Attended a very interesting health meeting today and it was brought to my attention that Havard School of Public Health (HSPH) updated the Food Pyramid in 2008 based on the best available scientific evidence about the links between diet and health. According to HSPB this new Food Pyramid fixes the fundamental flaws in the original US Department of Agriculture (USDA) Pyramid and offers sound information to help people make better choices about what to eat.
HSPB has also kindly listed the top 5 tips to be healthy:
1. Start with exercise : A healthy diet is built on a base of regular exercise
2. Focus on food, not grams: Don't worry about specific servings or grams of food. It is important to note that everybody is different with different sizes, pre-existing conditions, family history etc. so there shouldn't be a set amount of serving.
3. Go with plants: Eating a plant base diet is the healthiest. Aim for lots of greens and healthy fats like olive oil and canola oil
4. Cut way back on American staples: Cut down on red meat, sugary drinks, potatoes and salty snacks.
5. Take a multivitamin: Taking a multivitamin can be a good nutrition insurance policy as it can fill in nutrient holes that may affect even the most careful eaters. Choose one multivitamin and top it up with Vitamin D. There is growing evidence Vitamin D lowers the risk of Colon and Breast Cancer.
For more info you can check out HSPB's handout here
I think this Food Pyramid is more in line with current average person's activity and nutritional requirements. Back in the days, my parents had lots of daily exercises working in the farm hence there was no need to put this in the pyramid. What do you think about current living trends?
In a very interesting study of 586 participants done in 2009, multivitamin use was related to longer telomere length in women aged 35–74 years (1). Compared with nonusers, the relative telomere length of leukocyte DNA was on average 5.1% longer among daily multivitamin users (P for trend = 0.002). As you probably already know, telomere length is related to biological aging and excessive telomere shortening may play an important role in development of some chronic diseases eg. Type 2 Diabetes.
It is understandable that regular multivitamin users tend to follow a healthy lifestyle and have a higher intake of micronutrients. The same study found that higher intakes of vitamins C and E from foods were each associated with longer telomeres too, even after adjustment for multivitamin use.
Researchers believe that the findings are related to the antioxidant power of many of the vitamins and minerals in the multivitamins which help prevent damage to all parts of DNA, including telomeres.
1: Xu Q, Parks CG, DeRoo LA, Cawthon RM, Sandler DP, Chen H. Multivitamin use and telomere length in women. Am J Clin Nutr. 2009 Jun;89(6):1857-63. doi: 10.3945/ajcn.2008.26986. Epub 2009 Mar 11. PubMed PMID: 19279081; PubMed Central PMCID: PMC2714373.
I don't know why this hasn't been mentioned in ANY midwife visits, routine immunisations, parents groups, playgroups etc that I have been to since the birth of my daughter few months ago. With my recent obsession with Vitamin D and it so happened today that I stumbled upon a CDC recommendation that infants should have 400IU of Vitamin D supplement a day! Moreover, this recommendation was given by American Academy of Paediatrics in their 2008 report which states ' It is now recommended that all infants and children, including adolescents, have a minimum daily intake of 400 IU of vitamin D beginning soon after birth.' This is another clear example of how millions of good research and recommendations never make it to the public.
It is however quite obvious you are not going to expose your precious babies under the sun for extended period of time just to get adequate amount of Vitamin D for the prevention of infant rickets. Not to mention the risk of skin cancer and wrinkling of skin increase with sunlight exposure.
According to the CDC website, 'Human milk typically contains a vitamin D concentration of 25 IU per liter or less' and I don't believe any baby under 6 months can go through 2 liters of breastmilk a day (equivalent to only 50IU of Vitamin D). So mothers, knowing how Vitamin D is essential for our human body (and many more benefits are currently being researched), do not deprive your babies of Vitamin D supplementation if you choose to exclusively breastfeed. If you are like me, lucky enough to have been supplementing formula with breastmilk, your babies will get Vitamin D from the formula.
Bottom line, breastmilk does not contain everything your baby needs. It is important to always be aware and educate yourself.
