Controlling influence on our health in an uncertain world

  Controlling influence on our health in an uncertain world

The world around us has changed significantly over time. Some changes have taken place gradually over decades, so gradually, in fact, that we have barely noticed.  Other changes have been rapidand drastic – a good example of this is the Covid-19 global pandemic when the whole world changed significantly - seemingly overnight.  

This article explores how we cope with change and how it impacts on our health.
Charles Darwin’s work around the origin of species involved looking at how species survive (or not if we consider natural selection) by adapting to their external environment and making minor modifications through successive generations – also known as ‘survival of the fittest.’

So, how has our understanding of evolution well, evolved?

Alongside our understanding that we can inherit height, speed and eye-colour, epigenetics has taught us that health impacts from our environment can also be passed down in our genes.  Health impacts are still being felt, for example, as a result of the Dutch Famine, two generations on, as explored in this New York Times article

Today, in many parts of the world, wee largely have no famine – so what external factors impact our health now?

Sedentary lifestyle and associated health problems

The biggest change to our external world is technology, which continues to evolve at a rapid rate.  Technology has many positive health benefits and it has done wonders for many industries and for healthcare worldwide, but it has a downside too.  

Technological advancements have resulted in less physical activity from humans.  There’s the obvious link with transport – i.e. cars, buses, trains, etc taking preference over the physical movement of walking.  Of course we cannot walk everywhere it simply isn’t practical, but the convenience of modern transport makes it all too easy to opt for the easy option each time, rather than only when it is necessary. Combine our increased use of transport with the broader technological advances to industry that has seen many people taking on seated, perhaps office-based roles rather than physical labour, and we quickly have a significant reduction in movement. 

Human beings are designed biologically, anatomically and physiologically to move. So not moving much is actually very bad for our overall health and well-being.   

Sitting disease

Whilst not a recognised medical diagnosis, the term ‘sitting disease’ is used widely amongst the scientific community to describe the combination of symptoms and medical conditions associated with a sedentary lifestyle. These include:

• Decreased bone-density and increased osteoporosis risk
• Increased cardiovascular disease risk
• Increased metabolic dysfunctions such as obesity and Type 2 Diabetes 
• Negative impact on vascular health 
• Increased risk of some cancers
• Premature mortality
• Increased hypertension
• Increased risk for high cholesterol
• Musculo-skeletal pains
• Increased risk of depression
• Poor sleep
• Decreased cognitive function
• Infertility 

Looking at the range and significance of the above shows us we we simply cannot afford to underestimate how big an issue sedentary lifestyles are. Recognising this, the World Health Organisation (WHO) said:“Sedentary lifestyles increase all causes of mortality, double the risk of cardiovascular diseases, diabetes, and obesity, and increase the risks of colon cancer, high blood pressure, osteoporosis, lipid disorders, depression and anxiety”


Additionally, according to WHO – “60 to 85% of people in the world—from both developed and developing countries—lead sedentary lifestyles, making it one of the more serious yet insufficiently addressed public health problems of our time. It is estimated that nearly two-thirds of children are also insufficiently active, with serious implications for their future health”.

So how can we address sedentary lifestyles?

As these developments have made our world seem smaller and tasks easier, the toll on our physical and mental health is a big price to pay.   To begin to address this, we should aim to be as active as our capabilities allow. There are some simple changes we can make to do this, for example:

• Walking the last two stops of your bus route

• Taking the stairs instead of the lift
• Taking breaks to move around from a seated role
• Trying a standing desk option 
• Taking a short walk in a work-break
• Doing seated strength exercises if you cannot walk, as this will enable your muscles to still be activated.
• Playing a game that is active rather than seated (Charades, for example can be quite physical)

We cannot change the world around us, it will continue to make things easier for us but we have to remember what we are designed for and move as much and as often as we can.  

Technological change and its impact on mental health

So we know that advances in technology have taken their toll  on our physical health, but what have they done to our mental health? 

Technology has been both beneficial and detrimental to our mental health.  In many ways during the pandemic, social interaction was solely reliant on technology and this, no doubt, was a life-line for many people.  Technological advances also meant that a large percentage of the working population could carry on working whilst staying at home, and millions of children worldwide were having their education over Zoom.  

The flipside of technology is that we feel we are ‘available’ all of the time. We don’t physically leave our workplace and we see/hear messages coming in at all times of the day and night. It’s human nature to have a look when an email or text message pings but this can lead to hours of over-work and cause stress.  

Additionally, for both children and adults, there’s the distressing rise in cyber bullying, which is possibly one of the most detrimental aspects of technology. 

