Category: Nutrition & Lifestyle

  • Can You Still Eat Beef and Be Heart Healthy?

    Can You Still Eat Beef and Be Heart Healthy?

    Is beef heart healthy? Red meat has had a rough ride in recent decades. It’s been linked to everything from heart disease to early death, with no shortage of headlines declaring it public enemy number one. But a recent meta-analysis has taken a more measured look at one particular type of red meat: lean, unprocessed beef.

    The study examined 20 randomised controlled trials (RCTs) involving over 1,000 adults. Researchers focused on key cardiovascular disease (CVD) risk factors, including blood lipids like LDL and HDL cholesterol, triglycerides, and blood pressure. Essentially, the study found that beef is not quite the villain it’s made out to be.

    What the Study Looked At

    This was a systematic review and meta-analysis. A trial design that is about as robust as nutritional evidence gets. Researchers pooled data from high-quality trials that compared diets with varying amounts of lean beef. The aim was to isolate beef’s impact on heart health. The study aimed to avoid the usual confusion that comes from lumping it together with other red meats or with heavily processed sausages and burgers.

    Most participants were either healthy or had common metabolic issues such as high cholesterol or type 2 diabetes. The average beef intake in the high-beef groups was around 160 grams per day, roughly two servings. Which, in my opinion, is quite a lot of beef. Comparators were diets with little or no beef.

    The Verdict on Cholesterol and Blood Pressure

    The key takeaway was that eating lean, unprocessed beef had no meaningful impact on most heart health markers.

    Total cholesterol, HDL and triglycerides stayed broadly the same, regardless of how much beef people ate. Both systolic and diastolic blood pressure also remained broadly unchanged. There was a very small increase in LDL cholesterol, around 2.7 mg/dL or 0.07mmol/L. This might sound concerning. However, this is a trivial increase. For context, that’s the kind of variation you might get from eating a slightly different breakfast.

    Even this tiny effect on LDL was mostly driven by one influential study. When that study was removed in a sensitivity analysis, the difference disappeared.

    It is also worth noting that lean beef tends to be higher in cholesterol-lowering fats (monounsaturated and polyunsaturated) than cholesterol-raising saturated fats. Many of the included trials also tried to match saturated fat across diets. This makes it unlikely that saturated fat was a major driver.

    So, Is Beef Heart Healthy?

    The answer, based on this analysis, is that it is certainly not harmful. At least not in the form studied here. Eating lean, unprocessed beef in moderate amounts does not appear to harm cholesterol levels or blood pressure. In fact, it can be a useful source of high-quality protein, iron, zinc, and vitamin B12. These are nutrients that many people are deficient in.

    Of course, this does not mean you should eat steak every day and skip the vegetables. A balanced diet is still key, and occasionally swapping beef for fish or plant-based proteins is still a good idea. But the idea that any amount of beef will clog your arteries and cut your life short is not supported by this data.

    But What About the Funding?

    Yes, the study was funded by the Beef Checkoff, an industry body. That should always raise eyebrows. However, the researchers clearly disclosed this. The study used rigorous methods and followed gold-standard protocols like PRISMA. In fact, over 70 per cent of the industry-funded trials included were rated as low risk of bias. That was better than some of the non-industry-funded ones.

    This does not mean we take the results at face value without scrutiny. However, we should be cautious about dismissing them just because of who paid for the research. The rigour was there.

    Where This Leaves Us

    Nutritional science is messy, and red meat is a prime example. Much of the scare comes from observational studies that cannot separate diet from lifestyle. People who eat lots of red meat often do fewer healthy things overall. They tend to exercise less, smoke more, and eat fewer vegetables. That makes it tricky to tease out cause and effect.

    What this meta-analysis gives us is a cleaner look at the question. And the answer, at least for lean, unprocessed beef, appears to be that there is no major impact on lipids or blood pressure. It is important to mention that this study did not look at hard outcomes. It did not, for example, tell us whether people who ate more lean beef were more likely to die or a heart attack or stroke. It merely points out that people who ate lean beef had no change in the risk factors for heart disease and stroke. 

    If you enjoy beef, there is no need to swear it off entirely. Choose lean cuts, don’t char it to oblivion, and pair it with plenty of plant-based foods. A steak night now and then, as part of an overall healthy lifestyle, is unlikely to be the thing that tips the balance.

    Nutrition is full of strong opinions. But evidence beats ideology. This latest study adds a little sanity back into the red meat debate. It is not a green light to live on burgers, but it is a reminder that context, portion size, and overall diet quality matter far more than demonising single foods.

    And if someone tries to guilt you over your Sunday roast, you now at least have a well-referenced comeback.

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

    Book a Health Screening

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Cardiovascular Health Guides

  • Ultra-Processed Foods: Are They Really That Bad for You

    Walk into any supermarket and try to avoid ultra-processed foods. It’s nearly impossible. Ready meals, packaged snacks, ‘healthy’ protein bars, and supermarket bread. They all fall into this category. Even some foods marketed as nutritious are ultra-processed, full of additives, preservatives, and ingredients that barely resemble anything found in nature.

