Food as medicine: how what you eat shapes the health of your lungs



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Shifting your diet away from processed foods and towards fruits and vegetables can reduce symptoms of asthma.
from www.shutterstock.com

Lisa Wood, University of Newcastle

This article is part of a three-part package “food as medicine”, exploring how food prevents and cures disease. Read other articles in the series here. The Conversation


We all understand that eating too much of the wrong foods – those that are high in energy and low in nutrients, such as fast foods, processed foods and takeaways – causes weight gain and can lead to obesity. These foods are often high in saturated fat, refined carbohydrates (or sugars) and sodium, which increase the risk of developing diabetes, heart disease and some cancers.

But eating poorly has other, somewhat more surprising ramifications. Recently we have come to understand that unhealthy eating patterns can affect our lungs. Switching your diet to one rich in fruit and vegetables could help you breathe easier.

Healthy diets and healthy lungs

Most of the epidemiological evidence linking diet with lung function has focused on chronic obstructive pulmonary disease (COPD). Linked to smoking, COPD causes progressive lung deterioration and asthma.

Several large studies have observed people over time, and found that an unhealthy eating pattern (including refined grains, cured and red meats, desserts and French fries) increases the risk of lung function decline and COPD onset, compared to a healthy eating pattern (including fruit, vegetables, fish and wholegrains).

A recent study followed more than 40,000 men for 13 years, and found a high fruit and vegetable intake was associated with reduced risk of COPD. Current and ex-smokers eating five or more serves a day of fruit and vegetables were 30 to 40% less likely to develop COPD compared to those eating fewer than two serves per day.

A three year study in patients with existing COPD revealed those consuming a high fruit and vegetable diet had an improvement in lung function.

In asthma, there is evidence westernised diets, fast foods and processed foods increase the risk of asthma attacks, lung function decline, wheeze and breathlessness.

We have tested the effect of a high fruit and vegetable diet in asthma sufferers over three months. We found people consuming seven or more servings of fruit and vegetables per day had a reduced risk of asthma attacks, compared to people who consumed a low fruit and vegetable diet (fewer than three servings per day).

Another intervention study in asthma used a diet originally designed to reduce high blood pressure – the Dietary Approaches to Stop Hypertension (DASH) diet – for six months. One of the DASH dietary goals was to consume seven to 12 servings of fruit and vegetables, as well as two to four servings of low-fat/fat-free dairy products, and limiting daily fat and sodium intake. This led to improvements in asthma control and quality of life.

How do fruit and vegetables improve lung health?

People with respiratory diseases such as COPD and asthma typically suffer from inflamed airways. The airway tissue becomes swollen and hypersensitive, excess mucus is produced and the breathing tubes become damaged, sometimes irreversibly. The resulting narrowing of the airways makes it difficult for air to pass in and out of the lungs.

Failure to breathe freely can very quickly become life threatening. Restricted airflow can also have a debilitating effect on day-to-day activities, causing symptoms such as coughing, wheezing, breathlessness and chest tightness in people with asthma and COPD.

Fruit and vegetables are a rich source of several nutrients, in particular soluble fibre and antioxidants, that have been shown to reduce inflammation in the airways.

Dietary fibre reduces lung inflammation

Dietary fibre exists in soluble and insoluble forms. Soluble fibre is fermented by gut bacteria to produce short chain fatty acids. These can bind to specific receptors on the surface of immune cells, which suppress airway inflammation. We have shown a single dose of soluble fibre activates these receptors and reduces inflammation in human airways within just four hours.

Short chain fatty acids can also inhibit expression of the genes that cause airway inflammation, through a process known as epigenetic modification. So a high soluble-fibre intake has the potential to protect against airway inflammation through both activation of anti-inflammatory immune receptors, and inhibition of genes controlling inflammation.

Antioxidants are also anti-inflammatory

Antioxidants present in fruit and vegetables – such as vitamin C, carotenoids and flavonoids – are also beneficial, as they can protect against the damaging effects of free radicals, which are highly reactive molecules produced by activated inflammatory cells that can damage asthmatic airways. Many observational studies have linked antioxidants with lung health.

However, data from antioxidant supplementation trials in asthma are not convincing. Few studies show a beneficial effect, likely due to the use of individual nutrients. Multiple antioxidants exist together in fruit and vegetables, which have interdependent roles that are likely to be critical for their protective effects. So dietary modifications using whole fruit and vegetables is a better strategy.

