Revive and be Kind

 

By Dr Karen Faisandier

As I start writing this piece, I sit wondering where 2019 went – as you may also be wondering. There’s a sense each year is becoming faster and faster, like a merry-go-round we can’t find our way off. The quicker life gets, the greater my instinct to slow myself down; do less, spend less, simplify life. As a form of self-preservation, I focus my energy on what is “essential” to me.

However, my work with people in my integrative practice involves various flavours of the ‘stressed and depressed’ or ‘burnt out’ continuum. A simple description of burnout that I use is “the combination of overwhelming fatigue and loss of motivation caused by chronic stress or frustration.” We live with unresolvable stress through an environmental mismatch with our human evolutionary design.  Much of my recent reading, thinking, and creating has been in this space – with a focus on remedying loss of ‘zest’ through re-aligning lifestyle practices with our human design. I call this “Reviving”.

Reviving is a return to full consciousness that fosters new health, strength or spirit

We risk losing our zest by this time of the year. The usual contenders come up, that we in the evolutionary health world know we should do; adequate sleep matched to our natural circadian rhythm (guided by light exposure and meal timing), physical movement (outdoors in nature = even better), nutritious real food, time out for relaxation and pleasure, and engaging in meaningful connections. Yet, I know too well many of these vital health pillars are no longer implemented by the end of the year – as a sprint to the finish line is endured for individual reasons.

December can be especially challenging for those facing adversity, such as difficult relationships, health challenges, financial stress, as well as those grappling with recent loss and trauma. Life can pull the rug out from under us (and our loved ones) at any time, which rattles our security and grounding in the world. Bearing witness to tragic events more broadly – in our community and world – can also bring what is essential back to focus. These experiences are that harsh prod to remind us that the things we angst over in a state of stress often do not matter. Not as much as love, kindness and community.

Remembering that we are wired to work together as groups, with connection and collaboration, instantly provides us with resources we can tap into. These involve small steps taken regularly. Looking out for others may inadvertently revive our own energy. We feel happier and more connected when we engage in acts of service, instead of focusing on our own problems.

Here are findings about how serving others may positively affect us, from the World Happiness Report (2019).

Three avenues to help others that may inadvertently help yourself:

  • giving your time (volunteering).
  • pro-social spending (money on others instead of yourself).
  • small acts of generosity (e.g., non-monetary but using other currencies such as helping someone with directions, finding someone’s wallet for them).

There are several criteria for the mental health benefits from helping others to occur:

  • you feel free to choose whether or how to help.
  • you feel connected to the people you are helping in some way.
  • you can see how your help is making a difference.

In order to generate feelings of wellbeing from helping others, the other catch is that your acts of kindness arise from a genuine desire to care about or help others.

Other findings show pro-social behaviour is enhanced by experiencing awe (e.g. viewing scenes of nature) beforehand. Feeling more connected to our planet and wider purpose can in turn increase connections with our peers, and our role in something bigger than ourselves. Sigmund Freud, the father of psychology, had a name for this experience of nature induced awe. He called it an oceanic feeling – defined as a “sensation of eternity” or “being one with the external world as a whole”.

May you all have a safe holiday full of oceanic experiences, in whatever shape or form this takes for you. If you are in the position, consider offering a hand (in whatever way you can) to those in need – it may mean the world to them and make you feel more uplifted.

Imagine if we all could do this – it would truly be a gift that really keeps giving.

Read more about Karen and her work HERE 

Are you eating enough to get a period?

 

By Dr Lara Briden

As more women move to restricted diets such as “clean eating”, vegan, or keto, more women are losing their periods.

Losing periods to undereating is called hypothalamic amenorrhea, and it’s common.

How does under-eating stop periods?

Too few calories or too little of any macronutrient can switch off signalling from the hypothalamus to the ovaries. It’s an ovarian “off switch” and not a malfunction. It’s a woman’s hormonal system working exactly the way it’s supposed to work. 

A woman’s hormonal system is different from a man’s in that she needs to do a lot more than just be healthy and make a few hormones. A woman’s hormonal system has to make the life-or-death decision of whether there is likely to be an additional 75,000 calories available to safely complete a pregnancy. 

If the hypothalamus perceives signals from the environment that food is scarce (or likely to be scarce), then the hypothalamus will make the very sensible decision to switch off reproduction

Is carbohydrate availability part of the “signal”?

What are the dietary signals that the hypothalamus is waiting for? Well, adequate calorie intake for starters. And almost certainly adequate protein intake. And there is reason to believe that the hypothalamus is also waiting for adequate carbohydrate intake for some women

There is substantial anecdotal evidence that some young women become amenorrheic (lose periods) on a low-carb or keto diet — even when they are eating sufficient calories and protein. 

Also, physiologist Prof Anne Loucks says that, when it comes to maintaining menstrual cycles, the hypothalamus is just as sensitive to carbohydrate availability as it is to total calorie availability. She states that pituitary “LH pulsatility is regulated by brain glucose availability” and “may depend specifically on carbohydrate availability rather than energy availability in women, just as it does in other mammals.”

There are a few things to say at this point. 1) This doesn’t apply to men, 2) it probably doesn’t apply to women over 30 or women who have insulin resistance, and 3) it depends on ancestry. In other words, starch signalling may be more important for women descended from agrarian ancestors.

In her book Fragile Wisdom, evolutionary biologist Grazyna Jasienska builds the case that the hypothalamic-pituitary-ovarian (HPO) axis is calibrated to relatively recent ancestry. She calls it “ovarian set point,” which she defines as the ability to ovulate given a particular energy availability. 

Like so many things in women’s health, there is almost no research, but one 2003 clinical trial of the keto diet for teenagers found that 45 percent of the female participants lost their periods within six months

 

Why does it matter? 

Menstrual cycles are not just for making a baby. Ovulation and the making of ovarian hormones are also highly beneficial for general health. 

For example, every monthly dose of estrogen promotes muscle gain, insulin sensitivity, and the long-term health of bones, brain, and the cardiovascular system. Every monthly dose of progesterone reduces inflammation, regulates the immune system and supports thyroid, brain, bones, and breast tissue.

According to Canadian endocrinology professor Jerilynn Prior, “women benefit from 35 to 40 years of ovulatory cycles, not just for fertility but also to prevent osteoporosis, stroke, dementia, heart disease, and breast cancer.” In that sense, each and every ovulation is like a monthly deposit into the bank account of long-term health.

What if you have PCOS?

Women with polycystic ovary syndrome (PCOS are often told to avoid carbohydrate. Reducing carbohydrate can definitely be helpful for the insulin-resistant type of PCOS. It’s less helpful for other types of PCOS or for hypothalamic amenorrhea that has been misdiagnosed as PCOS because there were polycystic ovaries on ultrasound. Read Maybe It’s Not PCOS.

Hormonal birth control is not the answer

The pill doesn’t solve the problem of amenorrhea because pill-bleeds are not periods and contraceptive drugs are not hormones. The current consensus is that the pill does not improve bone density, and one study found that the pill can actually impair recovery from hypothalamic amenorrhea

The solution is to eat more. A lot more. To recover from hypothalamic amenorrhea, most women need at least 2500 calories per day, including some starch. Recovery can take at least six months.

If you’re frightened by the idea of eating more, please consider whether you have an eating disorder and reach out for help. One possible resource is The Eating Disorder Association of New Zealand

 

Bio: Lara Briden is a naturopathic doctor and Executive Member of the Society (AHSNZ). She is also the author of the bestselling book Period Repair Manual.

Daylight Robbery: Part 2

 

By Jamie Scott

As previously mentioned, there is much focus on melatonin as our primary ‘sleep hormone’ because of the association of low levels of melatonin and poor sleep architecture (such as delayed sleep onset or an inability to stay asleep for long).  This often leads to people trying to boost melatonin levels via supplementation (either with melatonin directly, or its amino acid precursors) immediately prior to their intended sleep time, either as an everyday sleep aid, or when travelling between time zones and trying to stave off the worst of the associated jet lag.  Melatonin, however, is most potent when produced endogenously as a downstream product of our daytime physiology and bright light exposure, specifically, its precursor, serotonin.

