OnCore Nutrition - Two Peas in a Podcast

I’m talking about one of my all time favourite things…sleep. I’ll take you through a chronotype quiz to help you understand your ideal sleep and wake times, followed by a bunch of practical, science-backed strategies to boost your chances of falling and staying asleep.

Get ready to fuel your marathon! This episode is all about endurance event fuelling so tune in to nail your nutrition and hydration strategy and hit your PBs.

SHOW NOTESWhat impact does surgery have on the body?Intentional trauma Physiological response Psychosocial impact StressWhen we think about surgery, it's essential to understand that it triggers a significant reaction in the body known as the 'stress response.' This response is a complex interplay of hormonal and metabolic changes directly linked to the degree of tissue damage during surgery. It can intensify if there are any complications after the operation. Let's break it down: The whole process starts when the hypothalamic-pituitary-adrenal axis, or HPA axis, kicks into gear. This leads to a surge in hormones like cortisol, growth hormone, glucagon and catecholamines. These hormones are important because they help the body cope with stress by boosting energy availability and adjusting other bodily functions.Ebb phase (0-48hrs)Increased catabolism of stored glycogen (glycogenolysis)Suppression of insulin secretion → transient hyperglycemiaIncreased catecholamines, cortisol, and inflammatory cytokines (IL-6, TNF-α)Flow phase (3-10 days)Hypermetabolism (increased BMR)Increased protein catabolism → muscle breakdown (to provide amino acids for tissue repair and immune function)Increased lipolysis (fat breakdown) for energySustained insulin resistance → continued hyperglycemiaEnhanced GNG Pro-inflammatory response → increased cytokines and acute-phase protein productionIn the initial stages after surgery, the body releases a wave of pro-inflammatory cytokines. These cytokines jumpstart the healing process by promoting inflammation, which is important for healing surgical wounds. However, to keep this inflammation from going overboard, the body soon follows up with anti-inflammatory cytokines.These inflammatory processes have widespread effects across the body. For example, they can influence how the hypothalamus regulates body temperature or how the liver produces certain proteins that help fight infection and aid in wound healing.But here’s where it gets even more interesting: other hormones like glucagon, cortisol, and adrenaline also play a role in modulating these responses. They can affect everything from your blood sugar levels to how your cardiovascular system handles the stress.So, why is all this important? Well, by understanding and managing these responses effectively, we can significantly improve how patients recover from surgery. It’s all about helping the body maintain balance during a time when it’s incredibly vulnerableDisruption of Metabolic Homeostasis: Surgery often disrupts the body's normal metabolic balance, notably through insulin resistance, where cells fail to respond effectively to insulin, leading to 'diabetes of the injury.' Insulin Resistance and Hyperglycemia: Insulin resistance can cause high blood sugar levels, significantly increasing the risk of surgical complications and mortality. Post-surgery, the body may enter a catabolic state, breaking down muscle instead of fat, which impairs wound healing, weakens the immune system, and reduces muscle strength. Increased Risks for Vulnerable Groups: Elderly, diabetics, and cancer patients are particularly at risk due to their compromised metabolic and inflammatory states. These groups have less physiological reserve, leading to pronounced catabolic states and increased risk of severe post-operative complications. Impact on Recovery and Outcomes: The metabolic chaos from insulin resistance to protein loss not only delays recovery but also exacerbates risks of infection and other complications. Effective management of these changes is crucial for improving surgical outcomes and ensuring that patients thrive post-surgery.ERAS helps to mitigate these by Surgery isn't just about the physical repair or removal of tissue; it triggers a cascade of stress responses in the body that can complicate recovery. These include everything from the psychological impacts of anxiety and the physiological effects of fasting to direct tissue damage and the systemic reactions to it, such as fluid shifts and hormonal imbalances.Key Components of ERAS:Comprehensive Care: ERAS isn't just a single technique but a suite of practices designed to address every aspect of the patient's journey — before, during, and after surgery. This approach aims to minimise the stress responses by controlling pain, reducing fasting times, optimising fluid management, and promoting early mobility.Minimising Fasting: One traditional practice that ERAS revises significantly is the preoperative fasting rule. Old guidelines that required fasting from midnight before surgery are now replaced with more lenient, evidence-based practices that allow intake of clear fluids up to two hours and solids up to six hours before surgery. This change helps maintain normal blood glucose levels, reduces stress, and decreases the body's shift into a catabolic (muscle-degrading) state.Nutritional Optimisation: ERAS protocols emphasise the importance of not entering surgery in a depleted state. By allowing a carbohydrate-rich drink shortly before surgery, patients are better hydrated and less anxious, which in turn reduces insulin resistance and preserves muscle mass — critical factors in speeding up recovery post-surgery. Post-operatively, oral nutrition may be delayed by the medical team until bowel function returns, typically taking close to a week. This delay is stated to reduce postoperative complications such as abdominal distension and nausea/vomiting.For the first several days post surgery fluids of limited nutritional value such as water are provided to patient until tolerance is established leading to insufficient nutrition intake during this time increasing the risk of malnutrition. The ERAS protocol promotes early oral intake within 24 hours post surgery departing from traditional fasting practices. Research suggests that between 40-50% of surgical patients have some degree of malnutrition. Pre-operative malnutrition is an independent predictor of poor post-operative outcomes. Therefore addressing malnutrition is a key component of the ERAS protocol.Immune-Enhancing Diets: Post-surgery nutrition is just as crucial. ERAS encourages diets rich in nutrients that bolster the immune system and enhance wound healing. This includes omega-3 fatty acids, which help modulate the inflammatory response; arginine, which supports protein synthesis and tissue growth; glutamine, which is vital for cellular health and recovery; and nucleotides, which are essential for rapid cell division and immune function .Immuno-nutrition is a specialised medical nutrition therapy that has been shown to adjust the body's inflammatory response: It incorporates specific nutrients like omega-3 fatty acids, arginine, polyunsaturated fatty acids, and nucleotides. It's typically recommended starting 5-7 days before surgery and continuing post-operatively for over 7 days or until oral intake meets at least 60% of the patient's nutritional requirements.How can we use this info to optimize surgical outcomes?Patient education Early nutrition pre and post surgery - Minimise fasting time What is ERAS? How does it differ from traditional care/practice?Introduced by Henrik Kehlet in 1997, the Enhanced Recovery After Surgery (ERAS) protocol has revolutionised surgical practices by optimising perioperative care. A key aspect of ERAS is its interdisciplinary approach, involving healthcare professionals from various specialties to minimise surgical stress and facilitate recovery. What is malnutrition?Malnutrition, is defined as an involuntary reduction in body weight, muscle mass and physical capabilities, affects up to 65% of surgical patients and can worsen during hospital stays. Enhancing nutritional status and promoting functional nutrition therapy is essential, even forpatients without evident malnutrition, particularly when prolonged perioperative oral intake challenges arise. Addressing malnutrition is essential for preventing surgical complications, prolongedhospital stays and higher healthcare costs. What are the benefits of ERAS for the patient?It has been shown that the key physiological benefits include:-enhances the body’s anabolic processes-promotes wound healing, which is critical for patient recovery.-Reduces the risk of nutritional depletion-Minimises insulin resistance, a common issue post-surgery, allowing for better blood sugar control and improved metabolic function.-Reduce protein catabolism-And lowers the risk of pressure injuries, which can develop due to extended immobility after surgery.What are the benefits of ERAS from a healthcare perspective? From a healthcare perspective, ERAS has been shown to-shorter length of hospital stay for patients,-Lower risk of ICU transfer rates-reduce readmission rates-And all of these improvements lead to lower healthcare costs, not just for the hospital but for the overall healthcare system, as fewer complications and shorter stays reduce the financial strain.Step 1: Screen & StrengthenIf you’ve lost any weight unintentionally in the lead up to surgery, or been eating poorly because of a reduced appetite, you may be at risk of malnutrition and it’s really important to address this prior to surgery. Research suggests that between 40-50% of surgical patients have some degree of malnutrition. Pre-operative malnutrition is an independent predictor of poor post-operative outcomes. Addressing malnutrition is a key component of the ERAS protocol and why it’s effective in improving surgical outcomes for patients.Book an appointment with a dietitian who can guide you on appropriate dietary changes to minimise muscle loss, build you up and optimise nutritional status and stores pre-op. A well-nourished body tolerates surgery better, heals faster, has a stronger immune system to fight infection, and experiences fewer complications.Step 2: Consider Immunonutrition If you’re planned for major surgery, especially certain cancer and abdominal surgeries, consider the use of an immunonutrition sup

