10 tips to help reduce your water-bloat

I got a question on my members’ Facebook page a couple of weeks ago regarding water retention. There is nothing worse than a bloated tummy – it can not only make you feel physically uncomfortable, but can also wreak havoc on your psychological state (as many people equate the bloating to ‘feeling fat’, despite there being no relationship between the two). Further, a bloated stomach impacts on your ability to move properly. We can’t engage our core muscles, so aren’t able to move, lift, push or pull in a way that is functionally optimal. This has important implications for our core strength and injury prevention. Of course water rentention affects more than just our stomach – a long haul flight to somewhere warm can turn anyone’s lean calves into kankles due to changes in the pressure in the capillaries, causing fluid to leak out into the body tissues. There can be many reasons for this, so I thought I would investigate the most common causes and possible solutions.

  1. Minimize your sodium intake. Although sodium (aka salt) is an essential mineral because it’s used to regulate the fluid levels in body tissues, bringing water into the cells. Excess intake of sodium may cause excessive fluid retention in the body tissues. While the evidence behind this recommendation suggests it isn’t something that affects everyone, this may help some people, particularly those who are salt sensitive or hypertensive. Do note, though, that if you follow the types of principles that I suggest, your diet is probably quite low in salt anyway, as most salt comes from processed foods (around 70%). However, there are whole foods that are high in sodium, such as cheese, miso, cured meats and biltong, so you could reduce these, and avoid adding salt to your food to see if this makes a difference.
  2. I probably don’t need to tell you to avoid eating too many refined carbohydrates – these tend to spike insulin, which causes sodium (often found in these foods) to be re-absorbed back into the kidneys, thus increasing water retention. Your best bet for carbohydrate foods are those whole-food, minimally refined varieties that have negligible sodium for a start, and that you eat in a mixed meal with good fats and proteins to help slow down the release of carbohydrate into your bloodstream, minimising insulin response.
  3. Any form of dehydration can cause your body to hold onto water. Therefore, ensure that if you drink alcohol, do extended exercise training sessions, or are in a hotter environment that you remain well hydrated to offset any potential for dehydration. The fluid you lose during exercise should be replaced in the three hours after training, and at 1.5 times the amount lost – you can work out how much this is by weighing yourself before and after an exercise session. The amount of weight lost roughly equates to the amount of fluid lost. Prior to drinking alcohol, have a couple of glasses of water (this will also help slow down your drinking). And be an adult about how you drink: is it necessary to drink more than a few in any one sitting?
  4. Take adequate amounts of vitamin B6 combined with magnesium. For women, prior to your period you can feel a little bloated and that you are retaining water. Interestingly, however, some research investigating the timing of this around the menstrual cycle has found bloating occurs more in the onset of your cycle (day 1) after which is rapidly declines, despite the perception of puffiness or bloating in the week prior to menstruation. This puffiness, however, could well be related to food choices in that week, as the intake of higher sugar choices can increase for some.
  5. If you have water retention before your period, you may, however, benefit from taking both a magnesium supplement (at 250mg per day) combined with a vitamin B6 supplement (40mg) daily – a study found this combination the most effective for decreasing premenstrual symptoms when administered for two months by balancing your hormone levels.
  6. Potassium works in conjunction with sodium, pumping fluid out of the body cells. Therefore, if you aren’t consuming enough then it could cause problems with water retention. The reality is, though, that you are following the meal plan and including plenty of vegetables, your potassium intake is likely fine. However, if you don’t have a good intake of vegetables (at least 7 serves per day) then increasing these is a good idea. This will also bump up your fibre intake, which can further help reduce fluid retention.
  7. Take natural diuretics. Dandelion root has long been used to help flush water out of the body – therefore investing in a good tea such as this Golden Fields one is not only delicious (often used as a substitute to coffee), it will also be beneficial. In addition, this kidney cleanse tea from Artemis has other natural diuretics to help flush water out.
  8. Exercise regularly. Exercise can help reduce water retention, not just by increasing sweating, but by moving water from the intercellular compartments to the muscles.
  9. Increase your caloric intake, if only for a day. I know – this one sounds weird, but a ground-breaking study in the 1950s called the Minnesota Experiment found something interesting mid-way through their study. The study followed men on a 1500 Calorie diet for 6 months, and subjected to hours of hard labour per day. Half way through the trial the men were allowed a celebration meal, effectively increasing their caloric intake to 2300 Calories. Following a night of getting up to go to the bathroom several times, the men were a few pounds lighter the following morning. Obviously, the weight lost was water weight – but why would this be the case? Potentially the long-term calorie deficit caused an increase in cortisol levels, and this increases water retention in the body. By increasing caloric load, the body reduced cortisol levels and this reduced water retention.
  10. Reduce overall stress load. As we have just discovered, higher cortisol levels will increase water retention, therefore anything you can do to reduce stress is going to impact favourably on water loss. Let’s not forget the impact that high stress levels have on blood sugar levels, inflammation and fat gain (to name just three areas it impacts). While stress is a perception of a situation, and changing your mind-set is one of the best things you can do to lower stress levels, ensure you are getting adequate sleep, time in nature, time with loved ones and taking time just for yourself. These are going to help lower your cortisol levels and combat any stress-related water retention.

So… not a definitive list, but hopefully a few pointers to help you get to the bottom of your fluid retention issues and make some improvements. For more individual advice, don’t hesitate to contact me for a consultation or for online nutrition coaching. Further, if you’re in the Bay of Plenty, Queenstown, Nelson or Wellington regions, then I’m headed your way for an evening of ‘real food’ talk – click here to find out more information and to book tickets!

 

LCHF…why isn’t it working for me? (Part 2)

Last week I posted three reasons why many people undertaking a LCHF diet stall with their success or never get it off the ground to begin with. The following delve a little deeper into the less obvious reasons why people struggle with their diet, and offer some options to help troubleshoot.

