Naturopaths Need to Reclaim Wellness

When I was studying my under-graduate I imagined my clinic was going to be full of them: well patients wanting to maintain or even improve upon their wellness. Turns out…not so much…all the really really sick people have taken their spots and the former has been listed as an endangered species.  But I do catch glimpses of them, as I am sure we all do, in their natural habitat, with over-flowing baskets at the organic grocery store or farmer’s market, routinely up the front of the pilates class and also sometimes in our clinics. So now that naturopathy, by consumer demand, not practitioner intent, has transitioned so much into the ‘unwellness space’, do we know anymore what to do with the well ones??

I heard some great talks at the NHAA conference recently. One, in particular, was by my stellar colleague, Liza Oates, who observed that contemporary naturopaths tend to respond to these clients in 1 of 2 ways:

a) Unaccustomed to a patient who eats, exercises, sleeps and balances their work & non-work worlds better than themselves…PANIC… 

b) Dig deep back through the dusty archives of their personal & family medical history until they FIND A PROBLEM THEY CAN TREAT!!! such as, ‘Once I was constipated for a couple of days’ or, ‘Once I took a course of antibiotics’.

I know…we’re hilarious…we have to laugh at ourselves 😉  Liza offered up some great ideas about how to approach our consults with these patients. Many of her tips, however, could be applied to the rest of our patients as well to gather some really valuable insights. And it’s always great to hear from someone who has been seeing patients over decades…there’s so much to be gained from those who’ve gone before us (or alongside us…in my case!) and can speak to these firsthand lessons.  Here are just a few of her pearls

The ‘not stressed’ patient

We encounter a lot of people who can misreport their stress levels, not because they are trying to lead us astray but that’s that slippery slope of self-reporting & the possibility that someone has normalised their ‘load’.  Liza says she likes to step away from that potential trigger word, ‘stress’ and instead ask, ” What are your tell-tale signs when the demands exceed your capacity?”

This is not so that we can fulfil option b) mentioned at the beginning…digging desperately to find some unwellness to treat – but rather as an aid for both practitioner and patient alike to understand better that individual’s response to their psychosocial environment.

Ask them to design their own health retreat

If they reply, “I would start every day with a little meditation and yoga, a chai and then a healthy hot meal”, then these can be translated into little goals we can set to bring some of their ‘best self ‘ into their every day. It also helps to better understand their values, individualised self-soothing and self-care & great prescriptions to begin with, given they’re telling you they are already at contemplation in terms of their readiness for behavioural change. They’re not going to require too much convincing – they’re already converts they just need permission and support to implement.

And if you’re sitting there reading this and thinking, ‘Hey! These are exactly the patients I want my clinic full of”…then to hear more of Liza & Greg Connolly’s commentary and insights about how the wellness space has been hijacked by others and how naturopathy needs to move centre-stage in this increasingly popular trend, take a listen to this interview they recorded at the conference.

Want to Improve Your Patients’ Compliance?

This UU30 recording from our back catalogue on the behavioural change model and how it impacts patients’ response to our advice is a key element in developing a professional approach that actually works. Unless practitioners are aware of the way that patients approach changing their dietary behaviour or exercise regimes, they the mystery of non-compliance will never be solved!

 

 

 

 

 

 

 

 

Have you heard? It All Comes Back to the Gut

How often were we told this in our training?  And how often have we found this to be true in practice?  And now suddenly, it seems, the medical researchers (at last!) are rapidly coming around to this core concept?? Our microbiome is suddenly the hottest property on the body block, and it seems every interested party is shouting, ‘Buy!Buy!Buy!’ As integrative health practitioners, of course, we had a major head-start, not just by appreciating the gut’s central positioning in the whole health story (iridology beliefs, maps & teasers aside!!) but also a heads-up about the damage the western diet, our medication exposures and lifestyle tend to wreak upon it. A favourite quote of Jason Hawrelak’s by Justin Sonnenburg, “The western diet starves your microbial self”, underscores the significance of just one element of this impact. And…are we all clear that the increasing number of patients reporting adverse food reactions, once again, overwhelmingly are a response to aberrant processes in the GIT?

