OnCore Nutrition - Two Peas in a Podcast

SHOW NOTESWhat impact does surgery have on the body?Intentional trauma Physiological response Psychosocial impact StressWhen we think about surgery, it's essential to understand that it triggers a significant reaction in the body known as the 'stress response.' This response is a complex interplay of hormonal and metabolic changes directly linked to the degree of tissue damage during surgery. It can intensify if there are any complications after the operation. Let's break it down: The whole process starts when the hypothalamic-pituitary-adrenal axis, or HPA axis, kicks into gear. This leads to a surge in hormones like cortisol, growth hormone, glucagon and catecholamines. These hormones are important because they help the body cope with stress by boosting energy availability and adjusting other bodily functions.Ebb phase (0-48hrs)Increased catabolism of stored glycogen (glycogenolysis)Suppression of insulin secretion → transient hyperglycemiaIncreased catecholamines, cortisol, and inflammatory cytokines (IL-6, TNF-α)Flow phase (3-10 days)Hypermetabolism (increased BMR)Increased protein catabolism → muscle breakdown (to provide amino acids for tissue repair and immune function)Increased lipolysis (fat breakdown) for energySustained insulin resistance → continued hyperglycemiaEnhanced GNG Pro-inflammatory response → increased cytokines and acute-phase protein productionIn the initial stages after surgery, the body releases a wave of pro-inflammatory cytokines. These cytokines jumpstart the healing process by promoting inflammation, which is important for healing surgical wounds. However, to keep this inflammation from going overboard, the body soon follows up with anti-inflammatory cytokines.These inflammatory processes have widespread effects across the body. For example, they can influence how the hypothalamus regulates body temperature or how the liver produces certain proteins that help fight infection and aid in wound healing.But here's where it gets even more interesting: other hormones like glucagon, cortisol, and adrenaline also play a role in modulating these responses. They can affect everything from your blood sugar levels to how your cardiovascular system handles the stress.So, why is all this important? Well, by understanding and managing these responses effectively, we can significantly improve how patients recover from surgery. It's all about helping the body maintain balance during a time when it's incredibly vulnerableDisruption of Metabolic Homeostasis: Surgery often disrupts the body's normal metabolic balance, notably through insulin resistance, where cells fail to respond effectively to insulin, leading to 'diabetes of the injury.' Insulin Resistance and Hyperglycemia: Insulin resistance can cause high blood sugar levels, significantly increasing the risk of surgical complications and mortality. Post-surgery, the body may enter a catabolic state, breaking down muscle instead of fat, which impairs wound healing, weakens the immune system, and reduces muscle strength. Increased Risks for Vulnerable Groups: Elderly, diabetics, and cancer patients are particularly at risk due to their compromised metabolic and inflammatory states. These groups have less physiological reserve, leading to pronounced catabolic states and increased risk of severe post-operative complications. Impact on Recovery and Outcomes: The metabolic chaos from insulin resistance to protein loss not only delays recovery but also exacerbates risks of infection and other complications. Effective management of these changes is crucial for improving surgical outcomes and ensuring that patients thrive post-surgery.ERAS helps to mitigate these by Surgery isn't just about the physical repair or removal of tissue; it triggers a cascade of stress responses in the body that can complicate recovery. These include everything from the psychological impacts of anxiety and the physiological effects of fasting to direct tissue damage and the systemic reactions to it, such as fluid shifts and hormonal imbalances.Key Components of ERAS:Comprehensive Care: ERAS isn't just a single technique but a suite of practices designed to address every aspect of the patient's journey — before, during, and after surgery. This approach aims to minimise the stress responses by controlling pain, reducing fasting times, optimising fluid management, and promoting early mobility.Minimising Fasting: One traditional practice that ERAS revises significantly is the preoperative fasting rule. Old guidelines that required fasting from midnight before surgery are now replaced with more lenient, evidence-based practices that allow intake of clear fluids up to two hours and solids up to six hours before surgery. This change helps maintain normal blood glucose levels, reduces stress, and decreases the body's shift into a catabolic (muscle-degrading) state.Nutritional Optimisation: ERAS protocols emphasise the importance of not entering surgery in a depleted state. By allowing a carbohydrate-rich drink shortly before surgery, patients are better hydrated and less anxious, which in turn reduces insulin resistance and preserves muscle mass — critical factors in speeding up recovery post-surgery. Post-operatively, oral nutrition may be delayed by the medical team until bowel function returns, typically taking close to a week. This delay is stated to reduce postoperative complications such as abdominal distension and nausea/vomiting.For the first several days post surgery fluids of limited nutritional value such as water are provided to patient until tolerance is established leading to insufficient nutrition intake during this time increasing the risk of malnutrition. The ERAS protocol promotes early oral intake within 24 hours post surgery departing from traditional fasting practices. Research suggests that between 40-50% of surgical patients have some degree of malnutrition. Pre-operative malnutrition is an independent predictor of poor post-operative outcomes. Therefore addressing malnutrition is a key component of the ERAS protocol.Immune-Enhancing Diets: Post-surgery nutrition is just as crucial. ERAS encourages diets rich in nutrients that bolster the immune system and enhance wound healing. This includes omega-3 fatty acids, which help modulate the inflammatory response; arginine, which supports protein synthesis and tissue growth; glutamine, which is vital for cellular health and recovery; and nucleotides, which are essential for rapid cell division and immune function .Immuno-nutrition is a specialised medical nutrition therapy that has been shown to adjust the body's inflammatory response: It incorporates specific nutrients like omega-3 fatty acids, arginine, polyunsaturated fatty acids, and nucleotides. It's typically recommended starting 5-7 days before surgery and continuing post-operatively for over 7 days or until oral intake meets at least 60% of the patient's nutritional requirements.How can we use this info to optimize surgical outcomes?Patient education Early nutrition pre and post surgery - Minimise fasting time What is ERAS? How does it differ from traditional care/practice?Introduced by Henrik Kehlet in 1997, the Enhanced Recovery After Surgery (ERAS) protocol has revolutionised surgical practices by optimising perioperative care. A key aspect of ERAS is its interdisciplinary approach, involving healthcare professionals from various specialties to minimise surgical stress and facilitate recovery. What is malnutrition?Malnutrition, is defined as an involuntary reduction in body weight, muscle mass and physical capabilities, affects up to 65% of surgical patients and can worsen during hospital stays. Enhancing nutritional status and promoting functional nutrition therapy is essential, even forpatients without evident malnutrition, particularly when prolonged perioperative oral intake challenges arise. Addressing malnutrition is essential for preventing surgical complications, prolongedhospital stays and higher healthcare costs. What are the benefits of ERAS for the patient?It has been shown that the key physiological benefits include:-enhances the body's anabolic processes-promotes wound healing, which is critical for patient recovery.-Reduces the risk of nutritional depletion-Minimises insulin resistance, a common issue post-surgery, allowing for better blood sugar control and improved metabolic function.-Reduce protein catabolism-And lowers the risk of pressure injuries, which can develop due to extended immobility after surgery.What are the benefits of ERAS from a healthcare perspective? From a healthcare perspective, ERAS has been shown to-shorter length of hospital stay for patients,-Lower risk of ICU transfer rates-reduce readmission rates-And all of these improvements lead to lower healthcare costs, not just for the hospital but for the overall healthcare system, as fewer complications and shorter stays reduce the financial strain.Step 1: Screen & StrengthenIf you've lost any weight unintentionally in the lead up to surgery, or been eating poorly because of a reduced appetite, you may be at risk of malnutrition and it's really important to address this prior to surgery. Research suggests that between 40-50% of surgical patients have some degree of malnutrition. Pre-operative malnutrition is an independent predictor of poor post-operative outcomes. Addressing malnutrition is a key component of the ERAS protocol and why it's effective in improving surgical outcomes for patients.Book an appointment with a dietitian who can guide you on appropriate dietary changes to minimise muscle loss, build you up and optimise nutritional status and stores pre-op. A well-nourished body tolerates surgery better, heals faster, has a stronger immune system to fight infection, and experiences fewer complications.Step 2: Consider Immunonutrition If you're planned for major surgery, especially certain cancer and abdominal surgeries, consider the use of an immunonutrition supplement in the 5-7 days pre op. These are the supplements loaded with arginine, n3s, glutamine and nucleotides to support the immune system and reduce inflammatory responses, potentially leading to fewer infections and better recovery.Step 3: Build Your Strength & Energy Stores prior to surgery Carb load with food in the days leading up to surgery - think that big bowl of pasta a footy player would have the night before the grand final. ERAS protocols have significantly reduced or eliminated long periods of "nil by mouth" (NBM) before surgery.Ask your surgical team exactly when you need to stop eating solid food – it might be much later than you think, often around 6 hours before surgery for a light meal. For clear fluids, it could be as little as 2 hours before!We'll make the most of every second to prevent unnecessary dehydration, hunger, anxiety, and preserve your body's energyStep 4: The Pre-Surgery Carb Load using clear fluidsMany ERAS protocols include a special carbohydrate-rich drink taken a few hours before surgery. Your hospital may provide this, but if they don't, we can organise orders for you or point you in the right direction.  It's usually a clear, sweet drink. Think of it as topping off your fuel tank right before the 'race'."These have been shown to reduce post-operative insulin resistance (which can slow healing), help maintain muscle strength, can reduce nausea, and improve overall wellbeing. It basically tells your body it's in a 'fed' state, not a 'starvation' state, heading into surgery.This is best done with tailor made medical nutrition drinks as they come prepped with the correct doses of maltodextrin-polymer carbs and a lower osmolality than other solutions, which essentially means they gentler on your gut and better for gastric emptying so they don't linger in your gut during surgery. Always follow surgical instructions, but ideally we're aiming for 100 grams of carbohydrate the night before surgery and about 50 grams of carbohydrate in clear fluids approximately 2 hours before anesthesia. This might look like 4 x 200ml drinks the night before, and 2 the morning of surgery If you can't access these drinks, apple or cranberry juice are reasonable replacements.  Drop us an email or message or give us a call if you'd like advice on where to get pre-op and immunonutrition supplement drinks. Then we move on to post op and Step 5 which is aiming to eat early.  ERAS encourages starting to eat and drink as soon as it's safe after surgery – often within hours, not days!As soon as your team says it's okay, try sipping water, then progress to other clear fluids, and then light foods as tolerated. Even small, frequent amounts help. This helps to stimulates your gut to start working again, reducing the risk of ileus – a slow, sleepy bowel, provides energy for healing, and can help you feel more normal, faster.If you haven't been told you can eat or drink, keep asking the question! You are your best advocate! Another tip that can help here is step 6:  Chew GumIf your team allows it, start chewing sugar-free gum several times a day once you're able. It sounds simple, but it can be surprisingly helpful in mimicking eating even when you're not allowed to, and can stimulate your digestive system to return to usual function sooner and reduce the risk of ileus.Step 7 is to Nourish to Heal This is where we bring in our good friend protein to optimise tissue repair and recovery Include protein rich food at each meal, and chat to us if you're finding this difficult because there are plenty of hacks if you're not feeling up to chicken breast and steak! And finally step 8 is to Listen to Your BodyWhile ERAS encourages early eating, we always want you to be tuned in to your body's cues and speaking up to your medical team and us if something doesn't feel right. There are plenty of interventions that can be used to keep you comfortable while still optimising your nutrition to get the best outcomes from surgery. Weimann, A., Braga, M., Carli, F., Higashiguchi, T., Hübner, M., Klek, S., et al. (2021). ESPEN practical guideline: Clinical nutrition in surgery. Clinical Nutrition, 40(7), 4745-4761.Weimann, A., Braga, M., Carli, F., Higashiguchi, T., Laviano, A., Ljungqvist, O., et al. (2017). ESPEN guideline: Clinical nutrition in surgery. Clinical Nutrition, 36(3), 623-650.Gustafsson, U. O., Scott, M. J., Schwenk, W., Demartines, N., Roulin, D., Francis, N., et al. (2019). Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations: 2018. Clinical Nutrition, 38(2), 576-586. (Note: The ERAS® Society website, erassociety.org, is the primary source for the most current and comprehensive suite of procedure-specific guidelines.)Ljungqvist, O., Scott, M., & Fearon, K. C. (2017). Enhanced Recovery After Surgery: A review. JAMA Surgery, 152(3), 292-298.Thiele, R. H., Raghunathan, K., Brudney, C. S., Campos, S., Candiotti, K., Chaves, S., et al. (2016). American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on perioperative fluid management in adults. Perioperative Medicine, 5, 26. (Note: This is an example of ASER/POQI consensus; look for other relevant POQI statements on specific surgical procedures and their nutritional components.)Soon, K., Levy, G. M., Cusack, L. A., Varma, S., & Nicholson, G. A. (2020). The effect of preoperative carbohydrate loading on patient outcomes in elective surgery: A systematic review and meta-analysis. Systematic Reviews, 9(1), 254.Lewis, S. J., Egger, M., Sylvester, P. A., & Thomas, S. (2001). Early enteral feeding versus "nil by mouth" after gastrointestinal surgery: systematic review and meta-analysis of controlled trials. BMJ, 323(7316), 773-776.Osland, E. J., Hossain, M. A., Khan, S., & Memon, M. A. (2014). Effect of timing of oral feeding on patient outcomes after elective colorectal surgery: A systematic review and meta-analysis. Journal of Gastrointestinal Surgery, 18(5), 1039-1051.Braga, M., Gianotti, L., Nespoli, L., Radaelli, G., & Di Carlo, V. (2002). Nutritional approach in malnourished surgical patients: a prospective randomized study. Archives of Surgery, 137(2), 174-180.Marimuthu, K., Varadhan, K. K., Ljungqvist, O., & Lobo, D. N. (2012). A meta-analysis of the effect of combinations of enhanced recovery after surgery (ERAS) interventions on postoperative outcomes. Annals of Surgery, 255(4), 640-649.

