by Tanya HAFFNER | Mar 2, 2018 | Hot Topics in nutrition, Media in context, The Nation’s Health, Surveys and insights, Catering/Out of Home
This week, the Daily Mail and the Independent reported that showing the calorie content of meals in restaurants can help lower people’s calorie intake.
This is based on a systematic review of 28 studies, which concluded that nutritional labelling on restaurant menus can reduce the amount of energy (i.e. calories) purchased.
Overall, it was found that nutritional labelling could reduce calorific intake by up to 12% – around 72 calories for a typical 600kcal meal. That’s equivalent to three boiled new potatoes or around 150ml of juice.
Behind the headlines: the Nutrilicious dietetic view
This study is very relevant, considering that on average we eat out for around a quarter of our meals. These meals can often be served as large portions and can be high in sugar and salt.
More and more restaurants in the UK are now providing the nutritional values of meals, which are often available online. They include Nandos, Starbucks, Prezzo, Wagamama, Zizzis, Giraffe and many more. However, previous research has only shown mixed results as to the effects of having the nutritional values available.
There are some limitations to the review – many of the individual studies it’s based on were graded as poor quality. Nevertheless, it provides evidence that displaying nutritional values to restaurant menus may help to lower calorie intake in individuals.
Another weapon in the battle against obesity
Just this week, Cancer Research UK released a report showing that on current trends 70 per cent of millennials – those born between the early 1980s to mid-1990s – will be overweight or obese by the age 35 to 45.That’s more than any other generation since records began. The UK is already the most overweight nation in Western Europe, with obesity rates rising even faster than in the US. We know definitively from the McKinsey Global Institute Report on Overcoming Obesity: an initial economic analysis that we need as many nudge strategies as possible to help overcome this very serious obesity issue.
Professor Theresa Marteau, the review’s lead author and head of the Behaviour and Health Research Unit at Cambridge University, summed it up: “This evidence suggests that using nutritional labelling could help reduce calorie intake and make a useful impact as part of a wider set of measures aimed at tackling obesity. There is no magic bullet to solve the obesity problem, so while calorie labelling may help, other measures to reduce calorie intake are needed.”
Her thoughts are echoed by many experts. Professor Ian Caterson, president of the World Obesity Federation, stated: “Energy labelling has been shown to be effective – people see it and read it and there is a resulting decrease in calories purchased. Combined with a suite of other interventions, such changes will help slow and eventually turn around the continuing rise in body weight.”
Sue Davies, Which? food policy expert, says it’s not just the experts who believe access to more information is important: “This research highlights the value of calorie information and why it is so important that it is provided more widely for people when eating out. In a recent Which? survey, 63% of people agreed that calorie information should be provided on the food in cafes and restaurants for transparency.”
The United States is leading the way on this front: the Food and Drug Administration recently implemented a policy whereby restaurants with 20 or more locations must show calorie counts on their menus from May 2018. It will be interesting to monitor the impact.
Takeaway message
There are many measures that are needed to help reduce obesity, and the serious health issues that it causes. Ensuring nutritional values are available to consumers may be a simple strategy amongst many that are needed to help individuals take steps to make wiser meal choices.
There are other steps we can take to help us make healthier choices when eating out. The NHS provides some useful advice and tips
At Nutrilicious, we enjoy helping all organisations to implement, measure and communicate nudge strategies to help the nation overcome the urgent problem of obesity. If you would like to discuss how your organisation could contribute, please get in touch – we would be more than happy to discuss and help.
by Tanya HAFFNER | Feb 23, 2018 | Media in context, The Nation’s Health, Surveys and insights
Popular in the news this week is the story linking eating ‘ultra-processed’ foods and cancer, as reported by the Independent (‘Processed food, sugary cereals and sliced bread may contribute to cancer risk, study claims‘) the BBC the Daily Mail and The Guardian.
