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Author Archives: Arlie Miguel

BRISBANE NUTRITIONIST KATIE KING   →  Articles by: Arlie Miguel
Categories HORMONES

Diet and PCOS

Author Arlie Miguel Posted on Leave a comment

Polycystic ovarian syndrome affects 1 in 5 women making it one of the most common hormonal conditions experienced by females (1). Its consequences can appear alarming and many women may feel quite hopeless as far as managing the condition is concerned. However, its highly responsive to nutritional intervention and here’s why:

First, a brief look at PCOS. For a diagnosis to be made, 2 of the 3 criteria (2) must be satisfied:

-absence of a regular period

-evidence of hyperandrogenism (that’s high testosterone)

-the detection of cysts on the ovaries when viewed on ultrasound

Other consequences are metabolic, cardiovascular and hormonal in nature and generally include the following:
-reduced insulin sensitivity: women with PCOS seem to have up to 40% reduced insulin uptake when compared with non-PCOS women. I.e. the ability to handle simple carbohydrates is significantly reduced, much like type 2 diabetes.

-increased circulating insulin can drive up central adiposity; i.e. fat around the waist. In general, weight management is usually more difficult for women with PCOS.

-higher cardiovascular risk factors; cholesterol, blood pressure and homocysteine to name a few, are more likely to be sub optimal. This is a cumulative effect of higher blood sugars, unbalanced hormones and increased central fat: all drive up systemic inflammation.

-Compromised mental health including higher incidences of depression and anxiety. Likely a cumulative effect of higher systemic inflammation and out of whack hormones.

What does PCOS have to do with Nutrition?

A lot actually. PCOS is sometimes referred to as ‘diabetes of the ovaries’  so considering the diet will go a long way in managing the condition. We can reduce insulin resistance by including adequate protein and healthy fats alongside fibre rich, unrefined carbohydrates with each meal. A women with PCOS is NOT going to thrive on a low fat diet.

Improving blood sugar and insulin sensitivity may assist with weight management. This may in turn have a positive effect on lowering inflammation which will improve cardiovascular risk factors and support healthy mental health.

Plus, there’s loads of research as far as specific nutrients and nutritional medicine* is concerned. Here are some of the tools we have in our belts:
-N acetylcysteine a naturally occurring amino acid taken at certain dosages assists with ovulation and fertility in women with PCOS. View the full meta-analysis here.

-Inositol, (an often forgotten B vitamin) currently one of my favourite supplements in clinic can reduce elevated testosterone levels and improve insulin levels as shown in many papers including this one here.

-Neurotransmitter support such as natural GABA, 5 hydroxy-tryptophan (precursor for serotonin) and SAMe are viable and important options for PCOS sufferers seeking mental health support without side effects.

This represents the tip of the iceberg and takes a birds eye view on a condition that may vary from person to person. The drivers are more complicated than this article allows, but the take home point is: PCOS is not a ticket to infertility. There is hope outside of the contraceptive pill, IVF and diet shakes which may work for some women, but result in suffering and side effects for others. You deserve to know your body, understand your condition and know your options. 

*Don’t take herbs or supplements without consultation with a practitioner. They can interact with medications so should be used with caution and prescribed by a professional. Don’t purchase herbs and supplements over the internet as they may not be regulated by the TGA (Australia’s supplement ‘watchdog’) and they may not be formulated to therapeutic strengths or formulas.

REFERENCES

  1. Statistics from Royal Australian College of General Practitioners, webpage available here.
  2. The Diagnosis of Polycystic Ovarian Syndrome in Adolescents, available here.
  3. N-acetyl Cysteine for Polycystic Ovarian Syndrome : A systematic Review and meta-analysis of Randomised Controlled Clinical Trials. Available here.
  4.  Metabolic and Hormonal Effects of myo-inositol in women with polycystic ovaries, available here.
Categories Diabetes

2017: Reversing Australia’s Health Crisis

Author Arlie Miguel Posted on Leave a comment

Happy New Year

And welcome to 2017.
I spent the holiday period decompressing and considering my pathway forward for 2017. Over the break, I was overwhelmed by the sheer volume of conflicting nutritional advice that popped up on my social media feed from others in the health industry ranging from personal trainers, weekender nutritionists and right through to PhD qualified industry leaders. If it was overwhelming for me, then I can only imagine what it’s like for the everyday person. In addition, the myriad of beautiful yet insanely complicated (not to mention expensive) recipes that pop up on Instagram these days…. Seriously. If it takes longer than 20 minutes in the kitchen (and it can’t be prepared in bulk), quite frankly, I’m really not interested. Plus bee pollen in smoothies, blue green algae, ‘detoxifying’ charcoal…. Hmmm, funky ingredients aren’t going to solve the global health crisis.

In order to get clear, I had to revisit my values and look where I was really needed to ascertain exactly where I am going to focus my energy this year. This is what I decided…..

We’re inaccessible.

The first thing that bothers me is that CAM (complementary medicine – the umbrella that I as a nutritional medicine practitioner falls under) is inaccessible. We might qualify for private health rebates, but Medicare doesn’t recognize us. Perhaps 2% of the population may book in to see a privately billed health practitioner when really, the other 98% need us far more.

Treatment and advice still needs to be individualized, so the face to face model is still important. Last year, I bought a clinic in Carindale where we also offer acupuncture, naturopathy, counselling kinesiology and massage. In order to reach more people who truly need us, we have come up with the concept of shared care consultations. Read more about that here.

N.B. 1 on 1 consultations still available, this is simply an additional service.

Chronic Disease

I’ll be shifting my focus more to chronic disease this year because the current epidemic isn’t acceptable. In particular, I’ll be focusing more on type 1 and type 2 Diabetes. Almost 2 million Australians are now living with diabetes and yet it’s a condition where diet is the single most effective management tool. Yet, diabetics aren’t getting the information that they need to stop the progression of their condition or reverse it. I’ll be tackling type 2 diabetes in a series of shared care consultations, face to face at my Carindale clinic beginning in February. You can read more about that here. Phone me (07 3398 1977) or email me to enquire / enrol.

Athletes

I haven’t forgotten about you guys, but again I’ll be offering additional options for consulting. I’ll have a series of small group consultations launching in the next 6 weeks aimed at answering these questions and more:

-what you should be eating on a daily basis for recovery, performance, longevity
-how to fuel to prevent running out of gas
-what sports nutrition products are good and when to consider supplementation

No dates are finalized at this point, but if you are after the facts delivered to you simplistically so you can implement this stuff right away, then let me know you are interested please by contacting me here. I’m taking 5 people at a time – no more. (1 on 1 still available).

