Nutrition I-Mag - Target Publishing
Transcription
Nutrition I-Mag - Target Publishing
Nutriti n I-Mag READ THE NUTRITION I-MAG AND REGISTER YOUR SELFDIRECTED CPD CREDITS WWW.NUTRITIONIMAG.COM MAY/JUNE 2016 RESEARCH AND EDUCATION FOR TOMORROW’S PRACTITIONER MATTERS OF THE HEART The experts discuss how to protect our heart health READ OUR ‘IN FOCUS - GUT HEALTH’ SPECIAL THE ALLERGY EFFECT Protocols to survive the hay fever season A TIME TO CHANGE Nutritional guidelines for managing menopausal clients VITAMIN B12 IN DETAIL ✦RESEARCH NEWS ✦THE ROAD AHEAD FOR ION ✦NEW PRODUCT INNOVATION ✦I-MAG GIVEAWAYS WELCOME www.nutritionimag.com Nutrition I-Mag WWW.NUTRITIONIMAG.COM In partnership with: Welcome T he digital world is a fast-moving, ever evolving one, in which we can access whatever we want, at the touch of a button, any time of day. When you look at this sector, technology is advancing hugely; from our own perspective, the CAM Conference webinar programme, which is in association with Nutrition I-Mag and CAM magazine, are sell-out events because Nutritional Therapists want to access up to date, well-researched clinical information from experts in the field. And in a similar way, that’s what this magazine is all about; Nutrition I-Mag has always been a digital magazine, but this issue, we are taking things up a level. We have invested hugely in the technology used with this magazine, and this issue, we are very excited to bring you the result; a more interactive, easy to navigate magazine, using the very latest in technology. In this issue, you will find some expert advice at dealing with a range of issues that are common in clinic; we bring you features on heart health, hay fever and the menopause, as well as all the regular highlights. We hope that you like what we have done with Nutrition I-Mag and welcome all your comments; simply email me at rachel.symonds@ targetpublishing.com On another note, education is at the forefront of the business of Nutritional Therapists, and Target Publishing, which publishes Nutrition I-Mag, is committed to supporting this with the CAM Conference series of events. There are a host of events held throughout the year on themes of direct relevance to your work. Find out more at www.camconferences. co.uk or turn to page 14 for information on the upcoming events. Rachel RACHEL SYMONDS, EDITOR NUTRITION I-MAG, Target Publishing Limited, The Old Dairy, Hudsons Farm, Fieldgate Lane, Ugley Green, Bishops Stortford CM22 6HJ t: 01279 816300 e: [email protected] www.nutritionimag.com Meet The Team EDITOR Rachel Symonds CONTRIBUTORS Caroline Harmer, Michael Ash, Richard G Stead, Clare Daley SALES DIRECTOR Ruth Gilmour e: [email protected] GROUP SALES MANAGER Abigail Morris e: [email protected] SENIOR SALES EXECUTIVE Fiona Christodoulides e: [email protected] DESIGN/PRODUCTION Hannah Wade e: [email protected] MARKETING EXECUTIVE Sarah Kenny e: [email protected] MARKETING MANAGER James Rix e: [email protected] ACCOUNTS Lorraine Evans e: [email protected] MANAGING DIRECTOR David Cann e: [email protected] The Nutrition I-Mag is published by Target Publishing Limited, the leading publisher and conference organiser serving the natural, complementary health markets, as well as the leisure, education, sport and eco markets. www.targetpublishing.com ISSN 2049-4017 CONTENTS 6 N EWS The latest developments in the world of nutrition 7 R ESEARCH We bring you up to date with the scientific news www.nutritionimag.com CONTENTS FEATURES 8 PRODUCT WATCH What’s new to market 14 MENOPAUSE An expert guide into helping your clients ease through the transition 10 E DUCATION Book now for the 2016 series of CAM Conferences 17 HAY FEVER Discover the role of nutritional in alleviating symptoms of seasonal allergies 12 BANT All the news from the leading professional body 24 N UTRITION I-MAG GIVEAWAYS 22 A SK THE EXPERTS Nutritional experts answer your questions 17 20 HEART HEALTH An update into the latest findings when it comes to nutrition and cardiovascular disease 14 23 I NGREDIENT FOCUS Understanding the functions of vitamin B12 25 CPD DIRECTORY Seminar, webinar and conference dates for your diary 26 COMPANY PROFILE We bring your the latest news from the education experts, ION 27 RECIPES Satisfy a sweet tooth with the tastiest raw cakes 20 BIOGS www.nutritionimag.com OUR CONTRIBUTORS Each issue, Nutrition I-Mag enjoys contributions from many leading authorities in the nutrition world. This issue, our writers include: Dr Marilyn Glenville PhD Michael Ash DO, ND, BSc, DipION Marilyn is the UK’s leading nutritionist specialising in women’s health. She is the former President of the Food and Health Forum at the Royal Society of Medicine, a registered nutritionist, psychologist, author and popular broadcaster. For over 30 years, Dr Glenville, has studied and practiced nutritional medicine specialising in the natural approach to female hormone problems. The Glenville Nutrition Clinics works in Harley Street, London and Tunbridge Wells, Kent, and also has practices in Dublin, Cork and Galway in Ireland. Michael was in full-time clinical practice for 25 years, during which time he founded and developed the largest integrative medicine practice in the south west of England, incorporating the philosophy of functional medicine. He has specialised in the role of the wet tissues in human health for over 20 years. An author, researcher and presenter with skills in business development as well as clinical care, he has also been an adjunct member of the Institute for Functional Medicines faculty for many years. Lorna Driver-Davies Eli Sarre Lorna is Nutritional Therapist and Technical Assistant at Wild Nutrition. Lorna also regularly sees clients at Grace Belgravia Medical Clinic, London, and in East Sussex. Lorna uses a functional medicine approach and applications of naturopathy and herbal medicine and has a special interest in endocrine nutrition, female menstrual health and reproduction, as well as auto immune conditions and gastrointestinal health. Eli is a Nutritional Therapist specialising in gastrointestinal health and works with Foresight Preconception care, a charity offering fertility support. She is a registered member of The British Association for Applied Nutrition and Nutritional Therapy, and the CNHC. She is the founder of Wildfare Nutrition, a nutrition and marketing agency located in Bristol UK. Kay Ali Clare Daley Kay is Head of Nutrition at Bare Biology, the purest omega 3 brand in the UK. She is a specialist in omega 3 and has a particular interest in gastrointestinal health. She is a member of BANT and a Senior Associate Member of the Royal Society of Medicine. Clare joined Cytoplan in September 2015 as an in-house Nutritional Therapist. Clare has a BSc (Hons) in Biological Sciences and a Postgraduate Diploma in Nutritional Therapy. On qualifying in 2010 as a BANT and CNHC Registered Nutritional Therapist, Clare worked in private practice. She has a broad interest in nutrition but she is particularly interested in digestive health as good digestion is so central to overall health and wellbeing. NEWS www.nutritionimag.com News bites A round-up of the news from the natural health industry. Royal seal of approval for Protexin P rotexin has been awarded the Queen’s Award for Enterprise for the second time. Probiotics International Ltd (Protexin), which manufactures the Bio-Kult and Lepicol ranges, secured the accolade in recognition of the company’s outstanding achievement in the International Trade category. Jonathan Sowler, Commercial Director, commented: “The Queen’s Award for Enterprise is a global stamp of approval and is well known across the world. To be recognised again that we have excelled in an industry that we are passionate about and dedicated to is fantastic. “We have built strong international relationships across the globe with our trusted partners, who are committed to educating their markets about our products and appreciate our high quality manufacturing standards (MHRA, cGMP), as well as our commitment to robust scientific research. They are a huge part of this success. “Business continues to grow in all markets at home and abroad and we will continue to work hard on bringing exciting new products to the markets we operate in as well as continuously demonstrating our commitment to scientific research. There are tremendous plans ahead for Protexin, with more exciting news to come.” Since Protexin won the award for the first time in 2011, it has demonstrated substantial commercial growth over the past five years. During this time, export sales have tripled and international trade accounts for 60 per cent of Protexin’s business across over 80 countries. Toby Lewis, Managing Director, added: “Winning in 2011 was an honour for the company. To be recognised for a second time in 2016 really is exceptional. It is testimony to the hard work of everyone within the company over the past five years who have helped to ensure our business continues to thrive.” Nutritionist secures prestigious accolade The British Diabetic Association has awarded a Nutritionist a top accolade. Laurent Bannock, (pictured left), the leader of Middlesex University’s Sport and Exercise Nutrition Programme, has become the first ever recipient of the Professor Clyde Williams OBE Award at the British Diabetic Association Live event. Laurent was recognised because of his innovative podcast series, ‘We do Science!’, which features interviews with physiology and performance nutrition scientists and practitioner researchers. The podcast series discusses important topics with prominent scientists who have just published new research or have expertise at a very high level. The evidence is unpacked into a variety of real world contexts and is now being used by universities worldwide as recommended reading for undergraduate and postgraduate students, and is also widely acclaimed by leading professors and practitioners in the field. Stuart Galloway, Chair of the Sports and Exercise Nutrition Register, said: “The award recognises the impact of researchers, educationalists and practitioners in Sport and Exercise Nutrition. These podcasts have brought many of the very best sport and exercise nutrition researchers and practitioners to a large audience. A key element of the podcasts is that they focus on applying research into practice, thus promoting evidence based approach to nutrition advice for sport/ exercise.” NEWS Supplement brand advises on importance of vitamin D in light of new research Following publication of new research linking vitamin D deficiency with breastfed youngsters, BetterYou has advised of the need for supplementation. According to a study published in the American Journal of Public Health, breastfed children who do not receive vitamin D supplements are at risk of vitamin D deficiency, especially if breastfeeding extends beyond one year. Breast milk does not provide enough vitamin D, particularly for people in northern parts of the world, where the mother may be deficient herself, said Dr Jonathon Maguire, a paediatrician and researcher at St Michael’s Hospital, in Toronto. As a company, BetterYou is at the forefront of research into vitamin D levels and its range of vitamin D oral sprays are recommended by the NHS. Andrew Thomas, Founder and Managing Director, said: “The UK Department of Health highlights children under five years as an at risk group for vitamin D deficiency and recommend that they should be given a daily supplement. Sadly, vitamin D deficiency is becoming commonplace, with around one in six children, having low vitamin D status. By your child taking just one spray a day of our DLux oral sprays, you can ensure your child’s vitamin D levels can be effectively managed.” www.nutritionimag.com Parliamentary group discusses need for better nutrition among pregnant women A new Parliamentary committee set up to highlight the importantance of micronutrients for health has held its inaugural meeting. As one of its 50th anniversary legacy initiatives, the Health Food Manufacturers’ Association (HFMA) supported the foundation of a new All-Party Parliamentary Group (APPG), which held its first meeting recently at the House of Commons. The Micronutrients and Health group, chaired by Rosie Cooper MP, aims to promote awareness and understanding, and to help form strategies in Parliament, of the vital role of micronutrients in helping people to be healthier. The meeting focused on ‘Nutrition before and during pregnancy: ensuring that mother and child stay healthy’, with Cooper observing that the issue is very topical in Westminster, given the interest in the ongoing debate about the mandatory fortification of flour with folic acid. The formation of the group is significant because, whilst there are currently a number of APPGs in Westminster looking at health issues, there are none that specifically focus on micronutrients and food supplements so this group is the first of its kind. At the first meeting, presentations were provided by consultant nutritionist Dr Michele Sadler, and Martine Austin, Programme Manager for Global Prevention at the International Federation for Spina Bifida and Hydrocephalus, who both discussed the huge impact of neural tube defects (NTDs) on the lives of families and the importance of pre-pregnancy nutrition in preventing these. Sadler highlighted that the take-up of supplements by women of child-bearing age was extremely low. Austin pointed out that there is currently no national strategy on NTD prevention, and a distinct lack of public information on this area of nutrition, arguing that the politics around this situation may be eclipsing the issues at hand. Cooper commented: “It was clear from our discussions that there needed to be a targeted public health campaign, which emphasised to appropriate groups the need to take folic acid, rather than simply adding folic acid to bread. I fully understand the strong arguments for this, and appreciated offers of support from those present at the meeting, but would now much prefer to see real action, rather than just words.” The new APPG will meet four times a year to discuss a different policy topic relating to the role of micronutrients in the various life stages of consumers. Healthy ageing a key priority for supplement sector A new poll has revealed that healthy ageing is the single most important health category in the global nutraceutical market. That’s according to a survey conducted for the Vitafoods Europe Conference 2016, in which researchers asked a sample of visitors who attended last year’s Vitafoods Europe about the health categories most of interest to them. Healthy ageing was selected by more than a quarter of respondents (26 per cent), digestive health by 23 per cent, cardiovascular health by 22 per cent and weight management by 21 per cent. The Vitafoods Europe Conference runs alongside the first two days of the Vitafoods Europe exhibition at Palexpo, Geneva, on May 10-11. RESEARCH NEWS www.nutritionimag.com In Research Nutrition I-Mag rounds up the latest research studies in the nutrition world. World Cancer Research Fund publishes major analysis over stomach cancer links S everal lifestyle factors have been linked to stomach cancer in a new report from the World Cancer Research Fund International. It found that eating processed meat, drinking alcohol and being overweight all increase the risk of developing stomach cancers. Stomach cancers are classified into two main types according to where in the stomach they occur. Cardia stomach cancer is located at the top of the stomach and is more common in high-income countries. Non-cardia stomach cancer affects the rest of the stomach and is common in Asia and associated with H.pylori infection. The analysis of global research demonstrated strong new evidence that eating 50g per day of processed meat – around two rashers of bacon – increases the risk of non-cardia stomach cancer by 18 per cent, while drinking 45g of alcohol per day – the equivalent of about three drinks – significantly increases the risk of stomach cancers. The risk is most significant in men, as well as smokers and ex-smokers. Furthermore, being overweight or obese is found to increase the risk of cardia stomach cancer, which brings the number of cancers linked to being overweight to eleven. The research showed a 23 per cent increased risk of stomach cancer per five body mass index units. World Cancer Research Fund’s Head of Research Interpretation, Dr Rachel Thompson, said: “This research will hopefully help people better understand what increases their risk of the disease so that they can make more informed decisions about their lifestyle choices.” The review included 89 studies from around the world and 77,000 cases of stomach cancer, and builds on findings from the organisation’s last review of worldwide research on stomach cancer in the 2007 Second Expert Report. The research attracted comment from the Meat Adsiory Council, with Public Health Nutritionist, Dr Emma Derbyshire, saying: “In the UK, we already have clear official guidelines on healthy amounts of red and processed meat. The Scientific Advisory Committee on Nutrition (SACN) has made an evidence-based judgement on red and processed meat intakes. As a result, adults have been advised to keep their daily red meat consumption to less than 90g with an average of 70g, and that is what the majority is eating. Nowadays, the average intake in UK adults is 71g, with nine out 10 women and six out of 10 men well within the recommendation. This