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    OnCore Nutrition - Two Peas in a Podcast

    Your Accredited Practising Dietitians simplifying the overwhelming world of health and nutrition with evidence-based science
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    Episodes (46)

    Episode 46: Long COVID - supporting recovery with nutrition, exercise and lifestyle intervention

    Episode 46: Long COVID - supporting recovery with nutrition, exercise and lifestyle intervention

    SHOW NOTES

    Post-COVID questionnaire: https://chroniccare.snapforms.com.au/form/post-covid-questionnaire

    Post COVID Recovery steps

     

     

     

    References

    https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1

    https://www.bmj.com/content/372/bmj.n136

    https://www.bmj.com/content/372/bmj.n136/rapid-responses

    http://www.buckshealthcare.nhs.uk/pifs/nutrition-and-long-covid/

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8429479/

    NICE (2020) “COVID-19 guideline scope: management of the long-term effects of COVID-19” https://www.nice.org.uk/guidance/ng188/documents/final-scope]

    Leon et al. (2021) ‘More than 50 Long-term effects of COVID-19: a systematic review and meta-analysis”. [ https://pubmed.ncbi.nlm.nih.gov/33532785]

    Afrin et al. (2020) “Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndrome”. International journal of infectious diseases, 100: 327–332 https://pubmed.ncbi.nlm.nih.gov/17490952/]

    Casas et al. (2016) “The Immune Protective Effect of the Mediterranean Diet against Chronic Low-grade Inflammatory Diseases”. Endocr Metab Immune Disord Drug Targets. 14(4): 245–254. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443792/

    LaTrobe Research

    https://www.latrobe.edu.au/news/articles/2022/release/possible-cause-of-long-covid-brain-fog

    Souvenaid 

    https://nutricia.com.au/souvenaid/

    https://www.cuh.nhs.uk/news/friendly-gut-bacteria-speeds-long-covid-recovery/

    https://www.pomi-t.co.uk/national-trial/

    https://pubmed.ncbi.nlm.nih.gov/35334962/

     

    https://pubmed.ncbi.nlm.nih.gov/33933299/

     

    https://www.bda.uk.com/resource/long-covid-and-diet.html

     

    https://www.buckshealthcare.nhs.uk/wp-content/uploads/2021/10/Nutrition-and-Long-COVID.pdf

     

     

    https://www.google.com/amp/s/metro.co.uk/2022/03/15/long-covid-and-nutrition-can-you-eat-yourself-well-16237485/amp/

     

     

    https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-expert-shares-5-early-care-tips-for-people-with-long-covid/

     

     

    https://www.todaysdietitian.com/newarchives/ND21p40.shtml

     

    https://www.google.com/amp/s/metro.co.uk/2022/03/15/long-covid-and-nutrition-can-you-eat-yourself-well-16237485/amp/

     

     

    https://www.google.com/amp/s/metro.co.uk/2022/03/15/long-covid-and-nutrition-can-you-eat-yourself-well-16237485/amp/

     

    https://www.healthspan.co.uk/advice/long-covid-diet-and-lifestyle-changes-that-can-help

    Smell training

    https://www.fifthsense.org.uk/smell-training/

    https://abscent.org/learn-us/smell-training/how-smell-train

    https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiac136/6569364?login=false

    https://www.cidrap.umn.edu/news-perspective/2022/04/global-data-reveal-half-may-have-long-covid-4-months

    Episode 42: Are your exercise habits healthy?

    Episode 42: Are your exercise habits healthy?

    Rebecca Gawler

    rebecca@reload.physio 

    Instagram handles: @reloadphysio

    Facebook page: https://www.facebook.com/ReloadPhysio

     

    Are you exercising to  make you feel good or enhance your health or is it the opposite? Are you feeling compelled to exercise and if you're unable to meet your targets does this cause you concern or guilt?

     

    HAES practitioners (to find personal trainers who promote intuitive movement): https://haesaustraliainc.wildapricot.org/find-a-provider

     

    The Physiotherapy Eating Disorders Professional Network Group https://cpmh.csp.org.uk/content/physiotherapy-eating-disorders

     

    A website Bec has put together to summarise the research/info on dysfunctional exercise, intuitive exercise and physio for eating disorders: https://eating-disorder-physiotherapy7.webnode.com/?fbclid=IwAR0Uz0wrMmvX2tdFnYPueCXagmotGGQwHhVmtC3yJ91RoDnPXziZZ1hqI

     

    Virtual care

    https://chroniccare.com.au/

    Speak to the team to arrange an appointment with the most appropriate professional. 

     

    Platinum Physio 

    Women’s Health Physio 

    Episode 40: Calling all the ladies! What lap dancers have taught us about our hormonal superpowers

    Episode 40: Calling all the ladies! What lap dancers have taught us about our hormonal superpowers

    SHOW NOTES

     

    OnCore Nutrition Ladies Lunch Series

    Ladies Lunch 1 - Understanding your cycle

    Wed 27th Oct 1-1:45pm

    Ladies Lunch 2 - Lifestyle strategies to harness your health, feel and perform at your best throughout each season of your cycle

    Wed 3rd Nov 1-1:45pm

    Tickets and info via Eventbrite

     

     

     

    Study discussed

    Ovulatory Cycle Effects on Tip Earnings by Lap Dancers: Economic Evidence for Human Estrus? 

    https://www.researchgate.net/publication/228632689_Ovulatory_Cycle_Effects_on_Tip_Earnings_by_Lap_Dancers_Economic_Evidence_for_Human_Estrus

    Episode 37 Re-Release - Tips for starting and progressing your nutrition career

    Episode 37 Re-Release - Tips for starting and progressing your nutrition career

    Episode Summary

    Calling all nutrition students and new grads...talking through tips to finding and fueling your fire and an exciting workshop we have planned just for you.

    Episode Notes

    Find and Fuel Your Fire Workshop

    Tickets via Eventbrite

     

    Getting a nutrition job is HARD! 

    The Dietetics Workforce Report 2018

    • There has been a 95% increase in dietetic grads over the last 7 years.
    • Grads in Vic ↑ from 65 to 127 per year from 2010 to 2016.
    • There is great concern that there is an oversupply of practitioners causing difficulties in new graduates finding positions and inhibiting movement for existing employees.
    • Many grads are still seeking work up to 12 mths post graduation.
    • In this time, grads are driven to volunteering - but not always meaningful
    • You are highly qualified. There is a significant need for your skills. We have an ageing population, chronic disease and dietitians provide such important prevention and management care
    • The report highlighted that Dietitians are highly qualified, however there are obvious gaps in business and professional skills in many courses.
    • Despite working in a clinical role 30% of dietitians had no clinical supervisor.

    file:///C:/Users/laure/Downloads/Dietetics%20Workforce%20Report.pdf

    Potential career pathways 

    Clinical dietetics

    • Popular!
    • When we’ve advertised for grad jobs there have been >100 applicants.
    • A quarter of organisations reported receiving >50 applicants for junior positions and advertisements were rare!
    • Hard to get grad jobs

    Consultancy and private practice

    • Often don’t graduate with skills for business set up and challenging to dive into sole practitioner position without prior experience. Requires ++ mentoring and supervision.
    • Important for your own development but also for the reputation of the profession

     

    Food service

    Media and marketing

    • Don’t expect to get here straight away - need some experience behind you
    • Be responsible with what you put out into the world, social media etc. Don’t know what you don’t know.

