rather than eating food for the enjoyment of it. If you prefer them, then fine, but ordering sweet potato fries when you don’t actually like them as much, to me defies the point of eating out altogether. We eat every day of our lives, so having a healthy relationship with our food, enjoying what we eat, and savouring that pleasure is something we should all try to embrace more.

References:

1.     Public Health England publishes latest data on nation’s diet: https://www.gov.uk/government/news/phe-publishes-latest-data-on-nations-diet (accessed 03.07.2018)

2.     Powles, J., Fahimi, S., Micha, R., et al. (2013). Global, regional and national sodium intakes in 1990 and 2010: A systematic analysis of 24 h urinary sodium excretion and dietary surveys worldwide. BMJ Open, 3(12), E003733.

3.     World Health Organisation issues new guidance on dietary salt and potassium: http://www.who.int/mediacentre/news/notes/2013/salt_potassium_20130131/en/ (accessed 03.07.2018)

4.     Patterson, E., Wall, R., Fitzgerald, G., Ross, R., & Stanton, C. (2012). Health Implications of High Dietary Omega-6 Polyunsaturated Fatty Acids. Journal of Nutrition and Metabolism, 2012(11), 16

5.     Lim, P., Jinap, S., Sanny, M., Tan, C., & Khatib, A. (2014). The Influence of Deep Frying Using Various Vegetable Oils on Acrylamide Formation in Sweet Potato ( Ipomoea batatas L. Lam) Chips. Journal of Food Science, 79(1), T115-T121.

6.     Food Standards Agency: Information on the risks of acylamide and how you an reduce the chances of being harmed by it: https://www.food.gov.uk/safety-hygiene/acrylamide (accessed 03.07.2018)

7.     Katragadda, Fullana, Sidhu, & Carbonell-Barrachina. (2010). Emissions of volatile aldehydes from heated cooking oils. Food Chemistry, 120(1), 59-65.

8.     Peng, Lan, Lin, & Kuo. (2017). Effects of cooking method, cooking oil, and food type on aldehyde emissions in cooking oil fumes. Journal of Hazardous Materials, 324(PB), 160-167. 

Why Smoothies Can Be So Healthy

Smoothies have been mega popular for a while now - any health, fitness or food page on Instagram just isn't complete without colourful glasses or bowls decorated with extravagant toppings and some of the smoothie temptingly overflowing down the sides. Some Instagrammers obviously spend hours making them look incredible, so it's easy to see this as just another health craze, only popular because they're so photogenic. But when done right, nutritionally-speaking, smoothies can be an incredibly healthy part of our diets. Here's why:

It's a really easy way to sneak in fruit and (even more importantly) vegetables

It's so easy to get several portions of fruit and veg into one smoothie (for instance in my go-to green smoothie or my blueberry protein smoothie bowl). The only other way you could realistically have several portions of vegetables in the morning would be to make a healthy vegan cooked breakfast, but we don't always have time for this (as much as a cooked breakfast every day would be amazing)! 

Fruit and veg are so incredibly important for our health. They contain protective bioactive compounds such as antioxidants, polyphenols, fibre, vitamins and minerals, which work through numerous complex mechanisms to reduce antioxidant stress, lower blood levels of VLDL and LDL cholesterol (the bad types), and help us to maintain a healthy weight.

So it's no surprise that higher consumption has been associated with reduced risk of type 2 diabetes (1), lower risk of developing several cancers (2), reduced risk of cardiovascular disease (3), and lower risk of becoming overweight (4). In fact, higher intake of fruit and vegetables is associated with a reduced overall mortality risk, by any cause (3).

The benefits extend beyond the recommended five portions a day, too - a review of 95 studies showed a dose-response relationship, meaning the more you eat, the more of these health benefits you get, even up to 10 portions a day (5). So a morning smoothie can be a really useful way to help get more fruit and veggies in!

They're a great way to take in absorbable iron

It's possible to get plenty of iron on a vegan diet. Legumes (like beans, lentils and chickpeas) and whole grains (like oats, quinoa, and brown rice) are great sources of iron, and have LOADS of other health benefits too. But again, we don't always have time to cook up legumes or grains in the mornings. Green leafy vegetables are another excellent source, so starting the day with some spinach or kale in your smoothie is a great way to keep your iron levels up. The iron in plant-based foods is different to animal sources - it's called non-haem iron and other foods we eat with it can either inhibit or enhance how much of the iron we absorb. Luckily, vitamin C massively increases how much we absorb (6), so combining the leafy greens with a handful of berries results in loads of absorbable (or bioavailable) iron in our smoothies. This helps to reduce fatigue and keep energy levels up. 

You can make your smoothie high in protein

Toast or cereal can be a healthy option for breakfast, especially if we choose wholegrain options and avoid sugary toppings. But it's the one time of the day when it's a little harder to have a high-protein meal, again due to time constraints. But it's really easy to get protein into a smoothie - just half a scoop of a vegan protein powder is such an easy way to make sure you're getting a good dose of protein in the morning, especially useful if you're training for fitness, strength, or weight loss. 

One quick point to make on this topic: protein supplements are absolutely not required if you're vegan - you'll get plenty of protein if your diet is balanced and varied. However, if like me you're into fitness, it's a useful tool to make sure your body's equipped with what it needs to optimise repair and growth, especially useful after working out. Many meat eaters have a protein shake after the gym for this same reason. 

It’s easy to incorporate omega-3 sources

Getting a daily source of omega-3 fatty acids is important for a large number of reasons. They’re an essential nutrient, meaning we have to get them from our diet, and studies show the benefits of omega-3 consumption range from fighting inflammation (7) to reducing risk factors for heart disease (8).

Great vegan sources of ALA omega-3 fatty acids include walnuts, flax seeds, chia seeds, and hemp seeds. Adding a tablespoon of one of these to your morning smoothie is a really easy way to incorporate some of these.

They're hydrating

After a long night's sleep without drinking water, getting our fluids in the morning is very important to re-hydrate. A smoothie made with fruit and vegetables, blended with water is a great way to start the day, with plenty of fluids. There's loads of benefits of staying hydrated, including improved reaction times (7), mood (8), and alertness (9). Also, starting exercise when you’re already dehydrated can significantly lower your performance levels (10,11) so stay on top of your game by starting the day with a healthy and hydrating smoothie!

My tips for the perfect smoothie:

1. Get some vegetables in - vegetables tend to be lower in sugar and calories than fruit and including them ensures a wide variety of nutrients in your smoothie

2. Have a variety of colours, always including some dark leafy greens - again, this general rule helps to ensure a wide variety of essential nutrients are taken in

3. Top up your smoothie with water - or use your favourite unsweetened nut milk - you need some liquid to blend up the ingredients, but topping up with fruit juice would add unwanted extra natural sugars and calories

4. Add some healthy fats - a tablespoon of ground flax seeds, chia seeds or hemp seeds is a great source of omega-3 and the protein and fat they contain help to keep you full for longer

Ps. Don't panic if your smoothie isn't a pretty colour. In fact, if it looks like pond-water, it's usually a good thing - it shows you've used a wide variety of colourful fruits and vegetables. Many mornings mine don't turn out a nice green or purple colour, they actually often end up brown, but still taste great and do me the world of good! 

References:

1. Carter, P., Gray, L., Troughton, J., Khunti, K., & Davies, M. (2010). Fruit and vegetable intake and incidence of type 2 diabetes mellitus: Systematic review and meta-analysis. BMJ, 341, BMJ, 19, 19 August August 2010, Vol.341.

2. Schwingshackl, L., & Hoffmann, G. (2014). Adherence to Mediterranean diet and risk of cancer: A systematic review and meta‐analysis of observational studies. International Journal of Cancer, 135(8), 1884-1897.

3. Wang, X., Ouyang, Y., Liu, J., Zhu, M., Zhao, G., Bao, W., & Hu, F. (2014). Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: Systematic review and dose-response meta-analysis of prospective cohort studies. BMJ, 349(7969), 9.

4. Mytton, O., Nnoaham, K., Eyles, H., Scarborough, P., & Mhurchu, C. (2014). Systematic review and meta-analysis of the effect of increased vegetable and fruit consumption on body weight and energy intake. Bmc Public Health, 14, Bmc Public Health, 2014 Aug 28, Vol.14.

5. Aune, Giovannucci, Boffetta, Fadnes, Keum, Norat, . . . Tonstad. (2017). Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality – a systematic review and dose-response meta-analysis of prospective studies. Ement.pdf-1056. ISSN 0300-5771.

6. Gillooly, M., Bothwell, T., Torrance, J., MacPhail, A., Derman, D., Bezwoda, W., Mayet, F. (1983). The effects of organic acids, phytates and polyphenols on the absorption of iron from vegetables. British Journal of Nutrition, 49(3), 331-342.