suggests that most people don’t need to eat less meat. “Putting things into context, it should be considered that the causes of stomach cancer are multi-faceted and as seen in this report, factors such as smoking, body weight, high alcohol intakes and sedentary lifestyles all have their role to play in the aetiology of stomach cancer, along with a genetic aetiology.” RESEARCH NEWS Clinical trial examining vitamin K and kidney disease The British Heart Foundation has welcomed new research examining whether vitamin K can reduce heart problems in people with chronic kidney disease (CKD). Those with kidney disease have a significantly greater risk of having a heart attack or stroke; the disease causes a layer of calcium to settle in the wall of blood vessels, making them stiff, which increases blood pressure and puts strain on the heart. And so the British Heart Foundation has announced it is funding researchers in Scotland with £290,000 to find out if vitamin K can improve cardiovascular health in people with the condition. The researchers, based at the University of Dundee and the University of Glasgow, will give either 400mcg of vitamin K or a placebo to 166 people with CKD once a day for a year and measure the stiffness of blood vessels. The first patients have begun receiving treatment in the new clinical trial to find out if vitamin K can improve heart and blood vessel health. Dr Miles Witham, the lead researcher on the trial at the University of Dundee, explained: “If successful, this trial could open up a whole new avenue of ways to reduce heart attacks and strokes, not only in people with chronic kidney disease but also in others affected by calcium build-up in their blood vessels.” Professor Jeremy Pearson, the British Heart Foundation’s Associate Medical Director, added: “We can only fund clinical trials like this with the support of the public. We receive no funding from Government so we rely on the continued and generous support of people making donations.” www.nutritionimag.com Power of turmeric to be investigated The University of Brighton has announced it has been awarded £148,600 to find new ways to deliver anti-cancer properties from the spice turmeric. Scientists are set to work with collaborators in Vietnam, where the climate and soil on higher ground is suitable to cultivate Curcuma longa from which turmeric, used in cooking in India and south Asia, as well as in traditional Chinese and Indian medicine, is derived. The funding has come from the Newton Institutional Links, part of the UK’s official development assistance programme, which provides grants for the development of research and innovation collaborations between the UK and partner countries. Members of the University of Brighton’s drug delivery research group, Professor John Smart and Dr Ananth Pannala, will work with the Vietnam Academy of Science and Technology on formulating curcumin preparations to be manufactured in Vietnam and marketed globally. Professor Smart commented: “Curcumin has antioxidant and anti-inflammatory activities and has been used for the prevention and treatment of cancer, diabetes, neurodegeneration and cardiovascular disease. It is poorly absorbed when given as a tablet or capsule, its limited solubility being a major factor. This work will develop a curcumincontaining tablet or capsule using soluble carriers or dispersible oils that are acceptable, stable and optimise bioavailability.” Hay fever help In a regular column for Nutrition I-Mag, Claire Barnes, Technical Adviser for Protexin, reviews the latest research. CLICK HERE FOR REFERENCES Seasonal allergic rhinitis (hay fever) is a chronic inflammation in the nasal mucosa triggered by inhaled aeroallergens.1 In a recent study by Price in 2015, the majority of hay fever sufferers reported using two or more medications in an attempt to control their symptoms, yet they still rated their symptoms as moderate severity despite co-medication.2 An imbalance between Th1 and Th2 cells is involved in hay fever,3 with a dominance towards Th2 response. A recent study in 2015 concluded that it is the Th2 cells that reside in the nasal mucosa that control the inflammatory response to the presentation of antigens.1 Establishing a balanced immune system in terms of Th1, Th2 and Treg cell responses through early microbial stimulation could be important in reducing the development of allergies.4 During pregnancy, a natural dominance to Th2 occurs, to avoid rejection of the immunologically incompatible fetus.5 Following birth, the Th2 phenotype shift to a Th1 phenotype, which provides protection from allergic reactions.6 Recent studies indicate that antibiotic use in infancy,7,8 poor exposure to microbes and strict hygiene may be associated with an increased risk of Th2 dominance and therefore developing atopic conditions.6 Studies on infants with allergic diseases showed less frequent intestinal colonisation with microbes such as Lactobacillus or Bifidobacterium and more frequent colonisation with Clostridium,9 while supplementation with Bifidobacterium appeared to modify the gut microbiota in a manner that may alleviate allergic inflammation.10 It is believed that probiotics exert a beneficial effect by modulating the intestinal immune system and inhibiting potential pathogens.4 Adequate probiotic intervention after antibiotic treatment may improve the intestinal ecosystem, and thereby prevent Th2 dominance induced by neonatal antibiotic use.7 NEW PRODUCTS www.nutritionimag.com New to market Nutrition I-Mag brings you the latest product developments in the world of health and nutrition. ADVANCED PROBIOTICS FOR G&G VITAMINS G&G Vitamins has developed a new range of advanced probiotic formulas. MICROlife includes three new products, all of which use Nebraska cultures, which were developed by Dr Khem Shahani, one of the leading pioneers in the field of probiotics, whose research led to the development of significantly superior probiotic strains, such as DDS-1 Lactobacillus acidophilus and Bifidobacterium triple strain blend. Advanced Micro Formula uses both of these highquality probiotics, blended expertly with a prebiotic and L-Glutamine to aid in protein synthesis. It delivers 15bn viable organisms at time of manufacture. These strains are also available individually as Lactobacillus acidophilus or Bifidobacterium; both are available as powder or in a capsule. G&G has also created a colostrum-based formula, Colostrum Plus. Bovine colostrum is used to boost the immune system, heal injuries, repair nervous system damage, improve mood and wellbeing, among others. Colostrum Plus uses ethically-sourced and highly-traceable natural European colostrum, blended with Lactobacillus acidophilus and Bifidobacterium. Advanced Micro Formula, Lactobacillus acidophilus and Bifidobacterium are certified kosher and vegetarian, and the whole range contains the prebiotic, FOS. ENZYME ADDITION A company specialising in enzymes has unveiled a new supplement designed to relieve discomfort caused by eating fatty foods. Enzymedica has developed Lypo Gold, with each individual capsule designed to help consumers optimise fat digestion by digesting up to 22g of fat. Lypo Gold uses a unique lipase blend, which can be helpful as the human body’s natural digestive enzymes start to decline with age. Enzymedica’s exclusive Thera-blend process, which involves blending enzyme strands together, produces potent and effective products to help with these digestive problems. Additionally, Lypo Gold ensures that healthy fats are doing their job as effectively as possible. PUKKA FOCUSES ON TURMERIC The Turmeric range within the Pukka Herbs portfolio has been given a makeover. The redesign took place as consumer demand for the spice continues to grow, and includes within the portfolio Wholistic Turmeric, LifeKind, Active and Active Oil. The redesigned range boasts a new eye-catching design to help it stand out on shelf and communicate the benefits to the customer. Pukka Herbs’ patented wholistic extraction method used across the range means that 75 per cent more turmerones are present in comparison to normal root turmeric, and 86 per cent more curcuminoids than root turmeric. ONCE A DAY RANGE DEVELOPED Quest Vitamins has introduced a new range of once a day supplements. The new range is targeted at various age and life stages, with each product developed to support and restore different areas of the body. Once A Day Iron Plus and Once A Day Iron Plus Liquid are designed to replenish the body during periods of increased iron requirements, such as menstruation, pregnancy or when experiencing fatigue, while Once A Day Pregna Multi includes 24 nutrients to promote optimal health for women during pregnancy and helps support the development of the baby after conception through to breastfeeding For children’s nutritional requirements during early years, Once A Day Infant Multi Liquid synergistic formula provides vitamins, minerals and DHA to help support immune function, bone, eye and brain development Once a Day Osteo is recommended for women, adolescents and the elderly, and contains vitamin D to help increase calcium absorption. For general wellbeing in both men and women, Once A Day Multi prevents deficiencies of essential nutrients caused by poor diet and lifestyle, while Once A Day Energy B & C helps those with a hectic lifestyle, supporting energy levels as well as concentration and memory. Once A Day Sunshine D supports immunity, bone, muscles and heart health and Once A Day Immune C is a protective nutrient for skin and tissue health and reduces infections and colds. CAM CONFERENCE www.nutritionimag.com Feeding the gut: Last chance to book Don’t miss out on hearing from three leading experts at the forthcoming CAM Conference. T aking place on Saturday, May 21, the third CAM Conference of 2016 in collaboration with BANT is already close to selling out. The event, titled Feeding the gut: health through microbiome modulation, will be held at the Cavendish Conference Centre, in London, and will welcome three top-class speakers to present their latest findings on the day. Starting the day, which carries 4.5 CPD BANT hours, is Naturopath, science writer and speaker, Ben Brown, who will talk on the theme of Modern Diets, Dysbiosis and Inflammatory Disease: Personalised Nutritional Microbiota Restoration. Following Ben is Research Microbiologist, Kiran Krishnan, who has been involved in the dietary supplement and nutrition market for the past 16 years. At the conference, Kiran will discuss ‘The Current Understanding of the Human Microbiome, its origin, development, form and function as it relates to human health and wellness’. The third and final speaker, Dr Tom O’Bryan, will deliver his keynote presentation, ‘The Neurological Ben Brown Kiran Krishnan cam 2016 conferences in collaboration with UnderBelly of the Gluten Free Lifestyle: Potential Benefits. Devastating Dangers’. Dr O’Bryan, founder of www.theDr.com and host of the paradigm-shifting online Gluten Summit, is a tireless researcher. CAM Conference delegates will be the first to hear Dr O’Bryan’s presentation on this controversial topic. He will explain the frightening statistics worldwide, and treatment protocols to arrest the increased morbidity and mortality for some on a GFD. He will also explain the biomarkers to identify whether your protocols are effective in reducing the patients’ risk. Standard tickets are priced at £92, with substantial discounts available for students, members of BANT and other associations, as well as those booking more than one event at one time. Guarantee your place today at www.camconferences.co.uk or telephone 01279 810080. Tom O’Bryan Unique mix of presenters for 2016 CAM Summit cam 2016 summit You won’t find such an eclectic mix of leading-edge CAM topics anywhere short of a huge US conference than at the CAM Summit. The event is back with a bang for 2016, with both a bigger education programme and a bigger exhibition. Organised by the team behind Nutrition I-Mag, the CAM Conferences and CAM magazine, the CAM Summit was created in response to delegates asking for speakers in a unique format that allows plenty of time to talk to exhibitors and to catch up with colleagues. There is Dr Dietrich Klinghardt, MD, PhD, conducting a special live videolink appearance. He is the latest signing, joining nutrigenomics and methylation world expert, Dr Ben Lynch, ND, Professor David Brady, Director of the Human Nutrition Institute at the University of Bridgeport and author of The Fibro Fix – a guide to reversing chronic pain and fatigue, Naturopath and parasite expert, Emma Lane, and award-winning Nutritional Therapist, Niki Gratrix, who will give the UK CAM world’s first presentation on startling research linking adverse childhood events to lifetime ill-health. The CAM Summit takes place on Saturday, June 25, at 155 Bishopsgate, London. It costs £65 (including VAT) for CAM students. Book at www.camsummit.co.uk. @cam_summit cam 2016 summit 25 JUNE 2016 Dr David Brady, Dr Ben Lynch, Dr Dietrich Klinghardt, Emma Lane and Niki Gratrix to speak at the CAM Summit Places cost £85 (inc.VAT), with an additional £20 discount also available for members of associations and CAM magazine subscribers What is the theme of the day? The CAM Summit differs from other conferences as it does not have a set theme to the day; instead it is unique in supplying delegates with the top speakers in the CAM industry, talking on their specialist subjects. The CAM Summit invites delegates to learn from a variety of top speakers in the CAM world, all under one roof, in one day. Where is the CAM Summit held? The CAM Summit takes place next to Liverpool Street Station, at 155 Bishopsgate. With Liverpool Street Station being the hub of London travel, this makes our venue one of the most accessible venues in central London. With its modern design and natural light, it is the ideal place to give our delegates the best insight into the latest research from the best speakers in the industry. Back for 2016, this CPD accredited event is a must-attend for registered nutritional therapists. Organised by the team behind the CAM Conferences and CAM magazine, the CAM Summit features the same, industry-leading, innovative education you are used to but on a bigger scale, in a modern, larger venue, 155 Bishopsgate. To book, and for more information, log on to www.camsummit.co.uk or call 01279 810080. BANT UPDATE www.nutritionimag.com BANT News The latest developments from the leading professional body for Registered Nutritional Therapists, BANT. BANT LOCAL NETWORKS AND REGIONAL BRANCHES T he BANT funded Regional Branch Meetings initiative has been launched to support the Local Networks (previously called Regional Coordinator Meetings) by providing quality speakers at regional events. Five new Regional Branches (RBs) will act as event hubs for their Local Networks across the UK in Scotland, the North, the Midlands, the South West and the South East and London. RBs will be managed by committees made up of Local Network Coordinators (LNCs), who will work closely with other LNCs in their region to host meetings that reflect the interests of its members THE BANT SUPERVISION SCHEME VIDEO The BANT Supervision Scheme is for every BANT Registered Nutritional Therapist – whether you have been in practice for years or have just qualified. It is the opportunity to work with other nutritional therapists and a fully trained and accredited BANT Supervisor to reflect on your skills , explore dilemmas, problem solve and find a new perspective to moving forwards with the everyday challenges faced by nutritional therapists. and secure high quality speakers. The RBs will also collaborate with the LNCs to raise awareness of BANT Local Networks to members. Please visit the Regional Branch Meetings page on the BANT website, www.bant.org.uk, for more details, including information on your closest RB. Simply click on ‘Join your BANT Local Network’ on the BANT homepage, then select ‘Regional Branch Meetings’ from the Members area on the left. You can also search for upcoming events in your region by visiting the CPD and Conferences page on the website. THE RESEARCH COUNCIL FOR COMPLEMENTARY MEDICINE (RCCM) SEEKS NEW TRUSTEES The RCCM was founded in 1983 to develop and promote good quality research into complementary medicine and to enhance evidence-based medicine in this area, and is now seeking new Trustees. Professor Nicky Robinson, RCCM Chair, said: “We need to look to the future to ensure complementary medicine research is seen positively. RCCM is proud of what it has achieved, with its conferences/ workshops, CAMRN e news and CAMSTRAND conference. We are in a good financial position and have successfully refreshed our website and brand. We now need new trustees to support RCCM’s professional development.” Previous trustee experience is not essential and being a trustee offers an excellent opportunity to enhance your career. RCCM is looking for at least two candidates, one of which could offer leadership in the future. Please note, the RCCM is a charity and there is no remuneration. Please contact Nicky Robinson for more details by emailing nicky.robinson@lsbu. ac.uk A Membership Support Organisation run by Nutritional Practitioners for Nutritional Practitioners ✓ Success through colaboration rather than isolation. ✓ Nutrition Jobs, useful Information & News ✓ Supportive Network & Educational Resources MENOPAUSE www.nutritionimag.com MENOPAUSE management CLICK HERE FOR REFERENCES As such