Create your own Blue Zone

What do Sardinia, Okiniwa, Loma Linda, Ikaria and Nicoya have in common? Other than that I had to Google them to find out where they are located on earth, these cities are all referred to as the Blue Zones. As detailed in-depth on http://www.bluezones.com, and in his book (1), Dan Buettner shares information of investigations by demographers, epidemiologists, medical personnel and ethnographers that discovered the commonalities in the way that people residing there live. The reason? These cities are home to the healthiest, longest living populations on earth, with many people thriving past 100 years of age. The research identified nine lifestyle characteristics which keep the residents in good health and, as we move towards 2014, it is timely to highlight what these are – particularly if you’re looking at setting any New Year resolutions for the year ahead. The goals of eating a better diet or undertaking more physical activity are stock standard for pretty much anyone, and if you’re reading this blog then it’s likely you either eat well or have the intention of doing so in the near future. So take a closer look at the other lifestyle aspects uncovered by the research. Optimal health is about so much more than just a good diet and regular exercise.

1. Move Naturally – There is good evidence to show that incidental activity, outside of structured exercise, is equally (if not more, in some cases) beneficial for health. Many athletes I know work hard during their two hour training session and then move very little throughout the day. Taking the opportunity to walk where possible, to garden, clean, stretching , all of these contribute to incidental activity that is important for metabolic health. So, athlete or not, find opportunities to move throughout the day in everyday life.

2. Have A Purpose – In Okinawa it’s “Ikigai” (icky-guy) and in Costa Rica call it “plan de vida”. In other words… “It’s why I wake up in the morning.” Having a sense of purpose can extend the number of healthy years you live.  Without clear goals people can become directionless, leading to poorer mental health outcomes. Depending on your lifestyle, setting goals around family, career, sport, community etc can help motivate and inspire you to get up every day. These don’t have to be monumental – just meaningful to you.

3. No Stress – Stress leads to chronic inflammation, well recognised now as the underlying cause of chronic disease. associated with every major age-related disease. Some stress is important – this is what helps us grow physically and mentally; however too much stress can burn you out and break you down. Perhaps a goal this year is to take time out for you – even a few minutes – to meditate, reflect, or even regroup for the coming day. This year I’m starting a gratitude journal – writing down three things morning and night that I’m grateful for. Not only has it been suggested that writing (pen and paper) help us connect better to the words written on the page, it helps remind us that, even in the most challenging of times, there are people, things and situations around us that we can be thankful for.

4. 80% Rule – “Hara hachi bu” – the Okinawans practice this Confucian principle of eating that is 2500 years old. It’s translation means to stop eating when you are 80% full. This takes some discipline and time to get used to – but a few strategies can help. Eat from a smaller plate and wait 10-20 minutes before seconds. Chew food properly and eat slowly to help digestion. Feel satisfied and not stuffed.

5. Plant based diet – Most Blue Zone people do not have a meat based diet – and similarly the paleo way is to eat a good amount of vegetables, some fruit, then including nutrient-dense animal protein along with nuts, seeds, eggs and good fats that occur naturally (butter, coconut) along with olive oil. Contrary to popular belief, many people following a paleo template would also describe their diet as ‘80% vegetarian.’

6. Wine @ 5
– Other than the Seventh-day Adventists, most people in the Blue Zones (not the Adventists) enjoy alcohol regularly, 1-2 glasses a day. While I wouldn’t encourage you to start drinking if you currently don’t, abstaining from moderate amounts of alcohol in the name of health is unnecessary in the context of other health promoting habits. Ensure you drink a non-alcoholic sparkling water prior to your first drink though, and don’t drink your weekly alcohol quota in one sitting.

7. Belong
 In A Community – Most centenarians were part of a community and connected to faith, whether it is a church based or praying to the ancestors. That didn’t seem to matter. It might not be a religion, but it’s a type of spirituality or connection that people can draw from. I don’t have a religious leaning, but, like many people, I have a sense of spirituality that I draw on in certain situations, or in certain settings. For me, being surrounded by bush, typically running, makes me feel more calm and grounded. I can’t think of how else to explain it (and I probably don’t need to for those who also love getting outdoors). There is research to suggest the act of ‘grounding’ and connecting to the earth helps reduce mental health issues and stress levels.

