Healthy Sunday Brunch

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I love making healthier versions of typical treat food. At the moment, I am having a smoothie most mornings for breakfast but come the weekend I love a change and coconut flour pancakes with bacon and a berry compote are on my go to list!

Recipe:

From start to finish it should take less than 30 minutes to make this meal for two.

I first start off preparing the coconut flour mix (see part 1 below). Coconut flour can be tricky to cook with and my advice is less is more! When I put the first part of the mixture onto the pan then I start on the berry compote (see part 2 below) and I also put the rashers/bacon under the grill and roast my pumpkin seeds (see part 3 below).

Part 1: Coconut flour pancakes (serves 2 people)

Ingredients

  • 1/3 cup coconut flour
  • 1/6 tsp baking flour
  • Pinch of salt
  • 1/4 cup coconut milk or any alternative milk of your choice
  • 2 tbsp of coconut oil
  • 3 eggs
  • Butter for cooking

Instructions

  • Thoroughly mix the eggs and coconut oil together.
  • Add the milk
  • Mix (not too much) in the coconut flour, baking flour, and salt.
  • Melt a about 1 tsp-tbsp of butter in your pan and then slowly add the batter. I usually just spread a thin layer of the mixture throughout the pan.
  • Keep the heat quiet low and cook for about 4 minutes and then flip with a spatula.
  • Once cooked you can place the pancake on a plate and just before serving you can warm these in the oven.

Part 2: Berry Compote

The berry compote is very quick, easy, healthy and tasty! It can be used as a topping to yoghurts, oats and granola!

Ingredients

  • 2 cups of frozen mixed berries or any berries you prefer!
  • 2 tbsp of ground linseeds, sunflowers and almonds (LSA) mix or if you prefer to make it more like a jam then you could use 2 tbsp of chia or linseeds.
  • 100-150mls of water

Instructions

  • Place the 2 cups of frozen mixed berries into a heated saucepan.
  • Once they start to melt/dissolve start to mash them with a fork.
  • Add water and LSA mix
  • Once all the berries are mixed well with the LSA you can allow to cool. The LSA will draw the water in and it will start to gel up within 10 minutes

Part 3: Rashers and Pumpkin seeds

Ingredients

  • 6 Streaky Bacon (serves 2). I recommend going to a good butcher or at least reading the ingredient label on the back of the package when buying your rashers. There is a broad range in pork quality available. Some bacon/rashers only contain 65% pork. Go for Bacon that contains at least 95% pork. The less ingredients the better. Some contain a lot of hidden sugars such as maltodextrin and dextrose.
  • 1 pack of pumpkin seeds 300g
  • 1 tbsp of coconut oil
  • Pinch of salt

Instructions

  • Once you have your pancakes on I recommend you put your rashers under the grill.
  • After 5 minutes under the grill switch to the oven if that’s possible.
  • Mix your pumpkin seeds with the coconut oil and salt. Sprinkle onto a oven tray and place in the bottom of the oven at low heat (~120 °C) while the rashers are cooking above .

 To serve:

  • I recommend placing the pancakes in the oven for 3 minutes before serving. Plate the pancakes and top with the berry compote (about 3 tbsp for each person).
  • Then place the bacon on top and sprinkle with pumpkin seeds. The rest of the pumpkin seeds can be allowed to cool and store in an airtight container (use as a topping to salads).
  • Although I enjoy this without any added sweetener, you are welcome to use a tsp of honey for a little sweetness!
  • Enjoy and please let me know how it tasted….!!

If you would like to read more of my nutrition blogs then please like my facebook page Our Food Karma. For more regular updates and interaction please like my instagram page: ourfoodkarma

 

An Antioxidant: What is it?

img_5032Nowadays, the term antioxidant is regularly used in support of the latest face cream or nutritional supplement.

However, people often struggle to understand what an antioxidant actually is.

Below is an explanation of what an antioxidant is and its role in the body.

What is an Antioxidant?

An antioxidant is a substance that neutralises or quenches unstable substances called free radicals (1).

An antioxidant is capable of donating an electron to a free radical and as a result ensures the free radical itself becomes stable (2).

Antioxidants are produced within the body but they are also particularly abundant in fruit and vegetables.

Some of the key antioxidants found in food include vitamin A, C, and E, selenium, copper, zinc and phytochemicals.

As long as there are sufficient antioxidants present then free radicals cause no apparent harm. In fact, free radicals can help protect the body (3).

However, excess free radical production within the body or exposure to free radicals in the environment can overwhelm the body’s antioxidant capacity (3).

Excess free radicals which have not been neutralised may go on to adversely affect lipids, proteins and DNA in an attempt to gain an electron (4, 5).

It is even proposed that free radical damage is the underlying cause of ageing and chronic diseases (4, 6).

Therefore, it makes sense to maximize the amount of antioxidants that are consumed throughout the day.

Each person is different and depending on your lifestyle you may need more or less antioxidants than someone else.

The key is to include a variety of fruit and vegetables in your diet each week.

A simple tip is to include different coloured fruits and vegetables in your shopping basket as you are likely to be getting a greater array of nutrients with antioxidant benefits.

Summary: An antioxidant helps to protect the body from damage caused by free radicals. Fruit and vegetables are high in antioxidants and help to maintain or improve health.

 

 

Why Bliss Balls changed my life!

This may seem like a bit of an over-exaggeration but making my own bliss balls changed my outlook on chocolate!

Over the last 10 years or so I’ve tried to improve my diet and although I was eating a mainly wholefood diet I still struggled with cutting out chocolate bars. I’m not too sure if it was psychological or physiological but I regularly craved shop bought chocolate bars. I also had the idea that chocolate is very unhealthy and I should be able to eliminate it from my diet. No wonder I thought that with the ingredients of one of my favourite chocolate bars containing so many highly processed ingredients and different forms of sugar!!

Table 1: Ingredients in a shop bought chocolate bar

Milk, sugar, vegetable fat (palm, shea), glucose syrup, dextrose, dried skimmed milk, cocoa butter, wheat flour, fat-reduced cocoa, cocoa mass, humectant (glycerol), dried whey (from milk), emulsifiers (E442, E471), flavourings, dried cellulose, salt, barley malt syrup, raising agent (sodium bicarbonate), tartaric acid, magnesium stearate.

I began to eat dark chocolate but usually the dark chocolate bars that were readily available only contained 50 to 60% cocoa, and there was still quite a lot of sugar present. About 3 years or so ago my lovely friend Claire shared some bliss balls she made. They were so tasty and chocolatey, and when she told me that she only used a mixture of nuts, seeds, dates and cacao I was very surprised!  How could this taste so good and not contain a lot of rubbish ingredients?! She told me about Deliciously Ella website and from there I started to make my own bliss balls. There is a simple bliss ball recipe from her website on the following link https://deliciouslyella.com/classic-almond-and-cacao-energy-balls/

From then I haven’t looked back. Every week I make a batch of bliss balls and I have one or two as a snack at around 3-4 pm to keep me going before the gym or whatever it is I’m doing before I have dinner later. It’s great to know that I’m eating ingredients that are really going to nourish my body. I also find that I’m satisfied after one or two and less likely to over do it as you easily can with regularly chocolate!

Now I just mix up whatever I have and see how it goes. Yesterday I mixed almonds, milled linseeds, sesame seeds, cacao, and as I didn’t have any dates I tried mashing up some fresh mango to make all the ingredients stick together and to give some sweetness. These all worked really well together!

If you don’t have a food processor you can buy ground up nuts and seeds. Cacao can be quite expensive so you can use cocoa instead. Cocoa undergoes more processing than cacao but it still contains minerals such as calcium, magnesium and zinc. Also, you can use any dates really as medjool dates can be expensive.

So there it is, I still love chocolate but bliss balls have allowed me to have my guilt free chocolate fix!

If you would like to read more of my nutrition blogs then please like my facebook page Our Food Karma. For more regular updates and interaction please add me on snapchat with username: sharuuu000 and instagram as ourfoodkarma

Sports supplements: Are they worth all the hype?!