A neurotransmitter, serotonin is involved in regulating mood, appetite, memory and learning, and, important to this discussion here, sleep.  Exposure to bright natural light (especially early in the morning) boosts serotonin production (in conjunction with the amino acid tryptophan and other vitamin and mineral co-factors consumed via a protein-rich breakfast), providing the raw materials for the melatonin required for our night-time physiology at the other end of the day.  The converse is also true.  The low melatonin leads to poor sleep train of thought is actually one of low morning light exposure plus a low protein intake (leading to low tryptophan and co-factor intake) leads to low serotonin production, which leads to low melatonin production, which leads to poor sleep.  Already low melatonin can be further reduced by the already mentioned night-time blue-light exposure (light-induced melatonin suppression, LIMS).

The low melatonin story doesn’t end with sleep disruption.  Indeed, melatonin performs a variety of functions in the human body.  In addition to its regulatory role in our light-dark physiology, melatonin has antioxidative capacity, immunomodulatory potency, and appears to be protective against a variety of cancers, especially breast and prostate cancer.  Melatonin receptors are also located in the ovaries, blood vessels, and intestinal tract.  The binding of melatonin to its receptors on the pituitary gland and the ovaries appears to play a role in regulating the release of reproductive hormones in females. For example, the timing, length, and frequency of menstrual cycles in women are influenced by melatonin.  Melatonin, in non-human mammals at least, also helps to signal the season and cue mating.

Serotonin, as a daytime neurohormone, is not the functional opposite to the night-time melatonin, however.  Serotonin is not the day to melatonin’s night, as it were.  That position is held by cortisol.  Like serotonin, cortisol production is also stimulated by exposure to bright light such as sunlight and is the primary hormone responsible for waking us up and getting us going in the morning.  In the context of typical health and wellbeing discussions, chronically elevated cortisol is often viewed negatively due to the association with it being a primary stress hormone.  But we do require a strong, well-timed cortisol rhythm, where cortisol rises sharply from early in the morning (just prior to sunrise), peaks around mid-morning following bright sunlight exposure (while melatonin is low), then drops away over the remainder of the day and into the evening (as melatonin begins to rise once again).

Even dopamine, the neurotransmitter responsible for, among other things, motivating us to get out and get stuff done, is made in conjunction with bright light exposure. 

So, you can hopefully see the potential problems here.  We spend a lot of time indoors.  Too much time.  It may also be dark when you go to work and dark when you come home.  The very low levels of bright blue spectrum light we experience during the day is seeing our feel good and motivation biochemistry tank.  With insufficient amounts of cortisol, serotonin, and dopamine in circulation, we’ll feel tired, fatigued, lethargic, apathetic, anxious, depressed… Sound familiar?

At night, the light intensity outdoors is generally well under 10 lux and mostly under 1 lux, even with bright moonlight.  Meanwhile, indoors, with all the LEDs burning bright (modern household lights, electronic device screens, etc), it can be 200-300 lux in some rooms.  During the day, this light intensity, relative to the outdoors, is very dark.  But now, at night, 200 lux is 200 times brighter than 1 lux.  Now this isn’t to say we should be sitting in the dark, huddled around candles, but it illustrates the light inversion we have in our modern world – our days are relatively dark, while our nights are relatively bright.  This is undeniably messing with our heads, quite literally.

Recent research has suggested that spending too much time in relatively low light rooms could be changing the way our brains process information and impairing the growth of new neural connections.  “Are Dim Lights Making Us Dimmer?”, read the headline of one report I reviewed.  Our increasingly indoor lifestyles are also thought to be behind the global short-sightedness (myopia) epidemic, where up to half of young adults in the United States and Europe, and up to 90% of Asian teenagers are affected – over double the prevalence of 50 years ago.  The strongest environmental risk factor for this large-scale loss of visual acuity across our populations of teenagers and young adults – the lack of bright natural light exposure associated with being indoors most of the day.

Many readers might be aware of, and perhaps even experienced, the phenomenon known commonly as the winter blues (Seasonal Affective Disorder – SAD).  There seems a clear link between light exposure and a change in our mood, outlook, and wellbeing.   A decline in serotonin levels with the reduced light exposure (length and intensity) and a concomitant increase in daytime melatonin levels, often in conjunction with dietary factors such as an insufficient specific amino acid intake, is at the heart of the winter blues we can often feel ourselves slip into.  Living far from the equator appears to be a key risk factor for experiencing seasonal affective disorders, adding further support to the suggestion that changes in natural light exposures are fuelling this phenomenon.

The symptoms of winter-onset SAD include low energy levels, tiredness, cravings for foods high in carbohydrate (driving increases in body fat), sleeping problems, difficulty in concentrating, feelings of hopelessness or worthlessness, and suicide ideation.  Summer individuals can experience a summer variant of seasonal affective disorder, but rather than depression, summer-onset SAD, driven by excessive light exposure (such as might be experienced during the “white nights” of high latitude countries in the summer months), is more likely to be characterized by anxiety and mania – easily over-stimulated, hyperactive, and displaying obsessive-compulsive type tendencies.

 

These extremes give us insight into the effects of light – too little, too much, poorly timed – on our mood and behaviour.  While both winter- and summer-onset SAD may represent extremes, most of us function and experience variances in our moods along a continuum of light exposures.   It’s hard not to see that rates of depression and anxiety are increasing while our light and dark exposure patterns are perhaps at their most extreme they’ve ever been in human history.

Like many of the common biological and evolutionary mismatches, the types of light exposures we experience now are relatively novel to us and our biochemistry.  Electric lighting, on an evolutionary scale, is new enough.  But as soon as you start considering urban life, work hours, LED lights, and our screen exposures, we are now considering something so very new to us and our delicately balanced brain chemistry.  We have, in no uncertain terms, disconnected ourselves from the light and dark cycles of the planet.  We cannot expect to do this without consequence.

It is at this point, as I wrap up, that we think about the practical solutions to dealing with this. 

The first thing for most people, as always, is awareness.  I encourage people to install a light meter app on their phones (given most phones have cameras, they already have a light meter installed – a simple app, such as Lux Meter, will allow access to this tool).  Once you have this, you can begin to map your world, as it were.

Take some readings in the places you hang out.  At your desk.  If it is too dark, see if you can get one closer to a window.  At your coffee shop.  If too dark, find another, or better still, sit outside.  Look for ways to get your eyes out into the bright light as often as you practically can, from as early in the day as you practically can.  Get away from buildings and walk more in the open if possible.  Don’t wear sunglasses first thing in the morning – it will feel bright at first (possibly a sign that your melatonin levels are still too high), but you will quickly adjust.  An important piece of research I found as part of this project, suggested that it is our daytime bright light exposure which is more important for setting our melatonin pulse at night than avoiding blue light at night, with the bright light exposure during the day mitigating most of the blue light at night effect.  That said, still use the light meter to measure your light exposure at night and take steps to darken your night as much as possible.

There is a lot of focus on sleep, diet, and exercise in the wellness space – and for good reason.  But a key fundamental we are all missing is our light exposure patterns and the impact these have on our ability to sleep, eat well, and be motivated and energised enough to exercise.  We need to take back the light, pushing back against the insidious daylight robbery we’ve all been exposed to.

For more reading on this subject, I can thoroughly recommend the book Chasing the Sun by Linda Geddes.

Daylight Robbery: Part 1

 

By Jamie Scott

Over the course of 2018-19, I was involved in a research and writing project, a part of which fundamentally changed how I view the key drivers of day-to-day wellbeing in our societies.  I was initially looking at the primary promoters and disrupters of sleep, and with respect to the disrupters, there was a major focus on light exposure at night.  It is becoming increasingly understood that night-time exposure to blue spectrum light is a fundamental disrupter of sleep across all ages in our society.  But what I was soon to realise was that as problematic as night-time light exposure is, a bigger issue is our distinct lack of light exposure during the day – a problem very few people are aware of.

To understand these issues and their importance, we need to step back from simply focusing on sleep as a key health behaviour to focusing on our circadian biology.  Humans operate via distinct rhythms and cycles.  While apparent when we consider something like menstrual cycles in women, many of our other rhythms and cycles have become lost in what I call the linearity of our modern world.