SHOW NOTESPost-COVID questionnaire: https://chroniccare.snapforms.com.au/form/post-covid-questionnairePost COVID Recovery steps   Referenceshttps://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1https://www.bmj.com/content/372/bmj.n136https://www.bmj.com/content/372/bmj.n136/rapid-responseshttp://www.buckshealthcare.nhs.uk/pifs/nutrition-and-long-covid/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8429479/NICE (2020) “COVID-19 guideline scope: management of the long-term effects of COVID-19” https://www.nice.org.uk/guidance/ng188/documents/final-scope]Leon et al. (2021) ‘More than 50 Long-term effects of COVID-19: a systematic review and meta-analysis”. [ https://pubmed.ncbi.nlm.nih.gov/33532785]Afrin et al. (2020) “Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndrome”. International journal of infectious diseases, 100: 327–332 https://pubmed.ncbi.nlm.nih.gov/17490952/]Casas et al. (2016) “The Immune Protective Effect of the Mediterranean Diet against Chronic Low-grade Inflammatory Diseases”. Endocr Metab Immune Disord Drug Targets. 14(4): 245–254. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443792/] LaTrobe Researchhttps://www.latrobe.edu.au/news/articles/2022/release/possible-cause-of-long-covid-brain-fogSouvenaid https://nutricia.com.au/souvenaid/https://www.cuh.nhs.uk/news/friendly-gut-bacteria-speeds-long-covid-recovery/https://www.pomi-t.co.uk/national-trial/https://pubmed.ncbi.nlm.nih.gov/35334962/ https://pubmed.ncbi.nlm.nih.gov/33933299/ https://www.bda.uk.com/resource/long-covid-and-diet.html https://www.buckshealthcare.nhs.uk/wp-content/uploads/2021/10/Nutrition-and-Long-COVID.pdf  https://www.google.com/amp/s/metro.co.uk/2022/03/15/long-covid-and-nutrition-can-you-eat-yourself-well-16237485/amp/  https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-expert-shares-5-early-care-tips-for-people-with-long-covid/  https://www.todaysdietitian.com/newarchives/ND21p40.shtml https://www.google.com/amp/s/metro.co.uk/2022/03/15/long-covid-and-nutrition-can-you-eat-yourself-well-16237485/amp/  https://www.google.com/amp/s/metro.co.uk/2022/03/15/long-covid-and-nutrition-can-you-eat-yourself-well-16237485/amp/ https://www.healthspan.co.uk/advice/long-covid-diet-and-lifestyle-changes-that-can-helpSmell traininghttps://www.fifthsense.org.uk/smell-training/https://abscent.org/learn-us/smell-training/how-smell-trainhttps://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiac136/6569364?login=falsehttps://www.cidrap.umn.edu/news-perspective/2022/04/global-data-reveal-half-may-have-long-covid-4-months

We take a wander through fad diet history to explore the weird and not so wonderful, and how to spot a fad.

https://www.cdc.gov/obesity/adult/defining.htmlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414803/https://www.aihw.gov.au/getmedia/384eafec-fa90-412d-8c98-b279fddc7911/ah16-4-4-overweight-obesity.pdf.aspxhttps://www.nature.com/articles/s41366-020-0547-1https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4386524/

SHOW NOTES  Mindful Eating Guide - free downloadHunger Fullness Guide - free downloadDiet Cycle Guide - free download

