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

Chronic Fatigue Syndrome

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It wasn’t that long ago that to proclaim the existence of ‘Chronic Fatigue Syndrome’ would have prompted the retort “it’s all in your head” in both medical and social settings. It was even given the unflattering nickname ‘Yuppie Flu’ to underline this inherent disbelief of it being anything more than a whining of the well-to-do in relation to life’s general responsibilities. That rather narrow minded view has, thankfully, largely faded away. Medical science now recognises CFS as a constellation of possible symptoms that are underpinned by the presence of fatigue at a level that causes disruption to daily activities in the absence of other medical conditions related to fatigue. It is a complex, multi faceted syndrome that can present in many different ways among the population, and which can be caused by a number of factors. CFS is estimated to affect approximately 10% of the adult population, however this figure varies depending on which diagnostic criteria you use. CFS seems to affect women at twice the rate of men.

The myriad symptoms associated with CFS

In addition to the fatigue mentioned above, associated symptoms of CFS can include:

  • Mild fever
  • Recurrent sore throat
  • Painful lymph nodes
  • Muscle weakness and pain
  • Prolonged fatigue after exercise
  • Recurrent headache
  • Migratory joint pain
  • Neurologic or psychological complaints such as sensitivity to light, forgetfulness, confusion, inability to concentrate, excessive irritability, and depression
  • Sleep disturbance

Source: CDC diagnostic criteria for Chronic Fatigue Syndrome

There is also significant correlation in symptomatology between CFS, Fibromyalgia, and Multiple Chemical Sensitivities. In one study researchers compared symptomatology of 90 patients divided into thirds with either CFS, FM, or MCS and found that 70% of FM and 30% of MCS patients could be diagnosed with CFS according to the CDC criteria.

What causes Chronic Fatigue Syndrome?

The causes of CFS, like its symptoms, can be varied. They can include depression, prolonged stress or adrenal dysfunction, impaired liver function, impaired immune function and subsequent chronic infection, food allergies, and leaky gut. It is important to view every case in an individual light so as to determine the specific underlying drivers of an individuals presentation of CFS. These investigations should ideally be performed under the supervision of a practitioner of functional medicine such as a Naturopath or an Integrative GP, with specific treatment tailored to addressing these specific drivers. There are, however, some fundamental cellular processes that can be examined and treated in most cases of CFS that tend to be common to all. I will review these treatments here, however I want to stress that these approaches will be likely to fail in restoring complete health in the long run without properly addressing the underlying causes.

Mitochondria in crisis

Inside almost every one of your trillions of body cells is a powerful little engine that provides almost all of its energy needs. These engines are called ‘Mitochondria’ and they are an amazing example of symbiosis between an organism of bacterial origin and the human being. Mitochondria basically exponentially multiply the energy producing potential of the cell through a series of chemical chain reactions, and they are absolutely intrinsic to our health. In CFS, the structure and function of these mitochondria appear to be commonly badly damaged. This will clearly have an impact on the energy producing capacity of that individual. Furthermore, the damage to these mitochondria causes a leakage of their contents into the cellular space, prompting an immune reaction in the form of an inflammatory response and thus further destruction of mitochondria. Crucial to preventing mitochondrial damage and dysfunction are Glutathione and Coenzyme Q10.  Both of these perform a protective function as powerful intra-cellular antioxidants. Glutathione can be be taken as a supplement, however due to its poor intestinal absorption it is often better to take it in its precursor form, N-Acetyl-Cysteine. CoQ10 has been shown to be significantly lower in CFS patients, reflecting its increased requirements in this condition.

Magnesium to the rescue (again)

Magnesium is a crucial component in the process by which the mitochondria produce energy in the cell. In one study of 32 CFS patients who received magnesium supplementation, 90% of those receiving active treatment reported significantly improved energy levels, improved emotional state, and less pain. The citrate and aspartate forms of magnesium are particularly beneficial in CFS as both of these chelating agents also take part in the mitochondrial energy production process.

