My review of AG1 and why it was the catalyst for change

Even as a Nutritional therapist the idea of drinking swampy green liquid first thing in the morning is not something I have ever been particularly keen on. I have watched fellow practitioners hold their noses as they force spirulina or chlorella down their throats, with the perceived health benefits clearly outweighing the awful taste.

And is it actually worth it?!

As a new Dad, at the ripe old age of 36, I have recently found that I need to work much harder to maintain the high level of energy and vitality that my job as a Nutritional therapist and Personal trainer demands. I also want to remain an inspiration to my clients and an example that you can live a busy work and family life, whilst maintaining a high level of health and vitality.

This is where AG1® came in (1).

One of the hardest challenges my clients face is how to create new habits and routines. Research and indeed common sense suggests that instilling small daily habits that are achievable and long-lasting will have the biggest effect on your long-term health (2,3). I wanted to incorporate a new daily habit into my routine, at the beginning of each day, aimed at putting me in a positive mindset regarding the health choices I would make throughout the day.

This was my main goal and motivation to try AG1®. But what is AG1®?

AG1® is a green power formula made up of 75 different vitamins, mineral, adaptogens, pre and probiotics. (For a full list of ingredients visit - Ingredients (drinkag1.com)) It comes as a powder which you mix with 12oz of water each morning and drink on an empty stomach.

What standout ingredients are in AG1®?

When reviewing the product, I looked through the ingredients list to ascertain the quality of the product. As a Nutritional therapist, I look for particular versions of certain ingredients such as whether is contains the more bioavailable, methylated versions of B12 (methylcobalamin) and folate 5-(methyltetrahydrofolate or 5-MTHF) or the less bioavailable versions cyanocobalamin (B12) and synthetic folic acid (4,5).

B12 and Folate are crucial for DNA synthesis and repair, as well as for cell division and growth. They also play a key role in energy metabolism and neurotransmitter production (6).

Methylated versions of these vitamins are able to mitigate for the MTHFR gene variation which can affect absorption of B vitamins and cause increases in homocysteine levels which are a risk factor for stroke and cardiovascular disease (7). The MTHFR gene is estimated to affect 25% of the global population, however, this figure may well be much higher (8).

So, this is was a good start. When I see these ingredients in particular, I start to take a supplement seriously and that the manufacturer has done their homework.

I was also impressed to find adaptogens Ashwagandha, Rhodiola and Eleuthero root included in the ingredients list. Adaptogens have shown to have a non-specific beneficial affect on stress levels, adipose tissue (fat) reduction, sleep and energy level via various glands and organs (9). Specifically, Ashwagandha has shown to be beneficial for anxiety and stress via modulation of the hypothalamus, pituitary adrenal axis (HPA axis). It has also shown to support testosterone production in middle aged, overweight males (11). Rhodiola has demonstrated similar findings for mitigating stress (12) and has also shown promise as an estrogen modulator to help reduce menopause related symptoms (13). Lastly, Eleuthero root or Siberian ginseng has shown to decrease triglyceride levels, supporting fat reduction and muscle synthesis (14). It should be noted that these adaptogens are present in quite low amounts, therefore additional intake may be needed to achieve therapeutic doses.

The last standout set of ingredients for me are the pre and probiotics. These classify AG1® as a ‘synbiotic’ as they are both included in the same formula. Prebiotics such as inulin feed beneficial bacteria and enable them to produce anti-inflammatory substances called short chain fatty acids (SCFA) (15). These are a source of energy for cells of the colon and also help to reduce inflammation (16). Research performed using AG1® specifically has shown that using AG1 significantly increased the production of SCFA’s (15).

The probiotics included are well known genera (families) lactobacillus and Bifidobacterium which have broadly shown promising health advantages, such as enhancing immune responses, eradicating microbial pathogens in the gastrointestinal tract, fortifying the intestinal mucosal barrier, lowering serum cholesterol levels and addressing various diarrheal and gastrointestinal ailments (17). Additional research into AG1® found that its use correlated with significant changes in the community of the gut microbiome, which potentially reinforces its suggested status as a ‘synbiotic’ product (18).

Now to the real questions…..

How does it taste?

Compared to the green sludge I have tried before; it actually tastes really nice. It has a largely pineapple finish to It, however you can tell it contains spirulina and chlorella, but those are more subtle than I thought it would be.

How much does it cost?

This may be a sticking point for some. AG1® is between £79 and £89 per month depending on package you choose. This is probably £20-£30 over what it should be, however, if you already take a multivitamin and general probiotic, you will be able to save on those, whilst gaining the other beneficial ingredients of AG1®(1).

Do I feel any different?

For the first few days taking AG1® I simply felt excited that I had made a change and that it would be something I did on a daily basis. This helped me to ensure my choices and behaviours during the rest of the day were more positively angled towards my health. For me this was the most important impact AG1® has had, which may surprise some of you. However, it has meant I have scheduled exercise in everyday, whereas before I was training twice per week. I changed my meal choices and reduced saturated fat intake, whilst increasing unsaturated fats such as olive oils, avocados and seeds. It may sound strange to relate these changes simply to taking AG1®, however, the way we perceive our own health can significantly impact our desire to make additional changes (19). In other words, I feel like I took a positive step towards improving my own health when I started AG1®, this motivated and empowered me to make further positive changes.

The manufacturers of AG1® suggest that the benefit is accumulative, i.e., the longer you take it the more difference you feel and see in your body. I would say this is exactly what I have experienced. After approximately two weeks, I can feel my energy levels have improved and I am not as irritable at the end of the day when my 2-year-old daughter has decided to squirt yogurt all over the back of the car whilst I am driving her home from nursery.  I have also noticed my skin has improved and people have commented that I look younger (although this may also be related to a change in my barber). Overall, I have noticed a really positive difference and probably more than I was expecting, which is a pleasant surprise.

Have I noticed any side effects?

My wife became very concerned a few weeks ago as my face went red and blotchy shortly after drinking AG1®, however, I reassured her that this was something called ‘niacin flush’ (20). AG1® contains 20mg of niacin per 12g serving which is 125% of the nutrient reference value (recommended amount) (1). Niacin flush occurs when the capillaries, (normally in your face and upper body), expand and blood flow is increased to the surface of the skin. This may be accompanied by tingling, itching and a warm feeling when you touch the affected area (20). This is harmless and over time, most people will develop a tolerance for niacin (21).