Rebecca Gawlerrebecca@reload.physio Instagram handles: @reloadphysioFacebook page: https://www.facebook.com/ReloadPhysio Are you exercising to  make you feel good or enhance your health or is it the opposite? Are you feeling compelled to exercise and if you're unable to meet your targets does this cause you concern or guilt? HAES practitioners (to find personal trainers who promote intuitive movement): https://haesaustraliainc.wildapricot.org/find-a-provider The Physiotherapy Eating Disorders Professional Network Group https://cpmh.csp.org.uk/content/physiotherapy-eating-disorders A website Bec has put together to summarise the research/info on dysfunctional exercise, intuitive exercise and physio for eating disorders: https://eating-disorder-physiotherapy7.webnode.com/?fbclid=IwAR0Uz0wrMmvX2tdFnYPueCXagmotGGQwHhVmtC3yJ91RoDnPXziZZ1hqI Virtual carehttps://chroniccare.com.au/Speak to the team to arrange an appointment with the most appropriate professional.  Platinum Physio Women’s Health Physio 

Find and Fuel Your FireThurs 24th Feb 6:30pm AEDTDetails and Tickets here 

SHOW NOTES OnCore Nutrition Ladies Lunch SeriesLadies Lunch 1 - Understanding your cycleWed 27th Oct 1-1:45pmLadies Lunch 2 - Lifestyle strategies to harness your health, feel and perform at your best throughout each season of your cycleWed 3rd Nov 1-1:45pmTickets and info via Eventbrite   Study discussedOvulatory Cycle Effects on Tip Earnings by Lap Dancers: Economic Evidence for Human Estrus? https://www.researchgate.net/publication/228632689_Ovulatory_Cycle_Effects_on_Tip_Earnings_by_Lap_Dancers_Economic_Evidence_for_Human_Estrus

Episode SummaryCalling all nutrition students and new grads...talking through tips to finding and fueling your fire and an exciting workshop we have planned just for you.Episode NotesFind and Fuel Your Fire WorkshopTickets via Eventbrite Getting a nutrition job is HARD! The Dietetics Workforce Report 2018There has been a 95% increase in dietetic grads over the last 7 years.Grads in Vic ↑ from 65 to 127 per year from 2010 to 2016.There is great concern that there is an oversupply of practitioners causing difficulties in new graduates finding positions and inhibiting movement for existing employees.Many grads are still seeking work up to 12 mths post graduation.In this time, grads are driven to volunteering - but not always meaningfulYou are highly qualified. There is a significant need for your skills. We have an ageing population, chronic disease and dietitians provide such important prevention and management careThe report highlighted that Dietitians are highly qualified, however there are obvious gaps in business and professional skills in many courses.Despite working in a clinical role 30% of dietitians had no clinical supervisor.file:///C:/Users/laure/Downloads/Dietetics%20Workforce%20Report.pdfPotential career pathways Clinical dieteticsPopular!When we’ve advertised for grad jobs there have been >100 applicants.A quarter of organisations reported receiving >50 applicants for junior positions and advertisements were rare!Hard to get grad jobsConsultancy and private practiceOften don’t graduate with skills for business set up and challenging to dive into sole practitioner position without prior experience. Requires ++ mentoring and supervision.Important for your own development but also for the reputation of the profession Food serviceMedia and marketingDon’t expect to get here straight away - need some experience behind youBe responsible with what you put out into the world, social media etc. Don’t know what you don’t know. Public health and nutritionEventually policy, health promotion, advocacyOften start as a public health dietitian, community dietitianFood industryConsultingFood analysis and product development, sensory evaluationFood technology and scienceResearch Nutrition research and educationGenerally requires specialisation and smaller projects or honours, masters, PhDhttps://www.deakin.edu.au/exercise-nutrition-sciences/careers-in-nutrition-and-dieteticshttps://www.myhealthcareer.com.au/dietetics-career/Our tipsVolunteer meaningfullyUpskillGet a mentor - a meaningful oneApply for everything - know your limits/hard passesApply wellPrepare for interviewsSeek feedback - and actually be prepared to take it Our upcoming workshophttps://www.eventbrite.com/e/find-and-fuel-your-fire-student-early-dietitian-nutritionist-workshop-tickets-159824540503 Wed 11th Aug 6pm  Topics to cover How to land the job you wantJob application preparationInterview (including phone/video interview) preparationSetting yourself apartWhat NOT to do!Volunteer / work experience opportunitiesProfessional developmentFinding your career niche / Progressing your career SpecialisingQuality projects opportunities in nutritionEducation opportunities in nutritionResearch opportunities in nutritionConference / presentation opportunitiesSupervision and mentoringFinding the right supervisorInnovation in dietetics  Identifying gapsPitching your ideaIntroduction to grants and proposalsDelivery Online2hr workshop2 sessions - one evening, one weekend‘Take home’ toolkit of resources

