The Lupus Solution – by Dr. Tiffany Caplan & Dr. Brent Caplan
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Lupus is not fun, and this book sets out to make it easier.
Starting off by explaining the basics of autoimmunity and how lupus works, the authors go on the address the triggers of lupus and how to avoid them—which if you’ve been suffering from lupus for a while, you probably know this part already, but it’s as well to give them a look over just in case you missed something.
The real value of the book though comes in the 8 chapters of the section “Tools & Therapies” which are mostly lifestyle adjustments though there are additionally some pharmaceutical approaches that can also help, and they are explained too. And no, it’s not just “reduce inflammation” (but yes, also that); rather, a whole array of things are examined that often aren’t thought of as related to lupus, but in fact can have a big impact.
The style is to-the-point and informational, and formatted for ease of reading. It doesn’t convey more hard science than necessary, but it does have a fair bibliography at the back.
It’s a short book, weighing in at 182 pages. If you want something more comprehensive, check out our review of The Lupus Encyclopedia, which is 848 pages of information-dense text and diagrams.
Bottom line: if you have lupus and would like fewer symptoms, this book can help you with that quite a bit without getting so technical as the aforementioned encyclopedia.
Click here to check out The Lupus Solution, and live more comfortably!
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Prostate Health: What You Should Know
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Prostate Health: What You Should Know
We’re aware that very many of our readers are women, who do not have a prostate.
However, dear reader: if you do have one, and/or love someone who has one, this is a good thing to know about.
The prostate gland is a (hopefully) walnut-sized gland (it actually looks a bit like a walnut too), that usually sits just under the bladder.
See also: How to Locate Your Prostate*
*The scale is not great in these diagrams, but they’ll get the job done. Besides, everyone is different on the inside, anyway. Not in a “special unique snowflake” way, but in a “you’d be surprised how much people’s insides move around” way.
Fun fact: did you ever feel like your intestines are squirming? That’s because they are.
You can’t feel it most of the time due to the paucity of that kind of nervous sensation down there, but the peristaltic motion that they use to move food along them on the inside, also causes them push against the rest of your guts, on the outside of them. This is the exact same way that many snakes move about.
If someone has to perform an operation in that region, sometimes it will be necessary to hang the intestines on a special rack, to keep them in one place for the surgery.
What can go wrong?
There are two very common things that can go wrong with the prostate:
- Benign Prostate Hyperplasia (BPH), otherwise known as an enlarged prostate
- Prostate cancer
For most men, the prostate gland continues to grow with age, which is how the former comes about so frequently.
For everyone, due to the nature of the mathematics involved in cellular mutation and replication, we will eventually get cancer if something else doesn’t kill us first.
- Prostate cancer affects 12% of men overall, and 60% of men aged 60+, with that percentage climbing each year thereafter.
- Prostate cancer can look like BPH in the early stages (and/or, an enlarged prostate can turn cancerous) so it’s important to not shrug off the symptoms of BPH.
How can BPH be avoided/managed?
There are prescription medications that can help reduce the size of the prostate, including testosterone blockers (such as spironolactone and bicalutamide) and 5α-reductase inhibitors, such as finasteride. Each have their pros and cons:
- Testosterone-blockers are the heavy-hitters, and work very well… but have more potential adverse side effects (your body is used to running on testosterone, after all)
- 5α-reductase inhibitors aren’t as powerful, but they block the conversion of free testosterone to dihydrogen testosterone (DHT), and it’s primarily DHT that causes the problems. By blocking the conversion of T to DHT, you may actually end up with higher serum testosterone levels, but fewer ill-effects. Exact results will vary depending on your personal physiology, and what else you are taking, though.
There are also supplements that can help, including saw palmetto and pumpkin seed oil. Here’s a good paper that covers both:
We have recommended saw palmetto before for a variety of uses, including against BPH:
Too much or too little testosterone? This one supplement may fix that
You might want to avoid certain medications that can worsen BPH symptoms (but not actually the size of the prostate itself). They include:
- Antihistamines
- Decongestants
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Tricyclic antidepressants (most modern antidepressants aren’t this kind; ask your pharmacist/doctor if unsure)
You also might want to reduce/skip:
- Alcohol
- Caffeine
In all the above cases, it’s because of how they affect the bladder, not the prostate, but given their neighborliness, each thing affects the other.