    We’ve long suspected they’re bad for us. But a massive new study has put the nail in the coffin. The more ultra-processed food you eat, the worse your health outcomes. Heart disease, obesity, type 2 diabetes, depression, and even early death; the risks go up across the board.

    What Are Ultra-Processed Foods?

    Ultra-processed foods (UPFs) are not just ‘junk food.’ They’re industrially formulated products packed with refined ingredients, chemical additives, and preservatives. The NOVA classification system groups food into four categories, with UPFs being the worst offenders. Think:

    • Pre-packaged meals
    • Fizzy drinks
    • Instant noodles
    • Mass-produced supermarket bread
    • Flavoured yoghurts with a list of ingredients longer than your arm
    • Protein bars masquerading as healthy options
    • Most breakfast cereals

    Essentially, ultra-processed food contains things you wouldn’t find in a normal kitchen: emulsifiers, artificial sweeteners, colourings, and stabilisers.

    What Does the Science Say?

    A new study reviewing data from nearly 10 million people has confirmed what we’ve suspected for a while: the more ultra-processed food you eat, the worse your health outcomes. Some of the key findings:

    • All-cause mortality: UPFs are linked to a higher risk of dying earlier.
    • Cardiovascular disease: Increased risk of heart attacks, strokes, and related deaths.
    • Type 2 diabetes: Strong evidence that UPFs contribute to insulin resistance and metabolic dysfunction.
    • Obesity and abdominal fat: They make you gain weight and store fat in all the wrong places.
    • Mental health issues: Higher rates of anxiety, depression, and even poor sleep patterns.

    These effects aren’t just from eating ‘bad’ foods like crisps and fizzy drinks. Even some foods we’ve been led to believe are healthy (high-protein snacks, low-fat yoghurts, certain plant-based alternatives) are ultra-processed and have similar effects.

    Why Are They So Bad?

    Ultra-processed foods are uniquely harmful for several reasons:

    1. Nutrient-Poor, Calorie-Dense
      They’re high in sugar, salt, and unhealthy fats, while lacking fibre, protein, and micronutrients. This leads to overconsumption and nutrient deficiencies.
    2. Disrupting the Gut Microbiome
      Additives, emulsifiers, and artificial sweeteners disturb gut bacteria, leading to inflammation, digestive issues, and even poor mental health.
    3. Inflammation and Metabolic Chaos
      Many of the chemical byproducts from food processing are pro-inflammatory, meaning they contribute to chronic diseases, from heart disease to autoimmune conditions.
    4. Engineered for Overconsumption
      These foods are designed to be hyper-palatable, triggering dopamine hits and encouraging overeating. Have you ever noticed how easy it is to eat an entire pack of biscuits but almost impossible to overeat steak and veg? That’s not an accident.

    Exposure to Harmful Chemicals
    The packaging itself can be a problem. It can leach chemicals like bisphenols and microplastics into food, which then enter our bodies.

    What Should You Do?

    You don’t need to live like a monk. But cutting back on UPFs is one of the best things you can do for your health. Here’s how:

    • Stick to real food: If it had a face, grew from the ground, or needed little intervention before reaching your plate, it’s a good choice.
    • Shop the perimeter of the supermarket: That’s where you’ll find meat, fish, eggs, fruit, veg, and dairy.
    • Check the ingredients list: If it reads like a chemistry experiment, think twice.
    • Cook more at home: It doesn’t have to be complicated. Simple meals with whole ingredients will always beat processed alternatives.
    • Follow the 80/20 rule: You don’t have to eliminate UPFs completely, but they should be an occasional treat rather than a daily staple.

    Final Thought

    You don’t need to listen to three-hour longevity podcasts to figure out what to eat. The healthiest diet is the simplest. Eat mostly real food, cook when you can, and don’t get sucked into the marketing hype.

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

    Book a Health Screening

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Nutrition & Lifestyle Guides
  • Nutritional Strategies for Effective Muscle Growth

    Nutritional Strategies for Effective Muscle Growth

    It’s a well-accepted tenet in fitness circles that protein reigns supreme when it comes to building muscle. Protein remains the cornerstone of muscle hypertrophy. However, a recent study from the University of Padova has shed light on an assortment of other nutrients that play critical roles in enhancing muscle response to resistance training. In this blog, I’ll delve deeper into how these nutrients support muscle growth and repair.

    Protein: The Foundation of Muscle Synthesis

    Protein is the most potent nutritional stimulus for building muscle. In scientific terms building muscle is described as muscle protein synthesis (MPS). The body uses the amino acids from dietary protein to repair and build muscle fibres. Current guidelines suggest varying levels of protein intake. A minimum of 0.8 g/kg of body weight has been suggested as being generally sufficient for non-active individuals. While as much as 2.4 g/kg is proposed for those engaged in rigorous strength training. However, the lower end of this spectrum is often considered inadequate for optimising muscle hypertrophy. This is particularly the case in those actively training. These levels of protein intake might not fully support the enhanced demands for muscle repair and growth in people who are training. And everyone who does not have an illness should be training. Studies suggest that people building muscle mass and strength need at least 1.7 g/kg of protein on non-training days to optimise muscle hypertrophic response. Even the need of protein to support muscle repair for an endurance athlete may be higher than it was previously thought. It should be (1.6–1.83 g/kg) and even higher the day following a training session.