a key transitional time for women, how can Nutritional Therapists support clients through the menopause? The experts offer their insights. I t was only late last year that the National Institute for Health and Care Excellence (NICE) published clinical guidance relating to how to manage the menopause. Given many millions of women worldwide experience symptoms – often debilitating – it seems perhaps surprising this has only just been published. The guidelines make wide-ranging recommendations for the NHS in relation to support, information and treatments needed to address the symptoms that women suffer. An estimated 1.5 million women – around 80 per cent of those going through menopause – experience some symptoms, which typically continue for around four years after the last period. But for around 10 per cent, symptoms can last up to 12 years. “Menopause is a transition, not a disease, with varying experience and symptoms for each woman. So a support programme should be holistic – because mind, mood and lifestyle are just as key to support as body chemistry and hormones,” commented Lorna Driver-Davies, Nutritional Therapist at Wild Nutrition. Judy Rocher, Education Manager at Rio Trading, continued: “The NHS information on menopause claims that eight in every 10 women are likely to get troubling symptomsi. These symptoms are commonly treated as being a ‘deficiency of hormones’, requiring synthetic hormones to correct the levels. The HRT (hormone replacement therapy) comes with many problems of its own, including increased risk of heart disease, breast cancer and strokeii.” THE PROCESS The menopause is a term used to MENOPAUSE describe the process, but actually doesn’t take into account the various stages. “When women talk about going through the menopause, they are actually describing the peri-menopause, which is quite a recent term. It is during this stage that they can experience most of the classic menopausal symptoms but it can start very subtly,” explained Dr Marilyn Glenville PhD, the UK’s leading nutritionist specialising in women’s health. “Many women will start to experience hormonal changes from around the age of 40. For some women, they can notice changes from the mid 30s onwards. These changes can be so subtle that they may wonder if it is all in their mind. This stage can last between two and six years. The actual ‘menopause’ is the point when the woman has her last ever period. Obviously, she won’t know it is her last period until she looks back, and she needs to have no periods for 12 months for the menopause to have occurred. “I would suggest that the earlier the woman sees a Nutritional Therapist the better because the more preparation that is done in those early perimenopause years can make the transition through the menopause much more comfortable and smoother.” Rocher added: “Menopause, also known as ‘the change of life’, is a word www.nutritionimag.com that describes the cessation of menses and usually occurs between the ages of 45 and 55. At this time, the pool of remaining ovarian follicles becomes exhausted and the ovaries become less responsive to hormonal stimulation. Levels of the hormone FSH (follicle stimulating hormone) and LH (lutenising hormone) increase to try to trigger ovulationiii. At the same time, the amount of oestrogen and progesterone produced by the ovaries declinesiv and many women experience symptoms such as hot flashes and night sweats.” SYMPTOM CHECK You will be familiar with common menopausal symptoms, but keep in mind the spectrum of other signs – which at first might not seem connected – that could indicate a women is approaching the menopause. Dr Glenville commented: “I think some women find the transition more difficult than others, depending on what else is happening in their lives. Many of these so-called ‘menopausal symptoms’ may have little to do with the menopause at all. Some are just a natural part of the ageing process and affect middle-aged men just as much as they affect women, for example, irritability, declining libido, weight gain, ageing skin and hair, depression and anxiety. It is important not to blame every symptom on the menopause. “Some symptoms may be related to particular events in women’s lives that have nothing to do with hormones. Some women sail through the menopause without any symptoms and the only thing they notice is their periods have stopped. On the other hand, some women I have seen in my clinic report being completely drenched in sweat day and night, and getting up to change nightclothes two or three times a night, or even taking a shower in the middle of the night. I also think that women are suffering more these days as factors such as changes in diet and stress are having a big impact on menopause symptoms.” Mariana Sulic, Nutritionist at Savant Distribution, which has the Cleanmarine krill oil brand in its portfolio, commented: “As the hormonal balance alters with the drop in oestrogen and progesterone levels, many signs associated with ageing can appear. Skin is more likely to wrinkle, there can be an increased growth of facial hair and muscles lose some strength and tone. Insomnia is common, making you feel tired and irritable during the day. “Your joints may begin to ache and bones become more brittle, increasing the risk of osteoporosis. Vaginal dryness often results from the change in hormone levels, causing painful or uncomfortable intercourse and leading to irritation and increased risk of “It is thought that 80 per cent of women(1) experience vasomotor symptoms. Vasomotor symptoms are more commonly referred to as hot flushes or night sweats, where women may experience often rapid changes in body temperature, palpitations and a shift between experiencing heat and chills.” infection, such as cystitis.”(1,2) Driver-Davies continued: “It usually occurs between ages 45 and 55, although the NHS states the average UK age is 51 years. So, this is the average age of full menopause (usually determined by the absence of a period for more than one year and potentially blood tests to confirm – usually to check oestrogen levels and FSH (follicle stimulating hormone). Symptoms of peri-menopause may continue for many years before full menopause is reached. It is thought that 80 per cent of women(1) experience vasomotor symptoms. Vasomotor symptoms are more commonly referred to as hot flushes or night sweats, where women may experience often rapid changes in body temperature, palpitations and a shift between experiencing heat and chills. MENOPAUSE “It appears that Western women suffer the most from menopausal symptoms and this has largely been attributed to poor dietary choices.” It’s thought that the hypothalamus, which controls body temperature, is affected by declines in oestrogen production but also that elevations in luteinizing hormone (LH) play a role too.” But what is the rationale behind the fact that some women suffer to a greater degree than others? “The reasons women may experience symptoms to a greater degree can be many but one can see some commonalities. Health or medical conditions before the onset of perimenopause/menopause will contribute in some way for some women. This will also include women with preexisting gynaecological conditions or even unrelated conditions. Medical intervention (surgery, medication etc) will also have an effect,” explained Driver-Davies. “Lifestyle status, so diet, exercise, stress management and psycho-social function and how well supported organs and systems such as the adrenal glands, thyroid, urinary tract, musculoskeletal structure and so on are, not just in the immediate but over the course of a women’s menstrual years. www.nutritionimag.com “We also know that female smokers(2) may experience the menopause earlier, or women who are overweight may experience a later onset of menopause(3) so one can also surmise that these factors lifestyle factors may also affect severity or frequency of symptoms.” She also pointed towards genetics(4), adding: “It can be helpful for some women to ask their mothers (and indeed grandmothers) what their own experience of the menopause was like and very often it’s a window into potential symptoms to come. “Clinically, in my experience, if there are existing weaknesses or dysfunctions in the endocrine system, cardiovascular, musculoskeletal and the detoxification and excretion systems organs (liver, colon) then some symptoms may be more bothersome or severe for those women. For example, a well functioning adrenal gland is required to produce much needed oestrone(5) (a form of oestrogen) to support women once they have moved into full menopause and the ovarian production of oestrogen has declined.” Driver-Davies went on: “Women who have genetic polymorphisms or single nucleotide polymorphisms (SNPs) such as COMT (catechol o methyltransferase), where they will lack the enzyme to breakdown certain neurotransmitter and oestrogens effectively, may find it more of a challenge to keep hormones in balance (and therefore symptoms increased) and certainly those women with that particular SNP are more at risk for breast cancer(6). Indeed, any genetic polymorphisms which affect liver enzymes, and therefore liver detoxification pathways, may play a role in symptoms – especially in peri-menopause when hormones are fluctuating up and down and excess production needs to be effectively excreted once not needed in order to keep the balance in check.” Rocher also pointed out: “It appears that Western women suffer the most from menopausal symptoms and this has largely been attributed to poor dietary choices. In other cultures, such as Japan, women suffer minimal symptoms, partly due to the high levels of phytoestrogens (plants with a weak oestrogenic effect) in the Japanese diet from foods such as soybean curd, fermented soybeans, soybean paste and soy flour.v Chronic stress is another major contributor. It is interesting that a form of oestrogen (called oestrone) continues to be made by conversion of the adrenal steroid, androstenediol, primarily in body fat and muscle cells, in order to make up for the diminishing production by the ovariesvi. Adrenal exhaustion through constant stress can affect this production. “Xenoestrogens, a category of endocrine disruptors from plastics, pesticides, herbicides, non-organic meats etc., can cause a state of ‘oestrogen dominance’ as these alter normal functioning of hormones. This excess oestrogen, unopposed by progesterone, exacerbates menopausal symptomsvii.” CLIENT PROTOCOL So, how can you as a Nutritional Therapist help? “I would recommend seeking professional advice from a Nutritional Therapist if you are experiencing menopausal symptoms that are causing you concern and affecting your daily life, if you’re experiencing symptoms of the menopause before 45 years of age and/ or a Nutritional Therapist can give you guidance on the right foods to eat and supplements to naturally support your body during the change,” Sulic advised. Driver-Davies added: “Women should seek advice as soon as they begin to see changes in their cycle. Peri-menopause can go on for some time, but it’s not to be confused with PMS symptoms and only a professional will be able to support deciphering the difference. A Nutritional Therapist may also recommend some hormone testing, either through the client’s GP or privately. Some changes in cycle and symptoms may be better managed naturally if dealt with earlier on. “Very often, women who are very tired, stressed and overworked will begin to MENOPAUSE find peri-menopause a challenge – and supporting the adrenal glands and energy systems should begin early. Since menopause is also a time where women are more at risk for osteoporosis and cardiovascular disease(13), women should seek advice early on to educate themselves over the many years of perimenopause into menopause.” So, what steps to take? Driver-Davies highlighted the key points when in clinic: ■ “Assess situation – what nutrient checks have they had completed or hormone tests. Refer for hormone test (with own GP or privately). Vitamin D essential to check at any stage but calcium and bone density should be checked once a woman moves into what appears to be full menopause. ■ Support routes of detoxification, including the gut. Also look at metabolising oestrogens. ■ Support HPA. ■ Support oestrogen and progesterone through lifestyle, diet, supplements, herbs, bioidentical hormones if necessary. ■ Cardiovascular support (supporting oestrogen supports this, plus heart nutrients plus adrenal gland support). ■ Geno-urinary support – often supported by supporting hormones. ■ Musculoskeletal support. ■ Cut down on stress, increase rest and sleep www.nutritionimag.com ■ Oils are important – hormone balance, modulating inflammation, some oils like flax also contain lignans that support oestrogen modulation. ■ Promoting regular exercise for general health but also that regular exercise supports bone density.”(14) Rocher highlighted the importance of functional testing, explaining: “Hair mineral test measures deficiencies or excess of 12 different minerals and also six toxic heavy metals, urine test to measure how much bone you are turning over – this is good to ascertain osteoporosis risk. Vitamin D levels; low levels have been shown to increase the risk of fractureviii, CDSA – comprehensive digestive stool analysis – to determine how well the gut is functioning, hormone levels – tests oestrogen, progesterone and testosterone levels and adrenal stress test – test cortisol and DHEA levels.” NUTRITIONAL INTERVENTION There are key dietary recommendations as part of a wider-reaching approach. “The menopause is a time of change and a woman’s female hormones are going to be fluctuating up and down as she goes through this stage until she comes out the other side and into the postmenopause, when her hormones will stabilise. The more gradually she can go through the menopause, the less hormone fluctuations she will experience and the easier the transition. What she eats at this stage can make the difference between having a difficult or easy menopause,” Dr Glenville explained. Rocher added: “Dietary recommendations include increasing phytoestrogenic foods, such as fermented soya, chickpeas, beans, lentils, hops, dandelion, red clover, sage and alfalfa, and minimising intake of processed foods, hydrogenated fats, simple carbohydrates, alcohol, caffeine, sugar and table salt. “Soy isoflavones have been shown to be helpful, and these are highest in whole soya beans.ix Soya milks and soy protein isolates are not recommended, however. Dietary lignans found in flaxseeds are beneficial, and studies have demonstrated that women with the highest lignan concentrations had a better metabolic profile and higher insulin sensitivity, with lower adiposity measuresx. Some studies have shown that women taking two tablespoons of flaxseeds twice a day halved the number of hot flashes within six weeks and reduced their intensityxi. Reduce the amount of red meat consumed to a palm-sized portion once a week or less, and only consume organic, grass fed meat. Maintain healthy blood sugar balance by consuming low GL foods.” MENOPAUSE Driver-Davies continued: “Increased alcohol and caffeine are associated with worsening of menopausal symptoms(8). Some foods will have the opposite beneficial effect. For example, research shows that increasing foods such as wholegrains and phytoestrogen-rich foods (miso, flax, tofu) is associated with a reduction of vasomotor symptoms(9). Remember, this relates to women whose oestrogen is low and is not necessarily helpful to those who have fluctuating oestrogen in peri-menopause. “Certainly in my experience, the extent to which a client is eating a healthy diet that supports detoxification (think of hormone balancing achieved via liver support and also the colon) and a diet and lifestyle that support the thyroid (for example, iodine, iron, zinc, selenium), adrenal glands and nervous system has an impact on symptoms. So, if these nutrients are missing, then symptoms, in my experience, worsen.” Sulic continued: “I would recommend increasing your intake of fresh and preferably organic fruits and vegetables to avoid chemicals that mimic oestrogens (xenoestrogens) found in pesticides and herbicides. Fermented, soya-based foods, such as miso, soya sauce and tempeh, are rich in isoflavones (phyto-estrogens) that have oestrogenlike effects on the body. Studies show that isoflavones particularly help to manage hot flushes associated with the www.nutritionimag.com menopause.