Sounds silly it’s so obvious right, but it’s easy to get distracted & misattribute blame…for example, it’s the food that’s the problem. Well yes in a minority of situations interactions between someone’s genes, immune system and a particular food turns something otherwise healthy into something pathological, but for the majority, the food itself & in others is healthy, & could  be beneficial to this individual, if only we could resolve their GIT issues…like FODMAPs for example.

Not the problem, just the messenger.

So if the ‘problem food’ is just the messenger, what’s the actual message we need to understand?  Is it that this patient has medication, disease or otherwise induced hypochlorhydria, impairing ‘chopping up’ of potential antigens implicated in immune mediated food reactions? Or is that this person’s got fat maldigestion &/or malabsorption so that in addition to not tolerating fats, they may experience dietary oxalate intolerance to boot? Or are the food reactions the result of altered microflora changing what we can and can’t digest (via their critical contribution) & absorb?

So what message does the presence of IgG antibodies to consumed foods send us about the state of someone’s gut? It’s telling us 2 things: this individual exhibits abnormal intestinal permeability  & currently in the context of this leaky gut, these foods may constitute a barrier to resolving this & other symptoms as well.

We’ve recently released the mp4 (that’s audio plus the movie version of the slideshow so grab your popcorn…that’s if you don’t have a corn issue!)  of A Guide to Investigating Adverse Food Reactions – What’s IgG got to do with it? which details the science behind IgG, including debunking, the incorrect debunking of IgG food antibody testing!! But more than this, it overviews the whole maze of adverse food reactions, articulates a logical investigative path for practitioners through this maze, and helps us to really understand that finding the food(s) responsible for a patient’s symptoms is not the final destination..and can be in fact a distraction, if we don’t cut to the chase and find out the why…and funnily enough…my dear old iridology teachers and colleagues...it almost always comes back to the gut 😉

Confronted with the possibility of adverse food reactions in an increasing number of our patients can be an overwhelming prospect, in terms of accurately identifying and understanding the faulty mechanism underpinning these aberrant responses to healthy foods.  Elimination of culprits in most situations is only a short term reliever, not an appropriate long term solution, so to optimise results we need to know the real mechanism of action.  The majority of these, of course, stem from the gut, but being able to elucidate exactly which of the many things that can go wrong there, is going wrong and therefore what foods are problematic until we address this, is the key. This 2hr mp4 is all about the bigger picture and helping you find method in the madness that can be the AFR landscape. Along the way, we detail the science of where IgG reactions fit into this and it’s a fascinating story that just might be the missing puzzle in your leaky gut patients.
and watch this presentation now in your online account.

Look What’s Just Dropped!

a. Some hip new (truly undanceable) track

b. Every herbalist’s jaw at my table at the NHAA conference gala dinner, when I got almost all my Latin binomials right during the trivia quiz?…and after some champagne, that’s a particular achievement 

c. My jaw, when I saw firsthand how much those herbalists could drink of ye-not-so-olde herbal extracts!!

d. The latest Update and Under 30 – Milk Madness Part 2

e. All of the above

If you answered, ‘e’…. you must have been one of those herbalists at my table, otherwise you have way too much insider information!  But yes you are correct on all accounts. So this latest UU30 is an extension of our discussion last month about the potential contribution from to mental health from dairy intake in a subset of patients.  This whole topic, the research for which dates all the way back to the 70s, was too big to fit into one – given the current evidence base that now depicts at least 2 different mechanisms that might be at play, and the different types of mental health problems, each has been linked with.  Last month was all about retracing the ‘dietary exorphin’ path, this month it’s about the propensity for some individuals to make antibodies to casein and the significant growing data that suggest this happens to a larger extent in patients with certain psychiatric diagnoses. More importantly, we talk about the ‘why’.

