Polycystic Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) effects from 12-21% of Australian women of reproductive age.[i] It is diagnosed by having 2 out of 3 of the following symptoms: irregular or absent ovulation, signs of excessive testosterone such as facial hair or acne, and polycystic ovaries.  The consequences of PCOS are reduced fertility, weight gain, irregular menstruation, insulin resistance (a pre-type II diabetic state in which cells do not respond to insulin leading to excess glucose in the blood) and increased risk of cardiovascular disease (CVD) and endometrial cancer.[ii]  There are other health problems that can seem similar so it is important to have appropriate testing done.  It is estimated that 70% of women with PCOS in Australia are undiagnosed. [iii] PCOS can have major health implications so if you have similar symptoms it is important to see your healthcare provider. Women with PCOS should have measurements taken for abdominal obesity, triglycerides, HDL, blood pressure, and glucose tolerance.

If you have been diagnosed with PCOS the biggest improvement can be seen with a 5-10% reduction in weight. This reduces insulin resistance as well as improving fertility and excess testosterone symptoms.  According to Australian guidelines, pharmaceutical fertility treatments should not be given to anyone with a BMI over 35 until weight is reduced because it is too big a health risk to mother and baby.[iv]  The best way to achieve weight loss is through diet modifications and exercise.  For advice on exercise please see my previous article.  A minimum of 150 minutes a week is needed to see results.  Even for women with PCOS who are not overweight exercise improves symptoms.

There are some supplements that can be helpful in improving symptoms.  Cinnamon can be taken as a supplement to help reduce fasting glucose and insulin resistance.  Berberine is a compound found in several plants and can be found in supplement form.  It has been shown to reduce insulin resistance, aid in weight loss, and improve lipid levels. Chromium and Magnesium can be helpful in reducing insulin resistance but will not help with the other symptoms of PCOS.  Inositol can also improve lipid levels, reduce CVD risk and improve fertility.

If you have PCOS and are planning on falling pregnant, it is important to improve the condition before conceiving.  Daughters of women with PCOS often have metabolic problems from infancy.[v]

If you have any questions about PCOS please see your local naturopath.

References

Some information for this article was taken from the following online presentation:

Villella S. Oligo and Amenorrhoea (unpublished lecture notes]. Health Masters Live, online; lecture given – 2013 Nov 14.

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[i] Jean Hailes Foundation for Women’s Health. Evidence based guideline for the assessment and management of polycystic ovarian syndrome. Clayton South: Jean Hailes Foundation for Women’s Health; 2011. 130 p.

[ii] Barclay L. New Guidelines for Polycystic Ovary Syndrome (internet). Medscape Medical News; 2004 Jan 28. Available from: www.medscape.org/viewarticle/467811

[iii] Jean Hailes Foundation for Women’s Health. Evidence based guideline for the assessment and management of polycystic ovarian syndrome. Clayton South: Jean Hailes Foundation for Women’s Health; 2011. 130 p.

[iv] Jean Hailes Foundation for Women’s Health. Evidence based guideline for the assessment and management of polycystic ovarian syndrome. Clayton South: Jean Hailes Foundation for Women’s Health; 2011. 130 p.

[v] Barclay L. New Guidelines for Polycystic Ovary Syndrome (internet). Medscape Medical News; 2004 Jan 28. Available from: www.medscape.org/viewarticle/467811

FAQs about Exercise

I talk about exercise in most of my articles as I believe it is one of the key factors to good health and long life.  The list of potential effects of exercise could take up most of my space but include improving cholesterol, blood pressure, diabetes, polycystic ovarian syndrome, depression, sleep apnoea, sleep, arthritis, immune health, and how you look and feel.  Most people know they should exercise but may be unsure about a few facts.  Here I will attempt to answer some of the more common questions about exercise in relation to weight loss.

