Are you super sensitive to chemicals, food, light and life?
Maybe you feel like you are allergic or reactive to everything and can’t understand why? There can be lots of different reasons for this but before we go removing this and that and trying to identify multiple triggers I like to ask the question “are your cell membranes working right?”
Our cell membranes act as the border control for our body. They control what gets in and what gets out. They act as both the gatekeeper and the hostess.
What happens though if your cell membranes are not in great condition? How would you know if this was a problem for you?
I like to think about it this way. Consider each of your cells as a tiny tent and imagine the tent fabric is your cell membrane. If it’s too floppy it will start to cave in and stick to you, or even itself, and the canvas will then start to leak. It’s similar with cell membranes. If they are too flexible and soft they won’t have the necessary structure to keep out undesirable molecules and toxins.
A properly pitched tent will have the necessary structure to filter out what isn’t required (rain). If the material is too rigid though, or poor quality or not breathable it will prevent air circulation. This might mean the inhabitants overheat or don’t breathe properly. Similarly if the tent shape creates too much wind resistance, the poles might break and the tent (membrane) could collapse. Inside your cells this could mean vital nutrients aren’t absorbed or they don’t receive sufficient energy or oxygen to function well.
A change in your cell membrane composition can have a multitude of downstream effects. If your cells aren’t properly nourished this can cause irritability and sensitivity in your body. You might become intolerant to chemicals and foods that were previously fine. Your pain threshold might become much lower. Your eyes might become much more sensitive to light, your tolerance to temperature fluctuations might diminish or touch sensitivity can become problematic. This issue can also be a factor in cardiac dysrhythmias and, if the cells in the brain are affected, brain energy supply will suffer and we get so called ‘brain fog’.
If we want our cells to perform their roles then we must nourish our cell membranes. This means we need to digest our food properly, so we need good levels of stomach acid. We need to absorb our food well which requires good enzyme function and a healthy intestinal barrier. We also need to eat enough fat in our diet of the right type. Fat digestion involves many steps and processes and requires good pancreatic and bile function. This means there are multiple links in the chain which can be vulnerable to malfunction. The good news is all of this can be helped with protocols to improve digestive function, bile function and addressing any deficiencies in diet or micronutrients.
Do your cells need an oil change?
Today’s modern diets can often mean we eat too much or too little fat, or frequently just the wrong type. Our cell membranes consist of lots of oil aka. fat. For optimal performance they require quite a specific ratio of different types of fats, especially with regard to the essential fatty acids (EFA’s), omega 3 and 6. If these are out of sync, cells can malfunction a bit like trying to run your car on the wrong type of oil or petrol.
Cell membranes are your cells’ border control. They control what gets in and what gets out. They act as both the gatekeeper and the hostess.
Every cell in your body has a cell membrane and your body has a lot of cells. Experts think we have in the region of 30 trillion, and we want every one of these to have a healthy cell membrane. If your cell membranes are working correctly, they will let micronutrients in and waste products out. As well as supervising which molecules can enter and exit, most cell metabolism takes place in, on, or around this location. It’s like your very own production line inside you, manufacturing energy and proteins, and churning out waste products such as urea and toxins.
The next thing to understand is that their structure is critical to how well they function. We don’t want them to be too rigid or nothing will get in, or out. We also don’t want them too soft and floppy. This might allow too much in or too much out and over time this could cause multiple issues.
So how can we nourish them and maintain their structure so they can function properly? Firstly, the fat they contain needs to be eaten, as the body cannot make it. Some of these fats have special functions such as the EFA’s. There are many arguments about the correct ratio of fats to eat in the diet but researchers generally agree that we tend to be more deficient in omega 3 which is found in fish, nuts, seeds and vegetable oils.
So by now I think you get the idea that I like my clients to achieve healthy cell membranes because “the stronger our cells the more resilient our selves”.
It’s easy to check our ratios with a simple finger prick test because the concentration in our blood has been found to strongly reflect our dietary intake. The current European average for our omega 3 percentage is less than 4% but research confirms that 8% is optimum, and that this ratio is associated with a 90% reduction in risk of sudden cardiac death.
There is nothing like analytics to demonstrate to my clients (and me) that we either need to work harder on our diet or take targeted supplements to give our cells what they need to function tip top.
Here’s some simple easy changes to boost your nutrition. Check my website for recipes and to sign up to my newsletter.
Salad dressings - swop salad dressing for olive oil and lemon/apple cider vinegar (ACV) or balsamic vinegar. Mixing 1 tbsp of tahini with 6 tbsp olive oil plus 1 tbsp of lemon juice or ACV is a delicious alternative to mayonnaise. Thin with water if needed.
Crispy stuff – make your own popcorn with popcorn and olive oil plus some butter or ghee and a little salt. Alternatively roast pumpkin seeds with paprika, salt and a dash of cumin or cayenne pepper, Remember all crisps tend to contain trans-fats as they are deep fried with non-stable vegetable oils.