7. Goldberg, R. J., & Katz, J. (2007). A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain, 129(12), 210-223.

8. Abdelhamid, A., Brown, T., Brainard, J., Biswas, P., Thorpe, G., Moore, H., . . . Hooper, L. (2018). Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease. The Cochrane Database of Systematic Reviews, 11(11), CD003177.

9. Edmonds CJ, Crombie R & Gardner MR (2013) Subjective thirst moderates changes in speed of responding associated with water consumption. Front Hum Neurosci 7, 363.

10. Rogers, Kainth, and Smit. "A Drink of Water Can Improve or Impair Mental Performance Depending on Small Differences in Thirst." Appetite 36.1 (2001): 57-58. Web.

11. Neave, Scholey, Emmett, Moss, Kennedy, & Wesnes. (2001). Water ingestion improves subjective alertness, but has no effect on cognitive performance in dehydrated healthy young volunteers. Appetite, 37(3), 255-256.

12. Goulet, E. (2012). Dehydration and endurance performance in competitive athletes. Nutrition Reviews, 70, S132-S136.

13. Bardis, C., Kavouras, S., Arnaoutis, G., Panagiotakos, D., & Sidossis, L. (2013). Mild Dehydration and Cycling Performance During 5-Kilometer Hill Climbing. Journal of Athletic Training, 48(6), 741-7.

Why do Vegans and Vegetarians Live Longer?

Before we get into the science and evidence about plant-based diets, there’s one important point to make: there are healthy meat-eaters, and there are unhealthy meat-eaters. Just as there are healthy and unhealthy vegans. But, on average, vegans and vegetarians do live longer - they have lower mortality rates than meat-eaters, and grow old with fewer health issues (1). For example, those on a plant-based diet tend to have:

• Healthier gut profiles - reduced abundance of pathogenic gut bacteria and greater abundance of protective species (2)

• Lower blood pressure (3)

• Lower incidence of heart disease (4)

• Lower overall cancer incidence (5)

• Lower risk of developing diabetes (6)

That’s a pretty impressive list of diseases you can be protected against by adopting a plant-based diet, and it includes two of the top killers in Western countries: heart disease and cancer. 

So Why do Vegans and Vegetarians Live Longer?

The reasons why plant-based diets can be so protective can be broken down into two main categories:

1.      Vegans and vegetarians don’t eat meat

Yes, this is stating the extremely obvious, but this is of course the main difference between meat-eaters and those on a plant-based diet. And it’s an important difference, because:

Replacing carcinogenic processed meats with healthful vegan foods like fruit, vegetables, grains, pulses, nuts and seeds comes with a vast array of health benefits.

• All meat, including white meat like chicken (7), contain high levels of saturated fat and cholesterol, which is associated with cardiovascular risk (8). Dairy and eggs are also high in saturated fat, so vegans benefit even more from these effects.

• Processed meat has been classified as a class-1 carcinogen (cancer-causing) by the World Health Organisation (9) – this means the evidence is just as strong as it is with smoking and asbestos, both also class-1 carcinogens! It's also classified all red meat (beef, lamb, pork, goat etc.) as class-2 carcinogens, meaning they are probably cancer-causing.

• Meat and dairy contain hormones and antibiotics, given to livestock to increase rates of weight gain and feed efficiency, and these can impact human health in a number of ways (10).

2.      Vegans and vegetarians tend to eat more healthful foods

This is almost by default – if you don’t eat meat, you tend to replace those calories with more vegetables, fruits, grains, pulses, beans, nuts and seeds. It may also be that vegetarians and vegans pay more attention to their health. Of course it isn’t always the case (some vegans live on junk food), but on average, consumption of these nutritious, whole plant-foods, tends to be higher. And this comes with a vast array of health benefits:

• Fruit and vegetables contain protective bioactive compounds such as antioxidants, polyphenols, fibre, vitamins and minerals, which work through numerous complex mechanisms to reduce antioxidant stress, lower blood levels of VLDL and LDL cholesterol (the bad types), and help to maintain a healthy weight. So it's no surprise that higher consumption has been associated with reduced risk of type 2 diabetes (11), lower risk of developing several cancers (12), reduced risk of cardiovascular disease (13), and lower risk of becoming overweight (14). In fact, higher intake of fruit and vegetables is associated with a reduced overall mortality risk, by any cause (13).

• Whole grains are also rich in phytochemicals, antioxidants, vitamins, trace minerals, fibre, and protein. In fact, because they’re so nutritious, increased intake of whole grains is associated with lower blood pressure, reduced risk of cardiovascular disease (15), reduced risk of some cancers (16,17), reduced risk of developing diabetes (18), and having a lower body weight (19). (More about the benefit of whole grains here).

• Consuming your protein from plant-based sources such as beans, legumes, pulses, and soy can actually lower VLDL and LDL-cholesterol by specific mechanisms, as well as by displacing meat consumption (20,21). So while a high protein intake from animal sources increases cancer death risk and diabetes mortality, replacing it with plant-based protein sources eliminates these risks (22).

• Nuts and seeds pack an impressive variety of vitamins and minerals, and are a great source of protein and fibre. High nut consumption has been shown to lower total cholesterol and LDL cholesterol and is associated with reduced risk of cardiovascular disease and cancer mortality (23,24).

You can get an abundance of protein from vegan sources such as pulses, whole grains, tofu, vegetables, nuts and seeds - plus they come with countless health benefits

So, by avoiding meat and instead replacing animal foods with more whole plant foods, it's possible to improve your health in a huge variety of ways (as well as the obvious benefits to the environment and animal welfare issues). Of course, you hear the occasional story about someone who tried a vegan diet and didn’t feel great, or of an avid meat-eater who had steak for lunch every day and lived to a ripe old age. Everyone is different and has different experiences, lifestyles, and genetics. But the growing body of high quality scientific evidence of the health benefits of a plant-based diet, as well as reports of so many vegan athletes surpassing their competitors, is a pretty compelling reason to at least give a plant-based diet a go. 

References:

1.  Song, M., Fung, T., Hu, F., Willett, W., Longo, V., Chan, A., & Giovannucci, E. (2016). Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality. JAMA Internal Medicine, 176(10), 1453-1463.

2.  Glick-Bauer, M. C., & Yeh, M. (2014). The health advantage of a vegan diet: Exploring the gut microbiota connection. Nutrients, 6(11), 4822-4838.

3.  Yokoyama, Y. D., Takegami, M., Miyamoto, Y., Barnard, N., Nishimura, K., Watanabe, M., Okamura, T. (2014). Vegetarian diets and blood pressure a meta-analysis. JAMA Internal Medicine, 174(4), 577-587.

4.  Huang, Tao, Yang, Bin, Zheng, Jusheng, Li, Guipu, Wahlqvist, Mark L., & Li, Duo. (2012). Cardiovascular Disease Mortality and Cancer Incidence in Vegetarians: A Meta-Analysis and Systematic Review. Annals of Nutrition and Metabolism, 60(4), 233-240.

5.  Dinu, M., Abbate, R., Gensini, G., Casini, A., & Sofi, F. (2017). Vegetarian, vegan diets and multiple health outcomes: A systematic review with meta-analysis of observational studies. Critical Reviews in Food Science and Nutrition, 57(17), 3640-3649.

6.  Vang, A., Singh, P., Lee, J., Haddad, E., & Brinegar, C. (2008). Meats, Processed Meats, Obesity, Weight Gain and Occurrence of Diabetes among Adults: Findings from Adventist Health Studies. Annals of Nutrition and Metabolism, 52(2), 96-104.      

7.  Wang, Y., Lehane, C., Ghebremeskel, K., & Crawford, M. (2010). Modern organic and broiler chickens sold for human consumption provide more energy from fat than protein. Public Health Nutrition, 13(3), 400-408.

8.  Hooper, L., Martin, N., Abdelhamid, A., & Smith, G. (2015). Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Of Systematic Reviews, (6), CD011737.

9.  WHO International Agency for Research on Cancer (2015). Q&A on the carcinogenicity of the consumption of red meat and prcessed meat. Accessed 11.10.17 at: https://www.iarc.fr/en/media-centre/iarcnews/pdf/Monographs-Q&A_Vol114.pdf 

10.  Jeong, Sang-Hee, Kang, Daejin, Lim, Myung-Woon, Kang, Chang Soo, & Sung, Ha Jung. (2010). Risk assessment of growth hormones and antimicrobial residues in meat. Toxicological Research, 26(4), 301-13.

11.  Carter, P., Gray, L., Troughton, J., Khunti, K., & Davies, M. (2010). Fruit and vegetable intake and incidence of type 2 diabetes mellitus: Systematic review and meta-analysis. BMJ, 341, BMJ, 19, 19 August August 2010, Vol.341.

12.  Schwingshackl, L., & Hoffmann, G. (2014). Adherence to Mediterranean diet and risk of cancer: A systematic review and meta‐analysis of observational studies. International Journal of Cancer, 135(8), 1884-1897.

