The UK’s leading health magazine
Summer‘15
5
top embarrassing problems solved
Summer
MID-LIFE WEIGHT GAIN? ...the expert way to shift it
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HOT HEALTH TIPS
ANTIOXIDANTS What you need to know
Meet our experts We aim to provide the most well-researched advice on health and nutrition matters with the help of our experts…
Dr Hilary Jones
qualified as a doctor in 1976. He is now best known as an expert on breakfast television and BBC radio.
On page 10 he looks at ways you can boost your wellbeing this summer
“The sun and heat can cause uncomfortable health problems. The good news is that there are easy solutions.”
Dr Dawn Harper
is a GP specialising in preventative medicine, women’s and family health. She appears regularly on TV and has a number of columns in various magazines.
On page 14 she tackles the taboos surrounding embarrassing health problems “We are undoubtably better
CONTRIBUTORS THIS ISSUE: Dr Sarah Brewer worked as a GP and hospital doctor. She specialises in nutritional medicine and is an award-winning health writer.
Sally Brown is a psychotherapist and health and lifestyle writer, working for national newspapers and magazines.
Eva Gizowska is a health journalist. She writes regularly in women’s magazines and national newspapers.
Robert Hobson is a registered nutritionist, runs two successful nutrition consultancies and has worked for the NHS.
Dr Adam Carey spent 19 years in the NHS. He specialises in nutrition for performance.
than we were about discussing intimate issues, but there is still a long way to go.”
Patsy Westcott is a health journalist. She also has a Master’s degree in Nutritional Medicine.
Dr Roger Henderson
qualified as a doctor in 1985. He is the medical columnist for The Sunday Times and writes regularly for other national newspapers and magazines.
On page 20 he explains the little known condition called Summer SAD “Even doctors are often unaware of its symptoms, which can be frustrating for the estimated 600,000 sufferers.”
The opinions expressed in Lifespan are not necessarily those of the editorial team, but of individual writers. Advice is for information only and should not replace medical care. Always seek medical advice before taking supplements, changing diet or embarking on a new exercise regime.
Angela Dowden is a registered nutritionist. She holds a degree in Food Science and is a regular health writer.
WELCOME
Summer survival guide Summer is here and to help you enjoy every minute of it in the best of health, this issue is packed with plenty of inspiration. The nation’s favourite GP, Dr Hilary Jones, explains how to make the most of your well-earned time off this summer, avoiding common hot weather health niggles along the way (see page 10). And if you’re jetting off anywhere exotic this summer, be sure to check out nutritionist Robert Hobson’s guide to the best things to eat around the world (see page 26) – without piling on unwanted pounds. You may well be intrigued to read Dr Roger Henderson’s article about the little known condition Summer SAD – similar to its winter counterpart – which offers tips and advice on how to recognise and deal with the symptoms of this often undiagnosed condition (see page 20). So why not sit out in the sunshine, relax and enjoy! Wishing you the best of health,
Emily Edwards, Editor
The UK’s leading supplement magazine Editor: Emily Edwards Contributing editor: Jane Garton Magazine design: James Colmer Jim Kelly Production manager: Tom Craik
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Contents S U M M E R 2 0 15
20
28
REGUL ARS 6
In the know News, views, research
9
Letters Your chance to have your say
13
Supplement focus Glucomannan
30
Take 3 ...Ways to stay flexible
31
Ask the experts The answers to your questions on health, diet and supplements
37
Supplement focus Black garlic
WELLBEING 10
Stand up to summer Give your body a helping hand this season
14
Focus on summer SAD Tips to put you in a sunnier mood
28
Menopause weight gain How to lose those excess pounds
NUTRITION 16
Are you drinking enough? Why staying hydrated is so important
22
A is for antioixdants The latest on these healthy compounds
26
Foreign Fare What to eat around the globe
HE AL TH
ON THE COVER
16
Let’s get intimate Beat those embarrassing problems the expert way
20
Sort those memory blips Here’s how to stay sharp and on the ball the easy way
24
Going through the motions Give your bowels the attention they deserve
RE AL LIFE 34
Healthspan Heroes Your stories
38
Me & My Health With Linda Barker
in the Knees up NEWS • VIEWS • RESEARCH Our leading health journalists look behind the headlines
Great news for glucosamine and chondroitin. A study from Australia has found that people with knee osteoarthritis taking a combination of the two compounds had half the joint space narrowing – when the junction between bones in a joint decreases resulting in friction and pain – to those taking a dummy pill. “If sustained,” say researchers, “it would be very meaningful indeed”. Why? The less the joint space is narrowed the less your likelihood of needing a knee replacement.
WHEEZE AWAY The health benefits of omega 3 continue to grow. And the latest research shows it may help in the treatment of asthma and other allergies. The reason? The two key omega 3s DHA and EPA have anti-inflammatory properties. The exact mechanism is unknown, but may involve multiple ‘pathways’ thought to be involved in the allergy process.
HIP FOR HIPS
Pedal power Get on your bike for National Bike Week (June 13th-21st). Cycling helps to strengthen your heart and lungs, tones your calves and thighs and can boost levels of endorphins, your body’s happy hormones. Don’t forget to don your helmet. 6
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You may think of the rosehip as an essential ingredient in jellies and jams, but it could also play an essential role in the health of your joints. Danish trials of rosehip extract for osteoarthritis of the knee and hip showed a reduction in pain after three weeks and a reduction in stiffness and general disability after three months. The secret seems to lie in its anti-inflammatory properties.
NEWS & VIEWS
trip advisor PYCNOGENOL
PROBIOTICS
CRANBERRY
MILK THISTLE
A powerful antioxidant derived from French maritime pine bark, which may help protect against deep vein thrombosis (DVT).
Live organisms that may help protect against traveller’s tum by maintaining the balance of good and bad bacteria in the gut.
Rich in antioxidants, it may help protect against urinary infections by stopping bacteria from sticking to the lining of the bladder.
A herbal remedy that may help alleviate symptoms of holiday over-indulgence and indigestion by supporting the liver.
WHY WE LOVE: Saw Palmetto
SUPPLEMENT IT Ideally, a balanced diet should provide all the vitamins, minerals and other nutrients you need to keep your summer healthy. However, sometimes, especially when you’re on the go, your diet may not be as good as it could be and this is when a high-quality multivitamin and mineral supplement can help to compensate. Look for one that includes a wide range of essential nutrients aimed specifically at your age group.
Eye spy Dark green leafy veg, including kale and spinach, and eggs, are rich sources of the compound, lutein, thought to help reduce the risk of age-related macular degeneration (AMD) and cataracts. But, say Polish researchers, dietary intakes in older men and women don’t always cut the mustard. Their advice is to take a daily supplement to make up for any deficiency.
Planning to jet off to foreign climes? Here’s some supplements to pop in your holdall...
The fruit of saw palmetto (serenoa repens), a small palm with fan-shaped leaves, is best known for its prostate-friendly properties, especially in the case of benign prostatic hypertrophy, which affects many men as they get older. It can also help recovery from prostate surgery and pelvic pain, according to US experts.
up to
25%
that’s by how much you could reduce the risk of developing type 2 diabetes by replacing a squash or other soft drink with plain water or unsweetened tea or coffee.
Skin saver The benefits of vitamin C aren’t just confined to boosting immunity. It is also vital for the formation of collagen, a gluey protein that helps to keep skin firm by supporting and binding its connective tissues. It can also help protect against the potential damage to skin of too much sun. Good sources include citrus fruits, kiwis, strawberries. Alternatively, consider taking a supplement.
“As vitamin C is water soluble and therefore not stored in the body, it is important to take any supplement daily...” Summer 2015
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NEWS & VIEWS
Did you know? Three hours gardening burns the same number of calories as an hour pounding away on the treadmill, plus you get the benefits of all that fresh air and the chance to replenish your levels of vitamin D.
IN SEASON: Broad beans
Make sure you get your fill of broad beans this summer. Why? They’re a great source of protein, vitamin A, calcium, iron, fibre and plant chemicals – all needed by the body for well-being. For a healthy starter try broad bean and yoghurt mint soup, whizz them up into a dip with garlic or simply pop them from the pod and enjoy them raw with a chunk of pecorino.
HEART TO HEART Low levels of CoQ10 in heart muscle cells are linked to cardiovascular problems. And now a large trial from Denmark shows supplementing with CoQ10 really can help improve symptoms as well as help reduce the risk of heart attacks.
Desert flower The Khoisan tribe of the Kalahari Desert has long used devil’s claw for a whole host of ailments from joint and muscle pains to headaches, fever and topically for skin inflammation. And now the tubers of this perennial shrub, that takes its name from the fierce spines covering its fruit, have been shown to contain beneficial chemical compounds. According to research these have antiinflammatory and analgesic properties, making it a potentially useful remedy for a range of rheumatic and arthritic complaints.