  1. Fat doesn’t fill you up. For some people, they don’t feel satisfied when swapping out their carbohydrate for more fat. If it takes a few handfuls of nuts or half a block of cheese to feel satisfied, then there can be some serious increase in calories that isn’t compensated for by an appropriate increase in satiety from the meal. Yes, cheese and nuts contain protein, but to be honest I treat them more as sources of fat than I do protein. If this is you, then.
    1. Increase the portion of protein you are consuming with your meals. I know many people are scared to consume more protein because protein can be broken down into glucose in the absence of carbohydrate, therefore pushing up their blood sugar levels. For people on a ketogenic diet (where 80% of their calories should come from fat), or those metabolically damaged (whereby there is a dramatic change in blood glucose response from a protein-rich meal), this may be a problem. For most people though? upping protein by 1/3 of a serve is no biggie. Still hungry? Up the protein some more.
    2. Drop out some fat –make room for the added protein by dropping out some of the fat – you could start with ½ – 1 serve and see how satisfied you feel when you do that. A serve of fat is typically 1 tablespoon of oil or butter, or ¼ avocado.
  2. You’re eating too much in one meal. A lot of people move from three meals a day, to two a day, to a ‘minimal food during the day’ approach, to sit down to a large meal at night, especially if they’ve been in the LCHF way of eating for a while and are further tweaking it. This may be awesome for some people, but not all. Eating most of your calories in one meal can, though, wreak havoc on your metabolic blood markers (such as blood glucose levels and insulin), increase fat gain, inflammation and reduce your day-to-day energy if this eating pattern doesn’t suit you. You’ll know if this is you, and if it is then:
    1. Spread your food intake out across 2-3 meals to lighten the caloric load and see if this makes a difference to your energy or other more objective markers mentioned above.
    2. Remember you’re still a rockstar even if you have to eat more often.
  3. You’ve got a high intake of dairy or nuts. Some, especially women, are not suited to high amounts of dairy or nuts, and when the begin to include more of these foods – ones they’ve avoided for years due to their fat content – they have a weight loss stall they can’t move past or, worse, they begin to store fat around their middle. While some suggest cheese is a food akin to crack, research investigating the addictive properties of the protein in cheese have not found this to be the case. Of course, if you personally can’t stop at one slice and find you’re eating the block, then perhaps it is for you. Nuts can also be trigger foods for some people, and they find it difficult to stop once they’ve started eating them. Ditto with a jar of peanut butter. What to do?
    1. Omit dairy for 30 days – sometimes it’s not the dairy per se, it’s the amounts that you’re eating it in that need to change. Removing it entirely will allow you to change your habits and then reintroduce it.
    2. Omit nuts and/or nut butter as per above in #6a.
    3. Swap snacks to those that are predominantly protein-based rather than fat based – despite the satiating effects of fat, for some, it’s just not like having protein. A hardboiled egg or some leftover chicken wrapped in lettuce or nori sheets (my current obsession) may satisfy you more.
  4. Genetically this isn’t the diet for you. If metabolic markers such as cholesterol, blood sugar or inflammatory factors go skewiff then it could be the LCHF approach doesn’t suit you. Genetic variation in the ApoE gene (ApoE4) is associated with LDL cholesterol not being recycled very well, and therefore it’s more likely to hang around the bloodstream and increase the chances of it becoming either oxidised or being transformed into smaller LDL particles, both highly atherogenic. Variants in the gene FTO can increase risk of obesity in the context of a high saturated fat and low polyunsaturated fat intake and may increase risk of high blood sugar and diabetes in individuals already overfat. The PPAR genes plays a role in ketogenesis (the oxidation of fat for energy) and storage of fat by activating genes associated with fatty acid transport and metabolism. Variants of this gene (particularly PPARa and PPARg ) are associated with increased risk of high triglycerides, total small dense LDL cholesterol and type 2 diabetes in the context of high saturated fat to polyunsaturated fat intake. Further, individual glycemic (blood sugar responses) vary considerably for the same amount of carbohydrate in food, suggesting there are a lot of factors to consider when determining the best diet for you (such as genetics, gut microbiome, activity level, stress etc), not just its macronutrient content. How to figure out if LCHF is not the diet for you? A few things to consider:
    1. Are you losing weight? If so, then wait until your weight stabilises and then retest your numbers – your body recycles triglycerides that are released from adipose (fat) tissue, therefore your triglyceride levels can appear high, but it is transient.
    2. Don’t get your cholesterol levels measured if injured, if you haven’t slept properly or you’ve been under significant stress. Cholesterol levels can change easily based on environmental triggers.
    3. Some people notice their cholesterol increases specifically in response to dairy fat, others to coconut fat – experiment for 6-12 weeks by dropping these out of your diet and get your cholesterol levels retested to see if this brings a drop in your numbers. Replace it with foods that have a more balanced fatty acid profile (such as lard or beef tallow) and foods high in monounsaturated fat or omega 3 fats, such as avocadoes, olive oil, nuts, seeds, salmon, mackerel, sardines.
    4. Here’s one I prepared earlier (and by ‘one’, I mean, ‘post on reducing your cholesterol naturally’. And by ‘naturally’ I mean ‘without Flora Pro Activ’).
    5. Get more in-depth testing of your cardiovascular disease risk profile – cholesterol is one measure and possibly not the most important one. CRP, fibrinogen, LDL particle size, number, oxidation and patterning can all give you more information than the run-of-the-mill lab test can. Contact me as I can help you arrange this testing which, for the most part, your doc might not even be aware of.
    6. Consider getting tested to find out your genetic predisposition (either through your doctor, or I can assist via Fitgenes gene testing).
    7. Consider dropping your fat intake, upping your protein intake and perhaps your carbohydrate intake too – ala the Zone diet approach. Despite its gimmicky name, it’s proven itself to be very effective for blood sugar stabilisation and blood cholesterol management. Some people just aren’t meant to eat a higher fat diet.
  5. You’ve got an intolerance you didn’t realise you had. Going LCHF means, for many, significantly increasing fat content in the diet from the obvious choices: cheese, nuts, seeds, avocados and coconut products. However, while these are awesome in terms of the nutrients they deliver, they can cause digestive issues in a number of people. Avocado, coconut, nuts and seeds are moderate-high in FODMAPs – a type of carbohydrate that can cause bloating, abdominal pain and other irritable bowel symptoms in many people. Further, the inclusion of larger amounts of cream, cheese or full fat yoghurt can be problematic due to an intolerance to the dairy protein or fat which can result in similar IBS in susceptible people. If you’ve been following a low-fat diet for many years, enzymes that help digest the fat and protein may be downregulated, so your body might not cope with the additional amounts. Sometimes it is a matter of backing down and building up, and sometimes it is that these foods just don’t agree with you. What to do? One of these tips may help:
    1. Follow a lower FODMAP approach to see if removing these foods settles down your discomfort. Doing this for at least 21 days and reintroducing a different food one at a time can pinpoint which one in particular might not agree with you.
    2. Introduce fermented foods as per #3e above to re-establish healthy bacteria in your gut.
    3. Replace dairy fat for alternative fat choices: nuts, seeds, avocado, coconut oil, beef tallow, lard.
    4. Ensure you chew your food properly at each meal to break it down, include lemon juice in water in the morning, and apple cider vinegar with meals to stimulate your digestive system, and consider ox bile supplement or a digestive enzyme that has lipase and/or pepsin enzymes to help you break down the fats and proteins.
  6. You’ve upped your alcohol intake because red wine and white spirits are “allowed” on LCHF. This might not even be intentional, but dropping your carbohydrate intake can lead to increased alcohol cravings, especially if your fat intake is too low, or your food intake is too low, or your stress levels are chronically too high. Or perhaps, you enjoy a moderate amount of alcohol but are continuing to gain weight on the LCHF diet.
    1. Be honest about how much you are drinking. Regularly consuming a ‘large’ as opposed to a ‘standard’ pour at the pub? Cracking open a bottle one night and then drinking to finish it off? Your plan to be alcohol free during the week has reduced to being alcohol free Monday – Wednesday? Evaluate if this is a problem for you … or not!
    2. Go alcohol free 5 nights a week, and enjoy a glass of whatever you fancy on the other nights. Ideally not those lolly water vodka mixes, but if you don’t like red wine, then choose something else. It’s not a deal breaker.
    3. Eat enough during the day so you’re not craving alcohol in the evening. This may mean including some additional starchy carbohydrate in your lunch meal – it doesn’t mean you’re not ‘low carb’ – as that in itself is a spectrum. This can really offset your cravings. Try it for 14 days to see if there is an effect.
    4. Lighten the load by choosing to have a low-fat meal if you drink. Old Skool 90s ‘dieting’ approach – those fat calories will only be missed by your adipose tissue, which is where they will be directed to when consumed with alcohol (which is processed first and foremost).
    5. Drink to ensure you are hydrated before you have your first alcoholic drink. This is like 101 really – we always drink more when we are thirsty, and then when we drink more, we become uninhibited and then all hell can break loose, right?
  7. Food timing: If you’re beginning your day with breakfast at 7am and winding down with a cup of tea and some dark chocolate at 10pm, you may be doing yourself a disservice. Eating over a time period of more than 12 hours can be deleterious to health. Recent research has found that restricting the eating period to 12 hours or less can improve insulin resistance and glucose tolerance, and reduce breast cancer risk even when the calories remain the same. Anything you consume that requires processing of any sort by the liver – including black coffee or herbal teas – will begin the metabolic process. When we eat is also important as our appetite hormones are on a circadian rhythm (food being an important signalling molecule for hormones), and eating late at night – even if overall eating window is short – can be problematic for your liver. The benefits derived from intermittent fasting (such as these) can still be realised if your version of fasting includes coffee in the morning, however it appears actual fasting (nothing but water) for at least 12 hours is most beneficial for metabolic health.
    1. Try to keep within a 12 hour window for consuming anything other than water. If you struggle with remembering to do this, there are apps that can help. It’s not as hard as it might seem – if you have breakfast at 7.30am and are done eating by 7.30pm then you’ve nailed it.
  8. You’ve focused entirely on diet without giving pause to consider other aspects of your lifestyle that contribute to your wellbeing. Lack of sleep, chronically elevated stress levels, over or under activity can all contribute to some of the common complaints people attribute to diet which have nothing to do with the food.
    1. Evaluate your sleep – are you getting to bed at a reasonable hour? Able to sleep through the night with ease? Feel refreshed waking up?
    2. Evaluate your physical activity – are you doing enough? Are you doing too much?
    3. Evaluate your stress levels – are you trying to do too much? Feeling overwhelmed? Or conversely is there not enough stress to keep you stimulated and motivated?

Of course these factors contribute to how your body responds to the food, but it isn’t the food per se. As I said last week, this isn’t a definitive list, however if any of these resonate with you then try some of the ideas I’ve listed, or enlist the help of someone like me to guide you to the best approach for you.

PS: I have organised a few talks over the next couple of months to talk about making a real food (aka LCHF) approach work for you. At the moment I have:

  • Takapuna 23 March @ Streetwise Organics, Byron Ave
  • Hawkes Bay 6 April – location TBC
  • Queenstown 25 May – location TBC

…with others to come, so watch this space 🙂

pres2

Yes, I created this pic myself 🙂

 

LCHF…why isn’t it working for me? (Part 1)

It’s about this time of year that I start seeing people come through my doors needing some minor (or major) tweaks to their LCHF eating approach. There are usually one of two scenarios.

Scenario #1: When they embarked on LCHF they saw ALL of the benefits they heard about, effortlessly shedding body fat, boundless energy (in training and afterwards), improvement in skin tone, hair condition, sleep and digestive problems. But lately the opposite is true. Despite seemingly nailing this LCHF lifestyle, they’ve noticed they are lacking energy, gaining weight (especially around the middle), latest blood tests have seen their cholesterol levels have shot up (and perhaps triglycerides), they are unable to sleep… … yet if anything, they’ve instigated (and nailed) the hacks they’ve read to optimise their LCHF eating approach. What gives??

Scenario #2: They’ve given it a good go on their own for the last 5 weeks, following it to the letter and despite this, it’s ‘not working for them.’ Worse, their husband/workmate/training partner has taken to it with ease.

Frustrating, much?

While we are all individual as to what is going to work for us, the LCHF approach is a really good one for most people, most of the time. Despite that, there are small things that can derail your best efforts to improve your diet, so I want to cover off the basic (and more nuanced) reasons people don’t fare well on a LCHF approach, and some tips on how to overcome them. I’ve ended up splitting this post into two parts as it was so long!

