Doctor in the House – Homocysteine and risk of heart disease

May 24th, 2017
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I was lucky enough to meet Dr Chatterjee star of Doctor in the House at the recent Applying Functional Medicine in Clinical Practice Module I attended in April earlier this year. he was a lovely guy and its great to see a Doctor working so intensively with his patients combining his medical knowledge with life stlye and nutritional advice.

In the episode on Tuesday the 23rd May he addressed a lady with chronic anxiety and a guy with some longterm sleep issues and after testing it turned out he had extremely high levels of homocysteine which is a known marker for assessing risk of cardiovascular disease. A Homocysteine test is simple to do and I have used it for years. You can find a link to our Homocysteine tests here 

If you have any questions about the test or other risk factors for heart disease or if you would like to book a nutritional therapy consultation so that we can work closely with you to make essential life style and dietary changes to move you towards optimum health then please get in touch.Our phone no is 01273 775480 or you can email me on emma@smartnutrition.co.uk

Trust me I’m a doctor – Check the diversity of your microbiome

January 27th, 2016
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Recent research discussed on tonight trust me I’m a doctor is showing the links between your microbiome – the types of bacteria, it’s diversity – the balance and or the mix different types and your weight and bility to lose weight. If you would like to check your microbiome and diversity then the GI Effects microbiology is the test for you. Click here for more info about the test and to order

Getting Serious About Salt

November 30th, 2015
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An American study has shown interesting results on the link with dietary salt, or sodium levels, and organ damage. We’re led to believe that salt is mainly a problem in conjunction with high blood pressure, but this study seems to show that some people can show damage internally without the external sign of raised blood pressure.

A review paper by a team from the University of Delaware indicates that even in the absence of an increase in blood pressure, excess dietary sodium can adversely affect target organs, including the blood vessels, heart, kidneys and brain. Authors of the paper, “Dietary Sodium and Health: More Than Just Blood Pressure,” include William Farquhar and David Edwards in UD’s Department of Kinesiology and Applied Physiology and William Weintraub, chief of cardiology at Christiana Care.

“Blood pressure responses to alterations in dietary sodium vary widely, which has led to the concept of ‘salt-sensitive’ blood pressure,” says Farquhar. “There are no standardized guidelines for classifying individuals as having salt-sensitive blood pressure, but if blood pressure increases during a period of high dietary sodium or decreases during a low-sodium period, the person is considered salt sensitive. If there’s no change in blood pressure with sodium restriction, an individual is considered salt resistant.”

However, the research cited in the paper points to evidence of adverse effects on multiple target organs and tissues, even for people who are salt resistant.

So what does the salt actually do internally?

Potential effects on the arteries include reduced function of the endothelium, which is the inner lining of blood vessels. Endothelial cells mediate a number of processes, including coagulation, platelet adhesion and immune function. Elevated dietary sodium can also increase arterial stiffness.

“High dietary sodium can also lead to left ventricular hypertrophy, or enlargement of the muscle tissue that makes up the wall of the heart’s main pumping chamber,” Edwards says. “As the walls of the chamber grow thicker, they become less compliant and eventually are unable to pump as forcefully as a healthy heart.”

Regarding the kidneys, evidence suggests that high sodium is associated with reduced renal function, a decline observed with only a minimal increase in blood pressure.

Finally, sodium may also affect the sympathetic nervous system, which activates what is often termed the fight-or-flight response.

“Chronically elevated dietary sodium may ‘sensitize’ sympathetic neurons in the brain, causing a greater response to a variety of stimuli, including skeletal muscle contraction,” Farquhar says. “Again, even if blood pressure isn’t increased, chronically increased sympathetic outflow may have harmful effects on target organs.”

Which foods contain all this salt?

Taking the salt shaker off the table is a good way to start, but it’s probably not enough, says Weintraub, whose work focuses on cardiology outcomes.

“Approximately 70 percent of the sodium in our diets comes from processed foods, including items that we don’t typically think of as salty such as breads and cereals,” he says. “Also, restaurant food typically contains more salt than dishes prepared at home, so eating out less can help reduce salt intake, especially if herbs and spices — instead of salt — are used to add flavor to home-cooked meals.”

But the authors acknowledge that shaking the salt habit won’t be easy, and it won’t happen overnight.

“Reducing sodium will take a coordinated effort involving organizations like the AHA, food producers and processors, restaurants, and public policy aimed at education,” Weintraub says.

