Is Your IBS Driving You Crazy?

Bloated, constipated, gassy, crampy, heavy, loose stools- just plain uncomfortable? One minute you can’t go to the loo and the next minute you can’t get off of it?

The likely cause is Irritable Bowel Syndrome (IBS). It’s incredibly common. According to Guts UK, a charity set up to promote awareness of and funding for digestive problems, it affects up to a third of people at some stage or another and it is one of the main reasons people visit their doctor.

Unfortunately, according to the NHS, there’s not a lot you can do. The official view is that it’s a lifelong problem that no one really understands and that there’s no cure for (although over-the-counter medicines can help symptoms). So sorry, move along and deal with it yourself.

As nutrition professionals will tell you, there IS hope. A consultation with a nutrition professional specialising in digestive health can help provide some natural solutions for you, if you prefer not to take over-the-counter medication. AND your nutritionist can help you get to the bottom of what is causing your IBS symptoms (excuse the pun), so that you can take steps to start feeling your best.

Causes

SIBO– One of the most common causes of IBS is SIBO (small intestinal bacterial overgrowth). Experts estimate that 60% – 80% of people with IBS actually have SIBO. This describes a condition where bacteria manage to grow and thrive in the small intestine. It’s not a question of ‘good’ or ‘bad’ bacteria. There shouldn’t really be many there at all.

Lactose/Fructose Intolerance– It might be that you have a lactose intolerance. This is when your body is not able to tolerate lactose, a type of sugar found naturally in milk and other dairy products, leading to a host of ‘IBS symptoms’. It might similarly be fructose malabsorption. Again, some people are not able to absorb fructose and symptoms are very similar to lactose intolerance.

Dysbiosis– is an imbalance in the normal levels of beneficial (good) and pathogenic (bad) bacteria in the large intestine or colon. It can potentially be caused by the overuse of antibiotics or alcohol, other medications such as the contraceptive pill, an increase in high sugar diets, and stress.

Yeast overgrowth– Candida normally co-exists with many other types of bacteria, in a state of balance. We all have small amounts of Candida growing in our digestive tracts and living on our skin, usually kept in check by our “friendly” bacteria. When the gut environment gets out of balance (due to dysbiosis) we become vulnerable to overgrowth of yeast.

In some cases, digestive problems can be tricky to solve, and it almost always involves a lot of detective work. Although IBS might be very common, it is not normal to experience these symptoms. If your symptoms are hampering your life in a significant way, please know that there ARE things you can do. You don’t need to feel resigned to living with them for the rest of your life.

What can I do about my IBS now?

There are some simple tricks you can put into practice today and that might make enough of a difference to help you get your life back on track. I’m going to tell you what they are in a moment.

It might be helpful to clarify a few things in your mind first. To what degree do your symptoms bother you? Do you feel OK with finding temporary solutions for your symptoms? Are you feeling positive that they will eventually go on their own? The answers to these questions might be enough for you to keep going as you are. If it isn’t,  please contact me to book in a free 30-minute digestive health call to get an idea of what might be possible for you.

10 ways to improve your digestion

The following suggestions are very simple, but surprisingly effective for many clients at improving their symptoms of digestive distress.

DO

  • Try a cup of hot water or ginger tea (just chop up fresh ginger and steep in hot water) before meals to stimulate digestion.
  • Apple cider vinegar also works – take 1tsp before a meal in a bit of water or as part of a salad.
  • Eat bitter greens as a starter to stimulate your digestion- these are green, leafy vegetables like spinach, rocket, watercress, kale, broccoli rabe, cabbage, collard greens
  • Try a few cubes of pineapple or papaya before a meal. These contain enzymes that can boost your digestion. You might also consider taking a natural digestive enzyme supplement from a health food store to support your body’s natural digestion process.
  • Think about your food before eating it – the thought and smell kickstarts the digestive process so that stomach acid and digestive enzymes are produced, which help break down your food.
  • Make sure you’re chewing properly so your digestive tract has an easier time breaking down your food. Digestion starts in your mouth as soon as you start to chew your food. Chewing signals your salivary glands to start producing saliva, which contains enzymes that help you break down food. If you had to spit out the mouthful, no one should be able to tell what you’ve been eating.
  • Take a 15-minute walk after eating if you can. This lowers blood sugar levels and gets your digestive system moving (see, your granny was right).

DON’T

  • Eat at your desk at work. Getting up and out is important for so many reasons. But in this case, checking emails while you are also eating may make you wolf down your food and/ or not chew properly. Neither are good for your digestive health.
  • Try to eat on the go or when you’re stressed out. You won’t digest your food properly or absorb the nutrients. This is the quickest way to get heartburn and bloating.
  • Don’t eat fruit aftera meal. Fruit likes a quick passage through the digestive system. It can get stuck behind other foods that are digested more slowly and then ferment, causing gas.
  • Although there isn’t much scientific evidence yet for this, many people find that drinking too much water or other fluids with their meal slows down digestion. This is because the extra fluid is thought to dilute stomach acid which is needed to break down food properly. The best thing is try and see if it helps you or not.