What if it’s cancer? How do I know and what do I do?
The creator of the Prostate Specific Antigen (PSA) test has since decried it as “a profit-driven health disaster” that is “no better than a coin toss”, but it remains the first go-to of many medical services.
However, there’s a newer, much more accurate test, called the Prostate Screening Episwitch (PSE) test, which is 94% accurate, so you might consider asking your healthcare provider whether that’s an option:
The new prostate cancer blood test with 94 per cent accuracy
As for where to go from there, we’re out of space for today, but we previously reviewed a very good book about this, Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer, and we highly recommend it—it could easily be a literal lifesaver.
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What causes food cravings? And what can we do about them?
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Many of us try to eat more fruits and vegetables and less ultra-processed food. But why is sticking to your goals so hard?
High-fat, sugar-rich and salty foods are simply so enjoyable to eat. And it’s not just you – we’ve evolved that way. These foods activate the brain’s reward system because in the past they were rare.
Now, they’re all around us. In wealthy modern societies we are bombarded by advertising which intentionally reminds us about the sight, smell and taste of calorie-dense foods. And in response to these powerful cues, our brains respond just as they’re designed to, triggering an intense urge to eat them.
Here’s how food cravings work and what you can do if you find yourself hunting for sweet or salty foods.
Fascinadora/Shutterstock What causes cravings?
A food craving is an intense desire or urge to eat something, often focused on a particular food.
We are programmed to learn how good a food tastes and smells and where we can find it again, especially if it’s high in fat, sugar or salt.
Something that reminds us of enjoying a certain food, such as an eye-catching ad or delicious smell, can cause us to crave it.
Our brains learn to crave foods based on what we’ve enjoyed before. fon thachakul/Shutterstock The cue triggers a physical response, increasing saliva production and gastric activity. These responses are relatively automatic and difficult to control.
What else influences our choices?
While the effect of cues on our physical response is relatively automatic, what we do next is influenced by complex factors.
Whether or not you eat the food might depend on things like cost, whether it’s easily available, and if eating it would align with your health goals.But it’s usually hard to keep healthy eating in mind. This is because we tend to prioritise a more immediate reward, like the pleasure of eating, over one that’s delayed or abstract – including health goals that will make us feel good in the long term.
Stress can also make us eat more. When hungry, we choose larger portions, underestimate calories and find eating more rewarding.
Looking for something salty or sweet
So what if a cue prompts us to look for a certain food, but it’s not available?
Previous research suggested you would then look for anything that makes you feel good. So if you saw someone eating a doughnut but there were none around, you might eat chips or even drink alcohol.
But our new research has confirmed something you probably knew: it’s more specific than that.
If an ad for chips makes you look for food, it’s likely a slice of cake won’t cut it – you’ll be looking for something salty. Cues in our environment don’t just make us crave food generally, they prompt us to look for certain food “categories”, such as salty, sweet or creamy.
Food cues and mindless eating
Your eating history and genetics can also make it harder to suppress food cravings. But don’t beat yourself up – relying on willpower alone is hard for almost everyone.
Food cues are so powerful they can prompt us to seek out a certain food, even if we’re not overcome by a particularly strong urge to eat it. The effect is more intense if the food is easily available.
This helps explain why we can eat an entire large bag of chips that’s in front of us, even though our pleasure decreases as we eat. Sometimes we use finishing the packet as the signal to stop eating rather than hunger or desire.
Is there anything I can do to resist cravings?
We largely don’t have control over cues in our environment and the cravings they trigger. But there are some ways you can try and control the situations you make food choices in.
- Acknowledge your craving and think about a healthier way to satisfy it. For example, if you’re craving chips, could you have lightly-salted nuts instead? If you want something sweet, you could try fruit.
- Avoid shopping when you’re hungry, and make a list beforehand. Making the most of supermarket “click and collect” or delivery options can also help avoid ads and impulse buys in the aisle.
- At home, have fruit and vegetables easily available – and easy to see. Also have other nutrient dense, fibre-rich and unprocessed foods on hand such as nuts or plain yoghurt. If you can, remove high-fat, sugar-rich and salty foods from your environment.