    Dietary protein supplementation stimulates MPS and is essential for hypertrophy. Key studies like those by Moore et al. (2009) highlight that protein intake after resistance training significantly enhances MPS. Optimal protein intake per meal is suggested around 20-25 grams to maximise muscle growth. Just this year a study by Trommelen and colleagues (2023) investigated consuming even higher doses of protein. They showed that the ingestion of 100 g of protein resulted in a greater and more prolonged (>12 h) anabolic response when compared to the ingestion of 25 g of protein. These findings suggest that the anabolic response to protein ingestion likely has no upper limit.

    Carbohydrates: More Than Just Fuel

    While their primary role is to replenish muscle glycogen, carbohydrates also enhance muscle recovery and growth. They do this by spiking insulin level. Yes, spikes in insulin are not all bad! Insulin is a potent anabolic hormone that improves glucose and amino acid uptake by muscles. Thus, facilitating muscle repair and growth after training.

    Carbohydrates do not directly contribute to MPS but play a supportive role. Studies such as those by Glynn et al. (2013) indicate that consuming carbohydrates and protein post-exercise can enhance the insulin response. This likely increases MPS indirectly through improved nutrient delivery and anabolism.

    Creatine: Enhancing Energy and Growth

    Creatine supplementation increases phosphocreatine stores within the muscle. These are essential for ATP regeneration during short, intense bursts of activity such as lifting weights or sprinting. This increase in available energy can significantly enhance muscle strength, power, and size. Creatine also helps increase muscle cell volume. This plays a role in muscle growth signalling pathways.

    Creatine supplementation has been very widely researched. Numerous studies have supported its efficacy in improving strength and muscle mass. For instance, research by Branch (2003) demonstrates that creatine enhances phosphocreatine recovery between sets. Therefore, creatine allows greater work output and training volume. These are both critical for stimulating MPS.

    The International Society of Sport Nutrition (ISSN) and the IOC consensus statement have released updated position statements on creatine monohydrate (CM). These suggest that the most effective strategy for increasing creatine stores is splitting supplementing into different phases. The first phase is the so called “loading phase.” During this phase 20.9 ± 4.5 g/day should be divided into four equal daily doses (5 g/dose or ~0.3 g/kg body weight). The loading phase lasts for 5–7 consecutive days. The subsequent phase of the protocol requires a “maintenance phase.” In this phase, 3–5 g of CM is taken daily for the entire duration of the supplementation period. Consuming carbohydrates and proteins (~50 g of proteins and CHO) increases the retention of creating muscle. An effect that is mediated via insulin.

    A second protocol involves the ingestion of 3 g/day of CM for 28 days. This is the approach that I take as it has fewer gastrointestinal side effects. But, until muscle creatine levels are completely saturated, it has lesser effects on exercise performance.

    Long term use of creatine has shown no negative health effects. (around 4 years of consequent supplementation).

    Omega-3 Fatty Acids: Anti-inflammatory Effects

    Omega-3 fatty acids, particularly EPA and DHA, are known for their anti-inflammatory properties. They help modulate the inflammation induced by rigorous training. This attenuation of inflammation supports muscle recovery and growth. Omega-3s also enhance the insulin sensitivity of muscles. This can further support muscle health by improving muscle nutrient delivery and reducing muscle breakdown.

    Omega-3s have been shown to not only reduce inflammation. It has been suggested that they increase MPS. Smith et al. (2011) found that omega-3 fatty acid supplementation effectively increased the mTOR pathway’s sensitivity to amino acids in humans. mTOR plays a vital role in muscle protein synthesis. Hence Omega-3 fatty acids stimulate muscle protein synthesis and may be useful for this purpose as a supplement.

    Vitamin D: A Direct Role in Muscle Function

    Vitamin D is crucial for more than just bone health. It directly influences muscle function and strength. It enhances the transcription of genes involved in muscle contraction and protein synthesis. Furthermore, vitamin D is involved in calcium regulation. Calcium is a key mineral in muscle contraction and signalling pathways related to muscle growth.

    Vitamin D’s role in muscle health extends beyond bone metabolism. Studies like those by Girgis et al. (2013) suggest that adequate vitamin D levels are linked to improved muscle repair and function. This impacts MPS through enhanced muscle cell proliferation and differentiation.