Google Trends Health and disease riskhttps://pubmed.ncbi.nlm.nih.gov/29276945/https://pubmed.ncbi.nlm.nih.gov/28853910/https://pubmed.ncbi.nlm.nih.gov/16507475/https://pubmed.ncbi.nlm.nih.gov/24671262/https://pubmed.ncbi.nlm.nih.gov/25156996/https://pubmed.ncbi.nlm.nih.gov/16685044/https://pubmed.ncbi.nlm.nih.gov/22591295/ Diuretic effect Despite the fact that caffeine is a mild diuretic, you don't lose more fluid than you take in by drinking coffee, so it cannot dehydrate you.While we don’t count coffee towards our fluid targets for the day, it doesn’t throw you into the negatives. It’s a net-neutral sort of scenario.  Coffee and exercise performanceThe impact of coffee on exercise performance is related to caffeine’s impact on the CNS. It’s a stimulant meaning it enhances alertness, and also  reduces our perception of fatigue and our perception of effort. So you feel like you’re not working as hard, and also feel less tired. Those that are most likely to benefit from caffeine are those involved in team or intermittent sports so basketball, footy etc, endurance sports and high intensity, short duration sports.How much do you need? While research initially focused on high doses of caffeine, more recent research indicates that lower doses can provide similar performance benefits with less negative side effects. Around 1-3 mg caffeine per kg body weight are sufficient to improve performance (so for a 60kg athlete this equates to roughly 1-2 cups of coffee).Timing is also important - coffee reaches peak concentrations 1hr post intake and will generally last for 3-4hrs. The ideal time to down your coffee is 30-45mins pre-training and often black is best if you’re likely to be sensitive to exercising on a tummy full of milk.https://www.sportsdietitians.com.au/factsheets/supplements/caffeine/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867441/ Coffee and sleepWe all know the joys of caffeine in perking us up, but does it affect our sleep? The stimulating effects of caffeine from coffee last 3–5 hours, and depending on individual differences, about half of the total caffeine you consume remains in your body after 5 hours. It’s no surprise that consuming coffee too close to bedtime can cause sleeping problems. Most studies suggest avoiding caffeine for 6 hours prior to bed. The good news is that a switch to tea in these 6 hrs, including green tea which contains about a third of the caffeine as coffee, will be helpful due to the presence of amino acid L-theanine, which has relaxing and calming properties.  Coffee and waking! Studies have shown that the ideal time to drink coffee is around 203hrs after waiting.  This is because of our hormones. As we wake up, a hormone called cortisol is at its highest. Cortisol is responsible for balancing our energy levels, blood pressure and how we respond to stress or danger. So, drinking coffee when cortisol is already at its highest may not be giving you any additional energy. In fact, it may be making you feel more tired and stressed or anxious later in the day. Science suggests waiting 2-3 hours after waking when cortisol is slowly declining to have your morning coffee for the most bang for your buck.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2257922/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684472/ Coffee napsSome research suggests that combining caffeine with naps is more energising than caffeine or sleep alone. Enter the coffee nap. The theory is that if you drink coffee (or anything caffeinated) before sleeping for a short period, you can boost your energy levels by increasing your brain’s capacity to receive caffeine. This is related to caffeine competing with adenosine for receptors in your brain. Adenosine is an organic compound whose derivatives are important for energy processes in the body amongst other things. Adenosine circulation increases when we feel tired and the act of sleep brings these levels down. But coffee might give us a double whammy by blocking some of the adenosine being registered in our brain. This can make us feel even less tired when we wake. Most of the research suggests the best way to take a coffee nap is to have some caffeine right before taking a 15–20 minute nap (and no more than 30mins).https://pubmed.ncbi.nlm.nih.gov/9401427/https://pubmed.ncbi.nlm.nih.gov/14652086/ Fun factsCoffee is the world’s most valuable traded commodity next to petroleum.Globally people consume about 2.25 billion cups of coffee every day.Coffee beans are fruit pips and not beans.A coffee bean is  the pip inside the bright red fruit often referred to as a the coffee cherry or coffee berry. Millennials spend an average of $2008 oer year on coffee https://www.ngpf.org/blog/budgeting/question-of-the-day-how-much-do-millennials-spend-every-year-on-coffee/Coffee grounds sprinkled on the ground around plants and the garden will stop snails and slugs from eating the plants.Studies have found an association between regular moderate coffee consumption (2-4 cups per day) and a reduced risk of suicide. Go for less the 8 cups per day.   https://pubmed.ncbi.nlm.nih.gov/23819683/ https://pubmed.ncbi.nlm.nih.gov/31254722/Scientists have successfully turned ground coffee into biodiesel, so one day coffee may be fuelling your carlaws of physics have proven that coffee with milk cools about 20% slower than black coffee - due to the colour. viscosity and rate of heat radiation. The Guinness World record holder for the "Oldest Cat Ever," a 38-year-old cat named Creme Puff - drank coffee every morning her whole life.

Find and Fuel Your Fire WorkshopTickets via Eventbrite Getting a nutrition job is HARD! The Dietetics Workforce Report 2018There has been a 95% increase in dietetic grads over the last 7 years.Grads in Vic ↑ from 65 to 127 per year from 2010 to 2016.There is great concern that there is an oversupply of practitioners causing difficulties in new graduates finding positions and inhibiting movement for existing employees. Many grads are still seeking work up to 12 mths post graduation.In this time, grads are driven to volunteering - but not always meaningful You are highly qualified. There is a significant need for your skills. We have an ageing population, chronic disease and dietitians provide such important prevention and management careThe report highlighted that Dietitians are highly qualified, however there are obvious gaps in business and professional skills in many courses. Despite working in a clinical role 30% of dietitians had no clinical supervisor.file:///C:/Users/laure/Downloads/Dietetics%20Workforce%20Report.pdfPotential career pathways Clinical dieteticsPopular!When we’ve advertised for grad jobs there have been >100 applicants. A quarter of organisations reported receiving >50 applicants for junior positions and advertisements were rare! Hard to get grad jobs Consultancy and private practiceOften don’t graduate with skills for business set up and challenging to dive into sole practitioner position without prior experience. Requires ++ mentoring and supervision. Important for your own development but also for the reputation of the profession  Food serviceMedia and marketingDon’t expect to get here straight away - need some experience behind you Be responsible with what you put out into the world, social media etc. Don’t know what you don’t know.  Public health and nutritionEventually policy, health promotion, advocacyOften start as a public health dietitian, community dietitianFood industryConsultingFood analysis and product development, sensory evaluationFood technology and scienceResearch  Nutrition research and educationGenerally requires specialisation and smaller projects or honours, masters, PhDhttps://www.deakin.edu.au/exercise-nutrition-sciences/careers-in-nutrition-and-dieteticshttps://www.myhealthcareer.com.au/dietetics-career/Our tipsVolunteer meaningfullyUpskill Get a mentor - a meaningful oneApply for everything - know your limits/hard passesApply wellPrepare for interviews Seek feedback - and actually be prepared to take it Our upcoming workshopshttps://www.eventbrite.com/e/find-and-fuel-your-fire-student-early-dietitian-nutritionist-workshop-tickets-112762650122Wed 26th Aug at 6pm Sun 29th aug at 2pmTopics to cover How to land the job you wantJob application preparationInterview (including phone/video interview) preparation Setting yourself apart What NOT to do! Volunteer / work experience opportunitiesProfessional development Finding your career niche / Progressing your career Specialising Quality projects opportunities in nutrition Education opportunities in nutrition Research opportunities in nutrition Conference / presentation opportunities Supervision and mentoringFinding the right supervisorInnovation in dietetics  Identifying gapsPitching your ideaIntroduction to grants and proposals Delivery Online 2hr workshop 2 sessions - one evening, one weekend ‘Take home’ toolkit of resources 

