In an ASLM Tweet I shared this weekend, I mentioned our own ‘Gut Guru’, Jason Hawrelak reported dietary saturated fat (including coconut oil) increases GIT endotoxin uptake and boy did that stir the pot! The social media switchboard lit up! It’s ok I know there isn’t a switchboard anymore…but I am old school 😉 This got just about everybody talking on Twitter & Facebook…and thinking out there in the real world…which is good, right? And if you read to the end you will find prizes galore for those of you that want to add to this discussion 🙂(more…)
I’ve been travelling a lot for work lately, so in my absence my teens have been under the influence of others and as a result they’ve returned with new & improved habits. This one is gold:
1 egg + 1 banana
beat egg & add to mashed banana
pour into a hot pan, coated with small amount of oil
flip and serve with youghurt and fresh berries(more…)
Ever got to the end of a day or a week and felt like this? Or woken up to find your skin looking like this?! Just quietly, me too. When my son was about 3 he was sitting in the back of my car with my mum (she would have been in her early 70s) and he asked how people get wrinkles. We told him it was from having a fun life with lots of laughter, to which he replied out loud while still staring intently at my mother’s face, ‘Wow Grandma! You must have had the best life ever!’ I digress.
I personally am not a crusader of anti-ageing (seen my pics recently?!!) but my recent research into effectively reducing Advanced Glycation End-products (AGE) via the diet, to in turn potentially lower both my risk of tuckshop arms AND just about every other disease you can name (cardiometabolic, neurodegenerative, psychiatric, malignant, you name it), got me sitting up and paying attention!(more…)
One of the many perks of my job is getting to attend the wonderful conferences I am lucky enough to speak at … and something even more special right now and totally unexpected, is that I have been given the opportunity to share half price (!) ASLM tickets with two of you.(more…)
Scrolling through the extensive list of speakers for the upcoming Australasian Society of Lifestyle Medicine conference, I see many familiar names and faces … impressive researchers, academics, health specialists, writers, business leaders … and I’m just talking about the naturopaths!
Yep, out of the 50 speaker’s list for ASLM 2017, alongside neuroscientists, psychiatrists, geneticists (just to name a few!), naturopaths are representing 10% of the line up … and that is important & impressive!
Lifestyle medicine, defined as “the intersection of medicine, healthcare and health policy with behavioural, social, environmental, socioeconomic, & political factors”, should by virtue be a broad conversation among myriad health professionals & stakeholders, and one that naturopaths contribute to. The speaker list for this year covers over 20 specialties and includes a keynote presentation by Professor Tim Flannery…and in the naturopathic corner: Jason Hawrelak, Nirala Jacobi, Tabitha McIntosh, Danielle Fairbrother and myself.(more…)
When I was studying my undergraduate I sat at the front of the class, especially for the medical sciences. My chemistry lecturer tried to talk me into transferring to chemistry. My biochemistry lecturer tried to convince me to become a biochemist. But what I loved was the union of the two: medical sciences and naturopathy. As a student I hogged all Q and A opportunities and I am confident I annoyed many many people.If this sounds familiar, not because you were a classmate and I still annoy you (!), but because you could also be labelled a ‘lab lover’, a ‘pathology perv’ and an EBM evangelist…then this might just be for you. You can find out by answering these Qs… (more…)
Felice Jacka is onto something. You might know her as the daughter of Judy Jacka (naturopathic trailblazer who established the SSNT), you might know her as the Australian researcher who really started the bigger international scientific conversation about diet and its potential to prevent or increase individuals’ risk for depression and anxiety. But Felice has moved onto something bigger.You could say she’s moved onto ‘the guts of the problem’.
Under the stewardship of Prof. Michael Berk, Felice has been studiously following the research trail of chronic low grade inflammation’s role in mental health and this trail, together with her findings of the potency of food on mood, has brought her and her research focus, not surprisingly, to the microbiome.
‘Microbiome Madness’ not an entirely new concept to you? Me neither. Naturopaths and integrative practitioners have been pointing the finger in this direction for some time and getting good results with treatment that addresses this. I think, however, when someone as prolific as Felice and as internationally collaborative & respected, puts the microbiome-mood nexus centre-stage – we should all sit up and pay attention, because chances are she’s going to discover something that helps fill the current gaps in our understanding and may even redefine our approach.(more…)
I say ‘Cyclic Breast Pain’ and you say, ‘Ouch!’ [because it just slipped out] but then you say, ‘Prolactin’, right? Me too.
