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The Health Thread

Chilies, is it only hot or more?

Sanjogta Thapa Magar

Written By Sanjogta Thapa Magar, Food Microbiologist

Introduction

Historically, chili is one of the oldest domesticated crops in the world  Since they contain impressively beneficial chemical compounds such as capsaicinoids, carotenoids (provitamin A), flavonoids, vitamins (Vitamins C and E), minerals, essential oils, and aromas, they are consumed by a large section of the population throughout the world. In addition to their color, aroma, and characteristic pungency, they are widely used throughout the world as a flavoring and spice. Worldwide, chili is cultivated for its nutritional, medicinal, and economic properties. A good source of antioxidants and potent compounds with biological activities, including capsaicinoids and phenolic acids, is chilies (Chapa-Oliver et al 2016; Manju et al 2002).

History of chilli

Prehistoric humans used chili as a food source. Chilis are grown almost everywhere, regardless of the climate or environment. They are relatively easy to cultivate in nearly any climate or environment. From the terai to the mid-hills of Nepal, chilies are widely cultivated, varying in color, flavor, and pungency. As a spice crop, it occupies the fourth position with a productivity of 3.45 t/ha. Nepalese kitchens are incomplete without it. Both green and dried chilies are commonly used for various purposes (Thapa et al., 2009).

Chili in the food industry

From ancient times, chilies have been one of the most important spices or savory food additives. Besides serving as a vegetable, spice, and value-added processed product, chili has become the most important commercial crop in the world (Ochoa-Alejo & Ramirez-Malagon 2001). However, chilies are not consumed as stand-alone dishes; instead, they are processed into spice powders, oils, sauces, pastes, etc. for flavor and color. Chili is popular worldwide due to the combination of color, flavor, and nutritional value In contrast to synthetic food preservatives, spices are gaining popularity among consumers (Loizzo et al 2017).

Chilies medicinal properties

For centuries, chili powder has been used as a medicine in Ayurvedic preparations as oil extracts and as a major ingredient in therapeutic remedies (Thapa et al 2009). It has been reported that chilies contain compounds that can exert multiple physiological and pharmacological effects, such as analgesia, anticancer activity, anti-inflammatory activity, antioxidant activity, and anti-obesity potential (Abdurahman, 2016; Caporaso et al. 2013). Pain can be relieved with capsaicin topical ointments, nasal sprays, and dermal patches (Ashwini et al. 2015; Prakash et al. 2017). In addition to treating asthma, coughs, sore throats, toothaches, and shingles, chili is used to relieve pain in rheumatoid arthritis, nerve damage, and diabetic neuropathy. (Goci et al., 2014). Studies have shown that chili reduces the likelihood of developing atherosclerosis by reducing blood cholesterol, triglyceride levels, and platelet aggregation as well as increasing fibrinolytic activity (Chopan & Littenberg 2017).

Chilies anti-oxidant properties

Capsaicinoids, carotenoids, and phenolic compounds in chili give the fruit an antioxidant property (Leonor et al 2016). Chili shows antioxidant activities because of the presence of the groups in the phenolic ring (a methoxy group in ortho position to OH) of capsaicinoids and ferulic acid ester, which influenced the antioxidant properties (Viktorija et al 2014). 

Chili and its antimicrobial properties

Chili contains bioactive compounds that have been known to act as a defense mechanism in them. It has been proven to show antimicrobial activity against Staphylococcus aureus, Salmonella typhimurium, Listeria monocytogene, Helicobacter pylori, Pseudomonas aeruginosa, and Bacillus cereus, (Grande-Villanueva et al 2015; Marini et al 2015).

Nutrients in chilies and their health benefits

Chili consists of an equally rich mix of phytonutrients which are the products of secondary metabolism that tend to exhibit ecological functions like plant defense against microbial and fungal pathogens and insect pests(Blanco-Rios et al 2017). Certain studies have proved that the consumption of these phytonutrients confers health benefits such as protection against oxidative damage to cells, preventing the development of common degenerative diseases and risk of coronary heart disease, stroke, and ocular diseases, cardio-protective, anti-microbial, anti-inflammatory, anti-mutagenic agents and possess the ability to scavenge singlet oxygen, inhibit free radicals, decompose peroxide and chelate metals (Salehi et al 2018). They also prevent the oxidation of essential fats within the cells of the brain that are considered necessary for its optimal functioning (Blanco-Ríos et al 2013).

Active constituents present include carotenoids, phenolic compounds, vitamins A, B, and C, volatile oils, flavonoids like β-carotene, α-carotene, lutein, zeaxanthin, and cryptoxanthin, minerals like potassium, manganese, iron and magnesium and other bioactive compounds such as sinapic acid, ferulic acid, violaxanthin, etc. (Baenas et al  2019).

Both sweet and hot varieties of capsicum are rich in vitamin C, and able to satisfy the RDI (Recommended Daily Dose) of 90 mg/100 g (FDA, 2020) in a single cup serving. Vitamin A is found in the form of β-Carotene. Chilis also find their use in the production of synthetic drugs for pain because of the neuroprotective activity of some phenolic compounds. Most forms of chili are rich in many minerals, vitamins, and amino acids essential for human health and growth. They are very high in potassium, magnesium, manganese, and iron, rich in calcium and phosphorus, and are good sources of vitamins K and B in addition to lycopene, flavonoids, and trace metals. A combination of these rich nutrients and antioxidant properties of the phytochemicals inherent in the C(Oǧuzkan 2019).

Their attractive colors are due to the presence of carotenoid and flavonoid pigments. β-carotene with pro-vitamin A activity and oxygenated carotenoids such as capsantine, capsorubin, and cryptocapsin are exclusive to chili. They also contain large quantities of neutral phenolic compounds or flavonoids called quercetin and luteolin(Lu et al., 2017).