 Here on our side of the pond we recommend no more than 6g of salt per day. The Department of Health published an annual report on dietary sodium intake based on an assessment of the sodium content of urine samples collected from July 2011 to December 2011 from a representative sample of 547 adults.

  • The mean estimated salt intake, derived from urinary sodium excretion, for adults aged 19 to 64 years was 8.1g per day. Men had a mean estimated intake of 9.3g per day, and women had a mean estimated intake of 6.8g per day
  • Overall, 70% of participants had a daily intake of salt higher than the recommendation of no more than 6g per day. 80% of men and 58% of women exceeded this recommendation.

So, what do we recommend for healthy sodium intakes? When cooking, choose fresh local ingredients over packaged, processed foods. Try not to add extra salt before serving as the taste can be diluted but the sodium content can still be detected in the food. Taste your food before adding salt at the table; a lot of products like bacon, smoked fish, and cheese have salt already so the overall meal can still taste salty without needing any extra added. And finally, choose a pure salt like Maldon flakes, Cornish seasalt or Himalayan salt as they don’t contain harmful nasties, and add sparingly.  Low sodium in the blood can lead to what is called hyponatremia.  Signs of hyponatremia are fatigue, seizures, muscle spasms, confusion and coma.  Sodium deficiency is usually caused by vomiting, diarrhea, drinking excessive fluid (especially water), and excessive sweating.  It is rarely caused by lack of sodium in the diet.

Sodium is used for synapses to fire in the brain and for muscle contractions so it’s imperative we have enough in our diets. Foods like milk, beets and celery all are a natural source of sodium. The US National Institute of Health says ‘Hidden sodium is in items such as Worcestershire sauce, soy sauce, onion salt, garlic salt, and bouillon cubes. Processed meats like bacon, sausage, and ham, and canned soups and vegetables also contain added sodium. Fast foods are generally very high in sodium.” So it’s easy to have enough, but also easy to have excess sodium. Eat smart, be healthy.


Reference:

William B. Farquhar, David G. Edwards, Claudine T. Jurkovitz, William S. Weintraub. Dietary Sodium and HealthJournal of the American College of Cardiology, 2015; 65 (10): 1042 DOI: 10.1016/j.jacc.2014.12.039

http://www.sciencedaily.com/releases/2015/03/150310160033.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily+%28Latest+Science+News+–+ScienceDaily%29

https://www.gov.uk/government/news/report-on-dietary-sodium-intakes

http://www.nlm.nih.gov/medlineplus/ency/article/002415.htm

 

Psoriosis Inflammation and IL4

November 30th, 2015
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Inflammation is the key to understanding many ailments, including autoimmune conditions. As science learns more about the intricate workings of the human immune system, we can find many ways to combat these illnesses.

In an article called “Marshalling the body’s own weapons against psoriasis” on Science Daily there was a great explanation of how psoriasis and other inflammatory autoimmune illnesses are beginning to be treated.

“Inflammation is a defence strategy of the body against invaders. Increased amounts of blood and fluid flow into the infected areas, and the release of signalling molecules summon immune cells to the site of infection to effectively neutralise the pathogens. However, poorly coordinated or misdirected immune reactions can trigger inflammation even in the absence of external agents, thus causing undue tissue damage. This is the case in psoriasis and other autoimmune diseases, such as multiple sclerosis and rheumatoid arthritis”

The article then goes on to show some German research into Interleukin 4; “The substance’s ability to inhibit inflammation is well known, but its mechanism of action was not fully understood.

Scientists have now shown in an animal model and in a study on patients how IL-4 helps against psoriasis at the molecular level.  “Together with colleagues from Tübingen, we were able to show in earlier studies that the signalling molecule IL-4 is a promising candidate for the treatment of psoriasis,” explains Prof. Tilo Biedermann, who holds the chair for Dermatology and Allergology and is Director of the Clinic and Polyclinic for Dermatology and Allergology. “However, before IL-4 can be used as a standardised medication, we have to understand the exact mechanism of action — and we’ve now succeeded in doing just that.” They first used human and mouse cells to unravel the molecular effects of IL-4 on inflammation. The scientists discovered that IL-4 inhibits specific immune cells in a natural way: it prevents the cells from synthesizing and releasing two signaling molecules. The scientists also checked the findings from the animal model in a patient study. Twenty-two patients with psoriasis received subcutaneous injections of IL-4 over a period of six weeks. Tilo Biedermann and his colleagues then examined samples from the patients’ affected skin areas before and after the treatment.