     

    Public health and nutrition

    Eventually policy, health promotion, advocacy

    • Often start as a public health dietitian, community dietitian

    Food industry

    • Consulting
    • Food analysis and product development, sensory evaluation
    • Food technology and science
    • Research

     

    Nutrition research and education

    • Generally requires specialisation and smaller projects or honours, masters, PhD

    https://www.deakin.edu.au/exercise-nutrition-sciences/careers-in-nutrition-and-dietetics

    https://www.myhealthcareer.com.au/dietetics-career/

    Our tips

    • Volunteer meaningfully
    • Upskill
    • Get a mentor - a meaningful one
    • Apply for everything - know your limits/hard passes
    • Apply well
    • Prepare for interviews
    • Seek feedback - and actually be prepared to take it

     

    Our upcoming workshop

    https://www.eventbrite.com/e/find-and-fuel-your-fire-student-early-dietitian-nutritionist-workshop-tickets-159824540503 

    Wed 11th Aug 6pm 

     

    Topics to cover 

    How to land the job you want

    • Job application preparation
    • Interview (including phone/video interview) preparation
    • Setting yourself apart
    • What NOT to do!
    • Volunteer / work experience opportunities
    • Professional development

    Finding your career niche / Progressing your career 

    • Specialising
    • Quality projects opportunities in nutrition
    • Education opportunities in nutrition
    • Research opportunities in nutrition
    • Conference / presentation opportunities

    Supervision and mentoring

    • Finding the right supervisor

    Innovation in dietetics  

    • Identifying gaps
    • Pitching your idea
    • Introduction to grants and proposals

    Delivery 

    • Online
    • 2hr workshop
    • 2 sessions - one evening, one weekend
    • ‘Take home’ toolkit of resources

    Episode 38: Coffee - exploring the health, sleep and performance impacts of our caffeinated friend

    Episode 38: Coffee - exploring the health, sleep and performance impacts of our caffeinated friend

    Google Trends

     

    Health and disease risk

    https://pubmed.ncbi.nlm.nih.gov/29276945/

    https://pubmed.ncbi.nlm.nih.gov/28853910/

    https://pubmed.ncbi.nlm.nih.gov/16507475/

    https://pubmed.ncbi.nlm.nih.gov/24671262/

    https://pubmed.ncbi.nlm.nih.gov/25156996/

    https://pubmed.ncbi.nlm.nih.gov/16685044/

    https://pubmed.ncbi.nlm.nih.gov/22591295/

     

    Diuretic effect 

    Despite the fact that caffeine is a mild diuretic, you don't lose more fluid than you take in by drinking coffee, so it cannot dehydrate you.

    While we don’t count coffee towards our fluid targets for the day, it doesn’t throw you into the negatives. It’s a net-neutral sort of scenario. 

     

    Coffee and exercise performance

    The impact of coffee on exercise performance is related to caffeine’s impact on the CNS. It’s a stimulant meaning it enhances alertness, and also  reduces our perception of fatigue and our perception of effort. So you feel like you’re not working as hard, and also feel less tired. 

    Those that are most likely to benefit from caffeine are those involved in team or intermittent sports so basketball, footy etc, endurance sports and high intensity, short duration sports.

    How much do you need? 

    While research initially focused on high doses of caffeine, more recent research indicates that lower doses can provide similar performance benefits with less negative side effects. Around 1-3 mg caffeine per kg body weight are sufficient to improve performance (so for a 60kg athlete this equates to roughly 1-2 cups of coffee).

    Timing is also important - coffee reaches peak concentrations 1hr post intake and will generally last for 3-4hrs. The ideal time to down your coffee is 30-45mins pre-training and often black is best if you’re likely to be sensitive to exercising on a tummy full of milk.

    https://www.sportsdietitians.com.au/factsheets/supplements/caffeine/

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867441/

     

    Coffee and sleep

    We all know the joys of caffeine in perking us up, but does it affect our sleep? 

    The stimulating effects of caffeine from coffee last 3–5 hours, and depending on individual differences, about half of the total caffeine you consume remains in your body after 5 hours. It’s no surprise that consuming coffee too close to bedtime can cause sleeping problems. Most studies suggest avoiding caffeine for 6 hours prior to bed. 

    The good news is that a switch to tea in these 6 hrs, including green tea which contains about a third of the caffeine as coffee, will be helpful due to the presence of amino acid L-theanine, which has relaxing and calming properties. 

     

    Coffee and waking! 

    Studies have shown that the ideal time to drink coffee is around 203hrs after waiting.  This is because of our hormones. 

    As we wake up, a hormone called cortisol is at its highest. Cortisol is responsible for balancing our energy levels, blood pressure and how we respond to stress or danger. 

    So, drinking coffee when cortisol is already at its highest may not be giving you any additional energy. In fact, it may be making you feel more tired and stressed or anxious later in the day. 

    Science suggests waiting 2-3 hours after waking when cortisol is slowly declining to have your morning coffee for the most bang for your buck.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2257922/

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684472/

     

    Coffee naps

    Some research suggests that combining caffeine with naps is more energising than caffeine or sleep alone. Enter the coffee nap. The theory is that if you drink coffee (or anything caffeinated) before sleeping for a short period, you can boost your energy levels by increasing your brain’s capacity to receive caffeine. 

    This is related to caffeine competing with adenosine for receptors in your brain. 

    Adenosine is an organic compound whose derivatives are important for energy processes in the body amongst other things. Adenosine circulation increases when we feel tired and the act of sleep brings these levels down. But coffee might give us a double whammy by blocking some of the adenosine being registered in our brain. This can make us feel even less tired when we wake. 

    Most of the research suggests the best way to take a coffee nap is to have some caffeine right before taking a 15–20 minute nap (and no more than 30mins).

    https://pubmed.ncbi.nlm.nih.gov/9401427/

    https://pubmed.ncbi.nlm.nih.gov/14652086/

     

    Fun facts

    • Coffee is the world’s most valuable traded commodity next to petroleum.
    • Globally people consume about 2.25 billion cups of coffee every day.
    • Coffee beans are fruit pips and not beans.A coffee bean is  the pip inside the bright red fruit often referred to as a the coffee cherry or coffee berry. 
    • Millennials spend an average of $2008 oer year on coffee https://www.ngpf.org/blog/budgeting/question-of-the-day-how-much-do-millennials-spend-every-year-on-coffee/
    • Coffee grounds sprinkled on the ground around plants and the garden will stop snails and slugs from eating the plants.
    • Studies have found an association between regular moderate coffee consumption (2-4 cups per day) and a reduced risk of suicide. Go for less the 8 cups per day.   https://pubmed.ncbi.nlm.nih.gov/23819683/ https://pubmed.ncbi.nlm.nih.gov/31254722/
    • Scientists have successfully turned ground coffee into biodiesel, so one day coffee may be fuelling your car
    • laws of physics have proven that coffee with milk cools about 20% slower than black coffee - due to the colour. viscosity and rate of heat radiation. 
    • The Guinness World record holder for the "Oldest Cat Ever," a 38-year-old cat named Creme Puff - drank coffee every morning her whole life.

    Episode 37 - Tips for starting and progressing your nutrition career

    Episode 37 - Tips for starting and progressing your nutrition career

    Find and Fuel Your Fire Workshop

    Tickets via Eventbrite

     

    Getting a nutrition job is HARD! 

    The Dietetics Workforce Report 2018

    • There has been a 95% increase in dietetic grads over the last 7 years.
    • Grads in Vic ↑ from 65 to 127 per year from 2010 to 2016.
    • There is great concern that there is an oversupply of practitioners causing difficulties in new graduates finding positions and inhibiting movement for existing employees. 
    • Many grads are still seeking work up to 12 mths post graduation.
    • In this time, grads are driven to volunteering - but not always meaningful 
    • You are highly qualified. There is a significant need for your skills. We have an ageing population, chronic disease and dietitians provide such important prevention and management care
    • The report highlighted that Dietitians are highly qualified, however there are obvious gaps in business and professional skills in many courses. 
    • Despite working in a clinical role 30% of dietitians had no clinical supervisor.

    file:///C:/Users/laure/Downloads/Dietetics%20Workforce%20Report.pdf

    Potential career pathways 

    Clinical dietetics

    • Popular!
    • When we’ve advertised for grad jobs there have been >100 applicants. 
    • A quarter of organisations reported receiving >50 applicants for junior positions and advertisements were rare! 
    • Hard to get grad jobs 

    Consultancy and private practice

    • Often don’t graduate with skills for business set up and challenging to dive into sole practitioner position without prior experience. Requires ++ mentoring and supervision. 
    • Important for your own development but also for the reputation of the profession 

     

    Food service

    Media and marketing

    • Don’t expect to get here straight away - need some experience behind you 
    • Be responsible with what you put out into the world, social media etc. Don’t know what you don’t know. 