 

Nutrition For Hay Fever

Itchy, watery eyes? Constantly sneezing? Hello hay fever! Now I really know it’s spring and you’re here to stay – like an uninvited guest – for the next six months. But while Mother Nature can be cruel, she is also kind. It might surprise you to know that changing what you eat can have a big impact on the severity of your symptoms. There is a noticeable correlation between what you eat and the severity of your hay fever symptoms. For example, if you are eating food products that contain high levels of histamine, then the chances are that this additional chemical influx will be intensifying your symptoms, making them more prominent and painful than ever before.

According to Allergy UK, as many as 30% of adults and 40% of children suffer from allergic rhinitis (the medical term for the condition), an allergic reaction to pollen. You might start noticing symptoms in March when the tree pollen season starts. Then there’s the grass pollen season, followed by the weed pollen season, which can go on into September.

If this is you, I sympathise: itchy, red or watery eyes; runny or blocked nose; sneezing and coughing; itchy throat, mouth, nose and ears; loss of smell; earache; headache; and feeling exhausted.

What Happens When You Get Hay Fever?

Airborne allergic reactions occur when substances called allergens connect to allergy receptors in the nasal cavity. The body releases a compound called histamine, which in turn causes a itchiness, runny nose, sneezes, watery eyes, and headaches. Histamine acts like a bouncer at a club. It helps your body get rid of something that’s bothering you — in this case, an allergy trigger, or “allergen.” Typical allergens can include dust mites, grass, tree and weed pollen, animal dander, and (shudder) cockroach parts.

When you have allergies, some of your triggers — such as pollen, pet dander, or dust — seem harmless. But your immune system sees them as a threat and responds. Your body’s intention — to keep you safe — is good. But its overreaction gives you those all-too-familiar allergy symptoms.

There are some foods will make the symptoms of hay fever worse, so try to cut these out or reduce them as much as you can during hay fever season. Other foods are naturally anti-inflammatory, so you’ll want to ensure you’re getting plenty of these in your diet.

Foods To Avoid

Foods and drinks containing high levels of histamine can aggravate your hay fever symptoms and include chocolate and alcohol- especially wine, champagne and beer (sorry about that), tomatoes, avocados and aubergines.

Histamine is not always present in certain food products, but it can be present in the bacteria that grows around them. So, food products that are aged, preserved, or fermented like vinegar, cured meats, sauerkraut, yoghurt, miso, soy sauce, and smoked and tinned fish can often end up being a big source of histamine.

There are also foods that, while they are not high in histamine themselves, are ‘histamine liberators’ and can trigger your mast cells (allergy cells) to release histamine. These include strawberries, pineapple, bananas, citrus fruits and egg whites.

Foods containing wheat – like bread and pasta, cakes and pastries –can stimulate an allergic reaction in those who suffer from grass pollen allergies.

Dairy products like milk and cheese thicken mucus, making blocked noses or ears much worse. Matured cheeses in particular tend to contain high levels of histamine. Dairy can also be responsible for releasing histamine into your systems. Even dairy alternatives such as soya milk should be considered with caution as soya milk contains a number of proteins that can cross-react with tree pollen, thereby stimulating an allergic reaction.

One of the most overlooked ways in which histamine tolerance can be improved is through the stabilisation of blood sugar levels. In the scientific literature, it is well-established that there is a bi-directional relationship between blood sugar control and histamine levels. This means that unstable blood sugar can increase histamine levels, and that we should reduce sugar intake and also make sure we have balanced meals with protein, fat and fibre rich carbohydrates at each meal.

Foods To Add In Or Increase When You Have Hay Fever

Some foods are anti-histamine foods and disrupt or block histamine receptors in your immune system, helping to reduce allergy symptoms. These include foods that contain the plant chemicals quercetin and beta carotene, and those high in vitamin C (see below)

Local honey also may be helpful because, although it contains trace elements of pollen, over time it may help your body become more familiar with the pollen entering your system and therefore reduce the inflammatory response it makes.

Quercetin containing foods: Onions, garlic, goji berries, asparagus, all berry fruits, apples, kale, okra, peppers, plums and red grapes.

Beta carotene containing foods: Sweet potato, carrots, butternut squash, red and yellow peppers, apricots, peas, broccoli, dark leafy greens like kale, and romaine lettuce.

Vitamin C containing foods: Blackcurrants, blueberries, peppers, kale, collard leaves, broccoli, kiwis, mango, courgettes, and cauliflower.

What To Drink

Drink plenty of water. Keeping well hydrated is helpful for all aspects of health. In the case of hay fever, it helps thin the mucous membranes in your nasal passages and reduces that ‘blocked up’ feeling.

Green tea is packed full of antioxidants, which are helpful for the immune system generally. It also contains a compound called EGCG, that is capable of blocking a key receptor involved with triggering an allergic reaction.

Ginger tea has been shown to help reduce allergic reactions by lowering your body’s IgE levels (the antibody involved in the specific immune reaction associated with hay fever).
Peppermint tea is worth trying because peppermint contains menthol, a natural decongestant that may help improve sinus symptoms.

