Dry January, a phenomenon that started in Scandinavia and has now gained more popularity in other parts of Europe. During “Dry January” people challenge themselves to temporary abstinence from alcohol for one month, in order to detox their bodies after the holiday season. The media states that one-month alcohol abstinence has a beneficial effect on your sleep pattern, alertness, mood, weight, skin, and your liver. Because I am currently participating in Dry January I was wondering if the results of alcohol abstinence for a short period of time are studied, and what these results might be.

Before we can understand what beneficial effects a month without alcohol can have, we need to know what alcohol does to our body. Alcohol has, amongst other things, an influence on our liver and on our mental health. When we consume alcohol, a part of the brain that is related to reward becomes active: the striatum. Also, dopamine is released which has an influence on feelings of reward and the control of impulsive behaviour. While the striatum is activated, the prefrontal cortex is inhibited which regulates impulses and emotion regulation.

When we consume an alcoholic beverage, the alcohol is absorbed in our blood which in turn is filtered by our liver. Alcohol damages the liver by stimulating the liver cells, which causes them to die. This leads to scarring of liver cells (fibrosis) and to shrinkage of the liver itself (cirrose). People with liver cirrose have a higher chance of developing liver cancer. The positive part of this story is the self-recovery function of our liver. Your liver can recover for up to 70% if you put aside alcohol for at least one month.

Researchers from the RadboudUMC1 in Nijmegen (2017) and the University of Sussex2 (2015) studied voluntarily temporary abstinence from alcohol to gain more insight in the effects of alcohol abstinence and alcohol use after Dry January and to gain more insight in the possibility of health-related benefits.

After going for a month without alcohol, 62% of the people reported better sleep and more energy2 and 57% had more concentration. Also, alertness was tested: participants who drank alcohol showed more impulsivity and were, therefore, quicker, but made more mistakes. After Dry January these participants reacted slightly slower but more accurate.

Also, various health-related benefits were reported: less liver cells were stimulated (2) or died (1), 54% had better skin and 70% had generally improved health (2). Also a reduction in belly fat was measured (1), this can be explained by the process in which the body breaks down fat cells, this process is slowed down by alcohol. Besides, the lowering of belly fat is also a result of a reduction of calorie intake (one glass of wine, for instance, has 82 kcal). Another quite important benefit: 88% of the participants saved money (2).

Before these studies, there was some negative criticism against Dry January. Professionals were scared that people would experience a rebound effect after the dry month, resulting in more alcohol consumption. However, the results reveal the opposite: one month of alcohol abstinence led to less alcohol consumption in the following six months (2). Saying “No” to alcohol for a month created an awareness about the effects of alcohol and the participants gained insight into their drinking behaviour (2).

Taken together it seems that quitting alcohol, even for a short period of time, has lots of beneficial effects. No reason to not try a dry month this year!

REFERENCES
1. Munsterman, I. Tjwa, E., Schellekens A. (2017). “Lever rust uit van een maand niet drinken”. https://dekennisvannu.nl/site/special/Een-maand-zonder-alcohol/82

2. De Visser, R.O., Robinson, E., Bond, R. (2016) Voluntary temporary abstinence from alcohol during “Dry January” and subsequent alcohol use. Health Psychology, Vol 35(3), 281-289

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Whenever I ask my patients, if they are eating their “5 a day”, the immediate answer is “Yes, sure”. However, sometimes I´m not sure if their “Yes, sure” belongs to their real eating behavior or if it is more like wishful thinking. This question applies for a broad range of behavior, like taking the stairs instead of the elevator, having enough sleep, walking the 10.000 steps a day etc.. But how can we be sure what people really do in their everyday life?

The answer is: Ambulatory Assessment

Ambulatory Assessment is the state of the art method for assessing current emotional states, feelings, and behavior in the natural environment of an individual’s everyday life. Equipped with smartphones and accelerometers, it is feasible to track how individuals feel at specific moments, what they are eating across a day and how they physically behave in real time and real life. Electronic e-diaries, provided by an App, prompt individuals whenever an event occur or randomly several times a day. Especially in patient groups with attention deficits, prompting short questionnaires several times a day show better recall than an extensive end-of-day questionnaire.

In the past, food-diaries were based on unhandy and retrospective paper-pencil-questionnaires or computer input. Nowadays, new technological opportunities pave the way to e-food-diaries on smartphones, enabling an immediate and flexible input capability. The design of e-food-diary-apps may be different, i.e., by photos, drop-down-menu, text, or voice records. Important is the documentation of what and how much the participants eat and drink and a database that can be connected to an international or national food code for data analysis.

