The Dirty Dozen and Clean Fifteen

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Every year the Environmental Working Group release a list of the produce that contains the most amount of pesticide residues, as well as a list of the least sprayed produce. This is The Dirty Dozen and Clean Fifteen list (which has expanded beyond the number in the title, but I guess the name’s just too catchy to change it!). This is a really useful resource to help shoppers choose the most important produce to buy organic, and to know what is relatively safe to buy in conventional non-organic forms. I’m including this here so that you can be armed with the knowledge necessary to make informed decisions on produce next time you’re browsing the supermarket aisles. Note that this list is American and so rockmelon is called canteloupe and capsicum is called sweet bell pepper, however the agricultural methods used to farm the items listed are shared across most countries. This is a guide to fruits and vegetables only. If you want to read more on the healthy options for other shopping necessities such as meat, eggs, dairy, breads and condiments, I encourage you to sign up to receive my email series ’10 Steps To A Healthier Life’ – Healthy supermarket shopping is step one.

Dirty Dozen & Clean Fifteen

Shop wisely!

In wellness

James

Hypothyroidism and Hashimoto’s Thyroiditis

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Hypothyroidism is one of the most prevalent disorders of the endocrine system worldwide, although its causes can differ significantly according to region. It can affect women at twenty times the rate of men, and may become particularly prevalent in the elderly. Although medical statistics place the rate of this condition at roughly 2.5% of the population, it may be argued that this grossly under represents the true prevalence. This is due to the fact that hormonal markers used to determine hypothyroid status are generally placed at the extreme end of triggering potential, thus missing a broad swathe of individuals experiencing sub-clinical manifestations of the disease. It is a truly multi-faceted and complex disease process, with many varied factors that can initiate and sustain it. As always, the treatment options listed here are only intended as a starting point to explore your own individual journey to recovery while working with an appropriate health professional.

Hypothyroidism – not simply a condition of insufficient thyroid hormone

The first important point to make is that Hypothyroidism is rarely simply a case of the thyroid gland not producing enough thyroid hormones (T4 & T3). This process is only a minor part of a much more complex interplay of hormones and neurotransmitters that eventuate in the cellular triggering that is the end game of thyroid activity. Initially, the hypothalamus (a region of the brain) must produce Thyrotropin Releasing Hormone (TRH). This then triggers the pituitary gland to produce Thyroid Stimulating Hormone (TSH), which in turn stimulates the thyroid gland to produce the thyroid hormones T4 and T3 (although the latter is produced in much smaller amounts). T4 is a relatively low activity thyroid hormone which must be converted to T3 in the liver, kidneys, gut, and other tissues for sufficient stimulating capacity in the body, and must be transported from the thyroid gland by Thyroid Binding Globulins (TBG) to reach these tissues. Each of these steps can be confounded by a number of factors, thus creating a hypothyroid presentation that will differ with every individual.

Autoimmunity the number one ’cause’ of hypothyroidism in the West

Although globally the number one cause of hypothyroidism is insufficient dietary intake of iodine (a crucial mineral in thyroid hormone production), in Western countries where this dietary deficiency has been largely eradicated the primary cause is an autoimmune reaction to the tissues of the thyroid gland, commonly presenting as Hashimoto’s Thyroiditis. I use inverted commas around the word ’cause’ in the subtitle as there are clearly underlying factors causing the autoimmunity itself. These factors are varied, however there are some common drivers that should be considered in most cases.

Firstly, reactivity to food allergens should be investigated, especially gluten. Gliadin (a protein found in gluten containing foods) has a striking molecular similarity to thyroid tissue, and as such a coeliac presentation or even gluten sensitivity may trigger a subsequent attack on the thyroid gland. Other dietary triggers such as dairy, egg, nuts, fish and artificial colours and flavours should also be investigated through IgE and IgG sensitivity panels as well as monitored elimination diets. Gut permeability should also be considered as a predisposing factor in the development of a food sensitivity or allergy, and appropriate healing protocols and dietary applications such as the GAPS diet should be utilised where appropriate.

Exposure to toxins such as lithium, mercury, fluoride, BPA, teflon and perchlorate (used in rocket fuels and explosives) can also trigger a thyroid autoimmune presentation. Detailed health and exposure history should be taken to determine whether appropriate detoxification measures may be called for.

Although insufficient dietary iodine can be a cause of hypothyroidism, an overload of iodine can in fact precipitate a Hashimoto’s presentation (especially when present alongside a deficiency of selenium, another crucial mineral in thyroid hormone production and transportation).

The complex interplay of hormones

Another possible cause of hypothyroidism may be fluctuations in other hormones, specifically oestrogen and testosterone. Elevations in oestrogen can increase Thyroid Binding Globulin, which in turn can decrease the availability of circulating T4 and T3. The use of the oral contraceptive pill, pregnancy, hormone replacement therapy, and the drug tamoxifen can all cause this increase in TBG. Assisting liver clearance of excess oestrogen may be a helpful therapeutic strategy in this case. Testosterone on the other hand can decrease TBG, which on the face of it should increase free circulating thyroid hormones and possibly cause a hyperthyroid symptom picture. In reality, however, a cellular resistance to thyroid hormones tends to develop and thus precipitate hypothyroidism. Polycystic ovarian syndrome and insulin resistance can be primary causes of increased levels of testosterone.

Excessive stress or an active infection may cause an overproduction of cortisol, in turn suppressing pituitary gland activity and therefore decreasing thyroid hormone production. Hypoglycaemia and insulin resistance can also trigger excessive cortisol production. Hyperglycaemia however will drive up the production of the hormone insulin which can in turn damage thyroid tissue.

