If you know your macro-nutrients you’ll know that carbohydrates are the body’s preferred source of energy. One of the best sources of good carbohydrate is fruit and vegetables and the average kiwi isn’t getting enough.  So being ‘tired’ and run down’ is more likely to be due to poor intakes of fresh fruit, vegetables and other good sources of carbohydrates such as wholegrain breads and cereals than vitamin deficiency.

As the name suggests ‘micro’-nutrients are nutrients the body needs in very small amounts.  Vitamins and minerals are micronutrients and just like carbohydrates, fats and proteins they are not food groups, rather they are nutrients that are found in the various food groups.  Food groups are; fruits and vegetables, breads and cereals, milk and milk products and lean meats, poultry, seafood, eggs, nuts, seeds and legumes.

Vitamins are divided into two groups; the water soluble vitamins (B-Complex & C) and the fat soluble vitamins (A, D, E & K). The fat soluble vitamins are absorbed with fats and well stored in fatty tissue. Reserves of these vitamins can last a long time and daily intake is not essential.  The water soluble vitamins cannot be stored and are easily excreted, making deficiency more likely and daily intake more important.  The following table summarises the functions of the major vitamins and the food groups that provide these

If followed, the Ministry of Health (MoH) guidelines for daily consumption of the major food groups should ensure that micro-nutrient requirements are easily met. Their information suggests that vitamin deficiency in the NZ diet is actually very rare.

Vitamins however can be ‘temperamental’!  Some, such as vitamin c can be easily destroyed by cooking.  The MoH estimates that boiling vegetables can destroy 50-80% of vitamin c content.  It recommends cooking with minimal water (steaming) or using the microwave.  And where possible fresh is best and raw is great.

Minerals are absorbed from the soil by plants.  They come into our diet through the plants we eat and/or the animals we eat that have eaten the plants.  New Zealand soils do tend to be deficient in iodine and selenium but the MoH has not determined that these soil deficiencies have actually resulted in deficiencies in our diet.  They recommend the use of iodised table salt if possible but advise people to be wary of adding salt to the diet as our intake of sodium is actually considered excessive and excessive sodium levels are linked to high blood pressure. 

There has been an increase in the use of supplemental selenium in animal feeds and the importation of wheat and other products from Australia where selenium in the soil is higher, to counter the low selenium levels in NZ soils. 

In both cases the MoH does not recommend the use of supplements unless under the supervision of a doctor.  The table below highlights some of the major minerals, their functions and common food sources.  

Probably the most controversial mineral is calcium. There is confusion over what the optimal intake is to achieve and maintain peak bone mass, protect from osteoporosis (brittle bones) and the subsequent risk of bone breakages. The MoH estimates that 20% of the population have an inadequate intake of calcium. Rather than encouraging supplementation, the MoH advises people to consume the recommended low fat intakes of milk & dairy products and other foods containing calcium. MoH also recommends preventing losses by minimising alcohol intake and smoking, and including regular exercise which aids calcium retention.

A mineral we in the fitness world are often interested in is iron, due to its importance in the transportation of oxygen to the body, and therefore to performance in endurance events that are largely dependant on an optimal supply of oxygenated blood to working muscles. 

According to its source, iron can be classified as ‘haem’, from meat, poultry and fish, or ‘non-haem’, from plant based foods, iron supplements and iron fortificants in food.  Approximately 20-30% of haem iron is absorbed by the body whereas only about 5% or less of non-haem iron is absorbed.  Because of this it has often been thought that vegetarians especially would be vulnerable to deficiency.  However iron deficiency is actually very low according to the MoH. 

To optimise the absorption of iron the MoH advises people to include foods high in vitamin c at mealtimes, and minimise the consumption of tea and coffee at mealtimes which hinders iron absorption.  Again the MoH only advises supplementation under medical supervision.

Supplements (as their name suggests) are only required to supplement a diet when a deficiency has been established.  As with vitamins, if the MoH’s recommendations for daily intakes of the food groups are met then so will the requirements for daily mineral intakes. 

When you read through the MoH guidelines it is very clear that supplementation (and indeed diagnosing the need for supplementation) is the domain of medical professionals and not fitness professionals. 

So what is our role in regard to micro-nutrient intakes and the use of supplements?  We should:

• Answer our client’s questions concerning micro-nutrient intakes with sound knowledge based on MoH guidelines for healthy eating
• Understand the MoH guidelines for daily intakes of the major food groups and help our clients to meet these guidelines
• Where necessary work with medical professionals to ensure the nutritional needs of all our clients can be met.

I remember a prominent NZ sports doctor referring to the urine at the Olympic Games as the ‘most expensive pee in the world’; because the athletes would take every supplement available on the chance it might offer them a split second advantage.  The reality is that the body only uses what it needs and excretes the rest, hence very expensive pee!  There are probably better things to spend ones money on than unnecessary supplements, such as fresh fruit and vegetables! 

For more information on micro-nutrients, their intakes and the MoH recommendations for healthy eating follow the hyperlink to this article

http://www.moh.govt.nz/moh.nsf/0/07BC6DBE764FDABBCC256DDB006D9AB4/$File/foodandnutritionguidelines-adults.pdf

Glycaemic Index or Glycaemic load – What’s the difference?

As the debate over carbohydrates (are they good or bad, what do they do, when can you not eat them) intensifies, the glycaemic index (GI), and glycaemic load (GL) have gained credibility as tools to help explain the effect carbohydrate foods have on the body, and thus which to avoid, and which to eat. 

The glycaemic index is a ranking of carbohydrate foods based on the effect they have on blood glucose levels after consumption.  After an overnight fast subjects are fed foods that contain 50grams of carbohydrate and their subsequent blood glucose levels are measured.  Foods that are deemed high GI are rapidly digested and absorbed, resulting in a greater rise in blood sugar levels, while foods deemed low GI are slowly digested and absorbed resulting in a lower rise in blood sugar levels.

