Fatty liver disease comprises a broad group of liver conditions, ranging from simple liver steatosis to steatohepatitis, fibrosis, and even cirrhosis.

Age and obesity increase its prevalence and there is a strong association with metabolic syndrome and increased cardiovascular mortality and malignant diseases. When should you suspect it? How is it diagnosed? How do we prevent it or even reverse it?

Dr. Débora Nuevo – Neolife Medical Team

When should you suspect it?

In patients where liver steatosis is suspected, an initial assessment is recommended through a complete anamnesis or medical history, a full physical examination, and some complementary tests.

1. Medical history:

The patient should be asked the following questions, and an alert should be raised if he or she presents:

• Alcohol intake of more than 20 mg/day in women or more than 30 mg/day in men
• History of hepatitis C and/or B virus infection
• Personal history or family history of diabetes, high blood pressure, and/or cardiovascular disease

2. Physical examination, attention should be paid to the following findings:

• Body Mass Index > 25
• Waist circumference > 102 cm in men or > 88 cm in women
• Significant changes in body weight

3. Complementary tests, monitoring parameters such as:

• Liver enzymes (GOT, GPT, GGT)
• Fasting blood sugar test, HBA1, insulin, HOMA index
• Complete blood count
• Total cholesterol, HDL. triglycerides, and uric acid

How is it diagnosed?

There are different methods for formulating a diagnosis, both noninvasive (like blood tests and a variety of imaging techniques) and invasive methods, like a liver biopsy.

Laboratory data:

• The GPT value has sometimes been used as a screening method for diagnosis. It may be elevated, though it does not usually double or triple the lab’s reference value.
• The relationship between the GOT and GPT, a GOT/GPT ratio > 0.8, allows us to suspect stages of advanced steatosis.
• Elevated liver enzymes and proteins like GGT, alpha-2-macoglobulin, haptoglobin, apolipoprotein A, and TIMP1 should be noted, though none of them is a specific marker.
• High levels of ferritin may also act as predictors of fibrosis.
• Pro-inflammatory cytokines, like TNF alfa and Interleukin 6 (IL-6) may be elevated compared to other patients with fatty liver disease without inflammation.

Imaging tests:

• Abdominal ultrasound: the most commonly used imaging test. It is safe, non-invasive, accessible, low cost, and quite accurate in terms of diagnosis. A fatty liver without steatosis shows a homogeneous echostructure similar to the renal cortex and spleen. A fatty liver has greater echogenicity (it is brighter) due to the accumulation of fat vacuoles within the cells. There are four grades of liver steatosis as seen in an ultrasound: grade 0, without steatosis; grade 1, mild; grade 2, moderate; and grade 4, severe. The sensitivity to detect steatosis is about 93% the more fat there is.
  
• CT scan: a very accurate way to diagnose grade 2 and 3 steatosis, but not to detect grade 1. The attenuation of the liver parenchyma in the CT scan may be altered by other factors like excess iron and glycogen.
• Magnetic resonance imaging: the most sensitive imaging method for detecting an increase in liver fat. It can detect steatosis with only 3% fat content. The only drawback is that it is somewhat more expensive and less readily available than ultrasound.
• Fibroscan or transient elastography: performed with ultrasonographic pulse. It can detect cirrhosis with high accuracy, but its accuracy is lower in stages with less fibrosis.

Invasive tests: A liver biopsy is the best method for diagnosing, classifying, and predicting the evolution of liver steatosis. However, it is an invasive method, not without possible complications, so it should be reserved for patients with high risk of advanced fibrosis to rule out other causes of steatosis or fibrosis.

How can we prevent and/or treat it?

There is currently no specific treatment for fatty liver disease. The goal, both to prevent it and to treat it once diagnosed, is to control risk factors.

• Weight control: in patients with obesity or overweight it is recommended that they lose 10% of the initial weight in the first 6 months (between half a kilo and one kilo a week).
• A diet rich in polyunsaturated fatty acids and low in saturated fats, with antioxidants, fiber, fruits, and vegetables.
• Exercise for at least 30 minutes a day.
• Maintaining optimal cholesterol and glucose levels.
• No smoking and avoiding alcohol.

Some pharmacological measures, such as oral hypoglycemic medications and statins are sometimes also necessary. Medications that aid weight loss, such as orlistat, which inhibits fat absorption, can be quite useful in these patients.

Additionally, there are other therapies under study, such as probiotics that decrease bacterial translocation and decrease levels of TNF Alpha and IL6, among others, lessening liver damage.

Melatonin and Omega 3 fatty acid supplements have also been studied with very good results in lowering the amount of fat and liver damage.

BIBLIOGRAPHY

(1) Aller R, et al. Documento de consenso. Manejo de la enfermedad hepática grasa no alcohólica (EHGNA) [Management of nonalcoholic fatty liver disease (NAFLD)]. Guía de práctica clínica. Gastroenterol Hepatol. 2018. https://doi.org/10.1016/j.gastrohep.2017.12.003

(2) European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of nonalcoholic fatty liver disease. J Hepatol. 2016;64:1388—402. 2.

(3) Rinella ME. Nonalcoholic fatty liver disease. A systematic review. JAMA. 2015;313:2263—73. 3. Loomba R, Sanyal AJ. The global NAFLD

(4) Nobili V, Alisi A, Raponi M. Pediatric non-alcoholic fatty liver disease: Preventive and therapeutic value of lifestyle.

(5) Elizabeth Hernández-Pérez, Plácido Enrique León García, Norma Edith López-Díazguerrero, Fernando Rivera-Cabrera, Elizabeth del Ángel Benítez. Hígado graso y esteatohepatitis no alcohólica: patogénesis y tratamiento [Fatty liver and nonalcoholic steatohepatitis: pathogenesis and treatment].

(6) Liver steatosis and nonalcoholic steatohepatitis: from pathogenesis to therapy. Medwave2016 Sep;16(8):e6535 doi: 10.5867/medwave.2016.08.6535

La entrada Fatty Liver: the New Epidemic of the 21st Century? Part II se publicó primero en Neolife.

Emergencies and hospital admissions increase by 25% over the holiday season, mainly due to peaks of high blood pressure, diabetic emergencies, attacks of gout, and various digestive disorders related to overeating.

The holiday season is the time of year when people overeat the most and alcohol consumption soars, which leads us to reflect on the impact these habits have on our health. The World Health Organization (WHO) reminds us that what we eat and drink can lead to our body developing future health problems, such as obesity, cardiovascular disease, diabetes, and cancer. The following article teaches us that it is possible to have a healthy holiday season if you know how.

Tania Mesa – Director of Neolife Nutrition and Nursing Unit

Alejandro Monzó – Neolife Nutrition and Nursing Unit

What if we start the year with a new concept of holiday cheer?

Eating habits, in all their cultural variants and in a broad sense, define people’s overall health, growth, and development. The promotion of a healthy diet is often based on reducing saturated fat and calorie intake, and increasing the consumption of fruit, vegetables, and fiber. Unfortunately, flavorful foods that are high in calories, fat, sugar, and salt are available anywhere and anytime, and are especially popular at the Christmas table (1).

Chronic noncommunicable diseases are one of the biggest dangers to our health in the 21st century. Changes in eating habits and lifestyle have the greatest potential to reduce the risk of disease and improve life expectancy and quality of life for the population.  The Spanish Society of Endocrinology and Nutrition (SEEN), after conducting several reviews and studies, has concluded that eating habits (1):

• Play an important role in the prevention of cardiovascular disease.
• Are a crucial factor in the causes of excess weight, type II diabetes mellitus, and metabolic syndrome.
• May play an important role, although it hasn’t been scientifically proven, in causing cancer.

In the 2018 World Cancer Research Fund (WCRF) report (Figure 1.), ten recommendations were presented for the acquisition of healthy lifestyle habits and the prevention of chronic diseases (2). There is a whole range of factors, which undoubtedly affect our health and with sufficient knowledge, we have the ability to make healthy choices, including during the holidays.

In general, the holiday season, and although a lot of people are on vacation, may pose risks to our health, because of the frequency with which, over the course of several days, healthy habits are replaced by others that are not so healthy (drinking more alcohol, smoking, sedentary activities, overeating sweets and fats, etc.). A simple meal or dinner, such as Christmas Eve and Christmas, both separated by only a few hours, may involve the consumption of up to 3000 kcal per day, which is almost double the daily recommended calorie intake for one person (on average).

To get an idea of the extraordinary calorie intake we have during a holiday meal, in addition to the snacks in between meals, let’s see a few examples:

Recently, new reviews show that people underestimate their calorie intake by up to 500 kilocalories a day. This type of food, all at once and in high quantities, add up to a very high caloric intake (3). And not only that, but the quality of those calories is also of paramount importance. According to a study published in Nutrition Reviews, most people underestimate the number of calories they ingest (3). Eating habits have undergone major changes from industrialization to the present day. And, therefore, the intake of foods that predominantly contain flours, sugars, and fats has increased, with no thought to the consequences that this entails.

