Well Being Article: How much Alcohol is too much? By Amelia Freer

Alcohol: How much is too much?

Tips and Guide to Alcohol Consumption

Alcohol: How much is too much?

I, like many, really do love a glass or two, especially at times of celebration, but I’m so often asked for guidance about how much is too much?

There is a general consensus that a little wine each evening is good for us, although most of us also know that swigging a bottle (easily done!) on a regular basis is too much.

But what is the actual evidence for this? And is it really correct? As always, I am a huge believer in spreading the message of balanced science – presenting you with the evidence directly, so that you can make your own informed choices. I know that sometimes this can in itself be frustrating, as we are often unconsciously seeking a set of simple ‘rules’ to live by. But I am afraid that there are very rarely any hard and fast rules when it comes to nutrition or lifestyle medicine. It is simply a case of weighing up the pros and cons of each individual circumstance, then deciding for yourself what is appropriate and right for you.

But, there may be a problem with the statistics in these studies  . . .

The people who drank no alcohol in these studies may have been more likely to be otherwise unwell. So, it could be the fact that they are already unwell which means that they don’t drink (and are therefore more likely to have increased mortality), rather than the fact that they don’t drink increasing mortality rates directly (Stockwell et al., 2016). It’s a subtle, but very important difference, which throws a big question mark over the idea that drinking moderately is better for us than not drinking at all.

Alcohol consumption has been linked to a huge number of problems. It is, after all, a psycho-active substance that can sadly lead to significant problems with addiction and dependency. It has also been linked to over 200 different disease and injury conditions, including:

  • Cancers of the mouth and throat, colon, breast, liver and rectum.
  • High blood pressure
  • Liver disease (such as cirrhosis)
  • Chronic pancreatitis
  • Accidental injury
  • Stroke

(WHO, 2014) (Corrao et al., 2004)

This may all be a little bit too reductionist. The context in which you choose to drink may be just as important as the amount you are drinking (within reason!). For example, wine is considered an important part of the Mediterranean Diet which has itself been associated with all sorts of health benefits.

In a study of over 18,000 Spanish participants, it was found that the closer people drank to a traditional, moderate, Mediterranean pattern of mainly red wine consumption, the greater the association with reduced mortality (Gea et al., 2014). In other words, if you do choose to drink, the best way to do so is probably copy the culture of Mediterranean countries:

Drink moderately with meals, mainly red wine, spread out evenly over the week and very rarely in excess.

Perhaps that small sunset glass of wine on the terrace with supper is ok!

Finally, the type of alcohol you choose is also important. Red wine in particular may have more beneficial than, for example, beer or spirits, effects (Grønbæk et al., 2000) (Arranz et al., 2012) (Chiva-Blanch et al., 2012). This may be because of its polyphenol content (dietary antioxidants), but this too is contentious, as some researchers argue that you would have to drink buckets of the stuff to get any meaningful antioxidant effects which is definitely NOT recommended! (Fernandes et al., 2017).

 

What’s my advice as a nutritional therapist?

  • If you don’t drink already, there is no good evidence to suggest that starting to drink will offer you any health benefits.
  • If you do drink, then it is important that you try your best to stick within the limits recommended by the government advisory boards, which is now 14 units per week for both men and women.
  • But if you want my personal opinion, I almost always recommend drinking less than this. My recommendation would therefore be to aim for <10 units per week, with at least 2 alcohol-free days. I think this is a sensible compromise between complete abstinence (which may be the ‘healthiest’ option) and drinking very merrily (which we shouldn’t forget can come with some social benefits).
  • There are, however, a number of diseases and conditions where complete abstinence form alcohol is certainly the safest option. If in doubt, seek the advice of a doctor or nutrition professional to help guide you.
  • If you are pregnant, or trying to conceive, it is very important that you avoid alcohol altogether. There is no safe limit for drinking in pregnancy, and the developing embryo is particularly vulnerable to the effects of alcohol in the very first few weeks – often before you even know you are pregnant. Seedlip produce a lovely alcohol-free spirit, which means that you can still enjoy a ‘grown-up’ tasting drink whilst completely avoiding alcohol (and no, I am not paid to advertise for them, I genuinely like it!)

What might this look like over the course of a week?

Assuming you are drinking wine of around 12% alcohol content, this may be the sort of pattern I would recommend to my generally healthy clients who want to continue drinking over the course of a week. Do note that the glass size is 125ml, so it is pretty small, but as I always point out, it is usually the first couple of sips that are the best anyway.

Guide to units of alcohol per week in the UK

Another tip I often share is to invest in a couple of incredibly beautiful and pleasurable-to-use small wine glasses. Antique ones are often smaller than modern ones anyway. Psychologically, we feel better about moderating our alcohol intake if we feel like we have had a whole glass – not just half a bigger glass.

The other benefit is that you are able to use the money you’ve saved on drinking less, to buy better quality (ideally organic) wine. Wine to savour and enjoy rather than glug down. Do get yourself a proper wine stopper though, so that a single bottle will keep for at least a week without going off. That way, you don’t have the pressure to ‘just finish it off’ to avoid wasting any.

Finally, if you are used to coming home from work and pouring a glass straight from the fridge, have some ice cold filtered water or fizzy water ready to go instead. Rehydrate yourself first, give it 10 minutes, and only then enjoy your glass of wine, perhaps with a few nuts or some kinds of protein to help balance the sugar effects.

. . . . . . . .

Useful resources

For more information on alcohol & units:

drinkaware.co.uk

patient.info/health/alcohol-and-sensible-drinking

Alcohol and You: A handy self-help guide:

ntw.nhs.uk/

References & Bibliography

Arranz, S., Chiva-Blanch, G., Valderas-Martínez, P., Medina-Remón, A., Lamuela-Raventós, R. and Estruch, R. (2012). Wine, Beer, Alcohol and Polyphenols on Cardiovascular Disease and Cancer. Nutrients, 4(12), pp.759-781.

Chiva-Blanch, G., Arranz, S., Lamuela-Raventos, R. and Estruch, R. (2013). Effects of Wine, Alcohol and Polyphenols on Cardiovascular Disease Risk Factors: Evidences from Human Studies. Alcohol and Alcoholism, 48(3), pp.270-277.

Corrao, G., Bagnardi, V., Zambon, A. and La Vecchia, C. (2004). A meta-analysis of alcohol consumption and the risk of 15 diseases. Preventive Medicine, 38(5), pp.613-619.

Fernandes, I., Pérez-Gregorio, R., Soares, S., Mateus, N. and de Freitas, V. (2017). Wine Flavonoids in Health and Disease Prevention. Molecules, 22(4), p.292.

Gea, A., Bes-Rastrollo, M., Toledo, E., Garcia-Lopez, M., Beunza, J., Estruch, R. and Martinez-Gonzalez, M. (2014). Mediterranean alcohol-drinking pattern and mortality in the SUN (Seguimiento Universidad de Navarra) Project: a prospective cohort study. British Journal of Nutrition, 111(10), pp.1871-1880.

Grønbæk, M., Becker, U., Johansen, D., Gottscahau, A., Schnohr, P., Hein, H. and et al. (2000). Type of Alcohol Consumed and Mortality from All Causes, Coronary Heart Disease, and Cancer. Annals of Internal Medicine, 133(6), p.411.

Stockwell, T., Zhao, J., Panwar, S., Roemer, A., Naimi, T. and Chikritzhs, T. (2016). Do “Moderate” Drinkers Have Reduced Mortality Risk? A Systematic Review and Meta-Analysis of Alcohol Consumption and All-Cause Mortality. Journal of Studies on Alcohol and Drugs, 77(2), pp.185-198.