     

    Public health and nutrition

    Eventually policy, health promotion, advocacy

    • Often start as a public health dietitian, community dietitian

    Food industry

    • Consulting
    • Food analysis and product development, sensory evaluation
    • Food technology and science
    • Research 

     

    Nutrition research and education

    • Generally requires specialisation and smaller projects or honours, masters, PhD

    https://www.deakin.edu.au/exercise-nutrition-sciences/careers-in-nutrition-and-dietetics

    https://www.myhealthcareer.com.au/dietetics-career/

    Our tips

    • Volunteer meaningfully
    • Upskill 
    • Get a mentor - a meaningful one
    • Apply for everything - know your limits/hard passes
    • Apply well
    • Prepare for interviews 
    • Seek feedback - and actually be prepared to take it 

    Our upcoming workshops

    https://www.eventbrite.com/e/find-and-fuel-your-fire-student-early-dietitian-nutritionist-workshop-tickets-112762650122

    Wed 26th Aug at 6pm 

    Sun 29th aug at 2pm

    Topics to cover 

    How to land the job you want

    • Job application preparation
    • Interview (including phone/video interview) preparation 
    • Setting yourself apart 
    • What NOT to do! 
    • Volunteer / work experience opportunities
    • Professional development 

    Finding your career niche / Progressing your career 

    • Specialising 
    • Quality projects opportunities in nutrition 
    • Education opportunities in nutrition 
    • Research opportunities in nutrition 
    • Conference / presentation opportunities 

    Supervision and mentoring

    • Finding the right supervisor

    Innovation in dietetics  

    • Identifying gaps
    • Pitching your idea
    • Introduction to grants and proposals 

    Delivery 

    • Online 
    • 2hr workshop 
    • 2 sessions - one evening, one weekend 
    • ‘Take home’ toolkit of resources 

    Episode 36: Fresh Produce! Fertility and Pregnancy Nutrition

    Episode 36: Fresh Produce! Fertility and Pregnancy Nutrition

    Fertility Nutrition

    • Important to highlight that conception is a miracle! And for many couples this is not an easy journey. 
    • 1 in 6 Australian couples are unable to become pregnant after a year of unprotected sex.
    • Nutrition and lifestyle can play a role and have a positive effect on fertility, in fact, it may improve fertility by up to 69%! https://pubmed.ncbi.nlm.nih.gov/17978119/

    Female Fertility

    • A balanced diet is important, including a wide variety of fresh produce daily
    • Mediterranean-style diets have been associated with improved fertility 
    • Which foods and nutrients are important to include? 
      • Folic acid has been shown to be important in female fertility, even with assisted reproduction. It is recommended to include a daily prenatal multivitamin supplement with folic acid (400-500 µg/day) from 12 weeks pre-conception and for the first 12 weeks of pregnancy to decrease the risk of neural tube defects. This supplementation is particularly important in early stages of pregnancy when many women may not yet know they are pregnant, so if you have the opportunity to forward plan it’s always a good idea. 
      • Vitamin B12 - animal products, vegans should consider supplementation under guidance from their doctor or dietitian 
      • Omega-3 fatty acids - EPA and DHA are important for fertility, conception and foetal development 
      • Antioxidants are important for fertility and conception. They help to keep both our sperm and eggs healthy! Include a wide variety of plant based products including vegetables, fruits, nuts, seeds and wholegrains to boost beneficial antioxidants like vitamins C, E, folate, beta-carotene and lutein. It’s beneficial to try to get these nutrients from food sources and always speak to your doctor or dietitian before considering a supplement (especially Vitamin E).
      • Opt for complex, low GI, high fibre carbohydrates from whole grains, vegetables, nuts and seeds. 
      • Include plant-based proteins, reducing your reliance on animal proteins. Get creative with legumes and pulses, whole grains, nuts and seeds.
      • Seafood may have a positive association with fertility. Couples eating more seafood were pregnant sooner than those rarely eating seafood.
      • Choose full fat instead of low fat dairy
      • Iodine may be important - get this from seafood, seaweed (nori), potatoes, cranberries, strawberries iodised salt and our bread supply which is fortified. This is a good one to start with folate in the lead up to conception, and is included in most prenatal vitamin blends. 
      • Your eating window may be important. Some studies suggest that shifting towards an earlier eating pattern, with a larger breakfast and lunch and a smaller evening meal with reduced late-night eating, may improve fertility. 
    • Which foods and nutrients are worth eating less of?
      • Swap out trans fats for mono- and omega 3 poly-unsaturated fats. This means less processed and fried foods, commercially-prepared baked   products and margarines.
      • Reduce processed meat intake. Replace these with lean meats, eggs, full cream dairy and plant alternatives such as legumes, tofu, nuts, seeds and grains. 
      • Reduce intake of refined carbohydrates found in sweet drinks, lollies, cakes, biscuits, desserts, and refined products like white bread, rice and cereals. Instead opt for the low GI options listed above. 
      • Energy drinks - it’s no surprise that they don’t do us any fertility favours. 
      • Reduce alcohol intake 
      • Don’t overdo the caffeine. Some studies have suggested that large intake (over 500 mg of caffeine daily) may take up to 9.5 months longer to get pregnant  https://pubmed.ncbi.nlm.nih.gov/9054236/
    • Movement is important! Exercise has many benefits for your health, including increased fertility. A sedentary lifestyle has been associated with a higher risk of infertility and increasing movement has been found to reduce the risk of infertility. 
    • Mindset and stress is another important factor. Managing stress and anxiety may be easier said than done, particularly when trying to conceive, so consider seeking professional support to optimising your mental wellbeing and therefore fertility. 
    • Recommend tailored advice from a dietitian in the case of any medical conditions  including PCOS, diabetes or GDM, if you’re in a small or larger body and have any concerns, and if taking any complementary or alternative therapies. 

    https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30311-8/fulltext

    https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(00)90458-6/fulltext

    https://www.thelancet.com/series/preconception-health

    https://www.health.harvard.edu/blog/fertility-and-diet-is-there-a-connection-2018053113949

    https://www.eatright.org/health/pregnancy/fertility-and-reproduction/fertility-foods

    https://www.healthline.com/nutrition/17-fertility-tips-to-get-pregnant#1.-Eat-Foods-That-Are-Rich-in-Antioxidants

    https://pubmed.ncbi.nlm.nih.gov/22425198/

    https://pubmed.ncbi.nlm.nih.gov/11880759/

    https://pubmed.ncbi.nlm.nih.gov/11594714/

    https://www.pennutrition.com/KnowledgePathway.aspx?kpid=1323&pqcatid=146&pqid=1313 - sweeteners 

    Male fertility 

    • A balanced diet is important, including a wide variety of fresh produce daily
    • Mediterranean-style diets have been associated with improved fertility and semen quality in men
    • Which foods and nutrients are important to include? 
      • Omega-3 fatty acids - EPA and DHA are important for fertility
      • Antioxidants are important for fertility and conception. They help to keep both our sperm and eggs healthy! Include a wide variety of plant based products including vegetables, fruits, nuts, seeds and wholegrains to boost beneficial antioxidants like vitamins C, E, folate, beta-carotene and lutein. It’s beneficial to try to get these nutrients from food sources and always speak to your doctor or dietitian before considering a supplement (especially Vitamin E).
    • Which foods and nutrients are worth eating less of?
      • Swap out trans fats for mono- and omega 3 poly-unsaturated fats. This means less processed and fried foods, commercially-prepared baked   products and margarines.
      • Reduce processed meat intake. Replace these with lean meats, eggs, full cream dairy and plant alternatives such as legumes, tofu, nuts, seeds and grains. 
      • Reduce intake of refined carbohydrates found in sweet drinks, lollies, cakes, biscuits, desserts, and refined products like white bread, rice and cereals. Instead opt for the low GI options listed above. 
      • Energy drinks - it’s no surprise that they don’t do us any fertility favours. 
    • Movement is important! Exercise has many benefits for your health, including increased fertility. A sedentary lifestyle has been associated with a higher risk of infertility and increasing movement has been found to reduce the risk of infertility. 
    • Mindset and stress is another important factor. Managing stress and anxiety may be easier said than done, particularly when trying to conceive, so consider seeking professional support to optimising your mental wellbeing and therefore fertility. 