Fibroid, also known as uterine myomas is a benign tumor made up of muscle and fibrous tissues that grows in the wall of uterus. According to Australia's BetterHealth site (betterhealth.vic.gov.au), 4 in 10 women over age 40 have fibroid. There is no known cause for fibroid but it seems to be related to hormone imbalance involving progesterone and estrogen hormone (1).
Symptoms of fibroid includes:
- Heavy, long, painful periods
- Spotting between periods
- Lump or swelling in abdomen
- Painful sex
- Anemia (due to heavy period)
What can you do if you are diagnosed with fibroid?
Of course there is the surgical option to excise the fibroid if needed. Here we will focus more on useful food and supplements you can take at home.
- Miso soup: regulates estrogen levels
- Flax seeds: balances hormone naturally
- Fresh vegetable juices
- Omega-3 supplements (Fish-oils): vital role in hormone production
- High strength multi-vitamin and mineral
- Fiber: prevent constipation as constipation aggravates fibroid symptoms.
1: Rein MS, Barbieri RL, Friedman AJ. Progesterone: a critical role in the pathogenesis of uterine myomas. Am J Obstet Gynecol. 1995 Jan;172(1 Pt 1):14-8. Review. PubMed PMID: 7847524.
Salt, also known as sodium chloride is an important element essential for health. In fact, every cell in your body needs salt to function. Effects of too little salt includes confusion, inability to concentrate and can even be potentially fatal.
The National Health and Medical Research Council (NHMRC) has set an ‘Adequate Intake’ of 460–920 mg of sodium chloride per day. This corresponds to 1.15–2.3 grams of salt (Sodium in grams x 2.5 = Salt in grams). Most Australian adults have a daily salt intake of about 10 grams which is many times the maximum value of the Adequate Intake range. A ‘Suggested Dietary Target’ of 4 grams of salt has been set for Australian adults. This is about half the average Australian adult’s current salt intake.
You might think that just because you don't add salt to anything you cook at home therefore you are in the safe zone. You might still be having high salt intake unknowingly simply because salt is in so many products that people consume daily. According to Australian Division of World Action on Salt and Health, 75% of the salt we eat comes from processed foods, such as bread, breakfast cereals and sauces. In fact, some takeaway meals contain double the amount of salt an adult is recommended to consume in a day.
Some examples include:
1. White Bread - 2 slices = 280mg of sodium (700mg salt)
2. Ketchup - 1 teaspoon = 150mg of sodium (375mg salt)
3. Packaged Oven Roasted Turkey - 60g = 670mg of sodium (1.7g salt)
4. Jarred Spaghetti Sauce - 1 cup = 1000mg of sodium (2.5g salt)
5. Corn Flakes - 100g = up to 1.8g salt
Shockingly, a Great Britain study published in 2007 showed salt was associated with raising blood pressure in children (1), According to the study, the average salt intake for 4 years old children was about 4.7g/day and by age 18, average salt intake was about 6.8g/day. There was a significant association of salt intake with systolic blood pressure. An increase of 1 g/day in salt intake was related to an increase of 0.4 mm Hg in systolic blood pressure.
It is therefore extremely important to control your salt intake (not just by not adding salt to your meals) and be vigilant about food contents listed by manufacturers. It is important to note that most manufacturers will list the food's sodium content and you will have to do the simple calculation shown above to convert sodium levels to salt levels.
1: He FJ, Marrero NM, Macgregor GA. Salt and blood pressure in children and adolescents. J Hum Hypertens. 2008 Jan;22(1):4-11. Epub 2007 Sep 6. PubMed PMID: 17823599.
Do you know that fibre plays a very important role in your diet and your weight?Observational studies show that obesity is less frequent in developing countries where there is high fibre consumption (1). In multi-center population based cohort study carried out over 10 years examining 2909 young individuals, the researchers reported an inverse relationship between total fibre intake, plasma insulin concentrations and body weight gain suggesting that fibre may play an important role in the prevention of insulin resistance and obesity (2). The idea is that fibre slows down digestion by delaying the emptying of your stomach and makes you feel full for longer which in turns helps control your weight. This slower stomach emptying also affects blood sugar levels and thus has a positive effect in insulin sensitivity and prevention of Type II Diabetes.
