Antioxidants Help Stave Off A Host Of Health Problems – But Figuring Out How Much You’re Getting Can Be Tricky

The antioxidant levels of a food can be affected by its storage time in the supermarket. d3sign/Moment via Getty Images

BY NATHANIEL JOHNSON

ASSISTANT PROFESSOR OF

NUTRITION AND DIETETICS,

UNIVERSITY OF NORTH DAKOTA

When it comes to describing what an antioxidant is, it’s all in the name: Antioxidants counter oxidants.

And that’s a good thing. Oxidants can damage the structure and function of the chemicals in your body critical to life – like the proteins and lipids within your cells, and your DNA, which stores genetic information. A special class of oxidants, free radicals, are even more reactive and dangerous.

As an assistant professor of nutrition, I’ve studied the long-standing research showing how the imbalances in antioxidants and oxidants lead to oxidative stress, which is linked to cancer, diabetes, cardiovascular disease and dementia and Alzheimer’s disease. In fact, a primary cause of aging is the damage accumulated across of a lifetime of oxidative stress.

Simply put: To help prevent oxidative stress, people need to eat foods with antioxidants and limit their exposure to oxidants, particularly free radicals.

The research: Food, not supplements

There’s no way for any of us to avoid some oxidative stress. Just metabolism – the processes in your body that keep you alive, such as breathing, digestion and maintaining body temperature – are a source of oxidants and free radicals. Inflammation, pollution and radiation are other sources.

As a result, everyone needs antioxidants. There are many different types: enzymes, minerals, vitamins and phytochemicals.

Two types of phytochemicals deserve special mention: carotenoids and flavonoids. Carotenoids are pigments, with the colors yellow, orange and red; they contain the antioxidants beta-carotene, lycopene and lutein. Some flavonoids, called anthocyanins, are pigments that give foods a blue, red or purple color.

Although your body produces some of these antioxidants, you can get them from the foods you eat, and they’re better for you than supplements.

In fact, researchers found that antioxidant supplements did not reduce deaths, and some supplements in excessive amounts contribute to oxidative stress, and may even increase the risk of dying.

It should be pointed out that in most of these studies, only one or two antioxidants were given, and often in amounts far greater than the recommended daily value. One study, for example, gave participants only vitamin A, and at an amount more than 60 times an adult’s recommended intake.

Foods rich in antioxidants

In contrast, increased antioxidant intake from whole foods is related to decreased risk of death. And although antioxidant supplementation didn’t reduce cancer rates in smokers, the antioxidants in whole foods did.

But measuring antioxidants in foods is complicated. Extensive laboratory testing is required, and too many foods exist to test them all anyway. Even individual food items that are the same exact variety of food – such as two Gala apples – can have different amounts of antioxidants. Where the food was grown and harvested, how it was processed and how it was stored during transportation and while in the supermarket are factors. The variety of the food also matters – the many different types of apples, for instance, can have different amounts of antioxidants.

Nonetheless, in 2018, researchers quantified the antioxidant content of more than 3,100 foods – the first antioxidant database. Each food’s antioxidant capacity was determined by the amount of oxidants neutralized by a given amount of food. The researchers measured this capacity in millimoles per 100 grams, or about 4 ounces.

For fruits easily found in the grocery store, the database shows blueberries have the most antioxidants – just over 9 millimoles per 4 ounces. The same serving of pomegranates and blackberries each have about 6.5 millimoles.

For common vegetables, cooked artichoke has 4.54 millimoles per 4 ounces; red kale, 4.09 millimoles; cooked red cabbage, 2.15; and orange bell pepper, 1.94.

Coffee has 2.5 millimoles per 4 ounces; green tea has 1.5; whole walnuts, just over 13; whole pecans, about 9.7; and sunflower seeds, just over 5. Herbs and spices have a lot: clove has 465 millimoles per 4 ounces; rosemary has 67; and thyme, about 64. But keep in mind that those enormous numbers are based on a quarter-pound. Still, just a normal sprinkle packs a powerful nutritional punch.

Other tips

Other ways to choose antioxidant-rich foods: Read the nutrition facts label and look for antioxidant vitamins and minerals – vitamins A, C, E, D, B2, B3 and B9, and the minerals selenium, zinc and manganese.

Just know the label has a drawback. Food producers and manufacturers are not required to list every nutrient of the food on the label. In fact, the only vitamins and minerals required by law are sodium, potassium, calcium, iron and vitamin D.

Also, focus on eating the rainbow. Colorful foods are often higher in antioxidants, like blue corn. Many darker foods are rich in antioxidants, too, like dark chocolate, black barley and dark leafy vegetables, such as kale and Swiss chard.

Although heat can degrade oxidants, that mostly occurs during the storage and transportation of the food. In some cases, cooking may increase the food’s antioxidant capacity, as with leafy green vegetables.

Keep in mind that while blueberries, red kale and pecans are great, their antioxidant profile will be different than that of other fruits, vegetables and nuts. That’s why diversity is the key: To increase the power of antioxidants, choose a variety of fresh, flavorful, colorful and, ideally, local foods.

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West Africa’s Trade Monitoring System Has Collapsed - Why This Is Dangerous For Food Security

BY OLIVIER WALTHER, ANDREA APOLLONI AND LACEY HARRIS-COBLE

A decade ago countries in West Africa set up a unique trade monitoring mechanism. Its purpose was to track intra-regional trade in agricultural products and livestock in the region. But the system was closed down in 2022 due to a lack of funding by regional organisations.

The mechanism provided West African countries with data from more than 320 markets and along 10 corridors, enabling the tracking of not only trade patterns but livestock and zoonotic diseases.

The lack of up-to-date trade data has a number of knock-on effects. Detailed intra-trade data are essential to help assess the impact of external shocks that can significantly affect food security and economic development. These include political crises, extreme weather events, currency devaluation, or epidemics.

Good data is also essential for mapping trade networks. In turn, this can strengthen market information systems and disease surveillance efforts. These rely heavily on the movement of goods, people, livestock and capital across the region.

Using data collected by the Permanent Interstate Committee for Drought Control in the Sahel from 2013 to 2017, researchers show the importance of considering the social structure of trade networks, their geography and temporal changes.

The social structure of trade networks could better inform market information systems and disease surveillance, both of which rely heavily on the movement of goods, people, livestock and capital across the region.

They conclude that regional bodies should support the resumption of trade data collection. They should also foster dialogue with national statistical offices and other national institutions that have experience in collecting data on informal regional food trade to work towards a coherent regional statistical approach.

A unique database on the regional economy

In West Africa, agricultural goods and livestock trade operates in well-established corridors. Animals, for example, flow from the Sahel to the major urban centres of the Atlantic Coast and of the Gulf of Guinea.

Our analysis of the trade data suggests that border markets play a key role in livestock trade and that a large proportion of movements are trans-boundary.

This high level of mobility facilitates the spread of livestock and zoonotic diseases. These include Rift Valley fever, Crimean-Congo haemorrhagic fever, Foot and Mouth disease, and Peste des petits ruminants. At the end of September 2025, for example, a new outbreak of Rift Valley fever was observed in Mauritania and Senegal. The two West African countries have very close ties when it comes to animal movements.

