The concerning trend is the number of individuals I am supporting who are starting the year already feeling burnt out and fatigued.  How can that be?  Normally, I see this trend starting in October.  Well, I definitely have some thoughts on this to share.

One would expect that after a long Christmas break which occurs for many people in Australia, that people would greet the new year feeling restored,  motivation levels replenished with a positive attitude.  This is not what I am finding.

Now one might say that as a naturopath, I am not going to have people come to see me who are feeling restored, motivated and energetic and that is true.  However, what I am experiencing is a huge increase in the number of people booking naturopathic consultations who are completely exhausted weeks into the new year.

I have a great educational blog on dealing with Burn out that of course will be helpful for most sufferers and discusses impact of lack of sleep, stress, an unhealthy diet and more – READ HERE.

So, we have had several years now where we dealt with covid and all that came with it, now it is inflation, less people to fill important jobs and rising interest rates as we see the world in chaos with war and natural disasters.  Christmas holidays are often full of activity, catching up with family, getting on long flights and for many amongst you, whilst you had a break from work, the time you had off was a far cry from being a restorative holiday where you jumped into 2023 fully energized with a skip in your step.

It is my assessment that many of us are absolutely exhausted from the last three years or so and more is needed to restore oneself back to a healthy state of motivation, good mood and energy.

Strategies that may have worked in the past probably need a re vamp.

In high demand people

So many of us I put in the category of being “in high demand” people and I know from clinical experience that this has more far reaching impacts than you may think on your health.

What does “in high demand” really mean?  I am referring to those of us who in our 24/7 society are juggling excessive amounts of daily responsibilities with little time left in the day to rest, relax, wind down and simply be still.

Does this sound like you?   Maybe you are what I term a “Superwoman”, juggling career, running busy households, trying to fit in daily exercise, dutifully visiting parents and friends on weekends, cooking after work each day, nurturing your children, partners or fur babies whilst having minimal down-time for yourself?

Maybe you are a mum at home with young children who require your undivided attention day in day out with no time for your own needs?  In my prior life where I advised senior women on important career decisions, it was abundantly clear that one of the most difficult jobs for them was being a stay-at-home mother with many describing their “work job” as much easier and much more appreciated! 

Maybe you are a father supporting your family in whatever way you can during challenging times, maybe you are in a constant state of worry about job stability, are building a new business or maybe you live on your own with no support, building your career and relying on yourself to make ends meet.

Whatever type of “in high demand” person you are, functioning in this way is stress as far as the biochemistry of your body is concerned.

Many of you may say “But I don’t feel stressed” or “this is my normal and has been for many years”.

But you see, what the body sees as stress may in fact surprise you.  Simply being in a constant “state of go” is a signal that your body automatically reacts to.

The body senses this “go state” as stress, just as if you were running from a swerving car, swimming from a shark or protecting your child from danger and it responds by producing chemicals such as adrenaline and cortisol to “fight or flight” this perceived threat.   From a biochemistry point of view, your body does not know the difference between the swerving car or you being in your natural, every day “go state”.  It is one in the same as far as your body is concerned.

In short bursts, stress acts to sharpen your focus and give you the extra strength and endurance needed to face an immediate issue or danger head on.  But when that threat is gone this reaction shuts down and normality returns.

The problem is that in modern society this cortisol and adrenaline production never turns off because your “go state” never turns off.  This leads to consistently elevated levels of these chemicals in your body and these chemicals do a lot of things.  Let me list a few:

•          Weight gain:  high cortisol tells your body to release sugar into your blood stream for your muscles to have the energy to “run from the threat”, but you are not running anywhere so this excess sugar sits in your blood.  Because excess sugar in the blood is dangerous, your body quickly stores this sugar as fat.  And it is mostly around the abdominal area too!   In addition, cortisol is a chemical that increases your appetite meaning you crave more carbs & sugar.

•          Reduced function of important body processes:  Whilst cortisol signals your body to increase muscle strength and blood sugar levels to run from that swerving car, it actually needs to shut down or inhibit other functions to do this.  Whilst facing this threat the body rightly determines that certain processes are less important.    Unfortunately, this means reduced digestion, immune strength and reproductive functions.  This is why being in the “go state” constantly will give rise to digestive issues, increased colds and flu and problems with fertility.

•          Reduced thyroid function: stress hormones reduce the level of thyroid hormones in your body.  This can lead to weight gain, fatigue, hormone related issues and infertility to name a few.

•          Anxiety & depression: cortisol is a very greedy chemical in your body, and it uses up a lot of nutrients that are also required to make “feel good” hormones and neurotransmitters.  There is simply not enough of these nutrients to go around when cortisol is being made by the body at such high levels and mood disorders can appear.

•          High blood pressure:  to run quickly from that swerving car for example, your body needs to be fast and strong immediately.  Again, cortisol and adrenaline come to the party and activate physiological changes to push blood to your muscles, heart and vital organs.  Your blood vessels quickly tighten and your blood pressure increases so that blood can get to these places quickly.  Being in a constant “go state” means that this is happening to you all of the time.

It is therefore incredibly important not to underestimate the powerful impact that stress may be having on your mental and physical well-being.  Daily rituals to switch off this “go state” is important for your happiness and future.  Daily moderate and enjoyable exercise, sunshine, getting into a good sleep routine, breathing exercises, a warm bath and a nutritious diet are some ideas that you could consider.

But it needs to be more than daily rituals especially if you have already reached a position of “burn out”.  Reviewing all home tasks, planning restoration holidays and hand balling tasks where possible is critical so that you can have an “alt control delete” and reboot your computer.

High performance self-care strategies

I made this term up as I see so many successful people, performing in their jobs, gym sessions each week, performing in their finances, performing in their studies, looking after everyone else however self-care and restoration strategies go by the way-side.  It is mostly because self-care is never really put on the list of performance KPI’s or in business plans and I am here to say that it damn well should be.

Burn out is very dangerous.  It leads to depression, anxiety and a body that can start to break down and get ill.

Preventing it by prioritizing self-care is critical.  So, what are some high-performance self-care strategies I recommend:

• A complete overhaul of activities at home including cleaning, school pick up, who cooks dinner when, grocery shopping.  Do you and your partner do some tasks together? Can they be separated so you get more you time? Can you get food delivered?  Can meal preparation be allocated amongst people in the house? Is it possible for a grandparent or someone else to drop kids off to school?  Can you afford a cleaner?  Can you work one day from home or can you reduce your hours or buy more leave from your employer or allocate more time if self-employed? Look closely at what is not negotiable here and what actually can be done to release time for self and give you less to do.
• 10-day relaxing holiday every year by yourself, with partner, close friend or immediate family; caveat is that it should be taken as a preventative and not once you have already reached burn out.  Now, these types of breaks don’t need to be expensive.  There are lots of lovely spots out of most cities or there is lots to do even if you stay at home.
• Put as much emphasis on relaxation as you do on fitness; add a weekly restorative yoga or meditation class to the schedule.
• Three hours a week – time just for you.  Could be a Saturday walk, could be a Thai foot massage and reading a book under a tree in the park.  In my household, I work from home on a Monday for half a day and then have the other half to myself and my husband is banned from working from home that day – it is mine (and my cat).  I work on Saturdays and so my husband has his solitude time.  It is healthy and we both really look forward to our own space.  There is a lot to be said about solitude.
• In your entertainment budget: people always make allocations for dinners, alcohol, movies.  Add self-care massage, long weekend at Airbnb, drive out of city into nature and quiet café onto the list.
• Last but certainly not least is to honor the commitments you make to yourself so that consistent restoration is a priority for thriving in life and patterns repeated year after year are finally ceased.

This list could be endless.  You may need the support of a counsellor to help you put in place life strategies that work for you so that your prevent burn out and the anguish that comes with it.

So, that is my thought piece for today.   I hope that the trend of early year exhaustion is not a sign of things to come and I hope if you are reading this that you make it a huge priority to preserve energy, nurture self-rejuvenation and KPI self-care in your life goals.

For additional support if you have reached burn-out or what support on managing a hectic life so that you prevent burnout, here are some additional blogs to support you https://www.performanceinhealth.com.au/2022/04/21/anxiety-depression-and-burnout-support https://www.performanceinhealth.com.au/2020/05/14/effects-of-daily-stress/.  Please book an initial naturopathic consultation with me via the contact tab here.

Founder, Naturopath

Tanya Edwards

Performance In Health

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Why is it such a healthy way of eating?

The Mediterranean Diet is an incredibly well studied, nutrient-dense way of eating that can be beneficial for so many of today’s chronic illnesses. With multi-decade studies providing thorough documentation of how this diet fares over the lifespan, the Mediterranean diet stands apart among modern diets as one backed by both science and traditional understandings of health. This blog provides you with some further information on what is and isn’t included in the Mediterranean diet, as well as some information on the types of health conditions that can benefit from this way of eating.

What Does a Mediterranean Diet Look Like?

There are numerous countries in the Mediterranean, so a number of versions exist, however some important points to remember are as follows:

• Food is mainly eaten from plant based sources, including fruits and vegetables, legumes, olive oil, nuts, seeds, and wholegrains.  An important aspect is that vegetables are the main event on the plate with good fats and meat as more of a side dish.
• Meals are home cooked and local and seasonal foods are used as much as possible.  This is not only environmentally friendly but ensures maximum nutrient content.
• Extra virgin Olive oil is the main fat used and is consumed daily and used in cooking.
• Legumes play an important role in the Mediterranean diet.
• Dark, leafy greens play a huge role and should be included in your diet daily as they are rich in antioxidants and have minimal calories.
• Maximum 4 eggs a week is common.
• Fresh fruit is a typical dessert of something sweet is desired.
• Be physically active and drink adequate water (2-3 litres a day).
• Red meat is mostly only consumed a few times every month.
• Whilst the traditional form of wholegrains was bread; managing blood glucose levels are important for most health conditions and as such I recommend that wholegrains come mostly from brown rice, quinoa, oats, thin sandwich wraps such as mountain bread or lavash.  Keep pasta to once a week and bread a few times a week with one piece at each sitting.

What’s excluded from the Mediterranean diet:

• Ultra-processed foods like potato chips
• Ready-made meals
• Soft drinks and other sugary beverages
• Frozen foods such as pies, pastries, pizzas and the like
• Deep fried foods
• Processed and refined grain foods such as white pasta and white bread
• Sweets and lollies
• Red meat is very limited (once per week or less, often only once per month)

The Mediterranean Diet Nutritional Profile

The nutritional profile of the Mediterranean diet is outstanding and offers real nourishment, suitable for children and adults throughout the lifespan. When compared to the standard Western dietary patterns typically eaten in places like Australia, the difference in nutritional profile is staggering. The standard Western diet is frequently insufficient in vital nutrients including iodine, vitamin E, magnesium, iron, vitamin A, selenium, vitamin C and folic acid. By contrast, people eating the Mediterranean diet are significantly more likely to be eating sufficient levels of these nutrients (and more) through their diet. People eating the Mediterranean diet are also more likely to have higher plasma concentrations of nutrients such as beta-carotene, folates, vitamin C and vitamin E, and HDL (“good”) cholesterol. Protein intake is higher while carbohydrate intake is lower compared to the standard Western diet, and there is a lower intake of inflammatory saturated and trans fats, instead having higher intake of anti-inflammatory unsaturated fats from foods like olive oil. The Mediterranean diet has low to no intake of processed and pre-cooked foods and is rich in fibre and antioxidants to protect health.

Some of the powerhouse nutrients that are rich in a Mediterranean diet include:

• Omega 3 fatty acids, mostly consumed through fish: vital fatty acids for regulating inflammation in the body and protective against cardiovascular disease, depression, Alzheimer’s disease and more.
• Unsaturated fatty acids, mostly through olive oil.
• Antioxidants, through vegetables, fruit, fresh herbs, and spices
• Fibre, through whole grains, legumes, vegetables, and fruits
• Polyphenols, flavonoids, and other anti-inflammatory compounds found in fruits, vegetables, legumes, nuts, seeds, and olive oil.

The Mediterranean Diet and Disease

Some of the health conditions that studies have found can benefit from the Mediterranean Diet include:

• Asthma
• Breast cancer
• Cardiovascular disease
• Cognitive decline and neurocognitive disorder
• Colorectal cancer
• Depression
• Diabetes
• Erectile dysfunction
• High blood pressure
• Inflammatory bowel disease
• Diverticulitis and proctitis
• Insulin Resistance
• Metabolic Syndrome
• Obesity
• PCOS
• Stroke prevention
• Arthritic conditions

Below is some further information about some of the major conditions that benefit from the Mediterranean diet.

Cardiovascular Disease

In fact, studies have found that the Mediterranean diet has similar efficacy to many standard treatments for cardiovascular disease such as beta blocks and ace inhibitors, without medication side effects. The Mediterranean diet helps to improve blood lipid profiles, reduce high blood pressure, reduce inflammation and oxidation, and reduce blood coagulation, meaning less plaque formation in arteries. Studies show its likely not any one individual food type in the Mediterranean diet that helps to improve cardiovascular health, but rather, the combination and balance of nutrients in the diet that has benefit. Omega 3 fatty acids from fish, antioxidants, polyphenols and fibre from vegetables, fruits and legumes, polyunsaturated fats from olive oil, each confer therapeutic benefits to the cardiovascular system, especially when eaten in a well-balanced diet like the Mediterranean diet.

Metabolic Syndrome

The Mediterranean diet helps with prevention of metabolic syndrome and protects against many of the risk factors of metabolic syndrome, such as waist circumference, blood glucose, blood lipids, and blood pressure.

Insulin Resistance and Diabetes

Studies have shown that the Mediterranean diet can help improve insulin sensitivity for those with diabetes and insulin resistance more effectively than other dietary plans. The high content of polyphenols and unsaturated fatty acids from foods such as olive oil, fruits and vegetables, and nuts helps to improve the body’s insulin and glucose levels. For those at risk of developing diabetes, the Mediterranean diet can reduce the risk by as much as 83%.

Non-Alcoholic Fatty Liver Disease

NAFLD is a serious condition associated with insulin resistance which can lead to serious liver complications in the long term. The Mediterranean diet has been shown to improve liver function and reduce complications of NAFLD by reducing inflammation, improving insulin resistance and blood glucose control, and reducing oxidative stress.