The study found that fats, sugars, alcohol, and sugary drinks are the food groups we underestimate the most. When attempting to lose weight (especially fatty tissue), people tend to underestimate their calorie intake, when their intake is actually much higher. The cocktail you drink when you’re cooking, the dressing you add to the salad, dishes with a lot of oil, snacks, pre-cooked and ultra-processed foods, etc. All this has an impact on our health goals and eating habits, and these excesses are plainly evident during the holiday season.

On the other hand, the Federación Española de Sociedades de Nutrición, Alimentación y Dietética,Spanish Federation of Nutrition, Food and Dietetics Societies, (FESNAD) reminds us of the importance of following the right diet during this time of year (5). The holidays don’t last 30 days, so you should avoid excesses during this time and limit snacking on key days, like Christmas.

According to the Spanish Society of Geriatrics and Gerontology Nutrition Work Group (SEGG), a majority of the population over 65 is diagnosed with a disease that could benefit from a healthy diet (6): over 60% have high blood pressure, 38% have diabetes, 50% have high cholesterol, 20-30% suffer from constipation, and 38% have osteoporosis. That’s where the importance of good eating habits lies for the elderly, and even more so during the holiday season. Emergencies and hospital admissions increase by 25% during the holiday season (7). The health of our loved ones is very important, and what better reason to raise awareness of the importance of healthy eating habits, than the aim of preventing disease and improving quality of life.

Once again, FESNAD emphasizes how important this is for those who suffer chronic diseases. On these special dates, patients should take special care with their salt intake, exercise a greater control of their consumption of sweets, and avoid excess fats and alcohol. As they conclude, even if there is nothing that is strictly prohibited, these patients and the general population should remember the need to maintain a healthy and balanced diet, exercising great measure.

In addition to the health problems we’ve already mentioned, people also suffer the following frequent ailments during the holidays (8):

• Acute gastroenteritis: it causes a transient alteration of the bowel’s ability to regulate the absorption and secretion of salts and water, as well as a rejection of food, which causes symptoms such as diarrhea, vomiting, fever, and abdominal pain. Although it usually improves on its own within one to three days, people may suffer this over the holidays.
• Stomach problems: the amount of food and the speed at which it is consumed may cause poor digestion, reflux, acidity, and stomach pain, among other problems.
• Fatigue and stress: copious amounts of food produce a lot of tiredness, sleepiness, and a lack of energy. Preparations, gift buying, or a hectic schedule during the holidays produce holiday stress that ends up affecting people on a muscular level.
• Constipation: during this time, there is a tendency to eat less fiber-rich food, as well as to consume less water and do less exercise, all of these key factors in good intestinal transit.
• Hemorrhoids: the excessive intake of spices, fats, spicy food, or alcohol that takes place over the holidays leads to an increase in the incidence of this ailment or a worsening if you already suffer from it.

At Neolife, we’d like to remind you that a first step towards eating healthier over the holidays is to ensure that any excess occurs only on the 4 or 5 truly festive days. If you are getting together with family and friends on additional days, you may want to propose other non food-related activities. We have mentioned the consequences that excesses on these dates may cause, in addition to the weight that is usually put on.

Therefore, this Newsletter, with the aim of improving your health for the coming years and raising awareness of its importance, presents simple guidelines for better eating habits, proposed by the Sociedad Española para el Estudio de la Obesidad, Spanish Society for the Study of Obesity, (SEEDO) and FESNAD, with which we will be able to enjoy the festivities without neglecting our nutrition nor suffering the negative consequences on our health (9):

• Don’t change your usual eating and exercise habits. Don’t forget to take your medication and keep your regular schedule. Save your “excesses” for special holiday meals.
• With just thirty more minutes of daily physical exercise we can compensate for the extra calories we take in during holiday meals.
• Control the alcohol you drink as it provides empty calories.
• Plan the menu. If the main course is very fatty (e.g. lamb, you should plan for light starters (e.g. vegetables).
• Plan your shopping to avoid leftovers.
• Don’t stop eating fruit. You can prepare as a dessert trays of tropical fruits or starters like salads or fruit skewers.
• While cooking, avoid snacking or grazing.
• Substitute manufactured sauces and dressings (which are very fatty) with homemade sauces made from vegetables, herbs, lemon juice, skimmed yogurt, and vinaigrettes.
• Prepare homemade desserts while reducing the sugar content (it can be substituted with Stevia) and fats.
• Eat just a little bit of everything. If you want to sample everything you see on the table, serve yourself small portions and don’t have seconds.

From everyone here at Neolife, we wish you a Happy and Prosperous New Year.

BIBLIOGRAPHY

(1)By Luis Román, D.A. et. al.. (2017). “Dietoterapia, nutrición clínica y metabolismo”. Tercera edición. Vegenat, Healthcare. Sociedad Española de Endocrinología y Nutrición (SEEN) y Grupo Aula Médica, S.L.

(2) World Cancer Research Fund/American Institute for Cancer Research. Diet, Nutrition, Physical Activity and Cancer: A Global Perspective. Continuous Update Project Expert Report 2018.

URL: https://www.wcrf.org/sites/default/files/Summary-third-expert-report.pdf

(3) Hall D., K. et. al. (2019). “Ultra-processed diets cause excess calorie and weight gain: an inpatient randomized controlled trial of ad libitum food intake”. Cell Metabolism, 30, 67-77.

URL: https://www.cell.com/cell-metabolism/pdf/S1550-4131(19)30248-7.pdf

(4) Mozaffarian, D. (2017). “Foods, obesity, and diabetes – are all calories created equal?”. Nutr. Rev, 75(1): 19-31.

URL: https://www.ncbi.nlm.nih.gov/pubmed/28049747

(5) (2015). “Evita los excesos en las comidas durante la navidad”. Gabinete de comunicación. Federación de Nutrición.

URL: https://www.fesnad.org/index.php?seccion=dinamico&subSeccion=noticia&idN=90

(6) (2015). “Ante los excesos navideños, la SEGG recuerda que la dieta es una herramienta efectiva para modular el envejecimiento”.

URL: https://www.segg.es/ciudadania/2015/12/21/ante-los-excesos-navide%C3%B1os-la-segg-recuerda-que-la-dieta-es-una-herramienta-efectiva-para-modular-el-envejecimiento (7) (2014). “Recomendaciones sobre alimentación en Navidad” [Recommendations for eating habits over the Christmas holidays]. Punto Farmacológico Nº61. URL:https://www.cofpo.org/tl_files/Docus/Puntos%20Farmacologicos%20CGCOG/20111230%20 INFORME%20RECOMENDACIONES%20SOBRE%20ALIMENTACION%20EN%20NAVIDAD.pdf (8) Maset, J. (2015). “Navidad saludable”. Cinfasalud. URL: https://www.cinfasalud.com/areas-de-salud/cuidado-diario/en-vacaciones/navidad-saludable/

(9) FESNAD-SEEDO. (2011). “Recomendaciones nutricionales basadas en la evidencia para la prevención y el tratamiento del sobrepeso y la obesidad en adultos”. Revista Española de Obesidad. Vol.10(1).

URL: https://www.seedo.es/images/site/documentacionConsenso/Documento-Consenso-FESNAD-SEEDO-Oct2011.pdf

La entrada A Healthy Letter to Santa se publicó primero en Neolife.

With the arrival of summer and high temperatures comes the season of enjoying getting drinks outside, and although alcohol has no place in a healthy diet, this time of year encourages its consumption. Excesses can ruin your vacation and we must set limits.

The Fundación Española del Corazón (Spanish Heart Foundation) (FEC) has warned about the increase in alcohol consumption during the summer, especially among young people, as it can cause an acceleration of the heart rate, also known as “holiday heart syndrome”. This pathology was first diagnosed in 1978 and is related to excessive alcohol consumption on a given day, the consequences of which can be fatal.

Tania Mesa – Director of Neolife’s Nutrition and Nursing Unit

Alejandro Monzó- Neolife Nutrition and Nursing Unit

Excessive drinking during the summer can lead to heart problems.

Holiday heart syndrome is a supraventricular arrhythmia that generally occurs in the atria and usually affects healthy, young individuals with no history of arrhythmias. It was first observed during the holidays around Christmas or New Year’s, and has now also been diagnosed during long vacation periods, such as the summer months, the FEC noted (1).

Since then, palpitations, shortness of breath, dizziness or chest pain have been observed in people who consume more alcohol. In most cases symptoms go away on their own once all the alcohol consumed has been metabolized. When symptoms do not go away, it may be due to ongoing consumption or even a genetic tendency of that person to suffer some kind of cardiovascular event (1).

The Sociedad Española de Cardiología (Spanish Cardiology Society) (SEC) explains that alcohol acts like a toxin in our heart. So the intake of high amounts of this substance in a short period of time releases adrenaline and norepinephrine, two hormones that cause an acceleration of the heart rate. In some cases arrhythmia may result in atrial fibrillation or be indicative of some serious cardiovascular event, such as a infarction, so it is very important to consider this information this vacation season (1).