These headlines are based on a study published in the British Medical Journal this month. In the study, foods were classified based on the NOVA system, which relates to the nature, extent and purpose of food processing. Those falling under the category of ‘ultra-processed’ include:
- Mass-produced bread and buns
- Sweet or savoury packaged snacks including crisps, chocolate bars and sweets
- Sodas and sweetened drinks
- Meatballs, poultry and fish nuggets
- Instant noodles and soups
- Frozen or shelf-life ready meals
- Foods made mostly or entirely from sugar, oils and fats
Study details and findings
A cohort of 105,000 people were followed for an average of five years. A 10% increase in the proportion of ultra-processed foods in the diet was associated with a significant 12% increase in the risk of overall cancer and 11% in the risk of breast cancer.
Alongside the original study, the British Medical Journal have also published an editorial further explaining the findings.
Behind the headlines: the Nutrilicious dietetic view
Limitations of the study
While this story has been heavily publicised, there are several limitations of the study which mean we cannot draw firm conclusions:
- Those who ate a lot of ultra-processed foods had other behaviours that have been linked to cancer which could skew the results. They include being more likely to smoke, being less active, consuming more calories overall and more likely to be taking the oral contraceptive. The researchers stated that their impact ‘cannot be entirely excluded’.
- Cause and effect cannot be established for an observational study: we cannot say that ‘ultra-processed foods have caused the increase in cancer’. It is an association found.
- The term ‘ultra-processed’ is still somewhat vague, so it’s difficult to establish which specific foods might be responsible for the increased cancer risk, and why.
- The participants were mainly women who had decided to take part in a health and diet study themselves, so were likely to be interested in their health. This means the sample may not be highly representative of the general public.
That said, we can give credit to the large sample size used in the study giving more reliability to the findings.
Response from Cancer UK
Helping to put this study into context, Professor Linda Bauld from Cancer Research UK responded: “It’s already known that eating a lot of these foods can lead to weight gain, and being overweight or obese can also increase your risk of cancer, so it’s hard to disentangle the effects of diet and weight.”
She also said the study was a ‘warning signal to us to have a healthy diet’ but individuals should not worry about eating a bit of processed food ‘here and there’ as long as they were getting plenty of fruit, vegetables and fibre.
So, can we reduce the risk of cancer?
It’s estimated that one in two people will develop cancer at some point in their lives. Whilst some risk factors for cancer are non-preventable (such as genetics), there are still lots of things we can do to help reduce our risk:
- Eating a healthy, balanced diet
- Limiting red meat and avoiding processed meats
- Maintaining a healthy weight
- Abstaining from smoking
- Keeping alcohol intakes below government guidelines
- Protecting your skin from sun damage
- Knowing your body (e.g. checking for lumps)
For more details on all of the above, go to the National Health Service. The World Cancer Research Fund also carry out a continuous review of the scientific evidence into the subject of diet, lifestyle and cancer risk. Read their cancer prevention recommendations.
Takeaway message
This study does not allow us to draw firm conclusions about ultra-processed foods and cancer. However, we should certainly be reminded of the importance of diet and lifestyle in cancer prevention.
After smoking, excess weight is one of the biggest causes of cancer and it has also been estimated that about one third of cancers could be prevented by changing our diet and lifestyle. This includes being a healthy weight, following a healthy diet and engaging in physical activity.
What changes could you make to help reduce your risk?
Reference: Macmillan Cancer and Cancer Research UK
by Tanya HAFFNER | Feb 19, 2018 | Thoughts, The Nation’s Health, Surveys and insights
Plant-based diets made the headlines again this week, with coverage of a study suggesting a vegan diet can prevent type 2 diabetes. It was reported by the Daily Mail (‘Going vegan can prevent overweight adults from falling victim to diabetes’) and Medical News Today.
In the study, 75 participants were put into two groups. One group was asked to follow a low-fat, plant-based vegan diet with no calorie restriction. The other was asked to make no dietary changes for a period of 16 weeks. Participants prepared all their own meals and for both groups, alcoholic drinks were restricted to one per day for women and two per day for men.