What compelled me to make time to look through all the literature on this was that there is some. No seriously.  When I initially learned of the GFCF dietary approach to ASD patients I was told that in spite of a lack of supportive research, the empirical clinical evidence was irrefutable, which I later saw with my own eyes.  In the couple of decades since, I only really heard about negative findings, short trials of the elimination diet specifically in ASD kids, that failed to produce significant change.  Funny how the bad stories rise to the top, right?  But when I spent the time doing a thorough literature review, I found these negative findings were far from the whole story.  In fact, I was really surprised by the high level of evidence employed by researchers of late, who have repeatedly found associations between either exorphin or antibody levels and patients with particular diagnoses, in addition to really progressing our understanding of why these measurable differences (urinary exorphins, plasma IgG and to a lesser extent IgA casein antibodies) are meaningful. Do we know everything? What do you think? The answer, of course, is always no.  But we know enough to consider this aspect in our comprehensive workup of mental health patients and all their biological drivers and we know dramatically more than anyone in mainstream medicine, or the dairy industry for that matter, is ever going to let on!

If you want to hear a synthesis of the casein antibody link with mental health then download the latest UU30 – Milk Madness – part 2.   If you can’t go that far, then “do yourself a favour” and read a couple of seriously important articles on this topic – and why not start at the deep end with this study by Severance in 2015.

Update in Under 30: Milk Madness – Is It A Thing? Part 2 

Could dairy intake in susceptible individuals be a risk promoter for mental health problems?  In addition to evidence of the exorphin derivatives from certain caseins interacting with our endogenous opiate system discussed in part 1, we now look at the evidence in support of other milk madness mechanisms.  Specifically, the IgG and,  to a much lesser extent, IgA antibodies about what this tells us about the patient sitting in front of us about their gut generally and about their mental health risks, specifically.  The literature in this area dates back to the 1970s but the findings of more recent and more rigorous research are compelling.

 

 

Q: If a patient says they can only tolerate 7 foods…

Q: If a patient says they can only tolerate 7 foods…how many did they start with?

A: Typically about 20

No, this answer doesn’t come from some complex mathematical formula…it comes from appreciating the low dietary diversity of those eating a Western diet.  When we boil down these diets to the number of foods from different biological origins (families) it can be a frighteningly small number.

You see, like most practitioners, I feel utter dread when I encounter the patient who prefaces their diet story with a statement similar to the one above. It speaks to the severity of their symptoms, their attribution of these with food, that by the way is essential for their sustenance and nutritional salvation, and implies an exhaustive pursuit they’ve undertaken probably over years to find ‘safe foods’.  And yes, as discussed in my recent talk A Guide to Investigating Adverse Food Reactions – What’s IgG got to do with it? – food reactions, as in more than one mechanism of food reaction, often do move in packs and that comes typically back to a poorly functioning gut…BUT…that latter assumption…’they’ve explored and exhausted all foods’ is the one we need to keep in check.

Have they tried daikon? Prickly pear or jambu? Okra?  Snake beans? Quail or duck eggs? Kangaroo? Crickets?  Etc Etc. Etc.

Are you catching my drift?  Because someone has DIY diagnosed a wheat, dairy, soy and, and, and, reaction (correctly or incorrectly) and perceive themselves to react also to most of the limited fruit and veg they can identify in Woolies…doesn’t mean they’ve remotely exhausted the global food supply! Where am I going with this?  When patients tell us they’re down to 7 foods they can tolerate – some sensible follow up actions on our behalf may include:

  1. Check the strength and validity of their level & strength of evidence for their DIY diagnosis
  2. Think about the linking ‘process’ (more than likely gut) that is the real potential issue (aka don’t eliminate the messenger and do nothing more!)
  3. Encourage and advise them to shop anywhere other than where they normally do – somewhere that sells fresh produce they don’t recognise at all…like Asian, Indian or Middle Eastern supermarkets and grocers

My tour of A Guide to Investigating Adverse Food Reactions – What’s IgG got to do with it? (and the weeks of lit review leading up to this) provided me with enormous food for thought…and this is just one! If you want to hear more about how to find method in the madness of food reactions…you should probably listen in to the whole shebang…goodness knows with the increasing number of patients who present with self-determined food reactions and an increasingly narrow menu of safe foods…practitioners and patients alike need all the help we can get!