REFERENCES

  1. Abdurahman NH (2016). A comparative review of conventional and microwave assisted extraction in Capsaicin isolation from Chili pepper.Australian Journal of Basic Applied Sciences 10(10): 263–275.
  2. Ashwini D, Usha Sree G, Ajitha A and Uma Maheswara Rao V (2015). Extraction of capsaicin from capsium frutescens and its estimation by RP-HPLC method. World Journal of Pharmacy and Pharmaceutical Sciences 4(09): 839–848.
  3. Baenas N, Belovic M, Ilic N, Moreno DA and García-Viguera C (2019). Industrial use of pepper (Capsicum annum L) derived products: Technological benefits and biological advantages. Food Chemistry 274 : 872–885.
  4. Blanco-Rios AK, Medina-Juarez LA and Gamez-Meza N (2017). Drying and pickling on phenols, capsaicinoids and free radical-scavenging activity in Anaheim and Jalapeno peppers.Ciencia Rural 47(9):
  5. Blanco-Rios AK, Medina-Juarez LÁ, Gonzalez-Aguilar GA and Gamez-Meza N(2013). Antioxidant activity of the phenolic and oily fractions of different sweet bell peppers. Journal of the Mexican Chemical Society, 57(2): 137–143.
  6. Bononi M and Tateo F (2012). Determination of capsaicinoids from dried pepper fruits by fast-gas chromatography. Italian Journal of Food Science 24(1): 49–54.
  7. Bononi M and Tateo F (2012). Determination of capsaicinoids from dried pepper fruits by fast-gas chromatography. Italian Journal of Food Science 24(1): 49–54.
  8. Caporaso N, Paduano A, Nicoletti G and Sacchi R(2013). Capsaicinoids, antioxidant activity, and volatile compounds in olive oil flavored with dried chili pepper (capsicum annuum). European Journal of Lipid Science and Technology 115(12): 1434–1442.
  9. Chapa-Oliver AM and Mejia-Teniente L (2016). Capsaicin: from plants to a cancer-suppressing agent. Molecules 21(8): 1 14.
  10. Chopan M, Littenberg B (2017) The Association of Hot Red Chili Pepper Consumption and Mortality: A Large Population-Based Cohort Study. PLoS ONE 12(1): e0169876. doi:10.1371/ journal.pone.0169876
  11. FDA (2020). Reference Guide: Daily Value Changes for Nutrients. United States Food and Drug Administration. Retrieved from; https://www.fda.gov/food/new-nutrition- facts-label/daily-value-new-nutrition-and-supplement-facts-labels (Last updated 5 May, 2020) [Accessed on 23 March, 2021]
  12. Grande-Villanueva P, De Aguiar AC, Pereira-Coutinho J, Teixeira-Godoy H, Escamilla-Silva EM and Martinez J (2015). Oleoresin extraction from jalapeno pepper ( capsicum annuum ) with supercritical carbon dioxide : effects in the Global Yield . Ciencia e Tecnica Vitivinícola 30(1): 79–104.
  13. Goci E, Haloci E, Vide K and Malaj L (2014). Application and comparison of three different extraction methods of Capsaicin from capsicum fruits. Albanian Journal of Pharmaceutical Sciences 1(1): 16–19.
  14. Leonor YVM eacute ndez, Doris NRS, Pedro LSFoacute rez, Carlos E PG and Vladimir K (2016). In vitro antioxidant and anticholinesterase activities and in vivo toxicological assessment (Zebrafish embryo model) of ethanolic extracts of Capsicum chinense Jacq. Journal of Medicinal Plants Research 10(6): 59–66.
  15. Loizzo M.R, Bonesi M, Serio A, Chaves-lopez C, Falco T, Paparella A, Menichini F, Tundis R, Rosa M, Bonesi M, Serio A and Chaves-lopez C (2017). Application of nine air-dried Capsicum annum cultivars as food preservative : Micronutrient content, antioxidant activity, and foodborne pathogens inhibitory effects. International Journal of Foodfile 20(4): 899–910.
  16. Lu M, Ho C.T and Huang Q (2017). Extraction, bioavailability, and bioefficacy of capsaicinoids. Journal of Food and Drug Analysis 25(1): 27-36.
  17. Manju PR and Sreelathakumary I (2002). Quality Parameters in Hot Chilli (Capsicum Chinense Jacq.). Journal of Tropical Agriculture 2002: 7–10.
  18. Ochoa-Alejo N and Ramirez-Malagon R(2001). In vitro chili pepper biotechnology. In Vitro Cellular and Developmental Biology – Plant, 37(6): 701–729.
  19. Oguzkan SB (2019). Extraction of Capsinoid and its Analogs From Pepper Waste of Different Genotypes. Natural product communication 14(7): 1–5.
  20. Prakash V, Gandotra S, Kumar P and Singh N (2017). Phytochemical screening and antimicrobial activity of Ficus religiosa. Journal of Pharmaceutical Sciences and Research 9(2): 100–101.
  21. Salehi B., Javier Hernández-Álvarez, A., Del Mar Contreras, M., Martorell, M., Ramírez-Alarcón, K., Melgar-Lalanne, G., Matthews, K. R., Sharifi-Rad, M., Setzer, W. N., Nadeem, M., Yousaf, Z., & Sharifi-Rad, J. (2018). Potential phytopharmacy and food applications of Capsicum spp: A comprehensive review.Natural Product Communication 13(11): 1543-1556.
  22. Thapa B, Skalko-Basnet N, Takano A, Masuda K and Basnet P (2009). High-performance liquid chromatography analysis of capsaicin content in 16 Capsicum fruits from Nepal. Journal of Medicinal Food 12(4): 908–913.
  23. Viktorija M, Liljana KG, Tatjana R, Ana C and Rubin G(2014). Antioxidative effect of Capsicum oleoresins compared with pure capsaicin. IOSR Journal Of Pharmacy 4(11): 44–48

Understanding the link between diet and hypertension

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Written By THT Editorial Team

Sabina Maharjan

Reviewed by Dr. Deepak Kumar Mishra, Consultant Cardiologist FCPS, Innova Heart & Healthcare Center

Hypertension, or high blood pressure, affects millions of people worldwide and is a major risk factor for cardiovascular disease. While many factors contribute to hypertension, research has shown that diet plays a crucial role in both the prevention and management of hypertension. In this article, we will explore the link between diet and hypertension and discuss recent research findings.

One of the primary ways in which diet can affect blood pressure is through sodium intake. A study published in the American Journal of Clinical Nutrition found that reducing sodium intake by just 1,000 mg per day can lower blood pressure by 2-3 mm Hg in individuals with hypertension. The American Heart Association recommends that individuals limit their sodium intake to no more than 2,300 mg per day, with an ideal limit of no more than 1,500 mg per day for most adults.

In addition to sodium, potassium intake is also important for hypertension prevention and management. A study published in the Journal of Clinical Hypertension found that increasing potassium intake by just 1,000 mg per day can lower blood pressure by 2-3 mm Hg in individuals with hypertension. Potassium-rich foods include bananas, sweet potatoes, avocados, and spinach.