This is the only side effect I have noticed personally, with AG1, however, having spoken to clients and colleagues, many have experienced other side effects, which I would like to explain.

The most common reported side effects of AG1® are all gastrointestinal related. Bloating, gas, loose stools and nausea. There may be a number of specific reasons for these and if anyone is concerned about any side effects that should consult their GP and contact AG1® directly, however, I believe one of the main causes is linked to the prebiotic ingredients. Prebiotics feed bacterial and where possible they will predominantly feed beneficial bacteria, however, if you have overgrown opportunistic bacteria, prebiotics will likely feed those as well (22). Some of these opportunistic bacteria (normally methane and hydrogen sulphide producing bacteria) can cause increases in gas production, bloating and change stool consistency, which may make using AG1® uncomfortable or even impossible until you are able to rebalance your microbiome (23).

If this is the case for you, I would advise contacting me and enquiring about how I can assess and improve your digestive health. This may involve functional testing, dietary changes and lifestyle modifications and, of course, we will be considering more than just your ability to drink AG1®.

My conclusion:

AG1® has been a huge success for me. It was the catalyst for change, that I needed to feel more energy, less irritable, more empowered and motivated to push myself further. The price is hefty, however, if you can justify it, it also serves as a motivating tool as you don’t want to see £80 per month wasted. Having heard from other people their experience of AG1®, it may not be for everyone but it may also push you to learn from your experience taking it and digging deeper into your gastrointestinal health to boost your health in other ways. I’m certainly going to continue with it and the other changes I have made to try to get as much out of this 36-year-old Dad bod as I possibly can.

Safety note:

(Please note that AG1 is not for everyone and should not replace a diverse and balanced diet and a healthy lifestyle. If you would like to try it and you have existing medical conditions, please consult your GP prior to doing so. AG1® is not suitable for individuals under 18 years, pregnant or breastfeeding women. Avoid concurrent intake of other zinc-containing food supplements. Individuals taking anticoagulant medication should seek medical counsel before consuming supplements containing vitamin K.)

Reference list:

1. AG1 (2024) AG1 by athletic greens®, AG1 by Athletic Greens®. Available at: https://drinkag1.com/en-uk/sq?mrasn=1168983.1449842.C4CJ0NT3 (Accessed: 06 March 2024).

2. Arlinghaus, K.R. and Johnston, C.A. (2018) ‘The importance of creating habits and routine’, American Journal of Lifestyle Medicine, 13(2), pp. 142–144. doi:10.1177/1559827618818044.

3. Rippe, J.M. (2018) ‘Lifestyle medicine: The health promoting power of daily habits and practices’, American Journal of Lifestyle Medicine, 12(6), pp. 499–512. doi:10.1177/1559827618785554.

4. Paul, C., & Brady, D. M. (2017). Comparative bioavailability and utilization of particular forms of B12 supplements with potential to mitigate B12-related genetic polymorphisms. Integrative Medicine (Encinitas), 16(1), 42-49.

5. Scaglione, F. and Panzavolta, G. (2014) ‘Folate, folic acid and 5-methyltetrahydrofolate are not the same thing’, Xenobiotica, 44(5), pp. 480–488. doi:10.3109/00498254.2013.845705.

6. Hanna, M. et al. (2022) ‘B vitamins: Functions and uses in medicine’, The Permanente Journal, 26(2), pp. 89–97. doi:10.7812/tpp/21.204.

7. Carboni L. (2022). Active Folate Versus Folic Acid: The Role of 5-MTHF (Methylfolate) in Human Health. Integrative medicine (Encinitas, Calif.), 21(3), 36–41.

8. Graydon, J.S. et al. (2019) ‘Ethnogeographic prevalence and implications of the 677C>T and 1298a>C MTHFR polymorphisms in US Primary Care Populations’, Biomarkers in Medicine, 13(8), pp. 649–661. doi:10.2217/bmm-2018-0392.

9. Liao, L. et al. (2018) ‘A preliminary review of studies on adaptogens: Comparison of their bioactivity in TCM with that of ginseng-like herbs used worldwide’, Chinese Medicine, 13(1). doi:10.1186/s13020-018-0214-9.

10. Salve, J. et al. (2019) ‘Adaptogenic and anxiolytic effects of ashwagandha root extract in healthy adults: A double-blind, randomized, placebo-controlled clinical study’, Cureus [Preprint]. doi:10.7759/cureus.6466.

11. Lopresti, A.L., Drummond, P.D. and Smith, S.J. (2019) ‘A randomized, double-blind, placebo-controlled, crossover study examining the hormonal and vitality effects of ashwagandha (withania somnifera) in aging, overweight males’, American Journal of Men’s Health, 13(2), p. 155798831983598. doi:10.1177/1557988319835985.

12. Ivanova Stojcheva, E. and Quintela, J.C. (2022) ‘The effectiveness of rhodiola rosea L. preparations in alleviating various aspects of life-stress symptoms and stress-induced conditions—encouraging clinical evidence’, Molecules, 27(12), p. 3902. doi:10.3390/molecules27123902.

13. Gerbarg, P.L. and Brown, R.P. (2016) ‘Pause menopause with rhodiola rosea, a natural selective estrogen receptor modulator’, Phytomedicine, 23(7), pp. 763–769. doi:10.1016/j.phymed.2015.11.013.

14. Ivanova Stojcheva, E. and Quintela, J.C. (2022) ‘The effectiveness of rhodiola rosea L. preparations in alleviating various aspects of life-stress symptoms and stress-induced conditions—encouraging clinical evidence’, Molecules, 27(12), p. 3902. doi:10.3390/molecules27123902.

15. Kirby, T.O. et al. (2023) ‘The novel Synbiotic, AG1®, increases short-chained fatty acid production in the simulator of human intestinal microbial ecosystem (shime) model®’, Nutraceuticals, 3(4), pp. 489–498. doi:10.3390/nutraceuticals3040035.