It is generally recommended that we eat more low GI foods as due to a slower digestion they will provide energy over a longer period than high GI foods which give a short burst of energy.  Eating low GI helps weight control as theoretically we eat less low GI foods due to the sustained nature of their breakdown.  As there is a lower response on blood glucose levels with low GI foods people with diabetes are advised to eat low GI to help control their blood sugar levels.  The table below shows the GI ratings of some common foods;

While the GI is useful it does have a major limitation as it doesn’t take into account the quantity of food consumed for testing in order to provide 50 grams of carbohydrate. Confused? Lets’ explain it basically. Carbohydrate is not a food per se, it is a nutrient found in lots of different foods, and it is found in these different foods in different concentrations. 

For example sugar (or sucrose) is pure carbohydrate, i.e. 50 grams of it provides 50 grams of carbohydrate, and in comparison it requires 800 grams of carrots to provide 50 grams of carbohydrate. Watermelon is another example, like carrots it is considered high GI, but only has 5 grams of carbohydrate per 100 grams, so we’d have to eat about 1 kg of it to provide 50 grams of carbohydrate (the rest is really just water and fibre). 

This is where the glycaemic load (GL) comes into play, as it takes into account how much carbohydrate a typical serving of food contains as well as its GI.  Glycaemic load is defined as the amount of carbohydrate in a portion of food multiplied by the GI value for the food, divided by 100.  Consequently some foods that we may have avoided due to being high GI are shown to actually be not that bad when we consider typical serving sizes.  For example, how often does anyone really sit down and eat 800 grams of carrots in one go, or 1 kg of watermelon-as that is what is required for those foods to cause the ‘high GI’ effect on blood sugar levels 

The table below shows the GL of some common foods including many of those from above, note how some have changed as the amount of food is considered;  

A comprehensive listing of the GI & GL of many foods

Neither the GI nor the GL take into account the effect of fibre.  Dietary fibre is found in fruit, vegetables, legumes and many cereals, it adds bulk to meals without calories, making us feel full, as well as slowing the process of digestion.  Many low GI & low GL foods are also high fibre foods, so there is an argument to suggest that the actual benefit of eating low GI and low GL is due to the effect of fibre and not the glycaemic effect on blood sugar levels.

While the GI and GL certainly have credibility and interest value, in many ways they actually add to the confusion in regard to what ‘healthy eating’ is. It would seem that supporting the general message from the New Zealand Ministry of Health in regard to eating more fresh fruit and vegetables, wholegrain foods and legumes such as beans, lentils and peas, is not only credible but much easier for the general population to understand, and therefore much more useful. 

Vitamins do not share a common chemistry, but they do share certain characteristics. They are all organic nutrients that are necessary in small amounts for normal metabolism and good health. Your diet or supplements provide most vitamins. The body can manufacture only three vitamins (D, K, and the B vitamin biotin) from nondietary sources. Unlike carbohydrates, fats, and proteins, vitamins are not sources of energy. Instead, vitamins are chemical partners for the enzymes involved in the body's metabolism, cell production, tissue repair, and other vital processes.

Vitamins are either fat soluble or water soluble. The fat-soluble vitamins, which include A, D, E, and K, are absorbed by the body using processes that closely parallel the absorption of fat. They are stored in the liver and used up by the body very slowly. The water-soluble vitamins include C and the B complex vitamins. The body uses these vitamins very quickly. Excess amounts are eliminated in urine.

Guidelines for Vitamin Adequate Intake

The Recommended Daily Allowance (RDA) for vitamins, set by the Food and Nutrition Board of the National Academy of Sciences-National Research Council, has been used for years as a guide for determining the amount of vitamins needed for a healthy diet. The RDA refers to an estimate of the average daily requirement. It is not completely adequate, however, for informing people about the amounts of vitamins they may need.

The RDA is gradually being enhanced using a new standard called the Dietary Reference Intake (DRI). The DRI is based on the following ratings, which will eventually appear on labels:

• The recommended daily allowance (RDA). This is the current rating on most vitamins.
• The estimated average requirement (EAR). This is the amount adequate for 50% of all people, which will be put on labels when it can be calculated.
• Adequate intake (AI). This is an amount that will be used if there is insufficient data to calculate the EAR.
• Tolerable upper intake level (UL). This is the maximum dose likely to be safe in nearly all individuals. It will be included on labels if this amount is known.

Food and supplement labels now typically list the Daily Value (DV). This is the percentage of the amount of a nutrient that experts believe a person needs in their daily diet. On food labels it is usually based on one serving size for a person who takes in 2,000 calories a day.

Regulating Quality

Regulation of dietary supplements by the U.S. Food and Drug Administration (FDA) is a complex issue.

Labels on vitamins and other dietary supplements now include nutrient information and list all ingredients, including identifying parts of plants from which ingredients may be taken. Unlike the labels for drugs, however, labels for vitamins and supplements may not claim to prevent or treat any specific disease. Labels for vitamins and supplements include one of the following:

• Health claim -- description of how the substance may reduce the risk of a health-related condition
• Nutrient claim -- description of the amount of the nutrient in the product or
• Structure or function claim -- description of how the product may affect organs or systems of the body, without claiming to prevent or treat specific disease

The quality of dietary supplements depends on the manufacturer and is not ensured by FDA. The US government does not require that supplements be standardized, meaning that the amounts or quality of nutrients may vary depending on the batch. So, more expensive supplements are not necessarily better than the less expensive ones. Government regulations are in the process of catching up to the boom in the supplement industry. In the meantime, some companies voluntarily adhere to rigorous quality controls, while others do not.