Sports nutrition continues to boom with interest in sports supplements extending beyond athletes and body builders. Your everyday gym goer wants to be lean and strong; strength has become a greater priority than the figures on the scales. There is a surge in fitness and health bloggers with their photos on Instagram and Facebook creating a desire and motivation to achieve a leaner body. Non-professional sports are becoming more and more competitive and individuals are increasingly more open to taking supplements in hope they will gain an added edge.

Although there is continued research and funding to show a given supplement can improve body composition or performance, very few supplements have been shown to be effective. Those that show effectiveness are often based on research conducted on a small number of male athletes (such as cyclists) and therefore, how can we be convinced that this will work for everyone?

Below are my top 5 supplements that have the most robust evidence and a good safety profile, but of course there is no substitute for disciplined training and a proper diet!

  1. Creatine:

Creatine phosphate is stored in your muscles and provides an excellent store of energy for very high intensity exercises (when oxygen supply to the muscles is insufficient). You will be using your creatine phosphate stores when you do an “all-out sprint” or lift maximum weights. Both of these examples cannot be maintained for very long and this is because the creatine phosphates are spilt to produce energy and they must be recycled. The recycling process requires oxygen so you will need to get your “breath back” in order to make more creatine phosphate.1

We consume creatine via meat and fish products and we can also make it in the liver; both of which amount to about 2g/day.  An average (70kg) athlete stores around 120g of creatine. Supplementation studies have shown that muscle creatine concentration can be increased by up to 20% using creatine supplements.2

This is achieved by creatine loading: 2

  • Consume 20-25 g/day of creatine over 5-6 days followed by 2g/day as maintenance or
  • Consume smaller amounts (around 3g/day) over 1 month.

Improvements in performance have been shown in weight lifters who loaded with creatine. Creatine supplementation can also cause weight gain (1-2 kg increase in total body mass has been documented after 20g/day loading with creatine for 4-28 days).2 Supplementation increases intracellular water in the muscle which may stimulate glycogen storage. However, there are responders and non-responders; it does not work for everybody! Lastly, anyone with kidney disease should avoid creatine supplementation as it may affect creatinine clearance.

Summary: Creatine supplements may allow maintenance of top speed/strength for longer but this does not always equate to improved performance.

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  1. Caffeine

Caffeine is a socially acceptable stimulatory drug. Caffeine can improve performance in endurance exercises such as running and cycling and also in high intensity sports such as rugby and soccer (from 1 to 3%).3 Caffeine is a central nervous system stimulant and works by reducing an athlete’s perception of effort and/or pain threshold.2 It has been used as an adjunct to weight loss but caffeine alone has not been shown to have an substantial effect on weight loss.  Unless you are already dehydration, caffeine has not been shown to negatively impact hydration status. Caffeine tends to work when 1-3 mg per kg body weight is consumed before or during exercise.4 A typical cup of coffee contains 80-100 mg of caffeine. You can also take caffeine supplements but if you drink coffee then you can just get your caffeine hit with coffee!

Caffeine is considered safe but excess (greater than 500 mg or greater than your own tolerance level) causes side effects such as increased blood pressure at rest and during exercise, increased heart rate, gastrointestinal distress and insomnia. Caffeine addiction has been documented with doses as low as 100 mg/day and sudden withdrawal can result in severe headaches, drowsiness, and inability to concentrate.1

Personally, I find a cup of coffee (although not a supplement!) before a run or the gym great for a boost but I do not take it before a competitive match because coffee heightens any nervousness I already have coming up to a game!

Summary: Caffeine can improve performance as it is a nervous system stimulant but in excess/above personal tolerance it can cause gastrointestinal distress, increased heart rate and insomnia.

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  1. Protein

The benefit of protein supplementation is more down to convenience than anything else! Protein supplements can be helpful for those going from work to training, or when it may not be possible to have a descent meal soon after training or for those with very high protein requirements; but protein supplementation itself is not more or less effective for increasing muscle mass than protein from food.2  Whey protein is a “fast acting” protein that is absorbed easily and therefore, its amino acids such as the branched chain amino acids- leucine, isoleucine and valine are quickly taken up by muscles. Ricotta cheese contains the highest amount of whey of any wholefood because it is made from whey protein. Casein is a “slow acting” protein with slower absorption compared to whey protein but it provides a more sustained rise in amino acids which may help supress muscle breakdown. Milk contains around 20% whey and 80% casein but all dairy products will contain a mixture of whey and casein. Milk is also rich in leucine which can minimise protein breakdown and is the only amino acid that by itself can stimulate protein synthesis! Research on other individual amino acids is mixed.2 For more on protein please read my recent blog what and when to eat to optimise sports performance

Summary: Protein supplements can be beneficial in enhancing muscle growth and recovery but has not been shown to be more superior to protein from food sources.

  1. Beetroot

Beetroot, spinach, rocket, carrots and most root vegetable contain nitrates. Nitrates can be converted in the body to nitric oxide which improves blood flow via vasodilation. Nitrate intake has been associated with enhanced exercise performance.1 A study by Murphy et al. in 2012 showed that whole beetroot consumption improved running time in 11 recreational fit men and women who ran 5km compared to those who consumed cranberry relish (12.3±2.7km/hr versus 11.9±2.6 km/hr).5  Furthermore, during the last 1.8 km of the 5-km run, running velocity was 5% faster (12.7±3.0 vs 12.1±2.6 km/hour; P=0.02) in the beetroot group. Although beetroot is a food and not a supplement it is worth a mention as the results have been very positive. Perhaps you could have a beetroot, spinach and carrot based smoothie pre-training!

Summary: Consumption of beetroot or an equivalent nitrate dose from other vegetables improves running performance in healthy adults.5

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  1. Probiotics

Athletes with prolonged, intense training often experience diarrhoea and upper respiratory tract infections. This is because vigorous exercise increases gastrointestinal permeability causing ‘leaky gut’. In 2011 West et al. showed that supplementation with a probiotic called Lactobacillus fermentum reduced the severity of self-reported symptoms of lower respiratory illness, use of cold and flu medication, and severity of gastrointestinal symptoms at higher training loads in Australian male athletes.6 Although this research was specific to male Australian athletes it may be worth a trial of this strain if you experience re-occurring diarrhoea and/or respiratory tract infections.

Summary: Athletes experiencing diarrhoea may benefit from a trial of probiotic bacteria called Lactobacillus fermentum.

If you would like to read more of my nutrition blogs then please like my facebook page Our Food Karma. For more regular updates and interaction please add me on snapchat with username: sharuuu000 and instagram as ourfoodkarma

References:

  1. Dunford, M. & Doyle, J.A. (2015). Nutrition for sport and exercise. (3rd edition) Stamford, CT: Cengage:
  2. Helms et al (2014). Evidence-based recommendations for natural bodybuilding contest preparation: nutrition and supplementation. Journal of the International Society of Sports Nutrition, 11:20
  3. Noakes, T.M. (2002). Love of running (4th Ed). Champaign, IL: Human Kinetics
  4. Burke, L.M. (2008). Caffeine and sports performance. Applied Physiology, Nutrition, and Metabolism, 33, 1319-1334.
  5. Murphy, M. et al. 2012 Whole Beetroot Consumption Acutely Improves Running Performance. Journal of the Academy of Nutrition and Dietetics 112;4:548-552
  6. West N.P, et al. (2011) Lactobacillus fermentum (PCC®) supplementation and gastrointestinal and respiratory-tract illness symptoms: a randomised control trial in athletes. Nutrition Journal, 10:30

What and when to eat to optimise sports performance

“What should I eat before, during and after exercise?” is a question I am asked a lot. The other question is “What supplements do you think I should be taking?” I’ll cover supplements in an upcoming blog but getting your overall nutrition sorted first is the key priority!

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Sometimes in sports there is a focus on macronutrients (proteins, carbohydrates and fats) but little emphasise on vitamins and minerals but these are essential! For example iron is an essential component of haemoglobin which transports oxygen to your body cells, magnesium acts in the enzymatic conversion of intermediate substances during ATP (energy) production, and B vitamins such as thiamine (B1), riboflavin (B2), and niacin (B3) are essential in generating large amounts of energy in the cell! So without having these vitamins and minerals present in adequate amounts you will find it hard to reach optimum performance and will likely fatique early.