No Fluff

In line with my values, I’ll be continuing to deliver the facts based on evidence, research and what gets results in a clinical setting.
Nutrition, lifestyle and complementary medicine can make a massively positive difference in the world, but the fluffy stuff isn’t really cutting it. In addition, you can forget about finding the perfect diet or that magic supplement to solve everyone’s ailments – we are all individuals, and many people now have serious health complications so the one size fits all model just isn’t going to work.
I look forward to working with more people in 2017 who are prepared to put the work in alongside me to restore health and start living.
Catch you on Facebook or here in a fortnight.

Categories VEGETARIAN

Vegetarian And Vegan Diets: Getting It Right.

Author Arlie Miguel Posted on Leave a comment

I see a wide variety of clients with different needs, lifestyles and conditions and obviously I encounter many different eating styles and patterns along the way. Whether someone chooses to eat meat and animal products or not is none of my business. My job is to make sure that whatever path they choose, they do this as healthily as possible. I see healthy vegetarians. I see healthy omnivores. But I do encounter unhealthy versions of both as well. This post is about addressing some of the more common issues on a vegetarian / vegan diet in an effort to help combat some of these errors so that long term chronic health problems can be avoided.

This is only a brief overview – top 3 rookie errors if you like. If you feel that your current diet is not optimized or if any of the below symptoms resonate with you then book in and lets discuss. Don’t leave it. Hopefully the below summary will give you a picture that this isn’t something to be messed around with. As I ALWAYS say, everything in the body starts with nutrition. Nutrition provides the building blocks for each and every process within us. So you NEED to be giving yourself all the nutrients you need every day otherwise serious health complications can arise over time.

Not getting enough protein

Problem: you miss out on essential amino acids (proteins are basically long chains of amino acids).

Issue: Most people are aware that amino acids are critical for new cell turnover (happening constantly in the body), new muscle growth and repair of all cells. But also consider this. Amino acids are the building blocks for our digestive enzymes so as soon as we end up in a protein deficit our digestion will be impaired. Without adequate digestive enzymes, it’s impossible to properly break down everything else you put in your mouth. So this is going to have serious flow on affect and lead to other nutritional deficiencies if not addressed early on.

Issue: Furthermore, amino acids such as phenylalanine, tryptophan and GABA are the precursors (or the ingredients if you like) for our neurotransmitters including serotonin and dopamine. These neurotransmitters control how we feel (happy or sad), our alertness, our motivation, memory, energy levels, movement and even our allergic responses. This is just one reason why nutrition is such a critical piece of the puzzle in mental health.

Solution: non-animal protein sources include nuts, seeds, tempeh, dairy (not vegan), chia seeds, nut butters, organic tofu, good quality protein powders, quinoa and buckwheat and legumes. Most vegetarians/vegans will need to be getting non-animal source of protein in with each and every meal or snack to negate deficiencies particularly if activity levels are high. This can take a bit of prep but health is always worth it right? Note that with the exception of quinoa and buckwheat, no other non-animal sources are ‘complete proteins’ containing all amino acids. The main culprits for deficiencies are lysine (critical for muscle growth) tryptophan (precursor for serotonin – not something you want to skimp on), methionine (needed for DNA turnover / methylation) and phenylalanine (my fav – precursor to dopamine)

Not getting enough B12

Problem: B12 deficiency is a very bad thang….

Issue: B12 is another essential ingredient for mental health, stress management and energy.

Issue: B12 deficiencies are associated with headaches / migraines and neurological symptoms, even tremors, tingles etc.

Issue: B12 is a critical ingredient for healthy red blood cells. Without enough, anaemia can set in which feels like fatigue, shortness of breath, loss of appetite, poor concentration, can’t get out of bed etc.

Issue: B12 has an ‘enzymatic role in about a billion other processes in the body. Ok, slight exaggeration but almost. This means it ‘helps’ lots of other processes happen. That are essential to life. So, once again, the flow on consequences can be wide spread.

Solution: dairy contains some B12 but that’s not an option for vegans. Nutritional yeast is an inexpensive vegan supplement worth considering. But to be honest, all vegans will need to supplement B12 and many vegetarians too. Consult a specialist about this – make sure you get the right form and dosage.

Not getting enough iron

Problem: Iron deficiency makes you feel tired, sluggish, exhausted, short of breath….

Issue: not only that, but iron is a critical factor in many other processes in the body, like B12. E.g. iron is critical for healthy immune function… not enough iron = compromised immunity. Second, iron is required for healthy thyroid. So a long term iron deficiency may add stress to the thyroid. This pops up a lot in clinic to be honest.

Issue: iron deficiency may affect your menstrual health ladies. Not good.

Solution: legumes, chickpeas, oats, green leafy vegetables, eggs, kelp and dulse flakes all contain some iron… but please keep in mind that non-heme (that’s non-meat) sources are much more difficult to glean iron from. Again, supplementation may be needed but should always be proceeded by blood test confirmation of low iron and iron stores. Iron requirements for women are greater than men due to monthly bleeds – 18mg/day to be precise. And during pregnancy – 27mg/day. Plus, athletes usually require a bit more too. Check the table below, you can see that getting enough iron may be a difficult task on a no meat diet.

Note: iron is available in different molecular forms. A common issue is constipation from taking a poorly absorbable form. You need to speak to a health professional, like a Nutritionist (i.e. contact me) and get a supplement that does not stop the pipes from working. K? It also needs to be administered with vitamin C, as C helps it absorb. There’s a reason why we have traditionally eaten ‘meat and veg.’

Look, I could go on all day. The most important thing on a vegetarian / vegan diet is to eat a wide variety of foods that you are happy to consume to try to avoid deficiencies. Make sure your GP knows your nutrition preferences so he/she can conduct blood tests regularly if he/she feels they are needed. And book in for a consultation if you are worried you haven’t quite ‘tweaked’ things to perfection just yet.