SHOW NOTESPost-COVID questionnaire: https://chroniccare.snapforms.com.au/form/post-covid-questionnairePost COVID Recovery steps   Referenceshttps://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1https://www.bmj.com/content/372/bmj.n136https://www.bmj.com/content/372/bmj.n136/rapid-responseshttp://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 Researchhttps://www.latrobe.edu.au/news/articles/2022/release/possible-cause-of-long-covid-brain-fogSouvenaid 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-helpSmell traininghttps://www.fifthsense.org.uk/smell-training/https://abscent.org/learn-us/smell-training/how-smell-trainhttps://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiac136/6569364?login=falsehttps://www.cidrap.umn.edu/news-perspective/2022/04/global-data-reveal-half-may-have-long-covid-4-months

We take a wander through fad diet history to explore the weird and not so wonderful, and how to spot a fad.

https://www.cdc.gov/obesity/adult/defining.htmlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414803/https://www.aihw.gov.au/getmedia/384eafec-fa90-412d-8c98-b279fddc7911/ah16-4-4-overweight-obesity.pdf.aspxhttps://www.nature.com/articles/s41366-020-0547-1https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4386524/

SHOW NOTES  Mindful Eating Guide - free downloadHunger Fullness Guide - free downloadDiet Cycle Guide - free download

Rebecca Gawlerrebecca@reload.physio Instagram handles: @reloadphysioFacebook 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 carehttps://chroniccare.com.au/Speak to the team to arrange an appointment with the most appropriate professional.  Platinum Physio Women's Health Physio 

Find and Fuel Your FireThurs 24th Feb 6:30pm AEDTDetails and Tickets here 

SHOW NOTES OnCore Nutrition Ladies Lunch SeriesLadies Lunch 1 - Understanding your cycleWed 27th Oct 1-1:45pmLadies Lunch 2 - Lifestyle strategies to harness your health, feel and perform at your best throughout each season of your cycleWed 3rd Nov 1-1:45pmTickets and info via Eventbrite   Study discussedOvulatory 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 SummaryCalling 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 NotesFind and Fuel Your Fire WorkshopTickets via Eventbrite Getting a nutrition job is HARD! The Dietetics Workforce Report 2018There 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 meaningfulYou 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 careThe 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.pdfPotential career pathways Clinical dieteticsPopular!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 jobsConsultancy and private practiceOften 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 serviceMedia and marketingDon't expect to get here straight away - need some experience behind youBe responsible with what you put out into the world, social media etc. Don't know what you don't know. Public health and nutritionEventually policy, health promotion, advocacyOften start as a public health dietitian, community dietitianFood industryConsultingFood analysis and product development, sensory evaluationFood technology and scienceResearch Nutrition research and educationGenerally requires specialisation and smaller projects or honours, masters, PhDhttps://www.deakin.edu.au/exercise-nutrition-sciences/careers-in-nutrition-and-dieteticshttps://www.myhealthcareer.com.au/dietetics-career/Our tipsVolunteer meaningfullyUpskillGet a mentor - a meaningful oneApply for everything - know your limits/hard passesApply wellPrepare for interviewsSeek feedback - and actually be prepared to take it Our upcoming workshophttps://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 wantJob application preparationInterview (including phone/video interview) preparationSetting yourself apartWhat NOT to do!Volunteer / work experience opportunitiesProfessional developmentFinding your career niche / Progressing your career SpecialisingQuality projects opportunities in nutritionEducation opportunities in nutritionResearch opportunities in nutritionConference / presentation opportunitiesSupervision and mentoringFinding the right supervisorInnovation in dietetics  Identifying gapsPitching your ideaIntroduction to grants and proposalsDelivery Online2hr workshop2 sessions - one evening, one weekend‘Take home' toolkit of resources

Google Trends Health and disease riskhttps://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 performanceThe 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 sleepWe 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 napsSome 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 factsCoffee 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 carlaws 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.

Find and Fuel Your Fire WorkshopTickets via Eventbrite Getting a nutrition job is HARD! The Dietetics Workforce Report 2018There 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 careThe 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.pdfPotential career pathways Clinical dieteticsPopular!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 practiceOften 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 serviceMedia and marketingDon’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 nutritionEventually policy, health promotion, advocacyOften start as a public health dietitian, community dietitianFood industryConsultingFood analysis and product development, sensory evaluationFood technology and scienceResearch  Nutrition research and educationGenerally requires specialisation and smaller projects or honours, masters, PhDhttps://www.deakin.edu.au/exercise-nutrition-sciences/careers-in-nutrition-and-dieteticshttps://www.myhealthcareer.com.au/dietetics-career/Our tipsVolunteer meaningfullyUpskill Get a mentor - a meaningful oneApply for everything - know your limits/hard passesApply wellPrepare for interviews Seek feedback - and actually be prepared to take it Our upcoming workshopshttps://www.eventbrite.com/e/find-and-fuel-your-fire-student-early-dietitian-nutritionist-workshop-tickets-112762650122Wed 26th Aug at 6pm Sun 29th aug at 2pmTopics to cover How to land the job you wantJob application preparationInterview (including phone/video interview) preparation Setting yourself apart What NOT to do! Volunteer / work experience opportunitiesProfessional 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 mentoringFinding the right supervisorInnovation in dietetics  Identifying gapsPitching your ideaIntroduction to grants and proposals Delivery Online 2hr workshop 2 sessions - one evening, one weekend ‘Take home’ toolkit of resources 

Fertility NutritionImportant 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 FertilityA balanced diet is important, including a wide variety of fresh produce dailyMediterranean-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 dairyIodine 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/fulltexthttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(00)90458-6/fulltexthttps://www.thelancet.com/series/preconception-healthhttps://www.health.harvard.edu/blog/fertility-and-diet-is-there-a-connection-2018053113949https://www.eatright.org/health/pregnancy/fertility-and-reproduction/fertility-foodshttps://www.healthline.com/nutrition/17-fertility-tips-to-get-pregnant#1.-Eat-Foods-That-Are-Rich-in-Antioxidantshttps://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 dailyMediterranean-style diets have been associated with improved fertility and semen quality in menWhich foods and nutrients are important to include? Omega-3 fatty acids - EPA and DHA are important for fertilityAntioxidants 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 fertilityYou 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 tsp1 Tsp of instant coffee - 60mg per tspEspresso shot (30-35ml) - 90-200mg Percolated - 100mg per cupEnergy drinks - up to 110mg per serveCola - 40mg per serveBlack Tea - 50mg Green tea - 30mgChocolate - 60g of milk or dark Choc has about 30-40mgPregnant women can safely have two instant coffees a day and two to three cups of tea OR one cap/latte Pesticides fertilitySome 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 PregnancyThings to be aware of / avoidVit 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 weeksExamples 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 cidersoft 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°Crefrigerated 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 lactationhttps://www.pennutrition.com/KnowledgePathway.aspx?kpid=3043&tkid=22118&secid=3104#1https://www.health.gov.au/resources/collections/pregnancy-care-guidelines-and-related-documentshttps://www.health.gov.au/sites/default/files/lifestyle-considerations_0.pdf

Farmer's Markets https://mfm.com.au/ Get in touchwww.oncorenutrition.comequiries@oncorenutrition.com

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.pdfIt 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 studyDietary 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 groupControl 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 reductionDifferences 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 AustraliaWeight 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 evidenceModest 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 regainNHMRC Guidelines  file:///C:/Users/Loz/Downloads/n57-obesity-guidelines-%20(1).pdf Also Scientific research that ideal BMI for longevity is 25-30kg/m2https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855514/https://www.bbmt.org/article/S1083-8791(05)01413-8/abstractWhy don’t diets work? A combination of physiology and psychologyFor the physiology behind why it doesn't work Listen to Episode 18 Interesting paper here https://www.ncbi.nlm.nih.gov/pubmed/23911805?dopt=AbstractDieting cycleBiology: (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 patternsPsychological impact of dieting/weight stigma Disordered eating patterns -greater emotional eating, uncontrolled eating, and loss-of-control eatingBody image and self esteem concernsPsychological stress Relationship breakdownIncreased anxiety and depressionSummary Weight is not tied to health and health looks different to everyoneLifestyle habits predict health better than weight aloneIf 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.fullWillpower as a finite resourceWhat you can actually doReduce decision fatigueDo 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. 

Common cancer nutrition mythsSugar feeds cancerMore 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 dietMore info hereOrganic Studies on the foods themselves in terms of nutritional content, levels of chemicals and resistant bacteriaStudies 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 limitsWhen 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 differenceSome 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.SoyLegume - 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.DairyDairy has been associated with reduced risk of colorectal cancer, but an increased risk of prostate cancer. Individualised advised, tailored to you, is key, FastingESPEN Nutrition guidelines Anti-cancer diets There is no diet or food that has been proven to prevent or cure cancerESPEN Nutrition guidelines Other resourceshttps://www.wcrf-uk.org/uk/recipes/diet-cancer-myths-debunkedhttp://www.espen.info/wp/wordpress/wp-content/uploads/2016/11/ESPEN-cancer-guidelines-2016-final-published.pdf

Nil show notes. Contact us at enquiries@oncorenutrition.com with any questions, comments or requests. 40 meaningful things to do when stuck at home in a pandemic

1. Keep a routineStick 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 drinkPosition 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 nutrientsWhy 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 scale10 minute challengePut a wedge inDuring the meal - put your knife and fork down.Speed bump3. Eat mindfullyWe 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 distractionServe 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 yourselfNice vs kindMindful eating starts well before you eat.Don’t shop hungryReview your goals - what you really want vs the quick highCheck 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 shineHome cooking vs take away = 20% fewer calories for the exact same mealStudy 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 boredomPut 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 gardenOur next episode we’ll be talking all about using your time to fuel your fire40 meaningful things to do when stuck at home in a pandemic

Tim Spector experiment https://theconversation.com/your-gut-bacteria-dont-like-junk-food-even-if-you-do-41564Tim 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 meSpurlock 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 cholesterolHeart palpitations experiencedMood swings, sexual dysfunction, lethargy, fat accumulation in his liver. It took him 14 months to lose all the weight gained Ultraprocessed FoodMinimally processedLightly processed Heavily processedUltra-processedpre-cut and peeled pumpkin, potatoes and other veges, bagged salad leaves, bagged spinach, sliced vegetables, and unsalted, roasted nuts Corn AppleCanned, dried or frozen such as dried fruit, canned legumes/fish, cheese, pasta, frozen veg, pasteurized milk / yoghurt.Recognisable ingredientsMake foods available out of season.Canned corn Tinned applesFood 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. DoritosApple pie  Other things that might be damaging your gut healthSmokinghttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3597605/Artificial and naturally intense sweetenersSaccharin, 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/S31/5307224We also know that in animal studies, when exposed to the artificial sweeteners, this saw a reduction in beneficial bacteria in the guthttps://www.ncbi.nlm.nih.gov/pubmed/25231862https://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/25021423https://www.hindawi.com/journals/omcl/2017/3831972/https://www.ncbi.nlm.nih.gov/pubmed/25825908https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0125889Alcoholhttps://www.ncbi.nlm.nih.gov/pubmed/2255202720 dayseach 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 cholesterolWhat to focus on Prebiotic FibreChicory RootJerusalem artichoke GarlicOnionLeek Asparagus Less ripe bananas BarleyOatsApples Flaxseeds Edamame 

DietitianTertiary 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 diseaseDietitians 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/ NutritionistMay 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 NaturopathNaturopathy takes a holistic approach to wellness.Interventions - see belowSource: https://www.researchgate.net/publication/331789476_An_evidence_based_overview_of_naturopathic_practice_in_AustraliaA 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-practitionershttps://www.nhaa.org.au/mediareleases/be-informed/regulation-of-practitionershttps://www.abc.net.au/news/2010-10-21/unregulated_naturopaths_putting_lives_at_risk/40276Whilst 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 efficacyhttps://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_Australiahttps://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4839.0~2016-17~Main%20Features~General%20practitioners~2https://www.racgp.org.au/download/Documents/Publications/Health-of-the-Nation-2018-Report.pdfhttps://www.abc.net.au/news/2010-10-21/unregulated_naturopaths_putting_lives_at_risk/40276https://www.researchgate.net/publication/331789476_An_evidence_based_overview_of_naturopathic_practice_in_Australiahttps://www.ncbi.nlm.nih.gov/pubmed/30785315What an influencer doesResearch 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 DietitiansDr Nicole Kiss - follow on Twitter @NicoleKissDr Tim Crowe - follow on Twitter @CroweTim, listen to podcast Thinking NutritionHayley Blieden  - https://austsuperfoods.com.au/ NutritionistsMelissa Eaton - follow on Instagram @eatonbalancedJules Tellidis -  follow on Instagram @wholesomehungryNaturopathsAbby Dolphin - https://olivewellnessinstitute.org/admember/abby-dolphin/Bianca Potenta - https://hwstudio.com.au/

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 2017https://www.thelancet.com/commissions/dementia2017Food, hormones and neurotransmittersCarbohydrates - 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 leafysLithium - 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, seedsDietary 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 approachIn summary those who made the greatest change to their diet saw the greatest benefit in regard to their depressionThis 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 groupRelationship 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. MedDietRich in fruits, veg, nuts, seeds, legumes, fish, lean poultry, EVOOPreference for selecting wholefoods and low in processed foods.Eat in a social environment - promotes social engagementLong-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.191338https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056912/Gut microbiome - bidirectional communication between gut and brainOur 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 profilePrebiotic 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, EVOOListen in to episode 3 but also stay tuned for an update on gut health in episodes coming soon!Other mood boosting strategiesCovered nutrition in depth.Exercise has been linked to improved mental healthEating with others - mediterraneans do this wellSleep - aim for 7-8 hours per nightMeditation 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.

Carnivore DietDiet consisting only animal productsThe 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 foodsAllowed 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 feelThe 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 healthhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940663/https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0791-yCancer riskhttps://www.sciencedirect.com/science/article/abs/pii/S1470204515004441?via%3Dihub Inuits literatureCompared 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/139/12/2322/4670601https://science.sciencemag.org/content/349/6254/1343https://www.sciencedirect.com/science/article/abs/pii/S1438463918306539?via%3Dihubhttps://www.ncbi.nlm.nih.gov/pubmed/29685826https://www.researchgate.net/publication/10943329_Low_incidence_of_cardiovascular_disease_among_the_Inuit_-_What_is_the_evidence