The cornerstone of our fundamental rhythms is our circadian rhythm – our 24-hour rhythm that is, or should be, tagged to the sun rising and setting.  We also have roughly 90-minute cycles inside of this 24-hour cycle (known as ultradian rhythms).  A woman’s menstrual cycle is a good example of an infradian rhythm – a rhythm greater than 24-hours.  Sadly, in our modern society, we often aim to flatten many of these rhythms, expecting to be able to work continuously across the day with consistent energy rather than understanding that our energy levels oscillate on roughly 90-minute cycles.  Behaviourally, in this example, in our low ebbs we’ll reach for caffeine/nicotine/sugar to keep pushing through rather than altering how we are working to match our biology.

Virtually all rhythms we have operating in our physiology are a part of the 24-hour circadian rhythm (our master rhythm, if you like). 

In the normal run of things, this 24-hour cycle would be tagged to two key synchronising events each day – sunrise and sunset.  Indeed, this is how our physiology is inextricably linked to our environment.  In simple terms, blue spectrum light is the specific portion of sunlight which stimulates our wakening state during the day, starting at sunrise.  In the evening, after the sun sets, the absence of this light – darkness – drives a shift from wakefulness to sleepiness.

Circadian biology research is beginning to understand that we have quite distinct daytime and night-time physiologies, with the switch between the two governed by our light exposure patterns.  Exposure to bright natural light stimulates, as you would expect, our daytime physiology.  In day mode, we are (or should be) alert, active, and hungry.  These states are driven by our key day mode neurotransmitters – cortisol, dopamine, and serotonin.  As the sun sets and relative darkness takes hold, we transition to night mode.  Our body temperature begins to lower from its peak of early evening, our metabolism falls, and our drive for sleep increases (or it should do at least).

With the darkness comes an increase in our melatonin levels – the hormone most commonly associated with initiating sleep (though it has many functions throughout our body and, in my opinion, is one of the most misunderstood and underrated hormones we have).  It is perhaps more accurate to think of melatonin not as a sleep hormone, but as a darkness hormone.  It is becoming more common knowledge that the light from our ubiquitous electronic devices is emitted largely in the same blue light spectrum as sunlight.  It is perhaps at this point that you can see where problems might begin to occur.

If relative darkness is required in order to allow melatonin to rise and begin orchestrating the various physiological processes which occur as part of our dark physiology (including sleep), yet we are spending our night-time exposed to blue light emitting devices (sunlight emitting devices, in effect), then you can see why sleep can be so hard to come by.  Even relatively small exposures to such intense light can delay your melatonin pulse significantly, with some research suggesting that as little as 30-minutes with your phone, laptop, or TV (often all three simultaneously) beaming intense blue light into your eyes can shift your melatonin pulse curve sideways by about two hours.

To illustrate this in a more real-world way, if you would normally be ready for sleep at 10pm but decided to spend your evening bathing in blue light prior to this, don’t be surprised if you are still struggling to initiate sleep well after midnight.  If you can fall asleep, you might find yourself getting bounced out of it early on and struggling to slip into anything deeper than a light slumber.  You may eventually get into a deep sleep around 3-5am, but here you are potentially only a couple of hours away from the alarm clock going off.

 

 

Being ripped out of deep sleep leads to that groggy feeling called sleep inertia.  What should have been a restorative night’s sleep was anything but.  It’s a feeling akin to jetlag, and unfortunately what I have described above is the norm for many (most?) in our modern world.  But it is not blue light exposure at night that changed my views on wellness.  It was the lack of blue light during the day that did.

For everything to work as it should, yes, we need relative darkness at night – much more than we typically afford ourselves.  But we also need bright light exposure during the day, and it was this fact that is the missing piece of the puzzle for many of us.  We are living in what I have come to call a light inversion. 

Our days are too dim and our nights too bright.

Sunlight contains full spectrum light – everything from UV light (where UVB is what we use to make vitamin D in our skin with), through to infrared light (which gives us the feeling of warmth).  In the middle is the visible spectrum light, including the blue spectrum light.  Receptors in our eyes (intrinsically photosensitive retinal ganglion cells – ipRGCs) that make up the light-receiving part of our circadian rhythm system, contain a vitamin A-derived protein pigment, melanopsin, that is maximally sensitive to intense blue wavelength light such that we get from sunlight not long after sunrise (peaking at wavelengths of 480nm as would occur at solar noon on a clear blue-sky day).

The blue-light stimulation of these receptors stimulates neural pathways in our brain, eventually triggering the release of neurotransmitters (such as serotonin and dopamine) and hormones (such as cortisol) which help increase our wakefulness and alertness, our body temperature, as well as suppress the synthesis of our primary night-time physiology hormone, melatonin.  As the intensity of blue light declines toward the end of the day, being replaced, at first by visible red light (690nm wavelength; such as is seen at sunset, or emitted by fire light), and eventually darkness – melatonin production is increased initiating our sleep processes and helping us to, hopefully, fall asleep.  Coordinating and synchronizing these light- and dark-triggered circadian rhythm events day after day is a key part of our brain, the suprachiasmatic nucleus (SCN), more commonly known as the master body clock.

Now here’s the rub.  An increasing proportion of people – children and adults – spend more time than ever in human history indoors, under artificial lights.  Rarely do these lights come even remotely close to being sufficiently intense to regulate the systems outlined above.  You wouldn’t need to think about it for long to come up with a very long list of occupations where people are indoors all day, including an increasing number in buildings with virtually no natural light.  In my research, I came across stats such as; most Americans spending 90% of their daytime hours indoors, or prisoners in Australia spending more time outdoors than the average Australian teenager.  I’ve no doubt that the situation isn’t any different here in New Zealand.

To get a sense of the problem here, I purchased a light meter and began taking measurements.  The specific intensity of a given light source in a given space is measured in lux (lumens is the measure of the brightness of a light at its source).  I began taking readings in various workplaces and public spaces over the course of 2018.  I was most interested by the readings I took over the winter period when it might be perceived as not being particularly bright outside, especially on a heavily overcast day.

 

Light reading taken at a food court situated within a local shopping mall, where most people are hanging out (plus a lot of workers who are there all day)

 

 

Sunset in July 2018

 

914 lux taken at sunset. Recall the mall was 225 lux.

 

The sun has now properly set

 

559 lux after sunset (in July, approx 5pm)

 

20 minutes after sunset

 

It is only at this point that the light levels outdoors match the light levels indoors. It is hard for humans to identify this, but we many of us work in near twilight conditions most days, even in what might seem a brightly lit room.

 

 

From relatively early in the day, even in the depths of winter, and even with dark clouds filling the sky, the light intensity outdoors was always several thousand lux.  At sunrise, the morning might start out at under 1000 lux, but would rapidly increase.  The lowest measurements taken on the darkest of days came in around 3000 lux, but most often the readings were upward of 50000 lux, and on bright summer days, well over 100000 lux.  But move indoors and things change very quickly.

The brightest of indoor spaces I measured was around 600 lux.  To give you a gauge on this, your lounge room with all the lights on might average 150-200 lux.  I took a set of readings throughout a suburban shopping mall in July (mid-winter).  It was around 250 lux on average.  I wanted to get a feel for what this translated to outdoors.  To get a similar reading outside, I had to wait until around 20 minutes after sunset.  In other words, the workers in this mall spent their entire day working in weak twilight.  It doesn’t take much to think what effect this might have on people if you kept them in weak twilight for significant portions of time.

No matter where I took readings and no matter what the cloud cover was outside, it was always 100 times brighter outdoors as a minimum.  The lowest reading I took for a workplace was in a café in Dunedin – 50 lux!  Incredibly dim.  Now this might be tolerable for a customer who is in there for 10-20 minutes while they drink their coffee, but what about the effects on the staff who are there all day?  I took readings in the Dunedin Public Library.  Dark.  Very dark.

One interesting experiment of mine in Dunedin involved walking down the main street with the light meter.  The shops there – being very old – have quite low overhangs.  Given my newfound recognition and respect for light, I got the sense that even outdoors it was very dark.  This was confirmed as I walked along the street, the light meter barely topping out over 250-300 lux, and often hovering under 100 lux.  When there was a break in the buildings for a crossing, it would immediately jump up over 5000 lux (it was early in the morning in winter).  Once safely across the road, the light intensity would drop back down again very quickly.  Despite how dark it was, there were still plenty of people wearing sunglasses.