The US Pharmacopeia, an independent organization that sets quality standards for drugs, has also implemented standards for vitamins. Consumers may look for the USP label on products of companies that adhere to these standards. USP verification means the following:

• What is in the bottle matches what is listed on the label.
• There are no harmful levels of contaminants.
• The supplement will be absorbed properly into the body.
• It has been produced according to good manufacturing standards.

Before selling any supplement introduced after 1994, manufacturers must submit information as to why the product is considered safe for people. The FDA may refuse to allow it on the market if it finds the evidence insufficient. The FDA does not require manufacturers to provide any scientific evidence that dietary supplements are safe and effective before a product is sold (unlike drugs, which must be proven both safe and effective through clinical trials). If a supplement causes side effects in people once it is for sale, the government may place restrictions on the supplement or withdraw it from the market. The FDA may also withdraw products from the market if their labels are misleading or false.

People Who Should Take Vitamin Supplements

About 30% of Americans take at least one vitamin or mineral supplement daily. In a large study that examined the death rates of 11,000 people, however, there was no difference in mortality rate between those who took vitamin supplements and those who didn't. If a diet is healthy, most people do not need vitamins, but there are some exceptions. Nevertheless, a number of experts do recommend that adults take a multivitamin every day.

Pregnant and Breast-Feeding Women. Women who are pregnant or who are breast-feeding generally need additional vitamins. The B vitamins are particularly important. Women who are vegetarians must be sure to avoid deficiencies, which can harm their offspring. Folic acid reduces the risk for neural tube defects and possibly facial abnormalities, such as cleft palate. Multivitamins that contain folic acid also appear to be somewhat protective. Taking extra folic acid plus multivitamin supplements (which have additional benefits) and starting them before a woman actually becomes pregnant is the optimal approach.

The human body stores several years' worth of vitamin B12, so nutritional deficiency of this vitamin is extremely rare. Although, people who follow a strict vegetarian diet and do not consume eggs or dairy products may require vitamin B12 supplements.

Folate levels from even healthy diets may not be protective enough for pregnant women and supplements are needed. Requirements are as follows:

• The RDA for folic acid prior to conception and during pregnancy is 400 mcg.
• During breast feeding between 260 and 280 mcg is recommended.

The following vitamins may have some value for pregnant women:

• Choline, another vitamin B, is also essential for pregnant (450 mg) and nursing women (550 mg).
• Vitamin B6 may help improve morning sickness.
• One study also suggested that if pregnant women took vitamin K supplements, their infants might not need the required injection of this vitamin after birth, but supplements of vitamin K during pregnancy are not currently recommended.

Some women have low vitamin A reserves in their liver. It is important to note, however, that too much vitamin A significantly increases the risk for birth defects. Daily amounts of 10,000 IU of vitamin A in supplements and food (an amount not far above the RDA level) can pose a danger. Experts recommend that pregnant women take in no more than 8,000 IU per day and avoid eating liver.

Infants and Children. Infants who are breastfed by healthy mothers receive enough vitamins except, in some cases, vitamins K and D. Human milk has low levels of K, and the newborn's immature intestinal tract may not produce enough of the baby's own supply. Most babies are given an injection of this vitamin at birth. Infants being breastfed by malnourished women or those who lack sufficient exposure to sunlight may be deficient in vitamin D. In these cases, supplements of 200 - 300 IU are recommended. Formulas are required to contain sufficient vitamins and minerals. One study suggests that vitamin supplements for infants under 1 year of age may help protect them from developing type 1 diabetes later on. Beyond infancy, most American children receive all the vitamins they need from their diet unless they are living in severely deprived circumstances.

Smokers. Smoking interferes with absorption of several vitamins, importantly vitamin C. In fact, in one study nearly 25% of female smokers and 31% of male smokers were deficient in vitamin C. Folic acid supplements may be important for all smokers. Taking high doses of antioxidant vitamins, however, may actually be harmful in smokers, especially beta carotene. Instead of taking supplements, most smokers should be sure their diets are rich in fresh fruits and vegetables and whole grains.

Alcoholics. Alcoholics often suffer from multiple vitamin deficiencies. The most dangerous deficiencies are from vitamins B1 (thiamin), folic acid, B6 (pyridoxine), B2 (riboflavin), and vitamin C.

Dieters and Vegetarians. People on weight-reduction diets with less than 1,000 calories a day should probably take a multivitamin and should also check regularly with a physician.

Vegetarians may need riboflavin, vitamin B12, and vitamin D supplements. Vegans, who do not eat dairy or eggs as well as meat, may be at further risk for vitamin A deficiencies if they do not also have plenty of dark colored fruits and vegetables. Those who eat eggs and dairy products need only watch their iron levels.

Deficiencies in vegetarian children may be particularly harmful. (One study, for example, reported that adolescents who had been on macrobiotic diets before age 6 and were deficient in vitamin B12 scored lower on psychologic tests.) Pregnant and breast-feeding women who are vegetarians must be sure to have sufficient vitamins. Of special note, maternal deficiencies in vitamin B12 may cause delayed growth and neurologic problems in their newborns.

Older Adults. Deficiencies of vitamins and important minerals have been observed in almost a third of elderly people. Often their dietary habits slip and they fail to eat balanced meals regularly. Multiple drug regimens may prevent absorption of some vitamins. Elderly people, particularly if they are not exposed to sunlight, may be deficient in vitamin D. They also may have low levels of important B vitamins. (Older adults showing signs of dementia should be checked for B12 deficiencies as well as other disorders causing mental disturbances.) One study reported that the immune systems of elderly people may benefit from higher levels of vitamin E than the daily recommended dosage. It should be noted, however, that metabolism slows down as a person ages, and in elderly people it takes the liver longer to eliminate drugs and vitamins from the body. The effect of some vitamin supplements, therefore, may be intensified. Dosage levels of vitamin A, for instance, which might be harmless in a younger adult, could be toxic in an elderly patient. Nevertheless, experts are increasingly recommending extra vitamin and mineral supplements for older people.

