Diabetes and Me

Has your weight been creeping up on you over the years and is proving difficult to shift – despite your best efforts? Or maybe your energy levels are on the floor? It’s easy to push to the back of your mind. Surely things can’t have got that bad… You’re not one of ‘those’ people whose food and lifestyle choices result in blood sugar levels so wonky, they find themselves in the prediabetes or diabetes trap… It’s easily done, and I see a lot of people in clinic who have been surprised to find they’re occupying that space. 

It really is worth getting your blood sugar levels checked out. Once you know your numbers, you can do something about it and make a huge shift in all aspects of your health, including your weight. Whatever the tests say, I want you to know that, by making some simple changes to your diet and lifestyle, it is possible to prevent, control and, in some cases, put it into remission. 

COULD IT BE ME? 

One in six people over the age of 40 is likely to have diabetes, with many more lurking in the grey area leading up to a diabetes diagnosis – prediabetes. 

There’s no upside to having diabetes. This is what may lie in store for anyone receiving the diagnosis: risk of stroke, heart disease, visual disturbances and other eye problems like cataracts and glaucoma, higher risk of bacterial, fungal and yeast infections, high blood pressure, damaged nerves and blood vessels, and fatigue and lack of energy. The list doesn’t stop there, but I think you get my drift. Diabetes is not a good thing.

WHAT IS DIABETES?

Diabetes is a condition in which levels of sugar (glucose) in the blood are higher than normal. 

There are two main kinds of diabetes (type 1 and 2). Both types involve insulin, a hormone responsible for controlling the level of glucose in the blood. Type 1 diabetic patients do not produce sufficient insulin and therefore need to inject it (this type of diabetes is the rarer kind, and often develops at a young age). 

Type 2 diabetic patients, produce insulin, but the cells become insensitive to it and so it fails to do its job properly. Type 2 diabetes accounts for over 90% of all people with diabetes, and the condition usually develops later in life. This type of diabetes is far more strongly associated with diet and lifestyle factors.

DIAGNOSING TYPE 2 DIABETES

Diabetes is diagnosed by testing your blood sugar level. If your fasting plasma glucose level (FBG) is too high (above 7 mmol/l) or your oral glucose tolerance (OGTT) is above 11.1mmol/l, your HbA1c (a measure of long-term blood sugar levels) is above 6.4%, this represents a diagnosis of diabetes. 

For prediabetes, a condition where your blood sugar levels are higher than normal and that often leads to type 2 diabetes, your FBG might read between 5.5 and 7 mmol/l, your OGTT might be between 7.8 and 11.1 mmol/l, and your HbA1c might be between 6% to 6.4%. 

It’s easy to dismiss the risk, but the shift into prediabetes can happen almost without your noticing it. You may experience niggling symptoms, like low energy or your weight creeping up on you, and your usual tricks to get it down no longer work as well as they once did. 

Common risk factors for prediabetes are these:

• You are overweight.
• You have a close relative – parent or sibling – who has a diabetes diagnosis.
• You have high blood pressure or low HDL (‘good’) cholesterol.
• You’re over 40.
• You’ve given birth to a baby over 9 pounds.

WHAT TO DO IF YOU THINK THIS APPLIES TO YOU

Your GP will be able to organise blood tests for you. You can also get tested privately. I offer a range of biochemical tests and can work with you to make manageable changes to your diet and lifestyle to get your health back on track. 

From a nutrition professional, what I’m about to say may sound a little biased, but I have seen so many diabetic clients receive unhelpful and incorrect advice about what to eat from doctors. Unfortunately, doctors receive no training in nutrition and have no other option than to follow the Eatwell Guide (published by Public Health England) – which, sadly, is outdated and not evidence-based. You may have been told that you could fix this just by losing a little weight, but I’m afraid that the way you might have gone about this in the past simply is not going to work anymore. And just starving yourself into losing a handful of pounds is not going to fix the underlying problem. It won’t miraculously change the numbers that came up in your test results.

What does work is a whole diet and lifestyle approach. I work with my clients to guide them to make better food choices that help lower their blood sugar levels. The strategy we create is tailored to you and no one else. What you like to eat, avoiding what you don’t like to eat, making changes at a speed that feels right for you to achieve your goals. We also look at these results in a bigger context of other annoying symptoms you might be experiencing and try to mop those up as we go along, too. You would be surprised the impact you can make on your health and how you experience life.