There has long been a great deal of controversy, as numerous scientific studies attribute various benefits to alcohol consumption, with such claims as “a glass of wine a day is healthy for your heart” (2). In light of such affirmations, this newsletter seeks to put an end to these myths we have always heard and raise awareness of the severity of consuming of alcohol on a regular basis, and now even more during vacation.

According to sources in the global report on alcohol and health conducted by the World Health Organization (WHO), Europe is the region of the world where the most diseases are caused by alcohol intake. One in five Europeans over the age of 15 have indicated excessive intake of alcohol (more than five drinks ingested on the same occasion or 60 grams of alcohol) at least once a week (3). This excessive intake occur at all ages throughout Europe, not just among young people. In terms of data and figures, the WHO report has published the negative effects of alcohol consumption globally:

• Every year 3 million deaths occur worldwide due to the harmful consumption of alcohol, representing 5.3% percent of all deaths.
• The harmful use of alcohol is a causal factor in more than 200 diseases and disorders.
• Overall, 5.1% of the global burden of disease and injury is attributable to alcohol consumption.
• Alcohol consumption causes death and disability at a relatively young age. In the 20-39 year old age group, 13.5% of deaths are attributable to alcohol consumption.
• There is a causal link between harmful consumption of alcohol and a number of mental and behavioral disorders, in addition to noncommunicable diseases and trauma.
• Recently, causal relationships have been identified between harmful consumption and the incidence of infectious diseases such as tuberculosis and HIV/AIDS.
• In addition to health consequences, the harmful consumption of alcohol causes significant social and economic losses, both for individuals and society as a whole.

Excessive alcohol consumption is defined as more than three drinks on any given day or more than seven drinks a week for women and men over 65, and more than four drinks on any given day or more than fourteen drinks a week for men 65 years old or younger. Therefore, excessive alcohol consumption has shown to potentially increase the risk of having serious health problems, including (4):

• Different types of cancer.
• Pancreatitis.
• Sudden death, if you already have heart disease.
• Damage to the heart muscle that leads to heart failure.
• Stroke.
• High blood pressure.
• Liver disease.
• Suicide.
• Serious injury or accidental death.

Moreover, major studies have shown the relationship between the risk of cancer and alcohol consumption. In 2018, the World Cancer Research Fund (WCRF) presented a report that brought together scientific evidence on the consumption of alcohol (table 1). There is a causal relationship between alcohol consumption and increased risk of cancer of the mouth, larynx, pharynx, esophagus, colorectal, liver and breast (5). The report also showed that only one or two alcohol drinks a day (i.e. about 30 grams or more of alcohol per day) increases the risk of this type of cancers. Therefore, it is important not to overdo it now during vacation.

As for the nutritional value of alcoholic beverages, their primary content is water, pure alcohol (ethanol) and varying amounts of sugar, while the proportions of proteins, vitamins or minerals are insignificant or null. Therefore, all possible caloric intake comes from sugars and alcohol itself. A number of studies have described the existence of the complex relationships between regular alcohol intake and nutritional condition (6). When consumed in excess, alcohol can seriously interfere with the drinker’s nutritional condition, either by altering the ingestion of the food, its absorption or the body’s use of nutrients.

In short, there are many reasons why alcohol consumption increases in the summer, and almost all have a social component. In the summer, the body loses more water than at other times of the year through sweat and urine. Alcohol encourages the loss of body water needed for alcohol neutralization, which, together with the reduced natural hydration typical of high temperatures, increases the risk of dehydration. This can encourage heatstroke and jeopardize our health (7).

At Neolife, we’re sending you the message that alcohol consumption is not recommended in ANY amount. There are many risks associated with its consumption, and if you don’t like to drink or have never done so, don’t start now. If you do enjoy it, don’t forget the information we’ve just presented to you and always consume in moderation and do so responsibly. Finally, to enjoy the holidays in good health, here are some recommendations to reduce your intake of alcohol while still drinking:

• Opt for smaller beverage sizes. Whenever you can, dilute them with water, sparkling water or ice.
• Drink slowly, savoring the drink.
• Alternate alcoholic beverages with other non-alcoholic beverages such as tomato juice or fruit-flavored water.
• Try to stay away from drinking completely several days a week.
• Keep alternative beverages such as sparkling water or different fruit-flavored beverages in your refrigerator to avoid resorting to alcoholic beverages.
• Purchase non-alcoholic beer or non-alcoholic wine.
• Be aware of what and how much you’re drinking.
• Be careful in restaurants and bars where it is easier to ingest larger amounts of alcohol than at home.

BIBLIOGRAPHY

(1) (2019). “El abuso del alcohol en verano, causante del síndrome del corazón en vacaciones”. Fundación Española del Corazón. URL: https://fundaciondelcorazon.com/prensa/notas-de-prensa/2673-abuso-del-alcohol-en-verano-causante-del-sindrome-del-corazon-en-vacaciones.html

(2) (2016). “Las bebidas alcohólicas en una dieta saludable… ¿son buenas o malas?”. URL: https://www.nutricion.org/noticias/noticia.asp?id=113

(3) (2018). “Global status report on alcohol and health 2018”. World Health Organization. URL: https://www.who.int/substance_abuse/publications/global_alcohol_report/en/

(4) Mayo Clinic. (2018). “Alcohol: weighing risk and potential benefits”. URL: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/alcohol/art-20044551

(5) (2018). “Alcoholic drinks and the risk of cancer”. World Cancer Research Found. URL: https://www.wcrf.org/sites/default/files/alcoholic-drinks.pdf

(6) Moreno, O.R. & Cortés, J.R. (2008). “Nutrición y alcoholismo crónico”. Nutrición Hospitalaria. URL: https://scielo.isciii.es/pdf/nh/v23s2/original1.pdf

(7) Rubio, H.J. (2017). “Ola de calor + alcohol = las peores resacas del año”. Verne. Diario El País. URL: https://verne.elpais.com/verne/2017/06/16/articulo/1497598529_176483.html

La entrada Alcohol robs us of our health more in the summer se publicó primero en Neolife.

Alcohol is a source of empty calories, so called because of the absence of micronutrients (essential amino acids, fibres, vitamins and minerals).

Due to its large amount of kcal and its poor nutritional quality, alcohol consumption is not really advised to anyone, let alone those who are on a low-calorie diet or are looking to maintain their desired weight. If that is the case, then what can we drink that is non-alcoholic when meeting up with friends, or family, or going to events and parties…? In this article, we will help you choose an alternative drink.

Tania Mesa – Director of the Neolife Nutrition and Nursing Unit

Estefanía Schoendorff – Neolife Nutrition and Nursing Unit

Not only does alcohol present a huge amount of calories but, according to the World Health Organization, it is also linked to more than 30 diseases.

In today’s society, drinking alcohol is tolerated, encouraged and defended. However, the harmful effects of alcohol have been known since ancient times: excessive drinking is dangerous and can lead to many diseases, along with alcoholism, which is a chronic, progressive and fatal disease characterized by the build up of alcohol tolerance, physical dependence and pathological changes to the body’s organs.

Unlike coffee and tobacco, alcohol changes the personality of those who consume it in excess and it significantly affects their self-awareness.

In the International Classification of Diseases by WHO (1) the term alcohol is referred to as the cause or aggravating factor in more than 30 diseases, some of the most common being: mental disorders, neurocognitive changes, changes affecting the digestive system, esophageal hemorrhages, cirrhosis of the liver and cancer…

However, in this article we are not here to talk about diseases caused by alcohol, but rather its nutritional characteristics, the absence of nutritional properties and how to choose the best alternative drink options at social, festive or work events.

When we ingest alcohol (2), 20% of this is absorbed in the stomach and the remaining 80% in the small intestine. The rate of absorption will depend on the amount ingested, the type and percentage of alcohol, if you have eaten, and of course, on the physiology of each person, including sex and age as determining factors.

Within 30 to 90 minutes after ingesting alcohol, it will have already been completely absorbed by the body, and will be in the process of being distributed though the bloodstream throughout the body.

Most of the alcohol is metabolized or destroyed in the liverby the dehydrogenase enzyme. The remaining alcohol, not metabolized by the liver, is eliminated through urine and a small part by sweating and exhaling (note the characteristic unpleasant ethanol smell on the breath of a drunk person). Therefore, with regards to the body, we can say that alcohol is dangerous and, when taken in abusive quantities, damages our body, makes us sick and accelerates the aging process.

When talking about alcohol in terms of nutrition, we tend to refer to ethyl alcohol (or ethanol). Alcoholic beverages contain a variable % of alcohol, which usually ranges between 2 and 4 abv (alcohol by volume) in lagers and sparkling wines, up to more than 50 abv in stronger high-alcohol content drinks.

The ethyl alcohol content present in various alcoholic beverages can be calculated following the formula: “grams of alcohol = (alcohol content in ml x 0.97) / 100”, since one abv corresponds to 1 ml of alcohol per 100 ml of beverage (1 ml of alcohol being equal to 0.9 g).

