Protein

Protein is a vital aspect of our diet and a crucial component of every cell. It is often referred to as the ‘building blocks of life’. Our digestive system breaks down protein to single bricks called ‘amino acids’ which our body absorbs and assimilates not only into muscles but also bones, collagen structures, neurotransmitters, hormones, immunoglobulins, transport proteins and other.

It also helps to keep blood glucose stable, keeps us fuller for longer, prevents cravings, snacking, sudden energy dips, ‘hanger’ and bouts of anxiety.

Increased protein intake is key on a weight loss journey - for body recomposition goals including muscle growth and the reduction of fat tissue. Increased protein intake prevents muscle loss which is a common issue these days due to chronic stress and a hectic lifestyle (during stress, muscle is used to create glucose to fuel up the constant fight-or-flight). I think that this is the main reason why we need a lot more protein these days. Those who retired, lead a more relaxed lifestyle and those who have no children generally do ok with smaller amounts.

More protein is indispensible in mood disorders, poor immunity and all autoimmune conditions. It is an unquestionable must for babies, children, pregnant and perimenopausal women, those who are stressed and on the go a lot.

Anyone who wants to heal should look into more protein.

The two main drivers of insufficient protein are:

• inadequate consumption of quality protein throughout the day

• impaired protein digestion and assimilation, regardless of adequate intake

What is quality protein?

There are two main factors which determine protein quality:

1. How digestible it is for humans (this determines how usable a protein is)

2. How many essential amino acids it contains (‘essential’ means that the body cannot make these and they have to come from food)

The DIAAS score is the latest measure of such protein quality. It evaluates which consumed amino acids are absorbed and utilised by the body.

• a score of 100 or more: high quality protein

• a score of 75-99: good quality protein

• a score <75: low quality protein / no protein claim can be made

In other words, it’s not the question of how much total protein there is in a food but rather if it’s of any use.

For example, peanut butter may have a decent amount of protein but it is lacking certain essential amino acids. Peanut butter scores only 46 which doesn’t qualify it as a protein. This does not mean one should not eat peanut butter! It provides plenty of nutritional value in the form of fibre, phytoestrogens and fats. It just isn’t a strong candidate for usable protein.

Protein requirements and serving sizes

In order to prevent malnutrition, the WHO recommends approximately 0.8 gram of protein per 1 kilogram of lean body mass. However, optimal intake goes beyond just bare survival and warrants that ALL bodily functions that depend on protein incuding mood, immunity and hormones, work well.

Functional optimum for protein intake ranges between 1.2 - 1.6 grams per 1 kg of lean body mass, which depends on one’s goals, fitness level and health status. Most of my clients don’t meet adequate protein requirements when we first meet.

I usually recommend 90-120g of protein for women and 100-150g for men per day. It can be divided into 25-35g of protein, split between 3-4 meals and snacks if needed. 30g per each main meal is a good place to start.

Again, this depends on individual factors. Protein has a limited absorption rate, meaning that if a lot is eaten in one sitting, some of it will remain undigested and reach the colon where it will undergo putrefaction under the influence of gut microbes. It is the undigested and putrefied protein that is associated with adverse health effects, including colon cancer. If your protein demands are bigger, then it is better to add an extra meal or snack rather than having a very large serving in one go.

Last but not least, addressing the gut and improving digestion by stomach acid, brush border enzymes and pancreatic enzymes is key to benefit from an increased protein intake while keeping health risks at bay.

Best sources of protein

I compiled a list of the best protein sources according to the highest DIAAS scores, 75 and up. The amount of protein in the amounts below is approximate.

Meat:

• Chicken breast (100g): 28g

• Lean pork cuts like tenderloin and ham (100g): 26g

• Fattier cuts of pork like ribs and shoulder (100g): 18-20g

• Lean steak like sirloin (100g): 26g

• Fattier steak like ribeye (100g): 20-22g

• Beef burger (100g): 20g

• Organ meats (100g): 22-25g

• Chicken thigh: 22g

• Sausages without fillers (100g): 16-20g

• Lamb chops, 3: 22g

• Traditionally cured meats like Iberico, Serrano, Parma ham (100g): 25g

Seafood:

• Oily fish like sardines, mackerel, anchovies, salmon, herring (100g): 20-25g

• Non-oily fish like tuna, hake, sea bass (100g): 22-26g

• Prawns 10-15 large: 24-26g

• Crab, 1 leg: 24-26g

• Clams, 10: 25g

• Mussels, 20-25: 22-24g

• Scallops, 6 large: 20-22g

• Tinned fish in brine or olive oil (50-60g of net weight): 12-15g

Vegetarian:

I don’t recommend exceeding the amounts of dairy below in order to get more protein. Dairy is generally inflammatory and insulinogenic. It is better to combine protein sources to reach your goal, e.g. eggs and cheese.

• Cottage cheese (200g): 24g

• Egg, 6g

• Feta (50g): 7g

• Greek yoghurt, fat free or low fat (full fat is predominantly a source of fat) (150g): 15g

• Halloumi (100g): 22g

• Kefir (250ml): 8g

• Paneer (100g): 18-20g

• Skyr (150g): 15g

• Whey protein isolate, 20-25g per serving, depending on the brand

Vegan:

As above, exceeding the numbers below in order to maximise protein intake may cause adverse reactions, especially digestive, inflmmatory and hormonal when eaten in larger amounts and on a regular basis. It is best to stick to the maximum recommended serving sizes. Legumes and quinoa are considered high protein vegan foods but they are mainly a starchy carbohydrate. Quinoa does not even make it to the list. By increasing the amounts to rich a protein goal, one will also significantly increase starch.

Seitan also scores high but because it is pure gluten, I will not recommend it to any of my clients.

• Chickpeas (75g cooked): 7g

• Edemame (75g cooked pods): 8g

• Natto (100g): 18g

• Pea protein powder: 15-20g per serving, depending on the brand

• Tempeh (100g): 18g

• Tofu (100g): 8g

• Yellow split peas (100g of cooked): 8g - borderline as yellow split peas scores 73

Raw egg yolks are a superfood

For a long time, we were told to stay away from dietary cholesterol, including egg yolks, because it was supposed to be the leading cause of heart disease. Thankfully, eggs have made a comeback due to the shifting mindset in relation to what really stands behind clogged arteries at the root. After all, eggs are a natural whole food, and these should be excluded last unless there are clear signs that you can’t tolerate them. You can read my post on cholesterol here.

Whole eggs are best cooked because raw egg whites should only be eaten on occasion. Raw egg whites can block certain digestive enzymes and frequent consumption can lead to gut issues. The whites are also a major allergen, especially raw. Yolks, on the other hand, are perfectly fine raw and many traditional cultures eat raw egg yolks on a regular basis.

What’s so special about raw egg yolks?

• Uncooked, they have been compared to breast milk, meaning most of their nutritional value is easily absorbed without requiring much digestion.

• They are a powerhouse of nutrients in their extra virgin form so are more nutritious than cooked. They provide quality protein, vitamins, minerals and good fats.

• A source of lecithin and choline: lecithin is a great emulsifier of fats and can replace bile. Fantastic for those who had their gallbladder removed or suffer from constipation. Raw egg yolks are much more potent at stimulating bowel movements than cooked. Lecithin contains choline, a type of B vitamin which is key for the brain (esp. memory and learning ) and liver health (e.g. it is effective against the fatty liver). It also enables the conversion of cholesterol to bile which can result in the lowering of total cholesterol while increasing HDL (the ‘good’) cholesterol.

• They are one of the richest sources of retinol, the only biologically active form of vitamin A that can only be obtained from animal fats (beta carotene is not vitamin A). Retinol is a vitamin I am adamant about because it is life giving. Necessary for reproduction, longevity, quality skin, eye sight, brain function, gut integrity and immunity. Without retinol, we can’t utilise dietary protein as efficiently. Therefore, egg white omelettes or egg white scramble should be avoided. Moreover, high protein diets can deplete retinol if you avoid animal fats. This is why I also recommend adding egg yolks to smoothies that contain a protein powder. If you are vegan, would you consider adding eggs or at least egg yolks into your diet?

• A source of vitamin K2 in the MK4 form, another nutrient that I cannot praise enough and can only be found in animal fats. This vitamin is getting more and more attention due to its magic function: it activates other nutrients. It directs calcium away from soft tissue like arteries (bye, bye arterial plaque) into hard tissues like bones and teeth, keeps wrinkles at bay and helps to maintain good blood glucose balance.

• A source of vitamin D which helps with the absorption of calcium and phosphorus in the gut. It’s a potent immune modulator which keeps allergies and infections at bay. Key for the brain, hormonal health and insulin sensitivity. Egg yolks are especially great in winter when the exposure to the sun is limited. Did you know that we produce vitamin D by exposing cholesterol in the skin to the sun? Interestingly, many foods that are a source of vitamin D3 (active form, present only in animal fats) are also a source of cholesterol.

• A source of essential fatty acids omega 3 and 6. ‘Essential’ means that the human body is unable to produce them and we have to obtain them from the diet. They are very prone to damage by heat and are best in an unadulterated form. On top of raw egg yolks - sushi, gravlax and carpaccio or steak tartare from grass fed beef are phenomenal for that too. EFA’s work together with vitamin A, D, K2 and calcium, all of which are supplied by the yolk.

• They are particularly rich in vitamin B12 which is key for the nervous system and building healthy blood (preventing anaemia and energising you).

Best quality eggs come from pastured hens that roam freely and eat all foods they come by: grass, herbs, bugs and even meat. Hens do not thrive on soy, corn or similar feeds, even if organic. They need ‘wild’ foods, which will yield a perfect omega 3:6 ratio in the yolks. If pastured eggs are hard to come by, get the best eggs that are available to you, even if far from perfect.

How to handle eggs if you ant to eat the yolks raw

The ‘how to’ is intended to minimise any potential health risks associated with salmonella. If present, salmonella is found on the egg shell and can penetrate the egg if it was broken. Please note that commercial eggs are washed and sanitised so the risk is small. Saying that, if you want to eat a raw egg yolk and feel safe, always pick an egg that has no cracks. Running some boiling water over the egg before you crack it is also a good idea.

The best way to crack an egg when you want to have a raw egg yolk is quickly bashing it with a sharp knife and letting the white run through your fingers while holding the yolk. This way, the yolk has no contact with the shell.

Where to add raw egg yolks

• Smoothies: energising smoothie , brain boosting smoothie , mango lassi style smoothie , liver lover smoothie

• Home made mayonnaise and alioli

• Salad dressing (e.g. vinegar, olive oil, mustard, honey, egg yolk, salt, pepper; shake all ingredients in a small jar)

• Cup of soup or meat stock (stir it in directly before eating, not while cooking)

• Home made ice cream: peanut butter ice cream , salted caramel style ice cream

• Russian custard

How to feel warm when you´re cold all the time

Feeling cold all the time is painful for the body and soul. In fact, it is a major stressor, to which the adrenal glands respond no different than to any other source of chronic stress. People may think you´re going crazy but it can lead to mental disturbances. If you´re cold all the time, it is important to look into the cause and act appropriately. Some are lifestyle related while other, like all types of anaemia, underactive thyroid or adrenal stress, require a whole-person approach. In this post, I will share some general tips on how to warm up.

1. Preserve the heat in the first place: for example, get dressed as soon as you get out of bed. Put your socks and slippers on and wrap up in a dressing gown or a warm cardigan. Do the same when you get out of the shower, although it is best for ‘cold’ people to shower before bedtime.

2. During the cooler months, do not get outside with wet hair. Preferably, wash it when you know you’re not going out again that day. If oily hair is a problem, try quality dry shampoos.

3. Dress appropriately: many people miss this vital aspect. It is good to wrap up like an onion so that you can easily remove layers when you do get too hot. The first layer should be close to the body and tucked in. The middle layer can be looser looser but warm enough; long sleeve is a must. The top layer should protect you from the wind and cold like a shield.

4. Cover the strategic body parts which, when uncovered, can make you feel cold overall:

• upper back and back of the neck: in Chinese medicine, this area is called the ´wind gate´ - a place that is easily penetrated by weather changes, especially moving air. This ‚wind’ invites all sorts of aches and pains. Always carry a scarf or snood with you and wear it when you can feel a draft. This is especially important for office workers who often sit directly under the aircon. Now during the Covid-19 pandemic, places have to be ventilated regularly. Unfortunately, it results in a constant exposure to drafts, which can make people more susceptible to getting sick. In acupuncture, stabbing upper back or shoulder pain is related to the so called ´wind invasion´ - something that golfers often suffer from. It is believed that it is not the swing itself but rather the weather´s effect on uncovered neck that can cause pain

• the waist / kidney area: the inner layer should always be tucked in; wearing short tops when it´s cold is a big no. If you have a daughter that likes to show her belly, try and make sure she doesn’t do it in the cooler months. This is especially important for girls and women who suffer from urinary tract infections and hormonal issues

• ankles: ditch ballerina pumps, short socks and cropped pants

• wrists: wear long sleeves and not the 3/4 length; fingerless mittens can be very useful, too

5. Move: especially when it´s cold. Never sit or stand when you can feel a draft. Needless to say, regular exercise of any kind can make a tremendous difference to circulation, especially when deep breathing is involved. 5 sun salutations first thing in the morning can make a big difference to your day! Rebounding or rope skipping are also fantastic.

6. Eat sufficient: if you skip meals (especially breakfast), it can cool you down for two reasons:

• lack of food means no fuel to produce heat

• lack of food can stimulate the release of adrenaline which can make your hands and feet ice cold. This is very important for those who start the day with coffee instead of food - you get a double shot of adrenaline! It is also common in those who rely on carbohydrates and sugar, or those with poor blood glucose control. A common scenario is cold hands and feet but sweaty armpits and / or heat around the chest, and enlarged pupils. It´s an adrenal sign.

7. Eat and drink according to the weather: it is best to leave salads, smoothies and cold drinks for the warmer months. Some people thrive on cooked foods all year round and there is nothing wrong about that. It is interesting that the Chinese and Ayurvedic medicine don´t stress raw foods at all. In fact, too much raw matter can weaken digestion, and weak digestion weakens the quality of blood. Porridges, soups, stews, casseroles, curries, stir fries, root vegetables, stewed fruit and warming beverages like my masala chai or a simple ginger and lemon tea are the best foods for cold people.