Did u yo know?
Devil’s claw tablets can differ in strength and quality so make sure you buy a registered herbal medicine (THR).
One for the boys Men! Taking care of your relationships could be one of the best ways to do your health a favour. That’s a key message of Men’s Health Week (June 15th – 21st), which this year is putting the spotlight on healthy living. Other steps include:
KICKING THE NICOTINE HABIT WATCHING YOUR ALCOHOL INTAKE STAYING ACTIVE KEEPING AN EYE ON THE SCALES TURNING UP FOR YOUR NHS HEALTH CHECK
For more about Men’s Health Week visit: www.menshealthforum.org.uk/mhw 8
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LETTERS
You say... We love hearing your thoughts and views so get writing
Star letter
CRANBERRY CALL
THINK DIFFERENTLY
For the last two years I have been plagued with urinary infections. I was drinking cranberry juice every day but it did not seem to help. One bout needed three lots of antibiotics, which was annoying, as I was on the south coast touring in my campervan. It’s no joke when you are a 68-year old lady travelling alone and having to find doctors in remote areas. However, on my return last year a friend recommended that I try cranberry capsules instead. I started on them straight away and my ‘wee’ problem seems to have been conquered! Long may my trouble-free state continue and am looking forward to a stress-free tour in my little campervan this summer.
Over a year ago I started having debilitating migraines. My doctor referred me to a vascular specialist who had no solutions. My uncle, a retired dentist, said: ‘go see an osteopath, your C1 and C2 neck vertebrae are out of alignment.’ I went and after only one appointment my problems ceased. The vertebrae had been affected when I hurt my shoulder. It shows that sometimes we need to think ‘outside the box.’ Health problems aren’t always caused by ageing!
Carol Williams, Leicester
GLUCOSAMINE BENEFITS
HRT DEBATE I was interested in your article on the perimenopause (Spring 2015). Dr Dawn Harper says under the heading “What About HRT?” that she is sad she no longer sees so many perimenopausal women. The answer to me is obvious. Women are realising that HRT is only a temporary solution. When you stop taking HRT all the symptoms return and you have simply delayed the problem. I speak from experience and the same goes for my older sister, who at 75 is still suffering hot flushes after coming off HRT some time ago. I imagine many women are deciding to use more natural methods of dealing with the menopause. Hilary Hicklin, Wiltshire
I was interested to read about the benefits of glucosamine (Spring 2015). I have taken it for many years and feel privileged to have reached 80 with my own hips, knees and husband! The first two are thanks to glucosamine as I have very few aches and pains. As for my husband he’s had an allotment for 22 years so the outdoor exercise has kept him flexible and the fresh fruits and vegetables have been good for us both. Thanks for a great magazine.
Doris Grimsley, London
Get in touch
Diane McLeay, Perthshire
Reader’s corner Email us your good health tips to the address below and you could win a year’s supply of multivitamins POLLEN RELIEF I used to suffer with really bad hay fever until I tried starflower oil capsules. That was 20 years ago. I have taken one 1,000mg capsule every day since and don’t have any more trouble with pollen.
Yvonne Gilroy, Northumberland
WRITE IT DOWN When trying to lose weight, I find a food diary an invaluable tool. But you need to be really honest and jot down EVERYTHING you eat and drink. I was able to monitor my calories, check my 5-a-day and see which vitamins and minerals I was getting.
Marijke Woolsey, Hove
We love receiving your letters or emails, whether it’s feedback on articles, supplements you’ve tried and tested or your own health tips and advice. Write to us at: You Say, Lifespan Magazine, Healthspan House, The Grange, St Peter Port, Guernsey, GY1 3WU. Or email: yousay@healthspan.co.uk STAR LETTER wins a hamper filled with skincare goodies! Summer 2015
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summer
STAND UP TO
Health niggles can quickly put a damper on the sunniest day, says Dr Hilary Jones. Here’s what to watch out for and best protective tactics
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WELLBEING
H
ot summer days are wonderful if you are relaxing in your swimming costume drinking Pimms by the water’s edge, but not such fun when you are sweating in a suit on a crowded commuter train on your way to work. Either way the sun and the heat can cause significant and uncomfortable health problems - but the good news is there are solutions.
Heat rash When the weather is humid as well as hot, skin can become waterlogged with sweat and red and itchy. This is known as prickly heat. There is another type of allergy to certain wavelengths of ultraviolet light. This is known as polymorphic light eruption (PLE). FIX IT Try to keep skin as cool as possible and covered with loose clothes to ward off the ultraviolet rays. Use a sunscreen with a high UVB factor as well as a five-star UVA rating and reapply frequently. Soaking in a bath to which you have added a palmful of baking soda can help to soothe any itch.
Excess sweating
Otherwise known as hyperhidrosis, excess sweating can be uncomfortable and embarrassing, especially if your palms are dripping when shaking someone’s hand or you find dark stains highlighted where your wet shirt or blouse is clinging to your armpits and back. You don’t have to suffer – there are steps you can take to keep cool. FIX IT Start by wearing loose-fitting, silk or cotton clothes and use a water spray to keep cool. Try using a roll-on deodorant containing a 20 per cent aluminium chloride hexahydrate solution on armpits, hands and feet. It can be very effective. A more unusual suggestion, perhaps, is to get Botox. When it’s injected into the apex of the armpit, it paralyses the tiny nerves, which enable the sweat glands to produce sweat, providing a long-term solution.
Food poisoning
The warmer the weather on buffet and barbecue days, the faster any microbes and the toxins they produce breed inside and on top of the food. As a result nausea and vomiting, tummy pain and diarrhoea can occur within two to 36 hours depending on the type of germ and the number consumed. FIX IT Avoid food contamination by never preparing raw or unwashed ingredients close to pre-cooked foods. Practise stringent hygiene when handling food and always cook it all the way through, especially on the barbie. Eat food piping hot and only reheat it once, if at all. Never eat buffet food that’s been left out in the open for more than one hour or if it’s been exposed to flies. On holiday avoid uncooked food unless you can peel or shell it yourself; food that has been kept warm; shellfish and food that has been exposed to flies and always wash any fruit before eating. If you do get ‘the runs’ or sickness, sip plenty of clear fluids or take rehydrating sachets such as Dioralyte to stay hydrated. Also consider Imodium tablets to prevent serious diarrhoea if you are travelling. Taking probiotics beforehand may be worth a try to offer some protection.
Top Tip
If you are g oing swimming, look for wa ter resistant su n cream. Th ey will still wea r off, but wil l last longer th an typical sun creams. ..
Sunburn
A healthy tan makes us look and feel so much better, but too much sun can cause untold damage to skin and even skin cancer. Staying safe in the sun includes wearing a broad brimmed hat and avoiding exposure between 11 am and 4 pm when the sun’s rays are at their hottest. In addition go for a broad-spectrum sunscreen with at least SPF 30 plus a 4 or 5 star UVA rating. Apply it 15-20 minutes before going out. Reapply every two hours and always after swimming. FIX IT If you do overdo it in the sun you can still treat symptoms. Cool the skin and apply oily calamine with one per cent phenol, which the pharmacist may be able to make up for you. Alternatively, aloe vera gel can help to cool things down. In more serious cases one percent hydrocortisone cream and antihistamines may be needed.
Summer 2015
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summer
STAND UP TO
Insect bites Just like you, wasps, bees,
mosquitoes, red ants, horseflies and hornets are out and about enjoying the warm weather, but unfortunately they do bite. And the poisons contained in their bites or stings may result in pain, redness and swelling. FIX IT Start by making sure to wear longsleeved clothing at dusk and avoid brightly coloured materials, which can attract bugs. Apply a good insect repellent containing DEET and if eating outside burn a citronella candle nearby. If you get bitten, using an antihistamine cream or taking tablets will help. Applying one per cent hydrocortisone cream or an ice cube are also worth a try.
Hives This red, blotchy, itchy skin rash is caused by some form of allergy. Lying on the grass on a warm summer’s day is a common trigger as is contact with nettles. Any garden plant, however, can potentially irritate skin especially on hot days. The reason? Blood flow in the skin is increased and the blood vessels become swollent and more likely to leak irritant chemicals such as histamine. FIX IT Keep your skin covered and take antihistamine in advance if you are vulnerable to prevent reactions occuring. Avoid contact with the things you know you react to and never wear tight restrictive clothing - any physical rubbing of the skin once you have developed hives can make things worse. Athlete’s Foot Those pesky fungi that thrive in a warm, moist, sweaty environment just adore those conditions between your toes during summer. So don’t make life easy for them. FIX IT It is easy enough to get rid of athlete’s foot itself by keeping the skin dry with thorough towelling between the toes after showering and by applying antifungal 12
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powder. Once the fungus has found its way into your toenails, however, it can be hard to get rid of. Use Canestan cream or a similar antifungal, available over-the-counter, for red, flaky itchy skin around and between the toes and on the soles of the feet. Continue using the cream for at least a fortnight after the fungus appears to have visibly cleared it up or it will just come back again. For fungal nail infection you may need antifungal tablets from your doctor which you may have to take for several months. There can also be side-effects which you need to discuss.