- Make sure your goals for eating are SMART. This means they are specific, measurable, achievable, relevant and time-bound.
- Be kind to yourself. Don’t beat yourself up if you eat something that doesn’t meet your health goals. Just keep on trying.
Gabrielle Weidemann, Associate Professor in Psychological Science, Western Sydney University and Justin Mahlberg, Research Fellow, Pyschology, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Zuranolone: What to know about the pill for postpartum depression
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In the year after giving birth, about one in eight people who give birth in the U.S. experience the debilitating symptoms of postpartum depression (PPD), including lack of energy and feeling sad, anxious, hopeless, and overwhelmed.
Postpartum depression is a serious, potentially life-threatening condition that can affect a person’s bond with their baby. Although it’s frequently confused with the so-called “baby blues,” it’s not the same.
The baby blues include similar, temporary symptoms that affect up to 80 percent of people who have recently given birth and usually go away within the first few weeks. PPD usually begins within the first month after giving birth and can last for months and interfere with a person’s daily life if left untreated. Thankfully, PPD is treatable and there is help available.
On August 4, the FDA approved zuranolone, branded as Zurzuvae, the first-ever oral medication to treat PPD. Until now, besides other common antidepressants, the only medication available to treat PPD specifically was the IV injection brexanolone, which is difficult to access and expensive and can only be administered in a hospital or health care setting.
Read on to find out more about zuranolone: what it is, how it works, how much it costs, and more.
What is zuranolone?
Zurzuvae is the brand name for zuranolone, an oral medication to treat postpartum depression. Developed by Sage Therapeutics in partnership with Biogen, it’s now available in the U.S. Zurzuvae is typically prescribed as two 25 mg capsules a day for 14 days. In clinical trials, the medication showed to be fast-acting, improving PPD symptoms in just three days.
How does zuranolone work?
Zuranolone is a neuroactive steroid, a type of medication that helps the neurotransmitter GABA’s receptors, which affect how the body reacts to anxiety, stress, and fear, function better.
“Zuranolone can be thought of as a synthetic version of [the neuroactive steroid] allopregnanolone,” says Dr. Katrina Furey, a reproductive psychiatrist, clinical instructor at Yale University, and co-host of the Analyze Scripts podcast. “Women with PPD have lower levels of allopregnenolone compared to women without PPD.”
How is it different from other antidepressants?
“What differentiates zuranolone from other previously available oral antidepressants is that it has a much more rapid response and a shorter course of treatment,” says Dr. Asima Ahmad, an OB-GYN, reproductive endocrinologist, and founder of Carrot Fertility.
“It can take effect as early as on day three of treatment, versus other oral antidepressants that can take up to six to 12 weeks to take full effect.”
What are Zurzuvae’s side effects?
According to the FDA, the most common side effects of Zurzuvae include dizziness, drowsiness, diarrhea, fatigue, the common cold, and urinary tract infection. Similar to other antidepressants, the medication may increase the risk of suicidal thoughts and actions in people 24 and younger. However, NPR noted that this type of labeling is required for all antidepressants, and researchers didn’t see any reports of suicidal thoughts in their trials.
“Drug trials also noted that the side effects for zuranolone were not as severe,” says Ahmad. “[There was] no sudden loss of consciousness as seen with brexanolone or weight gain and sexual dysfunction, which can be seen with other oral antidepressants.”
She adds: “Given the lower incidence of side effects and more rapid-acting onset, zuranolone could be a viable option for many,” including those looking for a treatment that offers faster symptom relief.
Can someone breastfeed while taking zuranolone?
It’s complicated. In clinical trials, participants were asked to stop breastfeeding (which, according to Furey, is common in early clinical trials).
A small study of people who were nursing while taking zuranolone found that 0.3 percent of the medication dose was passed on to breast milk, which, Furey says, is a pretty low amount of exposure for the baby. Ahmad says that “though some data suggests that the risk of harm to the baby may be low, there is still overall limited data.”
Overall, people should talk to their health care provider about the risks and benefits of breastfeeding while on the medication.