I went down to the University of Otago and while doing some writing in the main student library there, I decided to take some more readings.  I was sat right next to the only windows in the library – south facing.  Right by the windows it was 260 lux – still relatively dark.  But step even a few meters back into the heart of the library, and the light levels drop away very quickly.  Students spending their days here studying were sitting in under 100 lux of light.  This becomes problematic when you start to piece together what we use our bright light exposure for.

Plant Based Health Special Series: Why Women Thrive on Animal Protein

By Dr Lara Briden

As a biologist and a clinician, I’m a practical person. I don’t adhere to any particular theory or “diet philosophy” but am instead open to any way of eating that demonstrably supports the vitality and wellness of my patients.

For me, that’s the fundamental test: “Is this diet working for my patient? Is it nourishing her? Is she thriving?” And: “Is this diet supporting healthy regular ovulation and menstruation?” (Because ovulation is a useful barometer of general health.)

“Is this diet working?” is actually a fairly easy bar to clear for most whole food diets because the body is remarkably adaptable.

One of the few whole food diets that routinely does not pass my “patients thriving” test is an exclusively plant-based or vegan diet. Over the years, I’ve spoken to many patients who wanted to thrive on a vegan diet but did not. Instead, they felt well for six to twelve months and then started experiencing problems like fatigue and irregular periods.

When some of those same patients finally got back onto animal foods, they said things to me like:

“Since I switched back to an animal protein diet, I cannot even describe the energy I have!”

“If I don’t eat enough protein, I end up on the floor in tears.”

“Meat, as a female, makes you feel so much better.”

“Vegans really should tell you how awful you’re going to feel doing that diet.”

These are just anecdotes, of course. Some of my readers insist they do well on a vegan diet, and maybe that’s true, but I have not personally spoken to even one patient who was thriving on a long-term vegan diet.

I say “long-term” because a short-term vegan diet can deliver benefits such as clearer skin, lighter periods, and less brain fog–benefits which almost certainly come from avoiding dairy, not meat.

The Benefits of Avoiding Cow’s Dairy

Image result for free stock images milkA1 casein in cow’s dairy is a potentially inflammatory protein for some people. It worsens atopic reactions like eczema and asthma, and it contributes to women’s health problems such as PMS, period pain, and heavy periods. I routinely ask patients to try avoiding A1 cow’s dairy (but continue A2 dairy like goat and sheep), and many of them report significant improvements.

Eggs are the other animal food that can cause immune reactions and health problems in some people.

A sensitivity to dairy and/or eggs is a valid reason to avoid those two foods. It’s not a valid reason to avoid all animal foods.

 

 

Women’s Unique Requirement for Animal Protein

I think we can safely say that women need animal protein at least as much as men do–and maybe even more.

Why more? Because, for one thing, women have a higher requirement than men for the amino acid taurine. Taurine is an important nutrient involved not just in protein synthesis, but also in osmoregulation, detoxification, membrane stabilization, and brain health. (It’s even classified as a neurotransmitter!) The body contains up to 70 grams of taurine at any one time, and most of that needs to come from animal protein. Although it is possible to synthesise some amount of taurine from cysteine and methionine, it’s not easy to do and that’s why taurine is a “conditional amino acid.” Conditional means that taurine can be made by the body, but not under certain circumstances such as stress, insulin resistance, or impaired liver function. Taurine can also not be made in the presence of a large amount of estrogen, and so women who take exogenous estrogen (such as the birth control pill) need even more taurine!

The other reason why women may have a special requirement for animal protein is that we have the huge metabolic challenge of needing to ovulate every month. Ovulation requires optimal nutrition, not just for the actual event (which is energy-intensive) but also for the hormonal signaling that regulates ovulation. Regulation happens at the hypothalamus which is constantly monitoring food availability and deciding whether there is enough nutrition to make a baby.

My clinical experience is that women need to be fully nourished to be able to ovulate regularly. That includes getting adequate macronutrients, especially protein, and that includes getting adequate micronutrients including zinc, iron, selenium, vitamin A, and iodine. Those micronutrients are somewhat available from plant-based foods, but they are far more available from animal foods such as meat, eggs, and fish.

In conclusion, I routinely ask my patients to consume animal products to improve their hormonal health, and I see good results.

Sometimes I meet a patient who feels strongly that she will not eat animal products and I don’t pressure her. Instead, I say: “It’s your choice, of course, but we are going to have to lower our expectations about how healthy you can be.”

Bio: Lara Briden is a naturopathic doctor with 20 years experience in women’s health. Informed by a strong science background, she’s is a passionate communicator about women’s health and alternatives to hormonal birth control. Through her work with thousands of patients with PCOS, thyroid disease, and other conditions, she’s had the opportunity to witness first-hand the transformative power of ancestral health principles. She’s the author of Period Repair Manual and resides in Christchurch.

Join Lara, Kira Sutherland and Craig Zielinski at the upcoming AHSNZ event Women, Hormones, Strength and Health. November 10th in Christchurch. Get your ticket here.

Plant Based Health Special Series: Vegan diets and protein

By Dr Mikki Williden

While I’m an advocate of a whole-food based diet that includes animal protein, there are people who may do really well on a vegan diet (a diet that excludes meat). For most, though, there are nutritional considerations of excluding animal protein that I want to raise awareness of, and some practical ideas as to how to correct these so you (or someone else you know who may be following a vegan diet) can optimise their protein intake.

 

Protein Quantity

One of the main questions that those following a plant based approach get asked – and it’s a good question! While most plant based advocates insist that getting protein in their diet is a non-issue, I would argue that that isn’t the case – even though protein is in a wide variety of foods, plant and animal based, people still struggle to meet their recommendations- this is true of both omnivore and plant-based alike. The most recent adult nutrition survey (ANS) showed an average of 73-79g of protein was consumed by women aged 19-51 years. While we don’t have good New Zealand data, international literature consistently reports that people following a plant-based diet consume up to 30% less than their omnivore counterparts. This may be because it takes a considerably larger number of calories (and therefore food) to get the same amount of protein that would be found in animal-based foods, which can be tricky for females who may not have a large appetite.

The recommended daily intake according to the New Zealand Dietary Guidelines is 0.8g per kg bodyweight of protein, which would place the amount reported from the ANS within range. However, the nutrient reference values (NRV) document, a resource created by both Australian and New Zealand Government experts has an acceptable macronutrient distribution range (ADMR) of 15-25% of daily calorie intake coming from protein. This places protein requirements much higher, and is more in line with academics who research protein needs for populations and advocate for levels of approximately 1.5g per kg body weight for optimal health outcomes. The discordant recommendations come from a new understanding of protein’s role in many areas of the body such as the regulation of body composition and bone health, gastrointestinal function and bacterial flora, glucose homeostasis, cell signalling, and satiety. The RDI of 0.8g per kg bodyweight was based just on nitrogen balance and protein turnover. If we consider an ‘average’ weight of 68kg for females, putting their protein intakes at around 102g, of which 90% of the population fall below adequate intakes if we consider the ANS data.

 

Protein Quality

It’s not just quantity that is an issue –the quality of protein that also needs to be considered. Protein-containing food provides 22 amino acids to the body, 9 of these are considered essential or ‘indispensable’ – they can’t be produced by the body and must be provided for in the diet. All animal based sources contain these 9 essential amino acids, however vegetable sources of protein (including nuts, seeds, legumes, flours, vegetables) are missing at least one of them. Further, assessing quality historically didn’t consider indispensable amino acids beyond their ability to synthesize protein and its metabolites.  Now, experts agree we need to also account for protein’s role in the many other functions I listed earlier. There is also increased recognition that digestibility of protein needs to account for the presence of ‘anti-nutrient’ factors present in plant-based foods. This has led to the creation of a new method that assesses protein quality (called the Digestible Indispensable Amino Acid Score (DIASS) to replace the older Protein Digestibility Corrected Amino Acid Score (PDCAAS) – yes, both mouthfuls to say! When comparing plant versus animal protein sources using PDCAAS, some proteins were rated almost equal in their quality, (for example soy and whey protein). Now, though, the DIASS reduces the plant-based proteins by a considerable amount due to the presence of phytic acid, trypsins and alpha-galactosides in nuts, seeds and legumes which reduce digestibility of protein and other mineral absorption.

