We all get sick or injured. Eating fish regularly or taking fish oil and its derivatives as supplements can help get better sooner. Acute inflammatory responses are protective and are self-limiting. The initiation phase is followed by the resolution phase with “a temporal crescendo to resolution and decrescendo of initiation chemical mediator gradients”, from Serhan and Levy (2018)1.

Everyone knows that eating fish is good for you. But why is that exactly? The short answer is that it helps lower inflammation and more. So should you be taking a fish oil supplement?

Delayed-Onset Muscle Soreness is no joke. Minimising DOMS is always in the forefront of anybody who exercises. Many treatment options are available. Which work?

You have all been there: two days after leg day and walking down stairs is an exercise in pain.

Delayed Onset Muscle Soreness is the nemesis of all athletes. Your workout is great. Then by the end of the day after, you experience increasing stiffness and pain with movement. Why is that?

Part II of the series on Iron. In 2022, over 1.6 billion people worldwide were diagnosed with iron deficiency. Never-ending, debilitating fatigue is the most common sign of ID.

Similar to infection, psychological stress increase inflammatory markers in your central nervous system. Small molecules called cytokines are messengers that help coordinate the immune response.

Menopause is a hot topic right now. In 2024 Dr Lisa Mosconi published ground breaking research showing for the first time how estrogen decline affects brain regions directly.

Creatine supplementation is making a come back - for good reasons. Creatine benefits extend beyond exercise. Like many supplements, it can influence biomarkers on regular blood tests.

Many people manage to keep a stable weight over decades. How do they do it in the face of an ever increasing obesogenic environment?

Iron is necessary for physiological processes, such as oxygen transport, energy production, and cell division. Iron deficiency anaemia affects >30% of the world's population.

Current recommended minimum protein intakes may not be enough to stave off age related muscle loss known as Sarcopenia. Protein quantity and quality matters.
So many of us see our parents wasting before our eyes. The muscle appears to turn into skin and bone. They need to use their arms to get up from sitting. They struggle to get up two steps without using the handrail to pull themselves up.
And we get told it is normal: we will all lose muscle and strength as we get older.
Losing muscle year by year slowly drains our vitality and strength. Leading us to become frail and loose our independence.

But can you do something about it?

Interruption of blood flow to the brain is called a stroke. This can occur when a blood clot blocks a blood vessel (ischaemic stroke) or when a blood vessel breaks (hemorrhagic stroke) and the blood flows into the brain area. A mini (clot) stroke is called a Transient Ischaemic Attack (TIA) and symptoms disappear within 24 hours.
The most prominent risk factor for stroke is high blood pressure.

Metabolism is constant throughout adult life. Well, until you are 60y...
“I gained weight in my 40s because my metabolism slowed down”. Like me, you will no doubt have heard this many times. Maybe you have even said this.
The effect of ageing. The analysis also showed that from the age of 60 years there is a decline in energy expenditure of 0.7% per year independent of the accompanying muscle loss.

Few people talk about not being able to poop regularly. The quality of life of over 10% of people is impacted by constipation1. In my clinic it is the second biggest problem that people deal with on a daily basis. Not being able to sleep through the night is the number one problem.

Guayusa tea has been used for centuries as a herbal tea claiming to have medicinal properties as an oral hypoglycemic, antibacterial mouth wash, asthma, lactation, sex drive, kidney function, stomach pain, fever and fertility. Many of these health claims remain uncorroborated by scientific research.

My physiotherapists friends tells me that they were taught (years ago) that people with low bone mineral density (BMD) should avoid heavy lifting and definitely no high impact. Even today, some reputed medical establishments like the Mayo Clinic advise against high-impact activities such as jumping!

Fortunately the research evidence has in fact proved the opposite - that high-impact exercises can increase bone strength.

N-Acetylcysteine (NAC), is an amino acid derivative of L-cysteine and the precursor to glutathione. Glutathione is a powerful antioxidant involved in cellular redox balance. Direct supplementation of glutathione and cysteine has not very effective due to the degradation of the former by gastric juices in the stomach and the unstable molecule structure of the latter. NAC is therefore the preferred and effective mechanism to increase intracellular stores of glutathione.

NAC has direct antioxidant and anti-inflammatory effects and is used as a mucolytic. NAC helps break down mucus in the respiratory tract.

In an abnormal response to cold temperature, smaller arteries spasm (vasospasm) and restrict blood flow to parts of the body, typically the fingers and toes. Other areas that can be affected include the nose, ears, knees and nipples. The skin of the affected area first turns white due to the lack of (warm) blood and can even become blue if it lasts for a long time and oxygen levels fall below normal. In very severe cases, it can lead to tissue injury. When blood flow returns (this is called repurfusion) the skin becomes bright red and it can be very painful.

