Man’s best friend and more?

Last week saw a rather unusual story in the headlines in which a jack Russell took it upon itself to remove an infected toe from his sleeping owner. Jerry Douthett, a 48-year-old musician from Rockford, USA, had been out drinking, and on returning home had fallen into a deeper than usual sleep. He awoke, some hours later, to find the sheets of his bed blood soaked, and on further investigation, found the big toe that had been infected for several weeks, but for which he had not sought medical attention, had disappeared. It turned out that Kiko, the family dog, had detected the infection and chewed the toe to the point that is was completely removed. Whilst the story had a an edge of humour to it, it came to light that Mr Douthett had in fact been suffering from type II diabetes, a condition he was unaware of, but for which he is now is being treated. Some of the long term damaging effects of diabetes are to the blood vessels and nerves that supply the limbs. Neuropathy is the direct damage of nerves and results in gradual loss of sensation and, if the skin is damaged, can result in infection, as experienced first hand by Mr Douthett. Unfortunately, many people have type II diabetes for years without knowing it, simply because any early symptoms can be vague and may not cause undue concern, or seem important at the time. Symptoms, amongst others include feeling thirsty all the time, frequent urination, unexplained tiredness and unexplained weight loss, muscle wasting and frequent infections, or slow-healing sores. It is important, therefore, to be aware of these symptoms and visit your GP if you have any concerns. Catching diabetes early is a key factor to managing the condition successfully. In Mr Douthett’s case he had his dog’s ability to smell his infection to thank, as it has enabled him to now regulate his glucose levels and hopefully avoid any further losses!

A dogs’ ability to detect infection is not surprising, given their acute sense of smell, believed to be around 100,000 times more acute than that of humans. The distinct olfactory gift that is associated with the canine species has, in fact, led scientists to conduct small-scale studies of dogs’ ability to detect the chemical markers of cancer, specifically melanoma, with extremely promising results. Much of the research in this area is based on the theory that a disease causes subtle chemical changes in the body, or alterations in metabolism, which in turn releases a different smell or chemical marker to which dogs can be trained to recognise. Whilst the concept that dogs may be used as a cancer diagnostic tool is doubtful, their use in heath care is certainly of significance. Indeed, their use as guide dogs and hearing dogs is now advancing to their use to warn their owners of epileptic seizures, low blood sugar and heart attacks to name but a few. So they really are man’s best friend!

Remembering the importance of lifestyle choices

There has been a flurry of journal publication lately focusing on methods that can help stave off cognitive impairment and dementia. According to the most recent study, published in this month’s British Medical Journal, making dietary and lifestyle changes that ultimately reduce the risk of developing diabetes and depression, could have a significant impact on an individual’s future risk of developing dementia (Ritchie et al, 2010). The study, led by French researcher Dr Karen Ritchie, of the French National Institute of Medical research, analysed the lifestyle and health of 1,433 people over the age of 65 living in the south of France over a period of seven years. Whilst there is an element of genetic risk associated with the development of dementias such as Alzheimer’s disease, the role of diet and lifestyle are long known to be of significance, and that risk can be manipulated through specific changes. Dr Ritchie was quoted as saying “health chiefs should focus on encouraging literacy, prompt treatment of depressive symptoms and early screening for glucose intolerance and insulin resistance”. The study also highlighted the importance of consuming plenty of fruit and vegetables associated with a more ‘Mediterranean’ style of eating, which would also involve the consumption of foods such as seafood which is rich in neuroprotective omega-3s. In regards to the protective role that long term education has on brain health, this recent publication supports the findings of a study published in last months journal Brain. This study involved examining the brains of 872 participants in ECLIPSE (Epidemiological Clinicopathalogical Studies in Europe), a collaboration between three large population-based studies of ageing, in which a positive association was found between education and a reduced risk of developing dementia symptoms (Brayne et al, 2010). What was particularly interesting about this study was that education had no protection on dementia itself, but only on the symptoms. When the brains of individuals were examined, those individuals who had stayed in education still, showed the pathological and molecular signs of dementia, although whilst living, those individuals showed no physical symptoms of dementia. This would suggest that education in early life appears to enable some people to cope with a lot of changes in their brain before showing dementia symptoms.

So what do we learn from this? It seems that the same messages re-emerge over and over. That exercise, education and adoption of a ‘healthy’ diet offer protection against a myriad of diseases and conditions that are often considered to be just a part of growing old. However whilst it appears that we have a lot more say in our long term fate, putting into practice the advice offered by scientist may take both time and dedication as many of us are very settled in our ways. Educating people is the first step in initiating long term lifestyle changes.

