If you want to improve staff health, the boss needs to lead with healthy eating and exercise patterns him or herself. That was the message from speakers at Tuesday’s Optima-Life Firstbeat ‘Getting the Balance Right’ conference at Lord’s Cricket Ground, London.

NHS Confederation chief executive Mike Farrar opened the event saying: “Role modelling is part of leadership.”

This theme was picked up by former Unilever head of health and wellbeing Dr John Cooper, who told the story of a chief executive who started using a company gym at lunchtimes.  He said the boss would walk downstairs through an open-plan office in his “baggy t-shirt and shorts” and return sweaty carrying a banana and plastic bottle. Within weeks, 55 new staff had joined the gym.

Dr Cooper said that athletes spend 75 per cent of their time training – which includes scheduled time for “renewal and resilience”. They spend just 25 per cent of their time competing.

Athletes and business leaders are expected to be at peak performance, he said, yet the amount of time they each devote to rest and recovery is very different.

“Business people are competing 90 per cent of the time, but only spend ten per cent of their time in recovery. They see relaxing and sleep as being a bit wimpish,” he said.

When you ask leaders, how much time they rest, they say, “I take an annual vacation”, he said.

He added that research shows that the body needs recovery time several times a day, not once a year, and that recovery time leads to better performance. “Peak recovery is every two hours, not an annual vacation”.

Ole Peterson, CEO of Fit Im Job, a company in Zurich that coaches companies in wellness said: “You need to have the top guys down on the programmes. If the CEO is sending emails on a Saturday night, the staff think they have to do the same.”

“It’s all about energy balance. If you work late, it can be hard to switch off at the end of the day, and there may be a problem sleeping.”

Tips for business people from the conference included:

• Cut down on drinking alcohol, particularly evenings as this may affect quality of sleep.
• Take restful moments during the day for five minutes – eg use meditation to bring down stress hormones.
• Get some exercise into your busy day – even if it is a short walk at midday, or before work.
• Eat more fruit and vegetables, eat healthy snacks, avoid mindless eating, reduce caffeine.
• Prioritise sleep.

American Express discussed their Healthy Living wellness programme and estimated that the return on investment for the programme was £4.88 for every £1 spent. Part of the initiative involved reducing meetings from one hour to 45-minute slots. Staff had said they found back-to-back one-hour meetings stressful. The reduction to 45 minutes means staff now have time to refocus before the next slot.

The conference was organised by Optima-Life and Firstbeat who supply Heart Rate Variability (HRV) heart monitors to corporate clients and athletes. This technology produces data on the quality of sleep, resilience and stress levels of individuals. The data can be used to influence behavioural changes and improve energy and performance.

So, how could eating no grain carbs, or few grain carbs help manage your weight?

Well first the good news:

If you are eating meals without grain carbs you are likely having a piece of protein on your plate and replacing the empty space of the carbs with a big pile of vegetables, which we all know are a good thing.

Very few people eat enough vegetables. Five a day is the government mantra – but just two is what many people are having in practice. Vegetables are usually cited as a source of fibre – yes, yes. But their benefits are far wider eg from giving you energy, to helping your mood, to making your metabolism work well plus protecting you from catching coughs and colds and keeping your complexion glowing.

A benefit of protein with each meal is it takes a long time to digest. Therefore, you may be less likely to reach for sugary, white-refined carbohydrate grain foods which are nutrient poor and can affect your blood sugar levels leading to a vicious circle and more cravings for sweets and more white carbs.

Also a trade secret in the nutrition world is that protein has a high “thermogenesis” factor. Because it is a labour-intensive item to digest, up to 35 per cent of the calories of say your piece of meat, fish, eggs, beans or nuts will be spent just on digestion. So the result is less calories for you to exercise off or lay down as fat. This compares with between five and 15 per cent of other food groups.

Finally if you are going to go low carb/ no carb, it’s really important that the protein you do eat is good quality.