WHO: World Health Organisation (2014). Global status report on alcohol and health, 2014. 1st ed. Geneva: World Health Organization.


Gut Health, Part 3: 10 Ways to Help Support Gut Health

Gut Health, Part 3: 10 Ways To Help Support Gut Health

This is the third part of my series on gut health. Do check out The Basics of Gut Health and Probiotics and Prebiotics in Gut Health for further information on this popular topic.

How to eat more fibre

  1. Start with the basics

Whenever I am asked to consider ways to support individual organ systems or processes (such as brain health, skin health, immunity etc.), I always start by saying that we can’t isolate just one part of the body and focus only on that.

We exist as an intricately connected whole system. What affects one area of our body will also affect everywhere else, to a greater or lesser extent. This concept applies to our gut health. So while there are certain strategies that may specifically benefit our microbiota or digestive health, we must consider their wider effects, too.

Likewise, many aspects of our lifestyle beyond just diet can also influence our gut – from lack of sleep, to stress, to being consistently sedentary. Therefore, perhaps the most important first step to nourishing our gut is actually to nourish our whole body and mind. To establish those fundamental basics of health: restorative sleep, moderate alcohol intake, regular movement, a balanced and nourishing diet, active stress management and social connection.

Often, we may find that when these basics are in place, consistently (not perfectly – that’s not a realistic goal), much of the rest takes care of itself.

  1. Take time to eat, sit down & chew properly

Our digestion needs time to work properly, so sit down to eat, and try to give yourself at least 10 minutes for each meal, ideally undistracted. The more relaxed we are when eating, the more we activate the ‘rest and digest’ state of our nervous system. Which, as the name suggests, is very helpful to support efficient digestion.

Chew your food well and give your digestion a break between meals (I suggest at least 4-5 hours). These two simple factors can do an awful lot of good when it comes to gut health, especially bloating, without changing a single thing in your diet.

If you’d like more information on how to practice mindful eating (including a mindful exercise) as well as more on digestive health and nutrition, I suggest taking a look at my online course  which explores many of these topics in detail.

  1. Drink enough water

Your body maintains a finely tuned fluid balance by absorbing more water from your gut if you are getting a little dehydrated. This hardens the contents of your bowels, and so dehydration is a common cause of slow gut transit time and constipation.

Good hydration enables good elimination! For gut health, it is suggested that we aim for around 30-25ml fluids per kg of body weight per day (although this will vary according to the temperature and amount of exercise you are doing too, so as always, please listen to your body).

  1. Include healthy fats in your diet

For simplicity’s sake when it comes to healthy fats, I generally recommend using plain olive oil for cooking, and your fancy extra-virgin olive oils for salad dressings and drizzling. Other healthy fats, such as avocados, oily fish and nuts & seeds, are also very gut friendly.

There is a lot more information on how to build a healthy diet, including which healthy fats to go for in my third book, Nourish & Glow: The 10 Day Plan.

  1. Focus on fibre

A fibre-rich diet is associated with an increased diversity of the gut microbiota (and, in general, the greater the diversity the better), as well as helping to reduce constipation and other bowel-related problems. It may potentially even help to reduce the risk of heart disease and stroke (Wald, 2013) (Gobson and Shepher, 2010) (De Filippo et al., 2010).

Plus, fibre is filling and low in available calories, so great for those who are watching their weight. Aim for at least 30g/day, which you can get from lots of fresh vegetables, beans and pulses, and unrefined, whole-grain carbohydrates (oats, millet, quinoa, amaranth etc.).

See my article ‘Eat More Fibre’  for lots more on this topic.

  1. Eat a colourful diet rich in polyphenols

Plant polyphenols are important naturally occurring compounds that are found in a range of plants, fruits and vegetables which are thought to have all sorts of beneficial effects for both your gut and your body as a whole (Puupponen-Pimia et al., 2002).

Good sources of polyphenols include:

  • Citrus fruits (whole fruits though, not just the juice!).
  • Dark green leafy vegetables (spinach, chard, cabbage, kale etc)
  • Green Tea
  • Red and purple berries (I often recommend a portion a day for gut health – frozen ones are fine when fresh are out of season)
  • Nuts and seeds. Linseeds (also known as flax seeds) and chia seeds are a good example, although I would recommend soaking them for a few hours or overnight in water before eating them for maximum nutrient absorption. I would suggest trying to have a moderate portion of nuts, seeds or nut butter every day (assuming you tolerate them well and have no allergies)
  • Cacao – yep, that means chocolate! Either go for raw cacao or organic cocoa powder, or look out for organic chocolate with a cocoa content of > 85%. 10-25g per day is a sensible amount (that’s about 1-2 large squares).

For more information on polyphenols, take a look at my article Why ‘eating the rainbow’ is not just a cliched phrase – also contains lots and lots of colourful recipe inspiration.

  1. Include some probiotic & prebiotic foods

Probiotic foods include organic fermented dairy products such as bio live plain yoghurt, sour cream, aged cheese or kefir (if you tolerate casein protein and lactose). Alternatively, kimchi, kombucha, miso, natto, sauerkraut and tempeh are fermented too. Do make sure that these contain ‘active, live cultures though’ – if they have been pasteurized or heat-treated after fermentation then they will no longer have significant probiotic function.

Prebiotic foods include things like asparagus, under-ripe banana, aubergine, endive, garlic and onions, Jerusalem artichokes, leeks, pulses (such as beans, peas and lentils) and chicory. Unrefined wholegrains may also have some prebiotic function.

Please note: It’s recommended that you always start to include these foods very gradually into your diet. Adding a lot of probiotics and prebiotics at once can potentially lead to a significant exacerbation in gut symptoms. Sometimes I recommend just a teaspoon every other day to begin with (although others may be fine adding more). Listen to your own body, as always.

  1. Consider possible food allergies & intolerances

If you have a specific food allergy or intolerance, this food may need to be eliminated for a while (or indeed, indefinitely in some instances), to allow your gut and symptoms to heal.

It’s always best to speak to a Registered Nutritionist, Nutritional Therapist or Dietitian to advise you on this (head over to my FAQs page for info). As far as possible, eating a widely varied diet is important to ensure we don’t inadvertently develop nutrient insufficiencies, and to minimise the stress and anxiety we might feel around eating.

Please be wary of any online company that offers at-home tests to find if you have any allergies or intolerances – most of these are not proven to be effective, and may result in you restricting your diet unnecessarily.

  1. Reduce ultra-processed foods

It’s a good idea, both for our overall health as well as for our gut health, to cut down on the amount of heavily processed and/or junk food we consume, especially processed meats and high-sugar, high saturated fat foods. Although all foods do have their rightful place in a balanced diet, moderation is important when it comes to these sorts of foods. It’s best to base the majority of our meals on whole foods, such as fruits, vegetables, high-quality proteins, pulses, wholegrains and nuts & seeds, cooked simply.

  1. Actively manage stress

Stress can be a big factor in both our gut health and our overall health. Our brain, microbiota and gastrointestinal tract are all intricately connected, and can all affect each other. This book explains that connection really well.

Although we all feel stress, and a bit of it can actually be beneficial to us, too much is definitely unhelpful. Actively managing stress can take many forms. Some people find exercise incredibly helpful, others self care and others still seek social connection in times of challenge.

It’s less about what you do than actually doing it consistently. This book, offers a great deal of ideas, tips and suggestions if you’re not sure where to begin when it comes to reducing your own stress levels.

There are lots of recipes on my site rich with prebiotic foods –
why not give some of these a try?