    Caffeine for fertility

    You certainly don’t need to forego your daily coffee! If you’re trying to conceive it is a good idea to not overdo the caffeine. Some studies have suggested that large intake (over 500 mg of caffeine daily) may take up to 9.5 months longer to get pregnant  https://pubmed.ncbi.nlm.nih.gov/9054236/

    Decaf -3mg caffeine per tsp

    1 Tsp of instant coffee - 60mg per tsp

    Espresso shot (30-35ml) - 90-200mg 

    Percolated - 100mg per cup

    Energy drinks - up to 110mg per serve

    Cola - 40mg per serve

    Black Tea - 50mg 

    Green tea - 30mg

    Chocolate - 60g of milk or dark Choc has about 30-40mg

    Pregnant women can safely have two instant coffees a day and two to three cups of tea OR one cap/latte 

    Pesticides fertility

    Some studies suggest that higher consumption of produce prone to harbour higher pesticide residues may be associated with lower probabilities of pregnancy. Those looking to conceive may wish to consider where they source fruits and vegetables that may be more likely to hold residual pesticides, such as strawberries, spinach, capsicum, apples, pears, nectarines, peaches, cherries and grapes. 

    While this is important to be aware of, washing fresh produce well will help to reduce exposure. And it’s important to keep eating PLENTY of fresh produce as the nutritional benefits of this is very important to consider (as well as any possible pesticide risks). For many, this may be easy to achieve with non-organic produce that’s easier on the purse strings. 

    https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2659557

     

     

    During Pregnancy

    Things to be aware of / avoid

    • Vit A - Beta carotene safe, avoid retinol/retinyl esters - upper limit for preformed vitamin A (retinyl esters and retinol from food and supplements) during pregnancy of 3000 µg /day (~10,000 IU). Be cautious of liver (≤1 serving/week), particularly in 1st trimester. Avoid any topical creams, ointments, serums which contain vitamin A or vitamin A derivatives. 
    • Mercury in high doses may harm a developing baby's brain. Limit large loads of mercury by:
      • Limit orange roughy (sea perch) or catfish to 150 g/week and to have no other fish that week or 
      • Limit shark (flake) or billfish (swordfish/broadbill and marlin) to 150 g/two weeks and to have no other fish during those two weeks

    Examples of low mercury fish that are high in omega-3 fats include sardines, mackerel, silver warehou, Atlantic salmon, canned salmon and tuna in oil and herrings. Pregnant women are advised to consume 300-450 g/week of lower mercury fish and seafood. 

    • Food safety is important to minimise the risk of food-borne illness. Elevated progesterone levels in pregnancy suppressed the immune system, making women more prone to infection and illness. In particular, we want to reduce the risk of foodborne illnesses listeriosis, toxoplasmosis, campylobacteriosis and salmonellosis. The consequences of foodborne illness can be particularly devastating during pregnancy because both the woman and her foetus are at risk. Risk is very rare, especially in Australia (> 300,000 pregnancies per year and around seven cases of listeria during pregnancy). 

    Listeria risk:

    • raw or unpasteurized dairy products, fruit juices or cider
    • soft and semi-soft cheeses (e.g. Brie, Camembert, feta), blue-veined cheeses, gorgonzola, Hispanic-style fresh cheeses (e.g. queso blanco) unless they are cooked until steaming hot 74°C
    • refrigerated pâtés, meat spreads and smoked seafood 
    • pre-packaged or prepared fruit/vegetable salads and raw sprouts 
    • ready-to-eat deli meats and ready-prepared meals unless they are reheated until steaming hot (74°C)
    • raw or undercooked meat, poultry, seafood and eggs.

     

    Toxoplasma, Campylobacter and Salmonella infection:

    • Unpasteurized milk products and juices. 
    • Raw or undercooked meat, poultry, shellfish and eggs.
    • Rinse fresh fruits and vegetables thoroughly. 
    • Avoid raw sprouts.
    • Follow safe food handling practices including washing hands and food preparation surfaces well.

    Sushi - generally safe if the raw fish has been previously frozen, and is from a source that you trust. If raw fish hasn’t been previously frozen, it may contain small parasitic worms, called anisakis worms. And you don’t want day old rice - salmonella and listeria risk. 

    • Alcohol - no safe level and the recommendation is to avoid alcohol during pregnancy 
    • Avoid excessive flaxseed (linseed) intake - adverse events in rats 
    • Artificial sweeteners - most common sweeteners in Aus - aspartame, stevia, sucralose, sorbitol, mannitol, isomalt, xylitol have been approved for use during pregnancy and lactation

    https://www.pennutrition.com/KnowledgePathway.aspx?kpid=3043&tkid=22118&secid=3104#1

    https://www.health.gov.au/resources/collections/pregnancy-care-guidelines-and-related-documents

    https://www.health.gov.au/sites/default/files/lifestyle-considerations_0.pdf

    Episode 34: Why diets don’t work...and how to use weight loss science to your advantage

    Episode 34: Why diets don’t work...and how to use weight loss science to your advantage

    When it comes to dieting everyone is always looking for a quick fix.

    Effectiveness of diets long term 

    Interesting study https://www.bmj.com/content/bmj/369/bmj.m696.full.pdf

    • It looked at “Comparison of dietary macronutrient patterns of 14 popular named dietary programmes for weight and cardiovascular risk factor reduction in adults: systematic review and network meta-analysis of randomised trials”
    • Randomised trials that enrolled adults (≥18 years) who were overweight (body mass index 25-29) or obese (≥30) to a popular named diet or an alternative diet.
    • Outcome measures included change in body weight, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, BP (systolic blood pressure & diastolic blood pressure), and CRP at 6 and 12 month follow-up.
    • 121 trials made the cut (21,942 patients) - huge study
    • Dietary intervention group assessed based on macro breakdown were:
      • Low carb (e.g. Atkins, south beach, zone)
      • Moderate marcos (e.g. Biggest Loser, DASH, Jenny Craig, Mediterranean, Portfolio, Slimming World, Volumetrics, Weight Watchers)
      • Low fat (Ornish, Rosemary Conley)
    • Control group
      • Control diets included: maintain usual dietary habits, dietary advice (eg, received brochures, dietary materials including dietary guidelines, or consultation with a professional dietitian by email or telephone), and low fat diet (≤30% fat with or without advice about lowering calories). 
    • Results:
      • Positive weight loss improvements at the 12 month follow-up diminished.
      • Improvements in cardiovascular risk factors largely disappeared except for Mediterranean diet for LDL reduction
      • Differences between diets are, however, generally trivial to small, implying that people can choose the diet they prefer from among many of the available diets to adhere to what works best for them.
    • Bottomline: no matter if you like low carb, high carb, low fat, etc… diet’s are not effective in reducing weight and keeping it off.