How much do I need to do?   It has been found that doing at least 150 minutes of exercise in a week will have the best results for weight loss.  The duration is more important than the intensity.[i] This is because the longer you exercise the more fat you will burn.  The body stores carbohydrates in muscle as glycogen.  This muscle glycogen is used for energy in the first 20-30 minutes of exercise.  Between 30-50 minutes the body starts to use fat for energy.  At the transition point is when many people start to feel tired.  If you push through this feeling and do 50 minutes of moderate intensity exercise 3-4 times a week you will get the best results.

When should I exercise? Many people believe that exercising in the morning is the best time to get the best results.  Although this may bring slightly better results, time of day is less important than just getting out there. The best time is the time that fits into your schedule.

Should I eat before I exercise? The best results can be achieved with exercise on an empty stomach.  This will burn more fat, deposit more protein on the muscle and improve insulin sensitivity. [ii] Not everyone can exercise without eating first though.  If you feel lightheaded during exercise make sure you eat something first but just keep it small such as a piece of fruit.

Should I eat after exercise? Yes! This is the most important meal of the day. If you don’t eat then cortisol levels continue to rise leading to muscle breakdown, immune suppression and insulin resistance.  Your body also needs to replenish the glycogen it used so that you can exercise next time.  The best time to eat is within 30 minutes of exercising. [iii]

What should I eat after exercise? This is your chance to eat carbohydrates! Eat at a ratio of 3:1 carbohydrates to protein [iv] (this ratio is ONLY for post exercise).  Have some fruit or low GI grains with a good protein source.  Most protein powders will have a good ratio of protein to carbohydrates.

I’ve hit a plateau.  What do I do? As a person loses weight they need less energy to move around so they burn fewer calories.  If you have hit this point it means you need to step up your exercise.  You need to either exercise longer or increase the intensity.  Trying a different form of exercise can often be helpful too.

Many people are worried they may have gained weight over the holidays.  If you indulged a bit more than usual kick up the exercise level to compensate.  But remember that you don’t have to stop at every sausage sizzle you see.  If you have any questions about exercise talk to your local naturopath.  Make 2014 the year you get moving!

For those of you in the area, I will be practising in both Thirroul and Engadine starting in February. Check out my website for details: www.natactive.com.au

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[i] Chambliss HO. Exercise duration and intensity in a weight loss program. Clin J Sports Med. 2005 Mar; 15 (2): 113-115.

[ii] [iii] [iv] Sutherland K. Nutrition & Fuelling for Exercise and Leanness (unpublished lecture notes]. Health Masters Live, online; lecture given – 2013 July 24.

Are You Being Preserved?

In my previous article on the advantages of organic food, I focused on the health risks involved with pesticides.  In order to be organic, foods must also be free of chemical preservatives.

Many foods are prepackaged and need to be able to sit on the grocery store shelf for long periods of time.  This has led to manufacturers using preservatives to keep the food from going off before the consumer buys the product.  Some natural preservatives include sugar, salt, vinegar, ascorbic acid (vitamin C), freezing and pasteurizing (heat treating).  Others are not so natural and may be detrimental to your health.

The recent health trend to help reduce cardiovascular disease (CVD) has been to cut down on eating saturated fats and cholesterol by decreasing the intake of red meat.  This has led people to increase their intake of ‘low fat’ processed meats.  A study published this year in BMC Medicine found that there was no link between unprocessed red meat and CVD.  The link is only with processed meats due to the high sodium and preservative content. [i]  Another study found an increased risk of ovarian cancer from eating vegetables and meat containing preservatives. [ii]

A study from the US published this year found that kids who drank more soft drinks were more likely to have asthma regardless of their weight.  They only looked at kids who drank regular soft drink so they were not consuming artificial sweeteners.  The authors speculate this is most likely due to the preservatives. [iii] So just because you exercise and burn off the calories, soft drinks still have detrimental effects on your health.

Certain preservatives have been found to have a wide range of side effects.  Sodium sulfite (221) and sorbic acid (200) were found to suppress immune cells. [iv]  Sodium nitrate (251) and sodium benzoate (211) have been found to alter DNA, which is how many cancers begin. [v] Sodium sulfite and sodium benzoate were found to decrease the hormone leptin. [vi] Leptin levels falling are a trigger for us to eat.  Consumption of these preservatives can lead to overeating which leads to weight gain. Sodium benzoate and artificial food colouring have been linked to hyperactivity in children. [vii]  Sodium benzoate and potassium benzoate (212) when combined with ascorbic acid (found in juice) creates benzene, which is a known carcinogen.  Benzoates are slowly being phased out but they are still in circulation so you need to watch out for them.

