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Sunday, 29 June 2014

How fruit juice has turned into junk food


Modern methods mean even 'not from concentrate' drinks can be stored for a year

. Juice was popularised after Second World War as cheap health supplement
. But mass production methods take away much of what makes it healthy
. Juices give many vitamins and minerals - but no fibre and a lot of sugar



Mass production: Orange juice has changed over the years
Mass production: Orange juice has changed over the years

There was a time when  it was marketed as the ultimate health drink, a glass of sunshine packed with vitamins and energy.

Generations were raised to believe orange juice fights off colds, boosts the immune system, tones the skin and protects against cancer. Yet in the topsy-turvy world of health advice, what’s good for you one day, turns out to be bad for you the next.

This week an influential body of Government scientists blamed Britain’s love affair with orange juice and other sugary drinks for fuelling a crisis of obesity and ill health.

The warning follows calls to remove fruit juice as one of the recommended ‘five a day’ portions of fruit or vegetables, and for parents to ban it from the meal table.

So if fruit juice turns out to be such a devil in disguise, why have we all been led to believe it was so healthy for so long?

The idea goes back to the 1920s, when American nutritionist Elmer McCollum blamed a condition called acidosis, an excess of acid in the blood, on diets rich in bread and meat.  

His bizarre solution was lots of lettuce and — paradoxically — acidic citrus fruits.

At the time orange juice was not hugely popular, but fruit growers leapt on the acidosis panic and sales rose.

Juice got an even bigger boost thanks to World War II when the U.S. Government wanted a new way to get a product rich in  vitamin C to troops overseas. It poured money into research.

In 1947 — just in time for the post-war consumer boom — scientists invented a way to remove water from juice and freeze the concentrate into a palatable product.

The blocks of this concentrate could be sold to the new fridge-owning U.S. consumers or stored by manufacturers for months at a time, and sales exploded.


Meanwhile in the UK, war babies had been given rose hip, blackcurrant and concentrated orange juice by the Government as a cheap nutrition supplement in the 1940s. This continued into the 1950s, seeding the idea in a generation of baby boomers that juice is healthy.

By the 1980s orange juice was being marketed not just as a health drink, but also as the key to a stylish, modern life  — a status it enjoys today.

But while the juice in the supermarket is often sold as ‘natural’ or ‘fresh’, it is usually anything but.

Concentrating juice doesn’t just remove water, it also removes the flavour. After it has been reconstituted, manufacturers add ‘flavour packs’ — cocktails of chemicals which restore ‘natural’ oranginess.

You may think ‘not from concentrate’ juice means a more authentic product. You’d be wrong.

Juice made that way is heated and stored in air-free tanks for up to a year. Again, the process strips the juice of flavour, which has to be added afterwards. But the flavour packs contain orange essence and orange oil so don’t have to appear separately on the ingredients list.


Manufacturers say they help give their product a consistent flavour. They also explain why juice in cartons doesn’t taste like fresh juice.

‘Naturalness’ isn’t the only dubious claim made for juice. For decades, health gurus, and some doctors, have claimed the vitamin C in juice fights common colds.

But while the immune system needs vitamin C, there’s little evidence that regularly taking the stuff prevents colds.

Research shows that the best that can be claimed for vitamin C is that it might shorten colds by a day or two. Given that most of us get two colds a year, worrying about vitamin C every day seems an over-reaction.

There’s another myth about vitamin C, that citrus fruits are the best source. Yet plenty of vegetables, including broccoli, potatoes, kale and peppers, have doses comparable to those in fruit.
Hidden sugar in food

What you will get from juice is sugar. Lots and lots of it.

The new advice this week from the Scientific Advisory Committee on Nutrition is that men should have a maximum of 35g of sugar a day — seven to eight teaspoons — while women should not exceed 25g — five to six teaspoons. A single 330ml glass of orange juice has eight teaspoons.

Helen Bond, spokeswoman for the British Dietetic Association, says: ‘People have lost sight of how much sugar is in food and portion sizes have got bigger. A 150ml glass provides one of your five a day and anything more than that doesn’t count. But measure people’s glasses and they are often 250ml.

‘Juice provides a lot of vitamins and minerals, but unlike fresh fruit you don’t get the healthy fibre.’

