Two Peas In A Podcast

The impact of coffee on exercise performance is related to caffeine’s impact on the CNS. It’s a stimulant meaning it enhances alertness, and also reduces our perception of fatigue and our perception of effort. So you feel like you’re not working as hard, and also feel less tired.

Those that are most likely to benefit from caffeine are those involved in team or intermittent sports so basketball, footy etc, endurance sports and high intensity, short duration sports.

How much do you need?

While research initially focused on high doses of caffeine, more recent research indicates that lower doses can provide similar performance benefits with less negative side effects. Around 1-3 mg caffeine per kg body weight are sufficient to improve performance (so for a 60kg athlete this equates to roughly 1-2 cups of coffee).

Timing is also important – coffee reaches peak concentrations 1hr post intake and will generally last for 3-4hrs. The ideal time to down your coffee is 30-45mins pre-training and often black is best if you’re likely to be sensitive to exercising on a tummy full of milk.

https://www.sportsdietitians.com.au/factsheets/supplements/caffeine/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867441/

Coffee and sleep

We all know the joys of caffeine in perking us up, but does it affect our sleep?

The stimulating effects of caffeine from coffee last 3–5 hours, and depending on individual differences, about half of the total caffeine you consume remains in your body after 5 hours. It’s no surprise that consuming coffee too close to bedtime can cause sleeping problems. Most studies suggest avoiding caffeine for 6 hours prior to bed.

The good news is that a switch to tea in these 6 hrs, including green tea which contains about a third of the caffeine as coffee, will be helpful due to the presence of amino acid L-theanine, which has relaxing and calming properties.

Coffee and waking!

Studies have shown that the ideal time to drink coffee is around 203hrs after waiting. This is because of our hormones.

As we wake up, a hormone called cortisol is at its highest. Cortisol is responsible for balancing our energy levels, blood pressure and how we respond to stress or danger.

So, drinking coffee when cortisol is already at its highest may not be giving you any additional energy. In fact, it may be making you feel more tired and stressed or anxious later in the day.

Science suggests waiting 2-3 hours after waking when cortisol is slowly declining to have your morning coffee for the most bang for your buck.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2257922/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684472/

Coffee naps

Some research suggests that combining caffeine with naps is more energising than caffeine or sleep alone. Enter the coffee nap. The theory is that if you drink coffee (or anything caffeinated) before sleeping for a short period, you can boost your energy levels by increasing your brain’s capacity to receive caffeine.

This is related to caffeine competing with adenosine for receptors in your brain.

Adenosine is an organic compound whose derivatives are important for energy processes in the body amongst other things. Adenosine circulation increases when we feel tired and the act of sleep brings these levels down. But coffee might give us a double whammy by blocking some of the adenosine being registered in our brain. This can make us feel even less tired when we wake.

Most of the research suggests the best way to take a coffee nap is to have some caffeine right before taking a 15–20 minute nap (and no more than 30mins).

https://pubmed.ncbi.nlm.nih.gov/9401427/

https://pubmed.ncbi.nlm.nih.gov/14652086/

Fun facts

Coffee is the world’s most valuable traded commodity next to petroleum.
Globally people consume about 2.25 billion cups of coffee every day.
Coffee beans are fruit pips and not beans.A coffee bean is the pip inside the bright red fruit often referred to as a the coffee cherry or coffee berry.
Millennials spend an average of $2008 oer year on coffee https://www.ngpf.org/blog/budgeting/question-of-the-day-how-much-do-millennials-spend-every-year-on-coffee/
Coffee grounds sprinkled on the ground around plants and the garden will stop snails and slugs from eating the plants.
Studies have found an association between regular moderate coffee consumption (2-4 cups per day) and a reduced risk of suicide. Go for less the 8 cups per day. https://pubmed.ncbi.nlm.nih.gov/23819683/ https://pubmed.ncbi.nlm.nih.gov/31254722/
Scientists have successfully turned ground coffee into biodiesel, so one day coffee may be fuelling your car
laws of physics have proven that coffee with milk cools about 20% slower than black coffee – due to the colour. viscosity and rate of heat radiation.
The Guinness World record holder for the “Oldest Cat Ever,” a 38-year-old cat named Creme Puff – drank coffee every morning her whole life.

Find and Fuel Your Fire Workshop

Tickets via Eventbrite

Getting a nutrition job is HARD!

The Dietetics Workforce Report 2018

There has been a 95% increase in dietetic grads over the last 7 years.
Grads in Vic ↑ from 65 to 127 per year from 2010 to 2016.
There is great concern that there is an oversupply of practitioners causing difficulties in new graduates finding positions and inhibiting movement for existing employees.
Many grads are still seeking work up to 12 mths post graduation.
In this time, grads are driven to volunteering – but not always meaningful
You are highly qualified. There is a significant need for your skills. We have an ageing population, chronic disease and dietitians provide such important prevention and management care
The report highlighted that Dietitians are highly qualified, however there are obvious gaps in business and professional skills in many courses.
Despite working in a clinical role 30% of dietitians had no clinical supervisor.

file:///C:/Users/laure/Downloads/Dietetics%20Workforce%20Report.pdf

Potential career pathways

Clinical dietetics

Popular!
When we’ve advertised for grad jobs there have been >100 applicants.
A quarter of organisations reported receiving >50 applicants for junior positions and advertisements were rare!
Hard to get grad jobs

Consultancy and private practice

Often don’t graduate with skills for business set up and challenging to dive into sole practitioner position without prior experience. Requires ++ mentoring and supervision.
Important for your own development but also for the reputation of the profession

Food service

Media and marketing

Don’t expect to get here straight away – need some experience behind you
Be responsible with what you put out into the world, social media etc. Don’t know what you don’t know.

Public health and nutrition

Eventually policy, health promotion, advocacy

Often start as a public health dietitian, community dietitian

Food industry

Consulting
Food analysis and product development, sensory evaluation
Food technology and science
Research

Nutrition research and education

Generally requires specialisation and smaller projects or honours, masters, PhD

https://www.deakin.edu.au/exercise-nutrition-sciences/careers-in-nutrition-and-dietetics

https://www.myhealthcareer.com.au/dietetics-career/

Our tips

Volunteer meaningfully
Upskill
Get a mentor – a meaningful one
Apply for everything – know your limits/hard passes
Apply well
Prepare for interviews
Seek feedback – and actually be prepared to take it

Our upcoming workshops

https://www.eventbrite.com/e/find-and-fuel-your-fire-student-early-dietitian-nutritionist-workshop-tickets-112762650122

Wed 26th Aug at 6pm

Sat 29th aug at 2pm

Topics to cover

How to land the job you want

Job application preparation
Interview (including phone/video interview) preparation
Setting yourself apart
What NOT to do!
Volunteer / work experience opportunities
Professional development

Finding your career niche / Progressing your career

Specialising
Quality projects opportunities in nutrition
Education opportunities in nutrition
Research opportunities in nutrition
Conference / presentation opportunities

Supervision and mentoring

Finding the right supervisor

Innovation in dietetics

Identifying gaps
Pitching your idea
Introduction to grants and proposals

Delivery

Online
2hr workshop
2 sessions – one evening, one weekend
‘Take home’ toolkit of resources

Fertility Nutrition

Important to highlight that conception is a miracle! And for many couples this is not an easy journey.
1 in 6 Australian couples are unable to become pregnant after a year of unprotected sex.
Nutrition and lifestyle can play a role and have a positive effect on fertility, in fact, it may improve fertility by up to 69%! https://pubmed.ncbi.nlm.nih.gov/17978119/

Female Fertility

A balanced diet is important, including a wide variety of fresh produce daily
Mediterranean-style diets have been associated with improved fertility
Which foods and nutrients are important to include?
- Folic acid has been shown to be important in female fertility, even with assisted reproduction. It is recommended to include a daily prenatal multivitamin supplement with folic acid (400-500 µg/day) from 12 weeks pre-conception and for the first 12 weeks of pregnancy to decrease the risk of neural tube defects. This supplementation is particularly important in early stages of pregnancy when many women may not yet know they are pregnant, so if you have the opportunity to forward plan it’s always a good idea.
- Vitamin B12 – animal products, vegans should consider supplementation under guidance from their doctor or dietitian
- Omega-3 fatty acids – EPA and DHA are important for fertility, conception and foetal development
- Antioxidants are important for fertility and conception. They help to keep both our sperm and eggs healthy! Include a wide variety of plant based products including vegetables, fruits, nuts, seeds and wholegrains to boost beneficial antioxidants like vitamins C, E, folate, beta-carotene and lutein. It’s beneficial to try to get these nutrients from food sources and always speak to your doctor or dietitian before considering a supplement (especially Vitamin E).
- Opt for complex, low GI, high fibre carbohydrates from whole grains, vegetables, nuts and seeds.
- Include plant-based proteins, reducing your reliance on animal proteins. Get creative with legumes and pulses, whole grains, nuts and seeds.
- Seafood may have a positive association with fertility. Couples eating more seafood were pregnant sooner than those rarely eating seafood.
- Choose full fat instead of low fat dairy
- Iodine may be important – get this from seafood, seaweed (nori), potatoes, cranberries, strawberries iodised salt and our bread supply which is fortified. This is a good one to start with folate in the lead up to conception, and is included in most prenatal vitamin blends.
- Your eating window may be important. Some studies suggest that shifting towards an earlier eating pattern, with a larger breakfast and lunch and a smaller evening meal with reduced late-night eating, may improve fertility.
Which foods and nutrients are worth eating less of?
- Swap out trans fats for mono- and omega 3 poly-unsaturated fats. This means less processed and fried foods, commercially-prepared baked products and margarines.
- Reduce processed meat intake. Replace these with lean meats, eggs, full cream dairy and plant alternatives such as legumes, tofu, nuts, seeds and grains.
- Reduce intake of refined carbohydrates found in sweet drinks, lollies, cakes, biscuits, desserts, and refined products like white bread, rice and cereals. Instead opt for the low GI options listed above.
- Energy drinks – it’s no surprise that they don’t do us any fertility favours.
- Reduce alcohol intake
- Don’t overdo the caffeine. Some studies have suggested that large intake (over 500 mg of caffeine daily) may take up to 9.5 months longer to get pregnant https://pubmed.ncbi.nlm.nih.gov/9054236/
Movement is important! Exercise has many benefits for your health, including increased fertility. A sedentary lifestyle has been associated with a higher risk of infertility and increasing movement has been found to reduce the risk of infertility.
Mindset and stress is another important factor. Managing stress and anxiety may be easier said than done, particularly when trying to conceive, so consider seeking professional support to optimising your mental wellbeing and therefore fertility.
Recommend tailored advice from a dietitian in the case of any medical conditions including PCOS, diabetes or GDM, if you’re in a small or larger body and have any concerns, and if taking any complementary or alternative therapies.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30311-8/fulltext

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(00)90458-6/fulltext

https://www.thelancet.com/series/preconception-health

https://www.health.harvard.edu/blog/fertility-and-diet-is-there-a-connection-2018053113949

https://www.eatright.org/health/pregnancy/fertility-and-reproduction/fertility-foods

https://www.healthline.com/nutrition/17-fertility-tips-to-get-pregnant#1.-Eat-Foods-That-Are-Rich-in-Antioxidants

https://pubmed.ncbi.nlm.nih.gov/22425198/

https://pubmed.ncbi.nlm.nih.gov/11880759/

https://pubmed.ncbi.nlm.nih.gov/11594714/

https://www.pennutrition.com/KnowledgePathway.aspx?kpid=1323&pqcatid=146&pqid=1313 – sweeteners

Male fertility

A balanced diet is important, including a wide variety of fresh produce daily
Mediterranean-style diets have been associated with improved fertility and semen quality in men
Which foods and nutrients are important to include?
- Omega-3 fatty acids – EPA and DHA are important for fertility
- Antioxidants are important for fertility and conception. They help to keep both our sperm and eggs healthy! Include a wide variety of plant based products including vegetables, fruits, nuts, seeds and wholegrains to boost beneficial antioxidants like vitamins C, E, folate, beta-carotene and lutein. It’s beneficial to try to get these nutrients from food sources and always speak to your doctor or dietitian before considering a supplement (especially Vitamin E).
Which foods and nutrients are worth eating less of?
- Swap out trans fats for mono- and omega 3 poly-unsaturated fats. This means less processed and fried foods, commercially-prepared baked products and margarines.
- Reduce processed meat intake. Replace these with lean meats, eggs, full cream dairy and plant alternatives such as legumes, tofu, nuts, seeds and grains.
- Reduce intake of refined carbohydrates found in sweet drinks, lollies, cakes, biscuits, desserts, and refined products like white bread, rice and cereals. Instead opt for the low GI options listed above.
- Energy drinks – it’s no surprise that they don’t do us any fertility favours.
Movement is important! Exercise has many benefits for your health, including increased fertility. A sedentary lifestyle has been associated with a higher risk of infertility and increasing movement has been found to reduce the risk of infertility.
Mindset and stress is another important factor. Managing stress and anxiety may be easier said than done, particularly when trying to conceive, so consider seeking professional support to optimising your mental wellbeing and therefore fertility.

Caffeine for fertility

You certainly don’t need to forego your daily coffee! If you’re trying to conceive it is a good idea to not overdo the caffeine. Some studies have suggested that large intake (over 500 mg of caffeine daily) may take up to 9.5 months longer to get pregnant https://pubmed.ncbi.nlm.nih.gov/9054236/

Decaf -3mg caffeine per tsp

1 Tsp of instant coffee – 60mg per tsp

Espresso shot (30-35ml) – 90-200mg

Percolated – 100mg per cup

Energy drinks – up to 110mg per serve

Cola – 40mg per serve

Black Tea – 50mg

Green tea – 30mg

Chocolate – 60g of milk or dark Choc has about 30-40mg

Pregnant women can safely have two instant coffees a day and two to three cups of tea OR one cap/latte

Pesticides fertility

Some studies suggest that higher consumption of produce prone to harbour higher pesticide residues may be associated with lower probabilities of pregnancy. Those looking to conceive may wish to consider where they source fruits and vegetables that may be more likely to hold residual pesticides, such as strawberries, spinach, capsicum, apples, pears, nectarines, peaches, cherries and grapes.

While this is important to be aware of, washing fresh produce well will help to reduce exposure. And it’s important to keep eating PLENTY of fresh produce as the nutritional benefits of this is very important to consider (as well as any possible pesticide risks). For many, this may be easy to achieve with non-organic produce that’s easier on the purse strings.

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2659557

During Pregnancy

Things to be aware of / avoid

Vit A – Beta carotene safe, avoid retinol/retinyl esters – upper limit for preformed vitamin A (retinyl esters and retinol from food and supplements) during pregnancy of 3000 µg /day (~10,000 IU). Be cautious of liver (≤1 serving/week), particularly in 1st trimester. Avoid any topical creams, ointments, serums which contain vitamin A or vitamin A derivatives.
Mercury in high doses may harm a developing baby’s brain. Limit large loads of mercury by:
- Limit orange roughy (sea perch) or catfish to 150 g/week and to have no other fish that week or
- Limit shark (flake) or billfish (swordfish/broadbill and marlin) to 150 g/two weeks and to have no other fish during those two weeks

Examples of low mercury fish that are high in omega-3 fats include sardines, mackerel, silver warehou, Atlantic salmon, canned salmon and tuna in oil and herrings. Pregnant women are advised to consume 300-450 g/week of lower mercury fish and seafood.

Food safety is important to minimise the risk of food-borne illness. Elevated progesterone levels in pregnancy suppressed the immune system, making women more prone to infection and illness. In particular, we want to reduce the risk of foodborne illnesses listeriosis, toxoplasmosis, campylobacteriosis and salmonellosis. The consequences of foodborne illness can be particularly devastating during pregnancy because both the woman and her foetus are at risk. Risk is very rare, especially in Australia (> 300,000 pregnancies per year and around seven cases of listeria during pregnancy).

Listeria risk:

raw or unpasteurized dairy products, fruit juices or cider
soft and semi-soft cheeses (e.g. Brie, Camembert, feta), blue-veined cheeses, gorgonzola, Hispanic-style fresh cheeses (e.g. queso blanco) unless they are cooked until steaming hot 74°C
refrigerated pâtés, meat spreads and smoked seafood
pre-packaged or prepared fruit/vegetable salads and raw sprouts
ready-to-eat deli meats and ready-prepared meals unless they are reheated until steaming hot (74°C)
raw or undercooked meat, poultry, seafood and eggs.

Toxoplasma, Campylobacter and Salmonella infection:

Unpasteurized milk products and juices.
Raw or undercooked meat, poultry, shellfish and eggs.
Rinse fresh fruits and vegetables thoroughly.
Avoid raw sprouts.
Follow safe food handling practices including washing hands and food preparation surfaces well.

Sushi – generally safe if the raw fish has been previously frozen, and is from a source that you trust. If raw fish hasn’t been previously frozen, it may contain small parasitic worms, called anisakis worms. And you don’t want day old rice – salmonella and listeria risk.

Alcohol – no safe level and the recommendation is to avoid alcohol during pregnancy
Avoid excessive flaxseed (linseed) intake – adverse events in rats
Artificial sweeteners – most common sweeteners in Aus – aspartame, stevia, sucralose, sorbitol, mannitol, isomalt, xylitol have been approved for use during pregnancy and lactation

https://www.pennutrition.com/KnowledgePathway.aspx?kpid=3043&tkid=22118&secid=3104#1

https://www.health.gov.au/resources/collections/pregnancy-care-guidelines-and-related-documents

https://www.health.gov.au/sites/default/files/lifestyle-considerations_0.pdf

When it comes to dieting everyone is always looking for a quick fix.