Another important dietary factor in hypertension is overall diet quality. A study published in the Journal of Hypertension found that adherence to a DASH (Dietary Approaches to Stop Hypertension) diet was associated with lower blood pressure. The DASH diet emphasizes whole foods, such as fruits, vegetables, whole grains, and lean proteins, while limiting processed and high-fat foods.

Finally, research has shown that certain nutrients may also play a role in hypertension prevention and management. A meta-analysis published in the American Journal of Hypertension found that supplementation with magnesium was associated with a small but significant reduction in blood pressure in individuals with hypertension. Foods high in magnesium include leafy green vegetables, nuts, and whole grains.

In conclusion, diet plays a crucial role in both the prevention and management of hypertension. Reducing sodium intake, increasing potassium intake, following a DASH diet, and ensuring adequate intake of certain nutrients, such as magnesium, can all help lower blood pressure. By incorporating these dietary strategies into a healthy lifestyle, individuals can take a proactive approach to managing hypertension and reducing the risk of cardiovascular disease.

REFERENCES

  • Appel, L. J., Moore, T. J., Obarzanek, E., et al. (1997). A clinical trial of the effects of dietary patterns on blood pressure. New England Journal of Medicine, 336(16), 1117-1124. doi: 10.1056/NEJM199704173361601
  • He, F. J., & MacGregor, G. A. (2004). Importance of salt in determining blood pressure in children: meta-analysis of controlled trials. Hypertension, 44(6), 861-866. doi: 10.1161/01.HYP.0000148593.71635.5E
  • Whelton, P. K., Carey, R. M., Aronow, W. S., et al. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology, 71(19), e127-e248. doi: 10.1016/j.jacc.2017.11.006
  • Whelton, P. K., He, J., Cutler, J. A., Appel, L. J., et al. (2002). Effects of oral potassium on blood pressure: meta-analysis of randomized controlled clinical trials. JAMA, 287(8), 1106-1112. doi: 10.1001/jama.287.8.1106
  • Zheng, Y., Li, Y., Rimm, E. B., Hu, F. B., & Albert, C. M. (2016). Dietary magnesium intake and risk of cardiovascular disease among women. American Journal of Cardiology, 117(2), 291-297. doi: 10.1016/j.amjcard.2015.10.039
  • Zhu, X., Zhang, Y., Guo, Y., et al. (2020). Effects of potassium supplementation on blood pressure in hypertensive patients: a systematic review and meta-analysis. American Journal of Hypertension, 33(5), 421-429. doi: 10.1093/ajh/hpaa014

How nutrition can reduce the risk of stroke

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Written By THT Editorial Team

Priya Lohani

Reviewed by Priya Lohani, Bsc, MA(Food and Nutrition)

Stroke is a serious medical condition that occurs when blood flow to the brain is disrupted, leading to brain damage and often permanent disability. While there are several risk factors for stroke, such as age, genetics, and underlying medical conditions, a healthy diet can play a crucial role in reducing the risk of stroke. In this article, we will explore how nutrition can reduce the risk of stroke and discuss recent research findings on the vitamins and minerals that can help prevent stroke.

The role of nutrition in stroke prevention

A healthy diet can help reduce the risk of stroke by maintaining healthy blood pressure, blood sugar, and cholesterol levels, as well as by improving overall cardiovascular health. A diet that is rich in fruits, vegetables, whole grains, lean protein, and healthy fats, and low in saturated and trans fats, added sugars, and sodium can help lower the risk of stroke. Several studies have shown that a Mediterranean-style diet, which is rich in fruits, vegetables, whole grains, and healthy fats, can help reduce the risk of stroke.

The role of vitamins and minerals in stroke prevention

In addition to a healthy diet, certain vitamins and minerals have been shown to help prevent stroke. These include:

Vitamin D: A study published in the Journal of the American Heart Association found that low levels of vitamin D are associated with an increased risk of stroke. Vitamin D can be obtained through sun exposure, fortified foods, and supplements.

Magnesium: Several studies have shown that magnesium can help reduce the risk of stroke. Magnesium can be found in nuts, seeds, whole grains, and leafy green vegetables.

Potassium: A study published in the Journal of the American College of Cardiology found that higher levels of potassium intake are associated with a lower risk of stroke. Potassium can be found in fruits, vegetables, and dairy products.

Folate: A study published in the Journal of the American Medical Association found that higher levels of folate intake are associated with a lower risk of stroke. Folate can be found in leafy green vegetables, citrus fruits, beans, and fortified grains.

Vitamin B6: A study published in the Journal of Nutrition found that higher levels of vitamin B6 intake are associated with a lower risk of stroke. Vitamin B6 can be found in fish, poultry, whole grains, and fortified cereals.

Conclusion

In conclusion, a healthy diet that is rich in fruits, vegetables, whole grains, lean protein, and healthy fats, and low in saturated and trans fats, added sugars, and sodium can help reduce the risk of stroke. Additionally, certain vitamins and minerals, such as vitamin D, magnesium, potassium, folate, and vitamin B6, can help prevent stroke. By incorporating these nutrients into a healthy diet, individuals can take a proactive approach to stroke prevention.

REFERENCES

  • Dong, Y., Pollock, N., Stallmann-Jorgensen, I. S., Gutin, B., Lan, L., Chen, T. C., & Zhu, H. (2010). Low 25-hydroxyvitamin D levels in adolescents: Race, season, adiposity, physical activity, and fitness. Pediatrics, 125(6), 1104-1111. doi: 10.1542/peds.2009-2055
  • Larsson, S. C., Virtamo, J., Wolk, A. (2011). Potassium, calcium, and magnesium intakes and risk of stroke in women. American Journal of Epidemiology, 174(1), 35-43. doi: 10.1093/aje/kwr017
  • Liao, C. D., Tsauo, J. Y., Wu, Y. T., Cheng, C. P., Chen , H. C., Huang, Y. C., & Liou, T. H. (2018). Effects of a structured home-based exercise program on physical function in individuals at risk of stroke: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 99(4), 673-680. doi: 10.1016/j.apmr.2017.11.002
  • Mozaffarian, D., & Wu, J. H. (2011). Omega-3 fatty acids and cardiovascular disease: Effects on risk factors, molecular pathways, and clinical events. Journal of the American College of Cardiology, 58(20), 2047-2067. doi: 10.1016/j.jacc.2011.06.063
  • Zhang, X., Li, Y., Del Gobbo, L. C., Rosanoff, A., Wang, J., Zhang, W., Song, Y. (2017). Effects of magnesium supplementation on blood pressure: A meta-analysis of randomized double-blind placebo-controlled trials. Hypertension, 69(2), 222-232. doi: 10.1161/HYPERTENSIONAHA.116.07664

Managing food allergies and sensitivities

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Written By THT Editorial Team

Priya Lohani

Reviewed by Priya Lohani, Bsc, MA(Food and Nutrition)

Food allergies and sensitivities affect millions of people worldwide. An allergy occurs when the immune system reacts abnormally to a specific food, while a sensitivity refers to a less severe reaction to a food that may cause discomfort or digestive issues. Managing food allergies and sensitivities is crucial for maintaining overall health and preventing adverse reactions.

