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  1. The future health prospects of entire nations are highly likely to depend on the relatively new process of globalisation. The establishment of global markets and global trading systems facilitates ever increasing global trade. Developed countries often subsidise their agricultural sectors, leading to agreements (which are often international) that regulate standards of production. However, international food standards unfortunately do not at this time cover all aspects of food safety. To prevent trading problems and to ensure food safety, it is essential that information is shared globally regarding the sanitary measures taken during food production. Such transparency enables countries to more effectively introduce sanitary measures into areas where international standards are non-existent.[1]   One such area of concern regarding food safety is the chemical contamination of food products, as illustrated during the scandal surrounding melamine-contaminated milk products in China.[2][3] Melamine is an industrial chemical, which is used in laminates, glues, adhesives, and plastics. When added to milk, melamine increases the nitrogen concentration, which suggests a false increase in protein concentration.[4] In 2008, China reported an estimated total of 300,000 victims of this allegedly intentional contamination, with nearly 52,000 hospitalised and several dead.[5] This issue raised huge concerns regarding food production safety, as well as political corruption, in China, damaging  reputation of Chinese food exports and causing over 50 countries to cancel all imports of Chinese dairy products.[6] The European Food Safety Authority (EFSA) also warned that children who ate large amounts of confectionary and biscuits from China could theoretically be consuming melamine at nearly three times the prescribed European Union safety limits (0.5mg/kg of body weight).[7] Food exports from African countries have also undergone scrutiny following contamination issues with aflatoxins. Aflatoxins are mycotoxins (toxic substances produced by fungi) which are especially prevalent in hot and humid climates.[8] Aflatoxins are known to be genotoxic and carcinogenic, as their metabolism by the liver produces carcinogens that then acutely affect the liver.[9] In 2013 there was also a crisis surrounding aflatoxin-contaminated milk in Germany and the Netherlands. The cows were fed with contaminated maize imported from Serbia which subsequently contaminated their milk.[10]  As a result of this crisis, the European Union is developing new standards to prevent recurrences of such contamination.[11] But it is not only our food that is potentially at risk from globalisation: infectious disease is another huge challenge created by the ‘global village’. The phenomenal increase in global travel and trade provides microbes with seemingly limitless opportunities to spread around the world at unprecedented speed. There are many novel ways in which microbes can get transported, such as via travellers, animals, insects, food or cargo. Adventurous travellers encountering exotic wildlife and plants at close quarters may also return unwittingly transporting undesirable microbes. In the last two years sudden, unpredictable epidemics of comparatively new or formerly uncommon diseases have broken out all over the world.[12][13] Unfortunately with the increased ease of international travel, national borders have become equally porous to these highly mobile, easily disguised threats. As a consequence an outbreak of disease almost anywhere in the world can now be considered a threat everywhere else.[14] It can perhaps therefore be concluded that while globalisation can provide richer experiences and cheaper, easier travel, it also provides the potential for threats to health throughout the world. By Governments developing international standards and regulations, and by consumer taking the proper precautions, these threats can be minimised.   [1] WTO (2016) Principles of the Trading System. Retrieved April 2016 from, [2] Chan, EYY. et al. (2008) Public health risks of melamine in milk products. Lancet. 372(9648). 1444-5. [3] Hau, AKC. et al. (2009) Melamine toxicity and the kidney. JASN. 20(2). 245-50. [4] Draher, J. et al. (2014) Validation of a rapid method of analysis using ultrahigh-performance liquid chromatography - tandem mass spectrometry for nitrogen-rich adulterants in nutritional food ingredients. J Chromatogr A. 1373. 106-13. [5] South China Morning Post (2008) Number of melamine-sickened children revised up five-fold. Retrieved April 2016 from, [6] Reuters (2008) Factbox: China milk banned in Asia, Africa, European Union. Retrieved April 2016 from, [7] EFSA (2008) Statement of EFSA on risks for public health due to the presences of melamine in infant milk and other milk products in China. Retrieved April 2016 from, [8] Cotty, PJ. & Jaime-Garcia, R. (2007) Influences of climate on aflatoxin producing fungi and aflatoxin contamination. Int J Food Microbiol. 119(1-2). 109-15. [9] Eaton, DL. & Gallagher, EP. (1994) Mechanisms of aflatoxin carcinogenesis. Ann Rev Pharmacol Toxicol. 34. 135-72. [10] The Guardian. (2013) Germany tests milk in carcinogen scare. Retrieved April 2016 from, [11] EFSA (2009) Aflatoxins in food. Retrieved April 2016 from, [12] Reiter, P. (2010) Yello fever and dengue: a threat to Europe? Eurosurveillance. 15(10). 1-7. [13] NY Times (2015) How many ebola patients have been treated outside of Africa? Retrieved April 2016 from, [14] Heymann, DL. & Rodier, GR. (2001) Hot spots in a wired world: WHO surveillance of emerging and re-emerging infectious diseases. Lancet. 1(5). 345-53.
