Kent Ferments: The Benefits of Kimchi for Gut Health

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I had the pleasure of supporting Leila and James Fox of Kent Ferments and BoConcept Canterbury with a talk last evening : ‘Detox Your Home, Reset Your Gut Health.’ We discussed the myriad health benefits associated with fermented foods, with a special highlight on the wonders of Kimchi – for me, one of my favourite gut-friendly foods! We also discussed the impact that our home and working environment can have on our gut health and wellbeing.

Kimchi, a traditional Korean dish, involves fermenting napa cabbage and Korean radishes with a blend of ingredients like chili peppers, garlic, ginger, spring onions, and spices. The fermentation process, driven by lactic acid bacteria, not only imparts a tangy flavour but also brings numerous health benefits. Kimchi played a big part in Leila’s life growing up in Hawaii and I am thrilled she and James are now sharing their precious family recipe and enthusiasm for fermented health foods with us here in East Kent.

A most versatile condiment, a little kimchi can go a long way in boosting gut health and overall well-being, also to contributing to our optimum different 7 plants a day, 30 different plants a week. It is also for me a complete food in terms of ensuring prebiotics such as ginger and garlic which possess anti-inflammatory properties and promote the growth and activity of beneficial bacteria in the gut.

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Kent Ferments offers an original Kimchi No. 1 with medium heat and a smoky finish, while Kimchi No. 5 provides a milder taste, ideal for those new to Kimchi. Priced at £6.50 per 340g E Jar, you can find Kent Ferments at Wye Farmer’s Market.

Health Benefits of Kimchi

Health benefits of Kimchi include promoting good bacteria, essential for a balanced gut microbiome. Probiotics, especially Lactobacilli, aid digestion, nutrient absorption, and help prevent digestive issues. Kimchi can help support the immune system with the good bacteria modulating immune responses and defending against infections. Moreover, the low-calorie dish is rich in vitamins A and C, potassium, and calcium, with antioxidant properties from garlic and ginger.

Kimchi can also play a role in weight management and metabolic health. The fermentation process produces Butyrate, a short-chain fatty acid with diverse benefits. Butyrate enhances insulin sensitivity, regulates energy metabolism, and acts as an immune modulator, potentially managing autoimmune responses. In my experience, insufficient butyrate is often implicated in many of my IBS, ulcerative colitis and Crohn’s disease cases.

Furthermore, Butyrate influences gene expression as an HDAC inhibitor, offering neuroprotective benefits, anti-inflammatory properties, and contributing to cancer protection. It also impacts the gut-brain axis, influencing hormones like leptin which regulate appetite and help to prevent obesity.

In conclusion, incorporating Kimchi into your diet can be a flavourful and health-conscious choice. Its unique combination of taste and nutritional benefits makes it an excellent addition to meals, offering a delicious way to support your gut, immune system, and overall well-being.

For more information or to book a nutrition consultation, contact Charlotte Fraser at enquiries@naturopathic-nutrition.com.

The Gut Health Wheel © and The Gut, Brain, Heart Connection: 1st March 2023

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Do you suffer from bloating and digestive issues like irritable bowel, diarrhoea, constipation, acid reflux or heartburn? Do you feel tired all the time? Are you lethargic and sluggish, merely existing each day burdened with brain fog, anxious and depressed? Then this Journey is for you!

Join me and KAYLO for ‘The Gut, Brain, Heart Connection’, a Journey to help heal, nourish and transform your gut for optimal physical and emotional health. To contextualise and make the experience even more immersive and relatable, I will be guiding participants around The Gut Health Wheel © – they will get a special preview and be able to place themselves on a ‘holistic roadmap’.

I will be hosting the first session from 18.00-1930 on 1st March 2023. This will be a deep dive to understand how our gut health influences our physical, emotional and mental health.  

These sessions are designed to get to the root of what is happening in your body, so that you can begin to heal yourself. For indeed, when you have a chronic health condition, it can often be difficult to separate the wood from the trees. I developed The Gut Health Wheel © to help my nutrition clients have a deeper holistic understanding. To help them ‘join the dots’ of their journey more, so they become more their own experts.

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The Gut Health Wheel ©

The Gut Health Wheel © is unique, a complete synthesis of all my clinical experience and years of research. It is a visual that integrates signs and symptoms (physical, cognitive, emotional, psychological and behavioural), contextualising these within vitamin and mineral deficiencies and disease pathways. It also incorporates TCM, western medicine and scientific research.

The Gut Health Wheel © has been evolving a very long time to get to this – I’ve also been through a lot of canvas. The wheel also continues to be reviewed by GPs, health practitioners, writers, psychologists, and academics. Their expertise has been valuable. So too the feedback of my nutrition clients who have been on the journey from the beginning. I’m so grateful to everyone for all their encouragement, support and insight. Special thanks as always to my friend and fellow nutritionist Virginia Hills for the tea and sympathy, her positivity and engagement, and to Emily Hewett for capturing my thoughts so intuitively in her wonderful graphic.

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The Gut Health Wheel © Copyright Charlotte Fraser Naturopathic Nutrition 2023

My motivation for developing The Gut Health Wheel © stems in part from a question that once frustrated me when I was managing my Ulcerative Colitis in the early days: ‘How can I know if healing is taking place?’

Indeed! How do you know if you are getting better? How do you know that you are moving in the right direction? That question can often get lost amidst all the medical diagnostics and blood tests don’t tell the whole story.

To answer these fundamental questions, it’s essential to retrace your steps, to understand the journey that you have already taken.

To achieve optimum health and wellbeing, we need to understand and better interpret our body’s own signs and symptoms in order to progress to a more mindful and preventative approach which facilitates healing. This is where The Gut Health Wheel © can be very helpful in providing a holistic and more integrated overview.

In The Gut, Brain, Heart Connection, we will look at how genetics, medical history, lifestyle, diet, food diversity, environment and mindset can impact our health and nutritional ‘bank balance’. Also what we can do about it.

I will be talking about how our gut health so influences that of our brain and heart and vice versa.   We will also look at:

  • The latest science 
  • Talking about some of the most common mistakes people make with their diet
  • Some of the “universal truths”, the simple steps that everyone can take to improve their nutrition and lifestyle
  • My ‘golden rules’ for gut, brain and heart health.  What we can do nutritionally from a regenerative and preventative point of view
  • My 7 Day Gut Sabbatical to help take the pressure off and help do a reset
  • Supplements and whether we need to supplement at all

For more information and to book a place: Visit The Gut, Brain, Heart Connection.