13.  Wang, X., Ouyang, Y., Liu, J., Zhu, M., Zhao, G., Bao, W., & Hu, F. (2014). Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: Systematic review and dose-response meta-analysis of prospective cohort studies. BMJ, 349(7969), 9.

14.  Mytton, O., Nnoaham, K., Eyles, H., Scarborough, P., & Mhurchu, C. (2014). Systematic review and meta-analysis of the effect of increased vegetable and fruit consumption on body weight and energy intake. Bmc Public Health, 14, Bmc Public Health, 2014 Aug 28, Vol.14.

15.  Tighe, Paula, Duthie, Garry, Vaughan, Nicholas, Brittenden, Julie, Simpson, William G, Duthie, Susan, . . . Thies, Frank. (2010). Effect of increased consumption of whole-grain foods on blood pressure and other cardiovascular risk markers in healthy middle-aged persons: A randomized controlled trial. The American Journal of Clinical Nutrition, 92(4), 733-40.

16.  Aune, D., Chan, D., Lau, R., Vieira, R., Greenwood, D., Kampman, E., & Norat, T. (2011). Dietary fibre, whole grains, and risk of colorectal cancer: Systematic review and dose-response meta-analysis of prospective studies. BMJ : British Medical Journal, 343, BMJ : British Medical Journal, 2011, Vol.343.

17.  Skeie, G., Braaten, T., Olsen, A., Kyrø, C., Tjønneland, A., Landberg, R., . . . Lund, E. (2016). Intake of whole grains and incidence of oesophageal cancer in the HELGA Cohort. European Journal of Epidemiology, 31(4), 405-414.

18.  Chanson-Rolle, A., Meynier, A., Aubin, F., Lappi, J., Poutanen, K., Vinoy, S., . . . Barengo, N. (2015). Systematic Review and Meta-Analysis of Human Studies to Support a Quantitative Recommendation for Whole Grain Intake in Relation to Type 2 Diabetes (Meta-Analysis to Recommend a Whole Grain Intake). 10(6), E0131377.

19.  Giacco, Della Pepa, Luongo, & Riccardi. (2011). Whole grain intake in relation to body weight: From epidemiological evidence to clinical trials. Nutrition, Metabolism and Cardiovascular Diseases, 21(12), 901-908.

20.  Jenkins, D., Mirrahimi, A., Srichaikul, K., Berryman, C., Wang, L., Carleton, A., . . . Kris-Etherton, P. (2010). Soy protein reduces serum cholesterol by both intrinsic and food displacement mechanisms. The Journal of Nutrition, 140(12), 2302S-2311S.

21.  Ha, V., Sievenpiper, J., De Souza, R., Jayalath, V., Mirrahimi, A., Agarwal, A., . . . Jenkins, D. (2014). Effect of dietary pulse intake on established therapeutic lipid targets for cardiovascular risk reduction: A systematic review and meta-analysis of randomized controlled trials. Canadian Medical Association. Journal, 186(8), E252-62.

22.  Levine, Suarez, Brandhorst, Balasubramanian, Cheng, Madia, . . . Longo. (2014). Low Protein Intake Is Associated with a Major Reduction in IGF-1, Cancer, and Overall Mortality in the 65 and Younger but Not Older Population. Cell Metabolism,19(3), 407-417.

23.   Del Gobbo, L., Falk, M., Feldman, R., Lewis, K., & Mozaffarian, D. (2015). Effects of tree nuts on blood lipids, apolipoproteins, and blood pressure: Systematic review, meta-analysis, and dose-response of 61 controlled intervention trials. The American Journal of Clinical Nutrition, 102(6), 1347-56.

24.  Grosso, G., Yang, J., Marventano, S., Micek, A., Galvano, F., & Kales, S. (2015). Nut consumption on all-cause, cardiovascular, and cancer mortality risk: A systematic review and meta-analysis of epidemiologic studies. The American Journal of Clinical Nutrition, 101(4), 783-793.

The Raw Vegan Diet - Worth A Try?

Raw food diets are a big hit right now - Instagram is swamped with thousands of pictures of raw meals, and more raw food products keep popping up in our supermarkets and health food shops. Advocates of raw food diets, including celebrities like Gwyneth Paltrow, Sting, and Demi Moore, claim the health benefits range from weight loss to detoxifying our bodies. Many supporters of the diet also claim that raw food is 'alive' and cooked food is 'dead', because cooking food supposedly destroys nutrients and enzymes. 

On the other hand, most health care professionals dismiss raw food diets as a fad that puts dieters at risk of developing eating disorders, nutritional deficiencies, and of being stigmatized.

As ever, I want to take a balanced look at both sides of the argument using the best evidence we have, to answer some of the common questions about raw food diets:

What is a raw food diet?

The diet consists of uncooked, unprocessed foods – mainly raw fruits, vegetables, nuts, and seeds.

It’s possible to warm your food a bit – but not above 40C (104F). Some like to sprout grains and beans to make them edible without cooking them. Fermenting foods and the use of dehydrators are also allowed to provide a little more variety into your diet. 

Does cooking food destroy nutrients?

Yes and no. Certain nutrients, such as vitamin C and folate, are decreased during cooking, especially when vegetables are boiled rather than steamed or baked (1).

However, other nutrients, such as the carotenoids beta-carotene, lycopene, and lutein, are made much more bioavailable (your body can absorb more of it) when cooked (2). Carotenoids are really important because they've been shown to be associated with decreased risk of cancers, cardiovascular diseases, and obesity (3). Another example is curcumin, the yellow pigment found in turmeric that has antioxidant and anti-inflammatory effects shown to protect against many diseases, including cancers, cardiovascular disease, and even arthritis (4-6). Eaten raw, the health effects are limited because of its extremely limited water solubility. However, when cooked, there can be up to a 12-fold increase in the solubility and therefore the amount we can absorb and benefit from (7). One more example is oxalates, found in some plants, which inhibit the absorption of calcium, iron and zinc. Cooking vegetables significantly reduces oxalate levels (8), so when many plant foods are cooked, absorption of calcium, iron and zinc is actually improved.

There’s loads more examples of how cooking food can decrease levels of some nutrients, but increase the bioavailability of others. So while a raw food diet may help you take in higher levels of certain nutrients, sticking solely to raw foods can actually put you at risk of becoming deficient in several others.

Is a raw food diet nutritionally complete?

Raw food diets naturally encourage the consumption of more fruit and veg, and that’s always a good idea. Fruit and veg are rich in vitamins, minerals, fibre, phytonutrients and antioxidants, and a higher intake of them is associated with reduced risk of cardiovascular disease, cancer, and all-cause mortality (9).

However, while it is possible to eat beans and grains ‘raw’, the process involves soaking and sprouting, which can take days. While sprouted foods can be a great addition to the diet (see my guide to sprouting here), the effort involved means most raw foodies won’t eat them regularly enough. And since whole grains, beans, chickpeas, and lentils are significant sources of protein, iron, and zinc - especially important for vegans - it’s easy to become deficient in many of these essential nutrients on a raw food diet.

And this has been shown in human studies: people on raw food diets have shown to have low plasma lycopene (10), and low intakes of vitamin D, zinc, and calcium (11). In fact, almost a third of women surveyed on a raw food diet had partial or complete amenorrhea (missed periods) possibly due to the lack of certain nutrients and calories in the diet (12).

What about the enzymes?

It’s undeniably true – cooking food denatures enzymes found in plants, which is why raw foodies don’t heat their food over 40C.

But hang on a minute… memories of GCSE biology are kicking in here... doesn’t acid also denature enzymes? The hydrochloric acid released by the parietal cells in our stomachs is strong enough to kill bacteria, convert pepsinogen into pepsin to break down proteins, and it’s certainly strong enough to denature almost all plant enzymes. A few do make it through to the small intestine, for example fermented foods like sauerkraut can carry enzymes through to the gut. But the effect is minimal – digestion in the gut relies almost entirely on human-generated bile and pancreatic enzymes.

So it really seems that labelling raw food ‘alive’ and cooked food as ‘dead’ is a classic marketing tactic, designed to play to people’s emotions and to help sell diets / products.

Does a raw food diet help you lose weight?

Most of the evidence around the weight loss effects of raw food diets is anecdotal, not conducted under controlled conditions, and so should be taken with a pinch of salt (more on what evidence to believe here). That being said, it does make sense that you’d lose weight on the diet, seeing as processed foods like cakes, sweets, cookies, doughnuts, pastries, cheese, processed meats (you get the point, lots of the unhealthy foods) are shunned.