I find it difficult to drink enough fluids when it is really cold. Sure, I drink coffee (1) and tea (multiple), but drinking water takes conscious effort.

My recent hiking experiences in the Rocky Mountains of Canada, left me dehydrated on a few occasions. When your morning urine is very dark, it is a sure sign that you have not had enough fluids the previous day.
Hiking in cold weather it is easy to think you did not sweat much.

A dopamine mismatch or prediction error. Let me explain using a recent personal experience.

The RV Canada trip has been months in the making. Trying to decide where to go and what to see did feel overwhelming at times. And like most people I procrastinated until the last second! But I digress.

The diagnosis of osteopenia or osteoporosis can totally mess with your brain and induce a fear of falling in adults. I see this in many of my clients. Despite being physically strong and able, the mental stress of increased risk of fracture in the event of falling, can make many people refrain from their favourite activities like hiking, running, skiing or cycling. Suddenly, everyday activities become a hazard - the wet foot path poses a huge threat. It is reasonable to assume that this happens to older adults over 70 years. BUT, the clients that I see are often in their mid-50s.

Breathing through your nose should be the default way for most of your daily activities. Mouth breathing as default creates a list of problems almost as long as my arm. These include bad breath, dry mouth, frequent colds, dehydration, poor sleep quality, waking unrefreshed, snoring, asthma, feelings of anxiety, low concentration, brain fog, fatigue, low exercise performance, teeth crowding, facial deformities and nasal congestion.

Courtney Conley was a guest on the Peter Attia Drive Podcast episode #296 in April 2024 and they talked FEET. The podcast link is for the Youtube channel and the audio is available on usual places. I had my 1st bout of plantar fasciitis in 2012. Like many people I did not know what the pain in my heel was when it first started and I kept running. It got worse to the point where I had to crawl out of bed in the morning because walking was too painful.
It started in one foot but at stages both feet were so painful that I could not walk 500m.

Moderate drinking is generally defined as one drink per day for women and two for men1. This is a total of seven and 14 drinks per week for women and men respectively. Anything more than that is considered heavy drinking.
Chronic alcohol ingestion leads to low levels of vitamins and minerals through several mechanisms. The first is through by reducing the absorption of nutrients in the small intestine.
These include vitamin A, vitamin B1, vitamin B2, folate, vitamin C, and the minerals selenium, iron, magnesium and zinc.

Chronic sighing tells me a lot about your stress.
We all sigh many times during the day. Sighing is healthy and forms an important part of normal breathing.
But like so many things in biology, too much of a good thing is not good. If you are sighing every 30 seconds, it is not a good thing. And you are most likely annoying those around you. In the extreme, there is something called a sigh syndrome, characterised by irrepressible persistence of sighing1. A large percentage of these patients have a history of traumatic experience or anxiety.

This age-old advice to lose weight has been the fall back of doctors and dietitians for as long as weight loss has been a desired outcome (for some at least). It is easier said than done. Eating less takes considerable willpower, planning and most of all long-term consistency.

I want to focus on the Move More bit today.

People who regularly drink coffee in the morning have similar cortisol levels to those who do not.
Few things have so many myths and half-truths than coffee and caffeine. Last week I overheard a conversation where it was stated that your early morning coffee negatively affects your hormones. And that eating before coffee will prevent this effect.
Where to begin to unpack this? Which hormones exactly? And by what mechanism is it impacted? And should you even care?

Lifting heavy weights can reverse osteoporosis.

A landmark study in 2015, the LIFTMOR trial 1, showed that lifting heavy weights is safe and effective in improving bone density (BMD). This randomised controlled trial recruited 28 women over 60 years of age with low bone mass. The 8-month exercise program consisted of four exercises performed twice weekly for 30 minutes. Each workout consisted of five sets of five repetitions of the deadlift, squat, overhead press and jumping chin-ups/ drop landings. Weight was gradually added in order to sustain an 80-85% 1RM effort.

Something a little different today. I love reading and I hope some of you do as well. I have compiled a short list of book recommendations in the themes of Sleep, Move, Breathe, Stress and Nutrition.

Here are some of my favourite books I have read over the last year or so.
1. Sleep - Matthew Walker

The 4-7-8 breathing technique is referred to the “natural tranquilizer for the nervous system” - Dr Andrew Weil.

How to do it: inhale for a count of 4 - then hold your breath for a count of 7 - then exhale for a count of 8. Start with 6 rounds of breath. Increase to a total of 5-10 minute. Watch the video by Dr Andrew Weil or on my channel.