Sodium metabisulphite (223) has become more popular as a preservative but it actually kills food contaminants as opposed to the others, which just inhibit the growth.  It is used to sterilize equipment for wine and beer brewing.  It is used during processing and is present at levels lethal to bacteria when we consume the products that contain it.  As I have mentioned in previous articles, having healthy gut bacteria is important to our overall health status.  Consuming foods that contain lethal levels of preservatives is going to put your gut bacteria out of balance potentially causing illness.

In Australia, as in many other countries, if an ingredient is at a concentration of less than 10ppm it does not have to be declared on the label.  This has led some companies to advertise their products as ‘preservative free’ despite containing preservatives.  This is despite the fact that 10ppm is an effective level for killing bacteria.

Although it is important to keep microbes off our food, the best thing is to eat your food fresh so you don’t need to consume any chemicals.  If you do eat preserved food, make sure you check the labels carefully. 

References

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[i] Micha R, Michas G, Lajous M, Mozaffarian D. Processing of meats and cardiovascular risk: time to focus on preservatives. BMC Med. 2013 May 23; 11:136.

[ii] Lee AH, Su D, Pasalich M, Binns CW. Preserved foods associated with increased risk of ovarian cancer. Gynecol Oncol. 2013 Jun; 129(3): 570-3.

[iii] Park S, Blanck HM, Sherry B, Jones SE, Pan L. Regular-soda intake independent of weight status is associated with asthma among US high school students. J Acad Nutr Diet. 2013 Jan; 113(1): 106-11.

[iv] Winkler C, Frick B, Schroecksnadel K, Schennach H, Fuchs D. Food preservatives sodium sulfite and sorbic acid suppress mitogen-stimulated peripheral blood mononuclear cells. Food Chem Toxicol. 2006 Dec; 44(12): 2003-7.

[v] Loutsidou AC, Hatzi VI, Chasapis CT, Terzoudi GI, Spiliopoulou CA, Stefanidou ME. DNA content alterations in Tetrahymena pyriformis macronucleus after exposure to food preservatives sodium nitrate and sodium benzoate. Acta Biol Hung. 2012 Dec; 63(4): 483-9.

[vi] Ciardi C, Jenny M, Tschoner A, Ueberall F, Patsch J, Pedrini M, Ebenbichler C, Fuchs D. Food additives such as sodium sulphite, sodium benzoate and curcumin inhibit leptin release in lipopolysaccharide-treated murine adipocytes in vitro. Br J Nutr. 2012 Mar; 107(6): 826-33.

[vii] McCann D, Barrett A, Cooper A, Crumpler D, Dalen L, Grimshaw K, Kitchin E, Lok K, Porteous L, Prince E, Sonuga-Barke E, Warner JO, Stevenson J. Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial. Lancet. 2007 Nov 3; 370(9598):1560-7.

Is Eating Organic Worth It?

There is an ongoing debate about whether organic foods are really better for you than conventionally grown foods.  As it is more expensive, it is important to know whether it is worth the money or not.

For a product to become certified organic it must pass several criteria including being free from synthetic pesticides, herbicides, fertilizers, antibiotics and food additives.   These products are then labeled with the logo of the certifying body.  These organizations include the USDA, Australian Certified Organic, Canada Organic, or EU Organic Farming.  Some products aim to deceive by putting the word organic in their name, but this does not necessarily mean it is organic.  In Australia, several ‘organic water’ bottlers have been forced to remove the word organic from their name.  Water cannot be organic or otherwise.  Also, organic does not necessarily mean it is free from genetic modification, but these often go together.

