Cypriot grain salad

This is a delicious salad a friend brought to the table on my recent trip back to Sydney when a gaggle of us got together for a catch up feast.  It’s inspired by the ‘Hellenic Republic’ grain salad recipe by Melbourne chef George Dimitrios Calombaris.


Instead of freekah (cracked wheat) I used quinoa only because I didn’t have freekah in my pantry.  It’s a good gluten-free option although be aware that pseudo grains like quinoa can be a problem for grain-, or gluten-sensitive peeps.
I also used dairy-free coconut yoghurt as that’s what I had at hand – and with that the salad morphed into a vegan recipe!  And even though df yoghurt doesn’t sound very Hellenic it was absolutely delicious with the cumin and pomegranate swirled in it.  Also I snuck in some rocket because I love leafy greens and it’s such an easy way to get more into your daily diet.
All in all, this is a well-rounded dish with all the macronutrients you need, so enjoy it on its own, or alongside other dishes for a feast.  Last week we ate it as a side with falafel, very yummy.

 

Ingredients

(serves 4)

100g red and white quinoa (or freekah)
100g Puy lentils
1 bunch coriander, chopped
1 bunch parsely, chopped
handful rocket or any salad leaves you like
1 small red onion, finely chopped
2 tbsp (c 30g) toasted pine nuts
2 tbsp toasted flaked almonds
2 tbsp toasted pumpkin seeds
2-3 tbsp small capers
70g currants
3 tbsp extra virgin olive oil
1 lemon, juiced
100g pomegranate seeds (or a whole pomegranate)
100g Greek yoghurt or dairy free alternative
1 heaped tsp ground cumin

Method

Boil the Puy lentils and quinoa separately in water until cooked to your liking.  Drain and cool.
In a bowl, add these to the chopped herbs, toasted nuts and seeds, capers, currants, lemon juice and olive oil.  Mix well and then stir in the rocket or salad leaves.
Add the ground cumin and pomegranate to the yoghurt and dollop on top of the salad.
Easy, quick and very scrummy!

Sharing thoughts and inspirations this Christmas

In these days before Christmas, when some of us are seeing well-laid plans scuppered, or Xmas traditions taken away due to Omicron looming large, it feels like the right time to share some positives from my world of functional nutrition.  Not about Covid or immune health (we need a break, plus I wrote about it here back in March). https://www.appleaday.org.uk/immune-health-natural-tool-kit/

Instead, some books and a few of the many health ‘influencers’ and podcasts that have inspired and taught me, plus some health facts about the vagus nerve, which may sound random, but isn’t, because it has popped up at so many webinars, online conferences and health discussions this year.

Introducing the vagus nerve (VN):

This nerve may not be on your radar, but one of the reasons it keeps coming up in the health world is because it’s the main neural highway running from the brain down the length of the body.
In fact, it’s the longest nerve in the autonomic nervous system, and it travels or ‘wanders’ (= latin vagus) down the body to the colon, innervating organs as it passes the cardiovascular, digestive and reproductive systems, taking information from each and sending on messages from the brain.  Little wonder it has the potential to impact health!

The trouble is, like so many body parts, this nerve can lose tone from middle age.  It’s also affected by a sedentary lifestyle or chronic stress, trauma, poor diet, and more of the usual western world lifestyle habits.
And this loss of vagal tone can then undermine the organs and systems it passes through, affecting mood, digestion, breathing, heart rate, reflex actions, even relaxation.

So how do you improve vagal tone?

Meditation, yoga, pilates (really most form of exercise), will help improve your autonomic nervous system and the vagus nerve.  And then, interestingly, taking cold showers or swimming in cold water (maybe not something to start now if you’re living in the northern hemisphere!)

There are other even more unexpected and unusual practices that are at the top of the list when you read about improving vagal tone.  And they’re very do-able.

Humming or singing loudly 
How lovely is this!  By humming or singing, you actively stimulate the laryngeal muscles and improve the signalling of the VN.  If you don’t have a voice others appreciate sing in the car to the radio; it won’t complain!

Laugh loudly (the harder the better)
A smilar mechanism to singing, plus research already tells us that laughter improves physical and mental well being.  So if it also specifically helps vagal tone, there’s another reason to watch more comedies over Christmas.

Gargle with vigour!
Ideally 3x daily for a minimum of 20 seconds, which may sound short, but isn’t when you’re starting out.  Anecdotal evidence shows it can improve gut health, specifically peristalsis and symptoms of a hiatus hernia.
When you gargle you activate the three pharyngeal muscles at the back of the throat which stimulates the vagal nerve.   You’ll feel your diaphragm and muscles around your stomach and oesophagus getting quite a work out, and if tears pool in your eyes it’s apparently a sign you’re doing it correctly.  According to Dr N. Habib who wrote a comprehensive book called Activate your vagus nerve’ (yes, there are specialised books about it), the superior salivary nucleus is being stimulated, which triggers the glands around your eyes to produce fluid.
Like brushing your teeth, gargling should become part of your life…. your new noisy singing life!
And by adding salt to the gargle water you have the added benefit of an antimicrobial oral wash.

If any of this sounds like a Christmas fairytale just search online for vagus nerve and you’ll be inundated with a plethora of articles and studies referencing its importance.

Podcasts on health and life

Podcasts are such a great platform to hear the latest in health!  I love them and wish I had more time to listen to more…
Rangan Chatterjee’s ‘Feel Better Live More’ is still my overall favourite with so many expert guests sharing their unique insights and wisdom.
I particularly liked the May interview with investigative journalist, James Nestor.  The latter has written a brilliant book, ‘Breath’  which covers far more aspects of breathing than I ever thought possible.  In using himself as a guinea pig in all the different breathing techniques that are out there, he not only tells a great story but ultimately makes it clear how we should all be breathing for good health.
Another interview on July’s ‘Feel Better Live More’ that has stayed with me, was with Dr Rahul Jandial, a neuro surgeon.  He talked about the trials and joys of his training years and subsequent career, and how humbled he is by his patients.  Jandial’s book, ‘Life on a Knife’s edge’ is extraordinary, illuminating and at times unnerving.

Other great podcasts I try to find time for:
The happiness lab,  The Doctor’s Pharmacy, Natural MD Radio & Huberman lab (which is full of science if you’re into it)

 Some health books of many to ponder  

‘Hormone Intelligence’, by Aviva Romm;  should be on all bookshelves – and she’s written more excellent books!
‘Untamed – Stop pleasing, start living’, by Glennon Doyle. The title says it all.
‘Breath’ by James Nestor.  A must for anyone who breathes
‘The metabolic approach to cancer’, by Dr Nasha Winters.  An extraordinary functional ND, author, speaker, global cancer consultant who survived stage 4 cancer some 25 or 30 years ago.  Her next book is coming out in February  ‘Mistletoe and the Emerging future of Integrative Oncology’
(mistletoe extract has a century-old history of use in complementary medicine especially regarding cancer.  In Europe, mistletoe extract injections are among the most prescribed therapies used to treat cancer alongside chemo or exclusively.  Studies and testing have been ongoing for decades so I’m looking forward to discovering what Dr Winters puts forward in her book.