People Who Need to Avoid Sunlight. People who need to avoid sunlight and whose diet is low in foods that contain vitamin D should take supplements. People with darker skin are at higher risk for deficiencies than those with whiter skin. (Note: vitamin D is toxic in high doses, and no one should exceed the recommended daily intake of vitamin D except under the direction of a physician.)

Carotenoids

Carotenoids are a group of more than 700 fat soluble nutrients that produce the colors in foods such as carrots, pumpkins, sweet potatoes, tomatoes, and other deep green, yellow, orange, and red fruits and vegetables. Many are proving to be very important for health. Beta carotene is the most widely studied carotenoid, but others are proving to be of great interest. As with some, but not all, carotenoids, beta carotene is known as a provitamin A because it converts to the vitamin in the body.

They are categorized as either xanthophylls or carotenes according to their chemical composition.

Carotenes

Carotenes are hydrocarbons and most are found in yellow, orange, and red vegetables. They include beta and alpha carotene and lycopene.

• Beta Carotene and other Provitamin A Carotenoids. Beta carotene, alpha-carotene, and beta-cryptoxanthin are carotenes that are converted into vitamin A or retinol (the active form of vitamin A) in the body. They are found in many yellow fruits and vegetables. Beta carotene is the most widely studied carotenoid. Evidence now strongly suggests that when taken as a separate supplement it can have harmful effects.
• Lycopene. Lycopene is responsible for the red color in fruits and vegetables, including tomatoes, red grapes, watermelon, and pink grapefruit. It is also found in papayas and apricots. It does not convert to vitamin A but may have important cancer fighting properties and other health benefits.
• The beneficial actions of most carotenes such as those tomatoes, corn, and carrots, appear to be enhanced by cooking them, especially in oil (preferably olive, canola, or another monounsaturated oil). (Note: Cooking can also destroy certain nutrients, such as vitamin C, in these vegetables.)

Xanthophylls

Xanthophylls contain oxygen and most are found in green vegetables, such as broccoli, cabbage, and kale. They are also in yellow fruits and vegetables. Xanthophylls include lutein and zeaxanthin, which are both stored in the retina of the eye. Neither converts to vitamin A. Both are powerful antioxidants and may be very important for healthy eyes. Unlike carotenes, cooking may reduce the antioxidant activity of some xanthophylls in foods, although probably not to any significant degree.

Phytochemicals

The word phytochemicals means plant chemicals. Hundreds of phytochemicals are being studied. Many are believed to have a major positive impact on human health. Some contribute to the bright and vivid colors found in fruits and vegetables. The results of studies on specific phytochemicals are not necessarily applicable to the vegetables or fruits that harbor small concentrations of these chemicals.

Nevertheless, it is obvious that vegetables and fruits are healthful, which is probably due to some balance of phytochemicals, carotenoids, vitamins, fibers, and minerals rather than any single substance.

The benefits of individual phytochemical supplements are largely unproven. Furthermore, they are not regulated and high concentrations of some may behave like drugs and can be toxic and possibly even contribute to cancer cell growth.

Polyphenols and Flavonoids

Polyphenols are important phytochemicals, and flavonoids (or catechins) are members of the polyphenol family that may have significant health benefits. Laboratory studies have shown that specific flavonoids suppress tumor growth, interfere with sexual hormones, prevent blood clots, and have anti-inflammatory properties. In general, flavonoids are found in celery, cranberries, onions, kale, dark chocolate, broccoli, apples, cherries, berries, tea, red wine or purple grape juice, parsley, soybeans, tomatoes, eggplant, and thyme. Most common berries contain flavonoids and are particularly rich in potent antioxidants.

Among the important flavonoids are resveratrol, quercetin, and catechin. Evidence suggests that resveratrol (found in red wine, grapes, olive oil) may be extremely potent. In laboratory studies, it increases cell survival and has been shown to increase the life span of worms and fruit flies. Catechins are the primary flavonoids in tea and may be responsible for its possible beneficial effects. Flavonoids in dark chocolate may also be health protective.

Isoflavones (Phytoestrogens)

Isoflavones, commonly known as phytoestrogens, have actions that are similar to the female hormone estrogen. Isoflavones include compounds called genistein, daidzein, enterolactone, and equol. They act as antioxidants and tumor suppressors. These compounds may improve cholesterol, prevent bone loss, and suppress enzymes that stimulate certain cancers. Isoflavones are mainly found in soy products (not soy sauce) with smaller amounts found in chickpeas, flax and other seeds, barley, and milk products from cows feeding on clover.

Lignan is another phytoestrogen and is found in the fiber layers of whole-grains, berries, some seeds, some vegetables, and a few fruits.

Isothiocyanates

Isothiocyanates and related substances, indoles, are also known as mustard oils and are responsible for the sharp taste in cruciferous (also called brassica) vegetables. Such vegetables include broccoli, cabbage, Brussels sprouts, cauliflower, collards, kale, kohlrabi, mustard greens, rutabaga, turnips, and bok choy. Isothiocyanates also stimulate enzymes that convert estrogen to a more benign form and may block steroid hormones that promote breast and prostate cancers. (Cruciferous vegetables are also high in fiber, vitamin C, and selenium.)

Monoterpenes

Monoterpenes have two important phytochemicals, perillyl alcohol and limonene. They block proteins that stimulate cell growth and reproduction and are being tested for actions against cancer. Limonene is found in the peels of citrus fruits.