The transnational nature of trade in West Africa led to the creation of a regional database by the Permanent Interstate Committee for Drought Control in the Sahel in 2013. Data collected on more than 320 markets and along 10 corridors, from Guinea and Senegal in the west to Nigeria in the east, were unique on the African continent.

The data was particularly well suited for analysis of locally-produced food stuff and livestock at the regional level. This is because it incorporated both formal and informal trade. Both are prevalent throughout the region. Our recent work estimates informal activities could reach up to 85% of total trade, representing US$10 billion. This is six times higher than portrayed in official statistics.

Filling the statistical gap

The experience of recent years and the transnational nature of trade flows suggest one key step. That being regional institutions, rather than bilateral donors, take over data collection.

Initially, the data were collected within the framework of the Permanent Interstate Committee for Drought Control in the Sahel’s Regional Support Program of Market Access. This was developed to increase the volume and value of trade within the Economic Community of West African States and the West African Economic and Monetary Union .

From 2017 to 2019, the United States Agency for International Development provided funding to establish the database as part of its West Africa/Regional Agriculture Office. The data was eventually integrated to the ECOWAS Informal Cross Border Trade database. This was developed to monitor informal cross-border trade in the region in 2019.

The United States Agency for International Development programme ended in 2019. After this, data collection was transferred to the Family Farming, Regional Markets and Cross-Border Trade Corridors in the Sahel project. Launched in 2020, its aim was to develop a sustainable and self-financed means of collecting reliable data on agricultural and food trade in West Africa.

Funding for these activities was provided by the International Fund for Agricultural Development. It was locally managed by the West African Association for Cross-Border Trade in Agro-forestry-pastoral and Fisheries Products, based in Togo.

This initiative, covering 17 countries unfortunately came to an end in 2022 (agricultural products) and 2024 (livestock).

The cessation of this funding has had dire effects. It profoundly affected researchers’ ability to measure the impact of structural and political changes affecting the region. For example, it is still impossible to measure the extent to which the closure of certain borders following successive coups in Mali, Burkina Faso, and Niger in recent years has affected the trade networks linking the Sahel to the Gulf of Guinea.

Better data to monitor trade and animal diseases

Re-establishing a permanent data collection system by supporting local associations such as the West African Association for Cross-Border Trade in Agro-forestry-pastoral and Fisheries Products is one of the essential steps for policymakers wishing to strengthen the region’s resilience.

The World Animal Health Organisation’s International Animal Health Code has suggested centralising livestock mobility data. This could be a starting point. It is the most efficient way to prevent and respond to transnational disease spread through trade.

Accurate, timely and centralised data collection could help identify possible hotspots and reconstruct transmission patterns. It could also develop control measures and alert systems to protect unaffected areas.

Beyond disease control, resuming the collection of data on intra-regional trade would also contribute to design policies that support the adaptation of regional economy to new climate conditions and political unrest. Better trade data on West Africa’s informal sector could unlock climate adaptation finance by highlighting its real value.

For instance, in one of our latest reports, we estimate that regional livestock exports for Mali, Niger and Burkina Faso are likely to be close to USD 1 billion when counting unrecorded trade, against USD 80 million in official statistics.

The research for this article was carried out in conjunction with Mr. Brahima Cissé who coordinates the Regional Markets program at the Economic Community of West African States in Togo; Dr. Alban Masaparisi, an economist specialising in food systems transformation and agricultural policy at the OECD Sahel and West Africa Club, France and Mr. Koffi Zougbede, an economist working on food systems at the OECD Sahel and West Africa Club, France.

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BOOK REVIEW: How To Do A Midlife Self Review That Actually Works

In Live to 100 and Love It!: An Easy Road Map to Longevity Stacey Colino and the editors of Prevention share a science-backed, six-step routine for redefining your identity after 60.

BY STACEY COLINO

W hen you live for several decades viewing yourself a certain way—as a colleague, as a parent, as a certain type of person—it’s understandable that self-perceptions become solidified. Consciously or not, we all have beliefs about who we are that are based on our behaviors, abilities, feelings, and personality characteristics as well as how others see us and how they respond to us. This is what psychologists call “self-concept”—a reflection of how you see yourself as a person— and it has a powerful effect on the way you act, the choices you make, the attitudes you have, and how you move through life. If you’ve always been known as a go-getter or, conversely, a low-key person, you probably assume you’ll always be that way.

And then you hit middle age, and maybe you start to feel not quite like yourself. One reason may be that your reactions, preferences, needs, values, and expectations have shifted over time, but your self-concept hasn’t kept up. “We tend to think of ourselves as static, but we do change,” says Mark Leary, Ph.D., professor emeritus in the department of psychology and neuroscience at Duke University and author of The Curse of the Self.

Update Your Self Concept

Thinking of ourselves as being one way when we have in fact changed can leave us feeling confused, out of sorts, stuck, or full of self-doubt, says Leary. Research has found that this is a common phenomenon at a certain point in life: Self-concept clarity—the extent to which someone has a clear understanding of their self and identity—increases each decade until the 60s, then begins to decline; after that, “people become less sure of their identity,” the study authors noted, perhaps partly because of shifts in their work, family, and community roles at this life stage. Rediscovering a sense of self has been rated as one of the most challenging aspects of midlife for women, according to a study involving 81 women over 23 years.

Unfortunately, harboring outdated ideas about yourself can end up holding you back from taking smart risks and embracing new challenges when doing so might lead you to feel more fulfilled. “If we’re looking at ourselves through an old lens of who we are, we take those outdated views into our future and make decisions based on that,” says Michele Patterson Ford, Ph.D., a psychologist in private practice and a senior lecturer at Dickinson College in Pennsylvania. On the other hand, updating your self-concept to reflect who and how you are now can help you pursue experiences and activities that feel satisfying and meaningful and skip or minimize those that may not suit you anymore. After doing some self-reflection, you might realize that you’ve outgrown the intense fear of public speaking you used to have and might actually enjoy giving the professional talks you’ve been invited to present. Or maybe you’ll realize that you’ve had enough of the corporate grind and what you really want to do is pursue your artistic talent. And when you have a stronger, clearer sense of who you are now, you’re likely to feel more comfortable in your own skin, maybe even happier, which is valuable in its own right. Ultimately, the goal is to make choices and changes that are in your current best interest, rather than in the best interest of you 10 or 20 years ago. So how can you figure out if you’re working with a self-concept that reflects who you are now? You dig in and do an inventory.

6-Step Self Review

Step 1: Sit down and, in writing, take stock of your current strengths, weaknesses, values, and preferences, suggests Susan Krauss Whitbourne, Ph.D., professor emerita of psychological and brain sciences at the University of Massachusetts, Amherst. Ask yourself questions like these:What are 5–10 things I am good at? These could be anything from talents to work skills to hobbies to interpersonal qualities, etc.

What are 5–10 things I struggle with? These could be daily challenges you have, things you avoid, or where you have trouble with motivation, etc.

What are 5–10 values I closely hold?These might be hard work or kindness.

What are 5–10 things I love? These can be as wide-ranging as hanging out with your dog to working in your business.

Step 2 Ask people who know you well if you’ve got the right idea. Do they think you embody these talents, values, and passions (and struggles) as much as you believe you do?

