Thursday, November 19, 2009

Alcohol and healthy diets - what's the story?

We've been harping on about the so-called Mediterranean diet for some time. Much of the recent research on this has come from Spain, where researchers seem to have decided to define the southern European diet as an intrinsically healthy one ie one involving vegetables, nuts, fish and minimal animal fat.. According to this story, the Mediterranean countries only eat small amounts of meat and drink in great moderation. I find this hard to believe.

So today's report from Spain is gratifying. It does not exactly say that the Spanish are heavy drinkers but still quite healthy - but that is the implication. For the report says that the more a Spanish man drinks, the healthier his heart. As an aside, the researchers add that Spanish men  drink quite a lot and indeed the country's vineyards and granaries make it the world's third largest producer of alcohol.

There will be a lot of criticism of the findings. The definition of health is quite narrow - heart disease. What about the other problems alcohol may cause, including liver disease and stroke?

I think there's a more interesting question. Is the finding unique to Spain and similar countries? Is there something about Spain that means drinking is linked to better health. Now the researchers tried their best to disentangle drink from other factors but I wonder if they succeeded.

For instance, in a country that takes its alcohol with its meals, good drinking may be linked to good eating. And whereas in the UK, a good meal probably involves steak, chips and a sugary, fat-laden dessert, in Spain it may involve a menu that's a great deal healthier. In northern Europe also, heavy drinking is associated with the ubiquitous beer belly as drinkers also tend to pile on fat. It seems unbelievable that the obesity that many heavy drinkers suffer from does not also lead to heart disease.

So this is yet another plea for some research on the real diets of the southern European countries. These are diets rich in wine, olive oil and yes also vegetables, fruit, nuts and quite a lot of fish. Let's not pretend the Mediterran lifestyle is entirely healthy. But it may offer some clues as to how to enjoy alcohol better.

Thursday, November 5, 2009

Folic acid and pregnancy

folic acid and pregnancyAll women who are considering having a baby are encouraged to take folic acid. Some countries include the vitamin with their flour - to ensure all women get it.

The reason is that it has a dramatic impact in preventing the disability spina bifida and a range of conditions called neural tube defects.

So today's report linking it to the development of asthma in children is potentially alarming - as it might deter women from taking this important vitamin.

The Australian researchers stress their findings only apply to the taking of the vitamin in late pregnancy. To prevent spina bifida, it needs to be taken before conception or in early pregnancy.

However it does raise questions about adding folic acid to flour - as it might lead to women being over-exposed in late pregnancy.

The Englemed report allows you to link through to the original article.

We've seen some criticism of the research which says the following:
it was conducted by postal survey;
only 76 per cent of women took part.

If that was so, it would make it dangerously flawed as the increase in asthma risk is only about 23 per cent.

However those criticisms only apply to the final stage of the research, when the children were aged five. And no link with asthma was established at this age.

Most of the research was, in fact, done by research nurses who conducted interviews with the women. When the children were aged three, the women were interviewed again and this is the age at which the link with asthma was found. At this point 88 per cent of the original sample were taking part, just four percentage points fewer than the 92 per cent who successfully gave birth.

The numbers involved - just over 500 families - are not enormous so the findings have to be treated with caution. It does not seem they can be dismissed out of hand.

Asthma is quite a common condition in young children and a small increase could affect quite a few children. Ironically, folic acid fortification of flour was introduced in Australia after this research was done.

It will be interesting to see what other analysts make of this and what further research is done. For, yet again, it is thought-provoking research that raises some tricky issues.