Confronted with the possibility of adverse food reactions in an increasing number of our patients can be an overwhelming prospect, in terms of accurately identifying and understanding the faulty mechanism underpinning these aberrant responses to healthy foods.  Elimination of culprits in most situations is only a short term reliever, not an appropriate long term solution, so to optimise results we need to know the real mechanism of action.  The majority of these, of course stem from the gut, but being able to elucidate exactly which of the many things that can go wrong there, is going wrong and therefore what foods are problematic until we address this, is the key. This 2hr mp4 is all about the bigger picture and helping you find method in the madness that can be the AFR landscape. Along the way we detail the science of where IgG reactions fit into this and it’s a fascinating story that just might be the missing puzzle in your leaky gut patients.
Click here to purchase A Guide to Investigating Adverse Food Reactions – What’s IgG got to do with it?

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A Dash of Milk Madness?

So this is not news to most people who know me but I don’t like taking things out of people’s diet. As a result, in a room full of naturopaths & integrative medicos, I might be voted the least likely to use the phrase, “No Gluten or Dairy for you!” [said with the Soup Nazi’s accent from Seinfeld]. I must have slept through that class when we were taught to do this for absolutely every patient.  But seriously, I try not to remove or exclude foods without a very strong rationale and evidence-base that relates directly to the person sitting in front of me, for several reasons: 1) those seeds are powerful ones to plant in your patient’s mind…how do they carry that with them as they move through life, navigating food and social settings etc etc…all well and good if this is a proven life-long pathological provocation for them but otherwise… 2) dietary exclusion is stressful for families & in kids especially, can create disordered eating and a range of other psychological impacts and 3) GFDF diets are not necessarily healthier in the basic nutrition stakes…if you haven’t read Sue Shephard’s work on the deterioration of diet quality in GF patients…you should. It can be much healthier of course…but often the real-world application of the principle doesn’t always match the lovely ‘serving suggestion image’ on all the GFDF highly processed, packaged foods!!

So listen up people, because now I’m talking about when I would seriously consider joining in on the GFDF chant.  

The one patient group I’ve never quibbled over the benefits of GFDF, has been the autistic one.  I was taught the merits of this approach early on by a few fabulous courageous integrative doctors and paediatricians who came back from the front-line of their clinics, reporting good effects.  I then had the important firsthand experience of unprecedented verabilisation in a non-verbal ASD child’ after excluding these foods. But what I’ve been thinking a lot (and reading a lot!) about lately is the possibility that these ‘dietary exorphins’ may have negative mood effects in other subsets of mental health patients. My thought process is like slow TV! That aside, there’s a lot to be said for taking the time to really getting across an issue – even if that involves reading papers from as far back as the 1960s when the idea of a negative role for dietary exorphins in schizophrenics was first floated by Dohan & colleagues.

Let me say, when you go back to the beginning it’s undeniably a shaky start for the exorphin evidence base, but as you read the studies that emerge from decade to decade until the noughties…it reveals a nagging research topic that won’t go away and a fascinating process of discovery.

So is the devil really in the (regular commercial cow’s) milk? Well I think  for some patients it may well be a contributor – most notably those with features consistent with the pattern of excess opiate effects including a higher dopamine picture, regardless of the mental health label they’ve been given, although, more commonly seen in ASD, psychotic presentations etc.  But how do we work out which ones, because none of the evidence points to it affecting 100% of these groups…well that’s where we need to go back and truly understand the structure of these dietary exorphins and just how they potentially wreak havoc in some.

The latest UU30 takes your through the story of BCM-7 with a summary of research compile over half a century in Under 30 minutes!

There is a well-rehearsed chant in the integrative management for ASD individuals, “Gluten free- casein free diets” is based on the dietary exorphin theory which suggests these foods generate bioactive peptides that act unfavourably in the brain.  Where did this theory emerge from and how strong or weak is the evidence upon which this therapeutic intervention stands? Even more interesting, is there support of this theory in a wider range of mental health presentations such as schizophrenia, post-partum psychosis and depression. Is there such a thing as milk madness for a subset of our patients?
Hear all about it by listening to my latest Update in Under 30: Milk Madness – Is it a thing?
For all Update in Under 30 Subscribers, it’s now available in your online account and if you are not a subscriber you can purchase this individually here.