Meat can be a nutrient-dense food – it contains protein of course which is a raw material for growth and repair. It helps our brain chemistry to work properly and our hormone manufacture, plus the B vitamins are needed for energy and zinc for immunity.

However, as you may have seen in today’s press*, processed meats – which often come from intensively-farmed animals fed on grains and containing nitrates – may raise risks of cancer and heart disease.

Meats from animals that have eaten grass (the food they were designed to eat) rather than intensively-reared on grains, are known to have a better essential fatty acid profile – ie fats that have health benefits and are anti-inflammatory (eg helpful if you have allergies and intolerances).

There are also suspicions around the nitrites and nitrates in processed meats like hams, bacon and sausages.

However, if you really do fancy a sausage, I recommend you keep heaping the vegetables on the other side of your plate – as many different colours as you can, so the antioxidants counterbalance the carcinogens of the meat.

Finally – a note on portion sizes.

Government guidelines suggest 45g of protein per adult per day. That is the content of the protein NOT the weight of the food.

To fulfil this, you’d be looking at an egg for breakfast, a piece of meat the size and depth of a pack of playing cards at lunch and a piece of fish at dinner the size and depth of a cheque book.

If you find that no grain carbs really works for you, I suggest you look at The Paleo Diet, by Dr Lorain Cordain. Apart from weight loss, this diet has also been shown to improve many health conditions such as autoimmune diseases and allergies.

But remember, quality of your protein and piles of different –coloured vegetables are key if you follow this way of eating.

* http://www.guardian.co.uk/society/2013/mar/07/cancer-risk-processed-meat-study

That is unless you are carbohydrate shy or gluten intolerant. You see, If you work in the world of nutrition, just the word ‘pizza’ is a loaded word.

We sit down at the table and my son asks if he can have a Coke. More red danger flashing lights start whirring in my brain.

The words ‘high fructose corn syrup’ and the mountains of literature on that thorny subject flash up in front of me.

However, I keep my cool.

“Yes, sure – once in a while is fine,” I chirp.

Everything in moderation, I’m telling myself.

Son sighs relief and orders.

Son’s friend says to the waitress. “I’d like a Diet Coke please”.

My brain springs into full-scale anxiety. Artificial sweeteners…aspartame…oh my God… danger, danger danger…this time the file on my office crammed with scientific papers with research based on suspicions behind artificial sweeteners as depression triggers, appetite stimulants and therefore as obesogenics flash before me…

“Does your mum [a medical doctor by the way] let you have the diet versions?” I ask.

“Yep” he says.

My son looks pleadingly at me. I look horrified at his friend. The waitress looks around the table puzzled, notebook and pen poised.

Diet Coke gets ordered. Waitress leaves. There’s a pause.

Son’s friend turns to son. He says in a tone of pure sympathy and concern, no irony attached whatsoever:

“It must be terrible having a mum as a nutritionist.”

Faced with mountains of raw data on 12 people (six travellers v six non travellers) and working together with Nuffield Health’s chief physiologist Jay Brewer and leading psychotherapist Christine Webber, the story unfolded.

Journalists at the press launch expressed interest in the findings, but not surprise that holidays make your blood pressure go down, help you sleep better and help you recover from stress, with the benefits still being visible weeks after getting home.

The bit some were more surprised at was that some holidaymakers had lost weight around the middle of their bodies during the course of the study, although their body mass index had remained static.

Yes, their stomach circumferences went down. Hard to imagine hey? After all those leisurely lunches how did that happen?

This is where hormones come into play. Your waist is a very good measure of how your stress levels are. When we are stressed, we produce a hormone called cortisol. It is known as the fat-storage hormone. It makes us cling on to weight around the middle of our bodies and on our face. Therefore when you are under chronic stress it is common for people’s waist size to increase. On holiday, when you are having lots of quality sleep and are relaxing, you may produce less cortisol and therefore your waist measurement may go down.

