New Year Resolution - thinking of turning vegetarian?

The approach of the New Year always brings people to my door with questions about detox, weight loss and turning vegetarian. Almost always, the biggest problem I have is in informing my clients and putting correct the facts about vegetarian alternatives to meat. In particular it's my old favourite... setting the record straight about soya and soya products.

Many people are keen to become vegetarian, partly because of their beliefs in eating meat, disagreement about the conditions in which the animals are reared but increasingly because they are worried about the quality of the meat and what chemicals have been used to produce them in the interest of generating profit. Others change because they have a constitution that is simply intolerant to or incompatible with meat.

But whatever the reason, many have turned to meat alternatives such as soya as a substitute to the taste and texture of meat. However, over the past decade or so, there has been much media coverage on soya - its health benefits but increasingly the potential risks. This post attempts to clarify some important facts about soya and its use as a foodsource, why the health concerns have arisen but crucially, the numerous health benefits of traditional fermented soya and soya products which has somehow 'got lost in translation' due to the over zealous, profiteering food manufacturers of the West which has mistakenly generated confusion and alarm about the humble soya bean.

Deciding to become vegetarian is a big step requiring commitment, discipline and a deep belief in the reasons not to eat meat. It is a dietary choice and some would argue, a way of life - not all succeed especially if they lack the belief, the dedication to their choice and are swayed more by following a fad rather than a matter of real commitment to being a vegetarian. There are many who don't do their 'research' when embarking on a significant dietary change nor indeed find out about the health consequences of switching foods to vegetarian alternatives such as soya. So let's have a look at this remarkable food and what it can offer to those who want to start the New Year with a new dietary regime.

 

Why soya is so popular

Soya has always been popular in the far east, particularly in countries such as Japan, China, Korea and Indonesia where their cuisine is inherently designed around this staple food. It became incredibly popular in the West especially the US after the Food & Drug Administration (FDA) authorised use of health claims in October 1999 about the role of soy (soya) protein in reducing the risk of coronary heart disease (CHD). As a result of these and other studies into its protective benefits against the development of cancer, the multinational soy industry has invested millions of dollars into finding alternative uses and new markets for soybeans and soy protein foods including a custom-designed soybean. Many leading scientists at the time expressed deep concerns about genetically-manipulated soy and other crops.

 

Historical use of soyaThe humble soybean, also known as soya bean (Glycine max (L)., Merr Leguminosae) has been used for centuries in the far east for more than 2000 years. It started life in China from about 1000BC really by accident when it was discovered that the growth of a certain mold (fungus) on the soybeans destroyed the toxins present in the beans. Moreover, it increased the nutrient content of the soybeans which presented food opportunities for the people. The mold contamination had the effect of fermenting the soybeans and led to the creation of the still popular foods: tempeh, miso and natto. A few hundred years later, a simple process involving soaking & cooking the beans followed by treatment with a substance extracted from seawater (called nigari) yielded a product we called today as tofu (fermented soybean curd).

Plant defences & the chemical constituents of soya

Most plants have defence mechanisms as a way of protecting themselves from being eaten by foraging animals, in addition to other invaders and destructive processes such as radiation from the sun, bacteria, viruses and fungi. One of the these inherent protective systems is in its chemical constituents, collectively called anti-nutrients as it is, in essence, toxic to those who consume it and is particularly un-appetising to foraging animals. One of these anti-nutrients is phytic acid (also known as phytate) which is present in high concentrations in soya beans. Phytate has a high binding capacity to important minerals such as zinc (Zn), copper (Cu), Iron (Fe), magnesium (Mg) and calcium (Ca). It has a particularly strong affinity for Zn, a mineral that supports wound healing.

Health risks of unfermented soya

A consequence of phytate ingestion for humans is that it can lead to a number of health disortders from mineral deficiency and a host of other associated health conditions such as:

• digestive distress (due to enzyme inhibitors in soya)
• poor immune function and ultimately immune failure
• PMS (premenstrual syndrome)
• endometriosis
• reproductive disorders (in both men and women)
• allergies
• ADD and ADHD (attention deficit disorder & attention deficit hyperactive disorder)
• increased risk of heart disease
• increase risk of cancer
• malnutrition
• loss of libido

Soya has a high content of substances known as goitrogens which are thought to block the production of thyroid hormone. This presents all sorts of metabolic problems including a lack of efficient oxygen delivery to cells. Some argue that this starvation of cells to oxygen optimises condition for the onset of cancer. Furthermore, unfermented soyabeans also reduces the bioavailability of glucose to cells and the high phytate concentration accentuates the effects of genistein, an isoflavone which blocks the production of thyroid hormone. Phytate also binds up Zn and Cu which impacts further on thyroid hormone metabolism. This can indirectly have consequential effects on reproductive hormone metabolism which could explain, in part, some of the reproductive disorders seen, particularly in women since they are more likely to consume higher quantites of soya products.

The limiting effects of soya isoflavones is to impair cell division, memory consolidation, tissue repair and blood vessel health. However, it the very action of regulating cell division that made genistein a popular substance for fighting cancer. However, the benefits came at a high cost for Western women who were consuming large quantities of unfermented soya and soya isolates, sold on the idea of cancer-protective benefits of genistein with little regard for cellular damage to normal cells. Consuming large quantities of high genistein soya products to alleviate symptoms of menopause as a guard against bone loss (osteoporosis) and breast cancer actually promotes the onset of cancer by limiting blood supply (and therefore oxygen) to healthy cells not to mention the risk of other problems such as memory loss, reduced hair growth and senile dementia.

Health benefits of fermented soya

Traditional soya foods can be divided into 2 groups:

1. fermented products eg. miso, tempeh, tamari, natto, soy sauce, shoyu
2. non-fermented products eg. tofu, soya milk

Fermenting soya has a wealth of health benefits including:

• improved digestibility
• enhanced nutrition
• medicinal benefits
• increased bioavailability of isoflavones

Moreover, the fermentation process reduced the levels of genistein as well as releasing a number of other nutrients and transforms soya beans into a nutritious food. The microbes used in the fermention process boosts normal gut flora and so serves a crucial probiotic role and eating small amounts of fermented soya actually confers protection against cancer rather than promoting it. Other medicinal benefits are derived from the phyto-oestrogen content which can mitigate the worst symptoms of the menopause by mimicking weak oestrogenic activity, reduce cholesterol levels thereby inhibit atherosclerosis and so reducing CHD risk. Extensive studies on the traditional asian diets have further supported these medicinal benefits witnessed by the significantly lower incidence of such diseases in the far east compared to the West. Modern soya cuisine of the West has developed into something that is almost unrecognisable from the eastern counterpart with unsurprising health consequences.