8. Maintain optimal level of vitamin D: people who are cold all the time are often low in the sunshine vitamin. My favourite sources include cod liver oil, liver, egg yolks, pastured lard, oily fish, shellfish and fish eggs. Saying that, some people who have a diet rich in vitamin D may still have insufficient levels due to poor absorption in the gut. Optimal vit D level for general public is 45 ng/mL, especially that is not easy to raise vitamin D much higher naturally. People with chronic health issues may want to go higher and use supplemental aids.

9. Maintain optimal levels of iron, vitamin B12, folate and vitamin C: all of which are essential to build blood. My favourite sources include:

• B12: meat, liver, oysters, clams, pastured dairy, also produced by healthy gut microbes; most common deficiencies are seen in vegetarians, vegans, those with suboptimal gut function and individuals with pernicious anaemia

• folate: liver, dark green vegetables and legumes, also produced by healthy gut microbes

• vitamin C: sauerkraut, kimchi, cabbage, citrus fruit, berries, fresh vegetables and fruit in general

10. Maintain optimal temperature at home: which is around 20-22 Celcius degrees during the day and max. 19 at night. Even if you´re tempted, try and not make the house a furnace because it will weaken your own ability to warm up. However, it is important that there is no dampness as it can amplify feeling cold so invest in a dehumidifier if you feel that air quality is suboptimal.

11. Finish with a cold shower: it will make your blood moving, which will generate heat. You can dry brush your skin prior to the shower, too. If you´re brave enough, take a cold shower altogether or start ice baths if it suits your constitution. Warm showers and baths are best left for the evening time because they bring body temperature down, which is desired for quality sleep.

12. Lower your keyboard: if you work on the computer a lot and your hands are getting cold, try and lower your keyboard. It may mean getting a docking station and a few extra props but it can make a big difference.

Bread for people who can't eat bread

There is so much bad bread out there that it’s no surprise that all bread is under the radar, being blamed for various health issues and weight gain. People feel confused and desperately look for alternatives, especially that everyone loves a good vessle for the likes of pate, olive oil or fruit preserve. Sadly, education in this area can be poor, food labelling is misleading, and many of the so-called ‘healthy breads’ are often not any better.

So what is the problem with most of today’s bread?

Processing

Bleached flour, instant leavening with synthetic yeast, added gluten and other improvers may result in an appealing texture, but the end product is not real, nutricious food. It is mass-produced with very little TLC. And bread needs time.

Modern wheat and pesticides

Wheat is the most common grain used in baking and unfortunately, it’s not what it used to be. Large portion of commercial wheat is a GMO, Roundup-ready crop. It means that it can be sprayed with this killer herbicide and resist its highly toxic effects, which makes wheat highly profitable. Roundup (glyphosate) is not neutralised by the soil and can be found in baked goods, non-organic pasta, breakfast cereal and commercial dairy. A large portion of people react to glyphosate and not gluten, as they think.

Anti-nutrients

Cereal grains cannot escape from predators so they produce chemical weapons called ‘anti-nutrients’ that protect them from being eaten, the most notable of which is phytic acid. It blocks mineral absorption in the gut and can trigger digestive distress. Under the microscope, grains seem to be a good source of vitamins and minerals but they are not well utilised by the body, unless the grain has been properly prepared through fermentation. Whole grain and whole meal options, even though they seem to be healthier, are the richest source of phytic acid and unless fermented, they should be avoided.

Gluten

When flour is mixed with water, two proteins called gliadin and glutenin that are present in wheat, rye and barley, combine and form gluten (from Latin ‘glue’). Gliadin aids dough extensibility, and glutenin is responsible for its elasticity. Both help the dough rise and hold its shape. And the more gluten, the more attractive baked goods are to consumers.

All proteins are chains of smaller building blocks called amino acids, and it is the specific amino acid sequence in gliadin that is responsible for gluten sensitivity. More on that later.

Fructans

These are a type of sugar present in wheat, barley and rye. They are highly fermentable and are the main reason for unpleasant digestive symptoms in sensitive people. Bloating, heartburn, pain, cramps, excess gas and changes in bowel movements caused by fructans are often incorrectly blamed on gluten because coincidentally, glutenous grains are also high in fructans.

Real bread

Thankfully, not all bread is the same and health permitting, traditional sourdough bread is your best choice. It is made by fermenting (´pre-digesting´) the dough for 24-48 hours, a length of time that can pose challenge for industrial baking. No wonder that sourdough bread available in supermarkets is not the real deal because it still contains additives that speed up the leavening process without ´pre-digesting´ the grain.

Fermentation neutralises the anti-nutrients to a large degree. It reduces the levels of fructans, breaks down starch and gluten proteins - those with gluten sensitivity may be able to eat sourdough bread. The longer it´s been fermented, the more ‘predigested’ it is, taking the weight off our own digestive and immune systems. Research now shows that wild yeast that naturally occurs in sourdough can even metabolise glyphosate during fermentation, at least to some degree.

Natural leavening lowers bread’s glycaemic index, making it a friendlier option for insulin resistant people and those who want to shed a few pounds. It also eliminates the phytic acid and makes grain nutrients more bioavailable. Saying that, some people won’t be ready for any bread until their their health significantly improves, for which nutritional therapy is the best solution. In other words, the fact that sourdough bread is a better option, still doesn’t make it a suitable food for many people.

Proper sourdough is made only with 4 ingredients:

• flour (unbleached and free of glyphosate)

• water

• sourdough starter (mixture of flour and water which has been naturally colonised by lactobacilli and friendly yeasts)

• salt

How to find honest bread

Always look for traditional or artisan bakeries. Don’t be shy and talk to the bakers, ask how they make their bread and where the flour comes from. If it free of glyphosate? Honest bakers will only be proud to tell you about their passion that often has interesting stories and heritage behind. True bread is made with true love for baking, and understanding of its science. It is art.

Immunity - can you protect your child from getting sick? Online course for parents

Soon after schools and daycare start, the weather changes. Due to the temperature drop in the autumn months, it’s easier to catch all sorts of microbes. Parents often feel guilty about the frequent infections, not only because of missed work and school but most importantly, child’s discomfort . If you want to know how to best support your little ones during this sensitive period and beyond, this course is for you. In an easy to understand manner, I will address the most common concerns:

• how child’s immune system differs from adult’s - reasons to act differently

• how often can children get sick and how long can it last

• why some children get sick more often than other

• what damages the immune system

• best practices for strong immunity vs marketing promises

• popular immune ‘boosters’ vs antimicrobial agents

  Bonus: recipes for immune health

After this course, you will never think about immunity the same way.

When: 20 September 2021, 20:00-21:30 CEST

Where: ZOOM live, the course won’t be recorded

Investment: €30 (you will receive the link to the event in the afternoon on the 20th of Sept)

Foods to avoid on my health plans

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All my plans are individualised but there are some foods that everyone should limit as much as possible while working with me because they don’t bring any nutritional value needed to improve health. In fact, these can sabotage any efforts to feel better or lose weight, and that can go on for years. If you are unable to give them up or at least reduce their intake, your addiction may be rooted in emotions, unstable blood glucose, yeast overgrowth or poor neurotransmitter status. For example, everyone knows that sugar is bad and yet it can be so difficult to give it up. One of the reasons is that sugar and starchy foods are more addictive than cocaine. People with dopamine imbalances are prone to addictions which includes sugar addiction. The short term effects of sugar help them feel normal: have better energy, a clearer mind, no headaches, etc. But in the long run - the brain cries out for help from all the sugar and junk. The minute you fill your diet with nutritious foods, the body will not crave as much sugar or junk foods anymore.

First, you will have to set your priorities (do you want to feel and look better? are you ready for the change?) and acknowledge that there is no way around it but implement dietary changes. Secondly, set your environment for success. The first and most important step will be to stop buying these foods and replacing them with healthier options. I can help you overcome any challenges so open up if you feel that eating clean proves difficult. Learning new habits takes time as it means you will have to prepare more food at home or learn how to eat out - it’s a process and lifestyle change. Take your time and be kind to yourself - it will be well worth it.

I recommend avoiding or at least reducing the intake of the following foods:

• White sugar, inverted sugar, glucose syrup, glucose-fructose syrup, aspartame. A little sugar added to the likes of meats in the process of curing is fine. Side note: sugar is still better than the remaining sugar replacements

• Unnatural food colourings: colourful candy, icing, colourful drinks and ice cream

• Hard candy, jellies, lollipops

• Table salt (pure sodium chloride)

• Starchy snack foods, e.g. crisps, bread sticks, pretzels, crackers

• Fast food

• Fried and battered foods, e.g. potato fries, croquettes, calamari, battered fish and chicken, samosa, bhaji

• Ready-to-eat packaged meals unless they are healthy options

• Non-organic wheat and corn which includes their flowers and pasta. These are the two main crops that have been genetically modified to be resistant to glyphosate which means they are full of Roundup

• Fizzy and soft drinks (including diet soda), except for sparking water

• Fruit juice unless freshly pressed

• Puffed cereal

• Muesli (oats should only be eaten cooked and never raw or in the form of Bircher muesli aka overnight oats)

• The following oils: sunflower, rapeseed, grape seed, safflower, cottonseed unless they are cold pressed, kept in the fridge and used cold

• Margarine, shortening

• Processed cheese, e.g. Philadelphia, ‘slices’, string cheese and cheese spread

• Instant coffee, esp. with added creamer and sugar

• Instant soup (including ramen), sauces, gravy, stock cubes

• Jam and Nutella type spreads

• Ketchup, ready made salad dressing

• Soya milk (soya yoghurt, tofu, tamari soy sauce, edemame, tempeh and natto might be ok)

There is only one cholesterol

What is cholesterol

It is a yellowish, waxy substance that is soluble in fats but is not a fat as such. The actual fat in blood is called ‘triglycerides’. It is estimated that 75% of cholesterol is produced by the liver and all cells in the body while only 25% comes from the diet. In other words, the body produces the necessary amounts from all types of fats, carbohydrates and even proteins, regardless of ingested cholesterol - this is how vital it is. Some say that the less cholesterol we eat, the more work the body has to do.
We would not survive without sufficient cholesterol, and here is why.

Functions of cholesterol

• Integral component of cell membranes, modulating cell membrane fluidity. The membrane can’t be either too fluid or too rigid so that substances like nutrients and waste can get in and out of cells but crucial cell components called organelles don’t spill out

• Brain health: approx. 20% of total body cholesterol is taken by the brain

• Key component of the myelin sheath. The myelin insulates all nerve fibres so that electrical signals can be transmitted

• Precursor of all steroid hormones: cortisol, aldosterone, all sex hormones and vitamin D. A healthy response to stress and good fertility are only possible with ample cholesterol

• Anti-inflammatory / antioxidant agent

• Immune enhancer

• Precursor of bile which aids the digestion of fats, absorption of fat soluble vitamins A, D, E and K and detoxification. Bile is our master detoxifier. Without quality bile and good bile flow toxins don’t leave the body as they should. It’s often missed in detox programmes

There is only one cholesterol

Cholesterol can’t move in blood (fat-like substances and water don’t mix) so it needs a vessle. All vessles in the body are proteins and carry various molecules through body liquids like submarines. There are three major vessles that carry cholesterol around the body, called lipoproteins. These lipoproteins also carry fat soluble vitamins A, D, E and K, steroid hormones and triglycerides. They differ by density which pertains to the amount of protein in a given vessle. The less dense, the less protein in the vessle, and more fat. Total cholesterol reading means nothing - we can only tell a little more when we measure total cholesterol and the following 3 fractions:

• VLDL - very low density lipoprotein: contains the least protein but the most cholesterol and triglycerides. As it travels around the bloodstream, it loses some of its contents and becomes LDL. You don’t want VLDL high and if your LDL is high, ALWAYS check VLDL as well.

• LDL - low density lipoprotein: contains a little more protein and less cholesterol and triglycerides. LDL carries cholesterol, fat soluble vitamins and steroid hormones to tissues, like a site of inflammation or the endocrine system.

• HDL - high density lipoprotein: contains the most protein and the least amount of cholesterol and triglycerides. HDL takes the very same cholesterol back to the liver.

Basically, it’s the vessle that differentiates the ‘good’ and ‘bad’ cholesterol but cholesterol is always the very same substance. If, say, cholesterol needs to be sent to a site of damage to dampen inflammation, is it fair to call it ‘bad’? I love dr Natasha Campbell McBride’s explanation: calling LDL cholesterol ‘bad’ and HDL cholesterol ‘good’ it like calling an ambulance that goes to a site of an accident a ‘bad’ ambulance, but the one that brings the casualty back to the hospital is a ‘good’ ambulance.

In other words, it’s not the cholesterol itself that is the problem but why it’s present at higher amounts. If cholesterol is high, look for metabolic dysfunctions, poor bile flow, choline deficiency, some sort of a damage (like autoimmune processes), inflammation, immune deficiency or hereditary tendencies.

Optimal cholesterol

Since I look at functional, rather than conventional ranges, my optimum for total cholesterol is 180-220. I also think it’s absolutely fine at higher levels, given that insulin, glucose, HbaA1c, triglycerides, uric acid, ferritin, hs-CRP, Apo-A1, Apo B (od LDL-P), Lp(a) and homocysteine are optimal too, as these are associated with atherosclerosis. And the older one gets, the higher levels are desirable but again, given the other markers are good.

There should be sufficient HDL cholesterol (‘good’), between 60-70. When troops go to war, you hope to get them back. But obviously not more than you send out. Sometimes I see HDL higher than LDL which may look great for some. In fact, excess HDL is associated with oxidative stress and autoimmune processes.

One should also look into the total cholesterol to HDL, and triglycerides to HDL ratios.

In functional medicine, cholesterol equal to or lower than 150 is considered too low. This is where fertility, immunity, resilience to stress and the brain may need support. This is often a result of being on a low fat diet, impaired fat absorption or being a vegan.

When can cholesterol be high

• Inability to metabolise cholesterol into bile acids: cholesterol becomes a component of bile with certain enzymatic reactions that require nutrients, such as choline and taurine which can be deficient for various reasons, which can impair cholesterol metabolism. Poor bile flow will also cause a higher cholesterol.

  If you notice that your cholesterol goes up and stays up when you eat more animal fats, this may be why. In other words - it’s not the fat that’s to blame but how the body’s inability to process it correctly. A diet that reduces animal food intake does not address the cause. Saying that, if you experience this, please do include more veg, fruit, beans, flax and chia in your diet. Work on your digestion, bile flow and gut health. Interestingly, many people who need to work on their bile also tend to be constipated which, on top of everything else, disables cholesterol removal. The above foods will help.

  Please note that if you significantly increase animal fats but your bile is good, your cholesterol will most probably increase temporarily anyways because the body needs to adjust to the new way of eating.