(3) “Foods from the brassica vegetable family, such as cabbage, watercress, broccoli, Brussels sprouts, kale and cauliflower help to balance hormones and can greatly alleviate menopausal symptoms.” Driver-Davies recommended: “Foods rich in B vitamins to support mood, the liver and energy, foods rich in magnesium and zinc and generally minerals for hormone support, bones and more, and natural probiotic rich foods – sauerkraut, kimchi, natural yoghurt – to support ‘good’ flora to support the gut. This, in turn, supports elimination of unwanted oestrogens alongside a fibrerich diet. Protein for bones and muscle mass to support structure, plus providing amino acids for mood or detoxification support.” Dr Glenville advocated eating little and often. “This means not going more than three hours without eating. If she waits longer than this, her blood sugar will drop and the stress hormones adrenaline and cortisol will be released. It is the release of these hormones that gives rise to many of the symptoms relating to anxiety, tension, crying spells, depression and irritability,” she explained. USEFUL SUPPLEMENTS Dr Glenville believes starting with a good multivitamin and mineral designed for the menopause is ideal. “This will give her good levels of antioxidants like vitamins A and E and the minerals zinc and selenium (to help slow the ageing process), B vitamins (for anti-stress and energy), vitamin D3, calcium, and magnesium as citrate and boron (all these four for bone health), chromium (for blood sugar balance), digestive enzymes for optimum absorption,” she explained. Soya supplementation is important. “Giving soya supplements to women significantly reduces hot flushes and night sweats.1 Sage has been shown to decrease hot flushes by 50 per cent after four weeks and by 64 per cent after eight weeks. It also helps with decreasing insomnia, irritability, anxiety, physical and mental exhaustion by up to 47 per cent, which can all be symptoms around the menopause. Hops have been shown to help with both hot flushes and night sweats,” Dr Glenville explained.2 “Red clover is one of the most extensively studied herbs and research indicates that it significantly reduces vasomotor symptoms compared to a placebo. And that red clover and soya isoflavones can be safely used for women with a history of breast cancer and those receiving treatment for breast cancer such as tamoxifen.”3 Certain herbs are useful at this time. Driver-Davies suggested: “Dong quai supports oestrogen modulation and THE THYROID The thyroid also needs to be considered. “The thyroid can effect hormonal symptoms – for example – fluctuations of oestrogen can triggers Hashimoto’s (thyroid disease). This, in turn, affects metabolic rate and may increase symptoms such as hot flushes(10),” Driver-Davies suggested. “Progesterone improves signalling mechanisms of thyroid receptors. But too little progesterone depresses TPO (thyroid peroxidase enzyme), which equals low T4(11). So, women are more likely to experience a thyroid issue around menopause and this may heighten some common menopause symptoms such as disturbed sleep, weight fluctuations, temperature and energy (being more prone to lethargy). “Thyroid conditions can may the whole body sluggish and in my clinic, I see a relationship between hypothyroid conditions and slower liver detoxification. As we know, we want to keep detoxification running smoothly to support the passage of unwanted oestrogens via the pathway glucuronidation(12).” MENOPAUSE research has shown it to decrease the intensity of hot flushes, sleep disturbance and fatigue.(16) Ashwagandha is an adaptogenic herb, so assists with ‘cushioning’ stress and particularly supporting the adrenal glands. Once oestrogen production declines from the ovaries, the adrenals take over, so over the years they require special nurture. Excellent for sleep disturbance and exhaustion. Turmeric supports phase 2 liver detoxification*(17) – essential when supporting hormone metabolism. “Black cohosh (Actaea /Cimicifuga racemose) – which is oestrogen supporting and Agnus castus (Vitex) – does not contain progesterone but encourages pituitary gland to produce www.nutritionimag.com progesterone. Note, ‘rogue’ forms of black cohosh are questionably safe but the correct forms are safe to use. Associations with liver disease or harm are now refuted (see Government agency Medicines Healthcare products Regulatory Agency) and would only be assigned to ‘rogue’ forms. But some Google info still lists as caution. However, as with red clover or shatavari (asparagus racemosus), there would also be a caution with women with oestrogen-dependant cancers or taking Tamofen). Always purchase reputable products or seek assistance of medical herbalist.” Rocher highlighted supplements that may be beneficial as part of a nutritional programme. “A supplement containing vitamin C, hesperidin and other citrus flavonoids has been shown to be effective in relieving hot flashesxii. Gamma-oryzanol (ferulic acid) is a substance isolated from rice bran oil. Its benefit in relieving hot flashes is due to its ability to enhance pituitary function. In studies, a dosage of 300mg per day showed improvement in menopausal symptoms in 85 per cent of womenxiii “Due to the risk of osteoporosis, it is advisable to supplement calcium, magnesium (as citrate or malate), boron, silica (as orthosilicic acid), zinc (as citrate or methionine), manganese, vitamin K (as MK-7) and vitamin D3. A natural source of calcium such as coral calcium or calcified seaweed (lithothamnium calcareum) is recommended (calcium carbonate should be avoided)xiv. A good adrenal support formula is advised containing B vitamins, selenium, chromium, magnesium and kelp. “A whole form of vitamin E containing all eight tocopherols and tocotrienols is useful and studies have shown that it may be effective in reducing vaginal drynessxv. Liver support, such as milk thistle, dandelion, burdock, quebra pedra and calcium-D-glucarate, and maca (Lepidium meyenii) is an adaptogenic herb. Research on maca has shown that rather than adding oestrogen replacement to the body, maca increases the body’s own production of oestrogen and lowers levels of cortisol and adrenocorticotropic hormone. Its effects have been shown to improve sleep, mood, energy and reduce hot flashesxvi. Suma (Pfaffia paniculata) is another adaptogenic herb that increased plasma concentrations of estrogen, progesterone and testosterone with no adverse reactionsxvii.” Dr Glenville added: “Beneficial bacteria are also important at this stage as they help with the manufacture of vitamin K, which is important for bone health and they also increase calcium absorption and improve bone density.”4 FAT FACTS One area to focus on is essential fats, as these are crucial at this stage of life. Driver-Davies explained: “Essential fats – nuts, seeds, avocado, fish, flax oil, olive oil – for hormones, skin, vagina, joints, inflammation modulation and energy (coconut oil). Oily fish (omega 3) helps to increase beneficial oestrogens and decrease harmful oestrogen metabolites.”(14b) Krill oil is a useful recommendation, with Sulic commenting: “It contains omega 3 fatty acids and soy isoflavones, as studies show a beneficial effect of a dietary soy supplement containing 40mg of isoflavones/day(3) improved the management of hot flushes associated with the menopause.” l DO YOU DREAM OF A THRIVING PRACTICE IN NUTRITIONAL THERAPY? In an increasingly competitive market, BCNH gives you a huge advantage – as many of our students have gone on to discover. Members benefit from: ✓D irect media contact and promotion ✓ Preferential rate Insurance ✓ Approval route for NHS ✓ Discounted CPD ✓ Preferential rate Advertising ✓ Discounts on Publications ✓ On-going individual support ✓ Legal Advice Service ✓N ational and European representation ✓A pproval route for Private Healthcare Full Membership £42.50 a year The Federation of Nutritional Therapy Practitioners www.FNTP.org.uk BCNH is a small but exclusive college focused on offering top quality courses in Nutritional Therapy in central London. We offer part-time BSc (Hons) programme in Nutritional Therapy, in partnership with the University of Greenwich, as well as Level 6 Diploma courses. Both programmes are also accredited by NTEC. Our courses are designed with flexibility in mind. You can study by attendance, distance learning (online), or a combination of both - whichever method you choose. We use advanced technology to support you and to maintain regular contact, no matter how far away you are. We offer a range of courses:• Science Foundation Course • Level 6 Diploma and BSc in Nutritional Therapy • Short courses for general public - ‘Introduction to Nutrition’ • Various CPD lectures For detailed information on all our courses, please visit: www.bcnh.co.uk Please follow us on Twitter and Facebook Tel: 0207 433 2555 Web: www.bcnh.co.uk Email: [email protected] Train to be a Nutritional Therapist At CNELM, we teach undergraduate and postgraduate courses in nutrition validated by Middlesex University: • BSc (Hons) Nutritional Science* • MSc/PG Dip in Personalised Nutrition* * Accredited by the NTEC for nutritional therapy practice in combination with CNELM’s Nutritional Therapy Practice Diploma Available for full or part-time study and Distance Learning Short courses in Nutrition and Coaching also available: • Nutrition Coach Diploma • NLP Practitioner Course Enquiries: Centre for Nutrition Education & Lifestyle Management (CNELM) T: 0118 979 8686 E: [email protected] www.cnelm.co.uk Product Showcases Tranquil Woman Support – For women managing a busy lifestyle All the nutrients in Natural Health Practice’s Tranquil Woman Support® are aimed at helping women cope both mentally and physically with the stresses and strains of everyday life. 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Sweet Cures® - trusted for bladder support since 2003 at www.sweet-cures.com Ecomil Try Ecomil organic Almond milk: the only almond milk to be actually made where almonds are grown, from a delicious selection of premium Spanish almonds. Our Nature range is totally with no sugar and no sweeteners. At a time when sugar is in the firing line Ecomil is your pure and healthy option; no brown rice, no syrup or other concoction, no hidden additives or dodgy binders, just totally clean organic certified ingredients. What’s more we guarantee the highest content of almond in the market at 7%, compared to 2% with Alpro and Almond Breeze and only 1% with Rude Health Almond/Rice drink, that’s up to 7x more of the active ingredient. Would you like Ecomil samples to try the product out for free? We have some limited samples available. Just write to [email protected]. HAY FEVER www.nutritionimag.com SEASONAL ALLERGIES Understand the nutritional approaches to reduce symptoms of seasonal allergies. H ay fever, also known as seasonal allergic rhinitis, blights vast numbers of people every year, starting in the spring and, for the unfortunate ones, going right through until autumn. What we know is that incidences of hay fever are on the rise, and for a varied set of reasons. “Hay fever is an allergic response to inhaled pollen released from local trees, grasses and flowers. It is a common condition affecting one in five people globally and rising1,” commented Nutritional Therapist, Natalie Lamb, Technical Adviser at Protexin, which has the Bio-Kult and Lepicol ranges in its portfolio. Amanda Williams, Nutritional Therapist and Technical and Managing Director at Cytoplan, agreed, adding: Hay fever, medically termed seasonal allergic rhinitis, affects around one in five people in the UK and the number of allergy sufferers CLICK is rising. Some individuals HERE FOR REFERENCES can be more susceptible to hay fever than others. It’s often thought that it is an overactive immune system and can be due to an imbalance of Th1/Th2. An over sanitised experts in immunology and allergies, environment may also cause certain one in four people are suffering from people to be particularly vulnerable hay fever compared with one in eight to developing a TH1/TH2 imbalance. in the ‘80s. Jean Emberlin, Scientific Individual diets also affect sensitivities, Director of Allergy UK, states that particularly a processed inflammatory around 16m people in Britain suffer diet. Immune system activators and from hay fever and the figure is inflammation go hand in hand.” expected to rise to 30m within the next And Roz Crompton, Homeopath two decades.” and Marketing Manager at Helios And Susanne Haar, Superintendent Homeopathy, continued: “According to Pharmacist at Nelsons, pointed out: “It HAY FEVER is not just the younger generation that are seeking hay fever advice, people in their 40s and 50s are also experiencing hay fever for the first time in their life. It may even be worse than originally thought as a recent survey by Nelsons Pollenna found that a quarter of those surveyed suffer every hay fever season.i“ The most common symptoms experienced include inflammation of the mucosal lining of the nasal passages, throat and eyes, causing symptoms such as sore eyes, blocked nose, itching and sneezing. So, what role could a Nutritional Therapist play here? “Nutritional Therapists can help by identifying causative factors and the individual’s susceptibility to reacting to specific allergens. Genetic components can affect an individual’s vulnerability to developing hay fever so these should be established in order to provide appropriate diet and lifestyle advice, which can help to subdue susceptibility and symptoms,” Williams explained. “The best approach would be an individual assessment of all possible causative factors and susceptibility, including gut health and how antiinflammatory the individual’s diet.” AUTOIMMUNE REACTION Hay fever is deeply connected to the immune system. “Hay fever is associated with www.nutritionimag.com an oversensitive immune system, perceiving pollen as a foreign invader, causing an IgE inflammatory response and the release of histamine. As in other allergic conditions, an imbalance between Th1 and Th2 cells has been observed, whereby Th2 responses dominate,2” Lamb explained. “An individual’s response will vary dependent on how their immune system is functioning. The gut mucosal barrier houses approximately 70 per cent of the body’s immune cells, and is lined and influenced by a diverse microflora that plays an important role in the development and function of the corresponding immune system.3 An imbalanced microflora has been observed in those suffering allergic disease4 so it is not surprising, therefore, that there appears to be a link between the severity of such allergies and the health of our gut, which again can differ greatly per individual.” Eli Sarre, Nutritional Therapist and founder of Wildfare Nutrition, continued: “Hay fever is associated with allergy and atopy, a Th2 driven allergic cascade, including increased IgE and associated cytokines. This mechanism causes symptoms in the skin in the form of dermatitis and urticaria, in the respiratory tract in the form of asthma and allergic rhinitis, and in the GI tract in the form of digestive reactions and complaints. According to Allergy UK, the number of allergy sufferers is escalating by five per cent every year. “Mediating factors include genetic polymorphisms, defects in the lungs, skin or gut, environmental factors, such as excessive hygiene, and receipt of antibiotics in the first two years of life. Triggers include exposure to allergens in the diet or through the environment, tobacco smoke, and pollutants. “Aside from the familiar symptoms, we associate hay fever with increased Th2-mediated allergic inflammation. There may also be digestive symptoms arising from GI barrier permeability or ‘leaky gut’, dysbiosis and a compromised microbiome, there is evidence that suggests that caesarean section and formula feeding instead of breastfeeding may increase the risk of atopyii.” And there are other theories too. “Beverly Adams-Groom, of the National Pollen Research Unit, states there has been a spectacular increase in pollen levels, which may be related to climate change, with the milder temperatures the UK has been experiencing. The other factor may be hygiene hypothesis; basically, allergies are on the increase because we are too clean. This theory states that in our over sanitised, disinfected world, our immune system is simply not getting the ‘work out’ it needs to develop properly in “While there is evidence that pollutants can exacerbate existing airway allergy, the question of whether pollution can cause new allergy remains controversial. One hypothesis for which there is accumulating data is that the increase in allergy mirrors our declining exposure to bacteria and other micro-organisms in our environment.” childhood. As a result, the body fails to distinguish between harmless allergens, such as pollen and dust and harmful bacteria and overreacts.” Haar continued: “The increase in hay fever sufferers could stem from climate change and environmental factors that are altering plant growth so much so that trees and grasses sometimes release their pollen in a single burst when the weather gets hot, sending airborne concentrations to extraordinarily high levelsiii. “Researchers have suggested that a number of factors might cause one person to be allergic more than anotheriv. Genetics; in the UK today, children have a one in five predisposition to develop an allergy. However, the risk is doubled if one HAY FEVER parent has an allergy (particularly if that parent is the mother). If both parents have allergies, the risk is increased to 60-80 per cent. “Environmental factors; our environment today is very different from 50 years ago. While there is evidence that pollutants can exacerbate existing airway allergy, the question of whether pollution can cause new allergy remains controversial. One hypothesis for which there is accumulating data is that the increase in allergy mirrors our declining exposure to bacteria and other microorganisms in our environment.” DIETARY IMPACT Although hay fever is an autoimmune condition, and so is not directly caused by our diet, there are certain foods that can exacerbate symptoms. “The allergic response is to inhaled pollen in the environment, as opposed to food sources, but as we know what we eat and how we digest it can affect every aspect of our health. Hay fever is an inflammatory condition, so any natural solutions to support the immune system could only be of