Fertility NutritionImportant to highlight that conception is a miracle! And for many couples this is not an easy journey. 1 in 6 Australian couples are unable to become pregnant after a year of unprotected sex.Nutrition and lifestyle can play a role and have a positive effect on fertility, in fact, it may improve fertility by up to 69%! https://pubmed.ncbi.nlm.nih.gov/17978119/Female FertilityA balanced diet is important, including a wide variety of fresh produce dailyMediterranean-style diets have been associated with improved fertility Which foods and nutrients are important to include? Folic acid has been shown to be important in female fertility, even with assisted reproduction. It is recommended to include a daily prenatal multivitamin supplement with folic acid (400-500 µg/day) from 12 weeks pre-conception and for the first 12 weeks of pregnancy to decrease the risk of neural tube defects. This supplementation is particularly important in early stages of pregnancy when many women may not yet know they are pregnant, so if you have the opportunity to forward plan it’s always a good idea. Vitamin B12 - animal products, vegans should consider supplementation under guidance from their doctor or dietitian Omega-3 fatty acids - EPA and DHA are important for fertility, conception and foetal development Antioxidants are important for fertility and conception. They help to keep both our sperm and eggs healthy! Include a wide variety of plant based products including vegetables, fruits, nuts, seeds and wholegrains to boost beneficial antioxidants like vitamins C, E, folate, beta-carotene and lutein. It’s beneficial to try to get these nutrients from food sources and always speak to your doctor or dietitian before considering a supplement (especially Vitamin E).Opt for complex, low GI, high fibre carbohydrates from whole grains, vegetables, nuts and seeds. Include plant-based proteins, reducing your reliance on animal proteins. Get creative with legumes and pulses, whole grains, nuts and seeds.Seafood may have a positive association with fertility. Couples eating more seafood were pregnant sooner than those rarely eating seafood.Choose full fat instead of low fat dairyIodine may be important - get this from seafood, seaweed (nori), potatoes, cranberries, strawberries iodised salt and our bread supply which is fortified. This is a good one to start with folate in the lead up to conception, and is included in most prenatal vitamin blends. Your eating window may be important. Some studies suggest that shifting towards an earlier eating pattern, with a larger breakfast and lunch and a smaller evening meal with reduced late-night eating, may improve fertility. Which foods and nutrients are worth eating less of?Swap out trans fats for mono- and omega 3 poly-unsaturated fats. This means less processed and fried foods, commercially-prepared baked   products and margarines.Reduce processed meat intake. Replace these with lean meats, eggs, full cream dairy and plant alternatives such as legumes, tofu, nuts, seeds and grains. Reduce intake of refined carbohydrates found in sweet drinks, lollies, cakes, biscuits, desserts, and refined products like white bread, rice and cereals. Instead opt for the low GI options listed above. Energy drinks - it’s no surprise that they don’t do us any fertility favours. Reduce alcohol intake Don’t overdo the caffeine. Some studies have suggested that large intake (over 500 mg of caffeine daily) may take up to 9.5 months longer to get pregnant  https://pubmed.ncbi.nlm.nih.gov/9054236/Movement is important! Exercise has many benefits for your health, including increased fertility. A sedentary lifestyle has been associated with a higher risk of infertility and increasing movement has been found to reduce the risk of infertility. Mindset and stress is another important factor. Managing stress and anxiety may be easier said than done, particularly when trying to conceive, so consider seeking professional support to optimising your mental wellbeing and therefore fertility. Recommend tailored advice from a dietitian in the case of any medical conditions  including PCOS, diabetes or GDM, if you’re in a small or larger body and have any concerns, and if taking any complementary or alternative therapies. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30311-8/fulltexthttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(00)90458-6/fulltexthttps://www.thelancet.com/series/preconception-healthhttps://www.health.harvard.edu/blog/fertility-and-diet-is-there-a-connection-2018053113949https://www.eatright.org/health/pregnancy/fertility-and-reproduction/fertility-foodshttps://www.healthline.com/nutrition/17-fertility-tips-to-get-pregnant#1.-Eat-Foods-That-Are-Rich-in-Antioxidantshttps://pubmed.ncbi.nlm.nih.gov/22425198/https://pubmed.ncbi.nlm.nih.gov/11880759/https://pubmed.ncbi.nlm.nih.gov/11594714/https://www.pennutrition.com/KnowledgePathway.aspx?kpid=1323&pqcatid=146&pqid=1313 - sweeteners Male fertility A balanced diet is important, including a wide variety of fresh produce dailyMediterranean-style diets have been associated with improved fertility and semen quality in menWhich foods and nutrients are important to include? Omega-3 fatty acids - EPA and DHA are important for fertilityAntioxidants are important for fertility and conception. They help to keep both our sperm and eggs healthy! Include a wide variety of plant based products including vegetables, fruits, nuts, seeds and wholegrains to boost beneficial antioxidants like vitamins C, E, folate, beta-carotene and lutein. It’s beneficial to try to get these nutrients from food sources and always speak to your doctor or dietitian before considering a supplement (especially Vitamin E).Which foods and nutrients are worth eating less of?Swap out trans fats for mono- and omega 3 poly-unsaturated fats. This means less processed and fried foods, commercially-prepared baked   products and margarines.Reduce processed meat intake. Replace these with lean meats, eggs, full cream dairy and plant alternatives such as legumes, tofu, nuts, seeds and grains. Reduce intake of refined carbohydrates found in sweet drinks, lollies, cakes, biscuits, desserts, and refined products like white bread, rice and cereals. Instead opt for the low GI options listed above. Energy drinks - it’s no surprise that they don’t do us any fertility favours. Movement is important! Exercise has many benefits for your health, including increased fertility. A sedentary lifestyle has been associated with a higher risk of infertility and increasing movement has been found to reduce the risk of infertility. Mindset and stress is another important factor. Managing stress and anxiety may be easier said than done, particularly when trying to conceive, so consider seeking professional support to optimising your mental wellbeing and therefore fertility. Caffeine for fertilityYou certainly don’t need to forego your daily coffee! If you’re trying to conceive it is a good idea to not overdo the caffeine. Some studies have suggested that large intake (over 500 mg of caffeine daily) may take up to 9.5 months longer to get pregnant  https://pubmed.ncbi.nlm.nih.gov/9054236/Decaf -3mg caffeine per tsp1 Tsp of instant coffee - 60mg per tspEspresso shot (30-35ml) - 90-200mg Percolated - 100mg per cupEnergy drinks - up to 110mg per serveCola - 40mg per serveBlack Tea - 50mg Green tea - 30mgChocolate - 60g of milk or dark Choc has about 30-40mgPregnant women can safely have two instant coffees a day and two to three cups of tea OR one cap/latte Pesticides fertilitySome studies suggest that higher consumption of produce prone to harbour higher pesticide residues may be associated with lower probabilities of pregnancy. Those looking to conceive may wish to consider where they source fruits and vegetables that may be more likely to hold residual pesticides, such as strawberries, spinach, capsicum, apples, pears, nectarines, peaches, cherries and grapes. While this is important to be aware of, washing fresh produce well will help to reduce exposure. And it’s important to keep eating PLENTY of fresh produce as the nutritional benefits of this is very important to consider (as well as any possible pesticide risks). For many, this may be easy to achieve with non-organic produce that’s easier on the purse strings. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2659557  During PregnancyThings to be aware of / avoidVit A - Beta carotene safe, avoid retinol/retinyl esters - upper limit for preformed vitamin A (retinyl esters and retinol from food and supplements) during pregnancy of 3000 µg /day (~10,000 IU). Be cautious of liver (≤1 serving/week), particularly in 1st trimester. Avoid any topical creams, ointments, serums which contain vitamin A or vitamin A derivatives. Mercury in high doses may harm a developing baby's brain. Limit large loads of mercury by:Limit orange roughy (sea perch) or catfish to 150 g/week and to have no other fish that week or Limit shark (flake) or billfish (swordfish/broadbill and marlin) to 150 g/two weeks and to have no other fish during those two weeksExamples of low mercury fish that are high in omega-3 fats include sardines, mackerel, silver warehou, Atlantic salmon, canned salmon and tuna in oil and herrings. Pregnant women are advised to consume 300-450 g/week of lower mercury fish and seafood. Food safety is important to minimise the risk of food-borne illness. Elevated progesterone levels in pregnancy suppressed the immune system, making women more prone to infection and illness. In particular, we want to reduce the risk of foodborne illnesses listeriosis, toxoplasmosis, campylobacteriosis and salmonellosis. The consequences of foodborne illness can be particularly devastating during pregnancy because both the woman and her foetus are at risk. Risk is very rare, especially in Australia (> 300,000 pregnancies per year and around seven case