 

So how much of a problem does this pose? It’s difficult to say; many of the potential pitfalls here may not be apparent in the short term and could take years to develop. Research investigating the relationship between amino acid content of a vegan diet and the association between gastrointestinal function, gut microbiome and glucose homeostasis hasn’t been conducted over the long term in clinical trials, so we can’t establish risk. And environmental and genetic differences in every body mean that what we see as problematic for one person may be the reasons another person thrives. Short of introducing animal protein, my advice for all is to make protein the first nutrient you consider. While it may not be in the most bioavailable form in most plant based forms, ensuring a variety of whole grains, legumes, nuts and seeds will help people increase the variety of amino acids needed for optimal health and keep protein levels high.

  1. Quinoa is a pseudo-grain that has a higher protein content than most grains and makes it a good, gluten free choice for many people.
  2. Soaking any grains may benefit from adding an acid medium (such as apple cider vinegar) to help break down the phytic acid.
  3. Edamame beans (soy beans) and fermented soy (such as miso or natto) are complete protein sources and are either minimally processed or are produced in such a way that helps reduce the anti-nutrient factors present in legumes
  4. A grain bread that is made from soaked and sprouted grains (such as buckwheat, for example) will have more bioavailable nutrients than other types of bread. Essene bread is a good example of a bread that is available through health food stores and is made from soaked organic rye or wheat
  5. If preparing own legumes, ensure you soak for at least 12-24 hours, with traditional cultures recommending adding a pinch of bicarbonate of soda to the water for kidney-shaped beans – this is said to reduce the cooking time considerably. For other legumes (such as black beans), soaking in water (with or without a tablespoon of apple cider vinegar for each cup of legumes). Refresh the water every few hours to help enhance the digestibility.
  6. Soaking nuts such as almonds, pecans and walnuts for 12-18 hours and then drying out nuts in the oven at low temperatures for a long time (100 degrees for 6-8 hours) will enhance the absorption of nutrients, including protein, from these.

A final word on the emerging number of meat-substitute products out on the market. Some, such as the Sunfed range you will find in the freezer section of the supermarket, are made with pea protein and have minimal ingredients. These are some of the higher protein options out there. Other substitutes are made predominantly of wheat, contain vegetable oils, additives, flavours and colours, are low in protein, and are effectively more ‘junk’ foods than quality substitutes for people wanting to maximise their plant-based diet. Make it a habit to check the ingredients list before deciding to purchase or relying on these as a substitute for animal protein.

Plant-Based Health Special Series: Does going vegan stack up for the environment?

By Matthew Stewart – BCom BAppSc [Human Bio] MOst PDC

2017 seemed to be a break out year for vegan diets. Many celebrities adopted vegan diets and news reports extolled plant-exclusive as the best way to avert the multi-faceted consequences of climate change. But is adopting a meat-free diet the best option to address environmental degradation including climate change?

Any discussion of the environment, sustainability, and climate change is overlapping and complex. Vital to the dialogue are the economics and energy costs involved for the current food production system and discussing future alternative methods to address our global predicament.  It’s also important to recognise that economics and energy are a subset of the environment and not the other way around.  Orthodox economics typically sees limitless growth in a finite system which is clearly madness given there are biological limits to growth in any system whether it be bacteria in a Petri dish or a herd of wildebeests on the African savannah.

First let’s look at the agricultural output and energy expenditure of ancestral populations. For every calorie of energy expended in producing food, hunter-gathers yielded 20 calories of food (1). There is an argument that population growth fuels intensification of production, which increases the risk for populations subsisting on these crops, which leads to new innovations which increased production. These changes allowed people to subsist with less labour and a more stable food supply with surplus to store and trade.  In this picture, technology is the hero and progress is always ‘good’.

However, this picture was challenged by the work of Danish agricultural economist Ester Boserup (2) who revealed that there was a diminishing return on labour with increasing intensification(3). In other words, with each additional unit of labour a smaller increase in production is achieved; workloads tend to rise while efficiency drops. This process is called agricultural intensification. It is true that this method produces more food than shifting cultivation but farmers have to work much harder. Why would a population shift to a system of agriculture with a steep cost in terms of labour and quality of life? Moving to a system of high production with less efficiency is driven by population growth or farmers compelled to by those in positions of power.

“Fertiliser is good for the father and bad for the sons.” – Dutch proverb 

Moving from a hunter-gather food production system to horticulturalism the yield decreases to 15 calories of food for every one calorie of work, and for intensive agriculturalists, four calories for every one calorie of work.  Modern mechanised farming systems such as used to grow corn in the American Midwest is even less efficient, using 10 calories for energy for every single calorie of food. Whereas energy in the hunter-gather systems come from human effort collecting stores of energy (plant or animal) that harnessed the photosynthetic activity of plants and from the recycling of biomass by the soil food web, the energy subsidisation of modern mechanised industrial farming comes from fossil carbon, debt, and government subsidies, either directly or indirectly.

The inefficiency of agricultural intensification is reflected by farmers’ incomes relative to their increased agricultural output since the advent of large-scale monoculture cropping of hybrid and GMO cultivars and heavy use of chemical fertilisers and pesticides. In Australia, wheat yield doubled in the 20 years from 1980-2000 however farmers’ profits halved during this period. In Canada, from 1926- 2016 gross farm production totalled $1.53 trillion.  Of that $1.53 trillion, $1.32 trillion went to input suppliers such farm machinery dealers, seeds suppliers, fertiliser sales, biocides and fuel. The average age of the dwindling number of Canadian farmers is 55, reliant on off-farm income, tax-payer supported tax schemes, debt (at record levels), and land sales (4). NZ agricultural production doubled between 1931and 19 57 and then doubled again between 1985 and 2005 but have farmers’ profits doubled and doubled again?

“The nation that destroys its soil destroys itself” – Franklin D. Roosevelt, 1937

Many innovations have propelled agricultural output to new highs but at increasing costs to the environment.  The development of the Haber-Bosch process in 1910’s Germany allowed the conversion of atmospheric nitrogen (N2) to ammonia (NH3) for the use in munitions in WW1 and afterwards in nitrate fertilisers as industrial military complexes developed during war time were repurposed for agricultural use to solve ‘the hunger problem’.  Nitrogen fertilisers have undoubtedly resulted in a massive increase in agricultural production. Canadian geographer Vaclav Smil calculated that were it not for the industrial fixation of nitrogen (5), the world’s population would probably not have exceeded 4 billion people — 3.6 billion fewer than are alive today. However, the Haber–Bosch process now consumes 5% of the world’s annual natural gas supply, with half of this resource squandered as nitrogen use efficiency is typically less than 50% with farm runoff causing significant disruption of biological habitats.

Prior to the early 20th century, the source of nitrogen in food consumed originated from animal manures, nitrogen fixing legume crops, and soil micro-organisms, since then the extensive use of synthetic nitrogen fertilisers has resulted in 50% of the protein and 80% of the nitrogen in our bodies having their origin in the fossil carbon fuelled Haber–Bosch process.  We literately eat fossil fuels. We are far from being able to replicate nature’s efficiency at converting some of the 78.1% of the atmosphere that is nitrogen to useful fertility, which is done by nitrogen-fixing bacteria (diazotrophs) at soil temperature, rather than at 450°C and 200 times atmospheric pressure in the Haber–Bosch process (6).

According to studies by the Millennium Institute, the world currently grows enough food for 10 billion people, 4600 calories for every man woman and child – twice as much as we need to thrive (7).  The issue is not a shortage of food but the location of food production and distribution, and post-retail waste. Hunger is caused by poverty and inequality, not scarcity.

What is remarkable is that the supply side of the agricultural equation is often discussed but the demand side is not. Population control is rarely mentioned in climate change and the overshoot of Earth’s carrying capacity. The median UN population estimate for 2050 predicts an additional 2.5 billion people, the emissions from whom would be the climate equivalent of adding two United States worth of carbon emissions to the planet.

Analysis by Brian O’Neill at University of Colorado, Boulder found that promoting family planning and small family norms would yield between 16 and 29 percent of what is necessary to avoid catastrophic climate change (8), yet this is never mentioned when discussing solutions to climate change.