Inflammation as an inhibitor of cellular response to thyroid hormone

Inflammation can interfere with the function of all body systems, and specifically the highly sensitive cell membranes, and this may affect thyroid hormone status in three ways. Firstly, inflammation can suppress the entire hypothalamus-pituitary-thyroid axis, thus interfering with all steps of thyroid hormone production. Secondly, the conversion of T4 to T3 takes place in the cellular membranes and can thus be diminished. This means less highly active thyroid hormone in circulation and interacting with the cell receptors. Thirdlly, cellular inflammation can affect the thyroid hormone receptor activity in the membrane and thus diminish cellular response. Inflammation is such a common presentation in modern society that it is surprising (and testament to the robustness of our physiology) that more people do not present with full blown hypothyroidism. An individualised approach to reduce drivers of inflammation should be a part of any hypothyroid treatment strategy.

As you can plainly see, a presentation of hypothyroidism can be much more complex than at first assumed. Treatment with just a synthetic hormone replacement is unlikely to offer complete recovery (although it can be an important part of the treatment strategy). I’ll discuss some general treatment options from a naturopathic perspective, however as always it is important to work with a practitioner to determine your particular presentation and treat accordingly.

Diet and nutrition

Avoiding the consumption of foods that contain goitrogens is an important consideration in any hypothyroid presentation. These substances are found mainly in uncooked brassica vegetables (turnips, brocolli, kale, cauliflower, brussel sprouts etc.), soy milk, cassava, millet, pine nuts and peanuts, and can interfere with thyroid hormone production. The good news with the brassicas is that if you cook them the goitrogenic compounds are largely denatured and are rendered safe to eat.

As discussed above, removing gluten from your diet is highly recommended due to a high prevalence of cross reactivity with thyroid tissue (especially in Hashimoto’s presentations). Some other proteins can also trigger this effect due to structural similarity with gluten. Other foods with which to exercise caution are corn, oats and rice. Dairy can also be a problem, especially milk with a high casein (a type of milk protein) content.

Sugar can be inflammatory and its consumption a major predisposing factor in the development of metabolic disorders. These are two strong reasons why the consumption of refined carbohydrates should be strictly limited in hypothyroid individuals. Swapping out processed foods with a high sugar content and artificial additives for fresh fruits and vegetables is a sure way to reduce exposure to refined sugar and increase your intake of anti inflammatory compounds.

Increasing consumption of foods naturally high in iodine, selenium and zinc such as seafoods, seaweed and organ meat is a great way to get the nutrients your body needs for thyroid hormone production.

Supplemental nutrients that can assist may include vitamins A, C, E and D, as well as zinc, selenium, iodine, iron and tyrosine.

Herbal medicine

The herbs used in treatment will vary depending on an individuals presentation, however I will list the main classes of herbs used in various aspects of intervention.

Bladderwrack is useful for its ability to raise serum iodine. Coleus is effective as a metabolic stimulant and can stimulate the thyroid gland.

Anti-inflammatory herbs such as curcumin and ginger can effectively reduce the body’s inflammatory load and enhance HPT axis function and cellular signalling.

Herbs to help promote liver clearance of oestrogens include milk thistle, globe artichoke, dandelion root and curcumin.

Herbs to support insulin production and those with metabolic syndrome include gymnema, coleus and fenugreek.

Anti-oxidant herbs such as pine bark extract and grape seed can protect thyroid tissue from damage and improve cellular membrane function.

Adaptogen and nervine herbs can help reduce the damaging effects of stress and include withania, rhodiola, passionflower and zizyphus.

Immune balancing herbs such as echinacea and hemidesmus can reduce autoimmune tendency. Immune enhancing herbs such as cats claw and pau d’arco may be indicated where a predisposing factor for Hashimoto’s is suspected to be an underlying infection.

Again, treatment options are as varied as an individual’s presentation and must be approached and administered under the care of a qualified practitioner.

I hope this helps you to see a hypothyroid presentation as more than just a lack of thyroid hormone production, and to begin the process of digging deeper to determine the true underlying cause of your own individual disease process.

In wellness,

James

Asthma: Natural Treatment Solutions

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In Australia, asthma is thought to affect around 10% of both children and adults. It is a chronic inflammatory disorder of the airways, characterised by wheezing, shortness of breath, chronic cough and airway obstruction. The severity of its presentation can vary greatly, from low grade easily controlled forms, to high grade chronic presentations that can result in significant and permanent airway remodeling. Medical treatment is primarily focused on the application of one or a combination of five classes of drugs: B2 agonists, anticholinergics, theophyllines, cromones and corticosteroids. Although these medical agents are crucial in managing severe and possibly life-threatening instances of asthma attack, they do not address the underlying causes of asthma for true therapeutic resolution.

Asthma can be triggered by a number of environmental and physiological factors

Like most disease and condition states, the development of asthma cannot be narrowed down to a particular trigger for all individuals. There tend to be a number of factors that will contribute to a biological terrain in which asthma may present, and these factors and their combinations will differ for everybody. There are, however, some key considerations to investigate when looking for the key to understanding and eradicating the individual asthma presentation.

Exposure to environmental triggers

More often than not, a person presenting with early onset extrinsic (atopic) asthma will have some form of sensitivity to an environmental trigger such as dust mite, cockroaches, animal dander, cigarette smoke or other airborne pollution, or pollen. Sometimes the trigger may be diet based, such as eggs, dairy, nuts, chocolate or chemical additives (especially dyes). In those with late onset intrinsic asthma the trigger may be cold air, exercise or airborne pollution. Unfortunately simply eradicating this trigger will not usually resolve the condition, as there tend to be predisposing physiological mechanisms that have allowed the sensitivity to occur in the first place. Investigating and removing environmental triggers is still an important step, but digging deeper and understanding the predisposing factors is the most important step in treatment.

Underlying factors for sensitisation

As is almost always the case in a naturopathic approach, it’s important to consider the gut. Hypochlorhydria (low stomach acid) may inhibit the adequate breakdown of food constituents (especially proteins). This can then set up an inflammatory reaction in the gut, and ultimately a widening of the usually tight junctions between stomach wall cells that normally regulate the substances entering circulation. As these larger proteins entering the bloodstream are sampled by immune cells (and especially if this happens consistently over a period of time) the foods or environmental sources from which they came are then considered invaders and their presence will set up an inflammatory immune reaction. A comprehensive digestive stool analysis (CDSA) may be helpful in determining digestive status.