Effectiveness of diets long term

Interesting study https://www.bmj.com/content/bmj/369/bmj.m696.full.pdf

It looked at “Comparison of dietary macronutrient patterns of 14 popular named dietary programmes for weight and cardiovascular risk factor reduction in adults: systematic review and network meta-analysis of randomised trials”
Randomised trials that enrolled adults (≥18 years) who were overweight (body mass index 25-29) or obese (≥30) to a popular named diet or an alternative diet.
Outcome measures included change in body weight, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, BP (systolic blood pressure & diastolic blood pressure), and CRP at 6 and 12 month follow-up.
121 trials made the cut (21,942 patients) – huge study
Dietary intervention group assessed based on macro breakdown were:
- Low carb (e.g. Atkins, south beach, zone)
- Moderate marcos (e.g. Biggest Loser, DASH, Jenny Craig, Mediterranean, Portfolio, Slimming World, Volumetrics, Weight Watchers)
- Low fat (Ornish, Rosemary Conley)
Control group
- Control diets included: maintain usual dietary habits, dietary advice (eg, received brochures, dietary materials including dietary guidelines, or consultation with a professional dietitian by email or telephone), and low fat diet (≤30% fat with or without advice about lowering calories).
Results:
- Positive weight loss improvements at the 12 month follow-up diminished.
- Improvements in cardiovascular risk factors largely disappeared except for Mediterranean diet for LDL reduction
- Differences between diets are, however, generally trivial to small, implying that people can choose the diet they prefer from among many of the available diets to adhere to what works best for them.
Bottomline: no matter if you like low carb, high carb, low fat, etc… diet’s are not effective in reducing weight and keeping it off.

Other large scale reviews confirm that diets simply don’t work

Grade A evidence – NHMRC Clinical Practice Guidelines For The Management Of Overweight And Obesity In Adults, Adolescents And Children In Australia

Weight loss following lifestyle intervention is maximal at 6–12 months. Regardless of the degree of initial weight loss, most weight is regained within a 2-year period and by 5 years the majority of people are at their pre-intervention body weight.
Our suggestion: The intervention should never stop!

Grade A evidence

Modest weight loss improved CVD, T2DM risk factors and grade B evidence for sleep apnoea, joint issues, graed C for musculoskeletal problems, GI and urinary, self esteem, depression and QOL
For adults who are overweight or obese, strongly recommend lifestyle change—including reduced energy intake, increased physical activity and measures to support behavioural change.
6 For adults who achieve initial weight loss, strongly recommend the adoption of specific strategies, appropriate to their individual situation, to minimise weight regain
NHMRC Guidelines file:///C:/Users/Loz/Downloads/n57-obesity-guidelines-%20(1).pdf

Also Scientific research that ideal BMI for longevity is 25-30kg/m2

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855514/

https://www.bbmt.org/article/S1083-8791(05)01413-8/abstract

Why don’t diets work?

A combination of physiology and psychology

For the physiology behind why it doesn’t work Listen to Episode 18

Interesting paper here https://www.ncbi.nlm.nih.gov/pubmed/23911805?dopt=Abstract

Dieting cycle

Biology: (listen back to ep18)

Short term:
- Anyone who is below their set point (too thin for them) will experience many physiological symptoms, similar to that of starvation.
- What is important to know is that it doesn’t matter what weight you start at, but rather what is normal for you.
- Experience feeling of extreme hunger, metabolism suppressed so your body burns less energy, muscles use less energy during PA, feel cold, lethargic and obsessive over food – normal sx’s of your brain saying ‘alarm bells, food is needed’
- Biological pressure to restore body weight gets stronger as weight loss increases. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/pdf/nihms904015.pdf
Long term:
- Some people will be heavier than when they started and others will develop disordered eating patterns

Psychological impact of dieting/weight stigma

Disordered eating patterns -greater emotional eating, uncontrolled eating, and loss-of-control eating
Body image and self esteem concerns
Psychological stress
Relationship breakdown
Increased anxiety and depression

Summary

Weight is not tied to health and health looks different to everyone
Lifestyle habits predict health better than weight alone
If a ‘diet’ has a start and an end point – it’s unlikely to work.
There are some factors we don’t think of when it comes to health, e.g poverty, loneliness, hormones, low levels of physical activity.
So much energy is wasted on trying to change weight, when we should focus on making other health improvements, e.g. exercise goal – start somewhere e.g. walking and progress, improved relationships with friends and loved ones, cook more
https://www.jabfm.org/content/25/1/9.full
Willpower as a finite resource

What you can actually do

Reduce decision fatigue
Do it for YOU – explore your deep reasons why. We do this quite a lot with our clients. It may present as ‘the wedding’ or ‘reunion’ or to ‘feel better in my jeans’ or ‘fit into that dress’ but why is that actually important to you? Will it impact your self efficacy?
Use positivity. Research demonstrates that the feeling of success is more likely to drive positive change than actually achieving your goal
Emotions create habits
Micro goals – e.g change ‘exercise more’ to 2 squats per day, change ‘eat more veg’ to eat 1 carrot every 2 days. Can do more if you want, but you don’t have to. Beyond that is extra credit!
Anchor your desired activities to things you already do, e.g. brushing teeth or showering.

Common cancer nutrition myths

Sugar feeds cancer

More info here

Juicing

No evidence to support it’s use
Can lead to deficiency in valuable nutrients, weight loss, protein energy malnutrition
Antioxidant load can be potentially detrimental during radiotherapy and certain chemotherapy regimens.
More information here.

Alkaline diet

More info here

Organic

Studies on the foods themselves in terms of nutritional content, levels of chemicals and resistant bacteria
Studies on the health of humans long term
When we look at organic vs non-organic there may be slightly higher concentrations of antioxidants in organic produce. This is only in general, as organic milk has been found to have lower mineral content, and varies depending on the source.
When we look at chemicals and pesticide residues, organic produce may reduce exposure to these but important to note that the levels of toxins in non-organic produce is generally well below safe limits
When we look at health overall, in particular long term health of individuals that eat organic vs non organic produce, the benefits are far less clear.
No difference in cancer risk (studies of >600,000 women)
Huge systematic reviews show no difference
Some studies that report a difference need to be careful of other confounding factors. If we think about the profile of someone who may eat organic – they have chosen to and have the means to do so. In general,this often means they are more likely to be of a higher SES/income, better living environments, higher education level, health conscious therefore choose more fresh produce overall, get regular health check ups and screen for chronic diseases. It’s really difficult to attribute health benefits to the organic produce when there’s a whole bunch of other health-promoting behaviours, environmental and lifestyle factors contributing.
Bottom line: if you’ve got the means and it’s a priority for you – by all means! If you don’t – just keep aiming for your 5 serves of veggies and wash them well.

Soy

Legume – soybeans or edamame – eaten whole or processed in numerous ways – fermented to produce tofu, tempeh, miso, natto.
Rich – rich in phytooestrogen ‘Isoflavens – which act like a weak oestrogen in the body.
Since many breast cancers need oestrogen to grow, it would stand to reason that soy could increase breast cancer risk. However, this isn’t the case in most studies.
Most studies linking soy consumption to an increased risk of breast and other forms of cancer are
done in laboratory animals. But because humans metabolize soy differently than rodents, these findings might not apply to people.
Most observational studies indicate that consumption of soy products may reduce the risk of hormonally driven cancers such as breast, prostate, or endometrial (lining of the uterus), and there is some evidence it may lower the risk of certain other cancers. This might be because the isoflavones can actually block the more potent natural oestrogens in the blood.
Exposure early in life is beneficial and a change in soy intake in either direction, may be responsible for change in risk
Additionally, soy has been linked to a longer lifespan after breast cancer diagnosis.
In a review of five long-term studies, women who ate soy after diagnosis were 21% less likely to have a recurrence of cancer and 15% less likely to die than women who avoided soy.

Dairy

Dairy has been associated with reduced risk of colorectal cancer, but an increased risk of prostate cancer.
Individualised advised, tailored to you, is key

Fasting

ESPEN Nutrition guidelines

Fasting during cancer treatment

Anti-cancer diets

There is no diet or food that has been proven to prevent or cure cancer

ESPEN Nutrition guidelines

Other resources

https://www.wcrf-uk.org/uk/recipes/diet-cancer-myths-debunked

http://www.espen.info/wp/wordpress/wp-content/uploads/2016/11/ESPEN-cancer-guidelines-2016-final-published.pdf

Keep a routine

Stick to a schedule. If you used to have a lunch break at 12:30, try to do the same. Factor in snack and tea breaks as well!
And don’t forget to drink
Position yourself somewhere that’s hard to get to the kitchen!

Check in with yourself.

There are so many reasons we eat beyond hunger and nutrients
Why are you heading to the cupboard or fridge? Bored, procrastinating, stressed, emotions. Suss this out.
Won’t happen every time. But doing it sometimes might help reveal with honesty some patterns around your eating behaviours.

Strategies:

Hunger fullness scale
10 minute challenge
Put a wedge in
During the meal – put your knife and fork down.
Speed bump

Eat mindfully

We can often find ourselves eating on autopilot, munching into a meal while our attention is on our screens,to-do lists, multi-tasking or wandering around the kitchen or house.
Give yourself an opportunity to eat without distraction
Serve your food for yourself how you would serve it to a special someone.
Serve how much you want – rather than eating vita weats or crackers fresh out the packet, serve the 4, 10, however many you want on a plate! Prepare it.
Sit down. Not at your desk. Grab a knife and fork or a drink.
Switch off your devices, sit down uninterrupted.
Give yourself the time and space to savour your eating experience and feel truly satisfied.

Respect your food and yourself.

Just don’t buy it!

If you struggle to stop at 1 or 2 tim tams and just end up feeling crap about it, don’t buy them!
If you were trying to quit smoking would you have packets of cigarettes in the cupboard and fridge, in your desk drawer?
Don’t dangle the carrot, it’s just cruel to yourself
Nice vs kind
Mindful eating starts well before you eat.
Don’t shop hungry
Review your goals – what you really want vs the quick high
Check in at the shelves too!
Research has shown that visual exposure to high calorie foods stimulates the striatum, a part of your brain that modulates impulse control, which may lead to increased cravings and overeating.
Deprivation is not the answer. It is ineffective for long term weight loss and incredibly damaging to our relationship with food and our bodies.

Creative cooking!

If you were fortunate enough to bulk purchase tinned tomatoes, now’s your time to shine
Home cooking vs take away = 20% fewer calories for the exact same meal
Study of over 11000 ppl found that those who ate home cooked meals more than 5 x per week and better body comp (25% less likely to have excess body fat) and ate more veg and fruit.

Combat boredom

Put a wedge in first: Walk to the letterbox, paint your nails, pat the dog, do 10 pushups…BEFORE you head to the kitchen.
Consider why you’re bored on a larger scale.

Online course, puzzle, book, create something (number paintings, ikea furniture), plants or home garden
Our next episode we’ll be talking all about using your time to fuel your fire

We found a really unethical study that blew our mind! 16 years on from Supersize me, actual science is still discovering the impact of ultra-processed food.

Episode Notes

Tim Spector experiment

https://theconversation.com/your-gut-bacteria-dont-like-junk-food-even-if-you-do-41564

Tim Spector, professor of genetic epidemiology at King’s College London, enlisted his son Tom, a genetics student at University, to undergo an experiment where he lived on McDonalds food for ten days.

Supersize me

Spurlock ate at McDonald’s three times per day – used himself as a guinea pig (n=1) for 30 days.
Before starting the experiment he was assessed by doctors who confirmed he was in excellent health.
He did minimal exercise and limited his steps to 5,000 per day to mimic the lifestyle of many Americans who don’t move much and eat fast food regularly.
Average of 20.9MJ (5,000 kcal) (the equivalent of 9.26 Big Macs) per day during the experiment.
2.5 x the recommended caloric intake of average sized male
gained 11.1kg (24 lb) – 13% increase in weight
Increased his cholesterol
Heart palpitations experienced
Mood swings, sexual dysfunction, lethargy, fat accumulation in his liver.
It took him 14 months to lose all the weight gained

Ultraprocessed Food

Minimally processedLightly processed Heavily processedUltra-processedpre-cut and peeled pumpkin, potatoes and other veges, bagged salad leaves, bagged spinach, sliced vegetables, and unsalted, roasted nuts

Corn

Apple

Canned, dried or frozen such as dried fruit, canned legumes/fish, cheese, pasta, frozen veg, pasteurized milk / yoghurt.

Recognisable ingredients

Make foods available out of season.

Canned corn

Tinned apples

Food not in its original form or not naturally occurring, eg cereals, muesli bars, deli meats, oils, sugar and flours.

Tortilla chips

Apple juice

Considered ‘junk food’ eg chips biscuits, chocolates, sweets, nuggets, energy bars, and carbonated and sugared sweet drinks.

Doritos

Apple pie

Other things that might be damaging your gut health

Smoking

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3597605/

Artificial and naturally intense sweeteners

Saccharin, sucralose, stevia extracts shift the populations of gut microbiota.

Several polyols (fermentable carbohydrates), including isomalt and maltitol, may increase bifidobacteria numbers in healthy subjects, as these polyols may have prebiotic actions.

Large scale human studies are needed

https://academic.oup.com/advances/article/10/suppl_1/S31/5307224

We also know that in animal studies, when exposed to the artificial sweeteners, this saw a reduction in beneficial bacteria in the gut

https://www.ncbi.nlm.nih.gov/pubmed/25231862

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5464538/

They can also give us a preference for a sweeter palate, meaning we crave or feel like sweeter foods..

Exercise (lack of)

Recent studies suggest that physical activity may also alter the gut bacteria, improving gut health.
Higher fitness levels have been associated with a greater abundance of butyrate, a short-chain fatty acid that’s produced by fermentation of CHO’s in the lower GI tract, helps to keep the lining of our gut healthy and is also important for overall health.
One study found that professional rugby players had a more diverse gut flora and twice the number of bacterial families, compared to the control groups matched for body size, age and gender

https://www.ncbi.nlm.nih.gov/pubmed/25021423

https://www.hindawi.com/journals/omcl/2017/3831972/

https://www.ncbi.nlm.nih.gov/pubmed/25825908

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0125889

Alcohol

https://www.ncbi.nlm.nih.gov/pubmed/22552027

20 days
each individual consumed 272 ml of red wine OR de-alcoholized red wine or 100 ml of gin each day
Gin decreased the number of beneficial gut bacteria,
Red wine increased the abundance of bacteria known to promote gut health and decreased the number of harmful gut bacteria like Clostridium.
The beneficial effect of moderate red wine consumption on gut bacteria appears to be due to its polyphenol content.
Polyphenols are plant compounds that escape digestion and are broken down by gut bacteria. They may also help reduce blood pressure and improve cholesterol

What to focus on

Prebiotic Fibre

Chicory Root
Jerusalem artichoke
Garlic
Onion
Leek
Asparagus
Less ripe bananas
Barley
Oats
Apples
Flaxseeds
Edamame

Dietitian

Tertiary qualification in nutrition and dietetics recognised by national authorities.
Dietitians apply the science of nutrition to the feeding and education of groups of people and individuals in health and disease
Dietitians are also qualified to provide evidence based nutrition services to individual dietary counselling, medical nutrition therapy, group dietary therapy, food service management, public health nutrition, policy and research, food industry and community health.
A dietitian has undertaken a course of study that included substantial theory and supervised and assessed professional practice in clinical nutrition, medical nutrition therapy and food service management.
APDs work in hospitals and private practice, government, research and teaching, public health and community nutrition, the food and medical nutrition industries, and nutrition marketing and communications.
All APDs are automatically able to use the AN credential, because as part of their qualification in human nutrition, an APD has undertaken a course of study that has included supervised and assessed professional practice in public health nutrition, medical nutrition therapy and food service management.
Accredited Practising Dietitian is the only credential recognised by the Australian Government, Medicare, the Department of Veterans Affairs and most private health funds as the quality standard for nutrition and dietetics services in Australia. APDs are committed to the Dietitians Association of Australia Code of Professional Conduct, continuing professional development and providing quality services. A register of all current APDs can be found on the DAA website.
To maintain APD status, nutrition and dietetic professionals are required to undertake a specified level of continuing education and professional development to ensure currency of practice. APD status is reviewed annually by DAA.

https://daa.asn.au/what-dietitans-do/dietitian-or-nutritionist/

Nutritionist

May be tertiary qualified, but also may not be!
It’s important to note that the term ‘nutritionist’ is not regulated, therefore, this title may be used by dietitians, nutrition scientists and nutrition graduates – and also those with very limited qualifications in nutrition.
The Nutrition Society of Australia (NSA) has developed a voluntary Register of Nutritionists in Australia to help determine the level of training someone has undertaken.
These Nutritionists may work in a number of other roles, including research, nutrition consultants and advisors, public health and health promotion officers, community development officers, quality and nutrition coordinators, food technologists, media spokespeople and more.
APD = AN but AN does not = APD. ANs not qualified to provide medical nutrition therapy which includes individual and group dietary interventions.
Any responsible ‘nutritionist’ will not be allowed to provide individualised dietary advice for any underlying medical condition – from diabetes to high cholesterol to IBS.
There are currently no Medicare health fund rebates for clients of Nutritionists, and there is only limited private health insurance fund rebates for Nutritionists with some funds.

https://www.nutritionaustralia.org/national/resource/nutritionist-or-dietitian

Naturopath

Naturopathy takes a holistic approach to wellness.
Interventions – see below

Source: https://www.researchgate.net/publication/331789476_An_evidence_based_overview_of_naturopathic_practice_in_Australia

A professional naturopath is someone who has completed, at a minimum, an Advanced Diploma in either Naturopathy or Health Science, is registered with a professional body and is insured appropriately.

Aus gov warnings:

Naturopathy is not a treatment for specific illness or disease. Naturopathy is a complementary therapy in that it may be used alongside other medical and therapeutic techniques. Always be guided by your doctor or specialist before using naturopathy for any serious or chronic illness. Treat as suspect any practitioner who advises you to abandon your conventional medical treatment.

Regulation = self regulation only – voluntary and not governed

https://www.nhaa.org.au/mediareleases/be-informed/regulation-of-practitioners

https://www.abc.net.au/news/2010-10-21/unregulated_naturopaths_putting_lives_at_risk/40276

Whilst developments such as the Code of Conduct for Unregistered Practitioners certainly help, they do not replace proper regulation of major professions.