Coronavirus The WHO COVID-19 Situation Report as of March 5 reports 95,333 confirmed cases globally, including 3,282 deaths Our immune systems declines by about 2-3% a year from our 20s, which is why older people are more susceptible to infectionsMortality rates from diseases like pneumonia and bronchitis are three times higher among elderly people.Our top 10 tips to optimise your immune system1. Spice up your life. Use of garlic (allicin may boost our immune system), onions, ginger, turmeric, cayenne pepper, chilli, cinnamon, cloves, star anise, ginger, cumin in your cooking will boost your antioxidant intake. They may also assist with natural detoxification processes and may possess antimicrobial properties.2. Get plenty of polyphenols. These can help in numerous ways to activate our immune system and initiate immune responses. Drink green or black tea, red wineUse herbs in cooking (Peppermint, oregano, sage, rosemary, thyme, basil, lemon verbena, parsley, marjoram), dark choc, berries (the darker the colour the better)Add nuts and seeds to salad, brekky, snacksCook with EVOO and enjoy olivesEat plenty of fresh fruit + veg https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5925142/pdf/JIR2018-1264074.pdf3. Sweet dreams7-9hrs sleep can boost the spread of T-cells which fight infection in the body. One study also showed that just one night of 4 hours’ sleep depleted the body’s natural killer cells by 70%.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3256323/https://www.ncbi.nlm.nih.gov/pubmed/86210644. Remember that you’re sweet enoughEating or drinking high GI carbohydrates and simple sugars can reduce our immune response. Studies have suggested that after a dose of sugar, certain white blood cells called neutrophils were far less aggressive in attacking bacteria. Some viral studies suggest sugar may help!The body, and immune system needs glucose - we;re best off getting it from complex, slow release or low GI CHOs so we don’t have spikes in BGL. And if you’re keen to indulge, you might be better off doing so after exercise, so the uptake goes to the liver and muscles to replenish what you’ve used. https://academic.oup.com/ajcn/article-abstract/26/11/1180/4732762https://www.theatlantic.com/science/archive/2016/09/glucose-inflammation/498965/5. Get your vitamins and minerals - but don’t jump for a pill.Various micronutrients are essential for immunocompetence, particularly vitamins A, C, D, E, B2 (riboflavin), B6 (poultry, seeds, fish, chickpeas), and B12, folic acid, iron, selenium, and zinc.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6212925/https://www.frontiersin.org/articles/10.3389/fimmu.2018.03160/fullInclude brightly coloured fruits and vegetables, including berries, citrus fruits, kiwi, apples, red grapes, kale, onions, spinach, sweet potatoes, and carrots.Omega-3 fats - nuts, seeds, oily fish (and shellfish for Zn), avohttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6834330/6. Take care of your gutOur intestines encounter more antigens than any other part of the bodyAs many pathogens enter the body via the intestinal mucosa, it is vital the gut-associated lymphoid tissues (GALT) can provide effective immune responses when necessary.GALT represents almost 70% of the entire immune system and about 80% of plasma cells (mainly IgA-bearing cells) reside in GALT.Probiotics, prebiotics and gut health -  Imbalances in the gut microbiota may dysregulate immune responses.Listen in to our next few weeks where we’re planning an extra special gut loving episodehttps://www.nature.com/articles/nri3738https://www.immunology.org/public-information/bitesized-immunology/organs-and-tissues/immunity-in-the-gut7. Stress less Easier said than done if you’re running out of toilet paper!The brain and the immune system are buddies. They’re  in constant communication. When we’re stressed, the brain produces more cortisol to  prepare the body for emergency situations. But in doing so it depresses our immune system. Relaxation exercises like yoga, meditation, mindful colouring, get into nature, paint your nails, walk the dog, play with puppies take a bath, light a candle, whatever works for you!8. Exercise - studies suggest you’re more likely to get colds if you don’t exercise. The impact that exercise has on sleep quality might also indirectly strengthen our immune systems. We know CV is a virus which attacks our lungs, the better our lung function is the better you will be able to cope with the virus. If you don’t exercise, now is a great time to get started!9. Keep warm Cold viruses may be more infectious at temperatures lower than 37°C, which is the average core body temperature. Despite this, most health experts agree that the reason winter is "cold and flu season" is not that people are cold, but that they spend more time indoors, in closer contact with other people who can pass on their germs.Some experiments with mice suggest that cold exposure might reduce the ability to cope with infection.10. Drink up! Staying hydrated helps your body naturally eliminate toxins and other bacteria that might cause illness. Aim for 35-45ml/kg/day.We’ve spoken about this before - chicken veggie soup kill multiple birds with one stone - warm liquid, protein, vitamins and minerals. Supplements:Many over-the-counter products claim to ‘boost’ your immune system, but there is little evidence to show that they do. If you have a poor diet, it may help to take a daily multivitamin, but the preference is to get all your nutrients, including vitamins, minerals and bioactive compounds from food, negating the need for supplementsIf you include a diet with lots of veg, fruit, wholegrains or legumes, nuts, seeds or oily fish – your immune system should have everything it needs to run optimally.NAC or N-Acetyl Cysteine is the supplemental form of cysteine, a semi-essential amino acid. It’s considered semi-essential because your body can produce it from other amino acids, methionine and serine, and it only becomes essential when we don’t get enough methionine and serine. NAC and glutathione also boost immune health.A test-tube study indicated that in other immune-compromised situations, such as the flu, NAC may hamper the virus’s ability to replicate. https://www.ncbi.nlm.nih.gov/pubmed/19732754Most protein-rich foods, such as chicken, turkey, yogurt, cheese, eggs, sunflower seeds and legumes contain cysteineFor your body to make the amino acid cysteine, you need adequate amounts of folate, vitamin B6 and vitamin B12, which you can get from beans, lentils, spinach, bananas, salmon and tuna.NAC has low bioavailability as an oral supplement, meaning that it’s not well absorbed. High doses can cause GI upset. Zinc - An analysis of several clinical trials show that short-term use of zinc lozenges may reduce the length of a cold if started within 24 hours of cold symptoms.Blends such as ‘Armaforce’ - blend of herbal and nutritional ingredients andrographis, echinacea, olive leaf, vitamin C and zincAndrographis - Indian Echinacea - may reduce reduce duration and severity of cold and flu symptomsEchinacea - studies are mixed and generally don’t support its use. One clinical trial supports the use of echinacea for reducing the length of colds, but not the severity of symptoms. One large trial suggests a specific echinacea formulation could be as effective as a prescription drug to treat influenza, with fewer side effects.Olive leaf extract - In vitro studies show that OLE has antimicrobial activities against some infective agents including E. coli, Pseudomonas aeruginosa, Staph. aureus, Klebsiella pneumoniae and Candida albicans https://www.ncbi.nlm.nih.gov/pubmed/12870202https://www.ncbi.nlm.nih.gov/pubmed/17873849Vitamin C - Absorption is also to some extent dependent on the dosing regimen, e.g, there would be better absorption with 250 mg taken four times daily than 1,000 mg taken once daily. 1000 is the prudent upper limit and it’s very easy to get the RDI of 45mg/d with fruit + veg AVOID vitamin E supplements - no significant evidence that supplements support the immune system and research suggests possibly more harm than good (stroke and cardiac issues)Essential oils  - Some EOs have demonstrated immune enhancing properties but caution in pregnancy, blood pressure issues or epilepsyMost supplements have dosage and interaction warnings. If you have any medical conditions or take any medications or supplements please check with your doctor, pharmacist or dietitian to ensure no interactions. https://www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/integrative-medicine/herbs/search

Definition: https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexiaWhat is orthorexia?A fixation/preoccupation with so-called ‘healthy eating’ or ‘clean eating to a point where it becomes obsessional and begins in infiltrate their life - causing anxiety, stress and impacting in relationships. More common with the rise of the #cleaneating #sugarfree #dairyfree, etc.. phenomenon on social media. It is an eating disorder, however  there are no diagnostic criteria at present. There is a lot of work happening at the moment to help characterise it. Hopefully it will be able to be incorporated in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition)in the future. This makes it increasingly difficult for doctors or dietitians to characterise this condition, particularly those who work within a weight centric paradigm.It’s difficult to pick up because there are so many food and nutrition fads. Orthorexia can be quite easy to hide behind because a person can appear as if they are focused on ‘health’ and ‘wellbeing’ where as they’re battling a mental illness people may not know about. A person may often be at a healthy weight and not have any nutrient deficiencies (others will) - everyone is different depending on their restrictions. There can be many ways which orthorexia can develop e.g. previously mental illness or ED (many clients can transition from anorexia to orthorexia - meaning they may restore weight and start eating but the obsessions thoughts continue to infiltrate) or a health condition (e.g. autoimmune disease or bowel issues) or it may be a desire to just feel better and because we are inundated with health messages everywhere we go, it can be difficult to escape.Warning signs and symptomsCompulsive checking of ingredient lists and nutritional labelsAn increase in concern about the health of ingredientsCutting out an increasing number of food groups (all sugar, all carbs, all dairy, all meat, all animal products)An inability to eat anything but a narrow group of foods that are deemed ‘healthy’ or ‘pure’Unusual interest in the health of what others are eatingSpending hours per day thinking about what food might be served at upcoming eventsShowing high levels of distress when ‘safe’ or ‘healthy’ foods aren’t availableObsessive following of food and ‘healthy lifestyle’ blogs on Twitter and InstagramBody image concerns may or may not be presentRef: https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexiaCommon theme of when it becomes a problem:It’s impacting your moodImpacting your social lifeCompulsive checking of ingredient lists and nutritional labelsYou’re cutting out food groups or consistently skipping mealsYou feel guilty if you miss a training session or eat out of planYou fear losing control.You feel stressed or anxious about straying from your plan/usual actionsIt becomes too high on your ‘priority list’. Absorbs too much of your brain time. E.g. choose between brother’s bday dinner and gym / eating your planned meal and you choose the latterYou skip work, school, or social events to exercise or to avoid particular foods/eating behavioursYou feel the need to hide your behaviour - eating / training in secretYou continue to exercise when injured or sickFriends, family, or your provider are worried about your eating or exercise habits.Food and exercise are no longer funYou are overly critical of friend and family food choices + exercise habitsObsessively checking food labels Bottom line: If food is causing anxiety/stress- alarm bells. If you can’t eat a slice of cake on your boyfriend's birthday because it’s ‘unhealthy’, then there is a problem. Being healthy means being flexible and eating intuitively.TreatmentAt present there are no clinical treatments developed for orthorexia. We are reliant on the skills/experience from eating disorder clinicians to manage this condition - strong links with AN and OCD. Treatment team usually involved a psychologist (psychotherapy & anxiety/stress mx) and dietitian (aim to increase the variety of foods and manage anxiety relating to foods). Weight restoration may be required if the patient is underweight.At the core it is an inability to deviate and a sense of feeling ‘out of control’ if the rules and restrictions set can not be adhered to. One of my favourite lines that I heard from Dr. Stefanie Reinold (who also has her own brilliant podcast which we will link in the show notes) is “It’s not about the food”, there is a lot more going on underneath that we need to uncover to get to the core of the obsessive need to control food.  Strategies:Understand what is at the root of the obsession, as we know it’s not about the food so what is it about? Is it feeling out of control in your life and therefore feeling the need to control food? Are you having a stressful time with a loved one? Did something happen in your past?Adoption of a balanced mindset (which is easier said than done) - it would be important to seek professional help and work to increase flexibility with eating. Develop strategies to help manage anxiety or stress around food.Rules = guilt/shame - be more liberal with rules you put on yourselfAcknowledge everyone is different, what works for one doesn’t work for another - social media detox and following positive people.Knowing recovery is challenging, because rigidity and rules have been created and you need support to help break those down and remodel. Sticking to a particular diet can make you feel safe (even though it is not safe or ‘healthy’). Further information and supporthttps://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexiahttps://thebutterflyfoundation.org.au/https://headspace.org.au/https://daa.asn.au/

What makes something worth reading?PopulationFindingsTypes of studies - epidemiological, vs clinical trial etc..To really understand a study you need to read more than just the abstract. The abstract is a great introduction however doesn’t give us enough context or information.Each of the different studies have their own strengths and weaknesses. To summarise: Evidence Summaries (Systematic Reviews and Meta-analysis)Experimental studies (RCT’s and non-RCT’s)Observational studies (case control, case report, cohort study)Source: https://www.researchgate.net/publication/311504831_Options_for_basing_Dietary_Reference_Intakes_DRIs_on_chronic_disease_endpoints_report_from_a_joint_US-Canadian-sponsored_working_groupCASP (and other critical appraisal) toolshttps://casp-uk.net/casp-tools-checklists/Type of study - RCT vs cohort/observational vs systematic review vs case control. In vitro (test tube) vs in vivo, Animal vs humanRandomized, double-blind, placebo-controlled trials = gold standard Aims and study qnHow were subject recruited?Randomisation and blindingPopulation size + power of the findings - the bigger the sample size, the more reliable the study is.Demographics - age, sex, health status - this will help you indetify if the paper is relevant to you or your client group. No point in drawing inferences from a paper which looks at muscle mass in an elderly population group if the group you work with are

Disease preventionHeart diseaseVitamin E (almonds, peanuts, hazelnuts, sunflower seeds, avocado) and Beta Carotene (sweet potato, dark leafy greens, cantelope, capsicum) are often studied as it is hypothesized that these antioxidants can prevent the accumulation of atherosclerotic plaques.Results of larger trials haven’t shown as profound as we had hoped for, however we have rational for this!Women’s Health Study - 39,876 healthy women took 600 IU of natural source vitamin E or a placebo every other day for 10 years. The study did not see a reduction in CVD events, however it did find a 24% reduction in total cardiovascular mortality. Women’s Antioxidant Cardiovascular Study - 8,171 women randomised.looked at beta-carotene, vitamin E, vitamin C.Modest benefit for vitamin E among women with existing cardiovascular disease.Women in the active vitamin C and E experienced fewer strokes Patients taking vitamin E had significantly more heart failure. Vitamin E was linked to a 13% higher risk of heart failure and a 21% increased risk of hospitalization for heart failureLott, E. The Journal of the American Medical Association, March 16, 2005; vol 293: pp 1338-1347. Brown, B.G. The Journal of the American Medical Association, March 16, 2005; vol 293: pp 1387-1390..https://academic.oup.com/ajcn/article/69/6/1322S/4715025a recently published analysis of clinical trials involving nearly 136,000 people who took vitamin E for one reason or another found that the overall risk of dying was greater in those who took higher doses, compared to those who took lower doses.https://www.health.harvard.edu/press_releases/facts_about_vitamineNot a huge benefit when it comes to supplementation - this was also supported in a very highly regarded medical journal called The Lancet. We know that antioxidants in fruits and vegetables, which also contain valuable fibre can have a profound impact on heart health and prevention of heart disease.Cognitive conditions (dementia, alzheimers)Oxidative stress caused by free radical damage can contribute to brain aging, cognitive deterioration and conditions such as alzheimers or dementia. .The literature has some mixed results, however again we know there is more to this complex puzzle.Prevention of Alzheimer's Disease by Vitamin E and Selenium Trial (PREADViSE).This study aimed to determine if vitamin E or selenium supplements used alone or in combination can prevent dementia older men.3,700 men aged 60 or older for 6 yearsUnfortunately the antioxidant supplements did not prevent the onset of Alzehimers disease.Physicians' Health Study II (PHSII), - 5,956 men age greater than 65 years.The average treatment duration was 18 years - very long!Subjects were given 50 mg beta-carotene supplements or a placebo.Long term supplementation showed positive cognitive outcomes.Statement by the Alzheimers Society regarding use of antioxidants:“Though lab-based experiments on different types of antioxidants seem promising, there is only limited support for the claims that antioxidants may protect against Alzheimer's disease from studies involving people.However, increasing fresh fruit and vegetables in the diet has numerous benefits aside from increasing antioxidant intake and is highly recommended, especially as part of a Mediterranean diet”We know there is data to suggest that eating a Med type diet (which is rich in antioxidants) is beneficial in reducing the risk of dementia. Cancer Carotenoids and breast cancer riskDietary patterns and bladder cancer- looks at fruit and veg rather than supplementsDietary Soy Isoflavones (flavanoid family) and colon cancerhttp://oncorenutrition.com/dont-fight-yo-nutrients/We know that eating a diet rich in antioxidant rich fruit and vegetables and protective against a range of different cancers. Whilst there are some gaps in the literature there are some really exciting trials currently underway.Longevity & anti-aging If we can prevent the onset of chronic diseases through increasing our intake of antioxidants, we can lead a healthier life for longer!“Free Radical Theory of Aging” (FRTA), also known as “oxidative damage theory of ageing” is a concept that free radicals and other reactive oxygen species are a byproduct of metabolism and occurs as a result of a number of exogenous factors; and it is the accumulation of damaged cells are the reason we experience age-related diseases and aging. Why antioxidants are of interest in terms of aging and longevity, is because they can block or downregulate these damaging pathways.http://www.actabp.pl/pdf/2_2000/281.pdfThere are a number of different antioxidants that are of interest when we focus on anti-aging. These include - Ascorbic acid (Vit C), alpha-tocopherol (Vit E), Ubiquinol (Coenzyme Q10), Melatonin, Curcumin, resveratrol, etc.. Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3982418/Ubiquinol (Coenzyme Q10)It is a unique lipid-soluble antioxidant and is essential for mitochondrial electron transport chain (ETC), which is a fancy way of referring to energy production within our cells.Benefits from heart disease risk, kidney disease, inflammation, fertility, aging, metabolic syndrome.In regard to CVD a cochrane review in 2014 found that supplementing with Co-Q10 showed a significant reduction in systolic blood pressure without improvements in other CVD risk factors, such as diastolic blood pressure, total cholesterol, LDL- and high-density lipoprotein (HDL)-cholesterol, and triglycerides.Endothelial functionInflammation - Meta-analysis explored the effect of CoQ10 on C-reactive protein (inflammatory measure), interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α) in patients with inflammatory conditions such as multiple sclerosis, obesity, rheumatoid arthritis, diabetes, etc... It found that Co-Q10 doses between  60 to 500 mg/day for a 1-week -4-months significantly reduced production of inflammatory cytokines. Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5807419/#B39Food sources:Organ meats: Heart, liver and kidneySome muscle meats: Pork, beef and chickenFatty fish: Trout, herring, mackerel and sardineVegetables: Spinach, cauliflower and broccoliFruit: Oranges and strawberriesLegumes: Soybeans, lentils and peanutsNuts and seeds: Sesame seeds and pistachiosOils: Soybean and canola oilResveratrol (RSV) - A polyphenolic compound that stimulates cell defense pathways.Protects these plants against UV rays and some fungal infections.It has been hypothesised that it is RSV that is responsible for  the ‘French paradox’ - low rates of heart disease in France, despite a diet rich in cheese and red wine.There is evidence that resveratrol may be beneficial in the context of diabetes, CVD and cancer.Meta Analysis which looked at the evidence regarding RSV across a number of different species. It found that there are a few species that found life extension in response to RSV.Metabolic functionhttps://academic.oup.com/biomedgerontology/article/67/12/1307/605425https://www.sciencedirect.com/science/article/pii/S155041311100386XBe careful of high doses of resveratrol if history of breast cancerFood sources: Red wine, grapes, peanuts, pistachios, dark choc, cacao, strawberries 