Getting the most of soya

Soya should be regarded as a wholefood and fermented soya beans and products such as miso, tempeh and natto confer a number of health benefits as discussed above. It is important to conduct proper research into soya if deciding to become vegetarian to ensure that nutrition isn't compromised if cutting out meat, fish, poultry and dairy products. There are a multitude of ideas for cooking with soya and and a number of delicious and creative recipes readily available. And these meals are not confined to vegetarians!

 

Special Considerations

There are certain groups of people who should exercise caution when considering soya. These include the following:

1. soya and women - women tend to eat soya because of the beneficial effects in menopause. However, all of the above apply and fermented soya is essential, preferably organic. For women who cannot tolerate soya, ground linseeds, red clover tea and sage tea can all help to reduce symptoms. A consultation with a medical herbalist is highly recommended.
2. soya and infants - infant formulas that are soya-based can have too much sugar in them and is not really an ideal replacement to breast milk. However, if breast-feeding is a problem, consider goat's milk (also better for those who have problems digesting cow's milk). Recent research suggest a 2-fold risk of developing thyroid abnormalities in infants fed on soya milk and unsurprising given that using a phyto-oestrogen rich food source for a baby as a sole source of nutrition is bound to have consequences on a undeveloped system not designed to cope with it.
3. people who should avoid soy - people with thyroid disorders, digestive problems eg. IBS or those with sensitive systems such as food intolerances.

Additionally, if considering soya as an alternative to meat, do not choose soya products made with protein isolates, soya protein concentrates, hydrolysed soya protein or partially hydrogenated soya oil.

ConclusionsWhole soya foods have nourished entire civilisations for centuries and the health benefits of traditional soya diets are glaringly obvious. Modern, Western diets, mainly due to the commercial activities of food manufacturers have sold many on the idea of soya but have modified and manipulated the traditional fermented soya with a detrimental impact on health. My response to this movement is.. 'if it ain't broke, why fix it?' It is always best to seek proper advice and conduct proper research into vegetarian alternatives before embarking on a strict dietary regime as it can lead to dificiency states such as anaemia (a common risk for vegetarians). Experiment with food and vary the menu so that it is easier to stick to a vegetarian diet and to ensure a balance of all the nutrients that are essential for health. Alternatively, if you want to avoid soya altogether, there is incredible variety from cooking vegetables - look into any Indian vegetarian cookbooks.

Good menu choices can be found from the Vegetarian Society but remember the above: www.vegsoc.org/ or any books by Sophie Grigson (for vegetarian recipes).

Seek help and advice about nutrition from a medical herbalist: www.nimh.org.uk or The British Association of Nutritional Therapists: www.bant.org.uk

SOS - Save Our Supplements!

For years, many people have had the benefit and choice of being able to purchase nutritional and health supplements over the counter (OTC). These include a range of important high potency vitamin and mineral supplements which have had an established history of use and have been previously tested for their safety with calculations of RDAs (recommended daily allowance) clearly stipulated. Amongst these health supplements, there are a number of beneficial and useful herbal supplements that many people rely on heavily for a quality of life and health status not dependent on prescription drugs or regular visits to the doctor or GP.

For some time now, discussions have taken place that will very soon put into practice the proposal to limit or stop the availability of certain high potency supplements and selected herbal remedies. The EC (European Commission) will imminently bring forward the long-awaited proposals of the Food Supplements Directive to set maximum permitted dosage levels for supplements across all EU (European Union) member states.

A similar proposal has been underway in the US for a while now and campaigners warn of the disastrous consequences that this will have on the lives on many who are utterly reliant on the availability of such supplements and who actively take responsibility for their own health and well-being.

What this means for the consumer

The indications of the proposed Food Supplements Directive are that levels will be set well below the nutrient levels currently available today in EU member states (including Britain) and the US under their Senate ruling. This will mean that the higher doses (long established as safe and effective) of certain vitamins and minerals including some herbal remedies will be illegal to sell. This will significantly limit the range and choice that consumers have long had of the many supplements shown to improve health and well-being or indeed to manage a current medical condition by way of nutritional supplementation.

Moreover, the EU Traditional Herbal Remedies Products Directive threatens the availability of hundreds of beneficial herbal medicines from the UK market if their manufacturers do not submit applications to register them by April 2011. In the UK, the MHRA (Medicines and Heathcare Products Regulatory Agency) is conducting the process and only 14 applications have been approved since 2005 and only 21 applications are in lieu. To complicate the process, the regulations are such that registration in one EU member state does not automatically mean that it applies to all the other member states. Therefore a company that currently markets its products in a number of EU countries must apply for registration in each of the countries where availability is sought. And it's not as if it is a affordable process; Bioforce for example has spent over £80,000 to register their St. John's Wort product Hyperiforce (taken for low mood and mild anxiety).

With restricted sale of vital supplements, many healthcare practitioners are also worried that this will inevitably increase cost and many will end up paying more for supplements with meaningless doses that are worthless and ineffective. Worse still, campaigners are worried that the over-zealous lobbyists pushing this ill-thought out proposals of the Food Supplements Directive will, knowing the view of the medical profession on supplementation, result in many people being offerered a pharmaceutical/ prescription drug alternative. More profit for the big pharma industries..... quelle surprise!

Small, unique herbal manufacturers simply cannot afford this long and extremely expensive registration process and if nothing is done, many will go out of business along with the health shops that will no longer be able to sell their products.

What you can do
To find out more about the Save Our Supplements Campaign, please visit http://www.consumersforhealthchoice.com/ for the UK and EU campaign entitled 'Time is running out'. For the US campaign, please visit http://www.saveoursupplements.org/ to find out how your help can ensure continuity of choice that many rely on for keeping healthy and to enjoy optimum health. You can sign a petition, write a letter to the EU Commissioner for Health & Consumer Policy or lobby the government. Any action, small or big will all make a difference. ACT NOW TO SAVE OUR SUPPLEMENTS!!