Pesticides are made to kill bugs on plants.  Although they are allowed in low amounts on food, it only makes sense that if they can kill big bugs, that they could kill the small bugs in your gut.  Dr. Mark Donohoe is a GP in Sydney who previously thought there was no reason to eat organic, but has recently discovered that pesticides can have a big effect on your normal gut bacteria.  Good gut bacteria are needed to keep the bad bacteria at bay.  An overgrowth of bad gut bacteria has been connected to everything from IBS and headaches, to arthritis and weight gain.  With almost every health complaint I start by making sure a patient’s gut is functioning properly. 

It is still unknown the extent to the health problems that could be caused by pesticides but it is hard to believe they can kill bugs without affecting us.  The use of neonicotinoid insecticides has been banned in the EU due to its effects on bee health.  Beekeepers in Australia are calling for a ban on them too.

A study published in January 2013 found that fruit flies fed organic produce had greater fertility and lived longer. These flies were also more active and showed more resistance to stress.  Another study published in February found that tomatoes that were grown organically were subjected to more stress.  This stress caused them to be smaller, but higher in vitamin C and phenols.  Phenols can act as antioxidants that may help lower cholesterol.

A 2012 study found a higher risk of being exposed to antibiotic resistant bacteria after eating conventional chicken or pork as well as higher concentrations of pesticides in the urine of children eating conventionally grown foods.

To keep the cost of buying organic down, you can pick and choose some foods to buy organic and other conventional.  In Australia the foods with the highest pesticide residues are, in order, apples, wheat, strawberries, pears, grapes, lettuce, nectarines and peaches.  If you eat apples every day, but only have pears once in awhile, then you want to buy organic apples but could let the pears slide.  Buying seasonal, local foods is also cheaper.  When you do buy conventional produce, make sure that you wash it well.  Remember though, just because it is organic, doesn’t mean it is good for you.  Organic sugar is still sugar!

If you have any questions about organic produce, talk to your local naturopath.

References

Amis A. The Dose Makes The Poison (Internet). Friends of the Earth; 2012 Feb. Available from: http://www.foe.org.au/sites/default/files/TheDoseMakesThePoisonFeb2012_0.pdf

Australian Competition & Consumer Commission. ACCC negotiates removal of misleading ‘organic’ water claims (Internet). 2013 Jul 16. Available from: http://www.accc.gov.au/media-release/accc-negotiates-removal-of-misleading-‘organic’-water-claims

Australian Pesticides and Veterinary Medicine Authority. Neonicotinoids and honey bee health in Australia (Internet). 2013 Mar (updated 2013 May). Available from: http://www.apvma.gov.au/news_media/chemicals/neonics.php

Better Health Channel. Food - pesticides and other chemicals. 2011 July.  Available from: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Food_pesticides_and_other_chemicals

Chhabra R, Kolli S, Bauer JH. Organically Grown Food Provides Health Benefits to Drosophila melanogaster. PLoS ONE. 2013 Jan 9; 8(1). Available from: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0052988

Kamal-Eldin A, Frank J, Razdan A, Tengblad S, Basu S, Vessby B. Effects of dietary phenolic compounds on tocopherol, cholesterol, and fatty acids in rats. Lipids. 2000 Apr; 35(4):427-35.

Oliveira AB, Moura CFH, Gomes-Filho E, Marco CA, Urban L, Miranda MRA. The Impact of Organic Farming on Quality of Tomatoes Is Associated to Increased Oxidative Stress during Fruit Development. PLoS ONE, 2013; 8 (2). Available from: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0056354

Organic food better for bowel health, Dr Mark Donohoe says (Internet). The Australian. 2013 Aug 23. Available from:

http://www.theaustralian.com.au/news/health-science/organic-food-better-for-bowel-health-dr-mark-donohoe-says/story-e6frg8y6-1226702834484

Smith-Spangler C, Brandeau ML, Hunter GE, Bavinger JC, et al. Are Organic Foods Safer or Healthier Than Conventional Alternatives?: A Systematic Review. Ann Intern Med. 2012;157(5):348-366. 

Healthy Eating??