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The Elephant in the Room of the Diet Industry

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As many embark on a new year diet, I want to tackle the proverbial ‘elephant in the room’: the trillions of bacteria, fungi and viruses that we co-exist with. Consider the fact that we at only around 43% human and 57% microbial, how can we possibly ignore them?!

These microbes are also the reason why so many fad diets fail. What worked for the diet book author, your friend, or your family member, won’t necessarily work for you. Not unless you evolved in a clinically-sealed petri dish with the same shared dietary, social and environmental experiences. Realistically, it just isn’t possible and here’s why… let’s look at the science.

The majority of microbes inhabit our large intestine and every gut microbiome is wholly unique. Think of your gut microbiome like a biological fingerprint or signature. It is the embodiment of all our genetic, physical, mental,  emotional,  environmental, social, and cultural experiences. What we eat, our belief systems, movement, environment, nature, social and community engagement have all been found to influence the state of our microbiome in research studies.   

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The human intestinal tract harbours an estimated three trillion bacterial members, up to a 1000 different bacteria species, and the ratio of gut microbiota to human cells is roughly 1:1.   What’s more, the genetic diversity of gut microbiota is 100 times higher than that of human cells. That’s a huge amount of DNA we are carrying in us with an infinite numbers of variables possible between person to person.

In the exciting field of nutrigenomics, the focus is on gene expression, whether we activate a particular gene or not. Professor Vittorio Sebastiano, Epigeneticist at Stanford University says as much as 70% of our health outcomes are down to how we live, and not the ‘deterministic’ genes we inherited. The biggest influencer of gene expression is what we eat. However it doesn’t just stop there, as what we eat and how we live doesn’t just affect our DNA, but also the genes of the trillions of bacteria in our gut. The DNA scale and potential is huge, mind-boggling! The main takeaway I want to share however, is that there is a a HUGE amount we can do by means of what we eat and, as Professor Sebastiano says, “much of our destiny truly is in our hands.”

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There can be no “one size fits all diet

Even identical twins have been found to not process food the same way.  The largest ongoing scientific nutrition study of its kind, explored how more than 1000 participants (around 60 percent were sets of identical twins) process their meals. Surprisingly, the researchers found that even identical twins respond very differently to fats and carbohydrates.  The study was carried out by researchers from King’s College London, Massachusetts General Hospital and nutritional science company ZOE, co-founded by Professor Tim Spector, Professor of Genetic Epidemiology at King’s College London.

The results also suggested that personal differences in metabolism due to factors such as the gut microbiome, meal timing and exercise are just as important as the nutritional composition of foods. What fascinates me is that the study found twins shared only 37% of the same microbes with each other. That’s just a little more than unrelated individuals who share an average of 35% of the same microbes. 

A successful diet therefore requires an entirely personalised and person-centred or holistic approach. We really are all unique and that’s why I am passionate about supporting my clients in becoming their “own expert”. To help them tune into their own body, the many signs and symptoms that present, and to understand their own individual dietary needs. The focus has to be on sustainable wellness and more often than not, I am putting foods back into my clients’ diets.

Every gut microbiome is wholly unique. Think of it like a biological fingerprint or signature. Truly the embodiment of all our individual DNA, our genetic, physical, mental,  emotional,  environmental, social, and cultural experiences.  

Our DNA originally determines our microbiota.  We’re first exposed to microorganisms as an infant, during delivery in the birth canal and through the mother’s breast milk.   Later, environmental exposures, diet and lifestyle can alter our microbiome to be either beneficial to health or to place us at greater risk for disease.

A varied and diverse diet is key to optimum health and weight loss

Counting calories is very 1999 in dietary terms. In 2023, all the science suggests you should be counting plants.

Numerous science studies show that greater numbers and a more diverse range of good gut bacteria are key to successful weight loss and management. And key to having more good bacteria is to have a diverse and varied diet high in plants and whole foods. This is what our good bacteria feed on.

Indeed, the worst thing for health and weight management is to eat the same food every single day.

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Ideally, aim for more than 7 different plants a day and a minimum of 30 different varieties a week. By plants, I mean vegetables, legumes, fruits, shoots, leaves, nuts, seeds, whole grains, herbs and spices, etc.

Sadly, too many diets have a restrictive element and entail cutting out entire food groups which can result in nutritional imbalances and deficiencies. Instead the focus should be on variety and balance. I see a lot of gut health problems stem from people avoiding dairy and carbohydrates especially. In fact, some carbohydrates such as oats provide important sources of resistant starch which can help boost butyrate-producing microbes.

A lot of gut health problems stem from insufficient butyrate. Butyrate is a short chain fatty acid and the main source of fuel for the cells (colonocytes) lining the colon. Butyrate ensures the optimum environment for your gut microbes to flourish. It also helps insulate blood sugar levels and increase insulin sensitivity; helps regulate energy metabolism; has important anti-inflammatory properties; protects against cancer; and prevents obesity. Butyrate increases leptin gene expression. Leptin suppresses food intake, prevents low metabolism, and promotes weight loss. Higher butyrate levels also help increase levels of glutathione, an important antioxidant which helps strengthen the intestinal barrier and increase bioavailability of iron and zinc.

Fermented dairy products like kefir, bio yoghurt and certain probiotic cheeses are important sources of good bacteria (lactobacillus and bifidobacteria).

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In cutting out whole food groups, you can unwittingly exclude certain good bacteria which are very beneficial to health and aid weight loss. This isn’t a good idea. More so, when you consider that science research increasingly studies health conditions in relation to the lower incidence or absence of a certain gut microbe.

As for eliminating fat entirely from your diet, extra virgin olive oil is a valuable source of polyphenols which help promote Akkermansia Municiphilia, a beneficial bacteria that helps strengthen the intestinal lining. That lining, our gut epithelium, is the dividing line between the human and microbial worlds, and it plays a critical mediator role. It really is our front line defence to external threats, a key facet of our immune system.

Essential fatty acids such as omega 3 found in oily fish and flaxseeds also have anti-inflammatory properties and are important for vitamin A,D,E, and K absorption, hormonal health, blood sugar and cholesterol management; also gut, brain, liver and heart health. Good fats are also important for bile flow. Insufficient bile is another contributor to so many gut health problems that I see. Yo-yo fasting and low fat diets also risk later gallbladder removal.

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Our microbiome plays so many key roles in promoting the smooth everyday operation of the human body.  Most of our microbes are symbiotic (where both the human body and microbiota benefit) but some, in smaller numbers, are pathogenic (promoting disease).