Neurocognitive Disorder and Dementia

An analysis of 22 clinical studies found the Mediterranean Diet was consistently associated with a lower risk of a number of neurological and neurocognitive disorders, including cognitive impairment, dementia, and even Parkinson’s disease.

Mental Health

A 20-year cohort study published in 2021 followed nearly 50,000 Swedish women and found adherence to the Medi diet reduced the risk of depression in later life. A recent review of 37 studies has found that the high polyphenol content of the Mediterranean diet is likely to help reduce the risk of developing depression, as well as helping to relieve depressive symptoms.

Inflammatory Bowel Disease

Inflammatory bowels diseases such as Crohn’s disease and ulcerative colitis also benefit from the Mediterranean diet. This is because this diet can help to reduce inflammation, improve liver function, and blood lipids, reduce symptoms, and improve quality of life in IBD patients.   The foods in this diet feed healthy species of bacteria which in turn produce butyrate and other healing substances which heal the digestive system.

PCOS

Research shows the Mediterranean diet can be useful for PCOS by helping reduce insulin resistance, improve blood lipid levels, and even help to regulate the menstrual cycle. One of the ways it is able to assist with PCOS is through the high level of the antioxidant compound resveratrol, found in foods such as grapes, berries and red wine.

For a thorough and investigative naturopathic approach to your health condition or wellness goals, please book an appointment with me via the contact tab on my website here or email me on tanya@performanceinhealth.com.au.

References

Bayes, J., Schloss, J., & Sibbritt, D. (2020). Effects of polyphenols in a Mediterranean diet on symptoms of depression: A systematic literature review. Advances in Nutrition, 11(3), 602–615.

Castro-Quezada, I., Roman-Vinas, B., & Serra-Majem, L. (2014). The Mediterranean diet and nutritional adequacy: A review. Nutrients, 6(1), 231–248.

Chicco, F., Magri, S., Cingolani, A., Paduano, D., Pesenti, M., Zara, F., Tumbarello, F., Urru, E., Melis, A., & Casula, L. (2021). Multidimensional impact of Mediterranean diet on IBD patients. Inflammatory Bowel Diseases, 27(1).

Guasch-Ferre, M., Merino, J., Sun, Q., Fito, M., & Salas-Salvado, J. (2017). Dietary polyphenols, Mediterranean diet, prediabetes, and type 2 diabetes: A narrative review of the evidence. Oxidative Medicine and Cellular Longevity, 2017.

Mirabelli, M., Chiefari, E., Arcidiacono, B., Corigliano, D. M., Brunetti, F. S., Maggisano, V., Russo, D., Foti, D. P., & Brunetti, A. (2020). Mediterranean diet nutrients to turn the tide against insulin resistance and related diseases. Nutrients, 12.

Papadaki, A., Nolen-Doerr, E., & Mantzoros, C. S. (2020). The effect of the Mediterranean diet on metabolic health: A systematic review and meta-analysis of controlled trials in adults. Nutrients, 12(11).

Psaltopoulou, T., Sergentanis, T. N., Panagiotakos, D. B., Sergentanis, I. N., Kosti, R., & Scarmeas, N. (2013). Mediterranean diet, stroke, cognitive impairment, and depression: A meta-analysis. Annals of Neurology, 74(4), 580–591.

Widmer, R. J., Flammer, A. J., Lerman, L. O., & Lerman, A. (2015). The Mediterranean diet, its components, and cardiovascular disease. The American Journal of Medicine, 128(3), 229–238.

Yin, W., Lof, M., Chen, R., Hultman, C., Fang, F., & Sandin, S. (2021). Mediterranean diet and depression: A population-based cohort study. International Journal of Behavioural Nutrition and Physical Activity, 18.

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Iron is an essential mineral that is responsible for maintaining the health of every cell in the body by providing vital oxygen to the cells via its role in haemoglobin. Despite its importance to health, a staggering one third of women of reproductive age worldwide are iron deficient. Iron deficiency leads to a condition known as iron deficiency anaemia – a condition whereby there are low levels of red blood cells and/or low haemoglobin levels in the blood due to a deficiency in iron. This type of anaemia is sometimes also known as microcytic (“small cell”) anaemia. This is because being low in iron causes the red blood cells to be much smaller than usual. Symptoms of iron deficiency anaemia include:

• Fatigue and lethargy
• Dizziness
• Muscle weakness and spasms
• Brain fog
• Poor immune function
• Hair loss

So, how does iron deficiency happen? There are a number of reasons why a person can become deficient in iron, including:

• Not enough iron-rich foods in their diet (especially important if vegan/ vegetarian)
• Not absorbing iron well
  – because of low hydrochloric acid in the stomach (hypochlorhydria), or
  – because of high intake of calcium, which blocks iron absorption
• Heavy and/or prolonged periods caused by hormonal imbalance, endometriosis, fibroids.
• Low calorie diet
• Chronic digestive conditions such as irritable bowel syndrome (IBS), bacterial overgrowth in the small intestine known as SIBO, Coeliac disease or Inflammatory Bowel Disease including Crohn’s disease or ulcerative colitis, especially if it causes blood loss as well as impairing absorption.
• Pregnancy

Understanding the underlying cause/s of your iron deficiency is key to making lasting changes to your nutrient status. It is only by addressing these underlying causes that we can properly correct the deficiency, without just using supplements as a band-aid solution.

How Much Iron Do I Need?

Daily iron requirements vary a lot depending on age and sex. This is partly because women have slightly higher iron requirements if they menstruate. Pregnant women have even greater requirements because of the increased blood volume in pregnancy, which is part of the reason why iron deficiency can be a particular issue for women in pregnancy and postpartum.

Below are the recommended daily intake (RDI) levels for healthy individuals:

Infants and Children:

• 0-6 months: 0.2mg/day
• 7-12 months: 11mg/day
• 1-3 years: 9mg/day
• 4-13 years: 8mg/day
• Girls 14-18 years: 15mg/day
• Boys 14-18 years: 11mg/day

Adult Women:

• 19-50 years: 18mg/day
• Pregnancy: 27mg/day
• Lactation: 10mg/day
• 51-70+: 8mg/day

Adult Men:

• 19-70+: 8mg/day

As you can see, menstruating women require more than double the amount of iron that post-menopausal women or men require. This is why women of reproductive age are so much more likely to be deficient in iron.

Dietary Sources of Iron – Haem vs. Non-Haem

There are two types of iron found in food – haem and non-haem. Haem iron (the type found in meat) is more readily absorbed via specific transporters in the gut. Non-haem iron (found in plant foods) cannot use these same transporters, and is also often bound to other nutrients, so is less readily absorbed. This is why vegans and vegetarians need to eat higher amounts of iron-rich foods in order to meet their needs – a single plant food may contain a relatively high amount of iron, but you might not be absorbing all of that iron when you eat it.

Interpreting Iron Studies Results

As a naturopath, reviewing blood tests are important.  In addition to haemoglobin, iron levels, iron storage (ferritin) and other markers, it’s important to know that there are other types and causes of anaemia which may need to be ruled out, including:

• Low levels of vitamin B12 or folate
• Red blood cell disorders, such as thalassaemia
• Serious chronic diseases, such as autoimmune disease or chronic kidney disease
• Thyroid disease
• Infections

Treatment Strategies for Iron Deficiency

Naturopathic treatment strategies are unique to each client and will take into consideration the cause of iron deficiency and also consider dietary preferences.   I often recommend some form of the Mediterranean diet which is a healthy diet that has a high emphasis on unprocessed foods, dark, leafy greens, fresh fruit and vegetables, legumes, nuts & seeds, fish & seafood, eggs, and healthy fats with a balanced amount of red meat and chicken.  Vegetarians, vegans and pescatarians may require more iron supplementation when they follow a Mediterranean diet tailored to their dietary choices.

Being iron deficient does not mean eating meat in excess quantities to the detriment of important food groups and this will be discussed with you as part of your treatment plan.

Red meat is a very good source of iron when eaten as part of a healthy diet, however overeating it can cause other health issues.  I also recommend avoiding all processed meats such as bacon and salami.

Dietary Strategies

Eat Plenty of Iron-Rich Foods

Eating enough iron-rich foods is key to long-term iron status. A balanced, varied diet that includes plenty of the following food types will help to keep your iron levels in check. If you are vegan or vegetarian, it is particularly important to keep track of your intake.

• Haem (animal) sources of iron include: red meats (beef, lamb, kangaroo), liver, oysters, mussels, chicken, fish.
• Non-haem (plant) sources of iron include: legumes (chickpeas, cannellini beans, kidney beans, lentils, tempeh, tofu), oats, quinoa, pistachios, cashews, sesame seeds, pumpkin seeds, hemp seeds, almonds, tahini, green leafy vegetables (spinach, collard greens, Swiss chard), chanterelle, morel, and oyster mushrooms.
• What about eggs? eggs are a non-haem source of iron.  Whilst eggs are a powerhouse of important nutrients, there is some evidence that particular proteins in egg may inhibit iron absorption.  For this reason, do not have with a high iron content meal and eat separately 2 hours away.
• What about dried fruit?  Some dried fruit such as dried apricots and raisins are a good source of non-haem iron.  Due to the negative impact on blood glucose levels however, I only ever recommend small amounts of dried fruit as fresh is best.

Pair Iron-Rich Foods with Vitamin C

Vitamin C helps to increase the absorption of iron in the gut, making it ideal for pairing with your iron-rich foods. This can be as simple as serving some cooked broccoli alongside your meal or squeezing the juice of half a lemon or lime on your meals as you plate up. Foods rich in vitamin C include: citrus fruits, kiwifruit, strawberries, capsicum, broccoli, cauliflower, tomatoes, sweet potato.

Avoid Pairing Iron Inhibitors with Iron-Rich Foods

Certain foods and drinks impair or inhibit the absorption of iron. It’s best to avoid eating these foods at the same time as your iron-rich foods. Separate by 2 hours either side of your meal to prevent them from reducing iron absorption. Foods/ drinks that inhibit iron absorption:

• Coffee and tea (green and black)
• Chamomile tea
• Red wine
• Calcium

Support your Gastric Acid Production with Bitters

Gastric acid (also known as hydrochloric acid) is produced in the stomach to break down food and is an essential part of the process of iron absorption. Dietary bitters can help to increase the production of gastric acid by improving vagal nerve and parasympathetic nervous system tone. Dietary bitters are best taken around 15 minutes before your main meals, to give your body time to produce gastric acid. Below are some ways to boost your gastric acid production:

• Drink liquid herbal bitters 10-15 minutes before meals. A custom herbal blend containing bitter herbs such as gentian that I have in my herbal dispensary can be a powerful tool for improving overall digestion in certain individuals
• Mix the juice of half a lemon or 2 teaspoons of apple cider vinegar into 250ml of room temperature filtered water and sip 15 minutes before meals
• Make a pre-meal appetiser of bitter greens, such as rocket or dandelion greens. These make a great leafy salad starter. For an added bitter boost, pair with an apple cider vinegar dressing.

Eat Well-Cooked, Easy-to-Digest Meats

Meats that have been slow cooked are more easily digested. Slow cooked stews, soups and curries with good quality red meats are a great option for boosting iron intake and absorption.

Lifestyle Strategies

Practice Mindful Eating

Mindful eating is a good tool for boosting your absorption of all nutrients in your food, iron included. The practice of mindful eating involves sitting at a table to eat, paying attention to your meal, and avoiding distractions such as phones and TV. It’s also important to slow down and really chew your food, rather than eating as quickly as possible. Eating in this way promotes the cephalic phase of digestion, which boosts your body’s production of gastric acid and other digestive secretions, so you’re primed and ready to break down and absorb the nutrients in your food.

Supplementation

Iron Supplementation

Even with the above dietary and lifestyle changes, a supplement may be necessary to help get your iron levels back up quickly. Be aware that not all iron supplements are equal – the form of the iron matters! Certain types of iron supplement, such as Ferrous sulphate, are difficult for the body to break down and absorb, which is why they can cause side effects such as dark stools and constipation.  Certain practitioner brands of iron may be more suitable if you have a sensitive digestion and require a more easily absorbed form. This means it is better able to get your iron status back up quickly and also won’t cause constipation

As your naturopath, it is of critical importance that the underlying cause of your low iron is understood so that this can be addressed as a priority.

Once this has been determined, it is important that you increase your iron intake from food and supplements until your iron storage (ferritin) and iron levels are normal.  This may mean a higher dose for a period of time.

Treat the cause whilst reducing the symptoms: an important Naturopathic approach

Treating the cause of your iron deficiency is crucial.   Do you fully understand what to eat for optimal iron when cutting down on meat?    Do you have a parasite? Do you have digestive issues that are impacting iron absorption? Are your hormones unbalanced so that your periods are heavier than they should be, or do you have a condition such as endometriosis that is causing heavier menstruation?

For a thorough and supportive investigation as to the cause of your iron deficiency combined with treatments to support symptoms and fatigue and proper iron level improvement, please book an initial consultation with myself via the contact tab on this website.

References

Cave, J. (2022, September 6). A guide to boosting your iron levels, finally! https://halsahealth.com.au/a-guide-to-boosting-your-iron-levels-finally/

Ganima, K. (2018). Lactoferrin: An alternative approach to iron deficiency without the side effects. https://urbanherbalist.co.nz/blogs/urban-herbalist-blog-posts/lactoferrin-for-iron-deficiency-an-alternative-approach-without-the-side-effects

Huda, T., Dibley, M., El Arifeen, S., Islam, S., Ali, N., Raihana, S., Rahman, M., Qadri, F., Raqib, R., Tarnow-Mordi, W., Rahman, Q. S., & Bhuiya, S. (2019). Assessing the efficacy of bovine lactoferrin to correct iron deficiency anaemia in non-pregnant no-lactating women: A randomised controlled trial. Current Developments in Nutrition, 3(1).

Kell, D. B., Heyden, E. L., & Pretorius, E. (2020). The biology of lactoferrin, an iron-binding protein that can help defend against viruses and bacteria. Frontiers in Immunology, 11.