SHOP THE EDIT

Eat Yourself Happy | Dr Megan Rossi

SHOP

Be Good To Your Gut | Eve Kalinik

SHOP

The Joy of Healthy Eating | Amelia Freer

SHOP

Nourish & Glow: The 10 day plan | Amelia Freer

SHOP

Green Tea | Clipper Tea

SHOP

The Stress Solution | Dr Rangan Chatterjee

SHOP

Please note, this website uses some carefully selected affiliate links. If you buy through these links, we may earn an affiliate commission, at no additional cost to you. This helps to keep all of our online content free for everyone to access. Thank you.

Please note: This article is for information only and in no way replaces medical or personal nutrition advice. You should always speak to your healthcare provider in the first instance if you have any concerns whatsoever about your digestive or gut health. Please do not disregard or delay treatment based on anything you read on this website. I am not a doctor, nor am I your Nutritional Therapist. The information I share is very general and may not be relevant or appropriate for you as an individual.

References & Bibliography:

Bjarnason, I., Williams, P., Smethurst, P., Peters, T.J. and Levi, A.J. (1986) ‘Effect of non-steroidal anti-inflammatory drugs and prostaglandins on the permeability of the human small intestine’, Gut, 27(11), pp. 1292–1297. doi: 10.1136/gut.27.11.1292.

De Filippo, C., Cavalieri, D., Di Paola, M., Ramazzotti, M., Poullet, J.B. and Massart, S. (2010) ‘Impact of diet in shaping gut microbiota revealed by a comparative study in children from Europe and rural Africa’, Proceedings of the National Academy of Sciences, 107(33), pp. 14691–14696. doi: 10.1073/pnas.1005963107.

De-Souza, D.A. and Greene, L.J. (2005) ‘Intestinal permeability and systemic infections in critically ill patients: Effect of glutamine*’, Critical Care Medicine, 33(5), pp. 1125–1135. doi: 10.1097/01.ccm.0000162680.52397.97.

Dethlefsen, L. and Relman, D.A. (2010) ‘Incomplete recovery and individualized responses of the human distal gut microbiota to repeated antibiotic perturbation’, Proceedings of the National Academy of Sciences, 108(Supplement_1), pp. 4554–4561. doi: 10.1073/pnas.1000087107.

Gibson, P.R. and Shepherd, S.J. (2010) ‘Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach’, Journal of Gastroenterology and Hepatology, 25(2), pp. 252–258.

Lambert, G., Boylan, M., Laventure, J.., Bull, A. and Lanspa, S. (2007) ‘Effect of aspirin and ibuprofen on GI Permeability during exercise’, International Journal of Sports Medicine, 28(9), pp. 722–726. doi: 10.1055/s-2007-964891.

Puupponen-Pimiä, R., Aura, A.., Oksman-Caldentey, K.., Myllärinen, P., Saarela, M., Mattila-Sandholm, T. and Poutanen, K. (2002) ‘Development of functional ingredients for gut health’, Trends in Food Science & Technology, 13(1), pp. 3–11. doi: 10.1016/s0924-2244(02)00020-1.

Wald, A. (2013) Patient information: High-fiber diet (Beyond the Basics. Available at: UpToDate (Accessed: 1 December 2015).

Photos by Jen Rich and Darryl Leja


Gut Health, Part 2: Probiotics and Prebiotics in gut health

Gut Health, Part 2:  Probiotics & Prebiotics in Gut Health

What are probiotics?

Probiotics are “live micro-organisms, which when consumed in adequate amounts, confer a health effect on the host”. Use of probiotic foods is an ancient tradition – even as far back as the time of Genghis Khan, fermented milk was being drunk as an elixir of strength and health.

In the second part of this gut health series, we are going to look at the role of probiotics and prebiotics in gut health – possibly one of the most exciting new topics to emerge in nutrition in the last few years. If you missed Part 1: The basics of gut health  take a look at it first to give you a little more background.

Most often, probiotic foods or supplements contain strains of either Lactobacillus or Bifidobacterium bacteria, usually from fermented dairy products. However, before starting to act, they have to survive the hazardous journey to reach our gut:

  1. They need to first get through manufacturing, transportation and storage processes, to reach our fridge or kitchen cupboards alive and in good condition.
  2. Then they must make it through the acidic environment of our stomach (designed precisely to kill off any wayward bacteria) and through the swamp of potent digestive juices and enzymes secreted by the gallbladder and pancreas.
  3. Finally, if they succeed in reaching their destination, the large bowel, they then actually need do some good for the host rather than just going along for a free ride, or even possibly doing some untoward harm.

Because of these difficulties with getting the right probiotics to the right place, it is important to point out that the benefits which are seen in clinical trials may not all be possible to achieve with the yoghurts, tablets or other supplements available over-the-counter.

Despite all these challenges, however, good quality strains of probiotics have been associated with beneficial effects in some disease processes, such as reducing antibiotic-associated diarrhoea.  Researchers are also examining a huge range of other conditions that may benefit from probiotics (Tuohy et al., 2003) (NHS Choices, 2015). Further research is very much ongoing.

Limitations

Most of the clinical research that has been carried out on prebiotics has been in unwell populations, and even then they are not yet in widespread use. We do not yet know much about the impact that taking probiotics might have in generally healthy people (Puupponen-Pimia et al., 2002). Anecdotally, I have found them to be of tremendous benefit for myself and some of my clients. However, anecdote is not a strong form of evidence, and I am always cautious about recommending any supplements on this sort of platform, so please do speak to your doctor or an appropriately qualified nutrition professional prior to commencing any supplements.

Furthermore, probiotics, even as tablets, are also still regarded as foods. Therefore they do not have to undergo the same rigorous testing as medicines do, so it is difficult to know if they actually contain the bacteria they claim, alive, in an adequate dose, and are able to give you a tangible benefit (NHS choices, 2015). The European Food Safety Authority has even gone so far as to ban the probiotic food industry from certain advertising claims, such as that they ‘boost the immune system’, because there is insufficient evidence to back such claims up at the moment. A healthy dose of skepticism is often helpful in nutritional science!

As Dr Alessio Fasano so neatly puts it, we can compare our current knowledge of the microbiota to our knowledge of space. We know the universe exists (our microbiota), and we are getting to grips with the fact the Milky Way is there (the major strains of bacteria), but we are far off knowing where London is! In other words, there is a lot of detail still to understand before we are able to fully utilize probiotics for health.

What about prebiotics – are they the same thing?

No. Prebiotics are a class of nutrients called ‘oligosaccharides’ (a type of fibre) which pass through the upper portion of the gut undigested, to feed and stimulate the growth of microbes further down. I think about it as nectar for gut bugs!

Types of prebiotic that are thought to influence the microbiota include (Tuohy et al., 2003);)

  • Inulin & Fructooligosaccharides – found in foods such as Jerusalem artichoke, asparagus, leeks, green bananas, chicory and onions (Sabater-Molina et al., 2009)
  • Lactulose
  • Galactooligosaccharides – found naturally in breast milk to help feed the microbiota of new born babies.

In general, a dose of more than 20g a day of all of these combined, may lead to unwanted side effects such as flatulence and bloating (Tuohy et al., 2003). I would therefore suggest it is a sensible idea to always ‘start low and go slow’ when introducing these to your diet.

As an added benefit, when our gut microbes break down these prebiotic fibres, especially inulin, they release a compound called butyric acid (Scott et al., 2013). This may be particularly important in gut health, as not only is it thought to be anti-inflammatory, but it also helps build up the gut defence barrier and decreases oxidative stress. Plus it might even help to signal to our brain that we are full and satisfied at the end of a meal (Hamer et al., 2007).