Ritchie K et al. (2010) Designing prevention programmes to reduce incidence of dementia: prospective cohort study of modifiable risk factors. BMJ August 2010

Brayne C et al. (2010) Education, the brain and dementia: neuroprotection or compensation? Brain 133:2210-2216

The mood food connection

Each year on 10th October, the Mental Health Foundation marks the day by raising awareness about mental health and well-being. Whilst we would probably all consider ourselves as reasonably tolerant and open minded, there is still quite a significant stigma about depression. If we haven’t experienced depression directly, it’s highly probable that we know someone, perhaps a friend, relative or workmate, who suffers. Mental Health Statistics report that 1 in 4 British adults experience at least one diagnosable mental health problem in any one year and 1 in 6 of us experiences this at any given time. In 2001 the World Health Organisation (WHO) estimated that approximately 450 million people worldwide have a mental health problem, of which 154 million are affected by depression.One of the major side effects of depression is that the way we think about food changes and this can influence how we eat – both the types of food and how often. Because food can directly influence our mood, our diet is even more fundamental when we’re feeling low.

The Glycemic Index

The brain needs energy supplied at an even rate in order to function optimally. Sudden peaks in blood sugar will adversely affect behaviour, anxiety, depression, and fatigue, so it is particularly important for people with depression to keep their blood glucose levels even. Although commonly known for its diabetes and weight loss benefits, the glycemic index (most commonly referred to as GI index), which ranks carbohydrates according to their effect on blood glucose levels, is a good guide to informing us which foods to include as part of a healthy diet, and indeed which foods to limit.

While all carbohydrate foods are eventually broken down into glucose, quick-release simple carbohydrates (such as high sugar foods, glucose and fructose) are broken down more quickly into glucose than complex carbohydrates (such as wholemeal grains), releasing glucose rapidly into the bloodstream. Repeated ‘spikes’ of glucose can decrease insulin sensitivity, increasing the risk of type 2 diabetes, as well as promoting oxidative stress in the veins and arteries – a cause of coronary heart disease. After the highs come the energy-sapping blood sugar lows and, frequently, strong urges to reach for another sugary carbohydrate snack to perk us up. Indeed individuals who suffer from atypical depression (a subtype of depression) often overeat and report an almost irresistible craving for carbohydrates.

White sugar and other refined carbohydrates, such as those found in processed white bread and white pasta, white rice and most convenience foods, supply few nutrients to the body but use up important B vitamins, which are essential for our nervous and immune systems, as well as healthy digestion. Avoiding refined foods and sugar, as well as consuming foods with a low GI value, will help to keep blood sugar levels even. Perhaps a more accurate reference guide to prevent blood sugar spikes is the Glycemic Load(GL) ranking system, which is based on a food’s GI value and average portion size. For example, whilst an apple is not low GI, it has a low GL and will barely influence blood sugar levels.

Micronutrient deficiencies

It is extemely common for depression sufferers to have low levels of B vitamins and essential minerals such as zinc, selenium and magnesium. These water-soluble vitamins and minerals must be consumed daily to avoid depletion. Deficiency can, in turn, hinder the body’s ability to utilise specific omega-3 fatty acids, which are known to lift our mood by elevating serotonin and regulating levels of this important neurotransmitter.

EPA, a long-chain omega-3 fatty acid found in fish oil, not only influences serotonin and dopamine in the brain, but is also converted to powerful anti-inlammatories via a series of enzyme-mediated steps. It is these enzymes that rely on the presence of B vitamins and essential minerals in order to function, without which the body’s production of natural anti-inflammatories is minimal, and can even result in the production of inflammatory substances. Combining a good nutritional vitamin and mineral supplement with 1 gram EPA daily (or 4 capsules Vegepa) can help to balance serotonin levels and alleviate the symptoms of depression.

Carbohydrate cravings are also linked with low levels of chromium, which helps to regulate blood sugar levels and reduce cravings. This is because for blood sugar to provide energy, it must be escorted into each of our cells where the energy conversion takes place. Insulin then ‘unlocks’ the cell, allowing glucose to pass in. But there is a missing link. Insulin doesn’t work properly unless biologically active chromium is present as a cofactor (much like a catalyst).