Dysbiosis, or an imbalance of healthy and harmful gut microbiota, can also set up a tendency to inflammation and immune hyper responsiveness. Probiotics in the gut act as immune cell conditioners, offering themselves as sampling agents upon which the immune surveillance  ‘soldiers’ practice invader recognition and response. When these probiotics are not present in adequate numbers, the immune system will tend towards a more extreme response to relatively harmless substances.

An overgrowth of the common yeast Candida albicans in the gut may produce an acid protease that can act as an allergen and prime immune sensitivity.

Mental and emotional stress can also be a predisposing factor, by reducing the ability of the adrenal glands to produce adequate cortisol and adrenalin. Both of these hormones can be protective against bronchial constriction.

A deficiency of both oestrogen and progesterone may predispose females to asthma, as both of these hormones can act as smooth muscle relaxants.

A consistent dietary approach to reducing asthma incidence

Despite the varied triggers and sensitising factors listed above, the dietary approach to treating asthma is usually fairly consistent. It involves:

  • Reducing consumption of red meat
  • Reducing consumption of industrial seed oils
  • Reducing consumption of sugar
  • Eliminating consumption of artificial additives
  • Increasing consumption of cold water fatty fish
  • Increasing consumption of vegetables and fruits, ensuring a broad spectrum of colour

It can be helpful to undertake an elimination diet to determine specific foods that may trigger an asthma attack (this should be done under the care of a health practitioner). IgG and IgE food panels, as well as ALCAT food and chemical intolerance tests, may also be helpful in identifying specific triggers.

Nutritional supplementation

A primary focus of nutritional supplementation for asthma should involve broad spectrum anti oxidant therapy. Agents such as vitamin C, E and D, selenium, and CoQ10 are all beneficial. Magnesium acts as a smooth muscle relaxant. Fish oil is effective at dampening the inflammatory response. Probiotics (especially Lactobacillus rhamnosus) are effective at modulating the tendency to inflammation.

Herbal allies in asthma treatment

There are a range of herbs that can be useful in treating the symptoms of asthma, however as always they are of little use in resolving the condition if the underlying causes are not identified and treated. Some of the key herbs used are:

  • Ivy leaf: helps to relax the airways and expel mucous
  • Coleus: can decrease broncho-constriction
  • Tylophora: anti-histamine, reduces inflammation in the airways
  • Lobelia: stimulates production of adrenalin and noradrenalin
  • Boswellia: reduces systemic inflammation

As always any of the treatment approaches mentioned here should be applied under the care of a qualified health practitioner.

I hope this gives you a starting point to consider the various possible underlying causes of an asthma presentation, and hopefully encourage you to pursue further investigations to determine your own triggers and predisposing factors.

In wellness,

James

Sardine Super Food Spread

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Sardines are probably one of the most nutritious foods you can eat, but the problem is finding a way to make the little fellas taste good. This recipe has become a staple in our household. We always make sure we have the ingredients on hand to whip up a batch when in a pinch, and the best thing is that it is possibly one of the most nutrition dense meals we eat (and the easiest to make). The sardines provide omega 3, protein, calcium, magnesium, and various other essential minerals. The parsley provides vitamin K, vitamin C, vitamin A, B vitamins, and many detoxifying phytonutrients. The lemon provides vitamin C and its bioflavonoid cousins. And the olive oil provides some powerful antioxidants and healthy monounsaturated fats as well as vitamin E and vitamin K.  Generally we’ll spread this on a nice thick slab of toasted Sonoma spelt sourdough bread, but you can use it as a topping on pretty much any bread or cracker and it will always taste great. Our little girl will happily spoon the stuff straight into her mouth!

Ingredients

  • 1 tin of sardines (preferably in olive oil)
  • 1 small bunch of parsley
  • Juice of 1 lemon
  • A glug of olive oil
  • Pepper and Sea or Himalayan salt to taste

Method

Throw all of the ingredients into a food processor and whiz away. You’re looking for a consistency that isn’t watery (you may need to adjust the amount of olive oil you add according to the juiciness of the lemon and the amount of parsley you use) and spreads easily without making the bread soggy.

Eat it liberally and often – your body will thank you for it.

In wellness

James

Natural strategies for reducing cardiovascular disease risk

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Cardiovascular disease (CVD) is an illness of epic proportions. It is the number one killer of both males and females throughout the world (although cancer is catching up). CVD is actually an umbrella term for a range of conditions including coronary artery disease, heart attack, cardiac arrest, congestive heart failure, and congenital heart disease – however coronary artery disease is still the leading cause of death within the CVD grouping. The good news is that almost all of the risk factors for CVD are modifiable by dietary and lifestyle interventions, which I will be covering here.

Dietary risk factors for CVD – not what you may assume

Most assumptions regarding the dietary risk factors for CVD have until recently been fairly wide of the mark. Saturated fat and cholesterol have been targeted as the main culprits in the dietary causation of CVD, however most of the scientific literature simply does not bear this out (for more detail on this topic see my post The Cholesterol Myth). Rather, it is a diet high in refined carbohydrates, processed industrial seed oils, and chemical additives that seem to be the biggest causative dietary factors. Diets that are low in carbohydrates and high in healthy fats (more on these later) actually lower CVD risk by modifying several factors that play a role in its development. These include lowering serum triglycerides, fasting glucose, blood pressure, body mass index, plasma insulin and c-reactive protein.