The best way to get all of these vitamins and minerals is through a good diet. Improving your diet a week or two before a competition is beneficial but the greater benefit is seen in those who have integrated a good healthy eating plan during the year!

What is a good healthy eating plan?

A healthy eating plan includes plenty of vegetables (a mixture of dark green leafy vegetable, purple, yellow and orange vegetables); adding a few lettuce leaves and a slice of tomato to a sandwich is just not enough! Ideally you should be having 4-5 portions of vegetables a day (2 cups of salad leaves or 1 cup of carrots/peppers/tomatoes is considered one normal portion size). Two to four portions of fruit per day is sufficient for most people (depending on energy requirements).  Remember vegetables and fruit contribute to your overall carbohydrate intake!

The next thing is to ensure any grains you eat are wholegrain. These provide a range of B vitamins and plenty of fiber to support good bowel movement! My favourites are quinoa (keen wah) which has a good range of amino acids, oats and wholegrain rice. For anyone who follows a fat-adapted diet plan please read my previous blog on fat adaptation: Getting fat adapted

Good sources of protein rich foods should be included in every meal. Great protein sources are beef steak, lamb chops, chicken breast, tuna steaks, milk and eggs. Salmon and other oily fish also contain great sources of omega 3 which helps to dampen down inflammation in the body. Omega 3 is particularly important in regard to immunity and recovery from injury. There are also good non-animal sources of protein such as chick peas (hummus dips), kidney beans, lentils, nuts and seeds. The beauty about nuts and seeds is that they are convenient and contain an excellent range of minerals such as magnesium, calcium, selenium and zinc. Including some brazil nuts, cashews nuts, hazelnuts, pumpkin seeds and sesame seeds is a great way of upping your protein intake and getting some healthy polyunsaturated fats into the diet. Protein requirement for the general population is 0.8 grams (g) per kilogram (kg) of body weight but depending on your sport and body composition you may need 1 to 2 g per kg of body weight.1,2 For a 75 kg individual this equates to 60 g (general population) and 75 g up to 150 g of protein for athletes. To give you an idea; a portion of meat will provide about 25-30g of protein and an egg around 8g of protein. From my experience most people easily meet their protein requirements through diet alone. Unless you are lifting heavy weights and there is continued hypertrophy then you are unlikely to require any extra protein. Excess protein which is not used by muscle cells or for other functions will instead be used for energy, ultimately sparing fat stores; which is not good for anyone trying to reduce their body fat percentage!

In regard to fat, don’t be afraid to include some olive oil (for low heat) or coconut oil/macadamia nut oil (for high heat) at your main meals. Fats are also important for the structure of our cell membranes and hormone production but a low fat meal is best close to exercise.

What should I eat and drink before exercise/training/match/game?

This will all depend on whether you are elite, well-trained or a recreational sports person. Some people eat like they are an elite athlete but are not training or competing at a high level, and therefore may not need extra carbohydrate, protein shakes or supplements etc.

Before exercise you should eat to satisfy hunger and ensure glycogen is replenished. If you had a hard training session the evening before and are training again the next day you may need to have some extra carbohydrate on board to ensure your glycogen stores are topped up. Glycogen is the storage form of carbohydrate in your muscle and liver. We have a limited capacity to store glycogen but the more we have stored then the greater ability there is to use it as a quick fuel sources during exercise. Remember any carbohydrate that is not converted to glycogen can then be stored as fat so it’s important to find your sweet spot (eating enough carbohydrates to replenish glycogen but not too much to increase fat storage).

Individuals with greater muscle mass have a greater ability to store glycogen. For a big match or competition you may wish to try carbohydrate loading. This is where you taper training for a few days before a game and eat a large amount of low fiber carbohydrates (to maximise the amount of carbohydrate consume). However, many people do not tolerate large amounts of carbohydrate and the gastrointestinal symptoms may offset the extra glycogen stored!

The focus before exercise is on carbohydrates but including some branched chain amino acids (BCAA), may help improve time to exhaustion, maximise power output and stimulate protein synthesis after exercise.2,3 BCAAs include three amino acids; isoleucine, leucine and valine. Good sources of these are meat, dairy, egg whites, nuts and seeds.

Another important aspect is to leave time for digestion. If you are eating 3 to 4 hours before exercise then you can have a normal balance meal e.g. sweet potato with some green beans, peppers and a tuna steak. Or if you are going straight from work to training (around 1 to 2 hours before exercise) then it is better to eat something that can be easily digested such as some fruit, nuts and yoghurt. The higher the intensity the exercise is then the greater time you need to allow for digestion. Timing is also quiet individual, some people feel better eating at least 3 hours before training and others can tolerate food up to 1 hour before exercise.

There should be plenty of water on board before exercise and ideally only water should be consumed within an hour before exercise. Having a sugary drink may cause a spike in blood sugar followed by a surge in insulin release that rapidly lowers blood sugars (in people who are sensitive to sugar). You do not want to risk having low blood sugar just before you start training or a match! But in the last 10 minutes before exercise it is ok to drink a sports drink for example as there is not enough time for the body to pump insulin into the blood and by the time exercise starts your body has downregulated its insulin release!

2-3% body water loss can reduce performance but be aware that excess can cause low sodium levels (hyponatremia). It is important to sip water throughout the day and not gulp a liter or two just before training!

Table 1: Pre-exercise nutrition

Time before exercise Example
1 hour or less 500 ml water (no food), a sports drink or homemade sports drink 10 minutes before starting exercise
2 hours Smoothie made from yoghurt and low fiber fruit such as banana, peaches, honeydew and watermelon. Fibrous fruits that are best avoided too close to exercise include apples, berries, dates, figs, grapes, pears, mango and pineapple (but this will depend on personal tolerance level)
3 to 4 hours Quinoa with broccoli, cauliflower, cod fillet with a tomato based sauce

 

What should I eat and drink during exercise/training/match/game?

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For exercise up to 90 minutes the priority should be hydration with water. For endurance exercise such as running, water is sufficient but if you are exercising at high intensity and especially in the heat you may wish to drink a sports drink. Sports drinks will contain carbohydrates and electrolytes which help to maintain water balance in and out of the cells. A number of recent studies have shown that rinsing the mouth with a carbohydrate solution without actually consuming the drink has a positive effect on exercise performance. It may be that the carbohydrate drink stimulates rewards centers in the brain!2 If you decide to make your own sports drink make sure it does not contain fructose as the main sugar as it will not be absorbed very well and main create gut problems. A good idea is to use coconut water with a pinch of salt!

There will be significant glycogen depletion when exercising for greater than 90minutes. Sports drinks or gels with water will help to maintain carbohydrate. Glycogen depletion can cause muscle wasting as protein is then used as a fuel source.

What should I eat and drink after exercise/training/match/game?

Topping up low or empty glycogen stores after prolonged high intensity exercise is essential to guarantee stores for the next session. This can be achieved by consuming a high carbohydrate snack within 2 hours or within 30 minutes if you plan to exercise again within 8 hours. Liquid carbohydrate sources will be absorbed more quickly but this is only a priority if you are training again soon i.e. the next morning. Drinking juice or eating fruit is also sufficient to replace nearly all electrolytes.

In a 1 hour workout you can use up to 30g of protein (again this depends on the type pf exercise, intensity and your own body composition). If you are having a meal with some animal protein or good non-animal protein sources as mentioned earlier then that should meet your protein and BCAA needs. However, if you are not having a meal and are on the go then it is a good idea to have some nuts and yoghurt with you. Homemade or shop bought bought bliss balls can be great,  and a protein shake or a protein bar can also be useful.

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Conclusion

In the long term your nutrition goals should focus on adequate:

  • energy intake to meet the energy demands of training
  • replenishment of muscle and liver glycogen with dietary carbohydrates
  • protein intake for growth and repair of tissue, particularly skeletal muscle
  • hydration
  • overall diet to maintain good health

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If you would like to read more of my nutrition blogs then please like my facebook page Our Food Karma. For more regular updates and interaction please add me on snapchat with username: sharuuu000 and instagram as ourfoodkarma

 

Reference:

  1. NHMRC Nutrient reference values for Australia & New Zealand. Including recommended dietary intakes. (2005). National Health and Medical Research Council: Australia, & Ministry of Health:NZ.
  2. Dunford, M. & Doyle, J.A. (2015) Nutrition for sport and exercise. (3rd edition) Stamford, CT: Cengage.
  3. Cordain L, & Friel J. (2012). The Paleo Diet for Athletes: The Ancient Nutritional Formula for Peak Athletic Performance. 2nd Ed, Rodale Inc, New York.

