This book is designed to give a completely up-to-date summary of Nutritional Medicine as it applies to front line medical professionals, medical students and the interested layperson. Newspapers often give contradictory and confusing reports on issues such as alcohol intake, dietary sugars versus fats and the value or not of taking supplements. In addition, many GPs are as confused as their patients on these matters as they get very little education in nutrition either at medical school or afterwards. But nutritional medicine is not really that confusing. There is some disagreement among experts but there is a consensus on the most important issues, albeit with slight variations.
I have summarized these generally agreed opinions but explained where there are differences of opinion and the reasons for these. This book is written in a style I use to communicate with patients and GP colleagues, using minimal scientific jargON.
John Nichols graduated from Liverpool Medical School in 1967 and entered General Practice in Guildford in 1971. He spent six months as research assistant to Ian Watson at the Shere GP practice in Surrey working on various projects including a trial of revaccination against measles 5-10 years after primary immunisation which showed a decline in immunity that was boosted by revaccination. In 1973 he joined The Fairlands GP Practice near Guildford where he was able to collaborate with university colleagues on a number of research projects. He was also a GP trainer for 20 years. He graduated the MSc Nutritional Medicine in 2005 and was subsequently appointed as a Visiting Research Fellow in 2011. He has published research on zinc status and postnatal depression, trace elements and female infertility, smoking cessation, diverticular disease and the use of probiotics in primary care. Published books include two books on Nutritional Medicine and three works of fiction. One science fiction novel has been published as a paperback and two are currently only available as e-books; all available through Amazon books.
Trans-fatty acid (TFA) rich foods were incorrectly thought to be a healthy alternative to fats derived from animal sources. How important was this for the epidemic of deaths from heart attacks in the mid 20th century? This is unlikely to be the only cause of all those early deaths. I have dealt with another explanation elsewhere in this book. Poverty and starvation during the depression of the 1920s to 1930s had a lifelong affect on the unborn child increasing the risk of cardiovascular disease and heart attacks in middle life. However, TFAs were undoubtedly a major factor and the guilt of the scientists and the food industry involved has been downplayed.
Nutrition and Science
There is no controversy about the harmful effects of dietary trans-fatty acids (TFAs) in the development of the metabolic syndrome, diabetes and cardiovascular disease. Modern food has contained these artificially produced fats in significant quantity for about 100 years. They have been generated commercially by passing hydrogen through heated vegetable oil leading to random breakdown of carbon-carbon double bonds and substitution by hydrogen atoms to give a semi-solid fat or “margarine”. The product was found to be very stable and therefore useful in food manufacture as it improved shelf life. Unfortunately, the USA Nurses Study (n = 85,095) reported in 1993 that a high intake of TFAs gives a 1.5 relative risk of coronary events in eight years.