Have you ever been on a diet and despite starving yourself, you still have that tyre around the waist? Ever fuelled yourself up on coffee and been so busy you didn’t eat much, yet that tummy still lingered, or even increased? Ever gone on a low-fat diet and eaten lots of yoghurts and cereal bars (not knowing they are full of hidden sugar) and still looked like a barrel? This is because stress and stimulants such as coffee, sugar, alcohol or skipping meals can result in high cortisol the dreaded fat-storage hormone.

As a nutritional therapist I thoroughly recommend taking your full annual leave and peppering it throughout the year. Think of it as a thoroughly-enjoyable form of weight management.

To see the whole report go to: http://www.kuoni.co.uk/holiday-health-experiment

This is a group which is well-documented as being at higher risk of type II diabetes, hypertension (high blood pressure) and obesity when they move from a traditional diet in the Caribbean to the western diet over here.

I expected to see their London diets full of high-sugar, high-salt breakfast cereals which might contribute to the chronic diseases apparent in this population.

But no, they were sticking with the core of their childhood diets: cornmeal porridge with condensed milk (but without cinnamon), akee and saltfish (akee changed from fresh to tinned) or eggs (factory-farmed now rather than home-reared). They were eating far less fresh fruit and vegetables in the UK (where they are expensive) than in Jamaica where they said the fruits fell from the trees in their back yards for free.

I began to question if these small changes over many years in the UK – compared to their childhoods in Jamaica – may be contributing to poorer health in this country?

Remember, researchers have found that when Caribbean populations move to the UK, certain diseases are more prevalent. For example when a community of Caribbeans (mainly Jamaicans) were studied in Manchester in 1999, it was found that 14 per cent of them had diabetes. However, when the same age group (25 – 74 year olds) living in Jamaica was examined, only 8.5 per cent of them had diabetes.

The researchers also found that the body mass index (bmi) varied. The Jamaicans in Jamaica had an average bmi of 24 and the group in Manchester were larger with an average bmi of 27.  (Healthy bmi by the way is 18.5 – 25)

At home the cornmeal porridge often had fresh cinnamon bark in it or was washed down with cinnamon tea. The saltfish was accompanied by fresh akee fruits and drunk alongside coconut water directly from the trees. Fruits were eaten fresh and whole rather than juiced in a carton or tinned here in the UK.

Interestingly cinnamon – which is widely used in  diets in the Caribbean may reduce risk factors of diabetes (Khan et al, 2003).  Consumption of cinnamon bark has been shown to improve blood sugar levels and reduce the risk of type II diabetes in some human studies at doses starting at 1g per day (Dagoua, 2007).

Fresh bananas and coconut water contain potassium which if eaten regularly may mitigate the high salt content in the salt fish and may help keep blood pressure down.

Extensive studies have shown that increasing the ratio of potassium in the diet lowers blood pressure. (Houston, 2005) (ie eating foods such as fruits containing potassium could help). The optimal balance of potassium:sodium in our diets should be around 5:1 (Institute of Medicine, 2005). However in the UK, it is often the other way around – eg if you are eating lots of high sodium (salty) food and little fresh fruit containing potassium.

The potassium:sodium ratios were examined in the urine of a large group of west Africans and Caribbeans living in the US (therefore likely to be on the Standard American Diet – highly-refined carbohydrate diet with low fruit and vegetable intake). Their potassium:sodium ratios were 4:1 (sodium:potassium) – the wrong way round (cooper, 1997). In the same study, the people measured in Jamaica had equal amounts of sodium and potassium in their urine – not perfect, but potentially better for their blood pressures.

Fruit juice from a carton might push your sugar levels higher than if you eat the fruit including the skin and pith giving you a trickle of sugar into your bloodstream rather than a big hit followed by an insulin rush.

Eggs from hens that peck around the yard – eating worms and insects, vegetable peelings and seeds are known to have a more optimal essential fatty acid profile (ie contain beneficial fats) which are understood to be anti-inflammatory and could be beneficial to weight management and heart health.