8. Loved Ones – Centenarians in the Blue Zones have close ties to family – both immediate and extended. Your family isn’t necessarily those related by blood – family can equally be your friends and those close to you and who share in your everyday life. Whoever your family might be, take time out to connect with them frequently. While social networking may contribute to the disintegration of some relationships, I now have a relationship with my brother and sister who live elsewhere that I never had when we were younger, thanks to Facebook.

9. Be Part Of the Right Tribe
 – The centenarians who live in the Blue Zones chose to spend time with people who share similar behaviour patterns. Many of my friends enjoy training regularly, love healthy food and spend hours waxing lyrical about it over some good wine or craft beer. We never ruin a party by leaving too early – it’s almost expected. While that might seem unexciting to you,  it’s how we roll and wouldn’t have it any other way. If your close friends measure the success of a night by the number of shots they downed, that’s cool – but it’s not going to be as easy for you to follow a healthier lifestyle. Research shows that unhealthy lifestyle habits are ‘contagious’; likewise, living a healthy lifestyle can be too. I’m not saying you need to ditch your friends if they lead you astray on the path to good health, but perhaps you need to start a health revolution among them.

So as you reflect on 2013 and plan for 2014, perhaps you could adopt two or three strategies to create your own ‘Blue Zone’ within the busy-ness of modern-day living. While it doesn’t guarantee that you’ll live for a longer number of years, over time these habits may give you more life in the years you do live.

(1)  Buettner, D. (2012) The Blue Zones. 9 Lessons for living longer from the people who have lived the longest. (2nd Ed.) National Geographic Society: Washington, D.C.

Results may vary…

Is the phrase familiar? It will be if you’ve ever purchased something to do with fitness, diet or weight loss. It’s standard practice to advertise a product or service, then include an asterisk, then have written in smaller font that ‘results may vary’ or ‘results not typical.’ People don’t often read the fine print though. When weight loss is involved, people prefer dramatic, life-changing, knock-your-socks-off success stories. And I agree that the more people share these experiences, the more they will buy into the idea of eating real food for long-term health outcomes, instead of relying on calorie controlled  starvation diets that cause dramatic weight loss and (equally dramatic) weight gain. Success stories  motivate and inspire and (particularly this time of year), encourage others to make changes to their own diets. This is particularly true if people can relate to the person who is telling the story. However results do vary from person to person, and while I would like to tell you that weight loss is immediate and abundant energy is there for the taking, this isn’t always the case. I wanted to share today three emails I have recently received from past clients about their progress to date.

Hi Mikki

Yes I am a new man, down 30kg since embarking on my changed lifestyle. I still want to lose another 10kg+ but am confident that I will get there.

My diet has remained pretty much unchanged from our first consultation back in March or so. I have taken bread, rice, pasta, and potatoes out of my diet. The only dairy I have is cheese. 

Pretty much everything else is the same, I definitely eat more vegetables now and have a new love affair with them as I try so many more different ways of enjoying them. Loving all the good proteins and they definitely keep me feeling full.

Still drink more alcohol than I should but have pretty much cut out all beer and any mixers. I am a bit more sensible around it now and something I will work on for next year. My only other vice is low carb protein bars which fulfills any sweet tooth needs.

I wanted to drop you a note prior to Xmas to say thank you so much for all your help, support, and guidance. I feel so much better and more confident in all the choices I make and the great thing is that they are not hard choices as I don’t miss anything and is just a normal eating lifestyle for me now.

Hope all is well with you

Jason

And, in a similar vein:

Hi Mikki,

I just wanted to give you a progress update on how I am going after seeing you a couple of times.

I have no stomach pain or gas anymore, it’s incredible.  I have not felt this good in a very long time – my energy levels are through the roof and I have lost over 10kg.  Thank you so much for putting me on the right path, it’s been life changing.

 Many thanks for everything!!!

