Food

We have come a long way since the humble bowl of Corn Flakes. Kellogg’s signature cereal was famous for being best enjoyed with “ice cold” milk. Its latest cereal product, Optivita, is being sold along far more complicated lines. Current television advertisements for Optivita proudly proclaim that the cereal has been approved by Heart UK, “the cholesterol charity”. The idea is that by choosing Optivita (an amalgamation of “optimal” and “vitality”) you are going to do good things to your cholesterol, so eat on.

Let us remind ourselves what high cholesterol levels mean in practice. High cholesterol is a risk factor for cardiovascular disease, as are smoking, obesity, diabetes, high blood pressure and a sedentary lifestyle. People can also inherit high cholesterol levels – a condition called familial hypercholesterolemia, which usually requires medication.

Cholesterol receives a lot of attention because it is easily measurable and, unlike one’s family medical history or diabetes, modifiable. Statin medication helps, but many people would, very reasonably, prefer to improve their diet than take a pill. This is where breakfast comes in.

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Every year, as the Christmas festive season gets going, my heart starts to sink. Flyers for parties offering “10 free drinks per person!” are plastered all over the gym. Pubs roar with drunken office lunches. Getting sloshed seems to be normal, if not mandatory.

Excess, of course, can be lots of fun. I have six different types of gin in my house, and am not exactly unknown at the local bottle bank. The problem is that when it comes to alcohol, one can happily surpass excess without noticing anything particularly wrong, until it all goes very wrong indeed. A famous gastroenterologist used to do a “vomit audit” once a year in Aberdeen by counting vile pavement reminders of the night before on a pre-prescribed route. This gave a ready snapshot of gastric side effects. But this is not the biggest problem with alcoholic excess.

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Lots of media coverage on a new study today, which is apparently going to compare the reported offences of prisoners while taking either placebo or a fish oil+multivitamin+mineral supplement. Some headlines  have interpreted this as ’Prison study to investigate link between junk food and violence’. I think that’s an extrapolation too far; the quality of the food the people eat isn’t going to vary during the study (although nourishing food, and the social interactions of eating should perhaps be an area of further interest in this group of people.)

The apparent health improving qualities of fish oils have been much overhyped in recent years. However there have been previous studies done looking at the effects of fish oils in prisoners and good quality evidence on a larger scale is to be welcomed. I haven’t seen the trial protocol on the register yet, but will keep an eye on this story.

There are yogurts with cholesterol-reducing properties and other dairy products which can supposedly produce “optimal” bowel health. Then there are baked beans with “added omega threes” and drinks that profess to reduce blood pressure. The European Food Safety Authority is now providing “opinions” on the science behind such claims. However a lot of the claims seem to rely on evidence about surrogate markers (eg a product may reduce cholesterol, however what we do not know if this method of reducing cholesterol will go on to have an effect on avoiding heart attacks or stroke.) 

In the end, I suspect that there will not be many adverts rivalling the qualities of ordinary fruit and vegetables –  generally for sale without much in the way of flashy health claims.

Margaret McCartney’s Blog

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A forum on healthcare policy and professional issues, by Glasgow-based GP and FT Weekend columnist Margaret McCartney.

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