Organosulfur Compounds

Organosulfurs are part of the allium family of phytochemicals. Compounds, such as allicin, may have benefits on the immune system, assist the liver in rendering carcinogens harmless, and reduce production of cholesterol in the liver. These compounds are found in garlic, leeks, onions, chives, scallions, and shallots.

Saponins

Saponins are forms of carbohydrates that neutralize enzymes in the intestines that may cause cancer. They also may boost the immune system and promote wound healing. Saponins are found in ginseng, beans (including soy beans) and whole grains.

Capsaicin

Capsaicin seems to reduce levels of substance P, a compound that contributes to inflammation and the delivery of pain impulses from the central nervous system. Research suggests that it may inhibit cancer-generating substances. It is found in hot red peppers.

Sterols

Sterols, which include sitosterol, stigmasterol, campesterol, and squalene, are found in vegetable oils. Sitosterol is the most studied and appears to have cholesterol-lowering effects.

Beta-sitosterols may help improve urine flow and urinary symptoms in men with enlarged prostate glands (benign prostatic hyperplasia, or BPH). A recent review study of five randomized trials (519 men) found that urinary flow and other urinary symptoms improved in men who took the herbal remedy from 4 - 26 weeks. The study’s authors cautioned that while beta-sitosterols show effectiveness in the short term, their long-term effectiveness, ability to prevent complications from BPH, and safety are not known. More research is necessary. Beta-sitosterols come from South African star grass, Hypoxis rooperi, or species of Pinus and Picea.

Healthy Foods

Evidence increasingly suggests that a varied diet, not individual food chemicals, is essential for basic health and a longer life. Such diets are rich in fresh fruits and vegetables and whole grains, and low in saturated fats.

Some Examples of Healthy Foods

Dietary Health Benefits

The benefits of any dietary factors are very difficult to prove, and, to date, there is no hard evidence that any supplement protects against any major disease. Studies on population groups may not consider other lifestyle or genetic factors. They often rely on people self-reporting their own dietary habits and often such surveys only reflect short-term eating habits. Other studies are done in the laboratory on animals or blood samples, which may not reflect the effects of nutrients on humans. Nevertheless, it is never wrong to eat plenty of fresh fruits and vegetables and whole grains, the primary sources of vitamins, carotenoids, and vitamins, as well as of fiber and important minerals.

Protection Against Heart Disease

Vitamins and Heart Protection.

• Antioxidant Vitamins A, C, and E. Deficiencies in vitamins A, C, E, and beta carotene have been linked to heart disease. All of these nutrients have antioxidant effects and other properties that should benefit the heart. However, several studies have found no reductions in heart disease in people who have taken antioxidant vitamins. In fact, a 2005 study has found that taking high doses of vitamin E is associated with an increased risk of heart failure. In 2003, the US Preventive Service Task Force concluded that, to date, evidence is insufficient to confirm or refute the benefits of supplements of any of these vitamins in protecting against heart disease. It is important to note, in addition, that each of these supplements may even be harmful to the heart in high doses.
• Folate and B12 Vitamins. Deficiencies in the B vitamins folate (known also as folic acid) and B12 have been associated with elevated blood levels of homocysteine, an amino acid that has been associated with a higher risk for heart disease, stroke, and heart failure. Some studies in 2002, suggest that any risk posed by homocysteine or benefits from folic acid for heart disease are at most modest. One study, however, reported lower failure rates after heart surgery in patients who took folic acid and vitamins B12 and B6. And a major 2002 study suggested that lowering homocysteine levels with folic acid would reduce the risk for heart disease by 16% and stroke by 24%. More evidence is needed to determine whether homocysteine plays a causal role in cardiovascular disease and whether the B vitamins are protective. Folate improves blood flow through the arteries, which may be important for the heart, regardless of its effect on homocysteine.
• Niacin. Niacin (vitamin B3) is used for lowering unhealthy cholesterol levels. Although vitamin B3 is available over the counter, it can have significant side effects. A physician should prescribe niacin in order to ensure its safety and effectiveness. [For more information, see In-Depth Report #23, Cholesterol.]

Carotenoids and Heart Protection. Studies have reported that a high intake of fruits and vegetables containing beta carotene, lycopene, and other carotenoids may reduce the risk of heart attack. For example, lycopene-poor diets (particularly lycopene in tomatoes) were associated with a significantly higher risk of heart disease and stroke. In another study involving animals, lutein protected against early hardening of the arteries.

Atherosclerosis is a disease of the arteries in which fatty material is deposited in the vessel wall, resulting in narrowing and eventual impairment of blood flow. Severely restricted blood flow in the arteries to the heart muscle leads to symptoms such as chest pain. Atherosclerosis shows no symptoms until a complication occurs.

Phytochemicals and Heart Protection. Several phytochemicals are associated with heart protection.