Anne

I love getting emails like this! As a nutritionist I see it as my role to teach clients tools so they don’t need me – and that’s certainly what has happened with both Jason and Anne. Both are confident their dietary changes are long term and are really happy with where they are at. This isn’t always the case though and this email from Jo I received last week tells a slightly different story. I consulted with her and her husband on and had not seen her for around eight months. I bumped into her at a cafe last weekend. This tells a slightly different story (I have bolded sections for emphasis):

Hi Mikki,

So nice to see you last weekend, although, could you tell I was in a bit of shellshock, bumping in to you in an ‘eatery’ ,  as I started to give you a ‘report’?  haha.

Seriously, I was very much thinking, ‘really?  in a cafe?,  when I’m about to chow down with my friend here.’ Dear oh dear. You looked as lovely as ever.  We miss you a lot.   But it was my lack of focus, I was thinking I had to stop and regroup.  But also take on all the information you were giving me.

Fitness wise, I am ok.   Flowing better than before.  And we bought a treadmill.   I have given up the sugar Mikki.   It’s been five months.   I have had a few dessert treats these past few months – It feels, strangely, in control. So, I did the first three months hard out – as per the I Quit Sugar ebook we talked about.  I actually went out and bought the full book and followed recommendations.

And then I guess in the last two months I have let in blueberries on the weekend, in the smoothies.  Have started eating a few apples.  I am really quite happy about giving sugar a miss. I never thought this could happen.  That I can (and have had) treats, and that has been it.  It has not lead to 3 or 4 days bingeing after having that treat.  So…the journalist in the book lost about 4 kilograms.  And so did I.  That was about it.  

I have to say I was pretty disappointed that giving up sugar completely did not lead to weight falling off.  It was very slow. Then, because I gave up weighing, another 2 kilos came off without paying much attention to it all.  That was a surprise.   But really, five months to lose 7 kilo or so.  That’s pretty lame. (This is all post-Mikki self-destruction weight gain by the way). The lack of energy was extreme.   That’s another thing that annoyed me. From this end looking back though, the constant headaches ceased.  Not in the first month, that’s for sure.  But they are gone now. I was at the point where, all week long, I would just have this low grade migraine from first thing in the morning and then a spiking of pain in the afternoon.  Gone.  I just noticed one day, it was all gone. My concentration is better at work, and I generally have better sleeps.  My skin looks better.  And my energy is coming back also. 

I know you will be interested to hear how it impacted me. I never before imagined you could go without sugar. For me it was always something you’d go back to ‘once you lost the weight’ but I never had the self control.  And it is probably the fat that allows me to feel calm and not worried about sugar or dessert, or eating a bar of chocolate.

Anyway, lovely to see you and Merry Xmas from us both,

Jo

So Jo’s story paints quite a different picture to Jason and Anne. The tone itself is more subdued than the first two emails. The focus initially is on how much she hasn’t achieved, rather than what she has. While Jo is aware that there are definite improvements in other areas of her health (the headaches, the sleep, the increased energy), these were a long time coming and, in her mind, not the outcome she was pinning her success on. I read Jo’s email and see a lot of positives in it (as I’ve indicated with the italics) but it doesn’t matter what I think – it’s how Jo views it that is important. This isn’t your ‘whizz-bang-fireworks-frame-it-and-show-it-off’ client success story that you see in many client testimonials used to encourage others to change what they eat. But it’s equally important to share these to show that results do vary. Body composition changes and increased energy levels might happen in an instant, or they might take many months (as they did for Jo). Her success to date is definitely there, you just have to dig a little deeper to find it.

My advice to Jo (as to anyone) is to use yourself and your changed behaviour as benchmarks of success instead of gauging it against another person’s experience. Only you know how far you’ve come, so take the time to reflect back on that. However small they may seem, any dietary change in the right direction is one step closer to where you want to be. Results DO vary, and while the results stories of others may provide motivation to get you started, it’s consistency and good habits that keep you going.

Zymology and the gut: fighting the good fight

Heard of zymology? Me either, until I started doing a bit of digging around on the benefits of including fermented foods regularly in the diet. Fermented foods are the result of zymology (or fermentation); the process of converting carbohydrates to alcohols and carbon dioxide or another organic acid, using bacteria, yeasts or a combination of the two. Fermented foods are a great source of prebiotics – organisms that promote the growth of good bacteria in the gut; and probiotics – live microorganisms that can colonise the gut and increase the numbers of good bacteria in the gut. Our gut bacteria are present in their trillions (!) and are the gatekeepers of our immune system and overall health. Most people are aware of probiotics present in yoghurt and while we are familiar with the terms acidophilus bifidus, some are a little less clear of other food sources of these organisms which play such an important role in our health. This is a very brief overview of the what, why, how and when of fermented foods and gut bacteria.

