Yes to Life Radio Interview – ‘Test Match’
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Functional Medicine practitioner provides some pointers towards making choices from the vast range of tests now available to those with cancer
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Click here to listen to Podcast Interview Episode 054
In this episode of Dr Elmar Jung’s Tooth Talk Podcast, we discuss
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Delighted to have been asked to share my thoughts on how to build/maintain ‘Resilience Through Cancer Treatment’ using nutritional and lifestyle approaches on the Yes To Life CANCERTALK podcast (episode 2) hosted by Dr Penny Kechagioglou & Robin Daly –
Delighted to be invited to talk at the Nutritional Science & Cancer online congress on the 27th and 28th March being organised by Yes to Life
This two day Congress explores this fascinating and crucial topic from many angles. We have 14 top speakers including BBC Food Programme presenter Sheila Dillon, Naturopathic Oncologist Dr Nasha Winters, Founder of the Alliance for Natural Health Dr Rob Verkerk, Functional Medicine Practitioner Mark Bennett and Penny Brohn’s Dr Catherine Zollman. The Congress also includes a workshop-focused day delving into immunity and the microbiome, the anti-cancer diet and medicinal mushrooms.
It is wonderful to see research into the effects of nutrition in cancer accelerating, notably in countries which have embraced the concept of Integrative Medicine. As a result, our understanding is growing rapidly which in turn is leading to fresh strategies, as well as supporting some that have flourished as therapies outside of the mainstream.
Book your ticket now at www.yestolifeconference.org.uk
Cholesterol, Saturated Fat and Cardiovascular Disease:
* Please note that the following information is for your general knowledge only and is not a substitute for professional medical advice or treatment for specific medical conditions. Always consult your Dr/GP before making any health care decisions and/or adjusting prescribed medications/dosages. *
It is akin to an indisputable fact that elevated cholesterol levels are a considerable risk factor for cardiovascular disease. However, is this really the case? Both clinical experience in combination with recent evidence, would suggest that it is not as simple as that. Like most measurements in the body, levels should not be viewed in isolation, but instead within the context of overall metabolic health (i.e insulin resistance, blood sugar imbalances, elevated triglycerides and the HDL to LDL ratio). Stress levels are also a significant factor to take into consideration. Research suggests that cholesterol levels can be raised between 8 and 65%, free fatty acids by up to 150% and triglycerides by up to 111%, within an hour of a ‘stressful event’! https://tinyurl.com/y5vrwawr
Please see the following high powered, high quality reviews along with an expert opinion that really questions the whole premise that reducing cholesterol – even LDL cholesterol (the so called ‘bad’ cholesterol) is a fundamental requirement to reduce the risk of future cardiovascular events.
In respect of the so-called link between excessive saturated fat intake and cardiovascular disease, please see this recent review and expert opinion:
So what about the latest drugs that are now being used to drive cholesterol levels down, called PCSK9 inhibitors. Do they actually reduce the risk of having a cardiovascular event along with the risk of dying for any reason? The results of this recent meta analysis (a review of multiple studies) across both published and unpublished data would suggest otherwise: https://tinyurl.com/yxh9hh26 – with the following conclusion:
‘Our meta-analysis of clinical events registered on ClinicalTrials.gov did not show that PCSK9 inhibitors improve cardiovascular health. Evolocumab/Repatha increased the risk of all-cause mortality’.
If you are presenting with/or are concerned about cardiovascular disease/risk, you do have more control that you would first be led to believe. By employing a multifactorial personalised dietary, lifestyle and functional approach, alongside working in a safe and integrated manner with your GP/Dr, it is often possible to reduce or even stop certain prescribed medications.
Please remember that you should never under any circumstances adjust/stop any prescribed medication, without first checking with your GP/Dr.
The gallbladder is a small pouch/sac under the liver that releases bile into the gut in order to emulsify/disperse fats, so that digestive enzymes can break the fats down for optimal absorption. ‘Gallstones are small stones, usually made of cholesterol, that form in the gallbladder’ (NHS website).
Whilst it is estimated that between 10-15% of the UK population present with gallstones, the vast majority are symptom free (Royal College of Surgeons). If however gallstones move from the gallbladder to other areas such as the bile duct, it is possible for the stone to cause a blockage. This can stop the gallbladder emptying, as well as occasionally causing inflammation of the liver and/or pancreas. This can cause severe pain under the right rib cage, which commences suddenly and lasts anywhere from 30 minutes to many hours. Other symptoms include pain in the right shoulder and/or between the shoulder blades, nausea/vomiting and jaundice.
