Ask the experts
I get a very mixed bag of mail, though the layout of the column precludes me from giving answers that require less or more space than dictated by design. While I can often tackle weightier matters in the body of my page, this week gives me a welcome opportunity to respond to a few questions that demand briefer answers than usual. Most of the letters and emails I get concern a specific nutritional or health query, and this is reflected in the questions I have chosen to answer here. Not uncommonly, I get correspondence reporting the welcome results of approaches that have been recommended in my column. For instance, a new dad recently sent me a photo of his baby who he believed would not have been conceived without taking some advice I had given regarding the boosting of male fertility. I am not old or jaded enough to find this sort of positive feedback a real fillip, and it does help me focus on giving the most useful and constructive advice in the answers I give.
I am a 30 and have suffered from pre-menstrual syndrome for most of my adult life. My main symptoms are bloating, severe breast tenderness, irritability and anxiety. I took an antidepressant for about a year but this did not do anything for me. Is there something else that might help?
K North Wales
In natural medicine, the sort of pre-menstrual symptoms you describe are often believed to be related to a condition called ‘oestrogen dominance’: essentially a situation where levels of oestrogen are high relative to the other major female sex hormone – progesterone. The herb Agnus castus is believed to help enhance progesterone production in the female body, and in so doing may combat the relative excess of oestrogen that seems to be at the root of pre-menstrual symptoms such as your own. In practice, I have found Agnus castus to be generally very effective in the treatment of pre-menstrual syndrome. This herb is usually taken in tincture (alcoholic extract) form, at a dose of 40 drops in water each morning. It is not uncommon for this herb to bring significant relief from PMS within 2 or 3 cycles, although it can take several months for full benefit to be seen.
I love eating carrots, especially in the summer when they are most sweet and crisp. My carrot habit can cause my skin to develop a yellow tinge. I know this is due to the beta-carotene in carrots, but have read that this can convert to vitamin A in the body which has toxic potential. Could I be harming myself in any way?
Carrots are indeed rich in beta-carotene which can convert into vitamin A, excesses of which may have a variety of toxic effects in the body including nausea, bone pain and fatigue. However, it is generally believed that the body converts beta-carotene to vitamin A as it needs to, and vitamin A levels cannot build up to toxic levels through this route. While high levels of beta-carotene may tinge the skin yellow, there is no evidence suggests that beta-carotene derived from the diet can be harmful to the body in any dose.
I had a heart attack 8 years ago but am fit an healthy. I enjoy hill walking and wondered what would be the best foods for sustaining me on long trips?
The aim of the game here is to pack relatively calorie-dense but nutritious foods. Dried fruit is a good option, as this is very rich in carbohydrate that will help to reduce the risk of your running low on fuel (glycogen) stores in your liver and muscles. Another food that you might also find quite sustaining on your trips is nuts. These are calorie-packed too, and can really help to keep hunger at bay in a way that dried fruit alone is unlikely too. As an added benefit, their consumption is strongly linked with a reduced risk of heart disease, which may have particular relevance to you in the long term bearing in mind your past history of heart attack.
I recently read a report which suggested that eating less salt might actually increase the risk of heart disease. I know you have been anti-salt in the past, and wondered what you thought of this research.
Gordon North London
The report you refer to was presented recently at a meeting of the American Heart Association in Washington DC. While it is possible that low salt diets promote heart disease, this finding is not in keeping with a good deal of evidence which suggests that eating less salt can reduce blood pressure, and that lower blood pressure is associated with a reduced risk of heart disease. One potential explanation for these recent anomalous findings is that those individuals most affected by high blood pressure (or other risk factors for heart disease) are the ones most likely to attempt to reduce their salt intake. In this way, those at the greatest risk of heart disease may end up consuming the lowest amounts of salt.