A diet that can treat Autism, Attention Deficit Hyperactivity Disorder (ADHD), Depression and Schizophrenia?

I am currently researching diet strategies used in the management of different gut issues. This has come about because I have been asked to present at the NZ Society of Naturopaths and Naturopaths of NZ combined annual conference in Auckland in September. My presentation title is “Demystifying diets for functional gut problems” so here I am reviewing diets relating to gut problems!

Recently I wrote a blog on low FODMAPs diet for irritable bowel syndrome (IBS) Low FODMAP foods for IBS. In this blog I am going to focus on the Gut and Psychology Syndromes (GAPS) diet which claims to provide a natural treatment for Autism, ADHD, Dyslexia, Depression, and Schizophrenia.

What is GAPS?

Gut and Psychology Syndromes (GAPS) is a condition that is based on the connection between the function of the digestive system and the brain. It was coined by Dr Natasha Campbell-McBride in 2004 after her own child was diagnosed with learning difficulties. She believes “all diseases begin in the gut” and that the state of the digestive system links all the above mentioned conditions. She also believes that conditions such as asthma, eczema, allergies, eating disorders, and obsessive compulsive disorder can be vastly improved by following the GAPS diet.1

Healthy gut bacteria provide a physical barrier along the length of our intestines. These bacteria protect us from dangerous bacteria (pathogenic bacteria), viruses and fungi. They neutralise toxins, modify the immune system, ferment carbohydrates, produce vitamin K and B vitamins and even provide energy to the cells that line the intestines.1

If beneficial bacteria are weakened then the gut wall is considered open to invasion by various bacteria, parasites and yeast (Candida albicans). This can lead to chronic gut inflammation and malnourished intestinal cells. Intestinal cells are no longer able to function effectively and this results in impaired digestion and absorption “leaky gut”.1

In her book “Gut and Psychology Syndrome: Natural Treatment for Autism, ADD/ADHD, Dyslexia, Dyspraxia, Depression, Schizophrenia” Dr Campbell-McBride claims that once the intestinal lining is damaged, wheat and milk proteins are unable to be broken down by enzymes lining the gut wall and instead are absorbed intact. She explains that these proteins; gluteomorphines (wheat proteins) and casomorphines (milk proteins) can interfere with brain and immune system function.1

She also claims that abnormal gut flora can produce neurotoxins and cause the body to produce antibodies against its own cells in the brain and spinal cord.1 She explains that Candida albicans use glucose to form ethanol and acetaldehyde and that Candida overgrowth during pregnancy can affect child development (as the foetus accumulates toxins), and the infant then produces alcohol in their own gut. Dr Campbell-McBride links aldehyde production in the gut with altered myelin structure, which manifests as multiple sclerosis. She thinks this aldehyde production may be a cause of the neurologic picture of autistic and dyspraxic children. Aldehyde production binds to vitamin B6, preventing its use as a co-factor for neurotransmitters and fatty acid metabolism. She claims that mothers of GAPS children always have gut dysbiosis (imbalance).1

Diet and GAPS

Dr Campbell-McBride claims that sugar and processed carbohydrates increase Candida, Staphylococci, Streptococci, Clostridia and Bacteroids, and predisposes an individual to worms and parasites. She also claims that a high amount of grain intake predisposes individuals to IBS and bowel cancer. She even states that there were no cases of schizophrenia or coeliac disease documented in Ireland until post potato famine when grains became an integral part of the Irish diet! She explains in her book that diet plus other factors such as antibiotic use, surgery, chemotherapy, stress, pollution and oral contraceptive pills have a collective negative effective on beneficial bacteria.1

What does the GAPS diet entail?

The GAPS diet eliminates all complex carbohydrates and only allows smaller sized carbohydrates called monosaccharides (glucose, fructose and galactose) in the diet as these are relatively easy to absorb.  This means avoidance of all grains (wheat, millet, spelt, quinoa, and cous-cous etc), starchy vegetables and beans (potatoes, yams, parsnip, soybeans, mungbeans, bean sprouts, chick peas, and fava beans). All fresh fruit, honey and non-starchy vegetables (Table 1) are allowed. Homemade fermented yoghurt is allowed as the fermentation process breaks the carbohydrates into small sugars and the proteins into amino acids that can then be easily absorbed.1

 Table 1: Non starchy fresh veg and beans/ lentils allowed in the GAPS diettable 1 gaps diet

The GAPS diet involves the avoidance of proteins in wheat and dairy but allows easy to digest unprocessed proteins such as eggs, fish, and meat. There is an emphasis on liver, meat, bone and fish stock. She recommends avoidance of lean meats because she believes that we can only use meat fibers when they come with fat, collagen and other substances. She recommends eating meat that has a good covering of fat and to eat the skin of poultry and fish.1

Shelled/freshly shelled nuts and seeds are allowed but they should not be roasted, salted, coated or processed in any way. Seeds can be soaked in salty water for 12 hours to improve their digestibility. Fats are tolerated as they are not dependent on brush border enzymes (enzymes on the gut wall that help digest food). She recommends ghee made from organic butter, cold pressed oils and no processed oils.1

The GAPS diet starts off with an introduction diet which can last from a few weeks to a year, depending on the individual. This stage allows for gut healing and recovering. There are six stages and Table 2 includes some aspects of each stage.

 Table 2: Six stages of the Introduction dietTable 2 gaps diet

After the introduction diet is completed the full GAPS diet then should be followed for 2 years. The full gaps diet includes 85% meat, eggs, fish eggs, fermented dairy and vegetables. There needs to be 6 months normal digestion before including non-GAPS foods.

Is there evidence to support this diet?

There are no studies or published papers on the GAPS diet. Dr Campbell-McBride makes a lot of sweeping statements (she has never met a healthy vegetarian!) and even advises against vaccination in infants born to mothers with fibromyalgia, digestive problems, asthma, eczema, severe allergies, and autoimmune disorders because she claims that viruses from vaccines may survive and persist in GAPS individuals.1  

However it is recognised that 70% of our immune system is localised in the intestines (gut associated lymphoid tissue) and that gut microbiota can alter brain function.2  We know that poor diets can negatively alter bacteria in the gut, which can then affect our brain and cognitive function. The exact mechanism is still unknown but it may be via regulating immunity or hormonal and neural messages.2

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Many gastrointestinal diseases are associated with neurological affects e.g. migraines/headaches, brain fog, fatique and fainting. Untreated coeliac disease is associated with autistic and psychotic behaviours and neurological conditions. There is also an association with IBS and depression and anxiety.3

The GAPS diet is a traditional diet in many ways with the use of bone broths as a major part of the diet. When I was growing up there was always meat and vegetables in a saucepan together left on the stove which cooked for hours at low heat. This low heat cooking helped liberate nutrients from the bones. This is something I no longer practice but I have started keeping the bones from my roast chicken and lamb dinners to make soups and stews!

I think personally, because I truly believe nutrition can have profound effects on health that I would give this diet a try if I had a GAPS condition. However, I think the diet itself may be challenging, particularly because you need to be able to ferment all your own dairy products and some vegetables. I fermented cabbage before (saukerkraut) but I have not fermented my own dairy products; although I hear it is relatively simple and many people make their own kefir (fermented yoghurt). Fermenting food was not a major tradition in Ireland; apart from breads but bacteria/yeast are killed by the heat. Mead, the oldest alcoholic drink was made from fermented honey, water, herbs and spices! You would also need to get used of making your own breads with nut flours as otherwise it becomes quite expensive buying these breads. It may be extremely challenging for a parent to introduce these foods to a child with learning disabilities and it would require a lot of patience and perseverance. Likewise someone with a mental health condition may not feel motivated to make these changes and they would require a lot of support, and even with support unless they understand the value and are on board with the diet then compliance may be low.

