Breakfast in a Bottle - Friend or Foe?

By Niamh O’ Sullivan BSc (Hons), MSc, RD .

 

 

Breakfast choices have hit the headlines with concerns surrounding the sugar contents of popular breakfast cereals and what children are choosing to eat as their first meal of the day.

 

In the last 10 years the breakfast market has been transformed from the traditional cereals served in a bowl eaten at the table into a handy, easy-to-grab packaged option eaten on-the-go. We have seen the rise of the breakfast biscuit and more recently the emergence of breakfast drinks. We all know time and money are precious commodities, but can we really afford to condense our breakfast?

 

We wanted to look at the breakfast drink market to evaluate some of the current products available and to see if there is any benefit in having a liquid breakfast.

 

But firstly, let’s ask a basic question…what are the benefits of eating breakfast?

 

 

dsc_1947

 

 

Why bother with breakfast?

 

 

Breakfast is commonly labelled as “the most important meal of the day”, and although all meals are important, there is some evidence to suggest eating breakfast incurs nutritional benefits.

 

Up until recently dietary guidelines recommending the consumption of breakfast has been based largely on cross-sectional observational studies involving self-reported dietary intake (1,2). When looking at these studies, it is clear that breakfast brings positive impacts on our health, and has shown that those likely to skip breakfast are at an increased risk of adiposity (fat mass), diabetes and cardiovascular disease (3-7).

 

There has also been interesting research looking into the specific effects that eating breakfast regularly has on our health in lean and obese adults (8,9). Eating breakfast has shown to have positive effects on insulin sensitivity and blood sugar control and increased physical activity levels (8,9).  In obese adults, those who skipped breakfast were more likely to compensate by eating more food later in the day (9), with other research revealing that breakfast skippers are more likely to crave high calorie foods (10).

 

So it’s fair to say, breakfast is important! The evidence suggests that there are far more pros to kick starting the morning with a healthy breakfast to see us through the day ahead.

 

 

So what should breakfast provide?

 

 

When we think of what our first meal of the day should provide, we want it to be nutritious and satisfying (in terms of taste and creating a comfortable feeling of fullness). A healthy breakfast needs to provide our bodies with much needed energy and protein as well as vitamins and minerals such as the B vitamins, calcium, folate and iron.

 

For more information about healthy breakfast ideas click here.

 

 

Breakfast drinks – are they a morning meal contender?

 

 

We wanted to cast a critical eye at three of the most popular breakfast drinks available on the market (Weetabix ; Up & Go and Fuel 10K)  to see whether they really can provide a suitable candidate for a nutritious breakfast option?

 

 

dsc_1943-2

 

 

The Results…

 

Calorie Contents of Breakfast Drinks - Dietetic Information and Nutritional Evidence

 

 

  • Both Weetabix “On the Go” and Up & Go come in a volume of 250mls whilst Fuel 10k has a larger total volume of 330mls.

 

  • Weetabix “On the Go” contained the most calories per 100ml (85kcal ) and per total product ( 213kcal in 250ml).

 

  • Fuel 10k contained substantially less calories per 100ml, but due to coming in a bigger volume contained the second most calories per total product (330ml).

 

 

Sugar Content of Breakfast Drinks - Dietetic Information and Nutritional Evidence

  • The recommended daily intake of sugar per day for an adult is approximately 30g .

 

  •  All the breakfast drinks analysed  were exceptionally high in sugar, with Weetabix “On the Go” containing a staggering 20.1g sugar per total product.

 

  • Up & Go contained the least amount of sugar per product (18.5g).

 

 

Saturated Fat Content - Dietetic Information and Nutritional Evidence

 

  • Foods containing more than 5g saturated fat per 100g are deemed to be “high” in saturated fat. Whilst foods with 1.5g of saturates or less per 100g or 0.75g per 100ml are deemed to be “low” in saturated fat.

 

  • Weetabix “On the Go” contained 15x more saturated fat compared with the other breakfast drinks per total product, whilst Fuel 10k and Up & Go can be categorised as low in saturated fat in line with dietary recommendations.

 

 

Protein Content of Breakfast Drinks - Dietetic Information and Nutritional Evidence

  • 100ml semi-skimmed milk contains approximately 3.5-4 g protein.

 

  • Fuel 10k was substantially higher in protein both per 100ml and per total product compared with the other breakfast drinks. Fuel 10k had nearly double the protein content of 100ml semi-skimmed milk.

 

  • Weetabix “On the Go” contained the least amount of protein per 100g and per total product.

 

Fibre Content of Breakfast Drinks

 

  • It is recommended we try to have 30g fibre everyday for good health.   A portion of 2 weetabix (as in the breakfast cereal) provides approximately 3.8g fibre.

 

  • Both Up & Go and Weetabix “On the Go” contained higher amounts of fibre per total product (>5.5g) compared with the high protein drink Fuel 10k.

 

 

Our verdict!

 

 

It is hard to identify one of the drinks as the “winner” in this analysis. Each of the breakfast drinks we analysed all had different superior nutritional features e.g. for high intakes of protein Fuel 10k was the best product, whilst for fibre, both Up & Go and Weetabix “On the Go” would be better choices.

 

When you break it down, and look at what the breakfast drinks contain compared with a bowl of cereal with milk, it can be difficult to justify them as a superior option.  All the breakfast drinks we analysed were very high in sugar, arguably no better than many breakfast cereals which have been under scrutiny.

 

Current labelling makes it hard to work out just how much of the total sugar come from free sugars opposed to naturally occurring milk sugars, but this can somewhat be deciphered from the order of ingredients listed on the products. For example, Up & Go lists “sugar” and “fructose”  as the fourth and fifth ingredient,  leading to the assumption they contribute to a large proportion of the overall sugar content.

 

It appears that Up & Go have reformulated their product since they originally first launched the product in the UK, by adding in extra fibre and protein and reducing the saturated fat and sugar contents as well as boosting the vitamin and mineral content.

 

Also, there is not much high quality research evaluating the question of whether drinking our breakfast in a liquid form is better than having it in a solid form.  Evidence has shown that solid foods appear to be more satiating than liquids (13-20). This is attributed to the physiological processes of chewing and the fact that solid foods are digested more slowly. Solid foods seems to slow down gastric emptying (rate at which food leaves the stomach) compared with liquids, leading us to feel fuller for longer.

 

Whilst breakfast drinks do provide a convenient option for those struggling to make time for breakfast, this convenience comes at a cost! On average each of the breakfast drinks were found to cost ~£1.50 per unit, but other brands can be as costly as £4+ per unit.

 

But what we do know is that having breakfast is better than not having breakfast. The food industry and restaurants are constantly developing and offering equally convenient breakfast options, many of which are more nutritious and the same or a cheaper price than that of a breakfast drink!