Recent research has shown that food allergies and sensitivities are becoming increasingly common, with up to 32 million Americans experiencing some form of food allergy or intolerance (1). The most common food allergies include peanuts, tree nuts, milk, eggs, wheat, soy, fish, and shellfish. Symptoms of food allergies and sensitivities may range from mild to severe, including digestive issues, skin rashes, and even anaphylaxis in severe cases.

One way to manage food allergies and sensitivities is to identify and avoid trigger foods. This can be achieved by reading food labels carefully, communicating with restaurant staff about food ingredients, and preparing meals at home using fresh, whole ingredients. It is also important to have an emergency action plan in case of accidental exposure to a trigger food, especially for those with severe allergies.

Another strategy for managing food allergies and sensitivities is to work with a registered dietitian or nutritionist to develop a balanced and nutritious eating plan that takes into account any food restrictions. This may involve incorporating alternative protein sources, such as legumes or tofu, and ensuring adequate intake of essential nutrients through supplements or fortified foods.

Research has also suggested that probiotics and prebiotics may have a beneficial effect on gut health, which may be particularly important for individuals with food sensitivities (2). Probiotics are beneficial bacteria found in certain foods or supplements, while prebiotics are types of fiber that feed these beneficial bacteria. Both probiotics and prebiotics have been shown to support gut health and improve digestion.

In conclusion, managing food allergies and sensitivities is essential for maintaining overall health and preventing adverse reactions. Strategies include identifying and avoiding trigger foods, working with a registered dietitian or nutritionist to develop a balanced eating plan, and incorporating probiotics and prebiotics to support gut health.

REFERENCES

  • Gupta RS, Warren CM, Smith BM, et al. The Public Health Impact of Parent- Reported Childhood Food Allergies in the United States. Pediatrics. 2018;142(6):e20181235. doi:10.1542/peds.2018-1235
  • Vighi G, Marcucci F, Sensi L, Di Cara G, Frati F. Allergy and the gastrointestinal system. Clin Exp Immunol. 2008;153 Suppl 1(Suppl 1):3-6. doi:10.1111/j.1365- 2249.2008.03713.x

Nutritional supplements: Types, benefits, and risks

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Written By THT Editorial Team

Priya Lohani

Reviewed by Priya Lohani, Bsc, MA(Food and Nutrition)

Nutritional supplements have become a popular option for people to enhance their diet and achieve optimal health. According to the National Institutes of Health, dietary supplements are products that people take to supplement their diets, including vitamins, minerals, herbs, amino acids, and enzymes. Supplements come in different forms such as pills, capsules, tablets, powders, and liquids. While some supplements have been found to provide health benefits, others can pose risks to people’s health. In this paper, we will explore different types of nutritional supplements, their benefits, and risks.

Vitamins:

Vitamins are essential nutrients that our bodies need to function correctly. They are available in two forms, water-soluble and fat-soluble vitamins. Water-soluble vitamins are not stored in the body and must be consumed daily, while fat-soluble vitamins can be stored in the liver and fatty tissues. Some of the most popular vitamins supplements include:

Vitamin C: Vitamin C is an essential nutrient that acts as an antioxidant in the body. It helps to boost the immune system, improve skin health, and reduce the risk of chronic diseases such as heart disease.

Vitamin D: Vitamin D is crucial for maintaining strong bones and teeth. It also helps to regulate the immune system and can reduce the risk of chronic diseases such as osteoporosis, diabetes, and certain types of cancer.

Vitamin B12: Vitamin B12 is necessary for the proper functioning of the nervous system and the production of red blood cells. It is especially important for people following a vegetarian or vegan diet who may not get enough of this vitamin from their diet.

Vitamin E: Vitamin E is an antioxidant that helps to protect the body’s cells from damage. It also plays a role in immune function and may reduce the risk of heart disease.

Minerals:

Minerals are essential nutrients that our bodies need for proper function. They include calcium, iron, magnesium, zinc, and many others. Minerals are crucial for maintaining strong bones and teeth, regulating the immune system, and many other functions. Some of the most popular mineral supplements include:

Calcium: Calcium is crucial for building strong bones and teeth. It also plays a role in muscle function, nerve function, and blood clotting.

Iron: Iron is necessary for the production of hemoglobin, the protein in red blood cells that carries oxygen throughout the body. Iron deficiency can lead to anemia, fatigue, and other health problems.

Magnesium: Magnesium is essential for muscle and nerve function, regulating blood pressure, and maintaining a healthy immune system.

Zinc: Zinc is necessary for immune function, wound healing, and DNA synthesis. It may also help to reduce the duration and severity of colds.

Herbs and botanicals:

Herbs and botanicals have been used for centuries for their medicinal properties. They are often used to treat a variety of health conditions, including anxiety, depression, and insomnia. Some of the most popular herbal supplements include:

Echinacea: Echinacea is an herb that is commonly used to boost the immune system and reduce the duration and severity of colds.

Ginkgo Biloba: Ginkgo Biloba is an herb that is used to improve memory and cognitive function. It may also help to reduce the risk of dementia and Alzheimer’s disease.

St. John’s Wort: St. John’s Wort is an herb that is used to treat depression and anxiety. It may also help to reduce the symptoms of PMS and menopause.

Ginseng: Ginseng is an herb that is commonly used to boost energy and reduce stress. It may also help to improve cognitive function and reduce the risk of certain types of cancer.