Conclusion

Dr Campbell-McBride often uses indirect evidence as ways to give plausible explanations to her yet to be proven theories. I say yet because a lot of what she is saying may be true and in the future her diet may be recognised as a dietary management option for those suffering from learning disabilities and psychological disturbances. I also wonder if there could be some benefit of including some aspects of the GAPS diet (so it not as extreme) over the long-term e.g. reducing fermentable carbohydrates, including more bone broths and adding small amounts of fermented vegetable into the diet?

I hope you found this useful, if you would like to read more of my nutrition blogs then please like my facebook page Our Food Karma. For more regular updates and interaction please add me on snapchat with username: sharuuu000 and instagram as ourfoodkarma

References

  1. Campbell-McBride, N. Gut and Psychology Syndrome: Natural Treatment for Autism, ADD/ADHD, Dyslexia, Dyspraxia, Depression, Schizophrenia. 2015, (2nd edition) United Kingdom: Medinform Publishing.
  2. Holzer, P., Farz, A. Neuropeptides and the Microbiota-gut-brain-axis. Adv Exp Med Biol. 2014; 817:195-219
  3. De Magistris L, Siniscalco D, Bully C, Loguercio C. Gut-brain axis. A new revolution to understand the pathogenesis of autism and other severe neurological diseases. In Human Nutrition from the gastronenterologists perspective, 2016, pp49-65. E. Grossi, F. Pace (eds) Springer International Publishing Switzerland. DOI 10.1007/978-3-319-30361-1

 

 

When does ‘normal eating’ become disordered?

There is a lot of focus on the two extremes of the eating continuum; overeating leading to obesity and undereating to the point of anorexia nervosa, but where dose everyone else fit in? Are we all ‘normal’?

Normal eating is considered to be flexible and balanced. You eat when hungry and stop when full. You can eat healthy (nutrient rich) and unhealthy (nutrient poor) foods. There are some constraints so that you do not over indulge all the time but you are not too overly strict either. If this sounds like you then you have it sorted…..

However, what I’ve noticed is, that when it comes down to it many people suffer from disordered eating or at least crossed into disordered eating at some point in their life. Maybe you were a ‘normal eater’ but you noticed that you gained weight over a year or more. You may have felt uncomfortable in your clothes and your confidence was affected. You then decide to make a conscious effort to lose the weight that has crept on. You start to monitor what you eat and lose some weight. But then you start to feel guilty for eating that burger or ice-cream at the weekend. But it’s ok you will barely eat anything on Monday to make up for it… and so it goes, with a constant focus on weight with regular and severe restrictions.

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Disordered eating is difficult to define but it involves a deviation away from normal eating behaviours but not to the point of an eating disorder such as anorexia nervosa or bulimia nervosa.

Signs of disordered eating1

  • Constantly focusing on weight
  • Food intake strictly monitored and/or restricted
  • Not eating when hungry or waiting until a time you set
  • Unable to stop eating when full
  • Eating because you are bored, anxious or lonely

On the other hand you could have an obsession with healthy food to the point that it is no longer healthy “orthorexia nervosa”. You may be so fixated on healthy and pure food that it consumes your life. Your self-esteem becomes linked to whether or not you had a “good food day”. You may create severe food restrictions in order to show discipline and sometimes even superiority over others. It gets to the point that it affects relationships and your own mental and physical health. The prevalence rate of orthorexia nervosa is estimated to be about 7% in the general population and can range from 35-58% for high risk groups such as healthcare professional including dietitians/nutritionists.2

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I would be lying if I said that I’ve just always had a healthy and positive attitude towards food! I was obsessed with my weight from a very young age. I only realised how bad it was when a few years ago I read a diary that I had when I was nine, in which I wrote “I wish I wasn’t so fat”. I was not fat but I had already started to link weight and body size to self-worth and confidence.

This theme continued in my teens but I also had the realisation that food could affect my mood in both a positive and negative way. I started to notice that when I had meals with lots of fresh fruit and veg I felt better in myself, more positive and more energetic but when I ate processed, especially sugary foods I often felt more negative about things and I had lower energy levels overall. I also linked exercise to feeling good and confident, and I later learned that was because of all the endorphins being released!

In my first year of university I moved in with girls who were members of a commercial slimming programme. They followed a strict point system and used the points left over for alcohol. I never joined but I did start to make dinners like theirs, which were often plates of low point vegetables. I certainly upped my intake of vegetables but I was left feeling unsatisfied and often hungry within an hour or two.  I even actively avoided eating avocados because of the calorie density! I often craved snacks and when I didn’t give in to these cravings and went to bed with the start of hunger pains I felt good and knew it wouldn’t be long until weight started to come off. Then there were the days when I ‘wasn’t strong’ and ate and sometimes over ate. I felt guilty and needless to say my self-talk was very negative!

I became less social and had the mentality that I’d be happy when I was a certain weight. I avoided having a 21st as I didn’t want to see my friends until I had reached my weight loss goal and felt better in myself. The university I went to was over 4 hours from home so I usually only went home every 6 to 8 weeks. When I did go home my family and friends would either say to me “you look great and you’ve lost weight” or if I didn’t look that great then nothing would be said. These comments where all said with good intentions but it affected my self-esteem when I hadn’t lost weight and I didn’t look as good as I could have. Each time I headed back to college I made a goal that I’d be “X” weight before I went home again and if I hadn’t reached that goal I’d make up excuses like I had to work or I didn’t have money to do whatever was planned. I was also determined to get a first class honours degree and I was often stressed as I did not know if I was doing enough to achieve my goal. There were also a lot of family issues and food took the edge off this, albeit momentarily.

It was only after I finished my degree and went travelling that things started to change. I went travelling with two friends and we first went to China for a month. We joined a tour group of nine backpackers. We often had our meals organised for us and we ate together all the time. My whole attachment/controlling behaviour with food dwindled.  After that month we went to Australia. I had an amazing time and didn’t give too much thought to food until I arrived in Melbourne after a month travelling down the east coast. I realised at that point that I’d gained weight and by the time I was leaving Australia I was determined to lose this extra weight. I spent three months travelling solo in South East Asia. I started reading books about detoxes and fasts. I started to do a few day fasts and after reading a book on why a seven day fast would be good for me, I decided to do it! The only thing I allowed myself was a slice of lemon and water for seven days…! I don’t know whether I was delirious or not but I felt amazing after it. I’ve never tried it since and would not recommend it because of the potential serious adverse effects but it is just what happened at that stage in my life.

When I came home I became more and more interested in nutrition. I decided to apply for a Masters in Human Nutrition. I loved the course and I also wanted to learn more about holistic nutrition so I did another nutrition course at weekends. I also worked part-time in a health food store and overall I just loved what I was doing. At this stage I was much more of a ‘normal eater’.

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Although I loved the masters in nutrition I realised I was heading towards a research career but I wanted to help people change their diets. I decided to move to England to do a two year post-graduate diploma in dietetics. I lived with other student dietitians and I became more relaxed and viewed food more in terms of nutrient/health value rather than on kilocalorie content. I got back to basics and realised the simple things work. There were no more drastic diets but I still knew that I had to have discipline and strategies in place to prevent myself from gaining weight. I am not someone who can eat what I want and remain the same weight. I love food, and although I eat healthy the majority of time I do have some processed foods occasionally. Some people may disagree but even too much healthy food can lead to weight gain. I’m now quite relaxed with what I eat and the portions sizes because I know my body and I’ve so many good habits ingrained that I don’t need to think about my diet on a daily basis. But if I start to gain weight and I begin to feel uncomfortable then I’ll start monitoring my food intake more closely. When I speak about weight it’s not about the number on the scales; for me it’s about feeling good and comfortable with my body shape and size.

I am not someone who will ever just see food as an energy source, nor would I want to. Our food choices affect our physical and mental health, with these affects being more pronounced in some people more than others. Likewise our mood and emotions can also affect what we chose to eat. The type of food we eat even has positive or negative effects on the strains of bacteria which colonise our gut. These bacteria may then affect our overall health and even our brain and cognitive function (gut-brain axis)! The exact mechanism is still unknown but it may be via regulating immunity or hormonal and neural messages.3

I feel my own experience has helped me to be become an intuitive practitioner. I love weight management and I really empathise with clients. I understand that it is not as simple as just being in energy balance or to only eat a square of chocolate and save the rest for another time. What we eat on a daily basis is intrinsically linked to our emotions and our environment. What works for one person may not work for another.