Insomnia So you have had a beautiful day in the sun and you’ve been active all day. But now you’re tossing and turning in bed hot, sweaty, tired and unable to sleep. FIX IT Remove the duvet and replace it with a single light cotton sheet. Wet your hair and sprinkle water over the sheet before you climb into bed. These are both very cooling. Use a small electric fan on your bedside table and direct towards your face. Close the curtains tightly with a blackout blind pulled down behind them to keep the room dark. Pop some lavender oil on your pillow and consider taking a single 4mg tablet of Piriton, especially if you also suffer from hayfever to help you get to sleep.
“Whether you’re lighting the barbecue or spending time in the sun, look after your health to make the most of summer... ”
Hot weather tips
Wear sunglasses that block 100 per cent of UVA and UVB rays. Check the CE mark which shows they conform to an agreed European standard. There is also a British standard: BS EN 1836: 1997. Drink plenty of water, especially if you feel hot. Dehydration can trigger headaches or fatigue. Putting a sprig of fresh lavender on your pillow can help you to nod off fast on hot balmy nights. Feet tend to swell in the heat so wear more roomy open shoes. Go slow like the Mediterraneans. Walk slower, think slower and just go with the flow.
Supp lement focus
Glucomannan Looking for a supplement to help you lose weight, relieve constipation or keep a check on cholesterol? This could be it, says Dr Sarah Brewer
The facts
G
lucomannan is a soluble fibre derived from the root of the konjac plant. It’s also known as the elephant yam, as the grown tuber can weigh more than 5kg in weight! Glucomannan fibre has been used for thousands of years as a food and as a traditional medicine.
How does it work?
Glucomannan fibre is not absorbed when eaten, but swells in the intestines on contact with water to resemble wallpaper paste. This bulking-up helps to stimulate bowel movements and also slows or reduces the absorption of cholesterol, dietary fats and glucose from the intestines.
What can it help?
CONSTIPATION: The bulking action of glucomannan fibre is traditionally used as a natural treatment for constipation.
WEIGHT LOSS: By swelling and helping you to feel full, glucomannan reduces hunger and supports weight loss. After reviewing all the evidence, the European Commission has authorised a health claim that konjac
glucomannan, in the context of an energyrestricted diet, contributes to weight loss at a daily intake of 1g per serving, taken three times a day together with one or two glasses of water before a meal.
WHEN TO TAKE Ideally take 15-30 minutes before each meal with a large glass of water. Follow any advice that comes with your product about how much water must be consumed.
CHOLESTEROL CONTROL: As a soluble
PERFECT PARTNERS Conjugated Linoleic Acid (CLA) and Acai Berry Extract.
How much should I take?
ADDED EXTRAS Glucomannan is often combined with green coffee extract for an added caffeine boost, which has been linked to increased weight loss in many studies.
fibre, glucomannan acts like a sponge to bind cholesterol in the gut. This helps to lower cholesterol absorption – both of the cholesterol in your food, and the cholesterol secreted into your intestines from the liver via your bile. The European Commission has also authorised a health claim that glucomannan contributes to the maintenance of normal blood cholesterol levels at a daily dose of 4g.
TYPE 2 DIABETES: Glucomannan may help to regulate glucose absorption and is traditionally recommended to people with type 2 diabetes to help control their blood glucose levels.
Recommended doses vary from 1g to 4g per day.
Watch points
It is important to take glucomannan with plenty of water to ensure it reaches the stomach. Do not take if you have swallowing difficulties, as it could cause choking if it sticks in the oesophagus. If you have diabetes and are on glucose-lowering medication, monitor your blood glucose levels carefully and ensure you know how to change your drug dose. Summer 2015
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BEATING THE SUMMERTIME
blues
Feeling down in the dumps and low in energy? There’s a chance you could be suffering from summer SAD. Dr Roger Henderson looks at the symptoms and solutions.
B
lue skies and sunshine, holidays and long evenings are just some reasons why so many of us enjoy the summer months and it’s not just in the UK either. Across the world, most people say they feel better with the sun on their backs. So why is it that Australia’s Gold Coast and California - two of the world’s sun-drenched playgrounds - are home to the most depressed people in the world? The answer may surprise you summer depression. Although many of us have heard about the ‘winter blues’, or seasonal affective disorder (SAD), very few know of its summer counterpart, summer SAD or ‘reverse seasonal depression’. Even doctors are often unaware of its symptoms, which can be frustrating for the estimated 600,000 or so sufferers in the UK. Many sufferers notice their mood seems to change for the worse when the clocks go forward but can’t work out why. Although less common than its winter counterpart, from which as many as one in four of us may suffer to some degree, summer SAD is no less disabling and in extreme cases can lead to crippling depression and even suicide.
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MOOD FOODS Give yourself a lift with these healthy choices Keep energy up with slow-release wholegrains Stay hydrated with water and herbal teas Eat healthy fats from oily fish Pick proteins to protect your brain
The symptoms So how can you tell if you could be suffering from summer SAD? Symptoms usually start in the early spring, and carry on until the clocks go back in autumn (some sufferers say they can ‘set their clocks by their symptoms’). They include reduced appetite, insomnia, agitation and restlessness as well as an increased sense of heat at night. A general feeling of being miserable for no obvious reason and an inability to enjoy previously pleasurable activities are also common.
The triggers What triggers summer SAD remains unclear but many researchers believe that the increased exposure to sunlight and rising temperature in summer are key causes. Genes may also play a part, as
SA D r e m m Su ple nt of peo
per ce e also About 10 wintertim e h t in D merwith SA the sum in e s r e v re found get it in ies have d u t s e r, m time. So e equato h t r a e n ountries mmon that in c more co is D A S . summer ter SAD than win
more than two thirds of people suffering from summer SAD have a relative with some form of mental illness. Rising temperatures may affect the hypothalamus in the brain - the hormone control centre - which in turn alters our ability to cope with mental stress. Indeed studies have shown that sufferers not only tend to experience a significant temperature rise at night compared
WELLBEING
to non-sufferers, but also that their symptoms disappear when they are wrapped in cooling blankets. As soon as they go back into summer heat, however, their symptoms seem to return. It is no coincidence either that the effects of heat can be similar to those of depression - loss of motivation, more sitting around and a greater tendency to sleep problems - so summer SAD may also simply be an extreme variation of the body’s normal response to heat.
The solutions The treatment for summer SAD is very different to its winter counterpart where artificial light is one of the key treatments. BLACK IT OUT Use blackout curtains or blinds rather than ordinary curtains to help keep light out of the bedroom. FAN IT Open windows at night in the hot weather and get yourself a cooling fan for the bedroom. KEEP IT DARK Try to avoid bright light by wearing sunglasses whenever possible. GO COLD Have frequent cooling showers when the weather is hot. Take ice-cold water bottles or cooling blankets to bed. GET MOVING Exercise regularly as this can help boost the production of endorphins – nature’s ‘feel good hormones’. SEE YOUR GP Ask your GP for a thyroid check - some studies suggest that people with summer SAD have a low thyroid function. The thyroid gland - situated at the Adams’ apple in the throat - regulates the metabolism of every cell in our body making it crucial to wellbeing. LS
SUPPLEMENTARY BENEFITS St. John’s Wort
This well-known and trusted supplement interacts with our endorphins to help improve mood and is clinically effective in treating mild to moderate depression. It is important to consult your doctor before taking it, especially if you are on other medication.
Valerian Many people
with summer SAD have problems sleeping, which can make symptoms worse. Valerian is a traditional herbal remedy, which has been shown to help promote restful sleep and is popular with those who don’t want to opt for sleeping tablets from the GP.
5 occurs naturally in the body and is a precursor to the very important brain messenger, serotonin, which is vital for maintaining a good mood and promoting refreshing sleep. The perfect combination for those who might be suffering with Summer SAD.
-HTP
Summer 2015
Lifespan
15
Let’s get
intimate
Vaginal dryness, erectile dysfunction and loss of libido are more common than you might think. It’s time to get talking about them, says Dr Dawn Harper
M
y working week is divided between clinical practice and media and as you can imagine, there is a lot of overlap. Patients ask about medical headlines and when I do phoneins on radio or TV many of the questions are similar to those that I am asked in the surgery, with one notable exception – anything remotely embarrassing. We are undoubtedly better than we were at discussing intimate issues, but there is still a long way to go and embarrassing problems feature strongly when there is a degree of anonymity. So read on for some common problems, the causes and tips on what to do about them.
