Ask the doctor - food and health

My liver needs some TLC

I’m a recovering heavy drinker and have mild cirrhosis. Can anything help?

The liver has a remarkable ability to regenerate, and one of the most effective herbal treatments – even for people with cirrhosis – is milk thistle. It’s thought to work by maintaining levels of an important liver enzyme, and by boosting production of the proteins needed for liver cells to regenerate after damage. However, it’s a mild laxative in some people, due to increased production of bile. Globe artichoke also has beneficial effects on the liver and both herbs can be taken together. Although, if you have gallstones, seek advice first.

Dr Sarah Brewer, Prima 

What's so good about manuka honey?

I keep hearing about the medicinal properties of manuka honey. What can it be used for?

Honey has been used for centuries to promote the healing of wounds and leg ulcers, by being applied externally. Its high concentration of natural sugars absorbs fluid and creates an environment in which bacteria cannot thrive. Many honeys release low levels of antiseptics, such as hydrogen peroxide, that can inhibit the growth of skin bacteria. Some honeys, such as manuka, also contain powerful antibiotics. These have been shown to kill more than 250 different types of bacteria responsible for clinical infections, including antibiotic-resistant superbugs, such as MRSA. For best effect, select a honey with a unique manuka factor level of at least UMF10. This shows it is as effective at killing bacteria as a ten-per-cent phenol solution. Cheaper honeys may not be as effective. Medicinal honeys are also available - try Medihoney Antibacterial Wound Gel (£5.99 for 25g from health-food shops). For Helicobacter pylori (a bacterial infection of the stomach and duodenum), manuka honey can be eaten - the dose is four teaspoons, four times a day on an empty stomach for eight weeks. The only drawbacks are the 80 calories per dose and that it's not suitable for diabetics. Manuka honey may also help boost immunity against colds and infections generally, but there's not much research into this.
Dr Sarah Brewer, Prima

I need a bran alternative

I suffer from diverticular disease and have to take a fibre supplement. Bran seems to have stopped working for me. What else do you suggest?

Diverticular disease occurs when small pockets form in the large intestines, usually due to straining. Fibre stimulates the bowels and reduces constipation. Research suggests that bowel bacteria quickly adapt to the types of fibre you eat. After a few weeks of eating bran, for example, they release more of the enzymes needed to break it down, so regularly vary the types of fibre you eat. Try rotating bran with ispaghula (also known as psyllium) and sterculia every month or so. Eat as wide a range of fibre-rich foods as possible from wholegrain sources and fruit and veg, but increase intakes slowly so you don't develop wind and bloating from an initial fibre overload. Drink plenty of fluids - these are needed to help fibre swell and work effectively. Probiotic supplements, containing bowel-friendly bacteria, help to maintain optimum bowel function, while aloe vera juice has a useful cleansing and soothing action on the intestines.
Dr Sarah Brewer, Prima

 

What's so good about manuka honey?

I keep hearing about the medicinal properties of manuka honey. What can it be used for?

Honey has been used for centuries to promote the healing of wounds and leg ulcers, by being applied externally. Its high concentration of natural sugars absorbs fluid and creates an environment in which bacteria cannot thrive. Many honeys release low levels of antiseptics, such as hydrogen peroxide, that can inhibit the growth of skin bacteria. Some honeys, such as manuka, also contain powerful antibiotics. These have been shown to kill more than 250 different types of bacteria responsible for clinical infections, including antibiotic-resistant superbugs, such as MRSA. For best effect, select a honey with a unique manuka factor level of at least UMF10. This shows it is as effective at killing bacteria as a ten-per-cent phenol solution. Cheaper honeys may not be as effective. Medicinal honeys are also available - try Medihoney Antibacterial Wound Gel (£5.99 for 25g from health-food shops). For Helicobacter pylori (a bacterial infection of the stomach and duodenum), manuka honey can be eaten - the dose is four teaspoons, four times a day on an empty stomach for eight weeks. The only drawbacks are the 80 calories per dose and that it's not suitable for diabetics. Manuka honey may also help boost immunity against colds and infections generally, but there's not much research into this.
Dr Sarah Brewer, Prima

 

The truth about health foods

I know omega 3s are supposed to be good for my heart health, but I get very confused about all the foods labelled as being ‘fortified’ with omega 3 or having it ‘added’. Are these worth investing in, or should I take supplements instead?