 

Blowing Over On A UBT

A few months back I seriously ‘blew over’. Not on an RBT but on a UBT (Urea Breath Test).  In spite of it being not the kind of test you want to score top marks for, my result was in the high 2000s, when all I needed was around 800 to confirm, and anything over 50 to be suspicious, that Helicobacter pylori had taken up residence in my stomach lining. I tell you, I knew it when I blew it! 😉  After ingesting the radioactive urea and waiting to blow up my sampling balloon, I felt like I could still fill a room full of balloons with all the gas being produced in my stomach and those balloons, I imagined, would all rise to the ceiling as if full of helium! Yep…I burped all the way home, which was representative of what I’d been experiencing daily for a month beforehand and what lead me to get the test done.

But initially, it wasn’t so clear. 

The very first symptom I experienced was a sudden onset of severe tightness around my throat that lasted for minutes but started to happen multiple times in a day.  Yep..no one panic.  Together with a strange sensation of ‘extreme emptiness’ in my stomach on waking or delayed meals, and then mild nausea both with an empty and full stomach…only some days or weeks later the fabulously-unprecedented-&-socially-adorable-burping started, proper.

So a month or so later, I’ve solved my own mystery.  Happy? Not in the least…where the heck have I picked up H.pylori from? Yes…that’s what I said because it had to come from somewhere people…right?   I think there is much we have misunderstood about this bacteria with an incredibly long and interesting human history.  Animals don’t and can’t carry this bacteria.  The evidence suggests that it can’t survive for very long in the environment either (approx 4 days) but that is long enough to get into our food and water and maybe even onto shared chopsticks…just saying (listen in to hear the lowdown on all these and more!) Essentially hoomans are the traffickers, people!  In fact one of the things that surprises people the most is the very high prevalence in young children and the clusters of positive tests & identical strains within families…but once you learn a little more about this bacteria…it won’t surprise you at all. (more…)

One Small Step For Our Clients?

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…)

One Size Doesn’t Fit All – Not Even for Besties

I have a good friend…who happens to be a naturopath…who happens to also be a patient of mine.  Have you got a few of these as well? A month ago,  looking over her recent bloods which included fasting lipids that had been steadily climbing for the last couple of years, post-menopause, she said, ‘do you think I should take something for that?’ Ahhhhhh no. My reasoning went like this:

“You love saturated fat right? You eat butter and cheese and and and…and the type of elevated lipid pattern you have LOOKS like it is at least partially the result of this, your triglycerides are low, your HDLs are good it’s just this LDL component that is too high.  You could add in another supplement…and take it…forever…or you could do a little n=1 experiment and just lower your butter, cheese & coconut oil intake for a month and repeat the test.”

The horror on her face! You see I didn’t know exactly how much she loved butter but it all became clear with the first text a few hours after I had thrown down the gauntlet…which included a sobbing emoji and the comment that her afternoon snack will never be the same…turns out it was a shortbread biscuit with butter on it!!! But as a practitioner who does pride herself on walking the talk…off she went determined to give it a good go for a month.  But boy did it hurt! (more…)

Batmania here I come…

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.

(more…)

It’s Landed At Last! Aka ‘Kids’ Guts Can Be Mental’ [ft. Threadworm] Recording

Standing at the podium, I looked down at my notes & slowly read out the title of my presentation to the hundreds of people attending, ‘Paediatric Digestive Issues & Neurocognitive Abnormalities’ and briefly froze thinking, Holy Heck (!) this is someone else’s presentation!  Seriously. No, this is not one of my work stress dreams.  This happened. I thought…oh my how am I going to deliver this, it sounds very complex and lofty and scary!!

Then I saw my scribbled hand notes on the page, the unofficial name I had affectionately given this presentation as I researched, compiled my case studies and brought it into being, months prior and I instantly relaxed…oh…Kids’ Guts Are Mental…now that I have some serious experience with and something to say about! (more…)

It Won’t Happen Overnight but it Will Happen

hair

…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…)

Hypothyroid Without a Trace?