  1. Too low carb. The internet is a wonderful and terrible thing – information is everywhere, everyone is an expert and the version of paleo/LCHF/JERF that you’ve adopted based on what others are doing may well be too low carb for you. LCHF is a spectrum, and what is low carb for one person may well be higher carb for someone else – generally speaking, anything up to 200g of carbohydrate/day could be low carb. It all depends on context. I see a lot of people who are trying to stay strictly below 25g of carbohydrate a day – too strict (and unnecessary) for most people. Even Prof Tim Noakes, staunch advocate of a LCHF approach to eating (“banting”) has loosened up on this. The people who really benefit from a diet this low would be those embarking on it for therapeutic reasons: diabetes (both types), epilepsy, cognitive health (Alzheimer’s, for example). That’s not to say that others out there can’t make this level of carbohydrate work for them. But if you’ve noticed fat gain (especially around the middle), irritability, hormone imbalances (such as a missed menstrual period), lack of energy (past the initial phases of the LCHF approach), irregularity of bowel motions, sleeplessness – to name a few symptoms, then you may have gone too low. What to do?
    1. Track your diet for 4-5 days to get an average of the grams of carbohydrate you eat per day. If it’s on the very low end of the scale (less than 50g*, for example), then try adding back in some good quality starch to see if any of your symptoms improve. Don’t be pedantic about vegetables. Really. That includes carrots and tomatoes. To be honest, you don’t have to track your carbs if you’re not a numbers person – but it can be a good way to assess if this really is the problem. Use My Fitness Pal, Cron-o-meter, My Net Diary or Easy Diet Diary as nutritional tracking tools. (If you’re embarking on a lower carb diet, this is a good first step regardless, so you don’t make the jump from 400g a day to 60g a day).
    2. If your carbohydrate intake is in the realm of 80-100g carbohydrate, you may not be too low, it might be more of a timing problem – ensuring you have carbohydrate in the meal after a high intensity (i.e. CrossFit or F45) or long duration exercise session can help improve recovery and alleviate a lot of fatigue/irritability. If you’re struggling with insomnia, then adding in some kumara or potato into your evening meal increases production of precursors to melatonin.
    3. Is it more protein you need? Protein can help keep you fuller for longer, stabilise blood sugars (therefore has implications for focus/energy/concentration), promote recovery and help with sleep. Many people fear protein because of the potential for it to be converted to glucose in the body (via gluconeogenesis). For someone following a LCHF diet this isn’t an issue. Try upping your protein portions by 1/3 – ½ at each meal.
    4. If it’s in the initial phases, then up your intake of sodium – to levels more than you think you need. When we drop the carbohydrate content of the diet, we drop a lot of water stores too (hence a rapid loss on the scales) – this is because for every gram of carbohydrates stored, we store an additional 3g of water. Add salt to your meals, a pinch in your water bottle, make a miso drink or drink bone broth.
  2. Not low carb enough. I see this a lot. People equate carbohydrate to bread, pasta, rice and cereal and don’t think about other foods that are predominantly carbohydrate –fruit, dried fruit, ‘green smoothies’ with a fruit base, bliss balls, natural fruit and nut bars… In addition, many products are promoted as ‘sugar free’ when they contain dried fruit, maple sugar, rice malt syrup or some other type of natural sweetener. This may seem elementary to you, but I know many people are confused by this point. Regardless of what you hear, sugar IS just sugar – that one sugar is lower in fructose doesn’t mean it’s not going to influence your blood sugar levels, it’s likely to affect them more. This has to be my biggest bugbear of the ‘real food’ movement; not that these products contain sugar – but that they are marketed as not. This is no better than being told that Nutrigrain is healthy. We all know that’s not true.
    1. Again, track your numbers (as per above) via a tracking tool. A lower carbohydrate approach is not a fixed number, it’s a spectrum. But if you’re still consuming over 200g a day and not engaging in regular physical activity, then something might need to be tweaked (especially if you’re not seeing the results you’re after).
    2. Get rid of the bliss balls, the dried fruit, the paleo muffin or the smoothie from your favourite juice bar that you thought tasted suspiciously sweet for something ‘green’.
    3. Read the ingredient lists on the packages you buy. Sugar has over 56 different names. You probably don’t need to know them all, but it would be good to have an idea, right?
  3. Too many processed foods or snacks. Even if you’ve found a sweet spot with your macronutrient intake, having too many processed ‘low carb’ snacks can continue to drive your appetite hormones in a way that favours eating more than you need. Leptin is a hormone produced by fat cells that tells the body when we’ve had enough to eat, and is involved in the regulation of calories we burn and body fat that we store. A consequence of being over-fat is high circulating leptin levels in the bloodstream, and the brain stops reading signals sent by leptin that we’ve consumed enough food. Instead, it incorrectly believes that we are starving, thus we feel hungrier. Excess body fat increases Inflammation in the body, and is one of the drivers of leptin resistance, and processed food can drive inflammatory pathways in the body – even low carb processed food. And if you’re not over-fat? Well, vegetable oils and certain additives and preservatives found in these foods can drive inflammatory pathways in the body. In addition, an overabundance of processed flours may cause disruptions to our gut microbiome as they are easily digested, perhaps not even making it to the gut bacteria in our lower digestive tract. This can mean we are starving our good bacteria and instead feeding bacteria that release endotoxins, causing increasing inflammation. This can have a secondary effect of increasing your cholesterol level (see this post here). These foods are created in such a way to send signals to your brain’s pleasure centre and drive your appetite for more food that you just don’t need. One of the benefits of a real food approach (which naturally lowers your carbohydrate intake) is that inflammation reduces, insulin drops, gut bacteria can rebalance and the signalling pathways in the brain that regulate your appetite hormones can begin to normalise.
    1. Get rid of most foods or snacks that come in a package with ingredients you don’t recognise.
    2. Eat real food. Base your snacks around hardboiled eggs, cheese (for the dairy tolerant), vegetables, leftover meat, macadamia nuts, egg muffins.
    3. Drop the nut flours. Just because they’re low carb does not mean it’s a free for all with these processed flours.
    4. Increase foods that help balance out your fatty acid profile: more fatty fish (such as salmon, mackerel, sardines) and (grass fed) meat for omega 3 fats. Consider taking a fish oil or algae omega for those who don’t eat fish – and be picky about the supplement!
    5. Take care of your gut: consider a probiotic for 30-60 days (such as Lifestream Advanced, Inner Health Plus, Syntol or Prescript Assist) to help populate the gut with the good guys, but also keep them fed with fermented foods such as sauerkraut, raw apple cider vinegar, water kefir and an abundance of vegetable fibres.

I’ve got more – quite a bit more actually! – but will post that in Part 2 so as not to risk losing your attention ;-). These are three of the basics that people can get wrong (particularly in the initial phases), and the next post will cover some of the more nuanced reasons, and what you can do to correct them. If you’re not sure whether your LCHF diet is working for you, why not jump on and book a consultation with me? An expert eye can help take the thinking out of it for you and save a lot of stress long term.

*50g still pretty low actually! Again, it’s all context 😉

low-carb-zone

Are you in the zone? (PC: http://www.tripfitness.com)

Constant cravings? Here’s 18 evidence-backed (or anecdotal) tips that will curb them.

Are you back into the swing of things but your taste buds aren’t?  It happens! Especially around this time of year where intake of sugar, alcohol and processed carbohydrates tends to be higher for most people, and while going cold turkey can be the best move, it’s sometimes easier said than done. The good news is that by reducing these foods, you’ll begin to lose the taste for them, and they’ll no longer hold the appeal that they had. For some though, completely removing them is a better idea – even small amounts can continue to drive the appetite for them. Regardless of which camp you fall into, here are some proven, some anecdotal, and some interesting ways to combat those cravings.

  1. The basics: build your plate based around protein and fibre, with fat for satiety. Protein is well known to be the most satisfying nutrient, and along with fibre (also key for adding bulk and feeling full) will keep most people satisfied longer than either carbohydrate or fat. Any starchy or carbohydrate-based foods are best if they are minimally processed (such as potatoes, kumara, legumes, fruit) as these will provide more nutrient bang for your buck). How much of each? Protein-type foods (meat, fish, eggs, poultry) aim for 1-2 palm-sized portions. Starchy carbs (if included) at around a fist-sized amount.  Fat? 1-2 thumb-sized amounts, depending on the type of protein portion you’re eating: a fattier cut might be satisfying enough, however a lean chicken breast will likely require some added fat to help satisfy you. And vegetables? Go for gold – other than the starchier varieties (mentioned above) you could fill your boots with these. For some people, having a full plate is essential to feeling satisfied and if you can do that by adding more volume, it is going to have a positive effect on the satiety from a meal (that’s definitely me). For some ideas, check out my recipe e-book or my online coaching service.
  2. Get rid of anything that is ‘your poison’- if you are the person that hears the icecream calling you from the freezer, it is much better off out of the house. Out of sight, out of mind.
  3. Put all the ‘treat’ type food in one place in your house, preferably above eye level. This will save you seeing the Christmas cake when you are grabbing the eggs, and the chocolate almonds when you are searching for the bottle of olive oil. Constant reminders of all the things you are trying not to eat will NOT help your cause.
  4. Chew your food properly at each meal. Aim for 30 times per mouthful. That way you’ll digest your nutrients effectively, feel more nourished and less likely to be hungry an hour after eating because you wolfed that meal down.
  5. Do not substitute those refined sugars for ‘natural’ sugars. That dried fruit is pretty much just sugar – and (a few nutrients and fibre aside) no better than sugar and will continue to drive your sugar cravings. You shouldn’t rely on dried fruit (or any sweet food that is marketed as ‘refined sugar free’) as a substantial nutrient source . Any additional fibre or nutrients they provide in the diet is negligible compared to the whack of goodness you’ll get when you follow #1 above. When health bloggers or food producers market something based on the healthfulness of the ‘natural’ sugar, it is pure embellishment. 6 meedjol dates and a banana does not make a smoothie sugar free.
  6. Coconut oil – this is a favourite of Sarah Wilson’s: a teaspoon of extra virgin coconut oil can kill a craving in its tracks. If we head to the literature to find any peer reviewed papers on the topic (for what it’s worth, there is a LOT of research published by the Coconut Research Center), there isn’t a lot to definitively tell us that it will cut cravings. That said, there is some research has found that people who include more coconut oil in their diet (compared to other types of fat) have reduced food intake overall, particularly in the subsequent meals. Like most things, you have nothing to lose by trying it.
  7. Cocoa – chocolate is long associated with cravings, though right now, consumption of chocolate may well increase the cravings rather than stamp them out. It’s also not exactly useful if you’re trying to focus on reducing your intake of junk food! That said, chocolate is known for its cognitive and mood enhancing benefits. So how about some unsweetened cocoa (or cacao) in hot water with some milk to deliver the chocolate taste you are after. Add a touch of stevia if you wish. You could also do this cold with almond milk and ice – and add 1 tablespoon of psyllium husk or gelatin in there for some additional fibre or protein. If chocolate is what you’re after – go for the darkest that you can stand. Many people find they stop at 1-2 pieces of 90% chocolate instead of the 1-2 rows consumed of the 70%.
  8. Anything that lowers your blood sugar response to a meal is going to positively impact your cravings. The steep rise and fall of your blood sugar in response to a meal causes alarm bells to start going off in your brain. The body runs a tight ship and prefers when all systems are in homeostasis. Low blood sugar causes a release in stress hormones which tell your liver to dump glucose into the bloodstream, and create cravings so you can re-establish blood sugar to within a normal range. Including cinnamon can reduces glucose response after a meal (in amounts of 6g) and affects insulin response. Stabilising blood sugar is going to help reduce cravings. Sprinkle this gold dust on your breakfast, with your teaspoon of coconut oil, in your cocoa drink etc.
  9. Glutamine – can enhance secretion of GLP-1, a hormone which promotes insulin release that helps increase satiety and dampen appetite – this is only seen in some people however, suggesting there is individual variation of its effects. The flipside of this is that the insulin-releasing effects may override any satiety benefits, increasing hunger (and subsequent meal size) at the next meal. However, in practice this is a tool that many clinicians (myself included) have found useful for some (but not all) clients. The presence of glutamine in the bloodstream is associated with improved insulin sensitivity in healthy people. In addition to this, glutamine has been found to be beneficial for improving intestinal permeability and tight junction protein expression in the gut, being one of the most abundant amino acids in the body. If your cravings are related to gut dysbiosis then it could be useful from this perspective. In addition, it functions as part of neurotransmitter production. Taking L Glutamine by putting it under the tongue as a craving hits (1-3,000mg) may just work for you.
  10. Magnesium is a nutrient that is involved in over 250 processes in our body, and particularly when we are under stress, it is put under the pump. Sugar (or specifically) chocolate craving is often linked to a deficiency to magnesium, but that isn’t conclusive. At any rate, magnesium is perfectly safe to take, and as our food supply is relatively low in magnesium, looking for a supplement that is a magnesium glycinate, citrate or chelated with amino acids may be useful, at amounts of around 300-400mg elemental magnesium.
  11. Chromium is another supplement that some people have found useful for stopping cravings – research has found a reduction in carbohydrate cravings, food intake and an increase in satiety when supplementing with chromium…however this is in the laboratory using mice. There’s nothing definitive in the research to support using it for people who already have adequate amounts of this mineral. That said (as with anything), it’s individual – I know many clients who swear by using Chromium supplements when a craving hits. The only way to know if it works for you is to try it, by taking 1000mg chromium in two doses in meals that contain carbohydrate (due to its suggested benefits at reducing blood sugar response to carbohydrate meals)..
  12. Branched chain amino acids (BCAAs) are three amino acids that act as nutrient signallers which may help reduce food intake . Leucine (one of the BCAAs) activates mammalian target of rapamycin (mTOR) which is required for our brain to respond to leptin (a hormone that tells our body when we have had enough food). BCAAs are involved with hormone release in both the gastrointestinal tract and in fat deposits. BCAAs and dietary protein enhanced glucagon like peptide-1 (GLP-1) release and reduced the expression of genes required for synthesis and adsorption of fatty acids in a human intestinal cell line (NCI-H716), suggesting an intestinal mechanism for the beneficial effect of BCAAs. Those that have successfully used BCAAs suggest 5g in the AM and every few hours while you’re adjusting your diet back to baseline awesomeness.
  13. 5htp: 300-500mg taken with a meal to increase satiety of the meal – studies have found a reduced food intake (particularly carbohydrate). Studies conducted have focused on people who have reduced availability of tryptophan in the brain (a precursor to 5htp). Increasing 5htp increases tryptophan and therefore serotonin production, reducing cravings and overall food intake. (Don’t use if you are currently on antidepressants without clearance from your doctor.)
  14. Exercise. A no brainer, really, but research has found this to be super effective for reducing cravings. In fact, any activity done while in the midst of a craving will take your mind off it. So when a craving hits, doing something active for 10-15 minutes can reduce your desire for something sweet. Go for a powerwalk, shoot some hoops, do some hill sprints…
  15. Make sure you’re getting enough sleep! It’s hard this time of year with longer days and opportunities to take advantage of summer (when it shows up…) Sleep restriction enhances activity in brain regions involved in reward in response to energy dense, nutrient-void food (think: lollies, chips, chocolate), suggesting heightened sensitivity to rewarding properties of food. This can lead to increased cravings. If you are burning the candle at both ends and not yet back to your regular 7-8 hours sleep per night, then nailing this will go a long way to helping curb that sugar demon.
  16. Meditation: decentring – viewing your thoughts as separate from yourself – has been found to help reduce food cravings and want for unhealthy food items. Mindfulness practice is also useful for not only reduced cravings, but for reduced emotional eating, body image concerns. It doesn’t require a 90 minute class three times a week (though there’s nothing wrong with that!) Headspace, Calm or Buddhify are three smart phone applications which may help you get going and provide guided sessions of between 2-20 minutes long. It’s consistency and frequency that makes a difference (like any habit).
  17. Clay modelling to reduce cravings: yep. Researchers found that visual imagery plays a key role in reducing craving. Participants who worked for 10 minutes constructing shapes from plastacine had reduced cravings for chocolate compared to people who were left to their own thoughts or who were given a written task.
  18. Your gut bacteria can influence your cravings. There is indirect evidence for a connection between cravings and the type of bacteria lurking in your gut. For example, people who enjoy and crave chocolate have different microbial metabolites (i.e. bacteria by-products) in their urine than “chocolate indifferent” individuals, despite eating identical diets. In addition, gut bacteria can influence the production of our ‘feel good’ and motivation hormones (serotonin and dopamine), thereby influence food decision-making based on our mood. Finally treating mice with a probiotic reduced hunger-inducing hormones and food intake. Action points here? Yes, you could start with a probiotic, particularly when you’re in the thick of it all, as this will help ensure there are beneficial bacterial strains present in your gut. However, for ongoing gut health, the regular addition of probiotic and prebiotics through food will help you maintain a healthy gut microbiome. Therefore:
  • Include fermented vegetables into 1-2 meals daily, working up to 1-2 tablespoons at a time.
  • The addition of unsweetened yoghurt (dairy or coconut) as part of your everyday diet (as it contains beneficial bacteria).
  • Kombucha, at around 100-150ml per day (check the back of the label to ensure a lower sugar variety).
  • Water, milk or coconut kefir, start with around 100ml per day.
  • Raw apple cider vinegar in water – start with 1 tsp in a small amount of water, working up to 1 tablespoon. This will help stimulate stomach acid when taken prior to meals, helping you digest your food properly, and delaying gastric emptying, so your glucose response to the meal will be slower too.
  • Vegetables, in abundance, to include fibres that feed your gut bacteria.