You’re right to say that omega-3 fatty acids – of which oily fish and cod liver oils are the best source – are good for your heart, as well as your brain. You need around 450mg a day, if you haven’t had a heart attack, or 1000mg a day if you have. One portion of oily fish contains about 3000mg of omega 3s and should give you as much as you need for a week. Otherwise, a fish oil supplement of 500mg a day (or 1000mg a day if you’ve had a heart attack) is appropriate. Fortified products, such as eggs, milk, bread and ‘heart health’ drinks contain plant-based omega 3s – they’re useful if you’re vegetarian, but they can’t be used as efficiently by your body. What’s more, these products contain far less omega 3 than oily fish – you need five fortified eggs or a litre of fortified milk each day to get the right amount.
Dr Sarah Jarvis, Good Housekeeping
 

Soya and cancer link?

I’m a vegetarian, and I eat a lot of soya products. Now I’ve been told there’s a link between eating soya and cancer of the womb lining. Is this true?

Yes - but I'm delighted to say that it's a positive connection because eating soya protects you against cancer of the womb lining, also called endometrial cancer. Soya is a good source of protein and calcium, as well as being low in fat. This means it's also helpful if you're trying to maintain your weight and it's good for your heart. It's an all-round healthy option.
Dr Sarah Jarvis, Good Housekeeping
 

Women and alcohol

I’ve heard the number of units of alcohol considered safe for women has increased from 14 to 21 a week. Does this mean it’s fine to drink slightly more than before?

I'm afraid the answer is anything but! The weekly recommended limit for women is still 14 units. The confusion has arisen because there's now also a recommended daily limit of two to three units as some people were assuming they could drink all 14 weekly units at one sitting. Binge drinking - more than seven units (or a bottle of wine) a day - increases all sorts of risks, including those to your heart and liver. If you're drinking up to three units a day, though, you still need to have a couple of alcohol-free days in the week, too, in order to let your body recover. Dr Sarah Jarvis, Good Housekeeping
 

Do I need to worry about aluminium cooking pans?

I’ve always used aluminium cooking pans and was horrified to read that aluminium can cause Alzheimer’s disease. I was especially worried because I make a lot of jam, and apparently this produces a particularly high aluminium content. Do I need to worry?

I'm pleased to be able to reassure you that, while the possibility of a link between aluminium and Alzheimer's disease was first raised as long ago as 1965, there is no evidence to suggest that using aluminium in your everyday life is linked with developing this dreadful disease. You're right to say, however, that cooking very acidic ingredients such as fruits can increase the aluminium content in these foods - but again, no link with Alzheimer's has been found. The Alzheimer's Society has an excellent overview on the issue on its website, at www.alzheimers.org.uk, which may help you decide whether you want to minimise your exposure to aluminium. If you decide you do, then switch to coated, nonstick or hard anodised aluminium pans, which add virtually no aluminium to food.
Dr Sarah Jarvis, Good Housekeeping
 

Strawberries and allergy
 
Last summer I developed a rash, which my GP said was a result of eating strawberries. Of course, I won’t be eating them again (even though I love them), but am I likely to come up against the same problem with any other food?

It sounds as if you had a problem called urticaria, also known as hives. There are two main kinds - acute urticaria, which is often triggered by an allergy (and which lasts from a few hours to six weeks), and chronic urticaria, which lasts longer. Four in five people never find out the cause, but among the most common culprits are strawberries, shellfish, eggs and food colouring, a reaction to medicines such as aspirin and NSAIDs (non-steroidal anti-inflammatory drugs) or an allergy to materials like nickel, latex or perfume. Although it's rare, urticaria can occasionally be associated with painful swelling around your mouth and throat. If this happens, get medical help immediately.
Dr Sarah Jarvis, Good Housekeeping
 

Are vitamins bad for you?

I'm 45 and I've been taking antioxidant tablets (A, C and betacarotene) every day for several months for their anti-ageing benefits. But now I've just heard that taking these vitamin supplements might shorten my life. Is this true?