In the Eat2beNICE research project, we assess food intake every time participants eat or drink by a drop-down-menu that leads from general to very detailed food-items and asks for general meal portions and amounts every time participants eat and drink across the day. If a participant cannot find a particular food-item, he or she has the opportunity to enter a free text message or to record a voice message. If participants forget to enter some foods and drinks across the day, they will receive a reminder in the evening to add forgotten items. This procedure enables very accurate tracking of participant’s food intake in our study.

To sum up, thanks to modern technology we can now accurately measure what a person feels, does and eats throughout the day. Of course, the design of an e-food-diary on the smartphone depends on the projects’- and samples’ requirements. Overall, it has to be easy to use, easy to implement in daily life and to be fun for the participants to obtain a high level of compliance and a high-quality database.

REFERENCES:
Ebner-Priemer, U. W., & Trull, T. J. (2009). Ambulatory Assessment: An Innovative and Promising Approach for Clinical Psychology. European Psychologist, 14, 109–119. https://doi.org/10.1027/1016-9040.14.2.109.

Engel, S. G., Crosby, Ross, Thomas, G., Bond, D., Lavender, J. M., Mason, T., . . . Wonderlich, Stephen. (2016). Ecological Momentary Assessment in Eating Disorder and Obesity Research: a Review of the Recent Literature. Current Psychiatry Reports, 18, 37. https://doi.org/10.1007/s11920-016-0672-7.

Fuller, N. R., Fong, M., Gerofi, J., Ferkh, F., Leung, C., Leung, L., . . . Caterson, I. D. (2017). Comparison of an electronic versus traditional food diary for assessing dietary intake-A validation study. Obesity Research & Clinical Practice, 11, 647–654. https://doi.org/10.1016/j.orcp.2017.04.001.

Smyth, J., Wonderlich, S., Crosby, R., Miltenberger, R., Mitchell, J., & Rorty, M. (2001). The use of ecological momentary assessment approaches in eating disorder research. The International Journal of Eating Disorders, 30, 83–95.

Stein, K. F., & Corte, C. M. (2003). Ecologic momentary assessment of eating-disordered behaviors. The International Journal of Eating Disorders, 34, 349–360. https://doi.org/10.1002/eat.10194.

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The more diverse we eat, the more diverse our gut microbiome (i.e., the composition of trillions of microbes in our intestine) will become. Sounds reasonable, right? But – why is that a good thing?

Well, research has shown that a diverse gut microbiome is less susceptible to diseases, such as the well-known western lifestyle associated diseases like diabetes or Crohn’s disease (1). This might be because one’s microbiome and one’s immune system are closely linked. A healthy and diverse microbiome thus might support proper functioning of our immune system and help keeping us healthy.

Eating a variety of different food items also enhances the odds that your body gets all the nutrients like vitamins or minerals it needs for proper functioning. This can have an effect on our well-being as well as on our physical appearance, like shiny hair, strong fingernails and healthy-looking skin.

Besides, research suggests that the more diverse we eat, the better our cognitive abilities might be at older age (see my blog on this topic here:
http://newbrainnutrition.com/four-easy-rules-for-healthy-eating-and-lifestyle/)! Well, how about that!? Research supports the notion that our gut and our brain are more closely linked than we would have assumed. This would mean that our food choices can actually have an effect on our mental health. Great, right?

So let’s have a look at a few simple tips with which you can easily enhance your dietary diversity, and can have fun along the way, too!

1. Add seeds and nuts to your meals
2. Eat a set menu
3. Grow your own fresh herbs
4. Enlarge the variety of what you drink
5. Try alternatives to your staple foods
6. Try new dishes, restaurants and cuisines
7. Join a food cooperative
8. Distribute your homemade meals across different days
9. Experiment with seasonings
10. Try smoothies and soups
11. Share your meals
And the golden rule you should keep in mind:
12. Avoid antibiotics

Add seeds and nuts to your meals
By keeping a variety of seeds and nuts at home, you can easily add them to your meals. If you tend to overeat on nuts (and believe me, many people do), make sure to buy unsalted ones, and simply sprinkle them on top of your muesli, salad or sandwich. Nuts (like peanuts, walnuts, hazelnuts) and seeds (like sesame or flaxseed) are a great source of very healthy fats, important vitamins like B-vitamins and vitamin E, and they contain fibres, which our gut simply loves!

Eat a set menu
Yes, you heard me. This is my advice to select a sequence of dishes, instead of only one.
This will definitely result in a larger variety of what you eat. Of course, you should be aware of the overall amount of food – listen to your gut feeling! And I’m serious, this also includes dessert! If you have a little soup, a colorful salad, a light main course and a small treat, you’ve supplied your body with a variety of different nutrients it needs to stay healthy. My extra tip: Keep in mind to include your ‘five a day’ to make sure you eat enough fruit and especially enough vegetables.