Step 3 Reflect on their answers. If everything is aligned, move on to step 4. If the answer is no, take a look at how you spend your time so you can make a concerted effort to engage in more activities that reflect the qualities and things you value. Living in a way that aligns with what you value about yourself can help solidify your self-concept, says Ford.

Step 4 Think about what was important to you 10, 20, or 30 years ago and write a letter to your younger self sharing what you’ve learned about yourself over time, how you’ve changed, and what really matters to you now.

Step 5 Stay open-minded. You might have lost some qualities you care about over time. Updating your self-concept is as much about consciously letting go of notions that no longer suit you as it is reclaiming aspects of yourself that you value.

Step 6 Rethink the terms you use or yourself. Tune in to the ways you label or describe yourself— like calling yourself an introvert or an extrovert or seeing yourself as uncreative—and assess whether these terms accurately describe your current behaviors.

Now that you have a better understanding of who you are today, ask yourself the following questions to create a path to the future:What kinds of activities make you feel fulfilled? What do you truly enjoy doing?

What have you always wanted to do or try but haven’t? Can you do it now?

Is your social circle supportive and gratifying? If not, how can you expand it?

When you imagine the future, what do you want your life to look like in five years? Ten years? Fifteen years?

What do you value most in life, and are you living in a way that’s true to those values? If not, what can you do to change that?

What nonmaterial things would you like to have more of in your life?

How would you like people to remember you when you’re gone?

If today were your last day on earth, how would you spend it?

Now think about how you can set yourself up to bring more of these valuable experiences into your life. Assess this on a practical level, as well as on financial, psychological, and emotional levels. Also, think of older people you know who have these elements in their lives. Consider seeking their advice for steps you could take to cultivate them in yours.

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The Oyster Farmers Paving The Way For Women In West Africa

Oysters are sorted and measured for size and quality Credit: Jason Florio

BY JESSAMY CALKIN

Known as ‘the smiling coast of Africa’ the Gambia is a lively little country which wriggles through the middle of Senegal like an intestine. The river after which it was named starts in Guinea, and runs 700 miles directly through the Gambia to Banjul, where it joins the Atlantic Ocean.

It is not somewhere one might immediately associate with oysters, yet oysters are one of the mainstays of the Gambian diet – high in protein and essential nutrients, they grow prolifically on the roots of the mangroves that border the many tributaries of the river.

We are not talking about raw oysters served on an elegant dish with a slice of lemon and Tabasco and a glass of Picpoul; these oysters are shucked, cooked and sold in the market for 60 dalasi (about 60p) for a large cupful; tiny little things that look like mussels and are often served in a stew.

But oyster harvesting is a tough job, and 98 per cent of the people who do it are women. During the designated oyster harvesting season – which is four months of the year, from March to June – the women take canoes out on the water at low tide, and chip the oysters off the roots of the mangroves with small axes.

They then have to be sorted, shucked and cooked, before being sold at the market. It’s an arduous job, especially because many of the women can’t swim – there is no swimming culture in the Gambia, the river is something to be afraid of – so drowning is not uncommon. They have only very basic facilities where the preparation is done, with limited access to fresh water, and they have to rent canoes.

But thanks to an initiative called Fish4ACP, which was launched in 2022 by the FAO (Food and Agriculture Organisation) and partly funded by the EU and Germany (and, until recently, USAID) support and resources are on hand for the women: swimming lessons, lifejackets, canoes and new cultivating initiatives which will increase productivity and improve standards of living.

An unlikely sounding player in this is the founder and owner of the very successful Whitstable Oyster Company, James Green, who has been employed by the FAO since 2022 in an advisory capacity, to improve oyster productivity. Using coupelles and grow bags means that oysters can be cultivated in parts of the river where the water is at its purest. Cooking the oysters kills the pathogens and algotoxins, but the eventual aim is to be able to sell raw oysters to Gambia’s many tourists. Hopefully, this will come to fruition next year.

Green, who studied marine biology and has a Masters in Aquaculture, has been here several times over the last three years. “It takes 12-18 months for an oyster to grow here in Gambia, because it’s warm. In England it can take up to three years. My part of the project is to source a fresh oyster product: a quality individual oyster that people can have on the half shell, with a bit of lime or lemon juice.”

Another new initiative of the oyster industry, to supplement income, is a handicrafts and jewellery project, using the shells of oysters and other shellfish, which are painted and laminated and crafted into jewellery. The idea behind this is also to attract younger women into the business (known as ‘the young ones’) who might be put off by the hard grafting of hacking and shucking, but are interested in the creative side.

So we begin with a visit to Lamin, a village south east of Banjul in Tanbi wetland. Development is frenzied in Banjul and its surrounding areas and the roads are fringed with multitudes of unfinished buildings.

Traffic has dramatically improved thanks to a new three lane road, which was years in the making. There used to be only one traffic light in the country, our driver tells us, and people would use it as a landmark: ‘Go right at Traffic Light.’ And there was also only one roundabout, which was known as Turntable. “When it was first built, people didn’t know what it was and drove over it.”

At Lamin Lodge there is a lot of activity: women are cleaning oyster shells and painting them. Around the hut – indeed all over every beach we saw – are huge piles of discarded oyster shells like shingle, often with tiny goats climbing all over them. (The shells can be burned and reduced to lime to make paint, but that takes a lot of wood and costs more than it’s worth in labour and fuel.)

Profit from the sale of the jewellery is reinvested in buying materials and infrastructure for the handicrafts project, which is the initiative of TRY Oyster Collective, a community-based organisation with about 600 members (which is one of the beneficiaries of Fish4ACP) working to improve livelihoods and raise standards of living.

A lot of women in West Africa work in the shellfish sector; I am told that men tend to think that harvesting oysters is not worth their time; they stick to fishing, which is responsible for 12 per cent of the country’s GDP. But fishing here, like in many other African countries, has been vastly depleted by Chinese-owned trawlers and fishmeal factories, making it harder and harder for the local fishermen to make a living.

Fatou Jahna Mboob is the director of TRY, which she founded in 2007; a formidable and warm-hearted woman who has devoted herself to empowering the oyster women, and protecting the local ecosystem.

One of her goals is to get the younger generation on board. “One mother told me that harvesting oysters is very hard and they are only doing it in order to get a better education for their children – it is not how they want their children to end up, struggling in the water. But their children can do both – go to school, and work in oysters. Once you’ve been educated, and learned to swim, you can contribute a lot more.”

Thanks to Fatou, TRY now has exclusive harvesting rights in the Tanbi wetland complex, which covers about 6000 hectares, over two thirds of which is mangroves. Previously the women would cut the mangroves to remove the oysters, now they chip them off, which is arduous but more sustainable.

Further east along the river, at Kubeneh, the oyster harvesting is in full swing. Supervised by James Green, the women are removing rubber spat collectors (known as coupelles) from a wooden rack in the river, in the intertidal zone, where they have been languishing since October – to be stripped of their bounty. When oyster larvae attach themselves to a surface, it is known as spat, which will grow into adult oysters.

These oysters will be transferred to Kartong, where the water has been tested, to be put in the river to grow. “We take them off the spat collectors and put them into floating bags,” says Green, “and then you have to maintain the stock to keep the oysters individual – they’ve got a propensity to settle on other oyster shells and you don’t want oysters clumped together like on mangroves because you can’t sell those as a fresh product. The bags are secured to anchored floating lines where they stay for another year to grow into a market sized oyster.”