To find out more, why not book yourself in for a complimentary nutrition MOT and take your first steps back to good health today? Just click here.

Eat to improve your heart health

Many people fear a heart attack. Think of it as the last straw. Heart disease is, in many cases, a lifestyle disease that is avoidable and, with the right focus, you can avoid it, too.

There are some pretty big risk factors (outside of smoking and drinking in excess), and these include being diabetic, having high cholesterol and being overweight. 

What I want to talk to you about today is which dietary changes you might start to make from today, to protect your health and that of your loved ones. There’s fantastic news in this regard because a number of huge studies point to diet and lifestyle change being IT when it comes to prevention.

The INTERHEART study, published in the Lancet in 2004, followed 30,000 people in 52 countries. Researchers found that lifestyle changes could prevent at least 90 percent of all heart disease. 

This was another big one: the EPIC study in 2009 looked at how 23,000 people adhered to 4 simple behaviours: not smoking, exercising 3.5 hours a week, eating a healthy diet, and maintaining a healthy weight. Sticking to these four behaviours alone seemed to prevent 93% of cases of diabetes, 81% of cases of heart attacks, 50% of cases of strokes, and 36% of cases of all cancers. 

A SIMPLE STRATEGY FOR GOOD HEALTH

Of course, everyone is individual, and there is no official ‘single diet’ that all humans should eat. But if there were, this would be it because it handles what the essence of the problem is – overweight and a highly inflammatory internal environment.

Before I dive in with some of the answers, I want to say a little something about fat because chances are, if you’ve heard one thing about staving off a heart attack, it’s ‘cut back on fat’ (and especially the saturated kind). 

The success of some low-fat dietary models in weight loss is thought to be more likely due to the simultaneous reduction of sugar, refined carbohydrates and processed foods. 

Dietary fat actually turns off fat production in your liver. Unlike carbohydrates and protein, dietary fat does not trigger your pancreas to secrete insulin. 

There is one type of fat everyone should avoid, and it’s trans fats, a kind of Frankenstein fat added to food to improve shelf life and mouthfeel of products. One study actually found that the risk of coronary heart disease doubled with each 2 percent increase in calories from trans fats (Iqbal, 2014). Another researcher even concluded: “On a per-calorie basis, trans fats appear to increase the risk of CHD more than any other micronutrient.” (Mozaffarian et al., 2006).

THE REAL VILLIANS…

The real villains in the piece are refined grains and sugar. During processing, refined grains are stripped of the bran and germ, two parts of the grain kernel that contain a wealth of nutrients. The final product is starch with next to no nutritional value, providing little more than carbohydrates and calories. Refined carbohydrates can be found in a wide variety of foods, including white bread, pasta and rice, muffins, cakes, cookies, crackers, and bagels. Unfortunately, these foods make up a pretty good chunk of the modern Western diet and may be linked to a higher risk of heart disease. 

One study from China found that a higher carbohydrate intake, mainly from refined grains, was associated with an increased risk of coronary heart disease among 117,366 adults (Yu et al., 2013).

Sugar is one of the main culprits of heart disease. Added sugars from foods like sweets, desserts, juice and soft drinks can spike blood sugar levels, damaging the blood vessels, overloading the liver and increasing the risk of heart disease.

Interestingly, a study from Harvard School of Public Health actually found that participants who drank the highest amount of sugar-sweetened beverages had a 20 percent higher relative risk of developing coronary heart disease than those who drank the lowest amount (de Koning et al., 2012).

WHAT THIS MEANS IS …

A lower carbohydrate diet is recommended to balance blood sugar and therefore reduce insulin and blood glucose levels. Elevated insulin is a major risk factor for heart disease and promotes inflammation. You’re also likely will lose weight on a blood sugar balancing diet, and that in itself will reduce the risk for many chronic diseases, including heart disease and high blood pressure.