An Unsung Heroine of the Crimean War

Anyone who has studied plant remedies in any great detail or indeed the history of herbal medicine and herbal folklore throughout the world will have certainly come across Mary Seacole. Yet, given her prominenet status in the Caribbean and other regions of the American subcontinents, particularly South America, relatively few (until recent years) would have heard of her when one mentions the Crimean War. It has more often than not, been her English counterpart Florence Nightingale who has attracted notoreity and fame not to mention the numerous accolades and recognition for her contribution to nusing and care of the sick and injured.

However, more than any other, the Black History Month events and the many campaigns to raise awareness of the enormous contributions of key black people who have made history throughout the world via their work, life commitments and their causes, has meant that at long last, the significant work of Mary Seacole can be given due credit and its rightful place in history. We are only now fully realising her true and valid place in British history but sadly for many, many years, this remarkable woman with her courage, determination, fortitude and compassion remained one of the great unsung heroines of her generation.

Mary Seacole was born in Jamaica in 1805, the daughter of a white Scottish army officer and a free black woman who ran a boarding house in Kingston. Mary's knowledge of herbal remedies was gained early on from her mother who treated people who were ill using her various lotions and potions made from natural plant remedies. These medicines were based on the wealth of knowledge from the slaves that were brought over from Africa during the slave trade and Mary's eagerness to learn more about these amazing plant medicines and how to successfully administer them later earned her the informal title of 'doctress' and healer.

In 1850 however, Kingston was hit by a cholera epidemic and Mary, using her knowledge of herbal medicines was instrumental in bringing this disease under control and to prevent further loss of life. She wasn't to know at the time just how important her experience of tackling this disease outbreak was going to be but many would agree that this was unquestionably a rehearsal of what was to follow later on in European history. Moreover, she also successfully dealt with a yellow fever outbreak in Jamaica using her powerful herbal remedies. Her fame as a medical practitioner grew as many on the island came to rely on her expertise and knowledge of disease and sickness as well as her skill in treatment. Much of this herbal folklore and practice is very much in evidence today since many people in Jamaica as well as the other Caribbean islands routinely seek natural plant remedies as a first resort which is in direct contrast to Western medical practices in Europe and the US who seek conventional medicine and where herbal alternatives are very much the last resort.

Her love of travelling saw her visiting and acquiring herbal knowledge all the while in places such as Panama, Cuba, Haiti and the Bahamas. She collected details of how the indigenous people used the local plants and herbs to treat the sick and dying, especially in war-torn countries and its battlefields. Mary's reputation grew as well as her medical experience when she found herself conducting life-saving operations on people suffering from knife and gunshot wounds.

Of course, she frequently visited England, particularly to see her relatives on her father's side and in 1853 when Russia invaded Turkey, Britain and France went to Turkey's aid by sending thousands of their soldiers in a war now known as the Crimean War. Soon after the British soldiers arrived in Turkey, they came down with cholera and malaria, two of the most deadliest diseases at the time, and still is to some extent. When Mary heard of this, she travelled to Britain convinced she could help and volunteered her services to the British Army to help save the lives of the soldiers. It was clear that someting needed to be done since more soldiers were dying from disease than from injuries sustained on the battlefields. Whether it was prejudice against women or of her racial origin is unclear but what is clear is that she was refused. Undeterred by this, she financed the trip to Turkey herself by using her own resources and very much under her own steam unlike Florence Nightingale who among the other party of nurses was chosen by the British Army to travel to the affected area to treat the wounded officers.

When Mary arrived at the war zone she again went to volunteer her services, this time to Florence Nightingale directly citing her experience of treating cholera, of wounded soldiers and various related injuries. Florence Nightingale refused her offer of help. Again, Mary was forced to be resourceful and eventually found a way to open the British Hotel, a hotel built from salvaged driftwood, packaging cases, iron sheets and salvaged architectural items such as glass doors and window frames. With help from local labourers, the Hotel was finally open for business in March 1855. The Hotel flourished as a business and ostensibly catered for British soldiers by supplying food and drink as well as accommodation to those travelling from Britain to other parts of the country and to the rest of Europe. The success of her business meant that she was able to buy the urgent and necessary medical supplies that she needed to treat the casualties of the war. Unlike Florence Nightingale who was afforded the means to open a hospital, Mary often found herself at the site of the battlefields itself, and sometimes treating soldiers on both sides of the conflict even as the battle was going on. Her remarkable courage and determination to treat the wounded earnt her respect and praise although it was many years before Britain acknowledged her contribution, in particular, this detail about her perseverance and bravery. What a woman!

Florence Nightingale although on the surface seemed ambivalent about Mary's contribution to the war effort was actually unimpressed and accused her of intoxicating soldiers and running a brothel under the guise of a hotel. Despite this however, Mary Seacole's reputation rivalled if not was greater than that of Florence Nightingale's.

Mary returned to England, destitute and in ill-health. Publicity around her plight saw hundreds of war veterans and families of loved ones whose lives she had saved come to her rescue by raising money for her. In late 1857, she published her memoirs 'The Wonderful Adventures of Mrs Seacole in Many Lands'. In later life, she made many influential friends including members of the royal family and was a well known public figure at the time of her death in 1881. She is buried in Kensal Green, North West London. Sadly, after death she rapidly faded into obscurity and public memory. Her valuable work and contribution to British history was largely overshadowed by Florence Nightingale's for many years. However, in recent years, Mary Seacole's life and work has become celebrated and rightly noted being part of the schools' National Curriculum for history. Together with the global Black History Month movement, we are finally realising the enormity of this remarkable woman's contribution to history, medicine and the role of black women at a time when attitudes to them were steeped in racial prejudice and discrimination. Her achievements are made more remarkable given these constraints, difficulties and limitations and the fact she remained undaunted by them to fulfill her desire to treat the sick, vulnerable and dying. We all owe her an enormous gratitude.