Sometimes we can become overwhelmed by the nutrition messages in the media, which tell us to eat this and not eat that. Sometimes the advice seems contradictory and confusing. So here is a very simple and focused message for people with respiratory disease – eat more fruit and vegetables!

There’s really nothing to lose and everything to gain. As well as helping to maintain or achieve a healthy weight and reducing the risk of heart disease, diabetes and cancer, you will also be improving your lung health.


Further reading:

Food as medicine: why do we need to eat so many vegetables and what does a serve actually look like?

Food as Medicine: your brain really does want you to eat more veggies

Lisa Wood, Professor, University of Newcastle

This article was originally published on The Conversation. Read the original article.

Food as medicine: your brain really does want you to eat more veggies



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Diet reduces risk of depression through actions on bacteria in the gut, the immune system and the brain.
from www.shutterstock.com

Felice Jacka, Deakin University

This article is part of a three-part package “food as medicine”, exploring how food prevents and cures disease. Read other articles in the series here. The Conversation


As well as our physical health, the quality of our diet matters for our mental and brain health. Observational studies across countries, cultures and age groups show that better-quality diets – those high in vegetables, fruits, other plant foods (such as nuts and legumes), as well as good-quality proteins (such as fish and lean meat) – are consistently associated with reduced depression.

Unhealthy dietary patterns – higher in processed meat, refined grains, sweets and snack foods – are associated with increased depression and often anxiety.

Importantly, these relationships are independent of one another. Lack of nutritious food seems to be a problem even when junk food intake is low, while junk and processed foods seem to be problematic even in those who also eat vegetables, legumes and other nutrient-dense foods. We’ve documented these relationships in adolescents, adults and older adults.

Diet has an impact early in life

The diet-mental health relationship is evident right at the start of life. A study of more than 20,000 mothers and their children showed the children of mothers who ate an unhealthier diet during pregnancy had a higher level of behaviours linked to later mental disorders.

We also saw the children’s diets during the first years of life were associated with these behaviours. This suggests mothers’ diets during pregnancy and early life are both important in influencing the risk for mental health problems in children as they grow.

This is consistent with what we see in animal experiments. Unhealthy diets fed to pregnant animals results in many changes to the brain and behaviour in offspring. This is very important to understand if we want to think about preventing mental disorders in the first place.

Teasing out the cause from the correlation

It’s important to note that, at this stage, most of the existing data in this field come from observational studies, where it is difficult to tease apart cause and effect. Of course, the possibility that mental ill health promoting a change in diet explains the associations, rather than the other way around, is an important one to consider.

What comes first, the junk food or the depression?
from shutterstock.com

Many studies have investigated this and largely ruled it out as the explanation for the associations we see between diet quality and depression. In fact, we published a study suggesting that a past experience of depression was associated with better diets over time.

But the relatively young field of nutritional psychiatry is still lacking data from intervention studies (where study participants are given an intervention that aims to improve their diet in an attempt to affect their mental health). These sorts of studies are important in determining causality and for changing clinical practice.

Our recent trial was the first intervention study to examine the common question of whether diet will improve depression.

We recruited adults with major depressive disorder and randomly assigned them to receive either social support (which is known to be helpful for people with depression), or support from a clinical dietitian, over a three-month period.

The dietary group received information and assistance to improve the quality of their current diets. The focus was on increasing the consumption of vegetables, fruits, wholegrains, legumes, fish, lean red meats, olive oil and nuts, while reducing their consumption of unhealthy “extra” foods, such as sweets, refined cereals, fried food, fast food, processed meats and sugary drinks.

The results of the study showed that participants in the dietary intervention group had a much greater reduction in their depressive symptoms over the three months, compared to those in the social support group.

At the end of the trial, 32% of those in the dietary support group, compared to 8% of those in the social support group, met criteria for remission of major depression.

These results were not explained by changes in physical activity or body weight, but were closely related to the extent of dietary change. Those who adhered more closely to the dietary program experienced the greatest benefit to their depression symptoms.

While this study now needs to be replicated, it provides preliminary evidence that dietary improvement may be a useful strategy for treating depression.