Add nettle tea to your shopping list for its ability to relieve inflammation of the upper respiratory tract and ease nasal congestion, sneezing and itching.

An Anti-inflammatory Approach

Hay fever is an inflammatory condition and may be further helped by including other types of food that calm the inflammatory response. Top of the list are foods containing anti-inflammatory omega 3 fatty acids, which I often recommend to clients struggling with any inflammatory condition. These include all types of oily fish (like salmon, trout, sardines) as well as flaxseed and walnuts.

Coconut oil or milk is also anti-inflammatory due to being rich in medium-chain triglyceride (MCT’s) and can be used in cooking and baking or added to smoothies.

As well as adding flavour to your food, herbs like parsley, sage, thyme, oregano and basil have anti-inflammatory properties as do many spices, including turmeric, ginger, cardamom, cinnamon, clove, fennel and nutmeg.

While the main problem for hay fever sufferers is the pollen itself, you may also find that hidden food intolerances are making matters worse. I offer a range of testing options at my clinic if this is something you would like to investigate further.

Arthritis: What You Need To Know

As we get older, one of the things that can start to happen is that we experience aches and pains. If your aches and pains are a regular feature of your life, it’s definitely worth asking your doctor or physio for advice. Sometimes that regular twinge you are getting is something more serious, but don’t let the possibility of ‘something more serious’ prevent you from getting it checked out. If it’s nothing but creaking joints, that’s great. If it’s something else, well we can work on that too.

You may have guessed that the ‘something else’ I am thinking about is arthritis. I want to share some of my top tips for using food to help alleviate some of the symptoms of arthritis.

Types of Arthritis

There are 2 types of arthritis: osteoarthritis and rheumatoid arthritis.

Osteoarthritis occurs when cartilage between bones and joints wears down, allowing bones to rub together rather than giving them the protection and cushion they need. Cartilage is made up of collagen and other substances that make connective tissue both flexible and strong. Cartilage covers the ends of bones where they meet the joints — and deterioration over time can affect the shape and functionality of the joints, making it painful and difficult to carry out everyday tasks.

Under the age of 45, it’s more common in men, and over the age of 45, it’s more common in women. By the time they get to 50, 80% of people will have symptoms associated with this type of arthritis, which starts as a stiffness in the hips, back, knees or other joints. The joints then become increasingly swollen and inflexible.

Rheumatoid Arthritis is a chronic autoimmune disease that affects someone’s joints and causes ongoing pain, swelling, stiffness and limitations in terms of movements. For most people, their rheumatoid arthritis symptoms tend to flare up at times and become worse when inflammation levels rise, but then become better for a while, only to return once again. It can be triggered by genetics, or a bacterial or viral component, and also environmental or lifestyle factors. About 80% of sufferers are women. The body – for whatever the reason – develops antibodies against its own tissue, and it attacks the cartilage and connective tissue. Over time, joints become inflamed and enlarged.

There are a number of factors that are important in managing arthritis:

  • How good your digestion and detoxification are
  • Blood sugar balance
  • Inflammation
  • Levels of essential fats
  • Allergies

Underlying Causes

The key to improving the symptoms of arthritis is to work on the underlying causes rather than just treating the symptoms.

Digestion

The scene for inflammation – even if that inflammation is elsewhere in the body, e.g. the joints – is often set in the digestive tract. If the gut environment is disturbed (a disruption in the normal balance of bacteria), this can lead to bacterial infection, parasites, intestinal permeability (aka ‘leaky gut’), allergies and intolerances.

What then happens partially digested food proteins get into the bloodstream, along with other toxins and microbes, putting greater pressure on the body’s detoxification processes. Once the liver starts to become over-taxed, any dietary or environmental toxins may cause further inflammation.

A programme that works on creating a good gut environment is ideal. Probiotics and prebiotics can be very helpful.

Blood Sugar Balance

There is a big link between inflammation and how well your body responds to insulin, the hormone produced in the pancreas to help control blood sugar levels. If your body has a reduced sensitivity to insulin, for example due to long-term poor dietary/lifestyle habits or you are diabetic, this can lead to high levels of sugar and/or insulin in the blood. Too much of either is toxic and can trigger inflammatory reactions.

Learning to balance your blood sugar levels plays a key role in managing the symptoms of arthritis. This is achieved through eating adequate amounts of protein at every meal and snack, increasing the amount of non-starchy vegetables, and considering the quality and the quantity of the starchy carbohydrates you eat.

All of my work with clients looks at balancing blood sugar, which focusses on eating real foods (not weird things you can only buy at health food shops), keeps you feeling full, and helps you manage your cravings.

Inflammation

In pretty much every circumstance, joint problems are linked to inflammation and sometimes also to problems with the immune system (autoimmunity).

The body produces chemical agents in the body to either switch on or reduce inflammation.

Prostaglandins are one of the main chemicals in this process, and these are the easiest to manipulate with diet. There are 3 different types. Types 1 and 3 are anti-inflammatory and type 2 is pro-inflammatory (causes inflammation and promotes pain).