Health influencers, some of the people who’ve inspired me

Dr Caroline Leaf, a neuroscientist and mental health expert; always seems to find the perfect single sentence or paragraph to sum up a very long and difficult complex issue.
Robyn Puglia, functional medicine practitioner; lecturer, teacher and more.  Also runs online talks and QA sessions on facebook with the brilliant thryoid and brain author/educator Dr Datis Kharrazian (check out his weekly talks on his facebook page).
Ben Brown, functional nutritionist, lecturer and more; website newsletters offer well-researched commentary on current health conditions and studies.
Dr Nasha Winters, mentioned above; some of her talks and interviews are available on YouTube.
Avivia Romm, also mentioned above; her website is an encyclopaedia of knowledge 

So many other health professionals who are daily influencers for me, who are part of my practitioner world – Debbie Cotton, Moira Bradfield, Jason Hawrelak, Emma Beswick…. There will be YouTube talks by them out there.

As for food authors there are so many new, fab cookbooks available, I can’t keep up with them.  For me, Ottolenghi continues to deliver and I am currently still working my way through the vegetarian recipes in ‘Flavour’ (just reduce the sugar which he SO loves to add, in some form or other, to his recipes).
His mushroom-lentil ragu dish is a winner for us and will be part of our Xmas menu this year.

Niki Webster (aka Rebel recipes), is about to bring out another vegan cookbook, watch her space!

And for anyone wanting to do gluten free baking, Naomi Devlin offers so many excellent workshops online, take a look at her website.

Finally, my dear friend, and surrogate mum, 94 year old Hedi continues to be a big influencer for me.  She can still walk the length of Regent street and then enjoy a hearty meal.  I think she invented the word resilience.

I’d love to hear from you!

Tell me about some of the positives you’ve found this year, whether it’s some people you’ve met or books or happenings that have made your life, or illness, or Covid journey, aka slog, a little easier.

I’m back in my zoom clinic here, in Dorset, on Tuesday, 4th January.  As always I’m offering a Christmas gift discount for the month of January; 10% for all consultations.  Just email me for bookings.

Until then I’m sending you all huge hugs and lotsa merries, and a happy 2022 for us all.

Stay well friends!

x

Immune health natural tool kit

Immune health has understandably been in the spotlight since the start of the Covid-19 pandemic.  We’ve all been asking the same:  how to avoid catching Sars-CoV-2, and how to have less severe symptoms if we do catch it.  Staying home, socially distancing and wearing masks will all naturally minimize exposure to any pathogen, but what else can we be doing to support our immune system?

Since nutrition is such a big part of who I am at home, and in clinic, as a functional nutritionist, I’ll always think food first.  If research has shown that we are what we eat, then being vital and thriving versions of ourselves is the first step to being immune strong.

A daily rainbow of vegetables means we can piggy back on the defence mechanisms of the plant world; support our immune systems by eating a variety of colours and tastes.   Bright colours and strong smells and tastes – just think of garlic! – are the plants’ defences that translate into antioxidants, phytonutrients, vitamins and minerals for us.
Ten or twelve portions of vegetables, herbs and fruit may sound a lot, but it’s not that difficult to incorporate them into daily meals.  Salads, soups, juices, stir fries, oven roast veg, or a packed steam-pot.  Variety and colour are key.  Then add to that good quality protein, healthy fats – and clean, fresh water, always – and we have an arsenal of nutrients to battle any infection.

In order to absorb and effectively use these immune-enhancing nutrients our digestion has to be working well.  In fact, with Covid-19, we need to ensure our gastrointestinal AND oral & respiratory barriers are robust and healthy.  There are specific foods, nutrients and probiotics that can help us optimize the structure of these barriers, as well as increase the diversity of our gut’s microbiome.

Sleep ourselves well!  This is a quote by Matthew Walker, sleep specialist and author of the best seller ‘Why we Sleep’ who seemed to be on every health podcast in 2020 explaining the importance of sleep to our overall health and longevity (watch him on Youtube’s Ted series, 2019 and 2020).
Walker writes about the link to immune health, stating how during sleep we not only stimulate the production of different immune factors, but the body also increases its sensitivity to those factors.  We literally wake up immune stronger after a good night’s sleep.   Reason enough to hunker down and rest if we get sick.  According to Walker and other sleep experts we should be aiming for 7 and 9 hours each night to ensure continued wellness; more if you’re a child or teen – or ill.

Being outdoors is another vital part of good health.  It has been shown to improve overall well being and more specifically our immune status.
There are so many fascinating studies focussing on our deep bond with nature.  How simply looking at the sea or forest or at birds and clouds can lower blood pressure and be an antidote to stress (‘ecopsychology’), as well as improve our immunity.
Stand in a woodland amongst trees and we’re breathing in compounds called phytoncides, the airborne antimicrobial chemicals that plants release as protection against insects.  Shinrin yoku, (directly translated to forest bathing), enhances our immune health because these phytoncides have antimicrobial properties which our bodies respond to by increasing the activity of certain cells in our white blood cell army, namely our natural killer (NK) cells which kill off virus-infected cells.

Take it a step further, literally, and we have exercise, no newcomer to playing a role in our well being.  We all now understand how exercise of any sort, when not excessive, can improve so many body systems, from circulation and heart to bones and mental health a.o.
Endorphins, such as serotonin, rise when we exercise, and these higher ‘happy’ serotonin levels are yet another antidote to the damage that stress hormones can wreak.  Stress will always undermine our immune health.

Exercise immunology is a fairly new sub discipline of exercise physiology and looks at the relationship between exercise and immune function.   In an article from The Journal of Sport and Health Science (May 2019) we can read that short bursts of exercise enhance our anti-inflammatory cytokines and natural killer (NK) cells, as well as increase neutrophils and our T cells (according to many sources including BMJ, these T cells are the actual ‘superstars’ of our white blood cell army, in the fight against Covid; BMJ 2020;370:m3563).

When outdoors exercising we are being exposed to natural light.  This in turn affects our melatonin, the hormone that regulates sleep.  Being outdoors in the morning, ideally walking or exercising, exposes us to that natural light, helps set our natural clock for the day and also gives us a better sleep routine. Win-Win!
Interestingly, there have been numerous studies on melatonin during 2020 due to its antioxidant, anti inflammatory – and its immunomodulatory properties. It is being researched for potentially helping reduce the consequences of the SARS-Cov-2 infection, and studies continue on its potential antiviral action (Frontiers in Medicine. https://doi.org/10.3389/fmed.2020.00226).

If we’re social distancing and eating our rainbow diet (plus protein, healthy fats, water…), sleeping well and exercising, plus trying not to get stressed by work, or lack of it, or children home-learning or the latest global disaster (or certain irritating BBC journalists reporting on Covid), but we still end up catching SARS-Cov-2, or even the common cold, what other support is there for our immune system?

So many studies and papers were published during 2020 concerning Vitamin D.   In the functional nutrition world this vitamin has been in the limelight for a number of years now due to its immune-protective properties.  So it’s been heartening to see how doctors the world over, and the NHS here in UK, are recognising its importance and recommending we check D levels and supplement if low.
It may be difficult at the moment to get vitamin D blood levels checked if in lockdown or if medical staff and clinics are overwhelmed.  There are however labs across UK, and no doubt in other countries, which can send out Vit D finger prick test kits.  Easy to do and not expensive.  Here in UK a number of NHS hospitals are offering these kits online, just have a google.
Chances are, if living in the northern hemisphere, D levels will be low given the lack of sun, which is how we make Vitamin D.  And it’s likely to be the same in the warmer southern hemisphere if people are lathered in high factor sunscreens.
Foods like oily fish, egg yolks and some fortified foods will have small amounts of Vit D, however taking D in supplement form is a good solution (although the best solution will always be supplementing after having been tested since overdosing on Vit D, although not easy to do, can potentially be dangerous).