There is a gentle breeze as the women sit underneath the neem tree, shucking cooked oysters. Their hands are covered in callouses, but they are very lively and cheerful. Any excuse for shouting and singing. Lunchtime – spicy Pempem – soon turns into a song and dance session, with James and Khadija Diallo, project co-ordinator of the FAO, dragged in for good measure.

“We couldn’t find the right guy until James came along,” says Diallo, “but it was clear that he knew what he was doing; he listens to the women, and guides them – he’s been here several times and he’s like family to these communities. He understands the culture which is very important.”

There are 16 separate oyster gathering communities on the west coast of the Gambia. Fatou Sambou is the president of the Kubeneh community, which has grown from 15 members to 44 in the last two years (the youngest being 21 and the oldest 70) and has a backstory which is fairly typical: now aged 54, she never went to school and her parents were farmers.

She started working in oysters after she got married. She works on the oysters during the season, the rest of the time she picks up crabs and cockles; anything to help feed her six children (one of her own and five nephews and nieces who she has adopted.) Her husband lives in Senegal, where he has two other wives. “The oyster community is like my family – we look after each other and respect each other.”

The following day, in Kartong, we are beside the Allahein river on the border with Senegal, one km from the sea, and James and the oyster women are fixing plastic fasteners to the special bags that the oysters which we have brought from Kubeneh will be placed in to grow – about 300 oysters to each bag.

Marie Demba is 44 but looks much younger. She never finished school as both her parents died when she was young, and she has worked in oysters ever since leaving school. How has the oyster business changed since then?

“We had no money and struggled – we used to only be able to charge 10 dalasi (10p) for a cup – now it’s 60 dalasi. We are like a family now, this association.” The season finishes next month, and for the rest of the year she is a fish smoker, which is very bad for the lungs, and she has been hospitalised. “Others do gardening – grow okra, sorrel, onions, and sell them in the market.”

We wait until the tide is out and then climb in a boat. The boat trip is a rowdy affair – the women are wearing life jackets, special footwear and gloves. They take the bags and attach them to specially constructed floating racks; then check the cuprolles that are already in place there.

The following day we go to another site – Old Jeshwang, so I can see what the oyster harvesting in the mangroves is like. While we wait for the tide to be right, I talk to some of the women about their lives, and meet Alice, who is 26, a young man called Lima Manga, who does data collection for TRY, and Andrea, a volunteer and self-confessed ‘oyster nerd’ from Maine, USA who is researching the benefits of oysters for the environment.

Alice was studying to be an accountant but had to give up her studies when her father became sick; now she is involved with the handicrafts and helps her mother with shucking. Her mother wants her to continue her education, and not be an oyster harvester. “My mother says, ‘Look at my hands! Do you want to look like this?’”

Fatou tells me that TRY has helped the women manage their finances; and taught them how to save. Everyone keeps their own profits, but each community contributes a small amount to a central fund which helps out if someone is sick or needs a loan. “Before they didn’t use banks – sometimes they would bury their money under piles of oyster shells.” The involvement of the young will help, she thinks, they all speak English learned at school, for a start, and they know how to use technology.

Our boatman takes us out on the river to follow the women in their canoes who are headed for the mangroves. After about a mile we find a place where the oysters are deemed big and plentiful enough. The women use a small axe to hack the oysters off the mangroves and they all sing as they do it and shout, and tease each other. They have a way of making everything into a party here. When one of the women drops her axe in the water they all stop to help her

It is clear that being able to swim is crucial. “Believe it or not, most of these women never knew how to swim,” says Khadija. “There have been incidents of drowning that are never reported – they’ve seen family members washed away. It’s not our culture here in the Gambia, but we explained the benefits – to keep safe, and how it would boost their productivity.

“However we had to get permission from spouses and community leaders in order to implement the training programme. We have seven female instructors in the navy. Some women did not mind being trained by men. Others were very conservative – so we divided them into groups accordingly. Some of the women are elderly, and the Navy trainers – who are all young – showed them respect and earned their trust before they started to teach them.”

Several members of the Gambian Navy are waiting for us at Lamin the following day, for a swimming lesson, along with a medical team of three, who take people’s blood pressures and listen to their hearts, to make sure it’s safe for them to go into the water. If they find a problem, they will prescribe medicines. All statistics are carefully noted in a ledger by an army sergeant.

In the river, a man and his children are washing the family goat. After the First Aid session about 20 of the the women – aged from 26 to 72 – all get ready for the river in a bizarre assortment of outfits, and the Navy instructors – mostly men but a couple of women – put them through a quick aerobic work out, led by 42 year old Ibrima Colley, who is extremely tall and fit.

They jump in. Firstly they do floating exercises (the water is warm and buoyant and slightly salty as we are only three miles from the sea) looking like a bunch of slightly unruly synchronised swimmers, then there is some general stroke practise followed by a lifesaving demonstration and then a quick race. Funded by Fish4ACP, it’s a six week programme, with four sessions a week. So far, 150 women have been trained – and more sessions are scheduled for October.

Colley has been in the Navy for 19 years. “We’ll work whenever there is funding to employ us because we feel it’s our social responsibility to share life saving skills with the people who are seafarers.” This reduces the demand for one of the Navy’s other jobs – rescue operations.

“When I was a kid if we swam in the river, we would get flogged when we came home. Most of our parents couldn’t swim so they were afraid of water. We would sneak to the river, then find some fresh water in a well and rinse ourselves so when we got home they couldn’t tell that we’d been swimming.”

Oyster season is about to draw to a close and James is preparing to leave. The goal is to be able to serve up the first raw oysters to tourists next year – on newly established National Oyster Day in May. In a country where the fish supplies have deteriorated and the population is growing, the oyster sector is increasingly important to the economy and the livelihood of women, and the Gambian model is paving the way in West Africa.

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Nutrition Advice Is Rife With Misinformation − A Medical Education Specialist Explains How To Tell Valid Health Information From Pseudoscience

To parse pseudoscientific claims from sound advice about health and nutrition, it’s crucial to evaluate the information’s source. tadamichi/Getty Images

BY AIMEE PUGH BERNARD

ASSISTANT PROFESSOR OF 

IMMUNOLOGY AND MICROBIOLOGY,

UNIVERSITY OF COLORADO ANSCHUTZ

MEDICAL CAMPUS

The COVID-19 pandemic illuminated a vast landscape of misinformation about many topics, science and health chief among them.

Since then, information overload continues unabated, and many people are rightfully confused by an onslaught of conflicting health information. Even expert advice is often contradictory.

On top of that, people sometimes deliberately distort research findings to promote a certain agenda. For example, trisodium phosphate is a common food additive in cakes and cookies that is used to improve texture and prevent spoilage, but wellness influencers exploit the fact that a similarly named substance is used in paint and cleaning products to suggest it’s dangerous to your health.

Such claims can proliferate quickly, creating widespread misconceptions and undermining trust in legitimate scientific research and medical advice. Social media’s rise as a news and information source further fuels the spread of pseudoscientific views.

Misinformation is rampant in the realm of health and nutrition. Findings from nutrition research is rarely clear-cut because diet is just one of many behaviors and lifestyle factors affecting health, but the simplicity of using food and supplements as a cure-all is especially seductive.