Alcohol lacks nutrients: it is a source of empty calories, so called because of the absence of micronutrients (essential amino acids, fibres, vitamins and minerals). This is why alcohol does not nourish but rather fattens us up: representing 7 kcal per gram of pure alcohol. Therefore, at a nutritional level, the greater the abv of alcohol contained in the alcoholic beverage we are going to drink, the greater amount of empty calories we take on and the more difficult it will be to get rid of them. For example, 100 ml of Scotch whisky – around 40 abv – presents about 244 kcal, while 100 ml of cider – between 2 to 8 abv – would give us 42 kcal.

Due to its large amount of kcal and its poor nutritional quality, alcohol consumption is not really advised to anyone, let alone those who are on a low-calorie diet or are looking to maintain their desired weight.

If that is the case, then what can we drink that is non-alcoholic when meeting up with friends, or family, or going to events and parties…?

When socializing, we can find drinks that can be consumed daily, such as water, and other non-alcoholic drinks that can be consumed without misuse, and where the calorie content is mainly dependent on its sugar content.

For drinks consumed daily, we recommend:

• Water: the only thing that will actually quench our thirst, in addition to providing zero calories. Ideally, we ought to drink roughly between 1.5 to 2 liters of water per person per day.
• Sparkling water: this can be the alternative for those who want to drink something refreshing and fizzy when in a social setting.
• Fruit and vegetable juices or shakes(orsmoothies): 100% natural and non-processed, these help us to maintain weight and provide us with essential vitamins for our health. However, it is still much healthier to include whole fruit and vegetables in our diet, as these provide us with more fibre and help quench our thirst more quickly.
• Skimmed milk with pure cacao (0% added sugar ) sweetened with stevia: recommended in winter; with a low calorie content, this is a good alternative for those who dislike coffee.
• Infusions or teas: cold in summer and hot in winter, unsweetened or sweetened with Stevia. The most popular are green, red, black, and white tea.
• Coffee: a great companion for almost any time of the day, you can drink it on its own, add extra water for an Americano, or add a dash of milk and sweeten with Stevia. Avoid all types of coffee prepared with cream, caramel, sugar or sweeteners that add lots of kcal.

For occasional or moderate intake:

• Bitter Kas: a low calorie carbonated soft drink similar to sparkling water but with added flavor, for social events at any time of the day or night.
• Tonic: 34 kcal per 100 ml, an interesting alternative for those wanting a soft drink.
• Alcohol-free beer: 37 kcal per 100 ml.
• Nestea, sugar free: with only 1 kcal per serving, this could be a good alternative in social situations.
• Coca-Cola Zero or Light: provides 0-1 kcal per 100 ml.
• Kas Lemon or Orange: 33-34 kcal per 100 ml.
• Fanta Orange or Lemon: 38-46 kcal per 100 ml.
• Lemonade: 100 ml presents around 42 kcal and is almost 20% protein.
• Soda water (also known as Syphon): one glass presents around 35 kcal. Fat free, but limit your intake due to its 8.8 g of sugar in the form of carbohydrates.
• Alcohol-free grape must: 61 kcal per 100 ml, the ideal drink over ice in summer.
• Eggnog: 88 kcal per 100 ml, a good choice for the Christmas holidays.
• Gatorade (similar to Aquarius): 23 kcal per 100 ml.
• Blended fruit smoothie: drink only occasionally as it can represent around 261 kcal per 100 ml. It is better to eat portions of fruit instead and without mixing, if on a low calorie based diet.

For the occasional alcoholic drink:

• Cider: represents about 40 kcal per 100 ml, well suited to a Christmas party.
• Alcoholic beer: contains about 45 kcal per 100 ml. It would be better to choose 0% (alcohol free), as this can be suitable even when dieting to lose weight.
• Cava: a sparkling wine with around 60 kcal per 100 ml, ideal for social events at work or celebrations such as birthdays or anniversaries.
• With regards to wines(3), although we can make a distinction in terms of age, sweetness, and flavor… here we will use the more traditional classification:
  • Still wines: with alcohol content ranging between 8.5 and 14.5 abv. These wines are advised when dieting or controlling your weight.
    • Red wine: contains 75 kcal per 100 ml. A glass of red wine a day is recommended for its high content of antioxidants and nutrients which are beneficial to our health.
    • White wine: contains 82 kcal per 100 ml. As such, it is slightly higher in calories than red wine.
    • Rosé: one glass contains around 71 kcal.
  • Fortified wines: these are dry wines produced by select grapes and with an alcohol content ranging from 14 to 23 abv. Because of their high alcohol content, these represent a greater quantity of kcal (up to 150 kcal per 100 ml).
  • Natural sweet wines, mistelas and sparkling wines: these are characterized by a sugar content of around 5 g per liter. Due to their high sugar content, you should try to avoid drinking these.
• With regards to distilled beverages, below are some of the kcal per serving:
  • Patxaran: 83 kcal per shot (25 ml approx.).
  • Anisette: 117 kcal per serving (44 ml approx.)
  • Cognac: 103 kcal per serving.
  • Bourbon: 103 kcal per serving.
  • Whisky: 250 kcal per 100 ml
  • Rum: 231 kcal per 100 ml
  • Honey Rum: 440 kcal per 100 ml
  • Gin: 263 kcal per 100 ml
  • Tequila: 110 kcal per 100 ml

Spirits and liquors are very high in calories. In addition, if they are mixed with a sugary drink, we must then also take into account the additional calories of the mixer. Therefore, if we mix a serving of rum with Coca-Cola, Lemonade or Redbull, we can be taking in up to around 400 kcal per 100 ml.

Therefore, if you are on a low-calorie diet during the week, but when the weekend comes around you have on average 4 or 5 alcoholic drinks in a single night or during a single event, you will have ruined all of the work and effort you put in during the week, taking in way more calories than your body needs, and what is worse, without any nutritional value.

At Neolife, our aim is to teach you how to progressively reduce your alcohol intake on special occasions,whether social, with family or through work… We help you to achieve a healthy weight and then maintain it through a comprehensive and personalized treatment, with a specialized nutritional team.

BIBLIOGRAPHY

(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3307043/table/t1-arh-34-2-135/

(2) https://www.tabladecalorias.net/

(3) https://fundamentosdeenologia.wordpress.com/2013/02/20/el-vino-y-su-clasificacion

La entrada Alcohol, the great enemy of the bathroom scales se publicó primero en Neolife.

Bioidentical testosterone therapy, at the right doses, is completely safe and allows for a correct hormonal restoration. Nevertheless, myths and rumours still circulate despite lacking any scientific evidence.

Some of the misconceptions that abound in the collective imagination are: that testosterone is a “male” hormone; that its only role in women is for sexual desire and libido; that replacement therapy makes women more masculine; that it gives you a deeper (more manly) voice; that it causes hair loss; that it can have adverse side-effects on your cardiovascular system; that it causes aggression; or that it can increase the risk of breast cancer.

Dr. Iván Moreno – Neolife Medical Team

Many of these myths that create such a bad reputation for hormones are in fact extrapolations of the adverse effects seen from taking very high doses of anabolics, which have nothing to do with bioidentical testosterone.

Testosterone therapy is being increasingly used to alleviate symptoms of hormonal deficiency in pre and postmenopausal women.

Although numerous scientific studies show the safety and success of this treatment, rumours and myths have been created, which by sheer force of repetition seem to hold more “influence” despite lacking any supporting medical evidence.

Many of these myths are extrapolations of the adverse effects seen from taking very high doses of anabolics (testosterone derivatives) for other purposes (such as bodybuilding, doping, etc.).

In this article, we refer solely to therapy with bioidentical testosterone (which is identical to a human testosterone molecule) and only at replacement doses which aim to replenish the physiological levels we already had in our youth; this is the standard that governs a correct hormone restoration, which we employ here at Neolife.

Myth 1: Testosterone is a “male” hormone.

While it is true that men have higher levels of testosterone, the most abundant sex hormone present in a women’s body is also testosterone. Oestrogen (typically referred to as the “female” hormone), although present throughout a women’s life, is found in concentrations 10 times lower than that of testosterone. Testosterone, in balance with lower doses of oestradiol, is equally important for both sexes.

Fact: testosterone is the most abundant and biologically active hormone in women.

Myth 2: The only role of testosterone in women is for sexual desire and libido.

Another misconception, given that testosterone receptors are found in practically all tissues of a women’s body. Testosterone and its precursors decrease with age, and pre and postmenopausal women may experience symptoms of androgen deficiency such as: mood disorders, lack of well-being, fatigue, loss of bone density and muscle mass, mental dullness, memory disorders, hot flushes, joint discomfort, and sexual dysfunction etc.

Fact: testosterone is essential to a woman’s physical and mental health.

Myth 3: Testosterone treatment makes women more masculine.

Restoring a woman’s ideal hormone levels (to that which we had between the ages of 18-25 years old) far from making you more masculine, can in fact make you more feminine. Treatment should not be confused with the high supra-pharmacological doses which are administered to patients requiring more drastic changes due to gender issues; in which case, symptoms are still reversible by merely reducing the dosage.

Fact: excluding supra-pharmacological doses, testosterone has no masculinizing effects on women.

Myth 4: Testosterone will make your voice deeper (more masculine).