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When it comes to dieting everyone is always looking for a quick fix.Effectiveness of diets long term Interesting study https://www.bmj.com/content/bmj/369/bmj.m696.full.pdfIt looked at “Comparison of dietary macronutrient patterns of 14 popular named dietary programmes for weight and cardiovascular risk factor reduction in adults: systematic review and network meta-analysis of randomised trials”Randomised trials that enrolled adults (≥18 years) who were overweight (body mass index 25-29) or obese (≥30) to a popular named diet or an alternative diet.Outcome measures included change in body weight, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, BP (systolic blood pressure & diastolic blood pressure), and CRP at 6 and 12 month follow-up.121 trials made the cut (21,942 patients) - huge studyDietary intervention group assessed based on macro breakdown were:Low carb (e.g. Atkins, south beach, zone)Moderate marcos (e.g. Biggest Loser, DASH, Jenny Craig, Mediterranean, Portfolio, Slimming World, Volumetrics, Weight Watchers)Low fat (Ornish, Rosemary Conley)Control groupControl diets included: maintain usual dietary habits, dietary advice (eg, received brochures, dietary materials including dietary guidelines, or consultation with a professional dietitian by email or telephone), and low fat diet (≤30% fat with or without advice about lowering calories). Results:Positive weight loss improvements at the 12 month follow-up diminished.Improvements in cardiovascular risk factors largely disappeared except for Mediterranean diet for LDL reductionDifferences between diets are, however, generally trivial to small, implying that people can choose the diet they prefer from among many of the available diets to adhere to what works best for them.Bottomline: no matter if you like low carb, high carb, low fat, etc… diet’s are not effective in reducing weight and keeping it off.Other large scale reviews confirm that diets simply don’t work Grade A evidence - NHMRC Clinical Practice Guidelines For The Management Of Overweight And Obesity In Adults, Adolescents And Children In AustraliaWeight loss following lifestyle intervention is maximal at 6–12 months. Regardless of the degree of initial weight loss, most weight is regained within a 2-year period and by 5 years the majority of people are at their pre-intervention body weight.Our suggestion: The intervention should never stop! Grade A evidenceModest weight loss improved CVD, T2DM risk factors and grade B evidence for sleep apnoea, joint issues, graed C for musculoskeletal problems, GI and urinary, self esteem, depression and QOL For adults who are overweight or obese, strongly recommend lifestyle change—including reduced energy intake, increased physical activity and measures to support behavioural change.6 For adults who achieve initial weight loss, strongly recommend the adoption of specific strategies, appropriate to their individual situation, to minimise weight regainNHMRC Guidelines  file:///C:/Users/Loz/Downloads/n57-obesity-guidelines-%20(1).pdf Also Scientific research that ideal BMI for longevity is 25-30kg/m2https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855514/https://www.bbmt.org/article/S1083-8791(05)01413-8/abstractWhy don’t diets work? A combination of physiology and psychologyFor the physiology behind why it doesn't work Listen to Episode 18 Interesting paper here https://www.ncbi.nlm.nih.gov/pubmed/23911805?dopt=AbstractDieting cycleBiology: (listen back to ep18)Short term: Anyone who is below their set point (too thin for them) will experience many physiological symptoms, similar to that of starvation. What is important to know is that it doesn't matter what weight you start at, but rather what is normal for you.Experience feeling of extreme hunger, metabolism suppressed so your body burns less energy, muscles use less energy during PA, feel cold, lethargic and obsessive over food - normal sx’s of your brain saying ‘alarm bells, food is needed’Biological pressure to restore body weight gets stronger as weight loss increases.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/pdf/nihms904015.pdf Long term:Some people will be heavier than when they started and others will develop disordered eating patternsPsychological impact of dieting/weight stigma Disordered eating patterns -greater emotional eating, uncontrolled eating, and loss-of-control eatingBody image and self esteem concernsPsychological stress Relationship breakdownIncreased anxiety and depressionSummary Weight is not tied to health and health looks different to everyoneLifestyle habits predict health better than weight aloneIf a ‘diet’ has a start and an end point - it’s unlikely to work. There are some factors we don’t think of when it comes to health, e.g poverty, loneliness, hormones, low levels of physical activity.So much energy is wasted on trying to change weight, when we should focus on making other health improvements, e.g. exercise goal - start somewhere e.g. walking and progress, improved relationships with friends and loved ones, cook more https://www.jabfm.org/content/25/1/9.fullWillpower as a finite resourceWhat you can actually doReduce decision fatigueDo it for YOU - explore your deep reasons why. We do this quite a lot with our clients. It may present as ‘the wedding’ or ‘reunion’ or to ‘feel better in my jeans’ or ‘fit into that dress’ but why is that actually important to you? Will it impact your self efficacy? Use positivity. Research demonstrates that the feeling of success is more likely to drive positive change than actually achieving your goal Emotions create habits Micro goals - e.g change ‘exercise more’ to 2 squats per day, change ‘eat more veg’ to eat 1 carrot every 2 days. Can do more if you want, but you don’t have to. Beyond that is extra credit!Anchor your desired activities to things you already do, e.g. brushing teeth or showering. 