In a healthy body, pathogenic and symbiotic microbiota coexist happily. However, if there is a disturbance in that balance—brought on by infectious illnesses, certain diets, or the prolonged use of antibiotics, artificial sweeteners, or other bacteria-destroying medications—gut dysbiosis occurs. This stops the normal interactions and as a result, the body can become more susceptible to disease.

Gut dysbiosis is implicated in various conditions including IBS, allergies, autism, inflammatory bowel disease, rheumatoid arthritis, multiple sclerosis, Alzheimer’s, Parkinson’s disease, type 2 diabetes and obesity.

In particular, a high-fibre diet affects the type and amount of microbiota in the intestines. Dietary fibre can only be broken down and fermented by enzymes from microbiota living in the colon. These bacteria then release short chain fatty acids such as butyrates as a result of the fermentation process. This lowers the pH of the colon, which, in turn, determines the type of microbiota present that would survive in this acidic environment. The lower pH limits the growth of some harmful bacteria like Clostridium difficile.

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Our gut microbes aren’t just gate-crashing, they are integral to our health

Our gut microbiota help us:

  • Digest food
  • Produce metabolites such as short-chain fatty acids and vitamins, which strengthen the gut barrier and regulate/promote a healthy immune system 
  • Protect us against other pathogenic, disease-causing bacteria
  • Break down potentially toxic food compounds
  • Synthesise certain vitamins and amino acids, including B vitamins and Vitamin K
  • Help regulate our hormones, including the amount of oestrogen circulating in our system at any one time
  • Produce neurotransmitters that affect how we feel, including dopamine, serotonin, norepinephrine, and gamma-aminobutyric acid. These are key players in triggering intense feelings of happiness, reward, or anxiety

Indeed, our gut bacteria greatly impact our overall physical, emotional and mental health.  It is why I do scientific cognitive testing, anxiety, depression and perceived stress screening, so that clients can objectively measure their progress, Increasingly, research is looking into how our gut bacteria also influence our behaviour.

In 2023, Promote Food Diversity

The first UK Food Diversity Day will be taking place this Friday, on the 13th January. Professor Tim Spector will be taking part in that along with other leading experts. Dan Saladino, author of ‘Eating to Extinction’ has been really driving awareness of this important issue. Saladino’s article ‘Are we eating ourselves to extinction?’ explains why we really should be thinking more about what we put on our plate. What are the implications of the world’s increasingly homogeneous diet for the diversity of our gut microbiota and our overall health?

Here’s a scary statistic: of the 6,000 plant species humans have eaten over time, the world now mostly eats just nine, of which just three – rice, wheat and maize – provide 50% of all calories. Add potato, barley, palm oil, soy and sugar (beet and cane) and you have 75% of all the calories that fuel our species. As thousands of foods have become endangered and extinct, a small number have risen to dominance. For example soy which plays a starring role in an increasingly homogeneous diet eaten by billions of people.

These dietary shifts are taking place on a global level and are unprecedented. Global markets increasingly infringe on our food choices. They threaten the diversity of natural food sources so essential to our gut microbiome. I encourage everyone to incorporate more plants and whole foods in their diet, and to seek out new varieties! Try a new plant this week or try growing it in your garden. Our very future might depend on it.

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For more information or to book a nutrition consultation, contact Charlotte Fraser at enquiries@naturopathic-nutrition.com.

Lettuce and IBS

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Do you think they eat ice cream every day in the Arctic?   This may sound a daft question but it illustrates a point that I often raise with my clients suffering from IBS and gut health troubles.  

Why as a northern hemisphere nation do we eat so much cold, damp lettuce and raw salad leaves? We eat lettuce all year-round, even when it is snowing, cold and damp outside. It has become such a staple in everyone’s diet and we often reach for the the same variety, the same bag of lettuce each time too. Lettuce is just so routine it tends to pass under the radar when it comes to gut health problems. In fact, people don’t think about lettuce much at all.

Lettuce is rarely considered a possible culprit in irritable bowel syndrome and I can understand why as it seems so counter-intuitive. After all, we know that having lots of fibre is essential for digestive health and so it is a natural instinct to pack in the fibre and roughage if you experience any cramps, constipation or diarrhoea. However, if you are experiencing an Ulcerative Colitis flare-up for example, this can make symptoms worse.

Occasionally lettuce comes up as a food intolerance but more often than not this is a red herring. In gut health, it isn’t always helpful to look at food sensitivities in isolation. You need to look at context and balance, and timing as well. Small adjustments can make the world of difference.

What is it about lettuce?

There is a good reason why we don’t introduce lettuce early on when first weaning a baby onto solids: lettuce is too challenging for a baby’s developing digestive system.

We wouldn’t dream of hanging up our washing to dry in a cold and musty attic would we? Yet many of us don’t think twice about filling our overloaded digestive systems with cold and damp raw foods like lettuce. With IBS and gut health problems, it is often a case of doing some simple renovations to the attic before we move the wonderful, soft furnishings such as lettuce in.

Lettuce is healthy as part of a balanced and diverse diet. While we can’t put the bowel in a sling like we would a broken arm, we can give it a short sabbatical. We can reduce the bowel’s workload. Even a six day mini-break can do wonders.

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Simple tips and timings for a happier gut

Here are just some basic tips which can help support the bowel and reduce its in-tray in the short-term to help promote recovery:

For 7-days:

  • Avoid eating raw foods. Have cooked vegetables as the heating process make them easier to digest. The easiest thing is to roast a whole lot of different coloured vegetables and have any leftovers cold the next day with lunch. If you bake a potato or an apple, leave the skin.
  • Avoid eating too many heavy legumes and after the seven days, have legumes more at lunch rather than in the evening. Legumes such as lentils, chickpeas, kidney and soy beans and are more heavy duty on the digestive front. Like lettuce, chickpeas (and hummus) crop up a lot with my IBS cases. You might also want to try canned legumes as these are lower FODMAP than the dried variety.
  • Eat supper early (be finished by 8.30pm at the latest) and have a 14 hour overnight fast. There is a lot of scientific research into the benefits of intermittent fasting for your gut and brain health. If you eat at 6.00pm, have breakfast at 8.00am, or if at 7.00pm, breakfast at 9.00am. For more useful advice, I recommend Jeannette Hyde’s new book, the ’10-Hour Diet’. That book is also the subject of my next blog.
  • Drink more water. So much constipation and diarrhoea is connected to dehydration. So is hunger often.
  • Eat breakfast, lunch and supper at the same time as much as possible. The gut is a stickler for routine and finds change unsettling.
  • Aim for an optimum 8 hour sleep and sleep on your left hand side.