The dissertation made me question if  small tweaks to a traditional diet – which has been tried and tested and running well for years (in this case Jamaica via Cameroon) might potentially wreck havoc with health?

References

Cooper, R., Rotimi, C., Ataman, S., McGee, D., Osotimehin, B., Kadiri, S., Muna, W., Kingue, S., Fraser, H., Forrester, T., Bennett, F., Wilks, R. (1997). The prevalence of hypertension in seven populations of west African origin. American Journal of Public Health. 87 (2).

Dagoua, J., Seely, D., Perri, D., Cooley, K., Forelli, T., Mills, E., Koren, G., (2007). From type 2 diabetes to antioxidant activity: a systematic review of the safety and efficacy of common and cassia cinnamon bark. Canadian Journal of Physiology and Pharmacology. 85, 837-847.

Houston, M., (2005). Nutraceuticals, vitamins, antioxidants, and minerals in the prevention and treatment of hypertension. 47, (6), 396-449.

Institute of Medicine, (2005). Dietary reference intakes. Washington DC: The National Academies Press.

Khan, A., Safdar, M., Kahn, M., Khattak, K., Anderson, R. (2003). Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care. 26: 3215-3218.

Mbanya, J., Cruikshank, J., Forrester, T., Balkau, B., Ngogang, J., Riste, L., Forhan, A., Anderson, N., Bennett, F., Wlks, R., (1999). Standardised comparison of glucose intolerance in west African-origin populations of rural and urban Cameroon, Jamaica, and Caribbean migrants to Britain.  Diabetes Care. 22, 434-440.

The fashion seems to have become an overnight phenomenon (just check out any online diet forum to see what I mean) following doctor Michael Mosley’s BBC Horizon programme two months ago. In the documentary, Mosley lost a stone in five weeks following the 5:2 diet, based on current ongoing research by Dr Krista A Varady in Chicago.

He also reported that his total cholesterol dropped (but didn’t reveal by how much); his blood sugar levels slid from borderline diabetic to normal levels and his Insulin growth factor-1 (IGF-1) levels went down by “50 per cent” (no figures revealed).

High cholesterol is still thought to be a risk factor for heart disease. High glucose levels can lead to diabetes and complications such as amputated limbs and heart attacks. High IGF-1 levels may increase risk of certain cancers. so as you would imagine, Mosley was a very happy man with his results.

Many viewers seem to have been stunned and inspired by this news too. Hey, a quick fix to losing weight! Something simple with little thought about the content involved. Wow! Isn’t that alluring?

Remember the magic phrase here that is setting the nation alight? “You can literally eat what you like on the feed day.”  says Dr Varady as she and Mosley nose-bag burgers, fries, fizzy drinks and ice cream in a car at an American drive-thru.

The whole programme seemed to have been working up to this moment. Earlier we had met Jo in Washington, a CRONie  – someone who follows a Calorie Restriction with Optimal Nutrition diet. Notice the magic word here –Optimal Nutrition. I will come back to this later.

Jo is seen pouring large handfuls of frozen, organic raspberries, strawberries, blackcurrants and apple peel (the nutritious part of the apple which doesn’t contain all the sugar like the white, explains Jo) into a mixing bowl for breakfast.

The programme never explains what Jo does with this. Does he blend it and drink? Is he going to mix it with a protein shake? Is he going to eat it with porridge? Is he going to munch those frozen berries with his bare teeth? And what does he include in his typical diet the rest of the day?

Who knows. What we do know is that this fifty-something male eats on average 1,900 calories a day (as opposed to the average recommended for men of 2,300).

We also get a big eyeful of Jo’s six pack as he is prodded and poked for various tests which reveal he has the body of a “super athlete” and just 11.5 per cent body fat (compared to Moseley’s 27.1).

The programme also shows Mosley enduring a three night/four day fast consisting of water, black coffee and one packet of miso soup per day. No mention of quantities of water, rationale for coffee nor miso.