A heart healthy diet – start with cutting the refined carbs

The number one dietary step for CVD prevention is definitely reducing the intake of refined carbohydrates. Cutting out the addition of white sugar to your morning cup of tea or coffee is the most obvious and transparent example of this, however the number of foods and beverages that contain an unhealthy level of these triglyceride and insulin raising agents is staggering. Most packaged and processed food will contain at least some added sugar (as well as the other two CVD culprits – industrial seed oil and chemical additives) so it pays to examine every ingredient panel before adding them to the grocery cart. Unfortunately many manufacturers will attempt to sidestep the listing of ‘sugar’ on their ingredient list by using an alternative such as fruit juice concentrate, evaporated cane juice, malt syrup, glucose, fructose, dextrose, corn syrup, caramel etc. Even more deceptively, the ingredient list may have a number of these sugars scattered throughout so that the sugar content seems lower than it actually is (the ingredients are always listed in descending order from the largest to smallest input). Luckily in Australia the government standards require food manufacturers to list some nutrients, including carbohydrates, in a nutrition panel with the quantity per serve plus the quantity per 100g. The carbohydrate content has a sub section stated as sugar which tells you the true volume of sugar, as some carbohydrates may be fibre (which is actually an important consideration for CVD prevention – see below). My advice is to look at the sugar content per 100g, as this basically gives you the percentage of sugar contained in the product.

nutrition panel

Here is a nutrition panel in which the total carbohydrate content is the same as the total sugar content. This means that there is no fibre contained within the product. Also note that the % of total sugar is 12.4% (12.4g per 100g)

nutrition panel - high fiber

Here is a nutrition panel in which the total carbohydrate content is 89.4g per 100g, but only 25.1g are listed as sugars. This is still a product that contains a whopping 25.1% sugar though so is far from healthy

My advice is to avoid anything that has more than 5% sugar listed in the panel (or 5g per 100g). Look out for foods that may be considered healthy such as yoghurt and muesli – more often than not these contain considerably high levels of sugar. Of course sugar laden soft drinks, cordials, and fruit juices are absolutely to be avoided.

Reduce your intake of industrial seed oils

These are another major causative factor for CVD (and another example of completely misguided public health policy). As I outline in step one of my email series Five Steps To A Healthier Life, industrial seed oils such as sunflower, safflower, corn, soybean, cottonseed and canola are all highly harmful. When used in processed foods, these oils are readily oxidised, in turn causing systemic inflammation in the body and especially in the cardiovascular system. This inflammation sets the scene for the formation of occluding plaques in the arteries and blood vessels, the main driver of CVD. Unfortunately the predominant (and incorrect) medical opinion that saturated fat from animal products is a major causative factor for CVD has meant that the public health focus (and in turn that of food manufacturers) has been to decrease the consumption of animal fats such as butter and tallow as well as full fat dairy products, and to increase the consumption of the plant based industrial seed oils mentioned above. A perfect recipe for increasing rates of CVD.

Again when buying processed and packaged foods pay close attention to the ingredient listing (unfortunately the nutrient panel does not list ‘fat from industrial seed oil’ but rather only differentiates the saturated fat proportion of total fat content). Obviously you want to look out for the seed oils listed above, but also be on the lookout for anything listed as ‘hydrogenated’ or ‘partially hydrogenated’. Avoid using any of these oils in your cooking (heat is a strong driver of oxidation), but also avoid their use generally as even exposure to air can cause most of these oils to go rancid in a short period of time. Margarine is a definite no-no as it is a perfect storm of hydrogenated industrial seed oils – choose butter instead as a healthy option. When cooking use stable fats such as butter, tallow or lard, or coconut oil as a plant based alternative. Olive oil is really your healthiest choice when it comes to heat free application such as salad dressings, but look out for extra virgin varieties as they have the highest antioxidant content and are therefore the most stable.

Increase your intake of fibre

 Dietary fibre, particularly soluble fibre, has the ability to bind to and lower cholesterol in the digestive tract. This can be beneficial in those with hypercholesterolaemia as it will reduce to formation of serum lipoprotein carriers (particularly LDL and VLDL). However as noted in my post The Cholesterol Myth this may have little benefit if the advice above is not followed due to the fact that serum triglycerides are far more likely to cause an increase in LDL and VLDL, and these are raised predominately by a high sugar diet. Psyllium husk, oatmeal and barley are all excellent sources of soluble fibre. Fruit such as pears, apples, and berries are all great sources of soluble fibre (but it’s best to limit fruit consumption to a couple of serves a day to reduce sugar load). Legumes such as lentils, split peas, and black beans are also powerhouses of soluble fibre.

Supplemental nutrients 

Niacin (vitamin B3) has been shown to improve a number of CVD parameters including decreasing fibrinogen levels (a blood clotting agent), reducing LDL and VLDL as well as raising HDL, increasing LDL particle size, and reducing serum triglycerides. B vitamins are usually found in combination in nature so I always suggest taking a B complex in conjunction with a stand alone Niacin supplement.

Vitamin C is the body’s main water-soluble antioxidant and thus helps protect the arteries and blood vessels from free radical damage and subsequent plaque formation.

Essential fatty acids such as EPA and DHA from fish can be helpful in lowering serum triglycerides. Be mindful of flaxseed oil touted as an excellent source of these EFAs – they only exist in a precursor form that are difficult for your body to convert to the active EPA/DHA forms. Additionally flaxseed oil can be readily oxidised when exposed to heat, light and oxygen and so storage is paramount. When oxidised, these oils can be just as damaging as their industrial seed counterparts mentioned above.

Magnesium is a crucial cardiac nutrient, however unfortunately the majority of the population are deficient due to soil depletion and the over consumption of processed foods. Magnesium is best taken in the orotate, citrate and bisglycinate forms for cardiovascular health.

Coenzyme Q10 is a powerful antioxidant that can prevent the oxidation of VLDL and LDL particles in the bloodstream. It is also a crucial component of the energy cycle in cardiac cells.

Herbal medicine 

Garlic is an excellent herb for the prevention of CVD as it works on a number of levels: it can reduce total blood cholesterol, act as a serum antioxidant, and inhibit platelet aggregation and clot formation. To boost its effectiveness garlic should be consumed fresh, and be chopped or crushed and then put aside for ten minutes before swallowing to activate its health providing constituents.

Green tea can significantly reduce cholesterol and serum triglycerides, and raise HDL.

Globe artichoke has excellent blood lipid lowering effects through its ability to stimulate bile production.