In high-income countries such as the USA, United Kingdom and New Zealand, post-production – including storage and transport – contributes a large proportion of the food system’s greenhouse-gas emissions. A UN report reveals that people in developed countries throw away more than 30% of their food after they buy it.

So, will a swap to vegan food products change the unsustainability of the current food production system and its reliance of chemical fertilisers, pesticides and fossil carbon-powered mechanisation and transportation and food wastage outlined about? It is unlikely to be near enough to avert climate change and a transition to low carbon future.

The companies that are developing vegan meat substitutes are not addressing soil erosion, fossil fuel use, market skewing subsidies or carbon loss from soils due to tillage.  These venture-capital and multinational food processor-backed corporations are not marketing high-nutrient cultivars of carrots or high-protein cereals crops, rather they are racing to market with variations of ultra-processed nutrient-poor products based on cheap commodities such as grains, pulses, legumes, and vegetables or energy intensive cell-culturing (9).

This is reminiscent of the 1980’s and 90’s when some of the same corporations developed ultra-processed low-fat products from the same commodity products for the ‘heart-healthy’ and weight-loss market.

The current method of industrial agriculture in western developed countries is unsustainable. Most farmers and vegans would agree that meat production in confined animal feeding operations (CAFOs) is inhumane. But the problem is not the cow or the sow but the how; it is the current methods of agricultural production characterised by large-scale monoculture of pasture and crops, heavy use of chemical fertilisers and pesticides and GMO cultivars that lead to a loss of diversity, impoverished farmers, and massive soil erosion. About a third of the world’s soil – enough to feed 1.5 billion people – has already been degraded with 24 billion tonnes of fertile topsoil lost every year. New Zealand loses 192 million tonnes of soil to erosion every year with just under half of this loss from pasture and crop land (10,11). At the current rates of degradation, the UN’s Food and Agriculture Organization estimates the world has less than 60 years of topsoil left (12).

There are calls to make agriculture more sustainable. Sustainable agriculture has been described as ruining the land more slowly. What is required is restoration or regenerative agriculture.  Regenerative agriculture describes farming and grazing practices that, among other benefits, reverse climate change by rebuilding soil organic matter and restoring degraded soil biodiversity—resulting in both carbon drawdown and improving the water cycle. Small groups of farmers in Australia, USA, and New Zealand are implementing this approach with impressive results for their land and livelihood (see resources below).

We still operate out of a cultural meme that we humans are superior to everything else in nature, that we are big-brain mammals and can always come up with technology that is superior to anything nature does. New more sophisticated technology is prized and the more of it the better, no matter the cost. The criticism is that organic and regenerative methods are extolled by nostalgic Luddites and elitists who care only for those who can afford boutique produce. While this regenerative agriculture is reminiscent of the kind of agricultural practices of the past, what sets it apart is sophisticated knowledge and application of natural biological processes only recently revealed by modern science. A move to a high-knowledge, low technology, soil cherishing agriculture is required (13).

Those that stand to gain from this approach are the farmers and those who would directly benefit when farmers benefit; consumers. The entities that stand to lose revenues and profits are those that have ‘monetised Nature’ through the patenting of plant traits, pesticide resistant GMO cultivars, production of agro-chemicals, pesticides, herbicides, insecticides, fungicides and chemical fertilisers.

Consumers need a better understanding of the carbon cycle (14), water cycle and nitrogen cycle (15) to make more informed buying decisions rather than scare mongering marketing tactics of fake meat producers.

For more on Regenerative Agriculture

  • Call of the Reed Warbler: A New Agriculture – A New Earth, by Charles Massy (2017) University of Queensland Press.

Charles Massy writes on Australian farmers conversion to farming with the land rather than against it to restore the ecology, diversity, and profitability of their farms.

http://thisnzlife.co.nz/polyface-farming-mangarara-station/

http://www.radiolive.co.nz/home/articles/rex/2018/04/how-one-farm-is-using-soil-health-to-mitigate-climate-change.html

Nate Hagens PhD – Limits to Growth: Where We Are and What to Do About It

https://www.youtube.com/watch?v=U1_dsU1Dx0A

References

  1. Moberg M. Engaging Anthropological Theory: A Social and Political History [Internet]. Taylor & Francis; 2012. Available from: https://books.google.co.nz/books?id=g4PeBJoCtToC
  2. Ester Boserup [Internet]. Available from: https://en.wikipedia.org/wiki/Ester_Boserup
  3. Boserup E. Environment, population, and technology in primitive societies. Population and Development Review [Internet]. 1976;2(1):21–36. Available from: http://dx.doi.org/10.2307/1971529
  4. Standing Senate Committee on Agriculture and Forestry. Agriculture and Agri-Food Policy in Canada: Putting Farmers First! Senate Canada; 2006.
  5. Engelman R. The impact of ecological limits on population growth. The Guardian. 2011 Oct 14;
  6. Jacobs J. Water and air are all you need to make one of world’s most important chemicals [Internet]. 2014 [cited 2018 Jun 5]. Available from: https://theconversation.com/water-and-air-are-all-you-need-to-make-one-of-worlds-most-important-chemicals-30173
  7. Holt-Giménez E, Shattuck A, Altieri M, Herren H, Gliessman S. We Already Grow Enough Food for 10 Billion People … and Still Can’t End Hunger. Journal of Sustainable Agriculture [Internet]. Taylor & Francis Group ; 2012 Jul [cited 2018 Jun 6];36(6):595–8. Available from: http://www.tandfonline.com/doi/abs/10.1080/10440046.2012.695331
  8. O’Neill BC, Dalton M, Fuchs R, Jiang L, Pachauri S, Zigova K. Global demographic trends and future carbon emissions. Proceedings of the National Academy of Sciences of the United States of America [Internet]. 2010 Oct 12 [cited 2018 Jun 4];107(41):17521–6. Available from: http://www.pnas.org/lookup/doi/10.1073/pnas.1004581107
  9. Glotz J. Meat the disruptors: 15 startups shaking up the $90bn global meat industry [Internet]. The Grocer. 2018 [cited 2018 Jun 1]. Available from: https://www.thegrocer.co.uk/home/topics/future-of-meat/from-plant-based-burgers-to-lab-grown-meatballs-15-startups-disrupting-the-global-meat-industry/565785.article?redirCanon=1
  10. Frykberg E. NZ losing 192 million tonnes of soil every year. Radio New Zealand [Internet]. 2018 Apr 19; Available from: https://www.radionz.co.nz/news/national/355480/nz-losing-192-million-tonnes-of-soil-every-year
  11. Stats NZ, Ministry for the Environment. Our land 2018 [Internet]. 2018 [cited 2018 Jun 5]. Available from: http://www.mfe.govt.nz/land/environmental-reporting-land
  12. Arsenault C. Only 60 Years of Farming Left If Soil Degradation Continues. Scientific American Magazine. 2014;
  13. Jones C. Light Farming: Restoring carbon, organic nitrogen and biodiversity to agricultural soils [Internet]. Armadale, NSW; 2018. Available from: http://amazingcarbon.com/JONES-LightFarmingFINAL(2018).pdf
  14. Lovell T. Soil carbon -Putting carbon back where it belongs – In the Earth [Internet]. TEDxDubbo. Australia; 2011. Available from: https://www.youtube.com/watch?v=wgmssrVInP0
  15. Fields S. Global Nitrogen: Cycling out of Control. Environmental Health Perspectives [Internet]. National Institue of Environmental Health Sciences; 2004 Jul;112(10):A556–63. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1247398/

Winter Health Special, Part 2

 

In the last post Dr Anastasia Boulais spoke about what you can do every day to help yourself survive and enjoy winter. This time she’ll answer some questions which she most frequently gets in the clinic.

Do I have a cold or a flu?

While we frequently use these terms interchangeably they are quite different clinically.

A common cold can be caused by a variety of different viruses which attack your upper respiratory tract and result in an unpleasant collection of symptoms: runny nose, congested sinuses, sore throat, headache, cough, and occasionally low grade fever. Most people can carry on with their life and may only need to take a couple of days off work, although cough and runny nose may last for as long as 2-3 weeks.

