A review of the week’s plant-based nutrition news 9th August 2020

This week I cover so much! Plant-based diets for children, cinnamon for blood sugar control, high fat diets, antibiotics and gut health, arsenic in rice, impact of food policies and the link between livestock farming and infectious diseases.

PLANT-BASED DIETS FOR CHILDREN: This new factsheet on plant-based eating for children is excellent and endorsed by the BDA, the professional body representing dietitians in the UK. I strongly urge you to download, read and keep for future reference. It covers all the essential nutrients necessary for growth and development, dispells myths on the need for dairy and fish in the diet and provides information on supplements. The conclusion ‘Reducing consumption of animal-source foods at a population level in the UK, and prioritising high quality plant foods in the diet will lead to better outcomes for people and the planet. High quality plant-based diets are appropriate for the whole population, including during childhood and adolescence, with specific nutritional considerations varying according to where on the spectrum of plant- to animal-source food consumption, an individual sits’. The BDA are leading the way in promoting sustainable diets with their One Blue Dot campaign and this factsheet adds to their resources on promoting plant-based diets for planetary health.

Scare stories about infants dying when parents choose to raise their children on a vegan diet always crop up. But when you delve into the detail, it is clear that the diet was not adequately planned and did not not meet the child’s nutrition needs regardless of whether the diet was vegan or not. Studies on the health of vegan and vegetarian children have clearly shown that growth and development is normal with the only difference in some being that those who do not consume dairy may have a shorter final height. This is not a bad thing as it reflects lower exposure to IGF-1 from dairy in the diet and taller height is associated with an increased risk of cancer.

CINNAMON AND BLOOD SUGAR: I am a big advocate of using the whole diet as a means of preventing disease and not reaching for supplements as such. The best way to prevent type 2 diabetes or prediabetes is to eat a plant-based diet composed of fruits, vegetables, wholegrains and legumes. However, I was interested to read this study as its rare to find a randomised study, albeit small, of a nutritional supplement with positive results.

The study examined whether cinnamon capsules 500mg 3 times per day vs placebo was effective at controlling blood sugar in 56 patients with pre-diabetes from 2 countries — Korea, and U.S. After 12 weeks, the results showed that the cinnamon group had significantly lower fasting blood glucose compared to the placebo group and significant improvement in the oral glucose tolerance test. There were no adverse events in either group. The potential mechanisms of action of cinnamon are shown in the image below.

This is a short study and would need extending to understand the long-term impact on those with pre-diabetes. However, it adds to a growing list of non-toxic interventions that may be able to prevent the progression of pre-diabetes. All that said, it is best to concentrate on eating a whole food plant-based diet and using herbs and spices liberally in cooking. In addition, a whole lifestyle approach is effective at preventing progression of pre-diabetes to diabetes as demonstrated by the diabetes prevention programme. This large study was able to demonstrate the efficacy of a intensive lifestyle programme (7% weight loss and 150 minutes of exercise per week) in preventing the progression of pre-diabetes and was more effective than metformin.

HIGH FAT DIET AND ANTIBIOTICS TRIGGER INFLAMMATION AND CAN PREDISPOSE TO INFLAMMATORY BOWEL DISEASE: Disorders of the the gastrointestinal tract are common and irritable bowel syndrome (IBS) is increasingly prevalent, affecting 10–20% of adults. It is characterised by recurring episodes of abdominal pain, bloating and changes in bowel habits. IBS can be associated with inflammation of the gut lining and this is considered a precursor of inflammatory bowel disease (IBD).

This study measured faecal calprotectin levels in 43 healthy adults and 49 adult patients diagnosed with IBS. Calprotectin is a marker of intestinal inflammation and is elevated in patients with IBD and pre-IBD. 19 patients with IBS were found to have elevated calprotetin and considered to have pre-IBD. The study found that participants consuming a high-fat diet (40g fat/1000kcal/day and 13.5g saturated fat/1000kcal/day) and using antibiotics were at 8.6 times higher risk for having pre-IBD than those on a lower-fat diet and no recent history of antibiotic use. Participants with the highest fat consumption were about 2.8 times more likely to have pre-IBD than those with the lowest fat intake. A history of recent antibiotic usage alone was associated with 3.9 times higher likelihood of having pre-IBD. The cause for the inflammation was related back to disruption of the gut bacteria i.e. dysbiosis.

Diets high in saturated fat disrupt the epithelial lining of the gut and increase gut permeability, allowing inflammatory substances, such as bacteria and lipopolysaccharides (bacterial endotoxins) into the circulation, which contributes to inflammation. Diets high in saturated fat also have a negative effect on the gut microbiome, which is so crucial to maintaining the health and immune function of the gut lining and thus contributing to disorders of the gastrointestinal tract.

THE IMPACT OF LIVESTOCK FARMING AND LOSS OF BIODIVERSITY ON THE GENERATION OF INFECTIOUS DISEASES: It is clear that the majority of new and emerging infectious diseases in humans come from animal hosts. Infections with epidemic and pandemic potential have increased in the last century due to the destruction of animal habitats and the use of animals for food, be it factory farming or the wildlife trade. This report from ProVeg, that I am pleased to have supported, outlines how the global food system has led to the perfect conditions necessary for the generation of new infections with pandemic potential, including SARS-CoV-2 and the disease COVID-19.