Olive leaf is a powerful cardiovascular antioxidant, and can also reduce platelet aggregation.

Ginkgo is also an excellent cardiovascular antioxidant, as well as a promoter of peripheral blood flow.

Curcumin from Turmeric can significantly lower serum triglycerides, as well as act as an effective anti-inflammatory agent.

Berberine from various herbs such as Phellodendron, Barberry and Golden Seal can significantly lower serum triglycerides and LDL.

The importance of working with a practitioner

As always the advice given here is only a guide post in finding your way to a healthier life. I recommend working with a practitioner if you feel you are at risk for the development of CVD, and especially before undertaking any of the complimentary medicines mentioned due to their potential interactions with other medications. I encourage you to take charge of your own health and always take heed of the wise words of Benjamin Franklin: “An ounce of prevention is worth a pound of cure.”

In wellness,

James

The Cholesterol Myth

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If I took a stroll down a busy city street today and asked 100 people what comes to their minds when I mention the word ‘cholesterol’, I doubt many of the answers would be positive. For most people, cholesterol is thought of as a harmful substance in their body that can cause heart disease and stroke. This demonized view of cholesterol is not only misguided, but can also cause significant harm to your health when it leads to an unnecessarily restricted diet or the potentially unnecessary consumption of pharmaceutical drugs that can have significant adverse health effects.

Cholesterol is crucial for health

The majority of cholesterol found in the body is produced by the liver (around 75%) with the remainder coming from diet, and its levels are tightly regulated according to the body’s needs. This is because cholesterol plays a vital role in many cellular processes, from the production of hormones and vitamin D, to maintaining the stability of cellular membranes, aiding neurological function, and forming the bile acids which help in the absorption of dietary fats. We cannot live without cholesterol, and this alone should call into question the practice of drastically lowering your cholesterol in the belief it will negate your risk for cardiovascular disease.

The evolution of serum cholesterol markers: Total cholesterol, LDL, VLDL, HDL, LDL-C & LDL-P

Wow that’s quite a list isn’t it? There was a time in the not too recent past when the only serum marker deemed important to determine cardiovascular risk was your total cholesterol. Then there was a discernment made between two types of cholesterol carriers: LDL (low density lipoprotein) and HDL (high density lipoprotein). LDL was painted as the bad guy who delivered cholesterol into the bloodstream and thus caused plaque formation and subsequent heart disease, and HDL was seen as the good guy who removed cholesterol from circulation and lowered your risk of plaque formation. Relative risk could be determined by examining the ratio of LDL to HDL. If your LDL was up, and your HDL down, then your risk of heart disease was deemed high. If your LDL was up, but your HDL was also nice and high, your relative risk of heart disease was still pretty low (unfortunately there are still practitioners who only assess the LDL number without taking into account the amount of HDL). Then a further discernment was made between two types of LDL: your standard run-of-the-mill low density lipoprotein, and a smaller denser variety termed VLDL (very low density lipoprotein). If LDL was still considered a bad guy, then VLDL was the arch villain. The theory ran that the smaller and denser the  particle, the greater its ability to infiltrate the blood vessel wall and oxidise, thus triggering inflammation and plaque formation.

The underlying assumption behind most of these measurements is that the concentration of cholesterol bound to these lipoproteins (particulartly LDL, termed LDL-C in this instance) is the most specific measure of heart disease risk. Recently, however, there has been a shift in research that strongly suggests it is the number of LDL and VLDL particles in the bloodstream (called LDL-P), rather than the amount of cholesterol that they carry, that gives the most accurate measure of a persons cardiovascular disease risk. The best way to understand this idea is to use an analogy: Lipoproteins are like vehicles that can carry cholesterol and other fats (the passengers) around the body. The old assumption was that the number of passengers in the vehicles influenced disease risk – the more passengers, the greater the risk. However it now seems that it is actually the number of vehicles that is the greatest risk factor. Imagine your blood vessels as a series of transport tunnels. If the traffic in these tunnels is light (a low LDL-P), then there is a decreased risk of a collision between the tunnel wall and the vehicle. If there is heavier traffic (a high LDL-P), there is a greater risk of collision which would result in damage to the tunnel wall and the possible formation of a plaque.

Triglycerides and the true underlying cause of heart disease

So up to this point you may be thinking “Ok I’m with you that an increased number of LDL and VLDL particles can increase risk for heart disease, but aren’t they both elevated because of increased cholesterol in the body?”. That is a sensible question, and to answer it you need to understand the relative sizes of all of the particles carried by lipoprotein molecules. Of all the lipid components that these lipoproteins carry, triglycerides (the primary fat delivery molecules in the body) have by far the greatest size and molecular weight. The lipoproteins can only carry a limited amount of materials, so to increase the amount of triglycerides that they must carry will (in relation to other molecules such as cholesterol and fat soluble vitamins) disproportionately  drive up the number of lipoprotein particles in circulation. And guess what? Triglyceride volumes in the body are predominantly driven up by the dietary consumption of calories that are surplus to requirements, and the greatest contributor to these surplus calories are refined and processed carbohydrates i.e. sugar.  Your body has an amazingly efficient mechanism for converting simple sugars into these triglyceride forms for later use, as opposed to the consumption of healthy fats and  proteins that tend to be used preferentially for energy production or structural function.

The damage of the low fat food movement

Now you are probably beginning to see just how misguided our beliefs have been in relation to cholesterol, dietary fat consumption, and heart disease. The huge push for lowering our intake of dietary fats has resulted in a plethora of low fat products in the marketplace. These products typically contains large volumes of sugar to compensate for the lack of taste enhancing fats, and thus drive up serum triglycerides and increase LDL-P. The very strategy that has been employed to lower the incidence of heart disease in the population has achieved the exact opposite. Focusing on cholesterol as the cause of heart disease is like blaming the firefighters who arrive at the scene of a blaze to put out the fire. They are there help repair the damage (remember that cholesterol is a crucial component in every cellular membrane), damage already instigated by an increased LDL-P which is in turn driven up by a high carbohydrate, low fat diet.