 

 

References

 

  1. Casazza K, Fontaine KR, Astrup A, Birch LL, Brown AW, Bohan Brown MM, Durant N, Dutton G, Foster EM, Heymsfield SB, et al. Myths, presumptions, and facts about obesity. N Engl J Med 2013;368: 446–54.
  2. Brown AW, Bohan Brown MM, Allison DB. Belief beyond the evidence: using the proposed effect of breakfast on obesity to show 2 practices that distort scientific evidence. Am J Clin Nutr 2013;98: 1298–08.
  3. Fabry P, Hejl Z, Fodor J, Braun T, Zvolankova K. The frequency of meals. Its relation to overweight, hypercholesterolaemia, and decreased glucose-tolerance. Lancet 1964;2:614–5.
  4. Barton BA, Eldridge AL, Thompson D, Affenito SG, Striegel-Moore RH, Franko DL, Albertson AM, Crockett SJ. The relationship of breakfast and cereal consumption to nutrient intake and body mass index: the National Heart, Lung, and Blood Institute Growth and Health Study. J Am Diet Assoc 2005;105:1383–9.
  5. Kant AK, Schatzkin A, Graubard BI, Ballard-Barbash R. Frequency of eating occasions and weight change in the NHANES I Epidemiologic Follow-up Study. Int J Obes Relat Metab Disord 1995;19:468– 74.
  6. Smith KJ, Gall SL, McNaughton SA, Blizzard L, Dwyer T, Venn AJ. Skipping breakfast: longitudinal associations with cardiometabolic risk factors in the Childhood Determinants of Adult Health Study. Am J Clin Nutr 2010;92:1316–25.
  7. Cahill LE, Chiuve SE, Mekary RA, Jensen MK, Flint AJ, Hu FB, Rimm EB. Prospective study of breakfast eating and incident coronary heart disease in a cohort of male US health professionals. Circulation 2013;128:337–43.
  8. Betts JA, Richardson JD, Chowdhury EA, Holman GD, Tsintzas K, Thompson D. The causal role of breakfast in energy balance and health: a randomized controlled trial in lean adults. Am J Clin Nutr 2014;100:539–47.
  9. Enhad A Chowdhury, Judith D Richardson, Geoffrey D Holman, Kostas Tsintzas, Dylan Thompson, James A Betts. The causal role of breakfast in energy balance and health: a randomized controlled trial in obese adults. Am J Clin Nutr. 2016; 103(3): 747–756.
  1. Goldstone AP1, Prechtl de Hernandez CGBeaver JDMuhammed KCroese CBell GDurighel GHughes EWaldman ADFrost GBell JD. Fasting biases brain reward systems towards high-calorie foods. Eur J Neurosci.2009;30(8):1625-35
  1. European Commission. Regulation (EC) No 1924/2006 of the European Parliament and of the Council of 20 December 2006 on nutrition and health claims made on foods.Available at: http://ec.europa.eu/food/safety/labelling_nutrition/claims/nutrition_claims_en (accessed 25 October 2016).
  1. SACN(Scientific Advisory Committee on Nutrition). Carbohydrates and Health Report2015. Available at:https://www.gov.uk/government/publications/sacn-carbohydrates-and-health-report(accessed 23 October 2016).
  2. Mattes RD, Campbell WW. Effects of food form and timing of ingestion on appetite and energy intake in lean young adults and in young adults with obesity. J Am Diet Assoc. 2009;109(3):430-437.
  3. Cassady BA, Considine RV, Mattes RD. Beverage consumption, appetite, and energy intake: What did you expect? Am J Clin Nutr. 2012;95(3):587-593.
  4. Zhu Y, Hsu WH, Hollis JH. The impact of food viscosity on eating rate, subjective appetite, glycemic response and gastric emptying rate. PLoS ONE. 2013;8(6):1-6.
  5. Leidy HJ, Apolzan JW, Mattes RD, Campbell WW. Food form and portion size affect postprandial appetite sensations and hormonal responses in healthy, nonobese, older adults. Obesity (Silver Spring). 2010;18(2):293-299.
  6. Houchins JA, Tan S, Campbell WW, Mattes RD. Effects of fruit and vegetable, consumed in solid vs beverage forms, on acute and chronic appetitive responses in lean and obese adults. Int J Obes (Lond). 2013;37(8):1109-1115.
  7. Hogenkamp PS, Mars M, Stafleu A, de Graaf C. Repeated consumption of a large volume of liquid and semi-solid foods increases ad libitum intake, but does not change expected satiety. Appetite. 2012;59(2):419-424.
  8. Hogenkamp PS, Stafleu A, Mars M, de Graaf C. Learning about the energy density of liquid and semi-solid foods. Int J Obes. 2012;36(9):1229-1235.
  9. Zhu Y, Hsu WH, Hollis JH. The effect of food form on satiety. Int J Food Sci Nutr. 2013;64(4):385-391.

 

 

By Charlotte Foster BSc (Hons), MSc, RD.

 

 

With Christmas behind us, short days, long nights and no prospect of  a bank holiday for another few months,  it’s not uncommon to hear people suffering with the “January blues”.

 

However,  this phrase often trivialises the issue of feeling low in mood or suffering with depression.

 

The reality is, those feeling chronically low in mood or suffering with depression it can be highly debilitating and has a massive impact on quality of life.

 

But is there anything we can do in our diets to help boost our moods with food? Check out a few of our top tips!

 

 

Regular eating -keep your blood sugars steady!

 

By eating regularly we can regulate our blood sugar levels better and provide our body with a steady supply of nutrition and calories to sustain us through the day.  Focus on having low glycaemic (low GI), slow releasing carbohydrates to help avoid sharp rises and falls in blood sugar levels.

 

 

The effects of low GI & high GI foods on blood glucose levels (1).

 

Screenshot (3)

 

 

Don’t exclude food groups – all are important! Carbohydrates have had a lot of bad press in recent years, with many people advocating cutting out this food group altogether. The reality is, carbohydrates get broken down into glucose  which is the brain’s primary energy source.  Therefore, by not having enough carbohydrate in the diet, we can end up feeling fatigued and unable to concentrate.

 

So remember, to fuel your brain and nourish your body we need a combination of all food groups to obtain the nutrition we need. Try to have carbohydrates, fat and protein at every meal.

 

The  Eatwell Guide (2).

 

New Eat Well Plate

 

 

Get on board with good fats

 

Omega-3 and omega-6 are both polyunsaturated fatty acids which are both important for healthy brain function. Research has shown that low levels of omega-3 have been linked with a higher incidence of depression (3-5).

 

Omega-3 is essential for the production of  neurotrophic factors which regulate the growth of brain cells. It is also believed that omega-3  can affect gene expression.

 

There are two forms of omega-3 :

 

  • ALA (alpha-linolenic acid) – found in mainly plant sources (mainly nuts and seeds) , it cannot be made in the body and so must be obtained in our diet.

 

  • EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) – found primarily in fish, seafood and dairy sources, although  both can be synthesised from ALA can when necessary.

 

 

Good sources of where these essential fats can be found  include:

 

 

  • Oily fish

 

  • Poultry

 

  • Nuts (especially walnuts and almonds)

 

  • Olive and sunflower oils

 

  • Seeds (such as sunflower, pumpkin and chia)

 

  • Avocados

 

  • Dairy foods – milk, yoghurt, cheese etc

 

 

For more information on omega-3, click here.

 

 

DSC_3942

 

 

Pack in protein!

 

Protein is made up of amino acids, which make up the chemicals your brain needs to regulate your thoughts and feelings.

 

Good sources include:

 

  • Lean meat

 

  • Fish

 

  • Eggs

 

  • Cheese

 

  • Legumes (peas, beans and lentils)

 

  • Soya products

 

  • Nuts and seeds

 

 

Fruit & Vegetables – Get your 5 a day!

 

  • High in vitamins, minerals and fibre.

 

  • Fresh, frozen, tinned, dried all count.

 

  • Eat a range of colours to get a good range of nutrients – several portions of the same type of food won’t be so good for you.

 

  • Tomatoes, mushrooms and bananas all contain high levels of potassium which is essential for your whole nervous system, including your brain.

 

  • Think about cooking methods to preserve the nutrients – boiling/ cooking for too long can destroy some vitamins and minerals .

 

For more information on fruits and vegetables, click here.

 

DSC_3927

The Sunshine Vitamin – Vitamin D

 

Vitamin D plays a vital role in preventing rickets in children and osteomalacia, promoting calcium absorption, bone growth and bone remodelling. It is involved in cell growth, genetic coding and functioning, neuromuscular functioning, immune functioning and reducing inflammation.

 

Some evidence which suggests an association between low vitamin D levels and osteoporosis, diabetes, cardiovascular disease, tuberculosis, multiple sclerosis, preeclampsia and cancer.

 

In July 2016,  Public Health England released updated guidelines on  the recommendations for vitamin D:

 

  • Adults should aim for a daily dietary intake 10µg of vitamin D

 

  • During autumn and winter months  a daily supplement containing 10µg of vitamin D should be considered.