“A lot of factors will need to be weighed, such as overall health of the infant, age of the infant, etc., when making this decision,” Furey says.
How much does Zurzuvae cost?
Zurzuvae’s price before insurance coverage is $15,900 for the 14-day treatment. However, the Policy Center for Maternal Mental Health says insurance companies and Medicaid are expected to cover it because it’s the only drug of its kind.
Less than 1 percent of U.S. insurers have issued coverage guidelines so far, so it’s still unknown how much it will cost patients after insurance. Some insurers require patients to try another antidepressant first (like the more common SSRIs) before covering Zurzuvae. For uninsured and underinsured people, Sage Therapeutics said it will offer copay assistance.
The hefty price tag and potential issues with coverage may widen existing health disparities, says Ahmad. “We need to ensure that we are seeking out solutions to enable wide-scale access to all PPD treatments so that people have access to whatever treatment may work best for them.”
If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Dr. Greger’s Anti-Aging Eight
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Dr. Greger’s Anti-Aging Eight
This is Dr. Michael Greger. We’ve featured him before: Brain Food? The Eyes Have It!
This time, we’re working from his latest book, the excellent “How Not To Age”, which we reviewed all so recently. It is very information-dense, but we’re going to be focussing on one part, his “anti-aging eight”, that is to say, eight interventions he rates the most highly to slow aging in general (other parts of the book pertained to slowing eleven specific pathways of aging, or preserving specific bodily functions against aging, for example).
Without further ado, his “anti-aging eight” are…
- Nuts
- Greens
- Berries
- Xenohormesis & microRNA manipulation
- Prebiotics & postbiotics
- Caloric restriction / IF
- Protein restriction
- NAD+
As you may have noticed, some of these are things might appear already on your grocery shopping list; others don’t seem so “household”. Let’s break them down:
Nuts, greens, berries
These are amongst the most nutrient-dense and phytochemical-useful parts of the diet that Dr. Greger advocates for in his already-famous “Dr. Greger’s Daily Dozen”.
For brevity, we’ll not go into the science of these here, but will advise you: eat a daily portion of nuts, a daily portion of berries, and a couple of daily portions of greens.
Xenohormesis & microRNA manipulation
You might, actually, have these on your grocery shopping list too!
Hormesis, you may recall from previous editions of 10almonds, is about engaging in a small amount of eustress to trigger the body’s self-strengthening response, for example:
Xenohormesis is about getting similar benefits, second-hand.
For example, plants that have been grown to “organic” standards (i.e. without artificial pesticides, herbicides, fertilizers) have had to adapt to their relatively harsher environment by upping their levels of protective polyphenols and other phytochemicals that, as it turns out, are as beneficial to us as they are to the plants:
Hormetic Effects of Phytochemicals on Health and Longevity
Additionally, the flip side of xenohormesis is that some plant compounds can themselves act as a source of hormetic stress that end up bolstering us. For example:
In essence, it’s not just that it has anti-oxidant effect; it also provides a tiny oxidative-stress immunization against serious sources of oxidative stress—and thus, aging.
MicroRNA manipulation is, alas, too complex to truly summarize an entire chapter in a line or two, but it has to do with genetic information from the food that we eat having a beneficial or deleterious effect to our own health:
Diet-derived microRNAs: unicorn or silver bullet?
A couple of quick takeaways (out of very many) from Dr. Greger’s chapter on this is to spring for the better quality olive oil, and skip the cow’s milk:
- Impact of Phenol-Enriched Virgin Olive Oils on the Postprandial Levels of Circulating microRNAs Related to Cardiovascular Disease
- MicroRNA exosomes of pasteurized milk: potential pathogens of Western diseases
Prebiotics & Postbiotics
We’re short on space, so we’ll link you to a previous article, and tell you that it’s important against aging too:
Making Friends With Your Gut (You Can Thank Us Later)
An example of how one of Dr. Greger’s most-recommended postbiotics helps against aging, by the way:
- The mitophagy activator urolithin A is safe and induces a molecular signature of improved mitochondrial and cellular health in humans
- Urolithin A improves muscle strength, exercise performance, and biomarkers of mitochondrial health in a randomized trial in middle-aged adults
(Urolithin can be found in many plants, and especially those containing tannins)
See also: How to Make Urolithin Postbiotics from Tannins
Caloric restriction / Intermittent fasting
This is about lowering metabolic load and promoting cellular apoptosis (programmed cell death; sounds bad; is good) and autophagy (self-consumption; again, sounds bad; is good).