Inflammation and C-reactive protein 

Remember the analogy of the lipoprotein ‘vehicles’ only causing damage to the blood vessel ‘tunnels’ when there is a sufficiently high volume of traffic to cause a collision? There is another layer to this, and another condition that will generally need to be in place for this collision to cause damage. The blood vessel wall in its natural healthy state is relatively smooth and robust. Think of a tunnel made of reinforced and smooth steel. When a lipoprotein particle collides with this well structured wall, it will generally glance off its surface harmlessly and continue on its merry way. However if there is a roughening of the blood vessel lining, then the lipoprotein has a surface to which is can stick and become embedded. Once in this state, the particle can oxidise and attract a range of inflammatory chemicals that now see it as a threat. The body’s natural response to a threat is to contain it, thus the formation of what is called a ‘foam cell’ which can eventually form a hardened plaque and possibly occlude the blood vessel. So what can cause this initial roughening of the blood vessel? In a word: inflammation. And the main cause of this inflammation: excess consumption of refined sugar. Because the body regulates the volume of sugar in the blood within a very narrow range, any level beyond this range is quickly cleared from circulation by the hormone insulin and is driven into the cells. When the cells are full, the excess sugar is converted to triglycerides for storage (as discussed above). However when you constantly consume refined sugars, you overwhelm your insulin response and a cascade of reactions occur which cause the formation of blood vessel damaging complexes – imagine rubbing sandpaper on the inside of you blood vessels day in day out and you get the picture of how a typical Western diet effects our cardiovascular system. C-reactive protein is a marker used for determining systemic inflammation in the body. Couple high LDL-P with high C-reactive protein and you have a recipe for heart disease. The good news is that both of these markers are most effectively lowered by dietary interventions. It is important to note that there are many other possible contributors to blood vessel inflammation, including the consumption of unhealthy fats in the form of easily oxidised vegetable oils, as well as bacterial, viral and fungal infections. For a detailed list of foods and additives that can contribute to blood vessel inflammation, please sign up to my newsletter to receive my ten part series on living your healthiest life – this topic is covered in part one.

Statins and their effectiveness at lowering heart disease risk

I feel it is important to state that the use of statin drugs does have a place in lowering the risk of heart disease, however in a much smaller population segment than the broad spectrum approach in which it is currently applied. Those that have familial risk for heart disease and high cholesterol may benefit from the use of statin therapies to lower this risk. The use of dietary interventions would not be as effective for these individuals due to an inherent inability to remove cholesterol from circulation. Also those with a very high LDL-P may benefit from short term statin use to help lower this marker, but the majority of benefit and effectiveness will still be derived from a dietary shift away from processed carbohydrate dense food to one of higher protein and healthy fat consumption (again refer to part one of my ten part series on living your healthiest life). For pretty much everybody else, a focus on dietary intervention (working alongside a qualified health practitioner) will have a tremendously higher likelihood of decreasing heart disease risk. The myriad side effects of statins (including muscle pain, liver damage, cataracts, kidney failure, cognitive impairment, impotence and diabetes) should suggest an approach with no side effects and far greater effectiveness such as dietary intervention should be employed as a first line measure.

I hope this gives you some valuable information on the true causes of heart disease, and empowers you to have a healthy discussion with your doctor or health care professional regarding the various measures you can employ to lower your risk. Look out for my specific recommendations for lowering your risk of heart disease in a future post.

In wellness,

James

The many benefits of slow cooking

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Time is a precious resource in my world. From the moment I wake up (or more often from the moment a set of small lungs down the hallway wake me up!) to the moment I gratefully rest my head on the pillow at night, my day screams past faster than a formula 1 race car. Every opportunity to simplify a necessary daily task is welcomed with open arms – thus my complete infatuation with slow cooking.

The easiest way to prepare a delicious and healthy meal

Slow cooking is incredible in its simplicity. In the morning before leaving for work you simply need to allow 5 minutes to throw something together. Turn on the slow cooker. Add the meat of your choice (you don’t even need to chop it up as the slow cooking process will make the meat fall apart naturally, and browning the meat before hand is in my experience totally unnecessary). Add chopped veggies. Add some olive oil, spices, herbs, and any other liquid your recipe calls for (stock, tomato puree, wine, vinegar etc.). Then simply put on the lid and leave it until you get home. If you put the cooker on low, around 8 hours is the perfect amount of time for most recipes. Many slow cookers have a built in timer to automatically turn the heat down and keep your food warm once the designated time has elapsed. And what’s more, after a hard day at work you can actually relax instead of having to prepare the evening meal.

Slow cooking is the natural flavour booster

The process of slow cooking allows the flavour profile of food to develop more fully, and it’s pretty hard to make anything taste bad when you cook this way. It’s a godsend to anybody who is challenged in the culinary department, and can make the ‘I can’t even cook an egg’ bachelor look like a serious contender for the next round of Masterchef. The aroma of herbs, the natural oils from spices, the mineral tang of meat, and the nutty starches from vegetables are all accentuated in the slow cooking process.

Save time and money

Slow cookers use very little power – only the equivalent wattage of a single electric light bulb. This is in stark contrast to most ovens which use energy up at a rapid rate. And because a slow cooker does not put out radiant heat, you can leave the little fella running all day on a summer scorcher and not raise the internal temperature of your home  one degree. In addition, slow cooking lends itself to the use of tougher and cheaper cuts of meat, as these cuts tend to have a much richer and tastier flavour than their more expensive fast cooked counterparts.

A healthier way to cook

As if the ease of preparation, flavour enhancement, cost savings and increased levels of sanity weren’t enough to convince you to become a slow cooking convert, there is one more very important reason to use this method. Slow cooking your meals (those containing meat in particular) create the least amount of carcinogenic end products of any cooking method. When you barbecue or fry meat, you form complexes of proteins and sugars called advanced glycated end products (or AGEs for short) which have been linked to the formation of many cancers, particularly of the bowel. Slow cooking forms very few AGEs if any. Additionally, if you cook meat on the bone in your slow cooker you receive health promoting collagen, gelatin, and minerals that are not as readily available in the muscle meat we tend to consume in isolation much of the time. And finally, the relatively low cooking temperature means that the vitamins which are often destroyed in the higher temperatures related to other cooking methods are instead preserved.