A Pioneer of her Time

I recently had the great privilege of being invited to La Sorbonne - Universite de Paris in France and I was immediately reminded of my early childhood memory of this great place of learning and the prestige it holds for academic studies and research. Even as a fledgling scientist, I remember being fascinated by the pioneering work and steely determination of a great academic of her generation; Marie Curie (nee Sklodowska), who being of Polish descent and a woman, faced significant prejudice and hostility for entering any study at all but even the French had to ultimately concede to the sheer brilliance and genius of this remarkable and talented scientist. She not only shaped the way women in science are viewed today but the manner in which women can be held as equals in a field dominated by men, not to mention the enormous contribution that she made to science which has far-reaching medical applications to this day. Even Francois Mitterand who before ending his 14-year presidency, took the initiative to ensure her final resting place under the mighty dome of the Pantheon - a significantly high honour indeed only reserved for distinguished French citizens. She was the first woman to be laid to rest there and now lies alongside celebrated people in history such as Victor Hugo, Louis Pasteur and Louis Braille. And of course is laid to rest beside her beloved husband and collaborator, Pierre Curie.

Marie Curie's achievements are ever the more remarkable given the enormous struggles she faced to quench her thirst for knowledge and in the pursuit of higher education. Firstly, she was poor and had to honour her agreement with her sister Bronya to fund her medical studies in exchange for Bronya to return the favour when she had completed her training. It was not until Marie Curie was 24 years that she finally came to La Sorbonne to study physics and mathematics in 1891. Bearing in mind that this was still an era where the roles of women and attitudes towards them were very much entrenched in dogma and inequality, Marie Curie set a precedent that would determine the course for many pioneering women, particularly in education and research.

Of course, she completed her studies with flying colours with an intention to to take the teacher's diploma and then to return to Poland. Her meeting Pierre Curie was not only fortuitous for her (he made a great collaborator being her intellectual equal and sharing a mutual passion for scientific discovery) but also good fortune for science and medicine. Pierre Curie was a brilliant scientist and though not formally trained, he made a living as Head of a laboratory, an internationally known physicist but an outsider in the French scientific community. Together with his brother, he had discovered piezoelectricity; the generation of a (electrical) potential difference when mechanical stresses are applied to certain crystals including quartz. Such crystals are now used in a multitude of electronic gadgets including microphones, electronic apparatus and clocks... to name but a few! Therefore, it is easy to see the attraction between Pierre and Marie Curie.

Marie Curie submitted her doctoral thesis in 1895 on the connection between temperature and magnetism - a phenomenon that is now referred to as Curie's Law. However, it was her later work that was to earn her the distinction she so well deserved but it took many years of painful research and a dogged determination to prove her theories in order to get there. In 1896 Henri Becquerel discovered that uranium salts emitted rays that arose spontaneously, a discovery that later earned him a Nobel prize. It was this discovery that initiated Marie's research into radioactivity and in particular the nature and manner of it in 2 specific uranium minerals: pitcblende and torbernite (also known as chalcolite). Using the sensitive electrometer, a device designed by her husband and his brother to measure electrical charge, Marie Curie had shown that uranium had caused the air around the sample to conduct electricity. She further showed that radiation was not the outcome of some interaction of molecules (as was believed at the time) but must come from the atom itself. In scientific terms, this was the single most important piece of work that she conducted. In her systematic search for other substances that emitted radiation, Marie Curie had found that the element thorium was also radioactive.

This work was all-consuming and Pierre gave up his work on crystals to assist Marie in her research into isolating sufficient quantities of pure minerals that were radioactive. At the time, little was known about the potentially damaging effects of radiation, a discovery that was to have a devastating impact in Marie Curie's life in later years. In July 1898, they published their paper on the existence of 'polonium' (named in honour of Marie's native Poland) and later that year, in December 1898, they announced the discovery of a second element which they named 'radium' for its intense radioactivity. Extracting suffcient quantities of pure radium was a particularly arduous task, the harzards of which we only know in recent years. It was not until 1910 by continuing with this vital work despite losing her husband in a traffic accident in 1906 that she managed to isolate pure radium metal.

Above all her discoveries and devastating loss, one thing stands out for which we are eternally grateful and earns respect and admiration - she intentionally refused to patent the radium isolation process, a decision based on the premise that the scientific community could do research unhindered. Along with Henri Becquerel and her husband Pierre, she was awarded the Nobel prize for physics in 1903. She later went on to gain another one in chemistry (1911) but hey, who's counting?

Her legacy today is that the fields of physics, chemistry, medicine and diagnostics have all benefitted from her discoveries and her research. Without such pioneering work, her sheer brilliance combined with a detemination and diligence to scientific discovery, we would not enjoy the benefits of modern medicine (use of X-Rays and radiotherapy in cancer) or technology. She was independent, unique, uncompromising and above all, uncorrupted given that she refused to patent any of her discoveries when she could have had so much to gain financially.

Because of the high levels of radioactivity, her papers are considered too dangerous to handle. Some of her personal effects are stored in lead cases and others are too toxic to ever be exhibited to the public (unless you sign a disclaimer saying that you view them at your own risk!).

Marie Curie died of aplastic anaemia in 1934 almost certainly caused by exposure to radiation. Nowadays, aplastic anaemia is sometimes associated with exposure to toxins.

Health Poverty Action

Health inequalities have been around for as long as I can remember. I recently had a very lengthy discussion with a colleague of mine about the valuable work being done by charities and campaign groups to tackle this very issue and such differences that exist in healthcare provision and access to vital medicines. Much of this work involves addressing important issues such as access to services, access to medicines, treatments, education and information.

One such charity, Health Poverty Action have long campaigned for access to affordable medicines in poor nations, particularly Africa and parts of Asia. India is one of the biggest producers of life-saving, affordable generic medicines. These medicines are vital for the poorest people around the world who cannot afford branded, expensive drugs. The European Union (EU) and India are currently negotiating the terms of their Free Trade Agreement (FTA) to ensure that access to affordable medicines is not blocked as a result of this FTA.

Big pharmaceutical companies keep their products unnecessarily high, primarily for profit. But this ensures that only those who can afford it can gain access to the treatment. Diseases that afflict poorer nations such as malaria, TB and AIDS does not generate the kind of interest from wealthier nations because these diseases are not endemic in these countries. Equally, poor countries cannot afford these expensive drugs and so the profit potential for these big pharmaceitical industries does not encourage them to invest in treating the poor because there is no financial gain for them. To make matters worse, they have also had a part to play in ensuring that the cheaper, generic drugs which will offer the same treatment but at a fraction of the cost, is not made available through patenting laws and intellectual property rights. In essence, what they do is ensure that the patent for their branded drug is long-lasting and charging a very high price for it in order for a poorer country to produce it.