End of insurance subsidies in 2017 due to lack of evidence to support efficacy

https://sciencebasedmedicine.org/australia-ends-insurance-subsidies-for-naturopathy-homeopathy-and-more/

Impact

https://www.researchgate.net/publication/331789476_An_evidence_based_overview_of_naturopathic_practice_in_Australia

https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4839.0~2016-17~Main%20Features~General%20practitioners~2

https://www.racgp.org.au/download/Documents/Publications/Health-of-the-Nation-2018-Report.pdf

https://www.abc.net.au/news/2010-10-21/unregulated_naturopaths_putting_lives_at_risk/40276

https://www.researchgate.net/publication/331789476_An_evidence_based_overview_of_naturopathic_practice_in_Australia

https://www.ncbi.nlm.nih.gov/pubmed/30785315

What an influencer does

Research from the University of Glasgow found that almost 90% of social media influencers are sharing inaccurate and potentially harmful nutrition and weight loss advice.

https://www.medscape.com/viewarticle/912360

Dietitians

Dr Nicole Kiss – follow on Twitter @NicoleKiss

Dr Tim Crowe – follow on Twitter @CroweTim, listen to podcast Thinking Nutrition

Hayley Blieden – https://austsuperfoods.com.au/

Nutritionists

Melissa Eaton – follow on Instagram @eatonbalanced

Jules Tellidis – follow on Instagram @wholesomehungry

Naturopaths

Abby Dolphin – https://olivewellnessinstitute.org/admember/abby-dolphin/

Bianca Potenta – https://hwstudio.com.au/

Beyond Blue – 1 in 7 Australians will experience depression in their lifetime and 1 in 4 will experience anxiety.

Mood disorders are something we can’t ignore.

One area that’s gained a lot of traction is the way food, dietary patterns, dietary quality and lifestyle are having a profound impact on our mood and mental health.

Usually pharmacotherapy (medication) and psychotherapy are used as firstline treatment of depression, however remission can often be challenging to achieve.This has prompted the need for further strategies in relation to diet and lifestyle in the treatment of depression. What we eat can have an impact on our brain chemistry and brain health.

Whilst there is no single food that can help improve depression, we are discovering that what and how we eat as a whole can have an impact.

We often consider the brain for it’s psychology and forget it’s biology. The brain is an organ. Incredibly complex one. We need to care for it like we do any other organ. A heart that is not cared for will show signs of damage eg arrhythmias, blood pressure issues, poor exercise tolerance A brain that is not cared for will also show symptoms. The trouble is these symptoms are those related to brain function – mood, personality, decision making and processing and memory. These are biological symptoms of a biological organ. It’s not just psychology. Often these type of symptoms are brushed off. They’re easier to ignore than palpitations or tightness in the chest or wheezy breathing. The reality is that our brain cells are made up of essential fatty acids that we can only get from our diet. Our neurotransmitters require essential nutrients that you can only get from your diet We can look after our brains and take a preventative nutrition and lifestyle approach just as we would look after our heart and lungs

Lancet commission 2017

https://www.thelancet.com/commissions/dementia2017

Food, hormones and neurotransmitters

Carbohydrates – when we eat CHO’s this triggers a release of insulin to help transport the CHO’s into the cells to be used as energy. This insulin trigger also stimulates the release of tryptophan, which is an AA which is a precursor for serotonin (which is associated with improved mood and feeling happy). Low GI carbs are seen to be the most beneficial whereas high GI carbs will give an immediate but temporary effect in regard to serotinin release.
Protein – There are specific amino acids can affect our brain health as a number of neurotransmitters are made up of AA’s.In particular the neurotransmitter (messenger) dopamine is produced from the AA tyrosine and as mentioned above serotonin is made from the tryptophan. A lack of these particular AA’s, will result in downregulation of these neurotransmitters, which can precipitate lowered mood.
- There is a condition called phenylketonuria the buildup of AA can also result in brain damage and mental retardation. e.g the excessive buildup of phenylalanine can cause brain damage and mental retardation.
Omega-3 fatty acids – The brain is one of our organs that contains the most amount of fat in the body (~60% fat). There have been studies which support that sufficient intake of long chain PUFAs (particularly DHA), may reduce the risk of depression. DHA is also essential for brain growth and development in children.
Vitamins
- B12 – may be beneficial in the context of reducing dementia risk and assist with cognitive function in older adults. Sources include: beef, liver, chicken, fish, shellfish, dairy, eggs
- Folate – Researchers have found links between folate deficiency and depression. Still unclear if the poor nutrition, relating to the depression, causes the folate deficiency or the folate deficiency results in depressive symptoms. Sources include leafy greens (spinach, broccoli, peas, lentils, legumes)
- Vit D – ensuring levels are therapeutic has been found to have a positive benefit in the context of depression. In cold/dark countries where Vit D deficiency is more prevalent, as can be depression. Sources include eggs, oily fish and sunshine!
Minerals:
- Iron – Important in supplying oxygen to our brain and for the production of neurotransmitters and myelin (lipid rich layer/sheath that surrounds our nerves). Sources include red meat, fish, legumes, green leafys
- Lithium – well known in the mental health field and is present in many medications used for depression, bipolar, etc…
- Iodine – through the thyroid hormone supports energy metabolism in the cells of our brain. Iodine is particularly important during pregnancy as deficiency may result in cerebral dysfunction.
- Zinc – antioxidant which can protect brain cells and can also improve the uptake of antidepressant medication, sources include: meat, poultry, legumes, pulses, nuts, seeds

Dietary patterns:

SMILES trial (undertaken locally in Melbourne & Victoria)- An interventional study which used dietary improvements as a treatment modality for patients with pre-existing depression. The dietary intervention group received 7 sessions with a clinical dietitian for personalised nutrition advice and counselling. Also followed a modified med type diet.The control group received an interesting intervention known as ‘befriending’ or ‘social support’ which included trained professionals discussing topics of interest e.g. such news, music or sport. For subjects who were difficult to engage, cards or board games, were used as a tool to keep them engaged. The results found that participants in the dietary intervention group had a greater reduction in depressive symptoms over the 12 week period ( in comparison to the social support group). At the end of the trial, ~33% of the subjects in the dietary support group were considered in remission of their depression, in comparison to 8% in the social support group.
Another interesting point was that there wasn’t a change in weight or BMI – dietary quality may be more valuable than weight loss.
Economic evaluation – cost saving in using this treatment approach
In summary those who made the greatest change to their diet saw the greatest benefit in regard to their depression
This also highlights that we need improved pathways and access to dietetic care in the treatment of depression.
Depression in children and adolescents is hugely important because the average age of onset of anxiety and depression is in this group
Relationship Between Diet and Mental Health in Children and Adolescents: A Systematic Review – Showed a relationship between diet which was high in foods containing refined CHO’s, saturated fat and processed foods, and poorer mental health in both children and adolescents. We know the onset of anxiety and depression is coming up at a much younger age, therefore early intervention strategies such as improving dietary quality and a population level may be beneficial.
The impact of whole-of-diet interventions on depression and anxiety: a systematic review of randomised controlled trials – This paper reviewed the findings from RCT to assess the impact of dietary interventions (whole-of-diet approach) on both depression and anxiety. The good news is that many of the papers concluded that dietary interventions were effective in the management of depression, and at times was comparable to medication and psychotherapy. The evidence was less strong regarding anxiety management.

MedDiet

Rich in fruits, veg, nuts, seeds, legumes, fish, lean poultry, EVOO
Preference for selecting wholefoods and low in processed foods.
Eat in a social environment – promotes social engagement
Long-term treatment with the Mediterranean diet on depression for patients may be beneficial.
Anti Inflammatory foods seen as in the MedDiet – reduction in proinflammatory cytokines which can assist with neurotransmitter development/uptake.

Western Diet

Study of 110 healthy 18-22 year olds were randomised to either a Western diet for a week or their usual diet. Those on the Western diet (toastie and m/shake or waffles for breakfast and fast food meal for lunch and dinner)

showed impairments in learning and memory and also reduced appetite control.

https://royalsocietypublishing.org/doi/10.1098/rsos.191338

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056912/

Gut microbiome – bidirectional communication between gut and brain

Our gut bacteria can have a profound impact on our mood and mental health – many animal and human studies have looked into this.
Animal data + human data – bacteria important for physical and mental health. Diet is the most important component to affect the gut microbiota.
Gut microbiota interact with all cells in the body and also have an impact on our genetic profile
Prebiotic fibres to feed our gut bacteria – when gut bacteria and thriving this is likely to have a positive impact on our mood and mental health – diversity of fibre (diversity is a marker of food gut health). When our bacteria ferment dietary fibre they also produce neurotransmitters – more than 90% of serotonin is produced in the gut (still unsure if that makes it to the brain across the blood brain barrier).
Probiotics – Probiotic supplementation showed a significant reduction in depression – particularly Lactobacillus and Bifidobacterium. Include probiotic rich foods – kombucha, kimchi, yoghurt, kefir.
Polyphenols can also help increase the growth of our gut microbiota.
Poly + monounsaturated fats – from fish, nuts, EVOO
Listen in to episode 3 but also stay tuned for an update on gut health in episodes coming soon!

Other mood boosting strategies

Covered nutrition in depth.
Exercise has been linked to improved mental health
Eating with others – mediterraneans do this well
Sleep – aim for 7-8 hours per night
Meditation has been shown to help build more brain cells = better long term brain health. Exercise does the same. Improved connectivity.
Novelty – learning a new skill, language, dance, route home from work, meeting new people, changing hair colour or clothes style – may increase plasticity of the hippocampus (the ability to create new connections between neurons).

Upgrade Your Health Guide

http://oncorenutrition.com/eat-our-words/

Food and Mood: Improving Mental Health Through Diet and Nutrition

– link in shown notes to online course for anyone interested in learning more or using diet as a tool to support good mental health.

Coronavirus

The WHO COVID-19 Situation Report as of March 5 reports 95,333 confirmed cases globally, including 3,282 deaths

Our immune systems declines by about 2-3% a year from our 20s, which is why older people are more susceptible to infections

Mortality rates from diseases like pneumonia and bronchitis are three times higher among elderly people.

Our top 10 tips to optimise your immune system

Spice up your life.

Use of garlic (allicin may boost our immune system), onions, ginger, turmeric, cayenne pepper, chilli, cinnamon, cloves, star anise, ginger, cumin in your cooking will boost your antioxidant intake. They may also assist with natural detoxification processes and may possess antimicrobial properties.

Get plenty of polyphenols. These can help in numerous ways to activate our immune system and initiate immune responses.

Drink green or black tea, red wine
Use herbs in cooking (Peppermint, oregano, sage, rosemary, thyme, basil, lemon verbena, parsley, marjoram), dark choc, berries (the darker the colour the better)
Add nuts and seeds to salad, brekky, snacks
Cook with EVOO and enjoy olives
Eat plenty of fresh fruit + veg

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5925142/pdf/JIR2018-1264074.pdf

Sweet dreams

7-9hrs sleep can boost the spread of T-cells which fight infection in the body. One study also showed that just one night of 4 hours’ sleep depleted the body’s natural killer cells by 70%.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256323/

https://www.ncbi.nlm.nih.gov/pubmed/8621064

Remember that you’re sweet enough

Eating or drinking high GI carbohydrates and simple sugars can reduce our immune response. Studies have suggested that after a dose of sugar, certain white blood cells called neutrophils were far less aggressive in attacking bacteria. Some viral studies suggest sugar may help!

The body, and immune system needs glucose – we;re best off getting it from complex, slow release or low GI CHOs so we don’t have spikes in BGL. And if you’re keen to indulge, you might be better off doing so after exercise, so the uptake goes to the liver and muscles to replenish what you’ve used.

https://academic.oup.com/ajcn/article-abstract/26/11/1180/4732762

https://www.theatlantic.com/science/archive/2016/09/glucose-inflammation/498965/

Get your vitamins and minerals – but don’t jump for a pill.

Various micronutrients are essential for immunocompetence, particularly vitamins A, C, D, E, B2 (riboflavin), B6 (poultry, seeds, fish, chickpeas), and B12, folic acid, iron, selenium, and zinc.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6212925/

https://www.frontiersin.org/articles/10.3389/fimmu.2018.03160/full

Include brightly coloured fruits and vegetables, including berries, citrus fruits, kiwi, apples, red grapes, kale, onions, spinach, sweet potatoes, and carrots.

Omega-3 fats – nuts, seeds, oily fish (and shellfish for Zn), avo

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6834330/

Take care of your gut

Our intestines encounter more antigens than any other part of the body
As many pathogens enter the body via the intestinal mucosa, it is vital the gut-associated lymphoid tissues (GALT) can provide effective immune responses when necessary.
GALT represents almost 70% of the entire immune system and about 80% of plasma cells (mainly IgA-bearing cells) reside in GALT.
Probiotics, prebiotics and gut health – Imbalances in the gut microbiota may dysregulate immune responses.
Listen in to our next few weeks where we’re planning an extra special gut loving episode

https://www.nature.com/articles/nri3738

https://www.immunology.org/public-information/bitesized-immunology/organs-and-tissues/immunity-in-the-gut

Stress less Easier said than done if you’re running out of toilet paper!

The brain and the immune system are buddies. They’re in constant communication. When we’re stressed, the brain produces more cortisol to prepare the body for emergency situations. But in doing so it depresses our immune system. Relaxation exercises like yoga, meditation, mindful colouring, get into nature, paint your nails, walk the dog, play with puppies take a bath, light a candle, whatever works for you!

Exercise – studies suggest you’re more likely to get colds if you don’t exercise. The impact that exercise has on sleep quality might also indirectly strengthen our immune systems. We know CV is a virus which attacks our lungs, the better our lung function is the better you will be able to cope with the virus. If you don’t exercise, now is a great time to get started!

Keep warm

Cold viruses may be more infectious at temperatures lower than 37°C, which is the average core body temperature. Despite this, most health experts agree that the reason winter is “cold and flu season” is not that people are cold, but that they spend more time indoors, in closer contact with other people who can pass on their germs.

Some experiments with mice suggest that cold exposure might reduce the ability to cope with infection.

Drink up! Staying hydrated helps your body naturally eliminate toxins and other bacteria that might cause illness. Aim for 35-45ml/kg/day.

We’ve spoken about this before – chicken veggie soup kill multiple birds with one stone – warm liquid, protein, vitamins and minerals.

Supplements:

Many over-the-counter products claim to ‘boost’ your immune system, but there is little evidence to show that they do.
If you have a poor diet, it may help to take a daily multivitamin, but the preference is to get all your nutrients, including vitamins, minerals and bioactive compounds from food, negating the need for supplements
If you include a diet with lots of veg, fruit, wholegrains or legumes, nuts, seeds or oily fish – your immune system should have everything it needs to run optimally.

NAC or N-Acetyl Cysteine is the supplemental form of cysteine, a semi-essential amino acid. It’s considered semi-essential because your body can produce it from other amino acids, methionine and serine, and it only becomes essential when we don’t get enough methionine and serine. NAC and glutathione also boost immune health.
A test-tube study indicated that in other immune-compromised situations, such as the flu, NAC may hamper the virus’s ability to replicate. https://www.ncbi.nlm.nih.gov/pubmed/19732754
Most protein-rich foods, such as chicken, turkey, yogurt, cheese, eggs, sunflower seeds and legumes contain cysteine
For your body to make the amino acid cysteine, you need adequate amounts of folate, vitamin B6 and vitamin B12, which you can get from beans, lentils, spinach, bananas, salmon and tuna.
NAC has low bioavailability as an oral supplement, meaning that it’s not well absorbed. High doses can cause GI upset.

Zinc – An analysis of several clinical trials show that short-term use of zinc lozenges may reduce the length of a cold if started within 24 hours of cold symptoms.
Blends such as ‘Armaforce’ – blend of herbal and nutritional ingredients andrographis, echinacea, olive leaf, vitamin C and zinc
Andrographis – Indian Echinacea – may reduce reduce duration and severity of cold and flu symptoms
Echinacea – studies are mixed and generally don’t support its use. One clinical trial supports the use of echinacea for reducing the length of colds, but not the severity of symptoms. One large trial suggests a specific echinacea formulation could be as effective as a prescription drug to treat influenza, with fewer side effects.
Olive leaf extract – In vitro studies show that OLE has antimicrobial activities against some infective agents including E. coli, Pseudomonas aeruginosa, Staph. aureus, Klebsiella pneumoniae and Candida albicans

https://www.ncbi.nlm.nih.gov/pubmed/12870202

https://www.ncbi.nlm.nih.gov/pubmed/17873849

Vitamin C – Absorption is also to some extent dependent on the dosing regimen, e.g, there would be better absorption with 250 mg taken four times daily than 1,000 mg taken once daily. 1000 is the prudent upper limit and it’s very easy to get the RDI of 45mg/d with fruit + veg
AVOID vitamin E supplements – no significant evidence that supplements support the immune system and research suggests possibly more harm than good (stroke and cardiac issues)
Essential oils – Some EOs have demonstrated immune enhancing properties but caution in pregnancy, blood pressure issues or epilepsy

Most supplements have dosage and interaction warnings. If you have any medical conditions or take any medications or supplements please check with your doctor, pharmacist or dietitian to ensure no interactions.

https://www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/integrative-medicine/herbs/search

Definition: https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexia

What is orthorexia?

A fixation/preoccupation with so-called ‘healthy eating’ or ‘clean eating to a point where it becomes obsessional and begins in infiltrate their life – causing anxiety, stress and impacting in relationships. More common with the rise of the #cleaneating #sugarfree #dairyfree, etc.. phenomenon on social media.

It is an eating disorder, however there are no diagnostic criteria at present. There is a lot of work happening at the moment to help characterise it. Hopefully it will be able to be incorporated in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition)in the future. This makes it increasingly difficult for doctors or dietitians to characterise this condition, particularly those who work within a weight centric paradigm.

It’s difficult to pick up because there are so many food and nutrition fads. Orthorexia can be quite easy to hide behind because a person can appear as if they are focused on ‘health’ and ‘wellbeing’ where as they’re battling a mental illness people may not know about. A person may often be at a healthy weight and not have any nutrient deficiencies (others will) – everyone is different depending on their restrictions.

