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Food poisoning generally happens when someone eats food that is contaminated with bacteria or its toxins. According to the FSA, it is estimated that up to 5.5 million people in the UK are affected by food poisoning each year (NHS Direct, 2008d). However, it is difficult to know exactly how many people are affected as not all of those affected seek medical advice. Farmed salmon are even more of a concern than wild salmon due to the concentration of POPs in the feed they eat and their fatty nature as POPs can accumulate in fatty tissue. The research investigating the links between diet and MS dates back 60 years to Dr Roy Swank’s work first at the Montreal Neurological Institute in Norway, then at the Division of Neurology at the University of Oregon Medical School in the US.

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For example, nearly 80 per cent of the calories in smoked mackerel come from fat and over half of the calories in grilled salmon come from fat. Around one-fifth of the total fat in both these types of fish is saturated (FSA, 2002). Fish is not a popular food in the UK; people eat only a third of a portion of oily fish a week with seven out of ten people consuming none at all. The worst consequence of this is that more helpful advice on how to get omega-3s from plant-based foods is just not being given. In general they tend to contain less omega-3s than their wild counterparts and more toxins. In fact, the levels of toxins in farmed fish are a significant concern to many scientists.

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A long-term follow-up to the DART study (Ness et al., 2002), showed that the death rate in the two groups (fish and no fish) after an average follow-up of 15 years was almost identical. So the dietary advice given to former DART participants, over a decade previously, offered no long-term protective effect. So while fish oil may offer short-term protection to people who have suffered a heart attack, this protection does not appear to stand the test of time. Monounsaturated fats are found in nuts, peanuts, olives and olive oil, avocados and rapeseed oil.

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A large number of vegetarian and vegan studies show that plant-based diets offer numerous health benefits, including the prevention and therapy of many chronic diseases including arthritis (Leitzmann, 2005). Since vegetarian and vegan diets are more sustainable, environmentally and economically, they certainly deserve more consideration in both the prevention and treatment of disease. This message needs to filter down from the peer-reviewed studies into our hospitals, schools, workplaces and homes.

Feeding for life stage

• Similar findings were reported in the Nurses’ Health Study which looked at over 76,000 women over 10 years (Hu et al., 1999).
• Results showed that the fish group had a 29 per cent reduction in death during the two year recovery period following a heart attack.
• A dog in pup should be fed a normal young adult diet for their first two-thirds of pregnancy.
• Indeed excluding all animal foods from the diet will dramatically decrease the risk of food poisoning.
• For example, larvae might eat some contaminated algae, a fish then eats the larvae, and a bigger fish eats smaller fish and so on.
• Conversely, vegetables and wholegrains foods can supply as much or as little iron as is required, as well as an abundance of protective antioxidant vitamins, fibre and other nutrients.

In 2001, the first controlled study examining the long-term effect of a vegan, gluten-free diet on rheumatoid arthritis found that this diet could improve the signs and symptoms of this condition (Hafström et al., 2001). The authors of this study suggested that a gluten-free vegan diet may, in some people, reduce the immune response that triggers rheumatoid arthritis. Another study tested a low-fat, vegan diet in patients with moderate-to-severe rheumatoid arthritis (McDougall et al., 2002). Results also showed those who switched to this type of diet experienced a significant reduction in symptoms. Studies have been carried out to try to find whether omega-3 fats and/or fish oils can be helpful for osteoarthritis, but the results so far are inconclusive. Spence states that it is no longer reasonable for patients with heart disease to be prescribed diets containing a daily intake of animal flesh (Spence, 2002).

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The upshot of all this confusion and dislike for fish is that many people fail to understand the importance of omega-3s and do not realise how easy it is to obtain them from every-day plant foods. Promoting oily fish as the only ‘heart friendly’ solution could actually deter individuals from making the fundamental dietary changes necessary for real long-term heart and body health. A healthier and simpler solution would be to promote a plant-based diet containing EFA-rich seeds, nuts and oils. It binds it in an inactive form preventing selenium from acting as a cofactor for the protective enzyme glutathione peroxidase. This enzyme’s main biological role is to protect the body from oxidative damage. Mercury also has a very high affinity to sulfhydryl groups which play an important role in antioxidant reactions.