Amount (gms) Food source Iron content (mg)
1 cup Chickpeas (cooked) 4.74mg
1 cup Lentils (cooked) 6.59mg
1 cup Oats (cooked) 2.11mg
1 tsp (heaped) Cocao 0.36mg
X 2 Eggs 2mg
10 Almonds 0.5mg
1 tbs Brewers Yeast 0.3mg
1 tbs Molasses 0.9mg
1 tbs Kelp 0.14mg
1 tsp (heaped) Dulse flakes 0.8mg
1 tbs Tahini 1.5mg
Categories SPORT NUTRITION

Melbourne Marathon (18th October 2015) Recap

Author Arlie Miguel Posted on Leave a comment

It’s 3 days post Melbourne Marathon today at time of writing this! Here’s a recap of the race, mainly from a nutritional perspective for your benefit and entertainment!
Race morning was Sunday and I was extremely nervous and a little emotional standing on the start line with my good friend and training partner Amanda from GIYA running. It was unusual for me to feel nervous, but I had a time in mind, not just intent to finish. In addition (here’s a confession you’ll love) my nutrition in the 2 weeks leading up had not been ideal. My usual, fairly clean (but still delicious) balanced meals had been interrupted with bouts of ‘picking’ on cheese and biscuits, the odd spoonful of ice cream usually reserved for the occasional dessert and nibbles of chocolate here and there (if you just ‘nibble’ it doesn’t seem as bad right because you don’t really have any idea how much you are eating!?) This was a bit weird for me because I rarely suffer from self-control issues around food and I know the consequences for me when I eat badly (anxiety, misery, absolutely no energy whatsoever). I truly put it down to a little self sabotage and as a result I had been feeling heavier and lethargic in the days leading up to the race. Nevertheless it was race day, nothing could change what I had done and I did feel ready to run.
We crossed under the official start line and I began passing people up the side of the pack straight away. The first 10km passed uneventfully. Except for the fact that I was running fast. For me that is. I needed to average about 6min kms to come in at my desired time but some of my kms were as quick as 5:20. I was arguing with myself in my own head about pulling back, but I didn’t feel as though I was exerting myself so I figured I should just run where I was comfortable.
Once I headed into my second ‘race’ for the day (I had divided the marathon up into 4 races: 0-10km, 10-20km, 20-30km and 30-40km) I made a pact to try to hold 5:40kms and at this point I started drinking (water only) from the aid stations every 5kms. There is so much research around hydration in sport. I tend to focus on drinking to thirst and being conscious of getting some electrolyte in to maintain the ‘balance’ of water to salts. Hyponatraemia (basically too much water, not enough salt) is a more serious (and common) issue than dehydration in running despite the fact that many people drink to the point of being waterlogged. I was disappointed to see that the race ‘electrolyte’ at the aid stations was Gatorade when there are so many truly scientifically formulated sports drinks now available that would be far better than the sugar water provided. I had 2 Hammer Endurolyte tablets on hand that I took at around 25km so I didn’t have to rely on the sticky orange solution. It was lucky I did have these on hand – I was thirstier than normal and drinking from most of the aid stations. I put this down to not hydrating properly in the days leading up the race despite telling my clients to do this themselves; I had been travelling for work the week before but still, that’s no real excuse.
Close to the 30km mark my brain was on overdrive trying to work out whether I would need to take on some sort of carbohydrate fuel and when. My first marathon I had done without fuel, but I had been running faster than intended today so I was wary of churning through my glycogen stores. I was visualising my ‘metabolic fuel burning curve’ (below) and trying to do the math – it was a great distraction! I would normally go into a race with a homemade gel, but again due to logistics leading up to race day this had been impossible. I had a Vfuel gel (one of the most natural on the market) tucked into my sports bra and I had a ‘slurp’ of this at about 30km. Well, I think I managed a quarter of it and then I chucked it – my goodness gels do not float my boat! I grabbed a banana off one of the aid stations at 35km and had 1 mouthful of this. So not a lot of fuel all up – maybe 15g of carbohydrate, but it was enough to get me through and maintaining consistency. Without it, I think I may have hit the wall a few kms from the end. Oh and my breakfast on race morning (5:30am) was quinoa porridge – a balanced meal with quinoa (carbs/ proteins), some raw protein powder (protein), coconut oil (Medium chain Triglyceride; fat) and berries (carbs). A ‘practised’ meal; that is I knew I could run on it and feel fine.

At about 38.5km I felt a ‘shudder’ in my legs and I thought ‘oh no, am I about to bonk!?’ I have only experienced the true awfulness of bonking once in my entire life and that was earlier this year at River Run 100 at 23km (of a 25km leg). I had been exhausted in the week leading up and had not refuelled well after any exercise sessions so I figured my glycogen stores were kaput. It was actually a great lesson because it made me aware of how truly soul destroying and ‘real’ bonking is and more determined to help endurance athletes to preserve carb sources. Thank goodness, the shudder radiated down my body and left – it may have simply been the shock of a small incline as you round the botanical gardens and head for the last 3km.
If I could find the young boy who was handing out mini, lime, frozen icy poles at 39km I would hug and kiss him, because it was lovely to have a mouthful of sweet lime ice melt into my mouth heading back into the city towards the MCG. I always feel devastated for the people who are walking at this point… imagine getting that close to the end and being on track for around 4 hours and then having to walk. That’s the difference between a 4 hour and a 4:45 finish. That’s the challenge of the marathon I guess… is it more physical or more mental? Hmm… another argument you could have in your own end during a race to distract from the pain :).
Through the tunnel and into the MCG we went. When you see the finish you can finally relax and realise you will make it :). My splits were fairly even and I was so pleased to still be running strong all the way to the end. I crossed under at 4:11:38 and my official time was 4:10:16. In Canberra, my first marathon I did in 4:39 so quite a big PB.
I had a H2Pro500 electrolyte tablet (I now stock these) and some more water about half an hour after race finish but I wasn’t in state to eat much besides a little bit of fruit. We did have some champagne in our room around an hour after finish time; not the ideal rehydration strategy but it slid down quite easy all the same.  Lunch was fish and quinoa salad (with lots of salt) and dinner was an amazing Tortellini which I thoroughly enjoyed. Now I have returned to my ‘normal, balanced’ approach although a few extra carbs in there to replenish lost stores. I hit the pool today and I am looking forward to running again, which I guess is the best outcome after a marathon.
This is my race story not yours and your requirements may be different, however there are certain fundamentals I do believe in. This includes the idea that everyone (athletes included) should eat actual food (not ‘food like products’ that contain chemicals not ingredients) and should train and eat to preserve glycogen for as long as possible to get through an endurance event. Sports nutrition companies have plenty of people conned – I overhead lots of conversations during the run that made me chuckle a bit such as ‘oh I need to have my 4th gel for the day (this was at 20km?)’ and ‘I have a banana, 6 gels, a Mars bar and snakes so I should be right.’ The truth is, we have overcomplicated things a little and with GI distress on the rise, bonking still a common occurrence and hypoglycaemia (low blood sugar) happening during races you do need to think about your nutrition just like you think about your training. It doesn’t need to be complicated, but it does need to be well practiced, convenient, palatable, calculated and preferably real. In next week’s newsletter I am going to talk a little bit more about what is actually in these gels that we are told to throw back like there’s no tomorrow…
With that in mind, my next metabolic testing day is the 14th of November and if you have big plans for next year then let’s start nailing your plan NOW. Get set up with a training program (courtesy of the sports scientists I work with) and nutrition program that works for you and get educated along the way. Book here and I’ll chat to you soon.