• Flavonoids. Certain flavonoids, found in both black and green tea, dark chocolate, onions, red wine or red grape juice, and apples, appear to be strongly heart protective. In a 2003 study, people who consumed the most flavonoids in foods had a 20% lower risk for heart disease than those with low consumption. Flavonoids may protect against damage done by cholesterol and help prevent blood clots. A number of studies have now reported heart protection from the flavonoid catechin, which is found in both black and green tea. (Studies on tea-drinking however have been mixed. For example, the British consume a lot of tea but have high rates of heart disease.) The flavonoid resveratrol, which is found in grape skin, appears to be responsible for the well-known heart protective effects in red wine and purple grape juice. A glass or two of red wine a day may be healthful. For people who cannot drink alcohol, juice from red grapes may be beneficial.
• Organosulfurs. Organosulfurs found in onions and garlic have been under investigation for possible beneficial effects on cholesterol levels. Two well-conducted studies found no heart-benefits from taking capsules equivalent to between one and one and a half garlic cloves a day. The preparation of these products, however, may be responsible for the lack of effect. On a more positive note, a 2000 study reported an association between taking garlic capsules and significantly lower cholesterol-build up in the arteries of older women but not in older men. In the study, daily garlic supplements dramatically reduced the build-up of newly formed plaque in the arteries, while having much less effect on older, harder plaque deposits. Garlic supplements for cardiovascular disease may be most beneficial, then, when used during earlier years among men and later years among women.
• Isoflavones. Soy protein is the most studied source of isoflavones (known as phytoestrogens, or plant estrogens). Not all studies are consistent, but the majority has shown an improvement in at least one of the cholesterol components in people who consumed at least 25 grams of soy protein. Soy may also reduce other heart risk factors, at least in certain populations. For example, in one 2002 study, soy was beneficial for controlling blood sugar and lowering LDL in postmenopausal women with type 2 diabetes. In another study, soy protein was associated with lower systolic blood pressure in men. The best sources are soy products (tofu, soy milk) or whole soy protein. Powdered soy protein that contains at least 60 mg of isoflavones may provide similar benefits. Tablets of individual isoflavones found in soy do not appear to offer any advantages and may be harmful.
• Sterols. The plant sterols, including sitosterol, are also proving to be potent cholesterol fighters. Sitostanol, a derivative of sitosterol, is being used in new margarine products to lower cholesterol levels.

Protection Against Stroke

A healthy diet rich in fruits and vegetables and low in salt and saturated fats may significantly lower the risk for a first stroke, perhaps by helping to protect against high blood pressure -- a major risk factor for stroke.

Vitamins and Stroke Protection. The effects of antioxidant vitamins and carotenoids on stroke, dementia, or both are being studied. Studies are conflicting, however. A very important 2001 study reported no protection stroke with vitamins A, E or beta carotene.

The B vitamin folate (usually in the form of folic acid) may protect against stroke. Studies have suggested that people who have higher blood levels of folate have a lower than average risk for stroke. Its primary benefit in this case appears to be to reduce levels of homocysteine, an amino acid that has been strongly linked to an increased risk of coronary artery disease, stroke, and Alzheimer's disease. A major 2002 study suggested that lowering homocysteine levels with folic acid would reduce the risk for heart disease by 16% and stroke by 24%.

Carotenoids and Stroke Protection. Some, but not all, studies have reported a lower risk of stroke from carotenoids, including beta carotene and lycopene.

Protection Against Cancer

Many fresh fruits and vegetables contain chemicals that may fight many cancers, including lung, breast, colon, and prostate cancers. Examples of important cancer fighting foods include the following:

• Cruciferous vegetables (e.g., cabbage, Brussels sprouts, broccoli).
• Tomatoes (which contain lycopene).
• Carrots (which contain alpha carotene).

Some evidence suggests that antioxidants may enhance the anticancer effects of chemotherapy. In multiple studies, patients who maintained their antioxidant levels were better able to withstand the high stress caused by chemotherapy or radiation therapy compared to those with low antioxidant levels. Antioxidant nutrients that may help reduce the side effects of chemotherapy include vitamins E and C, beta carotene, genistein and daidzein (isoflavones found in soy), and quercetin (found in red wine an purple grape juice).

Any protective effects of vitamins or specific phytochemical against cancer, however, appear to depend on the cooperative effort among them. Individual supplements of any vitamin or food chemical have not as yet shown any benefits.

Vitamins and Cancer Protection. Because many cancers are thought to be initiated by the effects of oxygen-free radicals on DNA, the antioxidants A, C, and E and beta carotene have been intensively studied. A major study found that men who took selenium for 6 or 7 years reduced their risk of prostate cancer by 52%. Nevertheless, most individual supplements have not been proven to protect against cancer, and high doses may be dangerous.

• Vitamin A, C, and E. Although some studies have reported an association between low blood levels of these antioxidant vitamins and a higher risk for cancer, supplements of vitamins A, C, and E appear to have no advantages in most cases. And there are some studies finding higher cancer risks with high intakes of antioxidants. For example, a 2003 study reported a higher risk in melanoma in people with vitamin-C rich diets. A 2000 study also reported a higher risk for cancer in male smokers who took multivitamins plus A, C, or E. (Vitamin E may be protective against bladder cancer.)
• Vitamin D. Some studies have suggested that certain vitamin D compounds may inhibit certain cancer cells, specifically prostate cancer, from proliferating. More research is needed.
• Folic acid and B12. These B vitamins convert the amino acid homocysteine to methionine, a substance that helps prevent cells from becoming malignant. Folic acid may provide some protection against cervical and colon cancer. One small study showed a reduction of lung cancer cells in smokers taking folic acid and vitamin B12, but the study was very small, of short duration, and other factors might have biased the results. Still another study reported that folic acid may reduce the risk for breast cancer among women who regularly drink alcohol. (In the study, folic acid had no other effect on breast cancer.)

In 2006, a study for the National Institutes of Health reviewed randomized trials evaluating the effectiveness and safety of multivitamin and mineral supplements in preventing cancer and chronic disease. The studies had mixed results, and some supplements reduced cancer rates in certain populations. However, the reviewers concluded that current evidence is not sufficient to determine whether multivitamin and mineral supplements may prevent cancer and chronic disease.

Carotenoids and Cancer Protection. A number of studies have reported that fruits and vegetables rich in carotenoids are associated with protection against many cancers. Lycopene, found in tomatoes, may have particular value in protection against prostate, colon, lung, and bladder cancer. A 2005 study found that in one out of four men with genetic variations that cause them to be more sensitive to oxidative stress, supplementation with selenium, vitamin E, and lycopene significantly reduces the risk of prostate cancer. Individual supplements, however, do not offer any advantage. In fact, evidence now strongly suggests that beta carotene supplements increase the risk for lung cancer in smokers.