There can be many ways which orthorexia can develop e.g. previously mental illness or ED (many clients can transition from anorexia to orthorexia – meaning they may restore weight and start eating but the obsessions thoughts continue to infiltrate) or a health condition (e.g. autoimmune disease or bowel issues) or it may be a desire to just feel better and because we are inundated with health messages everywhere we go, it can be difficult to escape.

Warning signs and symptoms

Compulsive checking of ingredient lists and nutritional labels
An increase in concern about the health of ingredients
Cutting out an increasing number of food groups (all sugar, all carbs, all dairy, all meat, all animal products)
An inability to eat anything but a narrow group of foods that are deemed ‘healthy’ or ‘pure’
Unusual interest in the health of what others are eating
Spending hours per day thinking about what food might be served at upcoming events
Showing high levels of distress when ‘safe’ or ‘healthy’ foods aren’t available
Obsessive following of food and ‘healthy lifestyle’ blogs on Twitter and Instagram
Body image concerns may or may not be present

Ref: https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexia

Common theme of when it becomes a problem:

It’s impacting your mood

Impacting your social life
Compulsive checking of ingredient lists and nutritional labels
You’re cutting out food groups or consistently skipping meals
You feel guilty if you miss a training session or eat out of plan
You fear losing control.
You feel stressed or anxious about straying from your plan/usual actions
It becomes too high on your ‘priority list’. Absorbs too much of your brain time. E.g. choose between brother’s bday dinner and gym / eating your planned meal and you choose the latter
You skip work, school, or social events to exercise or to avoid particular foods/eating behaviours
You feel the need to hide your behaviour – eating / training in secret
You continue to exercise when injured or sick
You continue restricted diet with sick
Friends, family, or your provider are worried about your eating or exercise habits.
Food and exercise are no longer fun
You are overly critical of friend and family food choices + exercise habits
Obsessively checking food labels

Bottomline: If food is causing anxiety/stress- alarm bells. If you can’t eat a slice of cake on your boyfriend’s birthday because it’s ‘unhealthy’, then there is a problem. Being healthy means being flexible and eating intuitively.

Treatment:

At present there are no clinical treatments developed for orthorexia. We are reliant on the skills/experience from eating disorder clinicians to manage this condition – strong links with AN and OCD. Treatment team usually involved a psychologist (psychotherapy & anxiety/stress mx) and dietitian (aim to increase the variety of foods and manage anxiety relating to foods). Weight restoration may be required if the patient is underweight.

At the core it is an inability to deviate and a sense of feeling ‘out of control’ if the rules and restrictions set can not be adhered to. One of my favourite lines that I heard from Dr. Stefanie Reinold (who also has her own brilliant podcast which we will link in the show notes) is “It’s not about the food”, there is a lot more going on underneath that we need to uncover to get to the core of the obsessive need to control food.

Strategies:

Understand what is at the root of the obsession, as we know it’s not about the food so what is it about? Is it feeling out of control in your life and therefore feeling the need to control food? Are you having a stressful time with a loved one? Did something happen in your past?
Adoption of a balanced mindset (which is easier said than done) – it would be important to seek professional help and work to increase flexibility with eating. Develop strategies to help manage anxiety or stress around food.
Rules = guilt/shame – be more liberal with rules you put on yourself
Acknowledge everyone is different, what works for one doesn’t work for another – social media detox and following positive people.
Knowing recovery is challenging, because rigidity and rules have been created and you need support to help break those down and remodel. Sticking to a particular diet can make you feel safe (even though it is not safe or ‘healthy’).

Further information and support

https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexia

https://thebutterflyfoundation.org.au/

https://headspace.org.au/

https://daa.asn.au/

Episode 24

Good Science vs Bad Science: how never to get tricked by click bait again!

What makes something worth reading?

Population
Findings
Types of studies – epidemiological, vs clinical trial etc..

To really understand a study you need to read more than just the abstract. The abstract is a great introduction however doesn’t give us enough context or information.

Each of the different studies have their own strengths and weaknesses.

To summarise:

Evidence Summaries (Systematic Reviews and Meta-analysis)
Experimental studies (RCT’s and non-RCT’s)
Observational studies (case control, case report, cohort study)

Source: https://www.researchgate.net/publication/311504831_Options_for_basing_Dietary_Reference_Intakes_DRIs_on_chronic_disease_endpoints_report_from_a_joint_US-Canadian-sponsored_working_group

CASP (and other critical appraisal) tools

https://casp-uk.net/casp-tools-checklists/

Type of study – RCT vs cohort/observational vs systematic review vs case control. In vitro (test tube) vs in vivo, Animal vs human
Randomized, double-blind, placebo-controlled trials = gold standard
Aims and study qn
How were subject recruited?
Randomisation and blinding
Population size + power of the findings – the bigger the sample size, the more reliable the study is.
Demographics – age, sex, health status – this will help you indetify if the paper is relevant to you or your client group. No point in drawing inferences from a paper which looks at muscle mass in an elderly population group if the group you work with are <30 years old.
Confounder – a factor that may influence the results. E.g. if you’re looking at Vitamin C levels and immune function, you would want to ensure the group you’re looking at aren’t already on supplements while the others aren’t on anything. These people should be excluded from the study as they may influence the results.
If not RCT, measures to minimise bias? Observer and subject bias. Social conformity.
What methods were used? The methods section should have a clear endpoint – we want to clearly know what the researchers are trying to find – e.g. effect of the keto diet on weight loss or resistance training on muscle gain.
Similarity of the groups at baseline – heterogeneous sample size
Did anything else differ between groups other than the intervention?
Size of the effect – clinical vs statistical significance. This can be confusing for the general population. E.g. we may see improvements in clinical outcomes when looking at nutrition interventions prior to cancer surgery, however the results were not ‘statistically significant’.
- P-value (probability of obtaining the observed results of a test)
How long was the intervention or follow up? E.g. 6/12 for weight loss – perhaps not long enough! What happens in 5 years?
Consistency with other high quality evidence
Application of results to local population or groups
Harms and costs
Funding
COI – often mentioned at the end of the pape

What to do when you’re not sure if something is being honest or true: Fight back against the click bait.

Warning signs
- Selling something – food or supplement companies often cherry pick information – be aware of this!
- Lack of credentials
- Lack of references – skeptical even if accurate
- Alarmist
- Promise to cure / prevent

Is loaded with ‘testimonials’ (did you know that registered health professionals is Australia aren’t allowed to include

testimonials? This is because we base our advice on best-practice evidence rather than individual cases. What works for Sam won’t necessarily be right for Sally!)

- Makes no mention of seeking individual advice
- If it sounds too good to be true, it probably is!
- Headlines
How to cross check when you’re not sure.
- The best advice? Check anything you’re interested in trying, taking, applying with your training, governed health care professionals. And if you don’t get an answer from one, as, another!
- If you’re game, read a number of studies on the same topic

Social conformity

https://www.npr.org/2016/09/17/494360187/industry-influence-in-nutrition-research

https://www.google.com/amp/s/amp.theguardian.com/lifeandstyle/2016/dec/12/studies-health-nutrition-sugar-coca-cola-marion-nestle

https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2548255

Three applied examples

https://www.medicalnewstoday.com/articles/327046.php#1

https://www.sciencedaily.com/releases/2014/12/141203161134.htm

https://www.telegraph.co.uk/news/2017/08/29/low-fat-diet-linked-higher-death-rates-major-lancet-study-finds/

Episode 23

Antioxidants: keeping you feeling (and looking) young forever! Can you really keep eating red wine and eat dark choc guilt free?

Disease prevention

Heart disease

Vitamin E (almonds, peanuts, hazelnuts, sunflower seeds, avocado) and Beta Carotene (sweet potato, dark leafy greens, cantelope, capsicum) are often studied as it is hypothesized that these antioxidants can prevent the accumulation of atherosclerotic plaques.
Results of larger trials haven’t shown as profound as we had hoped for, however we have rational for this!
- Women’s Health Study – 39,876 healthy women took 600 IU of natural source vitamin E or a placebo every other day for 10 years.
- The study did not see a reduction in CVD events, however it did find a 24% reduction in total cardiovascular mortality.
Women’s Antioxidant Cardiovascular Study – 8,171 women randomised.
looked at beta-carotene, vitamin E, vitamin C.
Modest benefit for vitamin E among women with existing cardiovascular disease.
Women in the active vitamin C and E experienced fewer strokes
Patients taking vitamin E had significantly more heart failure. Vitamin E was linked to a 13% higher risk of heart failure and a 21% increased risk of hospitalization for heart failure
Lott, E. The Journal of the American Medical Association, March 16, 2005; vol 293: pp 1338-1347. Brown, B.G. The Journal of the American Medical Association, March 16, 2005; vol 293: pp 1387-1390.
.https://academic.oup.com/ajcn/article/69/6/1322S/4715025
a recently published analysis of clinical trials involving nearly 136,000 people who took vitamin E for one reason or another found that the overall risk of dying was greater in those who took higher doses, compared to those who took lower doses.
https://www.health.harvard.edu/press_releases/facts_about_vitamine
Not a huge benefit when it comes to supplementation – this was also supported in a very highly regarded medical journal called The Lancet. We know that antioxidants in fruits and vegetables, which also contain valuable fibre can have a profound impact on heart health and prevention of heart disease.

Cognitive conditions (dementia, alzheimers)

Oxidative stress caused by free radical damage can contribute to brain aging, cognitive deterioration and conditions such as alzheimers or dementia. .
The literature has some mixed results, however again we know there is more to this complex puzzle.
Prevention of Alzheimer’s Disease by Vitamin E and Selenium Trial (PREADViSE).
This study aimed to determine if vitamin E or selenium supplements used alone or in combination can prevent dementia older men.
3,700 men aged 60 or older for 6 years
Unfortunately the antioxidant supplements did not prevent the onset of Alzehimers disease.
Physicians’ Health Study II (PHSII), – 5,956 men age greater than 65 years.
The average treatment duration was 18 years – very long!
Subjects were given 50 mg beta-carotene supplements or a placebo.
Long term supplementation showed positive cognitive outcomes.

Statement by the Alzheimers Society regarding use of antioxidants:

“Though lab-based experiments on different types of antioxidants seem promising, there is only limited support for the claims that antioxidants may protect against Alzheimer’s disease from studies involving people.

However, increasing fresh fruit and vegetables in the diet has numerous benefits aside from increasing antioxidant intake and is highly recommended, especially as part of a Mediterranean diet”

We know there is data to suggest that eating a Med type diet (which is rich in antioxidants) is beneficial in reducing the risk of dementia.

Cancer

Carotenoids and breast cancer risk
Dietary patterns and bladder cancer– looks at fruit and veg rather than supplements
Dietary Soy Isoflavones (flavanoid family) and colon cancer
http://oncorenutrition.com/dont-fight-yo-nutrients/

We know that eating a diet rich in antioxidant rich fruit and vegetables and protective against a range of different cancers. Whilst there are some gaps in the literature there are some really exciting trials currently underway.

Longevity & anti-ageing

If we can prevent the onset of chronic diseases through increasing our intake of antioxidants, we can lead a healthier life for longer!

“Free Radical Theory of Aging” (FRTA), also known as “oxidative damage theory of ageing” is a concept that free radicals and other reactive oxygen species are a byproduct of metabolism and occurs as a result of a number of exogenous factors; and it is the accumulation of damaged cells are the reason we experience age-related diseases and aging. Why antioxidants are of interest in terms of aging and longevity, is because they can block or downregulate these damaging pathways.

http://www.actabp.pl/pdf/2_2000/281.pdf

There are a number of different antioxidants that are of interest when we focus on anti-aging. These include – Ascorbic acid (Vit C), alpha-tocopherol (Vit E), Ubiquinol (Coenzyme Q10), Melatonin, Curcumin, resveratrol, etc..

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3982418/

Ubiquinol (Coenzyme Q10)

It is a unique lipid-soluble antioxidant and is essential for mitochondrial electron transport chain (ETC), which is a fancy way of referring to energy production within our cells.
Benefits from heart disease risk, kidney disease, inflammation, fertility, aging, metabolic syndrome.
In regard to CVD a cochrane review in 2014 found that supplementing with Co-Q10 showed a significant reduction in systolic blood pressure without improvements in other CVD risk factors, such as diastolic blood pressure, total cholesterol, LDL- and high-density lipoprotein (HDL)-cholesterol, and triglycerides.
Endothelial function
Inflammation – Meta-analysis explored the effect of CoQ10 on C-reactive protein (inflammatory measure), interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α) in patients with inflammatory conditions such as multiple sclerosis, obesity, rheumatoid arthritis, diabetes, etc… It found that Co-Q10 doses between 60 to 500 mg/day for a 1-week -4-months significantly reduced production of inflammatory cytokines.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5807419/#B39

Food sources:

Organ meats: Heart, liver and kidney
Some muscle meats: Pork, beef and chicken
Fatty fish: Trout, herring, mackerel and sardine
Vegetables: Spinach, cauliflower and broccoli
Fruit: Oranges and strawberries
Legumes: Soybeans, lentils and peanuts
Nuts and seeds: Sesame seeds and pistachios
Oils: Soybean and canola oil

Resveratrol (RSV) – A polyphenolic compound that stimulates cell defense pathways.

Protects these plants against UV rays and some fungal infections.
It has been hypothesised that it is RSV that is responsible for the ‘French paradox’ – low rates of heart disease in France, despite a diet rich in cheese and red wine.
There is evidence that resveratrol may be beneficial in the context of diabetes, CVD and cancer.
Meta Analysis which looked at the evidence regarding RSV across a number of different species. It found that there are a few species that found life extension in response to RSV.
Metabolic function
- https://academic.oup.com/biomedgerontology/article/67/12/1307/605425
- https://www.sciencedirect.com/science/article/pii/S155041311100386X
Be careful of high doses of resveratrol if history of breast cancer
Food sources: Red wine, grapes, peanuts, pistachios, dark choc, cacao, strawberries

Episode 22

This week we’re making The Game Changers a reality. We give you the tools to actually go plant based or make ANY dietary changes stick!

Why go plant based?

Ethical
Environmental – A vegetarian, pescetarian or flexitarian diet with an increased intake of plants and reduced reliance on animal-based products (so not just a vegan diet) has been associated with significant reductions in premature mortality and environmental impact. https://www.thelancet.com/action/showPdf?pii=S2542-5196%2818%2930206-7
Health – https://academic.oup.com/jn/article/148/4/624/4965931 Dietary changes to balanced flexitarian, pescatarian, vegetarian, and vegan diets led to reductions in premature mortality of 19% (95% CI 18–20) for the flexitarian scenario to 22% (18–24) for the vegan scenario https://www.thelancet.com/action/showPdf?pii=S2542-5196%2818%2930206-7
https://www.ncbi.nlm.nih.gov/pubmed/28446499
Self-experiment
Financial
Combination

Nutrients to be aware of

If you’re planning on going fully plant-based, vegan, then there are some important nutritional considerations

Vit B12 – most will need a supplement. Check your levels.

Mushrooms, tempeh, miso and sea vegetables are often claimed to be a source of B12. However, this is not accurate. They contain a compound with a similar structure to B12, but it doesn’t work like B12 in the body.

Milk alternative

Bon Soy (25mg calcium per 100mL) vs VitaSoy CalciPlus (160mg per 100ml = 50% RDI)

Impressed Plant Milk (almond, cashew, pea, fava bean) (117mg per 100ml) or oat milk

Listen to our milk ep and find a fortified alternative

Calcium

Low oxalate dark green leafy veg – kale over spinach (the oxalates bind to the calcium), almonds, soy, white beans, edamame, broccoli, bok choy, okra

Selenium – include just one brazil nut per day

Iron – listen to ep 5

Iodine – iodised salt or miso/seaweed products

Omega-3s – you’ll get some from flaxseed meal, ground chia, walnuts → grinding enhanced the bioavailability which is still poor!). Consider a yeast or algae derived omega-3 supplement 0 chat to an APD or doctor.

Protein – it’s not hard to get enough protein. 0.8g/kg/d = 60kg person = 48g per day = 1 tin beans (15g) + glass plant milk (8.5g) + 2 cups broc or veg (15g) + ½ cup quinoa (4g) + handful nuts (5.2g)

Plant foods are lower in certain amino acids than animal products and it is important to get a complete AA profile across the day. This is fairly easy to do so long as we include a variety of plant foods daily – eg rice + beans or tofu + peanut satay sauce or soy milk + chia seeds.

Complete amino acid profile = soybeans, quinoa, chia, hemp, seitan

Health

Important to know that it’s not inherently healthier to be vegan/vegetarian vs omnivorous. What’s unanimously healthy is a diet rich in plant foods, but it doesn’t have to be a diet devoid of animal foods. You can be a vegan and also not have a healthy or balanced diet

Processed meat alternatives

Report: – World Health Organization Collaborating Centre on Population Salt Reduction, The George Institute for Global Health

https://www.georgeinstitute.org/sites/default/files/meat_alternatives_key_findings_report.pdf

Other Key References:

https://www.thelancet.com/action/showPdf?pii=S2542-5196%2818%2930206-7

https://www.ncbi.nlm.nih.gov/pubmed/28446499

Episode 21

IBS and tips for a less irritable gut ft. special guest Dr Carly Ymer

Causes and triggers

Brain-gut axis – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367209/pdf/AnnGastroenterol-28-203.pdf
Gut microbiome – https://onlinelibrary.wiley.com/doi/full/10.1111/apt.12728
Environmental factors

Post infection – (e.g. gastroenteritis infection or campylobacter pylori)

Beatty JK, Bhargava A, Buret AG. Post-infectious irritable bowel syndrome: mechanistic insights into chronic disturbances following enteric infection. World J Gastroenterol. 2014;20(14):3976-3985.
Enck P, Aziz Q, Barbara G, et al. Irritable bowel syndrome. Nat Rev Dis Primers. 2016;2:16014.
Thabane M, Marshall JK. Post-infectious irritable bowel syndrome. World J Gastroenterol. 2009;15(29):3591-3596.
Thompson JR. Is irritable bowel syndrome an infectious disease? World J Gastroenterol. 2016;22(4):1331-1334.