All the participants had a Body Mass Index (BMI) between 28kg/m2 and 40kg/m2 (putting them into the ‘overweight’ or ‘obese’ categories), with no history of diabetes.
At the end of the study, the plant-based group reported:
- Marked improvements in beta-cell functioning – these are the cells which produce the hormone insulin, which is important for controlling blood sugar levels (a key factor in diabetes where blood sugar levels are elevated or harder to control).
- A significant increase in how well the body responded to insulin – when the body is less sensitive to the hormone insulin, it increases the chances of developing type 2 diabetes.
- A decrease in BMI and body fat levels – this is important because excess body weight is strongly associated with increased risk of type 2 diabetes.
It was reported that neither group made any changes to their physical activity regimen, nor did they change the use of their medications.
Read more details of the original study
Behind the headlines: the Nutrilicious dietetic view
Whilst this is yet another study showing positive effects arising from a plant-based diet, we must be aware of its limitations:
- Efforts were made to help ensure adherence to the diet (such as dietitian telephone calls to the participants and food diaries completed at the start and end) but this still relies on the honesty and accuracy of the participant.
- As noted by the researchers, the participants used in the study were ‘generally health-conscious individuals’ who were willing to make significant dietary changes. Thus, we cannot be sure findings would be representative of the general population if they were to eat a vegan diet.
- The study is too short and too small to show conclusively that a vegan diet prevents type 2 diabetes.
- The meals were prepared by the participants and thus any changes or fluctuations were not controlled or recorded.
On the other hand, a strength of the study is that it was a randomised controlled trial, which is the gold standard in research for measuring the effectiveness of an intervention.
The link between plant-based diet and reduced risk of diabetes
The researchers recognised that the major factor accounting for the reduced risk of type 2 diabetes in the plant-based group was the weight lost (including visceral fat lost).
The link between the two is well established. Research shows that for every kilogram of weight loss, there is a 16% reduction in risk or type 2 diabetes.*
The generally higher fibre and lower fat content of plant-based diets (which also includes vegetarian diets) would be expected to be helpful in reducing the energy density, and thus total calorie content of the diet. This could help with reducing obesity.
*Hammam et al (2006) Effect of Weight Loss With Lifestyle Intervention on Risk of Diabetes.
Takeaway points
In the UK, 11.9 million people are at risk of developing type 2 diabetes: prevention is clearly of great importance. The disease can have both short-term and long-term complications.
Further research will be needed to determine whether a vegan diet could prevent type 2 diabetes, and whether the positive improvements noted in this study require a strict vegan diet or whether the positive effects could be achieved with smaller changes.
Evidence shows the best ways to reduce risk of type 2 diabetes include:
- maintaining a healthy weight;
- eating healthily; and
- keeping physically active,
Adopting principles from a plant-based diet can certainly help with the first two points. The range of benefits of adopting a more plant-based diet are discussed further in last week’s blog.
For more information on reducing risk see Diabetes UK alongside their useful information about veganism and diabetes.
by Tanya HAFFNER | Feb 16, 2018 | Hot Topics in nutrition, The Nation’s Health, Surveys and insights
The rise in popularity of vegetarian and vegan diets is in the news, including stories in the Daily Mail INews. This comes following a release by Kantar Worldpanel of supermarket sales figures and analysis of consumer behaviour. It revealed:
- Over January 2018, one in ten shoppers purchased a meat-free ready meal. This has increased by 15% compared with the same time last year.
- During January 2018, 29% of evening meals were now free of meat and fish.
- Britons consumed 3.9 billion meat free evening meals in the 12 months to October 2015. This rose to 4.3 billion in the 12 months to October 2017.
- As a nation, we consumed 87 million more entirely vegan-friendly meals in 2017 than in 2015.