1. PROTEIN Eat a source of protein at every meal and snack. This can be any fish/ seafood, poultry, meat, nuts, seeds, tofu, eggs. Given you probably eat enough meat already and many people don’t eat nearly enough vegetable protein, see if you can bring in more fish and more vegetable sources of protein over the week. Ideally, eat two to three vegetable-based protein meals weekly. Replace animal-based protein meals with lentils, legumes, tofu, quinoa or nuts and seeds, for example. If you’re a fish eater, get in wild-caught fish, which are rich in omega-3 fatty acids, twice a week.
2. FRUIT & VEG Get plenty of fruit and veg but focus specifically on eating veg that grow above the ground and fruit that can be grown in this country. These foods naturally contain either less natural sugar or lower amounts of carbohydrates, which have an impact on hormones. At each meal, have this cover at least half of your plate. The aim is 7 a day and ideally 5 from veg. Over the course of a week, aim to eat all different colours - span the rainbow to enjoy a diverse intake of nutrients. Enjoy berries, citrus fruit, peppers and leafy greens.
3. FIBRE is a great addition, the soluble kind you’ll find in oats, lentils, split peas, flaxseed, citrus fruits and apples. All of those are heart-healthy choices. From the insoluble category, eat nuts and whole grains.
4. FAT Some fats are healthy, and let’s not forget that fat is actually essential for life. Get your fat from avocados, oily fish, nuts and seeds. 
5. CARBS Think carefully about the quality (what kind) and the quantity (how much) of starchy carbs like bread, pasta, cereals, potato, rice. Focus on wholemeal over white, sweet potato over regular white potato, basmati or brown rice over long grain. You can also try throwing in a few ‘faux carbs’ like cauliflower or broccoli rice, courgetti (courgette spiralised into noodle shapes), butternut squash waffles, and so on. 
6. PROCESSED MEAT In recent years, there have been numerous studies connecting processed meats, like hot dogs, salami and tinned meat, to a range of adverse effects on health. Not surprisingly, processed meats can also negatively affect heart health, so best to give them a wide berth.
7. VEGETABLE OILS can be very damaging for heart health. Recent studies show that oils like rapeseed are not helpful (even though the supermarkets are brimming with these options). In fact, the linoleic acid they contain has been linked to cardiovascular disease and cancer.
8. SUGAR Remove as much sugar as you can from your diet as this is the real villain in the tale. That means saving sugary treats for high days and holidays and, most of the time, ditching breakfast cereals, cakes, cookies, pastries, and so on, and checking the label of jarred sauces, where sugar often lurks.
9. FIZZY POP Avoid fizzy soft drinks. Eliminating soft drinks is one of the best things that everyone can do for their heart. Besides being laden with controversial chemicals and unhealthy ingredients, soft drinks are also brimming with added sugars.

Do you notice a trend in my diet tips? What’s to focus on is real food. What you would benefit from decreasing is the processed stuff most people kid themselves is OK for them to eat. Truly, your body doesn't know what’s going on when you shovel in heavily processed or chemically altered foods. 

Eating this way - sometimes referred to as a low GL (glycaemic load) diet - will also help, providing your body with a steady supply of energy through the day, rather than a high-octane rollercoaster of energy spikes and troughs.

Putting the food work into your life alongside the commitment to regularly de-stress, move your body and prioritise sleep is not always easy to do on your own. It is always helpful to have someone – like me – in the wings helping you fit what you already know about eating well into your life and keeping you motivated to follow your plan for long enough that you really see a shift in your health. And if you would like some support - why not book in a call with me here? 

Top Tips for Men's Health

The 12^th to the 18^th June marks Men’s Health Week, and fortuitously end on Father’s Day. Men are notoriously bad at engaging with healthcare and wellbeing, but this seems to be changing. And it’s important that we take care of the men in our lives and ensure that they’re doing ok. 

Tragically, suicide is the main cause of death for men and boys between the ages of 5 and 49 – a shocking and desperately sad statistic. Suicide was the main cause of death in boys and younger men even before the Coronavirus pandemic. The social isolation during the pandemic has only made matters worse. 90% of people who attempt or commit suicide have mental health problems. More women than men suffer from depression, but women are more likely to talk about their issues and seek help. Men tend to bottle up their problems and negative feelings – until they can no longer cope. Men’s Health Week is a time when we can encourage men to speak out and seek help. 