Many of the poorest people around the world are unable to purchase expensive, genuine branded drugs and unwittingly buy cheaper, fake medicines that have infiltrated the markets worldwide. The reality is that it costs lives. Counterfeit medicines/drugs is a term that is familiar to those working to improve access to healthcare and to address the gross health ineqalities that exist in some of the pooerst countries in the world. A clear, agreed definition to the term 'counterfeit' medicines is currently under discussion within the international community and was on the agenda at the World Health Assembly in May 2010 to help countries legislate against them. However, it was argued that the definition for counterfeit was too broad, encompassing generic drugs (which are perfectly safe, effective and much cheaper than branded drugs) and should be restricted to fake drugs which are ineffective, potentially toxic and a real risk to health. Crucially, using broad definitions for counterfeit could block access to cheaper generic drugs which are vital to saving lives of the poorest people in the world.

To read about the latest briefing paper on counterfeit drugs from Health Poverty Action, click on the following link: http://www.healthpovertyaction.org/Policy/TradeandHealth/IntellectualPropertyandHealth

For more information about the vital work of Health Poverty Action, please visit http://www.healthunlimited.org/

Prebiotics, Probiotics & Antibiotics

Everyone's talking about bugs! Harmless bugs, infectious bugs and superbugs. With a new strain of superbug resistant to even the toughest antibiotic available with a growing number of cases in the UK (around 30 at the last count), it is hard to imagine that bugs can be anything but harmful.

On the contrary... there are millions of micro-organisms (to call bugs their proper name) that inhabit our gut and serve a vital role in protecting us from infection and disease. They exist in fine balance with other microbes to ward off infection from more virulent (more powerful and harmful) strains.

It is when this balance is disrupted that we fall ill. Very often, ordinary, relatively innocuous things like stress, poor diet, medication, hormonal imbalance and poor sleep can give rise to an imbalance resulting in opportunistic infections, particularly thrush (candidiasis) and is even linked to conditions such as irritable bowel syndrome (IBS) and rheumatoid arthritis. Other common symptoms are also invariably classified under the term dysbiosis. Given that the remedy is relatively simple, it is a wonder that many do not consider this as an option.

These beneficial bacteria (marketed frequently as 'friendly' bacteria by certain food manufacturers) help keep harmful, more virulent strains ('bad' bacteria) and yeast from growing in the gut. It is worth bearing in mind that these resident bacteria of our gut also make vitamin K, an important nutrient that keeps our immune systems functioning properly.

Prebiotics and probiotics together for part of a strategy to restore balance in the gut of these friendly bacteria, therfore boosting immunity and health.

Prebiotics is the general term given to the raw materials that feed the growth of the friendly bacteria because they won't flourish to healthy numbers if the food supply is low. These food materials are invariably indigestible foods that come from carbohydrate fibres called oligosaccharides. Because we can't digest them, they stay in the gut and stimulate the growth of our friendly bacteria. Good sources of oligosaccharides include fruits, legumes (eg. pulses, beans, nuts) and wholegrains (eg. wheat, oats, barley, rice). Fructo-oligosaccharides may be taken as supplements or added to foods. Yoghurts made with bifidobacteria contain oligosaccharides.

Probiotics on the other hand are the actual bugs themselves that are added to foods to introduce them directly into the gut. Normally, they are added to yoghurt as it is a common fermented food that we consume and one type of probiotic (Lactobacillus acidophilus) is usually found in it anyway so it is a convenient way to fortify the food. The other most common probiotic is Bifidobacterim (various strains) which are also beneficial.

Prebiotic and Probiotic Supplements

Probiotics are widely available as supplements. However, not all probiotic supplements are the same as they can have different formulations to suit various types and conditions so it is best to get advice from a qualified nutritionist or a medical herbalist. See my previous post on 'A Guide to Commercial Supplements' for further advice.

Antibiotics

Now this deserves a special mention as there is a lot of negative press about this important medicine. Of course, it has been over-used and the prescription protocol hopefully will change now that we have a better understanding of superbugs and ways of developing new strategies to eradicate them. It is true that antibiotics have been introduced into all manner of things from crops to meat, from fish and poultry to OTC throat sprays... to name but a few! However, antibiotics continue to serve a vital part in primary health intervention and in controlling the spread of infection. Many do not realise the important historical developments that led to their use today and probably take for granted their effectiveness given that there are more powerful drugs on the market which can do the same job but present with serious side-effects.

Modern food manufacturing, emerging food industries, modern lifestyles/societies, changes in prescription practices and overuse of antibiotics has all contributed to fairly harmless strains of bacteria mutating and developing a resistance to these once potent medicines. Given that there are so many ways in which we can combat infection naturally and that antibiotics should really be the LAST resort, not the first, it is unsurprising that superbugs did not emerge sooner than they did.

I recommend a wonderful book (written by a doctor interestingly!) entitled: 'Natural Alternatives to Antibiotics' by John Mckenna where he examines the various strains of infectious agents that have become resistant to antibiotics and explores the real effectiveness of herbal, homeopathic and nutritional medicines in the context of combating infection, boosting immunity and restoring health.

(Natural Alternatives to Antibiotics by Dr. John McKenna (2003) published by Newleaf

ISBN 0-7171-3435-0

To seek advice from a nutritionist contact www.bant.org.uk to find a registered practitioner and for herbal alternatives contact www.nimh.org.uk to find a qualified and registered practitioner in your local area.

To vaccinate or not - that is the question

On 24 May 2010, Dr. Andrew Wakefield, the surgeon at the centre of the MMR controversy was struck off the UK medical register by the General Medical Council (GMC) for serious professional misconduct after a two and a half year investigation.

To understand the controversy, one has to understand the story...

In a nutshell, Dr Wakefield & colleagues co-authored a paper that was published in 1998 in the esteemed Lancet, a highly respected, peer-reviewed medical journal. The paper was a write up into a study involving 12 children who were self-selected into his clinic due to gastric complications sometimes associated with autistic spectrum disorders. They were selected primarily due to parents' concerns over the link with the MMR triple vaccine reporting that symptoms had only begun following immunisation with the vaccine.