16. Caetano, M.A. and Castelucci, P. (2022) ‘Role of short chain fatty acids in gut health and possible therapeutic approaches in inflammatory bowel diseases’, World Journal of Clinical Cases, 10(28), pp. 9985–10003. doi:10.12998/wjcc.v10.i28.9985.

17. Abdelhamid, A.G., El-Masry, S.S. and El-Dougdoug, N.K. (2019) ‘Probiotic lactobacillus and Bifidobacterium strains possess safety characteristics, antiviral activities and host adherence factors revealed by Genome Mining’, EPMA Journal, 10(4), pp. 337–350. doi:10.1007/s13167-019-00184-z.

18. Kirby, T.O. et al. (2024) ‘AG1® induces a favorable impact on gut microbial structure and functionality in the simulator of human intestinal microbial ecosystem® model’, Current Issues in Molecular Biology, 46(1), pp. 557–569. doi:10.3390/cimb46010036.

19. Caramenti, M. and Castiglioni, I. (2022) ‘Determinants of self-perceived health: The importance of physical well-being but also of mental health and cognitive functioning’, Behavioral Sciences, 12(12), p. 498. doi:10.3390/bs12120498.

20. Jennings, K.-A. (2023) Is niacin flush harmful?, Healthline. Available at: https://www.healthline.com/nutrition/niacin-flush#What-is-niacin-flush? (Accessed: 06 March 2024).

21. Kamanna, V.S., Ganji, S.H. and Kashyap, M.L. (2009) ‘The mechanism and mitigation of niacin-induced flushing’, International Journal of Clinical Practice, 63(9), pp. 1369–1377. doi:10.1111/j.1742-1241.2009.02099.x.

22. Davani-Davari, D. et al. (2019) ‘Prebiotics: Definition, types, sources, mechanisms, and clinical applications’, Foods, 8(3), p. 92. doi:10.3390/foods8030092.

23. Villanueva-Millan, M.J. et al. (2022) ‘Methanogens and hydrogen sulfide producing bacteria guide distinct gut microbe profiles and irritable bowel syndrome subtypes’, American Journal of Gastroenterology, 117(12), pp. 2055–2066. doi:10.14309/ajg.0000000000001997.

Can you really run off your Christmas Dinner??

The festive season is upon us and with that comes a certain amount of gluttony and excess. The staff room at the office is awash with sweet treats and the kitchen cupboards are filling up with unnecessary amounts of cheese balls and twiglets.

But can we simply deal with these excess calories by adding in a few extra runs or gym sessions to balance the books??

Sounds sensible, in theory, and if you saw the article in the BBC last week this would appear to suggest exactly that.

The BBC reported that Loughborough University has proposed labeling junk food with how much exercise it would take to burn it off. In their research, this has shown to act as a deterrent and ensure people think twice before buying unhealthy foods. They report that it helps people equate the excess calories to something tangible, such as exercise, to better understand the energy cost of food.(1)

But is it this simple?

Can we work off our poor food choices?

And if we can…..does labeling our food with exercise v calories help us make better food choices?

At Christmas, on average, its reported that we consume up to 6,000 calories on Christmas day alone, which, by the calculations done by Loughborough university, would take us a 5.5 hour run to ‘burn’ off!(1,2)

I’m unsure how many of us will be heading out on Boxing day for a 5.5 hour run!?

But Christmas is only once a year. Its only one day. The rest of the year we dont make these poor food choices, do we?

Oops…

According to NHS statistics, 29% of Adults are obese. Which has risen 3% since 2016.(3) This cannot purely be blamed on a few extra pigs in blankets and mince pies.

What else could be dictating our food choices?

Can we blame our genetics?

In part, yes.

It has been reported that people found with two gene variants - FTO and DRD2, were more likely to crave high calorie foods containing fat and sugar. Participants with these two genes, demonstrated heightened activity in their brains reward systems when looking at pictures of high calorie foods.(4)

Talking of brains…

It has been well reported that sugar has a stimulating ‘feel good’ effect on our brains through increased dopamine release.(5) However, in a recent brain imaging study, fat and umami tastes also activated the reward systems in obese participants; only adding to the struggle in making healthy decisions around food.(6)

What about Hormones?… Surely not?

Yes, hormones are heavily involved in our food choices.

Hormones such as leptin, insulin, growth hormone, estrogens and androgens all effect appetite, body fat distribution and our metabolism. Obese individuals have hormone levels that encourage fat storage and accumulation. (7)

Leptin -

Leptin is our satiety hormone that reduces our appetites. It is produced via our fat cells, notifying us that we dont need to eat anymore. In obese people, the production of this hormone is increased due to the increase in adipose tissue (fat). This results in the individuals sensitivity to Leptin reducing. (7)

Insulin -

Insulin is our blood glucose regulatory hormone. Its job is to drive glucose into the cells that need it when our blood sugar is elevated. Again, in obese people, blood sugar control is a problem due to excessive consumption of processed carbohydrates. This increases glucose in the blood and therefore increases insulin secretion. This can lead to insulin resistance and increased blood sugar which is stored as fat. If left unchecked this can lead to Diabetes type II and metabolic syndrome.(7,8)

Growth Hormone -

Growth hormone is produced by our pituitary gland and influences muscle mass, height and bone growth. Growth Hormone is also involved in carbohydrate and lipid (fat) metabolism through its interactions with insulin.(9) In obese people, growth hormone levels are lower than in normal weight people.

Sex hormones Estrogen and Androgen’s (Testosterone) -

Estrogen -

Estrogen’s are produced primarily via the ovaries in women, but they are also produced in the adipocytes (fat cells) via aromatisation (converts testosterone into estrogen). Typically, obesity is associated with elevated estrogen’s levels.(7)

Fluctuations in both estrogen and testosterone, at differing ages, can have an effect over where and how much fat is stored within the body. Women of child baring age, when their ovarian estrogen production is higher, tend to store fat around their hips and thighs. Postmenopausal women with lower amounts of ovarian estrogen production, tend to store more fat around the middle (7)

Testosterone -

Testosterone in men has been seen to have a lipolytic (fat burning) effect on fat cells. As with obese women, obese men have lower levels of testosterone and generally higher levels of estrogen due to aromatisation.(7)

Yet another factor geared against weight loss in obese individuals!