Eating a healthy diet these days can often be confusing.  Many foods are advertised as being health foods, but if you look at the nutrition labels they are actually just as bad as known ‘junk foods’. 

The dairy aisle can be particularly deceiving.  Yogurts are advertised as being healthy and even able to cure most of your ailments.  While yoghurts do contain some very beneficial probiotics that can help improve digestion, unless you are eating plain unsweetened yoghurt you may be consuming a large amount of sugar.  Jalna Low Fat Vanilla Yoghurt contains almost 11% added sugar.  Activia yoghurts, which are specifically advertised as being able to help you live a healthier lifestyle, contain from 6% to 13% sugar depending on flavour.  Compare this with products we all know to be unhealthy such as Paul’s Regular Vanilla Custard containing 14% sugar and cola soft drink containing 9% sugar.

Many people try to avoid sugar by eating ‘light’ products but these often contain artificial sweeteners.  Please refer to my previous articles on sweeteners for more information on these.

Many people choose low fat dairy products to try to cut down on their saturated fat intake.  There is still some controversy on whether or not saturated fats in dairy need to be avoided, but the main problem is that low fat products do not make you feel full and so you are more likely to eat more as a result.  The same is true for low fat ice cream. 

Yoghurt can still be part of a healthy diet by buying unsweetened full fat yoghurt and adding your own fruit.

Another product in the dairy aisle that can cause confusion is milk.  Some people consume flavoured milks to try to get their calcium intake.  Oak’s chocolate milk contains over 10% sugar.  When you compare this to the sugar content of the above foods it should be considered a junk food.

If you look in the ‘Health Food’ aisle of the grocery store, you can find some other unhealthy foods. Just because a product is labeled ‘all natural’, gluten free, or organic does not mean that it is actually good for you.  Mini Macro Wholegrain Apple Fruit Filled Bars contain the same amount of sugar as their Gluten Free Choc Biscuits – over 21%.

I’m not saying that you should never eat these foods, but just that you should check nutrition labels so you are aware that these are treats that should be consumed only on occasion along with your regular healthy diet.

References

Activia

http://www.activia.com.au/what-is-activia

Accessed 12 August 2013

Jalna

http://www.jalna.com.au/wellbeing/nutritional-data.html

Accessed 12 August 2013

Parmalat

http://parmalat.com.au/

Accessed 12 August 2013

Woolworths Online

www.woolworthsonline.com.au

Accessed 12 August 2013

Are Cold Sores Getting you Down?

Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) are in the same family of viruses as the Varicella zoster virus that causes chicken pox and shingles and Epstein-Barr virus that causes mononucleosis (glandular fever).  HSV-1 generally causes oral infections (cold sores) and HSV-2 causes genital infections although they can be found in both locations.  It is estimated that over 75% of Australians are infected with HSV-1 and 12% with HSV-2.   This does not mean that all these people will show signs of the virus though.  Many people carry the virus, and can pass it on, without knowing.

Herpes is an opportunistic infection, which means that it comes out when your immune system is down.  Your immune system can be affected by many things including stress, lack of sleep, sugar, alcohol, some medications and food sensitivities. If you get Herpes infections there are several things you can do to help avoid outbreaks, or treat them when they do occur.

• Ice - put ice right on the sore.  It is best to do it for about 30 seconds and as often as possible.  This helps stop the virus from spreading.

• Tea tree - you can put the oil straight on, but only use a little the first time as some people find it too harsh.  You can get cold sore lip cream containing tea tree oil from most health food stores. 

• Lysine - Take 500-1000mg 3-4 times per day.

• Vitamin B12 – take 2000mcg/day orally or 1000mcg/day by injection.

• Probiotics - these improve your immune system.  While you have a sore you can take 2 capsules 2-3x/day.

• Olive leaf extract - take 2-3 capsules per day.  Always take with probiotics but not at the same time.

• Oregano  - you can buy this in oil and put directly on the sore as often as you can.

• Avoid all nuts, nut butters and chocolate as they contain arginine that aggravates the Herpes virus.

• Avoid alcohol.

• Avoid any foods that may lower your immune system – sugar, simple carbohydrates or any food you have a sensitivity to.