Loss of libido
Libido is complicated. It is normal to have days when you are just too exhausted to even think about sex, but if those days become more and more frequent, it can have a negative impact on your relationship. I see women in surgery from time to time who tell me their husband or partner has sent them because there ‘must be something wrong’. If this sounds familiar, ask yourself if you ever masturbate or have sexual thoughts. If the answer is yes, the 16
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MAKE IT EASY ON YOURSELF chances are you are looking at a relationship issue and it is time to start talking. If the answer is no and your lack of libido is at a mismatch with your partner, then you need to see your GP.
Urinary tract infections
Most urinary tract infections can be simply treated with a course of oral antibiotics, but left untreated, the infection can take hold leaving you feeling very unwell. People often try to restrict their fluid intake in an attempt to pass less urine to avoid the burning pain experienced when urinating with an infection. Sadly, this usually exacerbates the problem, as very concentrated urine irritates the bladder lining, so make sure you drink enough to keep your urine straw coloured and take a sample of urine to your GP. A simple dip test is usually all that is required to make the diagnosis. Research studies don’t all agree on this, but some of my patients find cranberry juice helps alleviate the symptoms.
Middle age spread
We have become so politically correct over the years that we rarely hear this phrase today but just because we don’t talk about
Check out minor problems with your pharmacist – most have areas where you can talk about your symptoms in private. If you need to see your GP ask to see a male or female doctor – whichever makes you feel the most comfortable. If you can’t face your GP make an appointment to see your practice nurse. They will be able to advise on whether you need to see the GP and may also be able to diffuse the embarrassment factor. If you really can’t face talking about your symptoms write them down and hand them to your doctor or nurse. Remember whoever your appointment is with they will have seen similar problems many times before – and may even have first hand experience.
HE AL TH
“We find it hard to talk about embarrassing issues...” it, doesn’t mean it isn’t a very real phenomenon. As we reach middle age our metabolism slows down, meaning that for most of us if we do nothing differently in terms of diet and activity level, we are likely to gain weight, which is usually deposited around the midriff. Pound for pound, weight around our middles is linked to a greater risk of developing heart disease and type 2 diabetes, than weight gained on the hips, so should not be ignored. Losing weight in middle age isn’t easy but the health benefits of doing so are worth it - if you
are a woman with a waist greater than 32 inches or a man with a waist greater than 37 inches (36 if you are of south Asian descent) it’s time to think about doing something about it.
Vaginal dryness
If I went out on the street and asked the first 100 people I met to name three symptoms of the menopause, even the men would be able to tell me about hot flushes and mood swings, but few would mention vaginal dryness. It is in fact an extremely common problem around the time of the menopause and is easily treated, so should not be suffered in silence. Vaginal dryness is a common cause of loss of libido as it can mean painful sex, which of course will put women off. Your pharmacist can advise on long acting lubricants and most pharmacies now have consulting rooms where you can discuss things privately. There are also oestrogen creams and pessaries available on prescription. These only act locally so even if you don’t want to consider HRT, it is worth having a chat with your GP. They really will have heard it all before, probably in the same week so don’t let embarrassment stop you.
Erectile dysfunction (ED)
The advent of drugs like Viagra has made it easier to discuss ED but this is one symptom not to be ignored. Every man will have the occasional episode where they are unable to achieve or maintain an erection, but a persistent problem could be a sign of vascular problems elsewhere. So it is important to check your risk factors for cardiovascular disease including body mass index, blood pressure and to have blood tests for diabetes and cholesterol. LS Summer 2015
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17
ARE YOU DRINKING ENOUGH
water?
Water, water, everywhere, but how much do we need to avoid dehydration? Dr Adam Carey takes a look
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Summer 2015
?
NUTRITION
W
ater is essential for life. While we can go without food for weeks, after only a few days without water we would perish. And even going without it for a relatively short period results in poor performance, especially when it comes to sporting activities in the hot weather. By the time an athlete is three per cent dehydrated, which can happen before they even feel thirsty, they will have lost 10 per cent of their strength and eight per cent of their speed. Sports experts are now starting to recognise that it is not only physical performance that suffers from dehydration, but also mental performance. The same can be said for non-athletes too. So what should we be doing to make sure we reach our daily quota?
THE BASICS
Top Tip
production naturally falls A squeeze during the night. Other things We hydrate by of orange o r lemon in yo that may affect the colour drinking but also ur glass can include the B vitamins, which from the foods we add zest to a bland tend to make urine fluorescent eat. Food provides drink of wa ter yellow for a while after taking about a third of the and large amounts of beetroot, water we consume. which can give it a red tinge. Additionally, we generate water from the metabolical processes that burn carbohydrates, THINKING AHEAD protein and fats within our cells. Fluid is lost When you drink is also critical. It is important in urine and faeces, but also when breathing to drink water before and during things like and through the skin, both of which are exercise, studying or working. It is also a affected by the climate and physical activity. good idea to drink around half a litre of Interestingly, drinking relatively small water soon after waking before having amounts of water seems to satisfy our thirst. breakfast. If you have been dehydrated This is fine most of the time, but the sweat most of the day and then decide to loss that can occur during exercise may not correct this during the evening it will be adequately replaced if we rely on our thirst just result in a disturbed night’s response alone. This is why the advice is to sleep and poor function during drink regularly during exercise. the day.
MONITORING LEVELS
So just how much fluid do we need each day to stay hydrated? And when do we need more? In the UK where most of the time the temperature is below 20˚C if we are active, aiming for a total fluid intake of around three litres a day is a good start. When exercising, sweat rate increases and you should aim for about a quarter of a litre for every 20 minutes of activity. It is actually quite easy to tell if you are drinking enough. Your urine should be clear and barely change the colour of the water in the toilet. If it is dark then you are dehydrated. The first pass on the day will be dark, as urine
HYDRATING CHOICES
I am often asked: “what is the ideal drink?” As a general rule the answer is the main drink of the day should be water. There is nothing wrong with the odd cup of tea or coffee, but too much can affect sleep quality. While caffeine is a mild diuretic, as long as you don’t overdo it, you won’t end up passing more water than you take in. The same cannot be said for most alcoholic beverages.
These are actively dehydrating, which is why you feel hung-over after over-indulging. If you are considering prolonged bouts of exercise then it is important to consume some electrolytes (salt) with your water, which is where a sports drink is helpful.
WATER QUALITY
The quality of the water you drink is also important. In recent years there has been a massive growth in bottled water sales, but in the UK the tap water is generally safe to drink and considerably cheaper. There may be concerns about its quality, but the other side of the coin is the significant negative impact to the environment in the production, transport and disposal of plastic bottles, most of which end up in land-fill sites. If you are worried about the quality of your tap water you can buy simple jugs that contain a carbon filter. This can help with any quality concerns while also being kind to the environment.
hydration IN NUMBERS
3
%
1.4L 1/3 9.3%
When an athelete is 3% dehydrated they will have lost 10 per cent of their strength and eight per cent of their speed. What the average person sweats in an hour of exercise. Food provides about a third of the water we consume Only 9.3% of adults drink the recommended 2 litres of water a day LS
Summer 2015
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19
SORT THOSE
Memory
blips
Say good-bye to ‘senior moments’ with Dr Sarah Brewer’s top memory-boosting tips
Y
our memory is a personal storehouse of information including learned facts and emotional events. As you get older, however, it is natural for memory to become less like a filing cabinet and more like a sieve - facts get harder to store and retrieve. That’s because as we age our brain cells die at an increasing rate, and connections between remaining brain cells are pruned away due to lack of use. However, all is not lost, as there is plenty you can do to keep your memory sharp. Following a healthy diet and lifestyle can help reduce hardening and furring up of the arteries supplying blood, oxygen and nutrients to the brain while mentally challenging activities can enhance your internal recall processes.
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EAT WELL The brain loves a wholefood diet with plenty of fresh fruit, vegetables, wholegrain cereals and fish. Making time for breakfast can also help. Eating cereal at breakfast has been found to improve memory in healthy adults, increasing the speed at which new information can be recalled, and improving concentration and mental performance. This is partly because it boosts glucose levels at a crucial time of the day, and partly because fortified breakfast cereals are a good source of vitamin B1, which improves mood and clarity of thought. DRINK WITH CARE Alcohol affects
the release of the brain chemicals, glutamate and GABA. This in turn blocks the brain’s ability to form new memories, especially for facts such as names or phone numbers and events. Alcohol also reduces your ability to
retrieve previously formed memories. Women should stick to 14 units of alcohol a week (no more than three a day) and men 21 units a week (no more than four a day).
STOP SMOKING If you are still smoking, top. Although nicotine can enhance memory in non-smokers, it has the opposite effect in those who do. In fact, just thinking about smoking can impair thought processes, as the urge tends to over-ride other thought processing. And, in the long-term, smoking reduces blood flow to the brain which can increase the risk of developing dementia. KEEP FIT Regular aerobic exercise that’s any activity that gets you slightly sweaty and breathless but not so intense
HE AL TH
SUPPLEMENTARY
benefits
B group vitamins are important for healthy
thought processes and memory. A growing body of evidence suggests that good intakes of B vitamins, especially B6, B12 and folic acid may decrease the risk of dementia.