Prolactin driven breast pain’s most characteristic form is the premenstrual ‘oh my goodness get these off me!!’ kind, with patients experiencing anything from burning, aching, bruised feelings and acute hypersensitivity to touch, which builds in intensity for days leading up to their bleed. Of course cyclic mastalgia can progress to being full-time mastalgia in women whose breasts start to exhibit structural tissue change in the form of cysts, fibrosis and ultimately fibrocystic breast disease. If you’ve ever experienced even a day of mastalgia it is truly hard to conceive there are so many women (about 50% of premenopausal women!!) living with it daily.
Adding to our concerns about this so-called ‘benign breast disease’ (BBD) is that researchers are now certain it’s a significant risk factor for breast cancer, with women with any form of BBD experiencing at least a doubling of risk of a subsequent breast cancer diagnosis, while those women with proliferative BBD exhibiting a risk of 3.5X that of women without BBD. Castells et al 2015 (more…)
My partner and I have a well rehearsed script whenever he is suffering from man flu, he says, “Am I going to die?” and I say “Yes, just not today.” First world peoples tend to specialise in the denial of several absolutes: like time & death. As Professor David Cameron-Smith, from the University of Auckland says, ‘old’ is something we always define as ‘other’. We are not old but we know people who are!I personally used to define ‘old’ as over 50 until that became rather close and uncomfortable at which point I noticed a completely unconscious increase in the lower limit! Now old is over 75 yrs…and stay tuned for more updates 😉
Scenario: Run into friends of friends who join us in the sunshine for a cuppa & we’re discussing the finer details of chai (western version V the real streets of Delhi stuff), tumeric lattes etc etc. as you do. I comment on how unpleasantly strong I found the cow’s milk in those downtown Delhi chais we had when we were there.
50 something man: Oh I LOVE that – I just LOVE cow’s milk. I drink loads of the stuff. I used to drink 2L a day but now it’s more like 1L a day.
Me: Seriously?
50 something man: Absolutely. Then there’s the cheese as well – I would eat at least 1kg of that a week. But it’s good for my bones, right? I have that thing, you know, before osteoporosis…brittle bones.(more…)
While we all know there can be a lack of specificity when it comes to some deficiency signs…like glossitis…eyeyiyi..naming a nutritional deficiency that doesn’t include this sign would be a tougher question 😉 but what a great reminder of some quirky things you may have forgotten or in fact deficiency features you may not have even known about.
A gem I love and apply frequently, is about zinc the ALP levels…watch out for the that later in the slideshow quiz.
Also note the distinct difference in opinion when it comes to vitamin D adequacy – with Medscape citing blood vitamin D result < 75 nmol/L unequivocally associated with osteoporotic change…in contrast to the …’anything over 50 nmol/L is a bonus’ line we’re being fed here in Aus and NZ! While we may not ever see some of these severe deficiency presentations walking through our doors – you can’t be so sure…given the reported resurfacing of scurvy in good ol’ Sydney just last year!
Is it just me? I love going back to nutrition 101. So tomorrow with your cuppa…test yourself and then let us know how you go 😉
Are you keen to keep developing your naturopathic knowledge in areas of diagnostics and nutrition? Rachel has a range of services that can help accelerate your learning. From the long list of great downloadable recordings in the store, that help fill your ‘knowledge potholes’ in a fun and engaging way that really brings these topics to life, to our Update in Under 30 Subscription: 30 mins of power-packed up-skilling delivered to your inbox every month, as well as our individual and group mentoring programs! There’s content galore and a delivery format to suit every clinician – come check out what’s on offer.
I am frequently asked what scientific journals I subscribe to and often by the same practitioners over and over, because they can’t reconcile my answer: “None”. Yet I constantly have my head in the scientific literature, right? The two are not mutually exclusive, it’s just about knowing which free scientific and medical news-feeds are worth their weight in gold! If you really are digging into the itty-bitty detail of things these won’t answer all your questions on all your topics but they do a great job of 1) keeping you up to date with the big headlines in general medicine, or, with the use of alert systems and filters, just the areas of health you’re particularly interested in and 2) offering you a huge highly credible resource database that is easily searchable.
Point 1, Exhibit A 😉 :
Here’s just a few examples from the last month that popped into my inbox from Medscape that got my pulse racing:
Watch the gap! You know I love a good diagnostic test probably (way!) more than the next person but I am slow to come around when there’s suddenly a ‘new-kid-on-the-block’ that every functional testing company wants to offer you. This is how I felt about serum zonulin testing as marker of intestinal permeability too. In spite of Fasano’s important work, identifying this molecule and its role in the reversible opening of tight junctions in the small intestine – I didn’t embrace the test.Why not? Didn’t I love Fasano’s ability to add this piece to the jigsaw that had been missing til now? Well I did. Does that make it an accurate and reliable marker of intestinal permeability in every client with any kind of digestive issue…? Well heck no! That’s not how science works friends and I suspect we may have really jumped the gun a little on this one.(more…)
Yet another sensational week of group mentoring last week. Holy guacamole…these cases just get more and more tasty! So much to talk about on every case presented, we all learnt buckets from a smorgasbord of conditions including: sudden onset thyroiditis (with a T4 of 45!!), azoospermia secondary to methylation and possible mitochondrial dysfunction and a 60 something female with chronic sleep issues, severe leg cramping with a differential ddx of intermittent claudication.
