Multivitamin supplements: are they effective?

Raise your hand if you have never taken a multivitamin supplement. I bet most of us have. I have. So, there must be a reason we all take them at some point, they must be useful. Are they?

The JAMA recently published the results of a cohort study of over 390,000 healthy American adults (Multivitamin Use and Mortality Risk in 3 Prospective US Cohorts). The study led by researchers at the National Institutes of Health’s National Cancer Institute analysed 27 years of participants data, looking at the association between mortality and self reported daily multivitamin intake. Overall, half of the population studied consumed daily multivitamins (similarly, nearly half of British adults do).

The results confirm that the intake of such supplements has no benefits in terms of longevity. There was no difference in mortality from cancer, heart disease and cerebrovascular diseases between those taking multivitamins and the others. (In fact, the former were very marginally more likely to die during the study period…).

The unregulated supplement industry is worth tens of billions, and many so called health experts and social media influencers try to convince people that they need supplements to be healthier, stronger, fitter. However, no scientific evidence support these claims. Multivitamins cannot replace a healthy diet, and paying for vitamins/minerals is essentially paying for expensive urine.

A few reminders:
– if you have a diagnosed deficiency, are pregnant or trying to conceive, or elderly, you are not a « healthy adult » 😉
– vitamin D supplements are always recommended during the winter months
– always check with your GP before taking OTC supplements if you take medication
– always consult with your GP if your health deteriorates.


Is personalised better?

Quite a few companies and individuals (with and without qualifications…) now sell personalised nutrition (PN) packages, based on your « unique metabolism and needs« . To assess these, they will first sell you kits to measure parameters such as glycemia, vitamin and mineral levels (iron, B12, D etc), hormone levels (in particular thyroid hormones), blood fats (cholesterol, triglycerides…), gut bacteria and even your genetics. They will also ask you to fill in questionnaires about your dietary habits, lifestyle, general health status (are you tired?) and phenotype (body type, skin colour).

Holzapfel & Drabsch (2019)

They will provide you with your results and their interpretation, and issue « tailored » dietary and lifestyle recommendations: eat more of this, less of that, move more. But does the personalised advice outperform general guidelines? NO.

Several studies have shown that PN does not do any better than general public health advice in healthy adults. In particular you can check the Food4Me European study and Food4Me RCT, The Personal Diet Study, Ben-Yacov et al, and even PREDICT 1 Study by Zoe. The magnitude of difference vs general advice is negligible, and linked to changes recommended in the general guidelines. At 6 month follow-up, most differences disappear. No additional benefits are shown with the addition of phenotype and genotype data. Furthermore, some of these studies are flawed: what is effective on an outcome is determined before the intervention, labelled as « personalised », and participants are told to do what we know will work: the benefit was therefore expected to occur.

The actual contribution of PN is negligible and of questionable relevance. If you are healthy, save your money and follow the general dietary guidelines to stay healthy. 😉

For the UK: the Eatwell Guide
Pour la France: Manger Bouger
Per l’Italia: Mangia Sano

If you wish to improve your diet or achieve a specific goal, work with a dietitian who will assess your needs and objectives, provide 1 to 1 coaching and support for lasting change.


Autism and nutrition

Food aversion and sensitivities are common in individuals with autism spectrum disorder (ASD), and behavioural issues can make mealtimes challenging, particularly with children. Some autistic people have a restricted diet, eating only a limited range of food, others may over-eat.

Dietary considerations for such individuals can be multifaceted, as each person’s needs and sensitivities may vary, yet their nutritional needs are the same as the general population. However, research shows that nutrition deficiencies are more common in children on the spectrum, adding to parents and carers’ concerns.

Here are some key nutrition points to keep in mind for individuals with ASD:

  • the need for routine around mealtimes: displaying mealtimes and menu can help, as well as using the same cutlery, plates etc.
  • sensitivity to smells, sights and sound: try maintain a calm environment at mealtimes. Playing a preferred music can help distracting from food/meal related anxiety.
  • food sensitivity: when the body reacts to some foods: identify and limit exposure. Introduce new foods gradually, identifying the person’s reactions.
  • food preferences: autistic individuals can have a strong preference for foods of a certain colour (often beige), cut in a certain way, avoid textures, prefer specific brands etc. Understanding these preferences will make mealtimes easier, you can bring small changes cautiously to see what works.
  • digestive issues are slightly more common in autistic individuals, try increase the fibre content of meals (wholegrains, vegetables, pulses) and offering probiotics. Make sure they hydrate sufficiently.
  • Many autistic individuals have special interests that can be channelled into developing healthy eating habits: for example, have your child research the diet of an astronaut and build their own.
Eat like a superhero! ESA

Food diaries can be a great tool to recognise patterns. With trial and error, and adequate communication about meals and food, parents and carers can understand these preferences and barriers and can offer nutritious meals.