(As a side note, any change to your gut environment can result in unintended (and unwanted) changes to your digestive tract! If you’re new to the fermented foods and/or probiotics, then start small and work your way up. If you end up spending way more time in the bathroom than you wanted, reduce back further. Consider yourself warned.)

You won’t need to do all of these – but I think #1-5, #14, #15, #16 and #18 would completely diminish that sugar demon so you can get back to feeling awesome.

cravings

Grab that cupcake and bin it immediately. Underneath something that will stop you from retrieving it later on. (PC: SamadiMD.com)

 

 

 

 

 

 

 

 

13 tips to help you have your cake and eat it too.

Want to minimise collateral damage when it comes to fat gain over the Christmas period? It happens! While I agree with sentiments around being relaxed and not stressing too much, sometimes people benefit from having structure around how to be more relaxed … as paradoxical as that might seem. Being relaxed means you’re less likely to view a disruption to your plan as a major catastrophe to your health goals – and we all know this makes you more likely to be successful in the long run. Further, sticking to a rigid diet can increase feelings of deprivation and increase dependence – these are not attributes that turn your nutrition plan into a lifestyle.

Despite this, many clients are not happy with advice to go with the flow and ‘do what you can’ – they are after guidelines to help them… have their (Christmas) cake and eat it too (so to speak). Is this possible? Well it could be. Here are some practical things you can put into place in the lead up to and days following an event like Christmas day to minimise fat gain and help you continue to progress. I’m not suggesting these will help you lose body fat, but more give you some strategies so you feel in control of your food intake, and not the other way around.

  1. Treat the Christmas and New Year period as an opportunity to put into practice all of your healthy habits that you’ve developed, rather than an insurmountable challenge to healthy eating which can only be dealt with by pushing “pause” until January 2nd.
  2. View Christmas day as a metabolic boost. Following a lower calorie diet can downregulate your metabolism – lower calories over a longer period can reduce active thyroid hormones, increase cortisol levels and increase ghrelin levels – all of which can shift the body into energy conservation and fat storage. Therefore, it stands to reason that periodic overfeeding may help reverse this, favourably influencing hormones (such as thyroid hormones and the appetite hormone leptin) and increased energy expenditure, sending signals to the brain that it doesn’t need to downregulate metabolism and stall fat loss.
  3. Studies conducted to test the effects of exercising before or after a big meal show that exercising after a meal burned more energy, and more so than exercising beforehand. Low intensity exercise will also have an effect (compared to no exercise at all). Therefore, regardless of whether you go for a gentle walk on the beach or on Christmas day or a more vigorous game of backyard cricket, it is all beneficial. That said….
  4. …if it’s not possible to do that, then any activity is better than none! Exercising prior to the meal to deplete muscle glycogen stores and activate proteins that help deliver glucose to the muscles will result in hormonal changes favourable for fat loss. The upshot of this? More calories used to restock and less hanging around to be stored as fat. Resistance training focusing on movements that recruit both big and small muscle groups (think squats, deadlifts, shoulder press and chin ups) or high intensity interval training are your best bet: time is money this time of year and you’re going to get more bang for your buck. Of course, if you’re an endurance athlete, then doing your long run or cycle will also suffice!
  5. Take advantage of the ‘second meal effect’: the hormonal response to your Christmas dinner will be improved if the meal before was based around an abundance of non-starchy vegetables (fibre), good sources of protein and a lower overall glycaemic load. You know, the kind of meal you might normally eat. It’s easy to do this around this time of year: think barbeque meats and salads, an omelette filled with feta cheese, pumpkin and asparagus, or a quick chicken stirfry.
  6. Psyllium husk. Research has found that around 20g psyllium husk (in water) 3 hours and immediately prior to a meal can have a gastric emptying and appetite reducing effect for the next 3-6 hours. While it’s tempting to think that this could be useful for long term caloric control and subsequent fat loss, there is no good evidence to support an effect on either of these. However if the additional fibre can make you feel less hungry and you’ll be less likely to eat as much then you’ve got nothing to lose by trying it, right? (And popping this into your breakfast meal or smoothie is an easy way to boost fibre intake and enhance that ‘second meal effect’).
  7. Fill your Christmas dinner plate with protein, fat and vegetables first, then think about your starchy sweet options – again, super easy if your table is filled with lamb, turkey, ham, vegetables – and aim to finish these before contemplating the dessert table. Minimally processed foods are more filling and will produce a lower blood sugar response, and let’s face it: it’s a lot harder to overeat on the pavlova if you’ve filled your plate with foods that boost satiety. Added bonus: you’ll be less likely to fall into a food coma and more likely to have more energy for some after meal activity (see #2).
  8. Chew your food properly. This is something you should do regardless, obviously, but it’s always good to be reminded of the basics. Not only will this help you digest the nutrients more effectively (minimising the amount of discomfort you might experience after a meal), a meta-analysis of studies looking at mastication (the scientific name for chewing. I know) found chewing your mouthful of food 40 times leads to changes in your gut hormones that favour an increased feeling of fullness and subsequent decrease in food intake later in the day. In addition, chewing is related to reduced stress hormones and increased alertness. These hormonal changes will change your hormonal and potentially your emotional response to food, and the increased cognitive functioning may help you make better decisions. Overall, this may help you feel relaxed about what you eat and less likely to overeat.
  9. Have 3-5 bites of the delicious foods you have on the Christmas table. While you might think that you want to finish the Christmas pudding and the pavlova, chances are, if you’ve followed some of what I’ve suggested above, you’re not going to be that hungry anyway. Does this mean you should miss out? Of course not – however practically speaking, the level of satisfaction derived from higher fat and higher sugar foods is transient – the last bite is never as delicious as the first. I could also add here to choose between the Christmas pudding or the pavlova (as research shows an increased variety of food increases overall intake at a single meal) but I’m not convinced this is a good strategy at Christmas for some people! This could potentially lead you to feeling deprived – deprivation does no one any good at all. Instead, savour every bite of the food you want to be eating, and really enjoy it.
  10. The day after Christmas? Get up and move around. Low level activity (and structured activity) is going to make you feel physically and psychologically better. And what of the food? My best advice for anyone looking for mitigate fat gain around Christmas is to not let Christmas day turn into Christmas week. So, clearly, I’d recommend NOT finishing the trifle off (sorry to be a Christmas leftover Grinch!) You are much better off having leftover cold meat, salads, perhaps some cold jersey benny potatoes (there are health benefits of these you know!) However, if you decide you want leftover trifle want to, then own it and don’t beat yourself up for it! Nutrition goals are not gained or lost in one meal or even four meals. Consistency is key, and it’s what you achieve over the course of the year that is most important, not what you don’t do over a few days.
  11. Jump back into your usual routine ASAP – if you need help with this, head over to my website for the perfect solution to get you back on track.
  12. Don’t weigh yourself if you’re tied to the number on the scales. Overeating will increase your carbohydrate stores and water stores, so you may naturally weigh more the next day and it can take a few days to return to baseline levels. For some, it might take a few days to Intellectually you know this, but it doesn’t change how you might feel about it. If the scales are your choice of measure, then wait at least four days before jumping back on them. That said…
  13. Aim to maintain, not lose, over the next two or so weeks. This doesn’t counteract what I’ve suggested above, however if fat loss (and weight loss) is your goal, I honestly think that it’s easier on you to decide not to focus on that right now and remember it’s normal for there to be peaks and troughs. Feeling comfortable about this means you’re at a place where your attitude towards food is less about rapid weight loss (you may have been there, done that) and more about health. You can still have an overall goal of losing body fat with this mindset – and will likely be far more successful in the long run with it.
christmas-is-coming