McNaughton, L. (2022, September 4). Importance of iron and combatting deficiency. https://www.lisamarienaturopath.com/blog/importance-of-iron-amp-combatting-deficiency

Nutrition Australia. (2014). Iron. https://nutritionaustralia.org/fact-sheets/iron/

Paesano, R., Torcia, F., Berlutti, F., PAcifici, E., Ebano, V., Moscarini, M., & Valenti, P. (2006). Oral administration of lactoferrin increases haemoglobin and total serum iron in pregnant women. Biochemistry and Cell Biology, 84(3).

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Haemochromatosis is a health condition whereby excess iron accumulates in the body (also known as iron overload). There are several ways that iron overload can occur including:

Excessive intake/ absorption of dietary iron

• Most commonly due to hereditary haemochromatosis, a common genetic condition affecting around 1 in every 200 people of European descent
• May also be due to high iron supplementation combined with high intake of iron-rich foods
• Multiple blood transfusions may also contribute

Inadequate excretion of iron

• Blood conditions such as thalassaemia may cause inadequate iron excretion
• Liver damage can reduce clearance of many substances from the body, including iron

Understanding the underlying causes and factors contributing to your haemochromatosis is important for establishing an appropriate treatment strategy. A detailed healthy history in combination with appropriate naturopathic testing will help to establish what is causing your haemochromatosis.

By and large, hereditary haemochromatosis is the most common cause of iron overload due to changes in iron transport and metabolism. This is a genetic condition (mutation of genes) whereby the body doesn’t produce enough of the chemical hepcidin as an example, which is responsible for regulating the amount of iron that the body can absorb. Low hepcidin levels means the body cannot identify when body iron stores have reached sufficient levels and so continues to absorb iron unimpeded. Typically, the body stores no more than 1 gram of iron, but for those with haemochromatosis, 5g or more may accumulate in the body, stored in parenchymal cells in the liver, pancreas, skin, heart, and other organs, in the form of ferritin.

There are 4 main types of hereditary haemochromatosis, which each develop symptoms at different stages in a person’s life

• Type 1 – the most common form – begins in adulthood. Symptoms typically develop between 40 and 60 in men, and just after menopause in women.  Type 1 hereditary hemochromatosis results from a genetic variation to the HFE gene on chromosome 6 and usually involves the C282Y and H63D alleles.
• Type 2 – also known as the juvenile onset form – begins in childhood and symptoms affect normal health and functioning by age 20
• Type 3 – symptoms develop by age 30
• Type 4 – similar in time of onset to type 1

Although the age of symptom onset varies, the treatment for all 4 types of haemochromatosis is the same.

Then there is what is known as Secondary hemochromatosis, and this is linked to an exposure to excess amounts of iron in the body.  This can be attributed to iron transfusions, dietary iron overload via consumption of high iron-containing food or via hemolysis-linked iron overload (destruction of red blood cells). 

Hemolysis-linked iron overload:  Whilst rare, exposure to toxic heavy metals can potentially trigger hemolysis (red blood cell death).  Heavy metal-induced hemolysis is controversial however the increase of free radicals from heavy metal exposure may play a role in disrupting red blood cell membranes.  In addition, heavy metals lead to a depletion of our body’s antioxidants or a disturbance of important enzymes.  This can cause severe oxidative stress-associated hemolysis (red blood cell death) and create hemochromatosis.

Foodborne infections and bacterial toxins can also trigger this hemolysis and be a rare cause of hemochromatosis.

In naturopathy, it is important to understand the cause of your hemochromatosis.  Whether it be primary or secondary, a focus on dietary strategies and herbs and supplements to counterbalance negative impacts on your body are important.

Why is Excess Iron an Issue?

Iron is an essential trace nutrient required for vital bodily functions, including carrying oxygen to every cell in the body via haemoglobin. However, too much of a good thing causes real problems for the body. If left to accumulate to high levels, iron becomes a toxin. Iron toxicity in cells causes oxidative stress, resulting in organ damage. Left untreated, haemochromatosis can lead to significant damage in many different organs in the body, but particularly the liver, kidneys, pancreas, and heart, where iron concentrations are the highest. It can even lead to serious illness, including infertility, cirrhosis, liver cancer, diabetes, arthritis, and organ failure. This is why regular iron studies and screening are important for those with a positive family history of the condition.

There are two types of iron in our diets – heme iron and non-heme iron. Heme iron is found in animal foods, particularly red meats (beef, lamb, kangaroo) and organ meats (such as liver), as well as in poultry (chicken, turkey, quail), pork and game meats, eggs, and dairy. Heme iron is readily absorbed by the body. Non-heme iron is the type found in plant foods. Particularly high sources of non-heme iron include legumes and dark leafy greens like spinach and kale. Non-heme iron is less readily absorbed by the body. This is because heme iron is bound up in other molecules, which the body needs to break down before being able to absorb the iron. Plant foods also contain nutrients and constituents such as oxalates and tannins, which can further impair iron absorption.

Symptoms

Haemochromatosis may be initially asymptomatic for many years. Early symptoms of haemochromatosis include:

• Fatigue
• Weight loss
• Abdominal pain
• Joint pain
• Low libido

In more advanced disease, where iron has accumulated in organs, symptoms may include:

• Jaundice, bruising and upper abdominal pain (liver damage)
• Increased thirst and frequent urination (diabetes or pre-diabetes symptoms due to pancreas damage)
• Heart palpitations, breathlessness, swollen ankles (heart damage)

Naturopathic Testing

Testing is required for establishing baseline iron levels, which can help to direct treatment strategies for management of the condition. Tests that may be ordered include:

• Iron studies including ferritin, iron level, total iron binding capacity (TIBC), and transferrin saturation
• Liver function tests including ALT and AST
• Genetic testing (if hereditary hemochromatosis is suspected but not confirmed)
• Heavy metal testing

Naturopathic Treatment Strategies

The primary goals of naturopathic treatment for haemochromatosis are fourfold:

1. Reduce the intake and absorption of iron
2. Increase the excretion of iron from the body
3. Repair damage to organs and body tissues
4. Increase antioxidant levels

Your GP may request that you have early treatment of haemochromatosis with weekly or twice-weekly phlebotomy/ venesection (similar to blood donation), until stored iron levels are normalised. Ongoing treatment generally involves phlebotomy two to four times a year to maintain safe levels in the long term. The Australian Red Cross Lifeblood has a therapeutic phlebotomy program that enables those with haemochromatosis to donate the blood taken during treatment if eligible. In addition to phlebotomy, diet and lifestyle changes following naturopathic principles will also help you to keep your iron levels in check in the long term.

Nutritional Treatment

This is a large component of the detailed treatment suggestion plan that I Provide to my clients when working with them to reduce iron overload.  Everyone’s plan is unique however it may include the following:

Increase consumption of plant-based meals or consider a vegetarian diet

As discussed above, the majority of iron for most people comes from animal products, especially red meats. One of the best ways to reduce iron overload in the body is to heavily reduce or eliminate meat intake and instead adopt a plant-based diet. This may not mean being completely vegetarian, but instead limiting your meat intake and making swaps for vegetarian protein sources whenever possible.

Avoiding iron supplements

Avoid consuming high amounts of vitamin C rich foods or drinks with meals high in iron

Reduce alcohol consumption

Alcohol increases the absorption of iron.

Reduce consumption of sugary foods

Sugar can increase the absorption of iron.

Eat Plenty of Antioxidant-Rich Fruits and Vegetables

In order to protect the liver and other organs from the oxidative stress caused by iron overload, we need to be consuming plenty of antioxidants in the diet.

Reduce the burden on your Liver

Due to the excess iron in your system that needs to be processed and excreted, the liver is very hard at work and may become burdened by additional stressors from toxins in your daily environment.  Naturopathic guidance on how to reduce this burden with dietary and lifestyle suggestions plus liver protective and nourishing herbs is always a component of the treatment suggestion plan.

Supplements and Herbs

Each person’s health situation is unique, and a tailored treatment plan would be devised for you, however some of the common herbs and supplements that may be required for you include the following:

Magnesium and Zinc

Both Magnesium and Zinc compete for absorption with Iron.

Fibre Supplement to bind to iron

Antioxidant Supplements to help boost antioxidant levels to combat tissue damage from iron overload.  

Herbal Medicines

Whilst certain herbs aren’t suitable to those with iron overload, there are many wonderful herbs that can be of help in managing haemochromatosis, such as milk thistle, globe artichoke, turmeric, or even hawthorn if the heart is affected.  Herbs to combat fatigue and other symptoms may also be prescribed should this be a symptom.

It is important to understand the cause of iron overload and keep levels reduced so please reach out for an initial naturopathic consultation via the contact tab on my website or book a complimentary fact finding call.  Alternatively, you can email me on tanya@performanceinhealth.com.au.

References

Brissot, P., Pietrangelo, A., Adams, P. C., de Graaf, B., McLaren, C. E., & Loreal, O. (2018). Haemochromatosis. Nature Reviews Disease Primers, 4.

Cooper, J. (2019, September 10). Haemochromatosis. https://advancedfunctionalmedicine.com.au/haemochromatosis/

Haemochromatosis Australia. (2022). Haemochromatosis. https://haemochromatosis.org.au/haemochromatosis/

Hechtman, L. (2012). Clinical naturopathic medicine. Elsevier Australia.

Oh, C. K., & Moon, Y. (2019). Dietary and Sentinel Factors Leading to Hemochromatosis. Nutrients, 11(5), 1047. https://doi.org/10.3390/nu11051047

The post Living with Haemochromatosis and having high iron levels appeared first on Performance in Health.

Food allergies and intolerances are on the rise in Australia, with a staggering 10% of infants under 1 and 4-8% of children under the age of 5 experiencing a food allergy. In fact, Australia has one of the highest rates of food allergy in the world! So, just why are food allergies and intolerances on the rise? This an important question and there aren’t yet clear or definitive answers, but some factors that play a role include:

• Genetics – allergies and intolerances often run in families. A family history of food or other allergies increases a child’s risk of having allergies. This includes families who experience eczema, hay fever, and asthma, too.
• Birth History: allergic type conditions are more prevalent in children who were born via caesarean, not breast fed or who were born prematurely due to the impact this has on important gut bacteria colonisation.
• Early or late food introduction – children who are exposed to solids very early (before 4 months of age) or who aren’t exposed to allergenic foods until late (after 1 year of age) have a higher risk of developing food allergies.
• Gut dysfunction – the gut is important for immune regulation and protecting the body from particles in our food that we might react to. Imbalances in gut bacteria and damage to the intestinal wall can both contribute to food intolerances, by allowing undigested proteins and other immune-reactive food particles to be absorbed into the blood.
• Low stomach acid production – stomach acid is needed for breaking down foods that can cause immune and intolerance reactions. Low stomach acid production can sometimes occur due to altered gut microbes.
• Low levels of vitamin D – an important nutrient for regulating the immune system and one which many Australians are deficient in.
• Gut microbiome – Altered gut microbiome thanks to diet and extent of antibiotic use.
• Medication use – including antacids, which affect the breakdown and absorption of nutrients.
• Stress – stress suppresses our immune function and can cause negative changes to gut bacteria, too.
• Limited or restricted diet – consuming the same foods repeatedly, without sufficient variation in the diet, can increase the risk of food intolerances.

Navigating food allergies and intolerances can be complex and overwhelming, but with education and planning, it can be very manageable. In fact, many children are able to improve their health and increase their tolerance to many foods that they previously were unable to eat, simply by modifying their diet in the short term and looking after their overall health in the long term. This blog provides you with the information and tools you need to help your child manage their food allergies and intolerances and regain control of their health.

What is the difference between allergy and intolerance?

Sometimes, the terms “allergy” and “intolerance” are used interchangeably, but there are important differences between the two.

Allergies

A true food allergy is an immunological response. The immune system mistakenly recognises a protein or other component within a certain food as being harmful and initiates a cellular (immune) response to the food when exposed to it. This response typically involves the release of IgE antibodies, which triggers the release of large amounts of histamine – the chemical responsible for symptoms such as itchy, watery eyes, nasal congestion, and hives. Allergic reactions to foods can occur when exposed to even the tiniest amount of the food. If your child has a severe food allergy, even breathing in particles from someone else’s meal may be enough to trigger an immune response. Allergies tend to have more sudden, severe symptoms, including anaphylaxis (the type of allergy that requires an EpiPen). However, not everyone with a food allergy experiences anaphylactic responses. They may instead experience less severe allergic-type symptoms, such as allergic asthma or hay fever, or even skin rashes.

Symptoms of a food allergy may include:

• Anaphylactic response – sudden and severe swelling of the throat, eyes, lips, with swelling causing difficulty breathing – a medical emergency that requires rapid care.
• Respiratory symptoms – sneezing, red itchy nose, sinus pain.
• Gastrointestinal symptoms – bloating, flatulence, abdominal cramps, tingling or itching sensation in the mouth, swelling of the mouth, tongue and throat, difficulty swallowing.
• Skin symptoms – hives, red and itchy rashes, swelling of the face.
• Other – feeling dizzy or light-headed.

Food allergy symptoms are typically very quick to develop after exposure to the allergen, often within a matter of minutes after exposure. Symptoms also tend to get worse with each subsequent exposure. This is why exposure is a serious issue with those with allergies.

Intolerances

A food intolerance is a chemical reaction to a food which results in symptoms. Food intolerances typically cause less severe symptoms than allergic reactions, but they can still be significant. Food intolerance reactions may occur due to a person lacking an enzyme required to properly digest a food or may occur in response to chemicals or additives found in foods. Symptoms of food intolerance can range from mild to severe. They tend to be more chronic and have less obvious symptoms compared to a food allergy. Food intolerance reactions can be much slower to develop compared to allergic responses, with a lag of several hours (and up to several days) after each exposure. This lag in symptom development is why it can be much more difficult to identify trigger foods for intolerance symptoms.

Symptoms of food intolerances in children may include:

• Gastrointestinal symptoms: abdominal pain, bloating, flatulence, diarrhoea, constipation, or erratic bowel movements, heartburn.
• Respiratory symptoms – sinus congestion, asthma, chronic cough, wheezing.
• Skin symptoms – rashes, hives, itchy skin, eczema.
• Neurological symptoms – headaches or migraines, fatigue, low energy, “brain fog”, poor concentration, mood changes, restlessness.