Another health aspect we need to cover is cancer, in particular prostate and testicular cancer. Although cancers affect both men and women, men are 60% more likely to get the disease and 70% more likely to die from cancer than women. There is much speculation about why that is. The most common cancers in men are prostate, lung and colon cancer – in that order. The most common one – prostate cancer – is a cancer that women cannot get. Cervical cancer in women has declined due to improved screening. Screening for prostate cancer is not (yet) routinely done. One reason for that is that there is still some discussion about how useful the PSA (prostate specific antigen) reading actually is. 

Throughout their life, women have a lot more contact with health professionals. Birth control, pregnancy, birth, child rearing and routine breast cancer and cervical screens means that they are in and out of doctors’ surgeries a lot more often than men as a matter of course. This reduces the reservations some may have about talking to medical professionals. It also offers ample opportunity to mention something they have been worried about. Stereotypically, men are more reluctant to make an appointment with a doctor. 

The most common cause of death for men between the ages of 50 and 79, however, is still heart disease, an issue the charity does not seem to emphasise very much. The good news is that for males, the death rates from heart disease and stroke have reduced by about 50% since 2001. The bad news is that the incidence of heart disease has barely changed. However, modern medicine has become much better at treating it, so that more people survive for longer. According to the British Heart foundation, 80% of people living with heart disease have at least one other health condition. It looks like in most cases that might be type 2 diabetes. A paper published in the European Heart Journal in 2015 found that 75% of patients with cardiovascular disease have abnormal blood sugar readings. 

While deaths from heart disease and lung cancer in men have reduced by 50% and 30% respectively since 2001, there has been an increase in the death rate from Alzheimer’s and dementia of more than 60% and from liver disease by 12%. Alzheimer’s is also the leading cause of death in men over the age of 80. 

Liver disease is almost entirely preventable. The most common causes are lifestyle-related: alcohol and obesity (together with hepatitis B, an infectious disease) account for 90% of cases. Alcohol is still the main reason for liver failure, but in recent years there has been a new version of liver disease: non-alcoholic fatty liver disease (NAFLD). At first, doctors often did not believe their patients when they said they didn’t drink – but presented with livers in a state of disease previously only seen in alcoholics. Now we know that something other than alcohol – sugar – can wreak just as much havoc on the liver as alcohol does.

As Alzheimer’s and dementia have been on the rise for decades, years of research have gone into finding out was causes it. Today, Alzheimer’s is referred to by some as “type 3 diabetes”, because here, too, blood sugar increases and insulin resistance has been observed. Although Alzheimer’s is known to have many contributing factors, there is no doubt that sugar is one of them. 

The bottom line is that diet appears to play a major role in the leading causes of death among men. Diabetes promotes silent low-grade but long-term inflammation that damages blood vessels, nerves and liver cells. Even suicide, usually preceded by mental health issues, is not exclusively psychological. A healthy diet may not prevent all mental health problems all by itself by any stretch of the imagination, but a diet of ultra-processed food certainly promotes them. 

So, if you are going to do just ONE thing to prolong your healthy lifespan it’s this: 

Eat real food

Ultra-processed foods have been linked to cardiovascular disease, cancer, non-alcoholic liver disease, and neuro-degenerative diseases – which is code for Alzheimer’s and dementia. We’re not cut out to subsist on man-made food. We evolved to eat natural foods: meat, fish, seafood, eggs, vegetables, fruit, nuts and seeds, herbs and spices. There is very little humans can do to improve on nature – except perhaps cooking (which allowed us to develop a bigger brain) and fermenting (which is not just a handy way to preserve food, but supports the gut).

If you are already eating real food or want to do TWO things to live a long and healthy life: 

Cut out sugar and refined carbohydrates

Much of this will have left your life once you started eating real food, but there may be room for improvement. Sugar is detrimental, and all starchy carbohydrates (think bread, rice, pasta, potatoes) ultimately turn into sugar in the process of digestion. How fast that happens and how much they will make your blood glucose rise depends on how processed they are. If you must have bread, pasta, and rice, go for the whole grain versions. Consider cutting them out altogether, because while there are essential fats and essential amino acids (the building blocks of protein), there are no essential carbohydrates. If you never eat pasta again, you’ll live. Probably a longer and healthier life to boot.