White for brown – this goes for rice, bread, pasta and crackers. The glycaemic index may still be high, although this is depends on the individual. But whole grain foods will retain more micro-nutrients the glycaemic response is likely to be lower, they will contain more fibre and protein and some folks do fine with them. If you soak brown rice overnight it will cook almost as quick as white.
Oats – go for steel cut or larger flakes. They are less processed and will take the body longer to breakdown, supplying a source of energy to longer.
Rice – for cauliflower rice. It’s actually very easy and it works, I’ve tried it. More fibre, more veg and less processed than rice.
Baked beans – swop your standard variety for low sugar and salt or make your own and freeze in portions.
Cow milk – for oat, rice, almond, soya or coconut. Cow milk is a major source of allergens, which are inflammatory and growth promotors. Plus many of us do not possess the lactase enzyme to digest lactose properly. It is also associated with an increased risk of osteoporosis, heart disease and auto-immunity.
Snacking on cakes, biscuits and pastries – switch to oat cakes and nut butter, nuts and seeds, one piece of fruit or a handful of berries with yogurt and hemp seeds, apple slices with a squeeze of lime juice, some nuts or seeds and a dollop of nut butter. Cakes and biscuits are full of processed ingredients and high in sugar so they will spike blood sugar and therefore insulin. They are also addictive, one is never enough.
Bread – switch to breadmaker bread and use rye flour or ancient grains such as spelt or kamut which have less gluten. You need a breadmaker that has these specialist options and it can take a while to perfect the recipe. If you are really up for the challenge switch to flax seed bread –I guarantee one slice will take you about 5 minutes to eat and you will struggle to eat a second.
Dessert – make a rule it has to be home made. I made this rule for all cakes and puddings when I first got into nutrition and as I am a lazy baker this immediately cut our consumption. Dessert, pudding, biscuits, cakes etc. need to be the exception not an expectation. But hey rules are made to be broken and a paleo crumble now and then is a great option. See my website for the recipe.
Staying alive in toxic times
This month I did a fascinating webinar with Dr Jenny Goodman, author of Staying Alive in Toxic Times, and more recently Getting Healthy in Toxic Times. Jenny is an ecological Doctor, very well respected author and rigorous researcher. The webinar was about her top 7 strategies, based on her up to date findings and research. The book will cover many more issues of course.
We all know now that everything is connected and we need to become kinder and more loving to everything, and everyone, especially nature. But how do we tackle this on an individual and daily basis? Her top three were nutrition, water filtration and cleaning up the home from indoor pollution. The issues covered in the book can cause overwhelm but as a practising Doctor she is an advocate of what I call ‘meeting people where they are’. So she includes advice regarding prioritisation and practical suggestions and ideas to tackle each area.
For example the first area ‘nutrition’ is a subject close to my heart but not everyone can afford top quality organic produce. My advice is always to buy the best you can afford. If you eat meat this is critical as animals concentrate toxicity through a process called bio-transformation. The body stores these toxins in fats to try to shield the body from harm.
There are useful strategies though such as avoiding those vegetables grown with the most pesticides such as grapes, strawberries and lettuce. You can sign up for a list of the ‘dirty dozen’ here https://mailchi.mp/pan-uk/dirty-dozen-23. There is of course also a prioritisation issue. According to Tim Spector we are one of the sickest countries in Europe but little attention is being paid to this. 33% of our income used to be spent on food, today just 8% so this is no doubt part of the problem.
Water filtration seems to be a rapidly developing area. I do have a hand-out on this if anyone is interested I am happy to send it out. She doesn’t give specific recommendations anymore because the companies themselves change what their products filter so the advice dates very quickly. What she outlines in her book are the questions which need to be checked before making a buying decision. The challenge of course is to filter out the harmful toxicity but retain or replenish the mineral content that can be lost in the process.
I was fascinated to learn that the Netherlands use physical filters and ultraviolet light to kill bacteria rather than chlorine as per the UK. This means they don’t drink ‘disinfection by- products’.
Where the home is concerned Jenny highlighted chemicals from cookware and soft furnishings, which are relatively easy to address. The most at risk are pregnant women and young children but pre conception couples should also take note here. Again there are options so if you can’t afford the organic mattress, you buy them in the summer and leave them to ‘detox’ with the windows open. Don’t paint the nursery very close to the birth etc.
I should add that there is also a lot of encouraging work being done by enterprising individuals, organisation’s and companies all of which is covered in the book. Her website if of interest is www.drjennygoodman.com.
Photo credit: Photo by Demure Storyteller on Unsplash Acera Palm known for it's ability to absorb toxic VOC compounds from the air.
The role of cholesterol and fats in cardiovascular disease (CVD)
Cholesterol and fat receive a lot of attention in the health and wellness media especially in connection with cardiovascular disease (CVD). Most of it is negative and places the blame for heart disease on high fats diets in general and more specifically the cholesterol molecule. Of course there are numerous CVD risk factors such as age, genetics, sedentary lifestyles, obesity, diabetes and so on but this blog is focused on clarifying the role of cholesterol and fats.
Where does cholesterol come from and what does it do?