Announcements of product sales and ranges underscore these figures. In just two examples, it was also reported in the news this week that sales of Quorn (a meat substitute product) have increased globally by 16%. Last month also saw Tesco bring out their own vegan range, Wicked Kitchen, highlighting the increasing demand for more plant-based options.
Behind the headlines: the Nutrilicious dietetic view
There are many reasons why we could be seeing an increase in the popularity of meat free meals.
The trend of ‘Veganuary’ (where individuals adopt a vegan diet for the month of January) is likely to have contributed to the findings which related to the month of January 2018.
Richard Allen, a spokesman for Kantar Worldpanel, emphasised increasing access to meat-free foods: “The surge in vegetarian evening meals over the past year is down to the wider availability of products which make eating meat-free more attractive and practical.”
He continued: “Our ideas about what’s healthy are also changing – we’re more focussed on foods that are natural and less processed and eating a varied diet.”
What are the benefits of a plant-based diet?
The evidence for plant-based diets is growing and can offer many benefits. Indeed, the updated ‘Eatwell Guide’ saw that plant sources of protein were listed ahead of animal food sources of protein. The protein group now has the title ‘Beans, pulses, fish, eggs, meat and other proteins’, highlighting the increased role plant-based diets can play.
Benefits of adopting a more plant-based diet include:
Health
- Research has shown that vegetarian and vegan populations tend to have lower blood pressure, cholesterol levels and rates of cardiovascular disease compared to their omnivorous counterparts. This could be due to less saturated fat in the diet and more polyunsaturated fats, in addition to other cardio-protective components in the diet such as soya and nuts.
- Plant-based diets tend to have a more balanced macronutrient profile. For example, the higher fibre content of plant-based diets is often accompanied by lower fat intakes. This can help reduce the energy density of the diet and thus help reduce the total energy (calorie) intake. This could help prevent people being overweight/obese, and therefore any related negative effects and co-morbidities (e.g. type 2 diabetes, increased cancer risk etc).
Environment/sustainability
- Animal foods are resource intensive (energy, land and water) and thus tend to have higher greenhouse gas emissions compared to plant foods per unit weight.
- Modelling work has shown that reducing the amount of animal foods in the diet will make a critical contribution to climate change mitigation.
Economic
- Recent research has suggested that the British government could reduce its healthcare and societal costs by £5.21 billion if just 10 per cent of the UK population emphasised plant-based foods in their diet.
References: Clarkson V, Plant Food Sources of Protein for Optimum Health, Muscle Status and Sustainability – The Evidence and Practice and Schepers J & Annemans L., The potential health and economic impact of plant-based food patterns in Belgium and the United Kingdom. Nutrition 15th December 2017 (in press)
Does this mean meat is off the menu?
Gaining the benefits of a plant-based diet does not have to mean a diet no with meat at all. A ‘flexitarian‘ diet is predominantly plant-based without completely eliminating meat and can be extremely beneficial for health and reducing carbon footprints.
Indeed, meat, poultry and fish are nutritious foods and can provide a range of nutrients beneficial for health. We are advised by the NHS to have two portions of fish per week, one of which is oily. They also advise how meat can fit into the diet.
Takeaway points
We welcome findings that plant-based meals are being explored and becoming more popular. We encourage everyone to enjoy a varied diet featuring a wide variety of plant-based whole foods.
Overall, plant-based eating isn’t new. It’s not radical. And it’s definitely not about cutting things out. A plant-based diet shouldn’t be defined by what it excludes, but by what it includes. The core message is ‘put plants first’. Instead of planning meals around meat, bring veggies, fruits, whole grains, pulses, legumes, nuts and seeds from the side of the plate to front and centre.
It doesn’t have to be wholesale change: many benefits can be achieved by simply reducing intake of meat rather than following a strict vegetarian or vegan diet. We recommend making small steps to include more plant-based foods and meals in your diet, to benefit your health and the planet.