Common Food Allergens

A food allergy can involve any food, but just eight different food-types make up 90% of cases of food allergy. The most common food allergens are:

• Dairy
• Wheat and gluten
• Soy
• Eggs
• Fish
• Shellfish
• Peanuts
• Tree nuts

Some less common food allergies include:

• Tomatoes
• Pineapple
• Corn
• Meat (sometimes occurs due to complications following tick bites)
• Sesame, sunflower, and poppy seeds
• Celery
• Carrot
• Avocado
• Potato
• Pumpkin
• Note: Allergic reactions to fresh fruits and vegetables is sometimes referred to as oral allergy syndrome.

Common Food Intolerances

The range of foods that can cause intolerance reactions is much larger and more varied. Here we have categorised them according to food intolerance type – histamine intolerance, salicylate sensitivity, FODMAPs, food additives and preservatives, nightshades, and other types of intolerance reactions. Your child may experience intolerance reactions to a number of different foods or may only react to one.

Histamine

Histamine is a chemical that causes allergic-type symptoms in the body. We all have a limit to how much histamine in food we can tolerate, but for some, this tolerance level is significantly reduced, leading to symptoms occurring from eating foods that others do not react to. Foods that are high in histamine include:

• Highly processed or smoked meats such as salami, bacon, hot dogs, pepperoni
• Fermented foods, such as kombucha, kefir, kimchi, sauerkraut, vinegar
• Fermented and/or aged dairy products, such as yoghurt, cheddar, parmesan, and Swiss cheese
• Dried fruits
• Processed and pre-packaged foods, including condiments like tomato sauce
• Leftovers, particularly once 24 hours+ old
• Coffee
• Fish and seafood
• Beef
• Strawberries, pineapple, citrus fruits
• Avocado, spinach, eggplant

Foods that trigger histamine release in the body:

While these foods themselves do not contain high amounts of histamine, they ca trigger the release of histamine in the body when we eat them, so are best avoided if histamine is causing health issues.

• Bananas, papaya, citrus fruits
• Tomatoes, beans
• Wheat germ
• Chocolate
• Walnuts
• Cashews, peanuts

Salicylates

Salicylates are a type of phenol that are found in many different plant foods. A salicylate sensitivity in children can present with behavioural and mood changes, including anxiety and depression, and even difficulty sleeping. Foods that are high in salicylates include:

• Vegetables: alfalfa, artichoke, broad beans, broccoli, capsicum, chilli, corn, chicory, cucumber, eggplant, endive, fava beans, gherkin, okra, canned mushrooms, spinach, squash, zucchini, olives, sweet potato, canned tomato, radishes, water cress
• Fruits: Apple (granny smith), avocado, cherries, dried figs, grapes, grapefruit, mandarin, oranges, loganberries, guava, dates, mulberry, peach, tangelo, prunes, raisins, pineapple, canned plums, raspberry, redcurrants, strawberries, sultanas, youngberry, cranberry, rockmelon, boysenberry, apricot, blackberries, blueberries
• Nuts, seeds and grains: pine nuts, macadamias, pistachios, almonds, peanuts, flavoured chips and crackers
• Herbs, spices, seasonings and condiments: all spice, anise seed, cayenne, celery, cinnamon, cumin, curry powder, dill, fenugreek, five spice, garam masala, ginger, honey, jam, vegemite, vinegar, mace, mint, mixed herbs, mustard, oregano, paprika, pepper, rosemary, sage, tarragon, turmeric, thyme, Worcestershire sauce
• Sweets and sugars: liquorice, mints and peppermints, chewing gum, fruit flavourings
• Beverages: tea, peppermint tea, fruit juices, cordials
• Non-food products: mint-flavour toothpaste, sunscreens, after sun lotion, certain soaps and cleansers, shampoo and conditioners

FODMAPs

FODMAPs (AKA fermentable oligo-, di-, monosaccharaides, and polyols) are specific types of sugars that are found in many types of food. These sugars are often associated with bloating, abdominal pain, and flatulence in conditions like IBS, but can also cause intolerance reactions. Examples of FODMAPs include:

• Oligosaccharides (such as fructan, inulin, and GOS): nectarines, watermelon, artichokes, garlic, onions, chickpeas, kidney beans, lentils, pistachios, cashews, wheat, barley, rye
• Disaccharides (such as lactose): dairy products – milk, ice cream, yoghurt, ricotta, cottage cheese, other soft cheeses
• Monosaccharides (such as fructose): honey, apples, boysenberries, figs, mangoes, pears, watermelon, asparagus, artichokes, dried fruits
• Polyols (such as xylitol, sorbitol, mannitol): apples, apricots, blackberries, plums, cauliflower, mushrooms, snow peas, artificial sweeteners and “low sugar” food products

Food Additives and Preservatives

Both artificial and natural food additives and preservatives can cause intolerance reactions and symptoms in children. If intolerance or sensitivity to food additives and preservatives is suspected, it is crucial to always read food labels – it can be surprising which foods contain these chemicals. The following are common intolerance reaction-causing chemicals:

• Glutamates: MSG, flavour enhancers (620-627) – found in many different foods, such as soy and yeast extracts, soy sauce and other condiments, processed meats, chips and other snack foods, fast food, frozen meals, and commercial seasoning blends
• Colours: coal tar/ petroleum food dyes, (102, 104, 110, 122, 123, 124, 127, 129, 132, 133, 142, 143, 151, 155) – these are commonly found in foods such as soft drinks, lollies, syrups, frozen treats, packet-mix gravy, and cereals
• Preservatives: sorbates (200- 203), benzoates (210-213), parabens (216, 218), sulphites (220-228), nitrates (249-252) – found in many commercially prepared, pre-packaged foods
• Preservatives: propionates (280-283), gallates (310-312), BHA (320), BHT (321) – found in many commercially prepared, pre-packaged foods

Nightshades

Nightshades are a family of plants, which contains a number of commonly eaten fruits and vegetables. A nightshades intolerance can lead to symptoms such as bloating and abdominal pain, or even fatigue and joint pain. Nightshades foods include:

• Potato
• Tomato
• Eggplant
• Capsicum
• Chilli
• Goji berries

Other

Other common foods that trigger food intolerance reactions include:

• Wheat and gluten (e.g., non-Coeliac gluten sensitivity, or NCGS)
• Eggs, especially egg whites
• Casein, the protein found in milk, which can also cause allergy

Health Consequences of Food Allergies and Intolerances

Gastrointestinal System and Microbiome Changes

Exposure to foods that cause an immune reaction over time leads to damage to the intestinal walls, as chronic inflammation damages cells and the gut barrier. This chronic inflammation can also cause negative changes to the gut microbiome. These changes not only lead to poor health overall but can even lead to an increased likelihood of reacting to even more types of foods, as the defence barriers in the gut are no longer working.

Immune System

Over time, the immune system becomes overloaded and overburdened. This can lead to poorer defences against other infections and an increased risk of illness.

Neurocognitive Changes and Mental Health

Chronic inflammation, altered microbiome, and ongoing immune reactivity can all wreak havoc on mental health. Depression, anxiety, insomnia, and behaviour issues can all result.

Health Conditions Associated with Food Allergies and Intolerances

Certain health conditions are associated with food allergies and intolerances and will often go hand-in-hand with an underlying, undiagnosed food intolerance or allergy.

Eczema

Eczema is a chronic skin condition that is due to an allergic-type immune reaction in the skin. It is often first diagnosed in childhood but can also develop for the first time in adulthood. For many (but not all) people, eczema occurs alongside other allergic-type conditions, such as asthma and hay fever, but the triggers for each may vary. Food is a common trigger for eczema flares. Common trigger foods include wheat, cow’s milk, soy, eggs, shellfish, nuts, and peanuts. Food additives, amines, and salicylates can also trigger eczema symptoms.

Asthma

Asthma is a chronic respiratory condition that often first develops in childhood. While many children will outgrow asthma, for others it is a lifelong issue. Like eczema, asthma is part of the group of common atopic (allergic) conditions that can affect children, along with hay fever and sinusitis. Asthma in children is very common, particularly in Australia, and can be due to underlying food intolerances or allergies.

Hay fever and Sinusitis

More allergic-type health conditions that can be associated with food allergy or intolerance. Hay fever is an allergic, immune response to specific irritants. Food allergies or intolerances can trigger or worsen hay fever symptoms. Sinusitis, which is due to an infection, can be a consequence of chronic hay fever and can make the condition worse. Hay fever and sinusitis may be misdiagnosed in children with an undiagnosed food allergy or intolerance, as they can present very similarly, with itchy, watery eyes, runny nose, cough, and fatigue.

Chronic Fatigue

Chronic and prolonged exposure to food intolerances or allergies can deplete vitality, leading to chronic fatigue. There may also be underlying gastrointestinal, immunological, and neurological inflammation that is contributing to the fatigue, as a result of the intolerance/ allergy.

Irritable Bowel Syndrome

IBS is becoming more commonly understood as often being associated with food intolerance, particularly an intolerance to FODMAPs.

Coeliac Disease

Whilst not technically a food intolerance or allergy, it’s worthwhile touching on Coeliac disease. Coeliac disease is an autoimmune response to gluten, found in wheat and other grain products. Although not an allergy, a diagnosis of coeliac disease requires life-long strict avoidance of gluten, similarly to food allergies.

Naturopathic Testing for Allergies and Intolerances

In young children, blood testing may not be the ideal approach initially. In older children, it is something commonly recommended and I often test for allergies, food intolerances and look at blood tests to identify nutrient deficiencies and allergic responses. Assessing for food allergies and intolerances requires a two-pronged approach – testing, followed by dietary assessment and intervention.

In addition to these, it may be necessary to assess your child’s level of certain important nutrients, such as vitamin D. Whilst allergies are more easily identified through blood tests, it is much more difficult to accurately identify food intolerances which is why the following is commonly used:

• Food & Symptom diary
• Elimination Diet
• Reintroduction/Challenge Diet
• Rotation Diet

A food and symptom diary is important so that as a naturopath I can review what your child is eating and how it coincides with symptoms.  There are common reactive foods that can be quickly identified.

The goal of an Elimination Diet and gradual reintroduction food challenge is the strategic identification of trigger foods and symptom relief whilst we focus on correcting a number of underlying processes that trigger an immune response including:

• Restoring healthy gut bacteria and digestion.  Repairing the gastrointestinal barrier.
• Supporting normal immune system function
• Symptom relief

Any known allergies from serious food reactions or IgE testing are simply excluded.

Developing a 4-Day rotation diet for children following the investigative process above means that symptoms of allergies, eczema and more are reduced.  As food reactions commonly occur within 3 days of exposure to the food, this gives your child’s body ample time for inflammation and immune response to die down again before the food is introduced again.  If a reaction does occur, there is not the added pressure on the immune system of having this food again the next day and the body is not exposed over and over, causing histamine related symptoms.  It is also much easier to identify any new culprit foods.

There is nothing more frustrating for parents than supporting their child with allergic type conditions.  Watching your child succumb to constant infections, itching with eczema or hay fever or trying to manage troublesome digestive issues can be traumatic for parents and their children.

Food allergies and intolerances are often the forgotten piece when supporting a child with the conditions mentioned in this blog.  As you will sense from reading this education piece, identifying culprit foods so that they may be included in your child’s rotation diet is no simple task.

If you require support in this process so that you have more unique information as to what your child may be reacting to, please reach out for an initial naturopathic consultation or email me on tanya@performanceinhealth.com.au

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As a naturopath, my unique treatment plans for each client will be developed around the type and causes of your acne however certain dietary and lifestyle strategies are appropriate for all acne cases as mentioned below in this blog.

So, what is Acne?

Acne vulgaris, more commonly known simply as acne, is an extremely common inflammatory skin condition that affects primarily the face, chest, shoulders, and back. It most commonly affects teens, although it can occur at any age. Symptoms range from mild to severe – some people may experience only a spot or two around the time of their period, while others may have significant inflammation, pimples, and boils over large areas of their skin.

There are four key steps in the process of acne:

• Hyperkeratinisation

Too much keratin (the protein our skin and nails are made of) is produced, leading to blocked pores. This process occurs as a protective measure by the skin due to inflammation.

• Increased sebum production

High levels of sebum (skin oil) are produced, including inside the blocked pores. This high sebum production is triggered by high levels of testosterone and DHT, two “male” type hormones (also known as androgens). Our oil glands are larger and more active on our face, chest, back and shoulders, which is why these are the most typical areas for acne to occur.

• Bacterial proliferation

Bacteria on the skin – specifically the Cutibacterium acnes species – proliferate inside the blocked pores, as it uses the sebum as an energy source.

• Inflammation

The body responds to the bacterial infiltration inside the pore by initiating an immune response and increasing inflammation in the area. It is this immune response that leads to the redness, swelling and pus formation seen in acne lesions.

Causes and Triggers of Acne

1. Hormonal Imbalance

Hormonal imbalance is a common underlying issue when it comes to acne. High testosterone (or an increased sensitivity to a normal amount of testosterone) is the typical underlying factor when it comes to hormonal acne. Testosterone and other androgens (“male” type hormones) signal to the skin to increase sebum production, directly worsening acne. Hormone imbalances can occur for a number of reasons, including:

• Overproduction of androgens – either the ovaries are overproducing testosterone, or the adrenal glands are overproducing DHEA. Both testosterone and DHEA can contribute to acne. This is often seen in PCOS and can be due to underlying insulin resistance.
• Underproduction of oestrogen, which leads to a high androgen to oestrogen ratio.
• Rapid changes in hormone levels can also play a role in acne, which is why acne may be worse at certain times of your cycle (such as during menstruation) or may be worse during pregnancy or menopause.
• Hormonal birth control with a high androgen index (high levels of “male” hormones), such as the Mirena IUD, Nexplanon implant, Nuvaring, and certain birth control pills.
• Poor liver function – the liver produces an important molecule called SHBG, which is needed for transporting excess hormones out of the body via the gut. If insufficient levels of SHBG are being produced, hormones can become unbalanced and both testosterone and oestrogen can become too high.