But hold on a minute – in order to cut out these junk foods, do you need to be on a raw food diet? Absolutely not. If weight loss is your goal, why not do it in a healthy way that doesn’t put you at risk of deficiencies and still benefits from all the wonderful foods that are usually cooked? For example, whole grains can help with weight loss and have a long list of other health benefits (as I explained here). Beans and pulses, which aren’t typically eaten often on a raw food diet, can also be really helpful with weight loss because they’re so high in protein and fibre, both of which help to increase satiety. Higher protein diets can help preserve muscle during weight loss (13), which improves metabolism and makes the weight loss more sustainable.

So yes, a raw vegan diet can help with weight loss, but it doesn’t seem to be the most sustainable (or enjoyable!) way to do it.

Can a raw vegan diet help with detoxing?

Hmmm, detoxing… I promised balanced arguments, but when it comes to detox diets, there really isn’t any science at all to back them up, so this point has to be a little one-sided!

What does detoxing mean to you? Flushing our system of an accumulation of toxins that builds up in our bodies over time, leaving our organs squeaky clean and healthy?

Well, firstly, isn’t that what our liver, kidneys, gut, skin, and even lungs are for? Your body is unimaginably expert at getting rid of toxins already, and it does so through thousands of complex chemical reactions to create substances that can then be excreted. In fact there’s no known way to make this incredibly complex system, which already works amazingly well, work any better.

Secondly, what toxins exactly are removed by raw food diets, or any ‘detox’ diet for that matter? If these toxins were named, then we could measure them before and after the ‘detoxes’ to test their effectiveness. They’re never actually named, because detoxes are untested, bogus treatments, that belong firmly in the realm of pseudoscience.

As you can probably tell, I feel quite strongly against detox diets. Unfortunately, the word ‘detox’ has been hijacked by entrepreneurs to sell products, treatments, and programmes in exchange for large sums of money. They also encourage people to believe that they can live unhealthily because they can always just ‘detox’ later on to reverse any damage they’ve done. So overall, people end up less healthy, and so do their bank accounts.

Are there any other drawbacks of raw vegan diets?

There’s no doubt about it: a raw vegan diet is restrictive. There are rarely raw food options at restaurants, so one of life’s greatest pleasures – dining out with family and friends – can be at best awkward, or at worst impossible. Friends may also find it difficult to cater for you at dinner parties and so it can even become socially isolating.

And just imagine all of those amazing cuisines / foods that are off the menu on a raw food diet: freshly baked bread, hearty winter stews, barbecued vegetables, rich pasta dishes, curry… imagine a life without curry!

Having a healthy relationship with food is one of the most important ways we can stay healthy and happy. Allowing yourself to believe that some foods can be ‘dead vs. alive’ or even ‘dirty vs. clean’ creates unhealthy eating habits and can even lead to eating disorders like orthorexia, an obsession with eating healthily that paradoxically often becomes dangerously unhealthy for both the mind and the body.

On a practical level, there’s a high level of effort involved with raw food diets too – if you want any kind of variety in your diet, you’ll need to use food dehydrators, and be constantly fermenting foods or soaking / sprouting grains and pulses. It has also been linked to dental problems – the high intake of acidic and sugary fruit, plus the tendency to ‘graze’ throughout the day on raw snacks and juices, leads to tooth decay as plaque acids form on your teeth and damage the enamel.

So what’s the take-home message?

There are some positive aspects of raw food diets: it cuts out processed junk foods and, as with pretty much any type of diet, it at least gets people conscious about what they eat (so many people just eat unconsciously, which in itself can be a dangerous habit).

However, a raw food diet can leave you at risk of deficiencies and can have many other social and psychological drawbacks. While it can help you to lose weight, there are other healthier, more enjoyable, and more sustainable ways to do it. And it certainly doesn't 'detox' your body. An important drawback for me, and for anyone else who enjoys great food, is that you miss out on so many wonderful and healthy cuisines - a travesty in my opinion! 

My advice? Eat lots of fruit and vegetables, that's the most important thing. And just eat them how you like them. A varied, balanced, diet containing lots of raw and cooked vegetables (along with whole grains, beans, pulses, nuts, and seeds) is the best solution - and most importantly remember... enjoy your food! 

References:

1. Chai, W., & Liebman, M. (2005). Effect of different cooking methods on vegetable oxalate content. Journal Of Agricultural And Food Chemistry, 53(8), 3027-3030.

2. Livny, O., Reifen, R., Levy, I., Madar, Z., Faulks, R., Southon, S., & Schwartz, B. (2003). β-carotene bioavailability from differently processed carrot meals in human ileostomy volunteers. European Journal of Nutrition, 42(6), 338-345.

3. Perveen, R., Suleria, H., Anjum, F., Butt, M., Pasha, I., & Ahmad, S. (2013). Tomato (Solanum lycopersicum) carotenoids & lycopenes chemistry; Metabolism, absorption, nutrition and allied health claims- A comprehensive review. Critical Reviews in Food Science and Nutrition, Critical Reviews in Food Science and Nutrition, 01 January 2013.

4. Teiten, M., Gaascht, F., Eifes, S., Dicato, M., & Diederich, M. (2010). Chemopreventive potential of curcumin in prostate cancer. Genes & Nutrition, 5(1), 61-74.

5. Wongcharoen, & Phrommintikul. (2009). The protective role of curcumin in cardiovascular diseases. International Journal of Cardiology, 133(2), 145-151.

6. Daily, J., Yang, M., & Park, S. (2016). Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Journal of Medicinal Food, 19(8), 717-729.

7. Kurien, B., Singh, A., Matsumoto, H., & Scofield, R. (2007). Improving the solubility and pharmacological efficacy of curcumin by heat treatment. Assay and Drug Development Technologies, 5(4), 567-76.

8. Chai, W., & Liebman, M. (2005). Effect of different cooking methods on vegetable oxalate content. Journal of Agricultural and Food Chemistry, 53(8), 3027-30.

9. Aune, D., Giovannucci, E., Boffetta, P., Fadnes, L., Keum, N., Norat, T., . . . Tonstad, S. (2017). Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality—a systematic review and dose-response meta-analysis of prospective studies. International Journal of Epidemiology, 46(3), 1029-1056.

10. Garcia, A., Koebnick, C., Dagnelie, P., Strassner, C., Elmadfa, I., Katz, N., . . . Hoffmann, I. (2008). Long-term strict raw food diet is associated with favourable plasma beta-carotene and low plasma lycopene concentrations in Germans. The British Journal of Nutrition, 99(6), 1293-300.

11. Strassner, C., Doerries, S., Kwanbunian, K., & Leitzmann, C. (1999). Vegetarian raw food diet: Health habits and nutrient intake. American Journal Of Clinical Nutrition, 70(3), 632S.

12. Koebnick, Strassner, Hoffmann, & Leitzmann. (1999). Consequences of a Long-Term Raw Food Diet on Body Weight and Menstruation: Results of a Questionnaire Survey. Annals of Nutrition & Metabolism, 43(2), 69-79.

13. Soenen, S., Martens, E., Hochstenbach-Waelen, A., Lemmens, S., & Westerterp-Plantenga, M. (2013). Normal protein intake is required for body weight loss and weight maintenance, and elevated protein intake for additional preservation of resting energy expenditure and fat free mass. The Journal of Nutrition, 143(5), 591-6.

Gluten - Friend or Foe?

For some, gluten can cause serious problems: diarrhoea, abdominal pain, indigestion, fatigue, deficiencies, and even nerve damage are some of the complications caused by eating gluten for people with coeliac disease. With the condition, eating gluten (a protein found in wheat, barley, and rye) causes the immune system to produce antibodies that attack the lining of the small intestine. Some people also suffer with wheat allergies, where an immune response to any of the proteins found in wheat (not just gluten) can cause vomiting, diarrhoea, hives, and difficulty breathing.

Quite rightly, it’s also more recently been recognised and accepted that non-coeliac or wheat allergy patients can suffer too, in the form of gluten sensitivity. Here, eating even small amounts can cause uncomfortable bloating, headaches, and chronic fatigue. For people who suffer from these conditions, the increase in the availability of gluten-free products is a real blessing as it makes dealing with strict gluten-free diets much easier.

But, seeing as these three conditions affect about 2% of the population (coeliac disease affects 1 in 100, wheat allergy approx. 1 in 1000, and gluten sensitivity around 1 in 100), why have sales of gluten-free products soared so high in recent years? 22% of the UK has bought or eaten a gluten-free product at least once in the last six months (1).

Most people buy gluten-free products because they believe they’re healthier, rather than for medical reasons. This could be down to celebrity endorsements from the likes of Miley Cyrus and Kim Kardashian who claim there are health benefits or even weight loss properties of gluten free diets.

It could also be because of the huge increase in clever marketing creating a ‘health halo’ effect (even the packaging of these products makes them look healthier). It’s understandable why investment in marketing campaigns is so extensive, as the industry was worth an estimated $5 billion globally last year and is set to continue growing. Producers and retailers are capitalising on this growth in demand: while many staple food products have been facing price deflation, gluten-free products increased in price by 23% on average between 2011 and 2016.