Omega-6 fats can convert into either type 1 or type 2 prostaglandins. Eating a diet high in omega-6 polyunsaturated animal fats (found in processed food, ready-made meals, meat and dairy produce – particularly non-organic) has the body producing more of these less desirable type 2 prostaglandins. Reducing animal proteins and dairy products can bring symptomatic relief.

Omega-3 fats on the other hand, can only go down the route towards the anti-inflammatory type 3 prostaglandin. Omega-3 polyunsaturated fats are found in foods like walnuts, flaxseeds, hemp, chia seeds, and oily fish. Monounsaturated fats, e.g. avocados and olive oil, are also anti-inflammatory but work differently and are not involved in these specific pathways.

High levels of sugar and insulin can also direct the conversion of omega-6 fats down the type 2 pro-inflammatory pathway.

There’s another group of chemicals called ‘free radicals’. These are highly reactive oxygen molecules that “steal” electrons (a negatively charged particle that orbits the nucleus in an atom of matter) from neighbouring molecules to stabilise themselves.  You might have heard of free radicals in skincare commercials. They are linked to accelerated ageing, cancer and other diseases. What helps keep these unstable molecules in check are antioxidants (again, something often talked about in skincare).

Antioxidants are found in large amounts in brightly coloured fruit and vegetables. The different colours tend to indicate the type of antioxidants produced – all are good. What we know about antioxidants is that they have a synergistic effect – eating a variety of different ones (by eating a large range of different coloured fruit and veg) has a greater effect that eating the same volume of the same type of fruit or veg.

Bottom line? Eat a LOT of vegetables and a moderate portion of low sugar fruits like berries (which have some of the highest antioxidant levels of all fruit).

If you have rheumatoid arthritis, talk to me about whether a more restrictive diet would work for you. This further cuts out all grains, nightshade foods (like potatoes, peppers, tomatoes, and aubergines) and other foods thought to play a role in causing an inflammatory environment.

Levels of Essential Fats

Omega 3 fatty acids (found in oily fish, seeds like flax, pumpkin and chia, and walnuts) are important to include daily because of their anti-inflammatory properties, which are well-documented.

Allergies

Many people with inflammatory conditions have allergies or intolerances, some of which may be due to leaky gut, where food proteins are able to get through the gut lining, triggering an inflammatory immune response. Common offenders are dairy products, yeast, wheat and gluten, other grains, eggs, beef, chilli, coffee and peanuts. If you experience arthritis – or in fact any other inflammatory condition, there may be mileage in having a food intolerance test. Ask me for details.

Food Action Plan

Remove Gluten and Dairy products

Reduce Animal protein

Increase non-starchy vegetables of all kinds (eat a rainbow of colours),vegetable protein such as pulses, oily fish, nuts, seeds, olive oil

Increase specific foods: celery, chilli, garlic, ginger, pineapple, red peppers, shiitake mushrooms, sweet potato, turmeric

Supplements– there are also numerous supplements which have been researched and can help reduce inflammation, including fish oil, curcumin, proteolytic enzymes, Boswellia. Ask me for details as it’s best to take them under supervision.

Stay Active

Low-impact exercise which doesn’t overly stress sensitive joints, including cycling, walking, water aerobics and yoga is beneficial for strengthening the muscles around the affected joint. this provides added support and reduces strain. Exercise has been shown to help lower inflammation and can even help prevent unnecessary replacement surgeries.

Sugar Substitutes

One of the things I am asked about most as a Nutritional Therapist and Health Coach is sugar substitutes. “What can I use instead of sugar ?” I am asked, so here’s the here’s the good, the bad and the ugly low down on some of  those sugar replacements you might think are healthy (and some that definitely aren’t).

Honey

Honey has a lot going for it in some regards. It contains amino acids, electrolytes and antioxidants, and antimicrobial compounds that can support your health. To get these extra benefits, you’ll want to choose a raw (unprocessed) local honey. It may also help relieve allergy symptoms, specifically hay fever, because the bees feast on the local pollen, and taking raw local honey can help you develop natural immunity over time. But, whichever way you cut it, honey is sugar. It may be natural, but sugar it is, and it behaves that way in your body, spiking blood sugar exactly as actual sugar would.

Medjool Dates

Dates are a popular feature of many paleo or natural sugar-free bars, because they are naturally very sweet. They have the highest nutritional benefit of all-natural sweeteners because they also contain minerals like selenium, copper, potassium and magnesium, as well as providing fibre to slow the speed at which the sugars hit your bloodstream. Studies show that they don’t spike your blood sugar levels that much and they’ve been proven to decrease cholesterol and boost bone health, and can help relieve constipation. Stick to 1 or 2 a day so there is no guilt associated with these caramel-like gems.

Maple syrup

It contains antioxidants (24 in fact), which are helpful in the fight against cell-damaging free radicals and inflammation. While studies show maple syrup does not spike your blood sugar levels as much, it is still wise to use sparingly. You’ll want grade A (lighter in flavour) or B (nutritionally better as it’s richer in antioxidants than grade A and with a more intense flavour). Avoid maple flavoured syrups as these are not the same.