benefit,” Lamb commented. “Ideally, changes should be made all through the year, as opposed to when symptoms have hit. Educating your client throughout the year and enabling them to see the links between their hay fever and other areas of their health www.nutritionimag.com may motivate them to make positive changes.” Williams continued: “A good diet and nutrition is vital for optimum function of the immune system. Allergens cause an inflammatory response in the body, therefore, it is important to eat an anti-inflammatory diet high in membrane stabilising nutrients to help prevent the release of histamine and an inflammatory/allergic cascade.” Crompton added: “Processed and refined foods and those with high levels of artificial ingredients, such as preservatives and colourings, can increase sensitivity to allergens, such as pollen. Avoid mucous forming foods, such as dairy, sugars and starches.” However, there may be certain triggers within food that are worth investigating, with Sarre commenting: “Dietary triggers include IgE food allergies, IgG delayed food hypersensitivities, cell mediated reactions, such as coeliac, non-immunological allergies and intolerances, such as reactions to tyramine and histamine, adverse reactions to foods may even include lactose intolerance, reactions to salicylates, MSG, and other food additives. “A Nutritional Therapist will be able to advise you regarding IgG and IgE food antibody testing and a comprehensive stool and digestive system analysis to assess dysbiosis HAY FEVER and intestinal permeability. Multiple reactions to foods may suggest intestinal hyperpermeability, in which case a Functional Medicine 5R protocol is advised. Individuals who have discovered food reactions may require additional support regarding elimination diets and replacing nutritional requirements. There may be an increased risk of malnutrition, stress and fatigue and professional guidance is recommended. Vitamin D and essential fatty acid testing is also advised.” In terms of a nutritional plan, there’s much that you can draw on that can help to reduce the symptoms. Lamb suggested: “Eating a rainbow of different coloured vegetables and salads should provide you with a wide range of immune supporting nutrients6, such as vitamin A, C and E, zinc and selenium, and antioxidants said to help prevent the release of the inflammatory chemical histamine. Cooking with natural flavours of onions, garlic, cayenne pepper, ginger and turmeric and consuming omega 3 fatty acids found in oily fish, avocados, nuts, seeds and oils, are all said to contain natural anti-inflammatory compounds.7 Traditionally, it would have been recommended to consume locally made honey from bees that have pollinated local plants, supposedly building up a tolerance to local plant antigens.”8 For Williams, looking to the www.nutritionimag.com Mediterranean diet is advised. “An anti-inflammatory diet high in membrane stabilising nutrients will help to prevent the body’s release of histamine when exposed to allergens. A Mediterranean diet rich in fish, fruits, vegetables, legumes and nuts will provide protective properties that will be beneficial for sufferers of hay fever,” she explained, adding: “Research provides benefits of the Mediterranean diet being anti-inflammatory and studies have shown this diet to reduce troublesome symptoms of hay fever. Processed foods, trans and saturated fats, refined sugars and alcohol should be avoided as these are all inflammatory.” Sarre suggested an elimination diet. “An elimination diet is the gold standard of all treatment. Removing gluten, dairy, eggs, peanuts, soy, fish and shellfish, and certain nuts including walnuts, cashews and almonds, is estimated to address 90 per cent of all food allergy. Gradually testing the reintroduction of these foods one by one will reveal any adverse reactions. If you have had allergy testing, removal of foods based on the results is advised,” she explained. Staying hydrated is crucial, Lamb explained: “Interestingly, it is thought that histamine is naturally produced when we are dehydrated to cause an increase in thirst and, therefore, water intake, so drinking plenty of water or herbal teas could be another solution.”5 As part of any nutritional regime, eliminating anything that lowers the immune system is crucial to ensure the body has a fighting chance of coping with the pollen. Crompton suggested: “Avoid excessive alcohol consumption as this weakens the body’s immune response to an allergen. Beer, wine and spirits contain histamine, the trigger to an allergic response. Avoid cigarette smoking as this aggravates an already inflamed nose and throat and weakens the immune system.” Stress must be kept in check too. “Increased and long-term stress can deplete the immune system and leave you more susceptible to allergies, such as hay fever. Look at ways of improving stress levels within your everyday life. Take time out for yourself, join a yoga or meditation class, which will help with breathing techniques to support the respiratory system.” NUTRIENT SPECIFIC Hay fever sufferers are recommended to increase intake of certain nutrients to reduce symptoms, whether through the diet or a combination of diet and supplementation. “Advising high consumption of HAY FEVER “Bioflavinoids may help to modify the body’s reaction to allergens such as pollen, and vitamin C may promote the function of a normal healthy immune system, whilst lowering histamine levels, which are raised in an allergic response such as hay fever.” fish or omega 3 oils, which are antiinflammatory, can help to prevent inflammatory response. 1/3 1/6 beta glucan can also be advised/prescribed to help increase the Th1/Th2 ratio, which will help to switch off the allergic response,” Williams suggested. “Membrane stabilising nutrients will help to prevent the body’s release of histamine. “I would recommend a good omega 3 supplement, such as fish oil, which is membrane stabilising and can reduce inflammatory eicosanoids. I would also recommend a supplement to support the immune system, containing 1/3 1/6 beta glucan and good levels of other protective nutrients. “Supplements containing powerful phytonutrients and phyto-antioxidants are membrane stabilising and can help to prevent the release of inflammatory cascade.” Crompton suggested: “Bioflavinoids www.nutritionimag.com may help to modify the body’s reaction to allergens such as pollen, and vitamin C may promote the function of a normal healthy immune system, whilst lowering histamine levels, which are raised in an allergic response such as hay fever. Zinc deficiency has been shown to increase the potential for allergic reactions and antioxidants may support normal healthy immunity.” Antioxidants are critical for Sarre, as well as essential fats. “Krill oil offers essential fatty acid support for prostaglandin balancing and anti-inflammatory. Vitamin D is anti-inflammatory and gut repair, zinc, selenium, probioticsv and vitamin A,” she said. PICK PROBIOTICS There is increasing research to show the importance of probiotics in relation to hay fever. Williams explained: “Maintaining good gut health is particularly important for people suffering with hay fever (seasonal allergic rhinitis) and is important to promote a healthy immune response. Therapeutic prevention of hay fever should address the ingestion of pollens in to the digestive tract, not just the respiratory tract.” Lamb continued: “Probiotics have been shown in studies to help rebalance the microflora, to support a healthy immune response and to reduce allergic responses, including symptoms of hay fever. A multi-strain probiotic could be said to provide a wider range of benefits to a wider range of people. “Probiotics have demonstrated their potential to significantly improve quality of life, in particular, a reduction in runny eyes,2 nasal itching9 and lower nasal congestion10. Probiotics’ direct mechanism of action could be by directly reducing pathogenic bacteria levels in the upper respiratory tract,11 and/or by modulating the immunological microenvironment at the nasal mucosa12. In 2014, Perrin et al,9 saw a decrease in inflammatory markers found in the nasal fluid, namely leukocytes and IL-5, alongside an increase in anti-inflammatory IL-10 secretion. Changes have also been observed in the rebalancing of the Th1/Th2 immune response.13 In 2011, Nagata et al, saw a significant increase in Th1 cells.”13 HOMEOPATHY Hay fever is also known to respond well to homeopathy. Crompton explained: “To use homeopathy successfully, you need to match the remedy as closely as possible to the symptoms. For mild hay fever, finding a remedy yourself is straightforward but for longstanding or severe symptoms a qualified homeopath is recommended.” Crompton suggested certain remedies for hay fever, dependent on symptoms, including a combination of the homeopathic remedies Allium Cepa, Euphrasia and Sabadailla, which can help with symptoms such as sore, irritated and inflamed eyes, streaming nose, sneezing, itching of the mouth and nose, tickly throat and cough. She also highlighted Wyethia 30c, explaining: “Intolerable itching felt on the roof of the mouth and behind the nose, sometimes extending into the throat and ears, strongly suggest the use of this remedy. Everything in the person’s head feels dry and irritated, but the nose may still be runny.” And then there is Natrum Muriaticum 30c. “The most characteristic symptom of Natrum Muriaticum is that discharges have the consistency of raw egg white. The catarrh is usually white or clear and watery and can be extremely profuse. There is often repeated violent sneezing – especially in the mornings, a loss of smell or taste, and itching in the nose,” Crompton explained. “The eyes can be watery and the throat can be dry and sore. Hay fever responding to this remedy can often be accompanied by violent, pulsating headaches made much worse by the heat of the sun, or by increased emotional sensitivity.” l HEART HEALTH www.nutritionimag.com THE HEART of the nation Nutrition I-Mag brings you the essential advice on maintaining a healthy heart. CLICK HERE FOR REFERENCES HEART HEALTH T he facts are pretty stark when we look at the UK’s heart health. Kay Ali, Head of Nutrition, Bare Biology, reported: “CVD is the second largest cause of death in the UK, resulting in 155,000 deaths in 2014. The British Heart Foundation cites that CVD causes one in four deaths in the UK. Just to put that into perspective, the most up-to-date research shows us that CVD represented 27 per cent of causes of death, whilst cancer represented 29%.”[1] Amy Pereira, National Educator at Enzymedica Inc, added: “According to data compiled annually by the American Heart Association, the Centers for Disease Control and Prevention, the National Institutes of Health, and other governmental sources, cardiovascular disease (CVD) continues to be the leading global cause of mortality. Cardiovascular deaths accounts for approximately one in three deaths, or 17.3m deaths per year. While, not isolated to Western societies, CVD is known to be the number one killer and takes more lives than all cancers combined and is of epidemic proportions in the Western world.1 Sadly, this number is expected to rise to nearly 24m by 2030.”1 Worryingly, it seems the message about looking after the heart isn’t getting across fully, as heart related conditions appear to be on the rise. www.nutritionimag.com “The number of hospital episodes related to CVD is on the increase in the UK.[1] The occurrence of CVD (excluding CHD and stroke) represents the greatest rises, increasing by 30 per cent between 2005/06 and 2013/14 in England,” Ali added.[1] “Regional and local mortality statistics show a complex picture of health inequalities in the UK. Premature CVD death (75 years and younger) are highest in Scotland and North West England, suggesting that there are sociogeographic factors driving this trend.”[1] But there’s much as Nutritional Therapists you can do to educate and advise your clients on reducing the risk of heart disease. Pereira continued: “While not much can be done about age, gender, ethnicity or genetics, many other risk factors like blood pressure, weight, blood sugar, stress, physical activity and diet can be addressed. Nutritional Therapists and practitioners who have a hand in shaping the diet and lifestyle of their clients often have the distinct advantage of being able to spend time educating about topics like the value of avoiding refined carbohydrates and saturated and trans fats and the benefits of incorporating more cardioprotective plant-foods. Educating on some of the established benefits of a Mediterranean diet and working to balance ratios of omega 3 to omega 6 essential fatty acids through both diet and supplementation may also be highly helpful and effective ways to impact positive change. “This education surrounding diet (and its ability to beneficially affect some biomarkers), coupled with encouraging smoking cessation and a healthy exercise plan (including 30 minutes of physical activity daily, if possible), can go a long way in shaping cardiovascular health in a manageable, non-invasive way.” RISK FACTORS There are a number of risk factors to CVD. “While there is no one factor that can be pinned to heart disease, there are numerous factors known to play a role in one’s risk for developing or experiencing the life-threatening effects of CVD,” Pereira said. “These include but may not be limited to the following; age, male gender, ethnicity, family history, smoking, inactivity/sedentary lifestyles, poor diet and unhealthy fat choice/intake, overweight/obesity, hypertension, unhealthy cholesterol, unhealthy blood sugar, and certain sleep disorders. Fortunately, there are also many steps that one can take to support cardiovascular health and reduced risk of CVD.1,2 “Many tests are utilised to determine biological markers that relate to one’s cardiovascular status and risk level. Practitioners commonly use biomarkers “While there is no one factor that can be pinned to heart disease, there are numerous factors known to play a role in one’s risk for developing or experiencing the lifethreatening effects of CVD.” such as low-density lipoprotein (LDL) and triglycerides, fasting blood glucose, homocysteine, fibrinogen, C-reactive protein (CRP), and arterial calcium to assess cardiovascular system status and one’s risk of experiencing cardiovascular system complications or adverse events. In addition to these biomarkers, many novel ones are continually being discovered and associated with heart health; however, science still has lingering questions around the ability of these tests and their data to accurately predict CVD events in a way that is superior to traditional risk factor models.”3 Ali added: “Inflammation, elevated homocysteine, elevated LDL, and hypertension are some of the most common biomarkers for risk of CVD. [7] There is new research focusing more specifically on genetic biomarkers too. This means that there is a genetic risk of developing CVD.” Nutrition is at the forefront of raising our risk of developing heart related HEART HEALTH problems. But what are the main culprits? And what should form part of a nutritional plan for a client? “Trans fatty acids have been linked to increased risk of CVD. They have been shown to increase the viscosity of the blood and encourage aggregation, which may increase risk of stroke,” Ali explained.[8] “A diet high in sugar may increase risk to CVD due to elevated risks with patients with diabetes.[9] A diet low in antioxidants and free radical inducing lifestyle factors, such as smoking, have also been linked to increasing risk CVD. Such factors have been shown to increase homocysteine levels, hence risk to CVD too.”[10] She went on: “The more inactive one is, the less flexible our blood vessels become. Importantly, the heart is a muscle, which may be strengthened through resistance exercise.[12] Therefore, lack of daily activity may suggest a weaker cardiovascular system.” Stress too is a major contributor to increasing the risk of cardiovascular disease, with Pereira adding: “While most risk factors (like diet, physical activity levels etc.) were addressed above, stress management is still another lifestyle factor that is a piece of the puzzle. Stress is known to raise cortisol levels. Consistently high levels of cortisol from long-term stress can increase blood pressure, blood sugar, www.nutritionimag.com cholesterol and triglycerides, and also lead to the build up of arterial plaque and inappropriate blood clotting. All the while, techniques for managing stress are often overlooked or underemphasised. DEAL WITH DEFICIENCY It’s important to identify any nutritional deficiencies, as certain nutrients are critical to maintain a healthy heart. Ali pinpointed omega 3 deficiency as a key concern. “Omega 3 fatty acids exert multiple positive physiological effects on the cardiovascular system and deficiencies are known to directly influence CVD risk. Prospective cohort studies associate cardiovascular health to fish consumption. The studies suggest that consuming fish high in omega 3 eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) is linked to decreased cardiovascular related deaths,” she explained. “The studies show that populations consuming high volumes of fish have high omega 3 red blood cell (RBC) membrane levels. High RBC EPA content is relevant because EPA is not only the precursor to anti-thrombogenic compounds but it also effectively reduces levels of the pro-inflammatory omega 6 fatty acid arachidonic acid (AA). This may result in a reduction of the AA to EPA ratio that favours a balance HEART HEALTH of anti-inflammatory, anti-atherogenic and anti-arrhythmic end products – all of which are plausible mechanisms for reducing the risk of CVD.”