  2. Amyotrophic lateral sclerosis (ALS), also known as motor neurone disease (MND), is a chronically progressive disease of the nervous system. ALS selectively affects motor neurons, the cells that control voluntary muscles in the body.[1] These voluntary actions includes important muscle activity such as breathing, walking, speaking, swallowing and gripping. As the condition progresses, this muscle activity becomes progressively more difficult until it becomes impossible, eventually resulting in death, typically within 3 years of onset.[2] Other muscle function remains preserved, however, including eye muscle activity and sphincter, bladder and sexual organ control.[3] Cognitive function is also usually maintained, except in rare cases when it is associated with frontotemporal dementia.[4] Lifestyle choice, particularly in respect of exercise for ALS sufferers is a largely unresolved issue and remains open to discussion between individual patients and their physicians.[3] However there is also continuing debate between clinicians and scientists over the potential role that exercise may play in causation of ALS disease. Only around 10% of ALS cases have a genetic origin,[5] and it is therefore thought that there may be environmental causes. ALS is also known as Lou Gehrig’s disease, after the famous New York Yankees baseball player who was diagnosed with the fatal disease at the age of 35, subsequently dying from it two years later. Similar cases have also been reported in other high performance athletes. One retrospective study performed on over 7,000 football players from Italian professional leagues demonstrated that the standardized morbidity ratios for the development of ALS were increased in the study population, compared to controls.[6] This increase was significant for younger onset patients(<49 years), but not for older subjects. The average age for the onset of ALS in the study population was 55 years, but was most commonly diagnosed at 60-69 years. It was shown that, interestingly, football players who had played for >5 years, particularly in the very active midfield position, were at the highest ALS risk. Other studies have suggested a similar increased risk of ALS in marathon runners, and in American football players.[7] [8] Thus it is important to consider the potential effects of sustained high intensity exercise on the risk of developing ALS, and to be aware of early warning signs of degenerative diseases in those who participate in excessive sporting activities.   [1] Kanning, KC. et al. (2010) Motor neuron diversity in development and disease. Ann Rev Neurosci. 33. 409-40. [2] Malaspina, A. et al. (2015) Disease origin and progression in amyotrophic lateral sclerosis: an immunology perspective. Int Immunol. 27(3). 117-29. [3] Centre for Neurological Treatment and Research (2016) ALS/Lou Gehrig’s disease. Retrieved April 2016 from, [4] Geser, F. et al. (2009) Amyotrophic lateral sclerosis, frontotemporal dementia and beyond: the TDP-43 diseases. J Neurol. 256(8). 1205-14. [5] Rosen, DR. et al. (1993) Mutations in Cu/Zn superoxide dismutase gene are associated with familial amyotrophic lateral sclerosis. Nature. (362(6415). 59-62. [6] Chiò, A. et al. (2005) Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players. Brain. 128(Pt 3). 472-6. [7] Kiernan, MC. (2009) Amyotrophic lateral sclerosis and the neuroprotective potential of exercise. J Physiol. 587(Pt 15). 3759-60. [8] Lehman, EJ. et al. (2012) Neurodegenerative causes of death among retired National Football League players. Neurology. 79(19). 1970-4.
  3.   What is healthy fluoride intake Fluoride is a mineral, and when present at the right level, it has long been believed to have two beneficial effects: preventing tooth decay and contributing to healthy bones.[1] Adding fluoride to drinking water (fluoridation) to prevent dental caries has often been regarded as one of the top ten public health achievements of the 20th century. In the US, fluoride is added to about 70% public drinking water. However, the benefits of fluoridation have come under recent scrutiny, due to the reliance on evidence from old statistical interpretations, rather than the up-to-date real-world evidence.[2] Reductions in dental caries attributable to fluoridation were initially estimated at approx. 50%-60%.[3] More recent estimates are much lower, 18%--40%, and are thought to probably be lower still, as the widespread use of oral hygiene in general terms has been improving and is now probably the most important factor for reducing dental caries.[3] Some studies have shown limited differences in tooth decay rates between countries with fluoridated and non-fluoridated water, or between states that fluoridate a high versus low percentage of their water.[4] [5] Higher levels of fluoridation of drinking water have been shown to correlate with an increased incidence of fluorosis, an abnormal condition caused by the excessive intake of fluorides, characterized in children by discolouration and pitting of the teeth. One meta-analysis suggested that, for a fluoride level of 0.7 ppm, the percentage of participants with “fluorosis of aesthetic concern” was approx. 12%. This rose to 40% when looking at fluorosis of any kind.[2] Numerous studies have shown that excessive fluoride intake in infancy and early childhood can have a wide array of devastating health effects. These outcomes can be irreversible and include structural and functional changes to the central nervous system that can lead to memory, learning and intellectual deficits.[6] Harvard researchers showed that children who live in areas where the level of fluoridation is higher had a “significantly lower IQ than those in low fluoride areas”, further showing a direct link with fluorosis (a consequence of high levels of fluoride in drinking water) and decreased IQ levels, stating that “the results support the possibility of an adverse effect of high fluoride exposure on children’s neurodevelopment”.[7] There have been literally hundreds of human and animal studies that link excessive fluoride to changes in the brain.[8] These adverse effects include reductions in communication pathways,[9] impaired defence systems[10] and damage to specific regions.[11] Given the harmful side effects associated with excessive exposure to fluoridated water, it is therefore wise to investigate the level of fluoridation of your own drinking water, particularly in homes with children, whose development may be affected. Those living in areas with fluoridated mains water may wish to consider the use of water filters or bottled water as an alternative source of drinking water, particularly for children.   [1] Smith, GE. (1985) Fluoride, teeth and bone. Med J Aust. 143(7). 283-6. [2] Iheozor-Ejiofor, Z. et al. (2015) Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev. [epub ahead of print] doi: 10.1002/14651858 [3] CDC (2001) Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States. Retrieved May 2016 from, [4] Ismail, AL. et al. (1993) Should the drinking water of Truro, Nova Scotia, be fluoridated? Water fluoridation in the 1990s. Community Dent Oral Epidemiol. 21(3). 118-25. [5] Franzolin Sde, O. et al. (2010) Epidemiology of fluorosis and dental caries according to different types of water supplies. Cien Saude Colet. 15. 1841-7. [6] Khan, SA. et al. (2015) Relationship Between Dental Fluorosis and Intelligence Quotient of School Going Children In and Around Lucknow District: A Cross-Sectional Study. J Clin Diagn Res. 9(11).  [epub ahead of print] doi: 10.7860/JCDR/2015/15518.6726. [7] Choi, AL. et al. (2012) Developmental Fluoride Neurotoxicity: A Systematic Review and Meta-Analysis. Environ Health Perspect. 120(10). 1362-8. [8] Niu, R. et al. (2015) Effects of fluoride on microtubule ultrastructure and expression of  Tubα1a and Tubβ2a in mouse hippocampus. Chemosphere. 139: 422-7. [9] Long, YG. et al. (2002) Chronic fluoride toxicity decreases the number of nicotinic acetylcholine receptors in rat brain. Neurotoxicol Teratol. 24(6). 751-7. [10] Niu, R. et al. (2016) Changes in Liver Antioxidant Status of Offspring Mice Induced by Maternal Fluoride Exposure During Gestation and Lactation. Biol Trace Elem Res. 172(1). 172-8. [11] Zhang, M. et al. (2007) Effects of fluoride on the expression of NCAM, oxidative stress, and apoptosis in primary cultured hippocampal neurons. Toxicology. 236(3). 208-16.