Depression is a whole-body disorder

It’s important to understand researchers now believe depression is not just a brain disorder, but rather a whole-body disorder, with chronic inflammation being an important risk factor. This inflammation is the result of many environmental stressors common in our lives: poor diet, lack of exercise, smoking, overweight and obesity, lack of sleep, lack of vitamin D, as well as stress.

Many of these factors influence gut microbiota (the bacteria and other microorganisms that live in your bowel, also referred to as your “microbiome”), which in turn influence the immune system and – we believe – mood and behaviour.

In fact, gut microbiota affect more than the immune system. New evidence in this field suggests they are important to almost every aspect of health including our metabolism and body weight, and brain function and health. Each of these factors is relevant to depression risk, reinforcing the idea of depression as a whole-body disorder.

What is the human microbiome?

If we do not consume enough nutrient-dense foods such as fruits, vegetables, fish and lean meats, this can lead to insufficiencies in nutrients, antioxidants and fibre. This has a detrimental impact on our immune system, gut microbiota and other aspects of physical and mental health.

Gut microbiota are particularly reliant on an adequate intake of dietary fibre, while the health of the gut may be compromised by added sugars, fats, emulsifiers and artificial sugars found in processed foods.

A diet high in added fats and refined sugars also has a potent negative impact on brain proteins that we know are important in depression: proteins called neurotrophins. These protect the brain against oxidative stress and promote the growth of new brain cells in our hippocampus (a part of the brain critical for learning and memory, and important to mental health). In older adults we have shown that diet quality is related to the size of the hippocampus.

Now we know diet is important to mental and brain health as well as physical health, we need to make healthy eating the easiest, cheapest and most socially acceptable option for people, no matter where they live.


Further reading:

Food as medicine: why do we need to eat so many vegetables and what does a serve actually look like?

Felice Jacka, Principal Research Fellow, Deakin University

This article was originally published on The Conversation. Read the original article.

Food as medicine: why do we need to eat so many vegetables and what does a serve actually look like?


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Why do we need so many serves of vegetables in a day?
Unsplash/Jonathan Pielmayer, CC BY-SA

Genevieve James-Martin, CSIRO; Gemma Williams, CSIRO, and Malcolm Riley, CSIRO

This is the first article in a three-part package “food as medicine”, exploring how food prevents and cures disease. The Conversation


Most Australian adults would know they’re meant to eat two or more serves of fruit and five or more serves of vegetables every day. Whether or not they get there is another question.

A recent national survey reported 45% of Australian women and 56% of Australian men didn’t eat enough fruit. And 90% of women and 96% of men didn’t eat enough vegetables. This figure is worse than for the preceding ten years.

Men had on average 1.6 serves of fruit and 2.3 serves of vegetables per day, and women had 1.8 serves of fruit and 2.5 serves of vegetables. A serve of fresh fruit is a medium piece (about 150 grams) and a serve of vegetables is half a cup of cooked vegetables or about a cup of salad.


The Conversation/Australian Dietary Guidelines, 2013, CC BY-ND

Why do we need so many veggies?

A high intake of fruit and vegetables lowers the risk of type 2 diabetes, heart disease, stroke and some cancers. These chronic diseases are unfortunately common – it’s been estimated A$269 million could have been saved in 2008 if everyone in Australia met fruit and vegetable recommendations.

The recommendation to include plenty of vegetables and fruit in our diet is based on a large body of evidence showing the risk of a range of health conditions is reduced as we eat more fruit and vegetables. The specific targets of two serves for fruit and five to six serves for vegetables are largely based on nutrient requirements for healthy people and what diets usually look like for the average Australian.

So to set these guidelines, certain assumptions are made about dietary practices, such as breakfast being based around cereal/grain and dairy foods, and main meals being comprised of meat and vegetables, usually with a side of something starchy like rice, pasta or the humble potato – an Australian staple.

Does this mean it’s the only pattern to meet all the nutrient requirements? No. Could an adult be equally healthy if they ate three serves of fruit and four serves of vegetables? Yes, probably.

Some recent research even suggests our current targets don’t go far enough. It estimates an optimal intake for reducing our risk of heart disease and early death to be around ten serves of fruit and vegetables a day. Whether we are aiming for two and five, or ten serves, is somewhat academic – the clear message is most of us need to increase our fruit and vegetable intake.

Aussies eat more potatoes than any other veggie.
Agence Producteurs Locaux Damien Kühn/Unsplash, CC BY

Why is two and five such a hard ask?