Other star antioxidant vitamins are A, E and C.  Vitamin C has a long history of immune support, but drinking huge glasses of orange juice won’t cut it.  Not only are you getting a detrimental sugar spike in your blood, but you’re missing the ‘whole’ fruit benefits.  Plus, in the end it won’t be anything near the levels of C you need if combatting a virus.  You can safely supplement 500 mg – 2000 mg in divided doses daily.
Vitamins A, E and C are all critical for immune health, with the bonus that they also improve the integrity of our gut and lung barriers.

Another crucial player when it comes to immune modulation is zinc.  Amongst its many attributes it stimulates the hormone in our thymus gland to produce new T cells.   Sadly, this mineral is sorely lacking in our diet since it’s lacking in our soils.  We also don’t get enough from fish when the fish is farmed.  And despite it being in a lot of fortified cereals these are rich in phytic acid which binds out the zinc so we can’t absorb it well.  Everyone tends to be low in zinc and a supplement of 15mg daily is generally safe.  Again, it’s best to check your zinc levels with a functional nutritionist or doctor so you know the amount you should supplement.

There are so many different herbs that are immune-supportive.  In fact, if we add a wide variety to our cooking, eg. rosemary, thyme, basil, oregano etc, then we’ll be adding a wide palette of phytonutrients that will not just be improving the flavour of our food but also our health status.
There are some stand-alone herbs which have either specific anti-viral action, like echinacea, or anti inflammatory properties like turmeric root, or herbs like andrographis, which have been traditionally used to support immunity in the respiratory tract.   Again, it’s best to work with someone in the know when it comes to herbal tinctures.

Last but by no means least, medicinal mushrooms have to be mentioned.  Mycology, the study of fungi, burst onto the health scene years ago due to the astonishing antioxidant properties and immunemodulating effects of specific mushrooms.   There are a number of varieties like reishi, shiitake, turkey tail (coriolus versicolor) and chaga which show anti-viral action, either by inhibiting viral replication or enhancing the cellular immune response to infection.  As long as you’re not allergic to them, adding fresh shiitake mushrooms to your menu or a reishi powder to your smoothie or soup can only be good, and there are some excellent supplements available.

Viruses are resilient so they certainly won’t be going away anytime soon.  However, nature has given us this wonderful tool kit to work with – food, specific nutrients, sleep, exercise, the outdoors – which can help us either as a preventative measure or in face of an acute infection.

Let’s make use of this tool kit and go safely forward into a healthier year!

FODMAPS diet, why and how

Moving away from the theme of viruses – hooray! –  and talking to you today about the FODMAPS diet, specifically the low FODMAPS diet.
If you’re wondering what this word even means, it’s an acronym for terms describing certain carbohydrates (and their fermentable effect on digestion):  Fermentable Oligosaccharides Disaccharides Monosaccharides And Polyols.
Easy to understand why the acronym’s preferred.  Those carbs are quite a mouthful!

low FODMAPS

Fodmaps are found naturally in a wide range of foods.  They are different types of carbohydrates that are not easily absorbed in the gut, and which therefore can kick off IBS-type symptoms in some people.

Due to this diversity of potentially troublesome carbs it can be difficult to navigate the low FODMAPS diet, so here is a broad brush stroke of information to help you decide if you want to give it a go, either with a therapist, or on your own.

Let’s look a bit closer at this acronym.
Fermentables:  This is what happens when your gut bacteria ferments undigested carbohydrates.
Oligosaccharides: mainly found in wheat, rye, pulses but also garlic and onions..and more.
Disaccharides: mainly in dairy produce, including those yoghurts you might be eating daily because you believe they’re healthy (which they are for some, and perhaps for you, once you’ve been eating low FODMAP and introduced it later, in a small way; possibly only occasionally.  All very individual).
Monosaccharides:  these mainly cover fructose and include a variety of fruit plus honey – and corn syrups (do read labels when you go shopping!)
Polyols:  these are also found in different veg and fruit; also in articial sweeteners.

First thing to keep in mind when considering this diet is that you have to be dealing with IBS symptoms.  This isn’t a weight loss programme, nor is it a particularly healthy diet to keep in your life.  On the contrary.  As it excludes a lot of normally healthy prebiotic foods, this is an eating regime to do SHORT-TERM in order to reduce your IBS-ish symptoms.  Some prebiotic foods are included but not many, and you need these prebiotics for a healthy gut, for your diversely populated microbiome, hence this isn’t a diet for the long haul.

I normally suggest two to three weeks with clients, but if you’re feeling vastly better on it then an extra week or two is fine.  Monash university, which developed it in the first place years ago, and have an excellent app (more about that below), states you can follow it up to eight weeks.  Personally, I prefer clients to move back onto some of those ‘missed’ higher FODMAP foods earlier than that.

And this brings me to the next stage of the diet.  After your three or so weeks of ‘low’ eating, you then gradually introduce one higher FODMAP food, from one of the above groups, back into your menu to see how it feels, to check if you react and have symptoms.

This sort of challenge is what a lot of clients try out in order to identify ‘intolerance’ foods.  Exclude then reintroduce, one at a time, giving yourself days inbetween to allow some slower symptoms to emerge – or not.

With the FODMAPS approach – which is not about intolerance foods but about hard-to-digest carbs – once you’ve followed it for your two or three weeks, you then introduce a higher FODMAP food to your meal.  In a small way the first time, then building up slightly the following day.  On the third day you try a ‘normal’ (not huge!) amount of that food with your meal.

I recommend waiting a couple of days before you try another new higher FODMAPS food so that you’re not overloading your digestion, not challenging it too much.
Some people find their old gut symptoms return when they’re stepping up the amounts, so back off with that food, wait a couple of days and then try another higher FODMAP food.  Waiting those two days inbetween these trials gives pause for your digestion.

Always play it safe.  Stick to re-introducing one new food in one FODMAP group at a time.  Start small and gradually.
Everyone is different.  Some digestions are more sensitive or reactive than others, and this is one reason why it may help to work with a practitioner.
Another reason to work with someone:  You might be starting this diet because you feel you’ve “tried everything”.  Left out gluten then excluded that daily biscuit or sweet, reduced wine hugely, stopped the pizzas, left out some cheese.
This approach can often be too random, and if nothing else, there should be a logical and informed plan to how you go about changing your diet.  Some people may want the support of a nutritionist or naturopath with this plan.

Also important to be aware of is that a lot of gut distress can be due to overgrowths of yeasts or bacteria or parasites.  Stool tests would then be indicated, or other home test kits to rule out SIBO or gut permeability for instance.  Dietary changes alone won’t clear up an overgrowth of pathogenic gut bacteria, and eliminating sugars (& using a pessary) won’t resolve systemic candida.

Stress, too, can play a huge role.  In clinic, when talking about stress, often a client will say, ‘yes I’m stressed but isn’t everyone?’  Short-term stress, sure.  That’s part of life, and your body is wonderfully geared to coping with it.
Ongoing chronic stress, however, should never be considered the norm.  A low FODMAPS diet might relieve some gut symptoms but if underlying anxiety, stress, anger or insomnia are big in your life, the triggers to your digestive distress, then switching diets won’t be the magic bullet.  (Luckily there are lots of other magic bullets that can help you!)

All this low and high FODMAP food talk may sound like a pfaff but you can either work with a therapist or use something like the Monash University FODMAP app.  And if you don’t use apps there are some excellent online lists of food and recipes you can print off.