If you’re up for even more steps towards better performance, more energy and less bulge, book in for a free 30-minute men’s health mini consultation. You can do that by clicking this link.

My top tips for happy mealtimes 

(these aren’t just for children! Most of these tips are valid for you too)

1. The aim is for mealtimes to be relaxed and happy.
2. Eat around a table - not in front of the TV (as this can encourage overeating due to focusing on something else rather than what’s going into your mouth).
3. Avoid using threats, bribery, or force feeding. Don’t feel obliged to finish your plate.
4. Avoid rewarding your child by giving them attention for not eating. This will only reinforce the behaviour. It is hard not to be concerned but they will eat eventually.
5. Pair something enjoyable with mealtimes, e.g., reading a story, non-food related conversation, having music on in the background.
6. Try to have a regular routine for eating and mealtimes so that everyone gets into the habit of balancing their blood sugar well. Try and stick to three meal a day, with no snacks. When works for you for regular breakfast, lunch, and dinner? Make a plan and stick to it.
7. Encourage everyone to try new foods (make this a normal part of eating). If you have children, from pre-1 year old if possible as it gets harder after this. Modelling: let your children copy you enjoying your food and trying different things. Think about adding new fruits and veg to your trolley with your weekly shop. Have a go of a fish recipe that you’ve not tried before. Push yourself out of your comfort zone!
8. Find non-food rewards – this is a key! Make a list of what’s relevant to you, and when you feel you deserve a treat think about what you can pick from that list.

Let me know how you get on. Which of these resonates with you? What can you change?

Asthma is a chronic respiratory disease – a long-term disease of the lungs. It causes your airways to get inflamed and narrow, and this makes breathing difficult. Typical symptoms include coughing, wheezing, shortness of breath and chest tightness. And it’s on the up. In England, more than 1 in 4 children now have asthma, compared to 1 in 18 back in the 1970s.

The question is, why? Most experts agree it’s likely down to changes in diet, lifestyle or environmental factors, with food allergies being very high on the list of contributing factors. Yet few sufferers are informed in any detail about the key contributory factors or checked out thoroughly for food allergies. Prescriptions for corticosteroid creams or inhalers are routine when you visit your GP (and, to be clear, you should always visit your GP if you are in any way concerned about your health).

There’s little doubt that the main anti-inflammatory drugs used to treat eczema and asthma, although they are very effective in providing relief particularly in the short term, can make things worse in the long run and there are often side effects. Conceptually, the best approach is to consider that an asthma attack is triggered when a person’s total load exceeds their capacity to adapt. While there may be a specific trigger (like stress or cigarette smoke) these triggers can be seen as ‘the straw that broke the camel’s back’ rather than the actual cause. Perhaps, then, the goal should be increasing your capacity to adapt and lessening the total load.

As a nutrition professional, I can tell you that checking for allergies and food intolerances, upping your intake of antioxidants, essential fats and other natural anti-inflammatory foods will, at worst, reduce the need for drugs and at best, may relieve symptoms. However, this is absolutely not a substitute for medical guidance or medication.  

While there’s a lack of good studies to prove the benefits of an all-round nutrition-based approach (which doesn’t mean that there’s no point in doing this, just that no one has actually studied it), there are plenty of good reasons to give these suggestions a go and see what happens to your symptoms.

NATURAL APPROACHES TO ASTHMA

FIND OUT WHAT YOU’RE ALLERGIC TO 
There are two kinds of allergies: IgE and IgG (sometimes referred to as intolerances/sensitivities). IgE (Immunoglobulin E) reactions are what you think of as conventional allergies. People with asthma often have higher levels of IgE, making them hypersensitive to certain substances. You can test your IgE sensitivity and identify specifically what you are reacting to with an IgE blood test. If you have asthma, you may already have had this done. If not, this can be done privately. 

The test involves taking a pinprick of blood with an easy-to-use home kit and posting it to the laboratory for testing. Most asthma suffers also have IgG sensitivities to foods. These intolerances are not as obvious (or immediate) as an allergic reaction and may not always precipitate an asthma attack. If they do, asthma symptoms may not occur until 24 hours later. Common foods that cause reactions are milk products, gluten cereals (wheat, rye, barley, oats) and yeast. However, I would not recommend cutting out entire food groups without the support of your GP or nutrition professional.