The populations of most Western countries report eating far less fruit and vegetables than they’re supposed to. So what’s making it so hard for us to get to two and five?

Diets higher in fat, sugar and grains are generally more affordable than the recommended healthy diets high in fruit and veg. In fact, for Australians on low incomes, a healthy food basket for a fortnight would cost 28 to 34% of their income, up to twice the national average for food expenditure.

As a result, people with limited access to food for financial reasons often choose foods with high energy content (because they are filling) over those with high nutritional value but low energy content like fruit and vegetables. These high-energy foods are also easy to over-consume and this may be a contributing factor to weight gain. People who are poorer generally have a diet poorer in quality but not lower in energy content, which contributes to a higher rate of obesity, particularly in women.

Fresh fruit and vegetables cost more to purchase on a dollars per kilojoule basis, and also perish more quickly than processed foods. They take more time and skill to prepare and, after all of that effort, if they don’t get eaten for reasons of personal preference, they go to waste. For many it may not stack up financially to fill the fridge with fruit and vegetables. Under these circumstances, pre-prepared or fast food, which the family is sure to eat without complaint or waste, is all too convenient.

How we can increase veggie intake

The home and school environments are two key influencers of children’s food preferences and intakes. Parents are the “food gatekeepers” and role models particularly for younger children. Where there is parental encouragement, role modelling and family rules, there is an increased fruit and vegetable intake.

Dietary behaviours and food choices often start in childhood and continue through adolescence to adulthood. So encouraging fruit and vegetable intake in schools by mechanisms such as “fruit snack times” may be a good investment.

Policy approaches include subsidies on healthy foods. Other examples include levying a tax on foods of low nutritional value, improved food labelling, and stricter controls on the marketing of unhealthy foods. In Australia debate continues around a tax on sugar-sweetened beverages, which could be used to subsidise healthy foods such as fruit and vegetables.

Research has found the more variety in fruit and vegetables available, the more we’ll consume. Those who meet the vegetable recommendation are more likely to report having at least three vegetable varieties at their evening meal. So increasing the number of different vegetables at the main meal is one simple strategy to increase intake.

This could be made a journey of discovery by adding one new vegetable to the household food supply each week. Buying “in season” fruit and vegetables and supplementing fresh varieties with frozen and canned options can bring down the total cost. Then it’s a matter of exploring simple, quick and tasty ways to prepare them so they become preferred foods for the family.

Genevieve James-Martin, Research Dietitian, CSIRO; Gemma Williams, Research Dietitian, CSIRO, and Malcolm Riley, Nutrition Epidemiologist, CSIRO

This article was originally published on The Conversation. Read the original article.

Tropical Cyclone Debbie has blown a hole in the winter vegetable supply


Ian Sinclair, University of Sydney; Brent Jacobs, University of Technology Sydney; Laura Wynne, University of Technology Sydney, and Rachel Carey, University of Melbourne

Cyclone Debbie, which lashed the Queensland coast a week ago, has hit farmers hard in the area around Bowen – a crucial supplier of vegetables to Sydney, Melbourne and much of eastern Australia. The Conversation

With the Queensland Farmers’ Federation estimating the damage at more than A$100 million and winter crop losses at 20%, the event looks set to affect the cost and availability of fresh food for millions of Australians. Growers are reportedly forecasting a price spike in May, when the damaged crops were scheduled to have arrived on shelves.

The incident also raises broader questions about the resilience of Australia’s fresh vegetable supply, much of which comes from a relatively small number of areas that are under pressure from climate and land use change.

In 2011 the Bowen area produced 33% of Australia’s fresh beans, 46% of capsicum and 23% of fresh tomatoes, making it the country’s largest producer of beans and capsicums, and number two in fresh tomatoes.

The region also produces a significant amount of chillies, corn, cucumbers, eggplant, pumpkin, zucchini and squash, and is a key production area for mangoes and melons.

Coastal Queensland’s vegetable regions are among the highest-producing in the country, especially for perishable vegetables. The Whitsunday region around Bowen, and the area around Bundaberg further south are each responsible for around 13% of the national perishable vegetable supply.

As the chart below shows, vegetable production is highly concentrated in particular regions, typically on the fringes of large cities. These “peri-urban” regions, when added to the two major growing areas in coastal Queensland, account for about 75% of Australia’s perishable vegetables.

