Mar
28

Important clinic update

Bondi Health & Wellness remains open for business! 

However, in line with government recommendations we have moved our clinic online and are offering Skype, Zoom and phone consultations.

Any of your individualised herb blends or supplements you may require are then simply shipped directly to your door.

We are well organised and well stocked to help support our community during this time of great change.

So feel free to contact us on (02) 93865163 if you would like to make an appointment, or book online here.

Oct
03

How to reduce inflammation naturally

What do cancer, cardiovascular disease, autoimmune disease, and all chronic degenerative diseases have in common? Inflammation.

Most people associate inflammation with injuries that they can see, such as a twisted ankle, scraped knee, or a bee sting. These are all examples of obvious inflammation, easily identified with the naked eye, which occur as part of the healing process in response to an acute injury.

However, it is the inflammation we can’t see – the subtle low-grade chronic inflammation that happens at a cellular level – that can eventually overwhelm our pre-set defences, resulting in tissue damage and degeneration associated with chronic disease.

So what causes inflammation and how can we adjust our diet and lifestyle to avoid the ultimate consequences of uncontrolled inflammation?

Inflammation is at the root of so many diseases it is impossible to estimate the physical and economic impact it has on the Australian population. For example, two common conditions that have their foundations firmly planted in chronic inflammation are cancer and cardiovascular disease.

These two conditions alone are estimated to make up approximately 37 percent of the total disease and injury burden in Australia. This is just the tip of the iceberg; then there are autoimmune diseases, arthritis, allergies, neurodegenerative conditions, obesity and even depression which are also associated with inflammation, making it the leading cause of ill health.

What is inflammation?

The term inflammation comes from the Latin inflammo, which means ‘to ignite’. The process of inflammation was described in detail in one of the oldest recorded medical and scientific texts, De Medicia, written by the Roman scholar Aulus Cornelius Celsus (c. 25BC-c.50AD).

He described the various stages of inflammation as follows: dolor (“pain”), calor (“heat”), rubor (“redness”), and tumor (“swelling”). Later scholars added a final term, ‘functio laesa’, which translates to loss of function.

These observations still stand the test of time, however we now have a greater understanding of the cellular mechanisms involved.

Inflammation is the body’s first line of defence. When the body senses that there is an injury, a complex cascade of chemical messengers is released which triggers an immediate inflammatory response in order to neutralise, or ‘burn out’, any bacteria or pathogens present and flood the affected site with cells that will initiate the healing process.

Inflammation is part of our innate immunity, which means it is an inbuilt protective mechanism we were born with. It is not specific to any particular pathogen or bacteria, but more of a generalised protective response. The immune system cells are first on the scene and act as the foreman of the healing process, neutralising any existing threats and overseeing repair work. This is how the body should respond to any acute injury.

However, what happens when the threat is continual and the immune system is perpetually activated causing widespread, low-grade inflammation? This is where things go wrong and tissue degeneration and damage occur.

Cancer

Uncontrolled inflammation caused by chronic infection or irritation is well-recognised as a cause of cancer. For example, Helicobacter pylori, a common bacterial infection of the stomach, is also associated with gastric cancer, while viral hepatitis C is associated with the development of liver cancer. The chemicals in cigarette smoke lead to significant tissue irritation and inflammation, which ultimately causes cancer.

Chronic inflammation eventually damages the DNA of cells, and once rogue cells are established they are able to replicate themselves to the point that they create microscopic tumours. These tumours can then further harness the inflammatory process, using it to create new blood vessels which deliver nutrients and oxygen to fuel greater growth and replication.

Preventing cancer by managing inflammation has attracted significant attention from the scientific community. Several large trials, involving a total of 23,000 people, investigated the ability of aspirin (a common anti-inflammatory drug) to prevent strokes and heart attacks. Interestingly, data also examined the development of cancer in the trial participants and – astoundingly – there was a 34 percent reduction in all cancers and a 54 percent reduction in gastrointestinal cancers specifically.

Despite these amazing results, even the Cancer Council of Australia agrees, taking aspirin is not an ideal solution. Managing inflammation naturally through diet, lifestyle and nutritional supplementation is the best way to reduce inflammation and overall cancer risk.

Cardiovascular disease

Sadly, cardiovascular disease kills one person every 12 minutes in Australia and despite the advances in medical treatment it remains the leading cause of death. Inflammation influences every aspect of cardiovascular disease, not only in the initiation of vascular disease but also the triggering of clot formation.

The delicate cells lining the blood vessel walls are easily damaged by oxidative stress. As part of the healing process, a complex interaction between inflammation and small dense cholesterol molecules occurs at the site, which causes microscopic scarring and plaque formation. If this process continues unchecked, atherosclerosis develops and it is only a matter of time before a cardiovascular event, such as a heart attack, happens.

Smoking is a well-known cause of atherosclerosis, which is at least partly due to its ability to trigger widespread oxidative stress and inflammation.

Studies show that while aspirin may be useful for the prevention of stroke in women, its efficacy in preventing heart attack is still not proven and the Australian Heart Foundation recommends that lifestyle measures should be the main aim of preventative treatment.

Autoimmune diseases

There is a wide variety of autoimmune diseases, ranging from multiple sclerosis to coeliac disease, all of which have inflammation as a primary driver. These diverse conditions are caused by the immune system mistaking our own tissue for a foreign invader and launching an inflammatory attack to neutralise the ‘threat’.

While the exact cause of autoimmune disease is unknown, several contributing factors have been identified.

Chronic bacterial or viral infection may play a role based on the concept of ‘molecular mimicry’, where specific proteins of some pathogens are so similar to our own that the immune system becomes confused and starts to attack our own tissue.

Another theory is the complex interaction between the bacteria in the digestive tract (called the gut microbiome) and its interaction with the immune system. The modern diet can significantly disrupt the microbiome and cause inflammation of the gut lining. This damages the delicate pores in the gut lining and leads to the absorption of irritant substances, including bacterial by-products, from inside the gut into the circulation where the immune system reads it as a foreign invader. The subsequent inflammatory reaction launched by the immune system can cause significant damage.

Obesity

This may not be the first condition that springs to mind when we think about inflammation, but mounting evidence suggests that obesity, insulin resistance, and even type II diabetes may be related to inflammation.

Obesity is at epidemic proportions in Australia, with three out of five adults being overweight or obese. Even more worrying is that one out of every four children is overweight or obese, setting up our next generation for a life of ill health. According to the Australian government, these figures have risen by five percent since 1995 and show no signs of slowing.

While we know that the modern diet is fundamentally at the heart of the obesity epidemic, what we may not have considered is its effect on inflammation. The modern Western diet is based on processed foods that are high in refined carbohydrates, sugars and fats and flooded with chemical additives.

While the refined foods cause us to gain body fat (which in itself is inflammatory) the numerous chemical additives contribute to the systemic inflammation.

Insulin receptor sites on the cell wall are easily damaged by inflammation, which is thought to contribute to insulin resistance. Further to this is the effect of a highly processed diet on the gut microbiome causing inflammation.

So it seems it is a double-edged sword: once obesity is established, inflammation can perpetuate it, contributing to significant metabolic disruption.

Depression

This is a newcomer to the group of diseases driven by inflammation; however, emerging evidence is offering new insights into a complex condition that affects approximately 45 percent of Australians at some stage in their life.

A recent study has identified significant inflammation in the brains of depressed patients, using sophisticated PET scanning technology. They found that people with depression had a 30 percent increase in inflammation compared to healthy controls; they also found that the worse the depression, the greater the inflammation.

While this area of study is in its infancy, it offers some hope to people looking for answers.

What you can do to reduce inflammation

Diet

The typical Australian diet is very inflammatory, due to high intake of processed foods, refined carbohydrates, sugar, salt and fat, not to mention chemical additives and pesticides and herbicides used in farming. Even some of the ‘healthy’ choices found on our supermarket shelves can fit into this category.

The best way to ensure that you have an anti-inflammatory diet is to avoid the supermarket and buy most of your food fresh from the greengrocer, fishmonger, and local butcher.