If you do decide to go further, the NHS gives advice on ensuring a vegetarian or vegan diet is balanced. The British Dietetic Association are part of an important alliance with the Vegan Society to share the message that all well-planned vegan diets can support healthy living in people of all ages.
by Tanya HAFFNER | Jan 24, 2018 | Thoughts, Media in context, The Nation’s Health
Each week we analyse some of the hot headlines in health and nutrition news. This week we look at the health effects of energy drinks; and a new report from Cancer Research UK on unhealthy food advertising for children.
HEADLINE 1: MORE THAN HALF OF YOUNG PEOPLE SUFFER SIDE EFFECTS FROM ENERGY DRINKS
This week the adverse effects of energy drinks have been reported by the Daily Mail, the Independent and The Sun.
The headlines are based on a study published in the Canadian Medical Association Journal. It carried out an online survey of 2,055 children and young adults aged 12-24, who were asked about their consumption of energy drinks and coffee, and any adverse outcomes they experienced.
55.4% of those who had ever consumed energy drinks (no more than 2 drinks per day) had experienced at least one adverse effect. The most common were fast heartbeat (24.7%), difficulty sleeping (24.1%) and headache (18.3%). Few reported nausea/vomiting/diarrhoea (5.1%), chest pain (3.6%) or seizures (0.2%). 3.1% of the respondents had sought medical advice.
The side effects were consistent with the potential effects of caffeine but were significantly more prevalent than with those who’d reported effects from coffee.
Behind the headlines: the Nutrilicious dietetic view
There are significant limitations to the study, making it impossible to draw any clear conclusions or new insights into the impact of energy drinks on health:
- The quantifies of caffeine consumed were unknown
- Medical history was not recorded.
- The authors admit that there were many other compounding factors to the side effects, such as alcohol and drug consumption.
- They also acknowledge difficulty with under- and over- reporting.
What the study does highlight, however, is the popularity of energy drinks among young people.
So what is considered ‘safe’ when it comes to energy drink consumption?
How energy drinks could affect your health
- The impact of caffeine
Caffeine is phytochemical stimulant of the central nervous system. It is naturally found in coffee, cocoa beans and tea leaves.
The effects of caffeine vary greatly between habitual drinkers and non-caffeine consumers, who may consume a one off-caffeine drink.
Habitual healthy caffeine drinkers consuming moderate amounts would not experience negative side effects from caffeine. Sugar-free variants will count towards hydration, improved sports performance and alertness.
As with all foods and drinks, moderation is key. Safety limits on daily intakes have been set by the UK based on European Food Safety Authority (EFSA) guidelines:
- For healthy adults (aged 16+, excluding pregnant and breastfeeding women): No more than 400mg caffeine per day (3-4 cups of coffee or 2-4 cans of energy drinks, depending on the size of the can). No more than 200mg caffeine (2 cups of coffee or 1-2 energy drinks) as a single dose. Some adults may be sensitive to caffeine. For them, single doses of 100mg may result in difficulty sleeping and reduce sleep duration, particularly when consumed close to bedtime.
- For pregnant and breast-feeding women: No more than 200mg per day (1-2 cups of coffee, 1-2 energy drinks). Doses greater than this have been associated with increased risk of miscarriage and lower birth weights
- For under 16s: Up to 3mg/kg body weight daily intakes of caffeine do not raise safety concerns. For a 14-year-old teenager weighing 51kg, this would equate to around 153mg of caffeine (1-2 cans energy drink).
- Taurine and other energy drinks constituents: EFSA’s 2015 scientific review found no evidence for safety concerns with regard to the interaction between caffeine and other energy drink constituents such as glucuronolactone and taurine.
- Increasing free sugars in the diet – the bigger concern
The more popular energy drinks are loaded with free sugars. Even if drunk in moderation in terms of caffeine content, the free sugars content will impact negatively on health.
A typical 250ml serving provides 27.5g sugars (7 teaspoons). That’s 92% of the recommended daily intake for children aged 11 upwards and exceeds daily recommendations for 7-10 year olds by 3.5g.
