Month: December 2017

Stressed about hot flushes?

Hot flushes are consistently reported as the most common symptom during the menopausal stage in women with approximately 75% of menopausal women experiencing them. Severity and frequency can vary widely between women, with some women finding their day to day life is affected.

What causes a hot flush?

It is not fully understood what causes a hot flush, however, research suggests that hot flushes are associated with altered hormone levels (oestrogen, progesterone and other hormones) as well as alterations in how the body regulates temperature (1).

The brain, or more specifically, the hypothalamus plays a central role in regulating body temperature. Each person has what it known as a ‘thermoneutral zone’, within which any fluctuation in body temperature does not cause sweating and flushing or shivering. Flushing appears to occur as a result of disturbance of the hypothalamus, and possibly by a reduction in the persons ‘thermoneutral zone’ (2).

Oestrogen appears to be critical to this process; supported by the positive results obtained via oestrogen therapy. The exact mechanism of action oestrogen has on hot flushes, however, is unknown (2).

So what role does stress have to play? It is thought that stress, or more specifically the hormone adrenaline, which is secreted during stress, may narrow the ‘thermoneutral zone’, increasing a persons risk of a hot flush (3).

To provide some evidence of this possible connection, a cohort study followed 233 women over 14 years and assessed hot flush frequency and severity, hormone levels, anxiety symptoms amongst other measures. The study found that women with high perceived anxiety had a greater risk of hot flushes (4).

Due to the close relationship between hot flushes and stress, it remains unclear whether stress is a cause or consequence of hot flushes.

How can we manage stress/anxiety in relation to hot flushes?

We know that stress increases circulating adrenaline which is the hormone potentially involved in exacerbating the hot flush, so how do we reduce it?

Deep, slow breathing is thought to help to reduce levels of this hormone and facilitate relaxation; so could be an easy technique to employ in the management of hot flushes.

A randomised controlled trial in 68 women over 9 weeks found that a 52% reduction in hot flushes in women undertaking a breathing technique of 6 breaths/minute for 15 minutes twice per day (5).

The 6 breaths/minute technique is easy to do and involves breathing ‘in for 4 counts’ and ‘out for 6 counts’ for 15 minutes twice per day…. so why not give it a go!!

Menopause and its relating symptoms are complex and individual. In addition to the above information there are many other potential recommendations that could be made to support you through menopause.

If you would like to find out how nutritional therapy can help support you please contact us or book a FREE 15 minute consultation.

References

1 Freedman, R. R. (2014). Menopausal hot flashes: mechanisms, endocrinology, treatment. The Journal of Steroid Biochemistry and Molecular Biology, 142, 115–20. https://doi.org/10.1016/j.jsbmb.2013.08.010

2 Sturdee, D. W. (2008). The menopausal hot flush—Anything new? Maturitas, 60(1), 42–49. https://doi.org/10.1016/j.maturitas.2008.02.006

3 Gast, G.-C. M., Grobbee, D. E., Pop, V. J. M., Keyzer, J. J., Wijnands-Van Gent, C. J. M., Samsioe, G. N., … Van Der Schouw, Y. T. (n.d.). Menopausal Complaints Are Associated With Cardiovascular Risk Factors. https://doi.org/10.1161/HYPERTENSIONAHA.107.106526

4 Freeman, E. W., & Sammel, M. D. (2016). Anxiety as a risk factor for menopausal hot flashes: evidence from the Penn Ovarian Aging cohort. Menopause (New York, N.Y.), 23(9), 942–9. https://doi.org/10.1097/GME.0000000000000662

5 Sood, R., Sood, A., Wolf, S. L., Linquist, B. M., Liu, H., Sloan, J. A., … Barton, D. L. (2012). Paced breathing compared with usual breathing for hot flashes. Menopause: The Journal of The North American Menopause Society, 20(2), 1. https://doi.org/10.1097/gme.0b013e31826934b6

Healthy bones: Calcium and more!