Phosphatidylserine appears to act as
a memory and thought enhancer. It may also improve cognitive functions in older people, including learning, recall, recognition and Ginkgo biloba concentration. leaf extracts improve blood flow may ones Isoflav to the brain and may help as oestrogen is improve memory, important for brain concentration and function and they though processes have been shown in some people. in to help memory older women.
that you can’t chat to a friend – boosts blood flow to the brain helping the area associated with memory, the hippocampus, to flourish. It also improves the consolidation of information into long-term memories. Good options include brisk walking, jogging or running, swimming and dancing. You should aim for at last 30 minutes of activity most days of the week and choose something you enjoy. That way you are more likely to stick with it. It can also help to exercise with a friend or a colleague to keep you motivated.
CHALLENGE IT The best memoryenhancing activities are those that take you out of your comfort zone, challenging you to use and develop new brain pathways. They can be anything as long as they are challenging and enjoyable.
Examples include learning a foreign language, doing the cryptic crossword, or learning to play a new instrument or sport.
SLEEP WELL Make sure you get
sufficient sleep. Some types of spatial memory are only laid down if learning is followed by a period of sleep. And scientific research now shows that as well as consolidating information, the brain is also organising memories and picking out the most salient information during those quiet night-time hours.
TRY ‘CHUNKING’
Dividing information into mind-sized chunks of no more than seven items can make your short-term memory more efficient. If you have a long list of
facts to remember, divide them into related groups just as you would divide your shopping list into fruit, vegetables, meat, fish, dairy, drinks and household items. Relate facts to each other. This technique grafts new pieces of information onto those you already know. For example, you might remember that the dose for one supplement is twice that of another one you take.
MAKE SENSE Remembering a complex sequence of instructions, such as how to programme the digital TV recorder, is much easier when you understand, or can visualise, what each step is designed to achieve. Around 20 minutes is the optimum time for initially learning new facts. Spend a few minutes revising them on consecutive days. You will forget more slowly, and remember for longer, after each revision. LS Summer 2015
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A
IS FOR ANTIOXIDANTS
Want to grow old heathily? Antioxidants could be the answer. Angela Dowden looks at their benefts and best ways to ensure you get your quota.
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A
ntioxidants have produced a rollercoaster ride of research findings that have sometimes left experts scratching their heads. While antioxidants are a complex bunch, there’s no arguing that a diet rich in them is one of the best nutritional strategies for healthy ageing. Read on for some commonly asked questions...
NUTRITION
What is oxidation?
We’ve all witnessed oxidation - when metal rusts, or the cut surface of an apple turns brown. Oxidation also happens every minute of every day in our cells when they combine oxygen with food to unlock energy. Unfortunately, an inevitable consequence of oxidation is the generation of very reactive chemicals known as free radicals.
What are free radicals?
As well as being made in our cells, free radicals are in the food we eat, the air we breathe and are produced by the action of sunlight on our skin and eyes. Free radicals have a chemical instability that drives them to react with substances around them. This can sometimes be a useful function, but can also wreak damage if they get out of control. For example, free radical damage can change the instructions coded in a strand of DNA, make a circulating LDL (bad cholesterol) molecule more likely to get trapped in an artery wall, or alter a cell’s membrane, changing the flow of what enters the cell and what leaves it. The bottom line? Free radicals are capable of damaging cells and genetic material, contributing to the chronic
Did you know?
diseases of ageing, from cancer and heart disease to Alzheimer’s disease and vision loss, as well as levels decreasing with age.
It is the colo ured pigmen ts in fruit and ve g that hold their antioxid ant content
How do antioxidants help?
Fortunately, antioxidants can provide an effective defence against this relentless free radical attack. Numbering in the hundreds and probably thousands, these vital substances do their bit by stabilising free radicals without becoming chemically unstable themselves. Some can be made by the body and others must be provided by food, with each having unique chemical behaviours and biological properties. Antioxidants also interact with each other in an elaborate network that we don’t yet fully understand. Most familiar are the old stalwarts - vitamins C, E, and beta carotene, along with the minerals selenium and manganese. But their ranks are swelled by the likes of co-enzyme Q10, lipoic acid, flavonoids, phenols, polyphenols, phytoestrogens, plus many more.
Some foods stand out as a particularly excellent source of one specific antioxidant – Brazil nuts as a source of selenium, curly kale as a source of lutein and carrots as a source of beta carotene, for example. So if these are foods you don’t eat or like, a daily supplement that contains a modest dose of key antioxidants could be a good idea to help boost your intake. Generally, however, the best and most reliable way to expand the variety you are getting is to keep tucking into those fruit and vegetables. Better still, shop a rainbow in the produce aisle in your local supermarket, as generally speaking the more colourful a spectrum you eat, the more powerful a protective panoply you’ll get. So it is not just a case of eating your greens, but also your purples, reds, whites and yellow/oranges!
Where do antioxidants come from?
The best sources of antioxidants are unprocessed plant foods, including whole grains, nuts, seeds, fruit and vegetables, herbs, spices and pulses. But they can crop up in animal foods like fish and lean red meats too. So it really pays to make your diet as varied as possible, while at the same time making sure it contains a minimum of five portions of fruit and vegetables a day.
FOCUS ON COQ10 Co-enzyme Q10 deserves a special mention as we produce lower amounts as we get older. WHY SPECIAL? As well as CoQ10
levels decreasing with age, statins can also deplete levels. These factors mean there’s a case for supplementation with CoQ10 once you reach 50, especially as, in addition to its antioxidant role, it plays a vital part in energy production and may help keep heart muscle healthy too.
WHAT TYPE? If you’re taking a CoQ10 supplement, the more useable form is actually a processed form of ubiquinone called ubiquinol. By taking pre-formed ubiquinol, you get round the issue of the body needing to do the conversion itself, which again happens less efficiently as we age.
WHAT DOSE? About 60mg a day is probably the optimum dose from middle age onwards, with lower levels (30mg) being fine for younger people (vegetarians may choose to supplement as their diets contain less). However, up to 100-200mg can be used if you are experiencing particular health problems.
Summer 2015
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23
GOING THROUGH THE
motions Healthy bowels are important for overall wellbeing. Dr Sarah Brewer looks at what you can do to keep yours working well
W
hen your bowels are working properly, it’s easy to take them for granted, but if they start to play up, bowel function – or lack of it - has a major impact on your quality of life. Some of us are tempted to ignore our bowels but as the nature and consistency of our motions indicates how rapidly food passes through the gut, they can reveal a lot about our digestive health. Read on for all you need to know about your bowels.
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THE STOOL SCALE
A team of gastroenterologists from Bristol devised a stool classification scale in 1997, which defines seven different types of bowel motion. (See right). The most recent guidelines for bowel health are based on new understandings of how the gut works, and responds to stress and alterations in bacterial balance. This means doctors are now able to diagnose some bowel problems according to their symptoms, without having to refer patients for invasive tests. Bowel problems
are not something you should diagnose yourself, however, as an examination is important to rule out more serious bowel disorders. Always seek medical advice if you notice a change in bowel habit, recurrent abdominal pain, or see blood or slime in your motions.
THE ROLE OF PROBIOTICS
What you may not realise is that your bowels contain around 11 trillion bacteria – more than the total number of human cells
HE AL TH
The
in your body. Together, these bacteria weigh around 1.5kg and play an important role in intestinal health. They ferment fibre and bulk up the stools to make going to the loo easier. In fact, every 1g in dietary fibre you consume increases the weight of your motions by around 5g – mostly due to increased weight of bacteria. Ideally, at least 70 per cent of bowel bacteria should be ‘probiotic’ which, by definition, provide definable health benefits. Only 30 per cent should be other types of bacteria, such as E.coli, which tend to produce gas and in some circumstances harmful toxins. Probiotic bacteria, such as Lactobacilli and Bifidobacter, secrete beneficial substances which discourage less acid tolerant bacteria, which are anti-inflammatory, and act as natural antibiotics.
BRISTOL STOOL
KEEPING A BALANCE
Because our bowel empties regularly, probiotic bacteria are lost from the body along with their less friendly relatives. If you are stressed, eating badly or taking antibiotics, however, the number of probiotic bacteria dwindles, which can lead to an imbalance known as dysbiosis. Lack of probiotic bacteria increases the risk of a number of digestive problems, including abnormal fermentation, bloating, diarrhoea, constipation and spasmodic pain – symptoms compatible with irritable bowel syndrome. To maintain a healthy balance of probiotic bacteria in your intestines, aim to replenish them regularly – ideally on a daily basis – in the form of a probiotic supplement. Prebiotics, often in the form of inulin, also help to promote the growth and survival of probiotic bacteria by providing them with a food source that they can ferment.