 

Another young female presents in my clinic with a newly diagnosed thyroid cancer and has been recommended urgent thyroidectomy.  Her story is increasingly common. If you’re not seeing it in your clinic, you will, because thyroid cancer, and almost exclusively papillary thyroid carcinoma (the form my patient and most young patients have), is dramatically increasing.  Since the 1970s there has been a 67% increase in the incidence in women and a 48% increase in men documented in 5 continents (Peterson et al 2012).  Australia, though less up to date with its data collection, found a similar increase between 1982-1997 (Burgess 2002). The question begging to be answered is why.

Increased screening and more effective detection of smaller tumours was the going theory for years.  New research rejects this absolutely and concludes instead this is a ‘true increase in occurrence’.  Increased radiation exposure?  Mutation studies say no.  Many researchers are pointing to is a ‘new environmental chemical and/or dietary factor’ and EDCs (Endocrine Disrupting Chemicals) that target the thyroid such as perchlorates, phthalates, parabens and phenols are the likely suspects. And, more than likely, with iodine deficiency to explain the increased susceptibility to these EDCs.

But wait there’s more. These ‘new goitrogens’ aren’t only implicated in thyroid cancer, a large number of human studies confirm the higher your urinary metabolites of these, the lower your thyroid function. More worryingly is that they might be doing this ‘without a trace’. With myriad impacts at the receptor level, altered hormone excretion rates, impaired peripheral conversion etc. the data to date suggest these patients TFT results might only look ‘slightly low’ or even ‘normal’ but the reality is they are suffering hypothyroidism. Sound familiar?

There is a HUGE body of scientific evidence we can pull from to understand the role of EDCs in thyroid problems in our patients, how to maximise prevention and minimise impact – even when your patient, like mine, is perhaps already in the full grip of the consequences.  I’ve read all the papers and summarised them in this 30min recording:  Hypothyroid without a trace – the role of EDCs.

Have you got patients with hypothyroid symptoms but normal results?  Or results that suggest the HPT axis just seems to be broken? Could it be the result of a combination of Endocrine Disrupting Chemicals (EDCs)? How do you assess  for these ‘new goitrogens’, which act more potently and more insidiously, inducing hypothyroidism ‘without a trace’. How do you maximise prevention for all of your clients and the most at risk sub-populations or minimise impact for those already in the full grip of their consequences.
 
This latest Update in Under 30 audio comes with 3 key related scientific articles and a bonus larger powerpoint presentation that Rachel presented at the ASLM 2017 conference.

We Have A Winner… Among Many!

dang sarah

Last week I threw down a challenge.  Following on from the ruffling of many feathers regarding Jason Hawrelak’s report that dietary saturated fat increases uptake of endotoxins from the gut,  I provided his reference list in support of this claim, effectively saying, “if you don’t like his findings, then make your own informed conclusions but make sure you read all the evidence first”.  I offered a prize to everyone who made an attempt and a year’s free subscription to Update in Under 30, to the person who produced arguably the best summary.

I’ve said it before and I will say it again, and again, and again: Our professional community abounds with extraordinary individuals. 

People’s response to this challenge proved that once again. (more…)

Does Saturated Fat Increase the Uptake of Endotoxins?

Jason ASLM

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…)

1 Egg, 1 Banana

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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…)

Are you feeling your AGE?

Saggy skin

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…)

Seriously..this $%*# is still happening

Milk the word

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.

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…)

‘Sup with Zonulin?

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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…)

Working on the Edge

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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…)

The Conference Trifecta! This is a Must Watch

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Recently, I posted about my very positive experience of the AIMA NZ conference, prior to that I was gabbing on about the upcoming ACNEM Brain Health conference in Melbourne in May and now I am going for the conference hat trick!  I want to revisit a really impacting lecture for me at last year’s Australasian Society of Lifestyle Medicine (ASLM) conference, delivered by the Emeritus Professor Mark L. Wahlqvist AO, BMedSc, MBBS, MD (Adelaide), MD (Uppsala), on the relationship between ecology and human health.

Why did I find his talk so impacting?  Why should every integrative practitioner take the time to watch this? (more…)

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