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Categories GENERAL HEALTH

Reflux – In Defense Of Stomach Acid

Author Arlie Miguel Posted on Leave a comment

Reflux and Stomach Acid: what you need to know

Let’s talk about reflux or more specifically Gastro Oesophageal reflux disorder (GORD) as I am seeing it increasingly in clinic. If you ever taste acid in your mouth after you eat or you experience burning in the chest portion of your digestive tract this is what I am referring to as reflux. It is a serious condition. Not only does it disrupt quality of life, it can cause  irreversible damage to the lining of the oesophegas. Basically, it can ‘burn’ the digestive tract and lead to ulcers and structural changes in the mucous lining. This is not intended to frighten, it’s merely an invitation to be proactive about treatment. Because I know a lot of people put it down to just a normal part of life. But if things are working well, we shouldn’t be dealing with heartburn after every meal. 

To clarify we have acid that gets produced in our stomachs and allows us to digest all nutrients. Yes the stomach is naturally an acidic environment. Most of the clients I see, seem to have this idea that reflux occurs as a result of excess stomach acid production. Not entirely accurate; GORD is stomach acid in the wrong place i.e. instead of remaining in your tummy its back flowing into your digestive tract. It might be due to over eating, eating foods that don’t agree with you, eating too quickly or lack of tone in the lower sphincter. The sphincter that acts as a barrier between your digestive tract and the entrance to your stomach that is.

Typically, sufferers are recommended proton pump inhibitor therapy (PPI). Think Nexium. These drugs act to block the pathways that stimulate gastric acid secretion (Ament, et. al. 2012) and they are one of the highest selling drugs in Australia and the US so clearly a lot of people are dealing with this issue. While they offer a great deal of relief to sufferers its still important to work out what’s driving the reflux in the first place. Why? Well, stomach acid is kind of important…. consider the following key points:

  • Research indicates that stomach acid did in fact evolve to serve as a pathological filter; the pH environment kills microbes (Beasley, et. al. 2015). I.e. stomach acid protects us from bad bugs! This consequence is of most concern in elderly adults already at higher risk of infection.
  • It may be more difficult for beneficial microbes to recolonize the gut in a less acidic environment (Beasley, et. al. 2015). Gut health is all the rage right now, hey? And for good reason. Your entire immune system and many of your neurotransmitters are produced there…. so we kind of want to preserve gut health and retain the goodies!
  • Prospective trials have shown an increased risk between vitamin B12 deficiency and suboptimal stomach acid. I can attest to this…. most of the clients I see in clinic who have been using PPIs for a long time have shockingly low vitamin B12 levels. B12 plays a critical role in so many functions including mental health, healthy red blood cell production, energy production, cellular renewal and protection against various cancers thus the long term effects of suboptimal B12 may lead to other issues. (N.B. For the biochemistry on this, for those interested consider that pepsin – an enzyme in the belly – is responsible for cleaving B12 from proteins and binding it with R proteins (Heidelbaugh, 2013). I.e. pepsin is needed to make B12 available to the body. And pepsin needs gastric acid to do its job. See the connection?)
  • Clinical evidence shows that PPI use reduces the availability of vitamin C in gastric juice and reduces the amount of the active vitamin C available in antioxidant form. Again, vitamin C deficiency has significant consequences to a host of systems in the body (Heidelbaugh, 2013) as its super important.
  • Calcium absorption, serum iron levels and magnesium may also be compromised when stomach acid is suboptimal (Heidelbaugh, 2013). Trials seem to suggest that less stomach acid means higher incidence of bone fractures.

This is not an invitation to stop taking a PPI, because you should only do that with your GP’s consent. But it is my little defense case on the importance of stomach acid because as a nutritionist, it kind of all starts there in the gut. And if you don’t have the juice mixed up with your food then you won’t breakdown the nutrients. So… you really aren’t capable of getting much nutritional benefit from your food whatsoever. And given that every hormone, neurotransmitter, enzyme and cell is physically made via the food we eat (this is true on a biochemical level!) then accessing the nutrients your food offers is pretty darn important. Ummm its kind of the key to overall health and keeping everything working in the body. Remember, it all starts with food.

A nutritionist can assist you with doing some preliminary work to ensure that one day you are able to kick the reflux and the drugs as well. Many people that suffer refux have a highly inflammed gastrointestinal tract and may even have ulcers and intestinal permeability which needs to be healed as a priority. Concentrated forms of nutrients including vitamin A, D, slippery elm, the herb liquorice, tumeric and aloe vera are backed by research to support gastrointestinal healing. Don’t do this yourself. Work with a professional. Adding an extra teaspoon of tumeric to your curry won’t do it; you need high quality, high concentration extracted form of the right nutrients in supplement form and these come prescribed by a practitioner. They don’t come from your local supermarket.

There is some neat new research indicating that reflux may be more of an immune mediated reaction then a mechanical one. You can read about that in this article on Medscape here if you are interested. This does not discount the rest of this article, it simply means that down regulating inflammation is important for healing too.

If you are burping up acid and feeling pretty rotten in general then its time to get some help. Drop me an email here or call the clinic on 07 3398 1977 to book.

Note: it is not only PPI’s that change the pH of the stomach. Bariatric surgery involves partial removal of the stomach which may increase the stomach pH to between 5.7 and 6.8. Thus weight loss clients must be supported long term in order to ensure the small amounts of food that they are eating are optimally absorbed. Furthermore, they are at higher risk of microbial overgrowth particularly in the small intestine – SIBO (Beasley, et. al. 2015)

REFERENCES

Cho, C. & Yu, J. (2012). From Inflammation to Cancer. World Scientific, London.