It is true that a recently published study (which looked at 47 different clinical trials) suggested that taking certain vitamin supplements – the type also known as antioxidants – may shorten people's lifespan.
The study looked at the benefits of vitamins A, E and C, alongside betacarotene and selenium. The researchers found that the risk of death was unchanged among selenium and vitamin C users but statistically there was a significant increase in risk for the other three supplements.

 If you are worried about these findings, there is an easy alternative to popping vitamin pills. Eating a wide range of healthy foods will ensure that your body gets all the nutrients it needs. In fact, most nutritionists would actually argue that taking supplements is no substitute for a balanced diet anyway. Natural antioxidants can be found in many foods, including brightly coloured fruit and vegetables (oranges, berries, peppers, carrots etc), olive oil, avocados, muesli, nuts, leafy green vegetables, wholemeal bread, cereals and egg yolks.
Dr Louise Selby, SHE
 

Could I be a binge drinker?

What exactly is ‘binge drinking’? I thought you needed to be really drunk to be considered ‘on a binge’. I think of myself as a social drinker, but I’m worried I might be overdoing it.

 A binge is the level at which your body can run into problems from an episode of drinking – such as low blood sugar, which can cause loss of consciousness, or even stroke. For a woman, more than six units (two thirds of a bottle of wine) in one day is ‘binge drinking’ – for a man, the figure is eight units. If you drink regularly, your body gets used to alcohol, and your intake can creep up to dangerous levels without you ever being really ‘drunk’. That’s why doctors recommend that, as well as keeping to below 14 units a week, women don’t exceed two to three units in a day.
Dr Sarah Jarvis, Good Housekeeping

 
Should I stop eating soya?

As a vegetarian, I’ve eaten soya products once or twice a week as part of my diet for many years. Now I’ve heard that they can cause all sorts of problems for babies. Is there a similar risk for adults?

There’s been some anxiety about babies fed exclusively on soya milk because of its levels of a natural, oestrogen-like hormone. However, there is a huge difference between eating nothing but soya and having a few portions a week – and a huge difference between babies and adults! In fact, there’s good evidence that eating regular soya protein can help to reduce your levels of ‘bad’ cholesterol. It may also help to relieve the symptoms of the menopause. All in all, I would actively encourage you to carry on eating soya products as part of a balanced diet.
Dr Sarah Jarvis, Good Housekeeping

 
Is soya good for you?

My mother is taking medication for heart disease and high cholesterol and I don’t want to follow suit. I’ve read that protein can be good for your heart, but a friend said soya milk can give you cancer.

There’s evidence that soya can help lower bad cholesterol in the blood, which will help protect against heart disease. A recent study suggests that taking soya supplements may help middle-aged women reduce the amount of fat they put on around their tummy, which is good news as excess abdominal fat has been linked with an increased risk of cardiovascular disease and diabetes. If high cholesterol and heart disease run in your family, it’s important to lead a healthy lifestyle – and eating soya as part of a balanced diet can help. Research suggests that far from causing cancer, soya can protect against some cancers and ease some symptoms of the menopause. Eat two servings, about 25g (1oz) of soya protein, a day. A serving is a cup of soya milk or half a cup of tofu, tempeh or edamame beans.
Dr Louise Selby, SHE

 

I need recipe ideas

I follow a gluten-free diet as I was recently diagnosed with Coeliac disease. Where can I find suitable recipes?

Coeliac disease is due to sensitivity to a protein – gluten – found in several cereals, including wheat, rye and barley. Some people are also sensitive to the small amount of gluten present in oats. Try reading Gluten-Free, Wheat-Free & Dairy-Free Recipes by Grace Cheetham (Duncan Baird, £14.99). This handy book contains over 100 recipes suitable for all the family – which is important as it isn’t always practical to prepare separate meals for yourself. Find information on gluten-free living from Coeliac UK (www.coeliac.co.uk or 0870 444 8804).
Dr Sarah Brewer, Prima

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The answers to specific problems may not apply to everyone and are not substitutes for professional medical advice. If you're worried, see your GP. For more information, visit www.netdoctor.co.uk