You can’t walk down a supermarket isle these days without noticing the ‘free from’ ranges and many people assume that these are the healthier options. Often, however, products that are free from something, such as gluten or fat, have a greater proportion of salt, sugar or other flavour enhancers to make up for the taste or texture that is lost, so you could be risking your health as well as your taste buds.1
A paper in the BMJ last year reported that a gluten free diet, when you aren’t medically required to follow one could, because of the nutrients you lack, increase your risk of heart disease over a period of time.2 Being gluten free is only really required if you have coeliac disease, an autoimmune condition where the gluten in wheat damages your gut lining as your body’s immune system attacks itself. It’s worth noting though that this condition only effects around 1% of the population, and the majority of these people have yet to be diagnosed.3 However it is becoming more common for people to reduce gluten from their diet in an attempt to lose weight or stop their stomach swelling after eating bread, for example.4 Some people do suffer from wheat intolerance, but there is speculation that the symptoms could be caused by something in the wheat other than the gluten. So perhaps restaurants, supermarkets and indeed ourselves are acting too swiftly by offering gluten free products or including them in their diets.2/3 Despite these facts, the sale of gluten free products are up by 15% since 2013 with 15% of UK households indicating they avoid wheat and gluten.3
Before cutting anything out of your diet, especially from a self or internet diagnosis, it could be a good idea to speak to a nutritionist, dietitian or your doctor who can ensure that any changes you make are healthy, balanced and will not cause you any harm. The BDA (British Dietetic Association) and NHS Choices give advice and produce factsheets to help you, your team or your patients with the right advice.4
As dental professionals, you are in a position to talk to your patients about their overall health and wellbeing, as well as their oral health. So now could be good time of year for you to be aware of the latest diet tends, scientific research and advice, not only for yourself but when discussing their eating and drinking habits with your patients, even more so if a change in their diet has a detrimental effect on their oral health.5
An article in Oral health magazine in May this year suggested that you should make patients aware of the fact that increasing exercise in duration or intensity, while of course is often good for you, high-intensity or prolonged exercise can be damaging to their oral health, as it lowers the production of saliva, increasing the production of bacteria. Alongside other issues such as oxidative damage and the increased use of sugary sports drinks.6 It has been suggested that last year nearly half of the British population tried to lose weight. If correct, that is likely to include a large proportion of your colleagues and patients. Great care should however be given when starting a new diet, as a poor diet excluding crucial food groups can lead to an impaired immune system and increased susceptibility to disease, amongst other factors.12
Food allergies vs intolerances
As with autoimmune conditions, a food allergy usually requires you to cut a particular food out of your diet, but compare this to a food intolerance which is the body’s inability to digest a particular food source properly. Only 6-8% of the child population and 4% of the teenager and adult population are actually allergic to certain foods, the main culprits being (for both groups) peanuts and tree nuts, eggs, milk and (except in children) shellfish.7
Many people now seem to be more aware of the implications of allergies and a few years ago all restaurants and food outlets had to begin to comply with the EU Food Information for Consumers Regulation. This called for allergen information to be much clearer on packaging. It will be interesting to see how long it is before the dental profession has to provide their patients with potential allergen information for the materials and substances used in practice.8
There are many different celebrity endorsed diets that claim the ‘latest research’ supports them, and many suggest cutting out certain food groups as a way to lose weight. It’s worth noting however before removing food groups from your diet that while both fat and carbohydrate are stored as fat if not used, they are equally important to our good general health9, 10 and neither shouldn’t be cut out of your diet entirely. Carbohydrates for example are required for energy (including meeting your daily basal metabolic rate requirements) and many fruit and vegetables contain essential vitamins such as A, D and K and plus E, are fat soluble, so our bodies can only utilise them if we eat a sufficient amount of fat. You can eat healthy unprocessed fats and carbohydrates such as nuts, olives, avocado and whole wheat that will keep you fuller for longer as they are low on the Glycaemic index (GI).9,10
Crash dieting is sometimes used to bring about quick and dramatic results and while it may have an impact on weight loss in the short term, in the long term it has been proven to be an unhealthy option. In fact the NHS warn us that crash dieting could actually have the opposite effect, slowing down our metabolism while depriving our bodies of vital nutrients and vitamins, as well as making us feel unwell. Having a structured diet of healthy eating may give you greater focus, allowing you to monitor your food and drink intake and, combined with a programme of moderate, regular exercise, could be more sustainable and heathier in the long run.11
An article in Dental Health magazine, also in May this year, evaluated possible risks to oral health of ‘fad diets’. Focusing on two of the most well-known, they found that the ‘Atkins’ diet, while seeming to help people lose weight, showed a side effect of xerostomia (causing recurrent oral infections) as well as a lack of energy from the shortage of carbohydrates. It also found that the ‘juicing’ diet, while providing a good proportion of healthy fruits and vegetables, often caused mastication issues and showed an increased risk of caries caused by the minimal chowing required and the high amount of sugars consumed.12
There have been a number of documentaries on the TV in recent years weighing up the difference between ‘superfoods’ and the nutritional similarities with more ‘old-fashioned’ ingredients. The New Scientist published an article in 2016 to dispel some of the myths about superfoods being nutritional magical cures. They noted that there is ‘hardly any published research in peer-reviewed scientific journals’ to support the claims made. They also reported that 61% of us admit to buying superfoods and 30% agreed with the statement that ‘superfoods are scientifically proven to have health benefits’; so is it just good marketing or a recent fad? As far back as 2007 the EU banned the use of the word ‘superfood’ on packaging unless it actually referred to a ‘specific claim based on convincing research’, which in itself is fairly subjective. The article reviewed the main culprits and any associated studies. In summary they found that goji berries were no better than strawberries for vitamin C, kale was no better than Brussel sprouts for glucosinolates, quinoa had no compelling health benefit over rice, blueberries were as good as any other berry, all wheatgrass claims were nonsense, coconut water was no better than water, rocket and lettuce are as good as beetroot for nitrates and salmon gives you as much omega-3 as chia seeds. On the plus side, fermented vegetables might be good for a heathy gut - being a natural probiotic.13
In May this year the New Scientist also reported on GM foods being healthier alternatives, calling them the new type of ‘superfood’. They haven’t been popular with consumers over the decades they have been around, as they are designed to provide an increased profit rather than increased health benefits. However, the next generation of GM foods are reported to have added health or flavour benefits, such as rapeseed oil that is rich in omega-3 and higher fibre white bread. 14
As with everything in life, balance and moderation is key. Having a balanced diet of all the food groups (unless medically required to exclude them) including fresh fruits and vegetables, carbohydrates for energy, protein for muscle growth and fat for storage all supporting our body’s essential daily functions and keep us fit and healthy. A good diet with no more than the occasional slip up, alongside regular exercise could be enough to make you feel fit and healthy and perhaps shed some unwanted pounds before summer.
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