Heidelbaugh, J. (2013). ‘Proton pump inhibitors and risk of vitamin and mineral deficiency: evidence and clinical implications.’ Therapeutic Advances in Drug Safety 4(3). Doi: 10.1177/2042098613482484

Agostan, T,. Dunbar, K., Odze, R. (2016). ‘Association of Acute Gastroesophageal Reflux Disease With Esophageal Histologic Changes’ Journal of American Medicine 315(19).Doi:10.1001/jama.2016.5657

Ament, P. Dicola, D., James, M. (2012). ‘Reducing Adverse Effects of Proton Pump Inhibitors.’ American Family Physician.  86(1). Available from  http://www.aafp.org/afp/2012/0701/p66.html  

Categories SPORT NUTRITION

Resting Metabolic Testing: My Results, Then And Now

Author Arlie Miguel Posted on Leave a comment

I know I bang on about metabolism testing with the team at JupiterHealth, but here are three reasons why I love it:

  1. It’s a test that gives us access to heaps of data that relates to your metabolism and your fitness and training ability*. When interpreted by professionals who understand every aspect of it, you can use the data in so many ways to improve your body composition, your performance and fitness, but above all else your health overall.

(*Note: downloading an internet program and entering your height, age and desired weight loss is a generic approach which may offer results for some but not many. Trust me, I’ve seen about 30 different test results now and we are ALL completely unique.)

  1. It looks at overall fat burning both at rest and during exercise. Calorie expenditure is one thing, but high fat burning ability is an indication of overall health. It generally means inflammation is lower, cellular respiration is better, mitochondrial efficiency is higher and overall energy levels will be far greater.
  1. Because the team at JupiterHealth are quite frankly awesome. They offer great service, their equipment is state of the art and Mark and Therese are true pioneers in the sphere of metabolism testing. Their approach is holistic and offers sustainable, long term results not overnight fixes. Mark is constantly updating the exercise programs based on new research; he’s pretty much a walking encyclopaedia of the latest exercise physiology research papers.

Oh and a fourth reason, the reason for this blog, is that I have benefited greatly from having my own metabolic testing done. It’s helped me improve my running, train more efficiently and effectively and most definitely resolve some fatigue issues I have battled since 2013*. (A story for another time: motto of the story, don’t expect to strip back to 10% body fat for competition body sculpting and not pay a large price).

So, I am now able to compare data after retesting my resting metabolism today at the centre. Here are the results from October last year:

Oct results

And here are the results from today’s test, 15 weeks later:

Now results

What’s changed and why is it significant?

The most significant change is my metabolism switching from a 60% carbohydrate engine to a 60% fat burning engine (at rest). My RQ,* a measurement which is increasingly being recognised as an important health marker, has dropped from 0.88 to 0.81. A higher RQ (closer to 1.0) indicates sluggish cellular respiration,* high inflammation and oxidative stress. It may also suggest other more serious underlying conditions including insulin resistance but that isn’t relevant in my case. It may manifest differently person to person but 2 common symptoms include fatigue and difficulty shifting body fat. In fact, JupiterHealth have done extensive work with clients suffering from chronic fatigue and often see carbohydrate burning as high as 90% in these cases. (*RQ: a measurement of the relevant amounts of macronutrients utilised by an individual based on carbon dioxide produced divided by oxygen consumed).

This is a significant change because it has greatly improved my wellbeing in the last 3 months. My energy levels have been far better than they were 3 months ago as has my mental health (read more here). My heart rate during exercise has come down a lot which will show up even more when I redo my exercise test. This in turn has benefitted my recovery and made training far more enjoyable and less stressful on my body. I have actually reduced my training load by 30% in the last couple of months but I am getting much more out of each session. Finally, an added bonus is weight loss of (now) more than 4kg. 59-60kg is basically ideal for me so I’ll be keeping it there.

Besides the HR training program issued to me by JupiterHealth (available to any of my clients who have their testing done) I have changed my nutrition a little by fuelling my high intensity sessions better and focusing on some key nutrients I think I was lacking including iodine.* I have also been taking Lipoic Acid*, CoEnzymeQ10*, 600mg of magnesium* with GABA*, a probiotic* and vitamin C* daily. It may sound like a lot, but there were other factors that I needed to address and this was my personal prescription. Please do not take this as individual supplement advice – consult a qualified Nutritionist or Naturopath and purchase evidence based supplementation, preferably from ‘practitioner only’  ranges (available only on script from a health practitioner – avoid nasty additives and supplements that contain trace nutrients only).

Oh, I can’t leave this blog without mentioning the fact that my resting energy expenditure has decreased from 1536 to 1305 calories per day. Although I am more about nutrients then calories this is still important because it indicates my metabolism has slowed down a little since last testing. My overall mass has decreased so naturally, my body needs less fuel, BUT this decrease of more than 200 calories per day still represents something I need to work on. I am fairly certain it reflects a loss of muscle mass, having only recommenced weight training in the last 10 days after a 6 week break. On Monday, I plan to scan my muscle and fat ratio in clinic and work on building up my muscle mass again to increase this resting energy expenditure.

I have a number of clients getting retested with JupiterHealth in coming weeks and I am looking forward to seeing their changes. This represents just a tip of the iceberg as far as the metabolic testing, but I hope it’s been of some interest to you.

Iodine: required for healthy levels of T3 and T4 thyroid hormones, making up more than 50% of these hormones

Lipoic Acid: powerful antioxidant and cofactor in healthy mitochondrial activity which has been shown in research studies to assist with both fatty acid and glucose metabolism. Specifically very effective in the treatment of Diabetes, often helping to reduce blood sugar levels and overall HbA1c.

CoQ10: Critical nutrient involved in energy production at the mitochondrial level, facilitating electron transport in the production of ATP. A key nutrient for endurance athletes in dosages of 150mg, preferably a mix of the active and inactive form. Recommended for people on statin drugs as statins appear to reduce the availability of CoQ10 in the body and may contribute to myopathy. 