L-Carnitine for premium fuel

The substance L-Carnitine is a crucial transporter of essential fatty acids into the cellular mitochondria, thus providing fuel for their function. This study compared the effectiveness of the drug amantidine (commonly used to relieve fatigue in patients with MS) to L-carnitine in CFS patients. While amantidine provided no clinically significant improvement after completion of the treatment period, L-Carnitine provided statistically significant clinical improvement in 12 of 18 studied parameters.

Cellular repair

The oxidative processes mentioned above damage not only the mitochondria housed within the cell, but also the cell itself. This damage is most apparent in the protective membrane of the cell, and through this damage the signalling capacity and utility of the cell becomes badly dysfunctional. This can have wide ranging effects in the body, most of which are encompassed in the CFS symptoms listed above. It is crucial to repair this membrane damage to restore the function of the cell, and this can be achieved by providing the building block of a healthy cellular membrane. Phospholipids in the form of phosphatidylcholine and phosphatidylserine, omega 3 fatty acids from fish and especially krill, tocotrienols from vitamin E, and vitamin D all play a crucial role in this membrane repair.

Herbal energy and adrenal restoration

Common to most cases of CFS is the presentation of low cortisol, a substance produced by the adrenal glands in response to stress. Low cortisol is a sign of adrenal dysfunction and can contribute to symptoms of fatigue and muscular pain. Fortunately herbal medicine is excellent at restoring adrenal function:

  • Licorice extract can increase cortisol levels and provide adrenal support
  • Panax (Korean) Ginseng produces corticosteroid like activity and can thus improve energy and reduce inflammation
  • Rhodiola has been shown in this study to reduce the negative aspects of the cortisol response to prolonged stress in patients with fatigue syndrome, while increasing energy and mental performance
  • Withania (Ashwaganda) is a gentle and restorative herb that can reduce anxiety and improve responses to prolonged stress

I hope the supplements mentioned above give you a starting point to explore the many treatment options available for those suffering from Chronic Fatigue Syndrome. Remember that these treatments, while effective at relieving many symptoms associated with CFS, will not provide true health resolution without significant investigations into the driving causes of cellular dysfunction underpinning any particular CFS presentation.

In wellness,

James

Why heirloom fruit and veg is better for your health

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Nearly 2,500 years ago, the Greek physician Hippocrates proclaimed “Let food be thy medicine and medicine be thy food” and at the time this was certainly a fundamental truth that all could benefit from adhering to. However as the decades and centuries have passed, and as techniques of farming and plant cultivation have become increasingly the stuff of laboratory experimentation, our “food” is no longer what it was. This is clearly seen in the prevalence of processed chemical laden food that has flooded our supermarkets, however it is also true in areas of food that may not be so apparent – namely the fruits and vegetables that most would assume are natural, unprocessed, and healthy.

To understand how a fruit or vegetable could be less than optimal for abundant health, you first need to understand the nature of plant phytochemicals and how they can assist our bodies. Phytochemicals are secondary plant metabolites that exist as a third tier of nutrient beyond the simple macronutrients (protein, carbohydrate and fat) and micronutrients (vitamins and minerals) already present. These phytochemicals are thought to play a defensive role in the plant against environmental stressors such as pests, disease, radiation, and drought. Interestingly these phytochemicals have been shown to not only aid the plant in question in becoming more robust and impervious to environmental stress, but to also aid those animals that consume the plant and thus ingest these phytochemicals. Examples of these health promoting phytochemicals are resveratrol from grape seed, caretonoids from yellow-orange fruit and veg, and curcumin from turmeric. These phytochemicals have been demonstrated to be effective in reducing the prevalence of many diseases, specifically the big four of the Western world: cancer, cardiovascular disease, diabetes and dementia.

However this is where modern agricultural techniques have let us down. Over the past century, plant breeders in the areas of edible plants have focused their efforts toward producing ever faster growing, plumper, sweeter varieties of most produce. Interestingly, many of the health promoting phytochemicals have bitter or astringent flavour profiles and thus they are bred out of the plants through this process. This selective breeding, along with intensive industrial farming that saturates the soil with unnaturally high levels of growth promoting nutrients such as phosphorous while at the same time destroying all pest and disease stressors through the application of pesticides, fungicides and herbicides, has effectively resulted in nutrient poor varieties of produce which produce extremely low levels of health promoting phytochemicals.