If working on your own, take your time to read about the FODMAP diet first.  Get your head around the aim of the diet, the foods and stages it involves so you are fully committed and have your kitchen stocked and those menu plans in place.  And don’t feel you have to eat a food just because it’s low FODMAP.  If you don’t normally want a banana, don’t eat it just because it’s ‘allowed’!

For those of you thinking life will be a vegetable misery for the weeks you’re on this diet you’ll be jumping for joy.  There are loads of fab veg which are low in FODMAPS.   Animal protein isn’t a problem, and there are good options for vegetarians like tempeh, eggs, quorn…

The above photo shows just a few vegetables I had at hand for some clients last month.  Instead of their regular follow-up, we had an extra hour of going through the foods together, then cooking a couple of dishes and eating the low FODMAP way.

Key points to remember:
First make sure this diet is right for you, that you’ve ruled out other players such as gut overgrowths, intolerance foods, stress….
Work with a therapist if you can, especially regarding the above issues you may not have considered.
If going it alone, I recommend downloading the above-mentioned Monash University app. There are other apps on the market – do take a look online – but this is the one I’m familiar with and which is specifically for tracking and working with FODMAPS and not overall diets.  Otherwise, google low FODMAPS diet and print off the food and menu lists.  Get your kitchen and your head ready for a couple of weeks of changed meals.

If you’d like any more information about the FODMAP diet I always offer 15 mins free calls.  And if you have any other worries about diet, health or well being do please contact me for a chat.

I’ve stopped 1:1 consultations during these times of social distancing, but skype, facetime and landline consultations work really well and have been part of my clinic for years.  Our voices and ears are in fine form and can side-step viruses to cross towns, counties and oceans via amazing technology.
How lucky we are for that!

High cholesterol, some facts and foods

It’s almost February, which seems so unlikely as the year only just began moments ago, surely?

In keeping with my new year’s resolution (which actually only dawned on me a week ago, well past new year, oops) I’m going to post more health info blogs on my website rather than just the short social media chat and occasional recipes.
This will keep me on my toes with some mindful research and deliberation, and will hopefully give you something to read and think about; a chance to make comments and suggestions as it’s all a learning game.  We are indeed unique, so our experiences will be very individual.

 
cholesterol lowering

On this last day of the first month (and almost the eleventh hour! Been a long day…) I’m kicking off with the somewhat prosaic topic of high cholesterol.
Oh I know, it feels like we’ve been here, done that, however, in the last two days I’ve seen four clients who came for very different health reasons but all have alarmingly high cholesterol.  Scarily high LDL in fact (more about that below).
I took it as a sign to blog about some cholesterol facts and foods.
Apart from this coincidence – these four clients sharing more than they will ever know – the topic of cholesterol has become quite a controversial one; well worth having a chat about.

Contrary to conventional medical thinking these past decades, many studies now show that high cholesterol is NOT the be-all and end-all of CV risk.
A big statement, some may think, however these studies are proving that the measure of cholesterol is not always relevant.
Some people have a high ‘bad’ LDL cholesterol but are living to a healthy heart-attack-free age because, in part at least, their equally rising ‘good’ cholesterol has been offering them protecton.  Studies are also showing that when high cholesterol IS relevant to a person’s heart health, it’s not the only ‘measure’ that plays a significant role.  As I said, it’s not the be-all and end-all of CV disease.
This is not to say we ignore it altogether.
There is a place on the heart health table for trying to keep high cholesterol in check; certainly if there are other contributing negative factors gathering around that table.  Factors such as eating the wrong foods, chronic stress, insufficient exercise, overall body inflammation, smoking, weight gain (obesity is inflammatory and, like stress, it worsens all conditions), familial history of strokes and heart attack, and age (we remove excess cholesterol less efficiently as we get older).

What is cholesterol anyway?
A waxy fat-like substance that’s surprisingly important to our health.  It helps make our hormones, converts sunshine (when it’s around!) to vitamin D, is necessary for digestion and brain function, and assists in the absorption of fat-soluble nutrients.  Vital in fact for all our cell membranes, so we really don’t want to have too little of it.

When we talk about cholesterol we’re actually talking about the lipoproteins that carry cholesterol around our bloodstream.  These are fat on the inside and protein on the out and come in various forms, the two most relevant being, LDL (low-density lipoprotein, the so-called ‘baddie’ of the two, but yes there’s more to it than that regarding particle size and actual ‘badness’; too involved to go through here but there are excellent sites to read about these).  And secondly, HDL, the high density lipoprotein which is the ‘good’ cholesterol as it’s protective in that it takes excess cholesterol back to the liver where it’s then used or excreted. (It’s the efficiency of this disposal which can slow down with age, as mentioned above).  By removing excess cholesterol the build-up of fatty plaque in your arteries is avoided;  a build-up which is associated with low density lipoprotein, LDL and which can then lead to narrowing of the arteries and atherosclerosis.

When you have your cholesterol measured it’s the ratio of these two – LDL and HDL – that’s important to be aware of, not just the total number.

A large proportion of cholesterol that’s circulating in your blood is produced by the liver and intestines; the rest is from diet.  This may explain why some people with high cholesterol haven’t had the huge improvement – reduction – in ‘numbers’ that they expected after radically changing their dietary habits.

Nonetheless, for many people the effectiveness of dietary change regarding high cholesterol is extraordinary.  I’ve seen it in clinic;  one reason I wanted to write this post.  It’s an easy and very successful first port of call.  Together with getting off your sofa!

So, what are the foods that will make a difference, which will help you avoid taking medications, those statins that can have side effects and which are so very controversial?

Take a look at the photo accompanying this blog.
Eat more of these foods, the likes of flax seeds containing plant sterols that are shown to significantly lower cholesterol.  And oats with their soluble fibre.  More leafy green fibre such as spinach, chard, kale, radicchio, romaine lettuce, fennel, dandelion, spring greens, rocket, chicory… the list is endless!  And more cruciferous veg like broccoli, cauliflower, cabbage.
Also tocotrienols – found in the Vit E family and in the likes of walnuts and virgin olive oil which have shown improvement in arterial health.
And turmeric, always!  It’s not just a way of lowering inflammation but it improves vascular function in coronary artery disease and can suppress early atherosclerotic lesions (similar to lovastatin).

Eat far less meat, less overall saturated fats, less ‘whites’ (rice, potatoes, sugar, flour), less fried foods, far less sugars and salt.
Give up smoking, hooray!
And try to get stress levels down, down….

Last but by no means least, get moving.
Exercise will help rebalance your body, move your blood, shift stagnation, drop some kilos, soften the stress in your life, improve energy and alertness, increase happy hormones – and will most definitely help lower your high cholesterol.

 

When food is the enemy

Recently I saw two new clients who are having serious problems eating food.  People with allergies and intolerances are frequent clients, however both these people have quite extreme issues going on.
One has been on such a restrictive diet for the past year he’s now frightened to try anything new, or for that matter anything old.  He saw his doctor in January who said he had IBS and reflux; he was given antacids and told to watch what he eats.
All year this man has been watching his food, to the point that there isn’t much now left on his plate to watch.  After seeing his doctor back in January, he began searching online, trying out too many different hypo-allergenic diets, gradually eliminating so many foods that he’s now left with a sad and paltry selection; some quite bizarre.  He’s tired all the time, he tells me, and has lost too much weight.  “My joints hurt. I don’t know what to eat coz everything gives me heartburn”.  As he talks his leg jiggles the table between us.

food warning

Another new client the day after was a woman eating a reasonably healthy diet.  After hearing, however, about her regular reactions that are verging on anaphalaxis, I was surprised – in awe! –  at the variety of food she’s actually coping with.
Her allergy consultant has prescribed steroids which she takes when she has these severe reactions, worse and more frequent in recent times:  A tightening in her chest and throat, swollen lips, breathlessness, sometimes a sudden drop in blood pressure.  Scary stuff indeed.  She’s had to swap meds several times as she reacts to those as well (no surprise).
“What can I eat?” she asked.  Such an upbeat smiley woman, I would’ve loved to have given her an instant answer.