A wholefood diet is arguably the single most effective step you can take to reduce inflammation. Not only is it high in valuable nutrients and low in irritating chemicals and additives, it also provides your body with the building blocks to fuel balanced immune responses, robust gut microbiome function, and effective elimination of toxins via healthy liver and gut function, all of which will help manage inflammation.

Vitamin D

This is a fat-soluble nutrient that helps us maintain bone strength and immune system health. Recently it has been shown to directly interact with the genes associated with inflammation and act as a powerful anti-inflammatory and pain reliever. Small amounts of vitamin D are found in fish, eggs and dairy.

Bioflavonoids

Vegetables are rich in a range of flavonoids that have significant anti-inflammatory effects. This group includes the powerful antioxidants found in berries and green tea, along with quercetin, rutin, and hesperidin, found in citrus fruit. A diet high in plant food should provide a wide range of flavonoids that will minimise inflammation; supplementing with bioflavonoids can also help.

Fish oil

Eicosapentaenoic acid (EPA), found in fish oil, acts to directly inhibit platelet aggregation and down-regulate the inflammatory cascade. Taking a high quality fish oil supplement daily can significantly reduce inflammation.

Turmeric

This is a potent anti-inflammatory herb which has been traditionally used to treat inflammatory conditions. Numerous studies and clinical trials have demonstrated that its active constituent, curcumin, is effective in both acute and chronic inflammation.

Boswellia

Found to reduce pain and inflammation in clinical trials, boswellia acts to significantly reduce inflammation without irritating the gut like pharmaceutical anti-inflammatories. Often included in formulas to treat arthritis.

Cat’s claw

A Peruvian vine traditionally used to treat arthritis and stomach complaints, cat’s claw has significant anti-inflammatory and pain-relieving properties.

Do’s and Don’ts

DO

  • Eat vegetables. Aim to have between six to nine serves of vegetables per day, buy organic where you can or soak and scrub them if they’re not.
  • Eat fruit. Enjoy a couple of pieces of fruit per day.
  • Eat deep-sea, oily fish such as wild-caught salmon, sardines or mackerel, at least three times per week.
  • Eat nuts and seeds – enjoy a handful a day.
  • Eat poultry. Choose organic, free-range poultry products.
  • Eat grass-fed, organic red meat sparingly – no more than a couple of times per week.
  • Eat whole grains. Choose small to moderate amounts of quinoa, buckwheat, amaranth, rice.
DON’T
  • Drink alcohol. Save it for special occasions only, as it’s very inflammatory.
  • Eat gluten. This is considered an inflammatory component of grains like wheat, barley and rye.
  • Eat too much sugar. It’s in nearly all processed foods, and nearly impossible to avoid if buying packaged foods.
  • Eat trans fats, which are found in fried food, potato crisps, margarine, bakery items, biscuits and many tinned and packaged foods.
  • Eat refined carbohydrates – this includes bread, biscuits, pastries and crackers.
  • Eat food additives. The range is endless, as they are found in almost all packaged and tinned foods.

Top 10 anti-inflammatory foods

  • Pineapple
  • Cherries
  • Ginger
  • Oily fish
  • Blueberries
  • Green tea
  • Garlic
  • Shiitake mushrooms
  • Papaya
  • Broccoli

If you suffer from inflammation or would like to reduce your risk of chronic disease see your health care practitioner today.

This article first appeared in Nature & Health magazine.
Download the article

Sep
09

Natural remedies for back pain

It’s hard to fathom the impact of back pain on your life unless you’ve experienced it. Tania Flack investigates what can go wrong, and how you can help.

Most people have had an aching back at some stage in their life, brought on by long hours at a desk or a heavy gym session. If you’re lucky, this type of back pain will ease in a day or two and soon be forgotten. However, when that pain becomes a dull roar which refuses to let up, we start to understand how chronic back pain can impact on your day-to-day life.

Of those Australians reporting back pain, nearly half experience difficulty with mobility, daily activities and self-care, which significantly impacts quality of life. And the financial impact of back pain on the Australian economy is staggering. It’s reported to cost approximately 1.2 billion dollars per year, split between hospital care, out-of-hospital appointments and prescription medications.

And that’s only a small part of the true costs, as many people manage back pain through modalities not reported in these statistics, like osteopathy, chiropractic, physiotherapy, acupuncture, or remedial massage.

Sadly, Australia seems to be leading the world in the impact of back pain on our society. Back pain ranks as the number one issue for Global Burden of Disease estimates in Australia, compared to sixth worldwide.

How can we treat back pain and what steps can we take to prevent it and avoid becoming part of the statistics?

What goes wrong

Muscle strain and tension

This is perhaps the most common type of back pain and most people will experience it at some stage. It often involves the neck and shoulder area or the lower back.

Stress is a common cause of muscle tension. When we are under stress, our fight-or-flight response launches a complex range of chemical and physical changes throughout the body, which are designed to help us get out of danger. Muscles tense up in preparation to fight off danger or flee. While this is useful if we are in physical danger, it can be problematic if we remain in this state for hours, which is often the case in the workplace.

Unrelenting muscle tension leads to muscle pain, strain, tension headaches, and fatigue.

Remedial massage, stretching and yoga are all effective treatments; however if this is an ongoing problem then meditation, mindfulness techniques, stress management and counselling can help you control stress and minimise muscle tension.

Another common cause of muscle strain is poor posture at work, especially if you sit all day. Inadequate lumbar support, incorrect placement of your computer screen or armrests set to the wrong height can all contribute to muscle strain. You should be able to adjust your workstation to suit your requirements. If you have repeated work-related muscle strain, speak to your employer and seek advice from your practitioner or an ergonomist who specialises in preventing work related postural injury.

Treatment options: Remedial massage, yoga, acupuncture, ergonomics, stress management.

Ligament or tendon strain

This type of injury is usually a direct result of over-stressing a joint, which can occur when lifting incorrectly. It can also be due to an accident: whiplash is a common example of this. The pain can be immediately obvious in some cases or may take up to 24 hours to become apparent, depending on the type and site of the injury.

The best first aid to apply is rest, ice and to limit movement until you see your practitioner. This helps to minimise inflammation and reduce pain.

Ligaments and tendons are avascular tissue, meaning they don’t have a blood supply, so this type of tissue can take some time to heal.

Treatment options: Physiotherapy, osteopathy. First aid: Rest, ice and limit movement. Arnica cream can reduce inflammation and speed healing.

Bulging disc

We have fibrous discs between each vertebra which help to cushion the spine against impact and protect the joints. These discs consist of a fibrous outer layer and a softer inner gel-like centre.

Like bones, discs are prone to degeneration with ageing and overuse, which can lead to herniation if the joint is put under undue pressure. When the disc herniates, the soft inner layer pushes through the outer layer of the disc and the resulting bulge can compress nerves in the spine. Often called a ‘slipped disc’, this type of back injury commonly occurs in the lumbar spine and sometimes in the neck.

It requires careful management and imaging , such as a CAT scan or MRI, to assess the degree of damage and help your practitioner formulate a treatment plan. This type of injury is often the cause of chronic back pain and severe cases may require surgery to relive pressure on the nerves.

Treatment options: Osteopathy, physiotherapy or chiropractic care. Imaging such as CAT scan or MRI is important and a medical consultation may be required.

Osteoarthritis

As we age, so do our vertebrae and over the course of our lives they are subjected to general wear and tear, which can lead to localised inflammation and osteoarthritic degeneration of the joint. This causes limited mobility and, in some cases, chronic back pain.

Maintaining strong bones is essential to help prevent osteoarthritis and having a whole-food diet rich vitamins and minerals will help maintain bone strength. A calcium supplement, along with glucosamine, chondroitin, vitamin D and K2, will support bone strength.

You can reduce inflammation by consuming oily fish such as salmon, mackerel, sardines and herring three times a week, and making sure you have lots of fresh green leafy vegetables in your diet. Avoiding foods known to promote inflammation – sugar, highly refined carbohydrates, preserved meats and fried foods – is also very important.

Herbal medicine, including turmeric, devil’s claw, cat’s claw, celery seed and ginger, can help relieve inflammation.

Treatment options: Nutritional medicine, herbal medicine, weight management, exercise and physiotherapy.

Sciatica

This describes the pain caused by compression and inflammation of the sciatic nerve, which exits the spine in the lower back and runs down the leg. This is a very important nerve and is involved in coordinating muscle movements when we walk.