Only about 20% of our cholesterol comes from diet, the remaining 80% is made by the liver. So why does our body make it, if it’s harmful?
Cholesterol is an essential component of many processes in the body including the formation of every cell membrane. Our cell membranes consist of 1/3 saturated fat, 1/3 polyunsaturated fat and 1/3 cholesterol and it is here that all cellular activity (metabolism) takes place.
Cholesterol is the raw material of hormone production and we manufacture vitamin D from it, via the action of sunlight. We also need it for bile, which facilitates fat absorption and toxin excretion. It’s a key component of the myelin sheath surrounding our nerve fibres making it important for brain and nerve function. The list goes on, but you can see how important it is for many critical functions.
How does cholesterol go wrong?
The problem occurs when there is damage to the delicate lining of our blood vessels. The immune system steps in creating plaques to try and repair the situation and over time they can narrow our arteries. This process can result in an oxidised cholesterol molecule (LDL-c), which depending on the size, density and number of them can increase cardiac risk.
If our cholesterol metabolism is working correctly however LDL-c should be picked up by HDL-c and returned to the liver for excretion. For this process to work properly it requires a consistent supply of antioxidants.
So as is often the case it’s a question of balance.
What causes blood vessel damage?
The biggest culprits are high blood pressure from stress, sugar, trans fats and inflammation. This is because:
High blood pressure caused by the stress hormone adrenaline causes turbulent blood flow, which can easily damage the delicate blood vessel lining. Adrenaline can be triggered by any stressor such as: erratic blood sugar, lack of sleep, financial or emotional difficulties.
Refined carbohydrates and refined sugar are pro-inflammatory and can form ‘advance glycation end products’ (AGE) which stick to plaques further narrowing the arteries.
Trans fats which are contained in most biscuits, cakes and ultra processed food, raise LDL-c as well as making these particles more dangerous (atherogenic).
Inflammation arises from various sources such as infection and toxicity but vascular cell damage is also inflammatory so a vicious cycle emerges.
What if cholesterol is high? WHAT IF TOTAL CHOLEST
This may or may not be a problem but it’s always wise to investigate. Ideally our total cholesterol:HDL-c ratio should be less than 4.5 for men and less than 4 for women. The other important ratio is the HDL:LDL - c ratio and this is kept in balance by our level of antioxidants.
Preliminary check
An easy way to assess if there might be an issue is to calculate your waist to hip ratio (WHR). This is a good indicator of the presence of fat around the organs (visceral fat). Women should be 0.8 or more with a waist measurement below 90 cm (35 inches). The ratio for men is 1.0 or more with a 102 cm (40 inch) waist or less.
Can nutrition and lifestyle help?
The good news is there is so much you can do with nutrition, lifestyle and supplements to balance cholesterol metabolism and reduce risk. Medication may be necessary especially if there are genetics at play but this can often be minimised if every thing else is addressed.
Nutritional therapy is always very unique and personalised but it tends to focus on the following:
Nutrition
Lowering inflammation levels - through dietary change and supplements if required. Levels of omega 3 in the diet are important to evaluate.
Making sure sources of fat in the diet are good quality and that fats used in cooking are very stable. Trans-fats should be eliminated as much as possible. Digestion and absorption of fats is assessed and improved if needed.
Is the diet high in processed carbohydrates and refined sugar? Any excess will be converted to fat. Fat in the body doesn’t only come from the fat we eat.
Ensuring sufficient Vitamin D levels – these are highly protective against heart disease.
Balancing the antioxidant status in the body and levels of B3 – testing can be useful here
Adjusting levels of fibre in the diet to facilitate cholesterol excretion.
Checking sulphur intake in the diet. We are often low due to soil deficiency or we may not convert it to sulphate so cholesterol circulates as LDL-c. Some diets such as FODMAP can be low in this nutrient.
Testing and supplementation
A preliminary urine and blood spot test can be done to gage risk, before making the decision to invest in a more expensive, comprehensive CVD profile. The latter does help to establish blood lipid (fat) levels and direct priorities. The number and size of LDL-c particles and whether or not they are oxidised also helps to pinpoint risk.
Appropriate supplementation to fill any dietary gaps and tackle priorities.
Lifestyle
Stress management - 75% of people admitted with heart attacks have normal cholesterol with LDL levels below average (Dr. Aseem Malhotra FRCP).
Improve sleep for physical and mental recovery.
Improving breathing function to maximise nitric oxide production. This relaxes the blood vessels, improving blood flow to deliver nutrients and oxygen to the tissues, including the heart and the lungs.
Exercise – the right sort appropriate for age.
References:
Samsel, A and Seneff, S. (2013) Glyphosate, pathways to modern diseases II: celiac sprue and gluten intolerance. InterdisciplinaryToxicology 6(4): 159–184. doi: 10.2478/intox-2013-0026
Wannamethee, G. et al. (1995) Low serum total cholesterol concentrations and mortality in middle aged British men. British Medical Journal 12:311(7002): pp. 409-13. doi: 10.1136/bmj.311.7002.409.