But Can Gluten Be Healthy?

For healthcare professionals, this growth in popularity of gluten-free diets is seriously perplexing. Because for the approximately 98% of the population who do not have gluten issues, whole grains (including wheat, barley, and rye) have some important and significant health-promoting effects. They’re rich in phytochemicals, antioxidants, vitamins, trace minerals, dietary fibre, and protein. In fact, because they’re so nutritious, increasing the amount in your diet has been shown to be associated with:

·       Lowered blood pressure and reduced risk of cardiovascular disease (2)

·       Reduced risk of some cancers (3,4)

·       Reduced risk of diabetes (5)

·       Lower body weight (6)

In fact, a gluten-free diet among healthy adults has been shown to negatively effect beneficial gut bacteria populations and immune function, because some of the components found in whole grains act as prebiotics, which feed our good gut bacteria (7). All of these reasons are why, as part of a balanced diet, experts suggest eating three portions of whole grains a day (8).

You may have heard stories about people without gluten issues feeling much better going gluten-free. This may well be the case, but if cutting out gluten means they’ve also shunned cakes, biscuits, doughnuts, pizza, pastries, and beer, then there’s no wonder they felt healthier. Cutting out gluten can also make it easier not to overeat. Think about it: pizza, pasta, and bread are some of the easiest foods to over-eat with, which can in itself cause bloating. Of course, if you feel unwell after eating just one slice of bread on an empty stomach, then it’s worth getting checked out (but you should see a doctor before you go gluten-free, because it’s more difficult to establish if someone has gluten issues after they’ve cut it out for a while).

The take home message? For the 98% of the population without gluten issues, save your money by avoiding expensive gluten-free products, and instead spend that money on higher quality foods - treat yourself to some fresh, locally made bread from the bakers (which won’t contain all the artificial softeners and preservatives that commercial bread contains). And try to aim for whole grains because the bran and the germ, which are removed in white cereals, are where you find most of the fibre and nutrients. But even white bread and pasta are significant sources of nutrients in the UK, as by law, white wheat flour is fortified with iron, calcium, thiamine and niacin. Aim for three portions of whole grains a day: it’s great for your health and – just as importantly – it means you get to enjoy some incredibly tasty foods. This ultimately is the key, because when you stop restricting yourself unnecessarily, you can build a really positive relationship with food, and you’re more likely to keep your healthy habits long into the future!

References

1. http://www.mintel.com/press-centre/food-and-drink/free-from-gains-momentum-sales-of-free-from-food-products-forecast-to-surpass-half-a-billion-in-the-uk-in-2016

2. Tighe, Paula, Duthie, Garry, Vaughan, Nicholas, Brittenden, Julie, Simpson, William G, Duthie, Susan, . . . Thies, Frank. (2010). Effect of increased consumption of whole-grain foods on blood pressure and other cardiovascular risk markers in healthy middle-aged persons: A randomized controlled trial. The American Journal of Clinical Nutrition, 92(4), 733-40.

3. Aune, D., Chan, D., Lau, R., Vieira, R., Greenwood, D., Kampman, E., & Norat, T. (2011). Dietary fibre, whole grains, and risk of colorectal cancer: Systematic review and dose-response meta-analysis of prospective studies. BMJ : British Medical Journal, 343, BMJ : British Medical Journal, 2011, Vol.343.

4. Skeie, G., Braaten, T., Olsen, A., Kyrø, C., Tjønneland, A., Landberg, R., . . . Lund, E. (2016). Intake of whole grains and incidence of oesophageal cancer in the HELGA Cohort. European Journal of Epidemiology, 31(4), 405-414.

5. Chanson-Rolle, A., Meynier, A., Aubin, F., Lappi, J., Poutanen, K., Vinoy, S., . . . Barengo, N. (2015). Systematic Review and Meta-Analysis of Human Studies to Support a Quantitative Recommendation for Whole Grain Intake in Relation to Type 2 Diabetes (Meta-Analysis to Recommend a Whole Grain Intake). 10(6), E0131377.

6. Giacco, Della Pepa, Luongo, & Riccardi. (2011). Whole grain intake in relation to body weight: From epidemiological evidence to clinical trials. Nutrition, Metabolism and Cardiovascular Diseases, 21(12), 901-908.

7. De Palma, G., Nadal, I., Collado, M., & Sanz, Y. (2009). Effects of a gluten-free diet on gut microbiota and immune function in healthy adult human subjects. British Journal of Nutrition, 102(8), 1154-1160.

8. https://www.bda.uk.com/foodfacts/wholegrains.pdf

Coconut oil – the pros, the cons, and the 'as-yet unknowns'

Not many food products in history have boomed in popularity like coconut oil has in recent years, with a 500% increase in global demand for the product over the last decade.

But not many food products in history also come with such conflicting messages about their effects on health.

Even as a nutritionist, until I looked a little deeper into the research, I didn’t really know what to make of all the information out there.

What I did notice was that information touting the health benefits of coconut oil seem to mostly focus on the topical uses (such as applying to hair or skin) as well as the health benefits of medium-chain triglycerides (a type of saturated fat that makes up over half of the fats in the oil).

And while there are good quality studies behind some of the health benefits of coconut oil, other information comes from more questionable sources like celebrity endorsements, food producers / retailers with a financial interest, and low quality studies (e.g. done on mice).

Comparatively, the quality of the evidence warning us of the detrimental health effects seems to be much more robust (see my article on which types of evidence to believe here).

Here’s a breakdown of the most significant pros and cons of coconut oil, along with any issues with the credibility of the evidence:

Coconut oil: health benefits

Coconut oil is very high in saturated fat, and while most sources of saturated fat are made up of a high proportion of long-chain triglycerides, more than half of the saturated fats in coconut oil are medium chain triglycerides (MCTs). It's these MCT's that are behind most of the health claims behind coconut oil:

• MCTs can be easily converted to ketones by the liver, providing an alternative energy source for the brain which can be beneficial in the treatment of Alzheimer’s disease (1). However, there is no evidence that coconut oil can prevent Alzheimer’s from developing in the first place.

• MCTs do have some antibiotic properties – they can disrupt the cell membranes of bacteria and inhibit the growth of some pathogens (2). However, this has only ever been shown in vitro (i.e. in test tubes, petri dishes etc). There are no studies to show that eating coconut oil can prevent diseases in the human body.

• Some studies suggest that MCTs can aid in weight loss (3,4) compared to other fats. However, the evidence is not the highest quality (most studies have been done on mice, or very low numbers of humans).

• Coconut oil can be used topically to treat dermatitis (5) and there’s some anecdotal reports that it can prevent dandruff, possibly due to the lauric acid content, which has antimicrobial and antifungal properties.

Coconut oil: the health risks

• While coconut oil has been shown in some studies to aid in weight loss, these changes are very minor and the reports encourage many people to add too much of it to their diets. All fats contain 9 calories per gram, and coconut oil is no exception. Therefore, if you are adding extra coconut oil on top of what you’d normally eat, you’re likely to gain weight, not lose weight. There are many MUCH more effective, healthier, and cheaper ways to help with weight loss!

• A systematic review (one of the best forms of evidence) evaluated 21 human studies of coconut oil and concluded that it raised total cholesterol and LDL cholesterol (the bad type) more than unsaturated plant oils such as olive oil (6). They concluded that replacing coconut oil with unsaturated plant oils alters blood lipid profiles and reduces risk factors for cardiovascular disease.

• The environment should be taken into consideration too - of course coconuts do not tend to grow in the West so transporting them from top producing countries like Indonesia and The Philippines requires burning through more fossil fuels than if we used home-grown oils like rapeseed. Coconuts also tend to be grown as a mono-crop, meaning large areas of land with low biodiversity which can effect the environment. Lastly, large proportions of small-scale coconut farmers live in poverty, averaging about $1 per day throughout the year.

What should we make of all this?!

To summarise, there is some (slightly weaker) evidence behind the health benefits of coconut oil, and some (slightly stronger) evidence behind the negative effects. But there are still a lot of 'as-yet-unknowns' too. Any article you read that shows a very strong opinion either way is probably biased somehow, as none of the scientific evidence is overwhelmingly strong. 

While I'll enjoy watching out for any higher quality future studies, I for one plan to continue using coconut oil occasionally. It does help to enhance the flavours of certain dishes like curries, and also because it's solid at room temperature it can improve the consistency of homemade sweet treats like these vegan brownies. As I mentioned in a previous post about fats, we certainly shouldn't avoid fats altogether. But I will limit how much I use - as with any oil it contains about 120 calories per tablespoon, and the evidence behind the effects on LDL cholesterol is pretty strong. 

Regarding the sustainability of coconut oil, buying Fair Trade goes a long way, because as well as helping the environment by improving water conservation and proper waste disposal, it also helps to ensure safe working conditions and fairer pay for coconut farmers. 