Grow your own fresh herbs
Do you notice that food pictures look more appealing when the food is sprinkled with fresh herbs? It will also appeal to your gut! Adding one or two fresh herbs to a dish will give it that little extra twist that it deserves. All it takes is a plant pot on your window sill. Some herbs can be harvested throughout the whole year, and for even more diversity, you can experiment with different plants as you go.

Enlarge the variety of what you drink
Tea or coffee? Both, please! When we think of nutritional diversity, let’s not only consider solid food. Imagine having your coffee and a glass of orange juice (or even a multivitamin drink) with your breakfast. How about some green or black tea as the day goes by? Or an apple spritzer? Herbal teas also offer a great range of different ingredients, and can be soothing in the evening. Just keep in mind that if you taste a few different lemonades, you well might enhance your variety of drinks, but you will consume a lot of sugar, too. The world health organization recommends that maximally 10% of your energy should come from sugar (2), which should be considered when ordering a drink.

Try alternatives to your staple foods
Are you a muesli guy? Or more of a bread person? Do you prefer pasta as your everyday dish or is your menu dominated by rice? Most of us tend to eat the same basic food items every day. But even here is the chance to enhance diversity: Instead of rice, try couscous, amaranth or millet. Buy a different type of bread every time you go to the bakery. Muesli offers a great chance of variety, you can add honey, yoghurt, marmalade, berries, spices… Talk to your friends to get more ideas.

Try new dishes, restaurants and cuisines
Every cuisine has its own flavours, specific components, and style. So why not raiding cook books and food blogs for inspiration? If you go out to eat, just be curious and pick the restaurant you always wanted to try, yet ending up at the same place you always went. This doesn’t only increase your daily diversity, but also the one across days, which is especially important: Imagine you create a super diverse menu and then eat it day after day after day… Sounds boring, right? Your gut will share this opinion! My extra tip: Choose restaurants that offer a buffet every now and then. This is specifically handy around lunchtime because you don’t have to wait for your food. Again, take a bit of everything, but be careful not to overload your plate. This gives you the chance to try out what you like when you taste a novel cuisine. And imagine the looks you get when you say “Hey, I’m doing this for my microbiome!”

Join a food cooperative
You know that homemade cooking is great. You are in charge of what goes into the pan, you control the ingredients’ quality. But, of course, it requires planning, shopping, cooking – not to forget cleaning the kitchen. An easy step towards a diverse, regular cooking habit is joining a cooperative or booking home delivery from organic farms nearby. You get a box full of seasonal, fresh, local fruit and veg delivered to your door weekly. If you know where it comes from, you might be more reluctant to throw it out, hence you might actually cook it and eat it! The surprising variety of what a season has to offer will boost your cooking creativity and enhance your nutritional diversity even further.

Some might object now and remark that when they look at the back of their ready-to-eat supermarket meals, is states that there are so many ingredients in one package, that there is no need to enhance nutritional diversity even more. Sure, there is a point there! But keep in mind that these foods are massively processed, thus having lost many of the original ingredients’ benefits like vitamins, etc. Also, if you look closely, you might detect declarations you don’t even know what they mean! Those different additives, like E-numbers, are mostly artificially produced, and there is long-term research missing what they actually do to our bodies – especially in interaction with all the other additives found in processed food. Don’t get me wrong – every now and then I also grab a bag of ready-to-eat food from the counter.
But what I personally do is to subtract the artificial ingredients from my daily diversity calculation (and now you also know that I like math).

Distribute your homemade meals across different days
This is the same approach as eating a set menu. Imagine you make yourself a nice pasta dish for the evening, and prepare a mixed salad for lunch the next day. How about splitting both in half? That way you expand your food across days, yet adding more daily eatables at the same time. Your microbiome will like the variety that goes along with this. Plus, you don’t have to buy canteen food the next day and might save some money – money that could be spent at the fancy restaurant we talked about earlier on!

And yes, distributing food across days also applies to cake and desserts. If you baked a cake (consider adding lots of fruit), have one piece now and one tomorrow! And remember to send your mum a picture of your delicious achievements, she will love it!

Experiment with seasonings
If you go through the seasonings in your kitchen cupboard, you will notice that some seasonings provide a literal boost for your nutritional diversity. I just found a curry powder with 13 ingredients! Of course, if you start and mix different seasonings, a few compounds will be redundant. But when you cook – or simply heat up a bought dish – add that little extra. That way, you can even reduce the amount of salt without giving up on flavour. The world health organization recommends 5 grams of salt per day (2). Simply use high-quality seasoning and herb mixtures instead, maybe add a drop of fine oil for flavour, and let it surprise you!

