Did someone explain the kidneys are like a really important, not to be forgotten, under-estimated, ignored or under-valued kind of organ in your training as a naturopath? No, me neither. I mean I know Buchu and Uva and Zea (on a first name basis only, clearly!) and …no actually, I’m done. But seriously, it didn’t take too long in practice to stumble across a whole lot of bad when kidneys aren’t getting the attention they warrant and equally to develop a slight obsession with renal markers in all of my patients not just because of their incredible impact on whole health but also because of what ‘lay beneath’.
As you might suspect, I get sent labs all the time from practitioners. Stop no! That is not an invitation!
Often it’s client’s renal markers which I do appreciate because it tells me there is an increasing number of praccies that absolutely have done some post-grad DIY knowledge building about these bean-shaped babies and their critical contribution to health. The results might come with a question like, “What’s going on with their kidneys?!” [insert worried face emoji of choosing]
To which my reply is often… “not much but boy do we need to talk about your patient’s GIT microbiome! [or] mental health! [or] sarcopenia!”
Say what? Yes abnormalities within the renal markers: urea, creatinine and uric acid may be a reflection of renal issues. But if you know where each of these molecules enters the blood,exits the body and all the interesting good & bad they can get up to in between…then the patterns speak less (if at all in some instances) to what’s going down in the kidneys but instead give you an incredible insight into key issues all over the body: from the gut to the brain. But wait there’s more! Want to know what’s the latest and greatest in management of advanced renal disease? Treat the gut to lower the urea. What about managing mania? Add in a gout treatment to lower uric acid. Dang! This is holistic health at its best with those poor kidneys no longer being left out in the cold!
“Who knew urea, creatinine, GFR and uric acid could be such a Goldmine….Mind…officially…blown!” New Graduate Mentee 2019
Want an Opportunity for ‘XXX sized’ up-skilling in Renal Markers & Health?
Most practitioners graduated with not much more than a few ‘kidney’ herbs and an under-appreciation of the contribution renal health makes to wellbeing. It’s not just about waste and water. In reality, the kidneys are pivotal in just about every major element: blood, bones, pH balance, methylation, control of oxidative stress, the GIT microbiome and more! And we are seeing the impact of this in our patients in all sorts of subtle and not so subtle presentations. This new instalment in diagnostics, brings the renal system into the spotlight so we can confidently identify and better manage its critical contribution. In addition to this, just like with other routine labs such as LFTs, we unpack how these so-called ‘renal markers’ can flag a plethora of other insights into your patients, from reflecting (un)healthy muscle mass to calculating individual dietary protein adequacy, from key ‘danger and distress’ signals in response to disturbed metabolism, oxidative stress to certain types of GIT dysbiosis! We call this Renal Markers: Explained, Expanded and Exploded because these routine labs can deliver XXX sized insights into your patients.
Do you know that saying, ‘mind your Ps and Qs?’ It basically means mind your manners and I heard that a lot as a kid 😉 But what we really need to hear now, as practitioners and promoters of healthy eating and wellness is really, Mind your P’s and P’s because a lot of biggest health consequences of any diet are determined by the balance or imbalance of two major players; protein and potassium. We’re always looking for simpler ways to enable patients and ourselves to be able to both recognise the strengths and weaknesses of their diets and, better still, apply a simple method to making better choices moving forward. Eyeballing the protein and potassium rich sources in any diet speaks volumes about other essential dietary characteristics and the likely impact of diet on health – and getting the relationship between these two right should be a goal for us all.
“World Health Organization (WHO) Dietary Targets for Sodium and Potassium are Unrealistic”, reads the recent headline from yet another study finding that humans would rather challenge the solid science of human potassium requirements than acknowledge the urgent need to turn this ship of fools around!
This large study, conducted over 18 countries, involving over 100 thousand individuals, reported that 0.002% met these targets. That’s 1 person in 50,000. Now, the researchers’ response to this is that we should lower our dietary potassium expectations….such that the targets are more achievable and so that (frankly) we are less perpetually disappointed in ourselves and our terrible food choices. Wha???? Back up there. The WHO guidelines, just like any other nutrition authority, derived these minimum amounts from a thorough review of the science that speaks to our physiological requirements and the level of nutrients that have been shown to be associated with health. Australia’s own fairly conservative NHMRC suggests even higher amounts for good health! Perhaps rather than revise the established dietary targets we should revise what we’re putting in our mouth!