Obligatory Christmas-related body composition picture

Injury-prone? Read this.

Nothing derails an athlete like an injury. We all know that consistency is one of the most important aspects to perform at your best, but getting to the start line in one piece is one of the biggest challenges that athletes face – particularly endurance athletes. For me, I have a long standing battle with my calves, and many people I talk to are similar: an old achillies injury, a hamstring problem, a niggly hip. However, this is hope! I listened to this great podcast where one of the leading researchers (Keith Baar) talked about his research that is helping athletes avoid injury and (when injured) recover more quickly. It is so practical and easy to apply that I had to share it. And whilst this is related specifically to athletes, I can’t think of any reason this couldn’t apply to anyone who may not think of themselves as an ‘athlete’ but struggles with an ongoing muscle or bone ailment.

A bit of background: Collagen, the most abundant protein form in the body, is made up of two amino acids, glycine and proline. It is found in bones, muscles, tendons and ligaments and has an almost scaffolding effect, to provide form and structure. Modern diets don’t contain a lot of glycine – it is found in the cartilage, bones and gelatinous part of animals and most people prefer the leaner cuts of meat (such as a steak, or a chicken breast). Most athletes I talk to would fall into this category; traditional sports nutrition guidelines would encourage them to fill up on carbohydrate, eat a moderate amount of lean protein and choose those leaner cuts of meat to ensure fat intake is kept low. Another easy source of glycine is found in gelatine – the wide, grainy powder found in the baking aisle used as a gelling agent in cooking. It is made predominantly of left over parts of the animal (bone, skin etc) that would otherwise not be used and has become more popular recently for its health promoting properties. Gelatine has also garnered the attention of sport scientists for its potential role in healing from injury and injury prevention.

While mere mortals wouldn’t typically think of tendon stiffness as a good thing, sport scientists have shown that the higher degree of stiffness you have in your muscle tendons, the better efficiency you’re going to have when using them. For a runner this would mean you’d expend less energy overall at a higher given intensity. And who doesn’t want that?

Tendon stiffness is determined largely by the amount of collagen AND the crosslinking of it. the collagen (tissue). Cross linking is determined by enzymatic processes that occur in the body, the expression and the activity of these enzymes increases when we are active. Baar’s research found that when they combined vitamin C (important for collagen synthesis) with glycine (one of the most common amino acids in collagen) there was an increase in strength of ligaments the engineered in the laboratory. They then conducted clinical trials in athletes to determine if this could be translated to a real world situation.

They conducted a randomised clinical trial, whereby they gave the group either a placebo, 5g or 15g of gelatine and measured the amino acids present in the blood stream over the following three hours. They found that the glycine peaked within the blood an hour after consuming the supplement. When they took the blood samples from the athletes and put it into their engineered ligament, they found an increase in the amount of collagen present in the ligament – a slight increase with 5g and a substantial increase with 15g of gelatine. Importantly, they found improved strength and stiffness in the ligaments that had the increase in collagen formation.

They then had the athletes jump-rope for six minutes (the length of time required to get a response from tissue cells in the bones, tendons and cartilage), rest for six hours, take the supplement again, wait an hour (for the peak amino acid expression) and jump-rope again. They did this three times a day for three days. The researchers found a doubling in the athletes’ collagen synthesis for those supplementing with 15g of gelatine, mostly from the bone.

What this shows us is if we want to improve the collagen response to an exercise bout, we can easily do this by adding gelatine as a supplement. Baar felt the initial study can be looked at as a bone recovery protocol. If we have an athlete who breaks a bone –  in the foot, a bone in the leg, bone in the back, what you can do is you can have them take the 15g gelatine alongside 50mg of vitamin C and then do five minutes of exercise an hour later. Now clearly this isn’t weighted activity – if you have access to an AlterG at your local university sports science lab that would be brilliant – something that is going to just direct those nutrients to where they need to go. Repeat this every 6h because it takes that long to get the cells to return to a state that they will then be responsive. The researchers suggest this is going to speed recovery time, something all athletes are interested in.

The above study can also be used as an injury prevention protocol, as the overall goal is to improve the mechanics of the connective tissue, reduce fatigue-related damage and optimise its strength and resilience. The protocol is the same; consume the 15g gelatine and 50mg of vitamin C then perform 5 min of activity that is going to load the area they are most concerned with. Long distance runners, for example, could supplement and then an hour later do 5-6 minutes of jump roping as this is going to load the hips, Achilles tendon, calves, tibia and femur – all areas of concern. For our long distance runners, they do five to six minutes of jump rope because if you have a history of tibial stress fractures or hip stress fractures or Achilles problems or plantar fasciitis, all of those structures are going to be loaded by the jump rope. They’re going to get just enough of a stimulus in that six minutes to have a response. Unlike muscle, bones and connective tissue don’t have a great blood supply – therefore providing nutrients then doing the exercise is like wringing out a sponge – suck the water out and it will suck up what’s left in the environment. The exercise impact is like wringing out the sponge, therefore the tissue will be responsive to up taking the nutrients.

Currently they’ve just tested the 5g and the 15g of gelatine – and while anecdotally the 5g has received favourable responses, the 15g amount was significantly more effective. The researchers don’t know for now if this is better scaled to body weight, but studies are underway to determine this. The study that is discussed here is in review and is about to be published.

In summary:

Bone healing / injury prevention protocol

  1. 15g gelatine + 50 mg vitamin C* (either added to smoothies, glass of water etc)
  2. Wait an hour for peak amino acid presentation in the bloodstream
  3. Undertake 5-6 minutes of activity that loads the area of interest (can be non-weighted) to direct nutrients to that area. For an ankle injury, this can be simply (carefully) tracing the alphabet with your ankle
  4. Do this every 6h
  5. (for injury prevention) – can do this anytime – or take the gelatine + vitamin C an hour before training if the training is including drills/warm up that targets area of interest.

*a little bit less than the amount of vitamin C found in a kiwifruit, most vitamin C tablets are over 250 mg, but you could easily have this instead.

Gelatine: I use the Great Lakes Gelatin, this is definitely pricier than what you’d find in the supermarket. This (and the I Quit Sugar brand or Vital Proteins brand) are marketed as being derived from either pig or beef that have been sustainably farmed and pasture raised. They are also free from additives and preservatives. You can purchase either the gelatine that will gel, or the collagen peptides which is the collagen broken down into smaller amino acid peptides. I haven’t seen any New Zealand gelatine – our cattle industry is one of the best. The brand in the supermarket I’ve seen (Mckenzie’s) includes a preservative which wouldn’t make it ideal for anyone wanting to use it for gut healing purposes (it’s 220, sulphite dioxide – many people are sensitive to this) and they don’t make the same animal and environmentally friendly claims. Further, if you do have an injury then the levels of inflammation in your tissues will likely be higher, and while the inflammation may not stem from your gut, it can affect your sensitivity to constituents in food such as preservatives and additives you would otherwise be fine with. In terms of the injury prevention effect though, I’ve seen nothing to suggest they wouldn’t be on par – so choose the one you can afford.

Do you need to snack? Here’s 31 ideas just in case (and because you’re awesome).

Sometimes you just want some new ideas. Or it’s a day where you just feel like mooching around and making a few things in the kitchen.

Snacking. As I said earlier this week on Facebook, I’m not a fan of snacking for most people as it often means they haven’t eaten properly in the previous meal, thus their need for a snack is due to roller coasting blood sugar levels which affects their stress hormones, energy and mood.

However, sometimes you just need to snack. And if you’ve eaten what you normally KNOW is a balanced meal with plenty of vegetables, a good hit of protein and some fat, but still feel hungry – then you should probably eat. And if you’re not sure what a balanced meal looks like, then check out Jamie’s blog discussing the Heart Foundation’s take on paleo – he outlines what his meals look like. Pretty simple. (And do read the whole post – it’s GREAT).