SHOW NOTESWhy?EthicalEnvironmental - A vegetarian, pescetarian or flexitarian diet  with an increased intake of plants and reduced reliance on animal-based products (so not just a vegan diet) has been associated with significant reductions in premature mortality and environmental impact.  https://www.thelancet.com/action/showPdf?pii=S2542-5196%2818%2930206-7Health - https://academic.oup.com/jn/article/148/4/624/4965931  Dietary changes to balanced flexitarian, pescatarian, vegetarian, and vegan diets led to reductions in premature mortality of 19% (95% CI 18–20) for the flexitarian scenario to 22% (18–24) for the vegan scenario https://www.thelancet.com/action/showPdf?pii=S2542-5196%2818%2930206-7https://www.ncbi.nlm.nih.gov/pubmed/28446499Self-experimentFinancial Combination Nutrients to be aware of If you’re planning on going fully plant-based, vegan, then there are some important nutritional considerationsVit B12 - most will need a supplement. Check your levels.Mushrooms, tempeh, miso and sea vegetables are often claimed to be a source of B12. However, this is not accurate. They contain a compound with a similar structure to B12, but it doesn’t work like B12 in the body.Don’t forget fats - mouthfeelMilk alternativeBon Soy (25mg calcium per 100mL) vs VitaSoy CalciPlus (160mg per 100ml = 50% RDI) Impressed Plant Milk (almond, cashew, pea, fava bean) (117mg per 100ml) or oat milkListen to our milk ep and find a fortified alternativeAnd if not - calciumLow oxalate dark green leafy veg - kale over spinach (the oxalates bind to the calcium), almonds, soy, white beans, edamame, broccoli, bok choy, okra  Selenium - include just one brazil nut per day Iron - listen to ep 5Iodine - iodised salt or miso/seaweed products Omega-3s - you’ll get some from flaxseed meal, ground chia, walnuts → grinding enhanced the bioavailability which is still poor!). Consider a yeast or algae derived omega-3 supplement 0 chat to an APD or doctor.   Protein - it’s not hard to get enough protein. 0.8g/kg/d = 60kg person = 48g per day = 1 tin beans (15g) + glass plant milk (8.5g) + 2 cups broc or veg (15g) + ½ cup quinoa (4g) + handful nuts (5.2g)Plant foods are lower in certain amino acids than animal products and it is important to get a complete AA profile across the day. This is fairly easy to do so long as we include a variety of plant foods daily - eg rice + beans or tofu + peanut satay sauce or soy milk + chia seeds. Complete = soybeans, quinoa, chia, hemp, seitan  Important to know that it’s not inherently healthier to be vegan/vegetarian vs omnivorous. What’s unanimously healthy is a diet rich in plant foods, but it doesn’t have to be a diet devoid of animal foods. You can be a vegan and also not have a healthy or balanced dietReport: -  World Health Organization Collaborating Centre on Population Salt Reduction, The George Institute for Global Healthhttps://www.georgeinstitute.org/sites/default/files/meat_alternatives_key_findings_report.pdfOther Key References:https://www.thelancet.com/action/showPdf?pii=S2542-5196%2818%2930206-7https://www.ncbi.nlm.nih.gov/pubmed/28446499

Causes and triggersBrain-gut axis - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367209/pdf/AnnGastroenterol-28-203.pdfGut microbiome - https://onlinelibrary.wiley.com/doi/full/10.1111/apt.12728Environmental factors Post infection - (e.g. gastroenteritis infection or campylobacter pylori) Beatty JK, Bhargava A, Buret AG. Post-infectious irritable bowel syndrome: mechanistic insights into chronic disturbances following enteric infection. World J Gastroenterol. 2014;20(14):3976-3985.Enck P, Aziz Q, Barbara G, et al. Irritable bowel syndrome. Nat Rev Dis Primers. 2016;2:16014.Thabane M, Marshall JK. Post-infectious irritable bowel syndrome. World J Gastroenterol. 2009;15(29):3591-3596.Thompson JR. Is irritable bowel syndrome an infectious disease? World J Gastroenterol. 2016;22(4):1331-1334.Investigations and Diagnosis: Blood tests, stool samples, family history, colonoscopy, gastroscopy Hydrogen Breath Testshttps://onlinelibrary.wiley.com/doi/pdf/10.1111/jgh.13689http://shepherdworks.com.au/fodmaps-breath-testing-are-you-blowing-your-money/Rome Criteriahttps://irritablebowelsyndrome.net/clinical/new-rome-iv-diagnostic-criteria/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704116/#!po=31.2500 Dietary interventionsLow FODMAP diet (Fermentable, Oligosaccharides, Disaccharides,Monosaccharides and Polyols)Management: 6-8 week elimination diet and slow reintroduction (under close guidance from a DT)FibreSoluble vs Insoluble - depends on your symptoms.Soluble fibre (e.g., psyllium husk) may assist in the management of IBS and can improve symptoms of patients.Supps may cause bloating - important to introduce this gradually. Probiotics/PrebioticsSome evidence for use of probiotics in the context of GIT infections and diarrhoea. About 7–30% of patients with infectious diarrhoea can develop IBS. Probiotics may help to improve the barrier that lines our gut.There is no specific probiotic that is recommended. If you choose a probiotic, take the same strain and dose for 4-weeks. If you feel better, continue with the same probiotic. If you do not feel better after 4-weeks, try a different dose or strain. We can guide you where to start depending on your Sx. Summary: Diets for the treatment of IBS symptoms are complex and multifactorial. Due to huge amounts of patient variation in severity of symptoms and intolerances, it can challenge to point point an exact method. Many different diets have been studies in the treatment of IBS, however there have been huge limitations in many of those published. At present the diet with the best level of evidence is the elimination diet (low fodmap and reintroduction) under the guidance of an APD.https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1365-2036.2004.02267.xMedical management references:American Gastroenterological Association Institute Technical Review on the Pharmacological Management of Irritable Bowel Syndrome- https://www.gastrojournal.org/article/S0016-5085(14)01090-7/fulltexthttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5291563/American Gastroenterological Association Institute Guideline on the Pharmacological Management of Irritable Bowel Syndrome - https://www.gastrojournal.org/article/S0016-5085(14)01089-0/fulltext   Dr Carly YmerDr Carly Ymer is a clinical psychologist who practices holistic psychotherapy, using her passion for mental and emotional wellbeing to help clients be their best. She believes and practices within an integrative and holistic framework of the synergy between thinking, emotions, and behaviour. Carly is passionate about working with children, teenagers and young adults, with a range of emotional, social and behavioural difficulties. https://beingwellclinic.com/

KETOGENIC DIETWhat is it?Very low-carb, moderate-protein and high-fat diet. It typically contains 75% fat, 20% protein and only 5% carbs.20g CHO per day  - Eg 1 apple + ½ cup peas + 4tbsp milk  OR sk latte + ¼ cup chickpeas OR 1 small banana   OR 1 small slice sourdough bread Does it work?Weight loss - very low CHO intake leads to increased fat metabolism for ketones. The rise in fat burning does not necessarily mean loss of fat stores given the intake of fat in the diet has significantly increased. Studies suggest that the overall body fat balance is equal if not in favour of fat storage!CHO insulin model - reduced insulin so less fat stored. Good in theory but a very intensive $40 million study of 17 men were admitted to metabolic wards for intensive monitoring for 2 months - one month high carb, one month ketogenic. Matched calories on both. Subjects spent 2 consecutive days each week residing in metabolic chambers to measure changes in exergy expenditure and underwent DEXA to measure body composition. The study found that the subjects lost more body weight on the ketogenic diet, but rate of fat loss was 50% slower on the keto diet and instead the on the ketogenic diet that subjects lost more water weight and suffered more LBM (muscle protein) catabolism. Interestingly, this was a study funded to explore their hypothesis which was the opposite!https://academic.oup.com/ajcn/article/104/2/324/4564649Epilepsy that is refractory to medication - often as third or fourth line therapy. Cancer - theory based on Warburg effect that cancer’s preferred fuel source is sugar and that by reducing CHO intake we can deplete tumour tissue of the glucose required for tumour cell metabolism. Unfortunately, that’s the case of most of the healthy cells in our body. Sugar fuels everything and cancer can feed off everything, including ketones. As it stands, there are no clinical trials demonstrating a benefit of a ketogenic diet in cancer patients. Studies underway exploring the ability to slow the growth of certain brain tumours. What our best practice guidelines do specify though is that while it may be difficult to induce tumour responses with a ketogenic diet, this does not argue against preferring fat to supply energy to patients with advanced cancer and inflammation-induced insulin resistance - so more avo, nuts, seeds and extra virgin olive oil and less refined sugars. DRAWBACKSGut HealthOur carbohydrate sources in our food supply don’t just provide energy. Think about a chickpea. Yeah it’s got carbs, but it’s also loaded with fibre, protein, folate and iron.One important factor that we miss when we significantly restrict CHO intake is fibre, prebiotics and the impact on our gut. Bowel cancer risk + digestive health Diabetes (T2DM)Some proponents suggest ketogenic diet to manage diabetesManaging the symptoms - high blood glucose levels - rather than the cause - insulin resistance (may be as a result of being overweight, lack of PA + poor dietary patterns).Ketogenic diet has been associated with development of NAFLD and associated hepatic insulin resistance in mice. This can induce or worsen insulin resistanceSome human studies show an initial improvement in insulin response on a ketogenic diet but this seems to only be temporary - which makes sense given the KD is reducing the symptoms (high blood glucose levels), but may actually be worsening the cause (fatty deposits in the liver and cells)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5452247/Cardiovascular disease KD are often high in saturated fatsBreakfast of egg, bacon, bullet coffee; lunch and dinner of M/C, small amount of veg and some cream for dessert...it’s no surprise that this will take its toll.  The majority of animal studies suggest that when KD are rich in saturated fats they negatively impact blood lipid profiles and cardiovascular disease risk In human studies, there are really varied results, often depending on the length of time subjects are followed and the profile of their fat intake.Some studies highlight that even in cases where KD show a reduction in total and LDL cholesterol, these were significantly more reduced with a high-protein medium-carbohydrate diet than with a KDComplianceHard! Even in retractable epilepsy compliance may drop to 50% after a few months. For epilepsy this is disappointing for ability to gain disease control, but for the general population this could be a protective mechanism...children have died from scurvy and selenium deficiency and the long term implication for cardiovascular and gut health just might not be what your human control centre wants. 20g CHO per day Eg 1 apple + ½ cup peas + 4tbsp milk OR 1 small banana  OR 1 small slice sourdough bread Exogenous ketonesIntroducing ketones from external source can mean you will test positive for the presence of ketones - suggesting you're in “ketosis”. Simply because the ketones exist doesn’t mean you’ve gone through the pathways to get there.The presence of ketones signals to the body that you’ve been making them, and therefore may slow or even stop it’s own production of ketones from fat stores. This is a particularly important safety mechanism because ketone blood levels become too high, your blood can become dangerously acidic.Therefore, taking exogenous ketones may prevent body fat from being used as fuel, at least in the short termOne benefit of exogenous ketone esters or slats - often taken as a drink - is that they may reduce circulating levels of our hunger hormone ghrelin. One study of 17 people found reportedly lower levels of hunger after taking the ketone drink. But only effective after a fast, not after a mealYou’ve also got to bare in mind that ketones contain calories. A single serving of exogenous ketone salts typically contains less than 100kcal or 420kJ, but to maintain a state of ketosis, you’ll need several servings each day = could add up to the energy in a main meal! https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813183/Bulletproof coffee/ MCT oil - contains medium-chain triglycerides, can help keto dieters add more fat to their diets and stay in ketosis. It’s digested more rapidly than traditional fats but can have digestive side effects and again a caloric load.ActionIf you’re going keto, prioritise unsaturated fats - avo, nuts, seeds, EVOOMake your carbs countDon’t rely solely on the white ones (white bread, white rice, white potatoes, white pasta)Choose CHO sources that offer something else: fibre, protein, vit, min Eg Fibre: wholegrains such as barley, bulghur, freekeh, spelt, quinoa, oats, legumes, peas, corn, pulse pasta  Protein: legumes, ricotta or cottage cheeseVitamins: sweet pot, peas, cornMinerals: greek yoghurt, milk, ricotta, cottage cheese OnCore Nutrition 15 min free phone consultshttps://oncorenutrition.com/15-minutes-free/ 