  4. What is healthy nutritional supplement There are two common misconceptions about dietary supplements: firstly that the more the better, and secondly that they can be taken to make up for a poor diet. Research into the value of supplements in both disease treatment and prevention is still ongoing, and there is often conflicting evidence associated with supplement intake.[1] [2] It seems increasingly clear that, despite scepticism, some supplements do have the potential to promote health by preventing certain diseases and conditions, but in other cases they can lead to serious side effects, including a suggestion that some may increase the risk of cancer.[2] For example, the risk of lung cancer in high risk populations is significantly increased in those who consume 20-30mg/day of B-carotene.[3] Another study showed a wide range of potentially damaging effects from taking calcium supplements, including the doubling of hospital admissions for gastrointestinal problems, 17% increase in kidney stones and 20-40% increase in the risk of a heart attack in those taking calcium supplements.[4] Dietary supplements can have specific benefits, though, for example it has long been known that taking folic acid during pregnancy reduces the development of birth defects.[5] The risks of developing certain diabetic complications such as heart disease and neuropathy are known to be reduced by taking supplements of omega-3 and alpha-lipoic acids.[6] [7] [8] There are also many severe medical conditions that are the direct result of nutrient deficiencies, possibly as the result of malabsorption, which can be reversed, or at least managed, by appropriate supplementation. These include bone fragility, anaemia, nervous system abnormalities and poor immune system functionality.[9] [10] [11] [12] Some deficiencies are actually classed as a condition in their own right (for example iron or vitamin B12 deficiencies). However, despite their potential beneficial effects, caution should be taken when using dietary supplements. As they are not classed as medicines or food, and thus they are not subject to the same manufacturing regulations as these products. Furthermore, due to insufficient evidence as to their impact on health, supplements should not legally make any claims regarding effects on health, although many do, and they are not officially intended to diagnose, treat, cure or prevent disease.[13] Supplements are therefore manufactured without the rigorous safety and efficacy testing demanded by law for any true medicinal product. In fact supplements are often manufactured from synthetic materials, such as hydrogenated sugar extracts or petrochemicals, and may contain genetically modified ingredients, artificial sweeteners and even carcinogenic substances.                                                       Some supplements are marketed as having “almost no side effects”, but when combined with other substances, or taken too frequently, can quickly become toxic. For example, large doses vitamin C or magnesium can cause diarrhoea, whereas excess iron intake is generally associated with constipation as well as abdominal pain, nausea and vomiting.[3] Worryingly, dietary supplements can also interact with prescribed medications with serious and even life-threatening results, e.g. warfarin, insulin and aspirin have many recorded adverse reactions when taken with dietary or herbal supplements.[14] In addition to these interactions, fat soluble vitamins such as vitamins A, D, E and K, can accumulate in the body if doses above the recommended daily limit are routinely taken. This toxicity can result in mental symptoms such as confusion[15] and physical symptoms, such as liver damage[16] and even death.[17]   There are many reason, to think twice about taking dietary supplements. There is a distinct lack of regulatory control, with none of the requirements that are required for medication approval in addition to the potential for adverse interactions with prescribed and over-the-counter medications. Far from being beneficial, some dietary supplements can actually cause serious harm when taken in excessive amounts or at the same time as other medications. The amount that is right for you will depend on numerous factors, and the recommended daily intake is not the one-size-fits-all that supplement manufacturers claim it is.   [1] The alpha-Tocopheral Beta Carotene Cancer Prevention Study Group. (1994) The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med. 330. 1029-35. [2] Russo M, et al. (2016) Understanding genistein in cancer: The "good" and the "bad" effects: A review. Food Chem. 196. 589-600 [3] Mulholland, CA. & Benford, DJ. (2007) What is known about the safety of multivitamin-multimineral supplements for the generally healthy population? Theoretical basis for harm. Am J Clin Nutr. 85(1). 318S-322S [4] Reid, IR. et al. (2015) Calcium supplements: benefits and risks. J Intern Med. 278(4). 354-68. [5] CDC (1992) Recommendations for the Use of Folic Acid to Reduce the Number of Cases of Spina Bifida and Other Neural Tube Defects. Retrieved April 2016 from, [6] Midaoui, AEL. et al. (2002) Lipoic acid prevents hypertension, hyperglycaemia, and the increase in heart mitochondrial superoxide production. Am J Hypertens. 16(3). 173-9 [7] Jeppensen, C. et al. (2013) Omega-3 and omega-6 fatty acids and type 2 diabetes. Curr Diab Rep. 13(2). 279-88. [8] Evans, JL. & Bahng, M. (2000) Non-pharmaceutical intervention options for Type 2 Diabetes: Diets and dietary supplements (Botanicals, antioxidants, and minerals). South Dartmouth (MA): Endotext. [9] Wizenberg, T. et al. (2012) Vitamin D and the musculoskeletal health of older adults. Aust Fam Physician. 41(3). 92-9. [10] Shipton, MJ. & Thachil, J. (2015) Vitamin B12 deficiency - A 21st century perspective. Clin Med (Lond). 15(2). 145-50. [11] Mpandzou, G. et al. (2016) Vitamin D deficiency and its role in neurological conditions: A review. Rev Neurol (Paris). 172(2). 109-22. [12] Spinas, E. et al. (2015) Crosstalk between vitamin B and immunity.  J Biol Regul Homeost Agents. 29(2). 283-8. [13] Camire, ME. & Kantor, MA. (1999) Dietary supplements: nutritional and legal considerations. Food Techonol. 53(7). 87-96. [14] Tsai, HH. et al. (2012) Evaluation of documented drug interactions and contraindications associated with herbs and dietary supplements: a systematic literature review. Int J Clin Prac. 66(11). 1056-78. [15] Maji, D. (2012) Vitamin D toxicity. Indian J Endocrinol Metab. 16(2). 295-6. [16] Castaño G. et al. (2006) Vitamin A toxicity in a physical culturist patient: a case report and review of the literature. Ann Heptaol. 5(4). 293-95. [17] de Oliveira, MR. (2015) Vitamin A and retinoids as mitochondrial toxicants. Oxid Med Cell Longev. [epub] doi: 10.1155/2015/140267.