    The evidence for protein, carbohydrates, creatine, omega-3s, and vitamin D is robust. Yet, several other nutrients have been studied for their potential supportive roles in muscle health and hypertrophy:

    Emerging and Supportive Roles in Muscle Health

    1. Magnesium and Zinc: Both are essential for muscle function and protein synthesis. Magnesium plays a pivotal role in energy production and electrolyte balance. These are crucial during intense training sessions. Zinc is critical for hormone regulation, including testosterone. Of course testosterone significantly impacts muscle growth and repair. However, the evidence linking direct supplementation with enhanced muscle hypertrophy is less conclusive than for the primary nutrients.
    2. Chromium: This mineral is known for enhancing insulin action. This potentially affects muscle protein synthesis by improving nutrient delivery to muscles. Still, direct impacts on muscle mass or strength are not well-supported by current research.
    3. Polyphenols: Found in fruits, vegetables, and teas, polyphenols like resveratrol and quercetin have anti-inflammatory and antioxidant properties. They may help reduce oxidative stress and support muscle recovery post-exercise. However, their direct impact on muscle growth is less understood.
    4. Prebiotics and Probiotics: These influence gut health. Our gut health can indirectly affect nutrient absorption and inflammation. Both of these factors are important for muscle health. While promising, the direct evidence linking these supplements with improved muscle hypertrophy is still emerging.

    Conclusion

    To truly optimise muscle growth and recovery, it’s crucial to consider a broad spectrum of nutrients beyond just protein. Protein, carbohydrates, creatine, omega-3s, and vitamin D form the backbone of a muscle-friendly diet. Yet, emerging evidence suggests that other nutrients like magnesium, zinc, chromium, polyphenols, and gut health supplements can also play supportive roles. Tailoring your diet to include a wide range of these nutrients can help maximise your training results. This will ensure that every workout brings you closer to your strength and muscle growth goals.

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

    Book a Health Screening

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Nutrition & Lifestyle Guides
  • Energy Drinks and Student Well-being

    Energy Drinks and Student Well-being

    It’s early summer 2005, Dr Lucy, Dr Kat and I stand outside Wilson House in Paddington. We are about to walk into the examination hall to sit our medical final exams, six years of study are leading up to this. Some of our fellow students laugh nervously, sharing jokes among themselves. Others frantically leaf through textbooks in search of last-minute medical revelations. Many hold in their hand a highly caffeinated energy drink. The magical elixir that they hope will give them the edge in the battle against the examiners. 

    Energy drinks have an undeniable allure. This is particularly the case among under-prepared students seeking a mental performance edge. They are marketed as modern-day elixirs of vitality and focus. These beverages are often seen as the essential fuel for late-night study sessions and intensive exam preparations. But, recent findings from the SHOT2022 study highlight the impact of these ubiquitous drinks on young adults’ sleep and overall health. SHOT2022 was a comprehensive survey of Norwegian students’ health. 

    The Study at a Glance

    The SHOT2022 study delved into the daily habits of over 53,000 young adults. It was conducted across a broad demographic of full-time students in Norway. The study explored the murky, sticky, sweet-smelling waters of energy drink consumption. This ritual was followed by 3.3% of female and 4.7% of male students each day. The study revealed a troubling association between energy drink intake and sleep disturbances. It suggested an urgent need to reassess our reliance on these potent brews.

    Energy Drinks and Sleep: A Fraught Relationship

    The allure of energy drinks lies in their promise of instant alertness. This is, of course, attributed primarily to their high caffeine content and sometimes, their taurine content. However, the study’s findings suggest that this short-term gain comes at a potentially high cost to long-term health. Regular consumers of energy drinks reported significantly shorter sleep durations and more frequent insomnia than their peers who abstained or indulged only occasionally.

    Interestingly, even infrequent consumption of energy drinks was associated with poor sleep outcomes. This highlights the potent effects of their ingredients. The stimulants in energy drinks go beyond caffeine to include sugars and other stimulants like guarana. These components can disrupt sleep patterns and decrease sleep quality. They ultimately leave students tired and offset the very gains in alertness and performance students seek.

    Gender Differences in Consumption and Impact

    The study also shed light on gender-specific responses to energy drinks. Men generally reported higher consumption rates. In addition, men showed stronger correlations between energy drink intake and disrupted sleep patterns. This included delayed bedtimes and reduced sleep efficiency. The study suggests that energy drinks tend to exacerbate the natural tendency among young men to engage in other behaviours that can also impair sleep. For example, men tended towards increased screen time and irregular sleep schedules.

    Navigating a Healthier Path

    For health-conscious individuals and those advising them, the takeaway is clear. Energy drinks can offer a temporary boost, but their long-term effects on sleep health are concerning. Instead of relying on these quick fixes, we should consider more sustainable methods to enhance academic performance and energy levels. Regular physical activity, balanced nutrition, and consistent sleep schedules are far more effective in fostering true cognitive and physical vitality. Of course, rigorous academic preparation is also crucial. 

    The broader implications of this research suggest advocating for healthier lifestyles among students. Rather than relying on the crutch of energy drinks, natural energy boosters and strategies that support both academic success and overall well-being should be emphasised. Encouraging a shift from energy drinks to wholesome alternatives would not only enhance students’ academic performance but also their quality of life.

    Conclusion

    We continue to establish the collateral health damage of modern dietary habits. Studies like SHOT2022 provide invaluable insights into the often-overlooked consequences of popular choices like energy drinks. Energy drinks reflect a more general trend in society towards quick fixes rather than perseverance and hard work. For students and young professionals navigating the demands of high-level education and early career challenges, understanding these impacts is crucial. It invites a reevaluation of how we fuel our bodies and minds. We should be aiming for sustained energy and focus. That would support not only academic and professional success but also long-term health and wellness.