Scale
i
TYPE 1
Separate hard lumps, like nuts
TYPE 2
Sausage shaped but lumpy
TYPE 3
Like a sausage or snake but with cracks on the surface
TYPE 4
Like a sausage or snake, smooth and soft
TYPE 5
Soft blobs with clear cut edges
TYPE 6
Fluffy pieces with ragged edges, a mushy stool
TYPE 7
Watery, no solid pieces
COOLING HELP
Peppermint, a traditional remedy for indigestion and bowel spasm, is among the most effective treatments for treating symptoms of irritable bowel syndrome such as abdominal cramps. A meta-analysis exploring the effectiveness of fibre, antispasmodics and peppermint oil found that peppermint oil was the most effective therapy of the three for irritable bowel syndrome.
FIRST LINE OF DEFENCE
Our gut is an important first line of defence against infection, and contains one of the largest concentrations of immune cells. The gut-associated lymphoid tissue continually samples bowel contents and helps to prime our immune system against any infections, while also promoting tolerance to normal food components. Your probiotic bacteria play an important role in this process, helping to boost our immunity and also protecting against common atopic conditions such as eczema and asthma.
FANTASTIC FIBRE
Many of us don’t eat the recommended minimum of 18g fibre per day, and a fibre supplement can help to maintain bowel regularity. Psyllium seed and husks is a highly effective, natural and gentle fibre source. Its effectiveness is due to its mucilage content, which swells to between 8 and 14 times its original volume when mixed with water. In the intestines, psyllium forms a laxative bulk that acts rather like a sponge, gently scrubbing the bowel clean as well as absorbing toxins and excess fats. It is particularly helpful for people who cannot tolerate other forms of fibre such as bran. Always consume with plenty of water.
AND FINALLY...
Don’t take your bowels for granted. Spend a bit more time gazing at what you produce, eat more fibre (fruit, veg, wholegrains). If necessary, introduce a fibre supplement and consume probiotic products regularly. If you do develop persistent symptoms don’t be embarrassed to seek medical advice.
What’s your type? TYPES 1 & 2 are abnormally hard (ie constipation) and result from a slow bowel transit time. TYPES 3 & 4 are described as “perfectly normal bowel motions.” TYPES 5 is poorly formed, soft and verging on abnormal. TYPES 6 & 7 are abnormally loose (ie diarrhoea). TYPES 1, 6 & 7 are considered abnormal and suggest a current bowel problem or increased risk of developing one in the future.
Summer 2015
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Foreign fare Jetting off to somewhere nice this summer? Nutritionist Rob Hobson shows you how to make the most of healthy eating while you’re abroad
W
ith summer holidays just around the corner many of us are thinking about how to lose that bit of winter insulation. By the time we arrive at our holiday destination most of us simply want to relax while eating and drinking to our hearts content without having to think too much about healthy living. Most of us gain a couple of pounds on holiday, but eating healthily on holiday doesn’t have to mean denying yourself your favourite dishes – the secret is to make careful food choices and to watch how you eat. Research released by Google last December revealed the top ten most searched for holiday destinations from the UK. Here are some of the contries and how to eat healthily when visiting them...
USA
American food is hugely diverse and comes in notoriously large portions. However, requesting how you would like your food to be served is more commonplace. You can opt for sauces on the side, grilled meats, bun-less burgers, salad instead of chips and share desserts. 26
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Mexico
Mexican food is full of flavour such as smoky chipotle, but the downside is that it can often involve a lot of fried foods and fatty cheese. Opt for fresh salsas, simple grilled meats, ceviche, grilled corn and a little guacamole, which is tasty and packed with healthy fats, folate and vitamin E.
NUTRITION
Foods around the world
WISE UP TO SAVVY EATING
Choosing to eat healthily on holiday is one thing but the foods available can affect your options. Some countries are renowned for the health benefits their foods have to offer. The Mediterranean, for example, is highly acclaimed for its healthy diet, which is attributed to lots of plant-based foods and ones rich in healthy fats.
Be realistic Put weight loss
The Japanese diet is also well known for its superior health benefits and includes an abundance of fish, sea vegetables, fermented foods and soy (the staple of many health foodies). The benefits of the Japanese diet are also clearly evident on the island of Okinawa, which has the highest proportion of centenarians in the world.
goals aside for your holiday. Aim to maintain your current weight instead - holidays are to be enjoyed.
Research it Check out the best places to eat that offer a good choice of healthy foods. Indulge yourself Pick one meal a day for treats and eat light at the rest – all-inclusive buffets often offer a good selection of foods to choose. Go local If self-catering make the
most of the interesting fresh local produce opting for grilled meat or fish with big fresh salads.
Watch the booze Think less like Derek Trotter (there are over 400 calories in a pina colada!) and mixing spirits with diet sodas or opting for refreshing spritzers. Snack carefully Savory snacks are all too temping after a few glasses of wine so try a small healthy snack before you go out or opt for veggies or a handful of olives rather than crisps and nuts.
Iceland
This country has some unusual foods including cured shark, which is definitely an acquired taste. Iceland does, however, serve up some of the freshest fish and a traditional food known as Skyr, a local product similar to yoghurt (made from milk curds) and currently a strong contender for this year’s ‘superfood’ crown.
France
French food is renowned for being rich and often calorific. France is also famous for its cheese and fantastic breads and croissants from its boulangeries. Eat like the French, opting for a little of what you fancy and try moules marinière (with wine not cream), onion soup and of course the odd glass of polyphenolrich red wine.
Greece
The Greek diet consists of plenty of bread and pulses along with lots of fruit and vegetables. Make the most of Mediterranean ingredients such as olives, olive oil, tomatoes, yoghurt (tzatziki), vine leaves, squid, aubergines and figs. Try to avoid local dishes made with phyllo dough such as baklava.
Croatia
Traditional foods are simple and often involve slow cooking such as a preparation method known as Ispod Peke. Meats are also traditionally cooked on a spit, which can be healthy when served simply with a salad. Ajvar is a healthy spicy red pepper sauce that can be served with grilled meat or fish. Summer 2015
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HE AL TH
Weighing up the
menopause For many women, the menopause also comes with a side-order of unwanted extra pounds. Try these smart strategies to avoid weight gain...
A
ccording to the International Menopause Society (IMS), women in mid-life typically gain an average of 0.5kg (about 1lb) a year in weight. This tendency to gain weight is a natural part of ageing, rather than the menopause itself. However, the drop in oestrogen levels has the unfortunate effect of redistributing body fat, so excess pounds tend to settle round the waist. Worse still, developing an ‘apple shape’ as we age can increase health risks. Fat in the abdomen and around the internal organs (visceral fat) is linked to serious illnesses, from heart disease and type 2 diabetes to some cancers. But it’s not all bad news gaining weight at menopause isn’t inevitable. By making some easy changes to your diet and lifestyle, you can manage your weight and boost your fitness and energy levels: all helping you sail through this time of hormonal transition.
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1 Focus on filling foods
Changing your energy balance, so you’re taking in fewer calories from food than you expend, is key to losing weight, but that needn’t mean weighing and measuring every mouthful. Nutritionist Hannah Bailey from Wise Choice Nutrition (wisechoicenutrition.co.uk), recommends basing meals on lean proteins, such as lean meat, chicken, fish or oily fish (salmon or mackerel), with plenty of vegetables. “Protein-rich foods are filling, and you can pile your plate with green vegetables without worrying about calorie counts,” she says. And carbs have a place on your plate, too: “We need complex carbs like rice and pasta to provide energy, boost bowel function and help us feel full,” advises Janine Fahri, a BANT-registered nutritional therapist. “Portion size also matters - aim for a tennis ball-sized serving”.
2 Keep your
metabolism motoring
“Our metabolism tends to slow down as we age, so eating smaller, more frequent meals will help to keep it ticking over,” says Hannah. “Spreading three meals a day into five reduces the need to snack and also helps balance blood sugar,” says Janine. “Start with breakfast and eat every three to four hours, including protein and carbohydrate at each meal to even out blood sugar spikes”.
“Alcohol is just liquid calories”
3 Don’t drink
your calories
We all know that too much alcohol is bad for health, but it can sabotage weight loss plans too. “Alcohol is just liquid calories; it’s dehydrating and interrupts sleep, which only makes typical menopause symptoms worse,” Janine explains. Drinking fruit juice is also not such a good idea. It’s high in sugar and low in fibre. “Limiting sugar is good for your weight, health and managing menopausal symptoms,” adds Hannah Bailey. Giving up sugar in tea and coffee, and avoiding full-sugar fizzy drinks, is an easy way to cut calories without missing out on nutrients.