Just wanted to share this incredible resource related to one of the other cases from last week – a female client with a long history of interstitial cystitis, bladder pain and pudendal neuralgia. One of the striking aspects of the case was the high frequency of acute onset UTI sx which, in site of being ‘culture negative’ on repeat analyses, respond favourably to UTI specific antibiotics. We’ve all come across these ‘ghost infection’ situations…not a trace to be found of the offending organism or even infectious markers on urinalysis but without a doubt an infectious driver – the problem has long been convincing other practitioners of this!..and sometimes ourselves!! (more…)
At the end of last week I spent 3 days engrossed in intensive ANS planning for 2018. As you can probably imagine these planning days are incredibly exciting, creative, stimulating processes. If everyone involved had brain PET scans performed during these discussions, I think the disco lighting effect in our results would be noteworthy (!) and distinctly different from the stimulation that comes from most of our other work pursuits. Does anyone do disco all the time though? Not many of us. This prompted me to reflect back on a little graph I drew for myself this last month – that depicts the various ways all my different forms of work & how they contribute either money or meaning, or better still both!
Diversification of income streams is a key business catch cry, right?
And this is especially pertinent to clinicians.
But work variety may also be important in meeting our multiple values and need for meaningful engagement.(more…)
This year I’ve given up sitting & I couldn’t be happier or more annoying. I’ve become one of those evangelical people that wants to now spread the word as far as possible. I bought a standing desk and it’s radically improved my energy at the end of every work day and, as a result, how I feel about and interact with my work.
I’m sure you’ve heard that ‘sitting is the new smoking’, so ask yourself… who on earth would still be smoking in this day and age right?! Or sitting all day, right?!
So…the good news is that standing desks are no longer the exclusive domain of ‘arty Apple users’ who live in lofts, work in graphics and have $ to burn (or was that just my impression?)…Standing desks are so mainstream & accessible they have made it even into an Officeworks near you!!(more…)
May was the month of teenage girls presenting with severe digestive problems, especially ‘food intolerances’, leading to avoidance of specific foods and at times significantly reduced food intake overall. As integrative health practitioners, validating and creating insight for clients on the nature and source of their food reactions is our bread and butter, right? Is it wheat? Dairy? Gluten? FODMAPs? Salicylates? Oxalates? We are not surprised by how many ‘sick’ patients we see in spite of a theoretically ‘healthy diet’ – healthy for others perhaps but not for the individual in front of you, right? But what if I told you that each of these teenage girls had a BMI < 18 kg/m2, does that change your opinion about your role? Would you assess, monitor and manage these teenage girls differently? You should.
Take the example of one of my clients: 14yo female with a BMI 16.3, who had her first confirmed food reaction under 2yo with failure to thrive, which was attributed by a paediatrician & dietitian at the time to severe salicylate sensitivity. She underwent jejunal biopsy at 3yo for suspected coeliac disease, due to ongoing concerns and a primary relative with CD but it was NAD. In the 11 years since, there have been a couple of other digestive diagnoses based on solid evidence, such as mainstream stool PCR testing. So surely, the fact that she is underweight & that she skips lunch at school due to digestive discomfort is proportionate and explained by her organic digestive issues. Or is it?(more…)
This year has been a steep learning curve but this is exactly as I had hoped and planned for. I strapped myself in for my roller-coaster ride, a series of intensive upskilling initiatives undertaken with mentors and experts in specialist areas, and I haven’t hurled yet or screamed loud enough to make the operator stop the ride (seriously this happened to me in about 1997 on a Pirate Ship in Rosebud!)…but I have come close 😉
One of the really big lessons has come from getting more into the science behind pyrroluria and urinary pyrrole testing again. What motivated me to tackle this spikey beast? Well, like many people who have been introduced to the concept of pyrrole testing and pyrrole driven mental health presentations – I had a lot of questions that hadn’t been adequately answered. Those gaps left me with some uncertainty about the validity of this investigation and about the interpretation of the results. I also have introduced this pyrrole theory to many naturopaths and hence feel a responsibility to polish up my knowledge on this and set the record straight.
Last but not least, in our local area we reputedly have a ‘pyrroluria plague’ at play – every man woman and their dog is getting this diagnosis and it had added not only to my misgivings about testing but also my concern about misdirected & unsafe treatment.(more…)