• Genetics (familial hypercholesterolemia): this is when total, HDL and LDL cholesterol markers are all elevated. It can be related to lipoprotein receptors dysfunction, inability to clear LDL particles, and an increased number of Lp(a) particles. Appropriate lifelong diet and lifestyle are key for people with hereditary tendencies.

• Metabolic syndrome (Syndrome X) and inflammation: a cluster of symptoms that may increase the risk of cardiovascular disease. It is characterised by increased triglycerides, poor glucose and insulin management, high total and LDL cholesterol, low HDL cholesterol, abdominal fat and often the fatty liver. The usual culprits include the reliance on processed carbohydrates, isolated sugars including processed fructose, commercial plant oils used for cooking and insufficient intake of quality fats and fibre. Since a pro-inflammatory diet is damaging to the artery walls, cholesterol will want to heal that inflammation. It works like a soothing plaster. When the source of inflammation is not addressed, cholesterol will keep building up and up. The process signalises a type of white blood cells called macrophages. They gobble up oxidised cholesterol in the artery wall but may eventually burst from ‘overeating’, which causes major inflammation. This is how atherosclerosis happens. To sum up, it’s the inflammation that needs addressing, not just the high cholesterol.

• Increased homocysteine: it’s a damaging waste product of lean protein metabolism which is cleared out of the system with sufficient folate, B12, B6, glycine (collagen, gelatin, collagen rich foods and broth) zinc and magnesium. Some people have a genetic mutation preventing them to metabolise folate and B12 effectively. Others may have an unhealthy gut resulting in the same. Homocysteine damages arterial walls which will induce the same process as described above. I usually address homocysteine when it goes above 8.

• Underactive thyroid: when thyroid hormone levels are low, the body cannot break down and remove LDL cholesterol efficiently. It may be a result of Hashimoto’s thyroditis.

• The menopause and andropause: since all steroid hormones are made from cholesterol, once the production of sex hormones drops, cholesterol may be high for a while, until the body adjusts to the new situation. Also, oestrogen and testosterone directly influence cholesterol metabolism so after the reproductive years cholesterol is naturally higher.

• Chronic infections: the body will produce as much as necessary to keep dealing with the invader on an ongoing basis. There is a link between high cholesterol and low white blood cell count.

• Gut flora imbalance (dysbiosis): some bacteria are responsible for cholesterol metabolism in the intestines, preventing it from circling back to the system or causing bile gallstones. An unhealthy gut can cause increased cholesterol, even in the absence of any gut symptoms.

• Being a lean mass hyper responder: some people (usually those who are slim and fit) who go on the keto diet may notice rapid elevations in cholesterol. To find out more, go to Dave Feldman’s Cholesterol Code.

• Lack of sunshine and a diet poor in sulphur: This is a new hypothesis that sun exposure and a diet rich in sulphur, help to produce cholesterol sulphate. In this form, it is water soluble and does not require a vessle to travel around in the body (no LDL or HDL). As a result, it doesn’t trigger macrophages, which keeps atherosclerosis at bay. Sulphur containing foods include cauliflower, broccoli, kale, cabbage, onion, garlic, leek, eggs, dairy, meat and seafood. Some people may have genetically impaired sulphonation in which case cholesterol sulphate or vitamin D sulphate are not produced at an optimal level. To learn more, check out Stephanie Seneff’s research.

What to do

To start with, cholesterol should never be evaluated as a stand-alone marker because it’s part of a bigger picture.

If total or LDL cholesterol is high and the ‘risky’ markers are optimal, let cholesterol do its job and support the body accordingly, e.g. nourish the adrenals or the immune system by eating quality sources of cholesterol including egg yolks, cold water fish and shellfish, while reducing processed carbohydrates and isolated sugar. A general anti-inflammatory diet, accompanied by some movement, is always a good place to start.

1. Reduce inflammatory foods: I recommend not to deep fry, perhaps even not using the frying pan for a couple of weeks. Roast and grill your meat and fish, boil or poach your eggs, and make frittatas in the oven. Add as much vegetables as possible, and dress them in cold pressed oils with vinegar or lemon juice. Get rid of crisps, fries, sweets, ice cream, carton juice, sweet fizzy drinks, beer, milk, processed meats like sausages and frankfurters, pies, mass produced bread and other baked goods. Eat antioxidant rich foods like berries, pomegranate and drink green tea.

2. Do not combine saturated fats with starchy carbs. Even though butter is great, you may have it on your broccoli instead of a baguette. Mashed potato is out. I mean, there is nothing wrong with these combinations for a healthy person but not when addressing metabolic health.

3. Support cholesterol removal: Oats, legumes and mushrooms contain a special type of fibre called ‘beta glucan’ which binds to excess cholesterol before it’s abrosbed. Flax and chia seeds also enable cholesterol removal and optimise bowel movements if sluggish. The seeds can be added conveniently to a smoothie or blended with kefir which will further optimise cholesterol metabolism through gut support. It’s important to keep the bowels moving because cholesterol is cleared via bile and the excess is excreted in feces. And the more bile stimulation, the more cholesterol will be directed towards its production because, again, cholesterol is a key component of bile. Beetroot is great for that.

4. Include plant sterols: they have a similar structure to cholesterol so they compete with cholesterol for absorption. The more sterols you eat, the less cholesterol will be absorbed. Plant sterols include nuts, seeds, quality soy foods (natto, tempeh, miso), other legumes and whole grains.

5. Include omega 3 fatty acids: these don’t reduce LDL as such but mitigate any risks associated with inflammation and heart disease. Foods rich in omega 3 fatty acids include SMASH fish (sardines, mackerel, anchovies, salmon and herring) but all fish is an excellent choice. Bake, poach or steam your fish for the best results, have some sushi and gravlax. Other foods include chia and flax seeds, walnuts, seaweed, pastured egg yolks and meats from grass fed and wild animals.

6. Increase HDL by eating olive oil, olives, avocado, nuts (esp. macadamia), fish, fish oil, cod liver oil, meat from pastured or wild animals and quality dairy, especially from goat and sheep’s milk. Coconut products are also great. By just increasing HDL cholesterol, some of the risk is already mitigated.

7. Supplementation is always individual and should support dysfunctional areas. Some supplements reduce cholesterol production while other help with its metabolism or excretion. Try and always get to the root of your issue. While plant sterols may work for some, red yeast rice, garlic, beta glucan or nattokinase might be better for others. Fish oils usually work well for everyone, to at least partially address inflammation and address elevated triglycerides. Last but not least are my four of my favourites: artichoke extract, phosphatydilcholine, taurine and beetroot extract, all of which support bile.

It is also worth mentioning the statins. Some people will definitely benefit from taking them for a short period of time while implementing dietary and lifestyle changes (if you decide to just take statins and do nothing else, your cholesterol will be back to square one as soon as you stop them). However, they do not address the cause and just block cholesterol synthesis while at the same time reducing coenzyme Q10 which is vital to a healthy heart function. In fact, the deficiency of CoQ10 is associated with the weakening of the heart muscle. Isn’t that counter effective? If you decide to go on statins, supplementing with CoQ10 is a must.

In my previous post I discussed what fats to use in the kitchen and when. I hope it will all come together :)

Guide to fats and oil supplements

Fats are essential to health. They are required for proper cell function, production of hormones, healthy stress response, immunity, detoxification, smooth digestion, and fat soluble vitamins A, D, E and K. Around 60% of the brain consists of fat. Some of the signs of having insufficient fats or fat malabsorption include:

• dry and flaky skin

• dandruff (can also be fungal)

• dry eye

• constipation

• poor bile flow and / or gall stones

• mood disorders, depression

• general inflammation

• pain (e.g. arthritis or chronic back pain)

• metabolic imbalance (blood sugar imbalance, high triglicerides, low HDL cholesterol, high LDL cholesterol)

Trust biochemistry, not marketing

Don’t skip this paragraph because it will help you make informed decisions.

The main differentiating factor between fatty acids is the presence or absence of double bonds between carbon atoms. In chemistry, double bonds are a site of oxidation - the place of potential damage. In other words, the more double bonds in a fatty acid, the more damaged it can become. In the world of nutrition, oxidised fats together with processed sugar are number 1 thing to avoid due to their inflammatory properties.

Oxidation stability is the most important aspect when determining what fat to cook with, no matter what the industry tries to sell. Some fats have a high smoke point but are easily oxidised. It means that they taste better when exposed to a higher temperature but might become toxic when heated, e.g. refined sunflower seed and rapeseed oil. And the other way round - some fats have a lower smoke point but are more resistant to oxidation. Ethical refining of oils increases their smoke point but it only makes sense for fats which are resistant to oxidation, like coconut oil.

Saturated and unsaturated fatty acids

Saturated fats: each atom of carbon is saturated with hydrogen due to the absence of double bonds, making the fat solid at room temperature and resistant to oxidation. In the body, saturated fats provide stability and integrity to cell membranes so that cell insides don’t spill out, and protect fragile unsaturated fats from damage. Examples: animal fats, butter and ghee, coconut oil and dairy.

Note: If you have cholesterol or metabolic issues like excess weight or insulin resistance, some sources of saturated fats should not be combined with starchy foods. For example, instead of putting butter on toast, use olive oil. Some people may notice best results from stopping starches altogether rather than reducing fat intake. This is why the ketogenic diet works well for some to improve metabolism and lipid panel. Read my post on cholesterol here.

Unsaturated fats: contain atoms of carbon that are not saturated with hydrogen due to the presence of double bonds so are liquid at room temperature and prone to oxidation. In the body, they maintain cell membrane fluidity so that things can get in and out of cells. Monounsaturated fats have one double bond, meaning there is only one place of potential damage. Examples: olive oil, avocado oil (sources of omega 9). Polyunsaturated fats have multiple double bonds so are much more prone to damage and should not be heated. Examples: nut, seed and supplemental oils (sources of omega 3 and / or 6).

All fats that occur in nature are a combination of saturated and unsaturated fatty acids but one type always dominates. For example, olive oil is 18% saturated. Intuitively, cells require both in order to function well. The key is to provide them in appropriate (and unprocessed) ways.

Fats suitable for cooking - resistant to oxidation

• Clarified butter and ghee

• Butter: ok for baking or cooking eggs; enjoy melted over cooked vegetables

• Non-extra virgin olive oil and avocado oil; also good for making mayonnaise and alioli due to the more neutral taste compared with extra virgin counterparts. In my view, avocado oil is too expensive to cook with

• Refined coconut oil which has a neutral taste. It should be mechanically or steam refined, like this one or this one

• Animal fats: duck and goose fat, lard, beef tallow, drippings

Fats suitable for cold use - prone to oxidation

Rich in polyphenols which act as antioxidants so it’s important to treat them with care - keep away from excess light and heat. Some of these are polyunsaturated fats and for that reason alone should not be heated.

• Extra virgin, cold pressed olive oil: use in salad dressings or over cooked vegetables

• Extra virgin, cold pressed coconut oil: use in smoothies, energy balls, bulletproof coffee, green tea, or for therapeutic purposes (off the spoon as appetite suppressant, topically for sun burns and anti-fungal properties)

• Flax oil: use in salad dressings, smoothies or take it off the spoon as a supplement; keep in a dark bottle in the fridge (polyunsaturated)

• All other nut and seed oils like sunflower seed, rapeseed, sesame, peanut, hemp, milk thistle or black seed. They should always be cold pressed and kept in the fridge (polyunsaturated)

Fats to avoid

• Regular sunflower seed and rapeseed oils (non-cold pressed, sold in most shops and marketed as suitable for cooking)

• Corn and vegetable oils

• Liquid coconut oil

• Artificial trans fats and all foods that contain them: margarine, vegetable shortening, frozen pizza, shop bought baked foods like croissants and doughnuts and cookies, refrigerated or frozen dough (puff pastry, shortcrust, rolls)

Supplemental oils

The body can make most fats except for two: omega 3 and 6. They are called essential fatty acids, meaning they must come from food or supplements. Omega 3 fatty acids are anti-inflammatory whereas omega 6 can either be either anti- or pro-inflammatory. For optimal health, appropriate balance of omega 6 to 3 should be maintained. Supplements on their own don’t warrant the overall balance but can help, especially when you don’t eat enough food sources on a regular basis.

• Fish oil: obtained from the flesh of fish and taken mostly for anti-inflammatory omega 3 fatty acids called DHA and EPA which plant based oils don’t provide. Plant based omega 3 (called ALA), for example from flax, can be converted into EPA and DHA but the process is inefficient and blocked by artificial trans fats and hyperinsulinemia.

• Krill oil: contains more antioxidants than fish oil and the body may utilise it even better than fish oil. It is, however, a lot more expensive.

• Cod liver oil: obtained from cod livers. Since the liver stores fat soluble nutrients, cod liver oil is taken for active vitamin A (retinol, not beta carotene), some vitamin D, and also omega 3 fatty acids.

• Algae based oils: the best option for vegans as they contain DHA and EPA.

• Evening primrose, borage, blackcurrant seed oils: provide anti-inflammatory omega 6 fatty acid called GLA. I usually recommend GLA on top of omega 3 in certain health conditions like autoimmunity, chronic pain or hormonal imbalance in females.

• Black seed oil (nigella seed): fantastic for people with any atopic condition including asthma, allergies and eczema. Also a great digestive tonic. It has a very strong so capsules might be more convenient.

• MCT: medium chain triglycerides obtained from coconut that don’t require much digestion, therefore serve as immediate source of energy. Those who are on the low carb or keto diet notice most benefits of taking MCT, for example in coffee or keto smoothies. Good option for epilepsy.

• Mixed oils: Udo’s oil is my favourite broad spectrum plant based oil. It contains flax, evening primrose, sunflower seed, coconut, sesame, rice bran, oat bran oils and non-gmo soy lecithin. There is also a version with added DHA from algae.

Summary

Your health should always dictate which fats are the best to use and in what combination with other foods. For example, coconut oil may be great but can contribute to acne in some individuals.

Culinary fats and supplemental oils complement rather than substitute each other and if possible, it’s good to have a variety and use them in different ways. For example, I scramble eggs and make Indian curries with ghee, cook Thai curries with coconut oil, use olive oil in salad dressings, drizzle stir fries with sesame oil and make potato fries with lard or duck fat. My personal regime for supplementing oils is 1 teaspoon of cod liver oil, 1 teaspoons of fish oil twice daily and 1 table spoon of Udo’s oil twice daily.