2. Inflammation

Chronic inflammation is another common trigger for acne. Inflammation can occur because of:

• Diet: inflammatory foods such as dairy, wheat, and sugar
• Food intolerances
• Digestive issues, IBS, coeliac disease
• Dysbiosis

Dysbiosis, e.g. high levels of “bad” bacteria and lower levels of “good” bacteria in the gut. This can be due to a huge number of reasons, including:

• IBS, coeliac disease, Crohn’s disease, or other digestive disorders
• Antibiotic use
• Diet low in fibre-rich foods (fruits, vegetables, nuts, seeds, legumes)
• Slow gut transit (constipation)
• Coming off the pill

3. Post-Pill Acne

Post-pill acne is a common sub-type of acne. Certain types of hormonal birth control pill, suppress the production of sebum to abnormally low levels – this is one of the reasons why they are prescribed to women with acne. Unfortunately, when you stop taking these pills, the skin responds by turning up oil production in the skin, sometimes for many months after you’ve finished taking the pill. At the same time, your hormone levels can become unbalanced, as your ovaries begin producing higher levels of hormones again. This combination of higher sebum production and higher testosterone levels, while temporary, can cause issues for up to a year or more after you stop taking the pill.

The withdrawal process from your sebum supressing oral contraceptive drug will take some time however it will come to an end which is good news.  The peak of symptoms over this 12 month period is normally at 3-6 months after coming off the pill which is why preparing to come off the pill for 3 months is always recommended for clients as this will support a less aggressive reaction from your body.  You may need to use barrier contraception if androgen reducing herbs and supplements are prescribed as this may impact the effectiveness of your oral contraception over this preparation period.  As a naturopath, I work closely with a lot of women who want to come off the pill, have a track record of acne and want to minimise their acne severity.

• Insulin Resistance

Acne is sometimes to referred to as “the diabetes of the skin”, because it is so often tied to underlying insulin resistance issues. Insulin resistance causes oestrogen to be converted into androgens like testosterone, DHT, and DHEA. As seen above, androgens are a significant problem when it comes to acne, so insulin resistance needs to be addressed to reduce acne symptoms.

• Poor Digestion and Elimination

The skin is the body’s largest organ and is one of several important channels of elimination in the body, which includes the bowels, the kidneys, and the lungs. If one of these other elimination channels aren’t working optimally, there can be increased pressure on the skin to eliminate toxins and metabolic wastes from the body, leading to congestion in the skin. Symptoms such as constipation may indicate that your digestive system isn’t working as it should and might be contributing to your acne symptoms.

• Stress

Stress can make acne worse, as cortisol not only causes increased levels of androgens, but can also stimulate the production of sebum directly.

Naturopathic Treatment Strategies for Acne

Testing

Possible testing that may be ordered for you including hormones, blood glucose and more.

Dietary Strategies

Eliminate Dairy

Dairy, and especially A1 dairy (which contains the inflammatory protein casein) should be completely eliminated from the diet as it increases the production of Insulin Growth Hormone Factor (IGF-1), which leads to high sebum production in the skin and worsens acne.

Reduce Sugar Intake and Eliminate Added Refined Sugar

All forms of refined sugar should be eliminated from the diet. Sugar consumption leads to high blood sugar and insulin levels, causes IGF-1 levels to spike, and is a highly inflammatory food. Read the labels of foods and be wary of wording on ingredient lists. Even “natural sugar” as an ingredient means extra sugar has been added to the food and home-made smoothies & protein balls can also cause trouble if not made well.  Check out the blog post here for more info.  Working with you on your diet and hidden sugars is always an important part of an acne treatment plan.

Cutting sugar from your diet can be tough, but is crucial and once we have balanced insulin, you will be able to enjoy the occasional sweet treat again I promise and some substitutes for the journey.

Eliminate “diet” foods and artificial sweeteners

Whilst these foods are typically low in sugar, they still negatively impact gut bacteria and contribute to high blood sugar levels and worsen insulin resistance. Foods such as diet soft drinks and “low sugar” lollies are particularly bad culprits, as well as “equal” and “sweet n’ low”.

Reduce Alcohol Intake

Another inflammatory food, and one that is generally full of sugar, too. Limit alcohol intake to no more than one standard drink per day and try to have plenty of alcohol-free days. When you do drink, choose low-sugar and high-antioxidant options, such as an organic red wine – there are plenty of great organic wines available these days.

Consider Eliminating Wheat

As with dairy, wheat is a highly inflammatory food, and one that is found in a huge number of food products. To best approach reducing acne, it is worthwhile considering eliminating wheat from your diet, and choosing wheat- and gluten-free foods. Wheat is used in bread, cake, cookies, biscuits, crackers, and pastries, and is also an ingredient in many processed foods.

Identify and Eliminate Food Intolerances

Exposure to food intolerances triggers inflammation as the body reacts to the “threat” of the food you are reactive to. Over time this can lead to significant chronic inflammation and gut damage and can worsen issues like acne. Common food intolerances which often impact those with acne include dairy and gluten/ wheat, but there are many other foods that can cause issues. A thorough naturopathic consultation will help understand what you may be reacting to.

Avoid Inflammatory Vegetable Oils

Certain vegetable oils increase inflammation and can make acne worse. These include sunflower, canola, soy, and corn oils. Instead, choose extra virgin olive oil, avocado oil, hemp seed oil, and avocado oils for use in cooking, and for making your own salad dressings.

Reduce Caffeine Intake

Caffeine triggers our “fight or flight” response and increases cortisol levels, which can upset normal hormonal balance and worsen your acne. Reduce your overall intake (ideally no more than one coffee per day) and be sure to consume caffeine in the morning, to reduce its impact on your sleep. Caffeine is primarily found in coffee, tea, chocolate, and energy drinks.

Eliminate high histamine foods

Foods high in histamine can increase inflammation, making acne worse. For more information on histamine, see our blog post here.

Eat Plenty of Anti-Inflammatory Fruits and Vegetables

Fresh fruits and vegetables provide many of the building blocks necessary for fighting inflammation, acne, and improving skin health, such as antioxidants, vitamins, and minerals, and even fibre for gut health and a healthy microbiome. Choose fruits and vegetables in a variety of colours to maximise your intake of different nutrients. For vegetables with edible skins, eating with the skin on can further increase insoluble fibre intake – but be sure to choose organic varieties and scrub the skins well before eating. Aim for 5 or more serves of vegetables or pulses each day, and 2 serves of fruit.

Eat Phytoestrogen-Rich Plant Foods

Phytoestrogens are molecules found in many plant foods which can bind to oestrogen receptors in the body. Phytoestrogens have a bad rap in Western culture as being damaging to our health, but this unfortunate misconception is due to a misunderstanding of how these molecules really work. They are actually able to re-balance oestrogen levels in the body, so can be very helpful with hormonal acne.

Phytoestrogens can be found in a huge range of foods, including:

• Organic soy products, such as tofu
• Ground flax seeds
• Chickpeas
• Linseed
• Mung beans
• Olives
• Pumpkin seeds
• Parsley
• Buckwheat
• Whole grains
• Sesame seeds
• Sunflower seeds

Eat Anti-Inflammatory Omega 3-Rich Foods

Omega 3 fatty acids are wonderful anti-inflammatory fats that can help to reduce some of the inflammation that makes acne worse. Omega 3 fatty acids are found in fatty fish (salmon, tuna, anchovies, sardines), walnuts, hemp seeds and hemp seed oil, flax seeds, and chia seeds.

Drink at least 2 litres of (filtered) water each day

Water is absolutely vital for ensuring your body can remove toxins. This is particularly important if your acne symptoms are associated with reduced elimination channel function, such as liver issues or constipation. Many of the herbs used to help with acne increase detoxification pathways, and without adequate hydration to move these toxins out via the kidneys and bowels, acne symptoms can be aggravated as the skin tries to remove toxins.  Avoid tap water due to small amounts of heavy metals like lead and copper, and both bottled and tap water contain microplastics.   Filtered water is the best option.

Eat Protein and Healthy Fats with Every Meal

Quality protein and healthy fats with every meal will help to balance blood sugar levels and promote healthy insulin functioning, too. Choose a variety of protein sources and remember not to overdo the animal-based products (meat and eggs). Good quality sources of protein can be found in legumes (lentils, chickpeas, black beans, kidney beans, cannellini beans), tofu, tempeh, edamame beans, quinoa, nuts (walnuts, almonds, cashews, Brazil nuts), seeds (hemp seeds, sunflower seeds, chia seeds, pumpkin seeds), and mushrooms. Be sure to build your meals and snacks around the protein source to make sure you’re not accidentally consuming too much carbohydrate. Add a good quality source of healthy fats as well – avocado, extra virgin olive oil, olives, or some nuts and seeds are all great options.

Use fresh herbs and spices

Herbs and spices are a fantastic source of antioxidants and are important for improving insulin functioning and fighting inflammation. Some spices, such as cinnamon, also directly increase the body’s sensitivity to insulin. Add to cooked meals, or even chop and use raw in salads and smoothies. There are a huge range of herbs and spices out there that are readily available fresh, so get creative! Some particularly good ones to try and include are turmeric, garlic, ginger, rosemary, coriander, basil, parsley, dill, chives, etc, can all be found in the fresh food section of the supermarket or are very easy to grow in a kitchen garden. Herbs can be used in soups, stews, homemade sauces, to flavour baked vegetables, or added fresh to salads.

Eat regularly and avoid skipping meals

Eating regularly through the day helps to prevent blood sugar levels from dipping and spiking throughout the day, which can make it more difficult to stabilise insulin secretion. Try eating snacks between your 3 main meals, or switch to eating 5 smaller meals per day. To prevent skipping meals, try keeping a snack on hand – such as a handful of nuts and seeds in a container – so that you’re not caught out when you’re out and about through the day.

Eat Plenty of Zinc-Rich Foods

Zinc is a powerhouse mineral that is involved in hundreds of processes in the body, and is a vital nutrient to consider when it comes to zinc, because it can:

• Reduce inflammation
• Helps the skin to heal by promoting collagen production
• Reduces overproduction of testosterone back to normal levels
• Kills bacteria, including those associated with acne
• Helps to heal the lining of the gut, reducing the effects of bacterial overgrowth and dysbiosis
• Reduces cortisol and the stress response

Zinc can be found in foods such as red meat, poultry, oysters, whole grains, pumpkin seeds, sunflower seeds, legumes (lentils, chickpeas, beans), cashews, and almonds.

Lifestyle Strategies

Reduce Stress

Stress has a huge impact on hormone health, as high cortisol (the stress hormone) disrupts healthy hormonal balance. Chronic stress also triggers inflammatory pathways in the body and has been shown to worsen symptoms of acne. You can help to combat the effect of stress with the following:

• Mindfulness meditation – even 10 minutes per day of mindfulness meditation can help reduce feelings of stress. Many meditation studios offer online classes, or you can use an app such as “insight timer” for access to thousands of guided meditations for free.
• Yoga or tai chi – as with meditation, these are both wonderful for helping to release stress. There are many apps available online, or you can try YouTube for free videos as well – “Yoga with Adrienne” is a popular YouTube channel with dozens of free videos to try.
• Counselling or psychology – if you don’t already have a regular counsellor or psychologist, it is worthwhile pursuing this. Having someone you can speak to about stressors in your life can make a huge impact on both your physical and mental wellbeing.

Skin Care

The following tips can be helpful with acne:

• Use cosmetics sparingly, to avoid further blocking pores
• Wash face gently with an unscented cleanser – avoid harsh cleansing agents and perfumes which can irritate already sensitive and inflamed skin
• Avoid picking at or squeezing pimples, as this can spread bacteria and worsen inflammation
• If you shave your face, use a new razor blade each time to reduce the risk of infection

Naturopathic Herbs and Supplements

Each naturopathic treatment plan is unique depending on what has caused and is sustaining your acne and may include the following:

Supplements 

• Zinc
• Vitamin A
• Omega 3 or fish oil
• Supplements that reduce androgens such as testosterone
• Magnesium
• Inositol, chromium and other blood glucose balancing nutrients

Herbs

There are many wonderful herbs that can help with acne. As with supplements, these will be individualised and tailored to your unique needs depending on the cause of your acne, but may include:

• Hormone-balancing herbs, such as peony, liquorice, vitex, or saw palmetto
• Liver herbs, such as dandelion root or globe artichoke
• Herbs to support insulin resistance such as olive lead, cinnamon
• Herbs to support the channels of elimination, such as burdock, nettle, or calendula
• Herbs to support circulation, such as rosemary
• Herbs for nervous system support, such as oats seed, skullcap, Siberian ginseng or ashwagandha

Acne is a complex condition and can often be the “Perfect storm” of a number of contributing factors.  An initial naturopathic consultation with Tanya, founder of Performance in Health Wellbeing Clinic is a very thorough investigation so that a comprehensive treatment plan can produce lasting results for you. 

The post Acne Causes & Strategies to Say Farewell to Acne appeared first on Performance in Health.

This blog provides some helpful strategies that reduce your risk from things you may be doing on a day to day basis.  These are known as preventable risk factors.

Your Heart & Cardiovascular Disease

Of the common preventable health conditions prevalent in Australia today, heart attack and cardiovascular disease remain one of the deadliest. In fact, cardiovascular disease accounts for one in four deaths in Australia. Research, education and advances in both treatment and prevention have helped to reduce deaths, but it remains a significant health issue for many of us; three-quarters of Australians are at risk of developing cardiovascular disease due to both preventable and non-preventable risk factors.

What is a Heart Attack?

A heart attack, also known as a myocardial infarction, usually occurs when one of the arteries supplying blood to the heart become blocked, cutting off blood (and oxygen) to the heart. Heart attacks can occur spontaneously but are most often caused by cardiovascular disease and can be seen as the culmination of the many different damaging processes that occur in cardiovascular disease.

The cardiovascular system, made up of the heart, arteries, veins, and capillaries, is a delicate and finely tuned system that supplies oxygen and nutrients to every cell in the body. It relies on flexible, unobstructed blood vessels to maintain the pressure and flow of blood within a very tight range, and its function affects many other systems within the body. High blood pressure, cholesterol, and chronic inflammation leave the cardiovascular system and the heart vulnerable to dangerous plaque build-up in arteries. These plaques can occlude arteries and cut off blood supply entirely and can even break away from artery walls to form blockages in other areas, including veins in the leg and even the lungs. These plaques may occlude the arteries of the heart itself and block its own blood supply, triggering a heart attack.