With many modern food processing methods, up to 80% of chromium is lost – particularly with whole wheat and raw sugar when they are processed to white flour and refined sugar. If we regularly opt for these refined foods over their healthy wholegrain relatives, chromium levels within the body can easily become depleted.

Whilst it is likely a low priority during episodes of low mood to concentrate on our eating habits, following a few general guidelines can help to restore healthy brain chemistry and minimise sugar-induced mood swings.

– Avoid processed foods.

– Keep red meat to a minimum or eat organic (red meat is high in inflammatory omega-6 unless animals are fed on natural grass).

– Drink plenty of water, as the brain needs to be hydrated to function at its best.

– Don’t forget your ‘five a day’. Make sure you get plenty of vitamins and minerals by eating a wide variety of fresh fruit and vegetables. If you eat them raw they’ll supply even more nutrients.

– Eat two portions of oily fish weekly to top up on omega-3, containing the natural antidepressant EPA, or take 2 capsules of Vegepa morning and night.

If you found this article interesting, you might like to read more about anti depression foods.

Coffee Controversy: is it good or is it bad for you?

I seem to have witnessed recently several identical conversations regarding coffee drinking. Is it good or bad for you? It’s not the coffee debate per say that intrigues me but this need for something to be so black or white, good or bad. I think it depends in part on where or from whom we get our information and the message that source wants to portray. It is true that coffee has well-documented side effects including anxiety, insomnia, tremor and palpitations. But on the plus side drinking coffee appears to improve alertness and some reports suggest that drinking 3 cups a day may even, reduce the risk of type 2 diabetes, protect against cancer and offer protections against dementia including reducing the risk of developing Alzheimer’s and Parkinson’s disease. So we have the good and the bad.

Coffee, however, like the majority of food stuffs we consume, is a complex composition. The side effects often associated with a steaming cup of java are actually the result of caffeine, which belongs to a group of stimulants called xanthenes. In moderation, caffeine can have very positive effects. It gives us more energy, heightens our ability to concentrate and makes us think more clearly and can even elevate our mood. That doesn’t sound so bad. But as with most things it merely boils down to moderation. If we drink caffeinated coffee in moderation it can increase alertness and mental stamina. If we drink too much too quickly, however, we are faced with the unpleasant side effects: nausea, confusion and excitability, which can be wholly unpleasant.

As with most things in life it’s not as simple as black or white. We need to look at the diet as a whole. Most foods we eat will have positive and negative factors, of which we are constantly being reminded by the tabloid headlines. Often telling just one side of the story, these messages can be somewhat confusing and frequently leave people rather bewildered as to what to consume and what to avoid. It’s a case of being sensible, taking everything in moderation and listening to the messages your body tells you. If you get the shakes after your morning espresso then that’s your body saying stop now, that’s enough.

Peripheral Neuropathy in Diabetics; what steps can we take to avoid it?

You might already be aware that of the many deteriorative conditions related to diabetes; ‘peripheral neuropathy’ is perhaps the most common, with an estimated 60-70% of diabetics reportedly experiencing symptoms. ‘Neuropathy’ describes damage, whether moderate or severe, to the peripheral nervous system (the ‘external’ portion of the nervous system, situated beyond the brain and spinal cord), which transmits information directly from the brain and spinal cord to the rest of the body.

Our nervous system acts very similarly to an electrical cable; with the nerve’s ‘impulse’ adopting the role of the electrical wire itself, and the ‘myelin sheath’ (the ‘skin’ of the nerve), mimicking the insulation surrounding the wire. If the wire becomes damaged, then the nerve signal will not travel efficiently along the wire, nor will it transmit the intended messages as instantaneously. This delay results inevitably in the ‘classic’ symptoms of neuropathy; namely; tingling, numbness, ‘burning’ and pain.

A causative link has been drawn between neuropathy and deficiencies of long-chain polyunsaturated fatty acids within the body. Indeed, insulin itself plays a pivotal role in the metabolism of EFAs (essential fatty acids), by alerting the genes necessary for enzyme-conversion to begin the process of converting short-chain fatty acids into a bio-available (i.e. usable by the body) long-chain fatty acid.

Where insulin is absent, or enzyme-activity impeded, the enzymes needed to create specific fatty acids cannot be produced and a deficiency results. Of the myelin layer which protects our vulnerable nerves, an estimated 75 % is composed exclusively of EFA’s (these are termed ‘essential’ because the body cannot generate them independently, but must instead source them externally from the diet). Depletion of this fatty, insulatory layer, leads to severe nerve damage (Neuropathy).