In the previous post I discussed how to take the most common supplements including supplemental oils, in order to get most benefits.

How to take supplements

General advice:

• Keep in mind that supplements are a temporary crutch. An underlying cause of deficiency or increased nutrient need should always be addressed, like poor absorption of nutrients in the gut despite a good diet.

• Supplementation does not replace lifestyle related deficiencies such as going to bed too late or getting up late, too little or too much exercise, drinking alcohol, smoking, etc.

• It takes time for nutrients to saturate cells. Give it 60-90 days to notice results. No point hoarding tons of products and trying them for just a short period of time. Better to get less but being consistent.

• Supplements undergo the same process of absorption as nutrients from food. In order to benefit from supplements, absorption and assimilation must be optimal and it often isn’t - the reason why people take supplements in the first place. If you sense that you’re not utilising nutrients well, work with a professional to improve digestion.

• There might be contraindications for taking certain supplements depending on your health condition and / or medications taken. E.g. fish oils are not recommended in epilepsy. Always consult with your doctor.

• Invest in quality. Cheap supplements often have not been tested for toxicity or effectiveness. They are usually produced in China or India where the supplement market is not well regulated. Quality supplements should not have undesired additives, too.

• Check the label for the dose, or discuss with your practitioner how much you should take. One one tablet / capsule / spray often does not equal a full or recommended dose.

  The recommended dose on the label is different to the therapeutic dose prescribed by a practitioner. Recommended dose is intended to correct minor imbalances while therapeutic dose aims at adressing specific health issues.

• Tannins in tea and coffee can negatively affect absorption of nutrients so best to take supplements with water.

• Although some practitioners advise taking certain supplements first thing in the morning on an empty stomach, I find that it almost always results in stomach upset over time and don’t advise doing so.

• At high doses, minerals compete for absorption and therefore should not be taken at the same time, e.g. zinc and magnesium. This is especially important when taking supplements without supervision.

• When taking an isolated nutrient for a prolonged period of time, it will get synergistic nutrients out of balance, e.g. taking zinc on its own may cause copper deficiency. While it’s often necessary to take isolated nutrients to correct deficiency or excess, it should be done under supervision.

How and when to take most common supplements:

• Multivitamin, B vitamins: in the morning due to their energising properties. If possible, I recommend dividing the dose into two servings because B vitamins (also as part of a multi) are water soluble and therefore quickly lost with urine. Take one after breakfast and one at noon. Otherwise, take the full dose after breakfast. B12 is the only B vitamin that is stored in the liver.

  Most effective multivitamins contain added foods like orange, apple or berries which increase bioavailability of nutrients.

• Vitamin C: any time. Vitamin C is also water soluble and it is best to divide the dose into 2-3 servings, if possible. The best vitamin C formulations contain bioflavonoids which are always present where vitamin C is naturally found (i.e. food). Bioflavonoids enable vitamin C to function properly. Otherwise, if finances allow, use liposomal vitamin which stays in the body for longer and is absorbed better.

• Vitamin A, D, E, K, beta carotene, cod liver oil, fish oil, plant based omegas: with food containing fat. These are fat soluble, and fat aids their optimal absorption. Fish oil should contain added vitamin E. Always match vitamin D dose with your current levels. If you supplement, retest every 3 months. See a separate article on fats and supplemental oils here.

• Probiotics: with food, preferably last meal, when stomach acid will be attached to food particles rather than the probiotic. Probiotics are a bit like medication - each microbial strain provides different health benefits. Unless you have some knowledge, it is best not take just any probiotic because it can exacerbate existing symptoms, e.g. constipation or rashes.

  You do not need to fear that probiotics are dead by the time they reach the desired place. Cell walls of dead bacteria can provide plenty of health benefits, from immune function to detoxification.

  Each probiotic strain must be accurately described on the packaging:

  with a generic name (e.g. Lactobacillus), species (rhamnosus) and also patent identification (e.g. ATCC 53103 or 299 v, etc.). If they don’t, then quality is questionable.

• Iron and zinc: betwen meals, 1-2 hours away from food, if possible. If iron and zinc supplements cause stomach upset, take them with food. Non-heme iron supplements (plant based) are best taken with vitamin C which aids its absorption, e.g. with freshly pressed orange juice.

  Since iron can feed bacteria, lactoferrin together with active B vitamins, cod liver oil and appropriate dietary interventions is my preferred way to increase iron status.

• Magnesium malate: in the morning as it aids energy production.

• Magnesium, other forms: can be taken any time as they aid both, energy and sleep

  • Magnesium glycinate: general use, great for anxiety, well tolerated

  • Magnesium citrate: strongest laxative properties of all Mg forms but can cause digestive upset in non-constipated individuals

  • Magnesium threonate: brain health

  • Magnesium taurate: cardiovascular health (e.g. reducing blood pressure)

• Selenium: most often recommended for Hashimoto’s thyroditis. If you’re are on thyroid hormone medication, it is important to keep a 2-hour break between taking the medication and selenium. Otherwise, ok to take any time.

• Turmeric: any time. The active substance in turmeric is called curcumin. It is fat soluble and best absorbed when taken with a source of fat and piperine from black pepper or cayenne peppers, which is not always possible. Turmeric with Meriva formulations already contain a form of fat so are more effective. The best (and most expensive) turmeric supplements are micellised, meaning water soluble and immediatly absorbable. The trademark for micellised curcumin is Theracurmin.

• Algae like chlorella and spirulina: first half of the day as they have invigorating properties.

• Wheat grass and barley grass powders: they should always be in the form of powdered juice. Humans cannot digest grasses, therefore taking unjuiced wheat grass and barley grass is counterproductive. Look for powdered wheat grass and / or barley grass juice instead. Also best to take in the first half of the day.

I have international clientele and want everyone to have access to the same quality supplements at a reasonable price, so I mainly use iHerb. Should you wish to use iHerb too, you can use my code QDB645 to get a discount off your first purchase.

How to succeed on my health plan

• Sometimes you won’t be able to follow my recommendations. In this case, choose the next best option, even if it’s far from optimal. In other words, eat the best foods that you can find in given circumstances. Don’t look for excuses though!

• Life gets in the way to get started like a busier time at work or a difficult situation at home. The truth is, everyone is busy these days, which contributes to health imbalances in the first place. But you still have to eat, right? There is never a perfect moment for change. First, make a decision about the things you will implement. Then, you will have to make the effort to learn how to shop for different foods, cook different meals or maybe go about your daily routine differently. Accept that it will cost some time and effort rather than looking for an easy fix. Get your environment ready for success so that you always have the right foods at hand. Change does not happen overnight. Initially, it will feel like an effort but soon it will become your new routine. I am happy to support you on your journey and make that change easier - you can always book health coaching sessions with me. Again, having more on does not mean you are stopping to eat. Quite the opposite - we need good nutrition during demanding times. Also, you may just have better things to do like sport and hobbies rather than prepare meals. This is a matter of balance and priorities, and ultimately, it comes to figuring out how make it work for YOU.

• More time spent in the kitchen: home cooking is key to better health. If you haven’t cooked regularly, you may find this frustrating, unless you have someone cooking for you or have access to a good catering company. The useful strategies here are availing of convenience foods listed in your notes, batch cooking, freezing and having a simple menu on rotation, like 3 breakfasts and 5 lunch / dinner options. For a little more variety, you can have 4 seasonal menus, 3 months per menu.

• Food restrictions: there is still lots that everyone can have on my plans. It just takes a bit of time to learn how to shop for and prepare new foods. It doesn’t mean more work per se, just working with different ingredients. Focus on the food list I attach. My meal recommendations should also help. Rather than thinking ‘I can’t eat xyz’, focus on the foods that you CAN have (again, your food list). There are logical reasons behind my recommendations. For example, if porridge is not on the list, it means it’s not doing you any favours right now.

• Sugar flu: when you clean up your diet of processed foods or reduce starches and sugary foods, sugar consumption will naturally go down, which may cause withdrawal symptoms and electrolyte imbalance. Symptoms include headaches, weakness, irritability, tiredness, craving sugar and starchy foods - because they are addictive. Optimal protein, fat and electrolyte intake is key, especially potassium (vegetables). Warm herbal teas work well, as well as adding electrolyte drops to water.

• Feeling worse than before starting my programme (´healing crisis´): all my programmes encourage detoxification. You may experience detox reactions as your body processes the released toxins. Side effects include: flu-like symptoms, brain fog, tiredness, headaches, diarrhoea, constipation, lack of belief in the therapy, poor concentration, dizziness, nausea, irritability, weakness, breakouts, exacerbation of all current symptoms. Perseverance is key. You should start to feel better again within 3-7 days.

  What can help immensely during the first few days is electrolytes. You can either try my power tonic, meat stock, bone broth or simply buy electrolyte drops.

• Money: eating more protein, vegetables and quality produce in general is more expensive. However, eating good quality foods is the best preventive medicine available to humans which can save money on healthcare expenses in the future.

• Social situations: friends and family will be asking ‘why don’t you eat xyz” or will be encouraging you to have xyz. This can be uncomfortable however your healing path is no one else’s, and it’s meant to improve your situation. Be prepared for questions and have a couple of answers ready so that you feel comfortable.

• Eating out: read a separate post here.

• Poor motivation: intrinsic motivation can be too week to last. Look for self-discipline instead. You may never be ready to get out of your comfort zone. At the same time, there will be no positive outcomes is you don’t change anything. The most important aspect of breaking the vicious cycle of poor lifestyle habits is making a decision about what it is exactly that you are changing and HOW, step by step. I recommend watching these two videos:

Tips for eating out and on the go

Following a nutritional plan doesn’t mean that you should avoid social situations or feel stressed and lost when you travel. After all, sharing meals with people can provide a sense of wellbeing, and work related travel might be unavoidable. It just takes a little time to get used to different choices and courage to speak up about your needs. Sometimes you may need to persuade friends and family where to eat, too. You may also have to quit your usual favourites. Saying that, restaurants are very accommodating and they don’t mind doing little tweaks, especially that you’re the customer who pays for the experience. Try and get creative ;)

One of my food related mantras is: you can always pick something better. This means that even if you’re in the worst possible junk food place, there will always be a better option. Even if far from good, you can always try and pick the best out of what is available to you.

Although health plans vary from person to person and some people will have to be more cautious (the 80/20 rule certainly does not apply to everyone!), here are my general tips to make the most out of dining:

• If possible, pick a restaurant with good food ethos although these can be expensive. Don’t get discouraged from eating out because of prices. Do the best that you can afford, even if it’s not ideal.

• Ask the waiter not to bring bread. Olives and pickles, on the other hand, are great as they can enhance digestion. Olives dipped in alioli are my favourite but be careful as it can be very filling and some people may find this combination hard to digest due to the high amount of combined fat.

• If you want to avoid sugar, ask the waiter not to bring out the dessert menu - you will avoid the temptation.

• When possible, play around with the menu, mix and match different menu components. You can, for example, order fish or meat from one dish and a vegetable side dish from another dish.

• Best to avoid deep fried or battered foods in general (e.g. KFC style chicken, fries, chicken Kiev, fish and chips, fried cheese, battered and fried calamari) but if you have no choice, go for just the protein and a salad or other vegetables that are available - skip sandwich type meals and do not get the fries.

• In general, I recommend ordering either grilled or quickly pan-seared meat or fish (or seafood) with a double portion of vegetables, or two vegetable sides. If you are active or want to bulk up, grab a portion of starch like rice or boiled potatoes. Drizzle vegetables with olive oil and vinegar or lemon juice, even if they are cooked. Vegetarians can go for grilled halloumi or goat’s cheese salad, or a veggie burger without a bun. The same double portion of vegetables and a possible starch rule applies.

• Fast food places: go for non-battered chicken wings or a burger patty or two (without a bun), with a double salad. This is possible even at McDonald’s.

• Italian restaurants: pick one that has options other than pasta and pizza. Carpaccio s always a great starter buf if dairy is ok for you, Caprese salad with buffalo mozzarella is a good choice too. For the main, you can ask for bolognese sauce over roasted or grilled vegetables instead of pasta. A good Italian place should also have a steak, meatballs and fish on the menu.

• Asian restaurants (Chinese, Japanese, Korean, Thai, Vietnamise): start with either a soup, skewers or ribs. For the main, opt for a stir fry type dish with rice or rice noodles, if starches are ok for you. If not, ask for extra vegetables on the side. If you like ramen, ask the waiter to swap ramen noodles for rice noodles. Sushi is excellent for rice eaters and one of the healthiest ways to eat fish. Sashimi is higher in protein than sushi and better if weightloss is your aim. If you’re new to raw fish, keep it mind that it’s practically flavourless but just to get you covered - wasabi mixed with soy sauce will mask anything :) Avoid meat and fish in batter like ‘sweet and sour’.

• Indian restaurants: if poppadoms are made with just gram flour (no added wheat) and legumes are ok for you, go for it. My best recommendation is tandoori meat or prawns with a vegetable side and optional rice. A cream and sugar free curry and steamed rice is also fine, plus a vegetable side. if rice is not recommended on your plan, then have the meal with a vegetable side dish like spinach and potato saag, or okra. Vegetarians can go for paneer curry, and a little dahl is fine too. The sauces that are free of cream include rogan josh, bhuna, jalfrezi or madras but double check with the restaurant. Biryani is also ok for rice eaters but get it with a side of vegetables.

• Burger: ask for no bun but keep the trimmings and get a side salad - this applies to both, meat and veggie burger. Perhaps the restaurant makes sweet potato fries - it’s always worth asking.

• Steak: ask for a large side of vegetables and alternatively mashed or boiled potatoes instead of fries.

• Salad dressing: ask for vinegar or a wedge of lemon and olive oil instead of ready-made dressings; dress the salad generously (approx. 2 table spoons of olive oil).

• Dessert: ask for a fruit salad. It will satisfy the sweet tooth without making you feel guilty about having a dessert. Otherwise, get a sorbet. Some health oriented restaurants make great desserts and there will be more options.

• Alcohol: if your health condition allows for some alcohol, enjoy a glass or two of dry, red wine, preferably biodynamic or organic. Otherwise, vodka with sparkling water, a couple of squeezed lime wedges and mint can replace a mojito. Neat rum is fine too, and so is gin and tonic. Alcohol dramatically slows down fat burning so keep that in mind if you are on a weight loss plan. For more information on alcohol and avoiding a hangover, read this post.