Some of the warning signs and symptoms of a heart attack include:

• Chest pain, such as a feeling of pressure or fullness in the chest. Pain may radiate into the jaw, back, arm, or neck
• Nausea and vomiting
• Feelings of anxiety and dizziness
• Sweating
• Shortness of breath or difficulty breathing

Symptoms including pain may come and go and typically last for several minutes. Some people may have no symptoms at all – something that is known as a “silent heart attack”.

Risk Factors for Heart Attack

Some risk factors are things you can’t change about yourself, such as:

• Age – the risk of heart attack increases as you get older
• Sex – being male increases your risk until menopause for women when risk factors increase
• Family history – you are more likely to have a heart attack if other people in your family have

Other risk factors are things within your control (or are issues that can be addressed through treatment strategies), such as:

• Smoking
• High cholesterol
• High blood pressure
• Low physical activity
• Obesity and overweight
• Type 2 diabetes
• Stress
• Sleep deprivation
• Drinking too much alcohol

Assessing Your Risk

If you are in a higher risk category, your GP may assess your risk of heart attack and may refer you for tests, including:

• Electrocardiogram
• Angiogram
• Cholesterol blood test (also known as a lipid profile)
• Hs-CRP (a blood test that looks for markers of inflammation)

You may also be referred to a cardiologist for more advanced assessment.

In addition to the above testing, naturopaths may refer you for tests such as:

• Blood glucose and blood insulin tests
• Homocysteine test (can indicate deficiencies in nutrients that can impact your cardiovascular health)
• Fatty acid profiles (to assess your level of good omega-3 fats compared to omega-6)

Other tests may also be recommended, depending on your individual health needs, such as thyroid testing, to better understand other factors which may be contributing to your condition.

Naturopathic Strategies for Heart Health

The good news is that diet and lifestyle changes can make a huge positive impact on your risk of cardiovascular disease and heart attack. Protecting yourself from heart attack means working towards maintaining a healthy cardiovascular system overall, as well as looking after your general health and wellbeing. Naturopathic strategies for protecting heart health take a holistic approach, looking at both the cardiovascular system specifically, as well as fostering healthy daily lifestyle practices to support your health more generally.

Diet

Eat Plenty of Fibre-Rich Fruits and Vegetables

It is recommended that we eat 5 or more serves of vegetables and 2 serves of fruit every day, yet a whopping 90% of us don’t currently meet this recommendation. Increasing your fruit and vegetable intake is a great place to start with supporting your heart health, as eating 5+ serves of vegetables can reduce your risk of CVD by nearly 17%.

Fruits and vegetables protect against cardiovascular diseases in a number of different ways:

• They contain heart-healthy vitamins, minerals, and phytochemicals such as vitamin C, magnesium, potassium, carotenoids
• They are rich in inflammation-fighting antioxidants
• They contain both soluble and insoluble fibre, which help to lower LDL cholesterol levels and reduce blood pressure

Choose a variety of vegetables and fruits and try to eat many different colours of vegetables and fruits each day. This way you can be sure you are maximising your nutrition, as many of the antioxidant and health-promoting nutrients in vegetables and fruits are found in the pigments that gives them their colour.

Reduce your intake of refined and added sugars

Eating foods and drinks that are high in refined and added sugars significantly increases your risk of developing cardiovascular disease, even if you are a healthy weight. A high intake of sugar signals to the liver to make more LDL (“bad”) cholesterol, and also leads to higher levels of triglycerides. Sugar also increases inflammation in the body, a risk factor for developing cardiovascular disease. Keep an eye on food labels and avoid foods with added sugars, even if they are “natural”. Better yet, focus on foods found in the outside edges of the supermarket that don’t require packaging – these foods are typically lower in sugar and other additives.

Make no mistake that processed carbohydrates turn to glucose in your blood and have a huge impact on insulin spikes and cholesterol.  Blood sugar spikes and lows affect blood vessels, blood pressure and more – eat more raw and wholegrain food is always my philosophy when improving cardiovascular health.

Reduce your intake of trans and saturated fats

Trans fatty acids, a type of dietary fat found in deep fried foods, increases the risk of cardiovascular disease by increasing “bad” LDL cholesterol and lowering “good” HDL cholesterol levels. These types of fats increase inflammation through the body and have been found to increase the risk of not only heart disease but also diabetes. In fact, research suggests that on a “per calorie” basis, trans fats increase the risk of heart disease more than any other nutrient!

The evidence for saturated fats, on the other hand, is less clear cut. While previous evidence has suggested that their intake needs to be reduced for heart health, emerging evidence shows that reducing intake of saturated fats may not have as significant an effect in the long term as was once thought, although the jury is still out. Reducing your intake of saturated fats will help to reduce serum cholesterol levels and may also be protective against heart disease but may not be the panacea for heart health that it was once thought to be. It is still prudent to be mindful of your consumption of saturated fats, which can easily take the place of unsaturated fats such as olive oil, which have positive health effects. Replacing even some of your saturated fat intake with unsaturated fats from foods such as walnuts and olive oil can help to improve your health and reduce your risk of cardiovascular disease.

Limit your Intake of Red Meat

Our modern Western diets contain far too much red meat, and it is making us sick. Consumption of both processed and unprocessed varieties of red meat is significantly associated with cardiovascular disease. Fish and poultry, on the other hand, don’t raise your risk, and fish in particular can be beneficial in protecting heart health. Keep red meat intake to a minimum – once a week or so – and instead choose fish, poultry, and vegetarian protein sources such as lentils, beans, tofu, and eggs.

Reduce your intake of salt

Excess salt in your diet can increase your blood pressure, putting you at risk of developing cardiovascular disease and even stroke. Added salt is difficult to avoid in processed foods, so reading labels is imperative when it comes to cutting down on your salt intake. You can also reduce your salt use in cooking by instead using plenty of fresh herbs and spices to keep dishes full of flavour, while adding in extra antioxidant goodness to your meals.

The Mediterranean Diet

I adore the original Mediterranean diet and it continues to be the healthiest way of eating in most studies.  If you prefer to have a more structured dietary plan, the Mediterranean diet is a wonderful, healthy option for improving heart health. Based on the traditional diets of people from the Mediterranean region in the 1960s, the Mediterranean diet is low in processed foods like pastries and pre-packaged foods, and rich in nutrient-dense vegetables, fruits, and whole grains. Fish is eaten in moderate amounts, and meat, dairy and eggs are consumed in low amounts – about once a week or less.

Some of the heart-healthy benefits of the Mediterranean diet include:

• Reduces cholesterol levels
• Protects against oxidative stress
• Protects against inflammation
• Reduces the “stickiness” of platelets to help slow down the development of plaques in arteries
• Reduces other risk factors of cardiovascular disease, including waist-hip ratio,

The DASH Diet

Another diet to consider for heart health is the DASH diet. The DASH diet was developed specifically to tackle hypertension and is similar to the Mediterranean diet in terms of both its content and its beneficial effects on heart health. In addition to helping manage blood pressure, the DASH diet has been shown to help with high cholesterol levels and can even be a useful tool for weight loss and is now used as a treatment tool for other chronic diseases, too.

Functional Foods and Heart Healthy Nutrients

Garlic

The humble garlic is a fantastic food for helping to keep your heart healthy. Extensive research has shown that garlic can help to combat cardiovascular diseases in a variety of ways. Garlic can help to reduce blood pressure, cholesterol, and triglyceride levels, as well as inflammation, and has been shown to improve several markers of cardiovascular disease such as arterial wall thickness. In addition to its benefits for heart health, garlic has been shown to be good for kidneys and liver health, and even helps to feed good gut bacteria, making it a fabulous addition to the diet for overall wellbeing. Buy whole garlic bulbs and crush fresh yourself to add to cooking and salad dressings, or roast whole bulbs to go with Sunday night roast vegetables.

Cacao

Cacao is a powerhouse food when it comes to heart health, thanks to its heart-healthy flavonoids, and minerals such as magnesium. Studies have found cacao can help to lower blood pressure and reduce the stickiness of platelets, to help prevent the build-up of plaques on artery walls. Remember to choose raw cacao or dark chocolate and avoid heavily sweetened products like milk chocolate – the sweetener, dairy, and food additives in these types of products will counteract any benefit offered by the cacao.

Green Tea

Green tea is a great option to include in your diet for heart health. It contains an abundance of heart healthy polyphenols like epigallocatechin and resveratrol, which protect against cardiovascular disease.  Green tea also has much less caffeine than black tea of coffee.  Be mindful however that caffeine can be stimulatory which is why I never recommend in excess especially when someone has high blood pressure.  In the right quantities it is a beautiful cardiovascular food source.

Spices

Spices such as turmeric, cinnamon, ginger, paprika, cumin, and pepper, have all been found to help with cardiovascular health. These foods contain high levels of phytochemicals that can reduce blood pressure and fight oxidative stress and inflammation. Add to soups, stews, and curries, or use in drinks such as chai and turmeric lattes. They can also be a great addition to foods to replace salt for flavouring dishes.

Antioxidants

Antioxidants fight inflammation and oxidative damage in the body, processes which can help to fight the damaging effects of the Western diet on heart health. There are so many different types of antioxidants in our foods, especially in vegetables and fruits. Some of the most-studied antioxidants for heart health include:

• Lycopene: found in tomatoes, lycopene is a type of carotenoid that is even more potent at fighting oxidation than vitamin E. It has been found to fight atherosclerosis and may even help to reduce blood lipid levels. Lycopene levels are highest in cooked tomatoes, so try adding grilled tomatoes to your breakfast or salad, or even cook up a tomato soup with plenty of garlic.
• Resveratrol: an antioxidant found in grapes, red wine, and green tea. Resveratrol has been extensively studied for its health benefits, including helping with cardiovascular disease, type 2 diabetes, and even cancer. Resveratrol reduces inflammation and helps with blood pressure, as well as preventing platelets clumping together in the blood.   If you are going to drink alcohol, low to moderate red wine consumption is what I recommend.  Excess red wine, as with any alcohol is damaging to your cardiovascular health.
• Quercetin: this antioxidant is found in a wide range of foods, including berries, cacao, citrus fruits, onions, broccoli, tomatoes, red grapes, and tea. Quercetin helps to lower blood pressure and prevent atherosclerosis, as well as opening blood vessels and reducing overall inflammation.
• Vitamin C: a potent antioxidant that helps to protect blood vessels from oxidative damage and protects LDL cholesterol molecules from being damaged.  Vitamin C is also essential for healthy tissue repair, so getting sufficient in your diet is vital. Vitamin C can be found in foods such as citrus fruits, strawberries, broccoli, and capsicum.

CoQ10

CoQ10 (AKA coenzyme Q10) is another antioxidant but deserves its own section because of its powerful antioxidant effects and its affinity for protecting the heart specifically. CoQ10 is produced by all cells of the body and is typically found in high concentrations in the heart, but our levels of this all-important micronutrient decrease with age, resulting in a need to supplement.  CoQ10 supplementation is particularly important for those on statins, as these medications can deplete the body of coQ10. Multiple different forms of CoQ10 supplement are available on the market right now, so speak to your naturopath for advice on the right supplement form for you.

Magnesium

Magnesium is a vitally important mineral in the body and plays a role in over 300 functions! It is a mineral that many people can become deficient in, particularly as it can become depleted when we are stressed – and in our high-stress world, chronic stress affects many of us. Frequent leg cramps are a sign that you may be low in magnesium. Supplementing with magnesium has been shown to help reduce blood pressure, prevents plaques from become calcified and hardened, and helps to open up arteries and veins for better blood flow (a process known as vasodilation).  It is also essential for balancing blood sugar levels, improving sleep and reducing stress which are all risk factors for reduced heart health.   Magnesium can be found in abundance in many foods, including dark green leafy vegetables, nuts and seeds, and legumes such as lentils.

Magnesium is the blood of plants – remember this statement…..

Omega 3 Fatty Acids

Omega 3 fatty acids truly are so important to good health, so it’s no surprise to find them on the list of nutrients for heart health. They are vital for counteracting the inflammation of their cousins, omega-6 fatty acids, which can be found in many of the foods popular in the Western diet. They have a demonstrated positive effect on the heart, helping reduce arrhythmia (irregular heartbeat), preventing platelets from sticking together to form clots, and improving the health of blood vessels. They also help to reduce inflammation and lower blood pressure, too. Omega 3 fatty acids are found in oily fish such as salmon, tuna, and sardines, as well as in walnuts, sunflower seeds, and flax seeds. Enjoy one or two serves of fatty fish per week and try adding walnuts and sunflower seeds to salads. Ground flax seeds can easily be added to porridge or even smoothies!

Fish oil supplements can also be helpful, but many supplements on the market are very poor quality and can even contain rancid oils. Speak with your naturopath about finding a high-quality product. Vegan options are also available and are usually algae-based.

Lifestyle

Exercise Daily

Almost two thirds of Australian adults are overweight or obese, and the number is unfortunately rising. Our cardiovascular system relies on physical activity to help it pump blood through the body – our veins contain specialised valves that work through physical movement, so keeping active is important for cardiovascular health. Aim for at least 30 minutes of vigorous physical activity each day, working hard enough to at least break a sweat.

Quit Smoking

We know that smoking is detrimental to health in so many ways, including affecting the cardiovascular system. The oxidative stress and toxin exposure from smoking causes damage to blood vessels, among a litany of other negative health outcomes. Quitting smoking can make a big difference to your cardiovascular disease and heart attack risk. If you’re ready to quit, speak to your naturopath to learn about strategies that can help you on your journey.

Stress

Stress is part of our everyday lives and is a protection mechanism, helpful to you when managed well.  But, if stress is constant, it can harm you as you are constantly in a “fight or flight” position, and this has enormous biochemical implications as far as your body is concerned. The hormone cortisol is released in response to this stress with scientific studies showing that chronic high levels of cortisol can increase your blood pressure, blood sugar levels, insulin spikes, blood cholesterol and plaque in your arteries, triglycerides and more. All of these things increase your risk factors for cardiovascular disease and heart related problems.