AVOID YOUR PROVEN ALLERGENS OR FOOD SENSITIVITIES 
Once you know what you are reacting to, you need to avoid your allergens. When it comes to IgE sensitivities, these last for life. You can, however, ‘grow out’ of IgG sensitivities if you avoid the allergens a number of months and take steps to allow your body to heal. 

However, not all allergens are easy to avoid. If, for example, you are allergic to pollen, you won’t be able to manage to avoid it completely. So, if you are pollen sensitive, you might choose to avoid grains (which are grasses) and dairy products (made from grass) during the pollen season as the body can ‘cross react’ to similar proteins. 

If you are allergic to house dust mites, which live in mattresses and carpets, you’ll need to go to war on these little creatures by changing your bedding regularly and always washing on a hot wash and dry really well.  House dust mite allergy has increased enormously since central heating became the norm because these bugs love moisture and don’t like big temperature changes. If you think you have an infestation, either get a new mattress or put yours out to sunbathe on a couple of extremely hot days. You might also look into having the mattress steam cleaned. Then use a house dust mite proof cover for your mattress and pillows. You can buy them from most big department stores and online.  

Invest in a bed base that lets the bed air really well. Although you may love the tidiness of a well-made bed, the best thing to do to prevent mites is to not make the bed and instead leave it to air naturally. You should let the room air as well – don’t be afraid to throw open the windows. In an ideal world, you wouldn’t have a carpet in the bedroom either. 

IMPROVE YOUR DIGESTION
One of the major causes of food allergies is poor digestion. A lack of stomach acid often means you don’t digest protein properly, so you end up with undigested food proteins in the gut. If your digestive tract becomes at all inflamed, for example by alcohol, these food proteins can cross into the blood and trigger allergies. 

Once you’ve identified and avoided your known food allergens, I’d recommend a 30-day digestive rest programme. This means minimal gluten (which irritates the gut), lots of fruit and vegetables, digestive enzymes with each main meal, plus other supplements (as needed) to help restore the integrity of the gut lining. Ask me for details.

INCREASE YOUR INTAKE OF ANTIOXIDANTS
There’s no doubt that increasing your intake of antioxidants makes a difference to all aspects of health, including asthma. Numerous studies have shown that a high intake of fresh fruit and vegetables reduces asthma severity, and there is a strong implication that it is the high antioxidant nutrient content of fruits and vegetables that does this. The antioxidant nutrients that come out top are vitamin C, vitamin E, beta-carotene and bioflavonoids (which are especially rich in berries). 

What will you want to add to your diet? Lots of broccoli, peppers, berries, citrus fruit, apples (all rich in vitamin C), carrots and tomatoes (rich in beta-carotene and lycopene) and seeds and fish (rich in vitamin E). 

And remember that old saying about an apple a day keeps the doctor at bay? Here’s why. A survey of 1,500 asthma sufferers in the UK found that people who ate at least two apples per week experienced a 22% to 32% lower asthma risk than those who ate fewer. Apart from vitamin C, apples contain the antioxidant quercetin, which reduces histamine and has been shown to have broncho-dilating properties (which is code for the fact they keep your airways nice and open). 

To have all bases covered, try to ‘eat a rainbow’, which means 'have as many different colours of vegetables as you can'. This is because fruit and veg tends to be colour-coded for the types of helpful plant chemicals they contain. What we know is that these plant chemicals have a synergistic effect in the body (their sum is greater than the individual parts), so try to get in as many different colours as you can over the course of a week.

INCREASE YOUR INTAKE OF NATURAL ANTI-INFLAMMATORIES
The actual constriction of the airways happens due to an inflammatory reaction. Allergic reactions can cause a release of histamine that triggers inflammation and consequently this constriction. 

Most anti-asthma drugs are acting as anti-inflammatories, the most common being steroid inhalers. These mimic the action of the body’s own cortisol hormone that acts as a powerful anti-inflammatory. 