 

 

Make sure you get your micronutrients!

 

Micronutrients (vitamins and minerals) all play an important role in the body. However, the following listed below are key to help ensure we have plenty of energy and maintain healthy brain function which together can help regulate our mood.

 

 

  • Selenium – found in brazil nuts, seeds,  meat, fish and wholemeal bread.

 

  • B vitamins-  found in wholegrain foods,  meat, fish, eggs and dairy products.

 

  • Iron – found in red meat and offal, eggs and dark leafy greens.

 

  •  Folate – found in green vegetables, citrus fruits, beans, liver  and fortified foods e.g. Marmite  or fortified cereals.

 

For more information, click here. 

 

 

Fill your glass with hydrating fluids!

 

Most of us don’t drink enough, which can massively impact our mood and ability to concentrate. Try to aim for ~ 1.5-2 L fluid everyday.

 

A lack of fluid can lead to :

 

  • Alteration in  appetite

 

  • Cause constipation

 

  • Impact concentration and exacerbate fatigue

 

 

Try to limit caffeinated drinks and alcohol as these can enhance feelings of anxiety and depression and impact appetite.

 

 

Dine-Nutritional Evidence-Coeliac, healthy eating, diabetes, clean eating diet0008

 

 

 

References:

 

 

1: Glycaemic Index Foundation (2016). What is Glycaemic Index? Available at  http://www.gisymbol.com/about/glycemic-index/ [last accessed 22/11/16].

 

 

2: The Eatwell Guide (2016) Available at https://www.gov.uk/government/publications/the-eatwell-guide  [last accessed 11/1/17].

 

 

3: Su, K. et al.  (2014) “Omega-3 Fatty Acids in the Prevention of Interferon-Alpha-Induced Depression: Results from a Randomized, Controlled Trial” Biological Psychiatry , 76 (7); 559–566.

 

 

4: Freeman MP, Hibbeln JR, Wisner KL, et al. (2006) Omega-3 fatty acids: evidence basis for treatment and future research in psychiatry. Journal of Clinical  Psychiatry,  67 (12); 1954-1967.

 

 

5: Sarris J, Mischoulon D, Schweitzer I. (2003) Omega-3 for bipolar disorder: meta-analyses of use in mania and bipolar depression. Journal of Clinical  Psychiatry, Epub ahead of print.

 

 

Useful Links:

 

 

British Dietetic Association – Omega-3

 

 

British Dietetic Association – Food & Mood 

 

 

British Dietetic Association – Fruit & Vegetables 

 

 

MIND – Food & Mood 

By Charlotte Foster BSc (Hons), MSc, RD.

 

How are you? Busy? Tired? Exhausted?

 

Many of us can relate to the rat race of early starts and late nights – we are busy, busy, busy and it can really take its toll!

 

Getting the balance of life’s demands during daylight hours can be a real challenge. Commuting long distances, juggling work/ friends/ family/ partners/gym/ exercise/sleep etc – life can be exhausting!

 

Sleep and exercise are definitely important, but is there anything we can do in our diets to help boost our energy levels?

 

Having recently returned from a 3 week break from work to get married, I am reflecting on my own lifestyle and the importance of implementing good dietary strategies to stave off fatigue…

 

 

Regular eating!

 

I hark on about this time and time again, because it is so easy to slip into bad habits and by eating regularly we can regulate our blood sugar levels better and provide our body with a regular steady supply of nutrition and calories to sustain us through the day.

 

 

Breakfast – break the fast!

 

By breaking the fast – breakfast (or the first meal of the day) helps to kick start our bodies, providing the “fuel” we need for the day ahead. The whole cheesy analogy of putting petrol into a car to get it going is a cliché for a reason…. there is some truth in it! For people in the UK, largely due to popular food choices, breakfast often provides an opportunity for obtaining a significant proportion of our fibre, calcium and iron intakes for the day ahead. Interestingly, evidence also suggests that breakfast skippers are more likely to gain weight, as summarised nicely by the National Obesity Observatory.

 

 

Dine-Nutritional Evidence-Coeliac, healthy eating, diabetes, clean eating diet0015

 

 

Fruits and Veg- the faithful friends!

How many portions are recommended by public health guidelines for good health? AT LEAST 5 portions, with some new evidence saying it should be nearer 7 portions a day (1).

But why? Because, they contain fibre, minerals, and a range of vitamins, many of which are antioxidants which are cardio protective (helpful for heart health) and have an anti-carcinogenic effect by stabilising “free radicals” (pollutants) which the body is exposed to.

 

DSC_3927

Pumpin’ iron!

 

Iron is a vital mineral that the body needs for the production of red blood cells. Haemoglobin binds to oxygen and transports it around the body to. A lack of iron can lead to iron deficiency anaemia resulting in symptoms including:

 

 

  • Fatigue / lethargy (feeling exhausted)

 

  • Pale complexion

 

  • Breathlessness

 

  • Heart palpitations

 

Now, there are two forms of iron in the diet “haem” iron (found in red meat and other animal sources) and “non haem” (e.g. fortified breakfast cereals, dark leafy vegetables e.g. spinach or watercress; beans and pulses; nuts and seeds; tofu and certain dried fruits). Haem iron is absorbed easily in the small intestines whilst non haem iron is absorbed in line with our body’s demands (2).

 

Vitamin C is required to help increase the absorption of iron and phenolic compounds and phytates can inhibit iron absorption (2).

 

For more information check out  The British Nutrition Foundation’s fact sheet on iron and iron deficiency anaemia.

 

 

Boost the B vitamins!

 

There are a range of B vitamins, and they all have slightly different roles, but the majority of them play a part in helping with the energy metabolism of food.

 

The main B vitamins are:

 

  • thiamin (vitamin B1)

 

  • riboflavin (vitamin B2)

 

  • niacin (vitamin B3)

 

  • pantothenic acid

 

  • vitamin B6

 

  • biotin (vitamin B7)

 

  • folic acid

 

  • vitamin B12

 

 

Without adequate folate or vitamin B12, anaemias can develop. You cannot store B vitamins in the body (similarly) to vitamin C, as they are water soluble.

 

For more information about the role of each of the B vitamins and for sources and recommended intakes check out NHS Choices article.

 

 

The “sleep boosting” minerals – magnesium & calcium

 

There are some claims that magnesium and calcium can help with sleep disturbance and insomnia.

 

One study looked at a 500mg supplementation of magnesium on insomnia and found that there were statistically significant results for participants taking a supplement of magnesium in several subjective parameters including sleep efficiency, sleep time and sleep onset latency, early morning awakening. However, there was no significant difference between groups in regards to total sleep (3). Magnesium is also essential for energy release from food (4).

 

Good sources of magnesium include (4):

 

  • green leafy vegetables  e.g. spinach

 

  • nuts

 

  • brown rice

 

  • bread (especially wholegrain)

 

  • fish

 

  • meat

 

  • dairy foods

 

 

Good sources of calcium include (5):

 

  • Dairy foods e.g. milk, yoghurt, cheese.

 

  • Dark leafy vegetables e.g. broccoli and cabbage

 

  • Tofu

 

  • Soya drinks fortified with calcium

 

  • Nuts

 

  • Foods made with fortified flour

 

  • Sardines, white bait and pilchards (fish where you eat the bones)

 

 

 

fat debate

 

Glycaemic index – choose slow releasing carbohydrates and watch the sugar!

 

Glycaemic index (GI) is a measure of the effect that certain foods have on the blood sugar levels. The higher the GI, the higher the blood sugar level will rise following consumption and digestion.

 

Most of us in the UK are eating far too much sugar. Sugar is an energy (calorie) dense source in the diet and can be useful to provide short and sharp bursts of energy in times of need. However, high sugar containing products will cause a sharp rise but also a sharp decline in blood sugar levels which can leave us feeling exhausted. Also, too much sugar has been linked to being overweight/obese.