There are small steps we can take to decrease the impact that technological advances have on our mental well-being: 

• Avoid scrolling on your screen late at night, if possible don’t take your phone into the bedroom at all.  Not only is the information we see potentially stress-inducing but biologically, the blue light which screens emit disrupts the body’s natural sleep cycle, making us feel mentally more alert and halting the production of melatonin (drowsy hormone)
• Limit the time you spend on social media each day – try to set time periods to ‘dip in’ rather than be at the beck and call of notifications
• If possible, put an out of hours reply on your phone and email to state that you will only reply to emails/phone calls during your specified hours – that way you won’t feel as anxious that the sender thinks you are ignoring them
• Some email signatures may state that they are sending emails at irregular hours as that is how they work, but that they do not expect an immediate response.
• Monitor children’s online activities very carefully, , ensure parental controls are in place to safeguard them against harmful content and risks, and make sure that they are not spending too much time on their screens

Changes to the food landscape and associated health problems

Our food landscape today is unrecognisable to what it was four decades ago. From the 1970’s onwards we began to see a rise in ‘convenient foods’ These didn’t require making from scratch and were considered revolutionary - they could go from a freezer to a microwave to your table in five minutes!  

Processed foods have, been around a while as you can consider Olive Oil, butter and tinned veg all forms of processed foods.  But over the years we have seen a big increase in the range of convenient processed foods, with the foods themselves getting more and more artificial therefore resulting in a new category of processed foods.  The new group is categorised as Group 4 – Ultra Processed Foods. These foods are about as far removed as you can get from the original whole food item. 


Impact on health from Ultra Processed Foods
 
There are three key reasons why ultra-processed foods are damaging to health, firstly, because of what they contain, secondly how they are produced and, thirdly , what they are missing.

Ultra-processed foods are derived in a laboratory and are unrecognisable to the foods of forty years ago. A lot of science has gone into making these foods to ensure that they are as appetising as possible, have a long shelf-life, be visually appealing and, in lots of cases, addictive. What that means for us is that we are able to eat a lot of these foods once we start. 

They are designed to be highly palatable, the term used is ‘Hyper Palatability’ the ‘perfect’ mix of sugar, salt and fat to ‘tickle your taste buds’ and activate your senses. These foods are even designed to have the ‘perfect’ texture so you don’t have to work as hard chewing, meaning you can eat more quickly, use less energy to eat the food and eat more and more food without getting full. In short, ultra-processed foods bypass your body’s natural ability to feel full by disabling your body’s production of Leptin, the hormone that tells you to stop eating.

In essence, once you start eating these foods, you won’t realise you are full, and they are therefore very easy to over consume. Additionally, due to some of the missing nutrients, you won’t feel satisfied and once your blood-sugar and mood crashes after the initial rush from the food, you will very soon be craving something else to eat.

The other problem with these foods is that they are predominantly comprised of ‘empty calories’ – or calories with no nutritional benefit.  Here’s just a few of the crucially important nutritional factors missing from UPF’s: -

• Protein – does more jobs in the body than you could imagine including muscle growth and repair, fixing cells, carrying oxygen around your blood, fighting infections, creating ‘messages’ around the body to stabilise your emotions and enabling you to feel full.
• Fibre – as there’s no fruit, veg or wholegrains there’s also no fibre! Fibre helps you to feel full but is also crucial for digestive and cardiovascular health.
• Vitamins and Minerals – a good balance is vitally important for overall physical and mental health 
• Essential Fatty Acids (EFA’s) –UPF’s tend to be very high in saturated fat and entirely lacking in EFA’s.  These ‘good fats’ support our brain health and our heart and are especially important in children - deficiencies of EFA’s in childhood can have significant health implications.

There’s no doubt that the changing food landscape is changing our health.  This is a global problem and a growing one.  There’s increasing research into the links with health and some countries, such as Brazil and Canada, are implementing national dietary guidance to reduce consumption.

Clearly this isn’t a problem that is going to go away any time soon, and we are seeing a big increase in people consuming a higher percentage of UPF’s than real food. What is most alarming, however, is the impact on children, who are not exempt from adult diseases such as Type 2 Diabetes.

1 in 5 people in the UK have a diet made up of 80% Ultra Processed Foods, more worryingly is that 64% of children get more than half their daily calories from this group, rising to 68% in teens. Here in the UK, we eat a huge amount of these foods, second only to the US.
Source – Dr Chris Van Tulleken – BBC 1 – What are we feeding our kids?

Food Choices
It isn’t easy to avoid these foods and, regardless of recent bans on some junk food advertising, there are many more issues we face relating to our food choices: -

• UPF’s are cheaper than convenient healthy foods (up to 3x cheaper)
• UPF’s are nearly always on offer in shops
• UPF’s are being marketed at children
• UPF’s are quick and easy
• UPF’s are everywhere!

So, what can we do? 