Wakefield's findings concluded that the associated gastric disease and symptoms of autistic spectrum disorder (developmental regression) in the group of children who were previously 'normal' was generally associated in time with 'possible environmental triggers'. These possible triggers were reported to be MMR in eight cases and measles infection in one.

Although no causal connection was proven in his study between the MMR vaccine and the symptoms, Wakefield called for a suspension of the triple vaccine combination until more research could be done. He also recommended that parents should opt for single jabs separated by at least a year.

The publication of the paper and the subsequent media coverage were linked to a steep decline in the vaccination rates in the UK and a sharp rise in confirmed cases of measles, with 2 child fatalities as well as others seriously ill on ventilators. What precipitated the crisis was a removal of the single vaccines altogether and therefore the removal of choice so that parents were left with an emotional and difficult decision as to take the unproven 'risks' allegedly associated with the MMR vaccine or the face the risk of their child contracting measles, mumps and/or rubella due to a lack of immunisation.

What further added to the debate was that Tony Blair, the prime minsiter at the time of the controversy famously refused to comment whether his child Leo was vaccinated with the MMR.

On 2 February 2010, the Lancet formally retracted Wakefield's 1998 paper with 10 of the 12 co-authors later publishing a retraction of the interpretation made in that paper.

About MMR

1. The MMR is a live measles, mumps and rubella triple vaccine containing attenuated (less potent than the actual disease-causing) viruses.
2. Two doses are required - one at pre-entry to primary school (around 13 months) and the second at around 3-5 years. The second dose is not a booster dose and is given to those who do not develop measles from the first dose.
3. It is sold by Merck as MMRII and by GSK Biologicals as Priorix.
4. Side Effects/Adverse Reactions (may occur from each component of the MMR) can include:

• fever
• malaise
• rash
• temporary joint pain
• acute or chronic arthritis (in older women)
• anaphylaxis (rare)
• neurological disorders (eg. temporary paralysis of the legs)
• aseptic meningitis (rare and not in the UK where the urabe mumps strain is not used in the MMR)
• upper respiratory tract infections
• irritability

Claims against Wakefield

• data fixing
• conflicts of interest (previously not declared)
• unethical obtaining of biopsy samples (often without parents' consent)
• paid to conduct the study by solicitors representing parents who believed their children had been harmed by MMR & failing to disclose this

The argument for MMR/ The safety of MMR

• no study to date has been able to reproduce the results from Wakefield's 1998 study
• numbers in his study were very small (12) to make any significant scientific conclusions
• since 1998, the MMR vaccine could have been improved to limit the adverse effects and side effects of the previous formulations
• historically, the introduction of mass vaccination programmes of governments across the world have benefitted from herd immunity resulting in the eradication of some of the most virulent and life-threatening global diseases. By and large, this is an example of a successful implementation programme

Defending the 1998 study (evidence, findings, interpretation)

• increased incidence of autism in line with the introduction of the MMR though correlation has not yet been proved
• decreased incidence of autism since a reduction in the uptake of MMR though correlation has not yet been proved
• Wakefield was never against vaccination per se - just the MMR triple vaccine combination stating that the risk of interactions from 3 live viruses were increased and that more research into MMR was required whilst offering single jabs
• the design and reporting of safety outcomes in MMR vaccine studies, both pre- and post-marketing is largely inadequate
• increased incidence of measles thought to be linked to the reduced uptake of the MMR could easily be attributed to parents not being offered the single jab alternatives

The campaign against Wakefield was spear-headed by The Sunday Times journalist Brian Deer who in February 2009 published his 2 year 'investigation' and a front page spin-off story alleging that Wakefield "changed and misreported results in his research, creating the appearance of a possible link with autism..." amidst various other lurid charges. Deer claimed that his 'investigation' was confirmed by evidence presented to the GMC.

However, what the newspaper did NOT report was that the GMC investigation (into Wakefield) was triggered by a complaint from... Brian Deer who used information in his report arising from a disciplinary hearing which he himself instigated by making allegations himself to the GMC. This is extraordinary! It is very difficult to interpret this other than a witch-hunt.

Conclusions

The clinical jury is still out on the risks of MMR. The claims that MMR has been conclusively proved to be safe is based on epidemiological research which at best remains methodologically inadequate and worst has been misleadingly spun. However, to date there is overwhelming scientific evidence that there is no causal link between the MMR triple vaccine and autism; Wakefield's data has not been reproducible. There is no proven correlation with an increase in autism since the introduction of the MMR vaccine and there is no proven correlation with a decrease in autism since the Wakefield controversy led to a decrease in its uptake. However, there IS an increase in the incidence of measles since the fall in MMR vaccine uptake rates. We have lost herd immunity for this disease and measles is again endemic in the UK.

Far from being disproved, Wakefield's Lancet findings of a new clinical syndrome have been replicated and his concern that a small proportion of children may be at risk through the impact of a MMR vaccine on some kind of pre-existing vulnerability looks ever more plausible and clearly, more research is desperately needed.

This problem would never have arisen if single vaccines were made available, thus ensuring the safety of public health by providing choice and a contingency. More importantly, it would have reassured anxious parents and would have prevented unnecessary alarm, concern and fear. But of course, this is far too costly and inconvenient for the Government, not to mention the fact that they were not prepared to concede any ground over the multiple vaccine (single vaccines cost more than the triple vaccine and would require a longer implementation time given that vaccinations need to be administered at timely intervals). To be fair, the spacing of single vaccines in 3 separate doses does not reduce the chance of adverse effects and may leave children exposed to risk of infection by the 2 diseases not immunised against first.

However, the media attempt to hang Wakefield now that the evidence is clearer on MMR is utterly reprehensible, thoroughly dishonest and grossly unfair. Wakefield's Press Releases were always cautious, but some media outlets were unnecessarily alarmist and together with Government agencies treated the public like moronic masses (justified in some quarters admittedly but in principle, incredibly insulting). They did their part in perpetuating the myth that MMR is linked to autism and now they want a scapegoat.