 

For more information on sugar make sure you read DINE’s article here.

 

By choosing foods with a lower glycaemic index, will help sustain our energy levels for longer. As outlined in the diagram below, the carbohydrates with a lower GI will not cause such a dramatic rise and fall in blood sugar level, providing a gentle and slow release of energy to sustain you across the day.

 

For more information about glycaemic index click the British Dietetic Association fact sheet.

 

 

The effects of low GI & high GI foods on blood glucose levels (6).

 

Screenshot (3)

 

Hydrate! Curb the caffeine and watch the alcohol!

 

When we are dehydrated we can often feel exhausted (7). Making sure you are drinking enough fluid is very important, and most of us don’t drink enough.

 

Caffeine is a stimulant and so can help boost energy levels during certain times, but too much caffeine can disturb sleep patterns and stop you switching off at bed time.  Herbal teas can provide a good alternative if you are craving a hot beverage and certain ones e.g. chamomile tea, are thought to evoke a calming, soothing and relaxing effect on the body.

 

Alcohol can also lead to a disturbed night by altering our sleep cycle and disrupting the deep sleep and REM sleep patterns and for some it can also make us snore! (8).

 

Both caffeine and alcohol can cause a diuretic effect, causing us to need the toilet more and can exacerbate dehydration.

 

Dine-Nutritional Evidence-Coeliac, healthy eating, diabetes, clean eating diet0006

 

 

What about supplements?

 

There are so many pills and supplements available on the market promising to “cure” our tiredness for good. Common supplements/ products that are often promoted as beneficial for boosting energy include:

 

  • Tryptophan

 

  • B vitamins

 

  • Magnesium

 

  • Iron

 

  • Ginseng

 

  • Energy drinks

 

  • Glucose tablets

 

  • Caffeine tablets

 

 

The reality is, we are designed to eat food! Supplements for some people are sometimes necessary, but for many of us we can obtain all the nutrition we need through food.

 

By making simple dietary changes e.g. boosting the fruit and vegetable contents of our diets, choosing complex carbohydrates and  reducing sugar, caffeine and alcohol, we can radically alter our body’s nutritional status and feel the energetic benefits of a healthy and balanced diet.

 

 

If your fatigue persists, it could be a symptom of a more chronic condition e.g. anaemia (iron of B vitamin related). If you have any concerns, be sure to book an appointment to see your GP.

 

 

Useful Links:

 

NHS Choices – The Energy Diet 

 

NHS Choices – Tiredness and fatigue 

 

The British Nutrition Foundation- Iron & anaemia fact sheet

 

NHS Choices – Vitamin B 

 

British Dietetic Association – Glycaemic Index fact sheet

 

Drink Aware – Alcohol & Sleep

 

 

References

 

1: Oyebode, O., Gordon-Dseagu, A., Mindell J.S. (2014) Fruit and vegetable consumption and all-cause, cancer and CVD mortality: analysis of Health Survey for England data. Journal of Epidemiology and Community Health ; published online.

 

2: The British Nutrition Foundation Nutrition, health and schoolchildren Iron Deficiency Anaemia. Available at https://www.nutrition.org.uk/attachments/article/546/Iron%20deficiency%20anaemia%20and%20school%20children.pdf [last accessed 22/11/16]

 

3: Abbasi, B., Kimijagar, M., Saeghnijat, K., Shirazi, M.M., Hedayati, M. & Rashidkhani B. (2012). The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial. Journal of Research in Medical Sciences 17(12);1161-1169.

 

4: NHS Choices (2015) Vitamins and minerals –Others. Available at http://www.nhs.uk/Conditions/vitamins-minerals/Pages/Other-vitamins-minerals.aspx#magnesium [last accessed 22/11/16].

 

(5): NHS Choices (2015) Calcium. Available at http://www.nhs.uk/Conditions/vitamins-minerals/Pages/Calcium.aspx [last accessed 22/11/16].

 

(6): Glycaemic Index Foundation (2016). What is Glycaemic Index? Available at  http://www.gisymbol.com/about/glycemic-index/ [last accessed 22/11/16].

 

(7):  NHS  Choices (2015) symptoms of dehydration. Available at http://www.nhs.uk/Conditions/Dehydration/Pages/Symptoms.aspx [last accessed 22/11/16].

 

(8): Drink Aware (2016) Alcohol and sleep. Available at https://www.drinkaware.co.uk/alcohol-facts/health-effects-of-alcohol/effects-on-the-body/alcohol-and-sleep [last accessed 22/11/16].

By Charlotte Foster BSc (Hons), MSc, RD

 

I recently returned from my honeymoon and it got me thinking about how challenging it can be to be mindful about eating healthily when on holiday or when travelling.

 

We were surrounded by SO much delicious food. The choice of several incredible restaurants to dine at, countless cocktails served with countless canapes was amazing,  but with so much delicious temptation everywhere, I actually found it quite overwhelming and difficult to maintain a balance! I never thought I would say this, but by the end of the trip, I really craved vegetables, bake beans and culinary simplicity!

 

Now, whilst I’m a firm believer in feasting on a feast day and enjoying all foods in moderation, indulging day in and day out took its toll!

 

However, there have also been trips where we have taken to the road with a more coin counting mentality! Being on a budget and with no means of refrigerating foods, (passing the time away with car karaoke!) eating anything other than highly processed snacks was a challenge.

 

Here are some of my top tips to navigate times of travel in the healthy eating arena!

 

 

Beware of the buffet!

 

Food glorious food! Buffets, serve yourself restaurants or all-inclusive holidays often encourage us to pile our plates to make the most of our money. The problem is this can encourage us to overeat and if done regularly will lead to us piling on the pounds as our bodies store the excess energy we consume.

 

 

Portion control!

 

When eating out at restaurants, it can be difficult to have control over the portion sizes of foods. Some countries/continents e.g. America are renowned for delivering larger plus size portions but more and more it is commonplace to order mammoth potions of food when eating out.  If you’re at a buffet and more in control be careful not to over fill your plate.  It can take up to 20 minutes for the feeling of satiety to kick in so take your time when dining!

 

For healthy eating, for a main meal the recommended portion sizes are:

 

 

  • 1/3 plate starchy carbohydrate (e.g. pasta, rice, potato, cous cous)

 

  • 1/3 plate protein (e.g. meat, fish, lentils, pulses etc)

 

  • 1/3 vegetables

 

 

In weight loss, to achieve a calorie deficit try aiming for the following adjustment in portion sizes:

 

 

  • ¼ plate starchy carbohydrate

 

  • ¼ plate protein

 

  • ½ plate vegetables

 

 

Eat your greens!

 

Get your 5 a day! As well as being nutritious, most fruits and veg don’t require refrigeration and make a fantastic  on the go snack if you’re travelling. Indulge in local/ seasonal produce to make sure you stock up on antioxidants, vitamins, minerals and fibre.

 

 

DSC_3927

Avoid raiding the mini bar!

 

If you’re staying in a hotel equipped with a little treat filled fridge, try to limit / avoid opening it and devouring the tempting contents. As well as encouraging you to snack on potentially high sugar, salt and fat containing snacks, there tends to be a monetary mark up, meaning It will end up costing your wallet as well as your waist line!

 

 

Learn to be a food sharer!

 

An area my husband has grown massively in… food sharing. If faced with an abundance of rich and calorific foods or simply intrigued to sample a wide variety of local cuisine, having a more “open” and “sharing” approach to food can help satisfy your culinary curiosity whilst reducing your calorie intake.

 

 

Stay hydrated!

 

Most of us definitely don’t drink enough! If you’re in a hotter climate your demands for fluid will be greater. Although caffeine and alcohol may be fluids, they both act as “diuretics” which can increase your urine output and can exacerbate dehydration. So up the “hydrating fluids” (no surprises, water being the best!) and enjoy the caffeine and alcohol in moderation!