My pragmatic approach, if you are generally well, and would like to boost your probiotic and prebiotic intake, is to use foods first as much as possible.

In part 3 of this series,10 Ways to Help Support Gut Health, we will explore lots of practical ideas on how to do this.

You’ll find lots of recipes here rich with prebiotic foods –
why not give some of these a try?

SHOP THE EDIT

Gut | Giulia Enders

SHOP

The Joy of Healthy Eating | Amelia Freer

SHOP

Eat Yourself Happy | Dr Megan Rossi

SHOP

Be Good To Your Gut | Eve Kalinik

SHOP

Smoky Pink Kraut | Eaten Alive

SHOP

Organic Kefir | BioKef

SHOP

Please note, this website uses some carefully selected affiliate links. If you buy through these links, we may earn an affiliate commission, at no additional cost to you. This helps to keep all of our online content free for everyone to access. Thank you.

Please note: This article is for information only and in no way replaces medical or personal nutrition advice. You should always speak to your healthcare provider in the first instance if you have any concerns whatsoever about your digestive or gut health. Please do not disregard or delay treatment based on anything you read on this website. I am not a doctor, nor am I your Nutritional Therapist. The information I share is very general and may not be relevant or appropriate for you as an individual.

References & Bibliography:

Hamer, H.M., Jonkers, D., Venema, K., Vanhoutvin, S., Troost, F.J. and Brummer, R.. (2007) ‘Review article: The role of butyrate on colonic function’, Alimentary Pharmacology & Therapeutics, 27(2), pp. 104–119. doi: 10.1111/j.1365-2036.2007.03562.x.

NHS Choices (2015) Probiotics – NHS choices. Available at: http://www.nhs.uk/Conditions/probiotics/Pages/Introduction.aspx (Accessed: 11 December 2015).

Puupponen-Pimiä, R., Aura, A.., Oksman-Caldentey, K.., Myllärinen, P., Saarela, M., Mattila-Sandholm, T. and Poutanen, K. (2002) ‘Development of functional ingredients for gut health’, Trends in Food Science & Technology, 13(1), pp. 3–11. doi: 10.1016/s0924-2244(02)00020-1.

Sabater-Molina, M., Larqué, E., Torrella, F. and Zamora, S. (2009) ‘Dietary fructooligosaccharides and potential benefits on health’, Journal of Physiology and Biochemistry, 65(3), pp. 315–328. doi: 10.1007/bf03180584.

Scott, K.P., Martin, J.C., Duncan, S.H. and Flint, H.J. (2013) ‘Prebiotic stimulation of human colonic butyrate-producing bacteria and bifidobacteria, in vitro’, FEMS Microbiology Ecology, 87(1), pp. 30–40. doi: 10.1111/1574-6941.12186.

Tuohy, K.M., Probert, H.M., Smejkal, C.W. and Gibson, G.R. (2003) ‘Using probiotics and prebiotics to improve gut health’, Drug Discovery Today, 8(15), pp. 692–700. doi: 10.1016/s1359-6446(03)02746-6.

Photos by Darryl Leja


Gut Health, Part 1: The Basics of Gut Health

Gut Health, Part 1: The Basics of Gut Health

In the Autumn of 2020, I asked my lovely newsletter subscribers what they would like to see more of from me in the future. The overwhelming response was ‘gut health’.

So, in response I have given this gut health mini-series (originally written a few years ago) a real overhaul, updated it to meet my current practice and philosophy, and linked in all sorts of useful and relevant articles to expand on various topics. I’ve also added some of my favourite products and gut health books at the end of each section, in case you’d like a few of my personal recommendations.  I hope you find it helpful.

What do we mean by the ‘gut’?

The gut is a collection of organs, running from the mouth to the bowels, with help from the stomach, liver, pancreas and gallbladder along the way. All of these structures work together to extract the greatest amount of nutrition from whatever we choose to eat.

Alongside our digestive organs, we increasingly understand the powerful impact that our gut microbiota has on health. The microbiota consists of trillions of microbes (bacteria, yeast, funghi and viruses), which live inside our bowels, interacting not only with the food we eat, but also with each other and with us. Each microbiota is unique to each person.

When in harmonious balance, these microbes helpfully aid our digestion, make vitamins and other nutrients, break down dietary toxins, strengthen the body’s internal barrier against the contents of gut, prevent overgrowth of bacteria which can make us unwell, and can even influence our immune system and mood (Butel, 2014). But when out of balance, these microbes may also have the potential to negatively impact our health, too. I therefore now see the ‘gut’ not only as an organ system, but as an ecosystem too.

All sorts of factors may affect the composition and function of our microbiota, and therefore our gut health, including:

Hippocrates reportedly said that ‘all disease starts in the gut’. Clearly this isn’t true all of the time (take genetic disorders, for example), but a significant proportion of chronic diseases may indeed be linked to gut health. It has just taken medical science a few thousand years to catch up!

What is a healthy gut?

There is actually no specific definition of what makes a ‘healthy’ gut, because that depends so much on the individual.

But in general, I personally would consider a healthy gut to:

  1. Be free from persistent digestive symptoms (such as bloating, abdominal pain or disrupted bowel habits). We all get the odd mild symptom from time to time though, but when things change, are persistent, or show any worrying signs (see below) this should be flagged to your healthcare provider promptly.
  2. Eliminate regular, formed (but easily passed) stools*
  3. Allow complete digestion and absorption of nutrition. The average time for the entire process of digestion / absorption is 24 hours, although this does vary a lot between individuals.

* This little step, which wraps around your loo, helps your body adopt a physiological squatting position when opening your bowels which some people find beneficial with constipation.

What is an unhealthy gut?

There are certain unhealthy gut symptoms that are known as ‘red flags’. These are important warning signs that should be discussed with a doctor as soon as possible. Although some of them may represent a harmless condition that will settle itself, it is important if you have any of these symptoms to seek a medical opinion promptly.

These signs may include (note that this is absolutely not an exhaustive list – please speak to your GP if you have any concerns whatsoever about your gut health);

  • A sudden, persistent change your bowel habits
  • Any bleeding, or black, tarry stools
  • Persistent bloating
  • Increasing heartburn, indigestion or stomach pains
  • Abdominal pain
  • Losing weight unintentionally
  • Any difficulty or pain on swallowing

Within the scope of my nutritional practice, I would also look at all sorts of other symptoms (even if they are not necessarily directly related to the gut), such as skin, mood, energy, weight and more. There’s an old phrase in Nutritional Therapy that states ‘what happens in the gut doesn’t stay in the gut’, and so I do look beyond just digestive symptoms when talking with my clients.

How might gut health affect weight?

We know that our gut needs to be functioning effectively to be able to digest and absorb the nutrition that we are eating. If this function becomes impaired, it could potentially lead to both weight loss, and perhaps even weight gain.

Perhaps the most important question to ask is firstly whether there could be an underlying medical problem that is driving poor digestion? The best way to work out if this is a possibility is to speak to your doctor or other healthcare provider. Problems with maldigestion or malabsorption may lead to an unintended decrease in weight (although not always).

Once any medical concerns have been ruled out (if necessary), the next step would be a more comprehensive look at overall digestion, and to see whether there are any signs and symptoms gut inflammation or irritation. This is often highly variable between people, so again, I would suggest that you find a well-qualified Nutritional Therapist, Dietitian or Registered Nutritionist (see FAQs for more info) to help. There simply isn’t a one-size-fits-all approach to gut health, so this individualised support is very important.