Lack of sleep

Your body considers lack of sleep as a stress on the body also which is why it is now considered “the new carcinogen”.  Not only does it affect cardiovascular disease but many other health related conditions.  If you are not sleeping well, have sleep apnoea or have terrible sleep habits, the time to fix this is now.

Conclusion

Preventable risk factors are something all of us need to consider for our health.  A good diet, daily exercise, stress management, giving up smoking and quality sleep are all enormously important whether you are managing genetic risk factors or proactively improving your overall heart health.   

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The Ins and Outs of the Paleo Diet

So, you’ve heard all about how popular the paleo diet is, but what exactly is it? The paleolithic (“paleo”) diet, is one based on estimations of what our ancestors ate prior to the onset of agriculture. Other names for the paleo diet include the “caveman” diet, the “stone-age” diet and the “hunter-gatherer” diet.

The paleolithic period (also known as the old stone age) was a period starting roughly 2.5 million years ago and ending around 10,000BCE with the development of agriculture. Many of the diet-related health issues encountered in modern times such as heart disease, diabetes, insulin resistance and even dementia have arisen in part due to dietary changes brought on with the rise of agriculture, which saw our diets move towards a diet much more focused on dairy and grains (of course, changes in physical activity, high chronic stress, and the development of highly processed foods also play a significant role here). Proponents of the paleo diet argue that our microbiota and physiology in general has not adapted to this changed diet and instead is better suited to the pre-agricultural dietary patterns of our ancestors. The paleo diet is an attempt to mimic the type of diet our ancestors might have eaten as hunter-gatherers, in order to try to emulate the diet that best suits our physiology.

So, what does this ancient eating pattern look like? Well, it certainly looks quite different to the standard Western diet. All dairy and grains are excluded – this includes not only wheat (e.g. bread, pasta), but also rice, oats, barley, quinoa, and even “ancient grains” like amaranth and millet. Dairy is completely excluded, including both cow and goat milks. In addition to excluding grains and dairy, the paleo diet excludes all legumes, such as lentils, chickpeas and beans. Refined carbohydrates and sugars are also off the menu, along with processed oils (e.g. vegetable oil, peanut oil), and heavily processed foods such as chips, lollies and cakes. Some foods, such as alcohol and potatoes, are up for debate and may or may not be included, depending on the individual’s ideas on the diet. Instead, the paleo diet is rich in fruits and vegetables, grass-fed lean meat, wild-caught fish, eggs, and nuts. Often times there is a focus on “the wilder the better” as far as meats and other animal foods are concerned, so game meats and even organ meats can be common choices with this diet.

Because of the focus on meats, the paleo diet is considerably higher in protein than other modern diets, with around 30% of calories coming from protein, compared to the standard Western diet’s 10-15%. This higher protein intake may be beneficial for athletes and those who are very active however, as higher amounts of physical activity does increase protein requirements. The paleo diet is also low in carbohydrate, although not as low as the keto diet. Around 25% of calories come from carbohydrates. By contrast, the standard Western diet is made up of 40-60% carbohydrates, and the keto diet is just 5-10%. The remaining 45% of calories come from fats, with 10% from saturated fats and the remaining 35% from mono and polyunsaturated fats.

Conditions it is Good For

Cardiovascular Disease

Whilst more research is needed to better evaluate the effects of the paleo diet on cardiovascular disease, the research available is positive. Studies have shown that the paleo diet can help to reduce a range of cardiovascular risk factors including blood pressure and cholesterol, as well as helping with reducing BMI and waist circumference. These beneficial effects begin very quickly, and even healthy individuals can enjoy better blood glucose levels and blood pressure by eating paleo.

Paradoxically, one study on the effects of the paleo diet on gut microbiota found long-term adherence to the diet led to increased levels of trimethylamine-N-oxide (or TMAO, for short), a by-product of certain gut microbes which is linked to cardiovascular disease. The low intake of resistant starch (one of the main food sources for our good gut bacteria) leads to changes in the amounts and types of bacteria in the gut. It’s unclear, however, whether this effect would outweigh the overall cardiovascular benefits of the diet. My love of the gut bacteria and the role they play means that other eating philosophies may be better for wholistic health..

Diabetes and Insulin Resistance

In diabetic patients, the paleo diet helps to lower glucose levels and HBA1c (a measure of glucose levels of a period of 3 months, which is used to assess longer-term trends in glucose levels). In fact, the paleo diet outperformed a diet designed specifically to help manage diabetes in terms of reducing blood sugar levels in diabetics in a 2009 study. The paleo diet also led to lower blood pressure, BMI and waist circumference, too.

Weight Loss

Much like the keto diet, the paleo diet has been found to be a beneficial dietary choice for those wishing to lose weight. A short-term study on healthy volunteers found just 3 weeks of the paleo diet led to an average weight loss of around 2.3 Kg (although some of this weight loss may be loss of body water due to a change in carbohydrate intake – see our blog on the keto diet for further info on this phenomenon). An added benefit of the paleo diet (and one which is shared with the keto diet, too) is that the higher intake of protein and fats means better satiety – feeling full after meals. Feeling full between meals can be hugely beneficial when it comes to weight loss, as it reduces the need for additional snacks.

Multiple Sclerosis

Whilst much of the research on the paleo diet has looked at its cardiovascular and metabolic benefits, there is emerging evidence to suggest it may also be beneficial in multiple sclerosis. MS is a common neurological condition that can be highly debilitating, with a host of symptoms including brain fog, physical and mental fatigue, pain, weakness, and vision problems. Studies show the use of the paleo diet helps to reduce some of the symptoms of multiple sclerosis, such as mental and physical fatigue, as well as improving exercise tolerance and hand and leg function. The result is improved quality of life for patients with MS. 

Cons of the Diet

One of the most significant cons of the paleo diet is cost. The exclusion of lower cost, economical foods such as grains and legumes drives up the price. So too does the inclusion of large amounts of meat, particularly grass-fed and wild caught options, which are typically more expensive choices. These expensive food choices could make the paleo diet difficult to stick to in the long term, particularly for those in lower socioeconomic situations. Another con of the paleo diet is its environmental cost. The paleo diet has a higher intake of animal-based foods compared to some other diets, and these foods have a higher carbon footprint compared to plant-based foods. The paleolithic diet has some nutritional shortfalls, too. It is unfortunately low in calcium, so a good quality calcium supplement is typically required to prevent bone mineral loss. Similarly, a study from 2017 found long-term use of the paleo diet led to iodine deficiency, so appropriate supplementation of iodine would also need to be considered. The paleo diet would not be suitable for vegans, as the lack of legumes would significantly reduce availability of protein-rich vegan foods. Vegetarians would likely find the diet very restrictive, however would have protein-rich food in the form of eggs.

It’s also important to consider just how “paleolithic” a modern paleolithic diet can be, and whether we should even be aiming to eat like our ancestors did. Although removing grains and dairy from the diet is a step towards what our ancestors ate, in reality the meats, fruits and vegetables that are readily available to the majority of us are vastly different to their ancient counterparts. One only has to look at the difference between a cultivated banana and a wild banana to see the difference! If our foods have changed so drastically in the last 12,000 years, surely our own bodies have also changed to adapt to our new diets in this time, too.  And do we do the exercise of our ancestors which may have been more appropriate with such a high protein diet?   I think not.

Whilst the paleo diet certainly has its benefits, there are shortfalls in terms of nutritional profile, particularly in the long term. If you are interested in changing your dietary habits, naturopaths are trained in developing detailed eating plans that are right for you and your unique situation. 

References

Cambeses-Franco, C., Gonzalez-Garcia, S., Gumersindo, F., & Moreira, M. T. (2021). Is the paleo diet safe for health and the environment? Science Of the Total Environment, 781.

Frassetto, L. A., Schloetter, M., Mietus-Synder, M., Morris Jr., R. C., & Sebastian, A. (2009). Metabolic and physiologic improvements from consuming a paleolithic, hunter-gatherer type diet. European Journal of Clinical Nutrition, 63, 947–955.

Genoni, A., Christophersen, C. T., Lo, J., Coghlan, M., Boyce, M. C., Bird, A. R., Lyons-Wall, P., & Devine, A. (2020). Long-term paleolithic diet is associated with lower resistant starch intake, different gut microbiota composition and increased serum TMAO concentrations. European Journal of Nutrition, 59, 1845–1858.

Ghaedi, E., Mohammadi, M., Mohammadi, H., Ramezani-Jolfaie, N., Malekzadeh, J., Hosseinzadeh, M., & Salehi-Abargouei, A. (2019). Effects of a paleolithic diet on cardiovascular disease risk factors: A systematic review and meta-analysis of randomized controlled trials. Advances in Nutrition, 10(4).

Irish, A. K., Erickson, C. M., Wahls, T. L., Snetselaar, L. G., & Darling, W. G. (2017). Randomized control trial evaluation of a modified paleolithic dietary intervention in the treatment of relapsing-remitting multiple sclerosis: A pilot study. Degenerative Neurology and Neuromuscular Diseases, 7.

Jonsson, T., Grandfeldt, Y., Ahren, B., Branell, U.-C., Palsson, G., Hansson, A., Soderstrom, M., & Lindeberg, S. (2009). Beneficial effects of a paleolithic diet on cardiovascular risk factors in type 2 diabetes: A randomized cross-over pilot study. Cardiovascular Diabetology, 8.

Jonsson, T., Grandfeldt, Y., Lindeberg, S., & Hallberg, A.-C. (2013). Subjective satiety and other experiences of a paleolithic diet compared to a diabetes diet in patients with type 2 diabetes. Nutrition Journal, 12.

Klonoff, D. C. (2009). The beneficial effects of a paleolithic diet on type 2 diabetes and other risk factors for cardiovascular disease. Journal of Diabetes Science and Technology, 3(6).

Manousou, S., Stal, M., Larsson, C., Mellberg, C., Lindahl, B., Eggertsen, R., Hulthen, L., Olsson, T., Ryberg, M., Sandberg, S., & Nystrom, H. F. (2018). A paleolithic-type diet results in iodine deficiency: A 2-year randomized trial in postmenopausal obese women. European Journal of Clinical Nutrition, 72, 124–129.

Osterdahl, M., Kocturk, T., Koochek, A., & Wandell, P. E. (2008). Effects of a short-term intervention with a paleolithic diet in healthy volunteers. European Journal of Clinical Nutrition, 62, 682–685.

Zopf, Y., Relijic, D., & Dieterich, W. (2018). Dietary effects on microbiota—New trends with gluten-free or paleo diet. Medical Sciences, 6(4).

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Although considered by many to be a recent “fad” diet, the ketogenic diet has a long, documented history of use as a therapeutic aid for a number of conditions. Since the 1920s, the ketogenic diet has been used in the treatment of epilepsy and was the standard treatment for both type 1 and 2 diabetes until relatively recently, too. So, what exactly is it? The ketogenic diet is uniquely different to other diet options because it is very high in fat and low in both protein and carbohydrates. Switching to fat as the primary fuel source for the body triggers a change in energy production in the body that is akin to how the body operates during starvation. The classic ketogenic diet (the one originally developed for managing epilepsy) also has restricted calories and fluid intake, in order to better mimic the effects of fasting on the body.

During fasting, the body switches from using primarily carbohydrates for fuel to instead utilising fat as a fuel source. The liver breaks down fatty acids released from the body’s fat stores and breaks these down into products called ketone bodies (or simply “ketones”), namely beta-hydroxybutyrate, acetoacetate and acetone (yep, acetone). This is a state known as ketosis. Ketones are considered a “super food” for the brain and can even be considered a “super fuel” for the body in general, because ketones produce more ATP energy in the body than glucose does. ATP energy is the main method of energy production throughout the body. Essentially, the body becomes more efficient at producing energy. The ketogenic diet forces the body into a state of ketosis by severely limiting the intake of carbohydrates, forcing the body to utilise alternate methods of energy production. Some detractors of this diet type argue that it goes against the body’s natural metabolic preferences to force it into ketosis, but there is evidence to suggest that the body can thrive in this state. Interestingly enough, human nutrition actually begins with ketones! Colostrum, the special breast milk produced in the first few days after birth, is ketogenic and provides all the nutrition newborns require in those first few days of life.

So, exactly how low do carbohydrates need to be in order to put the body into ketosis? To reach (and stay in) ketosis, carbohydrates need to make up less than 10% of total caloric intake. By contrast, the typical Western diet is made up of anywhere from 45-65% carbohydrates. The classic ketogenic diet requires around 90% of calories to come from fats, with the remaining 10% split between protein and carbohydrates (6% for protein and just 4% for carbohydrates). This strict restriction of carbohydrates and protein is difficult to adhere to and requires very careful planning and weighing of foods to meet requirements. The modern ketogenic diet more commonly followed in recent times is less strict than this, simply requiring the carbohydrates be 10% or less of daily calories and fat to make up 70% or more, without requiring weighing of food or restricting fluid intake. It’s important to note that even in ketogenic diets we still require some carbohydrates in our diet, as not all of our cells and organs can use ketone bodies for fuel. Red blood cells, for example, are only able to produce energy from carbohydrates and glucose. Similarly, the liver can’t use ketones, as it lacks an important enzyme needed for the ketone pathway.

Conditions that Can Benefit from the Ketogenic Diet

Epilepsy

Epilepsy is one of the most well-documented conditions that benefits from the ketogenic diet. Even in Ancient Greece, the benefits of fasting for epilepsy were known, and the classic ketogenic diet was specifically designed to mimic fasting and assist in the treatment of epilepsy. Nowadays, the ketogenic diet is used primarily for those with refractory epilepsy – that is, epilepsy that does not respond to anti-seizure medications or surgery. There are several different ways by which the ketogenic diet helps in epilepsy management. Firstly, switching to ketones as an energy source for the brain increases the brain’s energy reserves, stabilising neurons and reducing the “excitability” of the synapses (the connections between brain cells), reducing the tendency for seizures. Interestingly, research suggests that some of the benefit of the diet may also come from its effect on the gut microbiota. With reduced intake of carbohydrates, there is less fuel available for bacteria to consume in the bowels, leading to changes in the types and amounts of bacteria in the gut. Bacteria in the gut are able to impact neurological functioning through the production of a number of different neuroactive molecules, including GABA and glutamate, which can affect brain functioning and shift the balance of neurons in the brain towards a lower likelihood of seizure. A recent study on mice found the ketogenic diet resulted in marked increases in specific bacteria including the Parabacteroides bacteria species and led to reduced seizure activity in epileptic mice.