So, what to recommend when food becomes the enemy?

It may sound simplistic, or like some grandmother’s proverb but the logical start is, heal the gut.  These words are repeated around the globe every day by most nutritional therapists I’m sure!  And not just when food intolerances or bloating, flatulence, reflux and the like have become issues.  Given that 70% of our immune system is in our gastrointestinal system, we should all be wanting our digestion to be as happy as possible.

Healing the gut might mean different things for different people.  Removing certain gut microbes that shouldn’t be there, or are running rampant; increasing beneficial gut bacteria, strengthening the gut wall junctions, improving bile flow, increasing low levels of digestive enzymes or gastric acid a.o.  Some or all of the above; depends on the individual.
At the same time, too, expanding that digestive picture to include other important players linked to the health of our GI tract –  like the endocrine and nervous systems.

Food naturally will come into it, has to be part of the equation.  Not just because we have to eat to survive, or because that’s why people seek out a nutritional therapist, to find out which foods they should eat.
More due to that well-worn saying, we are what we eat – so true (just a shame it’s lost its impact with over-use). 

Food is a big part of healing the GI tract, of reducing chronic inflammation, of sustaining energy and improving well being.  Some foods have the potential to scupper digestive, or overall health – just think how sugar can spike everything into chaos in the body when it takes over every meal and isn’t treated with caution, kept to just an occasional treat.
Other foods have the nutrients, the astonishing ability to improve our immune health.  Those superpower foods, the likes of turmeric, green tea, fish oils, rainbow plant-based and fermented foods.  Or simply eating a balanced diet with healthy fats and quality protein (not to mention the humble green leafy veg, my fave… I’ll stop there, lol!)

After this posed question – what can I eat? – a dialogue begins. Discussing family history and other current health issues;  peeling back the layers and connecting as many dots as possible.  Trying not to overwhelm with too much information – that can be hard.  Working through food diaries and the results of lab tests. Seeing some of the puzzle pieces come together.
More often than not, the first step will focus on that healing of the gut as well as making careful changes to diet and invariably to lifestyle as well.  Suggesting people change habits they may rely on because they are part of their history, or convenient, needs to be considered.  The process has to be manageable and not too unfamiliar or threatening.

Removing, replacing, healing and restoring.  Adapting to the individual, to that person’s specific needs.  It’s a process, one step at a time.  A sharing of knowledge where it’s important to respect the difficulties in play.  Showing how food can be such a powerful medicine – as well as something delicious to eat!  And always with the aim of helping clients make food their friend and not the enemy. 

Appleaday’s Xmas gift this year, a 10% discount on first consultations – skype or 1:1 – during the month of Feburary 2020.  Email or message me on social media for available dates & times.

(Please note: the two clients above gave me permission to use some of their information.  I’ve kept it as general and vague as possible for privacy reasons).

 

Brain health: Focus on depression

Last week’s online docuseries, ‘The Broken Brain’, looked at so many different aspects of brain health that I thought it would be a great theme to address here in my blog over the coming months.

Today’s focus is on depression.  Not only do I see it a lot in clinic but also this is a condition that’s not gender or age specific.  It’s global; it’s on the rise.

depression

Some of the recommendations I’m sharing from ‘The Broken Brain’ may initially sound too difficult.  Exercise can be a hard one for some when motivation is missing.

Or it may sound trite hearing “don’t eat processed, reduce sugar”.  I agree, this isn’t new news, but the science behind it, which I’ll be sharing here, makes so much sense and can be empowering.

However deep you may be in your illness, here are some ideas and recommendations from the docuseries – gems of information to add to what you may or may not already be doing.

Depression can be such a complex, and sometimes seemingly impenetrable, health condition which is why the functional medicine approach works well.  It looks at the whole picture rather than just the symptoms plus it can give more time to the patient, which is often lacking in conventional medicine.

Antidepressants or SSRIs may be valid short-term conventional remedies to get you through a period of depression due to, say, grieving or trauma or stress.  They may end up being part of the prescriptive ‘whole’ treatment for someone, however, there can be side-effects to medications – an emotional blunting or a feeling of un-wellness as well as all the other mentioned side effects listed in the medication box!
(Saying that, if you are taking medication you must never stop cold turkey. Discuss any changes you’d like to make with your doctor or healthcare professional. Reductions should be made slowly, gradually, and with supervision).

Like most chronic health conditions, there are many different possible players with depression.

The first questions to answer may sound simplistic for a disorder that’s so multifaceted:
How did it all start? What else was going on at the time?  You may not know yourself – what did indeed kick start it all!?  It may feel like something you’ve lived with forever.

There are therapies that can help here – counselling or CBT or psychotherapy to name but a few.   Search online, read about what is available in your area and seek support.

An action plan, however, that you can try for yourself could be to mentally page through your life’s events, writing a journal, putting down memories that come into your head.  Doors can open up and let fresh air blow in, awakening thoughts which may help your process of understanding why you feel the way you do.
Possibly an ah-ha moment or two.

There are currently 3 epidemics that are affecting mental health – and overall health – in a big way.

1)    Too much cortisol.  This is an important stress hormone that works in tandem with adrenalin, another stress hormone; cortisol is supposed to ease off once the stressful situation – say, a tiger attack – is over.
I say tiger attack because this is how your body still functions.  Nothing has changed much since early man’s days, so your body can’t differentiate between that tiger attack, or being stuck in traffic or running very late for an appointment.  There’s no sliding scale, no ‘less’ pumping of stress hormones.
In our current society, cortisol levels often stay raised because the stress doesn’t stop, it just moves from one deadline to the next, from one traffic jam or ‘must do’ situation to the next.  Finances, relationships, children, partners, jobs, school pick-ups, cooking meals…you name it, they are all potential and willing stressors in today’s fast paced world.
Even ‘playtime’ can be stressful (& is often self-imposed) with less outdoor sport or walks and social interaction, and more ‘online’ time, computer screens, social media time, mobile texting.

Stress is a big driver of depression.  It cannot be underestimated.
Walking and even gentle movement if you find you can’t do more robust exercise, can relieve it by releasing endorphins, those happy neurotransmitters, especially if you combine it with scenery – the green outdoors, fresh air, parks, forests – and light.

Walking in sunshine ticks that other ‘outdoor’ box.  Vitamin D, which is often low with depression, is made in your body and requires good cholesterol levels (cholesterol is not always the enemy!), and exposure to sunshine, at least 15 minutes on bare legs, arms, face…the more the better.  Out of season, you could try using a lightbox.

Other de-stressors could be hobbies, movement classes (stretching, pilates, yoga) and mindfulness, a term we are hearing a lot at the moment – probably because it works!
There are currently so many mindfulness groups and sessions available around the country, around the world, so take a look at local noticeboards in your library, or ask in your local surgery or wellness centre.
For those who love ‘apps’, there is a plethora of relaxation apps – Insight Timer and Headspace to name just two.  These can also help with sleep which is so essential for brain health.  Even being deprived of sleep for only a couple of nights can heighten sensations of negativity and low mood!