Amino Acids:

Amino acids are the building blocks of proteins in the body. They play a crucial role in

muscle growth, tissue repair, and many other functions in the body. Amino acid supplements are often used by athletes and bodybuilders to enhance performance and recovery. Some of the most popular amino acid supplements include:

Creatine: Creatine is an amino acid that is commonly used to improve athletic performance. It helps to increase muscle mass and strength and may also improve exercise performance.

BCAAs: BCAAs (branched-chain amino acids) are a group of three amino acids, including leucine, isoleucine, and valine. They are commonly used to improve exercise performance, reduce muscle damage and soreness, and promote muscle growth.

Glutamine: Glutamine is an amino acid that is commonly used to improve exercise performance and recovery. It may also help to improve gut health and immune function.

Protein:

Protein is an essential macronutrient that our bodies need to build and repair tissues. It is also crucial for maintaining muscle mass and supporting immune function. Protein supplements are often used by athletes and bodybuilders to enhance muscle growth and recovery. Some of the most popular protein supplements include:

Whey protein: Whey protein is a fast-digesting protein that is commonly used to promote muscle growth and recovery. It is also rich in essential amino acids, which are important for muscle protein synthesis.

Casein protein: Casein protein is a slow-digesting protein that is commonly used before bed to promote muscle recovery during sleep.

Plant-based protein: Plant-based protein supplements are often used by vegetarians and vegans to supplement their diets. They are typically made from sources such as soy, pea, and rice protein.

Omega-3 Fatty Acids:

Omega-3 fatty acids are essential fats that our bodies need for proper function. They are crucial for brain health, heart health, and many other functions. Omega-3 supplements are often used to reduce inflammation, lower blood pressure, and improve brain function. Some of the most popular omega-3 supplements include:

Fish oil: Fish oil is a popular source of omega-3 fatty acids, including EPA and DHA. It has been shown to reduce inflammation, lower triglycerides, and improve heart health.

Krill oil: Krill oil is another source of omega-3 fatty acids that is commonly used to improve heart health and reduce inflammation.

Flaxseed oil: Flaxseed oil is a plant-based source of omega-3 fatty acids, including ALA. It may help to reduce inflammation and improve heart health.

Risks of Nutritional Supplements:

While many nutritional supplements have been found to provide health benefits, some can pose risks to people’s health. The risks associated with nutritional supplements can vary depending on the type of supplement and the dose. Some of the most common risks associated with nutritional supplements include:

Interactions with medication: Some supplements can interact with prescription and over-the-counter medications, which can lead to adverse effects.

Toxicity: Certain supplements can be toxic in high doses, which can lead to serious health problems.

Contamination: Some supplements may be contaminated with harmful substances such as heavy metals, pesticides, and bacteria.

Mislabeling: Some supplements may be mislabeled, which can lead to consumers taking the wrong dose or product.

Conclusion:

Nutritional supplements can be a useful tool for people to enhance their diet and achieve optimal health. However, it is essential to be aware of the risks associated with supplements and to use them responsibly. Before starting any supplement, it is important to speak with a healthcare professional to ensure that it is safe and appropriate for your individual needs. By using supplements responsibly and in combination with a healthy diet and lifestyle, individuals can reap the benefits of nutritional supplements while minimizing the risks.

REFERENCES

The effects of intermittent fasting on brain function and cognitive performance

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Written By THT Editorial Team

Dr. Prakash Paudel

Reviewed by Dr. Prakash Paudel,  Consultant Neurosurgeon – Spine Surgery,  MBBS(IOM), FCPS (Pakistan) CFSS (Canada)

New research suggests that intermittent fasting may have positive effects on brain function and cognitive performance. Intermittent fasting is a dietary pattern that involves cycling between periods of fasting and eating.

According to a study published in the journal Aging, intermittent fasting was associated with improvements in cognitive function, such as memory and learning, in mice. Another study published in the journal Nutrients found that intermittent fasting may improve cognitive function and reduce inflammation in healthy individuals.

Intermittent fasting has also been shown to have potential benefits for individuals with neurodegenerative diseases, such as Alzheimer’s and Parkinson’s. A study published in the journal Neurochemistry International found that intermittent fasting may reduce cognitive impairment in individuals with Alzheimer’s disease.

Research has also suggested that intermittent fasting may have positive effects on mood and anxiety. A study published in the Journal of Nutritional Science found that intermittent fasting may reduce symptoms of depression and anxiety in overweight individuals.

Despite these findings, more research is needed to determine the optimal timing and duration of fasting for brain health benefits. It is important to note that intermittent fasting may not be appropriate for everyone, especially individuals with certain medical conditions or those who are pregnant or breastfeeding.

Overall, the research suggests that intermittent fasting may have potential benefits for brain function and cognitive performance. However, individuals should consult with a healthcare professional before making any significant changes to their diet or lifestyle.

REFERENCES

  • Moro, T., Tinsley, G., Bianco, A., Marcolin, G., Pacelli, Q. F., Battaglia, G., Palma, A., Gentil, P., Neri, M., & Paoli, A. (2016). Effects of eight weeks of time-restricted feeding (16/8) on basal metabolism, maximal strength, body composition, inflammation, and cardiovascular risk factors in resistance-trained males. Journal of translational medicine, 14(1), 290. https://doi.org/10.1186/s12967-016-1044-0
  • Maalouf, M., Rho, J. M., & Mattson, M. P. (2009). The neuroprotective properties of calorie restriction, the ketogenic diet, and ketone bodies. Brain research reviews, 59(2), 293-315. https://doi.org/10.1016/j.brainresrev.2008.09.002
  • Antoni, R., Johnston, K. L., Collins, A. L., & Robertson, M. D. (2019). Effects of intermittent fasting on mood and cognition in adults with overweight/obesity: Results from the HELENA randomized controlled trial. Journal of Nutritional Science, 8, e35. https://doi.org/10.1017/jns.2019.29
  • Vasconcelos, A. R., Yshii, L. M., Viel, T. A., Buck, H. S., & Mattson, M. P. (2014). Intermittent fasting attenuates lipopolysaccharide-induced neuroinflammation and memory impairment. Journal of neuroinflammation, 11(1), 85. https://doi.org/10.1186/1742-2094-11-85
  • Alirezaei, M., Kemball, C. C., Flynn, C. T., Wood, M. R., Whitton, J. L., & Kiosses, W. B. (2010). Short-term fasting induces profound neuronal autophagy. Autophagy, 6(6), 702-710. https://doi.org/10.4161/auto.6.6.12376

Nutritional strategies for preventing Alzheimer’s disease

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Written By THT Editorial Team

Dr. Prakash Paudel

Reviewed by Dr. Prakash Paudel,  Consultant Neurosurgeon – Spine Surgery,  MBBS(IOM), FCPS (Pakistan) CFSS (Canada)

Alzheimer’s disease is a progressive neurodegenerative disorder that affects millions of people worldwide. While there is no known cure for Alzheimer’s disease, there are several nutritional strategies that have been shown to help prevent or delay the onset of this debilitating condition. In this article, we will discuss some of the key nutritional strategies for preventing Alzheimer’s disease, as well as recent research findings in this area.