Try smoothies and soups
For a quick energy boost in the morning, I recommend a smoothie. What I love about smoothies? You can virtually throw everything in there, and by adding just a few ingredients for flavour (like oranges) and texture (like bananas) you can create a tasty and always different vitamin shot. Again, remember seasoning like curcuma or cinnamon to increase variety and diversity. For later meals, there are great recipes for soups – even some that don’t require cooking! If you blend your soup, you can easily ‘hide’ some leftovers in there, or some bits of a vegetable you don’t really like.

Share your meals
This is my favourite tip. Have you noticed that also during lunch with colleagues, the grass is always greener on the other side? In our lab, we have switched to a food sharing concept where everybody can take a bit of everyone’s meal. In some cultures, like Corea, it is common to place all the food one orders in the middle of the table. They know that sharing is caring – especially caring about one’s microbiome diversity!

And last, not least: Avoid antibiotics!
Of course, there are some illnesses where antibiotics are essential. But did you know that animals are fed large amounts of antibiotics, and that we consume them, too, when we indulge into our chicken breast or piece of veal? These antibiotics not only kill unwanted microbes, they also heavily disrupt the ecology of our microbiome (3). So in order to keep your gut happy and to get the most out of your nutritional diversity experiment, think twice before you buy or order conventionally produced meat. Consider organic meat or vegetarian alternatives – hence adding even more possibilities for a diverse menu.

(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3577372/
(2) http://www.who.int/news-room/fact-sheets/detail/healthy-diet
(3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4831151/

Want to learn more? Visit http://www.bbc.co.uk/guides/zpf27hv#z8qrg82 for a little quiz and some more information and https://experiencelife.com/article/your-microbiome-the-ecosystem-inside/ to find out more about your microbiome.

 

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Every time I travel and enter the breakfast room of my hotel, I think of Japan.

And not just because of the curious surprises that I encountered when traveling there. (Once, the hotel’s definition of a ‘western style breakfast buffet’ was shrimp pasta and pepperoni pizza!) The Japanese have an interesting relationship with their nutrition. Japanese cuisine is said to have a much higher dietary diversity than western cultures do.

This is associated with a reduced intellectual decline at older age, as was reported by Rei Otsuka and colleagues in 2017 (among others).  In other words, daily intake of various kinds of food lower the risk that you encounter a reduction of your cognitive abilities as you grow older.

Outstanding, even in Japan, is the island of Okinawa, where many people grow very old very healthily. It is not only dietary diversity that contributes to a long and healthy life. The Okinawans have a useful saying: “Hara hachi bu,” which loosely translates to “only fill up to 80%”. Unlike many of us, they don’t snack, but leave their intestines several hours to process the food. And they move a lot – from walking to dancing and martial arts.

Four Easy Rules for Healthy Eating and Lifestyle

So when I approach the buffet, I like picking a little bit of everything – which is fun, contributes to an interesting breakfast conversation, and might even be a smart move for my brain function and mental health!

The real challenge at a buffet, of course, is not to overeat.

Otsuka, R., Nishita, Y., Tange, C., Tomida, M., Kato, Y., Nakamoto, M., Imai, T., Ando, F. & Hiroshi Shimokata, H. Dietary diversity decreases the risk of cognitive decline among Japanese older adults, Geriatr Gerontol Int, 17: 937–944 (2017)  https://onlinelibrary.wiley.com/doi/pdf/10.1111/ggi.12817

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Assessing someone’s diet can be tricky and particularly time-consuming. People choose from millions of groceries every day, and the vast range of products available adds a further level of complexity to accurately assessing diet. Traditionally, dietary research is based on food diaries, meaning participants keep record of what they eat and drink by writing it down on paper. To extract nutritional information, researchers have to input the paper-based data into nutrient analysis software by hand, which is extremely time-consuming and error-prone. Furthermore, each country has local and distinct food products to offer. These differences need to be considered when assessing nutritional intake in an international project such as New Brain Nutrition.

Faced with these difficulties we are delighted to announce the use of the online 24-h dietary assessment tool “Measure Your Food On One Day (myfood24)” at the University Hospital in Frankfurt for our project. The study aims to investigate the effects of exercise and nutrition on behavioural measures regarding impulsive, compulsive and externalising behaviours.

myfood24 is a quick and easy online dietary assessment tool that tracks, monitors, and analyses dietary intake.

myfood24 is based on a novel approach to assess food intake through technology.