Nutritional food for women

Both men and women experience bone loss with increased age, however it appears that women are more affected. A review concerning gender differences between men and women concluded that women start to lose bone at an earlier age and at a faster rate compared to men; women over 50 were found to have a four times higher rate of bone related disease compared with men (1).

When it comes to bone health, menopause is an important time. A cohort study of 1902 women found that bone loss accelerates substantially in the late peri menopause and post menopausal years (2).

So what factors should we consider in order to support optimal bone health during our lives and particularly in late peri menopause and post menopause?

Calcium 

Calcium is an important mineral for many body functions, including healthy bones. Most calcium in the body is stored in the bones and keeps them strong. Our bodies continually remove and replace calcium from the bones, this is a natural process; however if the body starts to remove more calcium than it can replace, this can lead to weaker bones that are more prone to breaking.

Dairy products such as milk are considered good sources of calcium, however, there are many other sources, including nuts, leafy green vegetables and fish.

Calcium is well understood for its benefits to bone health, however, newer research now understands that calcium alone may not provide optimal support to bone health.

So what else is important?

Magnesium

Magnesium is a vital nutrient and is involved in hundreds of processes in the body, including helping to maintain healthy bones. About 60% of magnesium is stored in the bone; it is thought that magnesium contributes to bone health directly but also indirectly by influencing a hormone which regulates calcium turnover in the bones (3).

Dietary sources of magnesium include green leafy vegetables, avocados, beans, nuts, wholegrain and brown rice.

Vitamin D

Vitamin D is a source of much media interest at the moment and is believed to be a common deficiency in the UK. Like most nutrients, Vitamin D has many functions in the body and is vital to maintain health. For bone health, adequate Vitamin D levels in the blood are required for calcium absorption in the intestine (4).

There are some food sources of vitamin D which include fish (salmon, mackerel, tuna), dairy products, eggs and liver, however the best source of Vitamin D is the sun. Vitamin D supplements are also available.

Due to deficiency being common in the UK, it may be useful to get your Vitamin D levels tested; you can then decide on the best course of action to increase Vitamin D levels and support your bones and overall health. Your GP or Nutritional Therapist can organise a Vitamin D test for you.

Vitamin K2

Vitamin K may be less well known than other nutrients such as calcium and vitamin D for bone health, however, it appears to be important. There are two dietary types of Vitamin K; K1 and K2. It is thought that Vitamin K2 is required by a hormone called Osteocalcin. Osteocalcin is found in bone and is important for the maintenance of bone mass (5).

Vitamin K2 is found in meats from grass fed animals, egg yolks and fermented foods such as soy (natto), kefir, sauerkraut and fermented dairy such as Gouda and Brie.

As you can see, maintaining health bones is about more than just calcium. Many other diet and lifestyle factors should also be considered to support bone health. For more information on supporting your bones please contact us or book a FREE 15 minute consultation.

References

1 Alswat, K. A. (2017). Gender Disparities in Osteoporosis. Journal of Clinical Medicine Research, 9(5), 382–387. https://doi.org/10.14740/jocmr2970w

2 Finkelstein, J. S., Brockwell, S. E., Mehta, V., Greendale, G. A., Sowers, M. R., Ettinger, B., … Neer, R. M. (2008). Bone mineral density changes during the menopause transition in a multiethnic cohort of women. The Journal of Clinical Endocrinology and Metabolism, 93(3), 861–8. https://doi.org/10.1210/jc.2007-1876

3 Castiglioni, S., Cazzaniga, A., Albisetti, W., & Maier, J. A. M. (2013). Magnesium and osteoporosis: current state of knowledge and future research directions. Nutrients, 5(8), 3022–33. https://doi.org/10.3390/nu5083022

4 Holick, M. F. (2004). Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. The American Journal of Clinical Nutrition, 80(6 Suppl), 1678S–88S. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15585788

5 O’Connor, E. M., & Durack, E. (2017). Osteocalcin: The extra-skeletal role of a vitamin K-dependent protein in glucose metabolism. Journal of Nutrition & Intermediary Metabolism, 7, 8–13. https://doi.org/10.1016/J.JNIM.2017.01.001

Weight loss: is it just about calories?