Hoarseness of voice can affect us at different times due to inflammation or infection of the throat, but is always reversible. There is no procedure whereby testosterone could produce such a phenomenon; even in cases of high doses of other androgens, there is no clear evidence of producing a deeper voice or any irreversible changes to the vocal chords.

Fact: there is no evidence that testosterone changes your voice.

Myth 5: Testosterone causes hair loss.

Hair loss is a complex and multifactorial process which is also genetically determined. “Androgenic” alopecia refers to the similar type of pattern baldness commonly found in men, not referring to the cause, but rather to the defined pattern. In any case, it is dihydrotestosterone (DHT), and not testosterone, which is involved. Obesity and insulin resistance, as well as alcohol, a sedentary lifestyle and some medications, can increase the conversion of testosterone to DHT and oestradiol in the hair follicle.

Approximately one third of women experience brittle hair and hair loss with age, which often coincides with a decrease in testosterone levels. However, there are studies in which hair regrowth has been achieved due to subcutaneous testosterone implants in such women.

Fact: testosterone does not cause hair loss; in fact, in some cases it can improve hair regrowth.

Myth 6: Testosterone has adverse effects at a cardiovascular level.

Unlike synthetic anabolics, there is no evidence that testosterone has any adverse effect at a cardiovascular level. In fact, its replacement has a beneficial effect on the metabolism of glucose and lipids, as well as on the maintenance of “lean mass” in both men and women’s bodies.

The most complete meta-analysis ³ carried out on this topic shows that there is no greater cardiovascular risk with testosterone replacement therapy; in fact, a lower occurrence of cardiovascular disease has been demonstrated in some groups (those presenting a higher cardiometabolic risk).

Fact: there is substantial evidence supporting the cardiovascular safety of testosterone, which even indicates a likely protective effect.

Myth 7: Testosterone damages the liver and can cause “clotting” (venous thromboembolic disease).

This is an “imported” rumour from the world of anabolic (synthetic androgens) over-use, which when taken orally in high doses, can in effect, cause liver damage. The truth is that parenteral testosterone (gels, skin patches or subcutaneous implants) avoids that first step through the liver and thus has no adverse effects (i.e. there is no increase in transaminase enzymes nor any alteration to the factors that affect blood clotting). There is therefore no relationship between testosterone administered in this way and the occurrence of blood clots (thrombosis, embolism), unlike synthetic steroids, or oestrogens taken without progesterone and progestins.

Fact: non-oral testosterone does not damage the liver or increase blood clotting.

Myth 8: Testosterone causes aggression.

Although the use of anabolics at high doses can cause aggression and attacks of “rage” (hence the rumour), this does not happen with testosterone. Even with supra-pharmacological doses of intramuscular testosterone, there has been no clear onset of aggression.

As has been previously mentioned, in cases of obesity, alcohol consumption, or a marked sedentary lifestyle, the conversion rate of testosterone to oestradiol can be seen to increase. The effects of excess oestrogen (oestradiol and its derivatives) however, have been associated with irritability and aggression in other species. In fact, in women presenting symptoms of androgen deficiency, treatment with testosterone has been shown to improve anxiety and irritability in more than 90% of cases².

Fact: testosterone therapy is not linked to aggression; even in women suffering from testosterone deficiency, therapy improves anxiety and irritability.

Myth 9: Testosterone may increase the risk of breast cancer.

Since 1937, it has been known that the development of breast cancer is usually dependent on oestrogen. Testosterone, however, could play a possible role in slowing down the growth of breast tissue, and may even be a treatment for breast cancer.

In recent studies, in which testosterone was administered together with an aromatase inhibitor (preventing any conversion into oestrogen), they found the tumour to reduce or even disappear⁵.

Fact: testosterone does not increase chances of breast cancer; in fact, it could help to prevent it.

Myth 10: the safety of testosterone use in women has not been tested.

Data of treatment at very high doses in transgender patients has existed for more than 40 years, and has shown this treatment to be safe. Any side-effects have been the consequence of oral intake (which is no longer used) or due to the conversion to oestradiol (which is rarely a problem at the doses used for bioidentical hormone replacement).

Fact: the safety of non-oral testosterone use has been well established in women for cases of very long-term treatments.

BIBLIOGRAPHY

(1) Glaser, R., & Dimitrakakis, C. (2013). Testosterone therapy in women: myths and misconceptions. Maturitas, 74(3), 230–234.

(2) Glaser R, York AE, Dimitrakakis C. Beneficial effects of testosterone therapy in women measured by the validated Menopause Rating Scale (MRS). Maturitas 2011; 68: 355–61.

(3) Corona G, Rastrelli G, Maggi M. Diagnosis and treatment of late onset hypogonadism: systematic review and meta- analysis of TRT outcomes. Best Pract Res Clin Endocrinol Metab 2013; 27: 557-579.

(4) Hackett, G., Kirby, M., Edwards, D., Jones, T. H., Wylie, K., Ossei-Gerning, N., et al. (2017). British Society for Sexual Medicine Guidelines on Adult Testosterone Deficiency, With Statements for UK Practice. The Journal of Sexual Medicine, 14(12), 1504–1523.

(5) Glaser, R., & Dimitrakakis, C. 2015. Testosterone and breast cancer prevention. Maturitas, 82(3), 291–295.

La entrada 10 myths about testosterone treatment in women se publicó primero en Neolife.

During the summer we have allowed ourselves the luxury of eating what we wanted when we wanted, in greater quantities, with an increase in sugars, fats and alcohol. And we’ve all noticed that on the scales.

That’s why we want to take a moment to share some recommendations with you that will allow you to recover from the excesses of summer and return to the weight you had before the holidays: drink at least 1.5L of water a day, do not over-indulge in alcoholic beverages, eat frequently but only a few times a day, avoid snacking on pastries, eat slowly and chew food well. It is important to opt for healthy and fresh foods, preferably wholegrain, avoid precooked or excessively processed, fried, battered and breaded foods whenever possible.

Tania Mesa – Nutritionist and Nurse from Neolife

To resume a balanced diet and a healthy weight, you must return to the sacrifices you made before you went on holiday and renounce fast and harmful weight loss

WE RETURN from our holidays and rediscover the reality of everyday life: we have enjoyed our holiday to the fullest or at least tried everything we could before returning home, we found ourselves forgetting our everyday obligations that we normally adhere to, and that is why we allowed ourselves the luxury of eating what we wanted when we wanted, in greater quantities, without schedules, with a general increase in excess sugars (ice cream, pastries, soft drinks), fats (tapas, fried foods, sandwiches, barbecues), alcohol etc. without forgetting that we have stopped exercising or have done less than we should whist we were on holiday – we have neglected our diet and now we have returned home with excess baggage.

But the surprise comes NOW when we return home and get on the scales. Before taking drastic measures as a result of your holiday, you should consider how best to return to a healthy weight and enjoy the benefits associated with a balanced diet. It is likely that you will have to make small sacrifices similar to those you made prior to going on holiday and we know that when we do our bodies and minds will feel better for our sacrifices. You should not be tempted into any plan to lose weight quickly or to attempt any diets or methods that are not the healthiest solution for your problem.

Next, I will share some recommendations with you about how you can recover from the excesses of summer and return to the weight you had before your holiday:

• When we are on vacation our bowel movements do not function as regularly as when we are at home and the intake of fibre often decreases as does the level of exercise we undertake.
• Similarly, we do not drink as much water All this causes us to suffer from fluid retention, which causes us to increase in volume considerably and feel bloated, heavy and irritable. As a result, we must remember when we return to our routine, that it is necessary to drink water (a minimum of 1.5L a day) or infusions (herbal tea) so that our body and our skin remain properly hydrated. This in turn will help our liver and kidneys to detox from the summer indulgence.
• Reduce salt intake. By doing this we will also avoid fluid retention and encourage the elimination of any liquids we have already retained. We can use herbs and spices as an alternative when cooking to ensure your dishes are even tastier.
• It is important not to fall into the temptation and reach for the refreshing drinks or juices, not even light or sugar-free drinks because although they do not provide kilocalories, their sweet taste increases the insulin level in blood, activate your appetite and lead to the accumulation of fat.
• Reorganise our schedules. It is important to consume small amounts of food every two / three hours. Or, failing that, adhere to a fasting or intermittent fasting plan as this will help you re-establish a healthy weight, not to mention the multiple benefits that fasting brings to our health (discussed previously in the article “Intermittent fasting could improve health and increase longevity”).
• Avoid dining late. Our dinners should be light and easily digested so that they do not interrupt our night’s rest.
• Eat slowly, small amounts, but often. By eating small amounts you not only facilitate the absorption of nutrients but such activity is essential to stimulate your metabolism and promote the feeling of fullness, which prevents us from reaching for foods when hunger strikes.
• Another good option is to opt for whole grains, which are healthier and provide more fibre (especially if you include the seeds), which produce a greater feeling of fullness, so you are likely to eat less.
• Do not snack between meals. Many people find it incredibly difficult not to snack on something more “rich, salty, sweet…” between meals. The key is to takes steps towards creating a positive habit little by little to not do the act or at least replace the act with healthier snacks: if you want to drink something, drink water, instead of crisps opt for pickled vegetables or cockles.
• To remove the empty feeling in the stomach that occurs mid-morning and in mid-afternoon it is important to change your habit. Salty snacks or sweets are not the only thing that can satisfy our anxiety during work hours: when at work it is the ideal moment to enjoy the taste of a good orange, a ham and tomato or turkey burrito or a delicious yogurt with three or four nuts to take away the hunger.
• If you find it a real sacrifice to stop eating sweets, you should not move to suddenly exclude them from your diet as this will be associated with frustration and anxiety. It is better to allow yourself to enjoy a small treat a week or to control the amount you eat.
• Plan your weekly menu so that your shopping list is fixed and you do not end up placing items you should not in your basket. Follow the recommendations and only make purchases after eating; this way you will be shopping when you feel less anxious and have less unhealthy cravings.
• Eat the same, but better. You do not need to stop eating or eat a spartan diet to lose weight. Our patients at Neolife know that the trick is to eat just enough to satisfy you (we do not weigh food), but yes, avoiding saturated fat, precooked meals, fast food and sugars is advised. Our diets focus on the importance of fresh products principally because they provide us with less Kcal and many more nutrients, that is to say, you “gain less weight but feed on more”. We are aware of the benefits of the Mediterranean diet and we apply the fundamental principles: do not over-indulge in animal proteins, increase the intake of legumes and cereals (whole grain), eat more fish, dress each meal with olive oil, eat fruit (2 pieces maximum per day, avoiding packaged/processed juices) and vegetables, the latter can be eaten cooked but also raw, in salads.
• If you go out to dine at a restaurant, ask for the “healthiest” option. Share the salad; ask for meat or fish, for example, grilled (the best cooking methods are en papillote (in parchment paper), boiled, steamed, grilled or baked. You should avoid fried, battered and breaded); accompany your selection with vegetables; and if you must order a dessert, share it with someone.
• Physical exercise is the best way to maintain good health and lose weight. Together with the correct diet, this should form the basis of your lifestyle. If you already were active in sports, you should return progressively to the sport and resume a routine, taking care to avoid injuries. If you are new to sports, now is the time for you to start a new activity. At Neolife we will help you adapt your physical activities on a regular basis and we will always take into account your needs and the most appropriate way for you to achieve your goals.
• We do not endorse reliance upon low-fat or light foods because these do not always reduce your caloric intake. Many times these products eliminate fats and sugars, but replace them with other types of sweeteners or lipids that can increase your energy intake. It is very important to read the nutritional information on the product in full before considering it as the magical saviour of ​​your diet (we recommend reading the previous articles on the interpretation of food labelling: “Do we really know what we eat?” and “Do we really know what we eat? (II)”).

Another belief is that in winter “we need more calories than in summer” because of the cold weather. This is a widespread belief, but totally untrue. During winter, as we are ‘covered’ by clothes, it is common for us to neglect our diet and let the extra kilos reset on our body. This causes alarm for most of us when the good weather appears again in the summer. So, why do we not start taking care of ourselves right now? If we do this then any change to our habits would be less radical and we would gain ground before spring arrives with the good weather. In short: you have to keep yourself properly hydrated and drink at least 1.5 L of water a day. You should not over indulge on alcoholic beverages. You should eat frequently but only a few times a day and avoid snacking on pastries (we can eat a sweet once in a while, but only when our goal is not to lose weight).

You should eat slowly and chew food well. Opt for healthy and fresh foods, preferably whole and avoid pre-cooked, over-processed, fried, battered and breaded… You should reduce calories little by little until you return to your usual diet and exercise regime to ensure you consume suitable amount of energy. You should not relax in the autumn and wait until next summer. You must start now! Above all: do not get become obsessed or stressed, never be discouraged and be persistent; If you skip a meal there is always time to make up for it during the next meal. In a short time you will see how you can achieve the results you expected. And remember that at Neolife we will be happy to redirect you should you need help this autumn.

La entrada Returning to healthy habits after the holidays se publicó primero en Neolife.

The actions that we propose below are very simple to carry out and you just need to remember them each day until they become part of your daily routine.

They are: make purchases of food in a planned manner and only on a full stomach, reduce your caloric intake, increase your daily physical activity, make 5 meals a day, eat slowly and without stress, avoid alcohol, drink at least 1.5 litres of water a day and drink tea.

Tania Mesa – Nutritionist and Nurse from Neolife

1. Eat less

The first cornerstone to losing weight is to reduce your daily caloric intake so that you achieve a negative energy balance, that is to say, eat less.

2. Purchase food when you are not hungry

Plan your purchases in advance and do not go to the shop on an empty stomach. In this way you will buy food and prepare healthier meals. When we are in situations where we feel hungry we react more to visual stimuli and impulse buy.

3. Exercise

Increase your daily physical activity. This is the key to losing weight and not gaining the weight again. It is very important to travel as far as possible on foot or go to the gym: the ideal exercise program is one hour three times a week or, if you can not manage this, at least half an hour three times a week. You will not notice significant changes in weight, but what is most beneficial is you will feel fit and agile which will encourage you to take more care of your body.

4. Eat 5 meals a day

Making several meals a day will help you avoid snacking between meals or excessive intake of food in a single serving. Eating at least every 3 or 4 hours is important to maintain blood glucose levels and avoid insulin spikes during the day.

5. Eat slowly and without stress

When we consume food quickly we reduce the segregation in the hormones that are responsible for the sensation of satiety (fullness), which can then lead to overeating.

6. Avoid alcohol

Alcohol contains a significant number of calories and can lead to an increase in snacking between drinks. When you reach your desired weight, there should be no problem in having a glass of wine with your main meal or during the weekend, since the wine can be a good contributor of antioxidants.

7. Drink a lot of water

Drink at least 1.5 litres of water each day.

8. Drink tea

Try many different variants: english breakfast tea or earl grey for breakfast, green / red tea during the day, chamomile at night etc. This is an excellent source of antioxidants and can be used to supplement your diet. If you suffer from insomnia you should not drink black tea after mid afternoon.

La entrada 8 weight-loss habits se publicó primero en Neolife.

An article has predicted that within 15 years the average life expectancy of women in certain countries will reach 90 years, and 84 years for men.

As there is a good chance that by the middle of the 21st century our life expectancy will exceed 90 years we must prepare now for the flood of ethical, political and social dilemmas that will accompany the new longevity: the changes required for a society that is currently centred on the adult-elderly; the steps required to ensure that the elderly live for decades through their “senior” years (over 60 years); concerns regarding their quality of life for those who reach the age; the challenge of being able to maintain a retired generation in these ageing societies…

Dr. Francisco Martínez Peñalver – Medical Director Neolife Marbella

A recent article has presented predictions of the average life expectancy for the next 15 years in different countries around the world.

According to the study –published in the prestigious magazine the Lancet (1)-, carried out in 35 industrialised countries, there will be an increase in the aforementioned index that marks the average life expectancy per inhabitant in each country. The study asserts that in countries such as South Korea, women will reach an average life expectancy of 90.8 years, something that was considered unattainable by some scientists only 15 years ago. Other countries such as France (88.6 years), Japan (88.4 years) and Spain are also heading towards a notable increase in longevity. In men, the top 3 countries for life expectancy is South Korea (84.1 years), Australia (84 years) and Switzerland (84 years). You may think that the US should be on the list, but even though their life expectancy will rise for women from 81.2 years in 2010 to 83.3 years by 2030, it is far from being at the top of the rankings. Inequalities in terms of access to healthcare and high perinatal mortality, amongst other reasons, prevent the US from being ranked higher in the study.

In the last century there has been a global increase in life expectancy of about 30 years, thanks to the availability of vaccines, antibiotics, and a notable improvement in hygiene-dietary conditions. In the future this increase will slow down and the focus will shift to chronic diseases -like diabetes, heart failure or COPD-, mental illnesses and pathologies relating to harmful substance addictions.

Another aspect that the study highlights is that as women have entered the labour market and have acquired the same habits as men (tobacco, alcohol, sedentary lifestyle etc.), the gap between life expectancy of the sexes has been narrowing. “If women smoke like men, they die like men,” says Dr. Ezzati, director of the study. As there is a good chance that by the middle of the 21st century our life expectancy will exceed 90 years, the article considers the flood of ethical, political and social dilemmas:

• On the one hand, we live in a society where 60-year-old people are considered elderly, and under this prism of increased life expectancy that would mean that the “elderly” will live for 30 years longer.

• One aspect that the study does not discuss is the quality of life which can be afforded to those who have reached the age, but it is notable that the study has focused on the 35 industrialised countries where the standard of quality of life is generally higher. Should we not assume that these 30 years of additional life will be lived with a quality of life similar to the standard they have lived through for the preceding 60 years?

• In the political sphere, will any country in the world be able to pay pensions for a period of up to 20 years more than what they currently sustain? Will it then be necessary to delay the retirement age in society? Increase the contribution rates and, therefore, increase taxes to the working classes that as time progresses will represent ever-decreasing percentage of the population?