After the seven days and for the longer-term, it is best to eat raw foods at breakfast or at lunch. Who wants all that cold, damp food festering in their gut overnight when it wants to be resting and recuperating? Some of the best advice I once received was at the Original FX Mayr: they advise ‘no raw food after 2.00pm’. They also encouraged an overnight fast. My own cut-off time for raw food is 4.00pm and of course, there are always exceptions to this rule. However, it’s what you do 80% of the time that can make a huge difference.

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Be more attuned to the environment, your location, external temperature and the time of year. Warming foods are more beneficial during the colder months. Eat foods in season as much as possible. Then, when you do eat lettuce, why stick to the same old Iceberg or Little Gem? There are so many varieties of lettuce, a vast array of different plants and leaves to enjoy. I encourage you to eat as many different plants, leaves, shoots and roots as possible. Explore all the different colours, flavours and textures available. The worst thing we can do is eat the same old foods every day. There is so much research now to show that it is in eating a varied diet, rich in diverse plants, that we really improve our gut and overall health. Your good bacteria, so key to immunity and weight management, will be sure to have a field day!

For more information or to book a nutrition consultation, contact Charlotte Fraser at enquiries@naturopathic-nutrition.com.

PHQ-9 Assessment for Depression

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Now, more than ever, mental health forms a major component of my work in nutrition. The COVID-19 pandemic has led to an unprecedented increase in stress among communities and individuals, worsening or triggering mental health conditions such as depression.

I now offer a free online PHQ-9 assessment.  The PHQ-9 is a simple, 9-question instrument for screening, diagnosing, monitoring and measuring the severity of depression.

PHQ-9 is one of the most used depression screens among Primary Care workers, clinicians and researchers. The assessment is endorsed by a number of leading health organizations, including the National Institute for Health and Care Excellence (NICE). The assessment takes 3 minutes to complete.

The PHQ-9 evaluation, together with the Creyos Health cognitive assessment, gives you a far deeper insight of what is going on with both your cognitive and mental health.   These scientifically-validated assessments help further inform your personal nutrition and care programme, providing quantifiable evidence.  

How do we evaluate the PHQ-9 Assessment?

We evaluate your PHQ-9 alongside other clinical considerations including the findings from your initial in-depth nutrition consultation. For instance, were your current symptoms triggered by a psychosocial stressor(s)? What is the duration of the present episode and are you receiving any other treatment or support?  To what degree are your symptoms impairing your usual work and activities?  Is there a history of similar episodes? Is there a family history?   

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How does depression relate to digestive health and nutrition?

There is mounting evidence that the good bacteria in the gut (our microbiota) influence our brain and our mood. And indeed, it is the food that we eat that determines the types of bacteria that inhabit our gut.   Some bacteria are beneficial but others are not and may contribute to inflammation in the body. This is where a targeted and individualised holistic nutrition programme may be beneficial: to help rebalance and strengthen your gut microbiome and help reduce inflammation.

Our gut bacteria produce hundreds of neurochemicals that the brain uses to regulate basic physiological processes as well as mental processes such as learning, memory and mood.. Our gut bacteria manufacture about 95 percent of our serotonin, which influences our mood and sleep patterns.

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People with chronic inflammatory diseases such as diabetes, cardiovascular disease and autoimmune disorders are at greater risk of developing depression. Depression can also be one of the symptoms of many inflammatory neurological conditions, such as multiple sclerosis and Parkinson’s disease. Depression may even be a risk in developing Alzheimer’s disease later in life.

How does inflammation contribute to depression?

Studies support that the brains of patients with depression have higher levels of inflammation. Their microglia – the brain’s immune system cells – are also more active. This increased activity could end up being detrimental, leading to changes in how the brains cells function and communicate.

Another study found that people with depression had more neutrophils, lymphocytes, and monocytes and inflammatory proteins in their blood compared to those without depression. This is another indicator of inflammation in the body in general.

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Additional benefits of a Cognitive Health and PHQ-9 Assessment

Research shows that even if your focus is not mental health, a quick measure of depression can be beneficial. Depression and cognition are associated with a wide variety of mental and physical illnesses. A study published in JAMA Psychiatry (Sullivan et al., 2013) found that depression was associated with accelerated cognitive decline among type 2 diabetes patients. The greatest decline occurred in patients with a PHQ-9 score of 10 or more at baseline and 20 months later. The researchers propose that depression may be causing or worsening the risk of dementia.

Another study (Hawkins et al., 2016) involved patients with heart failure, who have high rates of depression and cognitive impairment. The researchers found that certain PHQ-9 scores predicted performance in multiple cognitive domains. They suggest treatments known to affect depression and cognition, including CBT and physical exercise, may be most impactful on this population.

Latest Insights into Nutrition and COVID-19 Prevention

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Stress management, reduced stigma around obesity, healthy intakes of selenium, vitamin D and zinc, and a healthy gut microbiota… These were all highlighted as potential contributors to the fight against the effects of COVID-19 by expert scientists at the British Nutrition Foundation (BNF)’s virtual conference: Nutrition and COVID-19.  The conference took place on Tuesday 24th November 2020.

Eminent speakers working in the field of nutrition science discussed new and emerging research on the role nutrition plays – both in protecting against COVID-19 infection and in reducing the severity of associated health complications.

With the need for everyone to be more proactive about taking greater care of their own heath, I share some of the more interesting discussion points and conclusions.

Nutrients and Immunity

Prof Philip Calder at The University of Southampton explained that a well-functioning immune system is key to providing strong defence against infections such as COVID-19. He highlighted vitamin D, zinc and selenium as being important for anti-viral immunity:

Zinc
Calder emphasised the various roles zinc plays in the immune system and its specific function in preventing multiplication of single-strand RNA viruses, like Coronavirus, by inhibiting the enzymes they require to spread. Meat, poultry, cheese, shellfish, nuts, seeds and wholegrains provide natural sources of zinc.

Selenium
Selenium-deficiency can impair immune responses; increase susceptibility to viral infection; permit viruses to mutate; and allow weak viruses to become stronger. Calder shared previous research that suggests selenium supplementation in humans can help prevent viral mutation.   Poultry, fish, eggs, nuts, seeds and organ meats provide natural sources of selenium.

Vitamin D
Data suggests that low levels of vitamin D are associated with increased risk of COVID-19 infection, as well as hospitalisation. Calder stressed that this is an association and so does not provide evidence of causation and that there is currently not enough data available to recommend vitamin D for prevention of COVID-19.