Common cancer nutrition mythsSugar feeds cancerMore info here Juicing No evidence to support it’s use Can lead to deficiency in valuable nutrients, weight loss, protein energy malnutrition Antioxidant load can be potentially detrimental during radiotherapy and certain chemotherapy regimens. More information here. Alkaline dietMore info hereOrganic Studies on the foods themselves in terms of nutritional content, levels of chemicals and resistant bacteriaStudies on the health of humans long term When we look at organic vs non-organic there may be slightly higher concentrations of antioxidants in organic produce. This is only in general, as organic milk has been found to have lower mineral content, and varies depending on the source. When we look at chemicals and pesticide residues, organic produce may reduce exposure to these but important to note that the levels of toxins in non-organic produce is generally well below safe limitsWhen we look at health overall, in particular long term health of individuals that eat organic vs non organic produce, the benefits are far less clear. No difference in cancer risk (studies of >600,000 women)Huge systematic reviews show no differenceSome studies that report a difference need to be careful of other confounding factors. If we think about the profile of someone who may eat organic - they have chosen to and have the means to do so. In general,this often means they are more likely to be of a higher SES/income, better living environments, higher education level, health conscious therefore choose more fresh produce overall, get regular health check ups and screen for chronic diseases. It’s really difficult to attribute health benefits to the organic produce when there’s a whole bunch of other health-promoting behaviours, environmental and lifestyle factors contributing. Bottom line: if you’ve got the means and it’s a priority for you - by all means! If you don’t - just keep aiming for your 5 serves of veggies and wash them well.SoyLegume - soybeans or edamame - eaten whole or processed in numerous ways - fermented to produce tofu, tempeh, miso, natto. Rich - rich in phytooestrogen ‘Isoflavens - which act like a weak oestrogen in the body. Since many breast cancers need oestrogen to grow, it would stand to reason that soy could increase breast cancer risk. However, this isn’t the case in most studies.Most studies linking soy consumption to an increased risk of breast and other forms of cancer are done in laboratory animals. But because humans metabolize soy differently than rodents, these findings might not apply to people.Most observational studies indicate that consumption of soy products may reduce the risk of hormonally driven cancers such as breast, prostate, or endometrial (lining of the uterus), and there is some evidence it may lower the risk of certain other cancers. This might be because the isoflavones can actually block the more potent natural oestrogens in the blood.Exposure early in life is beneficial and a change in soy intake in either direction, may be responsible for change in risk Additionally, soy has been linked to a longer lifespan after breast cancer diagnosis.In a review of five long-term studies, women who ate soy after diagnosis were 21% less likely to have a recurrence of cancer and 15% less likely to die than women who avoided soy.DairyDairy has been associated with reduced risk of colorectal cancer, but an increased risk of prostate cancer. Individualised advised, tailored to you, is key, FastingESPEN Nutrition guidelines Anti-cancer diets There is no diet or food that has been proven to prevent or cure cancerESPEN Nutrition guidelines Other resourceshttps://www.wcrf-uk.org/uk/recipes/diet-cancer-myths-debunkedhttp://www.espen.info/wp/wordpress/wp-content/uploads/2016/11/ESPEN-cancer-guidelines-2016-final-published.pdf

Nil show notes. Contact us at enquiries@oncorenutrition.com with any questions, comments or requests. 40 meaningful things to do when stuck at home in a pandemic