[2] Certain vitamin deficiencies should also be borne in mind. Ali explained: “Deficiencies in vitamin B6, folate, and vitamin B12 are also risk factors in CVD due to their lowering effects on homocysteine. Homocysteine is a by-product of the methylation cycle. Elevated levels of circulating total homocysteine levels are a well-documented risk factor for the development of cardiovascular disease[3,4] “A decrease in serum homocysteine of 3μmol/L lowers the risk of myocardial infarction and stroke by 15 per cent and 24 per cent respectively, and each 5μmol/L increase in levels increases the risk of coronary heart disease events by approximately 20 per cent.[5] Levels of homocysteine in the blood are directly influenced by levels of the B complex vitamins (folic acid, vitamin B6 and vitamin B12),[6] with low levels directly contributing to elevated homocysteine.” HEART HEALTHY DIET There are some important foods to cut out of the diet as these are known to raise our risk of cardiovascular disease. But on the positive side, there are some wonderful foods that can be very supportive of the heart. www.nutritionimag.com “Saturated and trans fats are among the most well-known dietary offenders in contributing to poor cardiovascular and overall health. Excess intake of refined sugars, simple carbohydrates and high glycaemic index foods are also becoming more and more understood to adversely affect cardiovascular health and risk, due in part to these foods association with unhealthy fats (as in baked goods and packaged meals),” Pereira explained. “Sodium (also particularly high in processed, pre-prepared foods) intake is another significant dietary consideration, as excess consumption is directly linked to hypertension, another major risk factor for CVD. Finally, excess alcohol consumption can specifically increase our risk for heart disease; anything above moderation (suggested limits vary by country) may contribute to high blood pressure, high blood sugar, and weight gain, and ultimately increase risk for CVD.” Ali added: “Consume fresh, wild, small oily fish. Fish such as sardine, anchovy and mackerel are your best sources for omega 3 in the diet. Not only do they deliver a good dose of EPA and DHA, these fish tend to carry less toxins in comparison to larger fish such as tuna and salmon. Small oily fish have a much shorter lifespan and they do not feed on other toxic fish. Therefore, they’re not exposed to toxins for as long, nor do they experience the build up of heavy metals as found in larger predatory fish. “A diet high in antioxidants, incorporating a variety of colourful vegetables that are raw or lightly steamed, is the best way to ensure that you’re getting a broad spectrum of anti-inflammatory antioxidants. These may help prevent the oxidation and aggregation of cholesterol in the blood.” Pereira suggested: “Plant-based diet, lean protein sources, healthy ratios of omega 3 essential fatty acids to omega 6 essential fatty acids, either through consumption of sustainable, wise seafood choices or omega 3 supplements, limiting and replacing refined carbohydrate choices with healthy alternatives like squashes, yams or whole grains, foods with a longstanding reputation for supporting a healthy cardiovascular system, like natto (fermented soy food available in many Japanese restaurants or Asian import stores).” A focus on certain nutrients is also important. “Ensure sufficient sources of folate, vitamin B6 and B12 are available in the diet. These may help to lower homocysteine, a key biomarker of risk to CVD. Lean, grass fed beef is a great source of most B vitamins, although it is advised that it is not eaten too often. Alternative vegetarian options include pulses, beans, legumes and avocados,” “A diet high in antioxidants, incorporating a variety of colourful vegetables that are raw or lightly steamed, is the best way to ensure that you’re getting a broad spectrum of anti-inflammatory antioxidants. These may help prevent the oxidation and aggregation of cholesterol in the blood.” Ali suggested. “Switch simple refined carbohydrates in the diet to more complex alternatives that are higher in fibre. This involves switching white bread for wholegrain, pasta for lentils and chickpeas and cutting out sugary sweets and cakes for wholesome low sugar fruits, such as blueberries, apples and pears. Making these healthier upgrades should help to lower sugar intake, which is linked to increased risk of CVD. These foods also tend to contain a higher amount of fibre, which supports a slower release of glucose into the blood.”[13] USEFUL SUPPLEMENTS There are some important supplements you may want to consider adding in to a client programme. Ali commented: “At Bare Biology, we HEART HEALTH believe in food first; supplementation should only be considered when our diets cannot deliver an effective dose of the nutrients we need. Unfortunately, the most healthful types of omega 3, EPA and DHA, are vastly lacking in our diets for a number of reasons: In the UK, we don’t eat much fish at all. Importantly, if we are, we tend to avoid the oily types of fish that are much more concentrated with EPA and DHA; www.nutritionimag.com risk of heavy metal contamination. The UK Government recommends that we only consume a maximum of four portions of fish per week due to the risk of intoxication. This is even lower for pregnant women.” Coenzyme Q10 is critical for maintaining a healthy heart, but levels decline with age and medication, and so assessing a client’s levels is important. “Statins have been shown to deplete coenzyme Q10, a potent antioxidant which helps to prevent the oxidation of cholesterol.[11] Oxidised LDL has been linked to CVD,” Ali continued.[7] In terms of supplementation, the older a client, the more important it is they take the ubiquinol version of coenzyme Q10. Pereira pointed towards the benefits of soy, commenting: “Soy food natto tops the list of highly supportive foods for actively supporting cardiovascular health. Unfortunately, natto’s flavor is not one that is considered enjoyable or even palatable to most westerners (especially enough to ingest relatively large amounts of it on a daily basis); however, the enzyme which has been established to be responsible for natto’s heart health benefits is now available in supplement form. Discovered in the 1980s by a Japanese research team at the University of Chicago and studied extensively since, Nattokinase is the key enzyme in natto that is now classified as a fibrinolytic protease and understood for its properties in supporting cardiovascular health, circulatory function and plasmin (an endogenous enzyme that has a high specificity for fibrin) production.”6,7 And keep in mind proteases, Pereira reminded. “Research indicates that proteases, taken away from meals, are absorbed and carried into the bloodstream where they bind to other immune supportive proteins called Alpha-II-macroglobulins.8 Once proteases combine with the Alpha II-macroglobulins, the resulting complexes work together toward the removal of protein challenges,” she said. “Proteases are made by the body but enzyme production tends to decline with age. Enzyme deficiencies may help explain why some of us seem to have a harder time than others in reaching or maintaining our health goals.” OTHER INTERVENTIONS As already discussed, lifestyle plays a key role in determining the long-term health of the heart, and the starting point with this is getting active. “Aim to exercise for 20 minutes approximately three times a week. Resistance exercise has been shown to promote the flexibility and vitality of blood vessels that make up our cardiovascular system and strengthen the heart,” Ali recommended.[12] Pereira added: “Deep breathing, meditation, and relaxation techniques can be helpful tools in managing stress levels. Walking in nature or doing a yoga DVD in one’s home can also be invaluable stress management steps that also double as low-impact physical activity and can positively affect one’s wellbeing and cardiovascular health.”4,5 l ASK THE EXPERTS www.nutritionimag.com EXPERTADVICE Our panel of nutritional experts offer readers advice on dealing with a variety of issues. Q Why do people do well while taking probiotics but very soon after stopping probiotics the symptoms return? RICHARD STEAD EXPLAINS: This is an interesting question, the answer to which has been sought by numerous people and organisations. I am not an expert on probiotics but I am convinced of their efficacy. However, I am not convinced of the way they are used and it may be this reason that results in only short-term benefits. There are thousands of papers out there verifying the role of the gut in our health – if you have a good gut, you will enjoy good health but with gut dysbiosis, you have all sorts of problems and symptoms. It seems that probiotics can overcome the symptoms and lead to feeling well but for a short time only. I can propose two reasons for this; first, so many probiotics are built around a single organism. The body/nature rarely has a single effective molecule or organism. Almost everywhere the combination and symbiotic effect of groups of materials are active and effective. Our guts are made up of hundreds of different bacteria so the chance for a single probiotic to solve a problem is low. The second reason I propose is that we expect too much of the probiotic(s). By consuming huge numbers of the probiotic, we try to overwhelm the bad balance and bad bacteria but when we stop the probiotic, these bad bacteria are still there ready to rebound, which returns us to the dysbiosis and symptoms. The removal of the bad bacteria is what we need to work on right at the beginning – which is why we have used antibiotics for many years. Unfortunately, antibiotics have a double edge to them, as we know, by destroying so many of the good bacteria as well as the bad bacteria. Antibiotics are not prescribable by alternative practitioners and they probably would not want to prescribe them anyway. So, how to overcome the presence of bad bacteria? We have developed a nature identical molecule, which destroys only the bad bacteria and viruses by destroying a specific group on the cell wall. Nature designed it and nature would not arrange to kill off good bacteria. The good bacteria have a defence mechanism that stops the attack on the cell wall. Once these bad bacteria are gone, probiotics can then take their place and create a stable gut that will then lead to good health through a good diet designed for each patient. CLICK FOR MORE QUESTIONS THE EXPERTS CAROLINE HARMER is the Education Director for Renew Life, the UK’s leading digestive care and cleansing company. Renew Life believe that optimum health begins with a properly functioning digestive system. MICHAEL ASH DO, ND, BSc, DipION was in full-time clinical practice for 25 years, during which time he founded and developed the largest integrative medicine practice in the south west of England, incorporating the philosophy of functional medicine from 1991 onward. He has specialised in the role of the wet tissues (such as the gastrointestinal and respiratory tracts) in human health for over 20 years, through the application of food and lifestyle based interventions. An author, researcher and presenter with skills in business development as well as clinical care, he has also been an adjunct member of the Institute for Functional Medicines faculty for many years. RICHARD G. STEAD has a degree in Chemistry, and for the last five years has promoted naturally derived chemicals for innovative applications. He is the CEO at KiB Healthcare, which supplies products to combat pathogenic infections using the same chemistry as is in our tears. Many Nutritionists are achieving strong outcomes with this nature-identical technology. ASK THE EXPERTS www.nutritionimag.com Q There appears to be a lot of conflicting evidence about the best source of omega 3 essential fats. What guidance can you offer, and what research is there to support this? CAROLINE HARMER SUGGESTED: At this point in time, there are well over 7,000 studies on fish oil safety and efficacy for many different health issues. Yet debate exists over the superiority, bioavailability or safety of different forms of omega 3 – namely, that triglyceride fish oils (TG), re-esterified triglyceride (rTG) and phospholipid forms would seem to be better absorbed than ethyl ester (EE) form. Claims that the TG form is clinically more advantageous than the EE are not supported by science. The EE form has been used in the majority of scientific studies, including most of the cardiovascular related clinical trials. Results from human studies comparing absorption of omega 3 fatty acids from TG vs. EE have been a little conflicting. Some studies show no difference in absorption between forms(1-3). Other studies indicate that the absorption of EE may be lower(4-6). In general, however, studies that found lower absorption rates for EE tend to be of shorter duration (eight to 12 hours up to two weeks), and the studies where omega 3 was supplemented for several weeks or more show no significant difference in absorption. A few studies have indicated benefits for the TG form, yet reviews highlight that studies did not match the doses administered, nor the concentrations of EPA and DHA per supplement across such comparisons, leading to questionable conclusions. A review of all the scientific literature comparing TG, rTG and EE forms in terms of bioavailability, safety or efficacy indicate the differences are minor, inconsequential and cannot be judged to be physiologically or clinically significant. This conclusion was endorsed further recently by a randomised double blind study published in September 2015, which sought to assess the bioavailability of EPA and DHA between TG, rTG and phospholipid (krill) forms. The study results were: “No significant differences in total plasma EPA +DHA bioavailability were observed between fish oil EE (Ethel ester), fish oil TG (triglyceride) or krill oil”(7). In conclusion, scientific evidence is showing that all forms of omega 3, be they triglyceride, re-esterified triglyceride, ethyl ester or phospholipid forms, are of equal benefit to the body. Putting all the myths and hair splitting aside, the key reason for taking an omega 3 supplement is to increase total plasma EPA and DHA in the body, and all forms will do this. So, when choosing a therapeutic omega 3 supplement, key factors to consider is not the form of omega 3 used but the following: ■ How much EPA and DHA does it offer? ■ Is it certified free from containments? ■ Is it certified shelf stable? ■ Is it sourced from certified sustainable fish? ■ Is enhanced absorption available? CLICK FOR MORE QUESTIONS ASK THE EXPERTS Q www.nutritionimag.com Why do bacterial metabolites derived from foods have ‘yin and yang’ like effects on our health? MICHAEL ASH RECOMMENDED: The human body is colonised by a vast number of commensal organisms, collectively termed the microbiome. Importantly, dysbiosis – dyregulation of this endemic microbiome – has been implicated in a myriad of human diseases, ranging from inflammatory bowel disease to depression. Changes or advancements in the analytical screening of our intestinal microbiota via the development and use of next generation sequencing has revealed a state of affairs best described with the use of the old moniker – ‘holistic’. The result of these discoveries has been an intensive level of scientific enquiry to try and identify mechanisms that account for the changes in health and disease. In effect, how can organisms residing in the intestinal lumen and without invading the tissues affect our systemic physical/emotional status? One specific link elucidated between the microbiota and our physiological processes was first identified in a study by Mackay and colleagues (Maslowski et al., 2009), which provided the first evidence that microbial metabolites can directly affect human health. The microbiota has, of course, long been known to produce and require nutrients from the foods we ingest. Important metabolic by-products from this interaction include short-chain fatty acids (SCFAs), such as acetate, propionate and butyrate. Maslowski and colleagues reported that acetate beneficially changes several types of inflammatory responses in the gut, lung and joint. Germfree mice, which are devoid of the microbiota and hence lack SCFAs, they found, were highly sensitive to intestinal inflammation. Oral acetate administration prevented such inflammation, and this beneficial effect was absent in mice deficient for the acetate G protein-coupled receptor 43 (GPR43). This process confirms the value of SCFAs in managing adverse inflammation in the gut and elsewhere. ‘Microbiota-derived metabolites, it seems, have ‘yin and yang’ effects on our health’. Following this initial discovery, several subsequent studies have built on this notion that SCFAs have direct and indirect impact on the state of human health and that the impact of SCFAs produced by the intestinal microbiota on various aspects of immune and inflammatory responses operate in both a positive and negative manner. For example, Wang et al. discovered in 2011 that