How to support focus and attention

My youngest son is about to do his finals so I thought I would investigate the latest literature on L-theanine. It is reputed to support all the mental processes associated with gaining knowledge and comprehension of a subject, which are collectively known as cognition. L-theanine is a non-protein amino acid, found in the leaves of the tea plant Camellia sinensis.

Attention and performance

This review considered the literature and clinical trials and looked at outcomes related to attention, inhibitory control, mind-wandering, cognition and mood.

They found that alertness rating increased whilst those for headaches and tiredness reduced. Participants were able to carry out a greater amount of work, leading to the conclusion that overall attention and work performance both increased.

Some of the trials combined the L-theanine with caffeine for synergistic effects.

Stress and relaxation

Previous studies have reported that consumption of L-theanine can help to aid relaxation, without causing sedation or adversely impacting cognitive function. L-theanine is reported to cross the blood brain barrier and improve GABA levels. GABA is the primary inhibitory neurotransmitter in the central nervous system, acting as the brain's 'brake pedal' to reduce neuronal excitability and promote calmness. It play a crucial role in controlling anxiety, stress and fear.

Sleep

Sleep is essential for overall wellbeing but is also critical for cognitive function. A more recent study found that L-theanine is also a safe and effective way to support sleep, including measures linked to falling asleep more easily, maintaining sleep as well as feelings of sleep satisfaction, refreshment and recover on waking.

Quick summary

In a nutshell it decreases anxiety and stress with no known side effects. Dosages were between 200-450 mg/day and studies reveal the following actions:

We all need a little extra support sometimes and needless to say with exams looming I have treated him to a pot and he is finding it very helpful.

I am of course also a huge fan of breathwork for resetting the nervous system and to intercept the panic that can well up if we 'freeze' in the exam room. You can find out more about that here or get in touch, I'd love to hear from you.

Refs:

Sohail, A. et al. (2021) The cognitive-enhanving outcomes of caffeine and L-theanine: A systematic review. Cureus: Dec 30;12(12):e20828.

https://www.tandfonline.com/doi/full/10.1080/1028415X.2025.2556925#abstract

Why I trained in breathwork

The history

Until I learnt about the science of breathing, I really didn’t give breathing or how I breathed much thought.

If I ran up the stairs or if the gardening got a bit physical, it was just easier to open my mouth. No one told me not to!  I just didn’t think about it. We humans tend to take the easy option especially if we can’t see a reason not to.

The only other time I would think about breathing was if I was in an exercise class. If it ended with a relaxation the instructor might guide our attention to  follow the breath, perhaps breathing deeper or slower.  What I didn’t understand was that this mattered all day, every day, for every breath. That with every in-breath I took, my stomach and diaphragm should move out and down, and that the number of breath’s I took per minute was important.  Quite honestly I hadn’t understood any of this and yet it is a fundamental aspect of our physiology and therefore our health. 

The main reason

When I first trained in breathing the main reason I did so was because I knew that addressing oxidative stress, created as a by-product of metabolic processes, was critical for the body to function well. Our digestive system and the absorption of food is one the core metabolic processes. Your diet and your antioxidant balance is critical for this, but what about the oxidative stress caused by breathing? This is another essential metabolic process, perhaps even more important than food, given that most of us cannot survive more than a few minutes without it. What if, as well as ensuring sufficient antioxidant intake, you could minimise the creation of oxidative stress by breathing correctly?  It was this thought process that led me to explore breathwork.

Disordered breathing

How people breathe is frequently disordered, and this can have a negative impact on cellular and organ oxygenation, especially your muscles. This means cells and organs may not assimilate and process nutrients correctly or in sufficient amounts to function well. This can also impact any physical activity you undertake and especially if you are doing fitness or sports training or going to the gym. 

Poor breathing patterns also have a detrimental effect on the nervous system and your stress and anxiety levels, especially upper chest breathing. This is partly because it activates your fight/flight system but it’s also a chemical issue. Most of your alveoli are at the bottom of your lungs and if the breath is too shallow the oxygen doesn’t get to them.

Your heart rate variability measurement, which is how flexible and adaptable your heart is to changes in demand, is also affected by your breathing pattern. This makes sense as breathing and the heart are closely linked (see blog). There is even research to show that the number of breaths you take per minute affects your life span. Contrary to what you might think, breathing in lower levels of oxygen and taking fewer breaths per minute enhances longevity.  So, if you want to live longer you need to breathe better.