Coconut sugar

Coconut sugar has become very trendy of late and brings a lovely caramel flavour to your food. It contains small amounts of iron, zinc, calcium, potassium, and antioxidants, and a fibre known as inulin which  may help reduce the absorption of glucose. It is perfect for baking with and has a lesser impact on your blood sugar levels than regular sugar, but it is still sugar, so use sparingly.

Palmyra Jaggery

You may not even have heard of this, but it’s the crystalized nectar collected from the flower of the Palmyra palm and has a deep, warm caramel flavour. You use it exactly as you would sugar, and often you can reduce the amount needed by up to a half. It’s packed with B vitamins and has a much lower GL than table sugar.

Brown Rice Syrup

This has found its way into ‘healthy’ recipes. It’s made from fermented, cooked rice. It’s not a particularly good option as a sweetener as it’s highly processed, contains very little in the way of nutrition benefits and the effect on blood sugar is almost identical to standard sugar.

Agave Syrup

Agave syrup comes from a cactus, and the syrup is made from the pulp of the leaf. It’s very highly processed and is mainly fructose, which needs to be processed by the liver, causing more stress for an already over-worked organ. Fructose is actually worse for you than glucose. Agave syrup (or nectar) is very similar to the (deservedly) much-demonised high fructose corn syrup, that has contributed greatly to the obesity epidemic in the US. My advice? Do not use it!

Stevia

This is another natural sweetener. There a number of different types of stevia, and ideally you want full, green leaf stevia that is unadulterated with other sweeteners. There are many brands out there that you should avoid because they’re so highly processed, and they also add in other chemicals. Pure stevia will not unbalance your blood sugar levels, thus avoiding an energy rollercoaster. But, a little bit goes a long way, so use sparingly.

Xylitol

Often found in the UK under the brand names Total Sweet or Xyla, xylitol is a sugar alcohol. It’s a little sweeter than sugar, has fewer calories and (the important part) 75% less carbohydrate, so the impact of blood sugar levels is lower than it would be if you were to eat the same amount compared to real sugar. It’s the same stuff used in sugar free chewing gum, thanks to its antibacterial properties. The downside is it is very highly processed, and some people can be sensitive to large amounts and may find their stools a little loose, or they get bloated, if they eat too much. Note as well that it is toxic for dogs.

Artificial sweeteners (like aspartame and saccharin)

People usually resort to artificial sweeteners in a bid to cut calories. This is bad news for a number of reasons, but I’ll mention the two biggies here: Research into some of them shows a correlation with cancer (weak, perhaps, and refuted by the food industry, but personally I’m not taking any chances). Secondly, nutrition science conclusively proves that weight gain/loss has little to do with calories in and out but what happens hormonally inside the body – how much insulin your body makes (insulin being the fat storage hormone that also sabotages fat burning). Recent research shows that these artificial sweeteners can increase blood sugar (and consequently insulin) levels more than normal sugar. So really, what is the point? Thirdly, research shows that ironically, they actually increase hunger. My advice is to stop now.

BUT…

The very best scenario of all is that you wean yourself off sweeteners of any kind as this helps you appreciate and embrace natural sweetness from real food. If you continue to eat sweet things, your taste buds will always want sweet things. That’s because sugar has been shown to have an effect on the brain similar to that of addictive drugs like nicotine, cocaine, heroin, and alcohol. In fact, quickly removing it from your diet can cause withdrawal symptoms, including fatigue, depression, headaches and muscle aches. No wonder it isn’t easy to quit.

If your diet has traditionally been quite high in the white stuff, the first few weeks can be a little tricky as your body (and brain and taste buds) starts to adjust – but bear with it.

 

 

 

Polycystic Ovary Syndrome (PCOS)

What is Polycystic Ovary Syndrome?

Polycystic (literally, many cysts) ovary syndrome (PCOS or PCO) is a complex condition, characterise by hormonal imbalances that affects the ovaries (the organs in a woman’s body that produce eggs). In PCOS, the ovaries are generally bigger than average. The outer surface of the ovary has an abnormally large number of small follicles (the sac of fluid that grows around the egg under the influence of stimulating hormones from the brain).The ovaries are polycystic, with many small follicles scattered under the surface of the ovary (usually more than 10 or 15 in each ovary) and almost none in the middle of the ovary. In PCOS, these follicles remain immature, never growing to full development or ovulating to produce an egg capable of being fertilised.

This means that ovulation (releasing an egg) may rarely occur and can therefore lead to reduced fertility. In addition, periods may be irregular or absent. Other features include excess weight and body hair.

What are the symptoms of Polycystic Ovary Syndrome?

Symptoms that occur if you do not ovulate

  • Absent, irregular or light periods– periods can be as frequent as every five to six weeks, but might only occur once or twice a year, if at all
  • Fertility problems – you need to ovulate to become pregnant. You may not ovulate each month, and some women with PCOS do not ovulate at all. PCOS is one of the most common causes of infertility.