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One portion of pulses e.g. baked beans, lentils, chickpeas, soy beans also count. Fruit and vegetables are the body’s main source of vitamins, minerals and antioxidants (chemicals which reduce damage to the body). Starch is broken down to produce glucose (a type of sugar) which is used by the body for energy. English for Action (EFA) is an action-orientated charity that works with over 400 migrants, refugees and asylum seekers per year across London, to build their capacity in challenging systems of structural oppression. Current areas of particular concern for our students are migrants’ access to healthcare; access to English education; overcrowded housing; and vulnerable workers’ rights.

• Oily fish have fats throughout their whole body rather than only in the liver like non-oily (white) fish.
• Essential fatty acids are also required in higher levels for growth, including DHA (docosahexaenoic acid) which is needed for puppies’ brains, sight and hearing to develop normally.
• The fish used in organic fish feeds come from the discarded filleting wastes (blood, guts, tails and heads) of fish caught for human consumption and should not contain fish caught specifically for fish feed.
• In 1995, one study investigated why men in Eastern Finland have an exceptionally high level of mortality from CVD (Salonen et al., 1995).
• Fatty acids are essential for maintaining the structure of cells, they help manage inflammation and are needed for optimal functioning of various systems such as the eyes and brain.
• It is reported that omega-3 fats can help fight heart disease, asthma, type 1 diabetes and multiple sclerosis.
• It should be noted that the AHA also recommended plant foods that are high in the plant omega-3 ALA such as soya beans, rapeseed, walnuts and flaxseed and oils made from them.

Essential Fatty Acids (EFAs)

Those obtaining more than 10 per cent of their dietary energy from omega-6 fats should not increase their intake of this fat. Most people need to increase their intake of omega-3s to provide two per cent of dietary energy. Less than one per cent of calories (but preferably none), should come from trans fats. COMA recommended that among the general population there should be no further increase in average intakes of omega-6 fats but that intakes of long-chain omega-3 (EPA and DHA) fats should increase from about 0.1 grams to 0.2 grams per day (COMA, 1994). For example, as 60 per cent of the brain is made of fat, it is very important that it is provided with enough ‘bendy’ polyunsaturated fatty acids to stay supple and elastic in order to be able to respond to different stimuli such as hormones. If the cell membranes in the brain (and other parts of the body) are rigid they cannot react so well (Saldeen and Saldeen, 2006).

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• This policy paper provides analysis showing that if governments and donors make concerted efforts to meet the promises they made in 2000, basic education for all could be achieved by 2015.
• It is much cheaper to manufacture feed pellets from soya, rapeseed or corn with animal by-products and vitamin and mineral supplements.
• Studies have shown that people who are overweight or living with obesity tend to lose weight if they include plenty of high fibre, starchy carbohydrates in their diets.
• As stated, saturated fats have the maximum number of hydrogen atoms attached to the carbon atoms.
• Conversely, a healthier diet, such as the Mediterranean diet (rich in antioxidants and flavanoids), appears to reduce how readily LDL is oxidised (Lapointe et al., 2006).
• Clearly then, oily fish is not a significant contributor of omega-3 fatty acids in the diets of many people.

After just one year, 82 per cent of patients on this lifestyle change regime had regression of their heart disease with a 91 per cent reduction in chest pain and reduced cholesterol levels. Whereas the control group experienced a 165 per cent increase in the frequency of chest pain, cholesterol was worse and blockages of their arteries became worse. This trial has continued with similar results and continues to achieve better results than conventional surgical or medical intervention. The Lyon Diet Heart Study investigated whether a Mediterranean-type diet could reduce secondary heart disease (a second heart attack) compared to a prudent Western-type diet (de Lorgeril et al., 1999). Those taking blood-thinning medication (such as daily aspirin or warfarin), should speak to their GP before eating lots of food that has added omega-3 or before taking fish oil supplements, as this can also reduce blood-clotting.

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• This process reshapes the double bonds, twisting them so that the hydrogen atoms end up on different sides of the chain.
• The research indicates that the only thing vegetarians and vegans miss out on by avoiding fish is the toxic pollutants that contaminate them.
• A further study showed that an uncooked vegan diet, rich in antioxidants and fibre, decreased joint stiffness and pain in patients with rheumatoid arthritis (Hänninen et al., 2000).
• Results showed the ratio was 22 per cent higher in vegetarians than fish-eaters, indicating a higher conversion rate.
• This is why the Government has issued warnings to young people, pregnant and breast-feeding women, and those who may become pregnant one day, to limit how much oily fish they eat.
• Demyelination interferes with the messages that are sent between the brain and other parts of the body.
• Burr suggested that omega-3 fats may help normalise heartbeat rhythms by exerting what is called a beneficial anti-arrhythmic effect.