 

 

Dine-Nutritional Evidence-Coeliac, healthy eating, diabetes, clean eating diet0008

 

 

Watch the booze !

 

It is not uncommon that during times of rest, relaxation or celebration we may choose crack out our favourite tipple! As seen  below, alcohol is high in calories (especially compared with carbs and protein) and that’s without a sugary mixer added to it!

 

 

  • One gram of alcohol =7 kcal

 

  • One gram fat = 9 kcal

 

  • Once gram carbohydrates = 4kcal

 

  • One gram protein = 4 kcal

 

 

Not only is it energy dense, but alcohol can infact stimulate our appetites possibly making us even more ravenous for our favourite treats!

 

For more information about alcohol, click here for a fantastic fact sheet from the British Dietetic Association.

 

 

Get active!

 

Holidays and travelling is a time to switch off, rest, make new memories and experience new things. However, if you’re anything like me, I love to spend hours relaxing by a pool with a good book, doing NOTHING!

 

Again, there is absolutely nothing wrong with this from time to time – in fact, rest is very important for our bodies too, but it is important to remember that doing at least 30 minutes of moderate or greater intensity activity at least five days a week is important for maintaining good health.

 

Walking, swimming, shopping, exploring, cycling, sight seeing – it all counts (as long as you do it for 30 minutes and it gets your heart rate up!). So incorporate exercise into activities that you find enjoyable!

 

For more healthy eating tips on how to lose weight, make sure you check out our article on weight loss tips!

 

By Josie Townsend, MNutr, RD.

 

When it comes to people avoiding gluten and wheat, there are various conditions you might hear bandied around that sound pretty similar and it can get really confusing! It doesn’t help that many of the conditions (which may require the exclusion of gluten-containing and wheat-containing foods) share similar symptoms.

We hope to clarify and explain the differences between these conditions, to help explain why some people may be required to follow specific diets and eliminate certain foods.

 

 

Coeliac Disease

 

Coeliac disease is an autoimmune condition caused by the body’s immune system reacting to the protein “gluten” found in wheat, barley and rye. Oats contain a similar protein called “avenin” which can also trigger symptoms in some people.

 

The ingestion of gluten damages the lining of the small intestine, affecting nutrient absorption , leading to nutrient deficiencies and sometimes unpleasant gastrointestinal symptoms.  There is no cure for coeliac disease. However, symptoms and long-term complications, such as osteoporosis, can be prevented by strict adherence to a gluten-free diet.

 

Click here more information on coeliac disease and following a gluten free diet or watch DINE’s video to give an overview of the condition

 

 

Non-Coeliac Gluten Sensitivity (NCGS) and Wheat Intolerance

 

NCGS is a sensitivity to gluten or wheat, which results in similar gastrointestinal symptoms to coeliac disease but without the immune response or damage to the gut lining. It is therefore not associated with the same nutrient deficiencies or long-term complications as coeliac disease. However, to manage symptoms, the treatment is the same – avoiding gluten/wheat-containing foods. These may then be gradually reintroduced back into the diet following a period of elimination and according to an individual’s level of tolerance. It’s important to rule out coeliac disease before diagnosing gluten sensitivity or wheat intolerance.

 

It must be noted that those with a wheat intolerance may still experience symptoms with some gluten-free products. This is because only the in some processed gluten-free products the gluten protein has been washed out, leaving behind a non-gluten containing wheat based ingredient.

 

NCGS is poorly understood and an area for much needed research.

 

 

Wheat Allergy

 

An allergy is different to an intolerance. Whilst a food intolerance isn’t life threatening, an allergy can be. It occurs when there is an immune response to a particular protein, such as 1 of the 4 different proteins found in wheat, and this sets of a reaction normally fairly immediately but sometimes delayed for up to 24-48 hours. Symptoms often involve skin reactions, swelling and/or breathing difficulties, which is why a severe allergic reaction (known as anaphylaxis) should be treated as a medical emergency.

 

Treatment includes strict avoidance of the wheat-containing products, and the option to carry an auto-injector pen of adrenaline in case of accidental exposure to the allergen. Hospitalisation may also be required.

 

 

Irritable Bowel Syndrome (IBS)

 

IBS is a gastrointestinal condition , resulting in similar symptoms of coeliac disease and wheat/gluten intolerance . Therefore, it is important that the diagnosis of IBS is confirmed by a doctor ensuring that other conditions such e.g. coeliac disease and inflammatory bowel disease have been ruled out.

 

Symptoms of IBS can vary greatly between individuals and are generally characterised by the following (which are relieved on defaecation):

 

  • abdominal pain/ discomfort

 

  • bloating

 

  • change in bowel habit (diarrhoea/ constipation/ fluctuation between diarrhoea and constipation).

 

These should be accompanied by at least two of the following four symptoms:

 

  • altered stool passage (straining, urgency, incomplete evacuation)

 

  • abdominal bloating

 

  • distension, tension or hardness in stools

 

  • symptoms exacerbated after food

 

  •  passage of mucus.

 

Certain foods and drinks (not necessarily containing wheat or gluten) may trigger an individual’s IBS. Being overweight, increased stress and a lack of physical activity can also exacerbate symptoms.

 

Dietitians will provide dietary strategies and advice in order to help manage symptoms.

By Charlotte Foster BSc Hons, MSc, RD.

 

One common culinary conundrum surrounding the gluten-free diet is cost! At present, most gluten-free products tend to be more expensive than gluten containing equivalents (1&2).

 

Studies have been conducted to examine the barrier of cost and whether it influences compliance to the gluten-free diet, highlighting mixed results. One study reported that 51.3% of participants felt that the cost of gluten-free products was an important issue but 75.3% felt this did not make the gluten-free diet difficult to adhere to (3). However, another study demonstrated the opposite- that cost is an important factor affecting compliance to the diet (4).

 

 

So why are processed gluten-free foods usually more expensive?

 

There are several reasons for why gluten-free foods tend to be more expensive including:

 

  • Growing consumer demands in what used to be a specialist “niche” market – the demand for an extensive product range has only been developed in recent years (5).

 

  • Complex processing steps involved to ensure a satisfactory gluten-free equivalent food (5).

 

  • Additional safety and quality checks to ensure that foods are meeting the standards for those with coeliac disease (5).

 

  • Increased cost of ingredients and equipment to ensure no cross contamination (5).

 

 

Gluten-free on prescription

 

Those who have been formally diagnosed with coeliac disease may be eligible to receive certain gluten-free products on prescription which can be financially beneficial. However, due to budget cuts in the NHS certain areas may be exempt – speak to a GP or dietitian for further information.

 

Certain gluten-free foods that may be prescribed include:

 

  • Cereals

 

  • Crackers/Crisp breads

 

  • Bread

 

  • Pizza bases

 

  • Flour

 

  • Pasta

 

  • Oats

 

 

Coeliac UK are currently campaigning to see the protection of prescriptions. Click here to find out more information. 

 

 

Nutritional Evidence Gluten Free Bread Banner

 

 

Other tips for keeping the cost down:

 

If getting gluten-free foods on prescription is not an option there are still some simple tips you can try to help close the financial gap!

 

  • Keep gluten-free breads in the freezer and take slices out to use on an “as needs” basis.

 

  • Base dishes around naturally gluten-free foods vs processed gluten-free alternatives.

 

  • Batch cook and bulk out! Use beans, pulses, fruits and vegetables to make dishes nutritious and delicious, bulking them out last longer.

 

  • Plan ahead and stick to your shopping list!

 

  • Take advantage of offers and supermarket deals.

 

Coeliac UK have compiled a free and helpful fact sheet for following a gluten-free diet when on a budget. Click here to read more.

 

 

Further information:

 

 

 

 

References:

 

(1):Stevens, L. and M. Rashid (2008) Gluten-free and regular foods: a cost comparison. Canadian Journal of Dietetic Practice and Research 69(3); 147-150.