This nerve can be compressed by a bulging disc in the lower back or can become compressed by the piriformis muscle, deep in the gluteal region.

Once this nerve is compressed, inflammation gets trapped between the nerve and the myelin sheath and swelling travels down the length of the nerve, causing the pain and weakness in the leg and foot which is typical of sciatic pain. This needs to be professionally assessed and treated as the two common causes of sciatic pain are managed very differently.

Treatment options: Great relief can be achieved by releasing the piriformis muscle along with the other deep muscles of the hips. Remedial therapists can achieve this while Pilates and yoga can help to prevent a relapse of piriformis-induced sciatica. If sciatic pain is due to a bulging disc, an osteopath, physiotherapist or chiropractor can help. X-rays and a medical consultation may also be required.

How to reduce your risk

Watch your weight

Being overweight is perhaps one of the biggest risk factors when it comes to back pain. Carrying extra weight burdens joints unnecessarily and is a leading cause of osteoarthritis, along with ageing. Excess weight around the middle shifts our centre of gravity and puts pressure on the lower back, increasing the risk of muscle strain or spinal injury.

Being overweight at the time of a back injury significantly slows the healing process. This is particularly important in the case of a herniated disk, especially if surgery is required. Being overweight at the time of injury can lead to a vicious cycle, because back pain prevents people from exercising, which leads to more weight gain, which ultimately leads to more back pain.

Luckily, weight management can be successfully achieved through diet alone for people who have limited mobility. Consulting with a nutritionist to formulate a dietary plan can be the first step to recovery and maintaining a healthy weight protects against future back injury.

Regular exercise

Poor core muscle strength shifts much of the weightbearing strain to the spine and can lead to greater wear and tear of the joints and an increased risk of injury. Achieving and maintaining strong abdominal muscles is one of the best way you can protect your back.

Walking, swimming, and taking part in sports that use a range of different muscles all help to strengthen the core and maintain flexibility Pilates and yoga are great ways to strengthen the body, reduce muscle pain, increase flexibility and retrain postural core muscles.

Other excellent activities include the Alexander technique and the Feldenkrais method: these both help people to reconnect with their body, become more aware of their posture, and strengthen and rebalance the core muscles. They are marvellous therapies for preventing and treating back injury and reducing chronic pain.

Occupational risks

Certain occupations carry greater risk of back injury. Any job that involves sitting for long hours, such as office work or truck/taxi driving, puts a great deal of pressure on the back and spine. If you sit all day you should schedule a break every hour, get up and walk to the water cooler or pull over and take a five minute break to stretch your legs. If your job involves heavy lifting or repeated bending, put measures in place to minimise back strain. If your work is straining your back, speak to your employer; sometimes only small changes are needed to make a big difference.

We should all be more aware of back health. Staying fit and active throughout life, and maintaining strong, flexible core muscles and a healthy weight can all considerably reduce your risk of back pain. And, if you are experiencing back pain, remember early intervention is the key to a fast recovery.

Best therapies for back pain

Remedial massage, Osteopathy, Acupuncture, Chiropractic care, Physiotherapy, Pilates, Yoga, Feldenkrais method, Alexander technique, Herbal medicine

Best nutrients for back pain

Turmeric, Ginger, Garlic, Oily fish, Shellfish, Flaxseed, Berries, Cherries, Leafy green vegetables, Cold-pressed virgin olive oil

Anti-inflammatory foods for pain

  • Magnesium, for muscle spasm – red meat, chicken, turkey, almonds, pecans, pistachios, sesame seeds, sunflower seeds, legumes
  • Essential fatty acids, for inflammation – deep sea oily fish, such as salmon, mackerel, sardines, herring and flaxseed
  • Vitamin C, for tissue strength – citrus fruit, blackberries, kiwifruit, red capsicum, strawberries, papaya, broccoli, rockmelon
  • Zinc, for would healing – oysters, red meat, Brazil nuts, almonds, cashews, walnut, pine nuts, sunflower seeds, parsley
  • Folate, for tissue repair – leafy green vegetables, carrot, celery, cabbage, chickpeas, hazelnuts, chicken livers, oranges
  • Calcium, for bone strength – dairy products, small fish with edible bones, like sardines and anchovies, tahini, crab, duck, sunflower seeds
  • Vitamin D, for bone health – dairy, egg yolk, herring, calamari; it is also synthesised from exposure to sunlight.

This article first appeared in Nature & Health magazine.
Download the article

Aug
26

Natural remedies for fibromyalgia

If you think unrelenting pain through your whole body sounds dreadful, well it is. Imagine waking every morning in pain – even walking hurts.
Your pain and exhaustion become overwhelming, and you lose your job.

Your friends and family can’t understand; you struggle to maintain relationships, and feel isolated and depressed. After many trips to doctors and specialists, you are finally diagnosed with fibromyalgia – and told there is little you can do but manage the pain and find a new way to live within the confines of your condition.

Sadly, this is a common story among fibromyalgia sufferers, compounded by a lack of understanding as to what causes the condition and no clear clues for a path forward. However, research is shedding light on it and natural medicine can help alleviate the symptoms.

What causes fibromyalgia?

Fibromyalgia is a chronic disease characterised by widespread pain and multiple tender points in muscles and soft tissues throughout the body, accompanied by stiffness and fatigue.

It affects between two and 10 percent of Australians, and is the second most common rheumatic condition, following osteoarthritis. It is seven times more likely to strike women than men, commonly between the ages of 35-55 years, although men and children can also develop it.

Initially viewed with scepticism by the medical fraternity, due to a lack of obvious and measurable biomarkers, it wasn’t until 1990 that diagnostic criteria were developed by the American College of Rheumatology. These were later expanded in 2010 to encompass a broader range of symptoms, including sleep disturbance, morning stiffness, cognitive problems, headaches, migraines, and depression.

There is much crossover between fibromyalgia and other clinical syndromes, including chronic fatigue syndrome, irritable bowel syndrome, restless leg syndrome and multiple chemical sensitivities, so even getting a diagnosis can be a long, frustrating experience.

Fibromyalgia is a complex condition and the exact cause is unknown, but abnormalities of cell signalling and neuroendocrine function have been identified and are being investigated. While we don’t have the full picture yet, it is generally thought that fibromyalgia can be triggered by infection, physical trauma, psychological stress, hormonal alterations, or possibly exposure to some drugs or chemicals.

People with fibromyalgia have abnormalities in the way the neurons of their central nervous system respond to pain signals. Neuroimaging studies demonstrate clear differences in the brain responses of fibromyalgia sufferers compared to normal controls. Neurotransmitter abnormalities have also been identified, including lower serotonin levels in the central nervous system, which may alter pain signalling. A decrease in dopamine signalling in the brain also plays a role.

In keeping with these findings, antidepressants are the standard medical treatment for fibromyalgia and can provide some relief of symptoms. Neuroendocrine deficiencies have also been identified as a possible contributing factor; so are changes in the function of the hypothalamus-pituitary-adrenal axis, which can lead to a lower secretion of adrenal hormones, blunted cortisol response, and lowered DHEA levels.

Fibromyalgia sufferers have demonstrated low adrenal function in studies, along with hyposecretion of adrenal androgens, including DHEA and testosterone. Chronic stress – either physical or emotional, or a traumatic event – impacts the delicate balance of the hypothalamus-pituitary-adrenal axis and can be associated with onset of fibromyalgia.

Most recently, research has focused on the role of the mitochondria, the energy-producing powerhouse in all cells. Fibromyalgia sufferers have decreased levels of coenzyme Q10 (a powerful antioxidant enzyme involved in mitochondrial energy production), and increased levels of oxidative stress and mitochondrial dysfunction. Exciting breakthroughs in the link between mitochondrial dysfunction and chronic fatigue syndrome (a closely linked condition) have started to emerge, so hopefully this research will have benefits for fibromyalgia sufferers in the future.

Leaky gut and thyroid

Between 30 and 70 percent of all fibromyalgia sufferers also experience irritable bowel syndrome, which has led researchers to try to identify a link.