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

    Book a Health Screening

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Nutrition & Lifestyle Guides
  • A Closer Look At Calcium Supplements

    A Closer Look At Calcium Supplements

    Humphrey Davey wanted to study medicine. He was an apprentice to a surgeon and apocathery. But Davey never did study medicine. Instead, he became a self-taught chemist and he discovered several elements including calcium.

    The narrative surrounding calcium supplementation is as complex as it is fascinating. Calcium supplementation has roots deeply embedded in both science and societal beliefs. Calcium, the stalwart of bone health, has been championed for decades as a critical component of a healthy lifestyle. This has been particularly the case in improving bone health. This belief has not only permeated clinical guidelines but also the public consciousness. Consequently, a significant portion of the population, especially older women, incorporate calcium supplements into their daily regimen. In the United States alone, a striking 61% of women over 60 were taking calcium supplements between 2003 and 2006. This widespread adoption has catapulted calcium supplementation into a billion-dollar industry. Millions of people across various age groups seek to bolster their health through calcium supplements.

    Are Calcium Supplements Safe?

    Yet, the message of “more calcium equals better health” is increasingly being questioned. Initial studies posited that dietary calcium had a more pronounced effect on bone building compared to its supplemental counterpart. This is presumably due to its better absorption. Yet, the reality of dietary habits and the availability of calcium-rich foods means not everyone can achieve sufficient calcium intake through diet alone. All the more so with the recent trend towards milk substitutes. This underscores a potential role for supplementation in cases of dietary inadequacy.

    But as the practice of calcium supplementation has grown, so too have concerns about its safety. Recent years have seen a burgeoning debate. The discourse has been fueled by studies suggesting potential risks associated with indiscriminate calcium supplementation. Notably, a meta-analysis by Bischoff-Ferrari et al. highlighted an increased risk of hip fractures. A review of randomised clinical trials found that calcium supplementation did not correlate with a reduced risk of fractures among older adults. So, there was certainly evidence to suggest an either negative or at best neutral effect of calcium supplements on the risk of hip fractures. Remember, the main reason to take calcium is to avoid a devastating hip fracture. However, this discourse took a more concerning turn than merely suggesting a lack of benefit. Other findings suggested a significant increase in cardiovascular disease associated with calcium supplements. This was particularly the case in men.

    Are Calcium Supplements Harmful?

    Amidst this backdrop, the recent findings from a study leveraging the expansive UK Biobank dataset provide a nuanced perspective on the intersection of calcium supplementation and cardiovascular health. The research examined the associations between calcium supplementation and cardiovascular disease (CVD) events and mortality. In particular, it examined supplementation in individuals with and without diabetes. The results painted a stark picture for those with diabetes. Regular calcium supplement intake was linked to higher risks of heart disease and death in diabetics. No significant risk increase was observed in participants without diabetes.

    This dichotomy between individuals with and without diabetes underscores the need for a more tailored approach to calcium supplementation. It also challenges the prevailing “one-size-fits-all” mentality. The study’s implications are profound. It suggests healthcare providers weigh the potential adverse effects of calcium supplements against their benefits, particularly among diabetic patients.

    The dialogue surrounding calcium supplementation, once dominated by an uncritical endorsement of its benefits, is evolving. It calls for a reevaluation of how we perceive and prescribe these supplements. I would advocate for a balance that prioritises dietary sources of calcium. Supplementation should be recommended judiciously. The study serves as a reminder of the importance of personalised healthcare and the value of diet over supplements.

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

    Book a Health Screening

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Nutrition & Lifestyle Guides
  • Minerals and Mood

    Minerals and Mood

    Most of us are continuously juggling multiple roles and responsibilities and hence it’s easy to overlook something as basic as our dietary habits. However, a recent study showed some fascinating insights that suggest that, from a mental health point of view, our meal choices can be incredibly influential. 

    A Deep Dive into Dietary Minerals and Depression

    A comprehensive analysis involving over 20,000 participants from the National Health and Nutrition Examination Survey (2007-2018) brought to light the complex relationship between nine key dietary minerals and depressive symptoms. These minerals studied were:

    • Calcium (Ca)
    • Phosphorus
    • Magnesium (Mg)
    • Iron (Fe)
    • Zinc
    • Copper (Cu)
    • Sodium
    • Potassium (K)
    • Selenium (Se)

    The study employed sophisticated statistical models (such as the Bayesian kernel machine regression) to assess the impact of these minerals on depression, measured by the Patient Health Questionnaire-9 (PHQ-9) scores. This is a standard tool used in primary care to quantify the extent of patients’ depression. 

    It’s Not Just What You Eat, But How They Interact

    The results were intriguing:

    • Negative Association That’s Positive: A higher intake of these minerals was linked to lower PHQ-9 scores, indicating fewer depressive symptoms.
    • Role of Selenium and Potassium: Selenium emerged as the key player, showing the most significant impact, closely followed by potassium.
    • Interactions Matter: Interactions between certain minerals, like calcium and iron, also influenced depressive symptoms.
    • Gender-Specific Effects: Interestingly, copper showed a more pronounced effect in females.