Symptoms that can occur if you make too much testosterone (male hormone)

  • increased facial and body hair (hirsutism): usually found under the chin, on the upper lip, forearms, lower legs and on the abdomen (usually a vertical line of hair up to the umbilicus) .This is the only symptom in some cases.
  • Acne: which may persist beyond the normal teenage years.
  • Thinning of scalp hair (similar to male pattern baldness) occurs in some cases .

Other symptoms

  • Being overweight or obese: a common finding in women with PCOS because their body cells are resistant to the sugar-control hormone insulin. This insulin resistance prevents cells using sugar in the blood normally and the sugar is stored as fat instead
  • Miscarriage (sometimes recurrent): one of the hormonal abnormalities in PCOS, a raised level of luteinising hormone (LH – a hormone produced by the brain that affects ovary function), seems to be linked with miscarriage. Women with raised LH have a higher miscarriage rate (65 per cent of pregnancies end in miscarriage) compared with those who have normal LH values (around 12 per cent miscarriage rate).
  • Depression or poor self-esteem may develop as a result of the other symptoms.

Diagnosis

At least two of the following occur in PCOS, and often all three:

  • At least 12 follicles (tiny cysts) develop in your ovaries.
  • The balance of hormones that you make in the ovaries is altered. In particular, your ovaries make more testosterone (male hormone) than normal. The main hormones that are made in the ovaries are oestrogen and progesterone – the main female hormones, but the ovaries also normally make small amounts of male hormones (androgens) such as testosterone.
  • You do not ovulate each month. Some women do not ovulate at all. In PCOS, although the ovaries usually have many follicles, they do not develop fully and so ovulation often does not occur. If you do not ovulate then you do not have a period.

Therefore, it is possible to have polycystic ovaries without the typical symptoms that are in the syndrome. It is also possible to have PCOS without multiple cysts in the ovary.

Incidence

PCOS is relatively common among infertile women. If affects up to 10 per cent of all women between the ages of 15 and 50. In the general population, around 25 per cent of women will have polycystic ovaries seen on an ultrasound examination. But most have no other symptoms or signs of PCOS and have no health problems. The ultrasound appearance is also found in up to 14 per cent of women on the oral contraceptive pill.

What causes polycystic ovary syndrome?

The exact cause is not totally clear. Several factors probably play a part. These include the following:

1. A small increase in the amount of insulin and cellular resistance to its actions– insulin is a hormone that you make in your pancreas and its main role is to control your blood sugar level. Insulin acts mainly on fat and muscle cells to stimulate them to take in sugar (glucose) when your blood sugar level rises (as excess levels are toxic to cells). Insulin also stimulates the ovaries to produce testosterone (male hormone).

Women with PCOS have what is called insulin resistance, meaning that cells in the body are resistant to the effect of a normal level of insulin. Thus, more insulin is produced to keep the blood sugar normal.  Raised levels of insulin in the bloodstream are thought to be the main underlying reason why PCOS develops because this causes the ovaries to make too much testosterone. A high level of insulin and testosterone interfere with the normal development of follicles in the ovaries. As a result, many follicles tend to develop but often do not develop fully. This causes problems with ovulation: hence period problems and reduced fertility. Increased testosterone levels in the blood cause excess hair growth on the body and thinning of the scalp hair.
2. Raised luteinising hormone (LH) in the early part of the menstrual cycle- This hormone is made in the pituitary gland and stimulates the ovaries to ovulate and works alongside insulin to promote testosterone production. A high level of LH is found in about 4 in 10 women with PCOS. A high LH level combined with a high insulin level means that the ovaries are likely to produce too much testosterone.

3. Lower amounts of the blood protein that binds to and carries all sex hormones (called sex-hormone-binding globulin)– this  means that testosterone levels are higher and therefore more active. Sex-hormone-binding globulin levels are reduced in insulin resistance (meaning there are high insulin levels).

4. Hereditary factors- one or more genes may make you more prone to developing PCOS. PCOS is not strictly inherited from parents to children, but it may run in some families.

5. Weight– Being overweight or obese is not the underlying cause of PCOS. However, if you are overweight or obese, excess fat can make insulin resistance worse, a contributing factor to PCOS. This may then cause the level of insulin to not only rise even further, but high levels of insulin can contribute to further weight gain, producing a ‘vicious cycle’.

Risk factors for PCOS

  • a tendency in the family towards Type 2 diabetes (non-insulin dependent diabetes)
  • a close relative who already has PCOS
  • a tendency towards early baldness in the men in the family (before 30 years of age).

Nutritional and lifestyle approaches to PCOS

Research has shown that weight control improves many aspects of PCOS. Menstrual cycles become more regular, testosterone levels are reduced, fat and sugar metabolism improves, and spontaneous pregnancy may follow. Obese patients do not have to reach the normal body mass index; a weight reduction of even a few percent has clinical benefits. This is because visceral fat (intra-abdominal fat located inside the abdominal cavity, packed between the organs) is metabolically more hormonally active, and weight loss of a few percent is associated with significant loss of visceral fat.

Weight management through nutrition and exercise is now recommended to all overweight/obese women with PCOS (Kovacs 2006).