Nature’s most powerful anti-inflammatories are omega-3 fats, boswellia, curcumin, ginger, quercetin and MSM, which is a form of sulphur. Astaxanthin may also help. 

So how can you get more of these into your diet? 

Eat a diet high in oily fish (wild or organic salmon, mackerel, herring, kippers, sardines and tuna steak), omega-3 rich flaxseeds and pumpkin seeds to help lower levels of inflammation. 

IMPROVE YOUR AIR QUALITY 
Most people with asthma are hypersensitive to changes in air quality and do much better in clean air. It’s well worth investing in a decent ioniser for the bedroom and/or your major living space. Ionisers take dust and other tiny particles out of the air, including smoke and pollen. 

In addition to ionisers for your home, you can now buy discreet personal ionisers that can you can wear and help protect you whether you are out in the fields or in a smog-filled city street.

WORKING WITH YOUR DOCTOR

Many of the recommendations made here to reduce your inflammatory and allergic sensitivity can be put into action without interfering in any way with medical treatment. And they may well reduce the need for it.

For instance, if you have asthma and you find taking in some of these suggestions makes your condition much better, it is worth talking to you doctor about whether it makes sense to reduce how often you use your inhaler – do NOT simply stop using it, however, without medical advice. 

One of the most important factors to check for is allergies. Your doctor may be willing to refer you for allergy tests. It is important, however, that you are checked for both IgE and IgG allergies. As few doctors check for IgG-based allergies, you may need to do it using food allergy/ intolerance test. 

Why not book in a free 30 minute health review with me and I can tell you more about testing.

What’s the deal with post-COVID syndrome?

Over the last two years, nothing has ruled our lives and occupied our minds as much as the SARS-CoV2 pandemic. If we have not been personally affected yet, we all know someone who has. There is light at the end of the tunnel. One by one, countries are lifting their COVID restrictions to varying degrees and travel across borders is becoming easier. 

COVID-19 turned out to be a disease that comes in all shapes and sizes. Some people will have contracted SARS-CoV2 without even knowing as they do not develop symptoms. Most people affected experience mild to moderate symptoms, but about 20% get severely ill. Of those, 5% develop critical illness. According to the WHO, almost 6 million people have died to date in connection with this coronavirus, 

Typically, people infected with the virus develop symptoms within four to five days after exposure. If the disease is mild, they recover within seven to ten days. If they get severely or critically ill, it can take three to six weeks to recover. 

A minority requires hospitalisation, and the treatment can be long and traumatic. At first, it was thought that those who recovered from acute COVID-19 would simply get on with their lives once they regained their strength. Yet, as the pandemic progressed, it transpired that a significant percentage of people felt below par for weeks or even months after the initial infection. 

“Long COVID” or “post-COVID syndrome” is even more multi-faceted than the acute disease itself. For some people, it means that symptoms persist for much longer than usual. Others develop completely new symptoms, and even people whose initial infection went unnoticed can develop long-COVID. 

Most long COVID patients will test negative for SARS-CoV2. In other words, the virus has gone, but the patient remains ill. 

Long COVID symptoms

In acute COVID-19, people affected often experience flu-like symptoms – with or without fever - cough, sore throat, chest pain, shortness of breath, loss of smell, loss of appetite, headaches, diarrhoea and more. Those suffering from post-COVID syndrome experience such symptoms for much longer than usual, some continuously, some on and off. However, long COVID can also present with a completely new set and a broader range of symptoms, such as fatigue, poor quality of life, joint pain, muscle pain, skin rashes, palpitations, mental health problems, and more. 

Post-COVID syndrome can resemble other similarly puzzling diseases, such as postural orthostatic tachycardia syndrome (POTS) or myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS). Indeed, more than 10% of patients who have had COVID-19 later receive a diagnosis of either POTS or ME/CFS.

Another condition long COVID is reminiscent of is mast cell activation syndrome (MCAS). The SARS-CoV2 virus has been found to trigger inflammatory immune cell responses, including that of mast cells. Patients suffering from MCAS experience frequent episodes of anaphylaxis, i.e., allergic symptoms such as hives, swelling, low blood pressure, difficulty breathing and severe diarrhoea. They also find that they are reacting to more and more things, including foods, over time. 