As a nutrition tutor I try to be real with my students and let them know that it is not always about how much knowledge you can share but it’s about your ability to listen and build rapport with clients that will determine if they and their client are successful!

If you would like to read more of my blogs and nutrition updates please like my facebook page Our Food Karma and you can add me on snapchat: sharuuu0000

References:

  1. Dunford, M. & Doyle, J.A. (2015) Nutrition for sport and exercise. (3rd edition) Stamford, CT: Cengage.
  2. Varga, M., Dukay-Szabo, S., Tury, F., van Furth, E.F. (2013) Evidence and gaps in the literature on orthorexia nervosa. Eating and weight Disorders. Jun;18(2):103-11. doi: 10.1007/s40519-013-0026-y.
  3. Holzer, P., Farz, A. Neuropeptides and the Microbiota-gut-brain-axis. Adv Exp Med Biol. 2014; 817:195-219

 

Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a condition that affects around 10-20% of adolescents and adults globally. Up to half of patients seen in gastroenterology clinics have IBS.1 It is also more common in women than in men and in individuals below 50 years.1

People with IBS experience recurrent abdominal pain or discomfort that is often associated with pain relief by bowel movement, onset of pain relating to change in stool frequency and/or onset of pain being related to a change in stool appearance.1 IBS symptoms can come and go and it can lead to bloating, wind, constipation, diarrhoea along with general frustration, embarrassment and impaired quality of life.

Some people with IBS are more prone to diarrhoea (IBS-D), while others are more prone to constipation (IBS-C), and then some people do not quite fit into either of these and are considered mixed (IBS-M).1

People with IBS-D tend to have poor absorption of certain carbohydrates, which are then rapidly fermented by bacteria in the gut. The fermentation process in the colon creates gas and can create a laxative effect as they draw water into the colon, which can in turn cause diarrhoea.2  

The cause of IBS is multifactorial and in recent years there has been a greater focus on the gut-brain connection. People with IBS tend to have heightened visceral sensitivity (they feel a sharper pain in response to a stimulus) which can influence gut motility.2 There are also psychological factors such as stress at play.

Below are some general recommendations for IBS (Table 1). Probiotics (good bacteria) may be helpful and if tried should be taken for four weeks. Different strains of probiotics may have different effects so you may need to try different strains.3

Table 1: General recommendations for IBS3

GENERAL REC

FODMAP Diet

If general lifestyle and dietary advice does not resolve symptoms then a low FODMAP diet is sometimes recommended.3 FODMAP stands for Fermentable Oligosaccharide, Disaccharide, Monosaccharide, And Polyols. These are a group of short chain carbohydrates that are poorly absorbed in the small intestine and can cause gas, pain and diarrhoea in susceptible individuals. The Low FODMAP diet was created by a team of researchers at Monash University in Australia in 2005. The diet is dietitian led and it can improve overall gastrointestinal symptoms by up to 86%.4

The FODMAP diet aims to reduce the total intake of fermentable sugars in your diet for 6 to 8 weeks. Foods can then be gradually re-introduced. It is important at this stage to monitor your tolerance to each of the foods re-introduced in order to assess if there are particular foods which are causing symptoms. A way of re-introducing a food might be to try a glass of milk or 2 slices of wheat bread.2

Below are examples of high FODMAP foods (Table 2) and low FODMAP alternatives (Table 3).

Table 2: High FODMAP foods2,4

HIGH fodmap

Table 3: Low FODMAP foods4

low fodmap

If you have IBS type symptoms then you should definitely go to see your doctor. If you are diagnosed with IBS and the general recommendations do not alleviate your symptoms then it might really be worth trying the low FODMAPs diet. The diet is recommended to be followed under the supervision of a dietitian trained in using this dietary approach. The diet will be tailored based on food records and direct questioning. You will be provided with alternatives and you can problem solve any issues such as eating out. There is also a low FODMAP diet app by Monash University which can be downloaded for a small fee but is really helpful. We still do not know the long-term effects of this diet but so far short-term studies have shown greater improvement in symptoms in those following low FODMAP diet compared to their normal diet.5-7

I hope you found this useful, if you would like to read more nutrition blogs then please like my facebook page Our Food Karma. For more regular updates and interaction please add me on snapchat with username: sharuuu000

References

  1. Longstreth GF, Thompson WG, Chey WD, et al. Functional bowel disorders. Gastroenterol. 2006; 130(5):1480-1491.
  2. Gibson PR, Shepherd SJ. Evidence-based dietary management of functional gastrointestinal symptoms:  The FODMAP approach.  J Gastroenterol Hepatol. 2010;25(2):252-258.
  3. National Institute of Clinical Excellence. Irritable bowel syndrome in adults: diagnosis and management. NICE guidelines [CG61]. Available from https://nice.org.uk/guidance/CG61/chapter/1-Recommendations Accessed 18th July 2016
  4. Nanayakkara WS, Skidmore PML, O’Brien L, et al. Efficacy of the low FODMAP diet for treating irritable bowel syndrome: the evidence to date. Clin Exp Gastroenterol 2016:9 131–142.
  5. Staudacher HM, Lomer MC, Anderson JL, et al. Fermentable carbohydrate restriction reduces luminal bifidobacteria and gastrointestinal symptoms in patients with irritable bowel syndrome. J Nutr. 2012;142(8):1510–1518.
  6. Pedersen N, Andersen NN, Vegh Z, et al. Ehealth: low FODMAP diet vs Lactobacillus rhamnosus GG in irritable bowel syndrome. World J Gastroenterol. 2014;20(43):16215–16226 2010;25(8):1366–1373.
  7. Halmos EP, Power VA, Shepherd SJ, et al. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterol. 2014;146(1):67–75.e65.

 

Should I take supplements?

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This is a question I get asked all the time, and it’s a very tricky one to answer! Below are two proposed arguments for and against supplements and I’ll then give you some information which will help you make up your own mind!

“Vitamin and mineral supplements are a great insurance policy for my health?!”

Some people use supplements as an insurance policy, ‘in case of being low in a nutrient I’ll take a supplement to at least get what I need or maybe gain some extra benefits’. This is a reasonable argument. The recommended daily intakes are based on the estimated needs of most people to prevent deficiency but it does not take into account individual specific requirements. For example I may need more iron and less vitamin A than another woman of my age. It is argued that the requirements for optimal health may be substantially higher than the current recommendations. Intensive agriculture methods have resulted in depleted nutrients in our soil, which translates to reduced nutrients in our food.

“We are able to get enough vitamins and minerals from a good healthy diet..!”

“Eating a healthy balance diet is the best bet to ensure you are getting enough vitamins and minerals in your diet. There is nothing better than obtaining your vitamins and minerals through food. Not only do vitamins and minerals depend on each other for absorption and metabolism but there are also other substances in food called phytonutrients that have health benefits. These all work together (synergistically) in the body”. This is also a valid argument.

Water soluble and fat soluble vitamins

Let’s first look at water soluble and fat soluble vitamins. B vitamins and vitamin C are water soluble. The main thing that you need to know about water soluble vitamins is that they are not stored in your body. This means if you take a water soluble vitamin supplement there is a very low risk of side effects and toxicity if you take more than you need because these vitamins do not accumulate in your body. But it also means that any excess is excreted. So if you take more than required you may be urinating your money away! Vitamins A, D, E and K are fat soluble vitamins. These vitamins can be stored in your body, but because of this, supplementing with these vitamins over a long period of time may cause side effects and toxicity.

Vitamin A is important for skin, vision, immunity, reproduction and acts as an antioxidant. It is well know that you should not take vitamin A supplements during pregnancy as it can cause developmental defects. High dose vitamin A supplements may also cause liver damage over time. If you decide to supplement with vitamin A chose beta-carotene, as this can be converted to vitamin A but it does not cause harmful effects (only that you may turn into an umpa-lumpa!).