Investigations and Diagnosis:

Blood tests, stool samples, family history, colonoscopy, gastroscopy

Hydrogen Breath Tests

https://onlinelibrary.wiley.com/doi/pdf/10.1111/jgh.13689

http://shepherdworks.com.au/fodmaps-breath-testing-are-you-blowing-your-money/

Rome Criteria

https://irritablebowelsyndrome.net/clinical/new-rome-iv-diagnostic-criteria/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704116/#!po=31.2500

Dietary interventions

- Low FODMAP diet (Fermentable, Oligosaccharides, Disaccharides,Monosaccharides and Polyols)

Management: 6-8 week elimination diet and slow reintroduction (under close guidance from a DT)

Fibre
- Soluble vs Insoluble – depends on your symptoms.
- Soluble fibre (e.g., psyllium husk) may assist in the management of IBS and can improve symptoms of patients.
- Supps may cause bloating – important to introduce this gradually.
Probiotics/Prebiotics
- Some evidence for use of probiotics in the context of GIT infections and diarrhoea. About 7–30% of patients with infectious diarrhoea can develop IBS. Probiotics may help to improve the barrier that lines our gut.
- There is no specific probiotic that is recommended. If you choose a probiotic, take the same strain and dose for 4-weeks. If you feel better, continue with the same probiotic. If you do not feel better after 4-weeks, try a different dose or strain. We can guide you where to start depending on your Sx.

Summary: Diets for the treatment of IBS symptoms are complex and multifactorial. Due to huge amounts of patient variation in severity of symptoms and intolerances, it can challenge to point point an exact method.

Many different diets have been studies in the treatment of IBS, however there have been huge limitations in many of those published. At present the diet with the best level of evidence is the elimination diet (low fodmap and reintroduction) under the guidance of an APD.

https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1365-2036.2004.02267.x

Medical management references:

American Gastroenterological Association Institute Technical Review on the Pharmacological Management of Irritable Bowel Syndrome- https://www.gastrojournal.org/article/S0016-5085(14)01090-7/fulltext

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5291563/

Dr Carly Ymer – BIO:

Dr Carly Ymer is a clinical psychologist who practices holistic psychotherapy, using her passion for mental and emotional wellbeing to help clients be their best. She believes and practices within an integrative and holistic framework of the synergy between thinking, emotions, and behaviour. Carly is passionate about working with children, teenagers and young adults, with a range of emotional, social and behavioural difficulties.

https://beingwellclinic.com/

Episode 20

What we’ve learnt from the ketogenic diet and why you shouldn’t break up with carbs

KETOGENIC DIET

What is it?

Very low-carb, moderate-protein and high-fat diet. It typically contains 75% fat, 20% protein and only 5% carbs.
20g CHO per day – Eg 1 apple + ½ cup peas + 4tbsp milk OR sk latte + ¼ cup chickpeas OR 1 small banana OR 1 small slice sourdough bread

Does it work?

Weight loss – very low CHO intake leads to increased fat metabolism for ketones.

The rise in fat burning does not necessarily mean loss of fat stores given the intake of fat in the diet has significantly increased.

Studies suggest that the overall body fat balance is equal if not in favour of fat storage!
CHO insulin model – reduced insulin so less fat stored. Good in theory but a very intensive $40 million study of 17 men were admitted to metabolic wards for intensive monitoring for 2 months – one month high carb, one month ketogenic. Matched calories on both. Subjects spent 2 consecutive days each week residing in metabolic chambers to measure changes in exergy expenditure and underwent DEXA to measure body composition. The study found that the subjects lost more body weight on the ketogenic diet, but rate of fat loss was 50% slower on the keto diet and instead the on the ketogenic diet that subjects lost more water weight and suffered more LBM (muscle protein) catabolism. Interestingly, this was a study funded to explore their hypothesis which was the opposite!

https://academic.oup.com/ajcn/article/104/2/324/4564649

Epilepsy that is refractory to medication – often as third or fourth line therapy.
Cancer – theory based on Warburg effect that cancer’s preferred fuel source is sugar and that by reducing CHO intake we can deplete tumour tissue of the glucose required for tumour cell metabolism. Unfortunately, that’s the case of most of the healthy cells in our body. Sugar fuels everything and cancer can feed off everything, including ketones.
As it stands, there are no clinical trials demonstrating a benefit of a ketogenic diet in cancer patients. Studies underway exploring the ability to slow the growth of certain brain tumours.
What our best practice guidelines do specify though is that while it may be difficult to induce tumour responses with a ketogenic diet, this does not argue against preferring fat to supply energy to patients with advanced cancer and inflammation-induced insulin resistance – so more avo, nuts, seeds and extra virgin olive oil and less refined sugars.

DRAWBACKS

Gut Health

Our carbohydrate sources in our food supply don’t just provide energy. Think about a chickpea. Yeah it’s got carbs, but it’s also loaded with fibre, protein, folate and iron.
One important factor that we miss when we significantly restrict CHO intake is fibre, prebiotics and the impact on our gut.
Bowel cancer risk + digestive health

Diabetes (T2DM)

Some proponents suggest ketogenic diet to manage diabetes
Managing the symptoms – high blood glucose levels – rather than the cause – insulin resistance (may be as a result of being overweight, lack of PA + poor dietary patterns).

Ketogenic diet has been associated with development of NAFLD and associated hepatic insulin resistance in mice. This can induce or worsen insulin resistance
Some human studies show an initial improvement in insulin response on a ketogenic diet but this seems to only be temporary – which makes sense given the KD is reducing the symptoms (high blood glucose levels), but may actually be worsening the cause (fatty deposits in the liver and cells)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5452247/

Cardiovascular disease

KD are often high in saturated fats
Breakfast of egg, bacon, bullet coffee; lunch and dinner of M/C, small amount of veg and some cream for dessert…it’s no surprise that this will take its toll.
The majority of animal studies suggest that when KD are rich in saturated fats they negatively impact blood lipid profiles and cardiovascular disease risk
In human studies, there are really varied results, often depending on the length of time subjects are followed and the profile of their fat intake.
Some studies highlight that even in cases where KD show a reduction in total and LDL cholesterol, these were significantly more reduced with a high-protein medium-carbohydrate diet than with a KD

Compliance

Hard!
Even in retractable epilepsy compliance may drop to 50% after a few months. For epilepsy this is disappointing for ability to gain disease control, but for the general population this could be a protective mechanism…children have died from scurvy and selenium deficiency and the long term implication for cardiovascular and gut health just might not be what your human control centre wants.
20g CHO per day
Eg 1 apple + ½ cup peas + 4tbsp milk OR 1 small banana OR 1 small slice sourdough bread

Exogenous ketones

Introducing ketones from external source can mean you will test positive for the presence of ketones – suggesting you’re in “ketosis”. Simply because the ketones exist doesn’t mean you’ve gone through the pathways to get there.
The presence of ketones signals to the body that you’ve been making them, and therefore may slow or even stop it’s own production of ketones from fat stores. This is a particularly important safety mechanism because ketone blood levels become too high, your blood can become dangerously acidic.
Therefore, taking exogenous ketones may prevent body fat from being used as fuel, at least in the short term
One benefit of exogenous ketone esters or slats – often taken as a drink – is that they may reduce circulating levels of our hunger hormone ghrelin. One study of 17 people found reportedly lower levels of hunger after taking the ketone drink. But only effective after a fast, not after a meal
You’ve also got to bare in mind that ketones contain calories. A single serving of exogenous ketone salts typically contains less than 100kcal or 420kJ, but to maintain a state of ketosis, you’ll need several servings each day = could add up to the energy in a main meal!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813183/

Bulletproof coffee/ MCT oil – contains medium-chain triglycerides, can help keto dieters add more fat to their diets and stay in ketosis. It’s digested more rapidly than traditional fats but can have digestive side effects and again a caloric load.

Action

If you’re going keto, prioritise unsaturated fats – avo, nuts, seeds, EVOO
Make your carbs count

Don’t rely solely on the white ones (white bread, white rice, white potatoes, white pasta)

Choose CHO sources that offer something else: fibre, protein, vit, min
Eg
- Fibre: wholegrains such as barley, bulghur, freekeh, spelt, quinoa, oats, legumes, peas, corn, pulse pasta
- Protein: legumes, ricotta or cottage cheese
- Vitamins: sweet pot, peas, corn
- Minerals: greek yoghurt, milk, ricotta, cottage cheese

OnCore Nutrition 15 min free phone consults

https://oncorenutrition.com/15-minutes-free/

Episode 19

Spice Market: Why turmeric is so hot right now and the 5 other spices whose health benefits might surprise you

Turmeric, active ingredients are turmerone oil and water-soluble curcuminoids, among which curcumin has been the focus of research

Native to south Asia
Orange colour used in cosmetics and as a food colouring agent
Absorption is poor and it’s metabolised rapidly. Absorption can be improved if taken with pepper (piperine) or fat, but this depends on if you have a therapeutic goal.
A meta-analysis of randomized clinical trials revealed that curcumin is effective in decreasing the concentration of tumor necrosis factor-alpha, a key mediator in many inflammatory diseases.

Gut

Turmeric may help alleviate symptoms of irritable bowel syndrome or ulcerative colitis,

Joints

Turmeric extract was found to be safe and equally effective as a non-steroidal anti-inflammatory drug for the treatment of osteoarthritis of the knee. Need to absorb it so take with piperine/fat.

Cancer

Curcumin has been studied to have anticancer properties through really the 3 main pathways of cancer development:

It’s antioxidant properties and protection against DNA mutations and cell damage
It’s antiproliferative properties that reduce tumour growth and spread including inducing apoptosis (programmed cell death) and

3.Curcumin has shown ability to kill cancer cells directly by activating “execution enzymes” that destroy cancer cells from within.

As an added benefit, curcumin seems to focus on the cancer cells and leave our healthy cells alone, unlike chemotherapy and RT that can’t distinguish between malignant and healthy cells.
Several animal studies suggest that turmeric helps to prevent colon, stomach, and skin cancers in rats exposed to carcinogens.
Human studies are underway to validate these findings in humans
What’s interesting is that while curcumin shows benefit in breast cancer, pancreatic cancer, colon cancer, multiple myeloma, myelogenous leukaemia and skin, kidney and colorectal cancer, turmeric as a whole food has in some cases been shown to be even more effective!
In fact, a study was undertaken with turmeric where they removed the active component curcumin, and it was found to be just as effective!!
Topical turmeric-based cream has shown some ability to reduce radiotherapy-induced dermatitis in patients with head and neck cancer; and oral mucositis
Can interfere with some chemotherapy agents

Other

May improve concentrations of liver enzymes
Some but insufficient evidence for treatment of kidney stones and reduction in stomach and intestinal gas

When it’s not a good idea

Can interfere with many drugs, blood thinners and chemo agents when taken as a supplement.
One study – These findings support the hypothesis that dietary curcumin can inhibit chemotherapy-induced apoptosis through inhibition of ROS generation and blockade of JNK function, and suggest that additional studies are needed to determine whether breast cancer patients undergoing chemotherapy should avoid curcumin supplementation, and possibly even limit their exposure to curcumin-containing foods. https://www.ncbi.nlm.nih.gov/pubmed/12097302

Other spices with similar impact

It’s not the only option…Other anti-inflammatory and health promoting spices

Cumin

May improve digestion by increasing activity of digestive enzymes and increase release of bile from liver.

May assist IBS – a low level study explored cumin essential oil and found it reduced abdominal pain, bloating, fecal urgency and presence of mucus discharge during and after treatment with Cumin extract.
May improve BG control in Diabetes – still unclear the exact mechanisms or exactly how much is required to obtain the desired therapeutic outcomes.
Some studies suggest that supplementation may improve chol profile
The salicylic acid and other phenolic acids may have a anti-inflammatory and free-radical reducing properties to reduce cancer risk

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210012/

https://www.sciencedirect.com/science/article/pii/S0308814608002483

https://www.ncbi.nlm.nih.gov/pubmed/24829694

https://www.ncbi.nlm.nih.gov/pubmed/25766448

https://www.ncbi.nlm.nih.gov/pubmed/27664636

https://nutritionfacts.org/2019/12/26/the-foods-with-the-highest-aspirin-content/?utm_source=NutritionFacts.org&utm_campaign=b4e7d340b4-RSS_BLOG_DAILY&utm_medium=email&utm_term=0_40f9e497d1-b4e7d340b4-26955981&mc_cid=b4e7d340b4&mc_eid=b327dd2e50

Cinnamon – coined gift fit for kings

Anti-inflammatory properties similar to that of turmeric – high concentration of antioxidants (polyphenols).
Reduce insulin resistance – Cinnamon has shown to be able to improve insulin sensitivity, which means better able to reduce our BGLS.
Cinnamon contains contains enzymes which work in our GIT which slowing down the breakdown of CHO’s. This reduces the amount of glucose in our blood after a meal.
120mg per day can reduce total chol, LDL, TGs
May help protect neurons, normalize neurotransmitter levels and improve motor function – researchers interested for Alzheimer’. Human studies are lacking, however watch this space..

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003790/

https://www.ncbi.nlm.nih.gov/pubmed/14633804

https://www.ncbi.nlm.nih.gov/pubmed/24019277

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901047/

https://www.ncbi.nlm.nih.gov/pubmed/19433898

https://www.ncbi.nlm.nih.gov/pubmed/23531502

https://www.ncbi.nlm.nih.gov/pubmed/24349472

Ginger

Ginger root contains compounds that may help relieve or prevent nausea and vomiting. These substances can increase the flow of saliva and digestive juices and may also help calm the stomach and intestines. Some studies have found ginger may help nausea caused by chemotherapy, but larger studies are needed to confirm these effects.
Eating fresh ginger in high doses can have blood-thinning effects by preventing platelets from sticking together.
Laboratory studies suggest that ginger can protect brain cells from the plaques that cause Alzheimer’s disease, but this effect has not been studied in humans.
Some data in OA and RA
May reduce BGL
May reduce drug dependence!
May improve digestive health – reduce diarrhoea, gas and bloating
Supplemental doses can interfere with warfarin or blood thinners, NSAIDs, insulin, during pregnancy or pre-surgery. Stick to the real food!

https://www.mskcc.org/cancer-care/integrative-medicine/herbs/ginger

Ashwaghandha (Indian or asian Ginseng)

May assist with angina, T2DM management, immune function and…
Sexual dysfunction benefits for erectile dysfunction
Some reports of manic and psychotic episodes with supplements – stick to the food! Make into a tea or add to asian soups

https://www.mskcc.org/cancer-care/integrative-medicine/herbs/ginseng-asian

Supplemental doses of many of these spices can interfere with warfarin or blood thinners, NSAIDs, insulin, during pregnancy or pre-surgery or cause nasty side effects so stick to the real food!

Chili

What is it: Capsaicin is the active ingredient in chilli, cayenne pepper, capsicum
What for: Neuropathic pain and neuropathy, OA pain, weight loss, psoriasis, cluster headaches
Caution: GIT lining, reflux

Health benefits of capsaicin

- Weight loss: There is evidence to suggest intake of chilis (containing capsaicin) can enhance fat burning potential and reduce appetite, which of course can assist with weight loss. As always the literature suggested that regular ingestion of capsaicin compounds in conjunction with a healthy diet & lifestyle showed the most promising outcomes.
  - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257466/

Pain management: There is some low level evidence to support that Capsaicin has the ability to bind to pain receptors to reduce the pain sensation. However these were small studies and effects were not lasting.

Be cautious of:

GIT upset (abdominal pain/cramping or diarrhoea) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4102147/

Cancer: There is some suggestion of chemoprotective effects however the evidence of safety vs risk is mixed regarding chili consumption. As mentioned, adding too much chili may have the ability to burn the lining of our GIT and this has been seen in some observational studies.

Long term topical use may increase risk of skin cancer – eat don’t rub it Look out for capsaicin as active ingredient in some topical creams and nasal sprays. It is also available in a prescription-strength patch.
- https://academic.oup.com/aje/article-abstract/139/3/263/63603?redirectedFrom=fulltext
- https://www.mskcc.org/cancer-care/integrative-medicine/herbs/capsaicin

In summary: See what agrees with your body! If you love chilli, enjoy it! If you don’t moderate the amounts you eat.

Eat your spices

Add cinnamon and turmeric to oats – try our carrot cake bircher or make this into balls with some dates. Add yoghurt if you need to absorb it.
Ginger tea or water, stir fry, bliss balls,
Chilli, cumin, paprika, turmeric to your evening meals – veg chilli con carne, dhal or curry
Ginseng tea or add to your soup
TO DO: buy minced chilli, garlic, ginger, dried cumin, paprika, chilli, turmeric

Episode 18

Weight loss: the formula for success and the surprising things that might be holding you back

WEIGHT LOSS

In order to lose weight we do need to be at a caloric deficit
This is calories in vs calories out, but the in and out are far more complicated than you think
Energy in: fat, alcohol, carbs, protein. Fibre not absorbed
Energy out: BMR, non-exercise energy, activity factor, thermic effect of food (protein 30%, carbs 8-10%, fat 2-3%, fibre 30%)
For fat loss, we need to access fat stores = lipolysis (very complex), gluconeogenesis or ketogenesis
For weight loss we need a negative energy balance

Reduce energy in – (water, fibre)
Increase BMR – enhance lean body mass, heat, cold, glycaemic index, green tea, oolong tea, capsaicin, sleep (insulin, ghrelin, leptin balance), coffee, MCT vs LCT
Increase thermic effect of food – increase protein, reduce fat = increased energy output
Increase non-active energy expenditure and activity factor – increase energy output. HIIT has the added benefit of burning energy and enhancing LBM.

Golden rules

Aim for
Increase your BMR – lean body mass, sleep. Tea, chilli and some other compounds can help but the impact is minute.
Increase activity factors – both incidental and planned

ADRENAL FATIGUE

Adrenal fatigue… does it exist?