2)    Too much insulin.
Every time you eat something sweet, the hormone insulin is released from the pancreas to get the blood sugar back in balance, to move that sugar/energy to the body’s cells where the brain is assuming it must be needed (why else would this body have eaten so much glucose – must need energy to run away from that tiger, assumes the brain).

Think how many times a day you may be eating something sweet – from that white toast, to the pure orange juice (no fibre to slow down the sugar spike) and the biscuit or chocolate and evening glass of beer….
Insulin is being summoned by the brain again and again throughout your day – used and abused until your body becomes insulin resistant, unresponsive to the very hormone that is trying to keep blood sugar balanced.
This is our current diabetes, aka insulin epidemic. Worldwide.

Another fact about sugar is that it causes inflammation in the body plus, if inflammation is already going on – being overweight, ill from viral, bacterial infections, allergies, joint pain, migraines  a.o. – it will just make things worse.

I’m referring to sugar in any form, not just the white stuff with your cuppa.  Sugar in honey, maple syrup, alcohol, white bread (chew long enough and note how sweet those simple sugars in the bread taste) and fruit – but yes, fruit has fibre to slow down the sugar hit in the blood plus vitamins, phytonutrients, antioxidants – so a little is good.
And, most important, hidden sugars added to processed foods, often in the form of ‘ose’ names on labels (maltose, fructose, dextrose, lactose… loads of ose!)
Google all forms of sugar and be astounded.
Too many canned, bottled, packaged foods contain these ‘-ose’ sugars because your taste buds love them, they’re addictive, and so they sell and make money for the manufacturers at your health’s expense.  Bluntly stated.

If you’re suffering from depression you may not like hearing that the very sweet food which feels like it’s lifting your mood is actually making your depression worse.  The fact is, the lift is temporary.  No sooner do you get that blood sugar spike, the brain will want to get it back to normal by calling in the insulin to drag it out of your blood – and you’ll experience a crash.  That in turn will make you reach for yet more sugar.
Up and down, this seesaw can lead to insulin resistance and diabetes, weight gain and more depression.

Stopping sugar cold turkey is not the answer, but slowly reducing it might be.  And what a great step forward – to help not just your mind, but to reduce the inflammation in your body and keep diabetes at a distance.

What can you eat instead?  Fruit, as mentioned above, has many great nutrients, and will still help satisfy the sweet tooth to some extent.  Best eaten in moderation – a couple of fruit a day such as a handful of berries, stewed apples or pears, some banana.  Adding warm spices to stewed fruit such as cardamom or cinnamon will also help with blood sugar balancing.
And then an occasional sweet treat, a reward treat that you keep under control – as much as possible 🙂

Small steps are so effective – don’t beat yourself up if they don’t work all the time.  Early days, one step at a time.

3) The third epidemic is not having enough thyroid hormone.
The endocrine – hormone – system is interconnected which means that the aforementioned adrenal stress can have a knock-on effect on your thyroid hormone.
Burning the candle at both ends for too long can result in adrenal fatigue and possibly hypothyroidism (you can also become hypothyroid via an auto immune route, but that’s another story for another day).
Your thyroid gland is responsible for your metabolism, for how efficiently you function, how energetic you feel, how fast your body digests and eliminates food and so on.
A healthy thyroid is about feeling sparkly rather than sluggish; feeling upbeat rather than low.

Its health will affect other hormones and neurotransmitters and has a direct impact on your nervous system health.  Low thyroid – hypothyroidism – often has depression as one of its symptoms, so ask your doctor to check your thyroid levels because your depression may actually be a result of low thyroid function.

Drivers of inflammation that can lead to depression reel of the tongue easily:
Diet, stress, lack of exercise, toxins, infections….I’ve talked about some of these already.

Diet plays a huge role.  Are you eating the necessary nutrients that will help make your hormones and neurotransmitters in order to keep your nervous system healthy and buoyant?

Good levels of protein – for cellular repair and feeling satiated – such as oily fish – ideal also for their brain-supportive DHA/EPA healthy fat levels – but also organic chicken, some organic or free-range meats, local lamb….
And if you’re vegetarian and don’t have intolerances or problems digesting pulses and eggs (choline in eggs, yes, another great brain food), do include these daily.

Go for smart carbs with low glycaemic load – all those rainbow vegetables which smack of vitality.
The more colour, the more phytonutrients they contain! These colours, just like the strong tastes or smells in certain foods (think of garlic, onion, cruciferous veg etc), equate to the plant’s effective defence system and dense phytonutrient content that will improve your own defences, your immune system and general wellbeing – and subsequently your state of mind.

The brain is the fattiest organ in your body.  About 60% in fact.  Therefore essential fatty acids, specifically omega 3s, are crucial for good brain function.  Oily fish are the best source, but flaxseed, chia, all sorts of wild plants contain levels of omega 3s.  (If you were going to supplement anything, it would be omega 3 fish oils that I’d be recommending first of all).

Consider, too, the healthy fats found in nuts and seeds, in avocados, olives and olive oil…  And the saturated vegetable fat in coconut oil – how wonderful because saturated fats don’t oxidise in the brain the way unsaturated fats can be prone to free radical damage.

The next aspect to consider is, are you absorbing what you eat?  I’ve seen more lab tests this year showing hidden infections and intestinal permeability than ever before.  These will be compromising digestion & as a result will reduce absorption of the nutrients in your food.
If you have digestive symptoms – discomfort, reflux, flatulence, burping, pain – it would be invaluable to have a comprehensive stool test (sadly our NHS does not offer these tests) to ascertain if any hidden infections are in play.

Toxins!  A huge topic, but briefly a lot of people can react negatively, with mood disorders, to toxic exposure such as chemical cleaning agents, fumes from carpets and paints a.o.  Think about any toxic exposure you may have in the work place – chemicals? Mould in the building?  Smokers around you?
Heavy metals is another blog in itself, but needless to say, this will be pulling down your immune system, and that in turn will affect your mind health.  No myth that mercury caused the hatters of old to go mad.  It is indeed toxic to the brain and can still be found in some amalgams, and certainly in some fish esp. large, old fish such as tuna, swordfish…

Finally and so importantly, exercise… or movement.  Whatever you would like to call it!  Whether it’s kickboxing or running or cycling or fast walking, rowing…..
There are so many options, you just need to find the one that appeals.  Dancing may be your thing!  All will be great for circulation, for bone health, for improving motivation and increasing those ‘happy’ hormones.

A last word about supplements.
There are a lot of supplements which you can read about online, and which are advertised to relieve your depression.

It is something to consider however start with the food you’re eating, the thoughts you’re thinking.  Add a generous dash of daily movement, some kind and helpful support, tests from your doctor or private labs to rule out thyroid or gut issues….and take it from there.

You may find that swapping some foods, adding others, and going to a local zumba class gives you the uplifting start you need.
There are certainly wonderful herbs and complexes to suit all sorts of mood problems.  All very individual, so it’s best to speak to a functional medicine therapist about it.

Make a start and then see where you want to go from there.  Wishing you well on your journey!

Fig facts; musings from Greece

I’ve had an afternoon of discovering all sorts of facts about figs, from reading online sources and my tome of a herbal compendium.  Also after picking loads of them earlier today from a heavily-laden tree – a battle between me and the wasp population of Kefalonia!

fig blog

According to Dr Mercola’s site, the fig has been around so long that remnants of the fruit have been found in Neolithic excavation sites dating back to c 5000 BC.  It was thought to have first been cultivated in Egypt, then brought to Ancient Crete and then onto mainland Greece around 9th century BC.  Here the fig was held in such esteem that laws prohibited the export of the best quality ones – much the same as in Ancient Rome, where it was also considered sacred; in fact the wolf that nurtured the twin founders of Rome – Romulus and Remus – is pictured resting beneath a fig tree.  A random fact!

if you’re waiting to see a fig flower you’ll wait a long time and end up very frustrated. The tree doesn’t blossom as you’d expect since the flowers are on the inside, producing all those mini seeds you bite into when you eat them.