Prof Susan Lanham-New at The University of Surrey, who reviewed the evidence on vitamin D, concurred but highlighted the importance of vitamin D for bones and muscles in the context of widespread low vitamin D status in the UK.  Lanham-New emphasised that all members of the public should take the recommended daily vitamin D supplement of 10 micrograms between October and March as a precaution to ensure good bone and muscle health.   

Long overdue, the Government has in the past 24-hours committed to offering free vitamin D to 2.5 million of the most vulnerable in England and those in care homes.

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“Maintaining a healthy, balanced diet, including foods from all the main food groups, is the best way to help ensure you get all of the nutrients you need for a healthy immune system. However, everyone should consider taking a vitamin D supplement especially during the winter months and also during the summer months if they are spending more time indoors than usual.”

Sara Stanner, Science Director – BNF

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The Effect of Probiotics and Prebiotics on COVID-19 Symptoms

Prof Glenn Gibson at The University of Reading presented the “Emerging evidence for the role of the human gut microbiome in COVID-19 infection outcomes” . He explored the potential for probiotics and prebiotics to support the gut microbiome in fighting COVID-19.

The gut microbiome is a harbouring site for COVID-19 and clinical outcomes can be governed by the type of gut microbiome the patient has. If numbers of ‘good bacteria’ in the gut are low it can be more difficult for that individual to fight off the virus.  

Gibson shared promising results from a recent Italian study into the effect of probiotics on the recovery of patients with COVID-19. The study involved two groups of people. The control group was given hydroxychloroquine, antibiotics, and tocilizumab, alone or in combination. The second group was given the same treatment but with a specific formulation of probiotics added. Within 72 hours, nearly all patients treated with probiotics showed remission of diarrhoea and other symptoms. This compared to less than half in the control group and there was also reduced admission to ICU and fewer deaths. More research is needed to confirm these findings.  

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The Mental Health Impact of Obesity and COVID-19 Risk

In the talk ‘Obesity as a risk factor for COVID-19’ ,  Prof Jason Halford at The University of Leeds, presented evidence to show that people living with obesity have an increased risk of contracting the virus, hospitalisation, ICU admission and dying from COVID-19.
 
The European Coalition for People Living with Obesity conducted a survey which Halford shared. The survey revealed that 73 percent of respondents are concerned about COVID-19 due to their weight. However, 43 percent have also been comfort or binge eating since the beginning of the pandemic; 60 percent are experiencing low levels of motivation; and 60 percent are struggling daily with their mental health.
 
Halford emphasised the negative impact that unusual life events can have on weight gain. Events like quarantine and being under lockdown. He highlighted that many weight management services have been de-prioritised due to the pandemic.  As such, stigma around obesity, particularly on social media and in the press, is unhelpful in improving public health. Instead, strategies for supporting good mental health are needed to help the weight loss efforts of those living with obesity.

“This year we have all faced a plethora of new challenges, and mental health issues are often the silent symptom of this pandemic. It’s therefore important for us all to recognise that we are living through an extremely stressful time, not to be too hard on ourselves, to look for support in finding ways to manage stress and to eat as healthily as we can”

Sara Stanner, Science Director – BNF

A growing number of resources with information and advice on diet and COVID-19 can be found on the BNF’s website.

To complete an online Creyos Health Cognitive Health assessment and organise a nutrition consultation with Charlotte Fraser Naturopathic Nutrition, email: enquiries@naturopathic-nutrition.com.

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Back to School Nutrition Tips For Health Prevention

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After six months of homeschool and two days back at school, my 9 year old put in an impressive 90 minutes of homework last night… developing a cough.

“I have a cough Mummy. EHH… KKHHH.. KKUHGH… I will need to quarantine for two weeks at home,” he announced. This was all accompanied by a lot of grunting, like he was trying to swallow a rubber.

I resorted to the first line in my ‘Differential Diagnosis’ manual and recommended he take a spoonful of honey and go to bed early. This provoked an immediate recovery much to everyone’s relief. Of course, the symptoms just happened to coincide with the launch of a new season on his Xbox. Enough said!

The whole ‘back to school’ is extra challenging for teachers and parents this year. September is the start of cold and flu season and now we have Covid-19 to contend with. With everyone on high alert for Covid-19 symptoms, how do you differentiate between these and an ordinary cough and cold? The answer is you can’t easily, especially with diarrhoea and vomiting now also reported as a Covid symptom in children. These symptoms are all part and parcel of school life at this time of year.

While we sadly can’t magic Covid-19 away, we can build our natural defences to benefit our overall physical, emotional and mental wellbeing.

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Prevention is Better than Cure

We all need to do as much as we can to build our immune defences to protect our community and bubbles. There is only so much that the Government, the NHS and our schools can do. Ultimately, everyone has to take more responsibility for their own health and I wish this message of self-care was integrated more into Government strategy. There needs to be a more preventative national health policy, one that extends beyond hand washing, mask wearing and social distancing. There are some early steps to address the UK’s high obesity levels evidenced in higher Covid complications and death rates. Again, however, making more gastric band surgery available on the NHS isn’t the solution, let’s do more to prevent obesity.

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Back to School Basics: Ways to Strengthen your Immune System

As well as protecting yourself from viruses on the outside, you can build up your body’s defences from the inside by strengthening your immune system. What you eat is pivotal to this as 70% of your immune system is in your gut. Here are some tips:

  • Make sure your diet is as varied as possible. Variety and balance are integral to optimal health and building up your immune system. So don’t go crazy for one fruit or vegetable that is particularly high in a certain nutrient. Aim to have 5-7 different plants a day at a ratio of 1 fruit for every 4 vegetables ideally. Ensure you have more vegetables than fruits, go for a rainbow of colours on the plate. The more varied your diet, the more you feed the good bacteria in your gut microbiome – your natural defence system. You are also more likely to get the full spectrum of nutrients and micronutrients that you need.

  • Eat foods which contain microbiome-enriching good bacteria such as kefir, natural bio yoghurt, certain cheeses and fermented foods. For a more in-depth analysis as to the important role of probiotics in strengthening our immune system click here. There is also a list of good bacteria-friendly foods.
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  • Keep an eye on your Zinc levels. This mineral helps develop white blood cells, the immune cells that fight off foreign bacteria and viruses. Zinc also helps protect the mucous membranes that coat the nose, throat, lungs and digestive tract – the entry points for Covid-19. I especially look out for zinc deficiency around puberty as Zinc is involved in numerous aspects of cellular metabolism that influence growth and maturation. Puberty pulls on your Zinc reserves more. Look out for possible signs of deficiency: white spots on the nails, spotty skin, acne, constipation, IBS, obsessive or stuck behaviour, and a more ‘glass half empty’ outlook.