Vitamin D is the sunshine vitamin. People living further from the equator need more vitamin D (e.g. Northern Europe countries like Ireland and the UK) than those living closer to the equator (e.g. Singapore). There is also the fine balance between minimising UVB exposure (wearing sunscreen) while also trying to ensure your skin can manufacture enough vitamin D. You can also get vitamin D from animal food sources and mushrooms but these are not enough. Osteoporosis is becoming increasingly prevalent and it is what we do in our 20s-50s that will determine whether we develop weak and porous bones in the future. Vitamin D receptors are found all over your body and vitamin D may also be important for your heart and mental health. If you work or exercise outdoors a lot you should be able to produce enough vitamin D but if you are dark skinned and are indoors most of the time then a vitamin D supplement may be for you. However, be mindful that vitamin D is stored in the body and may become toxic if excess is consumed over time.

Be careful with taking a high dose of any single vitamin or mineral

Vitamins and minerals work best when they are available to your body in appropriate amounts. Vitamins and minerals do not work in isolation; they work together. Vitamins and minerals often depend on one another to work properly, for example vitamin D increases the absorption of calcium. However, too much of one vitamin or mineral can have a negative effect on another vitamin and mineral, for example a high dose supplement of vitamin A can interfere with the activation of vitamin D and thus decrease calcium absorption.1  Excess minerals such as copper, zinc, iron and magnesium can bind with some vitamins (e.g. vitamin B2) and prevent their absorption. Iron deficiency is common but taking a high dose supplement just because you think it might improve your health is not necessarily the right things to do. Excess iron can cause liver damage among other things in the long-term.2 Most pharmacies can test your iron level so it is worth getting it checked. The last time I tried to give blood my haemoglobin level was not high enough. I was within the normal range but too low to give blood. Because of this I take an iron supplement. I take it about 3 times a week to top up my iron levels. I also make sure I avoid coffee and tea with my meals to maximise absorption of iron from plant foods. Unless there is a deficiency or obvious suboptimal levels of a given vitamin or mineral then it is best to avoid single supplements.

Look at your current health status:

  • If you are eating a highly processed diet then you may be low in some nutrients.
  • Alcohol impairs the absorption of B vitamins2 so if you are drinking most weekends and/or during the week you may need to assess the need for supplementation (and your lifestyle choices!).
  • Are you taking medications? Certain medications interfere with the absorption or metabolism of certain vitamins and minerals. For example some blood pressure medications (diuretics) promote excretion of B vitamins and vitamin C. Drugs that reduce cholesterol absorption will also reduce fat soluble vitamin absorption. Medications that reduce acid secretion in the stomach may reduce vitamin B12 absorption because vitamin B12 absorption depends on sufficient acid production in the stomach. There is also an association between women taking an oral contraceptive pill and suboptimal levels of folate, vitamin B12 and vitamin 6.
  • If you are chronically stressed (perhaps you have a very stressful job or home life) you may require more vitamin C, B vitamins and antioxidants than a ‘normal’ individual.
  • If you do a lot of sports you may have higher requirements for particular vitamins and minerals (this is a blog in itself!). However, the recommendations for vitamin and mineral requirements for athletes are the same as the general population.

 

Food first

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Tuna steak with lots of veg and homemade yoghurt dressing (natural live yoghurt, ginger, garlic, dijon mustard, apple cider vinegar, avocado oil, paprika and chili)

Before supplementing I always look at ways of increasing nutrient intake through food.

  • Each week buy a variety of different coloured fruits and veg. As part of your fruit and veg shopping you could buy leek, kale and red peppers one week and the next week spinach, pumpkin and broccoli. This way you are getting an array of vitamins, minerals and phytonutrients. Try to be adventurous and try something new, this also prevents you from becoming bored with the same types of meals.
  • The soil in New Zealand is low in iodine and selenium. I’m conscious of this and I have started to use seaweed flakes more in salads, stir-fries and soups. Seaweed is a great source of iodine. Iodine is essential in the formation of thyroid hormones. Thyroid hormones help to regulate metabolism and promote fat breakdown and growth and development. Selenium is important for thyroid function (inadequate selenium impairs thyroid hormone metabolism) and it is also a great antioxidant! Brazil nuts contain unusually high levels of selenium, so I keep a pack of these at my desk in work and I eat 2-3 of these most days to ensure I am getting enough selenium.
  • The absorption of fat soluble vitamins is enhanced with fat. Adding a tablespoon of olive oil to a salad for example is a simple way of maximising the amount of vitamin A, E and K that is absorbed in your small intestines.
  • Perhaps you are not eating enough omega 3 foods? You may not be regularly eating fish or good fats such as linseeds, chia seeds and walnuts (please see my blog on fat and carb balance for info on the benefits of omega 3). The best approach here is to start to increase your oily fish intake and you can make simple changes like adding flax seed oil into your salad dressing or adding walnuts into a yoghurt. If you decide to take a fish oil supplement please go for a good quality brand to reduce the risk of mercury build up.
  • Overcooking food will dramatically reduce the amount of B vitamins and vitamin C present. Try to steam instead of boil or if you boil your veg use the water for a soup or casserole dish.
  • Think about adding more fresh or dried herbs and spices to your meals. This is another way of increasing your nutrient intake and also making your meals a lot tastier!
  • If you do wish to buy a supplement then go for a good multivitamin and mineral supplement (you usually get what you pay for).

 

 Exciting new research…!

In April I attended the Australasian Integrative Medicine Association conference in Auckland. Professor Julia Rucklidge (University of Canterbury) showed impressive evidence that supported micronutrients as a treatment for psychiatric disorders. She discussed several studies which showed that high dose micronutrient supplementation alleviated symptoms in individuals with attention deficit hyperactivity disorders (ADHDs), depression, and autism. The symptom relief experienced by participants allowed for reductions in medications. What was also interesting to see was that once supplementation stopped the symptoms often re-occurred.3

Interestingly about 20-30% of individuals in the studies did not respond to micronutrient supplementation. The results of her research found that nutritional status at baseline did not generally influence how an individual responded.3 So this may mean that it wasn’t just because a person was deficient in a given micronutrient that they experienced benefits from supplementation.

She went on to discuss how diet affects mood and the more of a Western type of diet that you follow then the more likely you are to develop depression.3 We all are unique and although our genes influence what diseases or conditions we may be more likely to develop, our diet can affect our health and it is not all down to our genes. What we don’t know is what affects our individual response to supplementation. What nutrients I need may be very different from what you need.

Nutrigenomics is the word used to describe how nutrients affect gene expression. It is a new area of nutritional research that aims to figure out which groups of individuals are most likely to benefit from a particular nutritional intervention and which groups may be at risk of harm. So some day we may all have our own unique dietary plan based on how nutrients affect our own individual genes..!

What to do if you really want a tailored supplementation plan…

  • If you really want to figure out if you should be taking a particular supplement then the best way forward is to book an appointment with a nutritionist or dietitian. Your dietitian/nutritionist will likely ask you to do a 3 day food diary (with one day being a weekend) before the consultation. This will give them a good idea of your usual eating habits. Most nutritionist/dietitians will use a dietary analysis software programme that analyses your intake of macronutrients (carbs, fats and protein) and micronutrients (vitamins and minerals). In New Zealand we use a programme called FoodWorks which includes common Kiwi foods! You are given a percentage estimate for each vitamin and mineral, for example vitamin C 78% means you consumed 78% of the recommend amount of vitamin C. I previously used CompEat software but there are many others available!
  • The next stage is assessment of these results. If the result for a particular vitamin or mineral is low then you may be referred to your GP in order to get tested for deficiency. Some nutritionists/dietitians may be able to take a sample and send it to a laboratory for testing. For example in New Zealand a company called Labtests allows health care professionals to send in client samples for testing. Some tests are free through your GP but some tests can be pricey. It is important to note that a 3 day food diary may not give a true reflection of your nutritional status but with further discussion (looking at symptoms, family history, medical history and lifestyle factors) your nutritionist/dietitian should be able to gain a true insight into your current nutritional status.
  • Depending on the assessment results your nutritionist/dietitian may recommend incorporating particular foods into your diet based on your food preferences, with the goal of increasing intake of particular nutrients.