To demonstrate just how depleted these phytonutrients can be, below is a diagram outlining the differences between some heirloom and modern varieties:

corn nutrient comparison

 

Bill Marsh/The New York Times; illustrations by Matt Curtius

It becomes clear that if we are to seriously attempt to maximize our health, we must choose our fruits and vegetables wisely. When shopping look for the more exotic varieties of produce, and don’t shy away from those blemished and slightly insect nibbled apples – they are likely to contain more phytochemicals due to greater exposure to environmental stress than their plump and perfectly waxed cousins.

There is another layer to this issue, and that is the length of time from when produce is harvested to when it arrives on your plate. Most major supermarkets will cold store fruit and vegetables for days or even weeks before you have the chance to purchase them. What many do not know is that this produce is not dead once it is harvested, it continues to respire and pursue its cellular processes, and over time this will deplete the produce of crucial nutrition. As an example: broccoli, kale, and spinach are all highly recommended nutrition dense foods, however within two or three days from harvest they may have half or even less of their original antioxidant levels. Buying local produce at farmers markets is a great way to ensure your produce contains the highest levels of nutrients (apart from growing and harvesting it yourself of course!).

So here are my tips for ensuring the fruits and vegetables you eat contain the highest level of nutrition possible:

  • Buy heirloom varieties of fruits and vegetables whenever possible. Swap examples include:
    • Swap orange carrots for purple carrots
    • Swap large tomatoes for multi coloured heirloom cherry tomatoes
    • Swap white potatoes for small fingerling varieties
    • Swap iceberg lettuce for rocket, kale and baby spinach
  • Eat your produce as soon as possible from purchase, especially broccoli, asparagus, kale and spinach
  • Buy you produce from local farmers markets
  • Store your produce well. For example, the best way to store leafy greens is to place them in a zip lock back, squeeze out all the air, prick a dozen or so small holes with a pin in either side of the bag, then store in the fridge.

And finally, have a go at growing some of your own produce. Even if you live in a small apartment, a few pots of herbs such as rosemary (full of incredible antioxidants by the way), thyme and basil, along with a small cherry tomato bush, will greatly boost your phytochemical intake and improve your health. If you live in a house with some land, why not reclaim some of that boring lawn and create a raised garden bed. You’ll be amazed at what you can grow yourself. I recommend purchasing heirloom seeds from a website such as Green Harvest and trying your hand at some ‘purple dragon’ carrots or ‘green sprouting calabrese’ broccoli – the flavour of produce you grow yourself can never be beaten!

In wellness

James

Coeliac disease and non-coeliac gluten sensitivity

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Browse any supermarket aisle these days and you’ll see a multitude of products offering the latest in what is considered ‘healthy’ food. These can include many brightly listed ‘free froms’ including:

  • Free from artificial colours
  • Free from artificial preservatives
  • Free from artificial sweeteners
  • Free from added sugar

However by far the most popular ‘free from’ of the moment is to be ‘free from gluten’. Gluten is the arch villain of the food world these days, and not without some good cause. Gluten is a protein found in the endosperm (seed covering) of the wheat plant, and can trigger severe inflammation and subsequent malabsorption in the small intestine of those who are reactive – namely those with coeliac disease. Now although the long term effects of the malabsorption caused by coeliac disease can be dire (the most profound of which seems to be a clear association with early death), until recently the medical attention paid to this condition amongst the general public was relatively scarce. This was mainly due to the fact that coeliac disease seems to affect approximately 1% of most populations and although this is relatively high compared to many other diseases, the prevalence is not high enough to warrant a widespread campaign of education and gluten elimination amongst the general populace.