    As well as being important for respiratory and gut health, Zinc is also an important mineral for your brain; Zinc deficiency is often implicated in my cognitive health and depression cases. If you supplement with Zinc it is best to choose a supplement such as Cytoplan’s Zinc & Copper; Zinc and Copper compete for the same absorption sites and too much of one can deplete the other. Similarly, ensure you get sufficient iron from natural food sources such as lean meat, spinach, lentils, apricots and eggs. Natural food sources high in zinc are oysters and shellfish, lean meat, pumpkin and other seeds.
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  • Watch your Vitamin D levels as this vitamin plays an important role in immune function. It is a common deficiency in the UK. Scientists are considering vitamin D supplementation as a preventive or therapeutic agent for severe COVID-19. They are researching Vitamin D deficiency as a possible risk factor. The body creates vitamin D from direct sunlight on the skin when outdoors. I recommend supplementation if you have dark skin which absorbs sunlight less easily or if you don’t get enough sunlight from October to March. Good natural food sources otherwise include: oily fish (salmon, trout, sardines, mackerel, herring, tuna and anchovies) and egg yolks.

  • Oily fish is important for brain and heart health. It is rich in omega-3 polyunsaturated fatty acids, which have been shown to reduce inflammation.
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  • Vitamin C is water-soluble: you don’t store it in your body and so you need to factor this into your daily diet. It is a common supplement but I encourage clients to get their Vitamin C in natural food sources. Bioflavonoids naturally accompany vitamin C in fruit and vegetables.  Vitamin C contributes to normal immune system function, and, as an antioxidant, the protection of cells from oxidative stress. It’s also important for bone and tooth formation, collagen production, Iodine conservation, wound healing , red blood cell formation, and infection resistance. Natural food sources include citrus fruits, kiwi fruit, Honeydew melon, potatoes, green peppers, broccoli, papayas, strawberries, rosehips, blackcurrants and tomatoes.

Do I Need to Supplement?

Nutrient shortfalls are caused by a number of different factors. Most people aren’t getting the essential nutrients they need for health and protection on a daily basis.

The following contribute to the nutritional ‘bank balance’ of our bodies and need to be factored into the equation:

  • Individual food choices
  • Food growing, processing and preparation methods
  • The actual nutrient content of the food you eat
  • The ability of you body to assimilate these nutrients
  • Lifestyle factors, such as stress and medications etc.
  • Activity levels and energy-expenditure
  • Certain life-stages, e,g. puberty where there is increased hormonal activity and growth

It isn’t always easy to determine what your child is eating in school dinners. And, a lot of school pack lunches lack the important variety factor so essential for good health. That’s when supplementation may be helpful.

Nutri-Bears is a good all-round wholefood supplement for primary school children who are fussy-eaters. For teenagers and young adults, Little People is a good option if you are looking for an additional layer of baseline support during the colder months.

All products referenced are available at www.cytoplan.co.uk. They supply science-based Food State and Wholefood nutritional supplements.

Please note that supplements aren’t a substitute for a healthy, varied diet. Keep introducing new plants and wholefoods to the mix and have fun experimenting with different textures and flavours. This really is the best recipe for optimum health.

If you have an underlying health condition or are on medication, I will be happy to provide more tailored advice for you. You should also consult your GP.

Contact Charlotte Fraser today to book a Nutrition Consultation.

Is Your Gut Microbiome Driving your Desire for Nature?

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I often allude to the microbiome, the colony of trillions of bacteria, fungi and viruses in our gut, as our internal rainforest.  This analogy resonates more as we recognise the importance of ensuring plant diversity in the natural world to safeguard the future wellbeing of our planet.  

Scientific studies show that we can boost our good gut bacteria by eating as diverse a diet as possible, and in consuming as many different plants especially.  The more diverse the diet, the more diverse the gut microbiome. Conversely, a loss in species diversity is a common finding in several disease states.

Though invisible to the naked eye, our good bacteria play an important role in maintaining our overall physical, emotional and mental wellbeing.  The gut and the brain are in constant communication and dynamic exchange determines metabolism, immune system function and appetite. 

Our thirst for nature and the great outdoors became especially pronounced during lockdown.  It isn’t just humans however who crave a change of scene and fresh air… our gut bacteria also relish diversity and new company!

The journal Science of The Total Environment recently published a new theory called “the Lovebug Effect.” This theory suggests that our gut microbiome may actually be driving our increased desire for nature holidays and woodland walks.

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The Lovebug Effect

The Lovebug Effect theorises that gut-brain communication drives our nature-seeking behaviour. When our gut microbes are starved of contact with their country cousins (environmental microbiota), they hijack the neural pathways between the brain and gut to make us venture outdoors to find them. Microbes intercept the gut-brain ‘switchboard’ by activating the vagus nerve and sympathetic neurons through the release of neurotransmitters including serotonin, dopamine and GABA.    

Certainly, being in nature can have a very tangible feel-good, stress-relieving effect. There have been numerous scientific studies also linking gut microbiome imbalances to increased depression and anxiety. However, what else might be fuelling our need for nature?

Why does our gut microbiome love the great outdoors?

When we immerse in nature, we surround ourselves with environmental microbiota. Nature is teeming with trillions of microbes: this provides our gut microbiome with endless choice when it comes to selecting which microbes to propagate. 

Fresh air offers a microbial diversity that avoids the build-up of harmful microbes. Exposure to soil microbes may boost the immune system.  Just a single teaspoon of rich garden soil can hold up to one billion bacteria.

The role of the environment in the make-up of the gut microbiota has yet to be fully understood. Studies have shown children (ages 1 to 5) from rural communities have a more diverse gut microbiota compared to children from Western populations. Early-life exposure to microbe-rich environments may be beneficial for human health by increasing the gut bacterial species pool. Studies have also shown that individuals who grow up in city environments have a less diverse gut microbiome. And that City-dwellers are more prone to inflammatory disorders and allergies. Urbanisation can lead to increased sanitation and antibiotic use, separation from the outdoors, and land management practices that reduce soil microbial biodiversity.

‘Baths in the Forest’ for full nature-immersion

Preidlhof in South Tyrol, has made Forest Bathing a central component of their Integrated Health and Transformational Wellness programmes. They also offer microbiome testing to assess the state of your gut bacteria, and champion mindful and sensorial eating.