It has been said that ‘you do not need a gallbladder to live’. Whilst this is technically true, it is important to remember that the gallbladder is not a design flaw of the human body and has an important role to play in digestion and maintaining the optimal health and function of the digestive system. Removal of the gallbladder can lead to accumulation of bile in the liver (which can cause its own issues) along with alterations in the balance of the gut bacteria possibly contributing to the development of Small Intestinal Bacterial Overgrowth (SIBO). Unless the underlying reasons for the production of gallstones are addressed, it is possible that stones may appear in the liver/bile ducts even without a gallbladder.
Modern medicine will either prescribe painkillers and a low fat diet (which can make the situation worse in the long term) in mild and infrequent cases or surgery. The complete removal of the gallbladder via surgery (cholecystectomy) is performed around 67,000 times per annum in the UK, costing £112 million (NICE 2014 data). Whilst surgery may be unavoidable in certain situations, the removal of the gallbladder should be avoided if at all possible.
Clinically, I have experienced a number of clients completely resolve their regular gallbladder attacks by changing diet (removing inflammatory foods), resolving imbalances in the microflora/healing ‘leaky gut’ and using if appropriate natural agents to help stimulate bile flow or supplementing with bile itself.
The main symptoms of constipation include having to strain to defaecate, the feeling of incomplete bowel evacuation, the passing of hard and lumpy output that is either larger or smaller than it should be and/or having less than 3 outputs per week. Other symptoms that may also be present include bloating, gas, nausea, migraines, headaches, lower back pain, anxiety and fatigue.
The reported prevalence rates of constipation in the UK vary widely between studies, with figures ranging from 4% to 20%. Constipation affects twice as many women as men and older people are five times more likely than younger adults to suffer from constipation (NICE data). Whilst being constipated maybe considered as ‘normal’ it is far from ‘optimal’, as it clearly reflects underlying functional system imbalances in the body.
There are a multitude of potential reasons as to why constipation occurs. These include poor diet, dehydration, lack of appropriate fiber (although increasing fiber with chronic functional idiopathic constipation – long term constipation with no known cause – can in fact make things worse), gluten related disorders and dairy sensitivities, other unidentified food sensitivities (will be unique to the individual), imbalances in the bacterial species of the gut (dysbiosis), small intestinal bacterial overgrowth (SIBO) – typically the production of too much methane, medication use – read the potential side effects of any medications that you are taking and discuss with your GP if required – opioid induced constipation is extremely common, stress, sub optimal magnesium status, thyroid dysfunction, hormonal imbalances, lack of exercise, food poisoning, accidents (damage to the vagus nerve) and even ‘long COVID’.
Often, simply adjusting diet (the general advice is to try increasing fiber), drinking more water and increased levels of exercise will improve/resolve the situation. If however these basic adjustments do not deliver the required benefits, then it is important to engage with your GP to ensure that there are no other significant underlying conditions (in rare cases chronic constipation is correlated with an increased risk of developing conditions such as Parkinson’s disease, multiple sclerosis and even bowel cancer). Please however note that relying long-term on the use of laxatives to achieve the desired output type and frequency, is not addressing ‘why’ you are constipated. By working with a suitably qualified practitioner and thoroughly evaluating the myriad of potential reasons as to why constipation is happening, should lead to answers and an effective solution.
Cancer is the second leading cause of death globally, accounting for an estimated 9.6 million deaths, or one in six deaths, in 2018’ (World Health Organisation – September 2020). Unfortunately the current situation is that there are approximately 1,000 new cancer cases every day in the UK (Cancer Research UK – September 2020) and 465,000 every day globally in 2018 (World Health Organisation – September 2020). ‘1 in 2 people in the UK born after 1960 will be diagnosed with some form of cancer during their lifetime’ (Cancer Research UK – September 2020). Is this acceptable? I would suggest not, especially as the current mainstream belief is that up to 40% of cancers could be prevented (Cancer Research UK – September 2020). ‘Obesity, chronic low-grade inflammation, and high blood glucose, insulin and insulin-like growth factor 1 levels have been associated with a higher risk not only of developing but also of dying from various cancers’ (Obesity and Diabetes: The Increased Risk of Cancer and Cancer-Related Mortality – Physiological Reviews 2015)
Whilst there have undoubtedly been considerable advances in recent years in the ‘standard’ treatment options available and ‘survival rates’ (defined as living for more than 10 years) have doubled in the past 40 years in the UK (Cancer Research UK – September 2020), this disease still continues to inflict an ever increasing and unacceptable economic, social and emotional burden on humanity. This is in spite of unimaginable amounts being spent on research and treatments since the ‘war on cancer’ was declared in 1971. ‘Survival rates’ are not uniform across cancer types, age and sex, ranging from 1% with pancreatic cancer to 98% with testicular cancer (Cancer Research UK – September 2020).