I am an assistant professor specializing in medical education and science communication. I also train scientists and future health care professionals how to communicate their science to the general public.

In my view, countering the voices of social media influencers and health activists promoting pseudoscientific health claims requires leaning into the science of disease prevention. Extensive research has produced a body of evidence-based practices and public health measures that have consistently been shown to improve the health of millions of people around the world. Evaluating popular health claims against the yardstick of this work can help distinguish which ones are based on sound science.

Navigating the terrain of tangled information

Conflicting information can be found on just about everything we eat and drink.

That’s because a food or beverage is rarely just good or bad. Instead, its health effects can depend on everything from the quantity a person consumes to their genetic makeup. Hundreds of scientific studies describe coffee’s health benefits and, on the flip side, its health risks. A bird’s-eye view can point in one direction or another, but news articles and social media posts often make claims based on a single study.

Things can get even more confusing with dietary supplements because people who promote them often make big claims about their health benefits. Take apple cider vinegar, for example – or ACV, if you’re in the know.

Apple cider vinegar has been touted as an all-natural remedy for a variety of ailments, including digestive issues, urinary health and weight management. Indeed, some studies have shown that it might help lower cholesterol, in addition to having other health benefits, but overall those studies have small sample sizes and are inconclusive.

Advocates of this substance often claim that one particular component of it – the cloudy sediment at the bottom of the bottle termed “the mother” – is especially beneficial because of the bacteria and yeast it contains. But there is no research that backs the claim that it offers any health benefits.

One good rule of thumb is that health hacks that promise quick fixes are almost always too good to be true. And even when supplements do offer some health benefits under specific circumstances, it’s important to remember that they are largely exempt from Food and Drug Administration regulations. That means the ingredients on their labels might contain more or less of the ingredients promised or other ingredients not listed, which can potentially cause harms such as liver toxicity.

It’s also important to keep in mind that the global dietary supplements industry is worth more than US$150 billion per year, so companies – and wellness influencers – selling supplements have a financial stake in convincing the public of their value.

How nutrition science gets twisted

There’s no doubt that good nutrition is fundamental for your health. Studies consistently show that a balanced diet containing a variety of essential nutrients can help prevent chronic diseases and promote overall well-being.

For instance, minerals such as calcium and iron support bone health and oxygen circulation in the blood, respectively. Proteins are essential for muscle repair and growth, and healthy fats, like those found in avocados and nuts, are vital for brain health.

However, pseudoscientific claims often twist such basic facts to promote the idea that specific diets or supplements can prevent or treat illness. For example, vitamin C is known to play a role in supporting the immune system and can help reduce the duration and severity of colds.

But despite assertions to the contrary, consuming large quantities of vitamin C does not prevent colds. In fact, the body needs only a certain amount of vitamin C to function properly, and any excess is simply excreted.

Companies sometimes claim their supplement is “scientifically proven” to cure illness or boost brain function, with no credible research to back it up.

Some companies overstate the benefits while underplaying the hazards.

For example, wellness influencers have promoted raw milk over pasteurized milk as a more natural and nutritious choice, but consuming it is risky. Unpasteurized milk can contain harmful bacteria that leads to gastrointestinal illness and, in some cases, much more serious and potentially life-threatening diseases such as avian influenza, or bird flu.

Such dietary myths aren’t harmless. Reliance on nutrition alone can lead to neglecting other critical aspects of health, such as regular medical checkups and lifesaving vaccinations.

The lure of dietary myths has led people with cancer to replace proven science-backed treatments, such as chemotherapy or radiation, with unproven and misleading nutrition programs.

How to spot less-than-solid science

Pseudoscience exploits your insecurities and emotions, taking advantage of your desire to live the healthiest life possible.

While the world around you may be uncertain and out of your control, you want to believe that at the very least, you have control over your own health. This is where the wellness industry steps in.

What makes pseudoscientific claims so confusing is that they use just enough scientific jargon to sound believable. Supplements or powders that claim to “boost immunity” often list ingredients such as adaptogens and superfoods. While these words sound real and convincing, they actually don’t mean anything in science. They are terms created by the wellness industry to sell products.

I’ve researched and written about reliable ways to distinguish science facts from false health claims. To stay alert and find credible information, I’d suggest you follow a few key steps.

First, check your emotions – strong emotional reactions, such as fear and anger, can be a red flag.

Next, check that the author has experience or expertise in the field of the topic. If they’re not an expert, they might not know what they are talking about. It’s always a good idea to make sure the source is reputable – ask yourself, would this source be trusted by scientists?

Finally, search for references that back up the information. If very little or nothing else exists in the science world to back up the claims, you may want to put your trust in a different source.

Following these steps will separate the facts from fake news and empower you to make evidence-based decisions.

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Vitamin Deficiency May Be Why You’re So Tired – A Nutritional Neuroscientist Explains How To Kickstart your energy By Getting Essential Nutrients In A Well-Rounded Diet, Along With More Sleep And Exercise

Along with salmon and sardines, the many vegan sources for omega-3 fatty acids include pecans, almonds and pumpkin seeds. fcafotodigital/E+ via Getty Images

BY LINA BEGDACHE

ASSOCIATE PROFESSOR OF HEALTH

AND WELLNESS STUDIES, 

BINGHAMTON UNIVERSITY,

STATE UNIVERSITY OF NEW YORK

Feeling drained and lethargic is common: A 2022 national survey found that 13.5% of U.S. adults said they felt “very tired” or “exhausted” most days or every day over a three-month period.

Women ages 18 to 44 had the highest rate of fatigue – just over 20%.

Being tired is linked to something deeper than just overwork or a sign of the times. I’m a registered dietitian and nutritional neuroscientist. My research, along with the work of others in the field, shows that your diet and lifestyle choices may contribute to your struggles. These two factors are closely interconnected and could be the key to understanding what’s holding you back.

In particular, not getting enough of three essential nutrients – vitamin D, vitamin B12 and omega-3 fatty acids – is linked to low energy levels.

Vitamin D

More than 40% of adult Americans are deficient in vitamin D. Low levels are linked to fatigue, bone pain, muscle weakness, mood disorders and cognitive decline.

Foods high in vitamin D include fatty fish like salmon, sardines, freshwater rainbow trout, fortified dairy products and egg yolks. Among the sources for vegetarians and vegans are fortified plant-based milks and cereals and some kinds of mushrooms.

The U.S. government’s recommended daily amount of vitamin D is 400 international units, or IU, for infants up to 12 months, 600 IU for people ages 1 to 70 and 800 IU for people over 70. Just over 5 ounces (150 grams) of sockeye salmon fillet has about 800 IU of vitamin D. If you are low in a vitamin, your doctor may prescribe you a higher dose than the recommended daily amount to elevate your blood levels to normal.

Vitamin B12

About 20% of Americans have inadequate vitamin B12 levels, which can impair energy production and lead to anemia, resulting in fatigue.

Low levels of B12 are notably higher in older people, pregnant and lactating women, people with gastrointestinal disorders like inflammatory bowel disease, those who take certain medications like proton-pump inhibitors, and people with alcohol use disorder.