While the cause of fibromyalgia is yet to be identified, there is a theory that dysbiosis (an imbalance of gut bacteria) causing an increase in the permeability of the gut lining (leaky gut) may be a contributing factor. Exposure to minute levels of bacterial endotoxins escaping the gut into the bloodstream is thought to trigger an inflammatory response in immune cells, which in turn alters cellular signalling, impacting pain perception, and causing depression and fatigue.

Poor diet, refined foods, sugar, alcohol, caffeine, some medications, herbicides and pesticides in foods, and stress all contribute to an unbalanced gut microbiome.

One study looking at the link between gut health and fibromyalgia found that 78 percent of all fibromyalgia patients tested positive for small intestinal bacterial overgrowth (SIBO), and when treated for this with antibiotics had significant improvements in gut symptoms, musculoskeletal pain and fatigue.

Other research examining the intestinal permeability of fibromyalgia sufferers has found that it is increased, compared to healthy controls.

Nutritional interventions designed to reduce symptoms of irritable bowel syndrome also significantly improve pain in fibromyalgia sufferers. Participants of one study ate a low-FODMAP (Fermentable Oligo-Di-Monosaccharides And Polyols) diet for four months, and were found to have significant reduction in overall pain scores and improvement in gut symptoms. The low FODMAP diet removes fermentable fibres from the diet, which reduces the total bacterial abundance in the digestive tract.

So these findings support the theory that levels of gut bacteria and the endotoxins they produce play a role in fibromyalgia.

Shifts in other hormones are also linked to fibromyalgia and evidence supports the hypothesis that fibromyalgia may, in part, be due to thyroid hormone resistance. Hypothyroidism is common in fibromyalgia sufferers; however, some people present with all the symptoms of thyroid disease but their blood results indicate normal thyroid function. This is thought to be due to thyroid resistance, which is a blunting of the cells’ responses to available hormone.

Several clinical trials have found that thyroid hormone replacement can significantly improve symptoms of fibromyalgia. Fibromyalgia sufferers displaying thyroid symptoms may benefit from supplemental iodine, selenium, zinc, and other cofactors to support thyroid hormone production, along with herbs like coleus and withania. A naturopath or nutritionist will be able to assess thyroid function, test for any nutritional deficiencies, and prescribe a tailored protocol if needed.

Nutritional medicine can help

SAMe: S-adenosylmethionine (SAMe) is an amino acid that has significant anti-inflammatory, painrelieving, and antidepressant activity in fibromyalgia. SAMe acts to down-regulate inflammation and has been shown to be as potent as non-steroidal anti-inflammatory medication in both animal studies and human clinical trials.

The antidepressant activity of SAMe is well-established, with many clinical trials finding that it provides equivalent antidepressant activity as standard pharmaceutical antidepressants, but without the side effects. A double-blind, placebo-controlled, randomised clinical trial has shown that even a relatively low dose of 200mg per day for 21 days reduces the number of tender trigger points and improves mood.

Acetyl-l carnitine: This antioxidant amino acid supports cell membrane health, mitochondrial activity, enhances energy production, and has significant neuroprotective properties. Clinical trials show that it alleviates depression in fibromyalgia sufferers, and a recent meta-analysis found that it has pain-reducing effects in peripheral neuropathy. One study involving over a hundred participants found that fibromyalgia sufferers given two 500mg of acetyl-l carnitine daily for 10 weeks had a significant reduction in musculoskeletal pain and depression.

Magnesium: This is essential for energy production in every cell in the body. Studies show that fibromyalgia sufferers have abnormal calcium and magnesium flow across the cell wall and low serum levels of magnesium. One study found that 300mg of magnesium citrate given daily for eight weeks significantly decreased the number of tender points, the level of tenderness, and depression scores. These results indicate that the combination of magnesium citrate with SAMe, which has been shown to have similar efficacy as standard antidepressants, may achieve similar results although no clinical trials have been done to date.

Coenzyme Q10 (CoQ10): This powerful antioxidant enzyme plays a critical role in mitochondrial function and energy production within the cell. Studies reveal that fibromyalgia patients often have deficiencies in CoQ10. One randomised, placebo-controlled, double-blind trial investigated the effects of 300mg of CoQ10 daily for 40 days in a group of 20 fibromyalgia patients. This produced significant reduction in pain, tender points, fatigue, and morning tiredness. Further investigation showed improvement in antioxidant enzyme activity, mitochondrial function, and inflammation. Another trial investigated the effects of a combination of 200mg of CoQ10 daily with 200mg of ginkgo biloba for 84 days. Ginkgo biloba is a powerful antioxidant herb that has a stimulatory effect on the microvasculature. Quality of life scores were monitored throughout the trial and 64 percent of participants reported improvement in symptoms.

Mind-body therapies

These are important management tools in any chronic painful condition, and fibromyalgia is no exception. Fibromyalgia sufferers can often feel that they are powerless to make changes in their health, due to their pain, which can lead to frustration, depression and isolation.

Partaking in gentle movement is an important part of learning to manage the symptoms of this debilitating condition, and several studies have identified benefit in meditation, mindfulness and other mind-body therapies, indicating that this type of intervention is an important addition to any fibromyalgia recovery program.

Qi Gong is a gentle movement therapy based on martial arts that uses physical poses, breathing techniques, and focused intention in order to promote the flow of qi or vital life force throughout the body. One randomised, controlled, cross-over study found that Qi Gong therapy over a course of seven weeks provided positive and reliable benefits and improved pain, psychological health and reduced distress.

Other studies have identified similar benefit from Tai Chi, which improves pain scores, sleep quality, physical and psychological function. Mindfulness-based meditation has been found to be effective for the depression and mood alterations associated with fibromyalgia; however, the movement-as-meditation therapies like Tai Chi and Qi Gong seem to have a broader range of benefits and are more successful in reducing pain.

6 steps to fibromyalgia recovery

Clean up your diet: Everything we eat has an impact on our body, and people with fibromyalgia need to take a ‘food as medicine’ approach to their diet and make every mouthful count. A predominantly plantbased, clean, wholefood diet is essential to help alkalise the system and keep your gut microbiome happy. Avoid processed foods, fried foods, sugar, caffeine, and alcohol.

Heal your gut: This is an important step towards recovery and diet should be your biggest focus here. However, pre- and probiotics, glucosamine, vitamin A, zinc, and bioflavonoids can help rebalance the gut and repair the gut wall. Herbs such as slippery elm, marshmallow and golden seal will also help. Speak to a professional about your gut health for proper assessment and treatment.

Dampen inflammation: A wholefoods diet is the best place to start. Eicosapentaenoic acid (EPA), a constituent from fish oils, can significantly reduce inflammation. Aim for a dose of 1.2g daily. Vitamin C and the bioflavonoids quercetin and rutin will also help. Herbs – turmeric, boswellia and cat’s claw – are also effective anti-inflammatories, but should be prescribed by a professional.

Control your stress: Being in pain is stressful and it’s vital that you take steps to manage stress as part of your recovery program. Managing stress reduces pain and protects against depression. Mindfulness techniques, meditation, Tai Chi and Qi Gong can be useful, as can the support of a psychologist specialising in chronic health conditions and pain management.

Keep moving: Even when muscle pain and fatigue limits activity, gentle movement can reduce stress, improve mood, release pain-reducing endorphins, and support healthy circulation and mobility.

Get specialised advice: Herbal medicine can be used to support recovery in fibromyalgia and may include herbs to support healthy adrenal and thyroid function, reduce pain, support mood, and promote restful sleep Herbal medicine needs to be prescribed on an individual basis by a trained professional, especially if you are taking other medicines, so speak to your naturopath or herbalist.

So the message is: don’t give up, but explore your options so you can find the perfect combination of support to help you on your path to recovery.

This article first appeared in Nature & Health magazine.
Download the article

Aug
12

Carbs: friend or foe?

The humble carbohydrate has become the great villain of nutrition in recent years. Are they good for you or not? Tania Flack sorts fact from fiction.

Several popular recent diet movements have promoted the belief that ‘carbs’ are the primary driving factor behind Australia’s ever-growing obesity crisis.

This trend is comparable to the low-fat movement of the 1980s, which painted dietary fats as the culprit behind cardiovascular disease, and subsequently led to a decrease in consumption of natural fats, and sprouted a high science industry producing ‘Frankenfood’ creations like margarine and low-fat salad dressings.