• Deep breathing – getting a herpes outbreak is a way of your body telling you to slow down and relax.

If you are getting cold sores often you should mention this to your naturopath so you can work on improving your immune system. 

References

Cunningham AL, Taylor R, Taylor J, Marks C, Shaw J, Mindel A. Prevalence of infection with herpes simplex virus types 1 and 2 in Australia: a nationwide population based survey. Sex Transm Infect 2006; 82:164-168. Available from: http://sti.bmj.com/content/82/2/164.abstract

Accessed 6 July 2013

Weight Loss. You can too!

There are many diets out there, but true lasting weight loss requires a change in lifestyle. Carrying extra weight results in a higher risk for type 2 diabetes, high cholesterol, high blood pressure, knee and hip pain, cardiovascular disease, gallstones, female hormone dependant cancers, prostate cancer, colorectal cancer, renal cancer, dementia in women and premature death. But with just modest weight loss these risks start going down and improvements can be seen. Here are few things you can do to help you on your weight loss journey.

Weight loss requires your body to burn its stored energy, so you need to expend more calories than you consume.  A simple way to reduce calorie intake at each meal is to use smaller plates to help in decreasing portion sizes.  For a typical dinner on your plate you want half vegetables, two thirds of the rest to be protein and the small amount left as carbohydrates.  The carbohydrates that you have on your plate should be low glycemic index and load foods (for explanation of these terms please see my previous article ) and free from sugar as much as possible.  Whenever possible try to eat brown rice and wholegrain bread instead of white.  Simply changing the amounts of different foods on your plate can be a great start in losing weight.

Increase the amount of good protein in your diet.  If you crave sugar if may be because you are not eating enough.  Eating protein helps you to feel full.  An easy way to do this is by adding a protein shake.  Protein is especially important to include in breakfast.  Some good breakfast foods are eggs, almond butter or yogurt.  Seek out grains that are high in protein such as spelt or Kamut. 

Add good fats to your diet from fish, olive oil, or nuts and seeds.  Avoid anything that contains trans fats or aspartame as these can cause your body to retain fat.

There are many online calculators that can help you know how much you are eating versus exercising.  A study found that smart phone apps had the best compliance.  People also tend to lose more weight when they are working together towards a common goal so join a fitness group or just find some friends to set goals with.  If you don’t currently do any exercise, just walking for about 30 minutes per day can start to show results. 

Adding activity to our daily routine burns lots of calories too.  Walk instead of drive, take the stairs, get in the pool with the kids instead of sitting on the side, kids make great weights (and they love being thrown around and carried), do squats while brushing your teeth.  Just keep moving!  Following crash diets and occasional fasting, like skipping a meal, will result in fluctuating blood sugar and be counter productive to staying active and losing weight.

Making sure your digestive system is working properly is also important for losing weight.  Make sure you are eating plenty of fibre and drinking lots of water.  You also may want to take a probiotic supplement.  B-Complex supplements have also been found to aid in weight loss by increasing metabolism.

Get some sleep! Sleep quality and total time spent sleeping can actually predict weight loss.  Exercising and losing weight also helps people sleep better.  For help in sleeping, check out my article on sleep.

Permanent weight loss requires changing habits, lifestyle and becoming the person you want to be.  It is easier to lose weight with help, so if you have any questions talk to you local naturopath.

References

Batra P, Das SK, Salinardi T, Robinson L, Saltzman E, Scott T, Pittas AG, Roberts

SB. Eating behaviors as predictors of weight loss in a 6 month weight loss

intervention. Obesity (Silver Spring). 2013 Mar 20.

Carter MC, Burley VJ, Nykjaer C, Cade JE. Adherence to a smartphone application for weight loss compared to website and paper diary: pilot randomized controlled trial. J Med Internet Res. 2013 Apr 15;15(4):e32.

Government of South Australia, Department of Health

Healthy Weight Fact Sheet 2

http://www.health.sa.gov.au/pehs/branches/health-promotion/healthy-weight-factsheet2.pdf

Accessed 11 May 2013

Jean-Philippe Chaput and Angelo Tremblay. Adequate sleep to improve the treatment of obesity. CMAJ. September 17, 2012.