Diagnosis can be tricky

COVID-19 and long COVID are still new and poorly understood. Long COVID affects all ages, people with or without pre-existing conditions, those who had acute COVID and those who apparently didn’t. Risk factors for long COVID include being female, over 70 and having pre-existing conditions. However, it still occurs in younger, male, and previously healthy people, including children.

The wide array of symptoms – of which sufferers may have one, two or many – may also distract from the root cause of a patient’s discomfort. There are no definitive tests (yet). Post-COVID syndrome can manifest itself in conditions affecting the lungs or the heart, the nervous or the digestive system, sometimes even in one person.

Many people who contracted SARS-CoV2 remain asymptomatic and never know they had it. Just a couple of weeks after infection, tests come back negative. Not everyone makes antibodies either, and in those who do, their number goes down after recovery from the acute illness. By the time long COVID symptoms develop, antibodies may be completely undetectable. Such circumstances hamper the diagnosis of post-COVID syndrome. 

What treatment options are there?

Considering how new and varied the disease is, it is not surprising that for now, treatment options are few and far between. There is as yet no drug that would ease symptoms, let alone cure the illness. As long COVID symptoms resemble those of POTS and ME/CFS, repurposing medications developed to treat those conditions may be helpful in long COVID, too. More research is needed in that area. 

At the moment, the most promising treatment seems to be rehabilitation. Light exercise tailored to the patient’s capability, breathing exercises to strengthen the lungs and cognitive behavioural therapy (CBT) over four to six weeks have been shown to improve the condition. 

Does exercise help? 

Exercise is generally seen as one of the pillars of good health, and it does indeed improve or even prevent a plethora of health conditions. However, in long COVID, a survey found that 86% of participants relapsed following mental or physical activities. Even light exercise as used in rehabilitation may be too much for some sufferers of post-COVID syndrome. A high resting heart rate, high or low blood pressure or low blood oxygen saturation mean that exercise is counter-indicated. 

What about nutrition? 

For now, research into nutritional therapy for long COVID is scarce. However, just as scientists are hopeful about repurposing pharmaceutical treatments designed to treat POTS and ME/CFS, there is the option of doing the same with the non-pharmaceutical therapies that are used to manage these conditions. As POTS and ME/CFS have been around for longer, research is available about how optimum nutrition can help, and many nutrition professionals are experienced in working with POTS and ME/CFS patients. 

In the absence of research specific to post-COVID syndrome, the current advice is to follow a generally healthy diet that reduces inflammation, strengthens the intestinal microflora, and supports the immune system. This way of eating is considered to do no harm, and it may actually help.

As long COVID patients can sometimes show MCAS symptoms, it stands to reason that dietary approaches developed for MCAS – e. g. a low histamine diet - may be an option here. Again, there is no research yet to say whether this would work. A low histamine diet is challenging and can be quite restrictive. It should, in any case, only be attempted with the guidance of a nutrition professional. 

Watch this space

Both COVID-19 and post-COVID syndrome are still new, and a lot of research still needs to be done to understand those conditions fully. Post-COVID has many faces, and sometime soon, scientists will probably present a list of the different guises it comes in. Each one of them may require its own treatment. Given that millions of people worldwide have been affected, there is a substantial population of patients. This helps because the more people are likely to benefit from a solution, the more interest there is in funding and conducting studies. Also, there are more people available to potentially participate in such studies. 

So, for now, we can only make the most of the (sparse) current treatment options, such as rehabilitation. Eating junk foods and burning the candle at both ends are unlikely to improve long COVID, so a healthy diet, sleep, me-time, and relaxation seem like a good place to start. Typically, exercise is part of this list of healthy habits. For long COVID patients, however, it can be counterproductive. 

While recovery from post-COVID syndrome can be slow, patients are getting better, and the majority make a full recovery. If you are suffering with long COVID and would like to talk to me about improving your diet and lifestyle, feel free to book in a call here.

Further reading

https://covid19.who.int/

Raveendran AV, Jayadevan R, Sashidharan S (2021). Long COVID: An overview. Diabetes Metab Syndr. 2021 May-Jun;15(3):869-875. 

Yong SJ (2021: Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments. Infect Dis (Lond). 2021 Oct;53(10):737-754.