With each swing of the pendulum, we are moving further away from a simple wholefoods diet, one that our bodies – and the vast colonies of bacteria contained within them – are genetically programmed to thrive on.

So, are carbs good for you, or bad? The truth lies somewhere in between and depends on which type of carbs you choose.

Know your carbs

Carbohydrates are promoted in the old-fashioned food pyramid as the primary source of fuel for the body, because the simple sugars, which are the final product of carbohydrate digestion, are easily utilised by all cells for energy.

However, it is the only one of the three macronutrients that technically has no minimum requirement, because the human body has been shown to thrive on a predominantly protein-and-fat diet, as seen in the Inuits, Laplanders and some Native Americans tribes who consume very limited amount of carbohydrates. That fact, along with examples of more primitive diets, has fuelled the question about our need for dietary carbohydrates.

But rather than being seen as the pinnacle of healthy eating, being able to survive with very minimal quantities of carbohydrates should be celebrated as yet another example of the supreme adaptive abilities of human physiology – not necessarily an ideal to aspire to.

Carbohydrates are produced by photosynthesis in plants, such as fruits, vegetables, grains, legumes, nuts, seeds, and tubers. Carbohydrates contain carbon, hydrogen and oxygen in a ratio of 1:2:1, and yield 4 calories per gram.

All carbohydrate-containing food can be digested or metabolically transformed into glucose, which is then used by cells as a primary source of energy. While proteins and fat can also be converted into fuel that can be used by cells, carbohydrate metabolism is a more direct process.

Carbohydrates can be classified broadly into three main groups – sugars, starches, and fibre – all of which have varying impacts on human health.

Sugars are the lightning-fast fuels that people love. Sugars are broken down into two categories, monosaccharides and disaccharides, based on their chemical structure.

Monosaccharides

Glucose: This is the end product of carbohydrate metabolism and is also found in some fruits, such as grapes. Glucose is the basic unit of energy for all cells in the body. When you have a blood sugar test, this is what is being measured.

The body has careful checks and balances to try to keep blood glucose levels in a healthy range; however, excess dietary sugar and processed carbohydrates can overwhelm these systems and lead to significant health problems.

Fructose: Found in most fruits, honey and some vegetables. It is easily converted to glucose in the liver and small intestine.

Galactose: Comes from the digestion and conversion of the milk sugar lactose. Like fructose, it is easily converted into glucose in the liver.

Disaccharides

Lactose: This is the only animal source of carbohydrate and is the sugar contained in milk.

Sucrose: Arguably the villain of the sugar group, mainly due to its intense sweetness and overuse in food production. It is found in sugar cane, sugar beets, maple syrup, molasses, sorghum and pineapple. It contains both fructose and glucose and provides a huge energy hit for very little digestive effort. Its connection with a vast array of health problems is well established.

Maltose: Two glucose molecules together, which is produced by the breakdown of many cereal grains. It is found commonly in beer, snacks, crackers and some breakfast cereals. Read labels to get a better idea of how common this form of sugar is.

Polysaccharides

The starches category of carbohydrates has longer chain molecules called polysaccharides, which, like the sugar group, are broken down into glucose; however, far more effort is needed for this process which is why they are known as complex carbohydrates.

Digestion starts in the mouth with special enzymes found in saliva, then other enzymes are required during the digestive process in order to produce the final glucose molecule, which is needed for energy production.

This group of carbs includes: Starchy root vegetables (e.g. potatoes, sweet potato, cassava, parsnip, beetroot), wholegrains (corn, wild rice, barley, oats, whole wheat), pseudograins (quinoa, buckwheat, amaranth, millet), and nuts and seeds (cashews, almonds, walnuts, pumpkin seeds, sesame seeds, pine nuts).

The final important group of carbohydrates is fibre, which provides structure in the plant cell wall. Dietary fibre has different beneficial effects on health and bowel function, depending on its structure. A low fibre diet is associated with an increased risk of colon cancer, cardiovascular disease, diabetes, obesity, diverticulitis, haemorrhoids, and a range of other bowel problems.

Fibre can be broken down into three groups:

Soluble: This draws water and turns into a gellike substance within the bowel, slowing transit time and helping you feel fuller for longer. This type of fibre is found in barley, oat bran, legumes, nuts and seeds and some fruits and vegetables.

Insoluble: This is found in the outer covering of wholegrains and the skin of some vegetables. It adds bulk to the stool and helps regulate bowel function and transit time.

Resistant starch: While not traditionally thought of as fibre, resistant starch acts in similar ways. It is found in unripe bananas and cooked and cooled rice and potatoes. This type of starch resists digestion in the small intestines and is broken down by beneficial bacteria in the large bowel which produces butyrate, a short chain fatty acid which is fuel for the cells lining the bowel.

Whole vs. processed

The benefits of a diet rich in wholegrains have been studied extensively and consistently found to lower the risk of atherosclerosis, cardiovascular disease and type II diabetes by between 20-40%. While these results are impressive, we need to be clear on what wholegrains are and understand how to incorporate them into the diet.

The term ‘wholegrain’ is bandied about by food manufacturers, when in actual fact, wholegrains by definition should not be processed – which rules out food manufacturers altogether. Often wholegrains are added to a refined carbohydrate product to boost its shelf appeal, but these foods provide little of the benefit of cooking wholegrains yourself and adding them to your diet.

The structure of grains can be broken down into three distinct fractions: the germ, the bran and the starchy endosperm. Wholegrains are rich in a variety of beneficial vitamins, minerals, fats and phytochemicals which act as potent antioxidants, much of which is contained in the germ and bran parts of the grain. The bran contains the most fibre of all the grain components and is largely responsible for the digestive benefits seen with wholegrain consumption.

During conventional processing, the nutritious germ and bran are removed from the grain leaving the starchy endosperm, which is the energy-dense component of the grain. This processing increases the speed of breakdown in the digestive tract and absorption of fuel into the bloodstream, increasing its glycaemic index and reducing the health benefits.

To ensure you are getting the benefits of wholegrains add barley, whole oats, brown rice, corn, quinoa, millet, amaranth, buckwheat and freekah to your diet.

High GI vs low GI

So, while research shows the benefits of a wholegrain diet, other large studies have found that an increased intake of carbohydrates does the exact opposite, and increases the risk of cardiovascular disease.

The key lies in the ‘glycaemic index’ of the carbohydrates we eat: the higher the blood glucose response to a carbohydrate, the higher the glycaemic index.

For example, a large American study followed the diets of 75,521 women for a decade. Increases in their total glycaemic load were associated with a significantly increased risk in coronary heart disease. Interestingly, the total glycaemic load of their diet was a greater predictor of coronary heart disease than their intake of simple versus complex carbohydrates.

While foods like rice and potatoes are traditionally considered complex carbohydrates, they each have a high glycaemic index and are digested and absorbed quickly, inducing a high blood glucose response. In contrast, simple carbs like vegetables and fruit, have a lower glycaemic index and yield only a small blood glucose response. So, the take-home message is: choose low glycaemic index carbohydrates and focus on vegetables.

Sweet poison

In the last century, sugar consumption in Australia has increased astronomically. It is so ingrained in our culture that it has led to generation after generation relying on sugar to self soothe. Isn’t it ‘normal’ to reward yourself with a piece of chocolate after a hard day, or give a child a sweet treat if they fall over and hurt themselves?

Refined sugar has no nutritional value aside from pure energy, and MRI scans demonstrate its ability to impact areas of the brain associated with pleasure and reward, making it very addictive. The psychology behind sugar consumption is fascinating, however its effects on human physiology is where the real damage is done.

The increase in refined sugars in the Western diet is a major driving factor behind obesity, type II diabetes and cardiovascular disease. According to the Australian Bureau of Statistics, the message about the health risks associated with sugar consumption has been trickling through and we have reduced our intake from the dizzying highs of 1995, due largely to the success of high profile programs such as ‘I Quit Sugar’ and the Paleo movement.

Despite this success, Australians still consume way too much sugar and we have a long way to go before we meet World Health Organization’s recommendations of less than 5% of our dietary energy coming from sugar.