It appears that simply putting a label on our food may not be enough to overcome these huge genetic, chemical and hormonal hurdles. Perhaps the biggest factor working against us, is one which is a little harder to identify on a national scale…..

Our emotions -

Emotional eating has been consistently associated with weight gain and obesity. Our emotions often override our desire for sensible, healthy food choices and is a common factor reported by people who are struggling to lose weight. (10)

Understanding why we are using food as an emotional support would go far further in changing behaviours of obese individuals, than labeling food. Indeed it has been reported by obese individual’s, that they use food as a way of coping with the problems life throws at them and that it can be part of a deeper issue that needs dealing with.(10)

There’s a lot going on…

It’s clear that this cocktail of genes, hormones, chemicals and emotions makes losing weight very complicated.

This is very much the reason for this blog, to show that although calories and exercise are important parts of weight management; there are a host of other factors going on. People trying to lose weight often need more support than society is willing to grant them. This is where Nutritional Therapy can be hugely beneficial.

For those of you who fancy trying the 5.5 hour run on Boxing day to ‘burn’ off your Christmas day calories. You have my full support!

To contact Benjamin Cooper regarding Nutritional Therapy, please email benjamin@coopercoaching.com or go to benjamincoopercoaching.com

Reference List:

1. Exercise calorie labels 'make food less tempting' [Internet]. BBC News. 2019 [cited 17 December 2019]. Available from: https://www.bbc.co.uk/news/health-50711652

2. The disgusting amount you are going to overeat on Christmas day, revealed [Internet]. The Independent. 2019 [cited 20 December 2019]. Available from: https://www.independent.co.uk/life-style/christmas/food-drink/average-british-person-eats-6000-calories-christmas-day-dinner-study-wrens-kitchen-a7451651.html

3. Statistics on Obesity, Physical Activity and Diet, England, 2019 - NHS Digital [Internet]. NHS Digital. 2019 [cited 20 December 2019]. Available from: https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-obesity-physical-activity-and-diet/statistics-on-obesity-physical-activity-and-diet-england-2019

4. (Scitech) u. Brain is hardwired to enjoy high-calorie foods [Internet]. Bariatric News. 2019 [cited 20 December 2019]. Available from: https://bariatricnews.net/?q=node/2218

5. Rada P, Avena N, Hoebel B. Daily bingeing on sugar repeatedly releases dopamine in the accumbens shell. Neuroscience. 2005;134(3):737-744.

6. Kure Liu C, Joseph P, Feldman D, Kroll D, Burns J, Manza P et al. Brain Imaging of Taste Perception in Obesity: a Review. Current Nutrition Reports. 2019;8(2):108-119.

7. Sidhu S, Parikh T, Burman KD. Endocrine Changes in Obesity. [Updated 2017 Oct 12]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279053/

8. Kahn S, Hull R, Utzschneider K. Mechanisms linking obesity to insulin resistance and type 2 diabetes. Nature. 2006;444(7121):840-846.

9. Vijayakumar A, Yakar S, LeRoith D. The Intricate Role of Growth Hormone in Metabolism. Frontiers in Endocrinology. 2011;2.

10. Frayn M, Livshits S, Knäuper B. Emotional eating and weight regulation: a qualitative study of compensatory behaviors and concerns. Journal of Eating Disorders. 2018;6(1).

CBD...What is it and what are the potential benefits to supplementing it?

In the last few weeks the NHS approved two cannabis based drugs used to treat epilepsy and multiple sclerosis. (1) One of the drugs, Epidyolex, has shown to reduce the number of seizures in children by as much as 40%.(2) This particular drug is made up only of CBD…… but what is CBD?

What is CBD?

CBD stands for Cannabidiol, which is one of over 100 chemical compounds found in cannabis plants marijuana and hemp. CBD together which tetrahydrocannabinol (THC) are the two main cannabinoids within cannabis. (3) CBD, however, should not be confused with THC, as THC is the psychoactive component within cannabis and responsible for the ‘high’ experienced when using the whole cannabis plant.(3)

How does CBD effect the body?

CBD effects a system known as the endocannabanoid system (ECS), which is widespread within our bodies. The ECS effects areas such as the central nervous system (CNS), our brain synapses and how we respond to environmental input.(4)

What are the potential benefits of CBD?

Anti-anxiety and Sleep

CBD has shown to improve gamma-Aminobutyric acid (GABA) receptor signalling. GABA is our calming / relaxation neurotransmitter and the effect CBD has on this could be why it has shown to help relieve anxiety and improve sleep. (5,6)

CBD has also shown to reduce anxiety by connecting with specific CNS receptors which are known to manage our fear response and anxious behaviours. These include 5-HT1A a serotonin (so called ‘happy chemical’) receptor and CB1R (Cannabinoid receptor type 1). The former aiding with anxiety reduction and the latter reducing fear. (7)

Inflammation and Pain

Pain, in part, is dictated by our bodies inflammatory responses and one of the key players in this are molecules called pro inflammatory cytokines.(8) Animal studies have shown that CBD significantly decreases pro inflammatory cytokines, thus potentially supporting the use of CBD in inflammatory disorders.(9) Another animal study showed that the use of topical CBD reduced pain and inflammation caused by arthritis.(10)

Further human trials are needed to shed more light on this area, but the outlook is positive for CBD and pain.

Gastrointestinal health

CBD has shown to improve intestinal barrier integrity and function following damaged caused by Clostridium difficile infections.(11)

CBD may also have benefits for people with irritable bowel disease (IBD). A recent study found that CBD and palmitoylethanolamide (PEA) reduced intestinal permeability, otherwise know as leaky gut. (PEA is a fatty acid amide know to reduce inflammation).(12)

There is also more research in the pipeline as to whether CBD may be a option for people suffering from Crohn's disease. (13)

Where to buy quality, scientifically tested CBD?

The quality of CBD varies widely depending on where you get it. I have found that U.K company Provacan produce high standard products using organic hemp; as well as having their products independently tested by a 3rd party organisation. Check out their website for more information and recommendations - https://provacan.co.uk/

Who shouldn’t use CBD?