Magnesium: the majority benefit from supplemental magnesium as its lacking in modern farming practises due to depleted soil levels. Relaxant of muscles, blood vessels, nerve conduction and many other processes. Indicated for high blood pressure, stress, muscle pain, muscle cramps, headaches, period pain, etc. Correct form is critical; magnesium glycinate, citrate and chelate show high absorbency. Best to avoid magnesium carbonate as may not be highly absorbable.

GABA: gamma-aminobutric acid. The chief of the inhibitory neurotransmitters, which I appear to be highly deficient in. Excellent for anxiety, stress, ‘calming the chatter,’ night terrors and various mental health issues. Should be practitioner prescribed and compounded carefully with supporting nutrients.

Probiotic: Various strains available (many – so again, get the right one from a professional otherwise you are wasting your money) for gut health.

Vitamin C: for adrenal support and immunity, as well as antioxidant status.

Categories MENTAL HEALTH

Nutrition, Mental Health And Functional Pathology Testing

Author Arlie Miguel Posted on Leave a comment

Disclaimer: I am not claiming to be an ‘expert’ in mental health by sharing the below article with you. I do however, have a strong interest in the nutritional biochemistry concerning neurotransmitters and neurochemicals that relate directly with mental health. Nutrition plays a very significant role in the balance of neurotransmitters in the brain and the gut and this needs to be integrated into treatment. This is a perrsonal story and if it benefits 1 person, its worth sharing. Mental health is a topic we can’t talk about enough – we need to keep the conversation alive. Please share this with anyone whom you think may benefit or relate to the discussion below.

For over 2 years now, I haven’t been feeling ‘quite right.’ Without going into too much detail I have been struggling with periods of extreme tiredness (I mean, I could seriously nap under the table by 10am in the morning!), struggling to find my usual motivation, experiencing really anxious tendencies and not always in a positive headspace. The fatigue thing was particularly concerning as it was having quite an impact. I had FULL blood tests done including comprehensive thyroid studies, iron and hormones and had spoken to a couple of GPs but nothing was coming up – all the more frustrating. I was having some success in recent months using nutritional support for neurotransmitter levels – but I was still leaving a lot of it to chance and ‘guessing’ what I needed so I bit the bullet and had a full neurotransmitter analysis done. The results came in yesterday and they’ve definitely provided a way forward. You can see the results below and I have provided a brief interpretation as well.

IMPORTANT POINTS:

-My serotonin levels are HIGH. With my symptoms, you would assume they would be low, however abnormally high serotonin can also induce many symptoms I can relate too: fatigue, anxiety, even susceptibility to cold. Standard treatment would have me on an SSRI however this would only exacerbate my symptoms. In addition, high serotonin can affect the GUT and digestion as the majority of serotonin is in the digestive system. It can lead to diarrhoea and even IBS (one of the reasons SSRIs can affect digestion).

-Dopamine: LOW. The neurotransmitter associated with MOTIVATION and reward and also the precursor to adrenalin.
-Adrenaline: LOW. Truth – I currently have no fight or flight response. I swear a bear could be chasing me in a forest and I wouldn’t react; I can’t remember getting that ‘surge’ for a long time. Further confirmation of this is very low serum cortisol levels that did show up in my bloods.
-Glutamate: LOW. Probably where you want it to be.
-The power of having results that validate how one feels is PRICELESS.

So, what now? Treating the cause and not just the symptoms means looking at rebalancing neurotransmitters and guess what? Nutrition provides the building blocks here. The inclusion of some foods can assist, but concentrated nutritional supplementation is indicated and extremely effective. Now I know exactly what I need and how much.

If your energy levels are extremely low or your mood is just not right, and you want options, ask your psychologist, integrated GP, Nutritionist or Naturopath if integrated Neurotransmitter testing may be right for you. This is science based testing conducted through specialised pathology labs and it enables personalised and tailored treatment for conditions that can be completely debilitating. Personally, I think this type of testing is GOLD considering the prevalence of mental health conditions in the country and the world today. Again, start the conversation and share this with people you think may need it. Always consult a psychologist or General Practitioner if your symptoms are severe and surround yourself with a team of practitioners that can tackle your health from all angles in an integrated manner for best results.

Categories SUGAR

Gut Health Changes Lives

Author Arlie Miguel Posted on Leave a comment

(Article 1 in a 3 part series examining the link between gut integrity and overall health)

Health is a journey and we all choose our own path. Whichever path that may be, the importance of good nutrition and a balanced lifestyle should always be considered, but unfortunately it’s often overlooked. Today, I talk to Jess Rath, Mother of 4 boys, teacher, fitness lover and blogger and I share her family’s journey with you to highlight just how effective nutritional intervention can be.

Prior to 2011, Jess’s family were like most other Australian families. Their diet typically consisted of toast, jam, cereal and milk for breakfast, sandwiches for lunch, muesli bars and other convenient snacks to fill the gaps plus quick and simple meals for dinner. There were 3 children, a fourth on the way and Jess’s oldest son Brayden was 15 at this time. When Brayden was 6 years-old, he had suffered from hives; a common skin condition involving a rash that can itch and burn. He had grown out of it, but out of the blue, the hives reappeared suddenly with a vengeance on a daily basis. Even worst, every 3rd or 4th day the hives were accompanied by severe swelling particularly around Brayden’s mouth and hands. This in turn affected his breathing and the family found themselves in hospital for treatment up to two times per week. Medical professionals insisted that Brayden’s condition was Anaphylaxis but allergists confirmed Brayden was not allergic to anything. Eventually, via skin biopsy Brayden was diagnosed with Urticarial Vasculitis, an autoimmune condition characterised by inflamed blood vessels and usually idiopathic in nature (no known cause). The recommended treatment was long term, low dose steroid use and because neither Jess nor Brayden were keen on this, Jess was determined to try other treatment options first.

With a young baby only a few months old and 3 other children to look after Jess bravely took on overhauling the family’s diet. The first literature Jess came across was the Paleo Autoimmune Protocol (AIP); quite a change for the family at the time. Based on this, Jess started by eliminating gluten and most conventional dairy and also installed a chemical maze app onto the 3 older boys’ mobile phones. This enabled the boys to take responsibility for their own nutrition when they were away from the family home and they were not to eat anything within the ‘red zone.’ Within a month, Brayden’s hives appeared every 3rd of 4th day (instead of daily) and the swelling was no longer an issue. Within 6 months, the rash was appearing on a weekly basis only. 8 months after removing most processed foods, gluten and dairy the hives made an appearance only once every 4 weeks. Now, 4 years on, Brayden is 18, living out of home, but still following the same nutritional guidelines and has had 2 cases of hives in the last 12 months.