Ignoring your hunger cues is not good in the long term – yes, even if your goal right now is to lean up, if you’re eating well and exercising appropriately, then it’s likely your muscle mass is increasing and you need to feed it! Don’t use the scales as a guide to your progress – this is gravitational pull – nothing more. In the last 6 months I’ve gained 10 kg to help restore hormonal equilibrium to my over-stressed body – and while on paper it might look like a lot, visually it’s not what you would imagine it to be, as I’ve kept up weight training and gotten a lot stronger. Of course I’ve got more body fat, but I’m a lot healthier too because I’ve got more muscle; it’s had the opportunity to grow as it hasn’t been broken down to use as fuel (which can happen when you’re over-stressed). The scales tell you nothing about the composition of your body. To under fuel (even when trying to lean up) would put your body in a catabolic state, stripping muscle and potentially bone too if you go too low in calories (protein is the major component of bone, you know).

The more you listen to your body and NOT eat to a schedule, set calorie number or macro nutrient goal, the better you will be at at figuring out what your body needs. For most people, we lose this ability at a very early age, because we are told to ‘eat everything on our plates because there are starving children in Africa.’ I feel sorry for parents actually, as almost everyone I know blames their parents for a certain lack of intuition around their eating. It’s not their fault. They were told the same thing.  The good news is, though, is that it’s not irreversible. We just have to start being more aware of what we eat (processed food which is quickly digested, low in fat or protein and not satisfying), how we eat (fast, slow), where we eat (at the table? in front of the TV?) and how much attention we are actually paying to what we eat (device use, TV etc). Here’s some quick tips about mindful eating. You can retrain yourself to listen to your body. It just takes time and effort, but it will be worth it. I’ve just ordered this book too – I’ve heard great things about it and think it will be a really valuable resource.

So back to snacks. Muesli bars, low fat fruit yoghurt and snack packs of Snax crackers are going to leave you hungrier than before you ate them. They are developed to provide the sensory pleasure to your brain that makes you want to eat more (called a Bliss point). They are also high in processed carbohydrate or sugar (especially that fruit yoghurt, these new yoghurt pouches have 4 teaspoons of sugar, around 3 of them from added sugar) which are just best avoided.

Here’s 31 other ideas in case you need some more inspo.

  1. A couple of hardboiled eggs (boil a dozen at the start of the week and make your way through them. They’ll last a good 5 days unpeeled).
  2. A couple of cooked chicken drumsticks (meat that is closer to the bone is far tastier and there are far more nutrients than just pure muscle meat).
  3. Half an avocado, seasoned with salt and pepper.
  4. Around 40g cheese (not Edam. Unless you really enjoy it! Full fat dairy has many important health benefits which for some reason got overlooked with the updated food guidelines. Didn’t they read my blog?
  5. Meatballs – make these and freeze in single serve packs to have an easy go-to snack. Try my sesame miso meatballs.
  6. Almost 4 ingredient chocolate chai brownie. No sugar added at all (I promise).
  7. Raspberry coconut berry bites.
  8. Lemon coconut lunchbox treat. Again, no sugar was harmed in the making of this deliciousness.
  9. A scoop of protein powder with minimal added crap (such as Clean Lean Protein, Vital Health, Balance Natural Whey powder) + ½ cup of full fat Greek yogurt topped with berries. There are many better quality protein powders now available on the market. And while protein powders aren’t my go-to for every day eating, those people who are more active and require protein to support their lifestyle, OR for people who for some reason can’t or don’t eat animal source protein, they can be a good addition to the diet. However there are many CRAP products out there, with a lot of additional fillers, preservatives, additives for flavour, thickeners etc. Check the ingredient lists.
  10. Half an avocado with 1/2 can salmon mixed in, lemon juice, salt and pepper.
  11. Steam some greens (broccoli, brussel sprouts, beans) + drizzle with 1-2 tablespoons of olive oil or butter, add salt and pepper.
  12. Vegetable chips (bit of prep) but thin sliced beetroot, carrot, parsnip, tossed in bag with 2 Tbsp olive or coconut oil + spice of choice OR salt/pepper – baked in preheated oven of 170 deg (350 deg far) for 10-12 min.
  13. Tamari almonds from Alison’s Pantry. These are dry roasted, unlike many that you find that are roasted in vegetable oils.
  14. A handful of Pure Delish cereal (look for 10g/100g or less sugar per 100g) – I love this cereal but to be honest, as a breakfast I’m not going to recommend it as a go-to. I think the brand itself is great, and perfect for tramping/camping as an easy breakfast option. But if you want to ensure you’re not going to go hungry, start your day with a bit more protein. This would fill you up but it is easy to over eat in order to feel satisfied.
  15. The only plant that would survive a nuclear holocaust chips, like these Ceres Organics ones. Hello. Delicious, but wow – expensive! Obviously super easy to make these yourself (many delicious ways to do this).
  16. Kelp leaves flash fried in coconut oil with salt (a great source of iodine, a mineral important for our thyroid function which isn’t easily available in the food supply for people who don’t enjoy seafood). This kiwi (and local to me!) product is seriously tasty.
  17. Dried meat snacks (Biltong, bier sticks) – such as Canterbury I love Epic bars in the States but while some are made with quality NZ meat, they aren’t available here. It’s hard to come by a brand which is minimally processed, so definitely read the ingredients list. Jack Links (despite the great radio adverts which I think are awesome – is NOT a great product. When you try Canterbury V Jack Links, you can taste the difference too – alongside the addition of preservatives other than spices and salt, it is a sweeter product, with 20g of sugar per 100g product, compared to between 1-3g per 100g for Canterbury.
  18. Crackers free of grains, such as Little Bird or Flackers – or make your own. Super simple and a lot cheaper too. There are a lot of variations to these, here’s mine.
  19. Apple slices layered with a tablespoon of peanut butter + 1 tsp chia seeds mixed through
  20. Meedjol date sliced lengthways, with salted pistachio nuts stuffed inside. This is small and not at all lower carb. Delicious though.
  21. Large tomato, scoop out middle, crack an egg in, grate some parmesan cheese, bake in a 180 degree oven till egg is cooked.
  22. The Vegery snack wraps: hello delicious! These would be a great lunch on the go or for a snack. Try the apple and coffee one with some peanut butter and grated carrot. Delicious.
  23. ½ cup cottage cheese + ½ small sliced banana + a handful of walnut halves.
  24. Rice paper (which has been dunked in warm water to soften, then patted dry, wrapped around sliced avocado, a slice smoke salmon, cucumber, grated carrot, snow peas.
  25. Lightly toast a handful of sunflower seeds in a pan, then pop some into a pitted avocado half, salt + pepper. Delicious change of texture.
  26. Cheese + sliced red pepper sliced wrapped in ham that has been sliced thinly off the bone.
  27. ¼ cup hummus (ideally home-made, like Jamie’s one, he is awesome) + teaspoon of pesto in bottom of jar, carrot/cucumber sticks standing up in them. Try to choose a pesto that has an olive oil base, such as this Genose one – not one that is made on a canola oil base.
  28. Apple slices cooked in coconut oil and topped with haloumi, a’la Sarah Wilson style.
  29. A leftover sausage, split into half lengthways, with some cheese grated into it and mustard, heated in microwave.
  30. A slice of my tahini chia loaf with avocado. Yum.
  31. 2 squares of 90% Lindt with a teaspoon of almond or peanut butter. Decadent. You’re worth it.

And I’ve plenty of other ideas where these come from. If you would like more individualised help, check out my services page or sign up to my online nutrition coaching system – it’s free for 28 days for you to try!

snack

PC: www. revive.ca

Does your doctor value nutrition? These 3 questions might help you find out.

How much does your doctor value nutrition? This has been a rather hot topic of late, with the recent gagging of Gary Fetke in Australia, an orthopaedic surgeon who co-owns a nutrition clinic that employees dietitians to help clients. He has recently been ‘gagged’ by the Australian Health Practitioner Regulation Agency (AHPRA) and is not able to talk about the role of nutrition in preventative health, nor in the management of chronic illness on any social media platform.

That’s troubling to say the least. Nutrition and talking about nutrition is certainly a contested field, and perhaps there is some protection of the patch when it comes to nutrition advice. I’m not going to lie to you – I can get a little scratchy myself when I read prescriptive advice from people who aren’t qualified in nutrition that push the boundaries in terms of scope of practice. Mainly because of the potential fall out if they aren’t equipped with the knowledge to either resolve and issue or refer it on. But to prevent a doctor talking about nutrition is just madness.  Doctors SHOULD be talking about nutrition – especially given that some of the most common reasons people go to their general practitioner (GP) can be improved (if not resolved) by diet. Thank goodness similar shenanigans have not been taking place this side of the ditch.

To what degree GPs should have the authority to discuss nutrition with their patients is a bit of a ridiculous question if you ask me. I know many brilliant GPs that use a holistic approach to their practice, who know a LOT about nutrition, give guidelines when that is all that is required and also who refer their patients on to more in-depth nutrition help if necessary. More important is asking your GP to what degree do they value nutrition. If you feel nutrition is an important part of your overall health, I think that having a GP who feels the same is rather important, and these three questions I heard on a podcast could be a good start to give you confidence that your needs will be met by their services.

  1. What affect does nutrition have on my health?

This may seem like a weird question to be asking your GP. I mean, surely everyone knows that diet and health are intricately linked, and doctors – well, it’s their job to know this stuff, right? Given the number of clients I have who leave their doctor’s clinic rooms feeling stupid for even mentioning diet, I don’t think we can take it for granted that your GP is going to be open to the idea of diet being a reasonable therapy (or adjunct therapy) to any condition. Sure, the diet-health connection isn’t foreign to them – there is the lipid hypothesis after all. And if you’ve ever stepped on the scales and been told your body mass index (BMI) is too high, so you need to eat less and exercise more to lose a little weight and reduce your overall health risk, then clearly your GP didn’t sleep through their three nutrition lectures provided in the medical school curriculum. However I wouldn’t be surprised if you know more about diet being able to prevent or manage conditions such as auto-immune disease (including type 1 diabetes), mood disorders, inflammatory bowel disease or irritable bowel syndrome, metabolic conditions (such as type 2 diabetes), asthma and allergies and the like. Now I’m not saying your GP is an idiot – at all! But time is a resource many health professionals don’t have, and while your GP might be open to exploring alternative or adjunct nutrition therapy, they may not have had the time to research this avenue. That (in my opinion) isn’t so much of an issue. It’s not as important (in my mind) that your GP may not know as much as you; being open to you exploring it speaks volumes, though. If your GP isn’t interested, then that is a problem. Given some of the reactions that clients have reported when mentioning to their GPs they use diet as a way to manage their health condition, there are clearly GPs who choose to remain ignorant. If you are dismissed, laughed at, or told in no uncertain terms that diet will not help, alarm bells should ring in your head. My advice would be to look for another GP.