There is also a lot of interest at the moment around the potential role of the gut microbiota in the development of obesity, and obesity-related diseases. Lots of this revolves around how certain microbes may potentially alter appetite, metabolic function and energy absorption by the body.

Unfortunately, we do not know enough about this topic yet to know which types of microbe could potentially help us to lose weight (or indeed, help us to gain weight). However, there are some promising studies emerging and research is certainly ongoing (Abenavoli et al.l, 2019, Kadooka et al., 2010)

Please click the links below for further related information;

Gut Health Part 2: Probiotics & Prebiotics in Gut Health

Gut Health Part 3: Ways to Support Gut Health

Eat More Fibre

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Gut | Giulia Enders

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The Joy of Healthy Eating | Amelia Freer

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Eat Yourself Happy | Dr Megan Rossi

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Be Good To Your Gut | Eve Kalinik

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The Mind-Gut Connection | Emeran Mayer

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Step Stool

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Please note, this website uses some carefully selected affiliate links. If you buy through these links, we may earn an affiliate commission, at no additional cost to you. This helps to keep all of our online content free for everyone to access. Thank you.

Please note: This article is for information only and in no way replaces medical or personal nutrition advice. You should always speak to your healthcare provider in the first instance if you have any concerns whatsoever about your digestive or gut health. Please do not disregard or delay treatment based on anything you read on this website. I am not a doctor, nor am I your Nutritional Therapist. The information I share is very general and may not be relevant or appropriate for you as an individual.

References

Kadooka, Y., Sato, M., Imaizumi, K., Ogawa, A., Ikuyama, K., Akai, Y., Okano, M., Kagoshima, M. and Tsuchida, T. (2010) ‘Regulation of abdominal adiposity by probiotics (Lactobacillus gasseri SBT2055) in adults with obese tendencies in a randomized controlled trial’, European Journal of Clinical Nutrition, 64(6), pp. 636–643. doi: 10.1038/ejcn.2010.19.

Krajmalnik-Brown, R., Ilhan, Z.., Kang, D.. and DiBaise, J.K. (2012) ‘Effects of gut microbes on nutrient absorption and energy regulation’, Nutrition in Clinical Practice, 27(2), pp. 201–214. doi: 10.1177/0884533611436116.

Abenavoli, L.; Scarpellini, E.; Colica, C.; Boccuto, L.; Salehi, B.; Sharifi-Rad, J; Aiello, V.; Romano, B.; De Lorenzo, A.; Izzo, A.A.; Capasso,R. Gut Microbiota and Obesity: A Role for Probiotics. Nutrients 2019, 11, 2690.

Credit – top image:  Darryl Leya, National Institutes of Health (NIH)


Article: Autumn Health by Amelia Freer

What is Functional Medicine?

Article: Autumn Health by Amelia Freer

what is functional medicine?

what is functional medicine?

You may have noticed in my bio that I have a qualification from the Institute of Functional Medicine. Not many people really understand exactly what Functional Medicine is, nor how it is different to conventional medicine. I therefore thought that it would be a good idea to do a sort of ‘Functional Medicine 101’ and hopefully share what it is about this approach that I think will make it the future of all chronic disease healthcare. Indeed, I hope that one day, Functional Medicine will just be called medicine!

“Functional medicine is medicine by cause, not by symptom. Practitioners don’t, in fact, treat disease. We treat your body’s ecosytem. We get rid of the bad stuff, put back the good stuff, and because your body is an intelligent system – it does the rest” Dr Mark Hyman MD

So what is the difference between conventional medicine and functional medicine?

Article: What is Functional Medicine?

I hope that this comparison has given you a flavour for the Functional Medicine model – in essence it is a truly holistic, root cause approach to healthcare, where the treatment focus is more on why this is happening and less on what is happening or just managing symptoms.

The drawbacks of this approach are sometimes obvious – if you are in a car crash, it is not the time to start considering how your diet might be impacting on your health! Conventional medicine is brilliant at acute care, where standardised treatments save time and therefore lives. The conventional approach is also a very efficient method of delivering high quality care to the entire population on an extremely tight budget. But I would argue that with the increasing burden of lifestyle-related chronic (i.e., long-term) diseases, such as diabetes, obesity and heart disease, we cannot afford NOT to tackle their root causes through a more functional medicine based approach.

Interested in finding out more?

There is a wealth of information available on functional medicine, for both patients and healthcare professionals. Take a look at the Institute for Functional Medicine website for a good overview (and professional training opportunities)

functionalmedicine.org/

How to find a functional medicine practitioner?

If you feel that you would benefit from seeing a functional medicine practitioner, you can search for accredited professionals through the Institute for Functional Medicine ‘Find a practitioner’ tool;

functionalmedicine.org/practitioner


Seasonal Affective Disorder

focus on: seasonal affective disorder

focus on: seasonal affective disorder

Around 2-10% of Europeans and North Americans are affected by SAD (1)*, with three quarters of them being women, although both genders are affected equally in older age. 60% of people suffering from SAD get it (to varying degrees) every winter (2)*, which is an awful lot of months feeling gloomy. An ounce of prevention, as they say, is better than cure – and so if you suffer from SAD, or indeed know someone who does, then having a good read through this article now may help this winter be one which is significantly less SAD.

Seasonal Affective Disorder (SAD) is a form of depression, which tends to keep coming back around late autumn / winter every year but completely goes over spring / summer. Given that there is a lot of crossover between SAD and other forms of depression, it is always wise to discuss any feelings of low mood with your GP, to help you get the appropriate support and treatment you may require.

What causes SAD?

There is no definitive explanation for what causes SAD just yet, although there are various hypotheses – from chemical imbalances (such as serotonin or melatonin), to reduced light exposure, to changes in the circadian rhythm. It is probably multi-factoral, but this also means that your actions, thoughts and feelings can help to break the cycle.

Although we all feel like winter is a time to shut off the outside world and hunker down under a duvet to a certain degree, some people get this feeling to an extreme, which can start to affect their daily lives.

What are the symptoms of SAD?

Sleep changes: Usually oversleeping, extreme tiredness and napping, although some people may also get insomnia or sleep disturbances too.

Appetite changes: Overeating is common – and particularly a strong craving for carbohydrates or sugary foods. You may find yourself putting on weight over winter. Some people may, however, get a decreased appetite.

Mood changes: Low mood, feelings of hopelessness (especially around the topic of winter, things like ‘I can’t stand this’ or ‘I hate winter’), withdrawing or avoiding social events, irritability and decreased enjoyment from life or hobbies.

Concentration: Trouble focusing, forgetting things, difficulty finishing tasks.

Physical symptoms: Low energy, muscle tension or pain, decreased libido, stomach and headaches, and a sensation that your body is heavier or harder to move around than normal ‘like moving through treacle’.

A vicious cycle may also develop – where certain symptoms worsen other symptoms (3). For example, extreme tiredness may mean that you have less energy to go out and socialize, so you become more isolated, which worsens your mood. If you have SAD, have you ever noticed which symptoms start off this cycle for you?

What are the solutions?

Let’s take a look at some ways to tackle those winter blues. For a multi-factoral problem, we have a multi-factoral set of solutions – and they work better together than they do alone.

Keep enjoying a healthy, balanced diet

Part of SAD can be a craving for carbohydrate rich or sugary foods, but this can itself cause a worsening of symptoms: high sugar loads lead to unstable blood sugars, irritability and low energy. Subsequent weight gain can then reduce self-esteem (and motivation to keep active). One of the best ways to help address these cravings is to make sure that you are getting a good source of protein at every meal – especially breakfast. Take a look at my breakfast section for lots of ideas. Plus a delicious breakfast to look forward to certainly helps to make getting out of bed that little bit easier.

