Despite six years at medical school and well-developed cynicism when it comes
to food fadism, I admit I have bought into the superfoods phenomenon. In
addition to oily fish, I make sure I consume pomegranates, blueberries, kiwi
fruit, broccoli and brazil nuts regularly, even though I know that if it’s
not deep fried, coated in lard or caked with sugar, pretty much any
vegetable or fruit is good for you.
The specific marketing of goods as ”superfoods’’ is prohibited in the
European Union unless backed by scientific evidence. But research into the
benefits of many of these foods is, at best, provisional and based on small
preliminary studies that are open to multiple factors that can skew the
results.
In 2011, the NHS looked at these wonder foods and examined some of the claims
made for them. The findings were critical not just of the media’s
sensationalist reporting of the research, but also of the research itself.
They pointed out that the plethora of contradictory reports was such that
”often the same food is declared healthy one day and harmful the next’’.
(I’m still not sure if red wine and chocolate will save my life or kill me.)
There are many reasons why the research is often not as promising as it first
appears. One problem is confounding factors – this is when a factor other
than the one being investigated is responsible for the effects. A study of
alcohol consumption by Dutch men over 40 years, for example, found that
those who consumed an average of half a glass of wine a day lived five years
longer than those who didn’t. While the researchers took into account some
factors that might explain the disparity – such as smoking and weight – they
didn’t consider exercise. So there’s no way of knowing if the results were
down to the wine, or because the men who drank half a glass a day took more
exercise, or a combination of both.
Another problem is that often the researchers use surrogate end points, in
which the studies measure outcomes not directly related to people’s health.
One widely reported study that claimed that eating oily fish could improve
people’s memory compared changes in the blood flow to the brain in those who
ate the fish and those who did not – but it didn’t actually test memory,
which is the only way to say for sure that oily fish bestows that benefit.
Also, many reported studies are performed on animals or in vitro in
laboratories, making any findings impossible to extrapolate in a meaningful
way to the average person.
And there are other factors that can affect the reliability of research, such
as bias and conflicts of interest over who funds the study and what they
want from it. In short, few claims that a food has a miracle benefit live up
to scrutiny.
So my advice is this: ensure you have a balanced, sensible diet and don’t eat
too much sugar, salt or fat. That’s pretty much it. While it might be
tempting to believe in miracles, the reality is more prosaic.
The good news for me is that for the first time in years, I can now look
forward to a decent Sunday brunch.
Mental health staff need help to calm violent patients
Ministers are planning to ban face-down restraint of mental health patients
after a Freedom of Information request showed that some mental health trusts
were using the procedure two or three times a day. In response to the
figures, health minister Norman Lamb said he was ”interested’’ in stopping
the procedure. Mind, the mental health charity, has also raised concerns.
Paul Farmer, Mind’s chief executive, says that physical restraint ”can be
humiliating, dangerous and even life-threatening’’.
Of course there are times when acutely disturbed or aggressive patients do
require restraint. But this can often be avoided when staff are trained in
”de-escalation’’ techniques – where physical confrontation is avoided
through methods such as monitoring body language and taking pre-emptive
measures. At present, control and restraint training is mandatory for those
working in mental health – but not training in de-escalation skills. This
must change. If we are going to tackle the high rates of restraint on mental
health wards, we should offer staff an alternative.
Don’t push Kate too hard
Are we going to see the “Kate effect” in childbirth, too? The Palace has let
it be known that the Duchess of Cambridge is planning on a natural birth and
this has been hailed by campaigners as welcome riposte to women dubbed ”too
posh to push’’ who opt for elective caesareans.
But spare a thought for the Duchess Most women are encouraged to make a birth
plan – an outline of what they would like to happen during labour. But how
many have their birth plan released to the media?
As if pregnancy and childbirth weren’t stressful enough, imagine having every
decision analysed, debated and critiqued.
The truth is that birth plans are more a wish list than a prescription, an
idealised vision of what often turns out to be a messy, chaotic and rapidly
changing event.
Kate, do whatever you want, it’s your pregnancy and it’s your baby. It’s
important not to lose sight of this.
Max Pemberton’s latest book, ‘The Doctor Will See You Now’, is published by
Hodder. To order a copy, call 0844 871 1515 or visit books.telegraph.co.uk