The results confirmed the previous experiments: Before treatment with IL-4, the study participants had high levels of the signaling molecules in their inflamed and itchy skin. After successful treatment, the two substances were barely detectable. The result was that inflammation and psoriatic skin changes had disappeared.” Research continues into a viable medical cure.

So what can we do in the meantime to help with inflammatory conditions like psoriasis? My father-in-law swears that he got over his by bathing with fresh rosemary branches chopped from his garden.

“Rosemary (Rosmarinus officinalis L.) is one of the most common household herbs, used as spice in a variety of foods, and employed in traditional medicine for its healing properties. Rosemary is a rich source of active antioxidant constituents such as phenolic diterpenes, flavonoids and phenolic acids. Caffeic acid and rosmarinic acid are the most important bioactive constituents. The chemical structure of rosmarinic acid derives from phenylalanine via caffeic acid and from tyrosine via dihydroxyphenyl-lactic acid. It is easily absorbed through gastrointestinal tract as well as the skin. Rosmarinic acid is one of the most important and well known natural antioxidant compounds, which possesses neuroprotective effects in different models of neuroinflammation, neurodegeneration, as well as chemical-induced neurotoxicity and oxidative stress.”

Some products like this one use rosemary in extract form as an antioxidant, or something which can slow down or reduce oxidative damage in the body.  Other anti-inflammatory and antioxidant supplements are these and foods like ginger and turmeric. Try adding these to your diet in some form or another (dried, fresh or powdered, and added to smoothies or curries for example) and reducing inflammation-causing foods and drinks like coffee, alcohol and refined carbohydrates to reduce inflammation, whether suffering from an inflammatory condition or not. You may be surprised at how good you feel!

Reference:

Research “The Cellular Protective Effects of Rosmarinic Acid: from Bench to Bedside.” http://www.ncbi.nlm.nih.gov/pubmed/25578431?report=abstract

http://www.sciencedaily.com/releases/2015/02/150226101631.htm?utm_source=feedburner

Emmanuella Guenova, Yuliya Skabytska, Wolfram Hoetzenecker, Günther Weindl, Karin Sauer, Manuela Tham, Kyu-Won Kim, Ji-Hyeon Park, Ji Hae Seo, Desislava Ignatova, Antonio Cozzio, Mitchell P. Levesque, Thomas Volz, Martin Köberle, Susanne Kaesler, Peter Thomas, Reinhard Mailhammer, Kamran Ghoreschi, Knut Schäkel, Boyko Amarov, Martin Eichner, Martin Schaller, Rachael A. Clark, Martin Röcken, Tilo Biedermann. IL-4 abrogates TH17 cell-mediated inflammation by selective silencing of IL-23 in antigen-presenting cellsProceedings of the National Academy of Sciences, 2015; 201416922 DOI: 10.1073/pnas.1416922112


Food unwrapped channel 4

January 5th, 2015
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I’m just watching this programme and am surprised to see that there is no mention of non celiac gluten sensitivity. This is actually now recognised by the NHS and is known to cause issues for some people who do react to gluten but its not an immune reaction like you get when you are celiac. Its a shame as its misleading to the general public. There is a plethora of science and evidence that shows this is a very real and distressing problem for some people. It’s ok to say some people – who aren’t celiac – needlessly avoid gluten but to say that unless you’re celiac its not an issue for anyone is irresponsibly misleading.

Gluten Free Banana Bread with a twist

November 1st, 2014
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This banana bread is super moist and is a very tasty teatime (or anytime) treat. Coconut adds a special twist to make this a favourite in any household. As well as being gluten and dairy free its also paleo friendly.

Ingedients

150g Gluten free flour Flour
2 teaspoons Baking Powder
1 Spotty banana
2 eggs
150g Fat (Coconut oil, Ghee, Grass feed butter)
100-120g (or to taste) Sweetner  -Coconut Palm Sugar is a good choice
1 cup dried dessicated coconut

Instructions

Pre heat the oven: 180C

Mash the banana and add the egg and mix then add all of the remaining ingredients together. Pour into a lined loaf tine and bake for 35 (ish) minutes….it really is that simple.