I have also found that some people have improved their mood by going gluten-free over the winter. This also has the beneficial side effect of reducing the temptation for bingeing on processed or snack foods (as most of these contain gluten). This anecdotal tactic might be worth having a think about.

If you have the time, Sunday night prep can be a lifesaver for helping you to stick to a healthy, balanced diet even when you’re getting home exhausted and don’t have the energy to cook. Having some prepared veggies and fruit, boiled eggs, cooked salmon or chicken etc. ready and waiting in the fridge means that packed lunches and suppers can be thrown together in minutes. Don’t forget – always try to cook once, eat twice, too. Also try to make sure you have plenty of healthy carbohydrates available, so that when those cravings come you can satisfy them without compromising your nutrition. Think minimally processed, natural forms – whole rolled oats, baked starchy vegetables (potatoes, squash, pumpkin, etc), legumes like chickpeas and beans, and gluten-free grains like buckwheat, quinoa, amaranth. These are all both satisfying and healthy options.

Watch out for an over-reliance on caffeine too – it can actually increase feelings of tiredness over time rather than decreasing them. 1-2 cups of coffee or 2-3 cups of caffeinated tea a day is enough – so you may want to start weaning yourself down ahead of time to avoid those dreaded withdrawal symptoms.

Action point: Make a list of simple, healthy, wintery recipes you want to have a go at. Look out especially for ones that use oily fish – a natural source of essential omega-3 fatty acids and dietary vitamin D, which may help with easing some of the symptoms of SAD. Aim for 2 portions of oily fish per week.


Phototherapy

Using light therapy is the mainstay of treatment for SAD at the moment. However, the research that has been done to date is not wholly conclusive, because it is very difficult to do rigorous scientific trials on SAD and phototherapy. However, the findings have been quite encouraging, and given that there are minimal (if any) side effects, then this can be a useful solution. The ‘doses’ are quite specific though: you are aiming for 5000 lux per day (this would be the equivalent of 2 hours of 2500 lux, or 30 minutes of 10,000 lux) (2). You should use a light lamp that is specifically designed for helping to treat SAD, and although you don’t need to look directly at the light, the light should reach your eyes (as it is thought the retina – part of the back of the eye – is important in signaling light exposure). For most people, it is best taken early in the morning (2).

If you cannot access light therapy, try to make your days as bright as possible – work next to a window, have lights and lamps on at home, spend as much time as possible outdoors. There is a reason why the Scandinavians love big windows! Natural sunlight is the best source of lux. Beware that people with macular degeneration, retinal disease or photosensitive skin conditions or medications should not use light therapy (4). Seek the advice of your doctor if you are unsure. 


Exercise outdoors

As well as the light we get from spending more time outdoors (rather than holed up in a sweaty gym), regular exercise itself is beneficial to help lift a low mood, will help to control your appetite, boost your immune system and optimise your energy levels (not to mention all the other cardiovascular and body composition benefits). So stock-up on your warm weather (and high visibility) workout gear, and get moving outdoors. Set yourself a realistic target ahead of time – perhaps commit to two outdoor workouts every week, although remember that anything is better than nothing (even if that is just a hasty 5 minutes during your lunch break). Perhaps rope in a buddy who you can make a plan with so you are more motivated to stick to it – I know this works for me. Or as a friend of mind does, plan a race or a new physical challenge each year. Whatever you can do to motivate you to keep going even when the lure of the sofa feels irresistibly strong.


Embrace Hygge

The Scandinavian countries have got this one just about right. In some areas of Northern Sweden, for example, they barely see daylight for weeks. SAD is therefore a significant problem, but they tackle this through embracing the concept of ‘Hygge’. Although it doesn’t directly translate into English, it means a feeling of cosiness of candlelight, warm blankets and enjoyable time with friends indoors. It is about not fighting the winter, but rather enjoying its benefits instead – firelight, dinner parties, nights in watching lovely films and snuggling under piles of rugs (and of course, a great excuse to enjoy some fab Scandinavian knitwear!).

Action point: Stock up on books you have been meaning to read but haven’t quite got around to yet, as well as a few candles. Who says Tuesday night kitchen supper should not be a candlelit affair?! Google ‘Hygge’ for more wintery inspiration.


Plan regular treats to look forwards to

This is vital for those of us who suffer badly from SAD. Throughout the summer we have lots of fun activities planned – beach days, weddings, parties, summer evenings sipping wine outdoors, but with winter these enjoyable events can taper off.

So, it is a good idea to make a concerted effort at the end of October to get some dates to look forwards to in your diary. They don’t need to be big, extravagant occasions (indeed, lots can be free), but try to plan at least one thing per week until Christmas, when you can repeat this activity through to the end of March. Look up your local theatre, comedy club, concert venue or cinema and book some tickets, or maybe sign up to an evening class. Plan a few ‘date nights’ with your partner or close friends. Maybe find some friends to enjoy autumnal or wintery walks and a good pub lunch with. Or even just pencil in an evening for reading a new book, running a big bath and putting your feet up. I do all of the above but my most favourite is planning a weekend away (or stay with family for a night) to change the scene.

The possibilities are endless, but doing this really helps to break the monotony of winter and a little forward thinking goes a long way (plus planned commitments are harder to wriggle out of, which will help to break that vicious symptom cycle discussed above, even if you don’t necessarily feel like doing it).

Action point: Write a list of pleasant things that you want to do over this winter, and slot them into your diary. Get the family involved too – it’s a fun evening’s activity to brainstorm your list.

 – – – – – – – – – – – – – – 

References:

(1) Mersch, P., Middendorp, H., Bouhuys, A., Beersma, D. and den, van (1999) ‘Seasonal affective disorder and latitude: A review of the literature’, Journal of affective disorders., 53(1), pp. 35–48.

(2) Kaminski-Hartenthaler, A., Forneris, C.A., Morgan, L.C., Sonis, J.H., Gaynes, B.N. and Greenblatt, A. (1996) ‘Light therapy for preventing seasonal affective disorder’, Cochrane Database of Systematic Reviews.

(3) Rohan, K.J. (2009) Coping with the seasons: A cognitive-behavioral approach to seasonal Affective disorder, therapist guide. Treatments that work. United States: Oxford University Press, USA.

(4) Williams, M. (2016) Seasonal affective disorder (SAD). Winter depression. Available at: http://patient.info/doctor/seasonal-affective-disorder-pro#nav-8 (Accessed: 30 August 2016).


Wellbeing Article: Autumn Health by Amelia Freer

Autumnal Health

Wellbeing Article: Autumn Health by Amelia Freer

autumnal health

Updated Sept 2020

As we move into deep autumn, my thoughts turn toward preparing both my larder and myself for the cold months ahead. This transition has never been something I dread – I adore the new flavours of the bountiful harvest season and the riotous display of turning leaves far too much for that.

There is something so magical about crisp, clear autumnal mornings as the mist lazily clings onto the hills and the ripe apples and blackberries provide a viable walk-thru breakfast option while out for a walk. Autumn is a season I look forward to with open arms, but that ‘back to school’ feeling (why is it that this doesn’t seem to leave us, even as adults?) can be put to great advantage by motivating me to do a little thinking ahead, particularly when it comes to my health and wellbeing.

This article covers three key topics that I tend to think most about at this time of year. Click on the links below to skip straight to the relevant section, or read on for a more holistic view:

Immune Function

This year, perhaps more than ever, many of us are thinking about practical ways in which we can help to support our immune function to reduce the risk (or severity) of potential infections over the colder months.