Gut health is important for overall health full stop, as 70% of body’s immune response originates from here. It’s not just about digestion, our gut is like our body’s armour shield against the environment, and the integrity of the gut lining is important in terms of protecting our system from proteins, toxins or foreign bodies that could trigger an immune response and cause inflammation. Children get their first exposure to immune boosting bacteria when they are born vaginally; in fact research shows that children who are born via caesarean have lower levels of good gut bacteria and are at higher risk of obesity, allergies and the development of chronic conditions later in life as their immune system doesn’t have the right bacteria to evoke an appropriate immune reaction.

Gut bacteria are responsible for breaking down compounds in food that could be harmful (carcinogens), synthesising b-vitamins (biotin, folate) and vitamin K, and help absorb minerals such as calcium, magnesium and iron. They also convert non-digestible carbohydrate (CHO) to short chain fatty acids (SCFA) acetate, propionate and butyrate, which provides energy and are beneficial to lining of the gut by stimulating the growth of cells that form the inner lining of the colon. In addition, butyrate has anti-inflammatory effects that can increase insulin sensitivity and may be useful in treating digestive-related conditions such as irritable bowel syndrome (IBS) and Crohns disease.

The inflammation that results from an imbalance of bacteria in the gut may contribute to development of many chronic conditions – both physical and mental health. Often people think that problems in the gut are evident only with digestive issues. Not so. When this imbalance leads to the intestinal tract becoming permeable, substances leak into our bloodstream and trigger an immune reaction – this contributes to the development of a range of conditions from autoimmune disease, to depression, obesity, skin disease. Leaky gut isn’t always obvious in terms of gut symptoms – but can be skin rashes (eczema, psoriasis) , anxiety, fatigue, joint pain, acne and fibromyalgia.

Lifestyle factors contributing to an imbalance of gut bacteria include the use of antiobiotics and other medications such as ibuprofen, a poor diet that is high in processed refined carbohydrate and industrial seed oils and low in nutrients; chronic stress (physical, mental and environmental), chronic infections and small intestinal bacteria overgrowth (SIBO). This is an overgrowth of bacteria in small intestine (instead of colon, where it belongs) – causing malabsorption of proteins, fats, fat soluble vitamins, b-vitamins and other micronutrients important for immune health.

So why fermented products? Research has shown their usefulness in  improving intestinal tract health, enhancing the immune system, synthesizing and enhancing the bioavailability of nutrients and decreasing the prevalence of allergy in susceptible individuals due to the availability of prebiotics and probiotics. Some common food sources are listed below. This isn’t an exhaustive list, but some found in the health food store or (in some instances) your supermarket include:

• Water kefir
• Dairy kefir
• Sauerkraut (raw, in refrigerated section – not Edgells canned variety)
• Kim chi
• Yoghurt high in cultures
• Raw apple cider vinegar
• Fermentable fibres in foods: fruits, vege, starches, nuts, seeds: this helps maintain the good bacteria that help produce SCFA.

Found in my local health food shop

Fermented vegetables aren’t for everyone, however. If you have a histamine intolerance (due to a reduction in enzymes responsible for breaking down histamine) then it’s best to avoid these. Fermented foods contain histamine, and the accumulation of this in the gut can trigger an immune reaction and mimic allergic reactions.

Those with an inability to digest foods containing FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) intolerance – an inability to break down these carbohydrate types lactose, fructose in fruit, coconut products, sweeteners and sugar alcohols (found in sugar free chewing gum). In addition, it’s best to avoid these if you have severe gut dysbiosis, until there is a better balance of good bacteria.