When to seek advice?
If an autistic person accepts a very small number of foods (less than 20), refuses a whole food group, loses or gains weight, does not develop healthily, is persistently tired, prone to infections and/or tooth decay, you should consult a GP who may direct you to a dietitian or nutritionist.


Preventing eating disorders in children and teens

While discussing our teenage daughters with a friend, the topic of eating disorders came up. Both of us were a bit puzzled by how much sweets they were having, because we never liked them at all (the sweets, we love our daughters!). We were unsure of how to tackle the subject of sweets, and more generally of food choices, missed meals, and what can appear as « poor eating habits ». Any discussion with a teen is such a minefield! What we absolutely want to avoid though, is that our children develop an eating disorder. How to can we prevent that and help our children have a healthy relationship with food?

All food is food.
When you have a child, you want to teach them that food is just food. Milk, nuts, fruit, veg, fish, biscuits are just food. It is that simple. The problem arises when we classify foods as « healthy/unhealthy », « good/bad », « clean/dirty » and attach emotional labels to it. Food is food, it has no moral value.

Don’t use food as a reward or a punishment.
Don’t take it away for a bad mark or bad behaviour. Using food as a treat encourages them to eat when they may not be hungry, potentially creating detrimental habits (for example regulating emotions with food). It can also make them assume that food is scarce, which can lead to overeating.

Listen to you body.
Teach your children to tune into their bodily sensations and notice when they are hungry and full, and to listen to these satiety signals. This goes with teaching them to trust their bodies, more than the messages about food we are bombarded with. Support your children by not forcing them to finish a meal.

Doing this can be difficult sometimes, because as parents we worry our children don’t eat enough of this or consume too much of that, consequently not getting the nutrients they need. Supporting our children and teens, offering them nutritious meals, and showing them we have a healthy relationship with our body and with food is the best we can do to prevent eating disorders.


In season: February

Some of us may start to feel bored with winter food (me!), but look, the days are getting longer and here and there hide the first signs of Spring.
Plus, February is the peak season for delicious fruits and vegetables! Here is a local selection valid for the UK and most northern Europe countries.

seasonal fruit veg february

Brussel sprouts, cauliflower, celeriac, kale, leeks, parsnips, potatoes, shallots, swedes, turnips, wild mushrooms, cabbage, winter squash…
End of season: beetroot and celery.
Beginning of season: rhubarb.

Apples, pears, clementines, lemon, oranges, kiwis, passion fruit, pomegranate…

Fish and seafood
Haddock, mussels, oysters, salmon…

Are you cooking this weekend? I will make an apple and rhubarb crumble, my daughter and I love it.


The nature fallacy

Today I explain the idea of the « nature fallacy » , also known as « naturalistic fallacy » or « appeal to nature » . The nature fallacy lies on the assumption that something is « good/better », « beneficial » or « superior » because it is « natural ». Conversely, this assumes that what is unnatural is bad or wrong.

In the context of nutrition and diet, the nature fallacy can manifest in various ways. For instance, people might believe that certain foods or diets are superior simply because they are perceived as more natural or traditional. Conversely, they will reject synthetic or fortified food of the basis that they would be « unnatural ». This perspective overlooks the complexity of nutritional science and the fact that what is « natural » doesn’t always equate to what is optimal for health.

It is important to repeat that the natural state of things doesn’t imply superiority. In the realm of nutrition, what matters most is evidence-based research and understanding the nutritional composition of foods rather than making assumptions based solely on their perceived naturalness.