Proportion of State Perishable Vegetable Production by weight.
ABS 7121.0 Agricultural Commodities Australia, 2010-11

Australia’s climate variability means that most fresh produce can be grown domestically. The seasonable variability allows production to move from the south to the north in the winter, when the Bundaberg and Bowen areas produce most of the winter vegetables consumed in Brisbane, Sydney and Melbourne. The Bowen Gumlu Growers Association estimates that during the spring growing season in September—October, the region produces 90% of Australia’s fresh tomatoes and 95% of capsicums.

Besides damaging crops, Cyclone Debbie has also destroyed many growers’ packing and cool storage sheds. The cost of rebuilding this infrastructure may be too much for many farmers, and the waterlogged soils are also set to make planting the next crop more difficult.

The recovery of production in these areas is crucial for the supply. Growers who have lost their May crop will first have to wait until the paddocks dry out, then source new seedlings and plant them. It could be weeks until crops can be replanted, and storage and processing facilities replaced.

The Queensland government has announced natural disaster relief funding, including concessional loans of up to A$250,000 and essential working capital loans of up to A$100,000, to help farmers replant and rebuild.

Meanwhile, consumers of fresh vegetables in Sydney and Melbourne and many other places are likely to find themselves paying more until the shortfall can be replaced.

Fresh food for growing cities

Australia’s cities are growing rapidly, along with those of many other countries. The United Nations has predicted that by 2050 about 87% of the world’s population will live in cities. This urban expansion is putting ever more pressure on peri-urban food bowls.

Food production is also under pressure from climate change, raising the risk of future food shocks and price spikes in the wake of disasters such as cyclones. Meanwhile, the desire for semi-rural lifestyles is also conflicting with the use of land for farming (see Sydney’s Food Futures and Foodprint Melbourne for more).

These pressures mean that Australia’s cities need to make their food systems more resilient, so that they can withstand food shocks more easily, and recover more quickly.

Key features of a resilient food system are likely to include:

  • geographic diversity in production, which spreads the risk of crop damage from extreme weather events across a number of different production areas;

  • more local food production, to reduce transportation and storage costs and avoid over-reliance on particular regions;

  • a diverse, healthy and innovative farming community;

  • greater consumer awareness of the importance of seasonal and locally produced food;

  • recycling of urban waste and water for use on farms, to reduce the use of fresh water and fertilisers;

  • the capacity to import food from overseas to meet shortfalls in domestic supply;

  • increased use of protected cropping systems such as greenhouses, which are better able to withstand adverse weather.

Two recent studies of food production around Sydney and Melbourne provide examples of a range of mechanisms and policies for increasing the resilience of the food systems of Australian cities.

Our food system has served us well until now, but land use pressures and climate change will make it harder in future. When a cyclone can knock out a major production region overnight, with knock-on effects for Australian consumers, this points to a lack of resilience in Australia’s fresh vegetable supply.

Ian Sinclair, PhD Candidate. Contested Landscapes – Managing the Tensions between Land Use Planning in Strategic Agricultural Regions on Australia’s Eastern Seaboard., University of Sydney; Brent Jacobs, Research Director, Institute for Sustainable Futures, University of Technology Sydney; Laura Wynne, Senior Research Consultant, Institute for Sustainable Futures, University of Technology Sydney, and Rachel Carey, Research Fellow, University of Melbourne

This article was originally published on The Conversation. Read the original article.

Vanuatu Faces Food Shortages After Cyclone Pam Devastates Crops


TIME

Survivors of Cyclone Pam on the South Pacific islands of Vanuatu are bracing for a lack of food over the coming months because crops were destroyed in the recent storm.

Much of the archipelago’s population relies on subsistence farming and when the monster cyclone ripped through the country last week it wiped out livelihoods as well as homes.

“There’s always a lot of attention in the beginning, the first few weeks of a big disaster. But now, we’re looking at a hunger gap over the next three to six months,” said World Vision’s Emergency Operations Manager in Vanuatu, Alex Snary.

Aid agencies are rushing to deliver desperately needed supplies, especially to communities on the remote outer islands, which are still out of contact.

At least 11 people were killed in the disaster and 3,3000 displaced.

“It’s almost miraculous [on Tanna Island] that there isn’t a large number of casualties, given…

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