A collaborative project between the University of Leeds (PI Prof Janet Cade) and Imperial College London recognized the need for a valid, reliable, low burden and user-friendly dietary assessment tool. Funded by a UK Medical Research Council grant, the team of experts developed and tested myfood24 for a wide range of age groups including adolescents, adults and older adults and validated myfood24 against a suite of biomarkers.

Participants enter all the foods and drinks they have consumed during one day (from midnight to midnight) into the online tool. They can choose from an extensive range of food items including generic foods (e.g. milk chocolate) and branded products (e.g. milka & daim chocolate). Food portion images are available for a variety of items to help quantify consumed foods. myfood24 is easy to use with no training required; it can also be interviewer-administered. These features help to maximise participation throughout the research project and to cater to a wide range of research project types, study participants and clinical needs.

The academic rigor, automated data processing, and immediate production of results contribute to improved data quality and a drastic time reduction.

myfood24 has 4 country-specific versions available: United Kingdom, Germany, Denmark and Australia. These include localised food databases and translations.

A teaching version is also available in the United Kingdom; it has been tailored to a classroom situation and allows for immediate feedback from the whole class to be explored together (without aggregating information elsewhere). Feedback includes a variety of visual and easy-to-interpret graphs at both the individual and group level and includes over 100 different nutrients. myfood24 has wide application in research, teaching and health settings, globally.

Click here to try a free demo of myfood24.

Further information on myfood24 can be found on the myfood24 website.

myfood24 was developed through Medical Research Council funding, grant G110235 by a collaborative project between the University of Leeds (PI Prof Janet Cade) and Imperial College, London. Requests to use myfood24 should be made to enquiries@myfood24.org

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How many total food-and beverage-related decisions do you make in one day? Have a guess!

You reckon more than 15 decisions per day?! Congratulations! You are closer than the average (14.4) of 139 participants who were asked exactly the same question in a study by Wansink and Sobal (2007). However, you might still be far off. Let’s have a closer look at the study.

Being aware of the impact nutrition has on our physical and mental health as well as brain functioning, you might expect people to make well-considered food decisions. Wansink and Sobal (2007) aimed to answer the two following questions:

Are we aware of how many food-related decisions we make?

The results are clear, indicating a large degree of unawareness regarding the number of daily food decisions. The participants underestimated the number of food-and beverage-related decisions in a day by more than 200 decisions. We make an estimated 226.7 food decisions each day. Were you close? The authors conclude that we often engage in mindless eating which results in a lack of control of our food intake. There is a need to increase the awareness of the decisions we make regarding what, when and how much we eat to promote a healthy lifestyle.

These findings raise the question which factors determine our food decisions if we don’t. One potential factor that should be considered is our environment which was addressed in the second question of the study.

Food Choices cartoonAre we aware of the environmental cues that lead us to overeat?

To shed light on the second question the authors analysed data from four studies in which participants were either assigned to the control condition or a so-called exaggerated treatment condition. Environmental factors such as package size, serving bowl and plate size differed for the two conditions. In each study participants in the treatment condition served/prepared/consumed more food than the control group (between 29 and 53 % more). Afterwards the 192 participants of the treatment group were asked “How much did you eat compared to what is typical for you?” Across all four studies 19 % said “less” and 73 % “about the same” as normally. Just 8 % were aware that they consumed more. Afterwards they were informed about the environmental cues and asked a second question: “In this study, you were in a group that was given [a larger bowl]. Those people in your group ate an average of 20%-50% more than those who were instead given [a smaller bowl]. Why do you think you might have eaten more?” Interestingly, 21 % still claimed they did not eat more. 69 % justified the greater food intake with being hungry and 6 % with other reasons. Just 4 % admitted that the environmental cues influenced them.

These findings highlight the unawareness or denial of the influence our environment has on us and our food intake. However, they can be used as a starting point to improve our nutrition. Changing your immediate environment to make it less conducive to overeating can help you improve your health. Start with putting the sweets just a bit further away from you.

Further information on how to make your environment less conducive to overeating you can find in the book “Slim by Design: Mindless Eating Solutions for Everyday Life” by Brian Wansink (https://www.slimbydesign.com/book)

You can also visit Brian Wansink’s website where you find more cartoons – like the one above -amongst other things: http://mindlesseating.org/index.php

Wansink, B., & Sobal, J. (2007). Mindless eating: The 200 daily food decisions we overlook.

Environment and Behavior, 39(1), 106-123.

http://journals.sagepub.com/doi/abs/10.1177/0013916506295573

 

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