    What Does This Mean for Us?

    This study adds to the growing body of evidence suggesting that our diet, specifically mineral intake, plays a significant role in mood regulation. Minerals are not just building blocks for our bodies; they are crucial for the synthesis of mood-regulating neurotransmitters like serotonin and dopamine.

    So, What Can We Do?

    Here’s a quick guide to foods rich in these crucial minerals:

    • Nuts and Seeds: A treasure trove of selenium, especially Brazil nuts. These are are great for reducing the risk of cardiovascular disease
    • Eggs: Dubbed nature’s multivitamin. Don not worry about the Mapco of eggs on cholesterol. 
    • Cruciferous Vegetables: Such as broccoli, cabbage, and Brussels sprouts.
    • Beans: High in fibre and a useful source protein (the bean soup at la Pizzica deli is highly recommended as the source of beans!).
    • Avocados and Berries: These are rich in omega-3 fatty acids and essential minerals.
    • Leafy Greens: Folate-rich and which is important for nutrient transport to the brain.
    • Shellfish and Sardines: High in zinc and omega-3s.

    A Note on Supplementation

    While a balanced diet is the gold standard, some patients, especially those facing severe mental health challenges, might find it difficult to maintain such a diet. In these cases, a multimineral supplement might be  helpful

    We’re here not just to treat but to educate and empower. This study offers a glimpse into the significant impact of diet on mental health. Try to embrace these findings in your culinary choices. And, as always, we’re here to guide you on this journey towards a healthier, happier you.

    P.S. For personalised advice on nutrition and mental health, to check your nutrient levels or to discuss this study further, feel free to book an appointment. 

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

    Book a Health Screening

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Nutrition & Lifestyle Guides
  • Exercise: A Balanced Recipe for Longevity

    Exercise: A Balanced Recipe for Longevity

    What is the perfect blend of exercise for a healthier, longer life? Now, this isn’t about preparing for ultra-marathons or entering Mr Olympia; it’s about understanding the right mix of physical activities to keep ourselves as fit as possible for as long as possible.

    A comprehensive study with over half a million participants has shed light on the best exercise regimen for longevity. The secret lies in a balanced trio: Moderate Physical Activity (MPA), Vigorous Physical Activity (VPA), and muscle strengthening.

    The Ideal Exercise Combo: It’s More Than a Walk in the Park

    The study, published in JAMA Internal Medicine, found that those with the lowest risk of early death clocked in more than 75 minutes of MPA, over 150 minutes of VPA, and a minimum of two muscle-strengthening sessions per week. 

    Tailoring for Cancer and Cardiovascular Health

    For those focusing on reducing the risks of cancer and heart disease, the formula adjusts slightly. More MPA ( 300 minutes weekly), a moderate dose of VPA, and consistent muscle-strengthening work best. It might sound daunting, but consider it an investment in your future well-being. Do you care for yourself enough to make the investment in your future health?

    More: Not Just Better, But Perhaps Essential

    This study suggests that when it comes to exercise, sometimes more is indeed better. Interestingly, this study’s recommendations surpass the conventional exercise guidelines by some distance, However, it’s crucial to remember that any amount of exercise is a positive step. Not everyone can or wants to commit to an intensive exercise regimen, and that’s perfectly okay. Consistency trumps intensity every time. You should not feel like you have been flogged after every exercise session. 

    A Thoughtful Approach to Exercise

    Our goal is not just to add years to life but also life to years. While that might mean increasing our exercise regimen, it’s about doing so mindfully and in a way that brings joy and vitality, not injury, dread or monotony.

    Your journey to optimal health is just (several thousand) steps away!

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

    Book a Health Screening

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Nutrition & Lifestyle Guides
  • Understanding heatstroke

    Understanding heatstroke

    1. What exactly is heat stroke and what causes it – what is going on inside the body on a cellular level?

    Heat stroke is the worse end of a big spectrum of heat related conditions.

    Exertional heat stroke is the type that is associated with exercising in the heat, it is a very serious condition when our body can no longer control its temperature and it starts to sky rocket.

    Usually when we work out we have lots of great mechanisms for helping our body cool off. Aside from our fancy work out gear our body cleverly sends more blood flow to the skin to help our skin produce more sweat which helps our body stay cool. To get more blood flow to the skin we send less blood to our digestive system which is why lots of people can find it hard to digest foods after exercise. In extreme heat this though can cause problems with less water being absorbed in our gut and even the gut becoming leaky and allowing toxins to enter our blood stream.

    If we become dehydrated during exercise it gets worse as our heart struggles to pump enough to keep up our circulation and becomes strained. If we can’t get enough blood to our muscles, they can start to overheat too and produce harm toxins which can actually damage the muscle tissue itself.

    We really start to worry about people when the body temperature is above 40 degrees centigrade. This is because this is called the ‘thermal threshold’, above this temperature the membranes, or outer layer of our cells, can become damaged, this can cause enough harm to cause the death of cells. In the worst-case scenario, the combination of these events can lead to unconsciousness, coma, multiple organ failure and even death.