Thanks to the chemical wizardry of the food manufacturing sector, getting clear information on sugar consumption is difficult because there are so many hidden sugars in processed foods. These foods are often marketed to teenagers who have the highest consumption, with teenage boys estimated to consume 92g or 18 teaspoons per day.

The best way to avoid sugar is to focus on a wholefoods diet; while it may take more time in food preparation, your intake of incidental sugars from processed foods will drop dramatically.

A sugar by any other name

When reading labels, be aware that sugar masquerades under many names:

  • Brown sugar
  • Corn sweetener
  • Corn syrup
  • Dextrose
  • Fructose
  • Fruit juice concentrates
  • Glucose
  • High fructose corn syrup
  • Honey
  • Invert sugar
  • Lactose
  • Maltose
  • Malt syrup
  • Molasses
  • Raw sugar
  • Sucrose
  • Sugar

Friend or foe?

So, the bottom line is, carbohydrates are not the devil that we have been led to believe. Certainly, you should be mindful of what types of carbs you consume and avoid processed carbohydrates and sugars.

Keep in mind if you have to read a label, it has had some sort of processing. Choose carbs that are as close to their natural state as you can get them.

Include a moderate amount of wholegrains, legumes, nuts and seeds in your diet along with an abundance of vegetables to reap the health benefits of carbohydrates.

Carbs: the golden rules

  1. Maximise your vegetables
  2. Choose wholegrains
  3. Enjoy low glycaemic index carbs
  4. Focus on fibre
  5. Avoid sugar

This article first appeared in Nature & Health magazine.
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Jul
29

Natural brain boosters

Once considered the territory of advanced old age, dementia and Alzheimer’s disease are slowly but surely making their presence known among younger Australians. Here are natural remedies to prevent problems before they start.

READ: How to keep your brain healthy

Co enzyme Q10 (CoQ10) is an enzyme found in every cell in the body. It plays an important role in intracellular energy production and acts as a powerful antioxidant that helps to reduce the oxidation of low-density lipoprotein (bad cholesterol) and protect blood vessels and throughout the body. A large Japanese study found lower serum CoQ10 levels were associated with a greater risk of dementia, while other studies have shown that it can help to improve cerebral energy and symptoms in supranuclear palsy and Parkinson’s disease.

Ginkgo This magnificent, long-living tree with heart-shaped leaves has been used in herbal medicine for thousands of years. It is renowned for its potent effect on circulation and brain health. A 2012 study found that taking ginkgo for 24 weeks improved cognition, mood, mental function and quality of life in patients with mild to moderate Alzheimer’s disease and vascular dementia. It has also been shown to improve the ability to perform demanding cognitive tasks among healthy middle-aged volunteers, indicating its potential as a cognitive enhancing supplement.

Bacopa This has been traditionally used in Ayurvedic medicine to protect brain health and promote mental clarity. Animal studies show that it has antioxidant, cell-protective effects and increases cerebral blood flow. In 2008, an Australian randomised, doubleblind, placebo-controlled trial showed that 300mg of bacopa per day, for 12 weeks, improved memory and decreased depression and anxiety in healthy, older adults. An Indian study found it improved self-control, restlessness, learning problems, attention deficit, impulsivity, and psychiatric problems in a group of participants with attention deficit hyperactivity disorder.

Rosemary The phrase “rosemary for remembrance” is no coincidence, and this humble backyard herb has been proven to enhance cerebral circulation and memory in several clinical trials. One study found that even short-term administration of 750mg of rosemary leaf powder improved the speed of memory in the hours following administration in a group of older adults, while smelling the essential oil improved the overall cognitive performance, alertness and mood among healthy volunteers.

Omega-3s Omega-3 essential fatty acids from fish and seafood have a range of benefits for brain health. They have powerful anti-inflammatory effects, support cell membranes and neurological health, including the brain. They also help maintaining healthy cholesterol levels and protect against cardiovascular disease. This may be a key factor in the success of the Mediterranean diet in protecting brain health. A 2005 Italian study found that consuming 4 grams of fish oil daily (1,600mg EPA and 800mg of DHA) improved mood and concentration in healthy adults, while other studies have demonstrated that eating fresh fish, even just once a week, was associated with a decreased the incidence of dementia.

Phosphatidyl serine (PS) This is an essential brain nutrient, vital for the healthy function of nerve cells and myelin, which covers the nerves. Various animal studies have shown that it crosses the blood-brain barrier, and slows or even prevents damage to neurological tissue. It has a beneficial effect on neurotransmitter release and neurotransmitter receptor concentrations in the brain. Human studies have shown that it supports cognitive function, including the formation of short-term memory, and also helps to consolidate long-term memory and create new memories, enhance concentration, recall and attention, and support reaction times and healthy reflexes.

B group vitamins play an essential role in brain health, especially folate and vitamins B12 and B6 which are vital co-factors in the methylation pathway, which is involved in energy production in the cells and DNA replication and repair. When folate intake is inadequate homocysteine levels rise, which is associated with an increased risk of damage to blood vessels and atherosclerosis. Many studies have investigated the impact of these nutrients on the development of dementia. One large Italian study followed the progress of over 800 elderly participants and found that those that developed dementia were more likely to have low serum folate levels and elevated homocysteine.

The Mediterranean diet A meta-analysis of the available studies has shown that the Mediterranean diet, which is in rich in plant foods, fibre, whole grains and seafood, is the best nutritional intervention to protect against the development of Alzheimer’s disease and dementia. This is likely due to its plentiful supply of folate, B group vitamins, omega 3 essential fatty acids, fibre, minerals and broad range of antioxidants and polyphenols, which all combine to protect the brain against oxidative damage while supporting cardiovascular and metabolic health.

Jul
29

How to keep your brain healthy

Tania Flack investigates what can go wrong with the body’s control centre – and how you can prevent problems before they start.

The brain can be looked upon as the control centre of the body, masterfully coordinating a range of complex physiological processes, receiving messages and responding to our environment, ensuring our survival, creating our emotions and storing our precious memories. But what happens when things go wrong?

Brain fog and difficulty concentrating are so common in our busy world, where information overload, continuous multi-tasking, poor sleep and fatigue all negatively impact the function of the brain. Combine this with the inflammation and oxidative stress caused by the standard Western diet and sedentary lifestyle, and we may well have a perfect recipe for neurological disaster.

Once considered the territory of advanced old age, dementia and Alzheimer’s disease are on the rise in Australia and are slowly but surely making their presence known among younger generations.

Recently these diseases have claimed many well loved public figures including Robin Williams, Glen Campbell, David Cassidy and our own, seemingly invincible, Malcolm Young of AC/DC fame, at the tender age of 64.

So what can we do to protect and even enhance our brain health and when should we start putting preventive measures in place?

Top 13 brain busters

  • Stress
  • Excess alcohol
  • Lack of sleep
  • Lack of exercise
  • Obesity/overweight
  • Diabetes
  • Insulin resistance
  • Unbalanced gut microbiome
  • High intake of saturated fats
  • Inflammatory diet
  • Smoking
  • High blood pressure
  • Heart rhythm abnormalities

Alzheimer’s and dementia

Dementia is the second leading cause of death in Australia, contributing to 5.4% of all deaths in men and 10.6% of all deaths in women. Each day, approximately 244 people are diagnosed with dementia in Australia, and without a significant medical breakthrough it is projected that over one million Australians will be living with dementia in 2056. If that comes to pass, it is expected to cost Australian taxpayers over $36.8 billion dollars, significantly impacting our national health budget.

Alzheimer’s disease is the most common cause of dementia, accounting for approximately 70% of all cases in Australia. It robs us of our memories by depositing amyloid beta-plaques and neurofibrillary tangles in the brain, which impair nerve synapses so signals cannot pass between the cells.

According to the Australian Alzheimer’s Association, once someone reaches the age of 65 their risk of developing Alzheimer’s disease doubles every five years, and while common among the elderly it can even affect people in their forties in rare cases.

Symptoms of Alzheimer’s disease may include difficulty remembering certain places, people or events, changes in mood or personality, trouble completing tasks that were once easy, and problems with communication.