Can't lose weight? 10 things to consider
This is a summary of some of the core reasons for why weight loss can be so difficult for some people. It’s a complex area involving biology, physiology, emotions and psychology to name just some. However if you feel like you have tried everything you could have a think about the list below which summarises some of the key areas to address.
Appetite regulation system, poor eating habits and compromised digestion.
This can include things like eating too fast. The satiety hormones take time to register and react to food intake. If we eat fast we can over eat before the feedback mechanism has time to respond and let us know we are full. Similarly, if we eat on the run or with our attention elsewhere such as the computer or TV, studies show that we eat more.
New research is showing that there are more stretch (mechano) receptors in the small intestine than the stomach. They tell the brain we are full via nerve feedback. If digestion is compromised in any way then food will take longer to reach the small intestine. It is now thought that this delays signals to the brain that we have eaten enough and extracted the nutrients we need. So improving digestive function can be part of the solution.
Eating slowly and chewing properly as well as other simple changes to the way we eat can make a big difference here. It takes an effort to change habits which are our default way of thinking about and consuming food. But once you correct them and the new habits are ingrained you can go back onto autopilot, it’s just one that serves you better.
Lack of movement and too few muscle cells.
The more muscle cells you have, the more mitochondria you will have. These organelles are responsible for turning food into energy. The more you have the higher your basic metabolic rate (BMR) will be. This is the amount of calories you burn to maintain your body’s function at rest. It is generally thought that our BMR accounts for 70%+ of our daily energy requirements. So another aspect of weight loss can be adjusting our training schedule to improve mitochondria numbers and function.
Lack of nutrition knowledge and understanding about how the body works.
This can result in a poor quality diet perhaps including a lot of ultra processed food (UPF) or a very low calorie diet and yo-yo dieting. Sometimes we need to keep an eye on portion size and plate content and a calorie assessment can be useful here. However I tend to focus initially on the nutrient and micronutrient content of the diet. Once we get this right and the body is nourished then we can take a look at tweaking plate content and construction. I think a lot of ‘diets’ fail because if the body isn’t nourished properly there maybe micronutrient deficiencies so the body craves food in an attempt to resolve this. This is interpreted as hunger.
There is no one method to lose weight. Different methods suit different people’s lifestyles, individual preference sand health status. To some extent they all work, at least initially. What’s important is to establish a baseline that keeps weight stable and the body healthy. This helps to make the body feel safe. Then we can mix and match different weight loss strategies to get the body to adapt. Remember we want it to do something it wouldn’t naturally want to do, based on evolution, which is to lose weight.
The problem with very low-calorie diets (VLCD) and yo yo dieting is the body does something called adaptive thermogenesis. It adapts to the altered calorie intake. It’s also very hard to maintain these over the long term and it can be stressful for the body. It is not a time to lose weight when we are stressed (see BLOG here https://helenmaxwellnutrition.co.uk/weight-gain-is-stress-to-blame/
Lack of hormetic challenge.
Exposure to hormetic stress builds resilience and occurs when we are challenged without overly exhausting ourselves. It includes such physical activities as high intensity interval training, cold exposure (showers or ice baths) and fasting. It’s the use it or lose it principle. It’s an adaptive response to a challenge generated by the environment. Even our response to drugs is a hormetic challenge of sorts. Modern life has evolved to reduce many of our physical hormetic challenges, think central heating, air conditioning and our indoor lifestyles. There are many simple ways to introduce this such as cold showers, breathwork and exercise.
This is probably the most useful starting point for most people. You need stable, well managed blood sugar (glucose) if you want to lose weight. If glucose levels in the blood are too high it has to be removed. Insulin takes glucose into the cells to use for energy but if there is no demand it will be taken to the liver where the majority will be stored as fat. Hence insulin is often referred to as the fat storage hormone. So we want to try and keep our levels of insulin low and there are numerous nutritional strategies and supplements that can help with this.
Equally if blood glucose is too low this is stressful for the body. Stress raises cortisol which triggers the release of glucose stores, known as glycogen, from the liver or muscle. Alternatively the body will make glucose by breaking down tissue. Initially this can trigger weight loss but if cortisol stimulation is ongoing, as in chronic stress, this can lead to sustained high blood sugar levels which will necessitate more and more insulin. If the cells become resistant to insulin from stress, poor diet, high sugar intake or poor liver function then insulin resistance can develop which is associated with fat storage (see https://helenmaxwellnutrition.co.uk/weight-gain-is-stress-to-blame/).
Poor thyroid and/or hormone function leading to a dysregulated metabolism.
Our thyroid regulates our metabolic rate which is how we make energy. If thyroid hormone production is low this effectively slows the metabolism causing symptoms such as ‘tired and wired’; anxiety; poor sleep; negativity and depression; shakiness between meals; irritability and a very short fuse. This often leads to abdominal weight gain. This kind of symptom pattern usually requires professional assistance from a qualified nutritional therapist and the medical profession to try to resolve the underlying hormone malfunction. Overproduction of cortisol can play a role in this so stress management is crucial, see below.