Jones, David S. Textbook of Functional Medicine. Johnson Printing: Boulder Colorado. Pg 132-133, 351; 2005.

Kullgren JT, Troxel AB, Loewenstein G, Asch DA, Norton LA, Wesby L, Tao Y, Zhu J, Volpp KG. Individual- versus group-based financial incentives for weight loss: a randomized, controlled trial. Ann Intern Med. 2013 Apr 2;158(7):505-14

Seshadri KG, Ananthakrishnan V, Tamilselvan B, Amarabalan R, Kumar RN. Effect of mild physical activity in obese and elderly women with type 2 diabetes. Indian J Endocrinol Metab. 2012 Dec;16(Suppl 2):S453-4.

Shils, Maurice E; Shike, Moshe; Ross, A. Catherine; Caballero, Benjamin; Cousins, Robert J; Modern Nutrition in Health and Disease.  Lippincott Williams & Wilkins: Baltimore. Pg 1035-1036; 2006.

Glycemic Index vs Glycemic Load

Glycemic Index

Glycemic index (GI) is a ranking of carbohydrate containing foods based on their immediate effect on blood glucose (blood sugar) levels. Carbohydrates which break down quickly during digestion have the highest glycemic indexes. The blood glucose response to these carbohydrates is fast and high. Carbohydrates which break down slowly, releasing glucose gradually into the blood stream, have low glycemic indexes.  The GI of glucose is 100 and everything else is compared to this.  Although each food is given just one number its GI can actually vary depending on variety, ripeness, cooking method and length of storage.

Glycemic Load

While each food has a GI ranking, glycemic load (GL) takes into account the quantity that is eaten by factoring in the amount of carbohydrate in a typical serving.  For example, watermelon has a high GI, but an average serving does not contain much carbohydrate (it is mostly water) so it has a low glycemic load.  For a serving of food, a GL greater than 20 is considered to be high, 11 to 19 is medium and 10 and below is low.  GL is defined as the grams of available carbohydrate in the food x the food’s GI/100. 

The Diet/Insulin Connection

Insulin is a hormone that responds directly to what you eat. Among its many roles in the body, insulin regulates fat metabolism and controls blood sugar levels. In an optimal state, the body maintains the blood sugar level in a fairly narrow range: not too low (hypoglycemia) and not too high (hyperglycemia).

Choosing low GI and GL foods means a smaller rise in blood glucose after meals. These foods can keep you feeling fuller longer and can improve the body’s sensitivity to insulin. They can also help people lose weight.

Eating a low GI or low GL diet has been found to be beneficial not only for diabetes and weight loss but also metabolic syndrome, insulin resistance, heart disease and cholesterol.  Eating high GI foods has been linked to obesity.

As a general rule, if you eat a varied diet trying to stick mostly with low to medium GL foods you will have the best results.

If you have questions about GI or GL, contact your local naturopathic doctor.

Having Trouble Sleeping?

As we are sleeping our bodies have many important jobs to do.  This is the optimum time for growth and rejuvenation of the immune, nervous, skeletal and muscular systems.  This is when muscle growth, tissue repair and protein synthesis occur.  Our bodies are healing, as this is the best time for white blood cell and antioxidant functioning.  We also secrete hormones such as growth hormone and melatonin and clear the build up of substances like adenosine.  Sleeping is also the key time for brain development and memory processing. 

Although we still don’t know everything our bodies do while we are sleeping, we do know what happens when we don’t get enough sleep.  Lack of sleep can more than double the risk of death from cardiovascular disease.  It can also be a risk factor for weight gain, high blood pressure and Type 2 diabetes.  Sleep difficulties are associated with depression, alcoholism and bipolar disorder.  Sleep deprivation affects judgment, mood, ability to learn and retain information and increases the risk of accidents and injury.  When sleep deprived our white blood cell count decreases.  In a study, animals deprived entirely of sleep lost all immune function and died within weeks.  Sleep problems have even been associated to digestive problems such as inflammatory bowel and Crohn’s disease.