  1. What do you think about the difference between normal lab ranges and optimal ranges for nutrient status?

There’s a difference? There appears to be, or at least, some doctors argue that there is. Vitamin D is a great example of this. In New Zealand, the adequate vitamin D level starts from 50nmol/L but a published review determined that looking at endpoints on a broader scale than just bone health (including  bone mineral density (BMD), lower-extremity function, dental health, and risk of falls, fractures, and colorectal cancer) determined it best to have serum concentrations of 25(OH)D begin at 75 nmol/L (30 ng/mL), and the best are between 90 and 100 nmol/L.

Low to low normal levels of serum folate are related to increased risk of depression and increased severity of depressions and affective disorders. Our ‘normal’ starts at above 7 nmol/L and research has shown that people with chronic mood disorders have lower morbidity when their nutrient status is above 18nmol/L, and symptoms began to alleviate when supplementation brought the levels up to above 13nmol/L. Low folate is also associated with higher homocysteine levels in the blood which is an independent risk factor for atherosclerosis.

While B12 levels in the blood are actually a poor indicator of B12 activity (as only 5-20% of the is bound to transports and able to be metabolically active), research has found a relationship between levels of B12 of 258pmol/L and lower in the bloodstream and depression. The ‘normal’ range starts at 170pmol/L, with borderline low from 110-169pmol/L. I know GPs who look for levels of 400pmol/L as being optimal for cognitive functioning and health. A sports doctor I am aware of uses higher cut-offs when it comes to haemoglobin and ferritin (both markers of iron deficiency) for athletes and will supplement to determine if a boost in iron intake helps address fatigue-related complaints or not, even if the athlete is within ‘normal’ range (see here).

Thyroid stimulating hormone, a commonly measured marker of thyroid function has a reference range between 0.5-4.0mIU/L. However, TSH is considered to be a poor indicator of thyroid function and the ‘normal range’ included people that had underactive thyroid or thyroid disease. The recommendation from the American Association of Clinical Endocrinologists association was to lower the range to 3, with a view of it lowering further to 2.5mIU/L because data from the National Academy of Clinical Biochemistry found more than 95% of rigorously screened normal euthyroid volunteers have serum TSH values between 0.4 and 2.5 mIU/L. Though this was recommended in 2003, it was contested by other governing bodies, potentially as it meant that the number of people in the US with subclinical thyroid function increased from 3 to 20% of the population, thus (as concluded in this paper) many more would require thyroxine medication as treatment.

These are just a few examples where you may fall into the ‘normal’ range, but may not be optimal according to the opinion of some doctors. At the very least, it may explain why you may be experiencing physical symptoms but these aren’t recognised by your lab test results.

  1. What will you do if my test results don’t marry up with what I’m telling you my symptoms are?

Important question, don’t you think? Let’s hope that your GP doesn’t respond with ‘perhaps you need to see a psychologist’ – as one of my clients reported. To be honest, I actually think there is a degree of psychosomatic issues that occur when someone is struggling with a health problem – most of us are familiar with the gut-brain axis and relationship between stress and digestive problems. This is partly driven by the return of seemingly ‘normal’ test results that don’t explain their ongoing concerns. However, to dismiss your symptoms as being unimportant because the results don’t reflect what you are reporting should (to me) set off alarm bells.

I think one problem could lie in the funding for lab tests. My GP is brilliant and will order me any test I want, but at my cost. I don’t blame her for this as there is pushback with GPs ordering tests. However I know that not all GPs are like this, and not all people can afford testing to get to the bottom of the issues. I think if more GPs appreciated the role nutrition can play in preventing, managing or reversing many of the chronic conditions people are dealing with today, then, then there would be more referrals to nutritionists or dietitians on the basis of reported symptoms or test results that may fit into the ‘normal’ range, but aren’t what is considered optimal.  From here, nutritionists, naturopaths and dietitians can order tests that delve further into hormonal issues, gut problems and even cholesterol levels if required. But this might not be necessary as they may pick up from your initial test results that certain nutritional strategies can help you optimise your nutrient levels without the need for further testing.

At the end of the day, you should feel confident that your GP values nutrition as much as you do.These questions may help you determine that and, if you suspect they do not, perhaps it’s time to find another GP.

Nutritionist

Obligatory doctor and fruit shot. I couldn’t find one with a steak.(PC: http://www.healthtrap.com)

 

Nutrigrain does not build Iron Men (or Women) + an Up and Go isn’t breakfast

(But I’m picking you know that).

By default, I’ve been in the sports nutrition world more than usual over the last couple of weeks. The Eat Well Live Well topic at New World (where I’m on hand to give nutrition advice and share good choices for foods), a sports nutrition talk during the week to a bunch of athletes and my first experience of Saturday morning kids winter sport this weekend. Well, first adult experience, as being your typical kiwi girl I was an enthusiastic netball player when I was in my early teens, and remember 9am starts at Kettle Park, playing on an ice-white netball court that had been frosted over the night before.

These experiences have reminded me that the ‘real food’ nutrition choices are not mainstream yet. And have a way to go before they will be. It’s still common for athletes to smash food straight after training (to make the most of the ’30 min window of opportunity’, to base their meals around processed carbohydrates (cereals, breads, pasta, rice) and to follow an eating style that didn’t allow for adequate delivery of fat and protein across the course of the day, so they are left irritable, tired, and hungry. The problem isn’t carbohydrates per se. It’s that processed carbohydrate has pervaded the diet to the extent that we now view it as an essential part of every meal at the expense of fat and protein which provide essential fatty acids and amino acids for healthy growth, development and recovery. This is especially true for children. It can get confusing though when cereal companies spend the big bucks persuading the consumer that products such as Nutrigrain or Special K are a nutritious, substantial start to the day. Such examples include:

  1. They fortify their cereals with micronutrients and can then sell them as a substantial source of vitamins and minerals, whereas we don’t know how effectively these are absorbed in the body. Nature is really smart at packaging nutrients in the correct ratios for maximum absorption when we eat, say, an apple. There’s so much about nutrition we don’t know, I doubt that Kellogg’s has cracked that nut yet.
  2. They pump their products with additional gluten and soy and can then promote them as being ‘high protein’ and ‘plant based’. A lot of people are sensitive to gluten and processed soy is far removed from the soy which is attributed to the many health benefits of a traditional Asian diet. And ‘plant based’ is bandied around so much these days, as if to insinuate it is nutritionally superior to a diet that contains animal protein. The opposite is true, given that many minerals and vitamins aren’t able to be as readily absorbed because of the phytic acid and other anti-nutrients which bind them.
  3. They put dried fruit and ‘ancient grains’ in their products, call them ‘Nourish’ and then sell it as real food. All this does is load them up with additional sugar.
  4. They pay sports stars and other influential people good money to front their ad campaigns. Even if you can do 12 Weet-bix in one hit, I’m picking that you’re not going to be able to do much else for the rest of the day if you make a habit of it.
  5. They compare a product to something else that we perceive as being  healthy or nutritious – for example, Up and Go being marketed as having as much ‘fibre, energy and protein as 2 Weet-bix and milk’. For the record, 2 Weet-bix and milk doesn’t have much fibre, protein or energy – but you wouldn’t know that from this claim which is what Sanitarium is counting on. There is 4.3g of fibre in a 250ml serve of Up and Go, and 19.3g of sugar. And a bunch of other additives, preservatives and vegetable oils to go with it.

    upandgo

    How many ways can you say sugar? There’s 5 right here.

The cereals I’ve mentioned above are as good (or bad) as junk food. But, do any of my points really matter if your kid is super active? They can’t just eat more of it, right? Hmm.  I’ve recently been reminded that there is a real culture in sports that suggest people who are active can ‘get away’ with eating high sugar junk food, and kids especially can eat sugar (I’ve heard some suggest they NEED sugar) as they can ‘burn it off.’ Nothing is further from the truth. Despite what the sports nutrition resources tell you, or what you might learn in a nutrition talk at the sports club, or see advertised on television, they don’t need additional sugar to make up for energy burnt during their practices or games. Sports drinks, white bread jam sandwiches, 2-3 jet planes aren’t necessary straight after exercise and are best left out of a young athletes menu. The ‘window’ of  opportunity of replenishing carbohydrate stores has been a convenient theory for sports nutrition products to justify their use, but we have since discovered the body can adequately restore carbohydrate up to 48 hours after a match or training. Unless, of course, there is a multi-day or multiple events on one day that requires a quick refuel, but even then there are options that allow for quick refuelling that are real food options.

A calorie is not a calorie, and active kids need more attention paid to their diet because of the heavier demands placed on their growing bodies. This expands their micronutrient and energy requirements. However, because we use body size as the main marker (or for some, the only marker) of health, we look at kids who are active and thin as ‘healthy’ without giving consideration to other equally (if not more) important indicators. I’ve worked with a number of adults who are prediabetic, yet have been fit and active their whole life, and a blood sugar screening reveals their metabolic state is probably worse than if they didn’t do any activity at all. A contributing factor to this is the carbohydrate-dominant diet that has fuelled them through the preceding years, and not just the additional treats they may have eaten because they could ‘eat what they liked.’ To the body, a high carbohydrate load is a high sugar load, regardless of where those carbs come from, because it’s broken down to the same single glucose unit.

So to save your active kids from the same fate, we need to set them up right from the get go.

Now I got a bad rap last year when I suggested that the new Weet-bix campaign that provided a ‘better brekkie’ was anything but. Weet-bix have long been the staple kiwi breakfast and growing up in winter, I had mine with hot water, warm milk, raw sugar, (because it was healthier*) and the aroma of a Gregg’s instant coffee with a freshly lit cigarette (it was the 80s, after all). Even now that combo conjures up that warm snuggly feeling of familiarity in me. The problem is that Weet-bix, or any cereal, isn’t typically a great vehicle for a nutrient dense, energy filling breakfast. Even with the campaign to make them a ‘better brekkie’. Most of the recipes on Sanitarium’s website sound amazing, but better breakfasts they are not.

So I offer a few suggestions**.