Pregnant and breastfeeding women are advised to avoid taking CBD.

CBD also interacts with the CYP450 enzyme and may effects prescription drugs metabolised through the CYP450 system. People taking these drugs should consult their doctor before using CBD.(14)

• Angiotensin II blockers

• Anesthetics

• Antiarrhythmics

• Antibiotics

• Antidepressants

• Anti-epileptics

• Antihistamines

• Antipsychotics

• Benzodiazepines

• Beta-blockers

• Calcium channel blockers

• HIV antivirals

• HMG CoA reductase inhibitors (aka statins)

• Immune modulators

• NSAIDs

• Oral hypoglycemic agents

• PPIs

• Prokinetics

• Steroids

• Sulfonylureas

Reference List:

1. Two cannabis medicines approved for NHS [Internet]. BBC News. 2019 [cited 26 November 2019]. Available from: https://www.bbc.co.uk/news/health-50351868

2. Sekar K, Pack A. Epidiolex as adjunct therapy for treatment of refractory epilepsy: a comprehensive review with a focus on adverse effects. F1000Research. 2019;8:234.

3. Genevieve Lafaye A. Cannabis, cannabinoids, and health [Internet]. PubMed Central (PMC). 2019 [cited 26 November 2019]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5741114/

4. Lu H, Mackie K. An Introduction to the Endogenous Cannabinoid System. Biological Psychiatry. 2016;79(7):516-525.

5. Bakas T, van Nieuwenhuijzen P, Devenish S, McGregor I, Arnold J, Chebib M. The direct actions of cannabidiol and 2-arachidonoyl glycerol at GABA A receptors. Pharmacological Research. 2017;119:358-370.

6. Shannon S. Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente Journal. 2019;.

7. Blessing E, Steenkamp M, Manzanares J, Marmar C. Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics. 2015;12(4):825-836.

8. Bruni N, Della Pepa C, Oliaro-Bosso S, Pessione E, Gastaldi D, Dosio F. Cannabinoid Delivery Systems for Pain and Inflammation Treatment. Molecules. 2018;23(10):2478.

9. Li H, Kong W, Chambers C, Yu D, Ganea D, Tuma R et al. The non-psychoactive phytocannabinoid cannabidiol (CBD) attenuates pro-inflammatory mediators, T cell infiltration, and thermal sensitivity following spinal cord injury in mice. Cellular Immunology. 2018;329:1-9.

10. Hammell D, Zhang L, Ma F, Abshire S, McIlwrath S, Stinchcomb A et al. Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis. European Journal of Pain. 2015;20(6):936-948.

11. Gigli S, Seguella L, Pesce M, Bruzzese E, D’Alessandro A, Cuomo R et al. Cannabidiol restores intestinal barrier dysfunction and inhibits the apoptotic process induced by Clostridium difficile toxin A in Caco-2 cells. United European Gastroenterology Journal. 2017;5(8):1108-1115.

12. Couch D, Cook H, Ortori C, Barrett D, Lund J, O’Sullivan S. Palmitoylethanolamide and Cannabidiol Prevent Inflammation-induced Hyperpermeability of the Human Gut In Vitro and In Vivo—A Randomized, Placebo-controlled, Double-blind Controlled Trial. Inflammatory Bowel Diseases. 2019;25(6):1006-1018.

13. Cannabidiol Usage as an Adjunct Therapy for Crohn's Disease - Full Text View - ClinicalTrials.gov [Internet]. Clinicaltrials.gov. 2019 [cited 1 December 2019]. Available from: https://clinicaltrials.gov/ct2/show/NCT03467620

14. Iffland K, Grotenhermen F. An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis and Cannabinoid Research. 2017;2(1):139-154.

Is Vegan film 'The Game Changers' actually a Game Changer?

For those of you who have not watched ‘The Game Changers’, its a film based around former MMA fighter James Wilks and his search for the best diet to help him recover from a serious knee injury. Wilks interviews various athletes from around the world who have adopted a fully plant based diet, including former steak guzzling Mr Universe himself, Arnold Schwarzenegger. These athletes then describe how a plant based diet has changed their lives both personally and professionally in differing scenarios.

So…… I watched it and was expecting big things based on what I had heard from my vegan friends. I thought it was going to be....'A Game Changer'….as the title suggests, however I was left feeling I had more questions than answers and also a little frustrated that people will watch it and, without perhaps knowing as much about nutrition or the human body, think it speaks total truth when much of it is deeply floored.

Firstly, what I agreed with:

Commercial Farming is BAD, particularly in the U.S -

I 100% agree we need to eat less, poor quality meat products. Commercial farming methods use far too much land and water, as well as devastating forests, which is not sustainable for the us, the animals or the planet. The animals are fed a diet of corn, soy and wheat which is not what they should be eating and is done for one purpose and thats to get the animal fat as quickly as possible so it sells for a higher price.(1) Many of the american fast food chains are reportedly responsible for (at least) some of this. (2)

Age is a factor -

Protein digestion starts primarily in the stomach, (after a good bit of chewing from the mouth), which is filled with hydrochloric acid (HCL). HCL is there to begin the process of separating the amino acid bonds found in protein and is also essential for the following digestive processes including pancreatic enzyme production and bile release from the gall bladder. However HCL production appears to reduce as we age, (unless you supplement with betaine HCL), so a more plant based diet may well be more beneficial as we get older however Vitamin B12 is still essential so supplementation would be necessary.(3)

My issues with the

film:

Possible conflict of interest from the Director -

Make of this what you will….. but 11 months before the film was aired on Netflix, the Director of ‘The Game Changers’, James Cameron, reportedly made an investment of $140,000,000 into a pea protein processing plant (easy for you to say) due to his belief that a plant based diet not only makes good business sense but is also best for the planet. (4)

Unrealistic for normal people -

The film centres around athletes and how they are performing at the highest level on a plant based diet. However, typically they appeared to have Chef's and Nutritionists available to them on a daily basis to ensure they are getting the right amount of nutrients within their diet. The vegan diet, in particular, is a very challenging diet to maintain, with reported deficiencies in proteins, iron, vitamin D, calcium, iodine, omega-3, and vitamin B12.(5)

Ethnic background shaping genetics -

Additionally the majority of the athletes that claimed to be thriving on a plant based diet were ethnically from equatorial genetic backgrounds. Their close ancestors originated from areas closer to the equator where there would be more plant based food available and less of a requirement for animal protein. The availability of meat and fish would be far lower due to location and higher temperatures. This would have shaped their genetics and thus they would suit a diet higher in plants. Their microbiome (which is passed down from generation to generation through child birth, unless C-section) will also thrive on a diet high in fibre .(6)

Strange comparisons to Cows / Ox and Gorillas -

This is where the film and the argument for veganism loses me completely. To compare the internal anatomy of a Human to that of a Cow / Ox or Gorilla baffles me.