But the family’s journey doesn’t end there. At Christmas time 2013, Jess and Paul’s youngest son William had just turned 2 and Jess began noting some unusual behaviours. William had become very sensitive to noise and wasn’t maintaining eye contact even with family members. He had started withdrawing from social situations with other children and reacting strongly to mild situations. Jess is a school teacher and had been around children diagnosed with Autism before and she was concerned by William’s traits. After various observations by professionals including a paediatrician and an occupational therapist, William was diagnosed with Autism; he was 3 at the time.

Having had success with nutritional changes in the past, this was once again where the family started. Jess stumbled across the GAPS* diet and took on some of these principles, with a view to treat William from the inside out. Bone broths for gut healing become a daily component of the diet and grains were eliminated. Jess taught herself to cook with alternative sweeteners and flours and ensured that William had his own snacks and ‘treats’ at birthday parties and other celebrations.

Prior to these specific nutritional interventions, William was having meltdowns 3 to 4 times per day and each was lasting in excess of 45 minutes. Within a month, meltdowns were a once daily occurrence, lasting 10 to 30 minutes. These episodes reduced in severity and William was able to take himself to his own bedroom, calm down and come back to re-join the family.

With access to early intervention support, other therapies including Occupational Therapy and Speech Pathology were introduced a couple of months after diagnosis. In addition, the family found a Chiropractor that also incorporated applied Kinesiology and acupuncture and this practitioner had experience treating kids with Autism. 18 months’ on, William is able to interact socially with other children and maintain eye contact well and he will be going into a mainstream school. His learning does not appear to have been hindered. William does take some specific nutritional supplements as well; these will be discussed in a follow up article.

As a Nutritionist I would like to stress the following about Jess’s story. Firstly, it is not unique – nutritional intervention as well as other allied health support is far more powerful than many people may think. Particularly when children are involved; please consider the size of their little bodies and the vulnerability of their systems – what we put inside their bodies is of upmost importance and lays the foundation for future health. Secondly, Jess worked with a team of professionals over a period of time to establish a path to long term sustainable health and wellness for her family –this was not an overnight success story and furthermore it was a collaboration of expertise from conventional medical professionals and allied health support. Thirdly, this story deserves both respect and gratitude; Jess chooses to share about private aspects of her family in the hope of benefiting others. Finally, I will add that this is not individual health advice and it does not replace the guidance of your primary care physician. If you are interested in exploring nutritional support or allied health services, a professional in any of these fields will work in with your current team and your path will not be the same as Jess’s as we are all individual.

You may now be left wondering ‘why’ and ‘how’ the food we eat and even the way we choose to live our lives can have so much of an effect on our health and wellbeing. I will be writing a follow up article highlighting the science and research that supports gut healing and it’s subsequent on mood and behaviour as this is largely relevant in this situation. I will be asking a number of different professionals to contribute to that article so stay tuned for part 2.

Jess now shares her recipes, her fitness ideas and her faith over on her website here. You can also find her on Facebook. Jess believes: “in order to be completely well we must first look after our faith, we must pay attention to the food we eat, and we must move our bodies every day.” Thank you Jess for sharing your story with the world.

Categories Uncategorized

Mike Willesee’s Paleo Journey

Author Arlie Miguel Posted on Leave a comment

I woke up this morning, flicked off my alarm and opened up social media. I was immediately reminded why I generally don’t start off my day like this because I was appalled. Gob smacked. Actually disgusted. At humans and how cruel we can truly be. Particularly on social media… what is that? People seem to have alternate personalities, one that they reserve for face to face contact and the other for slandering on social media. The amount of complete uproar and the degree of slandering that has come as a result of Mike Willesee’s absolutely tremendous health transformation is just pitiful. This is how I see things, in really simple terms, without adding any ambiguities to the situation:

1.Mike’s health was on a downward spiral. He admitted this, his Doctors admitted this, his family were aware of it.
2. Mike agreed to go paleo for 10 weeks to see if his health benefited from the dietary and lifestyle change.
3. Low and behold, his health has improved and its reflected in the blood results, his waistline and the scales. Furthermore, he feels energetic and has taken responsibility for making better food choices.

If I ran into Mike Willesee in a coffee shop, I’d like to say to him: “Well done Mike. Seriously, well done. You’ve not taken the easy road. Making nutritional and lifestyle changes requires commitment. But you’ve done it. Thank you for being an example to the world. For not rolling over and simply accepting that way of being or blaming your age or opting for more drugs or more surgeries. Thanks for taking a stand and showing people that it’s not a joke anymore. We can not expect to shovel garbage into our own bodies day in and day out and still expect them to perform. You join a minority group (some of them are my clients and I have been lucky enough to help in the journey) who are accepting that the status quo simply is not working and you have been willing to do something ‘different’ something ‘real’ for a different result.”

I feel bad for him. I hope he and Pete Evans both have really thick skin. We should be celebrating alongside him and yet people are criticising and bringing Mike and his team down. And if this is about paleo then let’s clear up a few things right here and right now:

1. Paleo is a real food lifestyle. With the added benefit of incorporating movement, down time and other stress reduction techniques. There are many variations of it in a sense, Pete Evan’s program is his own version and many people are benefiting from this particular template.
2. It’s not for everyone. However, real food, in my opinion is. And if you are on board with keeping it fairly real, I hate to break it to you, but you are probably not that far off paleo anyway.
3. There is fibre in fruits and vegetables and lots of it. Fibre does not need to come from highly processed cereals or even bread. This argument is getting a little tiring. We have an overconsumption issue, in general where starchy carbohydrates are concerned.
4. Paleo is ummm not about eating lots of meat. For those who are still at this stage, read ‘The Primal Blueprint’ by Mark Sisson or ‘The Paleo Diet’ by Loren Cordain (PhD.) Then, you can comment on a topic you understand.
5. Similarly, calcium is found in plenty of other foods, not just conventional dairy. Cheap and highly industrialised dairy products is about as far from real as you can get. Buy the good stuff or forget it. Avoid long life cardboard dairy products, $1 per litre milk and pre grated cheese. I really can’t believe we are concerned about the dairy issue… and yet its fine for us to accept the copious amounts of sugar, trans fats and take away products we consume as a nation day in day out….augh. This is not ok.