Because vitamin B12 is primarily found in meat, fish, dairy and eggs, vegetarians and vegans should consider taking a vitamin B12 supplement. The recommended daily amount for anyone ages 4 and older is 2.4 micrograms, about what’s found in 3 ounces of tuna or Atlantic salmon. Pregnant and breastfeeding women require slightly more.

Taking B12 supplements can be as effective as getting the vitamin from food – and taking the supplement with food may enhance its absorption.

That said, here’s a note on supplements in general: While they can be beneficial, they shouldn’t replace whole foods.

Not only are supplements less strictly regulated by the Food and Drug Administration compared to prescription and over-the-counter drugs, making their potency uncertain, but real food also provides a complex array of nutrients that work in a synergistic way. Many supplements on the market boast multiple servings of vegetables, but nothing beats the actual food.

Omega-3 fatty acids

About 87% of adults ages 40 to 59, and about 80% of those 60 and older, don’t get enough omega-3 fatty acids to meet dietary recommendations. Neither do many pregnant women.

Omega-3 fatty acids are crucial for brain health, and a deficiency can lead to higher anxiety and depression levels and impaired cognitive function. Taken together, these deficiencies can add to fatigue.

The best sources of omega-3 fatty acids are fatty fish, but if you’re strictly vegan, flaxseeds, chia seeds and walnuts can be great alternatives. However, it’s worth noting the omega-3s in fish are absorbed better in the body than plant sources – and that determines how efficiently the body can use the omega-3.

Also, whole flaxseed has a tough outer shell, which makes it more difficult to digest and absorb its nutrients. But ground flaxseed has been broken down, making the omega-3s and other nutrients more available for absorption.

The role of alcohol

Although alcohol may provide a sense of relaxation in the moment, it actually contributes to fatigue after the buzz wears off. Alcohol is a toxin; it forces your body to prioritize its metabolism over that of nutrients, which means the body reduces the use of carbohydrates and fat for energy.

Alcohol also reduces the absorption of B vitamins, which consequently affects energy production. The bottom line: If you drink alcohol, ultimately you will feel tired.

Lifestyle factors

Diet isn’t everything. Sunlight, exercise, better sleep and stress management are all critical factors for reducing fatigue.

Your body can make vitamin D from sunlight, and you don’t need a lot. A few minutes up to a half hour of sun exposure can help most people get what they need. The amount of time can vary depending on where you live, how much clothing you wear and what time of year you get the exposure. You’ll reach your vitamin D daily quota much faster on a sunny day during the summer than a cloudy day in winter.

And it may sound counterintuitive, but the more you exercise, the more energy you will produce; working out doesn’t drain you. Instead, it boosts energy, along with mood, by improving blood flow and helping to release endorphins, which are hormones produced by the body to relieve pain or stress.

Without exercise, the human body becomes less efficient at producing energy, which leads to lethargy. Coupled with erratic blood sugar levels – often caused by diets high in refined sugars and low in nutrients – these energy dips and spikes can leave you feeling irritable and drained.

Aim for at least 150 minutes of moderate exercise each week through activities like brisk walking, cycling, swimming and strength training.

Poor sleep makes things even worse. Not getting enough rest disrupts the body’s natural recovery processes and will leave you with diminished energy and focus.

So you should try to get seven to nine hours of quality sleep each night. For some people this is not easy; creating a calming bedtime routine helps, and limiting screen time is key.

Avoid phones, computers and other screens for at least 30 to 60 minutes before bed. The blue light emitted from screens can interfere with your body’s production of melatonin, a hormone that helps regulate sleep. Conversely, activities like reading, meditation or gentle stretching help signal to your body that it’s time to sleep.

In short, there are things you can do about your fatigue. Smart choices help optimize mood, energy levels and overall health, and reduce the surges of sluggishness you feel throughout the day.

Make no mistake: Your diet and lifestyle can make all the difference between being alert or wiped out.

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Why Heart Patients Have Trouble Sticking To A Healthy Diet, And 3 Things That Help Them Eat Better

AUTHORS:

GABRIELLE GHISI

AFFILIATE SCIENTIST, KITE RESEARCH

INSTITUTE, ADJUNCT PROFESSOR, 

DEPT. OF PHYSICAL THERAPY,

UNIVERSITY OF TORONTO

CAMILA KUMMEL DUARTE

PROFESSOR DO DEPARTMENTE DE

NUTRICAO, UNIVERSIDADE FEDERAL DE

MINAS GERAIS (UFMG)

Cardiovascular disease remains a leading cause of death worldwide, and managing it effectively requires more than just medical intervention: what you eat plays a crucial role in your heart’s health.

For cardiac patients, following nutritional recommendations isn’t just a suggestion; it’s a lifeline. A heart-healthy diet can help control risk factors like high blood pressure, cholesterol levels and obesity, all of which are key contributors to heart disease.

A healthy diet will help you prevent new heart problems, which is called secondary prevention, and it will help improve functional capacity and quality of life, giving you more independence for daily activities. But for many patients, adhering to these dietary guidelines can be a significant challenge even while they are in a cardiac rehabilitation program. This is especially challenging for those who live in low-resourced settings (areas or communities with few resources and little support for health and wellness).

Cardiac rehab is an interdisciplinary approach focused on interventions for secondary prevention and improving cardiovascular prognosis, to reduce the global impact of cardiovascular disease. We recently conducted a study aimed at understanding the barriers and facilitators that low-resourced patients face when trying to follow nutritional recommendations in cardiac rehab.

The findings underscore how critical, yet complex, it is for patients to maintain a heart-healthy diet. The results of this study are not just informative — they are a call to action for health-care providers, policymakers and communities alike.

The cost of healthy eating

One of the primary barriers we identified is the cost of healthy foods. Many heart-healthy foods — like fresh fruits, vegetables, and lean proteins — can be expensive, especially for individuals or families living on a tight budget. In low-income areas, access to these foods is often limited, with more affordable but less healthy options readily available.

This economic reality makes it difficult for patients to consistently choose foods that support their heart health. In the last few years the cost of healthy food in Canada, a high-income setting, has been rising due to high food inflation. Despite that, the current Canada’s Food Guide is less expensive for adults to follow compared to the previous ones.

Another significant barrier is the complexity of nutritional information. Patients are often bombarded with a wealth of dietary guidelines, which can be confusing and overwhelming. Without proper guidance, including education and individualization, it’s easy for someone to feel lost or discouraged, particularly if they lack basic nutritional knowledge. This can lead to frustration and, ultimately, poor adherence to dietary recommendations.

Cultural factors also play a role. In many cases, traditional diets may not align with the standard dietary guidelines recommended for heart health. Patients may find it challenging to adapt their eating habits without feeling like they are losing an important part of their cultural identity. This disconnect can make it even harder for patients to stick to a heart-healthy diet.

Empowering patients to eat better

Despite these challenges, our study also highlighted several facilitators that can make a significant difference. One of the most effective is community support. Programs that provide affordable access to healthy foods, like food banks or community gardens, can help alleviate some of the financial pressures.

Additionally, accessible information sources that break down complex nutritional advice into simple, actionable steps can empower patients to make healthier choices.

Importantly, incorporating culturally relevant foods into dietary plans can make the transition to a heart-healthy diet more manageable and acceptable. When patients see that their traditional foods can be part of their diet, they are more likely to embrace and maintain the recommended changes.