 

 

(2):Lee, A.R., et al.,(2007) Economic burden of a gluten-free diet. Journal of Human Nutrition & Dietetics 20(5); 423-430.

 

 

(3):Leffler, D.A., et al., (2008) Factors that influence adherence to a gluten-free diet in adults with celiac disease. Digestive Diseases and Sciences 53(6); 1573-1581.

 

 

(4):Hall, N.J., G. Rubin, and A. Charnock (2009) Systematic review: adherence to a gluten-free diet in adult patients with coeliac disease. Alimentary Pharmacology and Therapeutics, 30(4); 315-30.

 

 

(5):Coeliac UK (2016) Campaigning on the cost of gluten-free. Available at https://www.coeliac.org.uk/about-us/news/campaigning-on-the-cost-of-gluten-free/  [last accessed 25/4/16].

 

 

By Charlotte Foster BSc (Hons), MSc, RD.

 

 

Although we need food to provide us with nutrition, for many, food is at the heart of friendships and family. It creates a social outlet e.g. meeting for coffee/ going out for lunch/ having dinner.  Yet for some who have a food intolerance or allergy e.g. coeliac disease socialising around food can be a challenge.

 

 

With the level of intolerances and allergies on the rise, (and many people without complex dietary needs choosing to follow exclusion diets), the food industry have, and continue to respond, with booming ranges of food products which are gluten, dairy, egg and additive (to name a few) free.

 

 

Getting to grips with the management for coeliac disease (following the gluten-free diet and excluding wheat, rye, barley and possibly oats) can make the prospect of planning a meal/ entertaining seem a little overwhelming and a bit of a challenge.

 

 

Given this social relationship with food, it is essential that health professionals help those who have dietary-managed diseases not to feel excluded from food-orientated occasions. Here at DINE we want to help make it easier for friends and family of those who have coeliac disease, in order to make the “hassle” of cooking gluten-free a thing of the past.

 

 

Top tips for entertaining people with coeliac disease:

 

 

1. Get informed!

 

Make sure you read up on what coeliac disease is and what the gluten-free diet is .

 

 

2. Communication is key!

 

 

Be open and honest with your guest/ host. For people with coeliac disease, being sensitive to their dietary needs is essential. If you are cooking for people who have coeliac disease, don’t be afraid to ask questions and double check information.

 

 

 

3. Plan ahead & select a menu that is gluten-free but enjoyable for all!

 

 

There is such a variety of naturally gluten-free ingredients that cooking gluten-free is often easier than you think!

 

 

4. Read the labels!

 

Gluten is often found in unsuspecting food products such as marinades, salad dressings and many other ready-prepared food products. Make sure you read the food labels if in doubt.

 

 

5. Avoid cross-contamination!

 

This can often seem like a challenge as any food that comes into contact with the smallest amount of gluten will become contaminated. This poses a serious health risk for someone with coeliac disease. Therefore considering how you are going to cook the food is important.

 

 

  • Prepare the gluten-free meal first if you are choosing to cook a separate dish for your guest who has coeliac disease.

 

  • Wash up all kitchen utensils thoroughly in hot soapy water – you don’t need to buy new separate cooking utensils to cook a safe gluten-free meal.

 

  • Clean all kitchen work surfaces and ensure that the cooking/ food preparation area is uncontaminated from gluten.

 

  • Be diligent to ensure that the gluten-free meal is prepared safely – avoid using toasters/ appliances that are at high risk of gluten exposure.

 

  • Wrap it up! Use foil and thoroughly cleaned tuppaware to store gluten-free foods and ingredients and keep these away from any gluten-containing foods that could lead to cross contamination.

 

 

Remember to watch out for:

 

 

  1. Condiments: Knives/ utensils that have been used near gluten-containing foods which are “double dipped” into condiments pose a risk of gluten-contamination. Therefore, ensure you label condiments that are gluten-free and keep these stored separately.

 

 

      2.  Toasters: These pose a very big gluten cross-contamination hazard to coeliac disease     sufferers. Coeliac disease patients are advised to have their own toasters and to keep gluten-containing foods away from them.

 

 

    3. Chopping Boards & Utensils:  Cooking equipment made from porous substances like wood e.g. wooden spoons can hold onto particles of gluten. To be on the safe side it may be advisable to use plastic/ steel (insulated) alternatives.

 

 

 

 

Grab a copy of our handout to give to friends and family on cooking for people with coeliac disease by clicking the link below

 

 

Entertaining Gluten-Free!

 

 

By Charlotte Foster BSc (Hons), MSc, RD.

 

 

When speaking to people with coeliac disease about following a gluten-free diet, the reoccurring dissatisfaction relates to manufactured gluten-free bread and the disappointment with nationwide adored past-time of baking!

 

 

Here at DINE, we are passionate about getting people back into the kitchen and re-engaged with food! Following a gluten-free diet for coeliac disease patients can be an adjustment, so here are some top tips for approaching baking gluten-free!

 

 

You may be wondering why gluten-free baking is a challenge in the first place? So first thing’s first!

 

 

It’s important to understand why recipes list certain ingredients in order for the bakes to be a success! It’s not uncommon to think that  we can modify recipes by leaving out non gluten-free ingredients and then get frustrated when the bakes aren’t a success…. guilty as charged!!

 

 

To understand why the structure of these failed bakes aren’t working, we need to understand the role that the ingredients play…

 

 

A GREAT BRITISH BAKING EDUCATION….

 

 

What is the role of gluten in bread making and baking?

Gluten in its culinary context within wheat flours gives dough its elastic qualities and helps trap gas (produced by the addition of a raising agent e.g. yeast) within baked goods, to give rise to a desired airy crumb structure.

 

Without gluten, air pockets don’t form and the crumb structure is likely to become dense and dry. Therefore, replacing the gluten with ingredients that can replicate these qualities is essential.

 

Remember – ALWAYS READ THE LABELS!

 

 

Gluten can be found in many food products, even in ones you perhaps wouldn’t expect e.g. sauces and salad dressings!

 

So what gluten-free flours are there?

 

Gluten-free recipes will often refer to using “gluten-free flour blends”. These can be bought from supermarkets (often in the gluten-free aisle). However, they are not always as easy to get hold of compared with gluten-containing flours. Essentially, these pre-made blends contain a range of gluten-free flours mixed together mixed in with a binding agent (often xanthan gum). So why not have a go at making your own?

 

Gluten-free Flours

 

 

Flourtable 1Flourtable 2

 

 

 

Top tips!

 

 

  • Look at the recipes for the proportions of the different flours and don’t forget to add the binding agent e.g. xanthan gum!

 

  • Different flours have different flavour profiles so pay attention to the quantities recommended in recipes!

 

  • If you’re considering making your own gluten-free flours, refrigerating them will help keep them fresher for longer. Be sure to bring them to room temperature before baking with them.

 

 

Bringing it all together!

 

 

Eggs aren’t just a good source of protein! They are often a key feature in gluten-free baking, due to their ability to bind ingredients together and help create structure to foods.

 

However, there are 2 other ingredients that often feature in recipe lists – Guar gum and Xanthan gum (you can find these in the baking aisle of supermarkets). These are usually interchangeable and help to stabilise/ thicken gluten-free baked goods, so make sure you keep a pot of these in your cupboard!

 

 

Top tips when baking gluten-free…

 

 

  • Make the most of foods that are naturally gluten-free… there are so many!!

 

  • Try, test and invest in a recipe journal! Experiment with recipes, everyone will have a different taste! Journal the recipes that you like and that work well.

 

  • Have realistic expectations! Gluten-free variations of well loved dishes and bakes will never be exactly the same… try and be open minded.

 

  • Get the crunch! Steam baking will give your bread a lovely crust.

 

  • Seal in the freshness! Gluten-free baked goods can go stale quickly, so make sure you wrap them in cling film/ store in an airtight container to prevent them drying out!