Doctors say the huge volume of sugar in our diet is contributing to the obesity epidemic, causing heart disease, cancer and diabetes.

There is growing concern that not all sugars are the same — and that fructose, the type found in fruit, may be more harmful than table sugar. American hormone scientist Robert Lustig argues that it does more damage to the liver and cells than glucose or sucrose. He says excessive fructose intake is key to rising obesity and diabetes levels.

There is even evidence that fructose may contribute to higher uric acid levels in the blood — and increase the risk of gout, an excruciatingly painful condition that is becoming ever more common.

Orange juice can also rot your teeth. Around half of five-year-olds have signs of damage to their tooth enamel, and too much fruit juice is thought to be a key cause.

There have been signs this year, however, that the tide is turning.

Schools have been leading the way. In January, Elizabeth Chaplin, the head of Valence Primary School in Dagenham, London, told parents that pupils would not be allowed juice in their lunch boxes. Instead, they had to drink water.

Around that time, Professor Susan Jebb, the Government’s obesity tsar, said juice shouldn’t count towards your five a day.

‘Fruit juice is absorbed very fast,’ she said, ‘so by the time it gets to your stomach, your body doesn’t know whether it’s Coca-Cola or orange juice, frankly. I have to say it is a relatively easy thing to give up. If you are going to drink it, you should dilute it.’

Weaning Britain off fruit juice may be difficult. Market research firm Mintel says 83 per cent of us drink fruit juice or a smoothie at least once a week, while 76 per cent believe fruit juice to be healthy.

But if you need motivation when you sit down to breakfast, remember this: there is more sugar in a 250ml glass of fruit juice than in a large bowl of Frosties with milk.

And that’s food for thought.

Healthwise

http://www.dailymail.co.uk/health/article-2671635/How-fruit-juice-turned-junk-food-Modern-methods-mean-not-concentrate-drinks-stored-year.html

Britain becomes statins capital of Europe according to study

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'Indolent' lifestyles turn Britain into the statins capital of Europe