Our findings emphasize the importance of a tailored approach to nutritional guidance in cardiac rehab, especially for low-resourced patients. It’s not enough to simply tell patients what to eat — health-care providers need to listen and understand the unique challenges patients face and provide practical, sustainable solutions. This means working closely with patients, offering personalized advice that considers their financial situation, providing access to resources and considering cultural preferences.

Making heart-healthy diets accessible

The implications of our research extend beyond individual patient care. They highlight the need for systemic changes that make healthy eating more accessible for everyone. This could include policies that subsidize healthy foods, increase the availability of fresh produce in underserved areas or create educational programs that are accessible to all.

Following nutritional recommendations is vital for managing cardiovascular disease, but it’s not always easy, especially for those with limited resources. Identifying and addressing the specific barriers these patients face can help them make lasting, positive changes to their diet and, ultimately, their heart health.

This research underscores the need for a more equitable approach to health care, one that ensures all patients have the support they need to live healthier, longer lives.

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Diet-Related Diseases Are The No. 1 Cause Of Death In The US – Yet Many Doctors Receive Little To No Nutrition Education In Med School

BY NATHANIEL JOHNSON AND MADELINE COMEAU

On television shows like “Grey’s Anatomy,” “The Resident” and “Chicago Med,” physicians seem to always have the right answer.

But when it comes to nutrition and dietary advice, that may not be the case.

One of us is an assistant professor of nutrition and dietetics; the other is a medical student with a master’s degree in nutrition.

Both of us understand the powerful effects that food has on your health and longevity. A poor diet may lead to cardiovascular disease, diabetes, obesity and even psychological conditions like depression and anxiety. Diet-related diseases are the leading causes of death in the U.S., and a poor diet is responsible for more deaths than smoking.

These health problems are not only common and debilitating, but expensive. Treating high blood pressure, diabetes and high cholesterol costs about US$400 billion per year. Within 25 years, those costs are expected to triple, to $1.3 trillion.

These facts support the need for physicians to give accurate advice about diet to help prevent these diseases. But how much does a typical physician know about nutrition?

What doctors don’t know

In a 2023 survey of more than 1,000 U.S. medical students, about 58% of respondents said they received no formal nutrition education while in medical school for four years. Those who did averaged about three hours of nutrition education per year.

That is woefully short of the goals set by the U.S. Committee on Nutrition in Medical Education back in 1985: that med students should receive a total of 25 hours of nutrition education while in school – a little more than six hours per year.

But a 2015 study showed only 29% of medical schools met this goal, and a 2023 study suggests the problem has become even worse – only 7.8% of med students reported 20 or more hours of nutrition education across all four years of med school. If this is representative of medical schools throughout the country, it has happened despite efforts to bolster nutrition education through numerous government initiatives.

Not surprisingly, the lack of education has had a direct impact on physicians’ nutrition knowledge. In a study of 257 first- and second-year osteopathic medical students taking a nutrition knowledge quiz, more than half flunked the test. Prior to the test, more than half the students – 55% – felt comfortable counseling patients on nutrition.

Unfortunately, this problem is not limited to U.S. medical schools. A 2018 global study concluded that no matter the country, nutrition education of med students is insufficient throughout the world.

Bringing nutrition education back

Even though evidence suggests that nutrition education can be effective, there are many reasons why it’s lacking. Medical students and physicians are some of the busiest people in society. The amount of information taught in medical curricula is often described as overwhelming – like drinking out of a fire hose.

First- and second-year medical students focus on dense topics, including biochemistry, molecular biology and genetics, while they learn clinical skills such as interviewing patients and understanding heart and lung sounds. Third- and fourth-year students are practicing in clinics and hospitals as they learn from physicians and patients.

As a result, their schedules are already jammed. There is no room for nutrition. And once they are physicians, it gets no better. Providing preventive care including nutrition counseling to patients would take them more than seven hours per week – and that’s not counting the time they would have to spend on continuing education to keep up with new findings in nutrition science.

On top of that, the lack of nutrition education in medical schools has been attributed to a dearth of qualified instructors for nutrition courses, as most physicians do not understand nutrition well enough to teach it.

Ironically, many medical schools are part of universities that have nutrition departments with Ph.D.-trained professors; those academicians could fill this gap by teaching nutrition to medical students. But those classes are often taught by physicians who may not have adequate nutrition training – which means truly qualified instructors, within reach of most medical schools, are left out of the process.

Finding the right advice

The best source of nutrition information, whether for medical students or the general public, is a registered dietitian, certified nutrition specialist or some other type of nutrition professional with multiple degrees and certification. They study for years and record many practice hours in order to give dietary advice.

Although anyone can make an appointment with a nutrition professional for dietary counseling, typically a referral from a health care provider like a physician is needed for the appointment to be covered by insurance. So seeing a physician or other primary care provider is often a step before meeting with a nutrition professional.

This extra step might be one reason why many people look elsewhere, such as on their phones, for nutrition advice. However, the worst place to look for accurate nutrition information is social media. There, about 94% of posts about nutrition and diet are of low value – either inaccurate or lacking adequate data to back up the claim.

Keep in mind that anyone can post nutrition advice on social media, regardless of their qualifications. Good dietary advice is individualized and takes into account one’s age, sex, goals, body weight, goals and personal preferences. This complexity is tough to capture in a brief social media post.

The good news is that nutrition education, when it occurs, is effective, and most medical students and physicians acknowledge the critical role nutrition plays in health. In fact, close to 90% of med students say nutrition education should be a mandatory part of medical school.

We hope that nutrition education, after being devalued or ignored for decades, will soon be an integral part of every medical school’s curriculum. But given its history and current status, this seems unlikely to happen anytime soon.

In the meantime, those who want to learn more about a healthy diet should meet with a nutrition professional, or at the very least read the 2020-2025 Dietary Guidelines for Americans or the World Health Organization’s healthy diet recommendations.

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US Food Insecurity Rate Rose To 13.5% In 2023 As Government Benefits Declined And Food Prices Soared

BY MICHAEL LONG AND LARA GONCLAVES

The official U.S. food insecurity rate rose to 13.5% in 2023 from 12.8% in 2022, according to data the U.S. Department of Agriculture released on Sept. 4, 2024. That means more than 1 in 8 Americans – about 47 million people – couldn’t get enough food for themselves or their families at least some of the time.

This is a significant increase from a recent low of 10.2% in 2021. Food insecurity grew in the two years that followed due to a sharp decline in government benefits, including money for groceries from the Supplemental Nutrition Assistance Program and the program that pays for students to get lunch and breakfast for free at school.

Higher food prices, largely driven by rapid inflation, also played a big role, as did elevated housing costs.

We are sociologists who study food insecurity. We’re concerned about the growing scale of this problem, which can happen in many ways, in a country where there’s enough food for everyone living here – and about 40% of the food produced goes to waste.

What’s food insecurity?

If you can’t afford to refill the fridge, find keeping a balanced diet too expensive, eat too-small portions, skip meals altogether, experience the physical sensation of hunger or lose weight solely due to lacking the money to put food on the table, you’re experiencing food insecurity.

It’s common for more than one of these factors to apply at the same time.

This trend may surprise you, given the attention the public, policymakers, politicians and the media paid to food insecurity at the height of the pandemic in the U.S. and around the world.