The ancient Shinrin-Yoku (literally “Bath in the Forest”) came to the fore in the 1980s. Japan made Forest Bathing part of a national health programme to tackle stress-related disorders. Studies showed that conscious contact with the forest brought benefits to body and mind. It bolstered the immune system, reducing stress and blood pressure levels.

Preidlhof’s Forest Bathing takes place on Monte Tramontana, a dense area, rich in biodiversity, with woods, streams and small lakes.  Leading the sessions is Irmgard Mossmair, a 73-year-old official mountain guide. She found her source of healing in the wisdom of plants, trees and in the regenerating power of forests.  Irmgard has studied aromatherapy and natural remedies through herbs and Chinese medicine. 

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Forest bathing at Preidlhof in South Tyrol Image © Nicola Cipriani

Forest Bathing facilitates complete immersion in the woods, lights, scents, aromas, textures and pulsations of the earth. Sensory interaction with the forest helps to increase our frequency, and promote mental calm and awareness.

“Slowly, they open up to their surroundings and find themselves immersed in another world, in contact with nature and its secrets. The scents of the trees, the earth, the flight of birds and insects, the sound of the wind, the sunlight on the trees, the different shades of green… All these elements can facilitate a profound transformation.”  

Patrizia Bortolin Spa Director and Transformational Health Coach – Preidlhof

We can so easily take our access to nature for granted. What’s more, we increasingly inhabit a virtual and digital universe which provides a further disruptor. However, what Covid 19 has reminded us is that we are still all very much part of the natural world.  And our microbiome will act as a constant biological prompt to reconnect with us our ancient roots.  

For further recommendations on how to boost your gut bacteria through natural food sources, click here.

Covid-19: Can Probiotics Help Calm the Storm?

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As the global science community races to develop an effective vaccine to stop the Coronovirus pandemic, a recent article in The Korean Bio-Medical Review caught my attention: ‘Korean researchers found substance inhibiting COVID-19’.   At the time, I was researching the digestive symptoms some Covid-19 patients are reporting, as well as looking for the latest scientific research into probiotics. 

Good bacteria and probiotics were a very new field of scientific study when I first qualified as a nutritional therapist but I credit these microbes for helping me to transform my own health and to manage my Ulcerative Colitis.

The Korean scientific study claims that Sea Buckthorn Berry’s lactic acid bacteria can contain the spread of the new coronavirus by inhibiting the activation of its energy source.  More specifically, the probiotic bacteria extracted from fermented Sea Buckthorn Berry had lots of lactobaciullus gasseri (L.gasseri) and this repressed the activation of purine which the new coronavirus requires to mutate.     Purine is a base (such as adenine or guanine) that is a constituent of DNA or RNA.

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In China, a separate research team led by Professor Ruan Jishou from Nankai University in Tianjin recently discovered that COVID-19 in the human body mutated in a similar way to the Ebola and AIDS virus. According to the Chinese research team, Covid-19 creates spike protein to survive within the human body. The spike protein contacts the cell membrane and attacks purine to acquire energy for its replication.

Notably, Korea is also using AIDS drugs to treat COVID-19 patients by inhibiting proteolytic enzyme activity. A patient’s symptoms improved significantly in a few days after administrating Kaletra and AIDS drugs. Professor Yoon expects the probiotic bacteria in Sea Buckthorn Berry to be a supplementary treatment to suppress COVID-19 spread.

Covid-19 and Cytokine Storms

Delving further into lactobacillus gasseri, I came across a separate study published in October 2019 in Frontiers in Immunology. Lactobacillus gasseri was found to suppress the production of proinflammatory cytokines in Helicobacter pylori-infected macrophages.

Cytokine storms are a common complication not only of Covid-19 and flu but of other respiratory diseases caused by coronaviruses such as SARS and MERS.

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Cytokines act as chemical messengers between cells and interact with cells of the immune system to regulate the body’s response to disease and infection, as well as mediate normal cellular processes in the body. They are important in both health and disease specific to the host’s response to infection, immune responses, inflammation, trauma, sepsis, cancer, and reproduction.

Diseases such as Covid-19 and influenza can be fatal due to an overreaction of the body’s immune system which can provoke a cytokine storm. This is when the body attacks itself, unable to distinguish itself from the enemy invader or virus. An overproduction of immune cells, and their signaling compounds (cytokines) can trigger hyper-inflammation and this can cause substantial tissue damage, an effect of many autoimmune disorders such as Lupus, Rheumatoid Arthritis, MS, Diabetes, Crohn’s Disease and Ulcerative Colitis.

What is lactobacillus gasseri?

A probiotic, Lactobacillus gasseri is a strain of the Lactobacillus family of bacteria naturally found in the digestive and urinary tracts. The bacteria is thought to help the body suppress harmful bacteria and to enhance immune function and aids in digestion. A number of clinical trials have suggested that Lactobacillus gasseri may also help reduce abdominal fat and support weight loss, as well as be beneficial for managing inflammatory bowel disease.

Covid-19: Strengthen your body’s natural defences

Aside from taking precautions to protect yourself from the virus on the outside, you can also build up your body’s defences from the inside by strengthening your immune system. Replenishing the gut with more good bacteria is really pivotal to this and it is something you can do even whilst you are staying at home on lockdown.

Tim Spector, Professor of Genetic Epidemiology at King’s College London, provided some useful insights in The Conversation this past month. Professor Spector explains that the immune system is complex with many factors affecting its function. However, “what’s important to know is that most of these factors are not hard-coded in our genes but are influenced by lifestyle and the world around us”.

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Professor Spector says “One thing that you can control immediately is the health of the trillions of microbes living in your gut, collectively known as the microbiome. Recent research has shown that the gut microbiome plays an essential role in the body’s immune response to infection and in maintaining overall health. As well as mounting a response to infectious pathogens like coronavirus, a healthy gut microbiome also helps to prevent potentially dangerous immune over-reactions that damage the lungs and other vital organs. These excessive immune responses can cause respiratory failure and death. (This is also why we should talk about “supporting” rather than “boosting” the immune system, as an overactive immune response can be as risky as an underactive one.)”

Professor Spector also explains that “Gut bacteria produce many beneficial chemicals and also activate vitamin A in food” and that these “help to regulate the immune system.” Vitamin A is sourced from betacarotene-rich fruit and vegetables such as carrots, sweet potato and squash – and of course, Sea Buckthorn Berry if you happen to live near the coast.

How can I strengthen my microbiome and boost my good bacteria?

Eating a wide range of plant based foods and limiting highly-processed foods is the best way to increase microbiome diversity – your good bacteria. Avoid junk food!