Credit: Ievgenia Lytvynovych; Mikroman6; Ralf Menache; Hein Nouwens; Zu_09; Bauhaus1000; Ilbusca

The « nature fallacy » is widespread in social media in debates and « advice giving » about the health an nutrition. Here is how you can spot it:

  • Assuming natural is better: this suggests that if something is natural, it is automatically healthier, morally superior, or more desirable. An example is saying that organic foods are healthier than non-organic foods because they do not have pesticides or other chemicals (deemed « unnatural »), which may be potentially harmful to humans in large doses. Truth is some natural substances can kill you too. Another example is selling you « natural », totally unregulated, often useless, and potentially harmful health/food supplements.
  • Rejecting the unnatural: this form of the fallacy involves rejecting or condemning something simply because it is perceived as unnatural. An example could be dismissing genetically modified organisms (GMOs) in agriculture without considering the potential benefits or risks based solely on the fact that they are modified. Note that sometimes vocal advocates for the « natural is better » largely consume « unnatural » food supplements….
  • Idealising the past: Another manifestation of the nature fallacy involves idealising the past and assuming that things were better in a more « natural » state. This is often seen in discussions about food choices and lifestyle, where people argue that historical or ancestral diets are automatically optimal for modern health, without considering the cultural, environmental, and lifestyle differences. A typical example is the promotion of the Paleo diet.

By relying on scientific evidence and understanding individual dietary needs, a dietitian or registered nutritionist help you make informed choices about your nutrition, avoiding the nature fallacy and focusing on what is genuinely beneficial for your health and well-being.

If you have remarks or questions, I would love to hear from you.


Ready to ski? What to eat for winter sports.

It’s peak winter season and some of us are heading towards the mountains for a good dose of winter sports. An adequate « mountain diet » depends on the intensity of physical activity you plan to have and the altitude of the place you go to. For good and safe fun, ensure sufficient energy intake: you may need to increase your consumption of quality carbohydrates to compensate for the increased energy expenditure and slightly increased metabolism in altitude.

Also, it is always better to have regular physical activity to hit the slopes in good shape, or to prepare the month before with specific exercise (you can find ideas on YouTube). It significantly reduces the risk of injuries.

Start your day with a nutritious breakfast

Unless you are very fit, trained and habituated, don’t engage in intense physical activity on an empty stomach. After a good night’s sleep, help yourself to a warm drink to hydrate, accompany with porridge or bread (better if sourdough and wholemeal for the fibre content, slower release of energy and satiety). Try to vary the grains: wheat, rice, rye, oats… Have some jam, marmalade, honey or butter. You may want to add a dairy or non dairy product such as milk, yogurt, cheese.
A piece of fruit will reduce the oxidative stress, provide vitamins and minerals helping you fight the cold and the risk of muscle cramps.

Morning snack?

If you have been on the slope since 8 or 9am, you may want a morning break. It will be important to hydrate: in altitude, we feel thirst less, yet we lose significant amount of water through perspiration and breathe because of the exercise and altitude. Have a hot drink like tea or herbal tea to keep you hydrated and warm, maybe with a piece of dark chocolate, dry fruit or nuts.
Avoid alcohol which dehydrates, it increases the risk of chill burns, decreases attention, reflexes and coordination.

A light lunch to recharge your batteries

If you plan to continue skiing, snowshoeing or any other physical activity in the afternoon, avoid meals that are too heavy and rich in fats. Choose food that are easy to digest and good quality carbohydrates such as polenta, pasta or rice with a light sauce, vegetables, maybe lean proteins. A bowl of soup with a good piece of bread will provide energy and liquid, you also can make your own sandwich of lean meat, cheese and veg.
You may treat yourself to a glass of wine, but leave the raclette and fondue for the evenings or snowy days, otherwise you will feel lethargic on the slopes!

What to pack?

Hydration is essential, take a bottle with you, filled with water, hot tea or herbal tea, fruit juice diluted in water etc. Interesting snacks include dry fruits, nuts, (wholemeal) bread, dark chocolate. A piece of fruit will provide water and nutrients.
If you feel tired, have a warm drink with sugar, but don’t take risks and stop if you feel it is too much.


No, you don’t need a detox

Happy New Year my dear readers! I wish you all the best in 2024, and in particular good health and love.

This is January, many wellness influencers and magazines are rubbing their hands. They tell you that you had too much food, too many drinks, not enough exercise in the past couple weeks and that you need to fix that. And to fix that you need to buy their super quick and miraculous diet, on sale at the moment, how convenient is that? Detox diets and cleanses are another gimmick sold to you by the wellness industry. You don’t need them, you don’t need a detox, you don’t need expensive juices, supplements or monitoring devices.

Your beautiful body has a full set of organs that work together to clear itself of harmful substances and maintain a balanced internal environment:

  • Your liver is the primary organ responsible for detoxification. It filters toxins from the blood, metabolises drugs and chemicals, producing bile to eliminate waste products.
  • Your kidneys filter the blood, removing waste products and excess substances to form urine. They help eliminate toxins and maintain electrolyte balance.
  • Your skin acts as a detoxification organ by excreting toxins through sweat.
  • Your lungs eliminate toxins by exhaling carbon dioxide and expelling airborne pollutants when breathing.
  • Your colon removes waste and toxins from the body through bowel movements.