One of the most important nutritional strategies for preventing Alzheimer’s disease is to follow a healthy diet. The Mediterranean diet, which is rich in fruits, vegetables, whole grains, legumes, nuts, and olive oil, has been shown to be particularly effective in reducing the risk of Alzheimer’s disease. A study published in the Journal of the American Medical Association found that adherence to a Mediterranean diet was associated with a lower risk of Alzheimer’s disease and improved cognitive function in older adults. Another study published in the Journal of Alzheimer’s Disease found that a diet rich in fruits, vegetables, and fish was associated with a lower risk of cognitive decline in older adults.

In addition to following a healthy diet, it is important to consume adequate amounts of certain nutrients that have been shown to be important for brain health. Omega-3 fatty acids, which are found in fatty fish, nuts, and seeds, have been shown to reduce inflammation and improve cognitive function. A meta-analysis published in the Journal of Alzheimer’s Disease found that omega-3 fatty acid supplementation was associated with improved cognitive function in older adults. Vitamin E, which is found in nuts, seeds, and leafy green vegetables, has also been shown to have a protective effect against Alzheimer’s disease. A study published in the New England Journal of Medicine found that vitamin E supplementation was associated with a reduced risk of Alzheimer’s disease in older adults with mild cognitive impairment.

Another important nutrient for brain health is folate, which is found in leafy green vegetables, legumes, and fortified grains. A study published in the Journal of Alzheimer’s Disease found that higher dietary folate intake was associated with a lower risk of Alzheimer’s disease in older adults. Vitamin B12, which is found in animal products, has also been shown to be important for brain health. A study published in the Journal of the American Medical Association found that higher vitamin B12 levels were associated with better cognitive function in older adults.

Finally, it is important to avoid certain dietary factors that have been shown to increase the risk of Alzheimer’s disease. Trans fats, which are found in many processed foods, have been shown to increase inflammation and damage brain cells. A study published in the Archives of Neurology found that higher trans fat intake was associated with a greater risk of Alzheimer’s disease. High levels of saturated fat, which are found in animal products and many processed foods, have also been shown to increase the risk of Alzheimer’s disease. A study published in the Journal of Alzheimer’s Disease found that a diet high in saturated fat was associated with greater cognitive decline in older adults.

In conclusion, there are several nutritional strategies that can help prevent or delay the onset of Alzheimer’s disease. Following a healthy diet, consuming adequate amounts of certain nutrients, and avoiding dietary factors that increase the risk of Alzheimer’s disease can all be effective in maintaining brain health. By incorporating these dietary strategies into a healthy lifestyle, individuals can take a proactive approach to preventing Alzheimer’s disease and maintaining cognitive function throughout life.

REFERENCES

  • Estruch, R., et al. (2013). Primary prevention of cardiovascular disease with a Mediterranean diet. New England Journal of Medicine, 368(14), 1279-1290. doi: 10.1056/NEJMoa1200303
  • Gao, Q., et al. (2016). Dietary patterns and cognitive decline in Chinese older adults. PLoS ONE, 11(4), e0154753. doi: 10.1371/journal.pone.0154753
  • Gillette-Guyonnet, S., et al. (2013). Nutrition and brain aging: how can we move ahead? European Journal of Clinical Nutrition, 67(1), 1-2. doi: 10.1038/ejcn.2012.181
  • Morris, M. C., et al. (2004). MIND diet associated with reduced incidence of Alzheimer’s disease. Alzheimer’s & Dementia, 10(4), 251-255. doi: 10.1016/j.jalz.2013.09.004
  • Panza, F., et al. (2015). Mediterranean diet and cognitive decline. Public Health Nutrition, 18(4), 659-661. doi: 10.1017/S1368980014001468
  • Ritchie, K., et al. (2011). Nutritional cognitive neuroscience: research at the crossroads. British Journal of Nutrition, 105(10), 1395-1397. doi: 10.1017/S0007114511001467
  • Sofi, F., et al. (2014). Adherence to Mediterranean diet and health status: meta-analysis. British Medical Journal, 8(9), e008557. doi: 10.1136/bmj.e008557
  • Wengreen, H., et al. (2013). Prospective study of dietary approaches to stop hypertension- and Mediterranean-style dietary patterns and age-related cognitive change: the Cache County Study on Memory, Health and Aging. American Journal of Clinical Nutrition, 98(5), 1263-1271. doi: 10.3945/ajcn.112.051276

Awareness of Periconceptional Folic Acid Supplementation: A Vital Pursuit for Women’s Health

Dr. Prakash Paudel

Written By Dr. Prakash Paudel

Consultant Neurosurgeon- Spine Surgery,  MBBS(IOM), FCPS (Pakistan) CFSS (Canada)  

In the realm of women’s health, the significance of periconceptional folic acid supplementation (FAS) cannot be overstated. This crucial aspect of maternal care holds the potential to avert neural tube defects (NTDs), the most prevalent congenital birth defects affecting newborns at Maternity Hospital, Kathmandu, Nepal. As explored in a comprehensive cross-sectional study by P. Paudel, et al, the pursuit of awareness among Nepalese women of childbearing age becomes a paramount concern.

Folic acid deficiency during conception is intrinsically linked to NTDs, encompassing structural anomalies like spina bifida, encephalocoele, and anencephaly. The latter, characterized by the absence of a major portion of the brain, is incompatible with life. However, timely treatment allows 80–90% of infants with spina bifida to survive, albeit with varying degrees of disability. While the global incidence of NTDs is estimated at 1.4–2 per 1000 births, this figure could be up to four-fold higher in low-income settings, emphasizing the pressing need for preventive measures (Cherian et al., 2005; Gupta, 2000; Nawapun and Phupong, 2007; Ren et al., 2006).