Here’s where it gets controversial – recent studies have indicated that it is not necessary to have distinct coeliac disease in order to develop many of the signs and symptoms associated with it. These disease states tend to be grouped under the term ‘non-coeliac gluten sensitivity’ and some data suggests the prevalence of NCGS may affect up to 6% of the general population. This is a figure that starts to look much more deserving of attention, however at this stage there still tends to be a prevalent medical opinion that gluten sensitivity is only clinically relevant for those with clear coeliac disease. Thus many who present with symptoms of chronic diarrhea and weight loss, and who test negative to the human antitissue transglutaminase antibodies (Ig A anti-tTG) or jejunal biopsy commonly used to determine coeliac disease, are not instructed to eliminate gluten as a possible trigger.

So what do you do if you suspect that you have a sensitivity to gluten, or indeed coeliac disease? The first thing to determine is whether anyone in your immediate family has confirmed coeliac disease or NCGS, as there seems to be a clear genetic component in the development of these states. An easy and affordable way to determine whether you are reactive to gluten specifically is to eliminate it from your diet for a period of between four and eight weeks (depending on the severity of presenting symptoms), assess your symptom patterns throughout this elimination phase, and then reintroduce gluten containing foods and see if your symptoms re-emerge (assuming they did disappear during the elimination phase). This type of elimination challenge does require some effort on the part of the patient and I always suggest performing this assessment under the supervision of a health professional such as a dietician, nutritionist or naturopath. If this suggests gluten sensitivity then it is very important that you undergo the Ig A anti-tTG test (or jejunal biopsy) mentioned above to rule out or confirm coeliac disease due to the serious nature of this condition.

Should coeliac disease be confirmed, a strict avoidance of gluten containing foods is imperative. The foods containing gluten are:

  • Wheat (including ancient forms such as spelt)
  • Rye
  • Barley
  • Oats
  • Malt
  • Brewers yeast

There are many hidden sources of gluten and gliadin contained in processed foods, and as such a wholefood diet which excludes pre-packaged and processed additives such as sauces and other condiments should be followed as closely as possible.

The addition of pancreatic enzymes may provide some benefit during the early stages of gluten elimination, as they can assist in relieving the digestive load and thus freeing up our natural digestive processes to break up problematic proteins such as gluten before they trigger an immune reaction. Even more promising is the fungal sourced enzyme dipeptidyl peptidase IV (DPP-IV) which specifically targets the gliadin protein. The ongoing use of DPP-IV may prove beneficial to those with coeliac disease or NCGS so as to negate any possible damage caused by consumption of hidden sources of gluten.

Supporting liver function may be indicated in those with a predisposition to food sensitivities, as the Kupffer cells found in the liver should sequester any immunologically active material once absorbed through the intestinal wall and prevent it from triggering an immune reaction in the body. Prevalence of food sensitivity may indicate a weakness in this process, however many interrelated factors such as the degree of gut permeability as mentioned below must be considered before deciding on liver function as the target for treatment. The herbs milk thistle and schisandra may assist in restoring liver function.

Whether a confirmation of coeliac disease is determined or a non-coeliac gluten sensitivity seems more likely, there will certainly be some damage to the mucosal lining of the small intestine from prolonged exposure to gluten, and as such healing this damage is a priority of treatment. Glutamine is a crucial amino acid for the repair of the small intestinal mucosa, as is the mineral zinc. The herb golden seal is also excellent for the repair of intestinal mucous membranes. The herbs chamomile, turmeric and boswellia are particularly beneficial as anti-inflammatory agents in the intestinal tract, and the use of high dose fish oil as an up-stream suppressor of systemic inflammation should also be considered.

Avoiding any environmental allergens such as dust, pet hair, cigarette smoke and exhaust fumes is crucial in minimizing allergenic tendencies. The ubiquitous pesticide glyphosphate has been linked to the development of celiac disease and thus choosing organic produce is an important consideration when shopping for groceries. Adequate sleep and stress reduction are also important steps in reducing inflammation and allowing the body to heal.

As a final note, it is important to state that it is entirely possible to survive (many would say thrive) on a diet free of the grains containing gluten that I have listed above. Certainly moving to a more whole food diet free of processed chemical additives can only be a good thing for your health, and going gluten free can often have this effect as an unintended consequence (although as the food manufacturers cotton on to the popularity of gluten free foods there are more and more heavily processed options flooding our supermarkets).  Use your discretion and read every ingredient panel of the processed foods you buy – you may be shocked at the number of health damaging additives the most basic food item can contain.