• Digestive tips: eating out regularly compromises gut function, unfortunately. Practice caution if you often get bloated or suffer from IBS-like symptoms which includes diarrhoea, constipation or excess gas. Most importantly, enjoy the time out, don´t rush and chew properly. Lack of chewing is a starting point of more prominent digestive issues. The saliva activates important enzymes without which the small intestine cannot properly complete its job. The stomach doesn´t have any teeth so make it easier for the gut by chewing. If you order a salad, dress it liberally with olive oil and vinegar or lemon juice as it will greatly enhance digestion of raw veggies. You may also squeeze lemon juice over meat and seafood, for the very same reason. Ask for water without ice as cold drinks disrupt digestion and opt for either herbal tea which you can sip throughout the meal or a glass of dry wine. Wine acts as a digestive tonic but if you get a reaction to it like a rash, headache, burning, loose stools and insomnia - wine is clearly not a good option for you. If you tend to get bloated, quit starchy sides like potatoes, pasta, rice or noodles - even those gluten free. You can replace those with extra protein or cooked vegetables, depending on your preference or what you can digest better. Carry digestive enzymes, digestive bitters or fennel seeds to chew on with you. A glass of Cava or Prosecco with a little Campari is a great aperitif due to the bitterness. The golden rule in all gut conditions is simplicity. The less ingredients combined, the better.

What you should know about shop bought plant based milk

We are often advised to transition to plant based milk as a healthier and more environmentally friendly option than animal milk. Following the increasing demand, shops now offer various plant based milk alternatives:

• coconut

• grain based: oat, quinoa, rice, spelt

• nut based: almond, cashew, hazelnut, walnut

• seed based: chia, sesame

• soy

• other: tiger nuts (chufas), hemp

Just like we used to be told to drink plenty of milk, now we are advised to drink vegan alternatives. It reminds me of the butter vs margarine debate.

There is no doubt that plant based milk is a godsend for many. But unless it is freshly made and consumed within 2-3 days, it may not provide any benefits to either health or the planet. The fact that food is free of dairy, gluten and sugar, does not automatically make it either healthy or sustainable. In other words, what makes food healthy is what’s in the food as opposed to what is not.

What you should be aware of:

• Nut milk is not made of nuts in their raw form but rather from a defatted nut powder, water and an emulsifier so that the liquid does not separate and is attractive to consumers. As a result, it doesn’t have the health benefits of the actual nuts. 

• The emulsifying agent is usually a polyunsaturated fat, like low or medium oleic sunflower or rapeseed oil. Such oil should be placed in the fridge upon expelling. Otherwise, it gets damaged by the time it even gets on a shelf.

• In order to keep the emulsion stable, ultra high pressure homogenisation is applied. Although this doesn’t involve high temperature, mixing fat with water under high pressure may have negative effects on the fatty acids too.

• Often times, synthetic vitamins are added. Synthetic vitamins can block receptors for vitamins from food, which can cause nutrient imbalances over a period of time. A prime example is vitamin D2 that is added in place of vitamin D3. Vitamin D2 has the opposite effect to D3, i.e. it directs calcium from hard tissues, like bones, to soft tissues, like arteries.

• Grain and cereal based milk is made of uncooked grains. However, grains and cereals like oats, quinoa, spelt, buckwheat, teff and amaranth should be soaked and cooked prior to eating, to remove natural anti-nutrients and increase digestibility. Grain based milk is pretty much the soaking water from grains (traditionally, it is discarded). Even if you soak, discard the water and re-soak, uncooked grains are hard on the human digestive tract.

• Most alternatives come in septic TetraPaks. In order to ensure a sterile environment and prolong shelf life, the milk has to undergo UHT (ultra high temperature processing) treatment, which means heating the liquid 135 Celcius (275 Fahrenheit) degrees. The process oxidises the delicate fatty acids contained within polyunsaturated fats, rendering them proinflammatory. Moreover, TetraPaks are lined with polyethylene terephthalate (PET), the same type of plastic that is used for bottling mineral water. PET is a known endocrine disruptor due to leaching xenoestrogens, especially when exposed to a high temperature. We know that drinking water from a bottle that was left in a hot car is unhealthy but do we know that food packed in TetraPaks is even worse? Ultrapasteurisation is a processing method that kills the raw ingredient, even when the end product is labelled as organic.

• Rice milk is pretty much sugar water (100ml of unsweetened rice milk contains over 1 tea spoon of sugar).

• Coconut is special - its fatty acid profile is more resistant to temperature, making it a safer choice.

Plant based milk for babies

Plant milk is not a solution for babies under the age of 1. Grains and nuts are best avoided before the first birthday due to baby’s digestive inefficiency caused by the lack of certain enzymes. Moreover, the most important nutrient for babies is cholesterol which is absent in plant milk (and on the vegan diet in general). The fact that it is visually similar to animal milk, doesn’t make it a good substitute for either breast milk or formula. If your baby is breast fed and suffers from an allergy, it will be best to carry out an elimination diet, also for the mum if she is still breastfeeding. If your baby is formula fed, look into home made formula recipes like this one or peptide based formula. To avoid cow’s milk, home made formula can be made with fresh goat or sheep’s milk, or Mount Capra goat’s milk powder. Again, giving babies plant milk from TetraPaks exposes them to xenoestrogens from early days which may contribute to estrogen dominance syndrome later in life - one of the contributors to estrogen dependent cancers.

Allergy and intolerance to milk proteins

Milk protein casein or whey can cause a whole host of symptoms in both children and adults. However, even when abstaining from milk proteins, allergy or intolerance to them will remain unresolved unless one rebalances the immune system. Most people who react to dairy also react to other food proteins and it takes addressing multiple body ststems to tackle food reactions.

Lactose intolerance can be mitigated by fermentation (even breast milk can be fermented), probiotic therapy or supplementing with the enzyme lactase. Constipation in babies is usually a result of imbalanced gut flora and / or allergy to milk protein casein, in which case appropriate probiotic strains and fermentation can also help.

After the age of 1, babies can enjoy plant milk (preferably home-made) as an addition to a well balanced diet, rich in quality animal fats to supply the necessary fat soluble nutrients: cholesterol, retinol, vitamin D3 and vitamin K2 MK7. Nutrients obtained from plant milk are optional for a growing child.

Sustainability

The greatest environmental aspect of the production of conventional dairy milk is greenhouse gas emissions. But mass production of vegan alternatives doesn’t go without damage either, especially in terms of water use and exploiting the soil. Ideally, the best way to support the planet would be by not drinking neither conventional dairy, nor shop bought plant based milk. The most sustainable way to enjoy plant based milk is making your own from plants that grow near you.

Best options

1. Home made nut or coconut milk. The pulp can be rehydrated or used ‘wet’. Great in baking, granola, grain free ‘porridge’, energy balls, stuffing, or used as batter.

2. Some vegan cafés and healthy bars make and sell fresh plant based milk. You can also find it at farmer’s markets.

3. Coconut milk in BPA-free tins or carton which only has coconut and water on the list of ingredients. At least 60% of coconut is desirable and it can be diluted with water, e.g. when cooking porridge.

Holistic approach to depression

Depression is a tricky subject. On the one hand conventional medicine has become strongly specialised in its treatment, on the other hand more and more people fall victim of poor mental health. Diagnosing depression is also questionable. Since there are no standard diagnostic criteria, it’s at the doctor’s discretion to determine if one needs help, usually in the form of medication. Anti-depressants are hugely profitable and, although often needed, they don’t address the root cause, unless one suffers from Prosac deficiency. Moreover, finding the right medication with long term desired effect is rare and the majority of affected people are left without a lasting solution.

ONE CAN FEEL DEPRESSED WITHOUT HAVING A DEPRESSION

My way of telling the difference is that being depressed is a state of the mind while having a depression is a state of the brain which then affects the mind. I’ve seen so much depression in my own family that I can honestly tell that depression is often misunderstood by those who have never suffered from it. While therapies that focus on the mind are great, those with true depression need brain support first. People with depression often don’t have any reason to feel the way they do but can’t find a reason to be happy either. In fact, they can feel guilty for not being more grateful and positive so they shut down for fear of being judged. If only biochemical causes were spoken about more, people would not feel so alienated or think that they have gone crazy.

WHY IS TREATING DEPRESSION SO DIFFICULT?

Because depression is not a standalone condition but a symptom of underlying physiological imperfections which eventually affect the brain, and often goes hand in hand with other ‘conditions’ like anxiety. All of my clients with depression have a whole series of other symptoms including poor digestion, deficiencies, blood glucose dysregulation, anaemia or hormonal imbalances. Interestingly, most of them report dramatic mood and energy improvement once these symptoms have been addressed. Rarely anyone talks about food as a trigger because people don’t find it relevant. To me, it is central. But not in a way that one should just eat a balanced diet. Depression requires therapeutic nutritional support.

CLINICAL SIGNS AND SYMPTOMS OF DEPRESSION

• sadness, withdrawal, feeling of doom and gloom

• self-harm or suicidal thoughts

• anxiety, panic attacks, fear

• addictive behaviour (drugs, sugar, alcohol, food)

• insomnia or oversleeping

• decreased or increased appetite

• extreme fatigue or / and restlessness

• brain fog, confusion

• no motivation

• detachment from reality

DEPRESSION FROM THE FUNCTIONAL MEDICINE PERSPECTIVE

Depression is a limiting word. I think that ‘debilitating lack of vitality’ comes a lot closer to what it really is. In the field of neuroscience and functional neurology, this lack of vitality is caused by the brain’s frontal lobe not firing properly. For some reason, it is rarely talked about and addressed. The most common causes of the frontal lobe dysfunction include:

• impaired digestion leading to deficiencies in nutrients that support the brain, e.g. cholesterol, vit A, D, K2, essential fatty acids, B vitamins, magnesium, zinc, antioxidants, certain amino-acids. If you don’t break down proteins well, you will not be able to produce neurotransmitters

• impaired detoxification pathways, e.g. MTHFR gene mutation or too many toxins produced internally which can slow down detoxification

• brain inflammation caused by the leaky gut which eventually leads to the leaky brain. The leaky brain is a gateway for all sorts of inflammatory triggers. This is where I put in a lot of work with my clients

• brain injury and chronically elevated cortisol (stress of any origin), both of which can lead to prefrontal cortex damage. This is an area of the brain where serotonin and dopamine fire

• unstable blood glucose levels leading to impaired neurotransmitter production

• pyroluria: genetic condition related to zinc and B6 deficiency

• underactive thyroid and / or thyroid autoimmunity

• hormonal imbalance

• diet rich in pro-inflammatory foods and social toxins

• anaemia and poor circulation leading to poor brain oxygenation

There are usually a couple of underlying factors happening at the same time.

The gut-brain connection

DEPRESSION MAY BE MISUNDERSTOOD

As seen above, brain biochemistry is determined by multiple factors. The question then arises: what if depression was misunderstood? What if it wasn’t a mood disorder but a protective mechanism and a state of hibernation to store energy that has been depleted by chronic stress or other health issues? Should mood improvement really be the key point before the necessary steps are taken to address the root cause?

HOLISTIC APPROACH TO DEPRESSION

My priority is to find the root cause. I almost always start with addressing gut dysbiosis, the leaky gut, the leaky brain, brain inflammation and balancing blood glucose levels. Further stages depend on individual factors. General aspects to look into include:

Delegating self-care to those who can look after you: it’s almost impossible to do it on your own, especially at the initial stages where motivation can be very poor and it’s important to stick to a food plan. Perhaps someone can shop and cook for you for a little while?

Whole foods: they have no list of ingredients; they are ingredients. Things to watch out for include: glucose and fructose syrup, anything that ends with -ose, flavour enhancers, E’s, and generally anything you don’t understand the meaning of. The more additives, the more processed the food which means it is devoid of nutrients that support the brain.

Digestion in check: observe your body and see what foods make you bloated or change your bowel habits. If you can’t digest something, it means you’re not absorbing the nutrients properly. Quit these foods until digestion gets better. A little water with raw apple cider vinegar, HCL + pepsin, digestive enzymes, ox bile and certain probiotics can help tremendously.

Learn to do less: have you ever wondered why you need to be on the go all the time? 0ne or two hobbies is enough. A busy lifestyle is destructive, especially that it blocks the time that can be devoted to connecting with yourself, your partner, family, with food or even meditating a little. People who cannot and don’t want to relax often suffer from ADHD so addressing this too is key.

Basic anti-inflammatory elimination: removing added sugar, wheat, commercial cow’s dairy and plant oils like sunflower or rapeseed is a great start. These are known inflammatory triggers and most people notice a relief when avoiding these. Removing gluten and proteins that cross-react with gluten can make a big difference due to their negative effect on gut and brain barriers, and stimulation of the immune system (common allergens)

Anti-inflammatory support: additional compunds include but are not limited to omega 3 (EPA and DHA), curcumin and resveratrol.

Neurotransmitter support: depending on the symptoms, there are various ways to help the body produce, retain or degrade appropriate neurotransmitters. The most common ones include 5-HTP, l-tryptophan, St John’s wort, l-theanine, magnesium and active B vitamins.

Sleep: realistically, try and go to bed by 23:00 and get up by 07:00, at least mid-week. 22:00-06:00 would be ideal. The braim regenerates the best most 22:00 and 02:00 so it’s not just the length of sleep that matters.

Screen exposure: try and not look at screens after 8pm. It can do wonders to the quality of sleep.

Improving brain oxygenation: enjoyable movement, resolving anaeamia, addressing underactive thyroid and easing chronic tension all help to bring oxygen to the brain.

Natural exposure to light: it’s important that the sun rays hit your retina during the day as much as possible, even when it’s cloudy. The more you look at natural light in the morning, the better you will sleep at night.

Friends and community: on days when you feel a little more social, surround yourself with people who lift you.

Therapist: they are there for YOU when you’re ready. The more channels you try, the better the results because depression is complex.

I can help you through a holistic therapy which includes natural medicine, nutritional therapy and functional medicine diagnostics. For more details, visit my consultations page.

End heartburn forever

Heartburn is a digestive symptom characterised by painful burning sensations in the chest or upper abdomen. It is so common these days that Nexium and Rennie have almost become the new Tic Tacs. Antacids are profitable so the industry is not interested in treating the actual cause. One thing is certain: if you wish to end your heartburn forever, you’ll need to tackle the underlying triggers and not just the symptoms.

True cause and mechanism of heartburn

It is commonly believed that heartburn is caused by too much stomach acid. But heartburn is more related to the incorrect functioning of the lower oesophageal sphincter (the flap that closes the stomach from the food pipe) than acid itself.