Professor Spector says: “Following a Mediterranean diet has also been shown to improve gut microbiome diversity and reduce inflammation: eating plenty of fruit, vegetables, nuts, seeds and whole grains; healthy fats like high-quality extra virgin olive oil; and lean meat or fish. Avoid alcohol, salt, sweets and sugary drinks, and artificial sweeteners or other additives.”

You an also eat foods which contain microbiome enriching good bacteria – probiotics.

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Kefir and Berries

Best Sources of lactobacillus gasseri and probiotics:

There is a variety of natural food sources for probiotics. Full fat live bio yogurt is the best known and this is milk fermented with specific Lactobacillus or Bifidobacterium strains.

Other fermented foods that contain good ‘health-promoting’ bacteria include:

  • Kefir (You can make your own but I like Chuckling Goat’s Probiotic Live Goat’s Milk Kefir which has 35 probiotic strains including lactobacillus gasseri. You can even add extract of Sea Buckthorn powder (a source of rare omega-7, beta-carotene and phytonutrients that work together to support your immunity, mucosa function and skin health), or fresh berries.
  • Kombucha (Wild Fizz’s Organic Lavender & Rosemary is a Kombucha that I particularly like and I have Jeannette Hyde, Author of The Gut Makeover to thank for introducing this to me (I recommend Jeannette’s recipes too!) Watch out for added sweeteners in a lot of the supermarket brands of Kombucha though).
  • Fermented, raw cheeses (Emmental, aged Gouda, Gruyere, Parmesan – look for the words “raw”, “probiotic,” or “made from raw milk” on the label. Remember, no cooking or melting if you want to preserve the probiotic benefits!
  • Sauerkraut
  • Raw apple cider vinegar
  • Kimchi
  • Natto
  • Miso
  • Tempeh

Probiotics and good bacteria can be beneficial for most people but you may need to avoid Lactobacillus if you have a compromised immune systems. Those with advanced HIV infection, those who are organ transplant recipients, and those taking immunosuppressive drugs for cancer and other conditions should consult a medical practitioner first.

Objectively Quantify how Nutrition and Lifestyle Improve Brain Health

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Aside from feeling better, there is evidence of significant improvement in brain and cognitive health when you change your diet, improve sleep, and increase your fitness.   Reducing symptoms associated with stress, anxiety or depression can also make a huge difference!

Working with Creyos Health, I provide clients with a science and evidence-based means of quantitatively measuring how changes to your diet, sleep, and fitness routine can positively impact brain and cognitive health.

An engaging and scientifically-validated cognitive assessment

As well as understanding how your brain is functioning, you will be able to track how the changes you are making are impacting your brain.  Importantly, you will be able to visualise improvements with objective and quantifiable information, presented in an easy to understand format. Brain health integrates very much with gut health and provides a great indicator of your overall health and wellbeing.

You can take the Creyos Health cognitive assessment as a one-off to get a snapshot of your brain health in any point in time. However, you will get far deeper insight if you take the assessments over a series of weeks or months; this enables us to determine meaningful change. 

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Who benefits from doing this cognitive test?

Everyone can benefit. It is especially helpful to those who want to track whether making the smallest changes to their diet, their sleep routine, or increasing their fitness levels, makes a difference to their brain health and overall wellness. 

The Creyos Health test facilitates a highly personalized approach to healthcare. It provides useful biomarkers to enable you to take a proactive and preventative approach to optimizing your health and wellbeing.  I further support you with a nutritional and wellbeing programme tailored to your individual needs. We adapt this as required, during the course of the Cognitive Health programme and based on your test findings.  

The Creyos Health Test is not a diagnostic tool. However, it may be useful to clients with ADHD, Autism, Depression, Dyslexia, and Cognitive Impairment who wish to monitor progress from nutritional and other lifestyle changes.

What does the Creyos Health assessment entail?

Clients complete a series of fun and engaging neurocognitive tasks online, either during the consultation, or remotely, at home.  

You can relax because this isn’t an IQ test. We aren’t measuring IQ!

The tasks assess aspects of cognition including reasoning, memory, attention and verbal ability. 

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You are anonymously assessed against a sample of healthy control subjects.   We factor in your age and gender.

Creyos Health maintains a global normative database of more than 75,000 participants (built off of a larger database of 7 million+ completed tasks). This allows for detailed comparisons of individuals to specific populations. 

On completion of the assessment, I share your individual Creyos Health report and we discuss nutritional and lifestyle strategies for improvement. We schedule further tests at agreed intervals to monitor progress and assess meaningful change.  

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About Creyos Health

The Creyos health tasks were developed in the laboratory of Professor Adrian Owen OBE, Canada Excellence Research Chair in Cognitive Neuroscience and Imaging (owenlab.org). Over 300 scientific studies have been run to date using the Creyos Health tasks, yielding numerous publications in leading academic journals. 

The tasks were validated in studies of patients, brain imaging studies of healthy volunteers and in several large-scale public studies involving tens of thousands of volunteers. They have proven to be efficient and sensitive measures of baseline cognitive capacity. For example, in one study, the results of the 30-minute Creyos Health battery were comparable to those of a standard 2-3 hour (paper and pencil) neuropsychological battery (WAIS-R) (Levine et al., 2013). In another recent study of mental capacity in the elderly, the CBS battery outperformed a standard task of cognitive abilities (the MoCA) (Brenkel et al., 2017). Finally, performance on the CBS battery is highly predictive of reasoning and problem solving abilities, as indexed by “classic” tasks such as Raven’s Matrices and the Cattell Culture Fair task (Hampshire et al., 2012). 

How do we measure Meaningful Change?

The Meaningful Change Indicator compares the difference in an individual’s performance on any given task between two time points to the variability in repeated measurements that would occur in the absence of meaningful change. The latter is estimated from a sample of healthy control subjects. The reliable change index uses the test-retest reliability and the standard deviation of scores (measured in a control sample) of a task to describe the range of possible differences that occur in repeat task completions. If an individual’s change in performance from one time point to another is much larger than what is expected due to chance, then one can conclude that there was meaningful change. 

Assessing meaningful change requires data to be obtained in a control sample. Creyos Health has a database of over 8 million test scores, and their normative database consists of more than 75,000 individuals. The interval between self-administered repeated assessments ranges from less than a day, to more than a month. This massive database allows Creyos Health to characterize in the general population how performance on every task fluctuates naturally across a range of intervals. Creyos Health is therefore able to quantify the bounds of what constitutes a meaningful change for every task.