So, here are some tips to help reduce the hormonal imbalances associated with PCOS:

1. Research has shown that fat intake should be restricted to not more than 30% of total calories with a low proportion of saturated fat, which is found mostly in animal products such as meat and dairy. Healthy fats such as olive oil, nuts/seeds, avocados, and fish oil, and avocado are important parts of a PCOS–friendly diet however (Farshchi et al 2007).

2. Choose whole grain carbohydrates. The insulin level in your blood goes up after you eat. It increase the most after you eat or drink something that contains carbohydrates. Carbohydrates are found in grains (such as bread, pasta, rice, cereal, and potatoes), vegetables, fruits and drinks such as soda and juice. Even if you eat two foods that have the same amount of carbohydrate, they may have a different effect on your insulin level. This effect has a lot to do with the type of carbohydrate the food has.

Whole grain carbohydrates which contain fibre such as brown rice, whole wheat bread and pasta, oats, barley, etc. have a low Glycaemic Index (GI). GI is a term used to describe how a food affects blood sugar; the higher a food raises blood sugar, the higher the glycaemic index. The benefit of consuming low GI foods is that it helps keep your insulin level down, and also keeps hunger at bay for longer, thus aiding weight management. Sugary foods or refined grains (such as white bread, white rice and white pasta) on the other hand have a high GI and can cause insulin levels to go up and are also not very filling (which means you may feel hungry again shortly after eating them.

3. Always have some protein with each meal or snack– combining a carbohydrate food with protein lowers the GI because protein slows the release of sugar from foods into the bloodstream. This helps reduce blood sugar spikes and therefore helps prevent high insulin levels. Protein can be found in lean meats, fish, poultry, dairy products, tofu, eggs, beans, nuts and seeds. Try to consume plenty of plant proteins which are often high in fibre and low in fat, rather than just sticking to animal proteins.

4. Have balanced meals containing carbohydrates, protein, and fat – combining foods that contain protein or fat with a carbohydrate will help to slow down the absorption of the carbohydrate and keep insulin levels low. For example, have almond butter or hummus on bread rather than just a piece of bread by itself. A typical plate of food should consist of ¼ carbohydrates, ¼ protein and the remaining ½ plate of vegetables!

5. Have smaller, more frequent meals (every 3-4 hours) to help control blood glucose levels. Your insulin will go up much more if you have 3 cups of pasta than if you have 1 cup of pasta. This means it’s usually better to have small meals and snacks during the day than it is to have fewer really big meals to keep your insulin level lower.

6. Exercise– Research has shown that at least 150 minutes of moderate or vigorous activity per week for diabetes prevention. This is because exercise helps  your cells become more receptive to the effects of insulin which in turn helps lower insulin levels (Knowler et al 2002).

7. Supplements– there are a number of supplements which can be very helpful to rebalance hormones. Recommendations are based on your individual health profile and are discussed at your visit.

References

Cahill D (2010) Polycystic ovary syndrome (PCOS) last accessed 21.3.2013 online at http://www.netdoctor.co.uk/womenshealth/facts/pcos.htm

Farshchi H Rane A Love A Kennedy RL (2007) Diet and nutrition in polycystic ovary syndrome (PCOS): pointers for nutritional management.  J Obstet Gynaecol 27 8 762-73

Kenny T (2010) Polycystic Ovary Syndrome last accessed 21.3.2013 online at http://www.patient.co.uk/health/Polycystic-Ovary-Syndrome.htm

Knowler WC Barrett-Connor E Fowler SE et al (2002) Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346 393-403

Kovacs P (2006) Viewpoint: Lifestyle Modification is First-Line Treatment for PCOS last accessed 21.3.2013 online at http://www.medscape.com/viewarticle/522390

The Vitamin D Epidemic

By London Nutritionist Sylvia Hensher

How Vitamin D Deficient Is The UK?

A recent survey in the UK showed that more than half of the adult population in the UK has insufficient levels of vitamin D. In the winter and spring about 1 in 6 people has a severe deficiency. It is estimated that about 9 in 10 adults of South Asian origin may be vitamin D-deficient. Most affected people either don’t have any symptoms, or have vague aches and pains, and are unaware of the problem.

Why Do Your Vitamin D Levels Matter?

In addition to the well-known osteoporosis connection, deficiency of this fat-soluble vitamin can be linked to a wide range of health problems, from cancer and cardiovascular disease to cognitive impairment and problems with auto-immunity such as multiple sclerosis and type 1 diabetes. Huge increased research interest in this field is constantly bringing to light new evidence which underscores the enormous importance of vitamin D to human health.

Sources of Vitamin D

What many people don’t realise is that very few foods naturally contain vitamin D. Fortified milk, egg yolks and oily fish are the best sources, but we can’t rely on food to provide with optimal amounts of vitamin D on a daily basis. In fact, the major source (80 – 100%) of vitamin D is actually sunshine. Ultraviolet B (UVB) sunlight rays convert cholesterol in the skin into vitamin D.