These drinks are nutrient poor and energy rich, providing excess energy that our young do not need in our current environment of increasing obesity and micronutrient deficiencies.
Of major concern is the larger 500ml serving size of some energy drinks. These can exceed not only the daily caffeine recommendations for teenagers and young children (160mg per 500ml) but also the free sugars recommendation. One brand provides 80g free sugars per 500ml can. That’s three times the daily recommendation of free sugars for 7-10 year olds and 2.5 times for older children and adults.
Take home message
Sugar-free energy drinks containing caffeine can be drunk in moderation. They contribute to hydration, improve alertness and do not have any negative health implications. Habitual moderate caffeine consumption is perfectly safe. Large sizes loaded with sugar do not play a part in a balanced diet.
For more advice on healthy drink choices, go to the NHS website
HEADLINE 2: CANCER RESEARCH UK ARGUES LINK BETWEEN TV ADS AND CHILDHOOD OBESITY
This week, Cancer Research UK called for a ban on advertisements for high fat, salt or sugar (HFSS) foods during talent shows and live sports. This was picked up by the Daily Mail and the Express, as well as BBC’s Newsnight.
It follows their online survey involving 3,348 young people aged 11–19 years, a representative sample of the UK population. Comparisons were made between high commercial TV viewing (three hours per day or more) versus moderate (0.5-3 hours per day).
12 HFSS foods were investigated (confectionery, desserts, flavoured yogurts, cakes/biscuits, milk drinks, takeaways, sugary drinks, sweetened cereals, energy drinks, fried potato products & crisps).
See full details of the report and the methodology used
Key findings include:
- There was a significant increase in junk food consumption with the higher viewing of advertisements – 520 more junk food items were consumed per year for each child by those in the high vs moderate TV viewing group.
- Those in the high TV viewing group were more likely to have a greater overall HFSS food consumption across 10 out of the 12 HFSS foods investigated.
- Key times of exposure to junk food advertisements were in the evenings and weekends, i.e. not classified as ‘children’s viewing time’.
This is of relevance because currently advertising HFSS foods is banned during programmes aimed at children (introduced in 2008 – a decade old!), but the ban does not apply to later mainstream programmes such as live sport and talent shows. The TV regulator, Ofcom, have previously highlighted that 7-8pm is when children currently watch the most TV.
- Junk foods ads were equally effective on TV and on demand streaming.
As a result, Cancer Research UK is calling for restrictions up until 9pm on TV and tighter controls for online streaming.
Behind the headlines: the Nutrilicious dietetic view
This is a detailed survey from Cancer Research UK, involving a large number of participants and provides evidence (although not causal) that HFSS marketing could be driving unhealthy eating and drinking.
The lead researcher Dr Jyotsna Vohrarom Cancer Research has stated: ‘This is the strongest evidence yet that junk food adverts could increase how much teens choose to eat.’
It has been shown that high consumption of individual foods including takeaways, sugary drinks and confectionary items are linked to increased BMI in children and young adults.
While this report does not directly show that HFSS marketing causes childhood obesity, Cancer Research UK have announced that alongside other reports, they will release a report later this year investigating the link between marketing and weight.
The problem of childhood obesity
Childhood obesity is a huge public health issue in the UK, with nearly a third of children aged 2 to 15 years classed as overweight or obese. An obese child is five times more likely to become an obese adult. In the short term this can cause physiological and psychological harm and long term, negative health effects and the risk of cancer increases. See more details on our blog Behind the Headlines 11th December.
Take home messages
This year, much action is being taken to help combat the obesity crisis, including the sugar tax, calls for sugar reduction in foods, campaigns on children’s snacking and more – as discussed on the Government’s website.
This new report highlights that HFSS marketing poses a risk for consumption of unhealthy foods, which through excess calories could contribute to obesity.