some microbial metabolites derived from phosphatidylcholine containing foods, such as meat and fish, are in some people converted in the liver to harmful products that can cause cardiovascular disease. Thus, microbiota-derived metabolites have ‘yin and yang’ effects on our health and this in turn is by foods selected, the status of the host, their environment and the composition of their microbiota. Microbiota-associated genes, which are thought to far outnumber human genes, presumably encode unique enzymes that produce so-far-unknown metabolites. By understanding these microbial enzymes and their microbiota-derived metabolites, it should become possible to further elucidate many of the mechanisms of mutualism between the microbiota and humans and offer enhanced opportunities for improved health and resolution of disease. The one food group that has changed most dramatically in human diets is fibre, from around 120g a day being ingested 100 years ago to an average of 10g, this component of food, derived from vegetables and fruits, is a vital substrate for organisms to manage the variation in risk and favour health. INGREDIENT SPOTLIGHT www.nutritionimag.com - the lowdown CLICK HERE FOR REFERENCES Understand why vitamin B12 is so crucial, and the impact this could have on your clients’ health. B 12 is considered the most important factor in the maintenance of nerves. It also has a number of other important functions within the body, however, deficiency and depletion of B12 are prevalent around the world1. Estimations are that some level of deficiency is present in 10-40 per cent of the population; deficiency is frequently missed and contributes to cognitive decline, stroke and many other chronic diseases2,3. FUNCTIONS OF B12 Vitamin B12 is involved in the metabolism of every single cell in the human body and it also plays an important role in the synthesis and formation of the body’s genetic material, DNA and RNA. It’s needed for red blood cell formation, the synthesis of choline, brain and normal nerve cell function and it also contributes to protein, fat and carbohydrate metabolism. B12 helps to promote optimal utilisation of iron in the body. SYMPTOMS OF B12 DEFICIENCY B12 deficiency can affect many bodily systems, including neurologic, hematologic, immunologic, vascular, gastrointestinal, musculoskeletal and genitourinary. Symptoms include extreme tiredness/lack of energy, pins and needles, a sore and red tongue, muscle weakness, depression, problems with memory, understanding and judgement4, and many more5. ABSORPTION OF B12 The best way to ensure adequate B12 intake is through diet or supplementation. However, even adequate consumption of vitamin B12 can sometimes result in the possibility of deficiency because of the complexity of the absorption and methylation process. The absorption of B12 begins with gastric acid and the enzyme pepsin releasing the B12 from animal protein; it then binds firstly to R-protein, which transports it through the stomach and into the small intestine. The parietal cells of the stomach also produce another protein called Intrinsic Factor, which also travels to the small intestine. When the B12-R protein complex reaches the small intestine, it is released from this complex and attaches to Intrinsic Factor (IF), which protects it from digestion and assists with absorption in the ileum (i.e small intestine). Once in the bloodstream, it is transported bound to another protein called Transcobalamin II, which takes it to various tissues in the body and takes the excess to the liver for storage5,6. Inside the cell, it is converted to two active cofactors; adenoyslcobalamin and methylcobalamin. INGREDIENT SPOTLIGHT www.nutritionimag.com FACTORS THAT CAN CONTRIBUTE TO LOW B12 The liver stores enough vitamin B12 to last several years, and any conditions that may lead to vitamin B12 deficiency are likely to have been ongoing for around two or three years before symptoms would appear7. Factor that can contribute to low levels5 Reason Vegan or vegetarian diets B12 is bound to animal protein. Vegetarians will obtain some B12, for example, from eggs and dairy. Damage to parietal cells (for example, high alcohol intake, gastritis, autoimmunity versus parietal cells) Parietal cells in the stomach produce intrinsic factor. IF is needed for B12 absorption so low levels will reduce absorption. High alcohol intake, gastritis and autoimmunity (i.e as seen in pernicious anaemia) result in damage to parietal cells. Low stomach acid (for example, due to antacid medication, PPIs, H2 blockers, ageing, zinc deficiency) Stomach acid releases B12 from food. Antacid medication (for example, proton pump inhibitors) reduce stomach acidity so can lead to low levels of B12 if taken long-term. As we age, levels of stomach acid decrease. Zinc deficiency can lead to low stomach acid. Nitrous oxide (used in some surgical operations, including dental surgery) Active vitamin B12 contains cobalt in its reduced form. Nitrous oxide produces irreversible oxidation that renders vitamin B12 inactive5. Genetics, for example, TCN, MTR, MTRR mutations These genetic polymorphisms or mutations affect the transport (TCN), use and recycling (MTR / MTRR) of B128. Malabsorption, for example, Crohn’s, ulcerative colitis or coeliac disease Damage to cells of small intestine where absorption occurs. Surgery, for example, stomach or small intestine Gastric bypass: Loss of cells that produce hydrochloric acid and intrinsic factor. Intestinal surgery – loss of part or all of ileum will result in reduced surface area for absorption of B12. Other drugs In addition to antacids discussed above, some other prescription medications can impair B12 absorption, for example, metformin, colchicine, neomycin and others.5 FORMS OF VITAMIN B12 The most commonly found ‘forms’ of vitamin B12 used in supplements are cyanocobalamin, methylcobalamin, hydroxycobalamin and adenosylcobalamin. The last three forms also occur in food, along with another form called sulphitocobalamin9. In supplements, cyanocobalamin is the most commonly used form, despite methylcobalamin and hydroxycobalamin being better absorbed, retained and used by the body5. The inactive cyanocobalamin and hydroxycobalamin forms can be converted to the active cofactor forms – methylcobalamin in the cytoplasm of cells and adenosylcobalamin in the mitochondria. Rare inborn errors can affect cobalamin cofactor synthesis10. Cyanocobalamin is an inactive form of vitamin B12 and exists only via chemical supplementation. It is not present in nature, meaning the body does not metabolically recognise it and absorption is much less efficient. The cyano-compound found in cyanocobalamin is not needed by the body, so it quickly looks to convert it into active methylcobalamin. Not only does this mean that cyanocobalamin is a much less efficient form of supplementation of vitamin B12, but the body also has to ‘deal’ with a cyanide group that is liberated during conversion into methylcobalamin. Despite the levels of cyanide being rarely at a level to have a detrimental impact to health, it is vital that it is removed from the body as quickly as possible. This could be a particular problem for those with detoxification enzyme errors as when the cyanide component is not removed and accumulates it can INGREDIENT SPOTLIGHT lead to toxic overload. Cyanocobalamin is the cheapest of the forms. Hydroxycobalamin is a natural inactive form of vitamin B12, attached to a hydroxyl group. This form can be converted into active methylcobalamin and adenosylcobalamin in the body. For some people, this form may be indicated rather than the active methylcobalamin. Hydroxycobalamin has high affinity to plasma proteins. This property helps to retain the hydroxyl-protein complex in the blood stream for a much longer period of time, compared to cyanocobalamin5. Hydroxycobalamin may be indicated where high nitrous oxide levels are suspected as it is an effective nitrous oxide scavenger11. Too much nitric oxide can contribute to oxidative stress. Hydroxycobalamin may also be recommended for people who do not tolerate methyl groups. Methylcobalamin is the active form of B12, where the cyanide group is replaced by a methyl group. It occurs in the cytoplasm of cells and can be synthesised from hydroxycobalamin by the addition of a methyl group. It is needed for vital cellular processes, including methylation and DNA synthesis. Thus methylcobalamin is a co-factor in the methionine cycle. The purpose of this cycle is to regenerate SAM (S-adenosyl methionine), the universal methyl donor. In the process, homocysteine is converted to methionine. Methylation reactions using SAM occur over a billion times per second! Methylcobalamin is the only form able to across the blood-brain barrier without further metabolism, other forms need to be reduced5. This form of B12 may be recommended to provide ‘methyl’ groups or for people with specific genetic polymorphisms www.nutritionimag.com involved in energy production. It can be synthesised from hydroxycobalamin or methylcobalamin. People with certain genetic polymorphisms may have a reduced capacity to synthesise adenosylcobalamin. This can result in elevated levels of methylmalonic acid (MMA), which can be measured in blood or urine and which provides an indirect measure of B12 status. Due to its importance in energy production adenosylcobalamin is a form useful for people with severe fatigue. TESTING B12 LEVELS that don’t recycle B12 effectively. It would also be indicated where an active form is required, for example, if it is suspected that there are conversion issues from the inactive hydroxycobalamin form. Disturbances in methylcobalamin levels can result in elevated homocysteine, which is linked to many health conditions including cardiovascular disease, stroke and dementia. Studies have shown benefit in terms of helping with pain reduction and promoting regeneration of injured nerves. It has been used as a therapy for a number of disease conditions including Alzheimer’s and rheumatoid arthritis12. Adenosylcobalamin is the mitochondrial form of B12, which acts as a co-factor for a metabolic enzyme There is no gold standard test for B12 deficiency because as B12 deficiency occurs, blood serum values may be maintained while B12 tissue levels are depleted. Thus B12 serum values within the normal range do not necessarily indicate adequate B12 status. Other tests include measurement of methylmalonic acid – this test may be oversensitive especially in the elderly – and holotranscobalamin or plasma total homocysteine2. l Clare joined Cytoplan in 2015 as an in-house Nutritional Therapist. Clare has a BSc (Hons) in Biological Sciences and a Postgraduate Diploma in Nutritional Therapy. On qualifying in 2010 as a BANT and CNHC Registered Nutritional Therapist, Clare worked in private practice, seeing clients suffering from a wide range of conditions, including digestive issues, fibromyalgia, hormone imbalances and weight management. Clare has a broad interest in nutrition but she is particularly interested in digestive health as good digestion is so central to overall health and wellbeing. READER OFFERS www.nutritionimag.com I-Mag giveaways HIGHER NATURE’S TRUE FOOD MAXI CO-Q10 systems. True Food Maxi Co-Q10 is a highly absorbable complex, working within the electron transport chain responsible for energy release. Higher Nature True Food delivers nutrients as nature intended. They are more easily absorbed by the body, so smaller doses of nutrients can be used, avoiding mega doses. Gentler on the stomach, particularly important for sensitive digestive I:Win: We have 30 pots to give away. AMAZING GRASS ALKALYZE & DETOX Amazing Grass Alkalise & Detox Green Superfood Blend includes a proprietary combination of organic, non-GMO wheat grass, barley grass, alfalfa, spirulina, spinach, and broccoli, plus a carefully-selected combination of herbs, spices, fruit and vegetables, including over 12 cleansing ingredients, to help restore your pH balance and rid your body of harmful toxins. Every serving is chock full of all the necessary vitamins and minerals you and your loved ones need to start and finish the day feeling healthy. Raw, vegan, gluten free, simply mix one serving with eight or more ounces of water, juice, or mixed into your favourite smoothie. I:Win: We have three to give away. CLICK HERE TO WIN OPTIBAC PROBIOTICS ‘FOR WOMEN’ OptiBac Probiotics ‘For women’ contains two extensively researched strains, Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14, used specifically for women’s intimate health. These strains have been clinically trialled for 30 years by over 2,500 women, and are proven to survive the digestive tract and reach the female intimate area. This supplement is also safe and appropriate for women in the menopause, as well as for pregnant and breastfeeding mothers. I:Win: We have five 30-capsule packs to give away. We showcase a selection of giveaways on offer to readers this issue. NATURAL HEALTH PRACTICE’S TRANQUIL WOMAN SUPPORT All the nutrients in Natural Health Practice’s Tranquil Woman Support are aimed at helping women cope both mentally and physically with the stresses and strains of everyday life. It includes all the B vitamins, with extra B5, as well as magnesium for relaxation and sleep and chromium to help keep blood sugar in balance. Also contains other nutrients such as curcumin, Siberian ginseng, L-theanine and aloe vera to help with hormone balance, digestion and immune support, which can be affected when under stress. Tranquil Woman Support is the perfect supplement to help you take back control of your life. I:Win: We have 10 pots to give away. SOLGAR COLLAGEN HYALURONIC ACID COMPLEX This advanced complex combines a patented form of collagen (BioCell Collagen II), hyaluronic acid, chondroitin sulphate and vitamin C to help keep the skin looking soft, plump and supple and look less wrinkled. Vitamin C contributes to the normal collagen formation for the normal function of skin. Collagen is an important protein in our skin, connective tissue, cartilage and tendons. It supports the skin, thereby increasing skin firmness and integrity, helping to smooth out the appearance of fine lines and wrinkles. I:Win: We have 10 to give away. TRAINING www.nutritionimag.com CPD DIRECTORY If you want to top up your CPD points, take inspiration from these forthcoming events. Power to your practice Lamberts May 4 – Newcastle June 9 – London May 17 – Newcastle June 14 – Suffolk May 19 – Manchester June 21 – London May 26 – Exeter June 23 – Nottingham June 7 – Tunbridge Wells June 29 – Brighton CPD hours: BANT six hours Speakers: Lorraine Nicolle BA (Hons), Dip. BCNH, MBANT, MCIM, MSc, Detsios BSc (Can), ND (Aus), Justine Bold BA (Hons), Dip. BCNH, MBANT, Katie Sheen FdSc, DipION, MBANT, NTC, CNHC Cost: £44.98 (delegates receive a £30 product voucher after attendance at the seminar and a BANT certificate) Website: www.lambertshealthcare.co.uk BANT Supervision Group May 5 – Hampshire CPD hours: BANT two hours Speakers: BANT Supervisor, Ruth Taylor Cost: £30 Email: [email protected] Website: bant.org.uk/members-area/bantsupervision/meet-the-supervisors/#Ruth_ Taylor BANT Supervision Group May 13 – Suffolk June 20 – Colchester July 1 – Suffolk CPD hours: BANT two hours Speakers: BANT Supervisor, Fiona Mealing Cost: £30 Email: [email protected] Website: http://bit.ly/210Najm BANT Supervision Group May 13 – St Albans June 13 – St Albans CPD hours: BANT two hours Speakers: BANT Supervisor, Paula Werrett Cost: £30 Email: [email protected] Website: http://bit.ly/23LDJcI BANT Supervision Group May 13 – location TBC June 10 – location TBC CPD hours: BANT two hours Speakers: BANT Supervisor, Tracey Harper Cost: £30 Email: [email protected] Website: http://bit.ly/1plfhMc Cancer – Nutritional Support (three days) Optimum Nutrition May 24 – ION, Richmond CPD hours: BANT 15 hours Speakers: Dr Marie Polley BSc (Hons), PHD, PGCHE, Carol Granger BSc (Hons) MSc, MSB, CBiol, NTCC, MBANT Cost: £450 Website: http://bit.ly/1RzoslZ BANT Supervision Group May 25 – Manchester May 27 – Liverpool June 24 – Liverpool June 27 – Manchester CPD hours: BANT two hours Speakers: BANT Supervisor, Dalbinder Bains Cost: £30 Email: [email protected] Website: http://bit.ly/1plfnU5 BANT Supervision Group June 6 – Reading CPD hours: BANT two hours Speakers: BANT Supervisor, Kate DelmarMorgan Cost: £30 Email: [email protected] Website: http://bit.ly/26gRsqu BANT Supervision Group June 8 – Tunbridge Wells June 8 – Shoreham-by-Sea July 27 – Tunbridge Wells July 27 – Shoreham-by-Sea CPD hours: BANT two hours Speakers: BANT Supervisor, Carmel Buckley Cost: £30 Email: [email protected] Website: http://bit.ly/1NDt2vU BANT Supervision Group June 9 – Taunton CPD hours: BANT two hours Speakers: BANT Supervisor, Elizabeth Bray Cost: £30 Email: [email protected] Website: http://bit.ly/1WfBDvF FORTHCOMING WEBINARS TRAINING www.nutritionimag.com Forthcoming webinars Target Publishing, which publishes Nutrition I-Mag, is hosting a series of webinars for practitioners. Register at www.camconferences.co.uk/webinar Beta-Glucans & Beyond: Insights into the anti-inflammatory and immune actions of mushroom extracts Hifas da Terra Presented by Antony Haynes Tuesday June 1, 6.3pm-7.30pm Antony has been in private practice for over 24 years and is one of the most experienced and knowledgeable Nutritional Therapists in the country, and one of the first to implement the principles of Functional Medicine in the UK. Known as the