That’s right, although cholesterol is often a much maligned substance, our bodies literally could not survive without it! The sunlight has to fall directly on to bare skin (through a window is not enough). To add to the complexity of this issue, age, skin colour, geographic latitude, seasonal variations in sunlight availability and sunscreen use can impact on your body’s ability to produce all the vitamin D it needs. For example, darker skins need more sun to get the same amount of vitamin D as a fair-skinned person and because of geographic location, people in the United Kingdom cannot synthesise vitamin D from November to the end of March.

Why the Vitamin D Epidemic? Continue reading “The Vitamin D Epidemic”

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Food Allergies & Sensitivities

By London Nutritionist Sylvia Hensher

Different Types Of Food Reactions

Type 1 Immune Reactions

The best known and well-studied form of food allergies is called a Type 1 immune reaction, also known as a classical food allergy. Type 1 food allergies occur in approximately only 2-5% of the population, mostly in children and are less frequent in adults.  The reaction is immediate, usually appearing 15 – 30 minutes from the time of exposure to the offending food substance. Usually occurring in people who are genetically predisposed, the immune system begins creating a specific type of antibody called Immunoglobulin E (IgE) to certain foods. One side of the IgE antibody will recognise and bind to the allergic food.  The other side of the antibody is attached to a specialised immune cell called a mast cell which is packed with histamine. Histamine is one of the chemicals that is released in the body as part of an allergic reaction, and which causes the itching, sneezing, wheezing, and swelling typical of allergic symptoms.  Primed for action, the IgE antibody now patiently waits for re-exposure to food allergens.

So, when you eat the allergic food the next time, IgE antibodies hungrily latch onto the food.  Instantaneously, histamine and other allergy-related chemicals are released from the mast cell, quickly bringing on the unwelcome symptoms of stomach cramping, diarrhoea, skin rashes, hives, swelling, wheezing or the most dreaded of all Type 1 reactions, anaphylaxis. Anaphylaxis is a severe, potentially life-threatening allergic reaction which causes your blood pressure to drop suddenly and your airways to narrow, blocking normal breathing. It requires immediate emergency medical attention.

Clinical approach: In Type 1 food reactions, offending foods are completely avoided and nutritional immune and digestive support provided.

Type 3 immune reactions

Type 3 immune reactions are much more commonly involved in food sensitivities than Type 1 reactions.  In fact, 45-60% of the population has been reported as having delayed food allergies.  A delayed food sensitivity also involves the immune system and occurs when your immune system creates an overabundance of antibody Immunoglobulin G (IgG) to a specific food.  The IgG antibodies, instead of attaching to Mast cells, like IgE antibodies in Type 1 allergies, bind directly to the food as it enters the bloodstream, forming food allergens bound to antibodies circulating in the bloodstream.  The allergic symptoms in Type 3 immune reactions are delayed in onset – appearing anywhere from a couple of hours to several days after consuming allergic foods.  This delayed onset makes pinpointing the culprit food difficult. In this instance, laboratory testing may be useful.

Delayed food reactions may occur in any organ or tissue in the body and have been linked to over 100 allergic symptoms and well over 150 different medical diseases.

Clinical approach: In Type 3 immune reactions, it is important to identify food triggers, either through food exclusion tests or laboratory testing (more on this below).Depending on the symptoms,  these foods are then excluded for a period of time, and then reintroduced on a rotational diet to avoid retriggering symptoms. In addition, nutritional immune and digestive support is provided.

Why Has the Incidence of Food Sensitivities Risen? Continue reading “Food Allergies & Sensitivities”

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Curcumin, Pain And Inflammation In Osteoarthritis

By London Nutritionist Sylvia Hensher

What Is Osteoarthritis?

In osteoarthritis, the cartilage that cushions your joints deteriorates and the synovial fluid that keeps your joints lubricated and cushioned is typically reduced as well. It is the most common form of arthritis among the elderly. It’s normally associated with “wear and tear” on your joints, but can also be caused by repetitive stress or acute trauma. The pain is a result of your bones starting to come into contact with each other as cartilage and synovial fluid is reduced.

It causes joint stiffness, pain, inflammation and swelling that can become debilitating. Many patients turn to non-steroidal anti-inflammatories (NSAIDs) and analgesics for pain relief but the regular, chronic use of these types of medications is associated with side effects such as cardiovascular problems, gastrointestinal harm and kidney and/or liver damage. If you are taking an NSAID, you are at approximately three times greater risk for developing serious gastrointestinal side effects than those who aren’t.

What Is Curcumin?

Curcumin is the pigment that gives the curry spice turmeric its yellow-orange color and is the active ingredient in the herb turmeric. Both the ancient Chinese and Indian systems of medicine have recognized curcumin’s beneficial properties for thousands of years, and now modern research is showing it may be one of nature’s most powerful potential healers.

Curcumin is known for its potent anti-inflammatory properties. The compound has been shown to influence more than 700 genes, and it can inhibit both the activity and the synthesis of enzymes such as cyclooxygenase-2 (COX2) and 5-lipooxygenase (5-LOX) that have been implicated in inflammation.

How Can Curcumin Help Osteoarthritis Patients? Continue reading “Curcumin, Pain And Inflammation In Osteoarthritis”

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