I’m presuming the salty miso is to replace electrolytes to keep his nervous system working. It would have been helpful and a point of safety for the programme to have mentioned how much water you could drink per day while doing this kind of fast, however it did not.

Remembering a dieter widely reported in 2008 who died drinking four litres of water a day that swelled her brain, I started to feel very uncomfortable with this show.

Anyhow, we digress. Back to Mosley, whose IGF-1 plummets from 28 to 14 after four days of fasting.  However he later mentions you would have to do this kind of fast once a month to get those kind of results and he is filmed back in England (no timescale given) sadly saying that his IGF-1 levels are “higher than ever”. So what was the point of all that we wonder? Hence he is attracted to the idea of the 5:2 diet which he thinks will be “easier”.

Several pitiful scenes follow. Mosley on holiday outside a pub looking slightly light headed as fellow ramblers tuck into juicy steak and chips while he goes without. He’s seen stalking around his office at work, his stomach rumbling, looking in a state of famine. And here is the rub.

Are we supposed to believe that mid-fifties Mosley is going to continue this diet for the rest of his life? Two whole days a week in a state of total starvation?

My biggest worry about the 5:2 is what it does to your mental health. Ok maybe you don’t die of cancer or heart disease, but I would like to see figures a few years on from now of large populations doing this diet to see what the suicide and eating disorder rates look like. If you eat a junk food diet (low in B vitamins, essential fatty acids and minerals such as magnesium and zinc) which are vital for good mental health and you have no reserves for the fast days…well I rest my case.

While on the subject of mental health: I was struck by the comments by Professor Valter Longo saying that if we eat “lots” of protein our body gets locked into ”go-go mode”, meaning IGF-1 (and cancer risk) goes up. Mosley says it’s “about sticking to recommended guidelines, something most of us fail to do”. However the programme doesn’t mention what recommended guidelines of protein are per day. For your information the average person is advised to eat around 60g protein a day. That’s the equivalent of two eggs for breakfast and a piece of fish or meat the size and thickness of a pack of playing cards at both lunch and dinner. In fact many people (eg vegetarians) don’t eat enough. We need sufficient protein to make neurotransmitters and hormones. Hence insufficient may affect our mood big time.

I would also be interested to see what happens to your immune system. Junk food plus fasting…mmm. What infectious diseases are these populations going to fall to?

On a practical level, fasting while trying to do a high level job, commuting, socialising, having positive interactions with your family is a big ask. I wonder what productivity is like in that magazine office I mentioned earlier.

Fasting can make you feel very angry as well as hungry (or hangry as some people call it). There is a place for fasting – in some parts of the world fasting is a day put aside each week, a day of rest, meditation and a few sips of a nutritious electrolyte-dense broth.

In the days of our ancestors who were operating on the hunter-gatherer diet (popularised recently in The Paleo Diet, researched by Dr Cordain) of wild meat, fish, nuts, seeds, plants and berries, there would certainly have been days of enforced fasting – eg on unsuccessful hunting days. However, the baseline diet of this group was a better place to fast from. The essential fatty acids needed for brain and immune systems are abundant in a Paleo Diet.

I applaud Michael Mosley for original programme making and publicising fresh, new science. Too much of the current dietary advice in the public eye is based on ancient research which has changed (eg the cholesterol hypothesis which dates back to research in the 1950s). However, Dr Varady’s invitation to eat whatever you want and be alright if you’re fasting a couple of days a week is a bit early to interpret. Only in a few years or so can we really see the impact on populations of a diet like this. Perhaps this programme was made a tad prematurely?

I came away from the programme wishing we had learnt more about the CRONie. A diet of nutrient-dense portion-controlled food makes more sense to me. Jo the CRONie said he enjoyed his lifestyle (in stark contrast to Mosley who looked as if he was really suffering on his fasts). Filling your life with optimal nutrition is more social than unsocial and is do-able long term. But maybe that wouldn’t make such good telly.

Horizon (BBC). Eat, fast and live longer can be viewed on You Tube.