And/Or

  • He/she may recommend a particular supplement (even without testing), especially if you are experiencing symptoms associated with a lack of that vitamin(s) or mineral(s).
  • The next stage is monitoring. There should be a follow-up consultation to see if things have improved or in order to address any issues. It takes time to correct sub-optimal/deficient nutrient levels. The most common challenge I notice is compliance issues. You may have went to see someone with great intentions and at a stage where you were really motivated to make a change to your diet and health, but after a few days normal habits creep in and you stop making those changes that you told your nutritionists would be easy and/or you forget to take those supplements! A reminder comes for your appointment and you either cancel or decide to keep your appointment and be honest about your progress. Honesty is the best choice and from there you can work together with your nutritionist to reassess and problem-solve these challenges. You then leave with new tweaked goals and a plan in place!
  • Finally, more monitoring until you get to a stage where you have made progress and are confident to continue on your own.

I hope you found this useful, please like my facebook page https://www.facebook.com/Ourfoodkarma for more updates and interaction!

 

References

  1. Braun, L., & Cohen, M. (2015). Herbs & Natural Supplements, vol 1 (4th ed.). Australia, Elsevier Churchill Livingstone.
  2. NHMRC (2005) Nutrient reference values for Australia & New Zealand. Including recommended dietary intakes.  National Health and Medical Research Council: Australia, & Ministry of Health:NZ.
  3. Rucklidge, J. Micronutrients as a treatment for psychiatric disorders: Rethinking the scientific paradigm. Presented at Australasian Integrative Medicine Association conference, Auckland, 9th April 2016.

 

 

 

 

Top 5 Behavioural Weight Loss Tips

If I were to ask you “what do you need to do to lose weight?’ I think you would be able to tell me several things that you need to do in order to achieve this. But why is it that most people do not actually carry out the things required to make a long-lasting change? I am going to give you my top 5 behavioural tips that will help you achieve your weight loss goal. They require effort but with persistence they will become habit with much less effort needed.

Only recently I was at the gym and I weighed myself. I was 55kg and I had a moment of reflection and just thought “I’ve come along way”. In University I used to weigh from 60kg up to 63kg at my heaviest. I still had a healthy BMI but I was very unhappy with my figure. I was always dieting and I would lose weight for a while but I could never sustain it and I’d regain the weight I’d lost. No, I didn’t find the perfect diet that we are all striving for but as I started to learn more and more about nutrition my mind set changed. I started to view food in a more positive light and I started to make small changes that over time has got me to the point where I don’t obsess about my weight and when I do gain weight, for example at Christmas or on holidays I know that once I get back into my normal routine I will easily lose this weight again. This is mainly because I’ve made behavioural changes. I know I’m not perfect and I still want to get leaner; your goal may be quiet different to mine but this is what continues to help me achieve mine and it can also work for you.  

  1. Realistic Goal:

 Do you want to drop 5kg in two weeks or would you like to drop 10kg over 3 months? Losing 5kg in 2 weeks means severe diet restriction with the likelihood of regaining all the weight lost.  This situation is something I see time and time again and of course I have done this myself in the past! A client or someone I just meet tells me how they were doing so great and lost weight but after the holiday or wedding they regained the weight and even gained more weight. They share their so close but so far moments and often have feelings of shame or guilt for not keeping up with it. The problem with this strategy is that at the start of the diet you are motivated and even enjoy the food you are eating. But after a little while motivation may dwindle, you become bored with the limited food choice and your battle with hunger wins. You are really setting yourself up for failure and there will be hunger pangs, tiredness and maybe even dizziness. This is something that diet magazines or new wonder diets that promise 5kg weight loss in 14 days do not tell you! The other important thing here is that all those dramatic changes you made just cannot be sustained because they are just not habits yet. We only continue with things in the long-term that become a habit. Whereas a goal of losing 10kg over 3 months is more achievable as you can do it without severe restrictions. There will be changes but these can be made more gradually and once they become habit it will mean you are more likely to keep the weight off in the long-term. 

  1. SMART Changes:

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SMART changes follows on from realistic goals. SMART changes mean you decide on some actions that will help you achieve your main goal. These are like mini goals that are Specific, Measurable, Attainable, Realistic (and relevant) and Timely. I’ll give you an example, I could say “I’m going to eat healthier”. But there is no plan in place here; I need to know how I am going to do it. I must specify what I am going to do, how often and for how long I am going to do it for, and I need to make sure it’s attainable and realistic so it can become a habit. So instead, one of my SMART goals could be “I am going to make sure I cover half my lunch and dinner plate with vegetables Monday to Saturday”. This way you become accountable and can monitor how you are doing on a weekly basis. If you want to lose weight and keep it off then this is the way to go. Once you have the first three SMART changes made and you are comfortable with them you can add on more. This way you are starting to accumulate good habits and over time these pay off. Also if you have an indulgent day once in a while you can try to include at least one of your changes in that day as a way of still feeling confident in knowing that tomorrow you will get back to normal!  It’s a bit like training for a marathon you do not just become a runner overnight, you need to have small goals that over time makes you fitter and capable of running longer distances.

  1. Portion Size:

This may sound so basic but even if you start to include more healthy foods into your diet you will not reduce your body weight if you are eating large portions. We all need slightly different portion sizes based on our own metabolism (taking into account lean body mass, height and weight etc). It sometimes frustrates me that my boyfriend can eat and needs a much larger portion than me, but that’s just the way it is and I need to work with this. Things that help me include using a smaller plate, smaller lunch containers and sometimes when I use a spoon I opt for a teaspoon instead of a tablespoon. This is so simple but it works. It is all about perception..!

The other aspect of portion size is food shopping. Unless you are someone who can eat one chocolate biscuit and leave it at that, then you should only buy snacks/treats in a small portion as and when you really want them. Do not be tempted to bulk buy because you are saving money or you think you’ve got it right this time and will not want any more than one at a time. More often than not you will eat them all in a short space of time and you may even start to think to yourself “I just want them gone so I can start eating healthy again”. This is something I’ve heard and done myself all too often. Why create temptation for yourself?

  1. Use your Higher Brain Center:

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Sometimes I get a craving for a chocolate bar or something along that line; instead of just going along with my craving I try to assess why am I craving this now? Is it because I just seen an advertisement on TV or am I stressed with something? Sometimes we just do things without truly thinking and go on autopilot. This is helpful when driving a car but not when you have created unhelpful habits over the years. Have you ever eaten three too many biscuits and then immediately afterwards have feelings of regret and say to yourself “why did I do that?” Our emotions sometimes overrule our logic. When we try to assess these emotions or instincts we are bringing in our pre-frontal cortex which is important for rational thought, free will and assessing the consequences of our actions. Depending on how strong the craving is I’ll say to myself “Ok I can have this tomorrow if I really want it” or if it’s a really strong craving I’ll say “Ok, if I’m still feeling like this in 10 minutes I’ll have it”. This usually work but sometimes I still want that chocolate bar after the 10 minute period and I have it but over time it has become less and less frequent.

  1. Non Food Rewards:

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Stop using food as a reward. Instead swop your food rewards to ones that are helping to create a better you or at least not contradict your weight loss goal! My favourite is booking a massage or a facial but simple things like allowing yourself time to read a book, watch your favourite series, a new film or a match, hang out with some good friends or just go for a leisurely stroll. This also applies to your children. Telling your child that he or she can have sweets if they are good is creating associations that being good means they deserve to eat sugary sweets. Later, in adulthood when you feel like treating yourself you turn to these sugary treats. This is really setting up unhelpful habits. I know it is easy for me to say and sometimes when you’ve exhausted all other options you may end up using this but just try to limit it to when you really have no other options or at least use a healthier alternative like a piece of fruit as the reward.

My last bit of behavioural advice is to believe in yourself and in the words of Mahatama Gandi

“Your beliefs become your thoughts,
Your thoughts become your words,
Your words become your actions,
Your actions become your habits,
Your habits become your values,
Your values become your destiny.”

I hope you enjoyed the read, please like my facebook page https://www.facebook.com/Ourfoodkarma for more updates and interaction!