Firstly Cows have 4 stomach's or rumen, which are used to store grass and vegetation in. This vegetation, through fermentation by their microbiome, is turned into volatile fatty acids (VFA's) which they use for energy, they then obtain their protein from digested bacteria which happens in their fourth chamber. They are therefore built to digest vegetation, much the same as an Ox. (7)

Gorillas also have key differences to humans. They have a much longer colon than we do, which is why they have a giant, rotund belly as they only eat vegetation which, again, needs to be broken down and fermented by their microbiome to extract the nutrients. They also need to eat up to 40 pounds of vegetation a day, which, for a human, would mean we would constantly be eating with very little time for anything else. That alone indicates that we are adapted to eat more nutrient dense animal products which fill us up for longer.(8)

As I mentioned above, the first digestive organ that human food hits is the stomach. A perfectly engineered, HCL acid filled sack, designed to separate amino acid bonds. This acid is stimulated by protein with best results coming from animal protein.(9)

Extreme diet comparisons -

A number of experiments were performed during the film where fried chicken, hamburgers or burritos were used as examples of a meat eaters diet and then compared to a plant based option. This comparison was then used as scientific evidence that meat is bad. I think one of the main reasons people feel better on a plant based diet initially is it automatically means that have to start to cook, which removes a huge amount of the staples of the typical western diet (TWD), pizza, burgers, fried chicken etc. These not only contain poor quality meat, but are high in trans fats and poor quality processed carbohydrates. A vegan diet is always going to be better than the TWD but that does not prove that meat is bad for you and humans should eliminate it from their diet all together.

Heme v non Heme -

Heme iron (only available from meat products) is the most bio-available form of iron. Non - heme iron from plants requires vitamin c and other co-factors to aid absorption and is also diminished by phytates found in plants. (10) Yes, too much iron can be a problem but then if you are eating loads of meat you are probably not eating a balanced diet which will cause all sorts of other problems, too much iron being one.(11)

Make up your own mind:

Having watched the film and researched literature for this blog, my opinion on diet remains the same as it did before - As a Nutritional Therapist we are taught to treat every person as an individual and base our diet recommendations on that persons bespoke needs and symptoms. There is NO perfect diet and my job is to educate others on how to listen to their body effectively enough, that they discover what diet is right for them.

More info:

If you want to find out more information on the Vegan debate I really recommend the Chris Kresser and Joel Khan debate on the Joe Rogan podcast.

https://podcastnotes.org/2018/10/02/kresser-kahn/

Chris Kresser also provides an article containing a huge amount of research into whether eating meat is beneficial or not for humans beings, which I would definitely check out, if you are interested.

https://chriskresser.com/why-you-should-eat-meat-my-appearance-on-the-joe-rogan-experience/

References -

1. Daley, C., Abbott, A., Doyle, P., Nader, G. and Larson, S. (2010). A review of fatty acid profiles and antioxidant content in grass-fed and grain-fed beef. Nutrition Journal, 9(1).

2. Wasley, A. and Heal, A. (2019). Leading burger supplier sourced from Amazon farmer using deforested land. [online] the Guardian. Available at: https://www.theguardian.com/environment/2019/sep/17/leading-burger-supplier-sourced-from-amazon-farmer-guilty-of-deforestation [Accessed 21 Oct. 2019].

3. Britton, E. and McLaughlin, J. (2012). Ageing and the gut. Proceedings of the Nutrition Society, 72(1), pp.173-177.

4. Foodbusinessnews.net. (2019). Ingredion increases investment in plant-based protein j.v.. [online] Available at: https://www.foodbusinessnews.net/articles/14222-ingredion-increases-investment-in-plant-based-protein-jv [Accessed 22 Oct. 2019].

5. Sebastiani, G., Herranz Barbero, A., Borrás-Novell, C., Alsina Casanova, M., Aldecoa-Bilbao, V., Andreu-Fernández, V., Pascual Tutusaus, M., Ferrero Martínez, S., Gómez Roig, M. and García-Algar, O. (2019). The Effects of Vegetarian and Vegan Diet during Pregnancy on the Health of Mothers and Offspring. Nutrients, 11(3), p.557.

6. Schnorr, S., Candela, M., Rampelli, S., Centanni, M., Consolandi, C., Basaglia, G., Turroni, S., Biagi, E., Peano, C., Severgnini, M., Fiori, J., Gotti, R., De Bellis, G., Luiselli, D., Brigidi, P., Mabulla, A., Marlowe, F., Henry, A. and Crittenden, A. (2014). Gut microbiome of the Hadza hunter-gatherers. Nature Communications, 5(1).

7. The University Of Minnesota (2019). The ruminant digestive system. [online] Extension.umn.edu. Available at: https://extension.umn.edu/dairy-nutrition/ruminant-digestive-system [Accessed 21 Oct. 2019].

8. UC Davis Integrative Medicine. (2019). Why You’re Not a Cow or a Gorilla — (And You Don’t Eat Like One Either) - UC Davis Integrative Medicine. [online] Available at: https://ucdintegrativemedicine.com/2016/03/youre-not-cow-gorilla-dont-eat-like-one-either/#gs.bhzvta [Accessed 21 Oct. 2019].

9. Mcarthur, K., Walsh, J. and Richardson, C. (1988). Soy protein meals stimulate less gastric acid secretion and gastrin release than beef meals. Gastroenterology, 95(4), pp.920-926.