'Indolent' lifestyles turn Britain into the statins capital of Europe
The pills are now the most commonly prescribed medication in Britain Photo: Alamy
Britain has become the “statins capital” of Europe - and has the second highest prescribing levels in the Western world for the drugs to protect against strokes and heart attacks, an international study has found.
Last night, the former heart tsar said doctors in this country were handing out too many pills to the “worried well” and those living “indolent” lifestyles who were not prepared to take steps to improve their own health.
Increasing numbers of patients in this country have been put on statins in the last decade, amid spiralling obesity and more aggressive prescribing of the medications by family doctors, whose pay is linked to take-up of the pills among their patients.
The study by the Organisation for Economic Co-operation and Development (OECD), which examined 23 industrialised nations, found that this country has the highest levels of statins prescribing in Europe.
The pills, which cost the NHS less than 10p per patient per day, are now the most commonly prescribed medication in Britain, with eight million people on some type of anti-cholestoral drug.
Medical regulators are currently considering whether to go further and follow American guidance - which could mean a doubling in the numbers on the drugs.
Some cardiologists have suggested they should be automatically prescribed to all patients from the age of 50.
But others have said they are “disturbed” by the trend to dispense the pills ever more widely, exposing millions to potential side-effects.
Research has suggested up to one in five patients taking the drugs suffers some kind of ill-effect, including muscle aches, memory disturbance, cataracts and diabetes.
The new study says that while use of the cholesterol-lowering drugs has more than tripled across OECD countries between 2000 and 2011, levels in the UK are 40 per cent higher than average.
Britain had the highest prescribing levels of all European countries examined, with 13 per cent of the population on the drugs, in a shared position with the Slovak republic. Across all 23 OECD countries examined, only Australia had higher levels of prescribing, with 13.7 per cent of the population on statins.
Valerie Paris, an economist from the OECD’s health division, said Britain’s high place in the tables could be because GPs are given financial incentives to identify and treat heart disease as part of pay contracts which reward doctors for identifying and treating a long list so of diseases.
She said: “The question is whether these people are given advice about improving the lifestyle, or are they put quickly on to statins?”
Prof Sir Roger Boyle, Government heart tsar from 2000 to 2011, said he was concerned that too many doctors were adopting a blanket approach to the drugs, instead of targeting them closely, and offering more patients lifestyle advice.
He said: “The question is whether we are effectively targeting the statins accurately. I would like to see a rather more rigorous approach - rather than them being offered to the ‘worried well’ and giving them to people because they are 50, or 55, without a proper risk assessment.”
Prof Boyle said statins had played an important part in Britain’s battle with heart disease - with a 55 per cent reduction in deaths from heart attacks and strokes in the past eight years - but said doctors needed to do far more to convince the public to tackle unhealthy habits.
The cardiologist said: “I think we have a lot further to go in helping people make the choices to help their lifestyles - smoking, exercise and diet - the things that are actually far more difficult. We are the fattest in Europe; we have got a whole lot more to do to tackle the indolence and girth of the population.”
The former national director for heart disease said: “Statins are a very cheap and cost effective way of improving the health of the nation .. but if we were starting afresh we might not put so much emphasis on them.”
In October, an analysis published in the British Medical Journal cautioned against any expansion in prescribing.
One of its authors, Dr John D Abramson, clinical instructor of primary care, from Harvard Medical School, said wider use of statins “will benefit the pharmaceutical industry more than anyone else”.
“Instead of converting millions of people into statin customers, we should be focusing on the real factors that undeniably reduce the risk of heart disease: healthy diets, exercise and avoiding smoking,” he said.
The OECD report, Health at a Glance, says that in Germany, just seven per per cent of the population is on anti-cholesterol drugs and in France nine per cent, the study found.
The United States - where around 15 per cent of adults are currently estimated to be on statins - was not included in the research.
Maureen Talbot, Senior Cardiac Nurse at the British Heart Foundation, said: “We know that two thirds of the adult population in the UK have elevated cholesterol. Statins have been a great tool for doctors to help people who can’t lower their cholesterol level and therefore their risk of a heart attack or stroke, with positive lifestyle changes.”
Tam Fry, from the National Obesity Forum, said he feared GPs were prescribing statins too readily because it was “simpler to reach for the pad and write out a prescription” than to dole out lifestyle advice.
He said the festive season was a good time for people to take stock of their habits.
“A lot of people will have taken on twice the number of calories that they need over Christmas Day, and unless they spend an hour or two walking it off on Boxing Day it will hang around them - and that’s no good,” he said.
“The priority on Boxing Day is a to go on a walk - as brisk as you can, for as long as you can,” he added.
OBESITY
The OECD study confirms that Britain is the fattest nation in Europe – with 24.8 per cent of adults classed as obese - a body mass index of 30 or more - compared to just 12.9 per cent in France.
In the international league table, average obesity levels are 17 per cent, with the UK only exceeded by Chile, Canada, Australia, New Zealand, Mexico and the US, where 36.5 per cent of adults are obese.
DIABETES
The OECD study also shows that the UK is in the top three countries for prescribing drugs for diabetes - a disease which is often linked to high level of obesity.
Almost 8 per cent of people in the UK – around 4.5million – are on such medication, ranking just behind Finland and Germany.
The report says: “This growth can be explained by a rising prevalence of diabetes, largely liked to increases in the prevalence of obesity – a major risk factor for the development of Type-2 diabetes.”
ANTI-CHOLESTEROL DRUGS
Prescription of statins or statin-like medication, 2011
Daily doses per 1,000 people per day
1. Australia 137
2= UNITED KINGDOM 130
2= Slovakia 130
4. Belgium 122
5. Norway 116
6. Denmark 115
7. Luxembourg 112
8. Canada 109
9. Netherlands 101
10. Hungary 98
11. Finland 95
12. Slovenia 93
13= Czech Republic 92
13= France 92
15. Spain 90
16. Portugal 88
17. Iceland 80
18. Sweden 77
19. Italy 72
20. Germany 68
21. South Korea 34
22. Estonia 32
23. Chile 10
OECD AVERAGE 91
Source: OECD Health at a Glance 2013

Healthwise

Saturday, 28 June 2014

MUST READ: New NHS statins guidance 'risks harming patients'

Healthwise

Telling millions of healthy people to take statins risks harming 'many patients over many years', doctors warn Jeremy Hunt, the Health Secretary, and watchdogs