  1. Better breakfast shake: swap out the dates for an egg and add a tablespoon of peanut butter or tahini ( for a nut-free variety). We’ve lowered the sugar content and upped the fat, protein and calories. This will at least keep them awake for a little longer.
  2. Power porridge: swap the apple juice for grated apple. Use actual coconut milk (and not coconut flavoured milk), up the amount of rolled oats to a cup and add ¼ cup sunflower and pumpkin seeds. We’ve added more fibre, protein and lowered the sugar content.
  3. Weet-bix winter warmer: swap the trim milk for full fat (so much better for growing kids and adults alike actually) – or coconut milk, up the oats, add a few tablespoons of sunflower or pumpkin seeds and ditch the dried fruit. Stir through an egg before taking off the heat.
  4. Hot Weet-bix apple crumble: add ¼ cup shredded coconut, ½ cup roughly chopped mixed raw nuts – which you microwave with 1 Tbsp butter or coconut oil to make a crumble-type mixture.

Any of these would be okay if your kid feels a bit nervous before an early weekend sports game and just wanted something small. Otherwise, they will probably need some more food to go alongside the ideas above. Some good examples would be:

  1. Leftover cooked sausages or other meat leftover from dinner
  2. Scrambled eggs
  3. Hardboiled eggs (you’ve boiled these the night before)
  4. This tahini chia loaf with some nut butter spread on it
  5. Kumara ‘toast’ – slice and toast as you would your bread and top accordingly (mine took a couple of goes on high to get it to a cooked but still firm stage. So easy!)
  6. Three ingredient pancakes made with banana and eggs
  7. Peanut butter or tahini with chopped fruit
  8. Baked kumara or potato with butter
  9. Chicken drumsticks
  10. Glass of full milk and a banana

For more awesome ideas, click here for individualised nutrition advice or sign up for online nutrition coaching.

image1 (35)

Kumara toast spread with fennel pesto and topped with tasty cheese.

*it’s not healthier, but it the 80s we thought it was. Sugar is sugar is sugar. Including dried fruit, rice malt syrup, fruit juice and coconut sugar or coconut nectar.

** Weet-bix optional

11 things you may not know about perimenopause (and 10 things you can do about those symptoms).

I know what you’re thinking. She’s too young to be writing about perimenopause, right?! Actually, no. I might feel 24 years old, but it only takes being around younger age groups to remember I’m not! Despite the ‘M’ word being almost a taboo, unwanted phase of life that some women fear (and men too!) it is a natural part of our lifecycle. What isn’t natural are the symptoms associated with menopause. Like premenstrual symptoms, the discomfort experienced through perimenopause may be common, but it’s not normal. This was reaffirmed in my mind when I listened to a fabulous interview with Lara Briden (naturopath who works with women with hormone imbalances, based in Sydney and Christchurch). A wealth of information who had some great information around why we can experience symptoms and (importantly) what we can do about them.

  1. Defined as 10 years before going through menopause, practitioners often view this as highly variable, with women from 35 years to 55 years in this perimenopausal state. The average time spent here is around 4 years. Though, as with any ‘average’ this might not reflect your experience!
  2. All hormone levels change during perimenopause. There is first a decrease in progesterone, which changes the balance of progesterone to oestrogen (some describe this as ‘oestrogen dominance’, though not all practitioners like using this term). Testosterone also declines, and this is an important hormone for sex drive. Finally oestrogen drops – and while we will continue to produce oestrogen (as this occurs not only by the ovaries but by the liver, breasts, adrenal glands and by fat tissue, it is at amounts of around 30-60% lower.
  3. Oestrogen is a major regulator of a number of processes in the body, and the sex hormones and our glucocorticoid hormones (the most ‘known’ one, cortisol) are controlled by the hypothalamus -the part of our brain who is also the controller of our sex hormone regulation – therefore it makes sense that a change in one will result in a change in all of them.
  4. Some of the main symptoms of perimenopause are
    1. Heavy periods
    2. Hot flashes
    3. Breast tenderness
    4. Worsening of premenstrual symptoms
    5. Lower sex drive
    6. Headaches or migraines (due to sudden removal/reduction of oestrogen)
    7. Fatigue
    8. Decreased sense of wellbeing (research shows that extended periods of low oestrogen, fluctuating levels of oestrogen and sudden withdrawal of oestrogen – via surgery or stopping oral contraceptive pill – is affected with lower mood)
    9. Irregular periods
    10. Brain fog and memory – oestrogen helps consolidate both episodic and spatial memory in the brain, and protects against cognitive decline as we age.
    11. Vaginal dryness; discomfort during sex
    12. Urine leakagewhen coughing or sneezing and an urgent need to urinate more frequently – due to oestrogen’s role in maintaining the vascular mucosa folds in the vagina, acting as a watertight seal.
    13. Mood swings (via fluctuating levels of hormones)
    14. Trouble sleeping
  5. Some women are ABSOLUTELY FINE and sail through perimenopause. Generally, though, those that have been on the oral contraceptive pill are more likely to experience symptoms than those that haven’t. This may be due to the difference in the hormonal balance once the pill is removed. The pill provides large amounts of synthetic hormones, and it is a huge adjustment to go back to the normal (lower) levels of hormones. Approximately 147,000 women in New Zealand take the oral contraceptive pill, of which 80% of them are on a combined pill, delivering oestrogen and progesterone.
  6. The types of hormones in the pill are synthetic and are not ‘bioidentical’ – meaning that the amounts are higher than what the body would produce AND they are in a form that the body can’t use. The pill doesn’t regulate hormones, it shuts them off.
  7. During perimenopause, women can have fluctuating oestrogen levels due to variable concentrations of FSH (released by our pituitary gland in response to a low oestrogen environment – it isn’t necessarily all low oestrogen. This could also be a result of an inability to detoxify and clear out oestrogen metabolites.
  8. A well-functioning liver is required to remove oestrogen from our body and prevent build up and associated symptoms. Our liver packages up oestrogen metabolites and removes it through our detoxification pathways. We need our inbuilt antioxidants to be firing, along with certain nutrients (selenium, B vitamins and glycine (not present in large amounts in the standard diet) to do this.
  9. Many women going into perimenopause are insulin resistant (oestrogen has an insulin-sensitising role in the body and influences glucose uptake) – this partially explains the increase in body fat (particularly around the middle) that many women experience as they progress through. This makes it harder for their body to metabolise and use carbohydrate effectively
  10. Many women going into perimenopause have a low thyroid function due to age-related changes in thyroid physiology. These include a reduction of thyroid iodine uptake, synthesis of free thyroxine (FT4) and free triiodothyronine (FT3) and the conversion of FT4 to reverse triiodothyronine (rT3). TSH levels may be slightly elevated. Luteal-phase spotting, or lumpy breasts may indicate this.
  11. Your gut? SUPER IMPORTANT!!! The oestrogen might get detoxified (packaged up ready for removal) via pathways in your liver only to be unpackaged (deconjugated) again by nasty gut bacteria which pushes it back out into the blood stream as more toxic forms of oestrogen.

These 11 points may or may not have been news to you – certainly probably not to those experiencing some of the symptoms, or who have dug a bit deeper to determine the cause of the symptoms. This wasn’t a post for you to sigh in resignation and decide there is nothing you can do. Yes these symptoms and health outcomes are common – but (as stated earlier) they are not normal. Like many things, we normalise a lot of health issues because so many people experience them. We just think they are an inevitable process in ageing and moving into a different phase of life. Certainly (I gotta say), some health professionals don’t suggest otherwise so it’s no surprise many are led to believe this.

Some awesome tips from Lara as to how to start the process of mitigating symptoms – some are great DIY ones that you can put into action immediately; others will likely require the help of a practitioner who has a solid understanding of how our hormones interact – this may be your open-minded doctor, which is excellent – or naturopath, nutritionist or dietitian.

  1. Limit alcohol consumption – it impairs oestrogen clearance rates from the liver and may be one of the influencing factors in the relationship between alcohol and breast cancer risk
  2. Limit or omit dairy –dairy can increase oestrogen in the body, increase insulin release and the A1 caesin in dairy is pro-inflammatory and increases gastrointestinal inflammation (which could then push inflammation out to rest of your body).
  3. Ensure adequate vitamin D status – optimal is around 100-150nmol/L which is required for the production of all hormones, and related to other hormonal issues such as endometriosis
  4. Reduce intake of carbohydrate if following a higher carbohydrate approach, and get rid of processed, refined foods and sugar.
  5. Eat your brassicas: broccoli, Brussel sprouts, cauliflower, cabbage – all provide di-indolylmethane (DIM) which targets certain proteins in our body that help reduce inflammation and balance hormones (particularly detoxifying oestrogen). Supplementing with this is also really helpful, but only once you establish that oestrogen clearance is an issue for you – super unhelpful otherwise (a practitioner can help you find this out – and there is a test I’ve started using with clients called the D.U.T.C.H test which is able to measure each hormone and it’s metabolites in much more comprehensive detail than a blood test alone.
  6. Ensure a healthy gut: bloating, excessive gas, cramps and diarrhoea or constipation are not the normal consequence of eating (though they are extremely common). Keep a food diary to establish what might be causing your digestive upset by connecting your symptoms to your food intake. Work with a health practitioner experienced in the ‘real food’ digestive health to help not only heal your gut, but seal it too.
  7. Turmeric in therapeutic doses (more than you can get from food) helps reduce oestrogen related oxidative stress, reduce prostaglandins (inflammatory biomarkers) – opt for one that is also combined with bioperine (to make it more bioavailable) such as this Good Health 15800 Turmeric complex. The alternative is one that says it is formulated to have smaller, more bioavailable particles, and the Meriva formulated varieties have this.
  8. Iodine: low dose supplementation can be extremely helpful in supporting the pathways associated with thyroid hormone production which in turn affects the sex hormone production pathways. Again, talking to a practitioner is a good idea to establish your own requirement. However, 150 micrograms per day (and having 2-3 brazil nuts to balance this with selenium) is a safe amount.
  9. SLEEP. Hands down, the most often overlooked yet important restorative, nourishing thing you can do to support your hormone health.
  10. Meditation. Journalling. Yoga. Diaphragmatic and full belly breathing. Slowing down. Yep – stress reduction.

Regardless of if you are pre, peri or post menopausal, I think there is some excellent information here that will be helpful for hormones in general actually, and if you are experiencing some of the unwanted (and unnecessary in most cases) symptoms of hormone balance, this may give you some pointers as to how to combat them. Definitely check out Lara’s site for accessible and informative hormone related content.

PC www.gazetteinterviews.com

Let this not be you. Or your mum. Or your wife. PC http://www.gazetteinterviews.com.

 

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