4 Get the activity habit
Exercise is your best friend when you are going through menopause, says specialist personal trainer Rosemary Mallace of Over Fifty Fitness (overfiftyfitness.co.uk). “As we age we lose muscle mass, and muscle burns more calories than fat, so building muscle will help use more calories”. As well as maximising changes you make to your diet, exercise has a host of other benefits, from helping to reduce visceral fat and build bone density, to lowering cholesterol and blood pressure, as well as improving sleep and boosting mood. “Research has shown that just walking 6,000 steps a day can be beneficial to health, even without weight loss. Investing in a pedometer is a fun way to track and build up your steps each day,” says Rosemary. Walking is great all-round exercise that most of us can do, but exercises that build your strength and balance are important too.
“A good quality multivitamin can be beneficial” 6 Optimise your diet
While a healthy diet is always the priority, menopause is a time when you feel you might benefit from some extra nutritional support. “Around the menopause, a good-quality multivitamin and fish oil can be beneficial, and probiotics can help regulate the digestive function and repopulate gut flora,” says Janine. Hannah advises that women should consider flaxseed oil, a rich source of omega 3 fatty acids and evening primrose oil, which contains beneficial fatty acid GLA.
5 Stand up
As well as being active every day, research is showing that reducing the time we spend sitting down is vital for health. Standing up burns 50 calories per hour more than sitting, according to the Get Britain Standing campaign, so it’s worth taking every chance you can to stand instead of sit. “You can help keep muscles strong and joints mobile with ‘anytime, anywhere’ exercises,” Rosemary says. “For example, stand on one leg while waiting for the kettle to boil, or circle your ankles while watching TV”.
7 Change your snack strategy
“Many women experience weight gain because of a snacking habit, such as eating biscuits while watching TV,” says Hannah. “Lots of us crave sweet foods, but it’s possible to retrain your brain: swap biscuits for fruit, or a bar of milk chocolate for a couple of squares of quality dark chocolate”. Activity is also a great way to beat a snack attack. “If you’re exercising, you can’t eat!” says Rosemary Mallace. “And physical activity makes you feel good about yourself, so you’re less likely to comfort-eat” LS
MORE INFO? For more information about how to stay healthy during the menopause, visit: www.healthspan.co.uk/ menopause-advice
Summer 2015
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3
take
1
...ways to stay
flexible
Joints can stiffen up with age. Here’s how to keep them moving
THE EXERCISE
‘If you have joint problems you may think moving about will make things worse, but in fact exercise can ease stiffness, relieve pain, increase movement and improve stability by strengthening muscles, as well as improving overall fitness and mood,’ says GP Dr Tom Margham from Arthritis Research UK. Opt for a mixture of joint-friendly aerobic activities - think swimming, aquaerobics, walking, low impact dance, tai chi and cycling - resistance work (lifting weights or using weights machines at the gym) plus stretching in the form of yoga or Pilates. For more ideas visit www.arthritisresearchuk.org.
THE FOODS
‘Good nutrition is essential to keep joints flexible and strong,’ says dietitian Helen Bond. ‘Include plenty of fruit and veg. They are full of vitamins and minerals as well as being low in calories to help maintain a healthy weight and ease strain on joints.’ Berries in particular are full of antioxidants that may help reduce joint inflammation and pain. Oily fish - think herring, mackerel and sardines contain essential omega 3 fatty acids, to fight inflammation, joint pain and stiffness. Flaxseeds and oil, rapeseed oil, chia seeds and walnuts can all help top up those omega 3 stores too. Pecans, walnuts and hazelnuts are high in antioxidants and copper, to help support connective tissue.
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THE SUPPLEMENTS
2
‘The best supplements to help you stay flexible are omega 3 fish oils, which reduce inflammation and ‘oil’ your joints from the inside,’ says Dr Sarah Brewer. ‘Krill oil supplies additional antioxidants for extra benefit,’ she adds. Studies show that glucosamine and chondroitin taken together (glucosamine hydrochloride 1500mg daily plus chondroitin sulphate 1200mg daily) can more than halve symptoms of pain, stiffness, swelling and joint effusions in knee osteoarthritis after six months treatment. Devil’s claw extracts can also significantly improve osteoarthritis and general rheumatic pain and stiffness as well as being good for back pain.
Q&As
ask
THE EXPERTS From lowering blood pressure to kicking the clutter, our experts are here to help
THE GP:
THE NUTRIONIST:
THE PSYCHOTHERAPIST:
Dr Sarah Brewer has worked as a GP and hospital doctor. She now specialises in nutritional medicine and is an award winning writer.
Rob Hobson is a registered nutritionist, runs two successful nutrition consultancies and has worked for the NHS.
Sally Brown is a psychotherapist and health and lifestyle writer, working for national newspapers and magazines.
LOWERING BLOOD PRESSURE
Q
Since being diagnosed with high blood pressure I have improved my diet by including more fruit and vegetables and reducing my intake of salt and saturated fats. Is there anything else I can do?
DR SARAH BREWER: In addition to the sensible steps you´ve taken, there are a number of nutrients that may help. Eating more garlic or taking a garlic supplement can help lower blood pressure, as can omega 3 from oily fish or a supplement. Co-enzyme Q10 is also worth a try. If you’re already
HAYFEVER ALERT
Q
I get terrible hayfever. I take antihistamines but they only slightly alleviate my symptoms. Is there anything I can include in my diet?
taking medication, check with your doctor that it’s safe for you to increase your intake of specific nutrients, as some can interact with medication or increase the effects. For example, omega 3 and garlic can both thin the blood so caution is needed if you are already taking a blood-thinning drug.
ROB HOBSON: The key to controlling hayfever is to start treatments a month or so before symptoms are likely to occur to give the body a chance to be prepared. Foods like apples, onions, and tea, contain quercetin, a natural antihistamine. Vitamin C is also one, so eat plenty of fruit and taking a vitamin C supplement is worth considering. Pycnogenol is anti-inflammatory and helps to calm hay fever symptoms, as does magnesium that´s found in leafy green vegetables, nuts, meat and supplements.
Try this...
The science is mixed, but some people swear by eating a spo onful of loca lly made honey each day...
KICK THE CLUTTER
Q
My house is so filled with clutter and it’s really starting to affect my wellbeing. Are there any tips you can give me to make me feel better about my home?
SALLY BROWN: By tackling it and getting organised, you can lower your cortisol levels and enjoy spending time in your home. Recent research shows that you don’t have to sort out a large space to benefit psychologically. Clearing just one shelf or drawer is thought to be enough to lift mood.
Your clutter didn’t arrive overnight. Expecting to clear several months, years or even decades’ worth in one weekend is setting yourself up for disappointment. Start with one table top, shelf or drawer in one room. Avoid overwhelming yourself and you’ll find it much easier to make progress.
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Q&As
ask
THE EXPERTS continued...
NUTRIENT CHECK
Q
I have never been a huge fan of fruit and veg and don’t seem to be able to find the time to prepare it for meals. I take a comprehensive vitamin and mineral supplement to try to bolster my diet, but is there anything else that might improve my nutrient intake?
ROB HOBSON: As a nutritionist it would be wrong of me to say that there is an easy alternative to eating plenty of fruit and vegetables because there is not. There is no way that you can fully replace the lost nutrients in a diet devoid of them. So, I urge you to try and increase your intake. Try introducing a daily tumbler-full of pressed fruit or fruit and veg juice. If you are trying but still not managing your five-a-day then look for a supplement containing fruit and veg extracts. A good product will have a high ORAC value, which is a measure of its ability to neutralise free radicals.
HELP FOR MENOPAUSAL SYMPTOMS
Q
I have been suffering menopausal symptoms such as hot flushes for around six months and my hair and nails have become dry and brittle. Are there any supplements that might help, as I don’t want to go down the HRT route?
DR SARAH BREWER: Sage is a mild
BOOSTING MOOD
Q
I have found my mood has dipped in the past few months. I’m looking for ways to give myself a boost.
SALLY BROWN: Regular moderate exercise is a proven mood-booster as it boosts levels of endorphins – the body’s own fell good hormones. It doesn’t matter what exercise, the important thing is to do something you enjoy. Just going for a walk for 20 minutes outdoors can make a big difference. A regular intake throughout the day of carbohydrates found in foods, such as porridge, granola and other cereals, pasta, rice and potatoes, increases the production of the happy chemical, serotonin, in the brain. 32
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phyto-oestrogen (plant oestrogen) and can help to overcome hot flushes. Soy isoflavones are also phyto-oestrogens and research has shown these may help to lessen hot flushes. Supplementing with MSM may help to improve the quality of hair and nails. It´s important at this stage in life to ensure you get enough calcium and vitamin D to help maintain bone strength. Also, after the menopause, a woman´s risk of heart disease becomes similar to that of a man’s so eat a low-fat diet, and consider garlic and omega 3 essential fatty acid supplements to help protect the heart and circulation.