Similar to most breathing techniques used for relaxation, nasal breathing is encouraged. Some people may find the slow exhale difficult. If this is the case, it may help if you pretend to blow out candles on a birthday cake or use a hissing exhale, trickling the air out through the teeth.

Alcohol sedates you out of wakefulness, but it does not induce natural sleep - Matthew Walker in Why We Sleep.

Drinking alcohol 1-3 hours before bed makes you fall asleep faster, increases NREM sleep but decreases REM sleep during the first half of the night (1). During the second half, wakeful episodes increase and REM sleep “rebounds”. In other words: alcohol fragments sleep, it induces frequent light awakenings, severely compromise healthy sleep architecture. Your sleep is less restorative. Even if you drink alcohol late afternoon (6 hours before bed) your sleep is disrupted.

Glycine supplementation of 3g before bedtime improve sleep quality and reduces daytime sleepiness and fatigue compared to placebo (1) (2).

Glycine is a small amino acid that can act as an inhibitory neurotransmitter. It crosses the blood brain barrier and binds to glycine and NMDA receptors in many brain areas, including the suprachiasmatic nucleus (SCN) located in the hypothalamus. The SCN is known as the circadian pacemaker. The glycine binding in the SCN receptors initiate vasodilation to the skin (3). When blood vessels expands near the skin surface, we lose heat. This helps to reduce core body temperature which helps us fall asleep faster (4). Glycine also triggers muscle paralysis during REM sleep - this is important to prevent us acting out our dreams.

When is comes to maintaining your weight, sometimes having “black and white rules” about food are easier than “grey rules.”

This time of the year tasty morsels that tempt us to stray from our best intentions seem to be everywhere. Most people put on around 1-4kg (0.65% of a 70kg) between late November to mid January. It is not the Christmas lunch that is the main culprit, it is the little bit extra, everyday, over 8 weeks. Most research show that this weight is not lost after the festive season.

hronic stress release hormones that elevated blood sugar levels, increasing the risk for type II diabetes.
Glucocorticoids (cortisol) and catecholamines (adrenaline and nor-adrenaline) are the main hormonal response to stress. Acute stress is a healthy response that allows us to adapt. Glucocorticoids stimulate the liver to release stored glucose and at the same time reduce the ability for muscles to remove the glucose from the blood by blocking the action of insulin.

Supplementing with 30mg saffron extract lowers depressive symptoms, comparable to some SSRIs (1).

Many of you will know of saffron as a spice that makes your food yellow, often used in Middle Eastern and Indian dishes. Iran produces almost 90% of the worlds saffron flowers, Crocus Sativus. Active compounds include crocin, picrocrocin, safranol and zeaxanthin. Crocins have serotonergic effects, partially blocking the 5-HT2c signalling.

Grief is a psychological stressor resulting in increased inflammation markers including IL-6.

There are numerous blood markers that can be used to measure inflammation and these are called pro-inflammatory cytokines. Interleukin06 (IL-6) is a signalling molecule are released by immune cells. A study in 2022 found that IL-6 increased between 19-45% depending on the severity of grief symptoms after the death of a spouse. Grief temporarily dysregulates multiple bodily systems that negatively impact on the stress-response system. Grief and depression have overlapping emotional and physical manifestations.

High blood pressure is an under-appreciated risk for stroke and cardiovascular diseases. Slow and nasal breathing can lower your blood pressure. Almost 1.3 billion people are diagnosed with high blood pressure. There are many more people (another 1.1 billion!) that are unaware that they have hypertension (high blood pressure).

In my role as Clinical Nutritionist, I get the asked frequently if adding collagen powder is a good thing. And yes, it can be. But what is cannot do is count towards your daily protein intake.

The protein in foods is used by the body as the building blocks for structures including new cells, immune cells, hormones, enzymes, neurotransmitters, bones, and muscles.

As a Clinical Nutritionist I see many different types of health related challenges. Most often it is sleep. Not this time. About 18 months ago a client came to see me, let’s call her Laura, and her first words to me were “I think I am (stuffed)”. Her words were stronger but I think you get the drift. On my recommendation to be proactive about her long-term health she had a Bone Mineral Density scan (BMD). Laura’s results were borderline for osteoporosis. At the age of 56, her results showed a T-score* of -2.3 for the lower spine and -2.4 and -2.5 for the left and right hips respectively. In other words, the strength of her bones were considered below optimal. This increases her risk of fracture in the event of trauma, typically a fall. Her alarm was not unfounded. A low bone mineral density (BMD) is associated with frailty and with it comes early mortality.