Normally, the flap remains open only when food is coming. But when too much pressure is created in the abdomen, the flap is pushed up and remains open towards the oesophagus. Since the oesophagus is not coated by a protective film like the stomach, it can take as little as acidic fumes to cause a severe burning sensation. In other words, there would be no heartburn if the flap remained closed. The four most common causes of increased abdominal pressure are:

• pregnancy

• abdominal obesity

• small intestinal bacterial overgrowth (SIBO)

• excessive fermentation of carbohydrates; often goes hand in hand with SIBO

Paradoxically, the main cause of bacterial overgrowth and excessive carbohydrate fermentation is low stomach acid. Not only is strong stomach acid necessary to signal the pancreas to release its carbohydrate digesting enzymes, but is also the first line of defence against unwanted organisms. Contrary to the popular belief, it is low stomach acid that is a major culprit of heartburn, and I’ve had great success with clients by restoring their stomach acidity.

Some of the reasons for decreased stomach acidity include:

• eating a diet rich in processed carbohydrates (bread and other baked goods, pasta)

• eating too much starch together with animal foods (e.g. burger in a bun, with potato fries)

• chronic stress

• prolonged or frequent use of medication

• helicobacter pylori (h-pylori overgrowth happens when stomach acid is too low, and then the bacteria themselves have the ability to further reduce stomach acidity)

• autoimmunity against the parietal cells of the stomach

Factors which can further exacerbate the symptoms include:

• lack of protective microbes in the stomach and oesophagus

• eating foods that relax the sphincter such as alcohol, chocolate, coffee, garlic, leeks, onions, peppermint, spicy foods, shallots, strong black tea

• smoking, as it also relaxes the flap

• foods that delay gastric emptying; mostly high fibre foods

While antacids take the initial edge off, they often make the problem worse in the long run by contributing to the root cause: low stomach acid. This perpetuates the vicious cycle of relying on antacids, unless dietary and lifestyle changes are implemented.

What to do

Heartburn requires dietary and lifestyle modifications. Unfortunately, a diet that is colloquially called 'healthy' often fails to improve the symptoms because e.g. wholemeal bread, bran and whole grains can significantly worsen heartburn. It’s important to note that the reaction to foods is an individual matter, so the diet should be tailored to the person’s needs. Beyond looking into the usual suspects like coffee, sweet drinks and spicy foods , the following can make a real difference:

1. Consult your doctor about the possible removal of antacids while working on the underlying causes.

2. Cooking vegetables and stewing fruit might be a better idea than eating them raw.

3. Optimally, all grains should be removed until symptoms subside but if you cannot live without bread and pasta, spelt is the grain to go for. Rye can be problematic.

4. Practice simple food combining of eating animal foods with vegetables, and starches also with vegetables. Try not to combine starch and animal foods in one meal until digestion improves.

5. Be mindful about your milk intake. Soothing as it may initially seem, it can contribute to chronic heartburn.

6. Fermented foods like sauerkraut or home made yoghurt (can be coconut) are associated with the reduction of symptoms.

7. Home made stock and broth calm down the digestive tract. They can be used in soups, stews and curries, or enjoyed as a warm drink.

8. Raw honey should be the sweetener of choice because it has soothing and antimicrobial properties.

9. Address your stress levels and stress tolerance, practice relaxation and good sleep hygiene.

10. See a professional to help you restore stomach acidity and address any pathogenic outgrowths. The therapy includes a dietary and lifestyle plan, along with individually tailored supplementation consisting of digestive support, targeted probiotics, antimicrobials and botanicals that soothe the digestive tract.

At GLOW, I deal with various health concerns which can successfully be supported with functional nutritional therapy and lifestyle medicine. The cornerstone of my work is uncovering and addressing the underlying causes. Online consultations from any location, visits on yachts, in villas and workplaces are available.

Article published in The Islander, July ‘19 edition.

Burnout survival kit

We all go through moments of stress which is a normal part of life that helps us grow. But chronic stress has a destructive effect on the whole body, often without people even realising that it is the main culprit of their health issues. Eventually, it leads to a burnout called adrenal fatigue, adrenal insufficiency or hypoadrenia. Stress isn’t just ‘in the head’. It is an actual physiological mechanism which involves approximately 1400 various biochemical reactions. In other words, poor stress tolerance requires a holistic approach and not just stress management techniques.

Stress

Stress is body’s response to a stressor. For some, it might be of emotional origin (e.g. trauma), mental (e.g. workload), while others are faced with physiological stress (e.g. chronic inflammation). Regardless of the source, the response is always the same and involves the adrenal glands.

The adrenals and cortisol

During stress, the adrenals release a stress hormone cortisol which helps us fight or flight by providing instant energy. Technically speaking, it raises blood glucose levels so that we have fluel to deal with the stressor. But when stress is ongoing and the adrenals fire cortisol all the time, it eventually ‘exhausts’ the glands, leading to the so called adrenal fatigue - inability to produce sufficient cortisol. It causes a burnout because without cortisol blood sugar cannot be raised any longer... Unless you eat something sweet, have caffeine or alcohol. These, however, cause a blood sugar roller coaster which is a big stressor itself. So unless your diet and lifestyle are balanced, you can get into a vicious cycle of further depleting the adrenals.

Diagnostics

When standard blood test shows low cortisol, it already means a pathological state, namely Addison’s disease. In other words, It’s not a great test to indicate burnout as such because cortisol may test normal in the blood but will be functionally low. Instead, 24-hour cortisol cycle salivary or urine test with four samples taken is a better diagnostic tool. Tests are available in most labs but they are not cheap and symptoms are often sufficient to assume an imbalance.

Can you identify yourself with any of these symptoms?

• Extreme fatigue

• Decreased ability to handle stress

• Loss of tolerance (to situations, things, people)

• Underactive thyroid

• Inability to lose weight , especially around the middle

• Low or no libido, poor sexual performance

• Low blood pressure, fainting

• Dizzy upon standing up

• Cravings for salt, sugar, caffeine or alcohol

• Anxiety and/or depression

• Reduced immunity

How to restore the adrenals for optimal stress tolerance

1. Reassess your diet:

The adrenals need a regular influx of certain nutrients to function optimally. Therefore, have three solid meals a day, with breakfast being the most important one. All meals should be based on vegetables, quality animal protein and cholesterol. Yes, you read that right. Cortisol is made of cholesterol so the more building block is provided with diet, the more supported the adrenals are. Butter, pastured eggs, quality bacon, seafood, fattier pieces of ethically sourced meat and grass fed dairy are all good sources. Carbohydrates should come from fruits and root vegetables. Fizzy drinks, fruit juice, baked goods, chocolate bars and the like should be avoided because they wreck havoc on your blood sugar. Remember, fluctuating blood glucose is the most undesirable state for the adrenals, regardless of the source of stress. Reduce caffeine and switch to coconut water, highly mineralised water or alternatively water with a pinch of quality salt - these are all great adrenal tonics.

2. Reassess your lifestyle:

• Prioritise sleep: often those with adrenal fatigue burn the candle at both ends and are unable to fall asleep because they missed their optimal falling asleep window. Slowly adopt a new habit by going to bed 15-30 minutes earlier each week. Reading books can help tremendously.

• Get organised: predictability means safety and safety is relaxing. Organise your to-do lists in the order of priority, try a day planner or get a virtual personal assistant, if you can afford it. Deal with priorities and delegate the rest. Not everything can be controlled but get advantage of what you can.

• Stop intense cardio for a while and swap to walking, yoga, pilates, hiking or similar. High intensity exercise raises cortisol which can be even more destructive.

3. Take care of your overall health: cortisol receptors can be found on most cells in the body. Many chronic illnesses are associated with a prolonged stress response. And the other way round – ongoing health issues are stressors themselves and can burn us out without any apparent emotional stress involved. This is when one feels stressed but doesn’t know why.

4. Supplementation: there is a wide array of various adrenal supporting supplements. The most common ones include adaptogens, glandulars, pregnenolone, vitamin C and B vitamins. Supplementation should always be tailored individually because without the expertise, one may further deplete the adrenals (e.g.it’s common to take the ashwagandha which tends to lower cortisol levels).

4. Most importantly, see a specialist: At GLOW, I deal with various health concerns which can successfully be supported with functional nutritional therapy and lifestyle medicine. The cornerstone of my work is uncovering and addressing the underlying causes which can be both, emotional and physiological. Online consultations from any location, visits on yachts and workplaces are available.

Article published in The Islander, June ‘19 edition

A journey from conception to birth and beyond

I’ve recently had a baby and because I had a great pregnancy and birth, I want to share some practical insights. Obviously, this is my personal journey which may not be the same for other women. Nevertheless, I hope it will shed some light on the most important matters. Couples come to me for support when they struggle to get pregnant. But family planning is so much more than just conceiving. It also means preparing to sustain a comfortable pregnancy, having a smooth delivery and giving birth to a healthy baby who will become a healthy, happy adult. In other words, conscious preparation for the whole process is a lifetime investment for all future parents.

Special thanks to my friend Nathalie who had a baby 3 months ahead of me and was a wealth of knowledge, which made my own journey a lot easier.

PRECONCEPTION

I didn’t plan my pregnancy. Saying that, I was ready to have a baby because I prepared for many years in advance. Not specifically for pregnancy as such but I went through a process of getting my general health in order. I followed various dietary protocols, tested many supplements and tried different therapies because I don’t believe it’s ever about just one thing.

What was key for my reproductive health:

Resolving existing health concerns: I worked on digestion, energy, mood, oestrogen dominance and getting my pelvis aligned. Although none of my complaints had ever been ‘labelled’ as specific health conditions, they took a good bit of work. In the world of natural medicine diagnostic names are not important. Any ongoing dysfunction (symptom) is a stressor for the body, and during stress nature does not allow for creating a new human until conditions are more favourable. I wish more couples on fertility treatment programmes knew about this. I went down the holistic route, taking into account the body, mind and spirit. I found osteopathy, nutritional therapy, herbs and homeopathy invaluable.

Thorough diagnostics: I did regular blood tests every 6 months for the first two years which enabled me to track progress and implement changes according to the results. Numerous clients of mine who struggle to get pregnant find it challenging to get blood referrals from their doctors. It’s frustrating because guessing what’s going on in the body is not good enough after many years of ‘trying’. At the same time, there are plenty of private labs that can save the hassle and I would like to see more people using them. Tests can be costly but worth every penny because they allow for a targeted treatment, save time and money in the long run. As a practitioner, I find it challenging to address the root cause with limited data to work with.

Nutritional therapy: dietary changes had the most profound effect on my health. I’ve always cooked from scratch but it wasn’t until I worked on my gut that I realised that my nutrition was far from being right for ME. Moreover, non-industrialised societies around the world continue to prepare for conception emphasising animal foods, specifically organ meats, cholesterol (hormones are made of cholesterol) and fat soluble vitamins. Coincidentally, I followed a Paleo style diet for a long time which must have positively influenced my reproductive health, specifically the following:

• having a variety of foods based on seasonality

• significantly increasing animal fats and vegetables

• regular consumption of meat stock, bone broth, eggs and liver

• supplementation with cod liver oil and emu oil

PREGNANCY

It was the happiest time of my life, even though I was convinced it wasn’t going to be plain sailing. Remembering my mum being severely sick when pregnant with my brother, I was anticipating nausea day after day but to my surprise, it never came. Except for three headaches and a week of being tired, I didn’t experience any other pregnancy discomforts. Overall, It was a very comfortable pregnancy which I attribute to the following:

Diet: nutrient density is key during pregnancy. The more nutrients the less cravings, fewer unpleasant pregnancy symptoms and more reserves built for the postpartum period. I emphasised quality protein, animal fats and mineral rich foods. These not only support baby’s development but also mother’s health, both physical and mental. Some of my dietary choices may seem controversial but I went against some common misconceptions because I think that the typical guidelines don’t stress what’s truly important and are full of illogical myths. This actually deserves a separate post. Here is a brief outline of what I ate:

• a variety of meat, liver once a week, black pudding

• fish and seafood, including tinned fish in brine and olive oil, tinned cod livers, fish eggs

• meat and fish stock (great as a base for a variety of dishes)

• eggs in all forms, including raw egg yolks in smoothies

• lots of butter, ghee and coconut oil

• dairy: mostly artisan aged goat and sheep’s cheeses (made from raw milk when available)

• all vegetables and fruit

• no commercial dairy and rare cow’s dairy consumption

• very rare consumption of wheat

Extra nutrients:

• Multivitamin: I tried various products but the only one that made a difference was Garden of Live mykind Prenatal Once Daily. It’s important that the multivitamin is food based. If it’s not specified on the packaging, the nutrients are synthetic. It’s important that the product contains folate and not folic acid which is synthetic and should be avoided.

• Cod liver oil: for active vitamin A (retinol, not beta carotene), DHA and vitamin D3. Retinol is the key nutrient for fetal development, and cod liver oil is one of the richest sources. It is also required for iron absorption which is a common deficiency during pregnancy. Insufficient intake of retinol during pregnancy is also associated with spontaneous abortion. Moreover, baby’s brain needs plenty of DHA fatty acids, depletion of which is associated with postnatal depression. Therefore, supplementation helps the mother to build up reserves to have a good start into motherhood. No plant oil can supply DHA, and the conversion of plant oils into DHA is poor. Omega 3 fatty acids in general prevent from ‘the pregnancy mask’ (melasma) so that the sun can be enjoyed more safely.

  Many products have added synthetic vitamin A (retinyl palmitate) so beware of those. I took 3 teaspoons a day of orange Nordic Naturals which is a quality, natural product.

• Emu oil: the richest source of vitamin K2 which is a very special vitamin that activates all other nutrients in the body. I took Walkabout Australian Emu Oil, 1/2 tea spoon twice a day.

• Probiotics: key to maintain an overall health balance and help to colonise the birth canal with beneficial microbes. During labour the baby swallows maternal microflora which then populates baby’s gut and determines its health. As a practitioner, I always recommend targeted probiotics but there are some products that can be taken by a wider audience. One of them is BioKult which I took for a portion of my pregnancy.

• Collagen powder: collagen is key for the integrity of connective tissue and skin, which plays an important role in keeping the skin toned, the prevention of stretch marks, diastasis recti and post-labour healing. It is also a great source of protein which can be added to a variety of cold and hot foods (e.g. soups and smoothies). I like Great Lakes Collagen Hydrolysate because of good quality that comes at a reasonable price.

• If I didn’t eat liver, I would have also taken desiccated liver capsules.