practitioners’ practitioner, Antony employs his clinical experience in managing the nutritional needs of his patients, which number in excess of 14,000, at his clinic, The Nutrition Clinic, in Harley Street, London. In March 2011, Antony was awarded the prestigious CAM magazine Award for Outstanding Practice for his many years of educating, inspiring, motivating and helping practitioners and patients. Antony has spent his lifetime engaged in one type of sports or exercise, achieving success in competitive sport, representing the junior GB ski team, and Essex and the Eastern Counties grass hockey, and being club champion at tennis. In recent years, Antony has focused on auto-immune conditions, attempting to identify the causes of, and the means by which to ameliorate, prevent and even reverse them with Nutritional Therapy. Antony has learned about the connection of chronic infectious agents as a very common initiator of auto-immunity. Antony now sees many patients who have one or more autoimmune conditions and helps them to improve their health. The Science of Food; Lowering the Inflammatory Load Through Lifestyle Invivo Clinical Presented by Dr. Cheryl Burdette, ND Tuesday May 10, 6.30pm-7.30pm Allergic reactions are classified into four types. Specific food allergy profiles can detect Type II/III responses, which are associated with a delayed allergic response that is mediated by an IgG response and immune complexes. Within this immune complex, the complement component 3 (C3) is converted into C3d, which is an activator of the complement cascade. Food allergy testing is gains sensitivity when IgG is combined with C3d. Borrowing from technology developed by one of the original immunologist who worked on the polio vaccination, an expert in complement, noted that complement is amplified and is even necessary to trigger an allergic reaction, or, more specifically, a histaminergic reaction. While complement antigens as well as immunoglobulins are both documented in the literature to be associated with allergic reactions, it is the two together that are the most sensitive measure of delayed food sensitivity. When looking to the research, the phenomenon of complement binding to an IgG subtype to create pathology is well documented. This lecture will focus on the research around food sensitivities and why it is a viable part of management of inflammatory and oxidation driven pathologies. It will review different immunologic responses to foods such as IgE, IgG total and subtype 4, IgA and complement and distinguish clinical patterns between them, distinguish between sensitivity and allergies and determine clinical relevance of each, as well as symptomatic presentation. It will also review how activation of T cells and histamine release play a role in many chronic conditions, including auto-immune conditions, heart disease and certain cancers. Soya foods: Are there still controversies? Alpro Soya Presented by Professor Mark Messina Tuesday, June 14, 6.30pm-7.30pm Soya foods are now a popular food choice for many in the UK and other European countries, with an array of food and drink options. Naturally lower in saturated fat and a source of high quality plant protein, one to two daily servings of soya foods as part of a healthy balanced diet have the potential to help improve health outcomes. However, despite national and international dietary guidelines, recommending whole soya foods, and the lack of any human data for any negative health outcomes, there clearly remains confusion and concern with regard to soya isoflavones. Professor Mark Messina will cover the following; focus on current whole soya foods on the UK market, the national and international health organisations recommending one to two servings of whole soya foods as part of healthy eating guidelines, an overview of the health benefits associated with consumption of soya foods including heart health, hot flushes, sustainability, allergies, breast cancer and soya isoflavone basics, providing a clear understanding of isoflavones, what they are and how they impact on human health compared to animals or in test-tubes. For each popular controversy, Professor Messina will review the evidence it is based on, provide an overview of where the totality of the latest evidence lies and what it really means for human health. Fermented vs. non-fermented soya foods – is there a winner for health, soya compounds and preventing the absorption of essential minerals, child health and development, feminisation of men, increasing breast cancer risk and thyroid function will also be covered. COMPANY PROFILE www.nutritionimag.com INSPIRING EDUCATION ION is the most established provider of Nutritional Therapy training courses in the UK. Rachel Symonds discovered more about the cutting edge offering at this leading college. T raining and education is the cornerstone of the nutrition world, but in today’s busy world, where we are all time pressured, it can sometimes be hard to fit it all in. ION, or the Institute of Optimum Nutrition to give its full name, has been training future Nutritional Therapists for the last three decades. Making its courses accessible to students, so they can study in a way that suits them, is a key focus and is perhaps why, after 30 years, the institute is thriving. This independent, not for profit educational charity, whose principal goal is to further the knowledge and practice of optimum nutrition, offers a number of established courses, but what sets it apart from the rest is the flexibility it can offer students in the way that they learn. Paula Werrett, Head of Courses, who herself graduated from ION back in 2004, commented: “We have a long-established track record, and we are well known for the education we provide. I think what makes us different is the flexibility that we can offer to students, which is an integral part of our offering and what really sets us apart.” In terms of its credentials, ION, which currently has around 200 students, is a member of the Nutritional Therapy Council’s Schools Forum. Paula added: “We were one of the first providers to become accredited by the Nutritional Therapy Education Commission, which is fantastic for us as it is the benchmark for quality in the sector. That then COMPANY PROFILE enables our students to register with CNHC, which in turn gives the public confidence and peace of mind that they are speaking to a practitioner who adheres to certain standards and is registered.” EARLY PIONEERS ION was founded by Patrick Holford back in 1984, and the objectives today are to advance optimum nutrition throughout life and to educate and enthuse, instilling optimum nutrition as the foundation of health for all. “We were certainly one of the pioneers in terms of offering nutritional education,” Paula commented, adding: “ION was established to promote nutrition through the training of nutritional therapists, who could then go out and help people.” When it was set up, there were three main courses to choose from, which were designed by Patrick. Thirty years on, and the industry has changed greatly. “In those days, people didn’t know as much as they do now about the power of nutrition,” Paula explained. “Of course, we have seen awareness grow and grow www.nutritionimag.com and today, nutritional therapy is recognised much more in the mainstream. The establishment has grown, and the standards of the students we are taking on is getting higher because there is a greater understanding now.” As an organisation, ION prides itself on the skills and expertise it can offer students; as a minimum, the module leaders are all nutritional therapists, while many have masters and are encouraged to continue learning. “All the courses are accredited by NTEC; there is a core curriculum that we follow, and we have a process where the material is reviewed regularly to make sure it is still fit for purpose,” Paula added. ION EVOLUTION In 1992, ION became a registered educational charity and a company limited by guarantee, which has allowed for more of a set structure and procedures. “The reason we became a charity relates to needing a foundation in terms of funding and it has brought about a more balanced approach in the long-term,” Paula explained. The trustees, who are also Directors of the company, are responsible for the strategic direction, while there is a team dedicated to the day-to-day running of the organisation. Since that process happened, a CEO in the shape of Chris Mansi was brought on board, who brings with her a wealth of experience in the charity sector, while the Dean, Heather Rosa, worked for 15 years in the education sector. As technology has moved on so too has ION and it now offers video recordings of the lectures to allow people to continue their studies if they aren’t able to make the attendance days. “We understand people have other commitments and can’t be at every lecture, so that’s why we provide the recordings for them to catch up on them,” Paula explained, adding: “We also do webinars and every student has a personal tutor, who they can talk over any issues with.” COMPANY PROFILE But how else is ION evolving its offering? The main focus is on being flexible to ensure as a college it is meeting the needs of the modern student, which have certainly changed from when ION was first established. “We are really proud of the fact we can offer this course to a wider audience by doing it online; it means students can do it in their own time and at their own convenience,” Paula explained. “We offer a lot of flexibility, so students are able to switch back and forwards between e-learning and attendance – people’s lives change, they have other commitments, so it is important that we can be flexible.” THE ION DIFFERENCE Today, there is huge choice when it comes to training in the world of nutritional therapy, but for ION to have stood the test of time over three decades, clearly it is offering something special, and it certainly is in relation to its cutting edge diploma courses as well as its support of its students. Paula commented: “We offer excellent student support, we are investing a lot in our technology and in our virtual learning to improve the student experience, and we are constantly improving what we offer as knowledge develops.” Looking closer at the main courses, the Nutritional Therapy Diploma is www.nutritionimag.com the flagship course, internationally renowned as the market leading qualification in clinical practice for Nutritional Therapists. It was the first course of its kind to be fully accredited by the Nutritional Therapy Education Commission (NTEC), which recognises the academic integrity and rigour of the curriculum. This course, which is one of those offered as an e-learning option, is designed to deliver up-to-date theoretical knowledge, alongside rigorous clinical training. It covers everything from the components of food, and its role in human biochemistry and physiology, to the importance of dietary and environmental factors and their impact on health/disease and the balancing, healing and therapeutic effects of food and nutrients based on the principles of functional medicine. ION also works to educate the wider public on nutrition with its courses. By way of example, it offers the nonacademic Home Study Course, ideal for anyone interested in healthy eating for themselves or their family and for those to acquire sufficient knowledge to plan a personal nutrition programme. ION also runs short courses for existing nutritional therapists to build their CPD points. “We offer a lot of practitioner training now and that is something we are quite excited about,” Paula added. l “ION also works to educate the wider public on nutrition with its courses. By way of example, it offers the nonacademic Home Study Course, ideal for anyone interested in healthy eating for themselves or their family and for those to acquire sufficient knowledge to plan a personal nutrition programme.” RECIPES www.nutritionimag.com RAW INDULGENCE Following a raw food diet need not mean missing out. Simply take inspiration from these delectable recipes from the new book, Raw Cakes. Coconut Neapolitan cake Chocolate mousse cake Carrot cake RECIPES www.nutritionimag.com Coconut Neapolitan cake (Serves 8) Prep time: 45 minutes, plus soaking and chilling INGREDIENTS: • 1 cup of (150g) almonds • 2/3 cup (100g) hazelnuts • Generous ½ cup (100g) Brazil nuts • 8oz (225g) coconut flesh, brown skin removed • 2½ oz (65g) coconut oil • 2½ tbsp coconut palm sugar, plus 2tsp • 2tbsp cacao powder • 1tsp vanilla extract • 1/3 cup (40g) finely grated beet • Whipped coconut cream to serve METHOD: 1 Put the almonds, hazelnuts, and Brazil nuts in separate bowls, cover with cold water and let soak for several hours or overnight. 2 Line a 4in (10cm) round cake pan with plastic wrap (use a larger pan if you don’t have a small one, though the cake will be very shallow). 3 Put the coconut flesh in a food processor and process until finely ground. Remove seven tablespoons and reserve for decoration. 4 Put the coconut oil in a small heatproof bowl and stand it in a larger heatproof bowl of boiling water. Let melt. 5 Drain the almonds, then put in a heatproof bowl and cover with very hot water. Let stand for two minutes, then drain and plunge into cold water for one minute to loosen the skins. Peel away the skins (this takes a while and you don’t need to be too thorough. Peeling them gives a better color to the finished cake, particularly the vanilla layer. Omit this step if you prefer). 6 Drain the hazelnuts and Brazil nuts, then transfer to the food processor, add the almonds and the two tablespoons of coconut palm sugar and process until finely ground. Add the melted coconut oil and pulse briefly. 7 Put a third of the mixture in a separate bowl and beat in the cacao powder and remaining coconut palm sugar, then turn into the prepared pan and press down firmly. Beat the vanilla into half the remaining mixture, then pack into the pan on top of the chocolate mixture. Beat the beet into the remaining mixture and press into the pan. Freeze for 30 minutes to firm up slightly. 8 Put the reserved ground coconut on a plate. Carefully turn out the cake and remove the plastic wrap. Coat the sides and top of the cake in the coconut. Freeze for 30 minutes or chill for one to two hours to firm up a little. 9 Serve the cake cut into wedges with whipped coconut cream. Chocolate mousse cake Carrot cake RECIPES www.nutritionimag.com Chocolate mousse cake with summer berries (Serves 6) Prep time: 25 minutes plus chilling INGREDIENTS: • 2¾ oz (75g) coconut oil • 2 ripe avocados • Scant ½ cup (50g) cacao powder • Scant ½ cup (100ml) agave nectar METHOD: 1C ut 6x6in (15cm) squares of parchment paper. Press a square over an upturned dariole mold, creasing it down the sides to fit. Lift away and push the paper into the mold to form a lining (creasing it over the outside of the mold first makes it easier to fit neatly inside). Repeat to line five more molds. Alternatively, line six sections of a cupcake pan with paper cupcake cups. 2P ut the coconut oil in a small heatproof bowl and stand it in a larger heatproof bowl of boiling water. Let melt. Coconut Neapolitan cake • 2tsp vanilla extract • Squeeze of lemon juice • 1/3 cup (50g) raspberries • 1/3 cup (50g) blueberries or halved blackberries 3P ut the avocados, cacao powder, agave nectar, vanilla extract, and lemon juice in a food processor and process until smooth, scraping down the mixture from the sides of the bowl. Add the melted coconut oil and process again. Spoon the mixture into the prepared molds or cups and chill for several hours or overnight. 4T op the cakes with the raspberries and blueberries or blackberries and serve. Carrot cake RECIPES www.nutritionimag.com Carrot cake with lime cashew frosting (Serves 10) Prep time: 20 minutes plus chilling and soaking INGREDIENTS: • 7 carrots, about 1lb 1oz (525g) total weight • 1 cup (100g) soft dried pineapple • 1tsp ground ginger • ¼ tsp ground allspice • ¾ cup (150g) dried figs, stalks removed • Scant ½ cup (75g) golden raisins • 1 cup (150g) medium oatmeal • Edible flowers, to decorate (optional) METHOD: 1 Put the cashews in a bowl, cover with cold water and let soak for several hours or overnight. 2 L ine 2x6in (15cm) round cake pans with plastic wrap. 3F inely grate the carrots and pat dry between several thicknesses of paper towels. 4P ut the pineapple and spices in a food processor and process until chopped. Add the figs and process again until the mixture starts to cling together. Tip in the carrots, raisins, and oatmeal and process until evenly combined. Divide between the prepared pans and press down firmly. 5C hill for several hours or freeze for 30 minutes to firm up. Chocolate mousse cake FOR THE FROSTING: • Generous 1 cup (150g) cashews • ⅓ cup (75ml) almond milk • Scant ¼ cup (50ml) maple syrup • Finely grated zest of 1 lime, plus 3tsp juice 6T o make the frosting, thoroughly drain the nuts, then transfer to a food processor, add the almond milk and process until smooth. Add the maple syrup, lime zest and juice and thoroughly process until very thick, spreadable, and smooth, frequently scraping down the mixture from the sides of the bowl. 7C arefully turn one of the carrot cakes out onto a flat serving plate and peel away the plastic wrap. Spread with half the frosting and top with the second cake. Spread with the remaining frosting and chill until ready to serve. 8 Serve scattered with edible flowers, if liked. Coconut Neapolitan cake