It also shows that HFSS advertisements were viewed during family shows in evenings and weekends, which should be exempt based on the new Advertising Standards Authority (ASA) and the Committee of Advertising Practice (CAP) regulations (see our blog New rules on food advertising to help tackle childhood obesity.
We hope this important report will put pressure on Ofcom and the Government to enforce tighter regulations for HFSS marketing, furthering the fight against childhood obesity.
Policy recommendations as a result of the research are discussed in the full report.
by Tanya HAFFNER | Jan 15, 2018 | Hot Topics in nutrition, Thoughts, Media in context, The Nation’s Health
Each week we analyse some of the hot headlines in health and nutrition news. This week we look at the role of choline in pregnancy, the health aspects of coconut oil and whether sleep can help us cut down on sugar.
HEADLINE 1: EATING FRY UPS DURING PREGNANCY CAN BOOST BABIES’ INTELLIGENCE
The effect of choline during pregnancy has been in the news this week, reported by the Independent, The Times, the Daily Mail and the Mirror.
This is based on a small study of 26 women entering their third trimester of pregnancy, who were randomised to consume either 480mg or 930mg choline supplement in addition to a controlled diet.
Babies were tested at 4,7,10 and 13 months of age and it was found that reaction time was significantly faster in babies of mothers who consumed 930mg choline supplement daily.
Behind the headlines: the Nutrilicious dietetic view
We don’t hear of choline, which is a vitamin-like nutrient needed for the normal function of all cells, especially those in the liver and the central nervous system, including the brain.
Although choline is an essential nutrient, this study is a long way off proving that pregnant women need to focus on choline supplements to improve their children’s cognition, much less that fry ups result in intelligent babies:
- This was only a small study. It looked at a nutrient that does not register in UK dietary reference values as no incidence of choline deficiency has been reported.
- The women were given supplements rather than food in order to boost their levels – the headlines suggesting fry ups could be beneficial are misleading and could put mother and baby’s long-term health at risk.
- The reaction time results are of limited value for assessing the impact on cognitive development in the babies beyond 12 months.
Eating a healthy balanced diet, maintaining a healthy weight gain, keeping active and avoidance of alcohol and smoking during pregnancy will help ensure the best outcomes for the mother and the baby. Specific supplements of vitamin D and folic acid are also recommended by UK government. For tips on a healthy diet see the NHS
HEADLINE 2: IS COCONUT OIL A SUPERFOOD?
This week Dr Michael Mosley has been promoting the use of coconut oil as a health product, as picked up by the BBC, The Times and the Daily Mail. The suggestion is that despite high levels of saturated fat, coconut oil might still be good for you.
This report comes from the ‘Trust Me I’m a Doctor’ team, a new BBC series featuring Dr Mosley. 94 volunteers were involved, aged between 50 and 75 years, with no history of diabetes or heart disease. They were split into three research groups and for four weeks added to their diet as follows:
- Group 1: 50g of extra virgin coconut oil (about 4 tbsp) consumed daily
- Group 2: 50g of extra virgin olive oil (about 4 tbsp) consumed daily
- Group 3: 50g of unsalted butter (about 3 tbsp) consumed daily
Baseline measurements were taken for blood lipids, including LDL (‘bad’) and HDL (‘good’) cholesterol. The findings, averaged out, were as follows:
- Group 1 (coconut oil) – no rise in LDL levels; 15% rise in HDL levels
- Group 2 (olive oil) – small reduction in LDL (although deemed as non-significant); 5% rise in HDL
- Group 3 (butter) – 10% rise in LDL levels; 5% rise in HDL levels.
The participants’ weight and body fat remained unchanged.
Behind the headlines: the Nutrilicious dietetic view
This is a disappointing well-publicised study that will only serve to fuel consumers’ confusion about how they can reduce the incidence of UK’s number 1 killer, heart disease.
On the surface, the findings paint the picture that coconut oil could be good for the heart, through raising levels of HDL cholesterol.