If one really examines any research scientist and scrutinises the funding mechanism for important medical research with the level of determination, doggedness, detail and diligence as much as the case against Dr. Andrew Wakefield, one will invariably find some link to a drugs company, pharmaceutical giant or indeed a Government edict. It is highly probable that one can dig up suitable 'dirt' like this on anyone in this field of research if they delve deep enough. Understandably so given the reality of funding scientific research and its purpose and place within clinical medicine.

I would not want to be part of a culture that discourages scientists from reporting their findings and honest conclusions, or indeed whistle-blowing as the case may be especially if this relates to public health. They may be wrong, but they may just be right.

The story is not yet over.....

From holiday distress to a de-stress holiday

Given the recent political and economic events both nationally and globally, and the impact that it has had on individual households, a holiday has become more important now than ever before. With increasing workloads, the pressure to make funds stretch further for longer, the desire to escape from it all is ever pressing if only to retain a sense of balance and sanity. The mindset of many UK travellers has been the traditional 'jump on a plane' approach to distant shores with golden sands, aquamarine seas and plenty of summer sun. This doesn't seem to have changed much despite the stringent financial climate and rising costs of air travel (not mention the environmental impact but that is for another post....). However, the recent grounding of all European flights due to volcanic ash, the industrial strikes affecting some airlines and the general disruption and chaos that has ensued has generated much angst and distress to numerous holiday-makers. The solution is simple. One needs to recognise and identify what a holiday means, its value and its purpose. Events such as these has highlighted more than any other that the 'typical' summer holiday can easily result in more holiday distress and exacerbate any existing physical or mental condition and does nothing to boost emotional or spritual well-being.... the very thing that a peaceful and relaxing holiday is meant to help with. Even those lucky enough to escape the airport fiascos going out tend to worry about the potential mayhem awaiting them on their return flight. It is hard to see the appeal of air travel these days and it may be sensible to ask: 'who needs this aggravation?' A dictionary definition aptly describes the word holiday as a 'season of rest, relaxation, idleness and recreation'. This is certainly not in accord with the hassle of air travel and the debacle that can cause immense stress and does little to support this definition. Therefore , a break from the 'ol routine should suitably recharge and rejuvenate the mind, body & spirit. Useful suggestions for a stay at home vacation or so commonly termed a 'staycation' are:
Walking Holidays

Explore the Lake District, Highlands of Scotland, the Pembrokeshire coastline, the stunning Yorkshire Dales, the Sussex Downs, the West Country (Devon, Dorset, Somerset, Cornwall...). Get the children involved in nature and cultivate an appreciation of natural habitats and wildlife from a young age.

Spa Retreats & Health Resorts

Pamper yourself at a health spa or a health resort for a complete holistic approach to a holiday. Recharge the batteries and spend time pursuing gentle activities such as yoga, meditation, tai-chi to restore the health of the mind, body & soul. Educate yourself on good nutrition and detox and invigorate the mind and body by other activities such as cardiovascular exercise, swimming and massage. Highly recommended for the 'burnt-out' professional!

Activity Holidays

For the adrenaline junkies there is a range of activities such as water sports, walking, cycling, hill-climbing and rock-climbing... kids may love it too! Summer of 2010 is predicted to be a scorcher in the UK so consider camping or caravaning for an extended stay.

Home Swap Holidays

There are numerous holiday companies that specialise in these types of holidays... it is a convenient and cheaper way to have a holiday away from home (even if it is in another part of the country). It obviates the hassle factor and expense of air travel not to mention the cost of accommodation.

A Guide to Commercial Supplements

As a practitioner and health professional, I am continually asked for advice and recommendations on commercial supplements and this post is by way of addressing some of the common questions that people have about over the counter (OTC) supplements - herbal or nutritional.

The supplements market is a booming business, more so in the image-conscious US where the health & fitness industries dominate. However, the UK is catching up fast and partly due to the many health campaigns aimed at enabling people to take control of their own health & well-being, it has undoubtedly resulted in a growing market for nutritional and herbal supplements in an attempt to prevent illness, optimise health and improve vitality. However, due to the vast array of products on the market, the numerous brands each with their own style of aggressive marketing and selling technique, it is not surprising that many are baffled and downright confused as to what to buy. Here are some of the brands that I recommend to patients and those who seek my advice:

• Solgar http://www.solgar.co.uk/
• Solaray http://www.solaray.co.uk/
• Quest http://www.questexcellence.com/
• Lamberts http://www.lambertshealthcare.co.uk/
• Biocare http://www.biocare.co.uk/
• Higher Nature http://www.highernature.co.uk/
• Nature's Aid http://www.naturesaid.co.uk/
• A. Vogel (previously Bioforce) http://www.avogel.co.uk/
• Tisserand (for essential oils) http://www.tisserand.com/

I normally tell those who ask that it is never recommended that they buy a local or chain supermarket brand, nor any of the high street chemists' brand or the own brands from chain health food shops. The quality is not always great and many are persuaded by the cheap deals or bulk buys. On a long-term basis, this is not sensible and it is far more cost-effective to spend a little more on a brand of better quality which is likely to be effective rather than wasting money on supplements which are no better than chalk tablets.

Online purchasing is a mixed bag.... if you know the brand and it has been recommended, it is safe to purchase them but ONLY from their own brand's website if you want to be totally safe. However, there are other outlets that will sell these recommended brands so it may be worthwhile spending some time investigating the best option for you. It always astonishes me that so many are incredibly careless about what they purchase as supplements online without any regard to its safety or quality. They may as well be swallowing a whole load of placebos but worse still, it is hard to tell whether any of the products have any dangerous substances in them. Some of the unknown brands may have sub-therapeutic doses or may contain added ingredients (for example bulking agents, excipients or adjuvants) that are not listed in the ingredients. It is this very sort of thing that can prove to be unsafe as it is impossible to trace the cause of any adverse reaction or side effect to the supplement. The guarantee and reassurance that one has when purchasing from the brand's own website is really in its safety and effectiveness. A reputable high street health food shop (usually NOT part of a chain) should stock a good range of the above-mentioned brands. These shops normally sell whole foods and a range of other health products so it is worth investigating your nearest store.