Adrenal glands

Mayo clinic: ‘Perched atop each of your kidneys, your adrenal glands produce hormones that help regulate your metabolism, immune system, blood pressure and other essential functions.’They produce a variety of hormones including adrenaline and the steroids aldosterone and cortisol
- https://www.mayoclinic.org/adrenal-glands/img-20008674

The Theory

To keep it simple, the concept around adrenal fatigue is that under ongoing stress our body places pressure on our adrenal glands and over produces our stress hormone known as cortisol which essentially causes our adrenal glands to burn out and not work properly.
As our adrenal glands don’t work properly, this means they are unable to produce the necessary hormones to help our bodies function properly and therefore result in symptoms such as fatigue, trouble sleeping, weakness, brittle nails, weight gain/loss and alopecia.
Sadly this is a diagnosis given to patients from many alternative practitioners which gives them hope and a diagnosis for their problems/health issues..
Many supplements on the market targeted at ‘adrenal support’ with an expensive price tag

The evidence: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997656/

Large systematic review published in 2016.
From 3,470 articles found, only 58 studies met criteria for proposed adrenal fatigue.
- 33 were carried in healthy individuals, and 25 in symptomatic patients.
- The researchers found it difficult to draw conclusions, this is because there were many different methods used amongst the studies (when it comes to research consistent methodology & the use of validated tools are important) and this made it difficult to draw conclusions, the measures of fatigue were poorly documented and standardised tools were not used, the way cortisol was assessed was not endorsed by endocrinologists and I could keep going.
- As a result of these findings (or lack of findings) this systematic review concluded that adrenal fatigue is not a true medical diagnosis.
So if you are someone who has had this diagnosis, don’t feel lost, rather focus on managing your stress levels rather than putting a label on the way you feel.
Eg. Try to get into bed earlier and get more sleep, try meditation or yoga, make an effort to eat a more balanced diet.
Be careful when it comes to supplements, many of the drugs are not regulated or tested for safety.
If you’re unsure, contact your healthcare provider, GP, Endo, dietitian, etc..

FRESH VS FROZEN VEGETABLES

https://www.sciencedirect.com/science/article/abs/pii/S0889157517300418

The study mimics typical consumer purchasing and storage patterns of produce.
The study compares key nutrients in fresh, fresh-stored, and frozen produce.
Fresh produce loses vitamins over time during refrigerated storage.
Consumers’ assumption that fresh produce has much more nutritional value than frozen is incorrect.
In some situations, frozen produce is more nutritious than its 5-day fresh-stored counterpart.
Reduced food waste

Benefits of frozen

Nutritional profile – same if not better
Convenience
Reduced food waste
Lower cost
- Cost – e.g. broccoli – true cost by weight of fresh vs frozen = $7.38/kg fresh ($4.70 if use every single bit!) vs $5 frozen

Downsides of frozen:

Variety
Carbon footprint – look for local produce. Reduced waste may counterbalance this.
Packaging
Starchy veg
Less inspiring

Tips

Frozen winter veg, kale, spinach, stir fry mixes
Big packs vs little steam fresh – need about 4 of these for one serve!
Good way to eat more which is really the moral of the story – A recent meta-analysis into fruit and vegetable intake and the risk of cardiovascular disease, cancer and total mortality, by scientists, published in the International Journal of Epidemiology suggests that while disease risk can be reduced by consuming 5 portions of fruit and vegetables a day – the ‘5-a-day’ campaign – the largest benefit can be gained by eating around 800g, approx. 10 portions, per day. https://academic.oup.com/ije/article/46/3/1029/3039477

Episode 17

Intermittent fasting level: expert

Australian Bushfire Donations:

OnCore Intermittent Fasting Guides – https://store.oncorenutrition.com/collections/all

Physiological benefits

http://oncorenutrition.com/to-fast-or-not-to-fast/

Coffee https://www.ncbi.nlm.nih.gov/pubmed/28177691

Practicalities / sustainability / contraindications

http://oncorenutrition.com/the-fast-and-the-furious/

Guides: http://oncorenutrition.com/intermittent-fasting/

https://store.oncorenutrition.com/collections/all

IF and calorie deficit similar weight loss outcomes
Some find IF mentally challenging than consistent cal deficit, others find the opposite

Science currently unclear if IF vs CR is responsible for the body composition changes and good health.
Why the evidence is unclear is that many studies have been conducted in animal based models which we know has limitations
Human studies have been relatively poor (e.g. short duration) and mainly focused around weight loss (in the short term) rather than aging and disease risk.
https://www.ncbi.nlm.nih.gov/pubmed/28459931
100 obese participants – 6 women and 14 men, aged between 18–64 (the mean age was 44). Note they did not have metabolic conditions (e.g. T2DM).
Looked at different dieting patterns
- Alternate-day fasting – consumed 25% of their daily energy requirements on fast days and 125% of their daily requirements on alternate days.
- Calorie restriction diet plan where the subjects consumed slightly less than their energy need (~75%) each day.
- Another group with no dietary intervention.
- Results: With regard to the two dieting groups, they both lost a similar amount of weight and showed no significant difference regarding, blood pressure, heart rate, triglycerides, fasting glucose, fasting insulin, insulin resistance & inflammatory markers at month 6 or 12.
- Of note there was a higher drop out rate within the alternate fasting day group, which may indicate adherence and consistency may be a challenge with this method,
- Our recommendation: No real difference between the fasting vs calorie restriction group. There is no magic pill when it comes to weight loss. Do what works best for you and work with a professional who understands your needs.
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1467-789X.2011.00873.x
Intermittent CR and daily CR diets appear to be equally as effective in decreasing body weight, fat mass, and potentially, visceral fat mass. However, intermittent calorie restriction protocols may be superior in that they help conserve lean mass at the expense of fat mass. More research + longer term studies are required.

Circadian rhythms

According to your circadian rhythm, nighttime is for resting, not eating.

On average – we eat every 3hrs and 6 minutes and for a duration of approx 15hrs per day

Mice that eat in opposition to their circadian rhythm gain significantly more weight than mice that only eat during waking hours, even if they eat the same amount of food. Not all studies in humans support this notion.

At night, you may be more likely to choose unhealthy, calorie-dense foods.

Access
Convenience
High risk time for high fat, calorie dense foods
Emotional / non-hungry eating
Appetite changes when tired – https://www.ncbi.nlm.nih.gov/pubmed/20357041 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3763921/
Restriction/insufficient intake during the day → compensation

The first RCT in humans was published half way through 2019 to determine how meal timing affects 24-hour energy metabolism when food intake and meal frequency are matched

Small n= 11 men + women aged 25-45
two groups of people who ate the same three meals per day for 4 days but with different timings: the early time-restricted feeding (eTRF) schedule and the control schedule.
8am – 2pm (18hr fast) vs 8am – 8pm (12hr fast)
On the fourth day, 24‐hour energy expenditure and substrate oxidation were measured by whole‐room indirect calorimetry, in conjunction with appetite and metabolic hormones
No effect on 24hr energy expenditure
May enhance fatty acid oxidation – i.e. using fat for fuel rather than carbohydrates
TRF Decreased ghrelin levels, enhanced fullness, decreased desire to eat
Meal‐timing interventions facilitate weight loss primarily by decreasing appetite rather than by increasing energy expenditure. eTRF may also increase fat loss by increasing fat oxidation.

https://onlinelibrary.wiley.com/doi/full/10.1002/oby.22518

Another study 6am-7pm

Nothing unless than the hrs to adhere to – no type, amt of food, no record keeping
Ate fewer calories and lost weight

Another study

Same kJ at BF vs dinner – when given at BF = less weight gain
https://www.ncbi.nlm.nih.gov/pubmed/23512957

Another study

3 meals vs 1 meal – same calories
Normal-weight subjects are able to comply with a 1 meal/d diet. When meal frequency is decreased without a reduction in overall calorie intake, modest changes occur in body composition, some cardiovascular disease risk factors, and hematologic variables. Diurnal variations may affect outcomes.
Both late eating
Improvement in weight loss, but blood pressure and chol levels suffered!
https://www.ncbi.nlm.nih.gov/pubmed/17413096

Early TFR

eTRF (6-hr feeding period, with dinner before 3 p.m.) or a control schedule (12-hr feeding period) for 5 weeks and later crossed over to the other schedule.
eTRF improved insulin sensitivity, β cell responsiveness, blood pressure, oxidative stress, and appetite.
We demonstrate for the first time in humans that eTRF improves some aspects of cardiometabolic health and that IF’s effects are not solely due to weight loss.
https://www.ncbi.nlm.nih.gov/pubmed/29754952
Even 10-11hrs TRF beneficial – weight loss, improved energy levels, improved sleep

https://www.ncbi.nlm.nih.gov/pubmed/31808043

https://www.ncbi.nlm.nih.gov/pubmed/26693661

IF and breast cancer risk

https://www.ncbi.nlm.nih.gov/pubmed/26305095

These findings suggest that eating more frequently, reducing evening energy intake, and fasting for longer nightly intervals may lower systemic inflammation and subsequently reduce breast cancer risk. Randomized trials are needed to validate these associations.

Breast cancer prognosis

– 2413 women (mean [SD] age, 52.4 [8.9] years)

– mean (SD) fasting duration of 12.5 (1.7) hours per night.

– fasting less than 13 hours per night was associated with an increase in the risk of breast cancer recurrence compared with fasting 13 or more hours per night but wasn’t associated with mortality rates

NO RCTs YET!

https://www.ncbi.nlm.nih.gov/pubmed/27032109

Diabetes

Very small study n = 3 men who had had type 2 diabetes for 10-25 years.
Medical supervision
Fasted every other day or 3 days a week.
Within a month, all of the men were able to stop taking insulin. And in less than a year, they were able to cut down on or stop other diabetes medications.
Another small study, 10 obese men with type 2 diabetes followed a time-restricted eating plan. They improved their fasting glucose and lost weight over 6 weeks.
Bigger studies are needed to confirm those findings and to see how long the results last
The American Diabetes Association notes that if you’re overweight or obese, weight loss can help lower your HbA1c level (a gauge of your blood sugar control over the last 2-3 months) and lower your risk for heart disease.

Important to:

Talk to Dr/endocrinologist first
Adjust your insulin
Monitor for lower BGL
Beware of large carbohydrate load on first meal

Cell Metabolism: “Early Time-Restricted Feeding Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in Men with Prediabetes.”

BMJ Case Reports: “Therapeutic use of intermittent fasting for people with type 2 diabetes as an alternative to insulin.”

Joslin Diabetes Center: “Yom Kippur and Diabetes.”

BMJ Open Diabetes Research & Care: “Recommendations for management of diabetes during Ramadan: update 2015.”

Episode 16

Food Labels: all the hacks you need

Food labels

Labels must also have a list of ingredients. Ingredients must be listed by weight in descending order (i.e. the first ingredient contributes the largest amount to the product and the last ingredient contributes the least).
Regarding additives, products must show the number or the name of any additives they contain (e.g. monosodium glutamate may appear as MSG or 621). If you know you have sensitivities to any additives, it’s important you know their corresponding numbers so you can keep an eye out for them,
If the product contains any major allergens such as nuts (peanuts, cashews, almonds, walnuts, etc.), shellfish, fish, eggs, sesame seeds, soybeans, wheat, gluten, they must be declared on the label.
Sugar No added sugar: No added sucrose, glucose, honey, malt, fruit juice, etc.
Un-sweetened: No added intense (artificial) sweeteners, sucrose, glucose, honey, malt, fruit juice etc. Diet: At least 40% less kJ than regular product
Comparative claims eg ‘reduced’, ‘increased’, ‘light’ or ‘lite’ must refer to the reference food

Look out for:

Sugar aliases – dietitian colleague of ours has put together a list of 48 sugar aliases! Some derived from cane sugar, some from fruit, corn, beets, alternative sweeteners like agave and rice malt syrup,
Don’t be fooled by fancy marketing, sugars can have many different names, and we will put this list in the show notes for you all to have a look at. Just because a food contains rice malt syrup or coconut sugar, this is still sugar.

(https://foodwatch.com.au/blog/carbs-sugars-and-fibres/item/48-shades-of-hidden-sugars.html)

Foods containing more than 10mg sulphite preservatives/kg must be labelled as containing sulphite as this is the level that may trigger

Health claims

These are claims about something in a food and how it can affect your health. E.g. ‘Fibre helps keep you regular ’;. ‘This food is low in sodium (salt). A diet low in sodium may help reduce blood pressure’. Only pre-approved ‘food-health relationships’ for high level health claims are allowed to be made. All health claims must be supported by scientific evidence. Can’t refer to the prevention, diagnosis, cure or alleviation of a disease, disorder or condition

https://www.legislation.gov.au/Details/F2017C00711

https://foodregulation.gov.au/internet/fr/publishing.nsf/Content/31BDC68CEC4A1964CA25801B00166C1F/$File/Getting-Your-Claims-Right-2018.pdf

https://daa.asn.au/smart-eating-for-you/smart-eating-fast-facts/food-labels/what-are-health-claims-and-what-do-they-mean/

Health Star Rating

The Health Star Rating is a front-of-pack labelling system that rates the overall nutritional profile of packaged food and assigns it a rating from ½ a star to 5 stars.
Aims to provide a quick, easy, standard way to compare similar packaged foods.
Developed by Aus Gov with collaboration from industry and public

Drawbacks

Opt in, voluntary, all, some or none of their products
Compares products of the same category eg cereals with cereals
Food manufacturers and retailers are responsible for the correct and accurate use of the Health Star Rating system
Nutrients in isolation do not represent the value of a food
Doesn’t differentiate between whole foods and processed / packaged foods
Putting a health star rating on a processed food undermines message of good nutrition
Added sugars are not differentiated from natural sugars – eg a muesli bar with oats and dried fruit vs bar with tonnes of sugar
Products containing additional dietary fibre can get bonus points which can be used to offset negative points they get for saturated fat or sugar,
This is how Nutrigrain – 4 stars despite the fact it’s still literally 27 per cent sugar. Add inulin = bonus points. Very easy to manipulate.
Milo (4.5 stars, only IF consumed with a specific amt of skim milk, otherwise 1.5 stars if eaten alone!) literally receives a higher health star rating if eaten with ice-cream
Certain brands of clean, unsweetened Greek yoghurts sit at 1.5 stars. Some lolly bags sit at 2.5.
Salmon sits at 3 stars, beer battered chips sit at 4.

Shelf, fridge and freezer life

https://www.foodsafety.gov/food-safety-charts/cold-food-storage-charts

Serve size vs Per 100g

We look for (depending on the food of course)

Total kJ
Total protein per 100g
Sugar per 100g – check ingredients list to explore if natural vs added
Saturated / trans fats
Sodium
Fibre / Vit / Min

https://livelighter.com.au/Assets/resource-vic/wallet-and-postcard/traffic-lights-wallet-card.pdf

Food Switch App

Source of product and ingredients

Source : https://www.accc.gov.au/consumers/groceries/country-of-origin

Source: https://www.australianmade.com.au/media/477079/amcl_code_of_practice_2017.pdf

Remember, some of the healthiest foods may not have labels or health claims (e.g. fresh fruit and vegetables, nuts, lentils, beans, fresh meat and fish).

Episode 15

How to nail your New Year’s resolution

Trends in the New Year

Google trends data

Source https://noobgains.com/gym-membership-statistics/

https://fitness.org.au/articles/fitness-australia-annual-reports/fitness-australia-annual-report-2018-19/14/1880/19

Behaviour change

According to well known Clinical Psychologist Dr. Howard Rankin, expert on behavioural change, a large part of the problem is that we think we have control over our behaviour, when really we don’t.
Lauren and I see this regularly in practice. It’s wonderful to have goals and aspirations, but the psychology and motivation behind behaviour change in complex.
We know that habits (which often take 21 days to break) and stress, reduce our conscious control over the choices we make
What drives our behaviour is not always logical, as humans we are emotional! You guys would know, sometimes we do things we know aren’t good for us, but we don’t know what drives us to pursue them!
Quote by Dr Rankin: The more primitive, emotional brain generally has precedence over the newer, more rational brain.
This is really important to note when it comes to setting achievable goals for the new year.

Knowing this, we want to make sure you set yourself up for setting positive and realistic goals in the new year!

Why New Year’s resolutions don’t work

Abrupt change too quickly
Expectations too large therefore setting self up for failure
To successfully achieve these resolutions, small, short-term goals are the most effective and taking resolutions one step at a time is the best way to succeed
Fear is such a powerful emotion it can override our priorities and goals we set. Fight/flight. We run away from fear before we run towards pleasure. We can have a fear of failure, success, or just fear of change—stepping outside our comfort zones—that stops may of us in our tracks before resolution become habits.

How to make them stick

Make resolutions tangible and achievable. For example, instead of stating you will ‘lose 20kg in 2020,’ plan that you will ‘walk everyday for 2 weeks’ or ‘avoid choc after 8pm for 2 weeks’.
Say it out loud. Write it down. Tell someone. Anyone. Be accountable.
Enlist a support crew. Cheerleaders
Make your goals EXTREMELY SMALL. Like stupid small. For example, she suggests instead of aiming to workout three times a week, you start with two squats a day. The change is so small, you won’t stop with just two. Walk only to the letter box. No chocolate on Tuesdays. Walk only to the letterbox. And that’s how these small habits grow from ridiculously small to big. It’s hard to resist not doing more, because it’s just so easy.
Anchor it to something. Your squats for eg, tether it to something you already do every day, like brushing your teeth. It’s only 2 mins. And all of a sudden it’s achievable.
Opt in vs opt out. What are the things you always do? Eat lunch, brush your teeth, attend your specialist appts, go to work. Put your goals in that category. A MUST DO unless something major trumps it. Physically put them on your to do list, your calendar, your reminder list on repeat.
More positive less negative. – Set your phone calendar to give you positive messages or reminders about your goals a few times per day. Remind yourself to walk. Set an alarm that call your 8pm cut off time.
Time – it takes 17 to 21 days to form a habit; therefore, keeping a goal for those 21 days will support success

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC535950/

https://insights.ovid.com/article/00006205-201501000-00002

https://www.ncbi.nlm.nih.gov/m/pubmed/26671434/?i=6&from=/15604158/related

Episode 14

This week we’re giving you our top tips for navigating festive feasts!