A flu, or influenza, is caused by a particular family of viruses and is much more than a bad cold. The flu makes people quite sick with high fevers, sometimes debilitating muscle and joint pains, sore throat, cough, fatigue and lack of appetite. It can keep you in bed for days and I generally suggest that people take 5-7 days off work. It can be associated with complications such as pneumonia and dehydration, especially if you are pregnant, a smoker, or have a pre-existing chronic medical condition.

Why does everybody keep telling me to drink fluids?

When you are sick you lose a lot of fluids through sweating, respiratory secretions (that’s your phlegm and snot), and by the virtue of not eating and drinking as much. Dehydration can make your feel quite unwell, worsening your headache and making you feel downright miserable. A good guide to your hydration status is the colour and volume of your urine: we are looking for light yellow and large quantity.

Water, ginger and lemon tea, chicken soup are all valid options for rehydration. Cider and lemonade are not.

Can my doctor give me antibiotics just in case?

Whether you have a cold or a flu, antibiotics are not helpful. If you want to know the extent of the antibiotic resistance problem we’ll be facing in the next 50 years google “antibiotic apocalypse”. Why did your doctor give you antibiotics for your sniffly nose or cough last time? Maybe they thought you had a nasty bacterial sinusitis or pneumonia. Or maybe they said no to antibiotics 10 times that day and they were too tired of arguing with yet another patient. Yes, we are human too and sometimes we, regretfully, take the path of least resistance. Can we guarantee you are not going to develop complications? No. But if we give “just in case” antibiotics to everyone who has a cold we can guarantee there won’t be antibiotics left to treat your children’s wound infection or pneumonia in the future.

 

Do any of these work: zinc, vitamin C, echinacea, garlic?

You could spend hundreds of dollars on the multitudes of cold and flu remedies available now at the pharmacies or natural health stores, however for most of them the jury is still out. This may not be because they don’t work at all, we just don’t have sufficient evidence to recommend them routinely for everyone and none of them are a magic bullet.

The ever-popular Vitamin C has not been found to be helpful for prevention or treatment of colds in general population, however it does seem to reduce the number of colds in people under short term physical stress, such as marathon runners.

Zinc lozenges have been found to shorten the duration of colds if taken in the first 24 hours of the illness at a dose of >75mg daily in a Cochrane review. However, daily just-in-case zinc is not helpful and it can give you nausea and bad taste in your mouth.

Echinacea, ginseng and garlic supplements have all been tested but so far the evidence has come up blank on their cold and flu fighting efficacy.

I would say use your common sense. In spite of the optimistic promises of the “immune-boosting” properties of yet another supplement it is unlikely that you are going to get a miracle. As with every other nutrient, it is much better to get your zinc, garlic and vitamin C through your diet (see our previous newsletter), and save your hard-earned dollars on proper nutrition through winter.

 

 

What’s the deal with Vitamin D?

One of the few promising areas in the cold and flu research is the role of vitamin D. Some studies have shown that low levels of vitamin D in the blood increases the risk of catching the flu. In addition, among patients who develop the flu those who have higher blood vitamin D level end up recovering quicker. So it’s a good reason to make sure you get plenty of sunshine via sensible sun exposure in summer prior to the flu season.

What about supplements? There have been a couple of promising studies in some patient groups showing that supplementing with Vitamin D in the flu season can reduce the chance of catching it as well as speed up your recovery. The doses used were between 1200 IU and 2000 IU daily. Some medical practitioners report having a great success with high dose “vitamin D hammer” for those who caught the flu virus: 10,000 IU three times daily for 2-3 days. However, we are still far away from firm recommendations on Vitamin D and more research is needed

Winter Health Special, Part 1

Many of us feel that staying healthy in winter is almost an insurmountable challenge. We struggle to find motivation, reduce our activity levels, argue with our family and co-workers about the perfect heatpump temperature, and frequently succumb to the dreaded coughs and colds. But is there a way to stop wallowing in our own misery for three months and enjoy this season?

Here are a few tips from urgent care doctor and Regional Executive Officer (South Island) Anastasia Boulais, who was born in Northern Russia with its -20 deg Celsius temps, 4-hour day length, 6-month long winters. This more than qualifies Anastasia to share her perspective and lifestyle tips that will help you stay well through winter.

 

 

1. EAT WELL

I am not going to reprimand you for craving hearty dishes. In fact, I am going to encourage it. Winter is not the time for salads. If you want to curb your sweet cravings you need to be sated. The best way to ensure satiety is to structure your meals around a good source of protein and seasonal root vegetables. Slow cooked meats are a perfect cheap winter meal: lamb shanks, beef stews, curries, pulled pork, and many other delicious dishes full of nutrients and high satiety value. If you are somebody who feels the cold it is imperative that you eat enough, especially protein, to keep your metabolism firing through winter months. Be a rebel and have your leftovers for breakfast: starting the day with a high protein meal is proven to ward off hunger. And it’s a lot easier to say no to a piece of cake at morning tea when you are full of delicious meaty goodness. Don’t forget your vegetables and winter fruits, like persimmons and citrus, to keep up the micronutrients, especially vitamin C.

2. SLEEP SOUNDLY
Don’t feel bad about sleeping longer in winter. Our circadian rhythm is anchored to natural light so it’s no surprise we feel like we need to get some extra zzz’s. Turn off your TV early (is a reality show outcome really that vital?) and aim for an extra sleep cycle. Remember, we function in 90 minutes cycles, so it is reasonable to aim for 7.5 to 9 hour shut-eye time in winter. Sleep is essential for your immune system. One study found that efficacy of flu vaccine was reduced by over 50% in those who were sleep deprived for 4 nights in a row.

3. SEE THE LIGHT
While the darkness is one side of the circadian rhythm coin, it is the light that sends the signal which determines our sleep-arousal state. Unfortunately, in winter we frequently leave for work in the darkness, spend our day under artificial lights, and then return home after sunset. Seasonal Affective Disorder is a type of depression which is associated with darker winter season and it responds well to light therapy. But you don’t have to feel clinically depressed to be affected by darkness. Lack of energy and motivation, daytime sleepiness, trouble concentrating – all can be related to the lack of sunlight. Set yourself a goal to get outside every day. The light intensity (illuminance) on a most miserable cloudy day is still higher than what you will get in the brightest office. A short 10 minute stroll will do wonders for your alertness, energy levels, and the ability to fall asleep later that night.

4. ACTIVITY
Now that you have learned about the previous 3 factors you know why you may not feel like training hard in winter. While I want to encourage you to be active, you may need to back off early morning and late night intense exercise in favour of sleep and recovery. Focus on your strength development and addressing individual weaknesses through the winter months. A good gradual warm up is essential in cold conditions to prevent injuries.

5. EMBRACE THE COLD
Those of you who know me probably expected and dreaded me saying this: you need to have some cold exposure in order to be able to tolerate the cold. Our modern environment has effectively shielded us from temperature perturbations turning Western humans into a pampered species which can only function between 18 and 25 degrees Celsius. Contrast that to our ancestral past when we were exposed to the bitter cold during Ice Ages and oppressing African heat in interglacial periods. You don’t have to give up your merino tights and shiver without the heat pump. Instead, you build up your cold toughness by doing what Russian and Finnish “walruses” have done for centuries – cold water immersion. Your shower is a good place to start: alternate 30 seconds of cold water exposure with hot, and build up to a minute or two of standing under cold water. Alternating cold plunge tanks with soaking in hot pools is a fun activity at Lake Tekapo and Hanmer Springs. Find your own controlled environment to push your boundaries and you will learn to enjoy rather than hate the cold days.

Stay tuned for Part 2 coming soon!

AHSNZ International Symposium 2017 Opening Address

 

Tena koutou, tena koutou, tena koutou katoa

Nga mihi nui ki a koutou katoa

Ki a papatuanuku – tena koe

Ki te whare – tena koe

Ki te hunga mate

Ki te hunga ora

 

Ko Tawera te maunga

Ko Otakaro te awa

Ko Pakeha te iwi

Ko Jamie Scott ahau

Tena koutou katoa

 

Kia ora and greetings to everybody who has travelled, quite literally, from the four corners to be here today

To the earth mother (Papatuanuku), responsible for these majestic views – greetings

To this house, the Icon Room, where we gather together – greetings

To our ancestors, whose death gives us our life – farewell

To the living – welcome

As part of my introduction, I’ve introduced the mountain which I identify the most with – Mount Torlesse (Tawera), in North Canterbury, a mountain I grew up in front of in the early years of my life.  I also named my river, the Avon River (Otakaro) in Christchurch, which I live on the banks of currently.  