  5. What is healthy milk Raw milk undergoes a process termed homogenisation in order to end up with an even consistency. This homogenisation process is quite simple, and consists of mixing and blending different batches of milk from different dairies. If left untouched, raw milk will separate into a light fatty layer on top, with the heavier liquid portion at the bottom.  Homogenisation turns milk into an emulsion, by decreasing the size of the fat particles, so that they are evenly distributed throughout the milk and no longer able to separate upon standing, as with the raw state.[1] [2]  This is achieved by passing the milk through a fine sieve, that breaks up the fatty globules into tiny pieces.   It has previously been suggested that the widespread adoption of the homogenisation process could have an effect on health, potentially increasing the risk of heart disease for example, but there is currently no evidence to suggest that this is the case.[3] Some studies have actually suggested health benefits from homogenisation, such as increased ease with which milk is digested, due to smaller particles having a greater surface area on which digestive enzymes can work.[4] This is of particular benefit to individuals with diseases that impair fat digestion, e.g. gallstones or chronic pancreatitis.[5] However, for those people who are lactose intolerant, homogenising milk has no effect on the allergic response. Pasteurisation is the process of heating of milk to a controlled temperature (145°F/62.8°C) for a fixed period of time (30 mins) to reduce the presence of dangerous bacteria without imposing any major changes to the chemistry of the milk. However, the process also kills harmless probiotics, which are in fact microorganisms that are beneficial to health by protecting against enteric infections and preventing the development of chemically induced tumours.[6][7] However these probiotics have the ability to destroy commensal bacteria such as Salmonella enterica and Escherichia coli, creating a paradox enabling any residual harmful bacteria to flourish.[8] [9]   Despite the potentially conflicting beneficial and detrimental effects of pasteurisation, it seems that the overall evidence suggests raw milk carries a far greater risk of bacterial infection than pasteurised milk,meaning it is probably safer to use pasteurised milk products than other, raw products.   [1] Lee, DK. & Kwak, HS. (1999) Cholesterol removal from homogenized milk with β-cyclodextrin. J Dairy Sci. 82(11). 2327-30. [2] Cano-Ruiz, ME. & Richter, RL. (1997) Effect of homogenization pressure on the milk fat globule membrane proteins. J Dairy Sci. 80(11). 2732-9. [3] Clifford, AJ. et al. (1983) Homogenized bovine milk xanthine oxidase: a critique of the hypothesis relating to plasmalogen depletion and cardiovascular disease. Am J Clin Nutr. 38(2). 327-32. [4] Lopez, C. et al.. (2015) Organization of lipids in milks, infant milk formulas and various dairy products: role of technological processes and potential impacts. Dairy Sci Technol. 95. 863-93. [5] Berton, A. et al. (2012) Effect of size and interface composition of milk fat globules on their in vitro digestion by the human pancreatic lipase: native versus homogenized milk fat globules. Food Hydrocolloids. 29(1). 123-34. [6] Foo, NP. et al. (2011). Probiotics prevent the development of 1,2-dimethylhydrazine (DMH)-induced colonic tumorigenesis through suppressed colonic mucosa cellular proliferation and increased stimulation of macrophages. J Agric Food Chem. 59(24). 13,337-45. [7] Kumar, M. et al. (2012) Anticarcinogenic effect of probiotic fermented milk and chlorophyllin on aflatoxin-B1-induced liver carcinogenesis in rats. Br J Nutr. 107(7). 1006-16. [8] Cross, ML. (2006) Microbes versus microbes: immune signals generated by probiotic lactobacili and their role in protection against microbial pathogens. FEMS Immunol Med Microbiol. 34(4). 245-53. [9] Hudault, S. et al.(1997) Antagonistic activity exerted in vitro and in vivo by Lactobacillus casei (strain GG) against Salmonella typhimurium C5 infection. Appl. Environ. Microbiol. 63(2). 513-8.    
  6. Gain weight by going 'diet'

    What is healthy diet Sweeteners, used as sugar replacements, are compounds that are so intensely sweet that only a little is needed to replace a larger amount of sugar. They are available in two forms: natural sweeteners of plant origin and synthetic, artificial sweeteners. Natural sweeteners include glycyrrhizin, thaumatins, rabaudioside, stevioside, monellin, perillaldehyde and osladin.[1] Another natural product, miraculin, is not actually sweet, but transforms our perception of sour taste into sweet taste.[1] Artificial, or synthesised, sweeteners include aspartame, saccharin, acesulfame K and sucralose.[1] Among all sweeteners, artificial sweeteners are consider the worst for us, as they are thought to impact on our health, despite artificially sweetened products often being advertised as “diet” alternatives thanks to their reduced calorie content. This ‘diet’ label comes from old studies that showed artificially sweetened products can assist in weight loss and weight maintenance.[2] However, although sweeteners provide intense sweetness with minimal or no calories, studies suggest that they may actually increase appetite.[1] This can actually lead to increased carbohydrate cravings, boosting the inclination to overindulge.[3] [4] Some studies have also showed that artificially sweetened drinks are linked with an increased incidence of Type 2 Diabetes, although no causal link was identified.[5] One study of 3,682 individuals examined the long-term (7-8 year) relationship between ‘diet’ drink consumption and body weight.[6] Even after adjusting for other weight-gain risk factors (such as exercise and diet), results showed that those who regularly consumed ‘diet’ drinks had a 47% higher BMI increase across the follow-up period than those who did not. Another recent study that followed 474 diet soda drinkers for nearly 10 years, found that their waists grew 70% more than the waists of non-diet soda drinkers. In addition, those who drank two or more diet sodas per day had, on average, nearly 4 times the  increase in waist size during the 10 year study period compared to non-diet soda drinkers.[7] These effects are thought to potentially stem from the way that artificial sweeteners and sugar affect the brain. By providing sweetness without any calories, it is thought that consumption of artificial sweeteners can cause us to crave other sweet foods and drinks, which can contribute to excess calorie consumption. This is because artificial sweeteners provide less ‘sweetness satisfaction’, and actually reduce the ‘reward’ obtained when going on to consume actual sugar.[4] This means that, not only does the artificial sweetener not fully satisfy sweetness cravings, it also reduces how rewarding actual sugar is, and thus more is ingested. This is further supported by results from a study at the University of California, San Diego, in which volunteers underwent functional MRI scans as they took small sips of water sweetened with sugar or sucralose. Sugar activated regions of the brain involved in food reward, while sucralose didn’t.[8] In addition to these effects on carbohydrate cravings and weight gain, reports also suggest an association between the consumption of aspartame, a widely used artificial sweetener, and neurological and behavioural reactions.[9] Furthermore, aspartame has also been shown to have the potential to induce serious adverse reactions, including seizures.[10] Thus when trying to be healthy, opting for ‘diet’ options may not be the quick fix it first seems. Not only can artificial sweeteners cause numerous health problems, they can also actively contribute to weight gain, increased BMI and the development of type 2 diabetes. These sweeteners are therefore perhaps not so sweet after all.   [1] Sardesai, VM. & Waldshan, TH. (1991) Natural and synthetic intense sweeteners. J Nutr Biochem. 2(5). 236-44. [2] Bellisle, F. & Drewnowski, A. (2007)  Intense sweeteners, energy intake and the control of body weight. Eur J Clin Nutr. 61(6). 691-700. [3] Rudenga, KJ. & Small. DM. (2012) Amygdala response to sucrose consumption is inversely related to artificial sweetener use. Appetite. 58(2). 504-7. [4] Yang, Q. (2010) Gain weight by “going diet?” Artificial sweeteners and the neurobiology of sugar cravings. Yale J Biol Med. 83(2). 101-8. [5] Fagherazzi, G. et al. (2013). Consumption of artificially and sugar-sweetened beverages and incident type 2 diabetes in the Etude Epidemiologique aupres des femmes de la Mutuelle Generale de l'Education Nationale-European Prospective Investigation into Cancer and Nutrition cohort. Am J Clin Nutr. 97(3). 517-23. [6] Fowler, SP. et al. (2008) Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain. Obesity (Silver Spring). 16(8). 1894-900. [7] Fowler, RP. et al. (2015) Diet soda intake is associated with long-term increases in waist circumference in a biethnic cohort of older adults: the San Antonio Longitudinal Study of Aging. J Am Geriatr Soc. 63(4). 708-15 [8] Frank, GK. et al. (2008) Sucrose activates human taste pathways differently from artificial sweetener. Neuroimage. 39(4). 1559-69. [9] Lindseth, GN. et al. (2014) Neurobehavioural effects of aspartame consumption. Res Nurs Health. 37(3). 185-93. [10] Maher, TJ. & Wurtman, RJ. (1987) Possible neurologic effects of aspartame, a widely used food additive. Environ Health Perspect. 75. 53-7.