Turmeric, active ingredients are turmerone oil and water-soluble curcuminoids, among which curcumin has been the focus of researchNative to south AsiaOrange colour used in cosmetics and as a food colouring agentAbsorption is poor and it’s metabolised rapidly. Absorption can be improved if taken with pepper (piperine) or fat, but this depends on if you have a therapeutic goal. A meta-analysis of randomized clinical trials revealed that curcumin is effective in decreasing the concentration of tumor necrosis factor-alpha, a key mediator in many inflammatory diseases.Gut Turmeric may help alleviate symptoms of irritable bowel syndrome or ulcerative colitis,JointsTurmeric extract was found to be safe and equally effective as a non-steroidal anti-inflammatory drug for the treatment of osteoarthritis of the knee. Need to absorb it so take with piperine/fat. CancerCurcumin has been studied to have anticancer properties through really the 3 main pathways of cancer development: 1. It’s antioxidant properties and protection against DNA mutations and cell damage2. It’s antiproliferative properties that reduce tumour growth and spread including inducing apoptosis (programmed cell death) and 3.Curcumin has shown ability to kill cancer cells directly by activating “execution enzymes” that destroy cancer cells from within. As an added benefit, curcumin seems to focus on the cancer cells and leave our healthy cells alone, unlike chemotherapy and RT that can’t distinguish between malignant and healthy cells.Several animal studies suggest that turmeric helps to prevent colon, stomach, and skin cancers in rats exposed to carcinogens. Human studies are underway to validate these findings in humansWhat’s interesting is that while curcumin shows benefit in breast cancer, pancreatic cancer, colon cancer, multiple myeloma, myelogenous leukaemia and skin, kidney and colorectal cancer, turmeric as a whole food has in some cases been shown to be even more effective!In fact, a study was undertaken with turmeric where they removed the active component curcumin, and it was found to be just as effective!!Topical turmeric-based cream has shown some ability to reduce radiotherapy-induced dermatitis in patients with head and neck cancer; and oral mucositisCan interfere with some chemotherapy agents OtherMay improve concentrations of liver enzymesSome but insufficient evidence for treatment of kidney stones and reduction in stomach and intestinal gasWhen it’s not a good ideaCan interfere with many drugs, blood thinners and chemo agents when taken as a supplement. One study  - These findings support the hypothesis that dietary curcumin can inhibit chemotherapy-induced apoptosis through inhibition of ROS generation and blockade of JNK function, and suggest that additional studies are needed to determine whether breast cancer patients undergoing chemotherapy should avoid curcumin supplementation, and possibly even limit their exposure to curcumin-containing foods. https://www.ncbi.nlm.nih.gov/pubmed/12097302Other spices with similar impact It’s not the only option...Other anti-inflammatory and health promoting spicesCuminMay improve digestion by increasing activity of digestive enzymes and increase release of bile from liver. May assist IBS - a low level study explored cumin essential oil and found it reduced abdominal pain, bloating, fecal urgency and presence of mucus discharge during and after treatment with Cumin extract.May improve BG control in Diabetes - still unclear the exact mechanisms or exactly how much is required to obtain the desired therapeutic outcomes.Some studies suggest that supplementation may improve chol profileThe salicylic acid and other phenolic acids may have a anti-inflammatory and free-radical reducing properties to reduce cancer risk https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210012/https://www.sciencedirect.com/science/article/pii/S0308814608002483https://www.ncbi.nlm.nih.gov/pubmed/24829694https://www.ncbi.nlm.nih.gov/pubmed/25766448https://www.ncbi.nlm.nih.gov/pubmed/27664636https://nutritionfacts.org/2019/12/26/the-foods-with-the-highest-aspirin-content/?utm_source=NutritionFacts.org&utm_campaign=b4e7d340b4-RSS_BLOG_DAILY&utm_medium=email&utm_term=0_40f9e497d1-b4e7d340b4-26955981&mc_cid=b4e7d340b4&mc_eid=b327dd2e50Cinnamon - coined gift fit for kingsAnti-inflammatory properties similar to that of turmeric  - high concentration of antioxidants (polyphenols). Reduce insulin resistance - Cinnamon has shown to be able to improve insulin sensitivity, which means better able to reduce our BGLS.Cinnamon  contains contains enzymes which work  in our GIT which slowing down the breakdown of CHO’s. This reduces the amount of glucose in our blood after a meal.120mg per day can reduce total chol, LDL, TGs May help protect neurons, normalize neurotransmitter levels and improve motor function - researchers interested for Alzheimer'. Human studies are lacking, however watch this space..https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003790/https://www.ncbi.nlm.nih.gov/pubmed/14633804https://www.ncbi.nlm.nih.gov/pubmed/24019277https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901047/https://www.ncbi.nlm.nih.gov/pubmed/19433898https://www.ncbi.nlm.nih.gov/pubmed/23531502https://www.ncbi.nlm.nih.gov/pubmed/24349472GingerGinger root contains compounds that may help relieve or prevent nausea and vomiting. These substances can increase the flow of saliva and digestive juices and may also help calm the stomach and intestines. Some studies have found ginger may help nausea caused by chemotherapy, but larger studies are needed to confirm these effects.Eating fresh ginger in high doses can have blood-thinning effects by preventing platelets from sticking together. Laboratory studies suggest that ginger can protect brain cells from the plaques that cause Alzheimer’s disease, but this effect has not been studied in humans.Some data in OA and RA May reduce BGL May reduce drug dependence! May improve digestive health - reduce diarrhoea, gas and bloatingSupplemental doses can interfere with warfarin or blood thinners, NSAIDs, insulin, during pregnancy or pre-surgery. Stick to the real food! https://www.mskcc.org/cancer-care/integrative-medicine/herbs/gingerAshwaghandha (Indian or asian Ginseng)May assist with angina, T2DM management, immune function and…Sexual dysfunction benefits for erectile dysfunction Some reports of manic and psychotic episodes with supplements - stick to the food! Make into a tea or add to asian soups https://www.mskcc.org/cancer-care/integrative-medicine/herbs/ginseng-asianSupplemental doses of many of these spices can interfere with warfarin or blood thinners, NSAIDs, insulin, during pregnancy or pre-surgery or cause nasty side effects so stick to the real food! ChiliWhat is it: Capsaicin is the active ingredient in chilli, cayenne pepper, capsicum What for: Neuropathic pain and neuropathy, OA pain, weight loss, psoriasis, cluster headaches Caution: GIT lining, reflux Health benefits of capsaicin Weight loss: There is evidence to suggest intake of chilis (containing capsaicin) can enhance fat burning potential and reduce appetite, which of course can assist with weight loss. As always the literature suggested that regular ingestion of capsaicin compounds in conjunction with a healthy diet & lifestyle showed the most promising outcomes.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257466/Pain management: There is some low level evidence to support that Capsaicin has the ability to bind to pain receptors to reduce the pain sensation. However these were small studies and effects were not lasting.Be cautious of:GIT upset (abdominal pain/cramping or diarrhoea) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4102147/Cancer: There is some suggestion of chemoprotective effects however the evidence of safety vs risk is mixed regarding chili consumption. As mentioned, adding too much chili may have the ability to burn the lining of our GIT and this has been seen in some observational studies.Long term topical use may increase risk of skin cancer - eat don’t rub it Look out for capsaicin as active ingredient in some topical creams and nasal sprays. It is also available in a prescription-strength patch. https://academic.oup.com/aje/article-abstract/139/3/263/63603?redirectedFrom=fulltexthttps://www.mskcc.org/cancer-care/integrative-medicine/herbs/capsaicinIn summary: See what agrees with your body! If you love chilli, enjoy it! If you don’t moderate the amounts you eat.Eat your spicesAdd cinnamon and turmeric to oats - try our carrot cake bircher or make this into balls with some dates. Add yoghurt if you need to absorb it. Ginger tea or water, stir fry, bliss balls, Chilli, cumin, paprika, turmeric to your evening meals - veg chilli con carne, dhal or curry  Ginseng tea or add to your soup TO DO: buy minced chilli, garlic, ginger, dried cumin, paprika, chilli, turmeric 

SHOW NOTES WEIGHT  LOSSIn order to lose weight we do need to be at a caloric deficitThis is calories in vs calories out, but the in and out are far more complicated than you thinkEnergy in: fat, alcohol, carbs, protein. Fibre not absorbed Energy out: BMR, non-exercise energy, activity factor, thermic effect of food (protein 30%, carbs 8-10%, fat 2-3%, fibre 30%) For fat loss, we need to access fat stores = lipolysis (very complex), gluconeogenesis or ketogenesisFor weight loss we need a negative energy balanceReduce energy in - (water, fibre)Increase BMR - enhance lean body mass, heat, cold, glycaemic index, green tea, oolong tea, capsaicin, sleep (insulin, ghrelin, leptin balance), coffee, MCT vs LCTIncrease thermic effect of food - increase protein, reduce fat = increased energy outputIncrease non-active energy expenditure and activity factor - increase energy output. HIIT has the added benefit of burning energy and enhancing LBM.Golden rulesAim for

SHOW NOTESAustralian Bushfire Donations:WiresRed CrossCFAFood Bank OnCore Intermittent Fasting Guides - https://store.oncorenutrition.com/collections/all Physiological benefitshttp://oncorenutrition.com/to-fast-or-not-to-fast/Coffee https://www.ncbi.nlm.nih.gov/pubmed/28177691 Practicalities / sustainability / contraindicationshttp://oncorenutrition.com/the-fast-and-the-furious/Guides: http://oncorenutrition.com/intermittent-fasting/https://store.oncorenutrition.com/collections/allIF and calorie deficit similar weight loss outcomesSome find IF mentally challenging than consistent cal deficit, others find the oppositeScience currently unclear if IF vs CR is responsible for the body composition changes and good health.Why the evidence is unclear is that many studies have been conducted in animal based models which we know has limitationsHuman studies have been relatively poor (e.g. short duration) and mainly focused around weight loss (in the short term) rather than aging and disease risk.https://www.ncbi.nlm.nih.gov/pubmed/28459931100 obese participants - 6 women and 14 men, aged between 18–64 (the mean age was 44). Note they did not have metabolic conditions (e.g. T2DM).Looked at different dieting patternsAlternate-day fasting - consumed 25% of their daily energy requirements on fast days and 125% of their daily requirements on alternate days.Calorie restriction diet plan where the subjects consumed slightly less than their energy need (~75%) each day.Another group with no dietary intervention.Results: With regard to the two dieting groups, they both lost a similar amount of weight and showed no significant difference regarding, blood pressure, heart rate, triglycerides, fasting glucose, fasting insulin, insulin resistance & inflammatory markers at month 6 or 12.Of note there was a higher drop out rate within the alternate fasting day group, which may indicate adherence and consistency may be a challenge with this method,Our recommendation: No real difference between the fasting vs calorie restriction group. There is no magic pill when it comes to weight loss. Do what works best for you and work with a professional who understands your needs.https://onlinelibrary.wiley.com/doi/full/10.1111/j.1467-789X.2011.00873.xIntermittent CR and daily CR diets appear to be equally as effective in decreasing body weight, fat mass, and potentially, visceral fat mass. However, intermittent calorie restriction protocols may be superior in that they help conserve lean mass at the expense of fat mass. More research + longer term studies are required. Circadian rhythmsAccording to your circadian rhythm, nighttime is for resting, not eating.On average - we eat every 3hrs and 6 minutes and for a duration of approx 15hrs per dayMice that eat in opposition to their circadian rhythm gain significantly more weight than mice that only eat during waking hours, even if they eat the same amount of food. Not all studies in humans support this notion.At night, you may be more likely to choose unhealthy, calorie-dense foods.AccessConvenienceHigh risk time for high fat, calorie dense foodsEmotional / non-hungry eatingAppetite changes when tired - https://www.ncbi.nlm.nih.gov/pubmed/20357041 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3763921/Restriction/insufficient intake during the day → compensationThe first RCT in humans was published half way through 2019 to determine how meal timing affects 24-hour energy metabolism when food intake and meal frequency are matchedSmall n= 11 men + women aged 25-45two groups of people who ate the same three meals per day for 4 days but with different timings: the early time-restricted feeding (eTRF) schedule and the control schedule.8am - 2pm (18hr fast) vs 8am - 8pm (12hr fast)On the fourth day, 24‐hour energy expenditure and substrate oxidation were measured by whole‐room indirect calorimetry, in conjunction with appetite and metabolic hormonesNo effect on 24hr energy expenditureMay enhance fatty acid oxidation - i.e. using fat for fuel rather than carbohydratesTRF Decreased ghrelin levels, enhanced fullness, decreased desire to eatMeal‐timing interventions facilitate weight loss primarily by decreasing appetite rather than by increasing energy expenditure. eTRF may also increase fat loss by increasing fat oxidation.https://onlinelibrary.wiley.com/doi/full/10.1002/oby.22518Another study 6am-7pmNothing unless than the hrs to adhere to - no type, amt of food, no record keepingAte fewer calories and lost weightAnother studySame kJ at BF vs dinner - when given at BF = less weight gainhttps://www.ncbi.nlm.nih.gov/pubmed/23512957Another study3 meals vs 1 meal - same caloriesNormal-weight subjects are able to comply with a 1 meal/d diet. When meal frequency is decreased without a reduction in overall calorie intake, modest changes occur in body composition, some cardiovascular disease risk factors, and hematologic variables. Diurnal variations may affect outcomes.Both late eatingImprovement in weight loss, but blood pressure and chol levels suffered!https://www.ncbi.nlm.nih.gov/pubmed/17413096Early TFReTRF (6-hr feeding period, with dinner before 3 p.m.) or a control schedule (12-hr feeding period) for 5 weeks and later crossed over to the other schedule.eTRF improved insulin sensitivity, β cell responsiveness, blood pressure, oxidative stress, and appetite.We demonstrate for the first time in humans that eTRF improves some aspects of cardiometabolic health and that IF's effects are not solely due to weight loss.https://www.ncbi.nlm.nih.gov/pubmed/29754952Even 10-11hrs TRF beneficial - weight loss, improved energy levels, improved sleephttps://www.ncbi.nlm.nih.gov/pubmed/31808043https://www.ncbi.nlm.nih.gov/pubmed/26693661IF and breast cancer riskhttps://www.ncbi.nlm.nih.gov/pubmed/26305095These findings suggest that eating more frequently, reducing evening energy intake, and fasting for longer nightly intervals may lower systemic inflammation and subsequently reduce breast cancer risk. Randomized trials are needed to validate these associations.Breast cancer prognosis- 2413 women (mean [SD] age, 52.4 [8.9] years)- mean (SD) fasting duration of 12.5 (1.7) hours per night.- fasting less than 13 hours per night was associated with an increase in the risk of breast cancer recurrence compared with fasting 13 or more hours per night but wasn’t associated with mortality ratesNO RCTs YET!https://www.ncbi.nlm.nih.gov/pubmed/27032109 DiabetesVery small study n = 3 men who had had type 2 diabetes for 10-25 years.Medical supervisionFasted every other day or 3 days a week.Within a month, all of the men were able to stop taking insulin. And in less than a year, they were able to cut down on or stop other diabetes medications.Another small study, 10 obese men with type 2 diabetes followed a time-restricted eating plan. They improved their fasting glucose and lost weight over 6 weeks.Bigger studies are needed to confirm those findings and to see how long the results lastThe American Diabetes Association notes that if you’re overweight or obese, weight loss can help lower your HbA1c level (a gauge of your blood sugar control over the last 2-3 months) and lower your risk for heart disease.Important to:Talk to Dr/endocrinologist firstAdjust your insulinMonitor for lower BGLBeware of large carbohydrate load on first mealCell Metabolism: “Early Time-Restricted Feeding Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in Men with Prediabetes."BMJ Case Reports: “Therapeutic use of intermittent fasting for people with type 2 diabetes as an alternative to insulin."Joslin Diabetes Center: “Yom Kippur and Diabetes.”BMJ Open Diabetes Research & Care: “Recommendations for management of diabetes during Ramadan: update 2015."