So, if like me, you plan to continue using coconut oil but perhaps a little more sparsely, you can afford to go for a higher quality Fair Trade variety. 

References

1. Newport, Vanitallie, Kashiwaya, King, & Veech. (2015). A new way to produce hyperketonemia: Use of ketone ester in a case of Alzheimer's disease. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 11(1), 99-103.

2. Shilling, M., Matt, L., Rubin, E., Visitacion, M., Haller, N., Grey, S., & Woolverton, C. (2013). Antimicrobial effects of virgin coconut oil and its medium-chain fatty acids on Clostridium difficile. Journal of Medicinal Food, 16(12), 1079-85.

3. Lei, T., Xie, W., Han, J., Corkey, B., Hamilton, J., & Guo, W. (2004). Medium-chain Fatty acids attenuate agonist-stimulated lipolysis, mimicking the effects of starvation. Obesity Research, 12(4), 599-611.

4. Liau, K., Lee, Y., Chen, C., & Rasool, A. (2011). An Open-Label Pilot Study to Assess the Efficacy and Safety of Virgin Coconut Oil in Reducing Visceral Adiposity. ISRN Pharmacology, 2011, 7.

5. Verallo-Rowell, V., Dillague, K., & Syah-Tjundawan, B. (2008). Novel antibacterial and emollient effects of coconut and virgin olive oils in adult atopic dermatitis. Dermatitis : Contact, Atopic, Occupational, Drug,19(6), 308-15.

6. Eyres, Laurence, Eyres, Michael F., Chisholm, Alexandra, & Brown, Rachel C. (2016). Coconut oil consumption and cardiovascular risk factors in humans. Nutrition Reviews, 74(4), 267-280.

Should We Avoid Fats?

If we don’t want to get fat, we shouldn’t eat fat, right?

Well, the answer is not as simple as that. Yes, gram for gram, fat is the most calorific of the major food groups, containing 9 calories per gram (compared to 4 calories per gram of protein or carbohydrates). For this reason, it's suggested to limit fat intake to 70g per day (95g per day for men), because too much of any kind of fat can contribute to weight gain.

But does this mean we should be avoiding fat altogether? Most certainly not. Here are the reasons why:

Weight control

It sounds kind of counter-intuitive, but for weight loss or control, you should not be avoiding fats. Here’s why:

• Fats make you feel fuller. Fats take a long time to digest, and when fat hits your intestines, hormones that increase satiety, such as CCK and PYY, are released. In fact, studies have shown that meals rich in omega-3 fatty acids increase the feeling of fullness both directly after, and two hours after, eating the meal (2).
• Low fat foods are often high in sugars. When low (or zero) fat foods are made, in order to make them taste good, manufacturers tend to pump them full of sugar. Sugars raise blood sugar levels, triggering the release of insulin to bring them back down. How does insulin bring sugar levels down? Often by storing them as fat.
• Dietary fat can boost fat metabolism. Diets rich in healthy fats increase the release of the hormone adiponectin from your fat cells (3). Adiponectin plays important roles regulating insulin sensitivity, glucose and fat metabolism, which is why low levels of the hormone are associated with obesity. 

This sounds amazing – we no longer have to fear fats! While this is definitely true, it does come with two important caveats:

1. Not all fatty foods are created equal - the types of fats we eat are really important. We should aim to eat mono- and polyunsaturated fats, found in leafy vegetables, avocado, nuts, seeds, olive oil, and rapeseed oil. And we should limit saturated and trans fats, found in fatty meats, cheese, lard, cakes, biscuits, pies, and many processed or fried foods, as these can harm our health. 
2. Fat intake should still be within the UK guidelines. All fats, saturated or not, contain 9 calories per gram. So do add healthy fats to your diet, just not with reckless abandon, as the calories can mount up if you’re not careful.

Absorption of vitamins

Dietary fats are important for the absorption of fat-soluble vitamins (A, D, K and E). Without an adequate amount of fat in our diets, our bodies are unable to effectively absorb and process these vitamins, which are essential for our health.

Essential fatty acids

We can synthesise most fatty acids in our body. However, the ones we can’t make, and therefore must get from our diet, are the polyunsaturated fats linoleic acid (omega-6) and alpha-linoleic acid (omega-3). Omega-3 and 6 are essential for the normal functioning of all tissues in the body – so cutting out fats altogether can affect a whole host of symptoms and disorders. 

References:

1. https://www.nutrition.org.uk/nutritionscience/nutrients-food-and-ingredients/fat.html?limit=1&start=4

2.  Parra, Ramel, Bandarra, Kiely, Martínez, & Thorsdottir. (2008). A diet rich in long chain omega-3 fatty acids modulates satiety in overweight and obese volunteers during weight loss. Appetite,51(3), 676-680.

3.  Von Frankenberg, A., Silva, F., De Almeida, J., Piccoli, V., Do Nascimento, F., Sost, M., . . . Gerchman, F. (2014). Effect of dietary lipids on circulating adiponectin: A systematic review with meta-analysis of randomised controlled trials. The British Journal of Nutrition, 112(8), 1235-50.

The Truth About Soy

I get asked a lot whether or not soybeans and soy products, such as tofu and tempeh, are good for you. And it’s easy to see why there’s so much confusion on this topic, as many of the headline messages we see in the media are very conflicting. Some hail tofu as some kind of super-food, while after reading others you might expect to grow a third eye. So, I thought I would bring you the best quality and most up-to-date scientific evidence on the health topics surrounding soy.

Soy and hormones in men

The top concern I hear about from men is whether soy can affect male hormone levels. There have in the past been concerns about oestrogen-like activities of the isoflavones found in soy decreasing testosterone levels in men. However, the basis of these claims stems from early studies in rodents. And it’s been shown that rodents metabolise isoflavones very differently to humans. In fact, a recent meta-analysis – one of the best form of scientific evidence – combined the results from 15 human clinical trials, and concluded that soy foods do not alter testosterone levels in men (ref). Even at higher than average rates of consumption (higher than is even typical among some Asian cultures), there is also no evidence that soy isoflavones affect circulating oestrogen levels in men (ref). This does all kind of make sense… the hundreds of millions of men in Asian cultures who frequently eat soy products are not infertile or growing ‘man boobs’. In fact, there is reason to believe that soy is one of the reasons why the Japanese, among the biggest soy eating countries in the world, is also one of the healthiest nations. This brings me on to the health benefits of soy:

Soy is an excellent source of protein

Soybeans are a complete protein, meaning they provide all the essential amino acids (the ones we have to get from our food because we can’t make them in our body). A cup of cooked soy beans contains a whopping 22g protein, a 150g serving of tempeh has 28g, and a 150g serving of tofu contains 19g. This means for anyone looking to increase their protein intake, which can help with short-term weight loss or gaining muscle and strength, soy products can be an extremely useful addition to the diet.

Soy can replace foods that are bad for you

As mentioned, soy provides an excellent source of protein, and all without the cholesterol and saturated fat levels found in most meat products. So if you swap a pork sausage hot dog for a soy-based alternative, you are avoiding processed meat, which is bad for our health in a number of ways. If you’re replacing it with a high protein, low fat, high vitamin and mineral based food like tofu, there are significant advantages for your health.

Soy could be protective against cancer

This has been a topic of debate in the past, again because of early studies in rats who metabolise phyto-oestrogens differently to humans. But recent meta-analyses, which combine the results of numerous clinical trials in humans, show that soy consumption could in fact be associated with reduced risk of breast cancer incidence (ref) and prostate cancer (ref). These effects have been shown to be both through direct mehanims, and through the ‘displacement’ of red and processed meats (as mentioned above). That’s equally as important because red and processed meats have been classified by the World Health Organisation as carcinogens (cancer causing) (ref).

Soy can decrease risk of heart disease and stroke

Soy products can reduce our risk of heart disease and stroke, because they reduce our blood cholesterol levels (ref). It does this in two ways: firstly, by directly reducing our liver’s cholesterol output. Secondly, again through the ‘displacement’ theory - soy products like tofu are often eaten as a replacement in our meals for meat products, which are much higher in saturated fat. By replacing meat with tofu or tempeh, the saturated fat content of the meal is significantly reduced, which is why soy consumption is associated with lower risk of heart disease and stroke (ref).

Soy can improve bone health

Increased consumption of soy foods is associated with improved markers of bone health and lower risk of osteoporosis and bone fractures, especially in post-menopausal women (ref). More research is needed here but the evidence so far is very promising! (ref)

The downsides of soy products

Soy products that have been processed to resemble the taste of a bacon rasher or turkey slice require quite a bit of processing, and the ingredients list can look worryingly long. There is often added salt and fat in anything that has been battered, and other flavourings and colourings in mock-meat style products to give it a ‘meaty’ flavour. As with any foods, generally the less processing the better. For this reason, simple tofu is much better than the heavily processed imitation meats. Better still, tempeh which is made by simply fermenting cooked soybeans, is even less processed than tofu, and contains more protein too.