  7. What is healthy artificial sweetener “Artificial sweetener” is term used for any sugar substitute used to replace sucrose (table sugar). These sugar substitutes may be synthetically manufactured or derived from chemicals that occur naturally in sources including herbs and sucrose itself. They differ from sucrose in two main respects; firstly they are known as “intense” sugars, as they are many times sweeter than traditional sugar and secondly, their calorific value is much lower, sometimes reaching zero. The fact that the quantity required for the same level of sweetness is a fraction of that of regular sugar makes sweeteners an attractive sugar substitute, both in terms of the potential for weight loss and their use by diabetics, who normally have to avoid sugar.[1] Therefore, sweeteners are widely used in processed foods including baked goods, soft drinks, canned food and dairy products, as well as being available for home use, and in cooking.    Some artificial sweeteners are considered as ‘food additives’, and are officially as such regulated by government bodies such as the European Food Safety Authority (EFSA) or the Food and Drug Administration (FDA) in the US, requiring review and approval before use. The EFSA and FDA declare a substance “generally recognised as safe” if there are sufficient scientific safety data available. However in certain cases substances may be declared safe on the basis of a long history of common use in food. Upon approval, the food safety agency establishes an acceptable daily intake (ADI) for each substance which is intended to be a lot less than the smallest amount that may result in health concerns.[2] Scrutiny of artificial sweeteners has been intense for decades. Critics believe that they cause a variety of health problems, including cancer in the case of one sweetener, saccharin, EFSA approved food additive by code E954. These concerns are mainly derived from studies performed in the 1970s which linked saccharin to bladder cancer in laboratory rats.[3] These data resulted in saccharin carrying a health warning for some time.[4] However since these initial studies, The National Cancer Institute and other health agencies have been unable to find sound scientific evidence of a link between this approved artificial sweetener and cancer,[5] [6] and the warning label on saccharin was therefore subsequently lifted in 2001.[7] Sucralose, EFSA approved food additive by code E955, an artificial sweetener marketed as Splenda®, is found in a wide variety of low calorie foods including ‘diet’ carbonated drinks, chewing gum, table top sweeteners, breakfast cereals and salad dressings. As it is intensely sweet (up to 650 times sweeter than sugar) sucralose is often mixed with other, less sweet ingredients that are not calorie free, such as dextrose or maltodextrin, to dilute its sweetness. Splenda® gained FDA approval as a table-top sweetener in 1998 and for more general use in 1999.[8] However recent studies in rats indicated that administration of Splenda®  for 12 weeks exerted numerous adverse effects, including a reduction in beneficial faecal microflora, increased faecal pH and enhanced expression of key components of the pre-systemic detoxification system involved in first class drug metabolism, known to limit the bioavailability of orally administered drugs.[9] [10]   Another artificial sweetener, aspartame, EFSA approved food additive by code E951, has also been shown to have the potential to be harmful to health. Excessive intake can lead to cell death within the brain, caused by a buildup of its key components such as aspartate in the brain, which can lead to a process called excitotoxicity.[11] Indeed, aspartame has been shown to have numerous adverse effects, a large proportion of which are serious, including seizures and death.[12] It has also been suggested that artificial sweeteners may actually increase the risk of becoming obese, and may be associated with type 2 diabetes when consumed regularly over a long period. Indeed studies have shown that people who drink 1 or more ‘diet’ drinks per day are 67% more likely to develop diabetes than those who don’t drink any.[13]  It is thought that effects such as these may be due to increased carbohydrate cravings and an inclination to overindulge.[14] [15] This is because, despite the fact that artificial sweeteners trigger more communication with the brain’s pleasure centre than sugar, artificial sweeteners provide less actual ‘sweetness’ satisfaction.[14] There are numerous adverse health effects associated with artificial sweetener intake, and seemingly minimal benefits. It may therefore be wise to avoid them and to decrease calorie intake by opting for healthier, natural alternatives.   [1] Qurrat-ul-Ain. & Khan, SA. (2015) Artificial sweeteners: safe or unsafe? J Pak Med Assoc. 65(2). 225-7. [2] EFSA (date unknown) Food Additives. Retrieved October 2016 from,   [3] Price, JM. et al. (1970) Bladder tumors in rats fed cyclohexylamin or high doses of a mixture of cyclamate and saccharin. Science. 167(3921). 1131-2. [4] NIH (2009) Artificial sweeteners and cancer. Retrieved October 2016 from, [5] Mishra, A. et al. (2015) Systematic review of the relationship between artificial sweetener consumption and cancer in humans: analysis of 599,741 participants. Int J Clin Pract. 69(12). 1418-26. [6] Kamenickova, A. et al. (2013) Effects of artificial sweeteners on the AhR- and GR-dependent CYP1A1 expression in primary human hepatocytes and human cancer cells. Toxicology in Vitro. 27(8). 2283-88. [7] DUJS (2008) Artificial Sweeteners: The Truth About Diet Soda. Retrieved October 2016 from, [8] Stipanuk MH. & Caudill MA. (2012) Biochemical, Physiological and Molecular Aspects of Human Nutrition. 3rd edtn. Saunders, United States [9] Abou-Donia, MB. et al. (2008) Splenda alters gut microflora and increases intestinal p-glycoprotein and cytochrome p-450 in male rats. J Toxicol Environ Health A. 71(21). 1415-29. [10] Schiffman, SS. & Rother, KI. (2013) Sucralose, a synthetic organochlorine sweetener: overview of biological issues. J Toxicol Environ Health B Crit Rev. 16(7). 399-451. [11] Arundine, M. & Tymianski, M. (2003) Molecular mechanisms of calcium-dependent neurodegeneration in excitotoxicity. Cell Calcium. 34(4-5). 325-37. [12] Humphries, P. et al. (2008) Direct and indirect cellular effects of aspartame on the brain. Eur J Clin Nutr. 62(4). 451-62. [13] Nettleton JA, et al. (2009) Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care. 32(4). 688-94. [14] Rudenga, KJ. & Small. DM. (2012) Amygdala response to sucrose consumption is inversely related to artificial sweetener use. Appetite. 58(2). 504-7. [15] Yang, Q. (2010) Gain weight by “going diet?” Artificial sweeteners and the neurobiology of sugar cravings. Yale J Biol Med. 83(2). 101-8.          