So where does protein come into this? Well one of the most important and central nutrient dynamics is the balance or imbalance of our intake of both. And in this regard, yet again, we have a surprising lot in common with plants! Whether you’re trying to understand optimal nutrition conditions for growth (nitrogen alone won’t get a plant there, nor protein alone in a human) or the intricacies and nuances of finely tuning our physiological processes such as cardiovascular function, renal health, blood glucose management etc. the answer lies in a happy marriage between these two.
In this area of nutrition, we should be listening most closely in fact to renal specialists/researchers. These ‘undercover’ protein and potassium experts have been talking about this for a long time and in particular, in my humble opinion, Lynda Frassetto has lead that charge for decades. If you haven’t read much on this issue and want somewhere to start at least, jump into her pivotal paper from 2001 which eloquently explains why the human design can not shoulder a potassium shortfall…well not without causing real health problems…like the ones we’re seeing in record numbers currently and why the protein potassium balance of any diet is a major health determinant. That’s why giving ourselves and our patients the knowledge and the tools (yes lovely shiny meaningful infographics included!!), to quickly determine their protein potassium balance, are so necessary and important.
Thanks to Frassetto and many other researchers’ work, looking at food through this protein potassium lens has sharpened my focus and I think it’s about time we all took a good look 🙂
Check out the latest UU30 to hear the latest information…
The health consequences of any diet are largely determined by the balance or imbalance of two major players & proxy markers; protein and potassium. When it comes to this area of nutrition, we should be listening more closely to renal specialists whose research shows why the human design cannot support a potassium shortfall and the health consequences of this. Whether you’re trying to understand optimal nutrition conditions for growth (nitrogen alone won’t get a plant there, nor protein alone in a human) or the intricacies and nuances of finely tuning our physiological processes such as cardiovascular function, renal health, blood glucose management etc. the answer lies in a truly happy marriage between our intake of these two. These recording comes with a clinical resource tool to help you quickly identify the dietary protein:potassium balance for your clients.
As an avid reader of medical news I face a barrage of headlines both domestic & international everyday. I feel this is important for many reasons – not just so that I know what’s being said about their medicine but what they’re saying about ours as well! Anyone see the jaw-dropping headline last week: Could Probiotics be bad for your gut? Yep.
Now how many of you didn’t make it past the headline? It’s hard isn’t it.
There’s almost a reflexive shutdown for many of us to dismiss such a proposition as simply ‘ridiculous’, surely on par with our response to an article from a climate skeptic…as we shake our heads with ‘you gotta be joking right?’… but unless we read on, we’ll never know. (more…)
When I look back over how I’ve raised my kids there are a few serious ‘what tha…’ moments – like the time I thought shopping with a child in rollerskates was doable…I mean she loved those rollerskates and she was amazingly agile and good…just not quite good enough to hold onto that 1L Biodynamic Yoghurt sufficiently…who knew?! Dietary wise, I can look back and be critical in hindsight about different details, the contents of our fridge and pantry have morphed over the years with my changing knowledge (money & time!) but there are a few things I can confidently say – ‘Nailed it’, accompanied by a fist pump! We’re all meat eaters, not carnivores by any stretch of the imagination but we do partake, however the kids and I were just reflecting the other day on the absolute constancy of legumes in our life. (I know you want CCTV footage of our dinner time chats now don’t you 😉 ) There would rarely be a day in our house without them…several times!
Now I sound like I’m showing off but trust me it’s not that impressive or exotic – it goes a little something like this: soup,(split red lentils or cannellini), bolognaise & lasagne (1:4 brown lentils with the meat), nachos for school lunches (kidney beans 4:1 with mince), falafel & hummus (chick peas) & tofu (my kids love this stuff for snacks often & for mains at least once a week).