    2. What can trigger heat stroke?

    The biggest risk of heat stroke is when the temperature outdoors is above 28°C, in combination with doing some strenuous activity or high intensity exercise for an hour or more. So even an outdoors exercise class or a fast run could be a risky time.

    Definitely if you are not used to that exercise there is a bigger risk. So, the current brilliant weather is a great reason to enjoy being outdoors but not the perfect time to try out that boot camp class.

    If you have another complicating factor it can also be enough to get your body in trouble, even if you are super fit. Common things are having a virus or mild illness, being dehydrated before you start exercises, inappropriate clothing and being tired. Some medications such as anti-depressant medicines can also add to the risk.

    3. What are the symptoms of heat stroke? – from the most obvious to some which are perhaps a bit more surprising?

    Most of us have probably experienced mild symptoms such as feeling a headache and unwell after a long afternoon in the sun. These kind of exhaustion symptoms are probably a really good way our body tries to make sure we don’t keep exerting ourselves and put ourselves at risk of overheating even further

    Heatstroke though can progress really quickly, there is often a severe headache, feeling generally confused and restless. It might surprise people that the skin is often dry, they are no longer sweating which is part of the problem and they are usually quite red and dry skinned. Their pulse might be racing. If you measured your temperature it would usually be above 40 degrees centigrade. When symptoms have become this severe it is an emergency to cool that person, they can quickly deteriorate to becoming drowsy and then unconscious.

    4. What are the best forms of heat stroke prevention and management?

    As in most things prevention is much better than cure. So, try to make sure you are not putting yourself in a high-risk group. Keep well hydrated before exercise, if you are doing a long event such as a marathon it is important you keep hydrated but take care not to over drink. Pre-cooling by using cooling clothing, cold water immersion and taking cool drinks before exercise can help too.

    If you know you are not well or are just recovering from an illness, then it is sensible not to push yourself in hot conditions. Make sure you have clothing on which will allow your skin to sweat freely and keep cool. If you are concerned about any medication or illness you may have please check with your doctor before strenuous exercise. Stomach upsets and having had too much alcohol in the day before are common triggers.

    Anyone planning to take part in an event or exercise in hot conditions should plan to get their body used to this beforehand. Ideally this would be training in the same environment but if that’s not possible then a training in a hot room can help, it takes the body at least 7 days and up to 14 days to really get used to exercising in a hot climate. Start with 30 minutes at a time and build up to 100 minutes, your body will learn to cool itself better. Ideally this should be daily, but even every day or two will help. Heart rate monitors can help you check you are not pushing yourself too hard. Unfortunately, when it comes to getting used to exercising in heat we are not all equal, women are more at risk than men.

    Ice packs and cool flannels can help to reduce body temperature quickly, the back of the neck, underarms and groins are the best places for these. Plus using fans and cold-water sprays to help the body lose heat through the skin. Cool fluids and slushy ice drinks are useful too.

    If you or someone you are with is showing signs of heat stroke then it is important to get them to medical care quickly, this would usually be an Accident and Emergency department. Even young and fit people can deteriorate quite quickly. In hospital other techniques such as fluids via a drip and medicines can be used, as well as blood tests and checks to make sure that the person is not suffering any organ damage.

    DR LUCY HOOPER
    MB BS BSc MRCGP MA DRCOG DCH

    Lucy is a GP and co-founder of Coyne Medical. She graduated with honours from Imperial College London, trained at St Mary’s Hospital, and holds a Master’s in Medical Ethics and Law. Her clinical interests span women’s health, preventive medicine, and genomics, with a particular focus on using advanced biomarkers to build a more complete picture of long-term health.

    British Society for Genetic Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in BBC, The Guardian, Women’s Health, The Times and Tatler

    Book a GP Consultation

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Nutrition & Lifestyle Guides
  • The Impact of Excess Dietary Sugar on Health

    The Impact of Excess Dietary Sugar on Health

    Excess dietary sugar has been shown to have a significant impact on overall health, and this impact extends beyond just issues related to obesity. A recent umbrella review of 73 meta-analyses found that excess dietary sugar is associated with a higher risk of endocrine diseases, heart disease, cancer, and behavioural conditions.

    One of the most concerning findings was that excess sugar intake in children may lead to an increased lifetime risk of obesity, which can reduce longevity and healthspan. In rat models, excess dietary sugar has been found to lengthen the villi of intestinal cells. Villi are finger-like projections that line the inner surface of the small intestine, and they play a crucial role in nutrient absorption. The increased efficiency of sugar absorption from these longer villi can lead to obesity, particularly when it occurs at a young age

    Excess sugar intake during childhood has also been linked to a 27% higher risk of asthma, an inflammatory condition of the airways that can persist into adulthood. Additionally, excess sugar intake has been found to affect behaviour and mood. It has been linked to conditions such as ADHD and depression. Given the huge number of prescriptions being written to manage these conditions, it is always worth considering if there are any dietary interventions that can be made before a medication is prescribed. 