The following is a simple guide to some of the commercialy available preparations:

Tablets: A controlled quantity of finely milled herbal material is compressed and given a thin coating. Some are enteric-coated to prevent stomach acids from altering the active ingredients. These allow absorption of the herb in its original form and concentration in the small intestine without change in its chemical composition. A herbal practitioner may prescribe herbal tablets to be administered in a similar manner to conventional medicines, ie. to be taken at regular intervals before, with or after food.

Capsules: 80% of all herbal supplements are sold in this form. Convenient, palatable & portable. Disadvantage that it contains dried, ground herbs which may lose their potency more quickly. Need to take more of the whole herb extract unlike the concentrated extract. A herbal practitioner could prescribe these and they are taken in a similar manner to conventional medicines ie. before, with or after food.

Standardised Extracts: Preparations that have a known quantity of a key compound or ingredient that is the designated marker of the herb’s potency. This gives the assurance of potency & medicinal benefit. Standardised products are available in capsules, tablets & liquid form (tincture or glycerite). There is some argument over the actual benefit of standardisation over whole herb preparations and the synergy of active ingredients.

Tinctures & Fluid Extracts: Fresh or dried herbs are soaked (macerated) in a solvent – alcohol for tinctures and glycerine for gycerites (non-alcoholic) in order to release the active compounds. The process takes a few days and the mixture if filtered to produce the liquid preparation. Concentrations vary depending on the herb:solvent ratio ie. Fluid Extract (1:1) being the most concentrated and 1:5 tincture being the least concentrated. Using fresh herbs yield lower concentrations of active constituents than using dried herbs. Usually, a teaspoon of the tincture is taken 3 times a day in a little water before meals but again, this can vary, depending on the dosage requirements.

Herbal Teas: Most familiar & traditional form of preparation. Dried leaves and flowers are particularly suited to infusions as it releases important volatile oils (eg. mint, sage, chamomile) but bark, roots, seeds and berries are also used. Usually 2 heaped teaspoons of the dried herb is infused into a cup of boiling water for about 10 minutes. The liquid is strained and drunk at regular intervals depending on the dosage requirements.

Always follow dosage and storage instructions as stated by the manufacturers. To ensure the best quality and safety, it is always best to seek the advice and help from a professional herbalist or nutritionist. Never self-medicate and it is ill advised to mix prescription medicines with OTC supplements without seeking proper help and advice beforehand. For more information go to http://www.nimh.org.uk/ for herbal and nutritional supplements, or http://www.ion.ac.uk/ or http://www.bant.org.uk/ for specific help & advice on nutritional supplements.

Improving Liver Health

The whole purpose and function of a detox is to rid the body of toxins and to ensure that vital organs in this process, especially the liver are working at their best. A congested & over-burdened liver cannot function efficiently. There are a number of herbs that are useful in improving liver function which also indirectly improve digestive function as well.

Broad action of liver herbs include assisting, supporting, toning, strengthening and even protecting the liver. Some herbs directly improve bile prduction from the liver or improve its release from the gall bladder where it is stored. Bile of course is vital for digestive function. Other liver herbs can influence the regeneration process of the liver (which is phenomenal considering the level of toxic overload through modern living!) and this improves its overall efficiency & functioning. Some liver herbs are directly involved in the biochemical pathways that render toxic chemicals & by-products of metabolism less harmful and suitably safe for elimination.

Good examples of liver herbs:

• Milk Thistle (protects liver cells from damage, increases repair & regeneration of liver cells)
• Dandelion (mild laxative, diuretic, increases appetite, increases bile production & secretion)
• Artichoke (protects liver cells, increases appetite, increases bile producion, a general liver tonic)
• Turmeric (improves detox role of the liver, increases bile production)

The diet plays an important part in the health of the liver and in generally keeping the system relatively free from toxins or chemical overload. Many people have periodically tried fruit-only, vegetable-only, water-only fasts. Any kind of fast can be good in the short-term. This encourages the release of toxins from the cells into the bloodstream. Symptoms such as headache, lethargy, skin break-outs are all an indications of toxins being released into the blood. Sensible and continual fasting until it is completed will have enormous benfits such as increased vitality, a sense of rejuvenation, a healthy skin and improved functinoning of vital organs. However, doing a fast badly can produce severe adverse symptoms which are more unpleasant than they need to be. Always seek advice from a nutritionist or a herbalist before embarking on any fast and never adopt fasting as a habitual way of life or a long-term dietary measure.

Foods that are good for the liver:

• Vegetables (brassicas eg. cabbage, brocolli, artichoke, beetroot, watercress, alfalfa sprouts, herbs & spices eg. garlic, fennel, parsley, onions)
• Fruits (apples, grapefruit, grapes, lemons, pears, apricots, avocado, pineapple, papaya, watermelon)

Other examples of herbs include Chinese herbs such as shizandra and bupleurum which work by neutralising liver toxins. People who want a detox usually gain benefit from taking these herbs as well as others such as ginger, burdock, licorice and turmeric, quite often as supplements.

For more information and advice on how to improve liver health, contact your local herbalist (NIMH) or a nutritionist (BANT) - see useful links on the homepage for their contact details. Practitioners will be able to advise on suitability for fasts, supplementation and your general state of health regarding liver functioning.

A proper start to the New Year!

As with all New Year starts, there is a bewildering array of advice, information and instructions on the usual 'detox'. Much of this is really about sensible eating and moderating alcohol intake. However, there are only 3 key secrets to success when it comes to 'detox diets' and creating a 'new you' in the New Year:

• discipline
• determination
• will power

Crash dieting is disastrous for the body and never to be recommended, as are slimming pills and other 'natural' diet pills. To regain a healthy body after the festive season requires a nutritious diet and a calorie intake matched to physical exercise and energy output. There are no quick solutions to weight loss and to sustain a healthy body throughout the year quite often, requires:

• radical changes to the diet (choose healthier options to the usual culprits)
• plan an effective exercise regime (to suit your constitution and one that you are likely to stick to)
• make important lifestyle changes (aim to achieve that elusive, all-important work-life balance)

For help and advice on nutrition and exercise or to help with a diet plan, contact the British Association of Nutritional Therapists (http://www.bant.org.uk/) or the National Institute of Medical Herbalists (http://www.nimh.org.uk/) to help you achieve effective and long-lasting changes to your body through proper nutrition, exercise and herbal supplementation.