Ok now everyone relax, I don’t make our own almond milk, grow our own vegetables or ferment stuff…see…it’s swings & roundabouts 😉 (more…)
Help!!! I’m about to share the stage at the 3rd International Acid-Base Symposium on the 25th-27th Jun, with the best acid-base researchers in the world, all of whom I actively stalk (well read and recite everything they’ve ever published but close enough!) I’m terrified and excited in equal doses…but urgently need to change my presentation approach because until now I’ve had the privileged position of simply fulfilling the town-crier role, announcing far and wide the findings of their incredible research into acid base physiology and their findings about impact of chronic mild metabolic acidosis. But I can’t quote Arnett to Arnett! I can’t tell Dawson-Hughes about the incredible insights of Dawson-Hughes’ large body of work in this area! Oh my Goodness (cue, shaking knees), I’m going to meet Thomas Remer…of Potential Renal Acid Load Formula Fame!!
Yes, my partner is a musician and through him I have brushed shoulders with all kinds of famous…but nothing that has made my heart beat quite this fast!
Must buy an autograph book for them to all sign.
Joking (kind of). (more…)
No, I haven’t gone crazy for the ‘caped crusader’… but I thought that would get your attention…. oh look it did! 😉
I’m off to Melbourne for the ACNEM Conference May 5-6th and Batmania was one of the interim names of this very cool and happenin’ town before it became known as Melbourne in 1837! Things have certainly changed in nutrition and the environment since then and as practitioners we now need to address sometimes very complex dynamics between genes, gut, nutrition and environmental health. Which, luckily enough this conference is all about!
This year’s theme for ACNEM is Health for Life – Mastering the Integrated Approach.
I am fortunate to be included in the exceptional speaker line-up (thanks for lovely sentiments many of you have expressed so far about that 🙂 ) I am presenting on ageing..which many of you know that I am suddenly now very interested in…getting old and all.
Can you help me out here? My memory has failed me. Someone, somewhere (Mel? Syd? Auckland? Online during a mentoring session? In a Mullumbimby supermarket?!), in the past month asked me for this paper documenting the increased pain perception reported by subjects given IV saline with a slightly acidic pH compared to a neutral preparation. Quite an extraordinary illustration of the potency of small pH changes in the ECF and the impact this can have on our pain perception. This study is one Professor Vormann has previously talked about and as I’m touring with the fabulous German Professor right now I said, ‘Sure!’…then seemingly instantly erased from my mind who made this request! Is it you?
This month is a fabulous blur of travelling & speaking, getting back face to face with everyone at a bunch of seminars & conferences, which I love but I do forget some days where I am, who I am and exactly what I have promised and to whom! (more…)
…Chronic Kidney Disease (CKD) that is! That’s the ad we really need broadcast on prime time tv. On par with osteoporosis and other conditions that ‘seemingly appear out of nowhere’ in people’s 60s and beyond, there’s a potent combination of ignorance (patients) and denial (health professionals) at play it seems, when it comes to discussing the earliest signs of CKD that typically start decades before you’ll ever get a ‘diagnosis’. Being specialists in preventative health care – this is something we need to have firmly on our radar in terms of early identification and also in our repertoire when it comes to risk reduction. Most of us know about water intake and all the medical risks for renal impairment but are we equally onto the critical role that mild acidosis plays in driving this condition?
It’s not just me. Promise.
Check this out. (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…)
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 😉
Similarly none of us are ageing, right? (more…)
Setting: Local cafe
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.
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…)
Recently, while I was touring around the country talking all things Acid Base (!), I spent a bit of time talking to practitioners about the limitations of our current protocols and assessment tools for detecting ‘Bad Bones’. I was surrounded by a sea of nodding heads and when I offered a solution in the form of additional bone health markers, I could see light bulbs going on all over the room 🙂
We all appreciate that osteoporosis develops over a lifetime not overnight, yet the current screening recommendation in most countries suggests that women at the ripe old age of > 65yrs and men >70yrs undergo their FIRST (!) BMD scan! The only exception to this rule is that they recommend an earlier scan in those individuals at high risk…ahem….does anyone here not have their hand up?? (more…)
You might have heard me talk about using an ‘upstream’ rather than ‘downstream’ approach in nutrition – the concept is very naturopathic… look at the water source and address things there rather than just tweak things downriver! One of the most important upstream influences on patient health & wellbeing I can think of is systemic pH – the body’s constant struggle to neutralise its overwhelmingly acidic input, which comes from both metabolism, inflammation, stress and of course unbalanced diets.
It’s a war out there and most of our patients aren’t winning! (more…)