The take home message

The reason some people worry about soy foods is mainly because of early studies conducted in rats that used especially high levels of phyto-oestrogens. As mentioned before, rats metabolise the phyto-oestrogens in soy very differently to humans, and there’s a large (and growing) body of evidence showing the significant health benefits of soy products in humans. Want to incorporate soy into your diet more? Try my crispy sesame-coated baked tofu, incredible tofu quiche, or make a tofu ‘bacon’ BLT.

Should We Drink Coffee?

It seems that every few weeks there’s an article in the health sections of the papers about coffee or caffeine. Some of them seem to hail coffee as some kind of 'superfood', while others warn us of the dangers of drinking too much of the stuff. As with many nutritional messages reported by the media, the hype around coffee is pretty confusing and conflicting. But while we're drinking around 70 million cups of coffee every day in the UK, it’s worth knowing if we should be drinking it at all. Well, here’s a breakdown of the best scientific evidence behind that aromatic beverage so many of us love:

The Health Benefits of Drinking Coffee

As well as caffeine, coffee is loaded with potent compounds such as chlorogenic acid and polyphenols, which have antioxidant properties and contribute significantly towards antioxidant intake in Western diets (1). The combination of these compounds could delay the absorption of blood sugar, increase metabolic rate, and help blood vessels contract and relax. These actions may account for why coffee drinking is associated with lower risk of: 

• Obesity (2)

• Stroke (3)

• Developing type 2 diabetes (4)

• Neurological diseases such as Alzheimer’s (5) and Parkinson’s disease (6)

• Coffee has also been shown in meta-analyses (large reviews combining the results of numerous trials) to be significantly protective against several cancers, including colorectal (7), liver (8), oral (9), and pancreatic (10).

From a fitness perspective, the caffeine in coffee acts as a stimulant by blocking the inhibitory neurotransmitter adenosine (11) which can reduce fatigue, making you: Firstly, less likely to skip training sessions because you're feeling tired / sluggish; and secondly, improve alertness and concentration during training, meaning once you're at the gym, you're more likely to push yourself harder and make bigger improvements (12).

The Risks of Drinking Coffee

In some people, too much caffeine can lead to insomnia, nervousness, heart palpitations, and 'the jitters'. Caffeine taken in after lunchtime is particularly likely to interfere with sleep, and getting less sleep puts you at risk for other chronic conditions in the long term.

As mentioned, coffee reduces risk of several cancers. For most other cancers, it has no significant effect, with the exception of lung cancer, where risk is increased, but only amongst smokers (13). There is also some evidence that coffee could increase risk of non-fatal myocardial infarction (heart attack) amongst those with the gene that means caffeine is metabolised slowly (about half of us) (14, 15).

The polyphenols in coffee can inhibit absorption of non-heme iron (the kind found in plants) in a meal by between 50 and 90% (16). So vegetarians and vegans need to be particularly careful about holding back on the coffee for at least 30 minutes before or after eating to ensure iron absorption is maximised.

It’s also worth noting that all of the benefits mentioned above are referring to black coffee. The biggest risk of all comes from what you may add to it – creams, sugar, or sugary syrups add saturated fat and empty calories to your brew, raising blood sugar and promoting weight gain. It’s also important to brew coffee with filter paper, as unfiltered coffee (such as Turkish brew or French press) contains cafestol, a substance that can increase LDL (bad) cholesterol levels (17).

From an environmental perspective, it must be said that coffee isn’t great for the planet. Deforestation to make way for sun-cultivated coffee has seen off 2.5 million acres of natural ecosystems in Central America alone so far. There are also issues with water contamination, chemical use, waste, and soil quality / erosion. And take away coffees have the added impact of the used cups (7 million a day in the UK alone) that go to landfill, as most paper coffee cups are fused with polyethylene to make them waterproof and can’t be recycled. Coffee pods have also come under fire recently, with the vast majority of the 500 million pods sold just in the UK in 2015 ending up in landfill, where they will take 500+ years to break down. If this is an important issue to you, check out my five easy steps to reduce the amount of plastic you use.

Take-home messages

The protective effects of drinking coffee against many diseases may explain why there is good evidence that overall, drinking coffee could help you live longer (18). However, some people should limit coffee consumption, especially pregnant women, smokers, those with anxiety issues, high blood pressure, or insomnia.

If you already drink coffee, try following these guidelines to maximise the benefits:

• Stick to no more than five cups a day to keep your caffeine intake at a safe level

• Try to drink coffee in the mornings only, to avoid disrupting your sleep

• Limit the amount of unfiltered coffee you drink

• Leave 30 minutes either side of eating to reduce the inhibition of iron absorption

• Stick to black coffee without sugar, or use low fat nut / soy milk if you prefer

• Reduce your coffee intake if you would like to lower your environmental impact, or at least stick to making your own coffee instead of using takeaway cups or coffee pods

Lastly - if coffee isn’t already part of your daily rituals, don’t worry about starting a love affair with the stuff; it's not for everyone and there are plenty of other ways to stay healthy without forcing yourself to drink it. 

References:

1. Svilaas, Arne, Sakhi, Amrit, & Svilaas, Tone. (2004). Intakes of Antioxidants in Coffee, Wine, and Vegetables Are Correlated with Plasma Carotenoids in Humans1. The Journal of Nutrition, 134(3), 562-7.

2. Nordestgaard, Ask Tybjærg, Thomsen, Mette, & Nordestgaard, Børge Grønne. (2015). Coffee intake and risk of obesity, metabolic syndrome and type 2 diabetes: A Mendelian randomization study. International Journal of Epidemiology, 44(2), 551-565.

3. Zhang, R., Wang, Y., Song, B., Jørgensen, H., & Xu, S. (2012). Coffee consumption and risk of stroke: A meta-analysis of cohort studies. Central European Journal of Medicine, 7(3), 310-316.

4. Jiang, Xiubo, Zhang, Dongfeng, & Jiang, Wenjie. (2014). Coffee and caffeine intake and incidence of type 2 diabetes mellitus: A meta-analysis of prospective studies. European Journal of Nutrition, 53(1), 25-38.

5. Liu, Qing-Ping, Wu, Yan-Feng, Cheng, Hong-Yu, Xia, Tao, Ding, Hong, Wang, Hui, . . . Xu, Yun. (2016). Habitual coffee consumption and risk of cognitive decline/dementia: A systematic review and meta-analysis of prospective cohort studies. Nutrition, 32(6), 628-636.

6. Qi, H., & Li, S. (2014). Dose–response meta‐analysis on coffee, tea and caffeine consumption with risk of Parkinson's disease. Geriatrics & Gerontology International, 14(2), 430-439.

7. Li, G., Ma, D., Zhang, Y., Zheng, W., & Wang, P. (2013). Coffee consumption and risk of colorectal cancer: A meta-analysis of observational studies. 16(2), 346-357.

8. Yu, C., Cao, Q., Chen, P., Yang, S., Deng, M., Wang, Y., & Li, L. (2016). An updated dose-response meta-analysis of coffee consumption and liver cancer risk. Scientific Reports, 6, 37488.

9. Li, Ya-Min, Peng, Juan, & Li, Le-Zhi. (2016). Coffee consumption associated with reduced risk of oral cancer: A meta-analysis. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 121(4), 381-389.e1.

10. Jie Dong, Jian Zou, Xiao-Feng Yu. (2011). Coffee drinking and pancreatic cancer risk: A meta-analysis of cohort studies. World Journal of Gastroenterology, 17(9), 1204-1210.

11. Fredholm, B. (1995). Adenosine, Adenosine Receptors and the Actions of Caffeine *. Pharmacology & Toxicology, 76(2), 93-101. 

12. Doherty, M., & Smith, P. (2004). Effects of caffeine ingestion on exercise testing: A meta-analysis. International Journal of Sport Nutrition and Exercise Metabolism, 14(6), 626-46.

13. Anqiang Wang, Shanshan Wang, Chengpei Zhu, Hanchun Huang, Liangcai Wu, Xueshuai Wan, Haitao Zhao. (2016). Coffee and cancer risk: A meta-analysis of prospective observational studies. Scientific Reports, 6, Scientific Reports, 2016, Vol.6.

14. Cornelis, M., El-Sohemy, A., Kabagambe, E., & Campos, H. (2006). Coffee, CYP1A2 genotype, and risk of myocardial infarction. JAMA, 295(10), 1135-41.

15. Nawrot, Perez, Künzli, Munters, & Nemery. (2011). Public health importance of triggers of myocardial infarction: A comparative risk assessment. The Lancet, 377(9767), 732-740.

16. Hurrell, R., Reddy, M., & Cook, J. (1999). Inhibition of non-haem iron absorption in man by polyphenolic-containing beverages. British Journal of Nutrition, 81(4), 289-295.