  8. Risks and benefits of Honey vs. Sugar

    What is healthy sugar Granulated sugar, which is the most common type of sugar used for sweetening our cups of tea and coffee, consists of a mixture of 50% glucose and 50% fructose (the sugar naturally found in fruit). The pure sugar content of a 100g of granulated sugar is 99.8g, which has a calorific value of 387kcal. 100g of honey, however, has a smaller pure sugar content of 82.1g, and a lower calorific value of 304kcal. This is not the only difference, as honey is only about 30% glucose, and less than 40% fructose.[1] In addition, honey is more complex than granulated sugar, as it contains many other sugars, as well as proteins and amino acids.[2] Honey also may contain small quantities of minerals (e.g. selenium and zinc), trace elements and some vitamins.[2] This varies depending on the region from which the honey was sourced and from what plants the bees gathered nectar etc. One of the roles of our digestive system is to convert carbohydrates to glucose, for use as energy. The components of granulated sugar are broken down very easily, providing a surge in blood glucose levels.  Any excess glucose not immediately required is converted in fat and stored in the body. Many of the sugars contained in honey are more complex than those in granulated sugar, meaning that the amount of energy required to break them down into glucose is greater.[3] This can mean that the amount of calories you absorb are actually less than those from an equivalent calorific value of granulated sugar. The nutritional value of honey over and above calorific content is totally dependent on its source. It can range from being just a sugar substitute (with a slightly lower calorific value) to actually being quite nutritious. As stated above, honey contains traces of numerous vitamins and minerals,{2} which can have beneficial effects on the body. Honey has also been found to have anti-inflammatory and antiseptic properties, and to assist in the process of wound healing.[4] In fact honey is now included in some proprietary dressings. Furthermore, honey does not ‘go off’ or  deteriorate in quality over time and so has no requirement for any preservatives or any other food additives, which can themselves have adverse effects on health.[6][7][8] Whilst its relatively high sugar content means that the consumption of large quantities of honey should be avoided, its healthier composition than granulated sugar means that, as a sugar substitute, honey could be a healthier option. Furthermore, honey can have many beneficial components such as antioxidants with anticancer actions,[9] found in particularly high levels in good quality honey purchased from a reliable, genuinely organic source.   [1] USDA (2016) Full Report (All Nutrients): 19296, Honey. Retrieved April 2016, [2] Bristol University (2001) Chemical composition of honey. Retrieved April 2016, from [3] Elia, M. & Cummings, JH. (2007) Physiological aspects of energy metabolism and gastrointestinal effects of carbohydrates. Eur J Clin Nutr. 61 Suppl 1. S40-74. [4] Postmes, TJ. et al. (1997) Speeding up the healing of burns with honey: An experimental study with histological assessment of wound biopsies In bee products. Springer, US. [5] Lay-flurrie, K. (2008) Honey in wound care: effects, clinical application and patient benefit. Br J Nurs. 17(11). S32-6. [6] Yim, E. et al.(2014) Contact dermatitis caused by preservatives. Dermatitis. 25(5). 215-31. [7] Konikowska, K. et al. (2012) The influence of components of diet on the symptoms of ADHD in children. Rocz Panstw Zakl Hig. 63(2). 127-34. [8] Vally, H. et al. (2009) Clinical effects of sulphite additives. Clin Exp Allergy. 39(11). 1643-51. [9] Ahmed, S. & Othman, NH. (2013) Honey as a potential natural anticancer agent: a review of its mechanisms. Evid Based Complement Alternat Med. [epub] doi: 10.1155/2013/829070    
  9. What is healthy salmon Salmon is renowned for its health benefits, as it is high in omega-3 and -6, which are essential fatty acids (EFAs). Omega-3- and -6 are polyunsaturated EFAs that play vital roles within the human body.  It is thought that increasing polyunsaturated EFA consumption can reduce the risk of many diseases, including heart disease, multiple sclerosis and a variety of mental disorders. As many people are deficient in omega 3,[1] eating ‘oily’ fish such as salmon is one potential way to help increase omega-3 levels and to reduce the incidence of such diseases. Less than half the world’s salmon comes from the fish’s natural wild environment, with the rest coming from fish farms, also known as aquacultures.[2] Although wild salmon is still available, global stocks have been in decline for decades. Aquaculture on the other hand continues to flourish, with 90.4 million tonnes of farmed fish produced in 2012 alone.[3] Whilst wild salmon feed on their natural prey (other living organisms), farmed salmon are fed fat-rich commercial feeds. There are therefore some important differences in their nutritional composition; for example, farmed salmon has almost three times the fat content of wild salmon, a large constituent of which are EFAs.[4][5] It might be easy to assume that an increased EFA content might mean that farmed salmon are more beneficial to our health, however this is also coupled with an increased omega-6/omega-3 ratio.[4] In order to gain the main benefits of EFA consumption, omega-6 and -3 intake needs to be balanced. Many people today are consuming too much omega-6 relative to omega-3, which distorts this balance and negates some of the beneficial effects of EFA consumption. It has been speculated that the negative effects of an increased omega-6/omega-3 ratio in humans are due to increased inflammation within the body, and furthermore that it may play a role in the increased incidence of chronic diseases such as heart disease.[6] In addition to differing nutritional compositions, farmed and wild salmon contain varying levels of contaminants. Whilst wild fish do accumulate contaminants, farmed salmon contain much higher levels, which originate from their feed and contaminations of their environment.[7] [8] Studies have shown that the levels of contamination can vary depending on the geographical location of the farm. One study showed that European farms have more contaminants than American farms, with farms in Chile seeming to have the least.