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Classic Health Debates

Low carb or low fat. Treadmill or cross-trainer. Sugar or artificial sweetener. Here, the latest research and thinking on the best choices for your health.

Classic Health Debates

What’s healthier in your coffee – sugar or artificial sweeteners?

Winner: Sugar.

Go ahead and opt for the real stuff. Not because artificial sweeteners aren’t safe (they are, as regulatory authorities confirm), but the premise that we should eat “real foods” in moderation is persuasive. Whereas your body knows how to deal with sugar (ie, you burn it for energy and, if you eat too much of it, store the rest as fat), emerging animal research suggests that, on the other hand, a habit of artificial sweeteners may interfere with metabolism and blood sugar regulation, possibly even contributing to weight gain and glucose intolerance. (One possible exception: people with diabetes, who must closely monitor their blood sugar levels, should talk to their doctor about the healthiest choices for them.)

But more important than how you sweeten your cuppa is your overall intake of sugar or artificial sweeteners, says dietitian Elisa Zied, the author of Younger Next Week. The World Health Organization says adults should limit sugar intake to about six teaspoons total each day (one can of soft drink can have about ten teaspoons). While recommended limits for sweeteners vary, Zied advises using no more than a couple of packets a day.

Which provides a superior workout – treadmill or cross-trainer?

Winner: Treadmill.

You can raise your heart rate and burn kilojoules on any piece of cardio equipment, but every time your foot comes down on that treadmill belt, you get the bonus of building bone strength too, points out Jessica Matthews, senior adviser for health and fitness education for the American Council on Exercise. Unlike the cross-trainer (elliptical), only weight-bearing exercises – such as walking, jogging, jumping rope, and weight training – help to preserve bone density.

Most exercisers also simply like the treadmill more than the cross-trainer, found a recent study published in the journal Perceptual and Motor Skills, which is a helpful factor if they’re trying to stick to an exercise programme. That said, folks with arthritis or who are overweight may find the lower-impact elliptical to be more comfortable for their joints, says Matthews.

Which diet is more effective for weight loss – low fat, low carb or Mediterranean?

Winners: Low carb and Mediterranean.

Researchers have been bickering over this diet dilemma for decades, but a major 2015 meta-analysis of 53 published studies involving more than 68,000 adults has tipped the scales slightly in favour of low-carbohydrate and Mediterranean diets over low-fat diets. Trials that included dietary supplements or meal replacement drinks were excluded from the study.

The researchers found that lowering fat content did not offer any long-term benefit in actually losing weight or in maintaining weight loss over other dietary interventions. Nevertheless, people on low-carb diets only lost 1kg (2.2lbs) more than those on low-fat diets and the overall average weight loss after a year in the trials was 3.75kg.

The researchers found that no diets worked particularly well in the long term – defined as more than a year. The key to success seems to have more to do with sticking to a diet rather than any one particular weight-loss plan, notes Dr Deirdre Tobias, lead researcher in the study.

“We need to look beyond the ratios of calories from fat, carbs and protein to a discussion of healthy eating patterns, whole foods, and portion sizes,” she points out.

Which is better when you’re tired – exercise or an extra hour of sleep?

Winner: Both, but sleep wins out slightly.

“When you look at the research, regular physical activity is important for high-quality sleep, and high-quality sleep is important for physical performance,” says Cheri Mah, a sleep medicine researcher at Stanford University and the University of California, San Francisco, in a recent TIME article.

Experts say healthy routines start with going to bed and waking up at the same time to ensure enough rest. With a well-rested mind and body, you’re more likely to have the energy to exercise.

Making time for the recommended at least seven hours of sleep a night and a minimum of 2.5 hours of moderate-intensity aerobic exercise every week could come down to cutting out other less important activities.

“Almost everyone could forgo 30 minutes a day of internet or TV time,” Mah says.

Which is the better germ fighter – soap or hand sanitiser?

Winner: Soap.

While soap doesn’t kill microbes, as the alcohol in some sanitisers can, washing with suds and water makes for cleaner hands, according to the infectious-disease experts at the US Centers for Disease Control and Prevention (CDC). Multiple studies have found that the combo of running water, lathering with soap, and friction from rubbing hands for 20 seconds removes the highest number of certain sickness-causing bacteria and viruses. No need to use warm or hot water – it doesn’t seem to help clear any more germs than cool water does and may actually dry out your hands more. When you can’t get to soap and water, a hand sanitiser with at least 60% alcohol is a decent second choice, says the CDC.

Which is healthier for your feet – wedge heels or ballet flats?

Winner: Wedge heels.

Both allow for even distribution of your body weight, since there’s ample contact between the sole of the shoe and the floor (versus, say, stiletto heels). But more support can put wedges on top, says podiatrist and shoe designer Dr Michele Summers Colon. “Very flat flats are the worst shoes you can wear,” says Summers Colon. “There is no support for the mid-foot, so the ankle tends to roll inward, causing ankle, calf, and even knee soreness.”

Which toothbrush works better – electric or manual?

Winner: Electric.

Studies have seesawed, but finally a Cochrane review of 56 studies confirmed in 2014 that powered brushes removed 21% more plaque and delivered an up to 11% reduction in gingivitis. Another helpful feature of many electric brushes? The timer. “Patients often don’t realise how little time they spend cleaning their teeth,” says Dr Ricardo Vidal Gonzalez, of the Mayo Clinic. “Most dentists agree that proper brushing takes at least two minutes and recommend this to their patients, but many people brush less than a minute.”

Good brushing is one of the most critical ways to promote not only good oral health but systemic health as well, Gonzalez adds. “An infection in the mouth can negatively affect the cardiovascular system, diabetic patients, and the health of pregnant women.”

While most healthy people can keep their mouths in shape by brushing with a regular toothbrush twice a day, he says, those with gum disease or issues like arthritis, which can make regular brushing tough, will probably get more benefit from an electric toothbrush.

Which is preferable for good digestion – yoghurt or a probiotic supplement?

Winner: Yoghurt and other fermented foods.

“Food is always the best way to get your nutrients,” says Dr Gerard Mullin, director of Integrative GI Nutrition Services at Johns Hopkins University School of Medicine in Baltimore and author of The Gut Balance Revolution. The synergistic effects of all the components in whole foods can’t be duplicated in a supplement. When you’re shopping for probiotic-containing foods such as kimchi, miso, sauerkraut, kefir, yoghurt, and kombucha, look for live and active cultures on labels. If you can’t stand the taste of foods that contain probiotics, ask your doctor to recommend a high-quality supplement, says Mullin.



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