Once everything from public libraries to dentists’ offices shut down, there was a great deal of mobilization to help feed people during the COVID-19 pandemic lockdown.

Public schools began to make free breakfasts and lunches available for pickup; the federal government gave every family three rounds of economic impact payments and expanded the child tax credit; and food banks and pantries overcame logistical obstacles to keep their doors open and accommodate new clients.

Rates vary by state

Although the national food insecurity rate is significant, it doesn’t always reflect what’s happening everywhere. Rates vary a great deal between states, partly due to different levels of government support for people in need at the state and local level.

For example, the food insecurity rate in Oklahoma, where we both live and work, averaged 15.4% from 2021 to 2023. That was the fifth-highest rate after Arkansas, Texas, Mississippi and Louisiana, and more than three percentage points above the national level for the three-year period.

We believe that food insecurity remains on an upward trajectory. Barring any major policy changes that continue to slow inflation and dramatically reduce the price of food in 2024 or 2025, this rate is unlikely to drop again in the Biden administration’s final year or the first year of the next president’s term.

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Blood Sugar Fluctuations After Eating Play An Important Role In Anxiety And Depression

Diets high in legumes and dark green vegetables produce lower spikes in blood sugar. The Washington Post/Getty Images

BY MARY SCOURBOUTAKOS

FAMILY MEDICINE RESIDENT

AND NUTRITION EXPERT,

EASTERN VIRGINIA MEDICAL SCHOOL

The proverbial “sugar high” that follows the ingestion of a sweet treat is a familiar example of the potentially positive effects of food on mood.

On the flip side, feeling “hangry” – the phenomenon where hunger manifests in the form of anger or irritability – illustrates how what we eat, or don’t eat, can also provoke negative emotions.

The latest research suggests that blood sugar fluctuations are partly responsible for the connection between what we eat and how we feel. Through its effects on our hormones and our nervous system, blood sugar levels can be fuel for anxiety and depression.

Mental health is complex. There are countless social, psychological and biological factors that ultimately determine any one person’s experience. However, numerous randomized controlled trials have demonstrated that diet is one biological factor that can significantly influence risk for symptoms of depression and anxiety, especially in women.

As a family medicine resident with a Ph.D. in nutrition, I have witnessed the fact that antidepressant medications work for some patients but not others. Thus, in my view, mental health treatment strategies should target every risk factor, including nutrition.

The role of the glycemic index

Many of the randomized controlled trials that have proven the link between diet and mental health have tested the Mediterranean diet or a slightly modified version of it. The Mediterranean diet is typically characterized by lots of vegetables – especially dark green, leafy vegetables – fruit, olive oil, whole grains, legumes and nuts, with small amounts of fish, meat and dairy products. One of the many attributes of the Mediterranean diet that may be responsible for its effect on mood is its low glycemic index.

The glycemic index is a system that ranks foods and diets according to their potential to raise blood sugar. Thus, in keeping with the observation that blood sugar fluctuations affect mood, high glycemic index diets that produce drastic spikes in blood sugar have been associated with increased risk for depression and to some extent anxiety.

High glycemic index carbohydrates include white rice, white bread, crackers and baked goods. Therefore, diets high in these foods may increase risk for depression and anxiety. Meanwhile, low glycemic index carbs, such as parboiled rice and al dente pasta, that are more slowly absorbed and produce a smaller blood sugar spike are associated with decreased risk.

How diet affects mood

Many scientific mechanisms have been proposed to explain the connection between diet and mental health. One plausible explanation that links blood sugar fluctuations with mood is its effect on our hormones.

Every time we eat sugar or carbohydrates such as bread, rice, pasta, potatoes and crackers, the resulting rise in blood sugar triggers a cascade of hormones and signaling molecules. One example, dopamine – our brain’s pleasure signal – is the reason we can experience a “sugar high” following the consumption of dessert or baked goods. Dopamine is the body’s way of rewarding us for procuring the calories, or energy, that are necessary for survival.

Insulin is another hormone triggered by carbohydrates and sugar. Insulin’s job is to lower blood sugar levels by escorting the ingested sugar into our cells and tissues so that it can be used for energy. However, when we eat too much sugar, too many carbs, or high glycemic index carbs, the rapid increase in blood sugar prompts a drastic rise in insulin. This can result in blood sugar levels that dip below where they started.

This dip in blood sugar sparks the release of adrenaline and its cousin noradrenaline. Both of these hormones appropriately send glucose into the bloodstream to restore blood sugar to the appropriate level.

However, adrenaline influences more than just blood sugar levels. It also affects how we feel, and its release can manifest as anxiety, fear or aggression. Hence, diet affects mood through its effect on blood sugar levels, which trigger the hormones that dictate how we feel.

Interestingly, the rise in adrenaline that follows sugar and carbohydrate consumption doesn’t happen until four to five hours after eating. Thus, when eating sugar and carbs, dopamine makes us feel good in the short term; but in the long term, adrenaline can make us feel bad.

However, not everyone is equally affected. Identical meals can produce widely varying blood sugar responses in different people, depending on one’s sex, as well as genetics, sedentariness and the gut microbiome.

And it’s important to keep in mind that, as previously mentioned, mental health is complicated. So in certain circumstances, no amount of dietary optimization will overcome the social and psychological factors that may underpin one’s experience.

Nevertheless, a poor diet could certainly make a person’s experience worse and is thus relevant for anyone, especially women, hoping to optimize mental health. Research has shown that women, in particular, are more sensitive to the effects of the glycemic index and diet overall.

Unfortunately, simple solutions, such as swapping sugar for artificial sweeteners, are not an option. Research has shown that among all processed foods, artificial sweeteners and artificially sweetened beverages are most strongly associated with depression.

Optimizing mood with food

The most obvious way to stabilize blood sugar levels is to decrease sugar and carbohydrate intake. However, this is not the only way. Research has proven that simple changes can drastically mitigate volatile blood sugar fluctuations. Some strategies to stabilize blood sugar and optimize mood include:

Make low glycemic index carbohydrates such as parboiled rice, whole grain bread and al dente pasta dietary staples and be mindful of how many high glycemic index carbohydrates you consume. I give my patients this guide to increase their awareness of the glycemic index of various carbohydrates.

Eat carbohydrates earlier in the day such as breakfast or lunchtime, as opposed to later in the day, like dinner or, worse yet, as a nighttime snack. Our hormones follow a circadian rhythm, and carbs eaten earlier in the day produce a smaller blood sugar spike compared with carbs eaten later in the day.

Avoid eating carbohydrates on their own, such as snacking on a box of crackers or downing a bowl of rice. Always strive to combine carbohydrates with proteins such as beans, nuts, meat and fish, or with healthy fats such as olive oil and avocado. The combination of nutrients slows down the digestion of carbohydrates and thereby produces a smaller blood sugar spike.

Eat carbohydrates at the end of the meal, after eating vegetables and protein first. Just changing the order in which foods are eaten can drastically lower the blood sugar spike that comes after.

Eat a salad dressed with olive oil and vinegar prior to eating carbohydrates. The combination of vegetables, acid from the vinegar and fat from the olive oil, all work together to slow carbohydrate absorption and minimize the resultant blood sugar spike.

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