An easy way to add these into your diet would be to start the day with a tablespoon of raw apple cider vinegar in water, add a tablespoon or two of fermented vegetables to lunch and/or dinner, and for people including dairy in their diet, consume yoghurt that has live cultures or is a kefir-style yoghurt. While you can get yoghurt that contains sugar along with probiotics, it makes little sense to me to consume this as a way to promote good gut bacteria, given that sugar can trigger the growth of the bad guys. If you’re new to the idea of fermented food, it is a good idea to start adding these in slowly – perhaps roll with one of the ideas above and build on that. Too much can trigger further gut distress, particularly if you’ve got some nasties taking up space in your gut.

In addition, if you do have IBS or inflammatory bowel disorder, non-starchy vegetables high in insoluble fibre can further irritate an inflamed gut. These include: Greens, whole peas, (any peas), green beans, kernel corn, bell peppers, eggplant, celery, onions, (and the family), brassica (cabbage, Brussels, broccoli, cauliflower). Take care when eating these and ensure you cook them thoroughly to aid digestion, and don’t eat these on an empty stomach. Including vegetables that are higher in soluble fibre (ie carrots, pumpkin, potatoes, kumara, parsnips swede and beetroot) can also be useful.

As with anything, a whole food diet is a great foundation for healthy gut bacteria – and no amount of sauerkraut will offset the potential damage of a poor diet devoid nutrients. So fight the good fight and clean up your diet first and foremost.

NCEA Level 1: Adrenal fatigue

Counting down the days until you can switch the ‘out of office’ alert on your email and sign off for a couple of weeks? Same here. So many people I’ve talked to recently have been saying how burnt out they feel this year and, maybe it’s that we’ve all got short memories, but it seems so much worse than last year. One conversation in particular got me wondering at what point does ‘dire need of a break’ switch over to full-blown fatigue that won’t be reversed by two weeks in the sun. Before I actually did much reading around the topic I used to roll my eyes when I heard that yet another person was experiencing ‘adrenal fatigue.’ It seemed like an all-too common diagnosis and fashionable, like running skorts. It’s fair to say this speaks to my ignorance in the topic, rather than any research I conducted on what the potential causes were and how to try to stop them at the pass. A year down the track the reading I’ve done suggests that adrenal fatigue could be more common than I thought – certainly our lifestyles lend themselves to a state where we don’t let ourselves recover from the normal hustle and bustle of everyday life. So when does ‘burnt out’ turn into ‘adrenal fatigue’ and what are some of the things you can do to prevent it? I’m not claiming to be an expert in the area – nor is this going to be a comprehensive post that details all of the complexities of adrenal fatigue – but it will at least provide some basic information on what the condition is, and what dietary measures to take to prevent it from happening to you.

A bit of anatomy: your adrenal glands sit atop of your kidneys and produce hormones that are responsible for reacting to stressful situations in everyday life.  The glands are connected to the hypothalamus and the pituatary glands (collectively known as the HPA axis) and the hypothalamus is the ‘stress centre’; when the body recognises stress, the hypothalamus responds by releasing a hormone called corticotrophin-releasing hormone, which travels to the pituatary gland and stimulates the release of another hormone (adrenal corticotrophin hormone – ACTH) which goes through the blood to the adrenal cortex and stimulates the release of cortisol. Cortisol is one of three hormones the body produces in relation to stress – other hormones are norepinephrine, and Dehydroepiandrosterone (DHEA).

Norepinephrine (or adrenaline) is your ‘flight or fight’ hormone, and is released in response to a perception of threat. Its effects in the body (to sharpen the brain, make your heart pump blood to the muscles faster, increase blood pressure and pain tolerance) were necessary when we went in to battle. Nowadays, though, the battles we fight (peak hour traffic, work deadlines, an unexpectedly large bill) are not the same as they once were – obviously – though your body doesn’t make the distinction between the different types of threats; it recognises these as stress and responds accordingly. Over time these everyday occurrences can build up and suddenly your body’s ability to produce adrenaline is diminshed – leaving you in a position where there is too little adrenaline when you actually need it.