Top Tips for navigating Festive Feasts

1. Don’t overthink it. So you ate too much cheese. Acknowledge it then move on.

2. Move when you can. A brisk walk with the fam is a wonderful way to pull yourself out of a pudding nap. ‍

3. Food envy? Have a little bit of everything. But just a little bit. Recruit a friend and remember sharing is caring

4. Eat mindfully. Listen to your body. Stop when you’re satisfied.

5. Savour every mouthful. The festive season is delicious. Enjoy it with your loved ones!

6. Refer to point 1.

FREE Mindful Eating Guide

FREE Mindful Eating Meditation

Overeating is completely normal. It is our thoughts, feelings, and reactions to overeating that can be damaging beyond the overeating moment

Overcompensating by restricting is not the solution…

Our bodies need a regular supply of food to stay alive and perform all of the various chemical reactions and daily bodily functions (like keeping our heart beating, allowing our diaphragm to expand and relax with each breath, our kidneys as they remove our waste, our growing nails, cell turnover in our gut…etc).

Restriction → deprivation → protection through overcompensating

When our bodies feel the threat of scarcity (i.e. starvation from a evolutionary perspective)- even if that is in the form of intentional restriction- our bodies will look to protect us through eating more to compensate. This is a natural biological reaction..

Our suggestion is to in fact NOT skip breakfast! Many people skip breakfast in anticipation of the big festive meal, but in many cases that just makes it more likely that you’ll be ravenous at lunch or dinner time meaning you’re less likely to actually enjoy the food (i.e. scoff it!)and more likely to eat to the point of discomfort.

Give yourself permission to eat how you would want a loved one to eat. Should they skip the xmas pudding? Should they feel bad about enjoying the xmas ham? And therefore should you?

Revisit your values and goals. Give yourself the time and space to allow your actions to align your behaviours with these values

Feel and respect your fullness – but I would add a big caveat to this one: it’s okay if you eat past the point of fullness.There’s a lot of delicious food and a lot of food that we don’t get a chance to eat very often and we want to enjoy it all with the people who put the thought and care into making it. Notice and check in with how your body is feeling but know that it’s okay if you eat past the point of comfortable fullness. Notice it. Be curious but do not be judgemental! You’re allowed to eat for more reasons than just pure hunger.

Honour your fullness. Give yourself permission to not eat also! Social pressure, “eating for others”

Some tips:

“Thank you, this looks great but I’m actually feeling satisfied already.”
Postpone, save for later

Episode 11

On this week’s show we’re answering All your DRINKS questions – from diet soft drinks to milk, we’ll keep you hydrated!

Diet soft drinks

Diet soft drinks often replace sugar with artificial sweetener, often aspartame. Aspartame is around 200 times sweeter than sugar, so a very small amount is all that is needed to sweeten a product.

Aspartame safety

Studies performed in 1980 by Joint Expert Committee of Food and Agricultural Organization + World Health Organization (JECFS) established the Acceptable Daily Intake (ADI) of Aspartame as 40mg per kg of body weight, meaning that the average person can safely consume around 3400mg of aspartame daily without any adverse side effects. Can of Diet Cola is around 180mg = 18 cans per day.

Health impact of artificial sweeteners

Some observational studies have found high intake of artificial sweeteners and diet soft drink is associated with an increased risk of obesity and metabolic syndrome
Diet soft drink may increase appetite by stimulating hunger hormones (Grehlin), altering sweet taste receptors and triggering dopamine responses in the brain
Predispose us to want sweet, calorie dense foods and fluids
Observational (diet soft drink leads to weight gain) vs experimental studies (swap to diet soft drink leads to weight loss, but beware of funding source and bias)
Link to weight gain possibly from above, possibly from pre-existing poor dietary habits. One study of over 300 overweight participants – drink 710ml diet soft drink or water per day for a year. At the end of the study, the diet soda group had experienced an average weight loss of 6.21 kg compared to 2.5 kg https://www.ncbi.nlm.nih.gov/pubmed/26708700
Bias in the scientific literature – some studies (including this one) funded by the artificial sweetener industry have been found to have more favorable outcomes than non-industry studies, so we need to be careful when interpreting results.
Observational studies have found a link between high intake diet soft drink and the development of kidney disease ? related to acid load on the kidneys from high phosphorus content.
Gut microbiome: Artificial sweeteners alter the gut flora, leading to reduced blood sugar control. This may be one way diet soft drink increases the risk ofT2DM, but more research needed. https://www.ncbi.nlm.nih.gov/pubmed/27090230 https://www.ncbi.nlm.nih.gov/pubmed/25831243
Be careful if you have low bone density – particularly with phosphorus containing drinks, so cola, and those with caffeine. PO4 interferes with Ca absorption.

At the end of the day, diet soft drinks offer no nutritional benefit. The ingredients list is empty and doesn’t offer anything positive to our health.

If you’re a regular drinker, set yourself a challenge. 21 days to change a habit. Set a target, recruit some friends, get a calendar going to mark off days and set yourself a challenge. Try our sparkling iced teas. Challenge to break the habit so you can enjoy sugar-free soft drink on occasion, but it’s not a must have each day.

https://www.nature.com/articles/s41430-019-0407-z

Carbonated water and teeth

https://www.ada.org/en

Milk

Cows milk full vs skim = change in ratios, no sugar added. Permeates ensure consistency in nutritional composition of milk.

Soy – similar nutritional profile – has to be by food standards law, plant-based, sometimes sweetened

Almond – low protein, low kJ, low fat, low CHO, low Calcium. Some are sweetened, some calcium fortified.

Rice milk – low is kJ, protein, high in natural sugars. Hypoallergenic.

Coconut milk – low in carbs and kilojoules, but is significantly higher in saturated fat than other non-dairy alternatives, lacks protein and calcium (unless fortified).

Oat milk – same kJ as cows milk, half protein, low fat, higher CHO, equiv Ca, beta-glucans (soluble fibre reduce chol reabsorption)

Milk comparison table:

https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Milk-Allergy-Foods-and-Ingredients-to-Avoid.aspx

Heart Foundation guidelines

https://www.heartfoundation.org.au/news/new-advice-from-the-heart-foundation-on-meat-dairy-and-eggs

Episode 10

This week we’re responding to your influx of questions about the Game Changers. We give you our evidence-based thoughts on the good, the not-so-good and what it all means for you!

The positives

We love plants – lots of benefits to a diet rich in plants
Generating conversation!
Controversy is sadly often necessary to create a ‘movement’ we see why they did this! (We can’t because we’re trained and regulated health professionals – and therefore the most trustworthy source of nutrition advice)
Removing stigma around veganism and vegetarianism (although the terminology they use was interesting eg never said vegan but implied it)
They help clear up the stigma around soy – check episode 4 where we present the science in a less inflammatory way!
Farming and environmental concerns

THE SCIENCE

Unfortunately good TV often equals bad science

Supporting science – controversial sources, grand extrapolations from small studies, and statements that are misleading.

Anecdotal experience, conflicts of interest

Gladiators

Whole premise of doc built on concept that gladiators didn’t eat meat…Their exact words were “gladiators were likely predominantly vegetarian”. True-ish. 80% ish plant based. Not vegetarian. Not vegan. Just like us.
We were misled from the start
They also implied that the gladiators were vegan for performance reasons, which again is misleading. Gladiators ate more of a plant based diet because of many reasons including access to animal products, availability, seasons and money! And because carbohydrates fuel the human body. Meat is expensive and many ancient civilisations only ate what they had access to.
Gladiators weren’t overly lean – gladiators benefited from additional fat stores as food supplies were often scarce and this extra weight was protective when they went into battle/helped them stay alive. More fat = lasts longer in the arena. Different to many sports in today’s day and age.

Athletic performance

You don’t have to eat animals to build muscle
So many other variables to consider when exploring athletic performance
Nutritional advice should be tailored to the sport of choice, performance goals and outputs and individual variation
In one instance, they do cite actual peer-reviewed research, he narrates: “And when it comes to gaining strength and muscle mass, research comparing plant and animal protein has shown that as long as the proper amount of aminos acids are consumed the source is irrelevant.” https://www.ncbi.nlm.nih.gov/pubmed/15212753. What they fail to include is that the same study states that “as a group, vegetarians have lower mean muscle creatine concentrations than do omnivores, and this may affect supramaximal exercise performance.” (achieving higher than what is considered maxima) = prime example of cherry picking.
Theory: Beetroot juice consumption increases bench press by 19%. Beetroot study – review of 9 studies with total of 120 subjects numbers – The beetroot juice intervention led to significantly improved performance in four of the studies, while in another four no such effects were observed. In the show they quote a 19% increase in total strength for bench press, but this is referenced in the study cited not tested by it. Obviously we went and found the actual study. It was a cross over trial, 12 young men, lifting 60% of their 1RM (single rep max, the most they can lift). 3 sets until failure were performed and those reps were totalled. Those in the nitrate supplement group performed more reps. The weight equated to an 18.9% increase. “This study demonstrates that nitrate supplementation has the potential to improve resistance training performance and work output compared to a placebo.” The study was looking at a Nitric Oxide Enhancing Supplement, not just beetroot! Nitric oxide (NO) is generated from the nitrates in the beetroot. It’s a vasodilator so opens up blood vessels and improves flow in the short term. If you understand nutrition you’ll know that other foods contain nitrates, including beef, pork, chicken, liver, salmon, trout and tuna!
Beware of supplements and performance enhancing drugs

Experiments – endothelial function (cloudy blood) and erectile function

Neither are scientifically validated test. Looks good on screen. Convincing. But not scientifically meaningful.
The ‘cloudy’ portion of blood in the test tube does not necessarily indicate there is an issue, more it shows there are triglycerides and fat transporters present called chylomicrons. This is a completely natural and necessary process, however the documentary portrays it to be negative to support their argument.
If there was sufficient EVOO or avocado in the vegan burrito, the blood sample would have looked the same. 2hrs post meal. They didn’t specify how much avocado they put in. And they didn’t have to because this wasn’t a study!
We know the fat was seen in their blood, but we don’t know if their endothelial function was impaired and/or their blood flow disturbed in any way due to their meal.
The study that suppoerted their findings (n=11): “The high-fat meal consisted of 53.4 g fat (= 7.4 chicken breasts), 30.7 g protein, and 50 g carbohydrate, composed of 110 g rice, 100 g Korean barbecue, 20 g egg, 200 ml milk, 8 g oil, 25 g mayonnaise, 50 g vegetable.” The response shown, as stated in the paper’s title, was due to ‘oxidant stress’. Not the triglycerides
Another study n=10. The standardized high-fat meal consisted of whipping cream, liquid chocolate and non-fat dry milk and contained 65 g of fat, 25 g of carbohydrates.
Supporting study funded by the Hass Avocado Board
We know that lean protein sources (e.g. poultry and fish) can improve endothelial function
Neither of these “experiments” considered variables like sleep, muscle fatigue, stress, training, hydration, blood electrolyte levels, history of tobacco use, alcohol consumption, prior medical history, mental clarity, emotional state, genetic predispositions. n= 3 people. Not enough.

Clinically concerning hypertriglyceridaemia looks like this…

Source: https://en.wikipedia.org/wiki/Hypertriglyceridemia

Source: https://www.elynsgroup.com/journal/article/milky-serum-in-hypertriglyceridemia-clinical-image

Source: https://www.semanticscholar.org/paper/Severe-hypertriglyceridemia-presenting-as-eruptive-Vangara-Klingbeil/b3148cd3bb48f43711a7a0ced40d446b1ef74618

Nutritional profile

The show claims, animals eat plants, so we should bypass animals and eat plants too. To put it in context for you a cow has 4 stomachs (we have 1), can extract amino acids from plant based materials as a result of enzymes and bacteria that we as humans do not have. As humans our digestive tract is very different. We can not get the same nutrients from grass as cows do.
Compared to animal sources, plant based sources are a poorer source of leucine – important for muscle growth
Vegans can get a complete profile of AA’s however they need to be eating a wide range of plant based protein sources.
Estimated bioavaiability of protein in beef – 92%. Estimated bioavailbility of protein in kidney bean – 54%. Grams of protein does not equate to how much we as humans can absorb and access.
There’s a funny bit here where they reference a peanut butter sandwich as containing an equivalent amount of protein to 3 ounces of beef. To achieve the ~20g of protein that is in 3 ounces of beef, you would need to consume 2 slices bread plus 4 tablespoons peanut butter bringing the total to 510 calories (2100kJ), 20g protein, 34g fat, and 39g carbs. Beef – 213cal (894kJ), 20g pro, 13g fat, 0 CHO. So the peanut butter sandwich has yes the same protein, but more than double the calories, almost triple the fat, 40g vs 0g carbs
“Even iceberg lettuce has more antioxidants than salmon or eggs.” – worse than comparing apples & pears…Just because they’re not ‘antioxidants’ doesn’t mean they’re not valuable nutrients! Eg omega-3 fatty acids in salmon and protein in eggs are so valuable! How much protein or omega 3s are in iceberg lettuce?! Shall we compare it the other way?
Go to episode 2 for tips on upgrading your salad
Wilks claims that cow’s milk can increase oestrogen and lower testosterone in men. The 2010 study he references, published in the journal Pediatrics International, was conducted using the milk of pregnant cows. The scientists pulled from a pool of 18 people (seven men, six children, and five women), and found that milk reduced testosterone secretions—not overall testosterone —temporarily. Seven men. Temporarily. https://www.ncbi.nlm.nih.gov/pubmed/19496976
Focus on ADDING plants rather than REMOVING animal products.

OnCore Practical Plant-based tips

Our upgrade your health tips (not 0-100!)

It doesn’t have to be all or nothing.
Focus on adding plants rather than necessarily removing all animals.
Add veggies, fruit, spices or acidic marinades (such as yogurt or vinegar-based marinades) to your meats – this may decrease hetereocyclic amines (linked to cancer development) formation by up to 99%
Start with meat free monday
Upgrade to one meal per day – plant-based lunches
Still eat REAL food – avoid fake cheese, fake-on, tofurkey. This takes planning and knowledge and perhaps tailored expert advice and guidance.
It’s relatively easy to meet your protein needs. It’s hard not to overdo the carbohydrate load. Tailored advice from a dietitian will help ensure you’re eating to match your goals.
Watch a David Attenborough documentary instead – we think this gives a far more powerful, realistic perspective on how we could be better looking after our planet and health simultaneously
Think about where you’re getting your health information – underlying biases, conflicts of interest, governing bodies or registrations? We are required to stay up to date and be safe and fair to public.
Think about how you can ethically source your animal products (see below).

Sustainable produce

https://sustainabletable.org.au/all-things-ethical-eating/ethical-meat-suppliers-directory/

https://www.sustainability.vic.gov.au/You-and-your-home/Live-sustainably/Sustainable-shopping/Food-shopping

https://www.wwf.org.au/what-we-do/food#gs.g3u330

https://kb.rspca.org.au/knowledge-base/how-can-i-shop-for-animal-welfare-friendly-food/

https://www.coles.com.au/corporate-responsibility/sustainability/responsible-sourcing

https://www.ethical.org.au/3.4.2/get-informed/issues/food-miles-buying-local/

https://www.sustainability.vic.gov.au/You-and-your-home/Live-sustainably/Sustainable-shopping

The Game Changers References:

The Gladiator Diet

https://archive.archaeology.org/0811/abstracts/gladiator.html

Beetroot

https://www.ncbi.nlm.nih.gov/pubmed/29311764

Nutrient Profiles

https://www.ncbi.nlm.nih.gov/pubmed/23988511

https://pdfs.semanticscholar.org/0277/f4fd3e6205936e4d4c8e490abe9958607815.pdf

These are the studies cited with regards to vegetarian diets for athletes:

https://pdfs.semanticscholar.org/6358/c99b8b7047fd99f0867e148840829a125dd0.pdf

https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-12-86

https://www.ncbi.nlm.nih.gov/pubmed/26764320

Endothelial Function

https://www.ncbi.nlm.nih.gov/pubmed/11254924

https://www.researchgate.net/publication/12166386_Impaired_flow-mediated_vasoactivity_during_post-prandial_phase_in_young_healthy_men

https://www.ncbi.nlm.nih.gov/pubmed/23196671

https://www.ncbi.nlm.nih.gov/pubmed/10477529

https://www.ncbi.nlm.nih.gov/pubmed/20047267

https://www.ncbi.nlm.nih.gov/pubmed/24004888

https://www.ncbi.nlm.nih.gov/pubmed/19064532

https://www.ncbi.nlm.nih.gov/pubmed/15165919

https://www.ncbi.nlm.nih.gov/pubmed/24742818

https://www.ncbi.nlm.nih.gov/pubmed/22019438

https://www.ncbi.nlm.nih.gov/pubmed/11834139

https://www.ahajournals.org/doi/full/10.1161/01.cir.104.2.151

https://www.ncbi.nlm.nih.gov/pubmed/17916273

https://www.ncbi.nlm.nih.gov/pubmed/17609490

https://www.ncbi.nlm.nih.gov/pubmed/23848379

https://www.ncbi.nlm.nih.gov/pubmed/16027246

https://www.ncbi.nlm.nih.gov/pubmed/16365364

https://www.ncbi.nlm.nih.gov/pubmed/15547040

https://www.ncbi.nlm.nih.gov/pubmed/26024297

https://www.ncbi.nlm.nih.gov/pubmed/24706588

https://www.ncbi.nlm.nih.gov/pubmed/22091240

https://www.ncbi.nlm.nih.gov/pubmed/15190043

https://www.ncbi.nlm.nih.gov/pubmed/16198843

Antioxidants

https://www.ncbi.nlm.nih.gov/pubmed/30634559

https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-9-3

https://www.betterhealth.vic.gov.au/health/healthyliving/antioxidants

https://www.ncbi.nlm.nih.gov/pubmed/25637150

Plant Based Guide for Physicians

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991921/

Heme Iron

https://www.ncbi.nlm.nih.gov/pubmed/23708150 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3583546/)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2954454/

Cardiovascular Disease

https://www.ncbi.nlm.nih.gov/pubmed/24871675

https://www.ncbi.nlm.nih.gov/pubmed/1973470

https://www.ncbi.nlm.nih.gov/pubmed/24606898

Cancer Risk

https://www.ncbi.nlm.nih.gov/pubmed/11519764

https://www.ncbi.nlm.nih.gov/pubmed/9786231

Human Evolution

https://blogs.scientificamerican.com/guest-blog/human-ancestors-were-nearly-all-vegetarians/

https://www.academia.edu/28523514/The_evolution_of_body_size_within_the_genus_Homo_new_empirical_data_and_theoretical_perspectives

https://www.ncbi.nlm.nih.gov/mesh?Db=mesh&Cmd=DetailsSearch&Term=%22Vitamin+B+12+Deficiency%22%5BMeSH+Terms%5D

https://www.ncbi.nlm.nih.gov/pubmed/10648266

Testosterone

https://www.ncbi.nlm.nih.gov/pubmed/10479226

https://www.ncbi.nlm.nih.gov/pubmed/2400756

https://www.ncbi.nlm.nih.gov/pubmed/10883675

Phytoestrogens

https://www.sciencedirect.com/book/9780123984562/polyphenols-in-human-health-and-disease

Oestrogen

https://www.ncbi.nlm.nih.gov/pubmed/11392381

https://www.ncbi.nlm.nih.gov/pubmed/17474873

https://www.ncbi.nlm.nih.gov/pubmed/19496976

Cortisol

https://www.ncbi.nlm.nih.gov/pubmed/3573976

Episode 8

This week we’re talking all things skin! You heard us, your body’s largest organ. From supplements to serums we’ll give you all the tricks to glow from the inside out.