Stress and overload.
If the body is chronically stressed then it won’t be able to lose weight. To lose weight requires good digestion, good liver function and good blood sugar and insulin management. All of this requires energy for your internal organs to work properly. Chronic stress takes the energy away from internal function to the extremities, (arms and legs) and the heart so we can run, fight or hide. The body won’t undertake remodelling or restructuring when it’s focused on survival. It’s the same as life. When you are in a stressful life situation you focus on the essentials and the body is the same. You can read more on this here https://helenmaxwellnutrition.co.uk/weight-gain-is-stress-to-blame/
Gut and liver function.
The microbiome (bacteria) in our gut facilitates nutrient extraction from and absorption of food. The importance of nourishing the body in order to lose weight is covered in point 3 above. Most studies seem to point to the ratio of Firmicutes to Bacteroidetes being significantly higher in overweight and obese subjects (Ley, 2010; John and Mullin, 2016). In addition lean subjects appear to have a more diverse and complex microbiome (Kasai et al., 2015; Lv et al., 2019).
The gut microbiota plays a major role in energy generation (metabolism) from the fermentation of fibre and protein in the colon to produce short chain fatty acids (SCFA’s). SCFA’s affect body weight, glucose regulation and insulin sensitivity as well as playing roles in satiety and appetite. Hence the microbiome impacts weight in a number of complex ways through influencing food intake (type and quantity), gut microbiota, nutrient levels and metabolism.
Liver function is critical to maintain a healthy weight. It plays a major role in managing blood sugar (see 5). It controls the the conversion of excess glucose to fat and the breakdown of fat for energy. If liver function is impaired then this system can struggle, fat metabolism deteriorates, and as a result fat accumulates in the liver. This can lead to non-alcoholic fatty liver disease (NAFLD) and/or weight gain. The liver is of course the major detoxification organ of the body. If it malfunctions toxins can build up which can interfere with hormone function and affect metabolism, which often leads to weight gain.
Good gut and liver function are therefore key for successful weight loss. Focusing on improving both of these is often a significant part of any weight loss programme.
Sleep.
Modern lifestyles often mean insufficient sleep. Insufficient sleep causes stress which has already been discussed above. Stress and lack of sleep can lead to comfort eating which tends to be carbohydrate. This can easily become a vicious cycle as carbohydrates, if not wholegrain or good quality, elevate blood glucose quickly. This triggers a lot of insulin very quickly followed by a sudden drop which results in low blood glucose (hypoglycemia) and we end up with poor management of blood sugar (see 5).
The association between lack of sleep and being overweight is well known and shift workers are a prime example of this. Ideally we need 8-9 hours of sleep between 9:30pm and 6:30am. The emerging science of how circadian rhythm interacts with nutrition and health is called chrononutrition and adapting meal timing and structure to take account of our circadian rhythm can really help support weight loss and health.
Change and the brain.
Losing weight involves change on many levels and the organ of change is the brain. It contains the most neurons and the greatest potential to create change. There will often be a lot of negative thinking and slef around excess weight. We have 50-60 thousand thoughts a day and most are the same as the day before. To lose weight we want to start interrupting these thought patterns and changing our focus from what we don’t want, to what we do. Pictures of how you want to look, vision boards to remind you of your goals, even just taking a few minutes each day to tune into how you want to look and feel. Working with other therapists can help such as CBT, NLP, hypnotherapy, whatever it takes to keep on the right track. If meditation is your thing then Dr Joe Dispenza offers many options and this link talks about the brain and how to change https://www.youtube.com/watch?v=EpOMk1jOzgk&t=47s
References
Aoun, A. (2019) The Influence of the Gut Microbiome on Obesity in Adults and the Role of Probiotics, Prebiotics, and Synbiotics for Weight Loss. Cell: 179: pp.1129-1143. https://doi.org/10.1016/j.cell.2019.10.031
Kasai, C. et al. (2015) Comparison of the gut microbiota composition between obese and non-obese individuals in a Japanese population, as analyzed by terminal restriction fragment length polymorphism and next-generation sequencing. BMC Gastroenterology: 15(100). doi: 10.1186/s12876-015-0330-2
Muller, M.J. et al. (2016) Changes in Energy Expenditure with Weight Gain and Weight Loss in Humans, Current Obesity Reports: 5(4): pp. 413-423. doi: 10.1007/s13679-016-0237-4
Rattan, S.I.S and Demirovic, D. (2010) Hormesis can and Does Work in Humans. Dose-Response: 8(1) pp.58-63. doi:10.2203/dose-response.09-041.Rattan
Why is it that stress causes weight gain for some, whilst for others it just falls off? Both responses make sense based on our physiology. It may all be down to how often we are triggered, at what level and for how long?
Historically our survival threats were freezing, starving or being eaten so our nervous system has evolved to help us cope with this type of stress. Acute stress triggers cortisol. This raises sugar levels in the blood stream to provide energy for finding food, fighting or running away. In today’s modern world this inbuilt response doesn’t serve us so well. We have central heating and air-con for temperature control. We are often sitting down all day at computers, not using our limbs to run or hunt which means sugar levels in the blood stay high. This can only be tolerated temporarily as the maximum capacity for sugar (glucose) in the blood is 5 -10 ml.