17. Hingston, C., & Wise, M. (2015). Coffee brewing technique as a confounder in observational studies. Heart, 101(20), 1686.

18. Freedman, N., Park, Y., Abnet, C., Hollenbeck, A., & Sinha, R. (2012). Association of Coffee Drinking with Total and Cause-Specific Mortality. The New England Journal of Medicine, 366(20), 1891-1904.

How to eat to maximise your training

Whether you are trying to lose weight, put on muscle, or simply get fitter - how you eat is just as important as the training you do. If you've made a good start with your fitness plan, but are struggling to take your training to the next level, you may find that when you eat, as well as what you eat, could play a big part in pushing the boundaries. This is for two main reasons:

•    What and when you eat plays a huge part in how you feel when you exercise and therefore can influence how hard you push yourself. You should be pushing yourself to the limits every training session, and you're not going to make much progress if you go to the gym feeling sluggish and end up plodding along on the treadmill, hardly breaking a sweat. 

•    What you eat before and after exercise can affect muscle recovery and therefore to maximise on your hard work, getting the right fuel at the right times can lead to faster progress. 

So, here are four tips to make your eating habits work for you to maximise the results from your training:

1. Eat a healthy breakfast

This rule applies whatever your goals may be. Most of the energy you got from your dinner the previous night will be used up by the morning, meaning your muscle glycogen (stored carbohydrates that power your training), will likely be low. And whether trying to gain muscle or lose weight, you're not going to get much out of your morning gym session if you're feeling tired or lightheaded when you exercise. So make sure to eat to give your body the energy it needs to get a really productive session in. 

Despite many people claiming that eating breakfast 'kickstarts' your metabolism, there is no clear evidence of this. But there are definitely benefits: it has been shown that people who eat breakfast tend to expend more energy during the day (1). And especially if you have a high fibre breakfast, you are likely to feel fuller for longer, reducing the likelihood of making poor food choices later in the day (2). So even if you don’t work out in the morning, getting a healthy breakfast in will set you up for the day and lead to healthier habits. The best quick breakfasts for providing complex carbohydrates needed to fuel your sessions, along with protein for muscle recovery and fibre to keep you full, include:

·      A smoothie, made with at least 50% vegetables, mixed with fruit, water, plus a vegan protein powder

·      Wholegrain toast with peanut butter or homemade chia seed jam

·      Porridge made with almond milk, topped with a nut butter and sliced fruit

2. Size of your meals

On the other side of things, if you eat too much before a workout, you may feel slowed down and sluggish. As a general guideline:

•    Large meals - leave at least 3 hours before exercising

•    Small meals - leave at least 2 hours before exercising

•    Snacks - eat these 30-60 minutes before exercising 

3. Eating after you exercise

Muscle protein breakdown occurs during exercise. But don’t worry, it's the process you have to go through to promote muscle protein synthesis (muscle growth), which increases for up to 48 hours after working out. Because muscle protein synthesis peaks immediately after exercise, then reduces over time, intake of dietary protein soon after exercise is important to maximise muscle growth. However, this 'window of opportunity' is not as small as many gym-goers believe, so you do not need to instantly rush to neck a protein shake within five minutes of your workout – up to 30 minutes is fine. This is especially true if you follow tip number one, as the protein you consume in the hours before your workout will by now be absorbed and available in the bloodstream to aid muscle recovery and growth. In fact, spreading your protein intake more evenly during the day after training is more effective at promoting muscle growth than fewer, larger intakes of protein (3).

An equally important factor is making sure to consume carbohydrates after you exercise, because this inhibits the muscle protein breakdown that occurs during, and for a while after, your training. Eating carbohydrates, especially simple sugary carbohydrates, quickly increase blood sugar levels, and this triggers the release of insulin to try and bring blood sugar levels back down. Usually, you would want to avoid insulin spikes, but after exercise, increased insulin helps to drive nutrients, including amino acids, into the muscle cells, preventing muscle protein breakdown (4). So a small glass of fruit juice, some natural sweets or dextrose tablets, or a tablespoon of jam / syrup along with your protein source will aid muscle recovery, without promoting fat gain. Eating carbohydrates on the days you train also ensures that you replenish your muscle glycogen so you are ready to perform your best on your next session. 

So, in short, make sure to consume protein (10-20g) and simple carbohydrates (15-40g, depending on the intensity of your workout, your weight, your goals, etc) soon after your workouts, even if you are following a low carbohydrate diet. And make sure to spread your protein intake evenly throughout the day, not just immediately after training, as muscle protein synthesis will continue for up to 48 hours after you’ve finished.

4.     Stay hydrated

You need to drink enough fluids to avoid becoming dehydrated before, during, and after your workouts. The American College of Sports Medicine recommends to:

·      Drink about 2-3 cups of water during the 2-3 hours before your workout.

·      Drink about 1-2 cups of water every 30-40 minutes during your workout. This can be adjusted according to your workout intensity and the weather.

·      Drink about 2-3 cups of water for every pound of weight you lose during the exercise.

Most importantly - learn from your experiences!

Everyone is different when it comes to eating around exercise, and will depend on your fitness levels, your goals, your weight, and personal preferences. Notice how your body feels during workouts in response to your eating patterns and how your diet affects the progress you make, so you can adapt to what works best for you to achieve your fitness goals sooner.

1.     Wyatt, H., Grunwald, G., Mosca, C., Klem, M., Wing, R., & Hill, J. (2002). Long-term weight loss and breakfast in subjects in the National Weight Control Registry. Obesity Research, 10(2), 78-82.

2.     Turconi G, Bazzano R, Caramella R, Porrini M, Crovetti R, Lanzola E (1995). The effects of high intakes of fibre ingested at breakfast on satiety. Eur J Clin Nutr. 49: 281-285.

3.     Areta, J., Burke, L., Ross, M., Camera, D., West, D., Broad, E., Coffey, V. (2013). Timing and distribution of protein ingestion during prolonged recovery from resistance exercise alters myofibrillar protein synthesis. Journal of Physiology, 591(9), 2319-2331.

4.     Biolo, & Wolfe. (1993). Insulin action on protein metabolism. Bailliere's Clinical Endocrinology and Metabolism, 7(4), 989-1005.

Everything You Need To Know About Vitamin B12

Vitamin B12

Vitamin B12 (also referred to as cobalamin) is a really important nutrient for vegetarians, and especially vegans, to be aware of. This is because it is the only vitamin that cannot be found in plants. The UK government recommend an intake of 1.5μg (micrograms) per day for both male and female adults (British Nutrition Foundation, 2015).

Vitamin B12 is water soluble and 60% of B12 in the body is stored in the liver. These stores can last up to several years, and so after becoming vegan, it may be a year or two (or more) before initial signs of deficiency show, including fatigue and anaemia. Because it's an important vitamin for blood cell formation and the nervous system, further depletion can then lead to more severe features such as bone marrow suppression, abnormal reflexes, and memory loss.

So how can we make sure we're getting enough vitamin B12 in our diets? Well, vegetarians get some B12 from dairy and eggs, and many vegan foods are fortified with B12 - including breakfast cereals, spreads, nut milks, and some nutritional yeasts. The amounts vary from country to country and from brand to brand, so read the labels carefully.

Supplements are recommended for vegans who do not eat 2-3 fortified foods a day. B12, both in supplements and fortified foods, is simply sourced from culturing bacteria, which make B12 as a by-product. This is the same way that animals make B12 - the only difference is for them, the bacteria making it live inside their guts. So vegans get their B12 from the very same source as every other animal on the planet – micro-organisms! Getting your B12 from fortified foods or supplements doesn't cause suffering to animals, or cause environmental damage, so that's a win on every level. 

Here is the amount of B12 recommended intake by The Vegan Society (2001):

• Eat fortified foods 2-3 times a day to provide 3μg per day
• OR take a daily B12 supplement providing  at least 10μg
• OR take a weekly B12 supplement providing at least 2000μg

The reason they suggest the higher doses for the daily and weekly supplements is because B12 is absorbed better in small doses. So, the less frequently you obtain B12, the more you need to take.

Plant-based tip! Many meat eaters like to use B12 to criticise plant-based diets by saying that if vegans rely on a supplement, then their diet cannot be 'natural'. In fact, I find the opposite to be true, and I find being well informed and prepared very useful for when a debate on the topic might arise. So, here are my thoughts on why I am more than happy to take B12: 

• There is also nothing 'natural' about factory farming (where 90% of meat comes from)
• Evolution is natural, and humans have evolved to use their intelligence to enable a cruelty-free and sustainable diet. Why not take advantage of this?
• Most people (over half the US adult population) take supplements, so why only call vegan diets ‘unnatural’? 

I'd love to hear about any other stances you take when people try to criticise veganism on the grounds of requiring a supplement - leave your comments below!