Vascular dementia is the second leading cause of dementia in Australia. It is usually caused by a stroke or a series of mini-strokes due to tiny blood clots repeatedly blocking vessels in the brain. This leads to the death of brain cells and causes slow and steady decline in brain function. It is strongly associated with obesity, diabetes, heart arrhythmias, atherosclerosis (narrowing of blood vessels), and high blood pressure.

Smoking significantly increases the risk of vascular dementia.

Symptoms can include behavioural changes, difficulty understanding, disorientation, and inability to create new memories. Thanks to the clearly defined risk factors, it has the best scope for preventive care through diet and lifestyle modification.

Lewy body dementia shares many similarities to Alzheimer’s disease and is the third leading cause of dementia. It is characterised by the presence of Lewy bodies, which are abnormal sphere-shaped structures that interfere with cell signalling and ultimately damage brain cells.

Sufferers may experience hallucinations, mood disruption and changes in alertness and attention.

There is a well-established connection between metabolic syndrome and dementia, including both vascular dementia and Alzheimer’s disease. Metabolic syndrome is diagnosed when someone has central obesity (a waist measurement over 102 cm for men and 88 cm for women) accompanied by other factors such as high blood pressure, diabetes and high cholesterol. It is essentially a disease of Westernised cultures, where a sedentary lifestyle, combined with a diet high in refined carbohydrates, sugar, saturated fat and processed foods, disrupts normal metabolic function.

Like dementia, metabolic syndrome is on the rise, statistics from 2014-2015 show that a staggering 64% of all Australians are overweight or obese, which is the primary cause of metabolic syndrome.

READ: Natural brain boosters

Alzheimer’s and insulin resistance

While the exact cause of Alzheimer’s disease is unclear, researchers have identified a range of possible contributing factors, including environmental, biochemical and immune-mediated influences.

Most recently, research has identified problems with insulin signalling, glucose utilisation and energy metabolism within the brain as a potential cause, and the findings of myriad of both human and animal studies have contributed to the mounting evidence. Such is the weight of this evidence some researchers have described Alzheimer’s disease as ‘Type III diabetes’ or brain-based insulin resistance.

So how does this work? Insulin can be considered a transport molecule whose primary role is to facilitate the entry of glucose into the cell to provide energy. Insulin is produced in the pancreas and released into the bloodstream when glucose is absorbed from the food we eat. When insulin is present it helps unlock a cellular ‘door’ that allows glucose to enter the cell. In type I (autoimmune) diabetes, the pancreas fails to make enough insulin to facilitate this process, and in type II diabetes the receptor sites on the cells become damaged, so insulin is unable to connect with the cell and open the door.

In both cases, cells become starved of fuel and glucose floats around in the body at high levels, causing oxidative stress, which damages cells. The brain’s primary source of fuel is glucose, so when insulin fails to do its job the brain cells literally ‘starve’, which causes oxidative stress, destroying the cells inbuilt regulatory processes and ultimately leading to the death of brain cells.

The deposition of amyloid-beta plaques and neurofibrillary tangles is thought to be due to disruption of normal cell biochemistry, which in turn leads to further increased insulin resistance.

Metabolic syndrome causes a perfect biochemical storm of insulin resistance, oxidative stress and inflammation, which are all pivotal factors in the development of both vascular dementia and Alzheimer’s disease.

Insulin may also play a role in the development of Lewy body dementia and studies show that disruption of insulin-like growth factor may be involved.

Brain fog and the gut

Could your gut play a role in how clearly you think on a day-to-day basis? The research certainly suggests this is true.

We know that cognitive function declines in the presence of low grade systemic inflammation; this is one of the reasons your memory and mental performance suffer when you have a cold or a flu virus.

However, these are usually self-limiting, so the brain fog will lift as you get better. In the case of inflammation caused by an unbalanced gut microbiome, however, the effects are longer-lasting. We all carry trillions of bacteria in our gut, and in a healthy person these bacteria are essentially self-policing, in that they keep a healthy balance by nature of their diversity so no one group overpowers the other.

However, stress, a diet high in saturated fat and processed foods, antibiotics, chemicals, pesticides, alcohol, and sugar can all contribute to an overgrowth of opportunistic bacteria.

Some bacteria produce microscopic particles of endotoxin that can pass across the gut barrier, into the bloodstream, causing low-grade continuous inflammation.

One placebo-controlled, double-blind, cross-over study involving 12 healthy young men introduced endotoxins from bacteria into their bloodstream, and within 24 hours their inflammatory markers increased up to seven times their normal level and their memory was significantly impacted.

It is never too early to start looking after your brain health. Focus on maintaining excellent cardiovascular health, stay active, get enough rest and manage stress. You should see your local health practitioner for personalised support if you have a family history of dementia.

This article first appeared in Nature & Health magazine.
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Jul
15

How to survive the hormonal rollercoaster in your 40s

Mood swings, hot flushes and night sweats? Remember that menopause is not a disease, it won’t last forever, and natural therapies can be very helpful.

Menopause is a natural part of life, marking the end of our fertile years. But in our youth-focused culture, it can be treated like a dirty little secret and is rarely discussed openly.

Often, women will never have considered how their own personal journey through this time of transition will play out, until they get their first signs of change.

In an ideal world, there would be a period of gentle transition starting in your 40s where your body adjusts slowly to the gradual decrease in hormones, so that by the time your periods eventually stop, the process is all but completed. You are officially considered menopausal once you haven’t had a period for more than 12 months.

It’s a common misconception that the symptoms we associate with menopause in the West, such as hot flushes, insomnia and irritability, only occur once the menstrual cycle stops. It is actually the transition to menopause, or perimenopause, that is usually the most challenging time and some women will start to experience symptoms while they still get regular periods. Perimenopause and menopause are all part of the same continuum.

Signs and symptoms

Various factors dictate the start of perimenopause.

Women with a history of smoking are far more likely to experience earlier hormonal changes, due to accelerated ovarian ageing.

Having a healthy diet and lifestyle during your 20s and 30s helps to preserve ovarian function and protect against early perimenopause.

Other issues, such as how old you were when you got your first period, ethnicity and body mass index, also influence the age of perimenopause onset.

Speaking with your mother about her experiences may help, as genetic factors definitely play a role.

If you are in your 40s and starting to experience symptoms, it may be worthwhile having your hormones tested. A simple blood test will clarify matters: elevation of follicle-stimulating hormone and a decrease in oestrogen are markers that you’re starting perimenopause.

The female reproductive hormones are delicately balanced during our fertile years. As ovarian function starts to wane the master hormone, oestrogen, starts to decrease, along with other sex hormones.

These hormones play a much more complex role in our health than just reproduction and this is evidenced by the broad range of symptoms experienced during perimenopause and menopause. Hot flushes, depression, insomnia, irritability, anxiety, low libido, vaginal dryness, low energy, weight gain, back, neck and muscle pain are the most common symptoms of perimenopause. They can vary widely in severity; some women experience only mild symptoms, while others’ symptoms are so severe they significantly impact their life.

The intensity of these changes can cause women to reach for a quick solution. Often younger perimenopausal women are put on the oral contraceptive pill and older women may be offered hormone replacement therapy. These medications can stop symptoms, but there are a range of risk factors that need to be considered, including the fact that long-term hormone supplementation increases the risk of certain oestrogen-dependent conditions in susceptible women.

Another factor to consider is what happens when you eventually come off hormone supplementation. The sudden withdrawal of hormones can put you right back where you started.

Thankfully, natural medicine offers some very effective solutions.

Meal plans

There is a big disparity between the experiences of menopause in women from Western cultures and that of their Asian sisters. Hot flushes are reported by only 10 percent of Chinese women, while approximately 75 percent of Western women get them.

The reason for this contrast lies in the diet. Typical Western diets are much higher in animal protein and fat, which is associated with higher oestrogen levels. Westerners also consume far less fibre, which is needed to support healthy hormone metabolism.

Traditional Asian diets are rich in plant foods that provide beneficial phytoestrogens, such as isoflavones, flavones, coumestans, and lignans. These compounds bind to oestrogen receptors on the cell and exert weak oestrogenic activity. A diet high in plant phytoestrogens reduces the symptoms of menopause and softens the effects of decreased oestrogen.