Write in
Do you have a question to ask one of our panel? Simply email us at asktheexperts@healthspan.co.uk
We regret that no personal correspondence is possible but your question may be featured in a future issue. The information provided is for general information only and should not be treated as a substitute for the medical advice of your own doctor or other health care professional. Always seek medical advice before taking supplements, changing diet, or embarking on a new exercise regime, particularly if you have a medical condition or are already taking medication. LS
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r e m to s u c n a p s h lt a e H the best of health – joy en to u yo nt wa t jus n’t do We od health to good use… go at th t pu u yo lp he to nt wa we
H
ealthspan Heroes represents a charitable fund that is available to all our readers, enabling them to take part in fundraising events that they may otherwise have not been able to enter.
Whether you’re putting off entering that 5K run, have always wanted to do a charity skydive or are planning an epic trans-Siberian bicycle ride, we would love to hear about how we can help remove the barriers to get you to the start line.
Heroes round up...
34
SARAH is taking part in Cycle Africa 2015 to help raise £3,000 for Women V Cancer, Jo’s Cervical Cancer Trust and Ovarian Cancer Action. Sarah has seen the effects of cancer after her friend was sadly diagnosed with breast cancer and also experienced her mother-in-law’s battle to overcome breast cancer.
SUSAN is taking on a physically demanding double ironman triathlon (4.8 mile swim, 232 mile bike ride, 52 mile run) for the Cure Rett charity. Susan’s niece Emily, aged 7, has Rett Syndrome – a currently incurable condition. Susan is hoping to raise £1,000 to help aid research into a cure.
ANGELA is running the London Marathon to help raise money for the NSPCC. Angela told us that she regards the event as the best amateur event in the world and is training hard to complete the 26-mile run.
JILL has decided to pull on her walking boots and trek the plains of Tanzania later this year. She is motivated to complete this after being diagnosed with cancer last year and plans to raise money for Jersey Hospice Care.
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Summer 2015
MARY is flying stateside to participate in a Grand Canyon trek to raise £2,000 for the Medical Detection Dog charity. Mary has been involved with this charity for five years and has seen first-hand the positive difference it has already made on people’s lives.
“We wish all of our
Healthspan Heroes good luck with their training and we will keep you updated with them all and their challenges.”
RE AL LIFE
“Open water swimming is hard! ”
“Anything we can do to help generate funding can only be a good thing... ”
A NEW CHALLENGE Regular readers of Lifespan may remember Professor Paul Townsend for the amazing work he has been doing in the field of cancer research and precision medicine. He recently got in touch to report that £18 million pounds have been awarded to the University of Manchester, to extend these studies – with a little help from Healthspan customers. “This allows us to extend our research beyond cancer to other chronic diseases, such as diabetes and obesity, as these all share a common cause in metabolic and inflammatory imbalance.” Professor Townsend said. Not content to sit back and relax, Professor Townsend has now set himself a personal challenge: to take part in a triathlon with a team of scientists to raise money for leukaemia and lymphoma research. Every year, this group like to get involved in fundraising. “We are a mixed bag of competitors,” says Professor Townsend, who will be take part alongside Professor Mark Cragg from the University of Southampton. “Anything we can do to help generate funding and donations can only be a good thing.” THE EVENT The Blenheim Triathlon consists of a 750m swim, 20k bike ride and a 5.7k run. As part of the team, Paul will be completing a 400m swim, a 13.2km bike ride and a 3.1km run. Paul has had heart surgery recently, and so completing the triathlon will
Raising funds If you’d like to inspire the team to victory (no time limits completion is the goal this time), simply visit: http://uk.virginmoneygiving. com/team/Magnificienttri
be a real achievement. “Training has been interesting,” says Paul. “I’ve had no swimming coaching and keep floating sideways - not useful in a triathlon! Open water swimming in a wet suit is hard.” THE CHARITY Leukaemia & Lymphoma Research (LLR) is the only UK charity solely dedicated to research into blood cancers, including leukaemia, lymphoma and myeloma. They rely entirely on voluntary support to raise funds, as they receive no government funding. Established 50 years ago, they have built up a unique expertise in blood cancer research. This means that they invest in only the best UK research to bring us closer to a cure for all blood cancers. So we hope you agree it’s a worthwhile cause.”
LS
Want to be a hero? For all the latest news about the Healthspan Heroes scheme, all our award winners and to apply online, please visit:
www.healthspan.co.uk/customer-heroes The next round of applications will end on 31st August 2015. You can apply for up to £500 to help you cover the costs of taking part in an active event for charity. Full details can be found on the link above, as well as a link to an online application form and downloadable version to print and complete.
Summer 2015
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Supp lement focus
Black Garlic Few herbs offer the tried-and-trusted benefits of garlic. Dr Sarah Brewer discovers that exotic black garlic delivers too CHOLESTEROL: Black garlic extracts have
The facts
B
lack garlic is produced by naturally fermenting ordinary white garlic under carefully controlled conditions of high temperature and humidity. This converts unstable ‘smelly’ sulphurcontaining compounds into stable, odourless substances and also produces a dark pigment. Black garlic is highly prized by gourmands due to its soft, savoury-sweet flavour with molasses, balsamic and garlic undertones.
How does it work?
Research suggests that aged black garlic has stronger antioxidant activity than non-fermented garlic. Its growing popularity as a food supplement comes from a combination of this higher antioxidant potential and a significantly reduced garlic odour.
What can it help?
DIABETES: Raised glucose levels are linked with the production of free radicals that play a key role in the development of diabetes complications. As well has having a powerful antioxidant action, black garlic has also been shown to reduce glucose levels, which may make it beneficial for people with diabetes. If you have diabetes, always monitor glucose levels closely when making any dietary or lifestyle changes.
AVAILABLE FORMS: Tablets and capsules or in its whole form for use in cooking.
WATCH POINT: Avoid if you are allergic to members of the onion family. See your GP if you have a medical condition or take medication.
PERFECT PARTNER: Often taken alongside plant sterols to lower cholesterol.
been shown to lower total cholesterol and triglyceride levels, making them a useful addition to a cholesterol-lowering diet.
OBESITY: Black garlic extracts have been shown to inhibit fat accumulation in fat cells, and may play a supportive role in weight loss. It may also reduce fat accumulation in liver cells. IMMUNITY: In the laboratory, black garlic extracts increase the activity of immune cells, including macrophages and natural killer cells. This helps to boost immune defences by targeting abnormal body cells and those infected with a virus.
ALLERGIES: Anecdotal evidence from people with allergies suggests that black garlic extracts may reduce symptoms of rhinitis and watering eyes. This effect may be related to reduced activity of the B lymphocytes, which produce IgE antibodies linked with allergic reactions.
How much should I take?
A typical dose is 200mg concentrated extract, equivalent to 2g whole garlic. LS
Did you know?
Garlic is kno wn as Russia n penicillin aft er the Russia n government used it to tre a t soldiers duri ng World Wa r II after they ran out of antibiotic s.
Summer 2015
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RE AL LIFE
ME & MY HEALTH
LINDA BARKER
Linda Barker shares her health secrets with Eva Gizowska
Linda Barker, 53, is an interior designer and television presenter. She has worked as a designer on the BBC series Changing Rooms as well as appearing in the ITV1 show I’m A Celebrity... in 2002. Linda has also made a yoga DVD. She is currently on the design team of the ITV daytime series 60-Minute Makeover. She is married and lives in South London.
Do you exercise? Exercise has always been part of my life. I grew up liking sport and always try to make time for it. Do you sleep well? I do at the moment, but there have been moments in my life where I haven’t slept as well. When I was coming up to menopause, for example, my sleep wasn’t so good. Do you follow a healthy diet? I naturally crave healthy foods. For supper I might make something like a broccoli and spinach flan with lots of roasted vegetables. I’m also really into green juices for breakfast. If I fancy a snack, I have a handful of nuts or
some fresh fruit. I’m not vegetarian but I’ve done a few vegetarian-based cookery courses, including a raw food course.
Do you like alternative therapies? If I’m feeling run down I have a Shiatsu massage or some reflexology. I also love an Indian head massage and those hot and cold spa treatments, where you go from a hot steam room into an icy bath! They really work for me.
What do you do to relax? I find cooking relaxing and love having friends over for supper. I also do yoga for relaxation. Or, I might go to the cinema or the theatre. I also love going to an art gallery. I’m lucky that I live in London so there’s always something to do or see.
If you could change one thing about your body what would it be? I’m hesitant to say anything at all as I’m just happy that I’m strong, supple and in good health. I’m at an age where I am past thinking this or that is wrong with my body.
What exercise do you do? I only took up yoga in my 40s. I love it. It makes me feel good and keeps me toned and fit.
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LS
What is your favourite food? Raw food raw cheesecake tastes amazing
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