• Try not to shop when hungry
• Plan a shopping list you can make easy, wholesome meals from
• Avoid certain aisles in the shop (biscuits, chocolate, sweets etc) then you won’t see the offers
• Check the ingredients – if the list is very long with items you can’t pronounce try to avoid it
• Try to not introduce children to these foods too early (or at all) as they will develop a taste for them that will be hard to break

Summary

We cannot control the outside world but it can control us if we are not aware of its effects.  We must remember that technology is there to make our lives easier but biologically, we are designed to do certain things too such as walk, move, stretch, lift, dance, laugh, test our brains and relax.  Our food landscape has also changed, another result of tech developments, and this is having, and will continue to have, a dramatic, potentially devastating impact on our health.  

Making the right choices for our health in today’s world of convenience can be challenging. However, if we understand the risks involved in our modern-day lifestyles and foods, we can start to make more positive choices and enjoy a healthier, longer life.


Additional Reference Sources

• Too much sitting: a novel and important predictor of chronic disease risk?  British Journal of Sports Medicine Volume 43 Issue 2
• Sick of Sitting – 24 May 2015 Springer Link 
• Prolonged sitting - is it a distinct coronary heart disease risk factor? – Volume 26 Issue 5 – Current opinion in Cardiology 
• Sedentary Lifestyle: Overview of Updated Evidence of Potential Health Risks – Korean Journal of Family Medicine - PMCID: PMC7700832 PMID: 33242381
• Sedentary behaviour, physical inactivity and body composition in relation to idiopathic infertility among men and women – Pub Med - 2019 Apr 24;14(4):e0210770.
• Public health response to ultra-processed food and drinks – the BMJ June 2020 
• New evidence links ultra-processed foods with a range of health risks – BMJ – May 2019
• Ultra-processed foods: A global threat to public health – Global Food Research Programme 

An explanation of Ultra Processed Foods as defined by the NOVA food classifications


Understanding the groups that feature within NOVA food classifications:
 
Group 1 consists of both unprocessed and minimally processed foods 

The definition of unprocessed for these purposes is below: 
“Are obtained directly from plants or animals and do not undergo any alteration following their removal from nature”

Minimally processed foods can be defined as: 
"Natural foods that have been submitted to cleaning, removal of inedible or unwanted parts, fractioning, grinding, drying, fermentation, pasteurization, cooling, freezing, or other processes that may subtract part of the food, but which do not add oils, fats, sugar, salt or other substances to the original food"

Examples of Group 1 foods include: -

• Fresh and frozen fruits and vegetables 
• Dried fruit (not in oil or with added sugar)
• Meat, fish, poultry, seafood and raw eggs
• Plain yogurt
• Milk
• Nuts and seeds
• Herbs and spices 
• Tea, coffee beans and plain water

Group 2 consists of processed culinary ingredients. 

The definition of processed ingredients is below:
 
“These are products extracted from natural foods or from nature by processes such as pressing, grinding, crushing, pulverizing, and refining. They are used in homes and restaurants to season and cook food”

Examples of Group 2 foods include: -

• Salted butter
• Sugar 
• Oils from crushed olives or seeds
• Honey extracted from honeycombs
• Butter
• Corn starch 
• Coconut fat 

Group 3 consists of processed foods 

The definition of processed foods is:
 
“Products manufactured by industry with the use of salt, sugar, oil or other substances (e.g. from Group 2) added to natural or minimally processed foods (Group 1) to preserve or to make them more palatable”

Examples of Group 3 foods include: -

• Tinned vegetables
• Salted/cured meats
• Tinned fish 
• Tomato paste/puree
• Fermented alcoholic drinks (e.g. beer and wine)
• Freshly made cheeses
• Salted nuts

Group 4 consists of Ultra Processed Foods 

Ultra processed foods – of UPF’s – are defined below:

"UPF’s are industrial formulations made entirely or mostly from substances extracted from foods (oils, fats, sugar, starch, and proteins), derived from food constituents (hydrogenated fats and modified starch), or synthesized in laboratories from food substrates or other organic sources (flavour enhancers, colours, and several food additives used to make the product hyper-palatable). Manufacturing techniques include extrusion, moulding and pre-processing by frying. Beverages may be ultra-processed. Group 1 foods are a small proportion of, or are wholly absent from, ultra-processed products.

Examples of Group 4 foods include:

• Biscuits
• Chocolates and sweets
• Fizzy drinks
• Pre-prepared/packaged meat
• Pre-prepared/packaged pizza and pasta dishes
• Pre-prepared/packaged burgers and hot dogs (some sausages, you can source good ones from a butcher)
• Energy/sports drinks
• Dairy drinks (milkshakes etc)
• Margarine & spreads
• Instant soups, noodles, desserts (packet mixes of foods)
• Sweetened juices
• Breakfast cereals (most but not all)
• Pastries, cakes, cake mixes
• Packaged breads
• sweetened and flavoured yogurts, including fruit yogurts
• other animal products made from remnants
• baked products made with ingredients such as hydrogenated vegetable fat, sugar, yeast, whey, emulsifiers, and other additives
• ice cream and frozen desserts 
• fatty, sweet, savoury or salty packaged snacks
• Meal replacement shakes (many but not all)