Skin, hair, nails supplements

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3509882/

Many products on the market that claim to thicken our hair, improve the quality of out skin and strengthen nails.
Many of these products come with fancy marketing and an expensive price tag!
Are these supps all they;re cracked up to be? Here’s what the research shows:

What do these supplements usually contain (individual products do very)?

Hair, skin, and nail supplements commonly contain antioxidants (e.g. vitamins A, C, and E, and/or Coenzyme Q10).
biotin & B- vitamins can be in there too!
They can often contain the minerals manganese (helps your body utilize a number of vitamins and selenium (plays an important role in the health of the immune system by reducing oxidative stress), along with fatty acids (fish oil and/or flaxseed oil).
Deficiencies of these nutrients is uncommon
Over time, inadequate intake of vitamins A and E and biotin can affect our hair and skin, however this is rare!
Sadly I’ve seen some really poor quality products (with very fancy marketing) that don’t even contain all of these ingredients.

What does the science say?

For those with no deficiencies, there’s no good evidence that supplements can make a difference to our hair skin and nails.
I’m not aware of any robust data suggesting that any supplements can improve the inevitable age-related hair loss, skin elasticity or nail weakening.

What if you are one of those people who have nutritional deficiencies?

Most people get enough of the nutrients mentioned above through the diet, but in rare cases, a chronic disease and/or medical problem may cause a nutritional deficiencies, which as a result affect your hair, nails, or skin.
If you’re experiencing hair, skin or nail issues for no clear reason, talk with your doctor and request a blood test .
Supplements can often contain heavy metals and other ingredients that aren’t necessarily health promoting. We always recommend food first!

Our recommendations:

In summary: While nutrition plays a key role in many skin issues, consuming pills specifically to target these without making any other changes to your diet or lifestyle is likely counterintuitive – eat a healthy, balanced diet and save your pennies!

Vitamin A and skin

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4428712/

https://www.ncbi.nlm.nih.gov/pubmed/17515510

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699641/

Transdermal absorption

MUST be fat soluble! Lipophilic. All water sol vitamins won’t be well absorbed.

MUST be small

Vit D – sublingal vit D spray, not yet transdermal

https://www.nature.com/articles/s41430-019-0503-0

Magnesium – poorly absorbed. Requires sweat glands/hair follicles

Dead cells of the upper skin layer do not contain functional magnesium transporters, which have not yet been identified in detail, magnesium absorption may be possible only at the small area of sweat glands and hair follicles.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579607/

B12

Suitable alternative to oral or intramuscular injections at restoring serum B12 levels

The bioavailability of sublingual vitamin B12 appears to be equivalent to oral vitamin B12

https://www.ncbi.nlm.nih.gov/pubmed/30632091

https://www.ncbi.nlm.nih.gov/pubmed/29499976

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1884303/

Omega 3 fats

How does this impact our skin?

DHA = structural component of skin and keeps our cell membranes healthy. When the cell membrane is healthy, this means healthy skin – yay!
EPA has many benefits

Reduces signs of premature aging.
May reduce the risk of acne formation.
Skin hydration.
Can prevent Hyperkeratosis – thickening of skin

Omega-3s can protect skin from the UV rays emitted from the sun.
EPA in particular can help your body retain skin collagen after sun exposure

Episode 7

Get basic with the alkaline diet
A secret taste test to help you pick your drink
Putting eggs back on your plate
Your question about all those fancy bone broths

Alkaline diet

http://oncorenutrition.com/dont-be-basic/

Eggs and cholesterol

Let’s take it back, what is cholesterol?

Cholesterol is a fat-like substance that is produced by our bodies and also found in food.
Our bodies need cholesterol to function properly. e.g, cholesterol is used to build cell walls and hormone production.
About three quarters of cholesterol in the body is produced by your liver and the rest comes from the foods we consume.
Cholesterol is carried in the blood by lipoprotein as Lauren discussed last week. The main types of lipoproteins are high-density lipoprotein (HDL) and low-density lipoprotein (LDL). Obviously we want more of the good stuff (HDL) and less of the bad stuff (LDL)

Where’s the research at?

Research has shown that dietary cholesterol does not significantly impact cholesterol levels in your body.
Data from population studies showed a limited association between dietary cholesterol and heart disease in the general population.
Healthy foods that contain cholesterol (e.g. eggs, fish, shellfish, yoghurt) can be protective against heart disease and high cholesterol.

Eggs specifically?

The cholesterol found in eggs has little effect on your blood cholesterol levels.
Cholesterol levels influenced by saturated and trans fats.
Choose healthy sides to accompany you eggs, e.g. a slice of wholegrain rather than white bread and limit your intake of bacon.
If bacon is your side of choice to accompany your eggs, the bacon will likely have more of an impact on you blood cholesterol than the eggs! We encourage you to try some vegetable based sides, e.g. spinach, tomato, avocado, mushrooms or beans!

What is important to note is a small number of people are sensitive to eating dietary cholesterol that is naturally found in food. Therefore when they eat cholesterol rich foods, their LDL (not so good) cholesterol levels may increase.

Recommendation: 7 eggs per week.

Which foods will increase blood cholesterol?
The research suggests that processed foods which are high in saturated or trans fats will increase our blood cholesterol levels.

I was reading a large study in The American Journal of Clinical Nutrition, which followed over 300,000 people for 4–10 years. The subjects modified the type of fats consumed. Those who reduced their saturated fat intake by ~5% and selected polyunsaturated fats had lower rates of coronary illness or coronary related deaths.

Moral of the story: with a baseline healthy diet eggs are an excellent source of healthy fats and protein!

Pick your drink

G+T = up to 3 slices bread (short glass ~715kJ, 250ml tonic = 840kJ) = 14% daily energy needs.(7 = 100%)

Gin and soda = 1 slice bread (415kJ)

Cider = up to 4 slice bread

Cocktail – up to 5 slice bread

Dry wine, champagne, spirit = 1 slice bread

Beer = 2.5 slice bread

Better options

Spirit + soda
Champagne
Dry wine

You know the drill

Stay hydrated – 1 for 1
Get a long glass if it’s soda, short glass if it’s soft drink
Line your stomach → About 20 percent of the alcohol consumed is absorbed in the stomach, and about 80 percent is absorbed in the small intestine

Bone Broths

Bone broth? Do we need it?

These days, bone broths are being hailed as a new cure-all regarding gut health, skin, immune system and joint relief.
There are many testimonials to support this soups benefits— e.g. as wrinkle removers, gut bacteria boosters, bone builders and immune enhancers
Unfortunately, the science doesn’t quite back it up!
What is interesting is bone broth is something we have always had in my culture, my Omi makes the most delicious chicken soup and all these years we thought nothing of it (other than how delicious it was)!

What is bone broth?

Usually made with chicken stock or beef stock, but can be made with pork and fish. The soup bases made by simmering the bones with added spices and vegetables, often for as long as two days.
Bone broth is a fairly good source of protein and often contains ~ 6-12 grams a cup.

Where’s the evidence at?

Claims with some support:

Small studies which have found benefits on consuming chicken broth:

Chicken soup & mucous secretion. There is research to suggest that consuming hot chicken soup can help to loosen and clear secretions – study from 1978 and we have spoken about this in previous podcast.
Chicken soup & inflammation. Laboratory studies that found chicken soup inhibits the activity of neutrophils (white blood cells). However, this evidence is not overly strong

Both small studies but some evidence nonetheless

Claims with no support:

Bone broths & joint pain. Arthritis can occur as a result of collagen loss. Whilst bone broth contains collagen, dietary collagen isn’t necessarily absorbed and directed straight into your joints.
Bone broths & skin firming/elasticity. Claim also based on collagen, which forms a layer of tissue to support our skin. Just as dietary collagen isn’t transported directly to the joints, it isn’t taken necessarily directed to our skin either.
Bone broths & digestion. Bone broths contain gelatin, which has claims to support and improve digestion. Again another claim with little evidence
Bone broths & bones. Whilst the soup is made from bone, this doesn’t mean it will build bone or strengthen the bones in our bodies. The animals bones in the soup release very little calcium into the broth, despite being simmered for many hours/days

Of note

All bone broths are made differently – no consistency with products, therefore very difficult to test.

The bottom line: If you enjoy it, drink it or use it as a base for your soups, there is absolutely no harm. However it is not the cure-all it’s claimed to be! Save you $$ from the health food stores.

https://www.health.harvard.edu/healthy-eating/whats-the-scoop-on-bone-soup

Episode 5

The burning truth about ACV
Will chocolate make your skin break out?
Hacks to keep your iron stores high
A great question about how to top your toast – the butter vs marg debate!

Apple Cider Vinegar

http://oncorenutrition.com/apple-cider-vinegar/

Chocolate and acne

Researchers has found that high glycemic index foods (think white bread, lollies, cakes, biscuits and soft drink) may make acne worse.
On the contrary, a diet rich in low GI carbs, which includes wholegrain breads and cereals, legumes, fruits, vegetables has been found to improve acne.
Much more research needs to be done though, as the info we have is still early days
Good news for all you chocolate lovers: There is no evidence to support the claim that chocolate causes acne.
There is data to show that dark chocolate (which is rich in antioxidants) can be good for our skin. However, everything in moderation!
For some individuals, dairy products can trigger acne.
There have been studies which have shown a link between acne severity and consumption of dairy products.
It’s still farfetched to say that dairy causes acne, and avoiding dairy probably won’t cause acne to disappear. However, if you consume large volumes of dairy and experience acne, you may want to cut back on the dairy for a while and see if it has any effect on your skin.

Acne development is very complex and it’s highly unlikely that just changing one aspect of your diet is going to completely irradicate ones acne.

Iron hacks

Animal-based iron sources

Food	Serving size	Iron content
Chicken liver	100g	11mg
Beef	100g	3.5mg
Kangaroo	100g	3.2mg
Lamb	100g	2.5mg
Salmon	100g	1.28mg
Tinned tuna	100g	1.07mg
Lamb brains	100g	1.0mg
Pork	100g	0.8mg
Chicken	100g	0.4mg
Snapper	100g	0.3mg

Plant-based iron sources

Food	Serving size	Iron content
Weetbix TM	30g	4.2mg
All Bran TM	30g	3.2mg
Kidney beans	1 cup	3.1mg
Green lentils	1 cup	3.0mg
Tofu	100g	2.96mg
Chickpeas	1 cup	2.7mg
Cooked wholemeal pasta	140g (1 cup)	2.3mg
Cashew nuts	30g (20 nuts)	1.5mg
Raw spinach	1 cup	1.2mg
Rolled oats	30g	1.1mg
Almonds	30g	1.1mg
Dried apricot	30g (5 dried apricots)	0.93mg
Broccoli	1 cup	0.86mg
Cooked brown rice	140g (1 cup)	0.7mg
Wholegrain bread	1 slice	0.4mg

How much iron do I need?

Age	Recommended Daily Intake1
All 1-3 years	9mg per day
All 4-8	10mg per day
Girls 9-13	8mg per day
Girls 14–18	15mg per day
Boys 9-13	8mg per day
Boys 14–18	11mg per day
Females 19–50	18mg per day
Female 51+	8mg per day
Males 19+	8mg per day

Pregnant & lactating women	Recommended Daily Intake1
All pregnant women	27mg per day
Lactating women, 14–18 years	10mg per day
Lactating women, 19–30	9mg per day

Functional signs of Fe def:

– Redced physical work capacity,

– Delayed psychomotor development in infants,

– Impaired cognitive function

– Dizziness, headaches,

– Tmpaired immunity

– Challenges in pregnancy

– Tongue and mouth sores

– Pica (the compulsion to eat nonfood items, such as paper or ice chips)

– Get your serum Fe levels checked – measure the stores, the transporters and the saturation of the Fe on the transporters. A haemoglobin level might also be taken if there is suspicion of blood loss.

Tips to enhance absorption

– Eat foods high in vitamin C or citric acid with foods that contain iron.

– If possible or plausible, separate the intake of Fe rich foods with phytate rich foods such as whole grains, cereals, soy, nuts and legumes

– Cook your plant foods to improve the amount of available iron

– Avoid having tea, coffee or calcium during or directly after having a source of iron – if you’re taking supplements, split them up!

– Ensure that you only take iron supplements under the advice of a medical prof, as too much iron can also be harmful.

Butter vs Marg

https://www.health.harvard.edu/staying-healthy/butter-vs-margarine

Episode 1

Jumping off the celery juice bandwagon
The best things to eat when you’ve got a pesky cold
One simple food swap that can improve your longevity AND your bank account
Is going organic is worth the coin?

Celery juice – savvy marketing, early mornings, juicing vs blending and a heightened electricity bill!

http://oncorenutrition.com/sell-ery-juice/

The old wives tale ‘starve a fever, feed a cold’ and what to eat when you’ve got a cold versus a flu.

Dates back to 1954
People thought that eating would divert energy and resources away from fighting the fever, to the process of digesting your food…and that this would lead to more fever
When we eat, digestion creates something called the thermic effect of food, or the energy that it takes our bodies to break down our food. This process released a byproduct of heat, which is where this concern might have come from.
What science has been able to demonstrate is that in fact the opposite is true. Medical research suggests the saying should instead be “feed a cold, feed a fever.”
When we are unwell with fever or a cold, it requires additional energy to fight the infection. This means our body requires an increase in energy and nutrients to produce the immune cells required to fight the infection.
These immune cells, immunoglobulins for e.g. are made up of protein
Other micronutrients, including Zn, selenium, Fe, copper, vits A, C, E, B6 and folate, glutathione (cruciferous veg), bioflavanoids (citrus fruits) are all involved in immune processes and its important to have enough of these through eating a variety of whole foods.
Colds and flus are caused by viruses
Intermittent fasting may enhance immune function, but not so useful once you’re already sick
Starving a fever is of no benefit and may even delay your recovery
Drink plenty of fluids, rest if you need to, hearty soups such as minestrone, chicken and veg, can help provide nutrients and liquids – killing 2 birds with 1 stone. And the heat can help loosen mucous.
Listen to your body – eat when you’re hungry but also rest when you need to.
Some benefit in zinc , olive leaf extract at the first sign of a cold to reduce the severity and duration

Upgrade your health – swap your rice

Rice itself doesn’t offer much more than carbohydrates and calories so if you have an opportunity to swap it out for something that adds more value we’d encourage you to do so.
You could swap rice for a grain such as quinoa, barley or freekeh for significantly more protein and fibre; a legume like chickpeas or lentils, or get right amongst it and try some cauliflower rice. If it’s the curry you’re really after then you’re unlikely to miss it.
And if you just want rice, absolutely use it, keep your serves to the size of your fist. And select basmati rice, wild rice or a rice and quinoa blend to get the glycaemic response down.

Organic versus non organic produce

Studies on the foods themselves in terms of nutritional content, levels of chemicals and resistant bacteria
Studies on the health of humans long term
When we look at organic vs non-organic there may be slightly higher concentrations of antioxidants in organic produce. This is only in general, as organic milk has been found to have lower mineral content, and varies depending on the source.
When we look at chemicals and pesticide residues, organic produce may reduce exposure to these but important to note that the levels of toxins in non-organic produce is generally well below safe limits
When we look at health overall, in particular long term health of individuals that eat organic vs non organic produce, the benefits are far less clear.
No difference in cancer risk (studies of >600,000 women)
Huge systematic reviews show no difference
Some studies that report a difference need to be careful of other confounding factors. If we think about the profile of someone who may eat organic – they have chosen to and have the means to do so. In general,this often means they are more likely to be of a higher SES/income, better living environments, higher education level, health conscious therefore choose more fresh produce overall, get regular health check ups and screen for chronic diseases. It’s really difficult to attribute health benefits to the organic produce when there’s a whole bunch of other health-promoting behaviours, environmental and lifestyle factors contributing.
Bottom line: if you’ve got the means and it’s a priority for you – by all means! If you don’t – just keep aiming for your 5 serves of veggies and wash them well.

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Two Peas In A Podcast

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Two Peas In A Podcast

Your weekly dose of nutrition news from OnCore Nutrition.

Episode Notes

Episode 24

Episode 23

Episode 22

Episode 21

Episode 20

Episode 19

Episode 18

Episode 17

Episode 16

Episode 15

Episode 14

Episode 13

Episode 12

Episode 11

Episode 10

Episode 9

Episode 8

Episode 7

Episode 6

Episode 5

Animal-based iron sources

Plant-based iron sources

How much iron do I need?

Episode 4

Episode 3

Episode 2

Episode 1

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FREE 15 MINUTE PHONE CONSULT

We offer new clients a one off, obligation-free, 15 minute phone consult. Spaces are limited so book your slot in today and be on your way to your best you!

OUR RECENT POSTS

COVID 19 and our food relationships

Navigating the Festive Season

Pregnancy Nutrition

CONTACT INFORMATION

OUR LOCATIONS