Proposals to advise twelve million people to take statins could have “worrying” consequences because the plans were borne out of an “overdependence” on studies funded by the pharmaceutical industry
Proposals to advise twelve million people to take statins could have “worrying” consequences because the plans were borne out of an “overdependence” on studies funded by the pharmaceutical industry, doctors said Photo: Alamy
Millions of people over the age of 50 risk harming their health if they follow new NHS guidance telling them to take statins, leading doctors have warned the Health Secretary.
Proposals to advise 12 million people to take the drugs could have “worrying” consequences because the plans were borne out of an “overdependence” on studies funded by the pharmaceutical industry, they say.
The group cites research, independent of the drug industry, showing that statins have been associated with a 48 per cent increase in the risk of diabetes in middle-aged women. Other potential side effects could include depression, fatigue and erectile dysfunction, they warn.
In a letter to Jeremy Hunt, the prominent clinicians, including the head of the Royal College of Physicians and a former chairman of the Royal College of General Practitioners, say that the majority of the National Institute for Health and Care Excellence (Nice) panel responsible for drawing up the guidelines has “direct financial ties” to firms that manufacture statins.
They say that those with “industry conflicts” should be barred from helping to prepare drug guidelines.
Nice will publish its final recommendations next month, after a public consultation. In February it announced its plans to cut the “risk threshold” for statins in half — meaning that the vast majority of men aged over 50 and most women over the age of 60 are likely to be advised to take the drugs to guard against strokes and heart disease.
Experts said the changes would mean that the number of patients advised to take cholesterol-lowering drugs was likely to rise from seven million to 12 million, leaving one in four adults on the medication.
Nice says the guidance will prevent many people from becoming ill and dying prematurely.
By contrast, recent academic papers have questioned the widespread use of statins, claiming that they cause harmful side effects and do not cut death rates — although the authors of two such articles in the British Medical Journal have since withdrawn statements after some figures they cited were found to be incorrect.
In their letter to Mr Hunt and Nice, nine doctors and academics warn that the guidelines will result in the “medicalisation of five million healthy individuals”.
They call on Nice to shelve the proposals until independent experts have been allowed to examine the data on which they have been based.
“The potential consequences of not doing so are worrying: harm to many patients over many years, and the loss of public and professional faith in Nice as an independent assessor,” they write.
“Public interests need always to be put before other interests, particularly pharma.”
The doctors and academics highlight a series of concerns that they say should result in publication of the guidance being delayed.
Led by Sir Richard Thompson, the president of the Royal College of Physicians, they accuse Nice of relying on “hidden data” to reach its conclusions, arguing that crucial studies have not been open to scrutiny. Almost all the research was funded by pharmaceutical firms and should be “open to analysis by a third party with appropriate expertise”, they write.
The doctors, who also include Prof Clare Gerada, a former chairman of the Royal College of General Practitioners, and Prof David Haslam, the chairman of the National Obesity Forum, added that they were “seriously concerned” that eight members of the Guideline Development Group had “direct financial ties to the pharmaceutical companies that manufacture statins”.
The eight members highlighted by the signatories included Dr Anthony Wierzbicki, the chairman of the panel, who declared involvement in a number of commercial clinical trials of new cholesterol-lowering drugs.
The doctors also drew attention to Emma McGowan, a specialist heart nurse who held a post sponsored by AstraZeneca for a year and has been paid by Amgen, another firm, to work on studies.
Dr Dermot Neely, the head of the clinical biochemistry department at Newcastle University and another member of the panel, has received funding from Roche Pharma, Genzyme, Aegerion, Amgen and Sanofi for taking part in “one-off advisory boards”.
All of the links to pharmaceutical firms were declared to Nice at the time that the panel was preparing guidance. The watchdog said in each case the involvement was “judged not to be specific enough to warrant withdrawal”.
A spokesman for Nice said: “The conflicts of interest declared by committee members involved in producing this guideline have been managed appropriately. They have not influenced in any way the draft recommendations on the use of statins.”
Responding to the letter, Prof Mark Baker, the director of the centre for clinical practice at Nice, said: “The independent committee of experts found that if a patient and their doctor measure the risk and decide statins are the right choice, the evidence clearly shows there is no credible argument against their safety and clinical effectiveness.”

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