Like most New Zealanders of European descent, Pakeha, I’m a bit of a mongrel in my ancestry – some Irish, some German – but it predominates, on my father’s side, from the Scottish border clan,  The Scotts, and the English farmers , the Tegg’s, on my mother’s side.

I want to introduce you all to the Ancestral Health Society of New Zealand.

 

AHSNZ current Executive and Associate members. Photo by Steph Gaudreau

 

Somewhere around 2012/2013, we came up with this crazy idea to form a society around a core group of likeminded health professionals in New Zealand who use evolutionary biology as a starting point of enquiry for the work we were doing with individuals and groups.  

No matter what our particular professional backgrounds were, we found that by stripping our patients, our clients, and ourselves, back to the essentials of our evolutionary roots – good sleep and circadian rhythms, unprocessed meals based around high-quality protein, healthy movement patterns – moving slow, moving fast, lifting and carrying – and good, deep, supportive real-world social connections – our health, well-being, energy, vitality – whatever you want to call it – improved.  

Our resilience to the trials and tribulations of modern living improved with this essential foundation repaired and rebuilt.  But that resilience also suffered when the same modern life was just left to erode it in the insidious way that it tends to do, with our prevalent social and cultural attitudes and norms such as sleeping when you are dead, eating whatever you like as long as you balance your calories with cardio, and riding the self-esteem rollercoaster that is the likes, hearts, and thumbs of online social networking.  

From this seemingly revolutionary evolutionary approach, The Ancestral Health Society of New Zealand was born.  As we have grown, we have taken on a dual purpose.  The first being the essence of this symposium:

“The Ancestral Health Society of New Zealand aims to foster community and collaboration among health professionals, researchers, and laypersons, who study and communicate about health from an evolutionary perspective in order to develop solutions to the common biopsychosocial mismatches in our modern world and the health challenges these present.”

The second purpose of the Society is to provide safe harbour, professional support, and connection for its core members, all of whom, at one point or another, have been burned at the metaphorical stake for their ideas and practices.  For me, as someone with a decades’-worth of university qualifications in exercise science and human nutrition, I can make the case for better sleep from an evolutionary biology perspective – we evolved as creatures of the daylight, with our circadian rhythm tagged inextricably to the sun coming up and the sun going down – and nobody bats an eyelid.  But if I try making a similar evolution-based argument for how we should eat, people often start getting very upset at you very quickly.

The Society has members who are medical doctors, physical activity specialists, psychologists, researchers, nutrition professionals and social academics, all of whom have similar stories, and all of whom, at one point or another, have decided that is it generally easier to keep quiet, keep the head down, and stick with the guidelines and conventional wisdom, no matter how ineffective those guidelines or that wisdom might be.  As you can imagine, working this way can feel very isolating.  So AHSNZ provides a good sense of community and support to these professionals.  

In many ways, the foundation of AHSNZ mirrors that of the deep ecology movement from the 1960’s & 70’s (what is considered the foundation of today’s modern environmentalism).  In 1973, philosopher and mountaineer, Arne Naess, outlined what he saw as a short-sighted approach the environmental issues of the day – what he termed “shallow ecology.” In short, shallow ecology is about managing pollution (or at least that which is most visible to the public eye) and resource depletion, keeping everything else business as usual and not noticeably upsetting the lifestyles of the property owning class and the affluent.  

This short-term shallow approach actively tries to avoid making any fundamental changes and often plays on our common belief that technology – if we wait long enough – will fix whatever issue we happen to be facing, and in the meantime, we can carry on with our consumption-driven lifestyles and economics.  Anyone who was paying attention during New Zealand’s recent (2017) elections might recognise some of these central features of shallow ecology as they are direct from the National Party of New Zealand playbook.  

Conversely, deep ecology focuses on the balance between all organisms on this planet, including humans, taking a long-term, sustainable, and regenerative whole-systems approach to preserving – or rebuilding – ecological diversity.

Where shallow ecology is egocentric, deep ecology is ecocentric.

 

Photo by Steph Gaudreau

 

It is my belief that we can, and should, take this same deep approach to our health care systems – plural, not singular.  Few of the medical doctors within the AHSNZ team would argue that much of the medicine they practice couldn’t be characterised as shallow medicine.  We keep coming up with, and extolling the virtues of, new tests, technologies, and drugs all of the time, all reinforcing the notion that none of us really need change our lifestyle, habits, or environment anytime soon as the nanobots that will one day be put into our bloodstream will ultimately save us!  

By way of example, taking a deep health approach, and knowing what is actually fairly recent food history in the grand scheme of things, we might become far less enthusiastic for the current trend of plant-exclusive diets or the prospects of lab-grown synthetic meat as a supposed easy fix to climate change related problems.  Stories such as how Procter & Gamble was going to save us from the horrors of using animal fat for cooking with its trans-fat laden hydrogenated plant oils, or how we could simply replace breastfeeding, wet nursing, and animal milks with soy-based infant formula and a added few vitamins, should serve as precautionary tales and curb the enthusiasm for such limited, ultra-processed diets and high-tech foods.

I’ve watched, with interest, the debates in recent years about sitting versus standing in the workplace.  Sitting is apparently the new smoking, and so offices were quickly fitted out with electric height-adjustable desks.  But now the pendulum has swung back the other way as standing all day is causing issues such as back pain, knee pain, and deep vein thrombosis.  Our shallow, quick-fix mindset often blinds us to the deeper issues at play.

The deeper issue in our corporate settings, are stressed humans working in a relatively confined area, virtually chained to a desk, with few opportunities to engage in true human-type movement, with multiplier effects such as the required footwear and clothing of the modern corporate uniform.  The deep reality of our modern human environments is often too inconvenient for our shallow economic models and wealth accumulation, so we tend to mess about with novel quick fixes on the fringes, while largely keep our heads buried in the sand regarding the underlying real problems.

Let’s talk about our current “grassroots” health culture as we might see it on popular social media channels, where the message is that our health authorities have it all wrong, and our newfound health heroes & gurus can unlock all the truths and secrets that you need to know about.  In this shallow, social media-driven health model, it’s all about the ego.  It’s all about being thin or buff, or whatever it is you need to be depending on the virtue signals you are trying to send to your social media audience.  

Check the often silently sponsored social media feeds of these health gurus and influencers, and what do you see?  Mostly pictures of themselves, or if not, pictures of the products they are being quietly paid to spruik to you.  Do they talk about the bigger picture, the directions we all need to move in, and the part they are playing to help everyone get there?  Or are they spending all of their time talking about their egocentric selves, a few shallow hacks, and some product or service available via a link in their profile?

Over the next three days, you will see and hear all of our speakers talk to a deeper, more ecocentric approach to population health.  They will discuss our evolution and our history – necessary not only for a deeper understanding of where we have come from – but also in understanding that for every apparent solution other problems are potentially created. Some will encourage you to take a systems-approach to our core health issues, inspired by the health framework of indigenous cultures. Most speakers will define the common biopsychosocial mismatches we face.

And your role over the next three days?

After I’ve already suggested we shouldn’t be too egocentric, your first questions should be “how am I connected to this problem?” or “what influence does it have on my life?”

Be open and honest with yourself. Be prepared to challenge your own current world views. In the breaks, connect with each other. The shallow health approach often places the onus of change on individuals. But it is only when we join forces with others that any real environmental shift can come about. Forge your own community and support network with the people you meet over the next three days.

Lastly, connect with the environment here. Logistically and cost wise, it would have been easier for us to hold this event in a bunker type building in Auckland or Christchurch. But there is a reason we have come back here and you only need to look out that window to see why. Take some time to put your phones down while you are here in Queenstown and take in what you are surrounded by. If the scenes here don’t leave you feeling a deep sense of awe and wonder (not the kind that you have to Instagram or it didn’t happen), then you are almost certainly paddling in the shallow end of the pool.

END

 

Photo by Steph Gaudreau