 

Heading towards a stressful time

November 1st, 2014
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We all have meltdowns but to protect ourselves from the ravages of stress we need to learn and use effective stress management techniques. mindlfullness meditation has been getting a lot of attention lately and despite meditation being used for thousands of years by ancient traditions such as buddhism it has been slightly shunned by the medical profession as a new age pastime. Well now it available on the NHS  – It is a recommendation of the NICE (The National Institute for Health and Care Excellence) for stress and anxiety. Have a quick search and look up a some you tube videos to give you some guidance and get you started…. But if stress is getting the better of you and causing any of the following..

  • Low energy / fatigue
  • Insomnia
  • Depression
  • Loss of libido
  • Loss of motivation and drive
  • Irregular menstrual cycle
  • Infertility
  • PMS
  • Menopause / hot flushes
  • Cravings
  • Weight gain
  • Weight loss
  • Mood swings
  • Anxiety
  • Panic attacks
  • Nervousness and / or irritability
  • Digestive disturbances (diarrhoea, constipation, bloating, stomach aches/ pains)
  • Abdominal obesity

Then you may like to consider an Adrenal Stress Test. You can find more details about the Adrenal Stress Adrenal Stress Test here.

Oats are officially a suspect food for those with gluten intolerance and Coeliac Disease

October 2nd, 2014
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Over the years I have become suspicious about oats and haven’t included them in any gluten free exclusion diets I may have asked my clients to follow. A new study published in the journal GUT (1) has shown that there is a difference between the ‘cultivar” (cultivated varieties) of oats and that some will cause a considerable immune reaction, some will cause a slight immune reaction and some will cause no immune reaction. To some degree the study is inconclusive and further work needs to be done to find out which oats are designated as a low responder risk cereal.

1.Comino I, Real A, de Lorenzo L, Cornell H, López-Casado MA, Barro F, Lorite P, Torres MI, Cebolla A, Sousa C. Diversity in oat potential immunogenicity: basis for the selection of oat varieties with no toxicity in coeliac disease. Gut. 2011 Feb 12.

Delicious doesn’t touch it……..

July 14th, 2014
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The lovely Kate Lewis excelled herself when she created a 10 day pop up in Brixton Village. I popped down last night and sampled a variety of dishes ranging from cold pickled celeriac lasagne, pea shoot and micro cress salad with pea and truffle veloute – Delicious. Yellow Gazpacho – to die for, perfect for a hot balmy evening in the UK.I also tried the Avocado, Black Bean and corn cerviche with papaya jelly and plantain crisp – this was a serious taste sensation.

The delicious series of starters was followed by equally sumptuous mains;   Spiced lentil parcel, smoked ratatouille and salsa verde – another triumph,  jerk sweet potato and vegetable curry a smooth and creamy taste sensation and my favourite, Herbed tempeh roast served with crushed root vegetables, green beans and confit garlic mash with wild mushroom gravy.

Full though I was I managed to taste a range of desserts, a mango puree – one of the best I have had and believe me I’ve had many! And an old favourite of the Asparagasm team; Bitter chocolate, Avocado and chilli Terrine served with a vanilla cream. Yumm heaven is the only way to describe this.The perfect round off to the perfect meal.

An amazing array of dishes, delicious combinations, textures and tastes, super healthy and above all served with a funky style and panache  – Asparagasm set out to do what no one else has managed – to create asspirational fine vegan healthy and delicious dining of an extraordinary standard served with a whole heap of taste and satisfaction. They’ve done this and more – they are truly inspirational.

Keep an eye out and make sure you get on their mailing list and visit their next pop up  – visit www.asparagasm.com for details.

 

IBS Irritable Bowel Syndrome

April 10th, 2014
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This month the NHS in the UK are raising awareness about IBS.

Common IBS symptoms
• Alternating between diarrhoea and constipation
• Spasms along the digestive tract causing cramps
• Undigested food particles in stools
• Bloating and gas

 

We know that IBS is is really an umbrella term for a range of possible issues. I have seen many many clients over the years with IBS who infact have parasite – you can test for these here, others have a yeast overgrowth, some have a problem with the protein part of foods and others increasingly have an issue with the different kinds of natural sugars that occur in our diets – these people are FODMAP sensitive. If you are interested in trying to find out what is triggering your IBS please give me a call 01273775480 and I can see if a nutritional therapy consultation can help you. Emma

 

 

 

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