    Other large scale reviews confirm that diets simply don’t work 

    Grade A evidence - NHMRC Clinical Practice Guidelines For The Management Of Overweight And Obesity In Adults, Adolescents And Children In Australia

    • Weight loss following lifestyle intervention is maximal at 6–12 months. Regardless of the degree of initial weight loss, most weight is regained within a 2-year period and by 5 years the majority of people are at their pre-intervention body weight.
    • Our suggestion: The intervention should never stop! 

    Grade A evidence

    • Modest weight loss improved CVD, T2DM risk factors and grade B evidence for sleep apnoea, joint issues, graed C for musculoskeletal problems, GI and urinary, self esteem, depression and QOL 
    • For adults who are overweight or obese, strongly recommend lifestyle change—including reduced energy intake, increased physical activity and measures to support behavioural change.
    • 6 For adults who achieve initial weight loss, strongly recommend the adoption of specific strategies, appropriate to their individual situation, to minimise weight regain
    • NHMRC Guidelines  file:///C:/Users/Loz/Downloads/n57-obesity-guidelines-%20(1).pdf 

    Also Scientific research that ideal BMI for longevity is 25-30kg/m2

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855514/

    https://www.bbmt.org/article/S1083-8791(05)01413-8/abstract

    Why don’t diets work? 

    A combination of physiology and psychology

    For the physiology behind why it doesn't work Listen to Episode 18 

    Interesting paper here https://www.ncbi.nlm.nih.gov/pubmed/23911805?dopt=Abstract

    Dieting cycle

    Biology: (listen back to ep18)

    • Short term: 
      • Anyone who is below their set point (too thin for them) will experience many physiological symptoms, similar to that of starvation. 
      • What is important to know is that it doesn't matter what weight you start at, but rather what is normal for you.
      • Experience feeling of extreme hunger, metabolism suppressed so your body burns less energy, muscles use less energy during PA, feel cold, lethargic and obsessive over food - normal sx’s of your brain saying ‘alarm bells, food is needed’
      • Biological pressure to restore body weight gets stronger as weight loss increases.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/pdf/nihms904015.pdf

      •  
    • Long term:
      • Some people will be heavier than when they started and others will develop disordered eating patterns

    Psychological impact of dieting/weight stigma 

    • Disordered eating patterns -greater emotional eating, uncontrolled eating, and loss-of-control eating
    • Body image and self esteem concerns
    • Psychological stress 
    • Relationship breakdown
    • Increased anxiety and depression

    Summary 

    • Weight is not tied to health and health looks different to everyone
    • Lifestyle habits predict health better than weight alone
    • If a ‘diet’ has a start and an end point - it’s unlikely to work. 
    • There are some factors we don’t think of when it comes to health, e.g poverty, loneliness, hormones, low levels of physical activity.
    • So much energy is wasted on trying to change weight, when we should focus on making other health improvements, e.g. exercise goal - start somewhere e.g. walking and progress, improved relationships with friends and loved ones, cook more 
    • https://www.jabfm.org/content/25/1/9.full
    • Willpower as a finite resource

    What you can actually do

    • Reduce decision fatigue
    • Do it for YOU - explore your deep reasons why. We do this quite a lot with our clients. It may present as ‘the wedding’ or ‘reunion’ or to ‘feel better in my jeans’ or ‘fit into that dress’ but why is that actually important to you? Will it impact your self efficacy? 
    • Use positivity. Research demonstrates that the feeling of success is more likely to drive positive change than actually achieving your goal 
    • Emotions create habits 
    • Micro goals - e.g change ‘exercise more’ to 2 squats per day, change ‘eat more veg’ to eat 1 carrot every 2 days. Can do more if you want, but you don’t have to. Beyond that is extra credit!
    • Anchor your desired activities to things you already do, e.g. brushing teeth or showering. 

    Episode 33: Busting cancer nutrition myths

    Episode 33: Busting cancer nutrition myths

    Common cancer nutrition myths

    Sugar feeds cancer

    More info here 

    Juicing 

    No evidence to support it’s use 

    Can lead to deficiency in valuable nutrients, weight loss, protein energy malnutrition 

    Antioxidant load can be potentially detrimental during radiotherapy and certain chemotherapy regimens. More information here

    Alkaline diet

    More info here

    Organic 

    • Studies on the foods themselves in terms of nutritional content, levels of chemicals and resistant bacteria
    • Studies on the health of humans long term 
    • When we look at organic vs non-organic there may be slightly higher concentrations of antioxidants in organic produce. This is only in general, as organic milk has been found to have lower mineral content, and varies depending on the source. 
    • When we look at chemicals and pesticide residues, organic produce may reduce exposure to these but important to note that the levels of toxins in non-organic produce is generally well below safe limits
    • When we look at health overall, in particular long term health of individuals that eat organic vs non organic produce, the benefits are far less clear. 
    • No difference in cancer risk (studies of >600,000 women)
    • Huge systematic reviews show no difference
    • Some studies that report a difference need to be careful of other confounding factors. If we think about the profile of someone who may eat organic - they have chosen to and have the means to do so. In general,this often means they are more likely to be of a higher SES/income, better living environments, higher education level, health conscious therefore choose more fresh produce overall, get regular health check ups and screen for chronic diseases. It’s really difficult to attribute health benefits to the organic produce when there’s a whole bunch of other health-promoting behaviours, environmental and lifestyle factors contributing. 
    • Bottom line: if you’ve got the means and it’s a priority for you - by all means! If you don’t - just keep aiming for your 5 serves of veggies and wash them well.

    Soy

    • Legume - soybeans or edamame - eaten whole or processed in numerous ways - fermented to produce tofu, tempeh, miso, natto. 
    • Rich - rich in phytooestrogen ‘Isoflavens - which act like a weak oestrogen in the body. 
    • Since many breast cancers need oestrogen to grow, it would stand to reason that soy could increase breast cancer risk. However, this isn’t the case in most studies.
    • Most studies linking soy consumption to an increased risk of breast and other forms of cancer are 
    • done in laboratory animals. But because humans metabolize soy differently than rodents, these findings might not apply to people.
    • Most observational studies indicate that consumption of soy products may reduce the risk of hormonally driven cancers such as breast, prostate, or endometrial (lining of the uterus), and there is some evidence it may lower the risk of certain other cancers. This might be because the isoflavones can actually block the more potent natural oestrogens in the blood.
    • Exposure early in life is beneficial and a change in soy intake in either direction, may be responsible for change in risk 
    • Additionally, soy has been linked to a longer lifespan after breast cancer diagnosis.
    • In a review of five long-term studies, women who ate soy after diagnosis were 21% less likely to have a recurrence of cancer and 15% less likely to die than women who avoided soy.

    Dairy

    • Dairy has been associated with reduced risk of colorectal cancer, but an increased risk of prostate cancer. Individualised advised, tailored to you, is key, 

    Fasting

    ESPEN Nutrition guidelines 

    Anti-cancer diets 

    There is no diet or food that has been proven to prevent or cure cancer

    ESPEN Nutrition guidelines 

    Other resources

    https://www.wcrf-uk.org/uk/recipes/diet-cancer-myths-debunked

    http://www.espen.info/wp/wordpress/wp-content/uploads/2016/11/ESPEN-cancer-guidelines-2016-final-published.pdf

    Episode 31: Keep your eating habits healthy during isolation

    Episode 31: Keep your eating habits healthy during isolation

    1. Keep a routine

    • Stick to a schedule. If you used to have a lunch break at 12:30, try to do the same. Factor in snack and tea breaks as well!
    • And don’t forget to drink
    • Position yourself somewhere that’s hard to get to the kitchen!

    2. Check in with yourself. 

    • There are so many reasons we eat beyond hunger and nutrients
    • Why are you heading to the cupboard or fridge? Bored, procrastinating, stressed, emotions. Suss this out.
    • Won't happen every time. But doing it sometimes might help reveal with honesty some patterns around your eating behaviours.