It is thought that Western women have generally higher oestrogen levels due to dietary factors and therefore experience a far greater drop in oestrogen levels at perimenopause, causing more severe symptoms; while Asian women with a higher intake of phytoestrogens and fibre in the diet have a more gentle transition. It is essential to have ample vegetables in the diet. A good rule of thumb is to include two to three handfuls at each meal, which also boosts overall vitamin, mineral and antioxidant intake.

Cruciferous vegetables – broccoli, cabbage, Brussels sprouts, kale, cauliflower, bok choi and other leafy greens – are particularly beneficial as they support healthy liver function and effective hormone metabolism.

An increase in vegetables will also add beneficial fibre. A fibre-rich diet will ensure healthy bowel function and improve oestrogen metabolism and hormone health by encouraging effective elimination. Other great fibre foods include legumes – lentils, chickpeas and kidney beans – that have the added benefit of providing phytoestrogens, which reduce symptoms of menopause.

Exert yourself

Exercise is not only nature’s best antidepressant and energy booster, it also helps you maintain muscle mass, which in turn drives metabolism and keeps weight in check.

We start to lose bone mineral density during menopause, so regular weight-bearing exercise, a diet rich in calcium and vitamin D, and healthy exposure to sunlight are essential at this time to keep bones strong. Interestingly, regular exercise actually improves oestrogen metabolism.

Even though we are not making as much oestrogen as we used to, healthy hormone metabolism helps to lessen symptoms. Regular exercise has been shown to improve oestrogen metabolism, which partly explains why it reduces symptoms of menopause. Menopausal women who participated in a supervised regular exercise program over 12 months experienced significantly fewer symptoms than their non-exercising counterparts and reported an increase in their quality of life.

So the message is: Move! It doesn’t matter what type of exercise you do as long as it’s regular weight-bearing exercise. Thirty minutes, five times a week will get the best results.

Heal with herbs

Herbal medicine has long been used to support every stage of women’s hormonal health and is particularly effective in treating menopausal symptoms.

Black cohosh, wild yam and red clover are traditionally used to support women during menopause, because they are rich in phytoestrogens, which decrease hot flushes and minimise other symptoms; they also regulate hormone production.

Dong quai can be a lifesaver for perimenopausal women who are experiencing erratic periods and hormonal fluctuations. It has a balancing effect on hormones and gently regulates periods.

St John’s wort is an effective antidepressant herb which can be used to elevate mood and stabilise erratic emotions. It has a soothing effect on the nervous system and can also promote deeper sleep.

Other herbs, such as skullcap, oats and lemon balm, nourish the nervous system and soothe anxiety.

To tame night sweats, take 5 to 15 drops of sage tincture three times a day in half a cup of water. This herb has astringent qualities that can help ease abnormal sweating in a day or so.

Withania, rehmannia and licorice are adaptogenic herbs that have a beneficial effect on the adrenal glands and modulate the stress response. They are extremely useful if irritability and exhaustion are present.

Zizyphus and sage are particularly beneficial for hot flushes, acting specifically to reduce sweating.

However, as every woman’s experience of perimenopause and menopause is different, there is no ‘one size fits all’ approach to treatment. Herbal medicine needs to be prescribed individually after consultation with a qualified practitioner to get the best results.

Chill out

Stress management is vital during this phase of your life. Hormonal changes can cause a rollercoaster of emotions – irritability, anxiety and depression – which are worsened by broken sleep, due to night sweats.

Exercise is one of the best ways to manage stress; meditation, massage, yoga or tai chi are also very beneficial.

Remember, in many traditional cultures women who have reached this stage of life are held in a position of respect in their community, as it signifies experience and wisdom. In the West, however, it is seen as a sign of ageing and this can be quite challenging for women. Counselling can be of great benefit to help women adjust, especially if perimenopause has started at a younger age.

Top up your levels

While having a healthy balanced diet should be your first choice to provide a good range of nutrients, supplementation can also benefit women during perimenopause.

  • B group vitamins: Support the nervous system during stress; B6 is particularly important to assist with hormone balance.
  • Magnesium: Nourishes the nervous system, relaxes the body, and promotes restful sleep. It works synergistically with vitamin B6 to support healthy nervous system function and mood and also assists with hormone balance.
  • S-adenosyl methionine (SAMe): Supports serotonin production and helps to stabilise mood.
  • Flax seeds: Provide a valuable source of phytoestrogens. Clinical studies show that 40g of crushed flaxseeds daily provides significant relief from menopausal symptoms.
  • Calcium, phosphorus, vitamin D: Perimenopause is the perfect time to start thinking about supporting your bone health with these important nutrients.

This article first appeared in Nature & Health magazine.
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Jul
06

How natural medicine can help anxiety

Diet and nutrition

The body uses a lot of resources during stress and when constant anxiety is present the demands skyrocket.

READ: What causes anxiety?

B group vitamins are essential for correct nervous system function. Usually these can be found in abundance in a healthy wholefoods diet, however, when people are suffering from anxiety a supplement is warranted.

Research shows that a low magnesium intake increases anxiety. A high dietary intake of fat and/or calcium can intensify these effects by disturbing the magnesium-to-calcium ratio. Magnesium is found in red meat, chicken, nuts and seeds. However, a high dose supplement is essential.

Omega 3 essential fatty acids support brain and nervous system health. Daily supplementation over 12 weeks has been shown to reduce anxiety scores in medical students in a randomised controlled trial.

N-acetyl cysteine regulates the release of the excitatory neurotransmitter glutamate, and has been shown to significantly reduce anxiety-driven behaviours in Obsessive Compulsive Disorder (OCD).

Myo-inositol is another nutrient that has shown efficacy for reducing symptoms in OCD.

S-adenosyl methionine (SAMe) and 5-hydroxytryptophan can be very useful, due to their powerful action on the serotonergic system. These cannot be taken with other antidepressant medication and need to be professionally prescribed.

READ: What causes anxiety?

Herbal medicine

Herbal medicine offers a wealth of benefits for people suffering anxiety, and when professionally prescribed, can be used safely alongside standard pharmaceutical therapy. Herbs support the nervous system, balance neurotransmitters, and restore healthy adrenal function.

Withania, or ashwaganda, is a beautiful Ayurvedic herb that has traditionally been used for anxiety. It acts as a nervous system tonic and sedative and powerfully regulates adrenal function. It has been shown to reduce anxiety by 56 percent in a clinical trial while improving overall mental health, energy levels, concentration, and social functioning.

Other beneficial adaptogenic herbs that regulate adrenal function include rehmannia and American ginseng.

Originating from the South Pacific islands, kava has been used traditionally for relaxation and to induce sleep. It has been the subject of several randomised controlled trials and one meta-analysis found that kava significantly reduced anxiety compared to placebo.

Clinical trials have found passionflower to be as effective as pharmaceutical benzodiazepines in the treatment of anxiety.

Lemon balm and valerian in combination significantly reduce anxiety when administered in a moderate dose.

Other nervine herbs include skullcap, oats, lavender, hops, lime tree and zizyphus.

St John’s wort has potent anti-anxiety and antidepressant activity and can be useful to help balance neurotransmitter function. Note that this herb cannot be used alongside medical antidepressant medications and should be professionally prescribed.

Stress management

Counselling, cognitive behavioural therapy, and autogenic therapy can all be very effective in the treatment of anxiety. These types of therapies are an important part of any anxiety recovery program. They help us to identify the triggers of anxiety and develop new stress management skills.

Developing a personal meditation or mindfulness practice is very beneficial. These are learned skills that can take some time to master, but can make a world of difference in the fight against anxiety. Once you have mastered these skills you can use them to treat anxiety and prevent its return.

Gentle movement, stretching and breathing exercises help to relieve stress, reset the body’s circadian rhythms, and regulate neurotransmitter production and adrenal function.

There are many different forms of traditional exercise therapy, such as yoga, Tai chi and Qi qong, which help us to reconnect with the body and retrain the disordered breathing that is common in anxiety.

Studies on the effects of yoga have shown that 71 percent of patients who had not responded well to pharmaceutical treatment for anxiety were able to significantly reduce their symptoms with regular yoga practice – and of these, 41 percent of participants studied went into remission.

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