Keeping active:

I walked everywhere, often carried my groceries in a backpack, and always took the stairs. I also did 10-15 minutes of easy yoga practices on most days, using various YouTube channels. What I didn’t do was Kegel exercises because many women who train the pelvic floor during pregnancy can have a more difficult time giving birth. Kegel exercises are best after the labour.

Perineal massage:

The area between the vagina and anus needs both strength and flexibility, which can be enhanced with a massage. I recommend Weleda perineal oil, YouTube tutorials and partner’s help.

Balance:

I followed the 80 / 20 rule which means doing what’s optimal 80% of the time. I drank 1-2 coffees a day, had an occasional glass of wine, surrendered to a few serious sugar cravings and had a good few late nights out. But I didn’t let myself go. Pregnancy is not an excuse to eat rubbish and put on unnecessary weight. Especially that it can affect maternal and baby’s health, not to mention the postnatal struggle to get back into shape, both physical and mental.

BIRTH

Stage 1 (0-7cm dilation)

It started one day before my daughter was born and felt like period cramps that came at random intervals. At night they got stronger and more regular (every 30 minutes or so) but I didn’t think I was in labour yet because I was told that contractions were going to be very obvious. After all, false signs are common and I was expecting different pain. We even had a pregnancy photo shoot in the morning because we didn’t manage to get one done over the 9 months :) But when I saw blood on the tissue shortly after, my doula came over to check on me and we soon decided to go to the hospital. And rightly so because I was already 5 centimetres dilated and went straight to the delivery room. I was offered Epidural and gas but didn’t feel I needed anaesthesia, even though I was open to do whatever felt right at the time. Instead, I took a hot shower, bounced on the gym ball, walked around but most importantly - focused on breathing.

Stage 2 - transition (7-10cm dilation)

Apparently there is a time during labour when all women want to give up, not being able for more. It is caled ‚transition’ - the most challenging stage because the contractions get a lot more intense, you want to push but can’t just yet. The closest I can compare it to is an extreme urge to go to the bathroom but having to hold it while attempting to relax the pelvic muscles, which feels contradictory. Saying that, relaxing this area is the key to a faster delivery. I fell asleep between contractions for a minute or two which made me a little drowsy and yet gave me more energy. It’s amazing what the body can do to make the experience as smooth as possible. The good news is - when you are just ready to give up and can’t bear the pain any longer, this is when women are usually ready to get the baby out. Eventually, the contractions got so strong that I knew I had to push.

Stage 3: active labour (10 cm dilation)

Pushing made the pain productive which was a big relief. Due to baby’s rapid descent which caused extreme downward pressure, I had episiotomy. I didn’t feel a thing though because the skin is so tight that there is no need for an anaesthetic. Pushing didn’t hurt, it was just a bit of hard work. It was certainly the best part of labour, even though it may seem impossible that something as big as a baby gets out through such a small exit. Nature really does amazing things when we cooperate with it . The baby was born with the 4th pushing contraction. She was put on my chest straight away and the whole new chapter of my life began :)

Does the labour hurt? It’s intense but it’s not regular pain and certainly not something I wouldn’t like to go through again. Quite the opposite - it was amazing to experience the beautiful symphony of hormones and extreme euphoria that came with the baby.

Things that positively influenced my experience:

Trusting the process: although it’s good to understand what happens during labour, planning the process of delivery (which is unpredictable) can cause disappointment. Only during labour does it become clear what birthing position feels right or if anaesthesia is needed.

Choosing the right clinic: I chose Policlinica Miramar in Palma de Mallorca which promotes natural birth. The staff are fantastic, there is access to all sort of props, aromatherapy, music. They certainly know how to create homey atmosphere away from home. Stress hormones can stall the labour so it’s important to feel comfortable.

Doula: support of a professional that can be with you the whole time is invaluable, especially that she can help you make wise decisions when you’re not thinking clearly. I’m relatively new to Mallorca and except for my partner, she was the only one who was there for me. Very precious. Here you can read what a doula can do for you.

Ina May’s book on childbirth: the only book on the subject that I read, and I believe it’s the only one needed. I thought some aspects were a bit far-fetched but overall, it gave me a good understanding of the process.

Osteopathy: I saw an osteopath three times before birth and I’m certain she prepared my pelvis for labour more than enough. I highly recommend Kate Howe at OsteoPalma.

Lower back massage: during contractions my doula pushed my pelvis forward which gave me a great relief. I tried the TENS machine too but didn’t like the tingling sensation and found manual massage a lot better. She really knew what she was doing.

Focus: a friend told me ‘don’t waste your energy on screaming and unproductive breathing’. So true! Focused breathing gives the labour a calming rhythm. Challenging as it can be, it’s worth the effort.

Relaxing, breathing down, opening up: it’s a natural reflex to tighten the muscles when we experience pain because it’s a protective mechanism that numbs the sensation. Even though there is an urge to tense up during contractions, it’s important to relax the pelvic floor as it will help to speed up birth. Imagining that I was ‘opening up’ while relaxing the muscles and breathing down certainly helped to have such a fast birth. Strengthening the pelvic floor during pregnancy with the likes of Kegel exercises is contraindicated. The pelvic floor must be relaxed and elastic. Regaining strength in tha area is a homework for after birth and should be inteoduced slowly.

Low sounds while breathing out: they promote breathing down. I found long, mooing sounds very helpful (e.g. long mmmmmmm or uuuuuuuu while breathing out). Ujai breath is extremely helpful - here is an explanation how it works.

Surrendering to gravity: naturally makes things go down.

My partner: he was my ‘leverage’ during pushing contractions and reported the labour progress. He is a task-oriented person, and I used that to my advantage. Everyone has different needs though and not all people are suitable to assist a birthing woman, even the close ones. There is no right or wrong here. If you feel you would prefer to leave the partner behind, it’s perfectly fine to do so. Intuitive wisdom makes the labour smoother.

Homeopathic remedies: my homeopath who specialises in female health sent me remedies for a smooth delivery which I took prior to, during and after the labour. Contact Lilian Van Eyken for more details, she works remotely and sends remedies by post.

POSTPARTUM

It’s a vulnerable time and it’s important to prepare in advance so that you can focus on YOURSELF and not just the baby. I had a great start into motherhood but it can go either way, with hormones bringing about unexpected behaviours and feelings. On top of that, healing ‘down there’ is itchy and annoying. Nipples can be sore. Stepping into the new role as a mum may not feel natural. But the important message is that it all gets better day by day and it’s imperative to celebrate the little achievements and improvements. I recommend speaking to your partner about the potential obstacles you may face and changes in the daily routine. After all, it’s all about supporting each other in a way that works for you as a couple.

What I found helpful:

Frozen food: I cooked batches of freezable healing one pot dishes. As a base I used collagenous meat stock and bone broth. From beef Bourgignon to curries and chunky soups, it saved us a lot of time. Postpartum nutrition is medicine for the body and mind.

Nipple butter: made with edible ingredients, I found this fantastic. Now I use it as a lip balm.

Perineal balm: cooling and soothing with a beautiful smell. Designed to heal wounds and haemorrhoids.

Salt sitz bath: due to baby’s rapid descent, I developed a haematoma. Sitting in hot salt water completely brought it down in just a few days.

Preparation for breastfeeding: the more you understand, the better you can prepare.

• milk doesn’t come in right away and the baby is well prepared for this so there is no need to worry. Babies usually lose weight before they leave the hospital but gain it back quickly. The colostrum which comes in first may seem insufficient but it’s extremely nourishing, and perfectly enough for the little digestive tract. Diet, birthing experience, thoughts and emotions all affect lactation. Sometimes it’s easier said than done but in case of issues with the supply, there are various lactation teas on the market, Pukka being one of the favourites.

• If breastfeeding hurts, it means that the baby didn’t latch on properly. The baby should take not just the nipple (this is when it’s sore) but also the bottom part of the areola. It’s important not let the baby suck with a bad latch and not pull baby’s head away from the nipple because it will cause more pain. Instead, place the little finger between baby’s lips and the nipple to break the vavuum and start again.

  If you feel lost and hopeless, talk to a nurse, midwife, doula or a breastfeeding consultant as soon as possible. It can save a lot of tears.

• Nipple shields: during pregnancy my nipples got harder and flatter, and it was difficult for the baby to embrace them with the little mouth. Many say that shields are a bad idea but if anything can make breastfeeding more effective, why not use it? Now that she’s bigger, she takes the breast with no shield. I think Medela’s shields are great.

  It’s important that mums keep trying to feed the baby without the shields. If this is not made clear from the beginning, some mothers are stuck and unhappy that the baby won’t take the breast without it.

To sum up, it takes preparation to have a truly positive experience and it’s worth the investment. My role at GLOW is to support couples to have a positive experience with family planning, pregnancy and birth. Private consultations and workshops available.

How to avoid and cure a hangover

Many often wonder how to drink and not suffer the next day. I’m not saying alcohol is healthy and certainly I don’t entertain irresponsible drinking like there was no tomorrow. However, it’s undoubtedly a significant aspect of social life and I am personally far from abstinence. Although alcohol is certainly not for everyone and tolerance is individual, there are ways how to minimise its negative effects.

Fun fact

Alcohol is a controversial subject and some consider it a deadly poison. But is it really so toxic?

All of us host numerous strains of yeasts in the gut. Some of these produce alcohol in small amounts every single day, given the right nutrition: glucose, fructose and sucrose. It means that when we eat foods containing any of these sugars, the yeasts produce ethanol. In other words, we are physiologically designed to metabolise certain amounts of alcohol. Therefore, I do not agree that even the smallest amount is bad (at least not for an average person with no major health concerns). Especially that alcohol has been used medicinally for centuries and herbal medicine hugely relies on alcoholic tinctures.

Why people get hangovers

If you feel that even a small amount of alcohol affects you, it’s most probably down to your internal environment and not necessarily alcohol itself. A nutrient dense diet, efficient liver detoxification pathways, gut microflora composition and genetic predispositions all affect alcohol metabolism.

1. Slow conversion: alcohol is metabolised to acetaldehyde which is the villain behind nasty hangovers. Normally, it is further converted to acetate, and ultimately to carbon and water. That conversion is catalysed by an enzyme called aldehyde oxidase (AO). When the enzyme doesn’t work efficiently, acetaldehyde poisons the body. Enzymatic reactions hugely depend on gastrointestinal health, nutrient status and genetics.

2. Histamine intolerance: wine and beer are high in histamine which is normally degraded by an enzyme called diamine oxidase (DAO). When there are not enough DAO producing microbes or there are too many histamine producing microbes in the gut, one can react to dietary histamine. The most common symptoms are migraines and fast heartbeat.

3. Blood sugar drop: sweet mixers raise blood sugar fast which then drops below optimal level. Symptoms of reactive hypoglycaemia include lightheadedness, headaches, cold sweats, irritability. Wine and beer are quite high in sugar and can induce a blood glucose drop without adding mixers.

4. Hydration: alcohol draws water out of cells, dehydrating us from inside out. Without sufficient hydration, the brain shrinks. As it shrinks, it pulls away from the skull, causing tension headache.

5. Yeast overgrowth: this will result in excessive alcoholic fermentation in the body. People who produce a lot of ethanol don’t need to drink alcohol to feel drunk and hungover. It is called ‘self brewery syndrome’.

6. Amount and type of alcohol: while some alcohol can be perfectly fine, large amounts and poor choices of alcoholic drinks increase the chances of a hangover tenfold.

How to avoid a hangover

1. Eat while you drink. The French say to only drink wine with food and never on its own. While wine has some health benefits, cracking a bottle of vino right after work before you even eat your dinner will most probably damage your health. Sometimes it’s not about ‘how much’ but rather ‘how’.

   Most people crave greasy foods after a night out because the body requires three important compounds for alcohol to be detoxified, and fast foods provide all of them:

• fat (stimulates bile flow, and bile is body’s master detoxifier)

• protein (certain amino acids are needed for efficient detox pathways)

• soluble fibre (‘soakage’, also responsible for removing used bile with impurities)

Detox is often associated with juicing and other plant based remedies but without protein and fat the process is incomplete. This is also why a green juice is the last thing on a hungover person’s mind.

2. Choose your drinks wisely. Best alcohols in the order of purity are:

• potato vodka

• gin

• tequila

• rum

• whiskey

• dry champagne and cider

• biodynamic / organic dry wine

Saying that, these might not be the best for YOU as an individual.

My favourite going out drink that is not only tasty but keeps me hydrated:

• vodka

• sparkling water (San Pellegrino Essenza flavoured water works great)

• 2 wedges of lime, squeezed

• fresh mint

• ice

3. It is best not to mix different alcoholic beverages.

4. If you decide to mix, start with the lower percentage drink and move up the scale as opposed to the other way round.

5. Hydrate: have a glass of water per each alcoholic drink. And again, eat fat. Fat is metabolised to water which directly hydrates cells.

6. Do not get sweetened mixers, stick to dry options.

6. Supplements that are worth having at home if you drink on a regular basis:

• 1000mg of vitamin C right after drinking

• N-Acetylcysteine (NAC) right after drinking

• Probiotics on a regular basis

• Food based multivitamin which includes all B vitamins in natural forms

Hangover remedies

1. Water with a good pinch of sea salt or rock salt - to increase electrolyte content

2. Coconut water - rich in electrolytes

3. San Pellegrino water - high in sulphur which is key for detoxification

4. Meat stock and bone broth - rich in electrolytes, protein and fat

5. Home made curry - rich in protein, fat, detoxifying spices

6. Bananas and tomato juice - both rich in potassium

7. Eggs - rich in cysteine and choline which support detoxification

8. Walk in the fresh air, leave exercise for another day

How all disease begins in the gut

Hippocrates’ famous words are still eagerly cited over 2000 years later. Even though he knew that the digestive tract was a special place, at the time he may not have known why exactly. So what does it really mean that ‘all disease begins in the gut’? Many chronically ill people have never experienced any digestive symptoms so how can they relate?

The gateway to good health

The answer is in the INDIVIDUAL MICROBIAL ECOSYSTEM, also called the microbiota, microflora or microbiome. Although every part of the body has a unique microbial environment, most organisms colonise the gut and include bacteria, fungi, archaea, parasites and viruses. Even parasites play a key role for our health by helping us detoxify or modulate the immune system. Whether you like it or not, we all have them.

We now know that the human body has a lot more microbes than cells, and it has been estimated that our gut carries around 2 kilograms of various organisms. While we all have a similar DNA, only around 5% of microbial genetic code is shared among people. Some say we are only 1% human. Depending on the type and strain, the microbes produce all sorts of messengers, nutrients and toxins, making us who we are (yes, personality too!), energising us, keeping our metabolism in check or causing disease. While microbial imbalances can disrupt digestion, they often don’t, which depends on the specific organisms and their action within the human body. In other words, the fact your digestion is smooth doesn’t mean you don’t have a microbial imbalance.

