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Little and often

What foods you choose to eat may be crucial. But so are meal times ... Dr John
Briffa reveals why the secret to eating less is frequent feeding
Sunday February 13, 2005

Observer
In previous columns, I have expressed my enthusiasm for frequent feeding. One
benefit of spreading out our food intake during the day is that it helps to
equalise the body's biochemistry. Also, by reducing the risk of the appetite
running riot, regular ingestion can help quell a tendency to overeat. Recently,
British scientists have attempted to add to our understanding of how pattern of
eating may affect our physiology. The results of their research suggest that
when it comes to the impact eating has on our health, time can be of the essence.

Their study, published in December in the American Journal of Clinical
Nutrition, assessed the effects of two eating patterns in a group of overweight
women.

For two weeks, the women ate their normal diet, but as six discreet meals each
day. During another two-week spell, the women divided up their normal diet into
between three and nine portions during the day. The average number of daily
meals or snacks was six for both phases of the study. This enabled the
researchers to assess what, if any, advantages regularity in food intake has
over chaotic consumption.

Participants undertook a test that measured the ability of food to stimulate the
body's metabolism (known as the thermogenic effect of food, or Tef). A regular
eating pattern brought a significant boost to the Tef. In addition, participants
reported eating less when eating consistently. It is not uncommon for slimmers
to skip the odd meal. But the findings of this study suggest that those planning
to shed pounds would be best advised not to lose their lunch - or any other meal.

More regularised eating was also associated with lower levels of low density
lipoprotein (LDL) cholesterol, which is believed to raise the risk of heart
disease and stroke. In addition, consistency in eating pattern led to a
reduction in the amount of insulin secreted in response to food. This has
important implications, because lower levels of insulin in the long term should
protect against such conditions as obesity, diabetes and heart disease.

I am not of the mind that meal times should be strictly dictated by the clock,
but some regularity in eating pattern does seem to be one of the keys to good
health. In practice, individuals do well on three meals a day, with a snack of
some raw nuts, seeds or dried fruit in the mid- to late afternoon. Those who
take breakfast early might want to supplement with a similar snack in the late
morning, too. For those wishing to optimise their well-being through dietary
means, consistency is the order of the day.

Dear John

For five weeks I have been taking terbinafine tablets for a fungal infection in
my toenail. After about two weeks, I began to feel vaguely unwell. I am
wondering if this might be due to the effect of the drug on my liver. Can you
recommend a supplement to counteract this side-effect?
Melanie Lloyd

Terbinafine is used to treat fungal infections in the skin and/or nails. It is
recommended that the oral form be used with caution in individuals with any
history of impaired liver function, which reflects its potential to weaken or
damage this organ. It is possible that some or all of your symptoms are due to
the effect of terbinafine on your liver. One natural agent that may help
counteract such effects is milk thistle (Silybum marianum). This herb contains a
complex of compounds (known as 'silymarin') which seem to support liver function
and protect it from poisons and toxins. Take 200mg of a standardised supplement,
three times a day. Milk thistle is very safe to have in the long term. I advise
you to take it continually until a month after you come off the terbinafine.

Nutrition news

Research suggests that the Mediterranean diet - renowned for its preponderance
of fruits, vegetables, pulses, fish and olive oil - has the ability to reduce
the risk of heart disease as well as some forms of cancer.

Recently, Spanish researchers attempted to assess whether the eating of a
typically Mediterranean diet might have any benefits in terms of weight. In this
study, published in the Journal of Nutrition, the diet of more than 3,000 adults
was assessed for constituents typical of the Mediterranean diet.

The men and women were then divided into three bands relating to their
Mediterranean diet 'score'.

Compared to those in the lowest band, individuals in the highest band were found
to have a reduced tendency to be overweight. Even when other potentially
confounding factors such as exercise habits were taken into consideration, a
high Mediterranean- diet score was associated with about a 40 per cent reduction
in risk of obesity.

This study suggests that, in the long term, eating a Mediterranean diet might
help to maintain a healthy weight.

· If you have any issues you would like Dr Briffa to address in his column,
please email him on john.briffa@observer.co.uk. Please note that Dr Briffa
cannot enter into any correspondence. You can also visit drbriffa.com.

Before following any recommendations in this column, you should consult your own
medical adviser about any medical problems or special health conditions
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