• Finally there is the social aspect. As a society that in the 1980s celebrated the youth of people between 20 and 30 years old we must change towards a society centred on the adult-elderly, with all the challenges that this implies for business sectors including the health industry, where this new scenario will likely accelerate the development of strategies such as telemedicine (e-medicine) or devices that facilitate life to this section of the population.

The study does caution readers with the bad example of the US, where the difference between accessibility to health services and violent deaths prevent any growth in the life expectancy ratio, placing the life expectancy of women at birth in 2030 similar to the life expectancy in Croatia or Mexico. In a society with an inverted population pyramid it is easy to think of how this “bad example” could be extended to countries where the so-called “old age” is more dominant within the population.

Although we currently enjoy (at a regional level, not at a country-wide level) the longest life expectancy in the world within the Community of Madrid we have begun to witness a regression.

Fortunately, Spain is one of those countries cited in the article in the Lancet that is among those that will achieve the longest life expectancies. The excellent public health carelocated in a Mediterranean country where the general population are considered to be vitalist (although we also have our shortcomings) are deemed to underpin our higher life expectancy. However, the warning from the Lancet that the US “bad example” could be exported to other countries is already happening in our country, where child obesity rates place us amongst the top 10 countries in the world. Unless aggressive preventive policies are implemented to promote healthier lifestyles and other medical strategies we would not be surprised if the lengthening of our average life expectancy will slow or reverse entirely. In fact, in the Community of Madrid -where the longest life expectancy in the world (86.5 years for women, 81.2 for men and 84.02 on average for both sexes in 2015) is currently enjoyed (regionally, not by country)- this regression has begun to be observed, given that it was 84.21 years in 2013 and 84.29 in 2014 on average for both sexes. At the Neolife anti-ageing clinic the most advanced medical protocols are applied to ensure patients are able to reach an average life expectancy of 90 years without a decline in quality of life. We recommend the following blogs previously published on the revolutionary advances in the science of longevity and preventive anti-ageing medicine:

• The science of longevity in The Economist
• Neolife, in ABC Salud
• Antiaging, Age Management, Preventive Medicine…is it the same?
• Healthy Longevity, a trending topic (1)
• Healthy Longevity: a trending topic (2)

BIBLIOGRAPHY

(1) Kontis, V., Bennett, J, Matters, D. et al. “Future life expectancy in 35 industrialised countries: projections with a Bayesian model ensemble”. Lancet, 21 February 2017. DOI: https://dx.doi.org/10.1016/S0140-6736(16)32381-9

La entrada The 90 years average life expectancy is already here se publicó primero en Neolife.

According to a recent study conducted in the USA, the consumption of nuts could reduce the risk of developing colorectal cancer.

The researchers found that smaller tumor sizes were associated with a higher percentage of omega-3 in the tumor tissues. The incorporation of omega-3 fatty acids present in nuts caused a significant change in the expression profile of the nucleic acids present in the colorectal cancer tissue. That is to say, they were shown to reduce the inflammation and blood supply to the tumor, which led to a deceleration in the growth of the tumor.

Tania Mesa – Nutritionist and Nurse from Neolife

A study in mice with colon cancer demonstrated that those who consumed walnuts slowed the development of the tumor.

A new study by researchers at Harvard Medical School (USA) and published in the Journal of Nutritional Biochemistry (1), shows that nut consumption can reduce the development of colon tumors.

Walnuts are one of the most nutritious and healthy foods that exist, due to their antioxidant content (monounsaturated fatty acids, polyunsaturated fats, vitamin E and minerals). The nutritional properties are already well known most notably in the prevention of heart disease, diabetes and neurological disorders. But now, in addition to this long list we should add the slowing (deceleration) of colorectal tumor growth as they produce changes in the carcinogenic genes.

The micro ribonucleic acids (miRNA) are involved in the alteration of genetic expression. Research has shown that a diet rich in nuts causes significant changes in the expression profiles of miRNAs contained in colon cancer tissues.

The study analyzed two groups of mice who were injected with HT-29 colon cancer cells. The first group was fed 60 grams of nuts per day (equivalent to two servings per day), whilst the second group was fed a similar controlled diet, but without any nuts.

After 25 days, it was observed that the total amount of Omega-3 fatty acids, including the alpha-amino acid (ALA), a fatty acid vital for various body processes and known to reduce inflammation had increased up to 10 times in the tumor tissues of the mice fed with nuts.

There are multiple factors that can increase the risk of colorectal cancer: food, physical exercise, tobacco (smoking), alcohol consumption, age, family history, previous illnesses etc.

Colorectal cancer is one of the most prevalent tumors in Spain: there are approximately 20,000 new cases a year in men and 14,000 in women. In Europe alone, 150,000 new cases are detected every year. In Western countries it ranks second in the number of incidences, ranked only behind lung cancer in men and breast cancer in women. It accounts for approximately 10-15% of all cancers.

But what are the factors that, to a greater or lesser extent, increase the risk of suffering from this type of tumor:

• Food: diets rich in animal fats (red meat) and low in fiber increase the risk of suffering from this type of cancer.
• Physical inactivity: a sedentary lifestyle increases the risk of suffering from this disease.
• Tobacco use (Smoking): increases the risk of having polyps, which are usually the precursors of colorectal cancer.
• Alcohol consumption: alcohol may act to encourage the growth of colon mucosal cells, leading to the appearance of polyps.
• Age: the risk of developing this cancer increases with age, as it increases the likelihood of polyps presenting in the colon and rectum.
• Personal history of polyps: the appearance of adenomatous polyps increases the risk of suffering from this disease.
• Personal history of colorectal cancer: people diagnosed with a previous cancer have a higher risk of developing a second tumor in the colon or rectum.
• Inflammatory bowel diseases: the two main types of inflammatory diseases at this level are ulcerative colitis and Crohn’s disease. Both account for less than 1% of all colorectal cancers.
• Family history: in 5% of colon cancers, several genes have been identified, whose alteration can lead to syndromes that predispose an individual, to a greater or lesser extent, to the onset of bowel cancer.

Colon cancer causes, amongst other symptoms, blood in the stool, changes in stool frequency, narrower stools, tenesmus, abdominal pain or fatigue.

Colon cancer produces a series of symptoms that can vary depending on the location of the tumor within the large intestine:

• Blood in the stool: it is one of the most frequent symptoms of colon cancer. This can be red blood – more frequent in tumors of the sigmoid and descending colon – or black blood – which mixes with the feces, giving rise to black stools called melena-. After a certain amount of time bleeding or where the hemorrhage remains undetected or the doctor is not consulted for diagnosis and treatment, anemia usually presents. This anemia can produce, in turn, a series of symptoms such as a feeling of shortness of breath, tiredness, palpitations or dizziness.
• Change in bowel movement frequency: diarrhea or constipation may appear in people with normal bowel movements (most commonly interspersed periods of constipation with periods of diarrhea).
• Narrower stools: this occurs because the tumor is narrowing the bowel and does not allow the normal passage of stool.
• Tenesmus or sensation of incomplete evacuation: usually appears in tumors located in the most distal part of the colon.
• Abdominal pain: it is a frequent symptom, although it is usually a non-specific pain. When the tumor partially closes the caliber of the intestinal tube this leads to abdominal pain similar to cramps. In cases where the closure is full it is called intestinal obstruction, which is a serious clinical situation, which requires urgent medical assistance.
• Extreme fatigue or weight loss without an apparent cause: are general and non-specific symptoms that frequently occur in certain diseases, which includes advanced colon tumors.

There are two non-invasive predictive methods for colon cancer: septin 9 and fecal occult blood testing.

Colorectal cancer is one of the few cancers that can be diagnosed early, that is to say, before the person develops any symptoms. At the Neolife clinic we use two different tests:

• The test that detects the Septin 9 biomarker in the blood plasma. The presence of this biomarker is related to the existence of this type of cancer.
• The test for fecal occult blood in the stool (TSOH), which as its name indicates detects whether or not there is blood in the stool.

If the results of these tests are positive, a colonoscopy is used to visualize the source of the bleeding.

Therefore, colorectal cancer, despite the alarming figures, can be diagnosed early and treated during the early stages where survival rates are much higher. And not only that: you can even avoid the very onset of the disease.

At Neolife we focus on reducing or eliminating the previously defined risk factors, particularly in terms of food, alcohol, tobacco and physical exercise. We have taken steps to incorporate 30 grams of walnuts (preferably at night before bedtime) and supplemented by Omega-3 (369mg of EPA and 250 mg of DHA with antioxidant mixture) into the diets we prepare for our patients.

BIBLIOGRAPHY

(1) https://www.jnutbio.com/article/S0955-2863%2815%2900070-4/abstract.

La entrada Nuts vs colorectal cancer se publicó primero en Neolife.

The secret to avoid excess and maintain good health is moderation, as well as the need to compensate in the next meal for the excess ingested in the previous meal.

Achieving this can be easier than you think if you follow certain nutritional advice: eat vegetables and fruits, chew slowly, drink sensibly (know your limits), do not skip any meals, prioritize fish and poultry, moderate your consumption of salt, drink plenty of water, avoid processed foods and exercise regularly…

Tania Mesa – Nutritionist and Nurse from Neolife

Enjoying a good meal and taking care of our health at Christmas is possible if you follow a series of nutritional guidelines.