A note on immune ‘boosting’:

I am often asked by readers and journalists for advice on ways to ‘boost’ our immune system. And I wanted to clarify that we cannot ‘boost’ our immune system, nor should we want to. An overactive immune system may lead to autoimmune disease or a significant widespread inflammatory state, neither of which are desirable. Nor, however, is an underactive or compromised immune system desirable, as it may increase our risk of infection. What I suggest we aim for instead is immune balance. The best way to achieve this is to nurture our whole body wellbeing in all the sensible ways we already know about; restorative sleep, regular activity, active stress management, good hand hygiene (and currently, any other personal protective recommendations), a nourishing and balanced diet, avoiding smoking and moderating alcohol intake. It’s not original, but it is effective.

Below are some tips on my own personal immune supporting strategies, which I perhaps focus a little more on, and am more diligent about, in these autumnal months.

1. We now are all very familiar with regular hand washing, as well as trying to avoid touching our eyes, nose or mouth too often. I carry these mini bottles of hand sanitiser around in my handbag, and these are my preferred facemasks. To avoid horribly dry hands, I use Bramley hand wash and a little of their hand cream at home, as I find it is the gentlest option for my skin. It also smells divine.

2. Staying hydrated helps to maintain the important barrier functions of mucosa (found in the mouth and lining of the nose) – so keep plenty of water to hand, or regular mugs of steaming herbal tea.

3. I support my beneficial gut bacteria (which we now know plays a key role in helping our immune systems to function) by eating a widely varied diet packed full of fibre (see my 3-part series on Gut Health). That means lots of different whole fruits, veggies, legumes (things like beans, peas and lentils) and whole, minimally processed grains. Take a look at my warming chickpea & pumpkin curry recipe for a fibre-packed and filling meal, or my autumnal carrot & turmeric soup (it’s one of the most popular recipes on the site).

4. Get enough zinc. Zinc is important for normal immune function, yet many of us don’t get quite enough in our diets. Seafood, shellfish and nuts / seeds are all great natural sources. One of my favourite ways to get a tasty zinc boost is to bake up a few batches of my crunchy nut & seed granola to enjoy with all the delicious stewed fruit of the season (great for breakfast and puddings).

5. Take time out to relax. Stress is one of the worst culprits for knocking our immune system back, meaning we are less efficient in fighting infections. Aiming for a realistic balance in all areas of life – family, life, work, other commitments – is a challenge in itself, but is probably the most important step to help manage your stress. What one small shift could you try this autumn to help reduce your own stress levels? What little promise could you keep to yourself on a daily basis to make some little time to care for you? This book is filled with great stress-relieving tips and advice if you’re stuck for inspiration.

6. Don’t forget about vitamin D. We don’t make enough vitamin D in our skin here in the UK between October and March and it is hard to get enough from food sources alone during these months. Government guidelines therefore recommend that all adults consider taking a daily supplement of 10 micrograms / 400IU vitamin D per day during the autumn and winter months. Advice for children and babies varies. Please see my comprehensive vitamin D article for more information on safe supplementation.

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Bramley hand sanitizer

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Cloth masks

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Bramley nourishing hand wash & cream

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Bulk mixed nuts

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Vitamin D spray

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Time to drink water bottle

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Fatigue

It can be really tough some days, when the weather is foul and the nights are drawing in, to resist the urge to just curl back under your duvet and enter full hibernation mode. But I have found that there are a few great ways to help boost my own energy enough to fight off those urges and seize the day instead. For those of you severely affected with seasonal fatigue, however, do take a read of my article on Seasonal Affective Disorder too. As always, it’s sensible to discuss persistently low energy levels with your doctor in the first instance.

1. Get enough sleep. This is so often the cause of low energy and morning fatigue, and although it is obvious (and easier said than done for some), it is a really important point. If you need to wake up at 7am, and you know that you need 7-8 hours sleep for optimal energy, then that means you need to be in bed, ready to sleep by 11pm most nights. Most people take 30 mins to 1 hour to wind down after a long day, perhaps with a bath or shower, a warm drink and some time reading, so factor this in too. There is no shame in seeking out an early night. Do try to observe a ‘technology sundown’ too – ideally leaving all electronic devices outside of your bedroom whilst you sleep. Check out my article on 9 tips for a great night’s sleep for more ideas.

2. Get outside. Being outside in nature is a great way to see the beautiful colour displays of the changing leaves, and fresh air, a little sunshine and a bit of bracing cold can do absolute wonders to our energy levels (most especially if we are still working from home). I love the Swedish phrase that there ‘is no such thing as bad weather, only bad clothing’ because it reminds me that a spot of rain is never so bad, so I grab my wellington boots and waterproofs and get outside anyway – and always feel better for doing so.

3. Move in a way that works for you. I know that it can feel harder to motivate yourself to keep moving over the colder months than it is over the summer, but getting regular exercise usually boosts energy rather than sapping it. Any movement counts – so choose what you enjoy most. I like to walk most days and have recently been doing a cardio and resistance session a couple of times a week too. I also adore Movement for Modern Life (an online yoga platform).

4. Watch out for excessive sugar. Swinging high and low blood sugars make us feel tired, and the commonest cause of this is a high-sugar (or high refined carbohydrate) diet or reliance on sugary snacks or drinks. When we are feeling lethargic it may seem like we need a sugary pick-me-up as a ‘boost’, but it can in fact make matters worse in the long run. Getting enough protein with our meals helps to tackle any hunger that can lead to a sugary binge – and breakfast is often the most important point to boost protein intake. If you need some nourishing breakfast inspiration, there’s over 80 ideas in this article, or do as I do and have a go at making my everyday breakfast. There are lots more nutritious, energy-boosting recipes in Simply Good For You.

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Fitflop wellies

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Sunrise alarm clock

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Wild Nutrition B Complex Plus

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Cork yoga mat

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Energising aromatherapy

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Simply Good For You

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Seasonal Food

Although summer may nearly be over, the sudden abundance of delicious autumnal food is more than enough compensation. There is something deeply satisfying about filling up my freezer or food cupboards with lots of fresh and vibrant produce to see me through the winter months. It means that I can keep enjoying a wide variety of home-grown or local produce long into the winter – promising me a little ray of sunshine to brighten a gloomy January or February morning.

Here is a list of some of my favourite British foods in season over autumn, plus a few recipe ideas to make the most of them.

try these autumn recipes

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Willow oven dish

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Peeler

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Knives

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Chopping Board

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Soup bowl

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Cast iron casserole

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Please note, this article uses affiliate links. If you buy something through these links, we may earn an affiliate commission, at no additional cost to you. This helps to keep our online content free for everyone to access. Thank you.

The above content is for general information only and should not be treated as a substitute for the medical advice of your own doctor or any other healthcare or nutrition professional. If you have any concerns about your general health, you should contact your local healthcare provider. Please discuss all supplements with a qualified nutrition or healthcare provider prior to commencing.


Tap Water

tap water

Is the tap water in the UK safe to drink? What are the UK water regulations? Drinking water in the UK is very tightly regulated: it must fulfil a wide range of safety standards that are in place to protect us from harm, such as maximum levels of contamination with bacteria, minerals or chemicals.

This article will try to explore some of the commonly raised questions and queries about UK tap water consumption, and share some further resources if you’re interested in reading more. I hope you find it helpful.

What about Fluoride? Is it added to our water?