However, conducted over only a short period of time, overall diet quality of the participants was not assessed – including overall saturated fat, free sugars and refined carbohydrate intakes from other food sources. Based on this, it is unclear what brought about the changes in lipid profiles and no conclusions can safely be made on the benefits or harmful effects of coconut oil.
Contradicting studies
While this study fuels the growing trend for coconut oil, it cannot compare to the extensive scientific literature reviews of good-quality studies by leading heart health and academic experts. These have shown consistently that saturated fats have an overall negative effect of increasing LDL cholesterol.
We discuss the different types of saturated fats found in coconut oil amongst other key points in our blog, Is Coconut Oil Really Good for You?
What are the current recommendations for use of coconut oil?
Here are what some of the major health organisations have to say about coconut oil:
- Heart UK – published a statement on coconut oil that for people wanting to lower their cholesterol, coconut oil should be avoided.
- British Heart Foundation – state there is not enough good-quality research to provide us with a definitive answer as to whether the types of saturated fats in coconut oil are any better for us than other saturated fats.
- UK Department of Health – Advises to consume only small amounts of coconut oil
We need to promote good quality science, which is the basis for international and national guidelines with regard to saturated fat. These included reductions in saturated fat (a maximum of 20g and 30g daily for women and men, respectively), inclusion of unsaturated fats, replacement of refined carbohydrates with whole grains, minimising intakes of free sugars and increasing our fruit and vegetable intakes.
Two level tablespoons of coconut oil provides 19g of saturated fat and is therefore not considered a healthy choice for regular consumption. As part of a balanced diet, coconut oil is fine to have in small quantities.
We look forward to seeing the latest extensive review of research undertaken by the Scientific Advisory Committee on Nutrition, due to be published by March this year.
HEADLINE 3: A GOOD NIGHT’S SLEEP HELPS YOU CUT SUGAR
The Telegraph (Sleep yourself slim: how an extra 90 mins in bed can stop sugar cravings), The Times, the Sun and the Daily Mail (How 20 minutes’ extra sleep could help you say no to cake) have reported on the impact sleep could have on sugar intake.
A study involved 42 participants with poor sleeping habits (deemed as having typically between five and seven hours sleep per night), who were encouraged to follow a personalised sleep extension protocol. The body mass index (BMI) of each participant was between 18.5kg/ m2 to less than 30kg/m2. They each kept food diaries.
The four-week randomised control trial involved:
- Group 1 (intervention group): 21 participants received a behavioural consultation session targeting ‘sleep hygiene’ – this involved avoiding screens late at night, keeping work out of the bedroom and reducing caffeine.
- Group 2 (control group): 21 participants maintained habitual short sleep patterns
Over the four weeks, the intervention group extended their time in bed by 55 minutes on average and their sleep duration by 21 minutes compared with the control group.
On average, there was a reported 10g reduction in intake of free sugars compared to the control group. BMI did not change in the four-week period.
Free sugars are all the different types of sugar we have in our diet, excluding the sugars found naturally in intact fruit and vegetables, milk and milk products. 10g of free sugars is equivalent to 2.5 tsp of sugar, 1.5 tsp of honey, 90ml of cola or 110ml of fruit juice.
Behind the headlines: the Nutrilicious dietetic view
Once again, this study was only of a small number of people and for a short period of time. It was not designed in a way to accurately assess dietary intake, so we cannot be confident that improved sleep patterns will cause a reduction in sugar intake. Food diaries rely on the honesty of the patient and are not necessarily accurate.
Is there a link between sleep and body weight?
Some of the news outlets gave the impression that extra sleep will cause weight loss, but this was not found.
However, the NHS does recognise that sleeping less may contribute to weight gain, highlighting previous studies showing that people who sleep less than seven hours per day are 30% more likely to be obese than those who sleep for nine hours or more.
Sleep is important for mental and physical health and evidence for its role in weight loss/obesity is growing. The NHS recommends seven to nine hours a night. Find out more about ways to get a good night’s sleep.