According to UK's National Health Survey, average fibre consumption is a about 14g/day when the target should at least be 18g/day. This signifies that most people do not consume enough fibre in their daily diet.
So how can you increase your fibre intake? It is important to have more knowledge on what foods contain fibres and adding 'functional fibres' to your drinks and food (eg, orange juice, porridge etc) which is really fibres extracted from plants or animals and this is one of the most convenient way to boost your fibre content.
For natural fibres, we have soluble and insoluble fibres. Soluble fibres are found in oatmeal, lentils, apples, oranges, blueberries, nuts, flaxseeds, celery, carrots etc. These fibres draw in water and forms a gel after consumption. For insoluble fibres, they are found in whole wheat, seeds, nuts, barley, broccoli, raisins, grapes, tomatoes, onions etc. these fibres do not dissolve in water and passes through your gastrointestinal tract pretty intact and speeds up the passage of food and waste through your gut. They also provide a laxative effect and helps prevent constipation.
1: Babio N, Balanza R, Basulto J, Bulló M, Salas-Salvadó J. Dietary fibre: influence on body weight, glycemic control and plasma cholesterol profile. Nutr Hosp. 2010 May-Jun;25(3):327-40. Review. PubMed PMID: 20593113.
2. Ludwig DS, Pereira MA, Kroenke CH, Hilner JE, Van Horn L, Slattery ML, Jacobs DR Jr. Dietary fiber, weight gain, and cardiovascular disease risk factors in young adults. JAMA 1999; 282: 1539-46
Yesterday a colleague of mine came to me and told me that his wife is 6 months pregnant and has a Vitamin D level of 15nmol/L and he continued by saying that the doctor suggested her to take 2 Vitamin D tablets a day from now on. I was literally in shock, with a Vitamin D level of 15nmol/L which is categorised as severe Vitamin D deficiency during pregnancy is rather serious and if the treating doctor had paid attention to any recent clinical guidelines, the dosage suggested would have been more than just 2 Vitamin D tablets (2000IU of Vitamin D supplementation).
Have a look at the clinical guidelines for Vitamin D deficiency above which is taken from King Edward Memorial Women's Hospital in Perth, WA, Australia. They actually recommend taking 5000IU of Vitamin D plus calcium for 6 weeks if Vitamin D level is below 50nmol/L. It makes me wonder how can a treating doctor be so out of date with the current treatment plan and why didn't he/she highlight the importance of maintaining optimum Vitamin D level in pregnancy?
Interestingly, my colleague's wife has actually been taking a certain brand of Vitamin D supplementation ever since she found out that she was pregnant. All I have to say is maybe that brand is pretty low quality. If you would like to know further details, please email me.
Effects of low maternal Vitamin D includes:
- Low serum calcium in newborns, with or without convulsions
- Defective tooth enamel
- Lower birth rates and higher risk of small for gestational age
- Lower newborn bone mineral
- Affects fetal femoral bone development
- Greater risk for multiple sclerosis, cancer, insulin dependent diabetes mellitus, and schizophrenia in later life
Population that should be screened for Vitamin D deficiency:
- Dark skin population
- Have limited exposure to sunlight (tend to be indoors/ protected from sun when outdoors)
- Pre-pregnancy BMI > 40
I cannot stress enough the importance of Vitamin D and how common it is to find a person who is deficient in Vitamin D these days due to the risks of developing skin cancers with extreme sun exposures. In fact, a few of my close friends who are taking multivitamins think that there is enough Vitamin D supplementation in it! To be honest most multivitamins consist of minute amount of Vitamin D and it is not enough for good Vitamin D level maintenance.
The take home note, each and every pregnant woman should know their Vitamin D levels and understand the importance of maintaining the level throughout pregnancy.
Dr Nicole Ng (MBBS) is a medical doctor with a passion in women's health and medical research