SHOW NOTESFood labelsLabels must also have a list of ingredients. Ingredients must be listed by weight in descending order (i.e. the first ingredient contributes the largest amount to the product and the last ingredient contributes the least).Regarding additives, products must show the number or the name of any additives they contain (e.g. monosodium glutamate may appear as MSG or 621). If you know you have sensitivities to any additives, it’s important you know their corresponding numbers so you can keep an eye out for them,If the product contains any major allergens such as nuts (peanuts, cashews, almonds, walnuts, etc.), shellfish, fish, eggs, sesame seeds, soybeans, wheat, gluten, they must be declared on the label.Sugar No added sugar: No added sucrose, glucose, honey, malt, fruit juice, etc.Un-sweetened: No added intense (artificial) sweeteners, sucrose, glucose, honey, malt, fruit juice etc.    Diet: At least 40% less kJ than regular productComparative claims eg ‘reduced’, ‘increased’, ‘light’ or ‘lite’ must refer to the reference food Look out for:Sugar aliases    - dietitian colleague of ours has put together a list of 48 sugar aliases! Some derived from cane sugar, some from fruit, corn, beets, alternative sweeteners like agave and rice malt syrup, Don’t be fooled by fancy marketing, sugars can have many different names, and we will put this list in the show notes for you all to have a look at. Just because a food contains rice malt syrup or coconut sugar, this is still sugar.(https://foodwatch.com.au/blog/carbs-sugars-and-fibres/item/48-shades-of-hidden-sugars.html)Foods containing more than 10mg sulphite preservatives/kg must be labelled as containing sulphite as this is the level that may trigger Health claims These are claims about something in a food and how it can affect your health. E.g. ‘Fibre helps keep you regular ’;.  ‘This food is low in sodium (salt). A diet low in sodium may help reduce blood pressure’. Only pre-approved ‘food-health relationships’ for high level health claims are allowed to be made. All health claims must be supported by scientific evidence. Can’t  refer to the prevention, diagnosis, cure or alleviation of a disease, disorder or condition https://www.legislation.gov.au/Details/F2017C00711https://foodregulation.gov.au/internet/fr/publishing.nsf/Content/31BDC68CEC4A1964CA25801B00166C1F/$File/Getting-Your-Claims-Right-2018.pdfhttps://daa.asn.au/smart-eating-for-you/smart-eating-fast-facts/food-labels/what-are-health-claims-and-what-do-they-mean/Health Star Rating The Health Star Rating is a front-of-pack labelling system that rates the overall nutritional profile of packaged food and assigns it a rating from ½ a star to 5 stars.Aims to provide a quick, easy, standard way to compare similar packaged foods.Developed by Aus Gov with collaboration from industry and public DrawbacksOpt in, voluntary, all, some or none of their productsCompares products of the same category eg cereals with cereals Food manufacturers and retailers are responsible for the correct and accurate use of the Health Star Rating systemNutrients in isolation do not represent the value of a food Doesn't differentiate between whole foods and processed / packaged foodsPutting a health star rating on a processed food undermines message of good nutrition Added sugars are not differentiated from natural sugars - eg a muesli bar with oats and dried fruit vs bar with tonnes of sugar Products containing additional dietary fibre can get bonus points which can be used to offset negative points they get for saturated fat or sugar,This is how Nutrigrain - 4 stars  despite the fact it's still literally 27 per cent sugar. Add inulin = bonus points. Very easy to manipulate. Milo (4.5 stars, only IF consumed with a specific amt of skim milk, otherwise 1.5 stars if eaten alone!) literally receives a higher health star rating if eaten with ice-creamCertain brands of clean, unsweetened Greek yoghurts sit at 1.5 stars. Some lolly bags sit at 2.5.Salmon sits at 3 stars, beer battered chips sit at 4.Shelf, fridge and freezer lifehttps://www.foodsafety.gov/food-safety-charts/cold-food-storage-chartsServe size vs Per 100gWe look for (depending on the food of course) Total kJTotal protein per 100gSugar per 100g - check ingredients list to explore if natural vs addedSaturated / trans fatsSodiumFibre / Vit / Min https://livelighter.com.au/Assets/resource-vic/wallet-and-postcard/traffic-lights-wallet-card.pdfFood Switch App Source of product and ingredientsSource : https://www.accc.gov.au/consumers/groceries/country-of-originSource: https://www.australianmade.com.au/media/477079/amcl_code_of_practice_2017.pdfRemember, some of the healthiest foods may not have labels or health claims (e.g. fresh fruit and vegetables, nuts, lentils, beans, fresh meat and fish).

Trends in the New YearGoogle trends dataSource https://noobgains.com/gym-membership-statistics/https://fitness.org.au/articles/fitness-australia-annual-reports/fitness-australia-annual-report-2018-19/14/1880/19Behaviour changeAccording to well known Clinical Psychologist Dr. Howard Rankin, who is an expert on behavioral change, a large part of the problem is that we think we have control over our behavior, when really we don’t.Lauren and I see this regularly in practice. It’s wonderful to have goals and aspirations, but the psychology and motivation behind behaviour change in complex.We know that habits (which often take 21 days to break) and stress, reduce our conscious control over the choices we makeWhat drives our behaviour is not always logical, as humans we are emotional! You guys would know, sometimes we do things we know aren’t good for us, but we don’t know what drives us to pursue them!Quote by Dr Rankin: The more primitive, emotional brain generally has precedence over the newer, more rational brain.This is really important to note when it comes to setting achievable goals for the new year.Knowing this, we want to make sure you set yourself up for setting positive and realistic goals in the new year!Why New Year's resolutions don’t workAbrupt change too quicklyExpectations too large therefore setting self up for failureTo successfully achieve these resolutions, small, short-term goals are the most effective and taking resolutions one step at a time is the best way to succeedFear is such a powerful emotion it can override our priorities and goals we set. Fight/flight. We run away from fear before we run towards pleasure. We can have a fear of failure, success, or just fear of change—stepping outside our comfort zones—that stops may of us in our tracks before resolution become habits.How to make them stickMake resolutions tangible and achievable. For example, instead of stating you will 'lose 20kg in 2020,' plan that you will 'walk everyday for 2 weeks' or ‘avoid choc after 8pm for 2 weeks’.Say it out loud. Write it down. Tell someone. Anyone. Be accountable. Enlist a support crew. Cheerleaders Make your goals EXTREMELY SMALL. Like stupid small. For example, she suggests instead of aiming to workout three times a week, you start with two squats a day. The change is so small, you won’t stop with just two. Walk only to the letter box. No chocolate on Tuesdays. Walk only to the letterbox.  And that's how these small habits grow from ridiculously small to big. It's hard to resist not doing more, because it's just so easy. Anchor it to something. Your squats for eg, tether it to something you already do every day, like brushing your teeth. It’s only 2 mins. And all of a sudden it’s achievable.Opt in vs opt out. What are the things you always do? Eat lunch, brush your teeth, attend your specialist appts, go to work. Put your goals in that category. A MUST DO unless something major trumps it. Physically put them on your to do list, your calendar, your reminder list on repeat.  More positive less negative. - Set your phone calendar to give you positive messages or reminders about your goals a few times per day. Remind yourself to walk. Set an alarm that call your 8pm cut off time. Time - it takes 17 to 21 days to form a habit; therefore, keeping a goal for those 21 days will support successhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC535950/https://insights.ovid.com/article/00006205-201501000-00002https://www.ncbi.nlm.nih.gov/m/pubmed/26671434/?i=6&from=/15604158/related

Top Tips for navigating Festive Feasts1. Don’t overthink it. So you ate too much cheese. Acknowledge it then move on.

SHOW NOTESGreen Powders https://www.budgetdirect.com.au/home-contents-insurance/research/average-grocery-bill-statistics.htmlhttp://oncorenutrition.com/eat-or-drink-your-greens/Cheese http://oncorenutrition.com/the-bees-knees-of-cheese/Why we might not weigh youhttp://oncorenutrition.com/weight-bias-what-are-we-weighting-for/

 SHOW NOTESIf it fits your macros (IIFYM)What is this diet?Tracking energy (kJ/calories) and macronutrients (protein, carbohydrates and fats).Calculating basal metabolic rate based on predicted equations (BMR is how much energy your body uses at rest). Add activity +/- stress factor to estimate your total daily energy expenditure (TDEE).Depending on goals, establish a calorie deficit, maintenance or surplus.Apply macro percentages to your end calorie number, e.g. 30% energy from protein, etc…Once you have your macro calories and split you then build this into a meal plan and track it allPotential Benefits Nutrition knowledgeEye opening Label readingGoal oriented No forbidden foods Effective for weight loss ...but there is far more to health than number on scales.Some drawbacks It may promote an obsessive way of eating, body dysmorphia, disordered eating patternsPsychosocial limitationsDoes not encourage intuitive eating Practically arduous - weighingLow food variety Not necessarily an enjoyable or sustainable way to live life. Bottom lineWhen starting an eating plan, think about sustainability and true flexibility!Think about your sanity, relationships with loved ones and allow yourself to enjoy food in the moment!Listen to your body, eat when you’re hungry and stop when you’re full.There is so much more to life and enjoyment of food than calorie or macro counting.Food variety scoreAim for >30 per week http://www.nutritionaustralia.org/sites/default/files/Food%20Variety%20Checklist_0.pdfFrankenfield D, Roth-Yousey L, Compher C. Comparison of predictive equations for resting metabolic rate in healthy nonobese and obese adults: a systematic review. J Am Diet Assoc. 2005;105(5):775–89.

SHOW NOTESDiet soft drinksDiet soft drinks often replace sugar with artificial sweetener, often aspartame. Aspartame is around 200 times sweeter than sugar, so a very small amount is all that is needed to sweeten a product.Aspartame safetyStudies performed in 1980 by Joint Expert Committee of Food and Agricultural Organization + World Health Organization (JECFS) established the Acceptable Daily Intake (ADI) of Aspartame as 40mg per kg of body weight, meaning that the average person can safely consume around 3400mg of aspartame daily without any adverse side effects. Can of Diet Cola is around 180mg = 18 cans per day. Health impact of artificial sweetenersSome observational studies have found high intake of artificial sweeteners and diet soft drink is associated with an increased risk of obesity and metabolic syndromeDiet soft drink may increase appetite by stimulating hunger hormones (Grehlin), altering sweet taste receptors and triggering dopamine responses in the brainPredispose us to want sweet, calorie dense foods and fluids Observational (diet soft drink leads to weight gain) vs experimental studies (swap to diet soft drink leads to weight loss, but beware of funding source and bias)Link to weight gain possibly from above, possibly from pre-existing poor dietary habits. One study of over 300 overweight  participants - drink 710ml diet soft drink or water per day for a year. At the end of the study, the diet soda group had experienced an average weight loss of 6.21 kg compared to 2.5 kg     https://www.ncbi.nlm.nih.gov/pubmed/26708700Bias in the scientific literature - some studies (including this one) funded by the artificial sweetener industry have been found to have more favorable outcomes than non-industry studies, so we need to be careful when interpreting results.Observational studies have found a link between high intake diet soft drink and the development of kidney disease ? related to acid load on the kidneys from high phosphorus content.Gut microbiome: Artificial sweeteners alter the gut flora, leading to reduced blood sugar control. This may be one way diet soft drink increases the risk ofT2DM, but more research needed. https://www.ncbi.nlm.nih.gov/pubmed/27090230   https://www.ncbi.nlm.nih.gov/pubmed/25831243Be careful if you have low bone density - particularly with phosphorus containing drinks, so cola, and those with caffeine. PO4 interferes with Ca absorption. At the end of the day, diet soft drinks offer no nutritional benefit. The ingredients list is empty and doesn’t offer anything positive to our health. If you’re a regular drinker, set yourself a challenge. 21 days to change a habit. Set a target, recruit some friends, get a calendar going to mark off days and set yourself a challenge. Try our sparkling iced teas. Challenge to break the habit so you can enjoy sugar-free soft drink on occasion, but it’s not a must have each day. https://www.nature.com/articles/s41430-019-0407-zCarbonated water and teethhttps://www.ada.org/enMilk Cows milk full vs skim = change in ratios, no sugar added. Permeates ensure consistency in nutritional composition of milk.  Soy - similar nutritional profile - has to be by food standards law, plant-based, sometimes sweetenedAlmond - low protein, low kJ, low fat, low CHO, low Calcium. Some are sweetened, some calcium fortified.   Rice milk - low is kJ, protein, high in natural sugars. Hypoallergenic. Coconut milk - low in carbs and kilojoules, but is significantly higher in saturated fat than other non-dairy alternatives, lacks protein and calcium (unless fortified).Oat milk - same kJ as cows milk, half protein, low fat, higher CHO, equiv Ca,  beta-glucans (soluble fibre reduce chol reabsorption)Comparison table: https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Milk-Allergy-Foods-and-Ingredients-to-Avoid.aspxHeart Foundation guidelines https://www.heartfoundation.org.au/news/new-advice-from-the-heart-foundation-on-meat-dairy-and-eggs