    Strategies:

    • Hunger fullness scale
    • 10 minute challenge
    • Put a wedge in
    • During the meal - put your knife and fork down.
    • Speed bump

    3. Eat mindfully

    • We can often find ourselves eating on autopilot, munching into a meal while our attention is on our screens,to-do lists, multi-tasking or wandering around the kitchen or house.
    • Give yourself an opportunity to eat without distraction
    • Serve your food for yourself how you would serve it to a special someone.
    • Serve how much you want - rather than eating vita weats or crackers fresh out the packet, serve the 4, 10, however many you want on a plate! Prepare it.
    • Sit down. Not at your desk. Grab a knife and fork or a drink.
    • Switch off your devices, sit down uninterrupted.
    • Give yourself the time and space to savour your eating experience and feel truly satisfied.
    • Respect your food and yourself.

    4. Just don’t buy it!

    • If you struggle to stop at 1 or 2 tim tams and just end up feeling crap about it, don’t buy them!
    • If you were trying to quit smoking would you have packets of cigarettes in the cupboard and fridge, in your desk drawer?
    • Don’t dangle the carrot, it’s just cruel to yourself
    • Nice vs kind
    • Mindful eating starts well before you eat.
    • Don’t shop hungry
    • Review your goals - what you really want vs the quick high
    • Check in at the shelves too!
    • Research has shown that visual exposure to high calorie foods stimulates the striatum, a part of your brain that modulates impulse control, which may lead to increased cravings and overeating.
    • Deprivation is not the answer. It is ineffective for long term weight loss and incredibly damaging to our relationship with food and our bodies.

    5. Creative cooking!

    • If you were fortunate enough to bulk purchase tinned tomatoes, now's your time to shine
    • Home cooking vs take away = 20% fewer calories for the exact same meal
    • Study of over 11000 ppl found that those who ate home cooked meals more than 5 x per week and better body comp (25% less likely to have excess body fat) and ate more veg and fruit.

    6. Combat boredom

    • Put a wedge in first: Walk to the letterbox, paint your nails, pat the dog, do 10 pushups...BEFORE you head to the kitchen.
    • Consider why you’re bored on a larger scale.
    • Online course, puzzle, book, create something (number paintings, ikea furniture), plants or home garden
    • Our next episode we’ll be talking all about using your time to fuel your fire

    40 meaningful things to do when stuck at home in a pandemic

    Episode 30: Pimp your gut - The unethical study that blew our mind, Supersize Me and the impact of ultra-processed food

    Episode 30: Pimp your gut - The unethical study that blew our mind, Supersize Me and the impact of ultra-processed food

    Tim Spector experiment 

    https://theconversation.com/your-gut-bacteria-dont-like-junk-food-even-if-you-do-41564

    Tim Spector, professor of genetic epidemiology at King’s College London, enlisted his son Tom, a genetics student at University, to undergo an experiment where he lived on McDonalds food for ten days. 

    Supersize me

    • Spurlock ate at McDonald's three times per day - used himself as a guinea pig (n=1) for 30 days.
    • Before starting the experiment he was assessed by doctors who confirmed he was in excellent health.
    • He did minimal exercise and limited his steps to 5,000 per day to mimic the lifestyle of many Americans who don’t move much and eat fast food regularly.
    • Average of 20.9MJ (5,000 kcal) (the equivalent of 9.26 Big Macs) per day during the experiment.
    • 2.5 x the recommended caloric intake of average sized male 
    • gained 11.1kg (24 lb) - 13% increase in weight 
    • Increased his cholesterol
    • Heart palpitations experienced
    • Mood swings, sexual dysfunction, lethargy, fat accumulation in his liver. 
    • It took him 14 months to lose all the weight gained 

    Ultraprocessed Food

    Minimally processedLightly processed Heavily processedUltra-processed

    pre-cut and peeled pumpkin, potatoes and other veges, bagged salad leaves, bagged spinach, sliced vegetables, and unsalted, roasted nuts

     

    Corn 

    Apple

    Canned, dried or frozen such as dried fruit, canned legumes/fish, cheese, pasta, frozen veg, pasteurized milk / yoghurt.

    Recognisable ingredients

    Make foods available out of season.

    Canned corn 

    Tinned apples

    Food not in its original form or not naturally occurring, eg cereals, muesli bars, deli meats, oils, sugar and flours. 

    Tortilla chips 

    Apple juice 

    Considered ‘junk food’ eg chips biscuits, chocolates, sweets, nuggets, energy bars, and carbonated and sugared sweet drinks. 

    Doritos

    Apple pie 

     

    Other things that might be damaging your gut health

    Smoking

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3597605/

    Artificial and naturally intense sweeteners

    Saccharin, sucralose, stevia extracts shift the populations of gut microbiota. 

    Several polyols (fermentable carbohydrates), including isomalt and maltitol, may increase bifidobacteria numbers in healthy subjects, as these polyols may have prebiotic actions.

    Large scale human studies are needed 

    https://academic.oup.com/advances/article/10/suppl_1/S31/5307224

    We also know that in animal studies, when exposed to the artificial sweeteners, this saw a reduction in beneficial bacteria in the gut

    https://www.ncbi.nlm.nih.gov/pubmed/25231862

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5464538/

    They can also give us a preference for a sweeter palate, meaning we crave or feel like sweeter foods..

    Exercise (lack of)

    • Recent studies suggest that physical activity may also alter the gut bacteria, improving gut health.
    • Higher fitness levels have been associated with a greater abundance of butyrate, a short-chain fatty acid that's produced by fermentation of CHO’s in the lower GI tract, helps to keep the lining of our gut healthy and is also important for overall health.
    • One study found that professional rugby players had a more diverse gut flora and twice the number of bacterial families, compared to the control groups matched for body size, age and gender 

    https://www.ncbi.nlm.nih.gov/pubmed/25021423

    https://www.hindawi.com/journals/omcl/2017/3831972/

    https://www.ncbi.nlm.nih.gov/pubmed/25825908

    https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0125889

    Alcohol

    https://www.ncbi.nlm.nih.gov/pubmed/22552027

    • 20 days
    • each individual consumed 272 ml of red wine OR de-alcoholized red wine or 100 ml of gin each day 
    • Gin decreased the number of beneficial gut bacteria, 
    • Red wine increased the abundance of bacteria known to promote gut health and decreased the number of harmful gut bacteria like Clostridium.
    • The beneficial effect of moderate red wine consumption on gut bacteria appears to be due to its polyphenol content.
    • Polyphenols are plant compounds that escape digestion and are broken down by gut bacteria. They may also help reduce blood pressure and improve cholesterol

    What to focus on 

    Prebiotic Fibre

    • Chicory Root
    • Jerusalem artichoke 
    • Garlic
    • Onion
    • Leek 
    • Asparagus 
    • Less ripe bananas 
    • Barley
    • Oats
    • Apples 
    • Flaxseeds 
    • Edamame 

    Episode 29: Dietitian, nutritionist or naturopath?

    Episode 29: Dietitian, nutritionist or naturopath?