Diabetes

Until the development of synthetic insulin in the 1920s, the ketogenic diet was routinely used for both type 1 and type 2 diabetes management. Numerous studies on the effects of ketogenic diets in diabetes management have found it to be an effective treatment strategy. In as little as 14 days on a ketogenic diet, patients experience improved insulin function, reduced blood glucose and cholesterol levels and even begin to lose excess weight. In longer term studies, these markers continue to improve with ongoing use of the ketogenic diet. Even with the use of insulin for diabetes management, ketogenic diets can improve the health outcomes and reduce medication requirements for those with diabetes.

Obesity and Weight Loss

The ketogenic diet is often touted as a weight loss aid, and certainly the evidence is there to back up these claims. High fat diets are typically more effective than other diets in the management of obesity in part because of their improved satiety – people on a ketogenic diet simply feel less hungry between meals, which helps with sticking to the diet. Consuming lower levels of carbohydrates reduces the output of the hormone ghrelin, which is the hormone responsible for making us feel hungry. There are also other ways the ketogenic diet can help with weight loss. A recent study found that the ketogenic diet, in combination with exercise, shifted skeletal muscles towards utilising more fat as fuel and resulted in improved insulin levels, even in already healthy, fit individuals. There is also a shift in the body towards increasing the breakdown of body fat for fuel, and reduced substrate available for the body to replace body fat stores, as this process requires glucose. Studies on obese patients have found that the ketogenic diet not only helps with reducing body weight but also cholesterol and even blood pressure.

There is, however, an important caveat to discuss when it comes to the supposed “miracle” weight loss people experience when they first begin this diet. Whilst the ketogenic diet is good for weight loss it is important to note that at least some of the very early weight loss experienced by people who start the ketogenic diet is actually loss of body water. A certain level of water is required for glycogen storage in muscles and other tissues. When we suddenly severely limit our carbohydrates intake, our body uses up/ empties our glycogen stores, which leads to a sudden reduction in water weight. This process is also why people experience a rapid increase in weight when initially moving away from a ketogenic diet. The sudden increase in body water when moving out of ketosis is often falsely believed to be a sudden regaining of lost body fat, and unfortunately can unnecessarily deter people from stepping away from the ketogenic diet when it is no longer serving them.

PCOS

PCOS (polycystic ovarian syndrome) is a common hormonal condition, affecting up to 20% of women of reproductive age. It’s a complex condition but involves the overproduction of androgens (“male” type hormones), increased body fat and insulin resistance, and can even lead to obesity and type 2 diabetes. Women with PCOS typically experience menstrual and fertility issues, and it can lead to depression and significantly affect quality of life. Studies examining the effects of diet on PCOS have found the ketogenic diet reduces the overproduction of androgens, leading to normalised hormonal function, improved insulin function and even lowering of depressive symptoms.

Mental Health

The ketogenic diet also generates interest with regards to the treatment of a range of mental health conditions, because of the effect of ketones on the brain. Research suggests ketogenic diets are neuroprotective, because of the way they change energy utilisation in the brain, which leads to improved cognitive performance and cerebral function. The positive mental health effects may also be due to the effect of ketosis on neurotransmitters. The ketogenic diet has been shown to increase levels of GABA (also known as gamma-aminobutyric acid), which is known for producing feelings of calmness.

Alzheimer’s Disease

It’s not surprising that the ketogenic diet has been used in the management of Alzheimer’s disease, which is sometimes referred to as “the diabetes of the brain”. Alzheimer’s is a complex and poorly understood condition, however one of the major pathophysiological processes that lead to symptom development is poor glucose metabolism in the brain, which leads to the development of plaques in brain tissue. The ketogenic diet may help to relieve this by providing an alternative fuel source to the brain in the form of ketones. Studies have found the ketogenic diet, in addition to being neuroprotective, also reduces the build up of amyloid on the brain.

IBS

Interestingly, the ketogenic diet may also be beneficial in managing IBS symptoms. Part of this is due to the reduction in carbohydrate intake and the effect this has on the microbiome. In IBS, there is often an imbalance of gut bacteria (known as dysbiosis) and/or an overgrowth, which can lead to excessive fermentation in the gut in response to eating carbohydrates. The reduction in carbohydrates reduces the food source available for bacteria to ferment, in turn reducing the number of bacteria present in the gut (and reducing their effect on our health, too).

Cancer

A growing body of evidence suggests that the ketogenic diet might even be a useful tool in the battle against cancer. One of the primary ways it has been proposed to be of benefit is through the phenomenon known as the Warburg effect. Cancer cells prefer to use glucose for energy and are less able to use ketones as a fuel source when glucose becomes unavailable. By reducing the availability of glucose for energy consumption, the ketogenic diet can “starve” the cancer cells, limiting the ability of tumours to proliferate and grow. So far researchers have demonstrated this effect of the diet on brain, breast, colon, endometrial and prostate cancers. However, it’s important to note that the ketogenic diet in itself is of course not going to be a cure for cancer, although with more research it may form one tool for the cancer treatment toolkit.

Cons and Contraindications

The ketogenic diet is not without its side effects, some of which can be significant. Common mild side effects include headache, diarrhoea, constipation, and insomnia. Long term, the ketogenic diet can lead to deficiencies in minerals such as zinc, calcium and selenium, as well as low vitamin D, so it is important to have appropriate supplementation whilst on this diet.

Another significant con of the ketogenic diet is its hormonal effect, particularly in women. The low levels of fibre in the diet impact not only our gut microbiota but also our hormone levels. Fibre is crucial for the excretion of excess hormones such as oestrogen. Without sufficient dietary fibre, oestrogen and other hormones that would normally have been excreted are reabsorbed in the gut and re-enter circulation in a process known as “enterohepatic recycling”. This leads to an increase in circulating oestrogen levels, which can wreak havoc on women with conditions exacerbated by hormonal changes, such as endometriosis, PMS, and even menopause. The low levels of complex carbohydrates can also trigger an increase in cortisol production, which can further exacerbate menopausal symptoms. In women, elevated oestrogen levels can also suppress thyroid hormone production. Our thyroid hormones are responsible for metabolism – suppressing them can lead to weight gain, decreased energy levels and low libido. So, although women may lose weight initially, the effects of ketosis on thyroid hormones and metabolism may end up leading to weight gain in the long term. In fact, the suppressing effects of the ketogenic diet on thyroid hormones are so marked that in some patients on the ketogenic diet for epilepsy, synthetic thyroid hormone replacement is required. These effects on thyroid hormones also mean that the ketogenic diet may not be recommended for those who already experience thyroid hormone issues.

The overall health of gut microbiome which is the ecosystem of bacteria and other species is a major consideration whenever a keto diet is implemented long term.  With a range of carbohydrates representing the main food source for healthy species, reducing nutrient rich carbohydrate foods can have significant implications on mental health, immune system and much more.

Whilst the ketogenic diet can have fantastic results in helping to manage certain conditions and can be used for short-medium term health strategies, it’s not without its limitations and risks. Because of this, it’s vital to speak with a professional before embarking on a ketogenic diet, to make sure you are set up for success with your health.  Naturopathic expertise can point you in the right direction and give you the tools required to support optimum short, medium and long-term health.  This way you know whether this kind of diet is appropriate and for how long it should be used in your unique situation.

References

Gupta, L., Khandelwal, D., Kalra, S., Gupta, P., Dutta, D., & Aggarwal, S. (2017). Ketogenic diet in endocrine disorders: Current perspectives. Journal of Postgraduate Medicine, 63(4), 242–251.

Kose, E., Guzel, O., Demir, K., & Arslan, N. (2017). Changes of thyroid hormonal status in patients receiving ketogenic diet due to intractable epilepsy. Journal of Pediatric Endocrinology and Metabolism.

Ludwig, D. S. (2020). The ketogenic diet: Evidence for optimism but high-quality research needed. The Journal of Nutrition, 150(6), 1354–1359.

Meira, I. D., Romao, T. T., do Prado, H. J. P., Kruger, L. T., Pires, M. E. P., & da Conceicao, P. O. (2019). Ketogenic diet and epilepsy: What we know so far. Frontiers in Neuroscience.

Miller, V. J., LaFountain, R. A., Barnhart, E., Sapper, T. S., Short, J., Arnold, W. D., Hyde, P. N., Crabtree, C. D., Kackley, M. L., Kraemer, W. J., Villamena, F. A., & Volek, J. S. (2020). A ketogenic diet combined with exercise alters mitochondrial function in human skeletal muscle while improving metabolic health. American Journal of Physiology.

Newman, T. (2019). Keto diet: New study unearths sex differences. https://www.medicalnewstoday.com/articles/324792

Olson, C. A., Vuong, H. E., Yano, J. M., Liang, Q. Y., Nusbaum, D. J., & Jsiao, E. Y. (2018). The gut microbiota mediates the anti-seizure effects of the ketogenic diet. Cell, 173(7), 1728–1741.

Paoli, A., Mancin, L., Giacona, M. C., Bianco, A., & Caprio, M. (2020). Effects of a ketogenic diet in overweight women with polycystic ovary syndrome. Journal of Translational Medicine, 18.

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Sadly, many smoothies are not the “golden child” of healthy meals that you have been led to believe and in fact can be quite disastrous to your health.

If I am honest, I often cringe when someone tells me that they have a smoothie for breakfast every day because I know from experience that it is unlikely that the recipe is optimal for health.

The health of a smoothie all depends on what ingredients are in the smoothie and most importantly what the measurements are of those particular ingredients.

So, why don’t we investigate the ingredients and measurements of a smoothie that can make it an unhealthy meal option.

Too Much Fruit: Don’t get me wrong, I love fruit for health.  Two pieces of fruit a day, eaten with a good fat or protein and spread over the day has wonderful health benefits.  Too much fruit however in one hit with inadequate protein and/or good fat can turn fruit from a superstar to a very low performer indeed.  It is critical that fruit is eaten in a certain way and spread over the day if you want to benefit from its health powers.  Why is this the case?  Fruit is a carbohydrate and has a high fructose content and this can have a huge impact on blood sugar levels.  If your smoothie is full of fruit and has minimal or no protein or good fat, then it is considered a high glycaemic load food.

What is the big deal about a high glycemic load meal?

So, even though your smoothie may be jam packed full of healthy ingredients, it can cause insulin levels to spike if the right blend or ratios of ingredients are not considered.

A simplified explanation is that high glycaemic means that food eaten moves from your gastrointestinal tract into your blood really quickly. The body hates big dumps of sugar as it is dangerous to the body.  Carbohydrates are sugar so large amounts of sugar enter your blood all at once. Your insulin then increases very quickly, and this is a major cause of becoming insulin resistant, not to mention the energy slumps that soon follows. So, remember that if you eat a large amount of carbohydrates during a meal or snack, blood sugar levels will rise, making insulin levels spike and then as a consequence your blood sugar levels drastically fall. This can leave you feeling hungry again quite shortly after, fatigued and sometimes anxious instead of feeling satisfied and energized which is how you should feel for several hours after a properly put together meal.

So, what is a properly put together smoothie? 

A healthy smoothie that doesn’t create big dumps of sugar in your blood stream and unhealthy insulin spikes must have a certain proportion of carbohydrates, protein, good fats, and liquid.  When done well, this produces a smoothie that has a low glycaemic load and where the body happily spreads the energy over a longer period of time.  This keeps you feeling full for longer, energetic, your mood is supported for better balance and your cognition will be better performing.

My recommendations for ingredient proportions are as follows:

Choose your leafy greens: always include a few handfuls of healthy greens such as baby spinach, lettuce, or kale.

Add your fruit: for your fruit, a maximum of ½ cup or approximately 2 tablespoons of frozen berries, mango, banana, or fruit of choice.   For those smoothie die-hards, frozen fruit is the only way to go for a thick, icy smoothie.

Decide on your protein:  Protein is a critical component of practically every structure and function of the human body and is needed to build and repair muscle & tissues, energy production, hormone production, liver detoxification and regulation of mood.

Protein powders are an easy choice here but so many are full of hidden sugars or artificial sweeteners so simple is best.  I use a basic practitioner brand brown rice protein powder which is free of excipients and have 2 scoops which is 40 grams.  Other protein options include whey protein, pea protein, 2 tablespoons of raw nut butter, chia seeds, flaxseed meal.

Adding protein to any high carbohydrate meal reduces the glycaemic response and this is very important for health.

Add a good fat: 2 tablespoons of good fat are another addition to a healthy smoothie.  My favourite is avocado, nut butter, freshly ground flaxseed and chia seeds or coconut milk as your liquid base.

Good fats also help reduce the glycaemic response of high carbohydrate meals and are not simply a source of energy for our bodies.  Fats are used as structural building blocks for our bodies and for vital processes, nourishing the skin & brain, delivering fat-soluble nutrients and help keep us feel satiated for longer meaning that we eat less.  They are also important for mental and cardiovascular health to name a few.

Choose your liquid base:  Add 200 ml of your preferred fluid.  I find that with all of the ingredient’s above, filtered water is a great option with no added calories however other options may include coconut water or unsweetened nut milks, rice milk, or oat milk.

Other nutrient additions: might include some chlorophyll, spirulina, maca, cocao powder, medicinal mushrooms, cinnamon, broccoli sprouts or wheatgrass to top up the antioxidant and nutrient power of your smoothie meal replacement.

Let us recap

Keep an eye on the amount of fruit and always combine your fruit with some leafy greens, protein, and good fat, strategically managing the portions of each to keep energy flowing and insulin spikes down.

There is no doubt that green smoothies are a wonderful way to get important nutrients and antioxidants into your day however a badly thought-out smoothie can be detrimental to health so make wise recipe decisions.

Please click here for some healthy smoothie recipe options and enjoy.   

Enjoy

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