All super effective (unless disease), available 24/7 and FREE.

How can you support these wonderful bodily functions? Super easy: sufficient hydration, balanced diet and active lifestyle. Don’t waste your money and go for a walk.

If you want personalised no BS nutrition advice, contact me +447554787218.


From SAD to glad, how to beat the winter blues

Today I am writing about Seasonal Affection Disorder (SAD) and how to manage it. SAD (what great acronym!) is a transient depression, typically happening during winter months (there is however summer-onset SAD too) when there is less natural sunlight and shorter daylight hours. Since I have lived in London, I have always struggled with it. Now are the shorter days in the year, the weather is grey, rainy and the temperatures unpleasantly mild. It seems never ending…

SAD facts
The prevalence of SAD varies depending on geographical locations and other factors. It is estimated that up to 10% of the population suffers from SAD, and it is more prevalent in women. It is also more widespread in those who had depression in the past, suffer from mental health disorder or have a family history of SAD. Interestingly, it is more common in people born in Spring and Summer.

SAD symptoms and mechanism
SAD usually manifests as low mood, decreased pleasure and increased irritability, lethargy, tiredness, weight gain…
The physiopathology of SAD is not yet completely clear, hormonal dysregulation and low vitamin D are likely involved.

How to fight SAD?
You can combine various strategies if you suffer from SAD.

  • Light therapy: Daily early morning exposure to bright light really helps with SAD. You can buy these devices online, aim for at least 10,000lux.
  • The alternative, and for me a must, is to spend time outdoors, particularly in the morning. Walk to your bakery or coffee place, sweep the leaves, walk the dog… This naturally increases your exposure to daylight, which is effective even in the cloudiest weather.
  • Interestingly, people suffering from SAD show different dietary habits, such as more snacking and more abundant dinners. However, no nutrition intervention has been proven efficient in managing SAD yet. Radically changing your diet when you are struggling is never a good idea, but if you want to reduce snacking, increase wholegrains and fibre rich food for better satiety, and lean protein for easier digestion.
    Make sure you get enough vitamin D and limit alcohol.
  • Physical activity helps release « good mood » hormones that will help you feel better. Again, no need to be extravagant, a 15-30min yoga or weight session, a brisk walk in the neighbourhood will do the job, even more so if share it with a friend.
  • Social connections is indeed one of the easiest way to increase happiness. So for your own well being, be (selfishly) kind to others 🙂
  • You can try mindfulness and relaxation if you like this sort of things. Personally, it makes me worse.
  • Anything that helps decrease your stress levels will help, as well as having things to look forward to.
  • Last, but absolutely necessary, seek professional help if you feel that SAD has too big an impact on your life.

My dear readers, if you suffer from SAD, soon the days will get longer and the skies brighter. Close your eyes and imagine your dream place. Mine is anywhere by the ocean, on a sunny day… Much love x


Diet myths – carbs are bad

The biggest diet myth in my opinion, is that « carbs are bad« .

Carbohydrates are so misunderstood. They should be the main macronutrient of your diet (45% to 65% of your daily calorie intake should come from carbs) alongside proteins and fat. Carbs are molecules of various sizes made up of carbon, hydrogen and oxygen atoms.

simple carbohydrates or sugars are made of 1 or 2 molecules. They are also called mono or di-saccharides. Because they are small, they are very quick to digest and reach the blood. Examples are of course sugar, honey, maple syrup… These are also the sugars contained in fruits.
complex carbs are chains of more than 3 sugar molecules. They are called polysaccharides. They take longer to digest (that is, broken down in monosaccharides), providing a longer lasting source of energy. Typical sources include (whole grain) pasta, rice, starchy veg such as potatoes, legumes…
fibre is a type of carbohydrate that we can’t digest but plays an essential role in our metabolism: blood sugars regulation, satiety, good gut health and regular bowel movement…

Carbs are the essential fuel of human physiology (your brain relies on carbs/glucose) and as such support all bodily functions. They are found in foods that not only provide energy but also vitamins, minerals and chemicals important for good health.

While we all need to limit (not ban!) simple sugar (over the course of a week), complex carbs are an integral part of a healthy diet and crucial if you want to maintain or lose weight as they help you feel full for longer, reducing cravings. They also have an important role in the maintenance of healthy cholesterol levels.

In short, be smart, eat carbs 🙂