For example, he cites the intermittent fasters’ 46% lower risk of dying in the subsequent years of follow-up in this longitudinal study:
For brevity we’ll link to our previous IF article, but we’ll revisit caloric restriction in a main feature on of these days:
Fasting Without Crashing? We sort the science from the hype!
Dr. Greger favours caloric restriction over intermittent fasting, arguing that it is easier to adhere to and harder to get wrong if one has some confounding factor (e.g. diabetes, or a medication that requires food at certain times, etc). If adhered to healthily, the benefits appear to be comparable for each, though.
Protein restriction
In contrast to our recent main feature Protein vs Sarcopenia, in which that week’s featured expert argued for high protein consumption levels, protein restriction can, on the other hand, have anti-aging effects. A reminder that our body is a complex organism, and sometimes what’s good for one thing is bad for another!
Dr. Greger offers protein restriction as a way to get many of the benefits of caloric restriction, without caloric restriction. He further notes that caloric restriction without protein restriction doesn’t decrease IGF-1 levels (a marker of aging).
However, for FGF21 levels (these are good and we want them higher to stay younger), what matters more than lowering proteins in general is lowering levels of the amino acid methionine—found mostly in animal products, not plants—so the source of the protein matters:
For example, legumes deliver only 5–10% of the methionine that meat does, for the same amount of protein, so that’s a factor to bear in mind.
NAD+
This is about nicotinamide adenine dinucleotide, or NAD+ to its friends.
NAD+ levels decline with age, and that decline is a causal factor in aging, and boosting the levels can slow aging:
Therapeutic Potential of NAD-Boosting Molecules: The In Vivo Evidence
Can we get NAD+ from food? We can, but not in useful quantities or with sufficient bioavailability.
Supplements, then? Dr. Greger finds the evidence for their usefulness lacking, in interventional trials.
How to boost NAD+, then? Dr. Greger prescribes…
Exercise! It boosts levels by 127% (i.e., it more than doubles the levels), based on a modest three-week exercise bike regimen:
Skeletal muscle NAMPT is induced by exercise in humans
Another study on resistance training found the same 127% boost:
Take care!
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I have a stuffy nose, how can I tell if it’s hay fever, COVID or something else?
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Hay fever (also called allergic rhinitis) affects 24% of Australians. Symptoms include sneezing, a runny nose (which may feel blocked or stuffy) and itchy eyes. People can also experience an itchy nose, throat or ears.
But COVID is still spreading, and other viruses can cause cold-like symptoms. So how do you know which one you’ve got?
Lysenko Andrii/Shutterstock Remind me, how does hay fever cause symptoms?
Hay fever happens when a person has become “sensitised” to an allergen trigger. This means a person’s body is always primed to react to this trigger.
Triggers can include allergens in the air (such as pollen from trees, grasses and flowers), mould spores, animals or house dust mites which mostly live in people’s mattresses and bedding, and feed on shed skin.
When the body is exposed to the trigger, it produces IgE (immunoglobulin E) antibodies. These cause the release of many of the body’s own chemicals, including histamine, which result in hay fever symptoms.
People who have asthma may find their asthma symptoms (cough, wheeze, tight chest or trouble breathing) worsen when exposed to airborne allergens. Spring and sometimes into summer can be the worst time for people with grass, tree or flower allergies.
However, animal and house dust mite symptoms usually happen year-round.
Ryegrass pollen is a common culprit. bangku ceria/Shutterstock What else might be causing my symptoms?
Hay fever does not cause a fever, sore throat, muscle aches and pains, weakness, loss of taste or smell, nor does it cause you to cough up mucus.
These symptoms are likely to be caused by a virus, such as COVID, influenza, respiratory syncytial virus (RSV) or a “cold” (often caused by rhinoviruses). These conditions can occur all year round, with some overlap of symptoms:
Natasha Yates/The Conversation COVID still surrounds us. RSV and influenza rates appear higher than before the COVID pandemic, but it may be due to more testing.
