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LIST OF FOOD AND DISEASE RISK

Dietary Fats & Heart Disease  

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Saturated fats have been implicated as one of the main dietary contributors to heart disease. These fats do not block our arteries directly but can raise the concentration of blood cholesterol, which can form deposits inside arteries called ‘plaques’. The plaques can then become unstable and rupture, causing blood clot formation and a heart attack or stroke. For this reason, dietary guidelines limit the number of saturated fats we should eat. However, this recommendation has been challenged because of a possible lack of evidence for a direct relationship between saturated fats and heart disease mortality, and the complexity of the relationship between saturated fats and blood cholesterol. When we eat less saturated fats, the effect on blood cholesterol and other risk factors often depend on what the fats are replaced with. This can be another type of fat (polyunsaturated or monounsaturated fat) or carbohydrate, which will lower blood cholesterol and heart disease risk, with greater benefits from unsaturated fats. Not all foods that contain saturated fats have the same effect on blood cholesterol, including dairy foods. Compared to butter, the saturated fats in cheese are absorbed in the gut to a lesser extent, which reduces the relative potential of cheese to raise blood cholesterol.

Food Allergies & Intolerances 

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Food allergy and intolerance are adverse reactions to foods, which are dependent on the person rather than the food. Food allergies involve an immune response to food and can be severe (anaphylaxis) and sometimes fatal. Common foods causing allergy include cows’ milk, hens’ eggs, fish, shellfish, nuts, peanuts, wheat, and soy. After consuming the food, symptoms can develop rapidly or be delayed, and include vomiting, diarrhea, rashes, breathing problems, faintness and loss of consciousness. Coeliac disease is a specialized food allergy involving an immune response to gluten (found in wheat, barley, and rye). The body’s response damages the small intestine, causing gastrointestinal symptoms and malabsorption of nutrients. Food intolerances are disorders of digestion because of an inability to break down or take up the food in the normal way. They occur as a response to common foods and are not life-threatening. Lactose intolerance results from the reduced ability to break down milk sugar. Commonly screened for at birth, phenylketonuria is the result of an inability to break down the amino acid phenylalanine  (found in many dietary protein sources). Management of adverse reactions to food usually requires a physician/dietitian-guided reduction or avoidance of the food. 


Salt & Blood Pressure  

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Once considered more valuable than gold, salt has become a ubiquitous food ingredient, much maligned by the health establishment yet eaten daily by millions of people across the world. Common salt (sodium chloride) is obtained by evaporating brine, either in pressure vessels or in salt beds – a traditional method mostly seen in hot, dry countries. In ancient times, salt was highly valued and even used as a form of currency. Now it is produced on industrial levels, mainly in China and the US. Salt is used not just to flavor foods but also to preserve perishable goods such as meat, fish, and vegetables. This was one of the earliest food safety methods and is still used widely today. Excess salt intake has been associated with stomach cancer and raised blood pressure, a risk factor for heart disease and stroke. Controlled trials suggest that a fall in salt intake to 5–6 grams daily (typical intakes are around 8 grams) significantly lowers systolic blood pressure. However, lower sodium intakes do not consistently translate into reduced mortality or cardiovascular problems. Black, Asian and hypertensive people seem to benefit more from salt reduction than white normotensive people, in terms of blood pressure. It may be that some people are genetically responsive to salt reduction, while others are not.

Sugars & Sugar Substitutes 

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Sweet foods and drinks are perceived as pleasant and highly desirable by the majority of people. In evolutionary terms, this preference was a survival benefit,  as it enabled carbohydrate-rich foods, such as fruit, to be identified and consumed, providing a metabolic substrate for the brain. Unfortunately, the desirability of sweet foods can lead to overconsumption of sugars (glucose, fructose, sucrose, maltose) in food and drinks, which in turn can increase the risk of tooth decay, unintentional overconsumption of energy and weight gain. While carbohydrate intake is an essential component of the diet, there is no dietary requirement for sugars, as all of the glucose needed by the brain and other tissues can come from starch. Reducing the sucrose or high-fructose corn syrup content of the diet is challenging if sweet foods and drinks, or products such as cakes and biscuits (in which sucrose has a functional role), are consumed, and so sugar substitutes have to be considered. The replacement of sweetness can be achieved with non-nutritive sweeteners, and reports have shown the safety of these compounds. Replacing the bulk function has not yet been achieved satisfactorily. 
  

Alcohol      

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Whether or not to drink alcohol, especially for ‘health purposes’, needs careful balancing of the potential benefits with the potential harms. It appears that the difference in health effects lies largely in the dose and patterns of drinking – how much you drink matters more than what you drink. Drinking alcohol in moderation (half a standard glass of wine a day) can generally be beneficial for long-term heart health. On the other hand, when it comes to cancer risk, generally the more alcohol consumed, the higher the long-term risk (particularly breast cancer in women). Whether it’s a sip of spirits, wine, liquor or beer, alcohol’s active ingredient is the same: ethanol. Alcohol contains other substances, such as polyphenols and congeners, but it’s the dose of ethanol that plays the most important role in health effects. The bulk of ethanol in the body is broken down in the liver by an enzyme called ‘alcohol dehydrogenase’. Excessive alcohol intake can overwhelm the liver and inflict permanent and serious damage, notably liver cirrhosis (scarring) and cancer. This is due in part, to a build-up of toxic waste products such as acetaldehyde,  a contributing cause of hangover following alcohol consumption.

Red & Processed Meat  

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Red meat includes beef, lamb,  pork, and venison, and is usually a good source of important nutrients such as high-quality protein, iron, zinc and a number of B vitamins.  It is, however, very variable, notably in fat content, which will depend on, for example, the source of the meat, the particular cut and the age of the animal. Processed meat is an even more variable commodity as it is meat that has been transformed through a wide range of processes, and includes sausages, ham, bacon, and corned beef. Most processed meat contains beef or pork but can include other meats.  There has been much publicity suggesting that consumption of red and processed meat can increase the risk of coronary heart disease,  type 2 diabetes, and cancer of the large intestine and rectum. The hard evidence is clear: the risk of these diseases from the consumption of processed meat is substantially greater than from red meat. For example, the risk of intestinal cancer from processed meat is about twice that from red meat. It is, therefore, important to maintain a low consumption of processed meat. 

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