For conversion to energy the glucose must enter our cells which requires insulin. If the cells don’t require extra energy due to low energy demands, or insulin resistance, it must be removed from the blood by the liver. Small amounts can be stored here, or in muscle tissue, as glycogen but the remainder is converted to fat.
Our survival mechanisms influence subtle chemical and hormonal changes. Metabolism may be slowed to conserve resources or appetite raised to incur fat storage for warmth, or long-term energy. In times of food scarcity the body is primed to store fat. Modern diets often lack nutrient density and ultra processed foods can contain non-food items which confuse the body. This can be interpreted by the body as starvation which along with low calorie or yo-yo dieting may mistakenly trigger our fat storage programmes.
The inherent fight or flight response removes energy from our internal organs driving it to our limbs and heart so we can take action. This also triggers cortisol to breakdown tissue for energy. This is the origin of the weight loss we see in highly stressed individuals. Over time though, if we are constantly stressed, the organs responsible for keeping us healthy are deprived of energy. Essential processes like digestion, immunity, detoxification and organs such as the liver and heart may malfunction. Continual glucose stimulation tends to lead to insulin resistance and fat storage (see above) which is all linked to weight gain. To lose weight your organs need to function well, especially your liver which directs the utilisation, storage and generation of both glucose and fat.
It is thought that chronic (long-term) mental stress also activates our survival instincts. Overthinking and negative thoughts are interpreted by the subconscious as real. The brain can’t distinguish between our worry and an actual event. Scientists think chronic stress by-passes our normal stress circuitry so cortisol production stays switched on. The result is excess tissue breakdown and poor repair. This can lead to inflammation, poor appetite control and insulin resistance, ending in an overall collapse of our energy management processes (metabolism) and the accumulation of fat.
I always think that part of the weight loss equation is to make your body feel safe to lose weight, so that your body’s genetic fat storage programmes are not triggered. Regardless of how your body responds to stress, we focus on nourishing the body and working with ingrained stress responses to turn the fat storage triggers off. We gently convince it that weight loss is the right course of action.
References:
Wilcox, G, (2005) Insulin and insulin resistance; The Clinical Biochemist Review; 26(2); pp.19-39. PMC1204764.
Singh, B. and Maurya, N.K, ( 2024) The cortisol connection: Weight Gain and Stress Hormones; Pharmacyscijournal.com; doi.org/10.29328/journal.apps.1001050
Suffering with acne; infertility; tiredness and irregular menstrual cycles? Could it be polycystic ovary syndrome (PCOS)
This is such a distressing condition especially for young girls. As I am seeing it in clinic and the incidence is rising I thought I would summarise some of the current scientific information and clinical approaches here.
Diagnosis
For a diagnosis two out of the following three factors are required:
Irregular menstrual cycles: for years rather than months and this can mean they are very close together or more than 35 days apart and may include random bleeding.
Androgen excess – this can include total testosterone, free testosterone Dehydroepiandrosterone-sulfate (DHEA-S) and androstenodione.
Polycystic ovaries on ultra-sound – these are not cysts but follicles with an egg inside. In teenagers there is a risk of mis-diagnosis due to very sensitive ultra sound scans which are no longer recommended for this age range. This is because they may just have a lot of eggs because they have not fully gone through puberty yet or due to high stress levels. In addition birth control can cause cysts. A higher than average anti-mullerian hormone may help to clarify this.
Presentation and symptoms
Irregular or absent periods
Androgen excess symptoms such as: acne especially jawline acne, hair loss or coarse hair on the face, male pattern baldness.
Other symptoms can include cravings, poor appetite control, some abdominal weight or general weight gain.
PCOS is also the most common cause of infertility in the Western World.
So what’s going on?
1. Insulin resistance
This occurs when cells stop allowing insulin to escort sugar (glucose) into the cells. It is very often but not always present in PCOS although the severity is variable. If glucose can’t get into the cell it gets deposited in the liver resulting in abdominal fat, hence insulin is often called ‘the fat storage hormone’. With no glucose (energy) in the cells clients often feel exhausted and hungry and therefore eat more, so a vicious cycle emerges. Food should generate energy but instead it’s stored as fat (weight) which the body doesn’t utilise, for various reasons, and the resulting lack of energy promotes more food intake. Weight gain, especially abdominal, is therefore a common feature of PCOS. Both glucose and insulin in the blood are undesirable over certain levels and will damage blood vessels.
Insulin resistance can be tested by measuring and testing for: fasting insulin; fasting glucose; an oral glucose tolerance test; Haemoglobin A1c and High sensitivity CRP levels. Some clients will react to very low glucose levels as the sugar levels in their blood drop, others will have low levels of insulin or may struggle to detox it from the body.