Fluoride is naturally present in low levels in most of the drinking water in the UK. Some authorities, however, add more fluoride, because it may help to prevent tooth decay.However, this practice remains somewhat controversial 2 as it may in fact be the application of fluoride directly to the teeth (i.e. from toothpaste, or from our saliva if we ingest fluoride), which holds the key to good dental health – rather than whole body fluoridation. For a map of fluoride levels in water, click here dwi.gov.uk/consumers/advice-leaflets/fluoridemap.pdf. The UK has set a maximum upper limit for fluoride in drinking water at 1.5mg/l 3

And, are there any harmful effects from fluoride in our water?

This is a tricky question to answer, as there are rather a lot of conflicting views on this topic. It seems that if you are exposed to very largeamounts of fluoride (either from excessive or very concentrated fluoridated water or from other sources), there may be some risk to health.4 However, this is unlikely to occur with normal, everyday water consumption. It is generally thought that as long as water contains less than 1.5mg/l fluoride (the regulated UK upper limit), it does not pose a risk to human health.Indeed, a report from 2014 from Public Health England concluded that “water fluoridation is a safe and effective public health measure”3.

Is hard water bad for me?

Hard water is formed when rain filters through rocks rich in minerals, such as calcium and magnesium. Therefore, the hardness of your water will depend on your local geology. There are no proven negative health effects of having hard water (although your washing machine might not last so long!), and in fact, it may even provide a handy extra source of essential calcium and magnesium in your diet.Some people have found that using a water softener system for bath or shower water helps to improve their eczema. However, a randomised study of 336 children found that the water softeners provided no additional benefit to their eczema, compared to children without a water softener system 6, so it’s probably a case of personal trial and error.

What about lead?

If your house was built before 1970, then there is a small chance that you may have underground lead pipes connecting your home water supply to the network. Small traces of lead can ‘wash off’ the inside of these pipes and into your drinking water. The World Health Organisation has set a maximum limit of 10 micrograms / l of lead in drinking water, because levels higher than this are considered harmful, particularly for children and pregnant women.7 Overall, lead exposure should be kept to a minimum.

If you are concerned at all that your home may have lead pipes, you can ask your water company to test your tap water. Take a look at the following leaflet for more information: dwi.defra.gov.uk/consumers/advice-leaflets/lead.pdf 

What about chlorine?

The UK uses a low level of chlorine to keep drinking water free of bacteria and other microbes, especially as it travels along the miles of pipes from the treatment works to your home. Clean, safe drinking water is incredibly important to everyone’s health, keeping all sorts of dangerous waterborne infections at bay. Chlorine is therefore added as an important part of the water treatment process. However, concerns about this practice have been raised by some people.8 When chlorine reacts with organic matter (naturally found in water sources), it can spark a chemical reaction that forms a group of by-products known as ‘trihalomethanes’ (THMs). High levels of THMs have, hypothetically, been linked to various health problems – although inconclusively. Regulations have, however, now been set for maximum levels of THMs in our tap water to help minimise this risk.8

Activated carbon filters may be used to help remove chlorine and its by-products from drinking water.8 You may also find that it improves the taste of your water – which can be useful if you’re struggling to drink enough water throughout the day. Do make sure you follow the manufacturer’s instructions though, and change the filter regularly for optimum function.

Its important to point out that any potential risk posed to us from small amounts of chlorine (or its by-products) in our water is still significantly less than the risk posed by water which hasnt been disinfected.

And what about birth control pill residues?

River water downstream of waste water discharges may have some detectable levels of the active ingredient in most combined oral contraceptive pills – ethynyl oestradiol. However, both routine filtration and disinfection by water treatment plants is reportedly effective at removing this from our drinking water. 9

A note on reverse osmosis filters…

Reverse osmosis (RO) filters remove most dissolved solids and minerals from water, which can be useful for specialist work (such as photographic processing or growing plants using hydroponics). However, it is not generally recommended to drink RO water, unless all the appropriate minerals, in the right quantities, have been added back. It is also a requirement in law to let your water supplier know if you intend to install an RO system.10

And on ion exchange filters…

Water softener systems are sometimes installed in areas of particularly hard water. These work by replacing calcium and magnesium ions in the water with sodium. This can be helpful for domestic appliances, and makes soap lather up far better. However, the Department of Health doesn’t recommend drinking or using water treated this way for cooking. Sodium is the mineral responsible for the negative health effects of excessive salt in your diet. Therefore, treating your drinking water this way may potentially supply you with an extra hidden source of salt, so is probably best to avoid.10

The bottom line?

Ultimately, the water that comes out of our taps in the UK is generally considered safe to drink, and is undoubtedly more ecologically sound than relying on bottled water. However, there are still a number of unanswered questions regarding specific treatment processes, and also the best types of filtration systems (if any!) to use. It is ultimately down to your personal preference, budget and taste.

If you are concerned about the quality of your drinking water, however, you could contact your local water provider and ask for information regarding your own water supply systems and recent water quality test reports. This may be particularly important if there is a chance that you have lead pipes suppling your home.

Water filters

For more information about home water filters, you may find this leaflet useful:

dwi.defra.gov.uk/consumers/advice-leaflets/filters.pdf

I do not specifically endorse any particular type of water filter over another; it is important to do your own research to find a system that works for your needs, budget and family requirements, if tap water filtration is something you choose to do. However, there are a couple of filters that either myself or my colleagues use that I thought might be useful to list, just to get you started.

Once you invest in a water filtration system, it is important to follow the manufacturer’s directions (particularly around cartridge replacement), to ensure that it remains safe and effective.

. . . . .

Interested in finding out more?

britishwater.co.uk

Checking the quality of your drinking water:

gov.uk/check-drinking-water-quality

dwi.defra.gov.uk/consumers/advice-leaflet

More water quality advice leaflets: dwi.defra.gov.uk/consumers/advice

References & Bibliography:
Government of Canada (2016) It’s your health – Fluorides and human health [Health Canada, 2010]. Available at: http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/environ/fluor-eng.php (Accessed: 21 November 2016).

Peckham, S. and Awofeso, N. (2014) ‘Water Fluoridation: A critical review of the physiological effects of ingested fluoride as a public health intervention’, The Scientific World Journal, 2014, pp. 1–10. doi: 10.1155/2014/293019.

PHE: Public Health England (2014) Water Fluoridation. Available at: https://www.gov.uk/government/uploads/

NRC: National research council (2006) Fluoride in drinking water: A scientific review of EPA’s standards. Available at: https://www.nap.edu/read/11571/chapter/2#10 (Accessed: 8 September 2016).

Sengupta, P. (2013) ‘Potential health impacts of hard water’, International Journal of Preventative Medicine, 4(8), pp. 866–875.

Thomas, K.S., Dean, T., O’Leary, C., Sach, T.H., Koller, K., Frost, A. and Williams, H.C. (2011) ‘A Randomised controlled trial of ion-exchange water Softeners for the treatment of Eczema in children’, PLoS Medicine, 8(2), p. e1000395. doi: 10.1371/journal.pmed.1000395

WHO (2016) Lead poisoning and health. Available at: http://www.who.int/mediacentre/factsheets/fs379/en/ (Accessed: 21 November 2016).

Canada, G. of, Canada, H., Affairs, P., Consultation and Branch, C. (2006) It’s your health – drinking water Chlorination [Health Canada, 2004]. Available at: http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/environ/chlor-eng.php (Accessed: 21 November 2016).

DWI (Drinking water inspectorate) (2013) Pharmaceuticals and drinking water. Available at: http://www.dwi.gov.uk/consumers/advice-leaflets/pharmaceuticals.pdf (Accessed: 8 September 2016).

DWI (Drinking Water Inspectorate) (2013) Water filters and other home treatment units. Available at: http://www.dwi.gov.uk/consumers/advice-leaflets/filters.pdf (Accessed: 8 September 2016).

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