Cortisol is released as a back up to adrenaline to respond to stress. It helps with increasing appetite, releasing stored energy to be used when required (by dumping glucose into your blood stream, ready for quick utilisation), and helps reduce the effects of infection or inflammation on your body’s immune system. However, it’s not designed to cope with stress that is chronic, and therefore constantly high levels of cortisol can have adverse effects on musculoskeletal system (muscle and bone loss), can lead to kidney damage, spiking blood sugar levels (therefore stimulating unwanted insulin release and resulting in roller coaster energy levels) and increased vulnerability to bacteria and viruses through its immunosuppressant activity. The presence of cortisol in the body is proportional to the amount of DHEA. DHEA is the precursor to sex hormones (testosterone and oestrogen) and works much in the same way as adrenaline does– but also guards against the detrimental affects of chronically high cortisol levels.

Under ‘normal’ conditions, your ability to respond to stress is taken care of by these three hormones. However, under periods of prolonged stress, the adrenal glands become exhausted by constantly producing adrenaline, and (as the back ups) cortisol and DHEA. Over time the ability to produce the hormones is compromised, with levels of DHEA being the first hormone to be reduced. This leads to fluctuations in the levels of cortisol and adrenaline being produced, and over time, adrenal fatigue; a diminished ability to produce the hormones. Severe cases can result in very low levels of cortisol being produced.

How can you tell if you are just stressed and tired, or if you are actually suffering from adrenal fatigue? Short of a diagnosis from a qualified practitioner (which is fairly non-invasive, requiring repeated measures of salivary cortisol throughout the day), symptoms of adrenal fatigue can look like any number of health issues:

• Inability to wake up and feel on task until mid-morning;
• Physical fatigue;
• Afternoon lull between around 2-4pm
• Mood disorders (in part due to blood sugar crashes);
• Inability to concentrate;
• Insomnia (though exhausted) and waking frequently throughout the night;
• Loss of libido;
• Memory loss;
• Weight gain;
• Thinning of hair;
• Mild depression;
• Increased allergies or asthma symptoms (as there isn’t enough cortisol to suppress the immune system anymore);
• Hypotension (low blood pressure) and dizziness if you stand quickly from sitting;
• Craving for salt (as the adrenal glands require sodium for functioning properly)

So you can see that many of these symptoms are also related to a number of other health conditions, and while you may experience a number of these, it doesn’t necessarily mean you have adrenal fatigue. Regardless, the dietary strategies below could help prevent any stress hormone imbalance  from turning  full-blown adrenal fatigue.

Start with a paleo-approach to diet. unsurprisingly, a whole food diet that is comprised of minimally processed foods, rich in nutrients from vegetables, meat, nuts, fruit and starchy carbohydrates, eating all macronutrients at each meal will help provide stable blood sugars and prevent blood sugar crashes. As cortisol releases stored carbohydrate (CHO) into the bloodstream and there isn’t enough cortisol in the system, this will help balance energy levels.

Don’t go too low on the CHO. It’s likely that you’ll naturally lower your CHO by making a change toward real food but you don’t want to go too low in a misguided belief that the lower the better. This can stress your system more as a low CHO diet will increase cortisol production. You are better to try and eat balanced amounts throughout the day along with fat and protein to maintain blood glucose levels – so try and keep it above 100g CHO per day (if not 150g per day). But again, this is individual and depends on your level of intake now.

Vitamin C: This is stored in our adrenal glands and could be important for functioning – indeed it is thought the Inuit used to eat adrenal glands to prevent scurvy (a disease that occurs through vitamin c deficiency).

Magnesium: this helps stimulate the release of ACTH which is required for cortisol production. I would typically recommend magnesium for anyone under times of stress and a powder form that is in a chelate (combined) with an amino acid to help the body absorb it.

Vit B6: This B vitamin is important for the production of cortisol so supplementing with a good quality B complex vitamin is warranted.

Probiotics: encourage growth of good bacteria (such as fermented foods – sauerkraut, kefir, yoghurt with acidophilus bifidus) which positively influences the HPA axis, and is important in overall health and gut bacteria.

These are recommendations that could be some good initial steps to addressing fatigue and burn out. However if you are already doing these things, or if these make little difference to how you feel, then seeing a practitioner such as a naturopath who is qualified to make some more specific recommendations with regards to adrenal fatigue and supplements is warranted. Friends of mine recommend Adrenalfatigue.co.nz a go-to website for in-depth information on treatment.

On a final note though, all the dietary manipulations and supplements in the world will not help if the underlying reasons for the adrenal burnout in the first place aren’t addressed.