    Excess sugar intake can also lead to elevated uric acid levels, which can cause elevated levels of uric acid and gout. Uric acid is not only associated with gout, a very painful inflammation of the joints. It has been associated with insulin resistance and cardiovascular disease risk, both of which can impact longevity and healthspan. Fructose, a type of sugar, has been found to increase uric acid levels, worsen inflammation, and reduce nitric oxide, which can lead to endothelial dysfunction, another condition that negatively impacts longevity and healthspan.

    Endothelial dysfunction is a condition where the inner lining of blood vessels, the endothelium, does not function properly. It can contribute to the development of several cardiovascular diseases, including hypertension, atherosclerosis, and coronary artery disease. Endothelial dysfunction worsens when nitric oxide levels are reduced, and elevated uric acid levels have been linked to the development of this condition. By reducing sugar intake, individuals can significantly reduce their risk of endothelial dysfunction, which can improve longevity and healthspan.

    To mitigate the risks of excess sugar intake and promote longevity and healthspan, this review recommends that individuals keep their total added sugar intake to less than 25 grams per day. This is equivalent to about 5 to 6 teaspoons of sugar daily. 

    Excess dietary sugar poses significant risks to overall health, which can have an impact on longevity and healthspan. To promote a longer, healthier life, limit your added sugar intake to less than 25 grams per day, and enjoy the occasional sweet treat guilt-free!

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

    Book a Health Screening

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Nutrition & Lifestyle Guides
  • Personalising Coffee Intake for Optimal Health: Lessons from the CRAVE Trial

    Personalising Coffee Intake for Optimal Health: Lessons from the CRAVE Trial

    Coffee is one of the most popular beverages consumed globally and is certainly the most popular beverage at Coyne Medical. Its health effects have been the subject of numerous observational studies. However, the majority of these studies are prone to confounding by other factors, and there is a lack of randomised controlled trials examining the acute (short-term) effects of coffee consumption. The Coffee and Real-time Atrial and Ventricular Ectopy (CRAVE) trial was designed to address this gap in knowledge.

    The CRAVE trial involved 100 adults fitted with wearable monitors, including an electrocardiogram-recording device, an accelerometer, and a continuous glucose monitor. Participants were randomised via daily text messages to either consume all the caffeinated coffee they wanted or avoid all caffeine. Adherence to the randomisation assignment was assessed using various methods, including a real-time participant activation button on the ECG monitor to timestamp every cup of coffee.

    The primary outcome of the study was premature atrial contractions (PACs), which are a potent harbinger of atrial fibrillation risk. PACs are premature heartbeats that arise from the atria, the upper chambers of the heart. Atrial fibrillation is an important risk factor for stroke. The study found that consumption of caffeinated coffee was not associated with an increased frequency of PACs. However, days randomised to coffee were associated with 51% more premature ventricular contractions (PVCs), which are associated with an increased risk of subsequent heart failure in older adults. PVCs are premature beats that arise from the lower chambers of the heart. Those who consumed more than two cups of coffee experienced more than a doubling of their PVCs. 

    The study also found that on days randomised to coffee, participants took about 1000 more steps but experienced more than a half-hour less sleep. Despite epidemiological evidence that coffee consumers experience a lower risk of developing diabetes, no differences in serum glucose were observed in any of the analyses comparing exposure to coffee with caffeine avoidance.

    The study revealed complex acute effects of coffee related to several physiological processes fundamental to overall health, which manifest differently between individuals. The findings suggest that those concerned about PVC frequency and the associated risk of subsequent heart failure might consider reducing or eliminating coffee. These would be people who are known to have these types of abnormal heartbeats and are usually, over 65 years of age. However, those struggling with insomnia should incorporate this study data to motivate at least a trial of strict coffee avoidance to determine if it might benefit their sleep.

    The CRAVE trial provides valuable insights into the acute effects of coffee consumption and highlights the importance of personalised lifestyle goals. The multidimensional effects of caffeinated coffee consumption should be taken into consideration when making decisions about coffee consumption, and individuals should consider their own health concerns when determining their coffee intake. Taken overall, the study provides important information that can be used to facilitate improved shared decision-making and promote longevity and healthspan.

    DR J HUGH COYNE
    MBBS BSc PGDip (with merit) MRCGP DRCOG DCH

    Dr Hugh Coyne is a GP and co-founder of Coyne Medical, a private preventive health clinic at 660 Fulham Road, London. He trained at Imperial College London and has been in practice for over twenty years, with a particular focus on cardiovascular risk, metabolic health, and exercise medicine. After qualifying as a GP he went on to train in sport and exercise medicine, bringing a distinctly practical approach to prevention and long-term health.

    British Association of Sports and Exercise Medicine  ·  European Atherosclerosis Society  · 
    Independent Doctors Federation

    As seen in The Independent, The Daily Mail and Tatler

    Book a Health Screening

    For educational purposes. This article is written by a practising GP and is intended to inform, not replace a consultation with your own doctor. It does not constitute medical advice. A note on clinical guidelines: Coyne Medical is an independent private clinic. Our approach is guided by the best available evidence, tailored to each individual. This may go beyond standard NHS or NICE guidance, which is designed for population-level care and weighted by resource constraints.

    Read More Nutrition & Lifestyle Guides