It’s not only for stews

Slow cooking is incredibly versatile. Although stews are a common slow cooking fixture in our house, we have also slow cooked amazing roast chicken, lamb and beef. Soups done in the slow cooker are delicious (tip: use the bones from previous recipes to create a yummy stock base). Vegetarian options abound, especially considering the slow cooker’s ability to hydrate and soften dried pulses. It’s hard to beat a slow cooked curry, and deserts done in the slow cooker can be some of the best you’ve ever had.

If you don’t already own a slow cooker, trust me – buy one now! It will pay for itself in the energy and grocery savings over a few months, and the time it can save you is priceless. If you have a kids or a demanding work schedule it can be your saving grace, and the fact that you can provide a healthy and delicious meal for you and your loved ones with so little effort is something truly precious.

In wellness,

James

Berberine – phytochemical superstar

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Berberine is a phytochemical constituent of several medicinal plants that have been used for centuries in various cultures throughout the world. Some of these plants and their geographical origins include Goldenseal from North America, Barberry from Europe, and Goldenthread from China. It is a truly marvelous example of a plant constituent that has varied and powerful effectiveness in a wide range of conditions.

Powerful botanical antimicrobial

Historically the medicinal use of Berberine containing plants was primarily for their antimicrobial activity – a use for which they are incredibly effective. Berberine displays a broad spectrum antibiotic activity against bacteria, protozoa and fungi. In fact it has such a high degree of potency that it is often more effective than prescription antibiotics used to treat specific pathogens. Berberine has shown particular efficacy at treating infections initiated by group A streptococci (eg ‘strep throat’) as well as overgrowth of candida albicans. Other pathogens for which Berberine has shown antimicrobial efficacy include Escherichia coli, Pseudomonas spp., Shigella dysenteriae, and Salmonella typhi. Interestingly, Berberine appears to not only destroy the pathogen, but also prevents its adherence to host cells thus disabling the initiation of infection. One of the benefits of using herbal medicine for antibiotic therapy is their multi-faceted action on the pathogen, meaning that it is virtually impossible for that pathogen to develop resistance and evade destruction. This is in stark contrast to the over-prescription of pharmaceutical antibiotics which have singular modes of action, resulting in widespread prevalence of antibiotic resistant pathogens over the last few decades.

Cardiovascular protection

Berberine displays a wide range of cardiovascular activity: Berberine stimulates the up regulation of nitric oxide synthase, thus increasing vasodilation in the blood vessels and subsequently lowering blood pressure. Berberine also appears to lower thromboxane B2 levels via direct inhibition of calcium ion influx in the cell, markedly reducing blood coagulation and clot formation. Berberine also inhibits the voltage-dependent and ATP-sensitive potassium channels directly involved in cardiac arrhythmia, thus aiding the restoration of a regular heartbeat. And finally Berberine has displayed the ability to lower LDL cholesterol by up-regulating LDL receptor activity in the liver, effectively increasing the removal of LDL particles from circulation. Interestingly, this cholesterol lowering activity seems to be exponentially increased by the addition of plant stanols to the treatment protocol.

Anti diabetic activity

Berberine appears to have the ability to increase insulin receptor expression in the body, aiding the uptake of glucose from the bloodstream and reducing insulin resistance. It also stimulates the secretion of insulin from the beta cells of the pancreas, and blocks glucose absorption in the intestinal wall via the inhibition of alpha-glucosidase. This wide range of activity makes Berberine an incredibly powerful botanical ally in the treatment of type 2 diabetes, insulin resistance and metabolic syndrome. Amazingly, Berberine has displayed similar effectiveness to the drug metformin which is commonly used to treat type 2 diabetics, and without the associated possible side effects which include headaches, muscular weakness, indigestion, vomiting, and significant decreases in the absorption of vitamins B9 and B12.

A powerful ally in the treatment of diseases of the modern age

Through its efficacy in treating both cardiovascular disease as well as diabetes and metabolic syndrome, Berberine has an incredible utility in healing those chronic disease processes that seem to be such a part of the modern Western lifestyle. It really is a phytochemical superstar!

In wellness,

James

The eye of the storm

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I think you’d be hard pressed these days to find anyone not feeling bombarded by the seemingly endless demands of everyday life. I have personally felt pulled in many different directions most days, and the inevitable stress that comes with a feeling of drowning in your ‘to-do’ lists can lead to some serious health outcomes. And now, with the addition of  two (amazing) small kids into our family to help grow into caring and responsible adults, those earlier to-do lists seem pitifully brief and easily achievable!

I have unfortunately not been blessed with an inherent ability to maintain a zen-like state of calm in the face of every perceived disaster. Endless stress related health issues that became a frequent occurrence in my early career as an advertising TV and radio producer taught me that freaking out is not a good habit. I butted my head against that wall of stress for many years before I was forced to take a serious look at the way I was living my life and the likely result. Part of that process resulted in my decision to quit my job and study to become a Naturopath, and for that I will be eternally grateful. However I soon discovered that intense study had its own pressures and stresses, and once again I was on the ‘freak out’ treadmill. I needed some coping mechanisms to help deal with stress before it became an ugly beast that gave me chronic bouts of IBS and emotional turmoil again.

Treat yourself to some ‘me’ time everyday and find your place in the eye of the storm

Life is busy, and it goes by way too fast. It’s easy to think that there is no way you can find time for yourself. However without this practice in your life, the cumulative burden of everyday stress will eventually catch up with you. Your body is intelligent, it knows prolonged stress will cause damage, and when under extended pressure it will develop some physical ailment to force you to take time out and be still. Unfortunately, this process tends to cause significant harm. As in all areas of health, a preventative approach whereby you provide your body and mind with small windows of stress-less space everyday can help to avoid a health crisis further down the road.