The paper highlighted examines the link between emerging infections, livestock expansion (based on cattle farming) and loss of biodiveristy. We have entered the six mass extinction event and the rate of species loss is accelerating. The results showed that over the period studied (1960–2019) there has been a dramatic rise in cattle farming, outbreaks of human and animal infections and number of threatened wildlife species. As the number of wildlife species have declined, there has been a rise in infectious and parasitic infections in humans. The continuous increase in cattle farming is also positively correlated with the number of infectious outbreaks in animals and humans and to the increase in number of threatened wildlife species for the period 2000–2016. The authors conclude ‘This study highlights the importance of expanding livestock farming both as a threat to biodiversity and as increasingly putting human and animal health at risk’.

RICE CONSUMPTION AND EXPOSURE TO ARSENIC: Arsenic is a poison and carcinogen. There is no safe dose for humans. Arsenic is a naturally occurring element that can be found in rocks and soil, water, air, plants, and animals as well as in industrial and agricultural compounds. From these sources arsenic can enter our water and food supply. Arsenic is found in 2 forms: inorganic and organic compounds. Inorganic arsenic compounds are used in industry and in building products and are found in arsenic-contaminated water. It is this form that has been linked to cancer. The organic arsenic compounds are thought to be much less toxic and not thought to be linked to cancer. The highest levels of arsenic in food are found in seafood, rice, mushrooms, and poultry, although many other foods, including some fruit juices, can contain arsenic.

This ecological study examined the association between the consumption of rice, exposure to arsenic and risk of cardiovascular disease (CVD) mortality in England and Wales. After correcting the data for known CVD risk factors, including obesity, smoking, age, lack of income, lack of education, the results showed a significant association between increased risk of CVD mortality, recorded at a local authority level, and the consumption of inorganic arsenic from rice. Compared to those with the lowest consumption of rice, those consuming the most had a 6% increase risk of dying from CVD.

Ecological studies are merely hypothesis generating and can’t prove cause and effect. The impact of confounding factors can not be excluded. For example, certain ethnic groups eat more rice than others and also have an increased risk of CVD for a number of reasons. Similar studies from Bangladesh, where arsenic contamination of water has been a major problem, also show increased risk of CVD mortality. The precautionary principle needs to be applied and it is always best to reduce exposure to toxins from foods. We are familiar with the issue of drinking water contamination with arsenic in various parts of the world, with measures in place to mitigate this. However, there is less awareness of arsenic contamination of food crops irrigated with arsenic-contaminated ground water. Arsenic also accumulates in the soil of these irrigated areas, posing a threat to crop agriculture. Rice is the crop that is most affected by arsenic uptake because it is generally grown in flooded fields. There are ways to reduce arsenic accumulation in rice such as the system of rice intensification, which involves growing rice in an aerated soil instead of in flooded paddies, thus using much less water. Aerated soil conditions also significantly reduce methane production from rice paddies, which is a contributor to the greenhouse gas emissions from agriculture.

As consumers, we can try and reduce arsenic exposure from rice by consuming rice varieties, such as basmati and white rice (rather wholegrain rice), which are known to typically have lower inorganic arsenic contents. Clearly, it is best to choose wholegrains over refined grains and when cooking brown rice it is best to cook with an excess of water and drain off the water once cooked. Also, mix up your wholegrain consumption and include quinoa, couscous, bulgur, rye, barley, buckwheat, oats etc. rather than only choosing rice. Dr Michael Greger of Nutritionfacts.org has produced a series of videos on arsenic in food.

How Risky Is the Arsenic in Rice? | NutritionFacts.org

CHANGING THE UNHEALTHY FOOD SYSTEM: COVID-19 has highlighted the impact of overweight/obesity and chronic illness on adverse health outcomes. 80% of chronic illness could be eliminated through the adoption of healthy lifestyle behaviours. Diet choices are a major contributor to ill health and to environmental degradation and climate change. The UK government have highlighted the impact of obesity on COVID-19 in a report by Public Health England and the NHS has produced a 12 week weight loss plan for individuals to follow. But the public health messaging is confused. Alongside promoting weight loss, the UK Government are incentivising us to Eat Out to Help Out. This seems counterintuitive given that food eaten outside the home contributes greatly to excess calories and is implicated in promoting weight gain. Relying on individual choice without changing the food environment or policies towards food availability is unlikely to have a major impact on health outcomes. Back in 2007, the UK Government published the Foresight review, Tackling Obesities: Future Choices. It identified over 100 factors that contribute to overweight and obesity (see below). It concluded ‘The obesity epidemic cannot be prevented by individual action alone and demands a societal approach’.

This paper reviewed the literature on currently available global policies that address the combination of healthy and sustainable diets and that aim to reduce consumption of animal-based foods, increase plant-based foods consumption, and reduce overconsumption or prevent overweight and obesity. The study found that very few policies combined both health and sustainability aspects of the food system except for those that provide information such as food-based dietary guidelines. Very few policies explicitly recommend reducing the consumption of animal foods. Most policies focus on public health and are directed at individual consumers providing advice to eat lower calorie foods, less processed foods and more fruits and vegetables. The finding suggest that Governments are relunctant to address meat and dairy consumption due to the negative economic implications. The study concludes that policies targeting individual behaviour will not be enough. Food environments need to change. ‘Strong support from politicians, public health authorities, and civil society is necessary for the implementation of effective food policies aiming at a healthier diet in a sustainable food environment’

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