Key aspects of breathing

There are three key aspects to breathing:

Positive effects on the body and mind

There are many positive effects on your body and mind when functional breathing patterns are re-established. Here are a few to think about:

Refs: https://pmc.ncbi.nlm.nih.gov/articles/PMC12727135/

Nutrition for cognition

March 15th to the 21st was officially brain health awareness week.  You may or may not have noticed this but most people I meet know someone, or have a family member suffering from conditions such as Alzheimer’s or dementia.  I recently did a ‘nutrition for cognition’ training course with PharmaNord UK and thought I would summarise some key take aways. Some of them may surprise you.

Depending on my clients’ issues and symptoms I tend to focus on the following

We may also look at hormone balance; toxicity levels and liver function; the microbiome balance and gut function; as well as levels of fatty acids in the blood.

It all depends on what my client needs at this point in time.

My advice is always personalised and tailored to my client’s life circumstances, budget and personal preferences.  We are all so unique. It’s also designed to be practical with many recipes, handouts and hints to simplify the changes they need to make.

You can contact me here or find out more about the process here and here.

Minerals matter for cognition

A recent study examined the data from the UK National Diet and Nutrition Survey (2019-2023) and found that average intakes of 7 minerals were below the recommended nutrient intake (RNI). They included iron, selenium and magnesium, three important cognition minerals.

Reference

Iron and cognition

Iron is important for cognition because iron rich haem groups in the red blood cells carry oxygen to the brain. In 2023-24 there were 191,927 hospital admissions where the main reason was a lack of iron. This is almost 10 times the admissions in 1998-99.

I prefer to check ferritin levels (of iron storage) before supplementing however as too much iron is toxic to the cells.

Magnesium and cognition

Average magnesium intakes fell below the RNI benchmark. Over one in 10 adults aged 20-59 had magnesium intakes below the lower reference nutrient intake (LRNI).  Most people require the RNI, the LRNI only applying to 2.5% of the population the majority require the RNI. This deficiency was split 15% males and 12% females but for adults in their 20’s this figure rose to 1 in 5 (19%).

Magnesium levels below 0.75 mmol/L are associated with an increased risk of cognitive decline whilst those in the upper-normal range were protective.

Reference

Selenium and cognition

Research shows that in cases of selensium (Se) deficiency, the organ which remains Se replete for the longest is the brain. This suggests that Se plays an important role in brain function.  After supplementation of Se plus other nutrients, improvement in cognitive tests was observed in both Alzheimer’s and mild cognitive impairment patients. The window for over prescribing is however very small. I like to utilise food source to avoid any risk of toxicity.

Reference 1; Reference 2

Are you concerned about your cognitive function?  Perhaps you forget things here and there or experience brain fog.  The good news is there is so much that can be done.  You can get in touch here for more information or to see if I can help you.  There is more information here on nutritional therapy in general.

Helen Maxwell nutrition

The breath and heart function

Breathing is intimately connected to your how your heart functions. It affects gas exchange, circulation and blood flow which are all very important for the heart to operate well.  

The average person has approximately 60,000 miles of blood vessels including arteries, veins and capillaries.  It’s incredible to think that if this network was laid out flat it would circle the Earth more than twice.  The problem when we breathe too shallowly or too fast is that these vessels contract.  This means the heart has to work harder to make sure sufficient blood circulates to oxygenate your body as the narrowed blood vessels incur resistance.

If our breathing is erratic rather than rhythmic this also affects our hearts performance, especially our heart rate variability (HRV).  This is a measure of how easily your heart can adapt to changes in the demands placed on it. The more adaptable your heart is, the higher your HRV and the lower your cardiovascular (CVD) risk. Slow and regular breathing also helps to normalise our blood pressure, especially if you already have high blood pressure (hypertension).

Finally breathing in a healthy and functional way helps to oxygenate your heart and body properly. When we breathe through the nose we improve our levels of CO2 and nitric oxide which helps to relax our blood vessels. The exchange of oxygen between the body tissues and the blood takes place according to the concentration gradient between these two gases.  If our levels of CO2 are depleted from breathing too fast this exchange is hampered.  The yogi’s of old knew how important breathing was for health even if they didn’t know the science behind it. 

The good news is that you can retrain your breathing with various breathing exercises.  It’s not hard it just takes a little dedication and commitment to practice.