[7] These contaminants include polychlorinated biphenyls (PCBs), polybrominated diphenylethers (PBDEs), dioxins, and several chlorinated pesticides.[7] [8] Some of the most dangerous of these contaminants are PCBs, which have been strongly associated with cancer and other health problems.[9] Studies have shown that this PCB contamination can occur directly from farmed salmon feed,[8] [10] with one investigation of salmon from worldwide origins demonstrating that farmed salmon had almost ten time the PCB levels of wild salmon (51,216 vs 5,302 pg/g).[8] The study suggested that the cancer-risks associated with consuming these contaminants may potentially outweigh the benefits of EFA consumption. Evidence regarding contamination with trace element is a little more conflicting: arsenic levels have been found to be higher in farmed salmon, but levels of cobalt, copper and cadmium higher in wild salmon.[11] Given the lower levels of contamination and the reduced omega-6/omega-3 ratio in wild salmon compared to farmed salmon, it seems that wild salmon would be the safest option for your table, particularly when considering the benefits of polyunsaturated EFA consumption. However, as with all constituents of a balanced diet, intake should be moderated to avoid the potential ill effects of overconsumption.     [1] Simopoulos, AP. (2013) Dietary omega-3 fatty acid deficiency and high fructose intake in the development of metabolic syndrome, brain metabolic abnormalities, and non-alcoholic fatty liver disease. Nutrients. 5(8). 2901-23. [2]Foran, JA. et al. (2005) Quantitative analysis of the benefits and risks of consuming farmed and wild salmon. J Nutr. 135(11). 2639-43. [3] FAO (2014) The State of World Fisheries and Aquaculture. Retrieved April 2016 from, [4] Hamilton, MC. et al. (2005) Lipid composition and contaminants in farmed and wild salmon. Environ Sci Technol. 39(22). 8622-9.   [5]Blanchet, C. et al. (2005) Fatty acid composition of wild and farmed Atlantic salmon (Salmo salar) and rainbowtrout (Oncorhynchus mykiss). Lipids. 40(5). 529-31.   [6]Simopoulos, A. (2006) Evolutionary aspects of diet, the omega-6/omega-3 ratio and genetic variation: nutritional implications for chronic diseases. Biomed Pharmcother. 60(9). 502-7.   [7] Hites, RA. et al. (2004) Global assessment of polybrominated diphenyl ethers in farmed and wild salmon. Environ Sci Technol. 38(19). 4945-9. [8] Easton, MDL. et al. (2002) Preliminary examination of contaminant loadings in farmed salmon, wild salmon and commercial salmon feed. Chemosphere. 46(7). 1053-74. [9] Foran, JA. et al. (2005) Risk-based consumption advice for farmed Atlantic and wild Pacific salmon contaminated with dioxins and dioxin-like compounds. Environ Health Perspect. 113(5). 552-6. [10] Carlson, DL. & Hites, RA. (2005) Polychlorinated biphenyls in salmon and salmon feed: global differences and bioaccumulation. Environ Sci Technol. 39(19). 7389-95. [11] Foran, JA. et al. (2004) A survey of metals in tissues of farmed Atlantic and wild Pacific salmon. Environ Sci Technol. 23(9). 2108-10.    
  10. What is healthy cooked meat The health risks resulting from the cooking and consumption of charcoal grilled meat, poultry and fish have been acknowledged for several years. There is a lack of compelling evidence directly linking the act of charcoal grilling to cancer, as the exposure would need to be significant and of long duration. That being said, the risk obviously varies with both behaviour and general health, as some families do frequently cook food in this way, and an individual’s susceptibility to cancer is very variable. A more major concern, is that the chemicals produced within the food that is charcoal grilled have been linked to an increased risk of cancer. One large study of over 3,000 participants discovered that postmenopausal women who consume large quantities of grilled meat had a 47% increased risk of breast cancer.[1] BBQ smoke contains polycyclic aromatic hydrocarbons (PAHs), a group of over a hundred different chemicals found in the smoke emitted from the charcoal grilling of meat.[2] As a BBQ heats from below, the fat drips onto the coals and burns, creating smoke that is high in PAHs, which can cause lung damage and have been linked to lung and bladder cancer.[3] PAHs have the ability to damage cellular DNA, converting a normal cell to a cancerous one, and are therefore classified as carcinogens.[4] In addition to PAHs, flame-grilled meat also produces heterocyclic amines (HCAs).[5] HCAs are also classified as carcinogenic compounds, which are produced when amino acids (present in protein), and creatine (present in muscle) react at temperatures over 300͒ F (approx. 150͒ C).[6]This reaction commonly occurs during BBQing, where temperatures immediately above the flame can reach 500-1000͒ F (approx. 260-540͒ C). Research has revealed an association between HCAs and increased risk of prostate, pancreatic and colorectal cancers in adults.[7] [8] [9]   BBQing food can also cause the formation of nitrosamines, which are carcinogenic compounds produced by the reaction of nitrogen oxides and amines or amides contained in food.[10] These cancer-causing compounds are particularly concerning, as foods that are traditionally cooked on a BBQ are also those that are highest in amines (found in protein); meat and fish. BBQ cooking often includes meat, which is high in both protein and fat.  At high temperatures, a further chemical reaction occurs, producing toxins called advanced glycation end products (AGEs),[11]which are responsible for causing much of the damage caused by diabetes.[12] These toxins are linked to the imbalance of pro- and anti-oxidants, which can lead to significant inflammation within the body. This increased inflammation and oxidative stress can result in an increased risk of cardiovascular disease and diabetes.[11] [13] Given the harmful chemicals that charcoal grilling of meat produces, it may therefore prove sensible to not only limit the consumption of BBQed meat, but to also choose cuts and cooking methods that require minimal BBQing time, as the shorter the meat is grilled for, less harmful toxins are produced, reducing the risks to health.   [1] Steck, SE. et al. (2007) Cooked meat and risk of breast cancer- lifetime versus recent dietary intake. Epidemiology. 18(3). 