Factors that positively influence gut microbiota:

• Maternal health and diet before and during pregnancy

• Being born through the vaginal canal

• Being breastfed

• Diet and lifestyle throughout life

• Contact with animals and nature

• Getting your hands dirty (e.g. gardening)

Major disruptors of microbial balance:

• Antibiotic treatments and other medication (e.g. antacids, anti-fungals or the pill)

• Inappropriate diet

• Stress

• Living in a sterile environment

One man’s meat is another man’s poison

The main factor that influences health and diversity of our microflora is food. After all, we may not be what we eat but rather what our unique microbes can eat and process into beneficial or toxic substances. Before food is available to us, it is first processed by microbes. This brings nutrition onto a truly personalised level and is the main reason why I become a nutritional therapist. I think that out of all therapies, food has the most direct effect on the microflora, therefore influencing our biology and addressing the root cause of illness. While the reasoning and research behind Hippocrates’ words are relatively new, I hope that it will be the future of medicine.

While eating a whole food diet is great for anyone, there are no universally healthy foods. The various microbes feed on different substances, and what makes one person healthy can be inflammatory for another. For example, while some people do great on raw fruit and vegetables, others may get bloated after eating raw apples or carrots. Many are unable to tolerate fermented foods which are routinely recommended as a blanket remedy for gut health. Spinach, blueberries and broccoli may cause adverse reactions too, from joint pain to hives. My rule of thumb is:

“If something gives you a digestive discomfort, it’s most certainly a source of toxicity and therefore illness. ”

The same goes to fad diets. While one person may be doing great on a high fat diet, another will need a lot more carbohydrates. Research is now emerging about how the same food can affect two people differently, even in terms of weight management. Did you know that the microbiota are responsible for extracting calories from food?

Functions of microbiota

• Coating the gut, preventing it from toxins and allergens (i.e. preventing from the ‘leaky gut’)

• Digestion and absorption of nutrients

• Production of antimicrobial substances

• Production of various enzymes

• Production of antioxidant and anti-inflammatory substances

• Production of nutrients

• Appetite modulation

• Detoxification of hormones

• Modulation of cholesterol levels

• Immunity

• Metabolism (including extraction of calories from food)

• Energy production

• Ageing

• Binding and excretion of heavy metals

Health problems that originate in the gut

We are just starting to understand the microbiome but below are some health conditions that have been well researched in terms of their relationship to unhealthy microflora:

• Allergies, intolerances

• Autoimmune diseases

• Respiratory infections like asthma or chronic sinusitis

• Mental health disorders (depression, anxiety, schizofrenia, behavioural issues)

• Neurodegeneration (Alzheimer’s, Parkinson’s)

• Skin conditions

• Weight gain / obesity / metabolic syndrome

• Digestive issues

• Cancer

• Physical degeneration, e.g. arthritis

How does unhealthy microfora cause disease? By producing inflammatory toxins (called endotoxins or lipopolysaccharides) that escape through the ‘leaky gut’ and attach themselves to various tissues and receptors.

How to support the microbiome

‘Test, don’t guess’ is the first step to evaluate individual gut environment. After that, it’s about feeding specific beneficial microbes with the foods they thrive on, and eliminating any pathogenic overgrowths. Optimising digestion and stress response are key elements of the process because pathogens feed on undigested foods and tend to outgrow when chronic stress is present.

What about probiotics for gut health?

While there are many wonderful products on the market, probiotics should be left to professional advice. Each strain corresponds to specific health properties and without the expertise, it’s easy to waste a lot of time and money. Probiotics on their own won’t shift health if concurrent dietary and lifestyle changes are introduced anyways. Home made fermented foods is a safe start for anyone who can tolerate them.

How I can support you

In order to address any health complaint, I first analyse the function of the gut which covers digestive capacity, microbial balance, infections, gut integrity, inflammation and oral tolerance to foods. I can also offer advanced functional testing for all health concerns, with testing kits delivered to your preferred location. Based on the information I have gathered, I formulate a recommendations plan which includes a personalised list of foods that are optimal for you, meal ideas, lifestyle tips and supplementation, if needed.

Article published in The Islander, December’18 edition

The smelly side of yachting

Behind the glamurous scenes of yachting, probably all stewardesses and engineers know that toilets can be no fun. The substantial amount of toilet paper that lands in the drains poses a question: why so much? Ideally, there should be no or little need for tissue but bowel habits can be far from perfect.

Digestion is the primary area of dysfunction in the body that impacts all areas of health, even when no apparent digestive symptoms are present. In my experience, other ongoing issues often resolve themselves once the gastro-intestinal tract has been appropriately addressed. After all, we’re not so much what we eat but rather what we can break down and absorb. This is why people who ‘eat well’ can still look and feel unhealthy.

Why does it matter in the yachting industry? Because the level to which food is digested and absorbed dictates energy levels, overall health status and mental wellbeing.

What is digestion?

It is the process of mechanical, chemical and microbial breakdown of food, extraction, production and absorption of nutrients, and removal of waste. We do not absorb food as such but the extracted vitamins, minerals, amino acids, glucose and fatty acids. We then utilise them to regenerate, produce new cells, hormones,neurotransmitters, etc.

Digestion works in a cascade order, meaning one disrupted process will result in the impairment of all consecutive steps. The brain plays the important role of a command centre, and it can take as little as looking at the phone while eating to maldigest.

Most common reasons for impaired digestion:

• processed diet

• stress of any sort

• burning the candle at both ends

• mindless eating

• stimulants

• not chewing food properly, eating fast

• microbial imbalance

• lack of animal protein

• low fat diet

• coeliac disease, gluten intolerance

• nutrient deficiencies

• too much grains (baked goods, cereal, pasta, rice, etc)

• drinking while eating, especially cold beverages

Immediate signs:

• feeling of fullness after a small amount of food

• bloating, passing smelly wind or too much wind in general

• belching

• indigestion

• heartburn / acid reflux

• light coloured / floating stools

• pain / cramping in the abdomen

• constipation / diarrhoea

• sticky stool, the need to wipe with multiple pieces of paper

Long-term signs:

• nutrient deficiencies (zinc, calcium, iron, B12, folate, vit A, D, K2)

• inability to build muscle

• high cholesterol

• poor energy

• slow metabolism

• allergies and intolerances

• anaemia

• osteoporosis

• loss of smell / taste

• no desire for meat

• recurring infections

• dry / itchy skin / rosacea / acne

• mental issues, hormonal imbalances, cancer, autoimmunity and all other chronic health conditions

Due to the nature of work, stress levels and insufficient expertise in nutrition, diet and digestion on yachts leave a lot to be desired. Indeed, it can be tricky for chefs to cater for individual needs but it’s no coincidence that bathrooms can be smelly. Pasta, pizza, cereal, bread and sweets may be convenient fillers but ongoing indulgence can result in a post-season burnout. A number of chefs and stewardesses saw me after the season to help them bounce back. All of them had digestive symptoms.

What to do

• Look at your poop and have a think about the smell - much as it may seem gross, it’s an important ‘test’ that will tell you a lot about your health, for free. My next post will help you interpret your waste

• Squatty-Potty or just an Ikea foot stool is a great aid that can be kept in the toilet and used by everyone. It forces gentle squatting, imitating the way humans used to evacuate and making bowel movements easier

• Have a shot of water with lemon juice or raw apple cider vinegar (e.g. this brand) before each meal

• If salad is available, have it before rather than with the main meal, and dress it with olive oil and vinegar

• Eat slowly and mindfully - the stomach doesn’t have teeth. Chew well and put cutlery down each time you take a bite. Leave all phones in a designated place before sitting at the table. Tune into YOUR body and how YOU react to the various foods

• Add quality salt to your food (e.g. sea, Himalayan or Celtic) as it enhances digestion of protein

• Try not to combine animal protein with starches, e.g. steak and fries or spaghetti Bolognaise. Have the meat or ragu with vegetables instead and increase the portion if possible. Do not add fresh fruit to cereal, granola or porridge except for ripe banana

• Drink plain hot water during breaks. If available, add a bit of fresh ginger

• Manage stress, e.g. Headspace app, brief workout (especially stretching combined with diaphragmatic breathing), few deep breaths, book, even just a page a day. It is important to have a think about your possible stressors as these go beyond the emotional aspects, e.g. food intolerances or spinal misalignment

• Sleep whenever you can

How I can support you further

During consultations, I analyse the function of the entire digestive tract which includes the state of the gut in terms of dysbiosis, infections, leakiness, inflammation and oral tolerance to foods. All aspects of restoring digestive balance depend on individual factors and medical examination is often invaluable. I can also offer advanced functional testing, with testing kits delivered to your preferred location.

Outside the clinic, I support chefs in developing health oriented menus not only for crews but also guests who may have specific health ailments, with the main focus on digestion. I also help my clients organise their kitchen, pantry, and we go food shopping together.

Article published in The Islander, November’18 edition

The whys behind eating disorders

The 10th of October is World’s Mental Health Day, a perfect opportunity to bring up the complex subject of eating disorders. Many affected people try various therapies or take psychotropics for long years, yet the disorder never truly leaves. It can be managed to some degree, often just to satisfy the close ones, but the person may continue to live in the shadow of its controlling demon forever. One of the possible reasons why eating disorders are so difficult to resolve lies in an incomplete treatment, which can prevent one not only from improving but most importantly, WANTING to get better. What’s more, conventional dietary approach can even induce relapses. Below I will discuss some of the physiological (and often dismissed) aspects of eating disorders.

What are eating disorders?

They are defined as “mental disorders marked by an obsession with food or body shape” and include anorexia nervosa, bulimia nervosa, binge eating disorder, orthorexia, avoidant / restricting eating disorder, and other.

The important question is, what are the causes of eating disorders beyond the mental aspect? Not everyone who has suffered trauma or has low self esteem develops an eating disorder. Something else must come to the equation, and I believe it’s multiple physiological imbalances. Mental and emotional aspects are often just a trigger and not the root cause.

Impaired digestion, gut toxicity, deficiencies and dysglycaemia

All of my clients with eating disorders have some sort of digestive issues that started before developing the disorder - it can be IBS (diarrhoea / constipation), indigestion, bloating, acid reflux, heartburn, no desire for meat. This is an indication that gut microbes are out of balance and food is not broken down properly, which can lead to uncontrollable sugar cravings, an increased production of toxins, ‘leaky gut’, and poor absorption of nutrients. As the eating disorder starts and continues, digestion is compromised further. People stop wanting to eat much animal protein, which is also considered high in calories. As a result, they rely on eating processed carbohydrates which causes a blood sugar roller coaster. This perpetuates binging, and damages gut microflora even more. It’s a vicious cycle.

The most common deficiencies include amino acids from protein breakdown, fat soluble vitamins A, D, E and K, B vitamins, magnesium and zinc, all key for mental health. Strong zinc deficiency can lead to picky eating, where the smell, taste and texture of certain foods may become very unappealing. Plenty become vegetarians or vegans but because plant foods are mostly carbohydrates, they are prone to more deficiencies and constantly swinging blood glucose levels.

Neurotransmitter imbalance, ‘leaky brain’

‘Leaky gut’ can eventually lead to a ‘leaky brain’. Undigested proteins and microbial toxins can escape through the ‘leaks’ and affect mood, behaviour and perception.

Moreover, as a result of improper digestion of proteins and gut degeneration, one can become low in serotonin and dopamine. Low serotonin can contribute to depressive episodes, and low dopamine can trigger feelings of worthlessness and inability to handle stress or process trauma. Addictive and obsessive behaviour acts on dopamine which can numb anxiety – a common pattern in eating disorders.

Hormonal disruption

Proteins and fats are also required to build hormones which affect metabolism, sleep, emotions and stress response. Without the building blocks and with a concurrent frequent intake of processed carbohydrates, one can be anxious or put on weight quickly when not restricting food – a frequent cause why eating disorders keep relapsing.

Gluteomorphins and casomorphins (exorphins)

Inability to fully break down dairy protein ‘casein’ and grain protein ‘gluten’ can turn them into opiates which act like morphine. They are able to attach to serotonin and dopamine receptors, and induce obsessive behaviour. This is a possible reason why people with eating disorders often crave addictive foods like baked goods, starch, bananas and dairy. They are also called ‘exorphins’ (external endorphins, coming from the outside of the body) - substances which give a feeling of positive ‘hit’, inducing addictive behaviour.

What to do and what to be prepared for

Conventional dietary approach often focuses on sufficient calorific intake, portion control or generalised ‘healthy eating’ guidelines (what are these anyways?), and not necessarily on nutrient density or individual food triggers. Such a diet, often abundant in processed carbohydrates, can perpetuate feeding pathogenic microbes. This can result in further blood sugar swings, hormonal and neurotransmitter imbalances - all of which are the driving force behind eating disorders.

I believe that the treatment should be multidisciplinary, with psychotherapy and other complementary disciplines applied at the same time. Dietary changes should be implemented in stages, taking into consideration individual physiological symptoms, and not just the eating disorder itself. Saying that, in spite of perfect protocols, sticking to them is another thing because compliance is the main reason for therapy to fail. Plenty of my clients give up after stage one, often because they fear calories, there is of lack of support, depression and as a result - lack of motivation. Like with any chronic health condition, there are no magic supplements or shortcuts. Eating disorders take a long time to resolve and one should be aware that it will cost time and money.

Nutritional therapy should be truly restorative and therapeutic. The main aspects include:

• Enhancing digestion, microbial diversity and absorption should play a central role in nutritional therapy. Protein and fat digestion (not just their intake!) is key to a successful outcome

• Addressing the brain and gut connection, but also the brain and gut individually

• Individual deficiencies should be addressed

• Focusing on foods that are nutrient dense but relatively low in calories - the fear of putting on weight is a major roadblock to success

• Understanding that patience is key. Dietary changes can initially cause digestive upsets and bring about other unwanted changes but these calm down over time. Persistence is the only way to break the vicious cycle

• Sugar addiction, like any addiction, may require a specialist support on top of neurotransmitter balancing. L-tyrosine can be administered for addictive behaviour – consult with a professional

• Gymnema Sylvestre can help to combat sugar cravings – consult with a professional

Consultations from any location. To book, email contact@welcometoglow.com

Shorter version of the article was published in The Islander, October’18 edition