2. Low oestrogen
Oestrogen is required for many actions in the body including regulating metabolism and it is made from testosterone. The pituitary gland in the brain triggers luteinising hormone (LH) to signal testosterone which is converted to oestrogen by the ovaries. The conversion is carried out by an enzyme called aromatase which is initiated by a hormone called follicle stimulating hormone (FSH) also controlled by our pituitary gland. In PCOS this conversion isn’t working properly so oestrogen levels remain low and the brain keeps stimulating testosterone production. This then results in high testosterone levels which cause inflammation and overload the liver. Poor detoxification of testosterone and oestrogen can result and these metabolites tend to become toxic.
3. High androgens
High androgens such as testosterone will be an issue for most PCOS clients because of the hormone cascade detailed above. High testosterone alters the gut microbiome which in turn results in greater testosterone production. A vicious cycle emerges of low oestrogen triggering LH, FSH and testosterone production resulting in high androgens which cause distressing acne and hair growth or loss symptoms
4. Problems with immunity
There are many Immune cells lining the gut which also contain oestrogen receptors. Dr Gersh considers oestrogen the master of the immune system for men as well as women. Oestrogen helps to turn inflammation on and off as required but also modulates the reaction to avoid a strong inflammatory chemical cascade. In PCOS, compared to controls, the threshold for inflammatory process activation is much lower. This inflammation can create all sorts of gut issues including toxicity and permeability resulting in dysbiosis and it’s many associated issues.
The underlying cause
Genetically a mild defect in oestrogen production was an evolutionary benefit as slightly higher testosterone made women a little less fertile (fewer children) as well as stronger and braver. Modern times, chemical toxicity and the modern Western diet have twisted this advantage into a modern disease.
Many of the issues above start with metabolic dysfunction, which is the process of converting food into energy, in the gut and the liver.
The research is showing that plastics, phthalates (plasticisers), BPA, BPF, herbicides, heavy meals and air pollution present in the environment, in utero and during puberty cause hormonal and metabolic disruption, especially in women who are predisposed. These EDC’s can block, mimic or interfere with the body’s hormone system causing many health problems.
2. Microbiome
The gut lining and the enteric nervous system have oestrogen receptors which play a key role in the metabolism of food into energy. Low oestrogen levels can result in gut dysbiosis, gut permeability and poor gut motility (constipation). These factors in turn can lead to an increase in toxicity and inflammation for the liver to deal with.
3. Liver function and jet lag
Oestrogen is the master clock hormone and it co-ordinates our metabolic function in tune with our circadian rhythm. Over a third of our genes are clock genes and many others interact with these (60%). Dr Felice Gersh describes the body and it’s organs as an orchestra all tuned to our inbuilt circadian rhythm. Each and every one of your gut microbes (bacteria) has it's own circadian rhythm. So without sufficient oestrogen and poor absorption of what is produced, the body’s metabolism malfunctions. It thinks it’s day when its night and vice versa. Remember how awful you feel when you have jet lag? It’s the same scenario just a different cause.
The absence of food at the correct time is highly stressful, so the body will trigger cortisol. In response to this the liver will manufacture its own sugar (gluconeogenesis), for energy to respond to the ‘stressor’. This means the liver pours out sugar overnight thinking it is daytime, which triggers insulin which then stores as fat. In time this can lead to fatty liver. It is this overloaded and confused liver which results in the downstream effects of insulin resistance, poor detoxification and immune dysfunction known collectively as metabolic dysfunction.
Why weight gain and infertility are such a problem
1. Weight gain
PCOS sufferers are susceptible to weight gain for a number of reasons. Oestrogen regulates energy control (metabolism) and also appetite so low levels can result in increased appetite and poor energy generation. When we are tired we often over eat. In addition there may be insulin resistance which leads to fat storage. The metabolism and regulation of energy becomes very dysregulated hence the weight can increase. There are different types of PCOS however and a lean PCOS syndrome has also been identified.
2. Infertility
In addition to low oestrogen production the receptors for oestrogen often malfunction in PCOS sufferers. Every organ in the body has oestrogen receptors and oestrogen connects metabolic and reproductive mechanisms. Pregnancy is inherently a metabolic stressor and in PCOS there are already many metabolic issues. Infertility is therefore a common downstream issue.
Recovery strategy
It can seem like a rather depressing picture and PCOS sufferers do have a lot of work to do. But the good news is by paying attention to diet and lifestyle there is a great deal that can be done.
PCOS can be helped dramatically with resetting circadian rhythm via obtaining light at the right time and eating at the correct times. In one study insulin and testosterone fell by over 50% in one month just by changing the structure of meals.
There are also various eating strategies which can ease pressure on the liver and help to regulate insulin function. Eating a very nutrient dense diet helps the microbiome to flourish so it’s important to work on the quality of food as well as the diversity and quantity. There are lots of therapeutic ways to nourish and rebuild the gut lining which in turn helps with reducing toxicity and supporting the immune system. We also work to support the liver which controls insulin production and whether we burn glucose or fat for energy.
In addition there are several supplements which I have found can really support clients with their energy generation and regulation and help with cortisol regulation. This does two things. It gives the client hope and also with less fatigue they have more energy to make the changes required.