10. Gibson, R., Raboy, V. and King, J. (2018). Implications of phytate in plant-based foods for iron and zinc bioavailability, setting dietary requirements, and formulating programs and policies. Nutrition Reviews, 76(11), pp.793-804.

11. Geissler, C. and Singh, M. (2011). Iron, Meat and Health. Nutrients, 3(3), pp.283-316.

Does snacking make us fat?

Today there is an article on the BBC website suggesting that snacking should be banned on public transport in order to address the obesity crisis in this country. (1)

This suggestion has come from one of the chief Doctors in charge of public health in the country who, you would assume, can see the figures for obesity rising along with the costs of trying to manage the issue but is this the way to stop obesity and how could you possibly police it?

Let’s look at what a recent study says about snacking:

Snack Food, Satiety, and Weight (2016) suggests that the data is (predictably) very mixed as to whether eating snacks will increase your risk of obesity as (again predictably) it very much depends on the snack and the overall lifestyle of the person / family. (2)

The study suggests that snacks that are higher in fibre, protein and whole foods actually enhance satiety (feeling of fullness) when consumed and may actually delay the need for the next meal, whereas snacks higher in processed carbohydrates can increase the need to eat sooner after their consumption. (2)

My thoughts –

Calories v Blood sugar

This study indicates that children gain 27% of their daily caloric intake from snacks, however Nutrition is more than just calories. Carbohydrates, fats and proteins all have differing effects on your blood sugar levels and, as the study suggests, will affect your ‘feelings of hunger’ in very different ways.

Snacking on nuts, olives, vegetables, animal protein will not push your blood sugar levels up as high as having bread, potato snacks, rice snacks or sweet snacks will and therefore will address your ‘ ‘feelings of fullness’ for longer whilst maintaining your blood sugar levels.

Children and Snacking

My observation is that children will largely copy what their parents do and that will include, eating what they eat and moving as they move. (This observation is also reflected in the research) So it starts with the parents, let’s get them active and eating REAL food and that will reflect down to their children, who are the masters of imitation.(3)

Children’s brains are growing and learning more and more every day and therefore they require a really varied, nutritious diet, full of a good balance in carbohydrates, proteins and fats, not chicken nuggets and chips. Snacks can complement a child’s diet really well particularly if they are learning and active at school because they will need the calories but those snacks need to be balanced with fat and protein, not just blood sugar spiking carbohydrates.

This is a great snack or breakfast idea for kids to have in their lunch boxes which contains a great balance of nutrients –

Egg Mac Muffin’s -

Serves 2-3

Ingredients – All organic if possible:

2x Spring onions chopped

100g Raw cheese cubed

50g Pancetta / Bacon

1-2 Vine tomatoes cubed

25g of Fresh spinach

25g Red/green peppers

6 Free range Eggs, beaten. (If you like you can add a bit of raw milk or coconut milk)

Himalayan Sea salt and pepper to taste

You can try using chicken, beef, mince, sausage, ricotta and more. Whatever takes your fancy.

Method:

1. Preheat the oven to 180/200c

2. Grease your muffin tin with Butter or coconut oil.

3. If you are using meat, gently fry it off in a frying pan in little bit of coconut oil or until cooked through.

4. Add the veg/ meat and cheese to the muffin tins. Mix and match as much as you like.

5. Pour the beaten eggs into each muffin tin, ensuring the contents are covered.

6. Place the muffin pan into the oven and bake for 20 – 25 mins or until the muffins are light brown, puffy and the eggs are set.

7. Let the muffins cool before eating immediately. Alternatively you can refrigerate them to eat cold during the week.

References:

1. BBC News. (2019). 'Ban snacking on public transport'. [online] Available at: https://www.bbc.co.uk/news/health-49975720 [Accessed 10 Oct. 2019].

2. Njike, V., Smith, T., Shuval, O., Shuval, K., Edshteyn, I., Kalantari, V. and Yaroch, A. (2016). Snack Food, Satiety, and Weight. Advances in Nutrition, 7(5), pp.866-878.

3. Savage, J., Fisher, J. and Birch, L. (2007). Parental Influence on Eating Behavior: Conception to Adolescence. The Journal of Law, Medicine & Ethics, 35(1), pp.22-34.

What's the deal with Bone Broth?

Bone broth has been a ‘trend’ for a while now and many would argue that its been ‘trending’ in many cultures for hundreds of years but whats so good about it?

Winter is round the corner and one of the best additions to your diet to ward off the dreaded cold is…….. Bone Broth.

Bone Broth contains many precious minerals found in bones, cartilage, ligaments and tendons. Many of which are essential for keeping us healthy over the long British winter.

Collagen

Collagen type 1 is the most abundant protein found in humans. It not only provides structure to body but also is essential for tissue development and regulation. (1)

Glycine

Glycine makes up about 1/3 of collagen and has many roles including acting as a neurotransmitter. However the gut is where glycine does some of its best work to support the immune system. Glycine has shown to down-regulate pro-inflammatory immune cells, know as cytokines, therefore having a anti-inflammatory and immunomodulatory effect. (2)

Glutamine

Hopefully you have heard of' ‘leaky gut’ or ‘intestinal permeability’? This is where the cells within the intestinal wall become porous, allowing molecules through into the blood stream that normally wouldn’t be allowed through. This happens for multiple reasons but inflammation is heavily involved. Intestinal permeability has been linked to multiple disorders including inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), non-alcoholic liver disease (NAFD), liver cirrhosis, acute pancreatitis, type 1 and type 2 diabetes, depression and more. Glutamine improves intestinal barrier function and is protective against intestinal permeability. Intestinal epithelial cells and activated immune cells also consume glutamine for energy. (2,3)

If there was one thing you did this winter to try to stay healthy and full of energy, let it be making a pot of bone broth every week.

Chicken Bone Broth recipe -

Serves 7-8

Ingredients – All organic (if possible)

As required –

2-3 Organic Chicken Carcasses

2-3 Carrots

2-3 Onions

2-3 Sticks of Celery

2 Bay leaves

Sprigs of Thyme

Salt and pepper

Clean water to cover

1. Add all the ingredients to a large stock pot

2. Simmer for 3-4 hours

3. KEEP the fat on the top of the stock

4. Strain the broth through a sieve to remove solids.

5. Keep in the fridge for the week, heating each morning. You can also freeze if you make a lot and use it for soups and stews.