 

 

Tips to increase the nutrition of your gluten-free bakes

 

 

• Create your own nutritious gluten-free flour mixes by using a combination of gluten-free flours.
• Where possible, use whole grain or enriched, gluten-free flours (these will contain extra vitamins and minerals)

 

 

 

Tips to increase the moisture of your gluten-free bakes

 

  • Adding flaxseeds/ linseeds to gluten-free flours will help absorb moisture to help for a tender crumb structure.

 

  • Honey or agarve syrups can help retain moisture – be careful on how much you add as these are high in energy and sugar.

 

 

 

Tips to improve the structure of your gluten-free bakes

 

  • Use a combination of gluten-free flours and mix together thoroughly before adding to other ingredients.

 

  • Add dry milk solids or cottage cheese into recipe.

 

  • Use evaporated milk in place of regular milk.

 

  • To reduce grainy texture, mix rice flour or corn meal with liquid. Bring to a boil and cool before adding to recipe.

 

  • Add extra egg or egg white if product is too crumbly.

 

  • Do not over beat; kneading time is shorter since there is no gluten to develop.

 

  • When using a bread machine, use only one kneading cycle.

By Charlotte Foster BSc (Hons), MSc, RD.

 

 

Both natural and artificial, naturally existing in foods and manufactured into food products, sweeteners are everywhere!

 

But what effect do they have on our health? Are they healthier than sugar? Are they bad for our health?

 

We want to take a closer look.

 

To do this, it is important to examine the effect of them in relation to different disease states in order to weigh up what impact they have on our health.

 

 

Irritable Bowel Syndrome (IBS) – the effects on the gut

 

 

  • Watch out for certain polyols (mannitol, sorbitol and xylitol)!

 

  • Erithrytol and stevia, aspartame, saccharin should be better tolerated!

 

 

Some people with IBS may be advised to follow a specific diet (e.g. the low FODMAP) diet by a dietitian.

 

For some people with this condition, the consumption of a group of carbohydrates known as “polyols” or “sugar alcohols” can cause symptoms associated with IBS…

 

The problem is, many sweeteners  are in fact polyols! (e.g. sorbitol, xylitol, mannitol and erithrytol) (1).

 

For some people with IBS, when polyols are consumed (in amounts greater than can be tolerated) a laxative effect can occur resulting in symptoms e.g. diarrhoea (1).

 

It is the molecular size of the polyol which affects the absorption and it has been found that polyols with a six-carbon structure are poorly tolerated (mannitol, sorbitol, xylitol) (1).

 

However, erithrytol has a four-carbon structure and has been found to be better tolerated with IBS sufferers (1).

 

Other sweeteners that are not polyols should not cause any adverse gastrointestinal symptoms if consumed in small amounts.

 

 

Diabetes – effects on blood sugar levels

 

Sweeteners do not impact blood sugar levels, but it is unclear as to whether polyols should be taken into consideration by those who have diabetes and have been advised to “count carbohydrates” (2).

 

 

Polyols (sorbitol, xylitol, Erithrytol) are often added to food products marketed to those who have diabetes. Such food products are not advocated by Diabetes UK or the European Commission Regulations and are often high in calories and fat and when eaten in large amounts can lead to adverse gastrointestinal symptoms e.g. diarrhoea (2).

 

 

Dental health- effects to our oral health

 

Dental cavities can form when bacteria converts sugar into acid which erodes tooth enamel. The risk of tooth decay is reduced by good oral hygiene and not eating too much sugar which helps to reduce the amount of bacteria that produce acid that attacks the teeth (3).

 

So, surely as sweeteners are sugar-free, they should be better for our teeth?

 

Well, a study in 2011 published in the British Dental Journal highlighted that some polyol containing sugar-free foods/ drinks may help prevent the development of dental caries, but they have the potential to cause dental erosion. However, this could be due to the acidic flavourings/additives these foods contained (3).

 

All in all, further research is needed to determine the exact impact that sweeteners and sweetener- containing foods have on our dental health.

 

 

 

Cancer – will consuming sweeteners increase my risk of cancer?

 

In the 1980s there were claims that the artificial sweetener saccharin could cause bladder cancer in rats.  As a result, it was banned by the Canadian government and strong warnings were issued by the American government about the potential cancer causing risks. However, these claims came from rat studies, and have since been discredited.  In fact, the risk of developing bladder cancer  appears to be the same in those who have diabetes  and may use sweeteners more often (for blood sugar regulation) and the incidence of the disease did not appear to escalate in World War II when saccharin consumption was high (4).

 

Aspartame is another artificial sweetener that has had a lot of bad press regarding its link to cancer.  Concerns arose after research in rat studies showed possible increased risks of developing cancer (5&6).  However, the European Food Safety Authority (EFSA) has concluded that there is no evidence to suggest consumption of aspartame below the recommended level will cause an increased risk of cancer (7).

 

It appears that now there is a strong evidence base to suggest that artificial sweeteners are safe for human consumption (4).

 

 

Weight management – do sweeteners make you gain weight?

 

Sweeteners are often added to foods that are branded as “weight loss friendly” implying they are free from calories. However, it would appear that the evidence base is producing mixed messages, leaving many people confused as to whether sweeteners increase appetites, increase cravings for sugar- containing foods and lead to weight gain.

 

The problem is, there are a range of studies that have been published, but they all are comparing different types of sweeteners (e.g. artificial vs natural; or artificial vs artificial) and they all use different forms of sweeteners within the different studies (e.g. powders vs low-calorie sweetened drinks).

 

For example, an American review in 2010 in looked at the impact of different artificial sweeteners and concluded that they are ineffective for weight loss and there is a link between sweetener consumption and having an increased appetite with cravings for sugar (9).  Whereas, another study in 2010 comparing the effects of both artificial (aspartame) and natural sweeteners (stevia, and sucralose) concluded that the use of these sweeteners did not cause an increased calorie intake/ food consumption from participants (10).

 

There have been many other studies that support the use of sweeteners for weight management. A recent meta-analysis (review) conducted in America in 2014 looked at research from several randomised control trials. The author concluded that replacing full sugar drinks with low calorie sweetened versions can result in modest weight loss (8).

 

 

Summing it all up!

 

It would seem that the evidence shows that sweeteners may be useful to some people e.g. those with diabetes who are trying to control their blood sugar levels, whilst for others with gastrointestinal troubles relating to IBS they may aggravate the body. Despite accusations that sweeteners cause individuals to gain weight and increase the risk of cancer, these are currently unsupported by the evidence base.

 

Deciding whether to have sweeteners in the diet should be up to the individual, taking into account our own health issues.

 

 

Useful links :

 

 

 

 

References:

 

 

 

(1): Mäkinen., K.K.(1984) Effect of long-term, peroral administration of sugar alcohols on man.  Swedish Dental Journal 8(3); 113-124.

 

(2): Diabetes UK (2016) Sugar, Sweeteners and Diabetes. Available at https://www.diabetes.org.uk/Guide-to-diabetes/Enjoy-food/Carbohydrates-and-diabetes/Sugar-sweeteners-and-diabetes [last accessed 21/3/16].

 

(3): Nadimi, H., Wesamaa, H., Janket, S.J, Bollu, P. and Meurman, J.H. (2011) Are sugar-free confections really beneficial for dental health? British Dental Journal 211; E15.

 

(4): Cancer Research UK  (2015) Food Controversies. Available at http://www.cancerresearchuk.org/about-cancer/causes-of-cancer/diet-and-cancer/food-controversies#food_controversies1 [last accessed 21/3/16].

 

(5):Soffrirri, M., Belpoggi, F., Degli Esposti, D., Lambertini, L., Tibaldi, E. and Rigano, A. (2006) See comment in PubMed Commons belowFirst experimental demonstration of the multipotential carcinogenic effects of aspartame administered in the feed to Sprague-Dawley rats. Environmental Health Perspectives 114 (3); 379-385.