Sleep is important, but moments of ‘no mind’ in your waking hours are potent relievers of stress

Although seven to eight hours of rejuvenating sleep a night is incredibly important to achieving optimal health, this will not always restore and refresh your mind to the same degree as your body. Stress in your waking hours can just as easily burden you during sleep – anybody who has woken after a full nights sleep still feeling exhausted can attest to that fact. Finding moments during your day when you can switch off your mind and let it rest can be incredibly restorative.

Meditation is not the only answer

For many, the technique that comes to mind when imagining these moments of ‘no mind’ is meditation. Sitting in a quiet space and gently calming your mind through various meditative processes can definitely work, but it isn’t the only approach. Any act in which you become fully immersed in the process can have the same effect of ‘no mind’. I’m a keen surfer, and I definitely find moments of ‘no mind’ and immersion in the moment when riding a wave. Maybe tennis is your thing, and you become as focused as a zen master when hitting it out with a good friend. Perhaps you love to paint, and you find peace and calm with each stroke of the brush. The method differs, but the sense of calm and joy will always be there.

‘Me’ time is not selfish – it is crucial to good health

I sometimes feel that we have become far too serious in our society – everything is about achieving a goal or attaining status. We have forgotten how to play. Watch any child and see how they find countless opportunities to play and be in the moment every day. We need to prioritize play again, find your passion and make time for it in your life. And feel good about doing it, rather than feeling a sense of guilt that you aren’t spending every moment ‘achieving’.

What is your passion? What is it that makes you forget yourself and become fully absorbed in the moment? Find time in your day for this and well being will surely be the result.

In wellness,

James

Intermittent fasting

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Although I endeavor to live a balanced and healthy life, and generally manage to maintain what I consider to be a fairly good standard of vitality from day to day, I know that my physiological ‘Achilles heel’ is my gut. From having chronic IBS in the past, I know that my gut is always the canary in the coal mine when it comes to warning signs that my life may be slightly out of balance. And thus when I found myself experiencing sensations of bloating and poor digestion the other day, I knew that little warning signal was piping up and that I had better pay some attention. I ran through the mental checklist: excessive consumption of processed food? No. Too much alcohol? Nope. Antibiotic usage? Absolutely not. Stress? Not to my conscious knowledge! What I did realise, however, was that it had been some time since I’ve given my digestive system a break and it may be time for a fast to get me back on track.

Why intermittent fasting?

Your stomach is silently screaming!

Your stomach is silently screaming!

Our digestive systems are under a tremendous amount of pressure in our modern age – the combination of poor diet, stress, chemical exposure, and chronic consumption of both legal and illegal drugs mean that our poor gastro-intestinal tract is pulverized from dawn to dusk (and often right through the night as well). From an evolutionary perspective, the consistent and relentless consumption of food that is ever available these days would not have been possible in the past. Mankind would have endured extended periods of caloric restriction when having to hunt and gather from the wild, and there is now much evidence that this ‘intermittent fasting’ has significant benefits for our health. Essentially, the process of fasting sends a stress signal to the cells of the body which prompts an adaptive response involving improved metabolic functioning and the usage of adipose tissue for fuel. So what are the specific benefits of intermittent fasting?

Reduced incidence of cardiovascular disease

Some powerful studies have demonstrated the benefits of intermittent fasting on CVD. Goldhamer et al reported on a study involving hypertension in which 194 patients were able to achieve a sufficient drop in blood pressure to eliminate the need for medication. Other studies have shown reductions in serum triglyceride values, atheromas,  and total cholesterol, as well as increased ratio of HDL to LDL cholesterol.

Weight loss, diabetes and blood sugar regulation

Intermittent fasting seems to improve insulin sensitivity and reduce the need for diabetic medication in type II diabetics, as demonstrated in this study. Another study observed the weight loss outcomes of 107 overweight or obese women when comparing continuous caloric restriction with intermittent fasting, and found both approaches worked equally well for significant weight loss. Added benefits of fasting included a drop in c reactive protein (a marker of systemic inflammation), as well as a drop in reactive androgens. Intermittent fasting has become popular in the mainstream of late with the booming success of the ‘FAST’ diet, in which participants eat an unrestricted diet for 5 days of the week, and for the other 2 days eat one quarter of their normal recommended caloric intake.

Cancer

Although the evidence for reductions in cancer incidence in humans is relatively scarce, there are some fascinating animal studies that demonstrate this effect. This review gives some compelling evidence for further investigations in human trials for the anti-cancer benefits of intermittent fasting. One study demonstrated a 0% incidence of lymphoma in genetically predisposed mice after a regimen of IF, as compared with the non-intermittent fasted control group with a 33% incidence.

How to perform intermittent fasting

If using intermittent fasting to treat a particular condition, I recommend working alongside an integrative practitioner to ensure safe guidelines are adhered to and results are monitored throughout the fasting period. If, like me, you suspect your digestive system simply needs a break then I find the best approach is to fast for 3 days. Although some proponents of fasting will encourage only water consumption during the fasting period, I believe it is better to provide the body with nourishing vegetable juices to assist in health restoration (fruit should be avoided due to it’s ability to cause blood sugar spiking and insulin dysregulation). It may also be useful to assist the liver to detoxify the inevitable toxic milieu that is released from the cells during a fast with herbs such as Milk Thistle and Dandelion Root. Drinking plenty of pure filtered water is a must, and you should aim for at least 8 large glasses for each day of the fast. Make sure you fast during a period when you can take it easy and rest, as you will naturally experience a drop in metabolism and may inadvertently trigger a cortisol response if you push yourself too hard.

I hope this helps to put the health benefits of intermittent fasting in perspective, and gives you an easy way to implement an IF regimen in your life. I recommend performing a 3 day intermittent fast at every change of season, four times per year, in order to keep your metabolic machinery running smoothly.

In wellness,

James