6. Reheat each morning and take in a flask to work. The perfect start to the day.

1. Lullo, G. A. D., Sweeney, S. M., Körkkö, J., Ala-Kokko, L., & Antonio, J. D. S. (2001). Mapping the Ligand-binding Sites and Disease-associated Mutations on the Most Abundant Protein in the Human, Type I Collagen. Journal of Biological Chemistry, 277(6), 4223–4231. doi: 10.1074/jbc.m110709200

2. Liu, Y., Wang, X., & Hu, C.-A. (2017). Therapeutic Potential of Amino Acids in Inflammatory Bowel Disease. Nutrients, 9(9), 920. doi: 10.3390/nu9090920

3. Fukui, H. (2016). Increased Intestinal Permeability and Decreased Barrier Function: Does It Really Influence the Risk of Inflammation? Inflammatory Intestinal Diseases, 1(3), 135–145. doi: 10.1159/000447252

Winter is coming!!

Winter is coming!!!!! (In the voice of Jon snow)

As we all know this is the time of year that a few sniffles start to develop and with the long nights and short days, the thought of training may bring even more shivers?!?!

Always remember - A SUMMER BODY IS BUILT IN WINTER!!!

So here are my TOP 5 measures for staying well over the winter months - 

1. Bed time - This is a nice easy one. The nights are drawing in and lets face it, its dark by 6pm. A nice early night is what you need to keep your immune system healthy and energy high. 10 or 10.30 pm will do nicely.

2. Zinc and Vitamin C - Zinc is used for over 300 metabolic functions in the body and many of them immune related. Its also hugely beneficial for sleep. Vitamin C is an essential antioxidant that the body cannot create itself. Ask me for best sources if you are not sure. (Not Holland and Barrett please)

3. Soup - This weekend, get a few chicken carcasses, bung them in a pot with some celery, carrots and onions, season and simmer away until you have one of the most healing broths you will have ever tasted. This can be used as a base for any soup you like. Hands down one the the best ways to avoid a cold and keep that gut healthy.

4. Keep Moving - The immune system is intertwined with the lymphatic system which is reliant on the muscular system for its transport. Keep moving and you will detox a lot quicker and therefore be less likely to stagnate and get the dreaded sickness.

5. Vitamin D - Unless you have been forward thinking enough to book some winter sun this year, we wont be seeing the sun properly until next year. Vitamin D is essential for immune system health. Please ask for best sources if you'd like to know.

I look forward to seeing you all, healthy and happy, very soon.

Nutrition making waves in migraine research

As human beings, we have a tendency to research something and think ‘ah ha, we’ve got it’, only to look deeper into the subject and realise we haven’t quite got the whole picture. Migraine research is a prime example of this. The mechanisms behind migraines remain poorly understood but it has long been thought that their development was related to the vascular system and specifically vasodilatation (widening of blood vessels) around the brain. New research has identified that complex neurovascular mechanisms are more likely to be behind their occurrence and that nutrition could play a vital role in their reduction. 

There is now increasing research to demonstrate that nutrition could help in the reduction of migraines by reducing levels of substances which appear to have a massive impact on the onset of migraines.

Top Foods for migraine sufferers - 

• Garlic . Garlic oil has shown in animal models that it may be a viable approach in suppressing processes leading to migraines. (1)
• Grapes. Although wine is often viewed as a trigger for migraines, grapes in the form of pomace (dried grapes, stem and pulp) has shown to ‘dramatically’, in the words of the study’s author; inhibit the secretion of substances leading to migraines by up to 87 per cent. (1)
• Ginger also showed promise in the reduction of migraines. Ginger reduced cellular uptake of calcium (calcium uptake has been seen to stimulate the release of migraine causing substances) in turn reducing chances of migraines.(1)
• Cocoa. Chocolate has long been associated as a trigger of migraines, however this appears to lack a real scientific basis and in fact, cocoa has been shown in recent research to not only reduce the secretion of substances leading to migraines but also prevent inflammation in the nerves associated with headache pain in migraines. (2, 3)

Top Nutrients for Migraine sufferers - 

• Magnesium – A deficiency in magnesium may contribute towards migraines through alteration of mitochondrial metabolism having an effect on the sensitivity of tissue surrounding the brain. (4)
• Vitamin D – Vitamin D is needed for the absorption of magnesium and also could help migraines through aiding serotonin production, which has been seen to reduce migraines.(4)
• Riboflavin (B2) – Supplementation with Riboflavin helps with mitochondrial energy metabolism and therefore may help to support normal mitochondrial function, which could help reduce migraines.(4)
• Co Q10 – Co Q10 is vital in mitochondrial function and could aid in both reducing the severity and the frequency of migraines.(4)
• Cobalamin (B12) – Deficiency in vitamin B12 can cause increased levels of homocysteine, which is linked to neurogenic inflammation and migraine.(4)
• L-Carnitine – Often described as the ‘ferry’ nutrient due to its role as a transporter of substances such as long chain fatty acids into mitochondria. It Is also noted to regulate nitric oxide , which is implicated in migraine development. (4)

References - 

1. Slavin M, Bourguignon J, Jackson K, Orciga M. Impact of Food Components on in vitro Calcitonin Gene-Related Peptide Secretion—A Potential Mechanism for Dietary Influence on Migraine. Nutrients. 2016;8(7):406.
2. Cady R, Durham P. Cocoa-enriched diets enhance expression of phosphatases and decrease expression of inflammatory molecules in trigeminal ganglion neurons. Brain Research. 2010;1323:18-32.
3. Lippi G, Mattiuzzi C, Cervellin G. Chocolate and migraine: the history of an ambiguous association. Acta Biomedica. 2014;85(3):216-21.
4. Nattagh-Eshtivani E, Sani M, Dahri M, Ghalichi F, Ghavami A, Arjang P et al. The role of nutrients in the pathogenesis and treatment of migraine headaches: Review. Biomedicine & Pharmacotherapy. 2018;102:317-325.