So what is enough sleep? One study found that people who sleep six to seven hours each night live the longest.  But this is only if people wake naturally instead of with an alarm clock.  It is generally accepted that you have had enough sleep if you have no periods of tiredness through the day.

If you suffer from sleep problems the first thing to start with is to look at your sleep hygiene.

• Keep the TV, computer, tablet, phone, anything with a bright screen out of the bedroom.  Artificial light can shift your circadian rhythm.

• Sleep in complete darkness.  Even a little light can stop the creation of sleep hormones such as melatonin.

• Avoid stimulants such as coffee, tea or energy drinks after noon.  Some people can take as long as 18 hours to clear caffeine from their system so should not drink it at all.

• Try using an alarm clock with sleep stage monitoring.  This monitors what stage of sleep you are in so you are woken during a lighter sleep rather then a deep sleep.

• Avoid alcohol.  Although this will initially aid going to sleep it gives a worse quality sleep and you can wake in the night.

• Most sources say a routine is very important.  Counter to this is the theory that you should only go to bed when you are tired.  Try both and see what works best for you.

• And last but certainly not least, exercise and diet. Regular exercise and a healthy diet will improve your sleep along with most other ailments.

If you are still having problems with your sleep some supplements may be helpful in the short term, but talk to your naturopath before trying anything.

References

Ferrie JE, Shipley MJ, Cappuccio FP, Brunner E, et al. A prospective study of change in sleep duration: associations with mortality in the Whitehall II cohort. Sleep 30 (12): 1659–66.

Harvard Medical School: Healthy Sleep

http://healthysleep.med.harvard.edu/healthy/matters/benefits‐of‐sleep/why‐do‐ we‐sleep

Thase M. Depression and sleep: pathophysiology and treatment. Dialogues in clinical neuroscience 8 (2): 217–226.

Rowland R. "Experts challenge study linking sleep, life span". CNN.

Is Your Bowel Irritable?

Is your Bowel Irritable?

Poor digestion is often the cornerstone to most health problems.  If you are not digesting your food properly, you are not getting the nutrients you need.  As well, the toxins that your body is trying to expel are sitting there for longer than they should.  This can lead to any number of problems including cancer, arthritis, fatigue, migraines and depression.  Many symptoms will get better by improving digestion so it is very important to make sure that your gut is working properly.

Normally, a person should have at least one bowel movement a day.  It should feel complete and exit the body without pain or excessive straining.  It should be a light to medium brown colour and a solid consistency with no undigested food or mucous.  If you ever have a stool that is black or bloody see a doctor immediately as this indicates bleeding somewhere in your digestive tract.

Irritable Bowel Syndrome (IBS) is a diagnosis of exclusion.  This means that people are given this diagnosis when other reasons for their symptoms can’t be found.  Common symptoms are constipation or diarrhoea, urgency to have a bowel movement, a small volume of stool or pain in the abdomen all while appearing otherwise healthy.  Although IBS can seem to have no reason, for many people there are actually causes to their symptoms that can be treated.  Some causes are a high stress lifestyle, poor diet, being sedentary or most commonly food intolerances.  Another common cause is intestinal dysbiosis which is when there is an imbalance in the bacteria in the gut.  This can be caused by antibiotics, anti-acids, stress and infections.  It is important to make sure that your gut bacteria is in balance otherwise symptoms can simply get worse.

If you have these symptoms, you should make sure that you are checked for inflammatory bowel disease (crohn’s or ulcerative colitis) and diverticulitis through imaging studies, a viral, bacterial, fungal or parasitic infection through fecal tests or colorectal cancer through colonoscopy.  These other problems can look like IBS but have more serious consequences. 

Treatment for IBS needs to be specific for the patient as the causes and symptoms are individual, but a place to start is finding any food intolerances, increasing soluble fibre (fruits and veggies) and taking probiotics (good gut bacteria).

Contact your local Naturopathic Doctor to receive a personalized treatment plan.