Nutrition, as all Diabetics are painfully aware, is central to the manufacture of insulin and for creating the right ‘biological environment’ to encourage enzyme conversions to take place. By boosting or supplementing our dietary levels of long-chain fatty acids we can essentially sidestep the risk that the enzyme-mediated conversions will fail to progress past the initial hurdle.

Fatty acid supplementation nourishes the myelin sheath, and prevents further degeneration of inter-cellular communication; it reduces the risk of developing Neuropathy, and actually reinvigorates nerve endings to overcome numbness and the likelihood of eventual tissue loss. However, EPA, a specific omega-3 fatty acid found in fish oil that appears to have significant beneficial effects on diabetic neuropathy and serum lipids as well as other diabetic complications such as nephropathy (kidney damage) and macroangiopathy (damage to the blood vessels). EPA plays a role in the compaction, stabilization, and maintenance of myelin sheaths by regulating the production of proteolipid protein or PLP. PLP is literally the ‘glue’ that hold in place the sheets of protective fats that cover the nerve axon. Loss of PLP is associated with many conditions that have nerve damage including Multiple sclerosis, Alzheimer’s disease and Huntington chorea.

OmegaForce is a patented formulation of omega-3 and 6 long-chain fatty acids with a multitude of health-enhancing properties, including anti-inflammatory and pain-relieving actions. For more information on the relationship between EPA deficiency and the pathogenesis of Diabetic Neuropathy, please go to www.igennus.com

Omega-3 fish oil supplements reduce cardiovascular disease in diabetics

According to a new study from Tehran University of Medical Sciences in Iran, daily intake of omega-3 fatty acids may reduce levels of a trigger substance linked to heart disease in diabetics.

Results published in the peer-reviewed journal Nutrition, Metabolism and Cardiovascular Disease suggest that high doses of omega-3 fish oil daily (3 grams per day) cut levels of the amino acid homocysteine by 22%, compared with less than 1% in the placebo group.

81 diabetics took part in this randomised, double-blind placebo-controlled trial, which lasted two months with participants randomly assigned to either receive 3 grams of omega-3 or a sunflower oil placebo daily.

Previous research has linked increased levels of homocysteine with an increased risk of cardiovascular disease. By lowering levels of this amino acid in the blood, scientists believe it is possible to reduce their heart disease risk, providing support for the inclusion of omega-3s as part of the diabetic diet. Evidence is not yet conclusive however, and further research needs to be conducted before firm conclusions may be drawn.

The number of diabetics diagnosed with the disease soared by 70,000 in the UK between 2006-7, according to a report by the Information Centre for Health and Social Care.
According to their report, people affected by diabetes in the UK has climbed to 3.7 per cent, with a record number of 1,986,200 people diagnosed with the condition; a further 750,000 people are likely to have diabetes and not be aware of it. These figures paint a worrying picture for the health of the nation.

The Chief Executive of Diabetes UK, Douglas Smallwood, commented: “These figures are truly alarming as diabetes is a serious condition, which can lead to blindness, kidney failure, heart disease, stroke and nerve damage that can cause amputation . We need to do all we can to raise awareness of the condition and to encourage people to follow a healthy diet, and pursue an active lifestyle to help them reduce their risk of developing diabetes.”

When you consider that the impact of our 24/7 culture is that we tend to drive to work, drink a little too much, eat too few freshly prepared meals (not to mention that most of us are probably short on dietary fibre) you can appreciate why diabetes is becoming a real problem.

This is not to say that there’s nothing we can do about it, however. Simple changes to our diet and lifestyle and dramatically decrease our chance of developing diabetes and, if you’re affected already, it is definitely possible to influence the likelihood of associated health problems as the condition advances. As a nutrition scientist I would advise a diet with increased fibre, whole grains, few sugars, as well as cutting out the bad fats – this is actually a good approach for anyone.

I’d also add to the diet highly concentrated omega-3 fish oil containing pure EPA, an active component of fish oil which is especially beneficial for reducing the risk of complications in the cardiovascular system. OmegaForce is ideal in this respect, as it combines with pure EPA the omega-6 GLA (highly anti-inflammatory) with the omega-9 oleic acid from olive oil, its benefits associated with the healthy Mediterranean diet.

For more information about omega-3 fatty acids and how they can be included as part of the diet, click here.