373-82.   [2]European Commission. (2002) Polycyclic aromatic hydrocarbons - occurrence in foods, dietary exposure and health effects. Retrieved April 2016 from,   [3]Mastrangelo, G. et al. (1996) Polycyclic aromatic hydrocarbons and cancer in man. Environ Health Perspect. 104(11). 1166-70.   [4]Mordukhovich I. et al. (2016)  Polymorphisms in DNA repair genes, traffic-related polycyclic aromatic hydrocarbon exposure and breast cancer incidence. Int J Cancer. 139(2). 310-21.   [5]  Knize, MG. et al. (2002) Factors affecting human heterocyclic amine intake and the metabolism of PhIP. Mutat Res. 506-507. 153-62.   [6] National Cancer Institute. (2016) Chemicals in meat cooked at high temperatures and cancer risk. Retrieved April 2016 from,   [7]Anderson, KE. et al. (2002) Meat intake and cooking techniques: associations with pancreatic cancer. Mutat Res. 506-507. 225-31.   [8]Tang, D. et al. (2007) Grilled meat consumption and PhIP-DNA adducts in prostate carcinogenesis. Cancer Epedemiol Biomarkers Prev. 16(4). 803-8.   [9]Cross, AJ. et al. (2010) A large prospective study of meat consumption and colorectal cancer risk: an investigation of potential mechanisms underlying this association. Cancer Res. 70(6). 2406-14.   [10] Douglass, ML. et al. (1978) The chemistry of nitrosamine formation inhibition and destruction. J Soc Cosmet Chem. 29. 581-606.   [11]Uribarri, J. et al. (2010) Advanced glycation end products in foods and a practical guide to their reduction in the diet.  J Am Diet Assoc. 110(6). 911-16.   [12] Zhao, J. et al. (2014) Molecular mechanisms of AGE/RAGE-mediated fibrosis in the diabetic heart. World J Diabetes. 5(6). 860-7.   [13] Jones, DP. (2006) Redefining oxidative stress. Antioxid Redox Signal. 8(9-10). 1865-79.      
  11. What is healthy water consumption Water is a major and vital constituent of the human body. The average adult’s body is about 60% water, whilst an infant’s is 75% and an elderly person’s 55%. Even a few days without water can be fatal. The roles of water in the body are wide and far-reaching and include body temperature regulation, participation in many biochemical reactions at cell level, the flushing away of waste products, lubrication of joints and the moistening of tissue, such as the eyes, nose and mouth. It is also the solvent for distributing nutrients and minerals throughout the body. General organ function is enhanced by the presence of water, which also helps the muscles (including the heart) work with less stress.[1] There is increasing evidence to suggest that mild dehydration can promote the development of many chronic diseases. These include:[2] Exercise-induced asthma Urolithiasis Urinary tract infections Constipation Hypertension Fatal coronary heart disease Venous thromboembolism Cerebral infarct Bronchopulmonary disorders Hypertonic dehydration in infants Hyperglycaemia in diabetic ketoacidosis Mild dehydration also impairs important aspects of cognitive function, including alertness, concentration and short term memory.[3] The regulation of water balance is a very precise and complex process. In a healthy adult, an imbalance of just 1% is corrected by the body within about a day. However, in young children and the elderly, regulation is not so efficient, making them far more susceptible to dehydration and its accompanying health complications.[4]     The most common causes of dehydration are fever, heat exposure, excessive exercise, vomiting diarrhoea, and increased urination due to infection. Diseases such as diabetes can increase urine output, making diabetics more predisposed to dehydration.[5] The symptoms of moderate dehydration include increased thirst, dry mouth, headache and dizziness. As the body becomes more dehydrated, the urine becomes darker in colour (deep yellow or amber) and this in itself may be a useful indicator of dehydration. Severe dehydration can quickly become very serious, if not life threatening, particularly in the very young and the elderly. The exact water requirements of an adult are difficult to define, as there are many influencing factors. These include the climate in which we live and our level of physical activity etc. It is estimated that an average sedentary adult requires about a litre and a half of water per day. Mineral water is a preferable source of hydration compared to calorie-laden sweet drinks, beer, tea or coffee, which all may have diuretic effects, in addition to being associated with metabolic syndrome, fatty liver disease and obesity to name a few.[6] Soup is also a good source of water, as are fruit and vegetables, which are generally high in water content. Despite some claims, there is only limited evidence to suggest that drinking water has a direct effect on weight.[7] However water is known to aid the digestive process, and drinking water as a substitute for sugary or “diet” drinks, which are both associated at least with weight gain and adverse metabolic changes.[8] Thus the benefits of staying hydrated are clear - reduced risks of various health conditions, improved cognitive function, and the potential to aid weight loss if water is used as a substitute for other calorie-laden soft drinks. These positive effects may be most pronounced in those most susceptible to dehydration and care should therefore be taken in these populations when it comes to keeping topped up with enough water every day.   [1] Popkin, BM. et al. (2010) Water, hydration and health. Nutr Rev. 68(8). 439-58. [2] Manz, F. & Wentz, A. (2005) The importance of good hydration for the prevention of chronic diseases. Nutr Rev. 63(6 pt 2). S2-5 [3] Ritz, P. & Berrut, G. (2005) The importance of good hydration for day-to-day health. Nutr Rev. 63(6 pt 2). S6-13 [4] Jéquier, E. & Constant, F. (2010) Water as an essential nutrient: the physiological basis of hydration. Eur J Clin Nutr. 64(2). 115-23. [5] Adam, P. (1997) Evaluation and management of diabetes insipidus. Am Fam Physician. 55(6). 2146053. [6] Harvard T.H. Chan School of Public Health. (2015) Sugary drinks. Retrieved April 2016, from [7] Muckelbauer, R. et al. (2013) Association between water consumption and body weight outcomes: a systematic review. Am J Clin Nutr. 98(2). 282-99. [8] Vartanian, LR. et al. (2007) Effects of soft drink consumption on nutrition and health: a systematic review and meta-analysis. Am J Public Health. 97(4). 667-75.