Phytochemicals and Cancer Protection. The following phytochemicals appear to have cancer-protecting properties.

• Isothiocyanates. Isothiocyanates and sulforaphane, found in cruciferous vegetables, may block the effects of carcinogens and suppress tumor growth. In one study, for example, women with the highest consumption of cruciferous vegetables had a 24% lower risk of breast cancer than women with the lowest consumption.
• Isoflavones. Isoflavones, found in soy beans and flax seed, behave like estrogen in some ways and not in others. Researchers are very interested, then, in their effects on hormone-related cancers, including breast and prostate cancers. Much research has focused on soy. In general, a number of Asian studies have reported an association between a higher intake of soy and a lower incidence of reproductive and breast cancers. The effects of phytoestrogens, however, in all women are far from settled. Some evidence suggests the genistein in soy may have properties that are protective against lung cancer. Nonfermented soy products (tofu, soy milk) also may protect against stomach cancer, while fermented soy products (miso, soy paste) appears to increase the risk.
• Flavonoids. Flavonoids and polyphenols, including those found in apples, dark chocolate, onions, tea, and red wine, are coming under strong scrutiny for possible cancer fighting properties. In one 24-year study, people who ate flavonoid-rich foods had a 20% lower risk for cancer in general. Resveratrol is a particularly potent polyphenol found in grapes and red wine. It has been found have tumor-suppressing properties. In studies on mice it has reduced tumor promotion and progression. Quercetin, another polyphenol, may also be protective.
• Organosulfurs. The organosulfur compounds found in the onion and garlic family may have very potent properties in suppressing or blocking carcinogenic substances. Studies indicate that people who regularly consume fresh or cooked garlic have about half the risk of developing stomach cancer and two thirds the risk of colorectal cancer as people who eat little or no garlic. One possible explanation for garlic's anti-cancer effect in the stomach is its antibacterial action against H. pylori, which can promote stomach cancer. Taking garlic supplements, however, did not offer these benefits.

It should be noted that studies on the health benefits of vitamins and minerals have some important limitations. Some are held to rigorous standards, while others are not. In most cases, the results of existing research are complex, as they can easily be complicated by factors such as diet, exercise, the presence of healthy or unhealthy lifestyle behaviors, environmental factors, and more.

Lots More Information

Resources

• www.nal.usda.gov/fnic -- The Food and Nutrition Information Center
• http://dietary-supplements.info.nih.gov -- Office of Dietary Supplements, National Institutes of Health
• www.nal.usda.gov/fnic/foodcomp -- Nutrient Data Laboratory
• www.fda.gov -- Food and Drug Administration
• www.eatright.org -- The American Dietetic Association
• www.acsh.org -- American Council on Science and Health
• www.aicr.org -- American Institute for Cancer Research (800-843-8114)
• www.nutritiondata.com -- Information on vitamins and nutrients in foods
• www.consumerlab.com -- Independent testing of nutritional supplements' contents and quality
• www.usp.org -- US Pharmacopeia
• www.hrf.org -- Herb Research Foundation

References

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Reference – this article was sourced from howstuffworks

Macro-nutrients – the big bad basics for energy and health

Fruit and vegetables are good but ‘carbs’ are the enemy? Some fats are good but others aren’t? Try the latest high protein diet to lose weight or take a protein supplement to add some bulk to your frame? Have you ever thought that the nutritional information (or more appropriately ‘mis’-information) circulating in the public domain is confusing and often contradictory?  If it confuses you then consider what it does to the general public.    

The Ministry of Health (MoH) highlights poor diet as the leading cause of death in New Zealand. In 1997 it accounted for approximately 8500 deaths compared to 5000 deaths being attributed to tobacco consumption.  Considering this, is our time as fitness professionals best spent debating whether ‘carbs’ can be eaten after 3pm or actually addressing the facts relating to nutrition so we can give clear, effective guidance to our clients? 

If you agree with the latter then read on and we’ll go over the big bad basics of macro-nutrients

Macro-nutrients are nutrients the body needs in relatively large quantities, they are; carbohydrates (carbs), proteins, fats, fibre and fluids.  Macro-nutrients are not ‘foods’ in their own right, rather they are nutrients found in the various food groups.  So advising someone to ‘cut out the carbs’ or ‘eat more protein’ isn’t specific or useful advice.  The food groups that supply the macro-nutrients are; fruits and vegetables, breads and cereals, milk and milk products, lean meats (including poultry and seafood) and eggs, nuts, seeds and legumes.  Oh and who could forget…alcohol. 

Carbohydrates

Carbohydrates are the body’s major source of energy; they are broken down by the body to form glucose, otherwise known as ‘blood sugar’. Foods rich in carbohydrates are fruits and vegetables, which the MoH advise us to have 5+ serves of everyday for good health (3+ serves of vegetables, 2+ of fruit), breads and cereals which we should have 6+ serves of per day and legumes which we should have at least 1 serve of per day.  The last survey conducted by the MoH showed that only 43% of children consumed the recommended serves of fruit and only 57% the recommended consumption of vegetables.  For adults the figures were 55% and 69% respectively. 

Foods that are also classified as carbohydrate include confectionary (lollies) and aerated ‘soda’ drinks (coke) which are high in excess sugar.  In 2003/4 a survey of the retail trades showed that weekly household food expenditure on confectionary exceeded the expenditure on fresh fruit.  The MoH recommends that 50-55% of our daily energy intake should come from carbs, however at the last survey they accounted for only 46% of the average person’s diet.  So rather than ‘cutting out carbs’ a better message would be to increase the intake of fresh fruit, vegetables and wholegrain breads and cereals, and reduce the intake of confectionary and aerated soda drinks.