Finally stress management is key as nervous system sympathetic tone is important. So breath work and meditation, yoga or alternative techniques can all help with this.
So the message is one of positivity and hope. By working in a personalised way we can support the body to make the changes required in a way that suits each individuals physiology and lifestyle.
References:
Parker et al, (2022) Polycystic Ovary Syndrome: An Evolutionary Adaptation to Lifestyle and the Environment Int. J. Environ. Res. Public Health 2022, 19(3), 1336; https://doi.org/10.3390/ijerph19031336
The results are in. This (2019) study involved 20 adults following either an ultra-processed (UPF) or unprocessed diet for 2 weeks at the NIH Clinical Centre. This was followed immediately by 2 weeks of the alternate diet. The diets were matched for nutritional composition: calories; energy density; macronutrients; sugar; sodium and fibre and participants were free to eat as much as they liked.
Despite composition matching, subjects on the UPF diet consumed an average of 508 extra calories per day, comprising more carbohydrate and fat, but not protein. Participants gained more weight during the UPF diet, an average of 1kg, and lost weight during the unprocessed diet. This implies that there is something about the processing itself which causes a metabolic issue.
Other interesting points to note were:
During the UPF diet
• The eating rate was faster
• Sodium consumption increased
• To compensate for the lower fibre level and match fibre intake for both diets, beverages with dissolved fibre were given
• Body fat mass increased
During the un-processed food diet:
• Appetite suppressing hormone increased
• Hunger hormone decreased
• Total cholesterol decreased
• Inflammation markers decreased
• Fasting glucose and insulin levels decreased
One thing is clear. Whilst there is much conflict about which diet is the ‘best’ the whole world seems to agree that avoiding processed foods is a good thing.
Refs: Hall, K. D. (2019) Ultra-processed diets cause excess calorie intake and weight gain: An inpatient randomised controlled trial of ad libitum food intake. Cell Metabolism; 30(1) pp. 67-77. e3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7946062/
A lot of my clients rely on white rice or pasta for quick meals. I thought I would write this blog about the benefits of brown rice and how to prepare it. Hoping to convince you all that brown rice is the way forward.
Brown rice is a whole grain and a major source of complex carbohydrate, fibre, minerals and B vitamins. Once the husk is removed the rice is sold as whole or brown rice. Otherwise it is milled and polished at least three more times to remove the bran and the germ from the endosperm, producing white rice.
1. Slower energy release
White rice is quickly digested to sugar increasing the potential for blood sugar spikes which are associated with increased risk of type 2 diabetes and insulin resistance. The carbohydrate in brown rice is wrapped in fibre which our bodies can’t digest. This means brown rice is digested to sugar much more slowly with a much slower release of energy.
2. Fitter and fuller with fibre
Whole grains and fibre keep us full for longer which can help with weight management and keep our gut bacteria happy. This is turn supports our immune system, mental health and risk of multiple chronic diseases.
3. Good for the heart
The British Heart Foundation says: “Higher intakes of fibre are also associated with a lower risk of heart and circulatory disease, and some cancers.” Brown rice may therefore improve heart health due to its fibre content as well as another specific compound found in its outer layers.
4. Packed with nutrients
Most of the nutrients in a whole grain of rice can be found in its outer layers which are removed during the production of white rice. So brown rice is more nutritious being a better source of vitamins and minerals, including calcium, iron, phosphorous, magnesium, selenium, vitamin B1 (thiamine) and vitamin B6 (pyridoxine). Brown rice has 10 times the amount of B1 compared to white rice unless it is fortified. Vitamin B1 deficiency (beriberi) has been known to affect populations with a heavy reliance on white rice. This affects the heart, nerves and the muscles.
The protein content and the quality of whole grains is also much greater than that of refined grains.
5. Antioxidant supply
In January 2023, researchers identified the main antioxidant of brown rice as cycloartenyl ferulate (CAF). This not only protects cells it also boosts the production of antioxidants within other cells.
CAF is hybrid compound of two different types of antioxidant (polyphenols and phytosterols) which may help lower cholesterol levels, suppress inflammation and reduce chronic disease risk.
6. Soaking
This not only reduces cooking time but lowers the arsenic content which can be high in rice according to the FDA. The soaking also makes the nutrients in rice more absorbable because it helps to remove the phytic acid content. The latter can combine with minerals such as magnesium and zinc and block their absorption. Whole grains are effectively seeds so they contain enzyme inhibitors which are activated by water and warmth in preparation for growth. Soaking in essence pre-digests the grain making it’s nutrients more readily available.
I personally soak brown rice overnight if possible with water and a dash of lemon juice or apple cider vinegar. Even a few hours is helpful if I forget the night before. I am constantly surprised when discussing this with my older clients how many will tell me that their parents used to do this. We seem to lose many of our food traditions with the speed of modern life.
7. Leftovers
Cool quickly and store in fridge within an hour of cooking. Eat within 24 hours or you can freeze it. Defrost it in the fridge and reheat thoroughly.