Osteoarthritis is the most common type of arthritis in the UK, with an estimated 8.5 million people affected by the condition (NHS Direct, 2008a). This degenerative disease is sometimes referred to as ‘wear and tear’ arthritis. Cartilage is the strong, smooth surface that lines the bones and allows joints to move against each other easily without friction.

• They are harder, have a higher melting point, and crucially, a longer shelf-life than their cis-shaped equivalents.
• The alternative view is that the only thing ‘clever‘ about fish oils is the huge marketing campaign that has got thousands of people running to the health food shops.
• Mark undertook 2 specialist fellowships in both foot & ankle surgery and knee surgery during his training.
• This means they may protect against the harmful effects of free radicals by ‘mopping them up’.
• In fact, ARC states that if you are taking strong drugs for arthritis there is even more reason to eat a good diet as it can help to protect the body against some of the side-effects of the drugs.
• The majority of patients with MS have the relapsing-remitting form of the disease, characterised by attacks or relapses interspersed with periods of recovery or remission (Harbige and Sharief, 2007).
• This means that the level of chemicals found in an animal tissue rises the higher up the food chain the animal is.
• These recommendations are similar to those given by the World Health Organisation (WHO) and Food and Agriculture Organisation (FAO).

Oily fish

A well-balanced healthy diet can help you if you are taking strong drugs for arthritis. In fact, ARC states that if you are taking strong drugs for arthritis there is even more reason to eat a good diet as it can help to protect the body against some of the side-effects of the drugs. For example steroids, such as prednisolone, can cause osteoporosis, particularly if you stay on them for a long time. Our bodies use inflammation to protect tissues from infection, injury or disease. The inflammatory process usually promotes healing but, when uncontrolled, it can also harm.

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Conversely, a healthier diet, such as the Mediterranean diet (rich in antioxidants and flavanoids), appears to reduce how readily LDL is oxidised (Lapointe et al., 2006). Interestingly though, antioxidant supplements and fish oil supplements have not been clearly demonstrated to prevent LDL oxidation. The GISSI-Prevenzione trial similarly looked at the effect of EPA and DHA on 11,324 patients (primarily men) who had recently survived a heart attack. Half the participants received a daily supplement (1 gram per day) of omega-3 fish oil capsules, while the other half did not (GISSI, 1999). The answer lies, partly, in the role EFAs may have in lowering the risk of heart disease and stroke.

This means they may protect against the harmful effects of free radicals by ‘mopping them up’. However, antioxidants may be more useful in preventing damage before it occurs, rather than treating an already inflamed joint. The Arthritis Research Campaign (ARC) promotes medical research into the cause, treatment and cure of arthritic conditions. ARC’s dietary guidelines for people with arthritis suggest that one of the most important links between diet and arthritis is being overweight (ARC, 2006).

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Some arthritis sufferers may be concerned about their iron intake, particularly – they may be told – if they avoid eating red meat. This should not be a concern as the British Medical Association and the American Dietetic Association agree that vegetarians are no more likely to suffer from iron deficiency than meat-eaters (BMA, 1996; American Dietetic Association, 2003). Cow’s milk and dairy products are an extremely poor source of iron, containing hardly any, whereas pulses, dried fruits and dark leafy vegetables are all excellent sources. Arthritis Care is the UK’s largest voluntary organisation working with and for people with arthritis. It suggests that a diet high in fruit, vegetables, pasta, fish and white meat, and low in fatty foods such as red meat, cream and cheese can help (Arthritis Care, 2008). Most people would benefit from eating less saturated fat and sugar and eating more complex carbohydrates, fibre, vitamins and minerals.

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A new study to see if levels have fallen since then https://www.efas2023.org/forum/ has been completed, but is not expected to be published until June. The Irish report concluded that nobody was likely to be harmed by consuming the fish oils according to the manufacturers’ recommendations. Nor, since the EU limits have yet to come into force, are any in breach of regulations.

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The many arguments supporting the move towards plant-based omega-3s away from fish oils are indisputable. Environmental contamination of the oceans now means that when you take a mouthful of fish you are also taking a mouthful of neurotoxins and carcinogens (mercury, PCBs and dioxins). Some people might consider this game of Russian roulette worth the risk if the health benefits afforded from fish could not be gained elsewhere.