Here’s a summary of the five main ways breathing correctly helps your heart.

Blood vessel relaxation and flexibility

Healthy levels of CO₂ relax your blood vessels and this expansion increases blood flow to the heart. This means the heart does not have to beat as fast or generate as much pressure to move blood around the body. Think of the toothpaste analogy or those tubes of filler we use when we are decorating. The smaller the hole in the tube the more pressure we have to put on the tube.

Improves heart rate variability (HRV)

Studies show that regular, paced breathing improves heart rate variability (HRV). This is a measure of how adaptable your heart is to your bodys’ needs. A higher HRV has consistently been associated with lower cardiovascular (CVD) risk.

Improves vagal nerve function

The vagus nerve carries message both to and from the body. Breathing correctly improves nervous system function and balance. This in turn reduces the stress load on the heart thereby improving it’s resilience.

Helps to normalise blood pressure

Slow breathing lowers the heart rate and both systolic and diastolic blood pressure.

Oxygenates the heart

It’s not just about the air volume you breathe, it’s about how well you can oxygenate your heart.  Nasal breathing improves CO₂ and nitric oxide levels which stimulate blood vessel relaxation (see point 1). This improves gas exchange, circulation and blood flow which are all very important for heart function.

If you struggle with your breathing or any of the issues mentioned here please get in touch, I would love to hear from you. There is more information on breathwork here. You can get in touch with me by all the usual channels or via my website.

Get in touch

How breathing affects your heart

Heart health is something we often don’t think about until there is a problem. We all know that nutrition, exercise and stress management is important for heart health. Much less understood is that how you breathe impacts the heart. This is something you can train and ultimately have control over.  As the old saying goes ‘prevention is better than cure’! So lets find out how your breathing affects your heart function over time.

The heart and lungs work as a team.

The lungs oxygenate the body and remove carbon dioxide. The heart distributes this oxygen to every cell in the body via the blood. It then picks up the carbon dioxide to be exhaled by the lungs. This bi-directional exchange means that changing how you breathe influences how the heart behaves.

As you breathe in, your heart rate naturally speeds up. As you breathe out, it slows down. This normal rhythm is controlled by the vagus nerve which controls our autonomic nervous system (ANS). Our ANS runs all the automatic processes in the body which you never have to think about, but they keep you alive and functioning.

Your breathing rhythm

When this rhythm is strong and flexible, the nervous system works well. This means the heart can adapt to changes in demands placed upon it by activities, exercise, stress or emotions. When breathing is fast, shallow, or irregular, this rhythm weakens and puts more strain on the heart.

Breathing affects your blood chemistry

Breathing also changes carbon dioxide (CO₂) levels in the blood. CO₂ is not just a waste gas, it regulates blood flow and oxygen delivery.  When we breathe fast CO₂ levels drop, blood vessels constrict, and the heart must work harder to keep blood moving. If this becomes a habit, dysfunctional breathing patterns establish themselves affecting heart rate and blood pressure. This increases the workload on the heart, hampering its’ performance.

So how does breathing properly actually help?

Blood vessel relaxation and flexibility

Maintaining healthy CO₂ levels relaxes your blood vessels. This allows them to expand so the blood flow to the heart increases. This means the heart does not have to beat as fast or generate as much pressure to move blood around the body. Think of the toothpaste analogy or those tubes of filler we use when we are decorating. The smaller the hole in the tube the more pressure we have to put on the tube.

Improves heart rate variability (HRV)

Studies show that regular, paced breathing improves heart rate variability (HRV). This is a measure of how adaptable your heart is to changes in your body’s needs. A higher HRV has consistently been associated with lower cardiovascular (CVD) risk.

Improves vagal nerve function

This improves nervous system function and balance. This in turn reduces the stress load on the heart, improving it’s resilience.

Helps to normalise blood pressure

Slow breathing lowers the heart rate and both systolic and diastolic blood pressure, especially if you already have hypertension.

Oxygenates the heart

It’s not just about the air volume you breathe, it’s about how well you can oxygenate your heart.  Nasal breathing improves CO₂ and nitric oxide levels which stimulate blood vessel relaxation (see above). This improves gas exchange, circulation and blood flow which are all very important for heart function.

If you think your breathing might be disordered or you are struggling with your blood pressure or general breathlessness please get in touch to see if breathwork can help you.