Fibre

Fibre is a nutrient that does not actually provide us with energy.  Its role is to keep the digestive system healthy and protect us from constipation, bowel cancer, irritable bowel syndrome and haemorrhoids amongst other things.  It does this by passing directly through us without being digested; it helps make us feel full without actually providing us with any calories (energy).  Foods high in fibre are the same foods that supply us with carbohydrates, namely fruits and vegetables, breads and cereals. 

A problem with much of today’s food is that it is heavily processed, i.e. a lot happens to it in the factory before we consume it.  Fibre typically makes up the outer layers of plant foods and gives them their shape and structure.  During the processing of food much of the fibre is removed.  You can see this when you look at a loaf of white bread in comparison to wholegrain bread, you cant see the seeds and grains in white bread because most of the fibre has been removed during processing and much of the nutritional value has gone.

For this reason the MoH advise people to choose wholegrain breads and cereals.  But the white loafs are cheaper I hear you say…maybe so, but the wholegrain options provide sustained energy meaning you’ll actually eat less, resulting in lower calorie intake and less time spent uncomfortably on the toilet. Your choice really – healthy bowels and healthy body or cheap bread, poor performance and eventually, expensive illness. 

Fat

Fat is a very concentrated source of energy, 1 gram of it provides 9 calories of energy whereas 1 gram of carbohydrate or protein provides only 4 calories.  Because of this it is easy to over-consume calories when eating high fat foods.  The consequences of a high fat diet include; weight gain, obesity, diabetes, cardiovascular disease and hypertension (high blood pressure).  

Fat does actually serve a purpose. It is a source of energy for the body, it insulates and protects the vital organs and is required for the absorption of fat soluble vitamins (remember DEKA).  Fats are classified as either saturated or unsaturated.  Saturated fats are typically solid at room temperature and are known as the ‘bad fats’ because of their tendency to attach to artery walls and eventually cause blockages that can result in cardiovascular disease.  Most of our saturated fat comes from animal products: meat and diary foods.  Unsaturated fats are typically liquid at room temperature and come from plant foods and some seafood. These fats are known as the ‘good fats’ as they help break down the build up of saturated fats. 

The MoH recommends that between 30-33% of our daily energy intake should come from fat, of which no more than 12% of the daily intake should be from saturated fat.  The last surveys from the MoH showed that 35% of daily energy intake came from fat, and saturated fat was the predominant type contributing 15% of total daily energy intake.  Takeaway food is typically high fat food (often saturated) and it seems we are eating more and more of it. Between 2000 and 2005 the sales revenue from takeaway food outlets increased by 67%, during this same period the percentage of household food expenditure on meals away from home increased from 10.9% to 13.5%.

Protein

Protein is an essential nutrient for the growth and repair of body tissue.  We get protein from a variety of food groups including animal foods; meat, seafood, poultry, eggs and dairy products. We also get protein from some plant foods; cereals, nuts and legumes.  It is recommended that protein provides 11-15% of our daily energy intake. At the last survey it was shown that our typical intake slightly exceeds this.

High protein diets are popular these days; however as many of our protein sources are also sources of fat then a high protein diet can easily become a high fat diet, with associated risks.  There is no evidence to suggest that eating more protein makes you grow more, as the body tends to use what it needs and burn the rest as fuel or store it as body fat. 

Fluid

Approximately 70% of our body weight is water.  The main purpose of drinking water is to maintain this level, or in technical speak ‘stay adequately hydrated’.  To do this we need to consume about 6-8 large glasses of water everyday. There is no better source of water than tap water, it’s free and it has no calories!  Other sources of fluid are not so good, most aerated ‘soda’ drinks are extremely high in sugar, and alcohol which is also high in calories, has many negative health consequences. Alcohol accounts for between 3-5% of the average daily energy intake.

So now that you know some facts about macro-nutrients, consider this;

• In 2005 advertising expenditure on chocolate, confectionary and aerated drinks exceeded $57 million in NZ, which was over 9 times the amount spent on advertising fruit and vegetables ($6 million). 

• In 2005 total advertising expenditure on all fast food chains, restaurants and cafes in NZ exceeded $67 million, of which McDonalds accounted for $21million.

• Between 1997 and 2003 the prevalence of obesity in adults doubled from 9% to 20% in males and 11% to 22% in females. 

The fast food, confectionary and soda drink giants certainly have no problem getting their message across.  I hope you can appreciate how important it is to ensure the healthy message is not lost in the mis-information minefield.  Ultimately some simple messages for clients stand out. These are:

• Increase intake of fresh fruit and vegetables to meet recommendations and choose unprocessed wholegrain sources of breads and cereals

• Reduce fat intake by choosing low fat sources of meat and diary products and low fat cooking methods such as grilling rather than frying

• Reduce or eliminate unnecessary additions of fat to our diet such as butter, margarine and mayonnaise

• Save money by reducing or eliminating unnecessary sources of poor nutrition such as confectionary, chocolate, soda drinks and alcohol

• Drink a glass or two of water with every meal to provide a sense of fullness without extra calories

For more information on macronutrients and their intakes in NZ follow the hyperlink to these articles;

http://www.moh.govt.nz/moh.nsf/0/07BC6DBE764FDABBCC256DDB006D9AB4/$File/foodandnutritionguidelines-adults.pdf

Food and Nutrition Monitoring Report 2006

Note: National nutrition surveys are conducted approximately every 10 years, the last major one was in 1997.  The MoH is conducting another survey currently (2008/9) the results of which are due in 2011.