1. Keep a routineStick to a schedule. If you used to have a lunch break at 12:30, try to do the same. Factor in snack and tea breaks as well!And don’t forget to drinkPosition yourself somewhere that’s hard to get to the kitchen!2. Check in with yourself. There are so many reasons we eat beyond hunger and nutrientsWhy are you heading to the cupboard or fridge? Bored, procrastinating, stressed, emotions. Suss this out.Won't happen every time. But doing it sometimes might help reveal with honesty some patterns around your eating behaviours.Strategies:Hunger fullness scale10 minute challengePut a wedge inDuring the meal - put your knife and fork down.Speed bump3. Eat mindfullyWe can often find ourselves eating on autopilot, munching into a meal while our attention is on our screens,to-do lists, multi-tasking or wandering around the kitchen or house.Give yourself an opportunity to eat without distractionServe your food for yourself how you would serve it to a special someone.Serve how much you want - rather than eating vita weats or crackers fresh out the packet, serve the 4, 10, however many you want on a plate! Prepare it.Sit down. Not at your desk. Grab a knife and fork or a drink.Switch off your devices, sit down uninterrupted.Give yourself the time and space to savour your eating experience and feel truly satisfied.Respect your food and yourself.4. Just don’t buy it!If you struggle to stop at 1 or 2 tim tams and just end up feeling crap about it, don’t buy them!If you were trying to quit smoking would you have packets of cigarettes in the cupboard and fridge, in your desk drawer?Don’t dangle the carrot, it’s just cruel to yourselfNice vs kindMindful eating starts well before you eat.Don’t shop hungryReview your goals - what you really want vs the quick highCheck in at the shelves too!Research has shown that visual exposure to high calorie foods stimulates the striatum, a part of your brain that modulates impulse control, which may lead to increased cravings and overeating.Deprivation is not the answer. It is ineffective for long term weight loss and incredibly damaging to our relationship with food and our bodies.5. Creative cooking!If you were fortunate enough to bulk purchase tinned tomatoes, now's your time to shineHome cooking vs take away = 20% fewer calories for the exact same mealStudy of over 11000 ppl found that those who ate home cooked meals more than 5 x per week and better body comp (25% less likely to have excess body fat) and ate more veg and fruit.6. Combat boredomPut a wedge in first: Walk to the letterbox, paint your nails, pat the dog, do 10 pushups...BEFORE you head to the kitchen.Consider why you’re bored on a larger scale.Online course, puzzle, book, create something (number paintings, ikea furniture), plants or home gardenOur next episode we’ll be talking all about using your time to fuel your fire40 meaningful things to do when stuck at home in a pandemic

Tim Spector experiment https://theconversation.com/your-gut-bacteria-dont-like-junk-food-even-if-you-do-41564Tim Spector, professor of genetic epidemiology at King’s College London, enlisted his son Tom, a genetics student at University, to undergo an experiment where he lived on McDonalds food for ten days. Supersize meSpurlock ate at McDonald's three times per day - used himself as a guinea pig (n=1) for 30 days.Before starting the experiment he was assessed by doctors who confirmed he was in excellent health.He did minimal exercise and limited his steps to 5,000 per day to mimic the lifestyle of many Americans who don’t move much and eat fast food regularly.Average of 20.9MJ (5,000 kcal) (the equivalent of 9.26 Big Macs) per day during the experiment.2.5 x the recommended caloric intake of average sized male gained 11.1kg (24 lb) - 13% increase in weight Increased his cholesterolHeart palpitations experiencedMood swings, sexual dysfunction, lethargy, fat accumulation in his liver. It took him 14 months to lose all the weight gained Ultraprocessed FoodMinimally processedLightly processed Heavily processedUltra-processedpre-cut and peeled pumpkin, potatoes and other veges, bagged salad leaves, bagged spinach, sliced vegetables, and unsalted, roasted nuts Corn AppleCanned, dried or frozen such as dried fruit, canned legumes/fish, cheese, pasta, frozen veg, pasteurized milk / yoghurt.Recognisable ingredientsMake foods available out of season.Canned corn Tinned applesFood not in its original form or not naturally occurring, eg cereals, muesli bars, deli meats, oils, sugar and flours. Tortilla chips Apple juice Considered ‘junk food’ eg chips biscuits, chocolates, sweets, nuggets, energy bars, and carbonated and sugared sweet drinks. DoritosApple pie  Other things that might be damaging your gut healthSmokinghttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3597605/Artificial and naturally intense sweetenersSaccharin, sucralose, stevia extracts shift the populations of gut microbiota. Several polyols (fermentable carbohydrates), including isomalt and maltitol, may increase bifidobacteria numbers in healthy subjects, as these polyols may have prebiotic actions.Large scale human studies are needed https://academic.oup.com/advances/article/10/suppl_1/S31/5307224We also know that in animal studies, when exposed to the artificial sweeteners, this saw a reduction in beneficial bacteria in the guthttps://www.ncbi.nlm.nih.gov/pubmed/25231862https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5464538/They can also give us a preference for a sweeter palate, meaning we crave or feel like sweeter foods..Exercise (lack of)Recent studies suggest that physical activity may also alter the gut bacteria, improving gut health.Higher fitness levels have been associated with a greater abundance of butyrate, a short-chain fatty acid that's produced by fermentation of CHO’s in the lower GI tract, helps to keep the lining of our gut healthy and is also important for overall health.One study found that professional rugby players had a more diverse gut flora and twice the number of bacterial families, compared to the control groups matched for body size, age and gender https://www.ncbi.nlm.nih.gov/pubmed/25021423https://www.hindawi.com/journals/omcl/2017/3831972/https://www.ncbi.nlm.nih.gov/pubmed/25825908https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0125889Alcoholhttps://www.ncbi.nlm.nih.gov/pubmed/2255202720 dayseach individual consumed 272 ml of red wine OR de-alcoholized red wine or 100 ml of gin each day Gin decreased the number of beneficial gut bacteria, Red wine increased the abundance of bacteria known to promote gut health and decreased the number of harmful gut bacteria like Clostridium.The beneficial effect of moderate red wine consumption on gut bacteria appears to be due to its polyphenol content.Polyphenols are plant compounds that escape digestion and are broken down by gut bacteria. They may also help reduce blood pressure and improve cholesterolWhat to focus on Prebiotic FibreChicory RootJerusalem artichoke GarlicOnionLeek Asparagus Less ripe bananas BarleyOatsApples Flaxseeds Edamame