Get in touch

Low stomach acid - signs and symptoms

There is quite a long list of symptoms that may be related to or caused by low stomach acid. Just because you have these symptoms doesn’t necessarily mean low stomach acid is the issue.  Some of these symptoms can be caused by other factors. But it is worth investigating and considering or discussing with your health practitioner to see what they think.

This is not an exhaustive list but some of the most common acid reflux and GERD symptoms include the following.

Symptoms that may mean you have low stomach acid:

Many of these symptoms are downstream effects where the root cause can be traced back to low stomach acid or issues with digestive function.  Over time they can build up as one symptom can lead to another and so on. Everything in the body is designed to work in sync. So one thing goes out of balance there is a kind of knock on effect on many other systems in the body.

Unfortunately, it’s not always as simple as just rectifying the stomach acid levels, as once people start to experience reflux this can cause very distressing painful symptoms. It needs a kind of targeted approach working on many different areas with different strategies and specific supplements. I will put together a top ten list to help you get started so look out for this.  

Five ways your breathing affects your heart

Here’s a summary of the five main ways breathing impacts how your heart functions.

Blood vessel relaxation and flexibility

Healthy levels of CO₂ relax your blood vessels and this expansion increases blood flow to the heart. This means the heart does not have to beat as fast or generate as much pressure to move blood around the body. Think of the toothpaste analogy or those tubes of filler we use when we are decorating. The smaller the hole in the tube the more pressure we have to put on the tube.

Improves heart rate variability (HRV)

Studies show that regular, paced breathing improves heart rate variability (HRV). This is a measure of how adaptable your heart is to your bodys’ needs. A higher HRV has consistently been associated with lower cardiovascular (CVD) risk.

Improves vagal nerve function

The vagus nerve carries message both to and from the body. Breathing correctly improves nervous system function and balance. This in turn reduces the stress load on the heart thereby improving it’s resilience.

Helps to normalise blood pressure

Slow breathing lowers the heart rate and both systolic and diastolic blood pressure.

Oxygenates the heart

It’s not just about the air volume you breathe, it’s about how well you can oxygenate your heart.  Nasal breathing improves CO₂ and nitric oxide levels which stimulate blood vessel relaxation (see point 1). This improves gas exchange, circulation and blood flow which are all very important for heart function.

The good news is that you can retrain your breathing patterns to be functional and optimal for your heart and your health overall. There is more information on breathwork here.

Please get in touch for more information or to book a session.

Get in touch

Nutritional support for post-surgery

I frequently support clients who have either had or are going to have operations.

It is common knowledge that your nutritional status and health prior to an operation has a big impact on the outcome of surgery and your recovery post operation. It is estimated that between 24% and 65% of patients are malnourished and unfortunately this tends to increase during hospital stays. Nutritional supplementation has been shown to reduce hospitalisation costs being associated with fewer complications and shorter stays.

I have recently been researching this area for a client with impending surgery This blog is focused on protein and carbohydrate requirements post operation. I will consider micronutrient status in a future blog.

Some degree of muscle loss post-surgery is inevitable. Skeletal muscle serves as the primary source of essential amino acids. If protein intake is below the requirement to sustain daily functions the body will breakdown muscle for protein. To compound this the hormonal stress response following surgery can prevent normal protein generation. All of this is often complicated further by the forced rest and immobility due to the surgery itself.

It is important to try to minimise the muscle loss and if exercise is not feasible nutritional strategies can help to mitigate this.  In healthy individuals, loss of muscle tissue begins to occur in as little as 48 h of inactivity, with significant loss within five days. This is followed by loss of strength and functionality.

Post-surgical amino acid supplementation has been shown to effectively reduce the turnover of whole-body protein and muscle breakdown, and to stimulate an increase in protein generation.

General guidelines for nutrition post surgery

The goal of post-operative nutrition, on the other hand, is to promote nitrogen balance, reduce the loss of lean muscle mass, and facilitate rapid healing and recovery. The guidelines given here are aimed at minimising some of the metabolic consequences of surgery, using nutritional supplementation to overcome some of the issues that whole foods would otherwise present.

The post operative nutrition model is basically the reverse of the preoperative model.

In the early post-surgery period, patient appetite is often suppressed making consumption of solid foods difficult. During this time, free form EAA’s may help to support the immune system. Patients can transition to protein shakes and sports drinks until they are able to consume whole food sources or meals.