So if you have a fever, sore throat, muscle aches/pains, weakness, fatigue, or are coughing up mucus, stay home and avoid mixing with others to limit transmission.
People with COVID symptoms can take a rapid antigen test (RAT), ideally when symptoms start, then isolate until symptoms disappear. One negative RAT alone can’t rule out COVID if symptoms are still present, so test again 24–48 hours after your initial test if symptoms persist.
You can now test yourself for COVID, RSV and influenza in a combined RAT. But again, a negative test doesn’t rule out the virus. If your symptoms continue, test again 24–48 hours after the previous test.
If it’s hay fever, how do I treat it?
Treatment involves blocking the body’s histamine release, by taking antihistamine medication which helps reduce the symptoms.
Doctors, nurse practitioners and pharmacists can develop a hay fever care plan. This may include using a nasal spray containing a topical corticosteroid to help reduce the swelling inside the nose, which causes stuffiness or blockage.
Nasal sprays need to delivered using correct technique and used over several weeks to work properly. Often these sprays can also help lessen the itchy eyes of hay fever.
Drying bed linen and pyjamas inside during spring can lessen symptoms, as can putting a smear of Vaseline in the nostrils when going outside. Pollen sticks to the Vaseline, and gently blowing your nose later removes it.
People with asthma should also have an asthma plan, created by their doctor or nurse practitioner, explaining how to adjust their asthma reliever and preventer medications in hay fever seasons or on allergen exposure.
People with asthma also need to be alert for thunderstorms, where pollens can burst into tinier particles, be inhaled deeper in the lungs and cause a severe asthma attack, and even death.
What if it’s COVID, RSV or the flu?
Australians aged 70 and over and others with underlying health conditions who test positive for COVID are eligible for antivirals to reduce their chance of severe illness.
Most other people with COVID, RSV and influenza will recover at home with rest, fluids and paracetamol to relieve symptoms. However some groups are at greater risk of serious illness and may require additional treatment or hospitalisation.
For RSV, this includes premature infants, babies 12 months and younger, children under two who have other medical conditions, adults over 75, people with heart and lung conditions, or health conditions that lessens the immune system response.
For influenza, people at higher risk of severe illness are pregnant women, Aboriginal people, people under five or over 65 years, or people with long-term medical conditions, such as kidney, heart, lung or liver disease, diabetes and decreased immunity.
If you’re concerned about severe symptoms of COVID, RSV or influenza, consult your doctor or call 000 in an emergency.
If your symptoms are mild but persist, and you’re not sure what’s causing them, book an appointment with your doctor or nurse practitioner. Although hay fever season is here, we need to avoid spreading other serious infectious.
For more information, you can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria); use the online Symptom Checker; or visit healthdirect.gov.au or the Australian Society of Clinical Immunology and Allergy.
Deryn Thompson, Eczema and Allergy Nurse; Lecturer, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Not all ultra-processed foods are bad for your health, whatever you might have heard
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In recent years, there’s been increasing hype about the potential health risks associated with so-called “ultra-processed” foods.
But new evidence published this week found not all “ultra-processed” foods are linked to poor health. That includes the mass-produced wholegrain bread you buy from the supermarket.
While this newly published research and associated editorial are unlikely to end the wrangling about how best to define unhealthy foods and diets, it’s critical those debates don’t delay the implementation of policies that are likely to actually improve our diets.
What are ultra-processed foods?
Ultra-processed foods are industrially produced using a variety of processing techniques. They typically include ingredients that can’t be found in a home kitchen, such as preservatives, emulsifiers, sweeteners and/or artificial colours.
Common examples of ultra-processed foods include packaged chips, flavoured yoghurts, soft drinks, sausages and mass-produced packaged wholegrain bread.
In many other countries, ultra-processed foods make up a large proportion of what people eat. A recent study estimated they make up an average of 42% of total energy intake in Australia.
How do ultra-processed foods affect our health?
Previous studies have linked increased consumption of ultra-processed food with poorer health. High consumption of ultra-processed food, for example, has been associated with a higher risk of type 2 diabetes, and death from heart disease and stroke.