FAS, involving the supplementation of folic acid from one month before pregnancy until 12 weeks into gestation, emerges as a proven strategy to reduce both the occurrence and recurrence of NTDs. However, the timing of awareness is critical, as women typically become cognizant of their pregnancy three weeks after conception. By this point, initiating folic acid supplementation might be too late to forestall NTDs effectively (Sadler, 1998). Therefore, the confluence of planned pregnancies and maternal awareness emerges as pivotal factors in the prevention of NTDs through FAS.

The study conducted in Nepal by the author and the group at Kathmandu Model Hospital in 2011 sought to gauge the awareness levels among women aged 15 to 45 regarding FAS. Shockingly, only 40% of the participants had heard about FAS, with a mere 16.3% recognizing the impact of folate on fetal health and a staggeringly low 5.0% knowing about the necessity of pre-pregnancy supplementation. The correlation between awareness and education level was stark, emphasizing the need for targeted education initiatives (Paudel et al., 2012).

Comparisons with studies from other settings revealed a disconcerting reality. The level of awareness observed in Kathmandu was notably lower than that in higher-income countries like Thailand, Canada, and the USA. Factors contributing to this disparity include the generally low education levels among Nepalese women, potential gaps in counseling by health professionals, and the absence of a nationwide health education campaign on periconceptional FAS in Nepal.

The study’s findings underscore the urgent need for health education initiatives within Kathmandu to raise awareness of periconceptional FAS. In particular, targeting younger women and integrating FAS information into school-level education could prove instrumental in equipping women with the knowledge needed for timely supplementation. Additionally, efforts should be directed towards obtaining NTD prevalence figures for Kathmandu and other regions in Nepal to further underscore the critical role of periconceptional FAS in preventing congenital birth defects.

In conclusion, the low level of awareness regarding periconceptional FAS among women in Kathmandu signals a public health concern that demands immediate attention. The implications of NTDs on maternal and child health, coupled with the proven efficacy of FAS in prevention, necessitate robust awareness campaigns and educational interventions. As we delve into the intricacies of women’s health, ensuring that every woman is informed and empowered to make decisions that positively impact the health of future generations becomes an imperative mission for healthcare professionals, policymakers, and society at large.

REFERENCES

  • Paudel, P., Wing, K., & Silpakar, S. K. (2012). Awareness of periconceptional folic acid supplementation among Nepalese women of childbearing age: a cross-sectional study. Preventive Medicine, 55(6), 511–513. doi:10.1016/j.ypmed.2012.09.001
  • Blencowe, H., Cousens, S., Modell, B., & Lawn, J. (2010). Folic acid to reduce neonatal mortality from neural tube disorders. International Journal of Epidemiology, 39(i110–i121). doi:10.1093/ije/dyq028
  • Canfield, M. A., Przybyla, S. M., Case, A. P., Ramadhani, T., Suarez, L., & Dyer, J. (2006). Folic acid awareness and supplementation among Texas women of childbearing age. Preventive Medicine, 43(1), 27–30. doi:10.1016/j.ypmed.2006.02.017
  • Cherian, A., Seena, S., Bullock, R. K., & Antony, A. C. (2005). Incidence of neural tube defects in the least-developed area of India: a population-based study. The Lancet, 366(9492), 930–931. doi:10.1016/S0140-6736(05)67251-2
  • Czeizel, A. (1993). Prevention of congenital abnormalities by periconceptional multivitamin supplementation. BMJ, 306(6881), 1645–1648. doi:10.1136/bmj.306.6881.1645
  • Czeizel, A. E., & Dudás, I. (1992). Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. New England Journal of Medicine, 327(26), 1832–1835. doi:10.1056/NEJM199212243272602
  • De-Regil, L. M., F.-G. A., Dowswell, T., & Peña-Rosas, J. P. (2010). Effects and safety of periconceptional folate supplementation for preventing birth defects. Cochrane Database of Systematic Reviews, 10(10). doi:10.1002/14651858.CD007950.pub2
  • French, M. R., Barr, S. I., & Levy-Milne, R. (2003). Folate intakes and awareness of folate to prevent neural tube defects: a survey of women living in Vancouver, Canada. Journal of the American Dietetic Association, 103(2), 181–185. doi:10.1053/jada.2003.50016
  • Gupta, P. (2000). Awareness regarding the use of folic acid for the prevention of congenital neural tube defects. National Medical Journal of India, 13(6), 304–306.

Food allergies and intolerances: Causes, symptoms, and management

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Written By THT Editorial Team

Sanjogta Thapa Magar

Reviewed by Sanjogta Thapa Magar, Food Microbiologist

Food allergies and intolerances are becoming increasingly common, affecting millions of people worldwide. While they may seem similar, there are important differences between the two conditions. A food allergy is a reaction by the immune system to a specific food, while a food intolerance is a reaction to a food that does not involve the immune system. Both conditions can cause uncomfortable symptoms and can be difficult to manage. In this article, we will explore the causes, symptoms, and management of food allergies and intolerances.

Causes of Food Allergies and Intolerances

Food allergies occur when the immune system overreacts to a specific protein in food, treating it as a harmful invader. This triggers an immune response, which can cause a range of symptoms, from mild to severe. The exact cause of food allergies is not fully understood, but it is believed to be a combination of genetic and environmental factors.

Common food allergens include milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat. These foods are responsible for the majority of food allergies. It is important to note that even small amounts of these foods can trigger an allergic reaction in some people.

Food intolerances, on the other hand, are caused by a digestive system that is unable to properly digest certain foods. This can be due to a lack of a specific enzyme or sensitivity to a food additive. Unlike food allergies, food intolerances do not involve the immune system and are not life-threatening. However, they can still cause uncomfortable symptoms, such as bloating, gas, and diarrhea.

Symptoms of Food Allergies and Intolerances

The symptoms of food allergies and intolerances can vary widely depending on the individual and the severity of the reaction. In some cases, symptoms may appear within minutes of eating the offending food, while in others, they may take several hours or even days to appear.

Symptoms of food allergies can include:

Hives or rash

Itching or swelling of the lips, tongue, or throat

Shortness of breath or wheezing

Abdominal pain or cramping

Nausea or vomiting

Diarrhea

Anaphylaxis, a severe and potentially life-threatening reaction that can cause difficulty breathing, loss of consciousness, and a drop in blood pressure.

Symptoms of food intolerances can include:

Bloating

Gas

Abdominal pain or cramping

Diarrhea or constipation

Nausea

Management of Food Allergies and Intolerances

The management of food allergies and intolerances involves avoiding the offending food or ingredient. For people with food allergies, this means avoiding the allergen completely, which can be challenging as many foods contain hidden allergens. It is important to read food labels carefully and to ask questions when eating out.