I’m not a fan of wasps, as many will know, but it’s a tiny wasp that pollinates the fig tree – hooray for some wasp benefits.  However, it’s also the larger wasp variety that’s currently beating me to the fruit – and happy to sting for them!

There’s such a wide variety of fig fruit, from the purple-skinned/pink flesh ‘Black Mission’, to the ‘Brown Turkey’ (purple skinned/red flesh), to ‘Kadota’, Calymyrna’ and ‘Adriatic’ (green-skinned/beige-pink flesh) – and many more.
I’ve used the green Adriatic fig for my jam recipe that I recently pictured on instagram (and is the ‘mush’ photo above); this is also the type which is most commonly used to make fig bars.

Before they’re perfectly ripe, the fruit are sticky with ‘latex’ which can really irritate the skin, so if you’re picking them early, wear gloves.

As for their health benefits, apart from being high in fibre – definitely their global claim to fame – figs are a great source of minerals such as magnesium, manganese, potassium, copper and calcium; a large fig provides as much calcium as 1/2 cup milk.

Figs are also high in Vitamins K and B6, and are a high anti oxidant source [antioxidants fight so -called free radicals which our bodies have to deal with on a daily basis, both from natural metabolic processes producing ‘rubbish’, to external environmental sources adding to that toxic load].

The riper the fig, the more antioxidants they provide – and interestingly, all the nutrients mentioned above are potentiated when the fruit is dried.

What else?  In some cultures, fig leaves are also on the menu; the leaves apparently have anti-diabetic properties and can reduce the amount of insulin needed by those requiring injections. Saying that, don’t randomly eat the leaves!  A liquid extract was made from these leaves in a monitored lab study, and added to the breakfast of insulin-dependent diabetic subjects, resulting in these surprisingly beneficial facts.  Perhaps a qualified herbalist will be able to tell us more – please do if you’re reading this!

Figs are used as poultices for wounds and warts, plus the fruit and leaves have been crushed and then gargled to relieve sore throats.  Dried figs supposedly are heart protective, have inhibitive effects regarding some cancers esp. post menopausal breast cancer (according to the Mercola site), lower blood pressure and seem to have benefits re macular degeneration – more studies needed, however, on that last one as I’ve found no research results other than the obvious antioxidant benefits.

So, overall, figs are a fab fruit.
Make the most of them whilst they’re in season 🙂
I add them to my no-grain granola – the recipe for that  can be found on a past recipe page here – and it was easy to make a compote or jam.  You can also roast them with a drizzle of honey or add to a rocket salad or make an Ottolenghi-type tart with fetta…or just buy one and enjoy it as is.  The possibilities are endless and delicious!

 

Inflammatory bowel disease and SCD

I was talking about the Special Carbohydrate Diet (SCD) with a client yesterday, and how there are similarities to the paleo diet in that the foods recommended are the ones that early man ate before agriculture began.
If we think what a positive impact agriculture has had, giving us a global food source which many cultures literally rely on, why is it that grains can have such a negative impact on some people?

blog SCD

According to Breakingtheviciouscycle.info, a SCD site which offers loads of information, testimonials and recipes, we evolved over millions of years, eating predominantly meat, fish, eggs, vegetables, nuts and fruits.

Starches, legumes (lentils, chickpeas, borlotti beans and so on), and grains (bread, pasta, crispbreads, biscuits, cakes…. I’m being very explicit here for anyone in denial ;),  are considered the new foods on the block.

The complex carbohydrates, the disaccharides and polysaccharides in these ‘new’ foods are simply harder to digest, especially for people whose digestions are more sensitive, reactive or inflammed due to a number of other possible underlying causes apart from diet.

Keeping it simple, getting back-to-basics (ie. early man diet!) seems to work wonders in people who have digestive problems – in particular those with IBD such as Crohn’s disease of Ulcerative colitis (UC).

This morning a fascinating blog from Timeforwellness popped into my inbox and, again, the topic of SCD came up.  This time discussion of a study looking into the benefits of SCD regarding infectious bowel diseases.

A small study of 12 patients set out to assess the impact of  SCD in paediatric patients with mild to moderate Crohn’s or Ulcerative Colitis.

The results were so heartening!

After 12 weeks on the diet, disease activity had decreased considerably for both diseases, and the C-reactive protein (CRP is one of a few inflammatory markers used in practice to measure ‘inflammation’ in the body) had normalized in most patients.  Even the stool analyses showed significant changes in microbial composition.
For 10 of the 12 patients, dietary therapy proved to be extremely effective.

Remission and normalization in patients with IBD is what anyone with these diseases would hope for.

As the SCD is quite limiting, it’s best to work with a health professional or nutritional therapist who will help put a diet plan together and also help you rule out other triggers or mediators in the disease process.

Auto immune disease – what’s it all about?

A new client who was seeing me for hormone support told me yesterday that she wished she’d come to my autoimmune workshop the previous week.  I asked her if she had a relative or friend suffering from an autoimmune disease.  ‘No, but I seem to get one cold after another.’   Then she saw the puzzled look on my face and added,  ‘What IS an auto immune disease exactly?’

At last week’s workshop I realized there’s quite a bit of confusion when it comes to the term Autoimmunity.
People hear ‘immune’ and think it’s to do with winter colds and coughs and being run down.

Another perplexing aspect may be that there are now so many diseases being considered autoimmune in their aetiology.   From psoriasis to ulcerative colitis, Crohns, Hashimotos and another 100 + diseases.  And this number is on the rise as research uncovers possible autoimmune components to some known and familiar conditions.
Add to this the fact that some doctors don’t actually tell their patients that their disease is autoimmune in nature.  From a conventional medical perspective their treatment is the same, however, from a functional medicine point of view it makes a big difference.

Here’s some information on different aspects of autoimmunity which I’ve based on my own clinic experience, and IFM (Institute of Functional Medicine) teachings, as well as CAM – now IHCAN – conferences, seminars by Lamberts and NutriLink and various webinars.  There’s a wealth of literature out there on autoimmunity, from a functional medicine perspective, just google Dr Ballantyne’s AI Paleo approach, or Dr Kharrazian’s and Tom O’Bryan’s books, to mention just a few.

For a start, a smidgeon of basic science  🙂 Normally the immune system attacks a foreign body, such as bacteria, parasites or a virus (called ‘pathogens’) which tends to give you symptoms, make you feel unwell to varying degrees.  This takes place thanks to our antibodies, a type of protein whose job it is to recognize patterns in other proteins, find the ones that are foreign, like the aforementioned bacteria, viruses, fungi, and then bind and ‘deactivate’ them.

By binding to these foreign proteins the antibody is signalling to the immune system, ‘this is an invader, come and get it.’
A truly brilliant internal army of antibodies, proteins, chemicals a.o., all working together to then eliminate anything that shouldn’t be in our system.