Ultra-processed foods are typically high in energy, added sugars, salt and/or unhealthy fats. These have long been recognised as risk factors for a range of diseases.
Ultra-processed foods are usually high is energy, salt, fat, or sugar. Olga Dubravina/Shutterstock It has also been suggested that structural changes that happen to ultra-processed foods as part of the manufacturing process may lead you to eat more than you should. Potential explanations are that, due to the way they’re made, the foods are quicker to eat and more palatable.
It’s also possible certain food additives may impair normal body functions, such as the way our cells reproduce.
Is it harmful? It depends on the food’s nutrients
The new paper just published used 30 years of data from two large US cohort studies to evaluate the relationship between ultra-processed food consumption and long-term health. The study tried to disentangle the effects of the manufacturing process itself from the nutrient profile of foods.
The study found a small increase in the risk of early death with higher ultra-processed food consumption.
But importantly, the authors also looked at diet quality. They found that for people who had high quality diets (high in fruit, vegetables, wholegrains, as well as healthy fats, and low in sugary drinks, salt, and red and processed meat), there was no clear association between the amount of ultra-processed food they ate and risk of premature death.
This suggests overall diet quality has a stronger influence on long-term health than ultra-processed food consumption.
People who consume a healthy diet overall but still eat ultra-processed foods aren’t at greater risk of early death. Grusho Anna/Shutterstock When the researchers analysed ultra-processed foods by sub-category, mass-produced wholegrain products, such as supermarket wholegrain breads and wholegrain breakfast cereals, were not associated with poorer health.
This finding matches another recent study that suggests ultra-processed wholegrain foods are not a driver of poor health.
The authors concluded, while there was some support for limiting consumption of certain types of ultra-processed food for long-term health, not all ultra-processed food products should be universally restricted.
Should dietary guidelines advise against ultra-processed foods?
Existing national dietary guidelines have been developed and refined based on decades of nutrition evidence.
Much of the recent evidence related to ultra-processed foods tells us what we already knew: that products like soft drinks, alcohol and processed meats are bad for health.
Dietary guidelines generally already advise to eat mostly whole foods and to limit consumption of highly processed foods that are high in refined grains, saturated fat, sugar and salt.
But some nutrition researchers have called for dietary guidelines to be amended to recommend avoiding ultra-processed foods.
Based on the available evidence, it would be difficult to justify adding a sweeping statement about avoiding all ultra-processed foods.
Advice to avoid all ultra-processed foods would likely unfairly impact people on low-incomes, as many ultra-processed foods, such as supermarket breads, are relatively affordable and convenient.
Wholegrain breads also provide important nutrients, such as fibre. In many countries, bread is the biggest contributor to fibre intake. So it would be problematic to recommend avoiding supermarket wholegrain bread just because it’s ultra-processed.
So how can we improve our diets?
There is strong consensus on the need to implement evidence-based policies to improve population diets. This includes legislation to restrict children’s exposure to the marketing of unhealthy foods and brands, mandatory Health Star Rating nutrition labelling and taxes on sugary drinks.
Taxes on sugary drinks would reduce their consumption. MDV Edwards/Shutterstock These policies are underpinned by well-established systems for classifying the healthiness of foods. If new evidence unfolds about mechanisms by which ultra-processed foods drive health harms, these classification systems can be updated to reflect such evidence. If specific additives are found to be harmful to health, for example, this evidence can be incorporated into existing nutrient profiling systems, such as the Health Star Rating food labelling scheme.
Accordingly, policymakers can confidently progress food policy implementation using the tools for classifying the healthiness of foods that we already have.
Unhealthy diets and obesity are among the largest contributors to poor health. We can’t let the hype and academic debate around “ultra-processed” foods delay implementation of globally recommended policies for improving population diets.
Gary Sacks, Professor of Public Health Policy, Deakin University; Kathryn Backholer, Co-Director, Global Centre for Preventive Health and Nutrition, Deakin University; Kathryn Bradbury, Senior Research Fellow in the School of Population Health, University of Auckland, Waipapa Taumata Rau, and Sally Mackay, Senior Lecturer Epidemiology and Biostatistics, University of Auckland, Waipapa Taumata Rau
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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