SHOW NOTESThe positives We love plants - lots of benefits to a diet rich in plantsGenerating conversation! Controversy is sadly often necessary to create a ‘movement’ we see why they did this! (We can’t because we’re trained and regulated health professionals - and therefore the most trustworthy source of nutrition advice) Removing stigma around veganism and vegetarianism  (although the terminology they use was interesting eg never said vegan but implied it) They help clear up the stigma around soy - check episode 4 where we present the science in a less inflammatory way! Farming and environmental concerns THE SCIENCEUnfortunately good TV often equals bad scienceSupporting science - controversial sources, grand extrapolations from small studies, and statements that are misleading.Anecdotal experience, conflicts of interestGladiators Whole premise of doc built on concept that gladiators didn’t eat meat…Their exact words were “gladiators were likely predominantly vegetarian”. True-ish. 80% ish plant based. Not vegetarian. Not vegan. Just like us.  We were misled from the start They also implied that the gladiators were vegan for performance reasons, which again is misleading. Gladiators ate more of a plant based diet because of many reasons including access to animal products, availability, seasons and money! And because carbohydrates fuel the human body. Meat is expensive and many ancient civilisations only ate what they had access to.Gladiators weren’t overly lean - gladiators benefited from additional fat stores as food supplies were often scarce and this extra weight was protective when they went into battle/helped them stay alive. More fat = lasts longer in the arena. Different to many sports in today's day and age. Athletic performanceYou don’t have to eat animals to build muscle  So many other variables to consider when exploring athletic performanceNutritional advice should be tailored to the sport of choice, performance goals and outputs and individual variation In one instance, they do cite actual peer-reviewed research, he narrates: “And when it comes to gaining strength and muscle mass, research comparing plant and animal protein has shown that as long as the proper amount of aminos acids are consumed the source is irrelevant.” https://www.ncbi.nlm.nih.gov/pubmed/15212753. What they fail to include is that the same study states that “as a group, vegetarians have lower mean muscle creatine concentrations than do omnivores, and this may affect supramaximal exercise performance.” (achieving higher than what is considered maxima) = prime example of cherry picking.Theory: Beetroot juice consumption increases bench press by 19%. Beetroot study - review of 9 studies with total of 120 subjects numbers -  The beetroot juice intervention led to significantly improved performance in four of the studies, while in another four no such effects were observed. In the show they quote a 19% increase in total strength for bench press, but this is referenced in the study cited not tested by it. Obviously we went and found the actual study. It was a cross over trial, 12 young men, lifting 60% of their 1RM (single rep max, the most they can lift). 3 sets until failure were performed and those reps were totalled. Those in the nitrate supplement group performed more reps. The weight equated to an 18.9% increase. “This study demonstrates that nitrate supplementation has the potential to improve resistance training performance and work output compared to a placebo.” The study was looking at a Nitric Oxide Enhancing Supplement, not just beetroot! Nitric oxide (NO) is generated from the nitrates in the beetroot. It’s a vasodilator so opens up blood vessels and improves flow in the short term. If you understand nutrition you’ll know that other foods contain nitrates, including beef, pork, chicken, liver, salmon, trout and tuna!Beware of supplements and performance enhancing drugs Experiments - endothelial function (cloudy blood) and erectile function Neither are scientifically validated test. Looks good on screen. Convincing. But not scientifically meaningful.The ‘cloudy’ portion of blood in the test tube does not necessarily indicate there is an issue, more it shows there are triglycerides and fat transporters present called chylomicrons. This is a completely natural and necessary process, however the documentary portrays it to be negative to support their argument. If there was sufficient EVOO or avocado in the vegan burrito, the blood sample would have looked the same. 2hrs post meal. They didn’t specify how much avocado they put in. And they didn’t have to because this wasn’t a study!  We know the fat was seen in their blood, but we don’t know if their endothelial function was impaired and/or their blood flow disturbed in any way due to their meal.The study that suppoerted their findings (n=11): “The high-fat meal consisted of 53.4 g fat (= 7.4 chicken breasts), 30.7 g protein, and 50 g carbohydrate, composed of 110 g rice, 100 g Korean barbecue, 20 g egg, 200 ml milk, 8 g oil, 25 g mayonnaise, 50 g vegetable.” The response shown, as stated in the paper’s title, was due to ‘oxidant stress’. Not the triglycerides Another study n=10. The standardized high-fat meal consisted of whipping cream, liquid chocolate and non-fat dry milk and contained 65 g of fat, 25 g of carbohydrates.Supporting study funded by the Hass Avocado Board We know that lean protein sources (e.g. poultry and fish) can improve endothelial functionNeither of these “experiments” considered variables like sleep, muscle fatigue, stress, training, hydration, blood electrolyte levels, history of tobacco use, alcohol consumption, prior medical history, mental clarity, emotional state, genetic predispositions. n= 3 people. Not enough.  Clinically concerning hypertriglyceridaemia looks like this...Source: https://en.wikipedia.org/wiki/HypertriglyceridemiaSource: https://www.elynsgroup.com/journal/article/milky-serum-in-hypertriglyceridemia-clinical-imageSource: https://www.semanticscholar.org/paper/Severe-hypertriglyceridemia-presenting-as-eruptive-Vangara-Klingbeil/b3148cd3bb48f43711a7a0ced40d446b1ef74618Nutritional profileThe show claims, animals eat plants, so we should bypass animals and eat plants too. To put it in context for you a cow has 4 stomachs (we have 1), can extract amino acids from plant based materials as a result of enzymes and bacteria that we as humans do not have. As humans our digestive tract is very different. We can not get the same nutrients from grass as cows do.Compared to animal sources, plant based sources are a poorer source of leucine - important for muscle growth Vegans can get a complete profile of AA’s however they need to be eating a wide range of plant based protein sources.Estimated bioavaiability of protein in beef - 92%. Estimated bioavailbility of protein in kidney bean - 54%. Grams of protein does not equate to how much we as humans can absorb and access. There’s a funny bit here where they reference a peanut butter sandwich as containing an equivalent amount of protein to 3 ounces of beef. To achieve the ~20g of protein that is in 3 ounces of beef, you would need to consume 2 slices bread plus 4 tablespoons peanut butter bringing the total to 510 calories (2100kJ), 20g protein, 34g fat, and 39g carbs. Beef - 213cal (894kJ), 20g pro, 13g fat, 0 CHO. So the peanut butter sandwich has yes the same protein, but more than double the calories, almost triple the fat, 40g vs 0g carbs“Even iceberg lettuce has more antioxidants than salmon or eggs.” - worse than comparing apples & pears…Just because they’re not ‘antioxidants’ doesn’t mean they’re not valuable nutrients! Eg omega-3 fatty acids in salmon and protein in eggs are so valuable!  How much protein or omega 3s are in iceberg lettuce?! Shall we compare it the other way?Go to episode 2 for tips on upgrading your salad Wilks claims that cow’s milk can increase oestrogen and lower testosterone in men. The 2010 study he references, published in the journal Pediatrics International, was conducted using the milk of pregnant cows. The scientists pulled from a pool of 18 people (seven men, six children, and five women), and found that milk reduced testosterone secretions—not overall testosterone —temporarily. Seven men. Temporarily. https://www.ncbi.nlm.nih.gov/pubmed/19496976Focus on ADDING plants rather than REMOVING animal products.OnCore Practical Plant-based tips Our upgrade your health tips (not 0-100!) It doesn't have to be all or nothing. Focus on adding plants rather than necessarily removing all animals. Add veggies, fruit, spices or acidic marinades (such as yogurt or vinegar-based marinades) to your meats - this may decrease hetereocyclic amines (linked to cancer development) formation by up to 99%Start with meat free mondayUpgrade to one meal per day - plant-based lunchesStill eat REAL food - avoid fake cheese, fake-on, tofurkey. This takes planning and knowledge and perhaps tailored expert advice and guidance. It's relatively easy to meet your protein needs. It’s hard not to overdo the carbohydrate load. Tailored advice from a dietitian will help ensure you’re eating to match your goals. Watch a David Attenborough documentary instead - we think this gives a far more powerful, realistic perspective on how we could be better looking after our planet and health simultaneously Think about where you’re getting your health information - underlying biases, conflicts of interest, governing bodies or registrations? We are required to stay up to date and be safe and fair to public. Think about how you can ethically source your animal products (see below). Sustainable produce https://sustainabletable.org.au/all-things-ethical-eating/ethical-meat-suppliers-directory/https://www.sustainability.vic.gov.au/You-and-your-home/Live-sustainably/Sustainable-shopping/Food-shoppinghttps://www.wwf.org.au/what-we-do/food#gs.g3u330https://kb.rspca.org.au/knowledge-base/how-can-i-shop-for-animal-welfare-friendly-food/https://www.coles.com.au/corporate-responsibility/sustainability/responsible-sourcinghttps://www.ethical.org.au/3.4.2/get-informed/issues/food-miles-buying-local/https://www.sustainability.vic.gov.au/You-and-your-home/Live-sustainably/Sustainable-shopping The Game Changers References: The Gladiator Diethttps://archive.archaeology.org/0811/abstracts/gladiator.htmlBeetroothttps://www.ncbi.nlm.nih.gov/pubmed/29311764Nutrient Profiles https://www.ncbi.nlm.nih.gov/pubmed/23988511https://pdfs.semanticscholar.org/0277/f4fd3e6205936e4d4c8e490abe9958607815.pdfThese are the studies cited with regards to vegetarian diets for athletes:https://pdfs.semanticscholar.org/6358/c99b8b7047fd99f0867e148840829a125dd0.pdfhttps://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-12-86https://www.ncbi.nlm.nih.gov/pubmed/26764320Endothelial Functionhttps://www.ncbi.nlm.nih.gov/pubmed/11254924https://www.researchgate.net/publication/12166386_Impaired_flow-mediated_vasoactivity_during_post-prandial_phase_in_young_healthy_menhttps://www.ncbi.nlm.nih.gov/pubmed/23196671https://www.ncbi.nlm.nih.gov/pubmed/10477529https://www.ncbi.nlm.nih.gov/pubmed/20047267https://www.ncbi.nlm.nih.gov/pubmed/24004888https://www.ncbi.nlm.nih.gov/pubmed/19064532https://www.ncbi.nlm.nih.gov/pubmed/15165919https://www.ncbi.nlm.nih.gov/pubmed/24742818https://www.ncbi.nlm.nih.gov/pubmed/22019438https://www.ncbi.nlm.nih.gov/pubmed/11834139https://www.ahajournals.org/doi/full/10.1161/01.cir.104.2.151https://www.ncbi.nlm.nih.gov/pubmed/17916273https://www.ncbi.nlm.nih.gov/pubmed/17609490https://www.ncbi.nlm.nih.gov/pubmed/23848379https://www.ncbi.nlm.nih.gov/pubmed/16027246https://www.ncbi.nlm.nih.gov/pubmed/16365364https://www.ncbi.nlm.nih.gov/pubmed/15547040https://www.ncbi.nlm.nih.gov/pubmed/26024297https://www.ncbi.nlm.nih.gov/pubmed/24706588https://www.ncbi.nlm.nih.gov/pubmed/22091240https://www.ncbi.nlm.nih.gov/pubmed/15190043https://www.ncbi.nlm.nih.gov/pubmed/16198843Antioxidantshttps://www.ncbi.nlm.nih.gov/pubmed/30634559https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-9-3https://www.betterhealth.vic.gov.au/health/healthyliving/antioxidantshttps://www.ncbi.nlm.nih.gov/pubmed/25637150Plant Based Guide for Physicianshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4991921/Heme Ironhttps://www.ncbi.nlm.nih.gov/pubmed/23708150 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3583546/)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2954454/Cardiovascular Diseasehttps://www.ncbi.nlm.nih.gov/pubmed/24871675https://www.ncbi.nlm.nih.gov/pubmed/1973470https://www.ncbi.nlm.nih.gov/pubmed/24606898Cancer Riskhttps://www.ncbi.nlm.nih.gov/pubmed/11519764https://www.ncbi.nlm.nih.gov/pubmed/9786231Human Evolutionhttps://blogs.scientificamerican.com/guest-blog/human-ancestors-were-nearly-all-vegetarians/https://www.academia.edu/28523514/The_evolution_of_body_size_within_the_genus_Homo_new_empirical_data_and_theoretical_perspectiveshttps://www.ncbi.nlm.nih.gov/mesh?Db=mesh&Cmd=DetailsSearch&Term=%22Vitamin+B+12+Deficiency%22%5BMeSH+Terms%5Dhttps://www.ncbi.nlm.nih.gov/pubmed/10648266Testosteronehttps://www.ncbi.nlm.nih.gov/pubmed/10479226https://www.ncbi.nlm.nih.gov/pubmed/2400756https://www.ncbi.nlm.nih.gov/pubmed/10883675Phytoestrogenshttps://www.sciencedirect.com/book/9780123984562/polyphenols-in-human-health-and-diseaseOestrogenhttps://www.ncbi.nlm.nih.gov/pubmed/11392381https://www.ncbi.nlm.nih.gov/pubmed/17474873https://www.ncbi.nlm.nih.gov/pubmed/19496976Cortisolhttps://www.ncbi.nlm.nih.gov/pubmed/3573976

Types of Intermittent FastingADF - 25% energy reqs one day, nil restrictions on the next Complete alternate-day fasting (or total intermittent energy restriction) - no energy consumed on fast daysmodified alternate-day fasting (or partial intermittent energy restriction) - up to 25% of daily energy needs on fasting days instead of complete fasting.Most studies are in this method - mice and human In humans, Monks semi-fasted every other day with 1L milk + 500g fruit on fast day for 3 years> Less time in monastery infirmary & lived longer (but not sig).Periodic fasting 5:2 (Michael Mosely) - not a whole lot of evidence yet, but more emergingThe 2 Day Diet (Michelle Harvie) - 2 days 500-600Cal then eat & drink normal for rest of week24hr fastValter Longo– 5 day consecutive fast (800Cal/day) then normal for rest of month > evidence for protection against cancer.more extreme versions with several days or weeks of fasting. During the fasting days, it may be allowed approximately 500 to 600 calories or about 25% of regular daily caloric intake instead of complete fasting.Time-restricted feeding / TRE - eating only during a certain number of hours each day. Eg 16:8. This schedule is thought to leverage the circadian rhythm.Timing - earlier may be better. BF not most important meal of day but BF and lunch better for circadian rhythm and glucose tolerance the next day than lunch + dinner. Physiological benefitshttp://oncorenutrition.com/to-fast-or-not-to-fast/Coffee https://www.ncbi.nlm.nih.gov/pubmed/28177691Practicalities / sustainability / contraindications http://oncorenutrition.com/the-fast-and-the-furious/Guides: http://oncorenutrition.com/intermittent-fasting/https://store.oncorenutrition.com/collections/all  

Skin, hair, nails supplementshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3509882/Many products on the market that claim to thicken our hair, improve the quality of out skin and strengthen nails.Many of these products come with fancy marketing and an expensive price tag!Are these supps all they;re cracked up to be? Here's what the research shows:What do these supplements usually contain (individual products do very)?Hair, skin, and nail supplements commonly contain antioxidants (e.g. vitamins A, C, and E, and/or Coenzyme Q10).biotin & B- vitamins can be in there too!They can often contain the minerals manganese (helps your body utilize a number of vitamins and selenium (plays an important role in the health of the immune system by reducing oxidative stress), along with fatty acids (fish oil and/or flaxseed oil). Deficiencies of these nutrients is uncommonOver time, inadequate intake of vitamins A and E and biotin can affect our hair and skin, however this is rare!Sadly I’ve seen some really poor quality products (with very fancy marketing) that don’t even contain all of these ingredients.What does the science say?For those with no deficiencies, there's no good evidence that supplements can make a difference to our hair skin and nails.I’m not aware of any robust data suggesting that any supplements can improve the inevitable age-related hair loss, skin elasticity or nail weakening. What if you are one of those people who have nutritional deficiencies?Most people get enough of the nutrients mentioned above through the diet, but in rare cases, a chronic disease and/or medical problem may cause a nutritional deficiencies, which as a result affect your hair, nails, or skin.If you’re experiencing hair, skin or nail issues for no clear reason, talk with your doctor and request a blood test .  Supplements can often contain heavy metals and other ingredients that aren’t necessarily health promoting. We always recommend food first!Our recommendations:In summary: While nutrition plays a key role in many skin issues, consuming pills specifically to target these without making any other changes to your diet or lifestyle is likely counterintuitive - eat a healthy, balanced diet and save your pennies!Vitamin A and skinSource: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4428712/https://www.ncbi.nlm.nih.gov/pubmed/17515510https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699641/  Transdermal absorptionMUST be fat soluble! Lipophilic. All water sol vitamins won’t be well absorbed.MUST be smallVit D - sublingal vit D spray, not yet transdermalhttps://www.nature.com/articles/s41430-019-0503-0Magnesium - poorly absorbed. Requires sweat glands/hair folliclesDead cells of the upper skin layer do not contain functional magnesium transporters, which have not yet been identified in detail, magnesium absorption may be possible only at the small area of sweat glands and hair follicles.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579607/B12Suitable alternative to oral or intramuscular injections at restoring serum B12 levelsThe bioavailability of sublingual vitamin B12 appears to be equivalent to oral vitamin B12https://www.ncbi.nlm.nih.gov/pubmed/30632091https://www.ncbi.nlm.nih.gov/pubmed/29499976https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1884303/ Omega 3 fatsHow does this impact our skin?DHA = structural component of skin and keeps our cell membranes healthy. When the cell membrane is healthy, this means healthy skin - yay!EPA has many benefitsReduces signs of premature aging.May reduce the risk of acne formation.Skin hydration.Can prevent Hyperkeratosis - thickening of skin Omega-3s can protect skin from the UV rays emitted from the sun.EPA in particular can help your body retain skin collagen after sun exposure CORRECTIONSaturated fat content of coconut oil approx 80-90%Saturated fat of extra virgin olive oil approx 15%  