With an autoimmune disease, however, the body accidentally creates antibodies that target our bodies’ proteins, instead of the foreign invading pathogens’ proteins.  This happens because some of the amino acid (protein) sequences of a body organ or tissue can look very similar to the sequencing of that pathogen invader!
This mistaken identity is called molecular mimicry or cross reactivity.  Dr Sarah Ballantyne quite accurately calls it a “betrayal of our immune system”.  Instead of attacking foreign organisms, our immune system mistakenly attacks itself, hence the word ‘auto,’ which is Greek for ‘self.’

Diagnosing an autoimmune condition can be tricky.   Treatment may not be helping (because the root problem is still not addressed).  Symptoms may be vague or sporadic, ticking over for years and not doing anything dramatic, just making you feel very unwell at times, or all the time, with no clear ‘name’ of what the illness might be.  Very frustrating for you, the patient, as well as your doctor.

On top of that, there isn’t a specialist for autoimmune disease in general.   Conventional medical treatment is organ, or system, dependent.
Hence if you google ‘doctors for autoimmune conditions’ you’ll find a very long list, from nephrologist, a specialist treating kidney problems, hence also auto immune [AI] diseases affecting the kidney such as lupus; or a rheumatologist, for arthritis, but also AI rheumatic diseases, such as scleroderma; an endocrinologist, treating gland and/or hormone problems, hence also AI diseases like Hashimotos or Graves thyroid disease; a neurologist for nerve problems and hence also AI diseases such as multiple sclerosis; a gastroenterologist, for digestive system disorders, and thus also the AI disease Crohns or ulcerative colitis; a dermatologist for skin issues and also AI diseases such as urticaria and psoriasis.  And so it goes on.

Autoimmune diseases have a tendency to gather in numbers over time.  If you start off with one you may then acquire another and another, and end up having to juggle multiple specialist appointments and multiple medications… with multiple side effects.
Once diagnosed with an autoimmune disease you have it for life.  There’s no cure – yet. However management of symptoms can make it feel like you don’t have the disease, which is a real positive.

Typical medical treatments may include immunosuppressive medication or stronger drugs like anti rheumatics, plus pain medication.  These calm down the immune response, but won’t be solving the underlying problem (hence no cure. Yet).

Currently, a lot of research is being carried out regarding AI diseases as they are on the rise; worryingly so.  They are, in fact, the 3rd leading cause of mortality in the industrialised world after cancer and heart disease.  Plus, as mentioned above, there are over 100 already confirmed AI diseases, with more being implicated in having their roots in autoimmunity (ie. more diseases where research is showing the body attacking ‘self’).

From a functional medicine point of view, what is understood through research and practice, is that a triad of factors is normally present in order to develop an auto immune disease.  Genetics.  Environmental triggers.  Diet/lifestyle.

Genes alone are not enough, so don’t panic if autoimmune conditions run in the family.  Having these genetic links will, however, make you more vulnerable to an AI condition than someone without this genetic component.

Environmental triggers, the second factor, cover such a vast potential range that I can only touch on them with a light stroke that doesn’t do justice to their impact.
Infections, past and present, such as viruses, bacterial overgrowths in the gut, infections in the lungs and sinuses to point out just a few.  Inhaled or ingested toxins (think of all the chemicals surrounding us, from cleaning products, cosmetics, pesticides, food additives, plastics…).  Hormones, where our chemical messengers trigger changes in the body.  Stress or trauma, grief, unhealthy relationships…and the list goes on.

Often there is more than one ‘trigger’ involved; a synergy of different factors coming together at a certain point in your life, rather than blame being laid on just one.
That being said, coeliac disease, a well-known autoimmune condition, has its roots in just one trigger/mediator, namely gluten.  This is a protein found in many grains.  This is the reason why grains and pseudo grains are considered by many practitioners in the functional medicine world to be triggers or mediators in ALL auto immune diseases (do read Tom O’Bryan’s books on gluten, or watch on Youtube).

Unlike genetics, you can take control to varying degrees, of the environmental triggers in your life.

Diet and lifestyle, the third factor in this triad, have such an impact on your health, on your immune system, that it can’t be emphasised enough.  It may may sound like a cliche that slides too easily off the tongue, but You Are indeed What You Eat.

The gut wall, your digestive lining, is a vital barrier between your inside and outside world.
You ingest food via your mouth, and it remains enclosed within the tube of your digestive tract – which is still ‘outside’ the bloodstream and the rest of your body – until it is absorbed through the gut wall. There it enters your ‘inside’ world.  Nutrients are then transported all over your body, carried in your blood to the rest of your organs and body tissue.

This gut wall has to be selectively permeable in order to allow nutrients in, but at the same time keep out toxins, those pathogens mentioned above.

Little wonder about 80% of the immune system is here, in these tissues of the gut.  An army of antibodies, proteins and chemicals a.o. are all on guard to ensure that whatever passes through that gut wall ‘barrier’ isn’t foreign and make you ill.

Loss of this protection seems to be a critical factor in autoimmune disease.  Either the cells in the gut wall can become damaged, or the junctions between these cells can lose their closely formed tight integrity, thus allowing some contents of the gut to ‘leak’ into the bloodstream or lymphatic system – hence the term ‘leaky gut’.  This may then result in the whole immune system going into overdrive if you consider that undigested food, with unrecognisable sequencing, is entering the body when it shouldn’t and is being mistaken for pathogens. (This is a very brief and simple mini tour of what can go wrong!)

Currently it’s thought that leaky gut or intestinal permeability is implicated in most auto immune disease  Saying that, I have seen AI clients whose lab tests showed no intestinal permeability.  Interestingly, however, they had sinus and lung issues.  There is research looking at how the epithelial linings/barriers of other hollow spaces, such as lungs, sinuses, urinary tract, may be the compromised barriers in the body which are setting up this autoimmune landscape.

How to improve intestinal permeability?  The good news is that the gut wall cells turn over and heal very quickly, but infections and a potentially imbalanced microbiome should be investigated.  At the same time, dietary changes need to be made according to the individual.  There are certain foods that are never going to be great.  Processed and pre-packaged meals or high sugar/low nutrient diets.  Alcohol and coffee can be problematic for many.  Gluten and possibly other grains. Dairy.  Some people struggle with digesting certain proteins – meat or pulses.  And of course, there may be foods, some even so-called healthy foods, to which you have an allergy or intolerance.  Often people will only have to stay off ‘their’ problem foods for a relatively short time, some months.  However, others feel so much better when they exclude certain foods they keep off them.  It’s very individual, which is why it helps to work with someone, a qualified nutritionist or functional medicine practitioner.

As for lifestyle, the benefit of regular and manageable exercise is now so well understood regarding all disease, I won’t harp on it.
Stress, as always, plays a key role.  It can be both a trigger as well as an insidious mediator, propelling your auto immune disease ever forward.  We all have stress in our lives; we all have to ensure we can tone it down and find the ‘off; switch.
Sleep is vital.  If you’re not getting good sleep this will scupper your immune health.  There are so many ways to improve sleep, and tests to investigate why your sleep is disturbed so do contact me if you want to discuss this.

Mindfulness, supportive relationships at home or in the community and having purpose in life.   All of these are significant lifestyle factors.  Consider each one with care – mindfully.  This will be key in helping you manage your autoimmune disease and improve symptoms.

And if all the above is too much to get your head around, find someone to work with, a functional therapist or nutritionist who can help you organise lab tests and discuss diet and look at the different layers to your health.

Making a start with Intention is a great first step.  Keeping a food diary to see if you can tease out patterns to your symptoms.  Gradually increasing a manageable amount of daily exercise.  Taking a close look at the stress in your life, at the love in your life.  Surrounding yourself with angels who are supportive.

There’s a lot you can do and think about right now!