“For the first time in my life, I’ve stopped to think about the food I’m eating.” Mike Willesee 

I normally roll over this stuff. And I certainly do not post hate messages on other peoples Facebook pages or websites. Despite being the victim of some interesting social media tactics by others in this industry over the last few weeks, I will continue to keep things positive. I will not stoop to that level because I have a professional respect for others, their learnings and their approach. But I do have a commitment to my clients and on a larger level, to the world. And some of us are really keen to simply get the message out there that we have to start paying attention to food. I mean actual food. Not the stuff that passes as food but really isn’t. We pay more attention to the fuel we put into our cars then what passes between our lips and it really has to change. People, quite simply are not well. More drugs, more surgery, less fat in the diet… not solutions. Conventional medicine and the use of pharmaceutical drugs offers amazing possibilities and it is lifesaving where necessary. But how about we all take a little bit of responsibility for our own health and do whatever we can in our own power to avoid being sick in the first place? That’s a public health idea I would like to see policy built upon.

At 73 years of age Mike you have done exceptionally well. Congratulations on the lifestyle change and I hope you are an example to many others to follow. Ignore the people who are bringing pain to your moment of glory, they must be jealous because you look so damn fantastic!

If you missed the hoo ha, then catch up here.

Categories FATS, WEIGHT LOSS

Nutrition And Mental Health

Author Arlie Miguel Posted on Leave a comment

A few months ago I was introduced to a psychologist by the name of Carolyn Rogers and as a result of our mutual professional interests, we became friends quickly. You may be thinking what do nutrition and mental health have to do with each other?  Well actually quite a lot and Carolyn has both an interest and a broad knowledge of nutrition and its application in her particular field. This article is based on the conversations we shared when we recently caught up for lunch (at Paw Paw Café, Woolloongabba for those interested and yes it was tasty.)

Firstly, a bit about Carolyn. She has been a Psychologist for 16 ½ years and she has over 14 years’ experience working with clients to help them manage their weight. She was the Senior Consulting Psychologist for the Wesley Weight Management Clinic for five years and she continues to consult for a Bariatric Surgeon.  Bariatric surgery includes a variety of procedures that reduce the size of the stomach (or remove a portion of the stomach) including lap bands, gastric sleeves and gastric bypassing in order to prompt rapid weight loss by reducing appetite and portion sizes. I will add that prior to studying Psychology, Carolyn was a Registered Nurse for many years so her experience and involvement in healthcare and the medical community is extensive. From her many years of experience working with patients who are overweight, Carolyn has made some interesting observations.

Firstly, Carolyn feels very strongly that weight problems are usually physiological as opposed to psychological. She certainly does not take the viewpoint that her clients should simply exercise greater willpower by eating less and moving more. This realisation was founded many years ago when Carolyn was counselling clients who were placed on a low calorie, liquid diet. She observed that whilst many did lose weight initially they were mostly unable to keep it off. Others, despite following the program accurately, plateaued quickly and weight loss stalled. This prompted Carolyn to look into the work of Gary Taubes, author of Good Calories Bad Calories and Why We Get Fat which opened up a whole new perspective on weight management. These books in a nutshell, attempt to bury the low fat, high carbohydrate message for weight management and good health. They closely examine the role that insulin plays in the regulation of fat storage and the addictive effects of excessive carbohydrate. Carolyn has immersed herself into books and research articles about this topic ever since. She is particularly interested in the capabilities of sugar (fructose in particular) as a highjacker of the appetite suppressing hormones as well as the role that insulin resistance plays in obesity. She believes that the inclusion of good fats and protein and some degree of carbohydrate restriction is critical for long term weight management. In her experience, both binge eating and emotional eating is easier to overcome on a lower carbohydrate high fat diet, which is in fact the opposite of what most weight loss plans and shakes revolve around.

Further to this, Carolyn has an in depth knowledge of specific nutrients and the role these play in behaviour and emotion. In Nutritional Medicine studies, we are very concerned with the role of specific nutrients and the affect that deficiencies may have so it’s always great to meet other allied health professionals who recognise this. Some of the nutrients and herbs that Carolyn is particularly passionate about are outlined below:

  • Magnesium: we are aware that magnesium is involved in over 300 chemical reactions within the human body. Nutritionists will use magnesium in therapeutic combinations and dosages to treat irregular sleep patterns, stress, anxiety, high blood pressure and muscle pain to name just a few. Carolyn encourages all of her clients to take magnesium, particularly those that are highly stressed with poor sleep patterns.
  • Rhodiola: this is a herb that’s available in concentrated capsule form and studies have shown that it may be effective for stress management, mental fatigue and even exercise endurance. This article here discussed the merits of Rhodiola compared with the anti-depressant Zoloft for mild depressive disorder.
  • Zinc: studies have revealed that serum zinc levels tend to be much lower in subjects with mild to moderate depression as discussed by this psychologist here. Zinc together with B6 are essential supplements for those who suffer from Pyroluria, a condition where there is an abnormality in haemoglobin synthesis resulting in mood swings, anxiety and depression.
  • Vitamin D: the oh so important but too often overlooked vitamin D. Adequate vitamin D is critical for mental health. Carolyn prescribes ‘adequate sleep, moderate play in the sunshine and a healthy diet’ to maintain D levels and encourages supplementation to obtain optimal levels if necessary.

Finally, but perhaps most importantly Carolyn is passionate about gut health and the gut / brain connection. The gut is where everything happens. Even a perfect diet is useless if the gut is not healthy because unhealthy microbiome cannot synthesise nutrients. Fact: there is more serotonin produced in the gut than in the brain. Read more about our ‘second brain’ here.

On a final note, Carolyn states that mental health is about looking at the entire person and treating all aspects of the body, mind and the environment. Much the same as our outlook in Nutritional Medicine. It is important that no one point in this article is taken out of context and you must realise that this is general information only, not individual prescription. You need to work with suitably qualified health professionals in order to ascertain a treatment path for you, specific to your condition and your own body. This article was produced by me to once again emphasise the importance that nutrition plays as the foundation of good health and the true power of food especially in concentrated and complementary formulas.  This article is not intended to simplify any 1 health issue or provide a blanket solution. Refining diet and addressing nutritional deficiencies, just like psychology is a long term strategy and requires commitment from both practitioner and client. If you would like to discuss your needs please book in here. You can find out more about Carolyn Rogers at her website and I am sure I will share more about her in future articles.

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