Alkaline diethttp://oncorenutrition.com/dont-be-basic/ Eggs and cholesterolLet's take it back, what is cholesterol?Cholesterol is a fat-like substance that is produced by our bodies and also found in food.Our bodies need cholesterol to function properly. e.g, cholesterol is used to build cell walls and hormone production.About three quarters of cholesterol in the body is produced by your liver and the rest comes from the foods we consume.Cholesterol is carried in the blood by lipoprotein as Lauren discussed last week. The main types of lipoproteins are high-density lipoprotein (HDL) and low-density lipoprotein (LDL). Obviously we want more of the good stuff (HDL) and less of the bad stuff (LDL)Where’s the research at?Research has shown that dietary cholesterol does not significantly impact cholesterol levels in your body.Data from population studies showed a limited association between dietary cholesterol and heart disease in the general population.Healthy foods that contain cholesterol (e.g. eggs, fish, shellfish, yoghurt) can be protective against heart disease and high cholesterol.Eggs specifically?The cholesterol found in eggs has little effect on your blood cholesterol levels.Cholesterol levels influenced by saturated and trans fats.Choose healthy sides to accompany you eggs, e.g. a slice of wholegrain rather than white bread and limit your intake of bacon.If bacon is your side of choice to accompany your eggs, the bacon will likely have more of an impact on you blood cholesterol than the eggs! We encourage you to try some vegetable based sides, e.g. spinach, tomato, avocado, mushrooms or beans!What is important to note is a small number of people are sensitive to eating dietary cholesterol that is naturally found in food. Therefore when they eat cholesterol rich foods, their LDL (not so good) cholesterol levels may increase.Recommendation: 7 eggs per week.Which foods will increase blood cholesterol?The research suggests that processed foods which are high in saturated or trans fats will increase our blood cholesterol levels.I was reading a large study in The American Journal of Clinical Nutrition, which followed over 300,000 people for 4–10 years. The subjects modified the type of fats consumed. Those who reduced their saturated fat intake by ~5% and selected polyunsaturated fats had lower rates of coronary illness or coronary related deaths.Moral of the story: with a baseline healthy diet eggs are an excellent source of healthy fats and protein! Pick your drinkG+T = up to 3 slices bread (short glass ~715kJ, 250ml tonic = 840kJ) = 14% daily energy needs.(7 = 100%)Gin and soda = 1 slice bread (415kJ)Cider = up to 4 slice breadCocktail - up to 5 slice breadDry wine, champagne, spirit = 1 slice breadBeer = 2.5 slice breadBetter optionsSpirit + sodaChampagneDry wineYou know the drillStay hydrated - 1 for 1Get a long glass if it’s soda, short glass if it’s soft drinkLine your stomach → About 20 percent of the alcohol consumed is absorbed in the stomach, and about 80 percent is absorbed in the small intestine Bone BrothsBone broth? Do we need it?These days, bone broths are being hailed as a new curall regarding gut health, skin, immune system and joint relief.There are many testimonials to support this soups benefits— e.g. as wrinkle removers, gut bacteria boosters, bone builders and immune enhancersUnfortunately, the science doesn’t quite back it up!What is interesting is bone broth is something we have always had in my culture, my Omi makes the most delicious chicken soup and all these years we thought nothing of it (other than how delicious it was)!What is bone broth?Usually made with chicken stock or beef stock, but can be made with pork and fish. The soup bases made by simmering the bones with added spices and vegetables, often for as long as two days.Bone broth is a fairly good source of protein and often contains ~ 6-12 grams a cup.Where’s the evidence at?Claims with some support:Small studies which have found benefits on consuming chicken broth:Chicken soup & mucous secretion. There is research to suggest that consuming hot chicken soup can help to loosen and clear secretions - study from 1978 and we have spoken about this in previous prodcats.Chicken soup & inflammation. Laboratory studies that found chicken soup inhibits the activity of neutrophils (white blood cells). However, this evidence is not overly strongBoth small studies but some evidence nonethelessClaims with no support:Bone broths & joint pain. Arthritis can occur as a result of collagen loss. Whilst bone broth contains collagen, dietary collagen isn't necessarily absorbed and directed straight into your joints.Bone broths & skin firming/elasticity. Claim also based on collagen, which forms a layer of tissue to support our skin. Just as dietary collagen isn't transported directly to the joints, it isn't taken necessarily directed to our skin either.Bone broths & digestion. Bone broths contain gelatin, which has claims to support and improve digestion. Again another claim with little evidenceBone broths & bones. Whilst the soup is made from bone, this doesn't mean it will build bone or strengthen the bones in our bodies. The animals bones in the soup release very little calcium into the broth, despite being simmered for many hours/daysOf noteAll bone broths are made differently - no consistency with products, therefore very difficult to test.The bottomline: If you enjoy it, drink it or use it as a base for your soups, there is absolutely no harm. However it is not the cure-all it’s claimed to be! Save you $$ from the health food stores.https://www.health.harvard.edu/healthy-eating/whats-the-scoop-on-bone-soup 

Show NotesHow many carbs are enoughWill coffee cause problems during pregnancyWhy meat free Monday should be part of your weekly routine Is Collagen more than just a beauty regime?Carbohydrateshttp://oncorenutrition.com/gi/Coffee and pregnancyExercise cautionOver 200-300mg caffiene per day increasing risk of miscarriage and low birth weight Decaf safe -3mg caffeine per tsp - hard to overdo!1 Tsp of instant - 60mg per tspEspresso shot (30-35ml) - 90mg   but anywhere up to 200mgPercolated - 100mg per cupEnergy drinks - up to 110mg per serveCola - 40mg per serveBlack Tea - 50mg Green tea - 30mgChocolate - 60g of milk or dark Choc has about 30-40mgPregnant women can safely have two instant coffees a day and two to three cups of tea OR one cap/latte Collagenhttp://oncorenutrition.com/whats-the-deal-with-collagen/

Show NotesThe burning truth about ACVWill chocolate make your skin break out? Hacks to keep your iron stores highA great question about how to top your toast - the butter vs marg debate!Apple Cider Vinegarhttp://oncorenutrition.com/apple-cider-vinegar/Chocolate and acneResearchers has found that high glycaemic index foods (think white bread, lollies, cakes, biscuits and soft drink) may make acne worse. On the contrary, a diet rich in low GI carbs, which includes wholegrain breads and cereals, legumes, fruits, vegetables has been found to improve acne.Much more research needs to be done though, as the info we have is still early daysGood news for all you chocolate lovers: There is no evidence to support the claim that chocolate causes acne. There is data to show that dark chocolate (which is rich in antioxidants) can be good for our skin. However, everything in moderation!For some individuals, dairy products can trigger acne. There have been studies which  have shown a link between acne severity and consumption of dairy products.It's still farfetched to say that dairy causes acne, and avoiding dairy probably won't cause acne to disappear. However, if you consume large volumes of dairy and experience acne, you may want to cut back on the dairy for a while and see if it has any effect on your skin. Acne development is very complex and it's highly unlikely that just changing one aspect of your diet is going to completely irradicate ones acne.Iron hacksAnimal-based iron sourcesFoodServing sizeIron contentChicken liver100g11mgBeef100g3.5mgKangaroo100g3.2mgLamb100g2.5mgSalmon100g1.28mgTinned tuna100g1.07mgLamb brains100g1.0mgPork100g0.8mgChicken100g0.4mgSnapper100g0.3mgPlant-based iron sourcesFoodServing sizeIron contentWeetbix TM30g4.2mgAll Bran TM30g3.2mgKidney beans1 cup3.1mgGreen lentils1 cup3.0mgTofu100g2.96mgChickpeas1 cup2.7mgCooked wholemeal pasta140g (1 cup)2.3mgCashew nuts30g (20 nuts)1.5mgRaw spinach1 cup1.2mgRolled oats30g1.1mgAlmonds30g1.1mgDried apricot30g (5 dried apricots)0.93mgBroccoli1 cup0.86mgCooked brown rice140g (1 cup)0.7mgWholegrain bread1 slice0.4mgHow much iron do I need?AgeRecommended Daily Intake1All 1-3 years9mg per dayAll 4-810mg per dayGirls 9-138mg per dayGirls 14–1815mg per dayBoys 9-138mg per dayBoys 14–1811mg per dayFemales 19–5018mg per dayFemale 51+8mg per dayMales 19+8mg per day Pregnant & lactating womenRecommended Daily Intake1All pregnant women27mg per dayLactating women, 14–18 years10mg per dayLactating women, 19–30 9mg per day  Functional signs of Fe def:-   Redced physical work capacity,-       Delayed psychomotor development in infants,-       Impaired cognitive function-       Dizziness, headaches,-       Tmpaired immunity-       Challenges in pregnancy-       Tongue and mouth sores-       Pica (the compulsion to eat nonfood items, such as paper or ice chips)-   Get your serum Fe levels checked – measure the stores, the transporters and the saturation of the Fe on the transporters. A haemoglobin level might also be taken if there is suspicion of blood loss.Tips to enhance absorption -   Eat foods high in vitamin C or citric acid with foods that contain iron.-       If possible or plausible, separate the intake of Fe rich foods with phytate rich foods such as whole grains, cereals, soy, nuts and legumes-       Cook your plant foods to improve the amount of available iron-       Avoid having tea, coffee or calcium during or directly after having a source of iron – if you’re taking supplements, split them up!-   Ensure that you only take iron supplements under the advice of a medical prof, as too much iron can also be harmful.Butter vs Marghttps://www.health.harvard.edu/staying-healthy/butter-vs-margarine

Show NotesAre you eating too much red meat?Does dairy increase mucous production, Soy and hormonesCalcium supplements - are they safe?Red meathttps://www.wcrf.org/dietandcancerhttps://www.meatfreemondays.com/Dairy and mucousMucus is produced by cells in the nose and lungs. It consists of salt, water and various proteins which help to trap germs. SO there is very good reason that we produce mucous, even though it’s not overly pleasant.Antibacterial enzymes and proteins within mucous (called antibodies), recognise the germs so they can be removed by our immune system and protect us from further infection.Mucous actually helps us to remove the infection from our body.As it stands there is currently no evidence to suggest that dairy increases mucus production and delays recovery.Some people report that dairy can make their phlegm seem thicker, however it doesn't cause the body to increase phlegm production. Do what makes your feel best! Listen to your body.Dairy is a rich source of protein and contains a number of vitamins and minerals that may be immune boosting. Therefore, if you enjoy dairy, there is absolutely no reason to cut it out when you’re sick.Soy and hormoneshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2377415/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074428/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4129534/Calcium supplementshttps://www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/integrative-medicine/herbs/search

Show Notes Probiotics vs Prebioticshttps://www.mayoclinic.org/prebiotics-probiotics-and-your-health/art-20390058  PrunesPrunes = dried plums     1 cup prunes = 12g fibre = almost half daily fibre req (25-30g per day)3 prunes = 4g fibre 100g prunes = 7.8g fibre vs 3.8g in broc vs 2.4g in appleAlmost equal parts soluble and insoluble fibre which means it not only adds bulk to the stool to help you create something to pass in the first place, but the soluble fibre helps absorb fluid to create a formed stool and also feeds our good gut bacteria.Prunes are also a good source of sorbitol - a sugar alcohol that occurs naturally in dried fruit but also is commercially manufactured and added to things like diabetic jelly and sugar free gum. It gets fermented by our gut bacteria and draws fluid into the gut to help it, errrr slip out! Resistant starchThe research suggests that increasing your intake of resistant starch can be beneficial for the bacteria in our intestines as well as for your cells.Research has shown that the way you prepare common foods like grains, potatoes, rice and pasta may change their resistant starch content.One type of resistant starch is formed when foods are cooled after cooking. A great way to increase the amount of RS in your diet is simply cooking and cooling your carbs.Green bananas are also high in RS, however as they ripen and become sweeter, they amount of RS lessens.Faecal Transplanthttps://www.hopkinsmedicine.org/gastroenterology_hepatology/clinical_services/advanced_endoscopy/fecal_transplantation.html

Show NotesMiracle fruithttp://oncorenutrition.com/miracle-fruit/Tapeworm DietVictorian Era- late 1800s Tablet containing parasite egg - hatches and “eats extra calories” in the digestive systemPossibles side effects: nausea, vomiting, fever, diarrhoea, infection blocked bile ducts, pancreatic ducts, neurological issues (blurred vision, dementia), altered lung + liver failureUpgrade your health - salad leaveshttp://www.leanitup.com/upgrade-your-lettuce-game-boost-your-nutrient-intake-3000-with-this-two-second-salad-hack/Best vegan protein for muscle gainsNeed 8g leucine per day spread over meals and snacks (2.5g per serve) - amino acid - building block plus anabolic triggerMost leucine rich vegan protein powder = corn protein. Leucine rich foods include meat, chicken, fish, nuts & seeds, eggsFor those who prefer vegan protein, a corn protein isolate has a decent BCAA  profile and is an excellent source is leucine. Soy is also another option that is high in leucine.

Show NotesCelery juice - savvy marketing, early mornings, juicing vs blending and a heightened electricity bill! http://oncorenutrition.com/sell-ery-juice/The old wives tale ‘starve a fever, feed a cold’ and what to eat when you’ve got a cold versus a flu. Dates back to 1954People thought that eating would divert energy and resources away from fighting the fever, to the process of digesting your food...and that this would lead to more feverWhen we eat, digestion creates something called the thermic effect of food, or the energy that it takes our bodies to break down our food. This process released a byproduct of heat, which is where this concern might have come from. What science has been able to demonstrate is that in fact the opposite is true. Medical research suggests the saying should instead be “feed a cold, feed a fever.” When we are unwell with fever or a cold, it requires additional energy to fight the infection. This means our body requires an increase in energy and nutrients to produce the immune cells required to fight the infection. These immune cells, immunoglobulins for e.g. are made up of proteinOther micronutrients, including Zn, selenium, Fe, copper, vits A, C, E, B6 and folate, glutathione (cruciferous veg), bioflavanoids (citrus fruits) are all involved in immune processes and its important to have enough of these through eating a variety of whole foods. Colds and flus are caused by viruses Intermittent fasting may enhance immune function, but not so useful once you’re already sickStarving a fever is of no benefit and may even delay your recovery Drink plenty of fluids, rest if you need to, hearty soups such as minestrone, chicken and veg, can help provide nutrients and liquids - killing 2 birds with 1 stone. And the heat can help loosen mucous. Listen to your body - eat when you’re hungry but also rest when you need to. Some benefit in zinc , olive leaf extract at the first sign of a cold to reduce the severity and durationUpgrade your health - swap your riceRice itself doesn’t offer much more than carbohydrates and calories so if you have an opportunity to swap it out for something that adds more value we’d encourage you to do so. You could swap rice for a grain such as quinoa, barley or freekeh for significantly more protein and fibre; a legume like chickpeas or lentils, or get right amongst it and try some cauliflower rice. If it’s the curry you’re really after then you’re unlikely to miss it. And if you just want rice, absolutely use it, keep your serves to the size of your fist. And select basmati rice, wild rice or a rice and quinoa blend to get the glycaemic response down. Organic versus non organic produceStudies on the foods themselves in terms of nutritional content, levels of chemicals and resistant bacteriaStudies 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 limitsWhen 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 differenceSome 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.