During this period food becomes a principal part of our reunions and so it is important that you keep in mind the nutritional advice below to help you approach Christmas mealtimes in a healthy way. The celebration of Christmas is often associated with eating large quantities of food and drinking excessive amounts of alcohol. Furthermore, traditional festive foods are rich in salt and fat much like traditional sweet foodstuffs often consumed at this time of year. Consequently it is common for their consumption to cause weight gain.

Watching your figure and avoiding temptation is not always easy though. Notwithstanding the above there have been a number of different studies that have related Christmas with a health concern due to the subsequent side effects the event has on our health. However, at Neolife we believe that it is possible to enjoy the celebrations without eating or drinking to excess and take steps to maintain our health. The secret is moderation, as well as awareness of the need to compensate in the next meal for the excess ingested in the previous meal. Achieving this is much easier than you may think.

• Reduce the crucial days of Christmas to 5 or 6 at most. Do not lengthen the celebration – traditional celebrations take place from mid-November until Three Kings Day (also known as Epiphany). Be selective and on non-holiday days return to a suitable food routine.
• Create a balance between meals and dinners. During Christmas, almost all reunions, dinners and parties take place at night, so we know in advance that we will eat most of our food at this time of day. The ideal to aim for is to balance your calorie intake throughout the day and opt for a well-balanced breakfast, followed by a light lunch (non-fatty/skimmed broth without noodles, salad, sushi, fish or baked chicken and vegetables) with a fruit or yoghurt snack. As a result you will feel less hungry when the event takes place and have a little more freedom to eat at night, although you must remember the key is moderation.
• Do not skip any meals. Skipping breakfast is a mistake: 4 meals should be eaten, and if possible, 5 meals a day is better. Compensating for a previous fast by eating to excess in the next meal will only result in increased hunger at the wrong time and eating more of the foodstuffs you should not eat. This is because prolonged fasting reduces blood sugar levels and leads to an increase in endogenous production of insulin, which results in increased appetite and absorption as well as a faster carbohydrate metabolism.
• Plan your shopping list and menus in advance: do not keep leftovers in your house throughout January.
• Select foodstuffs that offer the best possible quality guarantee and avoid potential food poisoning.
• Do not eat excessively: eat everything but in small quantities. The key is to not overdo any single food category, avoid “picking at food” whilst cooking, eat slowly and comfortably (the signal from the stomach relating to satiety takes about 20 minutes to be received by the brain) and chew all food properly.
• The dishes should be prepared with balanced portions in mind and include vegetables, salads and a wide variety of colors and flavors (chicory, pomegranate, nuts/dried fruits, orange). Remember presentation is also important. You should also remove appetizers, or if you do not want to give up on canapés entirely, try skewers of cherry tomatoes with burgos cheese, pineapple with cheese, ham with melon, grilled vegetables with prawns, small portions of cod with oil and orange juice, salmorejo, mushrooms with caramelized onions etc. You must remember to modify the recipes that you are going to prepare, replace cream and butter with light or semi-skimmed alternatives.
• For the first course, opt for vegetables, preferably seasonal vegetables suited to this time of year, such as red cabbage or artichoke thistle. They can be placed in the oven instead of sautéed with béchamel or fried.
• In the second course, you should try to serve fish: your heart and your arteries will benefit from the polyunsaturated fatty acids contained in the fish.
• Seafood, low in calories, helps us enjoy large meals without increasing in size. It is the star ingredient in many Christmas menus and, as long as the pocket allows for it, seafood can be the first course in your meal as well. For example, prawns possess an excellent nutritional value, given their protein, mineral and vitamin content, which provides very clear benefits to your health. Nevertheless, we must be careful to avoid excessive consumption of seafood during these meals: you should not over indulge on seafood, since seafood contains uric acid, which if concentrated in the joints can produce pain and cause the dreaded “gout attack”.
• We recommend all types of fish, both white and oily (‘blue’ fishes) as their proteins are similar to those which can be found in meat, but contain less fat and calories.
• The most widely recommended meats to include in your meal are poultry (chicken or turkey), as well as rabbit, ostrich or lean beef. Priority should be given to lean pieces of meat (those with a whiter color) and in any event you should endeavor to remove any visible fat, as well as the skin from poultry prior to cooking. You must avoid intense red or very fatty meats like duck, suckling pig, lamb, sausages or cold meats – by doing so you can avoid excess saturated fats and unwanted cholesterol.
• Steam, oven and griddle are the healthiest cooking methods you can use. You should avoid battered or fried foods wherever possible.
• Avoid sauces that are rich in fat and sugars. We recommend that you season your dishes with herbs and spices (dill, lemon, garlic, onion), vinaigrettes, light mayonnaise (very small quantities), yoghurt sauce or raw oil (olive residue) with lemon. By doing this the dishes will be lighter.
• We recommend vegetable-based fats, particularly olive oil. We do not recommend animal or saturated (solid) fats from lard or deli meat, creams, pates or fatty cheeses.
• Moderate salt intake.
• Your intake of fiber should be consistent during this period, eating whole wheat bread, vegetables, pulses and fruits, since they help provide satiety.
• As for desserts, you should opt for homemade pastries. Homemade biscuits with nuts and apple are delicious and fun to make with your children or your partner; even traditional Three Kings cake can easily be made with a processor. Also you should choose fruit-based desserts: fruit salads, fruit skewers or gelatin based light yoghurt with red fruits. Pineapple and papaya are low-sugar fruits that also have a diuretic effect that can be very beneficial to your health. We also know that the intake of probiotic yoghurt facilitates digestion and reduces swelling and digestive discomfort.
• Consume Christmas sweets in moderation: nougat, marzipan, peanut brittle, Spanish shortbread pastries (mantecados)…are all processed products which contain a large amount of energy in the form of fats and sugars. These can be replaced by sweets which contain a considerable proportion of nuts, such as nougat, with a minimum percentage of 60% almonds, nuts or dried fruits (such as prunes or dried apricots). It is also preferable to choose chocolate and sweets with a higher percentage of cocoa, which is known to provide less calories than chocolate nougat.
• It is neither necessary nor justified to choose foods that are free from sugar or intended for diabetics only: they are more expensive and do not provide any significant health benefits.
• Substitute sugar for Stevia or brown sugar.
• Try not to leave the food on the table once everyone has finished. This causes us to continue eating despite not being genuinely hungry.
• Drink 1.5 to 2 liters of water and fruit juices per day, outside of meals. In addition to purifying our body and eliminating toxins this will help us feel satisfied and prevent us from eating between meals. Prepare fruit infusions (apple, cinnamon, peach, strawberry) as this will enable you to drink more.
• Replace coffee during the meals with fruit infused drinks as these will facilitate digestion and avoid unwanted flatulence, like chamomile, mint, anise or green tea.
• Drink alcohol in moderation. Try to drink from smaller cups and avoid alcohol beverages with a high alcohol content (ABV). The main meals can be accompanied by one or two glasses of a good wine or cava to facilitate digestion and this should be enough to satisfy all but the most demanding palates. Remember that cocktails (particularly sweet-mixes, which mix several liquors with creams and juices) are loaded with sugar and unnecessary calories. It is useful to remember that after drinking alcohol you must drink plenty of water before going to sleep. This is important as it facilitates the purification of any alcohol present in the blood and, above all, accelerates the elimination of the neurotoxic metabolite, acetaldehyde, responsible for most of the effects of the “hangover”.
• On these dates it is also normal practice to consume many more soft drinks than usual, which is usually reflected immediately in our weight and a swelling of our belly.
• Avoid wearing tight clothing after lunch and wait at least two hours before going to bed if you have consumed a large evening meal to facilitate digestion and avoid problems associated with reflux.
• Follow our exercise routine, if you have access to the routine, this should be used to control your weight during Christmas as it can also be used to combat stress that is often associated with this time of year. You can increase your daily physical activity by walking a little more; use the car less, climb stairs etc. You must not forget that physical activity helps improve digestion. Another good alternative is to dance.
• Continue taking any prescribed medication and, if there are any doubts about how they may react with alcohol you must consult your doctor.
• If after the holidays you discover you have gained weight, you should take steps to lose the weight in a healthy way and under medical supervision or with the help of a nutritionist. You should not fast or use miracle diets.

To conclude, we want to emphasize that your health does not take any vacations and that if you enjoy good food and take care of your health then you can enjoy Christmas just like you have before: there are no “good foods” or “bad foods”, but please remember to eat regularly and do not eat to excess.

From all of us here we wish you a “Happy and Prosperous new year 2016”, and remind you that the new year can be a good time to adopt new healthy habits: stop smoking, lose weight, increase the amount of physical exercise you undertake, start new lifestyle choices, control your cholesterol etc. We recommend you visit us: at the Neolife anti-ageing clinic you will receive professional advice, always from the perspective of Age Management Medicine.

La entrada Christmas: excess fat, alcohol and weight gain se publicó primero en Neolife.