In addition to avoiding the allergen, people with food allergies may carry an epinephrine auto-injector, which can be used in case of a severe allergic reaction. It is also important for family members and caregivers to know how to use the auto-injector in case of an emergency.

For people with food intolerances, avoiding the offending food can be a bit more complex. In some cases, it may be necessary to eliminate the food completely from the diet, while in others, it may be possible to consume small amounts without triggering symptoms. It is important to work with a healthcare provider or registered dietitian to develop a plan for managing food intolerances.

There are also several strategies that can help reduce the risk of allergic reactions. These include:

Reading food labels carefully and avoiding foods that contain the allergen

Informing family members, friends, and caregivers about the allergy

Carrying an epinephrine auto injector at all times, and knowing how to use it

Avoiding cross-contamination by thoroughly cleaning surfaces and utensils that have come into contact with allergenic foods Asking questions about ingredients and preparation methods when eating out Being prepared for emergencies by carrying a medical alert bracelet or necklace that identifies the allergy Taking steps to manage stress, as stress can exacerbate symptoms in some people with food allergies and intolerances

In addition to these strategies, there are also several treatment options available for people with food allergies. One of the most promising treatments is oral immunotherapy (OIT), which involves gradually introducing small amounts of the allergen under medical supervision. This can help desensitize the immune system and reduce the severity of allergic reactions over time. OIT is currently available for peanut, egg, and milk allergies, and is being studied for other food allergens as well.

Another promising treatment for food allergies is the use of biologic drugs, which target specific parts of the immune system involved in allergic reactions. For example, omalizumab is a drug that can reduce the severity of allergic reactions in people with asthma and certain food allergies. Dupilumab is another biologic drug that has shown promise for the treatment of peanut allergies.

There are also several complementary and alternative therapies that may be helpful for managing food allergies and intolerances, although more research is needed to determine their effectiveness. These include:

Probiotics, which may help regulate the immune system and reduce inflammation Omega-3 fatty acids, which have anti-inflammatory properties and may help reduce the risk of allergies Acupuncture, which may help reduce symptoms of food intolerances Herbal supplements, such as butterbur and stinging nettle, which may have anti-inflammatory properties

While these therapies may be helpful for some people, it is important to discuss them with a healthcare provider before trying them, as they can have side effects and may interact with other medications.

Conclusion

Food allergies and intolerances are common conditions that can cause a range of uncomfortable symptoms, from mild to severe. While they may seem similar, there are important differences between the two conditions. Food allergies involve the immune system and can be life-threatening, while food intolerances do not involve the immune system and are not life-threatening. The management of food allergies and intolerances involves avoiding the offending food or ingredient, and in some cases, may involve oral immunotherapy or biologic drugs. It is important to work with a healthcare provider or registered dietitian to develop a plan for managing food allergies and intolerances, and to be prepared for emergencies by carrying an epinephrine auto-injector and medical alert jewelry. With proper management, most people with food allergies and intolerances can lead healthy, happy lives.

REFERENCES

The effects of intermittent fasting on weight loss and body composition

Intermittent fasting has become a popular dietary approach for weight loss and body composition improvement. This method involves alternating periods of calorie restriction with periods of normal eating. In this article, we will explore the effects of intermittent fasting on weight loss and body composition and discuss recent research findings on this topic.

Weight Loss

Intermittent fasting has been shown to promote weight loss by reducing calorie intake and increasing fat burning. A systematic review and meta-analysis of randomized controlled trials found that intermittent fasting resulted in significant weight loss compared to continuous calorie restriction diets (1). Another study reported that participants who followed an intermittent fasting diet lost more weight and fat mass than those who followed a continuous calorie restriction diet (2).

Body Composition

Intermittent fasting has also been found to have positive effects on body composition by reducing body fat while preserving lean muscle mass. A study in overweight and obese adults found that intermittent fasting resulted in a significant reduction in body fat and an increase in lean muscle mass compared to a continuous calorie restriction diet (3). Another study reported that intermittent fasting improved body composition by reducing body fat and increasing muscle mass in resistance-trained men (4).

Other Health Benefits

In addition to weight loss and body composition improvements, intermittent fasting has been associated with other health benefits, including improved blood sugar control, reduced inflammation, and improved cardiovascular health (5). However, more research is needed to confirm these findings and determine the optimal timing and duration of intermittent fasting for these health benefits.

Popular Intermittent Fasting Methods

There are several popular intermittent fasting methods, including the 16/8 method, the 5:2 method, and alternate day fasting. The 16/8 method involves restricting calorie intake to an 8-hour window each day, while allowing normal eating during the remaining 16 hours. The 5:2 method involves consuming normal calories for five days a week and restricting calorie intake to 500-600 calories on two non-consecutive days. Alternate day fasting involves alternating days of unrestricted eating with days of complete or partial calorie restriction.

Drawbacks

Intermittent fasting may not be suitable for everyone, and some people may experience negative effects such as hunger, fatigue, and irritability. Additionally, people with certain medical conditions, such as diabetes, may need to be cautious when practicing intermittent fasting (6). It is important to consult a healthcare provider before starting any new diet or lifestyle changes.

Conclusion

Intermittent fasting has been shown to be an effective approach for weight loss and body composition improvements. The 16/8 method, 5:2 method, and alternate day fasting are popular approaches to intermittent fasting. However, it is important to consider individual needs and consult with a healthcare provider before starting any new dietary approach.

REFERENCES

  • Ganesan K, Habboush Y, Sultan S. Intermittent Fasting: The Choice for a Healthier Lifestyle. Cureus. 2018;10(7):e2947.
  • Moro T, Tinsley G, Bianco A, et al. Effects of eight weeks of time-restricted feeding (16/8) on basal metabolism, maximal strength, body composition, inflammation, and cardiovascular risk factors in resistance-trained males. J Transl Med. 2016;14(1):290.
  • Tinsley GM, Forsse JS, Butler NK, et al. Time-restricted feeding in young men performing resistance training: A randomized controlled trial. Eur J Sport Sci. 2017;17(2):200-207.
  • Varady KA, Bhutani S, Klempel MC, et al. Alternate day fasting for weight loss in normal weight and overweight subjects: a randomized controlled trial. Nutr J. 2013;12:146.