    Dietitian

    • Tertiary qualification in nutrition and dietetics recognised by national authorities.
    • Dietitians apply the science of nutrition to the feeding and education of groups of people and individuals in health and disease
    • Dietitians are also qualified to provide evidence based nutrition services to individual dietary counselling, medical nutrition therapy, group dietary therapy, food service management, public health nutrition, policy and research, food industry and community health.
    • A dietitian has undertaken a course of study that included substantial theory and supervised and assessed professional practice in clinical nutrition, medical nutrition therapy and food service management.
    • APDs work in hospitals and private practice, government, research and teaching, public health and community nutrition, the food and medical nutrition industries, and nutrition marketing and communications.
    • All APDs are automatically able to use the AN credential, because as part of their qualification in human nutrition, an APD has undertaken a course of study that has included supervised and assessed professional practice in public health nutrition, medical nutrition therapy and food service management.
    • Accredited Practising Dietitian is the only credential recognised by the Australian Government, Medicare, the Department of Veterans Affairs and most private health funds as the quality standard for nutrition and dietetics services in Australia. APDs are committed to the Dietitians Association of Australia Code of Professional Conduct, continuing professional development and providing quality services. A register of all current APDs can be found on the DAA website.
    • To maintain APD status, nutrition and dietetic professionals are required to undertake a specified level of continuing education and professional development to ensure currency of practice. APD status is reviewed annually by DAA.

    https://daa.asn.au/what-dietitans-do/dietitian-or-nutritionist/

     

    Nutritionist

    • May be tertiary qualified, but also may not be!
    • It’s important to note that the term ‘nutritionist’ is not regulated, therefore, this title may be used by dietitians, nutrition scientists and nutrition graduates – and also those with very limited qualifications in nutrition.
    • The Nutrition Society of Australia (NSA) has developed a voluntary Register of Nutritionists in Australia to help determine the level of training someone has undertaken.
    • These Nutritionists may work in a number of other roles, including research, nutrition consultants and advisors, public health and health promotion officers, community development officers, quality and nutrition coordinators, food technologists, media spokespeople and more.
    • APD = AN but AN does not = APD. ANs not qualified to provide medical nutrition therapy which includes individual and group dietary interventions.
    • Any responsible ‘nutritionist’ will not be allowed to provide individualised dietary advice for any underlying medical condition - from diabetes to high cholesterol to IBS.
    • There are currently no Medicare health fund rebates for clients of Nutritionists, and there is only limited private health insurance fund rebates for Nutritionists with some funds.

    https://www.nutritionaustralia.org/national/resource/nutritionist-or-dietitian

     

    Naturopath

    • Naturopathy takes a holistic approach to wellness.
    • Interventions - see below

    Source: https://www.researchgate.net/publication/331789476_An_evidence_based_overview_of_naturopathic_practice_in_Australia

    A professional naturopath is someone who has completed, at a minimum, an Advanced Diploma in either Naturopathy or Health Science, is registered with a professional body and is insured appropriately.

    Aus gov warnings:

    Naturopathy is not a treatment for specific illness or disease. Naturopathy is a complementary therapy in that it may be used alongside other medical and therapeutic techniques. Always be guided by your doctor or specialist before using naturopathy for any serious or chronic illness. Treat as suspect any practitioner who advises you to abandon your conventional medical treatment.

    Regulation = self regulation only - voluntary and not governed 

    https://www.nhaa.org.au/mediareleases/be-informed/regulation-of-practitioners

    https://www.nhaa.org.au/mediareleases/be-informed/regulation-of-practitioners

    https://www.abc.net.au/news/2010-10-21/unregulated_naturopaths_putting_lives_at_risk/40276

    Whilst developments such as the Code of Conduct for Unregistered Practitioners certainly help, they do not replace proper regulation of major professions.

    End of insurance subsidies in 2017 due to lack of evidence to support efficacy

    https://sciencebasedmedicine.org/australia-ends-insurance-subsidies-for-naturopathy-homeopathy-and-more/

    Impact 

    https://www.researchgate.net/publication/331789476_An_evidence_based_overview_of_naturopathic_practice_in_Australia

    https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4839.0~2016-17~Main%20Features~General%20practitioners~2

    https://www.racgp.org.au/download/Documents/Publications/Health-of-the-Nation-2018-Report.pdf

    https://www.abc.net.au/news/2010-10-21/unregulated_naturopaths_putting_lives_at_risk/40276

    https://www.researchgate.net/publication/331789476_An_evidence_based_overview_of_naturopathic_practice_in_Australia

    https://www.ncbi.nlm.nih.gov/pubmed/30785315

    What an influencer does

    Research from the University of Glasgow found that almost 90% of social media influencers are sharing inaccurate and potentially harmful nutrition and weight loss advice.

    https://www.medscape.com/viewarticle/912360

     

    Dietitians

    Dr Nicole Kiss - follow on Twitter @NicoleKiss

    Dr Tim Crowe - follow on Twitter @CroweTim, listen to podcast Thinking Nutrition

    Hayley Blieden  - https://austsuperfoods.com.au/ 

    Nutritionists

    Melissa Eaton - follow on Instagram @eatonbalanced

    Jules Tellidis -  follow on Instagram @wholesomehungry

    Naturopaths

    Abby Dolphin - https://olivewellnessinstitute.org/admember/abby-dolphin/

    Bianca Potenta - https://hwstudio.com.au/

    Episode 28: Food and mood

    Episode 28: Food and mood

    Beyond Blue - 1 in 7 Australians will experience depression in their lifetime and 1 in 4 will experience anxiety.

    Mood disorders are something we can’t ignore.

    One area that’s gained a lot of traction is the way food, dietary patterns, dietary quality and lifestyle are having a profound impact on our mood and mental health.

    Usually pharmacotherapy (medication) and psychotherapy are used as firstline treatment of depression, however remission can often be challenging to achieve.This has prompted the need for further strategies in relation to diet and lifestyle in the treatment of depression. What we eat can have an impact on our brain chemistry and brain health.

    Whilst there is no single food that can help improve depression, we are discovering that what and how we eat as a whole can have an impact.

    We often consider the brain for it’s psychology and forget it’s biology. The brain is an organ. Incredibly complex one. We need to care for it like we do any other organ. A heart that is not cared for will show signs of damage eg arrhythmias, blood pressure issues, poor exercise tolerance  A brain that is not cared for will also show symptoms. The trouble is these symptoms are those related to brain function - mood, personality, decision making and processing and memory. These are biological symptoms of a biological organ. It’s not just psychology. Often these type of symptoms are brushed off. They’re easier to ignore than palpitations or tightness in the chest or wheezy breathing. The reality is that our brain cells are made up of essential fatty acids that we can only get from our diet. Our neurotransmitters require essential nutrients that you can only get from your diet We can look after our brains and take a preventative nutrition and lifestyle approach just as we would look after our heart and lungs 

    Lancet commission 2017

    https://www.thelancet.com/commissions/dementia2017

    Food, hormones and neurotransmitters

    • Carbohydrates - when we eat CHO’s this triggers a release of insulin to help transport the CHO’s into the cells to be used as energy. This insulin trigger also stimulates the release of tryptophan, which is an AA which is a precursor for serotonin (which is associated with improved mood and feeling happy). Low GI carbs are seen to be the most beneficial whereas high GI carbs will give an immediate but temporary effect in regard to serotinin release. 
    • Protein -  There are specific amino acids can affect our brain health as a number of neurotransmitters are made up of AA’s.In particular  the neurotransmitter (messenger) dopamine is produced from the AA tyrosine and as mentioned above serotonin is made from the tryptophan. A  lack of these particular AA’s, will result in downregulation of these neurotransmitters, which can precipitate lowered mood. 
      • There is a condition called phenylketonuria the buildup of AA can also result in brain damage and mental retardation. e.g the excessive buildup of phenylalanine can cause brain damage and mental retardation.
    • Omega-3 fatty acids - The brain is one of our organs that contains the most amount of fat in the body (~60% fat). There have been studies which support that sufficient intake of long chain PUFAs (particularly DHA), may reduce the risk of depression. DHA is also essential for brain growth and development in children.
    • Vitamins 
      • B12 - may be beneficial in the context of reducing dementia risk and assist with cognitive function in older adults. Sources include: beef, liver, chicken, fish, shellfish, dairy, eggs 
      • Folate - Researchers have found links between folate deficiency and depression. Still unclear if the poor nutrition, relating to the depression, causes the folate deficiency or the folate deficiency results in depressive symptoms. Sources include leafy greens (spinach, broccoli, peas, lentils, legumes)
      • Vit D - ensuring levels are therapeutic has been found to have a positive benefit in the context of depression. In cold/dark countries where Vit D deficiency is more prevalent, as can be depression. Sources include eggs, oily fish and sunshine!
    • Minerals:
      • Iron - Important in supplying oxygen to our brain and for the production of neurotransmitters and myelin (lipid rich layer/sheath that surrounds our nerves). Sources include red meat, fish, legumes, green leafys
      • Lithium - well known in the mental health field and is present in many medications used for depression, bipolar, etc...
      • Iodine - through the thyroid hormone supports energy metabolism in the cells of our brain. Iodine is particularly important during pregnancy as deficiency may result in cerebral dysfunction.
      • Zinc - antioxidant which can protect brain cells and can also improve the uptake of antidepressant medication, sources include: meat, poultry, legumes, pulses, nuts, seeds