 

(6): Soffrirri, M., Belpoggi, F., Tibaldi, E., Esposti, DD., Lauriola, M. (2007) See comment in PubMed Commons belowLife-span exposure to low doses of aspartame beginning during prenatal life increases cancer effects in rats. Environmental Health Perspectives 115 (9); 1293-1297.

 

(7): European Food Safety Authority (2009) Opinion on a request from the European Commission related to the 2nd ERF carcinogenicity study on aspartame. Available at http://www.efsa.europa.eu/en/efsajournal/pub/945 [last accessed 21/3/16].

 

(8): Miller, P.E. and Perez, V. (2014) Low-calorie sweeteners and body weight and composition: a meta-analysis of randomized controlled trials and prospective cohort studies. American Journal of Clinical Nutrition doi: 10.3945/ ajcn.082826.

 

(9): Yang, Q. (2010) Gain weight by “going diet” Artificial sweeteners and the neurobiology of sugar cravings. Yale Journal of Biology and Medicine. 83(2); 101–108.

 

(10): Anton, S.D., Martin, C.K., Han, H., Coulon, S., Cefalu, W.T, Geiselman, P. and Williamson, D.A. (2010) Effects of stevia, aspartame and sucralose on food intake, satiety and postprandial glucose and insulin levels. Appetite 55 (1); 37-43.

 

By Charlotte Foster BSc (Hons), MSc, RD.

 

 

With the desire to live a “sugar-free” existence becoming more popular, the food industry has responded with a boom in sales of sweeteners (with the sweetener sector now valued at ~£60million) (1).

 

 

Sweeteners can be derived from natural sources and so are deemed to be “natural” as well as being synthetically created and labelled as “artificial”.  Both give the same sweetness to food that sugar does but with substantially less calories.

 

 

With over one quarter of British households buying in sweeteners, DINE has decided to look take a closer look into these sweet-tasting products.

 

Pro's & Con's

Sweeteners from Natural Sources

 

Artificial Sweeteners

 

 

Useful Links:

 

 

 

 

 

References

 

(1): Chatsudthipong, V. and Muanprasat, C. (2009) Stevioside and related compounds: Therapeutic benefits beyond sweetness. Pharmacology & Therapeutics 121 (1); 41-54.

 

(2): Chan, P., Tomlinson, B., Chen Y., Liu, J., Hsieh, M and Cheng, J. (2000) A double-blind placebo-controlled study of the effectiveness and tolerability of oral stevioside in human hypertension. British Journal of Clinical Pharmacology 50 (3):215-220.

 

(3): Hsieh, M., Chan, P.,Sue, Y., Liu, J., Liang, T., Huang, T., Tomlinson, B., Chow, M., Kao,P. and Chen, Y. (2003) Efficacy and tolerability of oral stevioside in patients with mild essential hypertension: A two-year, randomized, placebo-controlled study. Clinical Therapeutics 25 (11); 2797-2808.

 

(4): Greggersen, S., Jeppesen, P., Holst, J., Hermansen, K. (2004) Antihyperglycemic effects of stevioside in type 2 diabetic subjects. Metabolism 53. (1); 73-76.

 

(5): Geeraert, B., Crombe,F., Hulsmans, M., Benhabiles, N., Geuns, J.M. and Holvoet, P. (2010) Stevioside inhibits atherosclerosis by improving insulin signaling and antioxidant defense in obese insulin-resistant mice. International Journal of Obesity 34 (3); 569-577.

 

(6): Roberts, M.W. and Wright, T.J. (2012) Nonnutritive, Low Caloric Substitutes for Food Sugars: Clinical Implications for Addressing the Incidence of Dental Caries and Overweight/Obesity.  International Journal of Dentistry 2012; 625701.

 

(7): Noda, K., Nakayama, K. and Oku, T. (1994) Serum glucose and insulin levels and erythritol balance after oral administration of erythritol in healthy subjects.European Journal of Clinical Nutrition 48(4); 286-292.

 

(8): Honkala, S., Runnel, R., Saag, M., Olak, J., Nommela, R., Russak, S., Makinen, P.L., Vahlberg, T., Falony, G., Makinen, K. and Honkala, E. (2014) Effect of erythritol and xylitol on dental caries prevention in children. Caries research 48 (5); 482-490.

 

(9):Arrigoni, E., Bronus, F. and Amado, R. (2005) Human gut microbiota does not ferment erythritol, British Journal of Nutrition 94(5); 643-646.

 

(10): NHS (2014) Is xylitol good for your teeth? Available at http://www.nhs.uk/Livewell/Goodfood/Pages/the-truth-about-xylitol.aspx [last accessed 25/03/16].

 

(11): EFSA (2011)   Scientific Opinion on the substantiation of health claims related to the sugar replacers xylitol, sorbitol, mannitol, maltitol, lactitol, isomalt, erythritol, D-tagatose, isomaltulose, sucralose and polydextrose and maintenance of tooth mineralisation by decreasing tooth demineralisation (ID 463, 464, 563, 618, 647, 1182, 1591, 2907, 2921, 4300), and reduction of post-prandial glycaemic responses (ID 617, 619, 669, 1590, 1762, 2903, 2908, 2920) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal  9(4); 2076. Available at http://www.efsa.europa.eu/sites/default/files/scientific_output/files/main_documents/2076.pdf [last accessed 25/03/16].

 

(12): Commission of the European Communities (1985) Food Science & Techniques – Reports for the Scientific Committee for Foods.  Available at http://ec.europa.eu/food/fs/sc/scf/reports/scf_reports_16.pdf [last accessed 25/03/16].

 

(13): NHS (2014) Sorbitol: helpful for diabetics? Available at http://www.nhs.uk/Livewell/Goodfood/Pages/the-truth-about-sorbitol.aspx [last accessed 25/03/16].

 

(14): Gupta, A.K. and Kaur, N. (2000) Carbohydrate Reserves in Plants – Synthesis and Regulation, Elsevire 2000.

 

(15): NHS (2014) The truth about aspartame. Available at http://www.nhs.uk/Livewell/Goodfood/Pages/the-truth-about-aspartame.aspx [last accessed 25/03/16].

 

(16): Soffrirri, M., Belpoggi, F., Degli Esposti, D., Lambertini, L., Tibaldi, E. and Rigano, A. (2006) First experimental demonstration of the multipotential carcinogenic effects of aspartame administered in the feed to Sprague-Dawley rats. Environmental Health Perspectives 114 (3); 379-385.

 

(17): Soffrirri, M., Belpoggi, F., Tibaldi, E., Esposti, DD., Lauriola, M. (2007) See comment in PubMed Commons belowLife-span exposure to low doses of aspartame beginning during prenatal life increases cancer effects in rats. Environmental Health Perspectives 115 (9); 1293-1297.

 

(18): EFSA Panel on Food Additives and Nutrient Sources added to Food (2013) Scientific Opinion on the re-evaluation of aspartame (E 951) as a food additive. EFSA Journal 11(12); 3496.

 

(19): NHS (2014) Saccharin Link to cancer discredited. Available at http://www.nhs.uk/Livewell/Goodfood/Pages/the-truth-about-saccharin.aspx [last accessed 25/03/16].

 

(20): International Agency for Research on Cancer (IARC) (1999) Volume 73 -Saccharin and its salts. Available at http://monographs.iarc.fr/ENG/Monographs/vol73/mono73-24.pdf [last accessed 25/03/16].

 

(21): Commission of the European Communities (1995) Opinion on saccharin and its sodium, potassium and calcium. Available at SALTS http://ec.europa.eu/food/fs/sc/oldcomm7/out26_en.pdf [last accessed 25/03/16].

 

(22): NHS (2014) How safe is sucralose? Available at  http://www.nhs.uk/Livewell/Goodfood/Pages/the-truth-about-sucralose.aspx [last accessed 25/03/16].

 

(23): Patel, R.M., Sarma, R. and Grimsley, E. (2006) Popular sweetner sucralose as a migraine trigger. Headache 46 (8); 1303-1304.