During the rehabilitation period, protein intakes of at least 1.6 g/kg/day and up to 2.0–3.0 g/kg/day is generally recommended. If appetite is reduced and this goal is difficult to meet then consumption of EAA’s and/or protein shakes between meals can help to optimise protein and nutrient intake.

Conclusion

In conclusion protein intake supplies the amino acids needed for wound healing, immune function and preservation of muscle mass.  Following surgery, free form amino acids plus supplementary dietary protein can help to support protein generation and an increase in whole-body protein. Depending on proximity to surgery different sources of protein can be used to maximise nutritional intake. Supplemental sources can be useful to support intake during periods when whole foods are not tolerated.

This blog is written to help inform about nutritional needs post-surgery and is based on scientific rationale. However much of this research is relatively new and further research and trials are needed to elaborate. Therefore this information does not override any medical guidelines given directly to prepare for or recover from planned surgery. These will supersede this information unless your medical team are happy to sanction otherwise.

References

https://pmc.ncbi.nlm.nih.gov/articles/PMC8156786/figure/nutrients-13-01675-f003

Pre-operative nutrition

I frequently support clients who have either had or are going to have operations.

It is common knowledge that your nutritional status and health prior to an operation has a big impact on the outcome of surgery and your recovery post operation. It is estimated that between 24% and 65% of patients are malnourished and unfortunately this tends to increase during hospital stays. Nutritional supplementation has been shown to reduce hospitalisation costs being associated with fewer complications and shorter stays.

I have recently been researching this area for a client with impending surgery This blog is focused on protein and carbohydrate requirements pre-operation. I will consider micronutrient status in a future blog.

Surgery is stressful and our energy demands increase.  To cope with this our sugar stores (glycogen) are rapidly burnt from the liver and muscle. This can lead to significant skeletal muscles loss and some degree of this post-surgery is inevitable.

There some easy strategies you can implement though to help with muscle preservation and to support and accelerate healing.  Carbohydrate consumption pre-operation helps to:

General guidelines for nutrition before surgery

The goal is to prepare the body for the stress of surgery, support increased metabolic demand, whilst offsetting the consequences of the breakdown of body protein. The goal of pre-operative nutrition is to ensure adequate energy stores to meet the demands of the stress state. The guidelines given here are aimed at minimising some of the metabolic consequences of surgery, using nutritional supplementation to overcome some of the issues that whole foods would otherwise present.

7-10 days prior to surgery - emphasise high-quality carbohydrate and protein intake to ensure optimal nourishment. To maximise glycogen stores, the sports nutrition model suggests consuming ~60% of total energy (8 g per kg body mass) per day of carbohydrate for a minimum of 3–4 days. Protein intakes of 1.2–2.0 g/kg/day, from high-quality protein sources distributed throughout the day (20–40 g of protein per meal) is recommended to help ensure protein needs are met. 

6-12 hours before surgery – consume a well-rounded meal emphasising complex carbohydrates and high-quality protein.

6 hours before - begin abstaining from whole foods, but continue to consume protein and carbohydrate containing beverages, such as a protein shake, a sports drink, or chocolate milk. Since modified carbohydrate supplements rapidly empty from the stomach, consumption may sustain glucose levels for the duration of surgery.

2-4 hours before – It is suggested to ingest free form essential amino acids (EAA’s) to promote a positive protein balance. EAA’s contain all nine essential amino acids and do not require digestion.

Conclusion

In conclusion carbohydrate intake supports the increased post-surgical metabolic (energy) demand and wound healing. Protein intake supplies the amino acids needed for wound healing, immune function and preservation of muscle mass.  Combined amino acid and glucose intake can help to mitigate muscle loss and strength, especially prior to surgery. Depending on proximity to surgery different sources of carbohydrate and protein can be used to maximise nutritional intake. Supplemental sources can be useful to support intake during periods when whole foods are not tolerated.

This blog is written to help inform about nutritional needs pre-surgery and is based on scientific rationale. However much of this research is relatively new and further research and trials are needed to elaborate. Therefore this information does not override any medical guidelines given directly to prepare for planned surgery. These will supersede this information unless your medical team are happy to sanction otherwise.

References

https://pmc.ncbi.nlm.nih.gov/articles/PMC8156786/figure/nutrients-13-01675-f003