    Dietary patterns:

     

    • SMILES trial (undertaken locally in Melbourne & Victoria)- An interventional study which used dietary improvements as a treatment modality for patients with pre-existing depression. The dietary intervention group received 7 sessions with a clinical dietitian for personalised nutrition advice and counselling. Also followed a modified med type diet.The control group received an interesting intervention known as ‘befriending’ or ‘social support’ which included trained professionals discussing topics of interest e.g. such news, music or sport. For subjects who were difficult to engage, cards or board games, were used as a tool to keep them engaged. The results found that participants in the dietary intervention group had a greater reduction in depressive symptoms over the 12 week period ( in comparison to the social support group). At the end of the trial, ~33% of the subjects in the dietary support group were considered in remission of their depression, in comparison to 8% in the social support group.
    • Another interesting point was that there wasn't a change in weight or BMI - dietary quality may be more valuable than weight loss.
    • Economic evaluation - cost saving in using this treatment approach
    • In summary those who made the greatest change to their diet saw the greatest benefit in regard to their depression
    • This also highlights that we need improved pathways and access to dietetic care in the treatment of depression.

       
    • Depression in children and adolescents is hugely important because the average age of onset of anxiety and depression is in this group
    • Relationship Between Diet and Mental Health in Children and Adolescents: A Systematic Review - Showed a relationship between diet which was high in foods containing refined CHO’s, saturated fat and processed foods, and poorer mental health in both children and adolescents. We know the onset of anxiety and depression is coming up at a much younger age, therefore early intervention strategies such as improving dietary quality and a population level may be beneficial.

       
    • The impact of whole-of-diet interventions on depression and anxiety: a systematic review of randomised controlled trials - This paper reviewed the findings from RCT to assess the impact of dietary interventions (whole-of-diet approach) on both depression and anxiety. The good news is that many of the papers concluded that dietary interventions were effective in the management of depression, and at times was comparable to medication and psychotherapy. The evidence was less strong regarding anxiety management. 

    MedDiet

    • Rich in fruits, veg, nuts, seeds, legumes, fish, lean poultry, EVOO
    • Preference for selecting wholefoods and low in processed foods.
    • Eat in a social environment - promotes social engagement
    • Long-term treatment with the Mediterranean diet on depression for patients may be beneficial. 
    • Anti Inflammatory foods seen as in the MedDiet - reduction in proinflammatory cytokines which can assist with neurotransmitter development/uptake.

    Western Diet 

    Study of 110 healthy 18-22 year olds were randomised to either a Western diet for a week or their usual diet. Those on the Western diet (toastie and m/shake or waffles for breakfast and fast food meal for lunch and dinner)

    showed impairments in learning and memory and also reduced appetite control. 

    https://royalsocietypublishing.org/doi/10.1098/rsos.191338

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056912/

    Gut microbiome - bidirectional communication between gut and brain

    • Our gut bacteria can have a profound impact on our mood and mental health - many animal and human studies have looked into this.
    • Animal data + human data - bacteria important for physical and mental health. Diet is the most important component to affect the gut microbiota.
    • Gut microbiota interact with all cells in the body and also have an impact on our genetic profile
    • Prebiotic fibres to feed our gut bacteria - when gut bacteria and thriving this is likely to have a positive impact on our mood and mental health  - diversity of fibre (diversity is a marker of food gut health). When our bacteria ferment dietary fibre they also produce neurotransmitters - more than 90% of serotonin is produced in the gut (still unsure if that makes it to the brain across the blood brain barrier). 
    • Probiotics -  Probiotic supplementation showed a significant reduction in depression - particularly Lactobacillus and Bifidobacterium. Include probiotic rich foods - kombucha, kimchi, yoghurt, kefir.
    • Polyphenols can also help increase the growth of our gut microbiota.
    • Poly + monounsaturated fats - from fish, nuts, EVOO
    • Listen in to episode 3 but also stay tuned for an update on gut health in episodes coming soon!

    Other mood boosting strategies

    • Covered nutrition in depth.
    • Exercise has been linked to improved mental health
    • Eating with others - mediterraneans do this well
    • Sleep - aim for 7-8 hours per night
    • Meditation has been shown to help build more brain cells = better long term brain health. Exercise does the same. Improved connectivity. 
    • Novelty - learning a new skill, language, dance, route home from work, meeting new people, changing hair colour or clothes style -  may increase plasticity of the hippocampus (the ability to create new connections between neurons). 

    Upgrade Your Health Guide 

    http://oncorenutrition.com/eat-our-words/

    Food and Mood: Improving Mental Health Through Diet and Nutrition

    - link in shown notes to online course for anyone interested in learning more or using diet as a tool to support good mental health.

    Episode 27: The Carnivore Diet - The real reason you may feel better on the carnivore diet

    Episode 27: The Carnivore Diet - The real reason you may feel better on the carnivore diet

    Carnivore Diet

    • Diet consisting only animal products
    • The belief is centered around that the optimal fuel source should come from animal products rather than plants.
    • Excludes all other food groups including fruit, veg, wholegrains, processed foods
    • Allowed meat (fatty meats are endorsed), poultry, fish, offal (kidney, liver), eggs, ghee, lard and small amounts of low lactose dairy products (e.g. butter, cream and hard cheeses).
    • Include water and bone broth.
    • No tea, coffee or any other fluids, as they are derived from plants.
    • No supplements.
    • Goal is to aim for no carbohydrate intake (no fibre)
    • Variation of the keto diet, however they are not the same. On keto you are allowed low calorie vegetables, nuts, tea, coffee, dairy and sugar free products, where on CD you are not. 
    • The belief is that you will achieve ketosis as no CHO’s are consumed, however this may be unlikely given protein load and gluconeogens 
    • There is no guidance around calories or portion sizes, but rather to eat as you feel
    • The is a central focus that plants are not put on this earth to serve as food for humans. Rather they produce toxic compounds in our bodies and can result in a number of negative hea;th consequences. 
    • There is also the belief that we can get all our vitamins and minerals from animal products, meaning there is no need for plants. As well that the CD can prevent and reverse a number of chronic health conditions.

     

    Nutrition and health implications of Carnivore diet 


    Mood and mental health

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940663/

    https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0791-y

    Cancer risk

    https://www.sciencedirect.com/science/article/abs/pii/S1470204515004441?via%3Dihub

     

    Inuits literature

    Compared with general Canadians, Inuit had higher prevalence of heart attack, stroke, diabetes, obesity, and hypertension. However, Inuit had better blood lipid profile.

    https://academic.oup.com/jn/article/139/12/2322/4670601

    https://science.sciencemag.org/content/349/6254/1343

    https://www.sciencedirect.com/science/article/abs/pii/S1438463918306539?via%3Dihub

    https://www.ncbi.nlm.nih.gov/pubmed/29685826

    https://www.researchgate.net/publication/10943329_Low_incidence_of_cardiovascular_disease_among_the_Inuit_-_What_is_the_evidence