Apple for Bournemouth female nutrition

What is a calorie?

A calorie is simply a unit of energy. Energy is vital to the human body and is required for every body process to function.

Protein, fats and carbohydrates in our food and drink contain calories; protein and carbohydrate provide 4 calories/gram, and fat provides 9 calories/gram.

Each person will have their own specific daily calorie requirement based on your age, weight, and activity level. Ensuring this calorie requirement is met and not exceeded is a factor in maintaining a healthy weight as well as providing enough energy for your body to function and undertake daily activity.

Calories and weight management

In order to lose weight, you need to take in fewer calories than your body needs. When this happens the body will begin to break down ‘energy stores’, like fat, in order to provide the body with energy; resulting in weight loss.

BUT is it just about calories?

Well it appears it is not that simple!! Yes, it is true, to lose weight we must consume fewer calories than your body needs but HOW we achieve this appears to be an important factor when it comes to safely losing weight and, most importantly, maintaining that weight loss!

Three additional factors are important to consider;

  • Macronutrient content
  • Health
  • Sustainability

Macronutrient content

It is important to consider where your calories come from as each macronutrient has its own role when it comes to weight management.

Firstly protein (meat, fish, beans, pulses), fibre (from vegetables, whole fruit and wholegrains) and fat are all thought to keep you fuller for longer compared to simple carbohydrates (cakes, sugars, biscuits etc) and processed foods (white bread, white pasta, pizza etc).

In addition protein, fat and fibre are thought to slow down how quickly sugar enters your blood. Why is this important? Well, the amount of sugar entering your blood at any one time can have an impact on your weight. Sugar is the bodies main energy source and so the body likes to maintain a very stable amount of sugar in the blood at any one time. Too little or too much sugar will trigger your body to respond.

A sharp increase in blood sugar, as seen when consuming sugary/processed foods, triggers a large amount of a hormone called ‘insulin’ to be released. The role of insulin is to ‘pack away’ sugar safely into the cells in order to remove it from the blood. Some of this sugar will be stored in the liver and muscles as a quick source of energy; the remaining, excess sugar will be stored as fat. While insulin is being secreted, your body will find it very difficult to ‘burn fat’.

As we know, what goes up must come down….. following an increase in blood sugar comes a drop in blood sugar. Low blood sugar tends to be associated with feelings of low energy and mood as well as cravings for ‘sugary’ foods. Your body will secrete adrenaline (a stress hormone); the main action of adrenaline is to increase blood sugar levels….. it is common for a ‘blood sugar rollercoaster’ of up’s and down’s to occur throughout the day, having a negative impact on weight management.

Protein is also thought to have a much higher ‘thermic effect’ compared to carbohydrate and fat. This means during the digestive process, the body actually uses more energy than it does for carbohydrate and fat digestion, meaning less energy is available to be utilised by the body.

With this in mind, focus on a diet that provides a higher protein and fibre content. This should keep you fuller for longer and support you in your weight loss goals.

Health

How healthy you are is not only about what you weigh and how many calories you consume, it is also about what nutrients e.g. vitamins, minerals, fatty acids, amino acids you have available for your body to use. It is important to get as much ‘nutritional value’ i.e. vitamins and minerals, from every calorie in your diet.

Focus on foods that provide you with a high nutritional value. Vegetables (aim for 6 portions per day), fruit (aim for 1 portion per day), lean quality proteins, oily fish such as salmon, mackerel, anchovies and sardines, nuts and seeds all contain a variety of nutrients that help to keep us healthy.

Sustainability

To achieve long term weight loss, it is paramount that dietary changes are long term and sustainable. This means that the diet should provide good nutritional value but also contain enough food to keep you full and happy. Aim to make a lifestyle change for good rather than following a short term ‘diet’.

Weight management is complex with individual requirements and circumstances playing a role. For more information and personalised support in managing weight please contact us or book a FREE 15 minute consultation.