In health,

James

How to make Bulletproof coffee

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Hi all,

Well it’s all the rage with coffee aficionados and health fanatics, and if you do it properly there’s no going back to that boring flat white!

Bulletproof coffee is basically black coffee blended with unsalted butter and MCT oil (produced by refining coconut oil), with the health benefits of sustained energy without the coffee crash as well as increased mental alertness and energy well beyond what a standard cup of coffee would provide. It is also generally well tolerated by those who normally feel queasy after a milk heavy grande latte. However like all culinary experiences the quality of the ingredients as well as the techniques of production are everything. You should use organic coffee (did you know that coffee plantations are one of the most heavily pesticide sprayed crops?) as well as organic butter from grass fed cows which gives a creamier consistency once blended. And yes, you must blend the coffee and not just stir it with a spoon so that you properly emulsify the fats – unless of course you enjoy a thick film of pure butter sitting on top of your black coffee.

I use the ‘Mini Porlex’ ceramic burr grinder to grind my beans fresh – this is the best way to preserve the natural antioxidants found in vast quantities in coffee beans, and ceramic grinders do not produce the antioxidant destroying heat an electrical blade grinder would. The quality of the bean is also very important – please throw out the instant freeze dried floor scrapings you may have stored in your cupboard and invest in some quality java. I love the ‘BUN’ brand of coffee and choose the locally produced variety grown in the lush sub-tropics of Byron Bay.

I also use an ‘Aeropress’ coffee plunger, which is basically an extremely high tech french coffee press. The difference is that the quality seal on the Aeropress produces a huge amount of pressure for extracting the liquid coffee goodness from the beans. Have you noticed how expensive a high quality coffee machine can be, and that the cost usually correlates with the bar pressure capability the machine can produce? The Aeropress basically produces this same extreme pressure, and you don’t have to take out a second mortgage to afford one!

So here is the process (watch the video above for a visual blow-by-blow):

  1. Grind your beans (or use pre-ground beans that are as fresh as possible)
  2. Place one tablespoon of organic unsalted butter into the bottom of your mug (or blender jug)
  3. Place between 1 teaspoon and 1 tablespoon of MCT oil into the mug / blender (I recommend starting with the teaspoon and building up to the tablespoon over a week or so to avoid what Dave Asprey, Mr Bulletproof himself, refers to as ‘Disaster Pants’)
  4. Pour your extracted coffee onto the butter and MCT oil
  5. Blend away!
  6. Enjoy the creamy and health promoting goodness

That’s it. Please try it out for yourself and leave a comment below so that we can all share the love of bulletproof coffee (and hopefully not stories of ‘Disaster Pants’).

In wellness,

James

Super yummy home made ice cream

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Have you ever read the ingredients list on tubs of ice cream at the supermarket. It becomes frighteningly clear that most commercial varieties of this delicious desert (or breakfast if you are so inclined!) have far more sinister items contained within than just frozen cream. There are a number of chemical thickening agents, artificial flavors, colors, and preservatives. Not to mention a truckload of sugar. But not to worry, help is at hand. Try the healthy ice cream recipe below and you will never frequent the frozen food section of your local supermarket again (and you really can eat it for breakfast and not feel guilty).

  • Take 600ml of fresh cream and pour it into a saucepan
  • Add a 400ml can of coconut cream
  • Add 2 tablespoons of honey
  • Add 2 teaspoons of vanilla bean paste
  • Stir this together on low heat until it is hot but not simmering
  • In a heatproof bowl whisk together 3 egg yolks
  • Pour the hot cream mixture slowly over the egg yolks, whisking the whole time
  • Place the bowl in the fridge until the mixture is cool
  • Place the cooled mixture into your ice cream maker (believe me it is worth the investment) and churn for approximately 25 minutes

Voila, a tub of super creamy, super healthy ice cream. For a chocolate version, just add 2 tablespoons of raw cacao to the recipe above.

Enjoy!

Yours in health,

James