Whilst increasing survival rates are clearly a good thing, is simply ‘surviving’ as opposed to ‘thriving’ good enough? Should we take comfort from the fact that whilst 50% of us are expected to develop cancer at some point in our lives, that we should simply rely on standard modern medical treatments to come to our rescue at the point of crisis, with all their potential negative consequences for the rest of our lives, as opposed to thinking about other options, to not only help reduce the risk of developing cancer in the first place, but also improving outcomes?
Conventional cancer treatments are typically brutal leaving ‘a gruelling physical and mental legacy for many years afterwards….and many of these people are not living well…..living with multiple long term conditions…..including chronic fatigue, sexual difficulties, mental health problems, chronic pain, urinary and gastrointestinal problems and persistent tissue swelling’ (‘Throwing light on the consequences of cancer and its treatments’ – Macmillan Cancer Support, 2013). What are the actual long term social and economic costs associated with just using standard modern medical cancer treatments? What if we could reduce these risks and long term costs by working in a more integrated manner using appropriately constructed and implemented complementary interventions, improving the effectiveness of conventional treatments and reducing their potential long term negative consequences? What if we made this this type of approach available to everyone under NHS care, rather than it being a consideration for those of us that are fortunate enough to be able to consider such options. I would make an educated guess that the return on investment on working this way would be enormous, from both an economic and social perspective.
The other key area to look at in depth is the quality of the dietary advice that is being given on a population wide basis to help reduce the ever increasing number of people that are developing cancer. There is very strong evidence to support the notion that as we have moved further and further away from our ancestral diets, reducing fat intake and dramatically increasing carbohydrate consumption, that cancer frequency has increased (Nutrition and Physical Degeneration: A Comparison of Primitive and Modern Diets and Their Effects. Oxford, Benediction Classics, 2010). Is it possible that the current dietary guidelines and trajectory are completely incongruent with maximising human heath and well-being? Unfortunately we do not have the space to discuss that thought here!
As a functionally trained practitioner, working with a number of cancer clients at any one point in time, my experience and understanding is that cancer is a complex multifactorial chronic disease. The evidence would strongly suggest that complementary approaches when combined with modern medical treatments can significantly improve patient outcomes. Here are a few examples:
The evidence supporting the use of a ketogenic dietary approach (the very strict control of carbohydrate intake, with moderate protein consumption and the majority of calories coming from high quality fats) improving the effectiveness of radiotherapy is convincing (Fasting, Fats, and Physics: Combining Ketogenic and Radiation Therapy against Cancer – Complementary Medicine Research 2018). A ketogenic state would appear to protect healthy cells, but not cancer cells, from high dose chemotherapy (Starvation-dependent differential stress resistance protects normal but not cancer cells against high-dose chemotherapy – PNAS 2008). The effectiveness of a ketogenic approach in combination with hyperbaric oxygen, hyperthermia (increasing temperature in a targeted manner) and chemotherapy in the most aggressive form of breast cancer has been observed (Efficacy of Metabolically Supported Chemotherapy Combined with Ketogenic Diet, Hyperthermia, and Hyperbaric Oxygen Therapy for Stage IV Triple-Negative Breast Cancer – Cureus 2017). There is very strong evidence to support the notion that the combination of hyperthermia in combination with radiotherapy translates into a 25% improvement in ‘complete resolution’ of head and neck cancers (Hyperthermia and radiotherapy in the management of head and neck cancers: A systematic review and meta-analysis – International Journal of Hyperthermia 2015). High dose medicinal mushroom therapy (Mycotherapy) can be a very powerful complementary approach – ‘there are more than 5,000 publications that indicate the beneficial effect of the extract of certain mushrooms in cancer’ (Dr Pere Gascón (oncologist) for ‘InFocus’ – IHCAN and Nutrition May 2019).
The current standard medical solutions being offered to the cancer patient are not good enough. Why are we not offering complementary approaches that have real evidence of potentially making a difference to their outcomes to all cancer patients? These options may of course not be to everyone’s liking, but at least provide the patient with the choice and run through the potential benefits of doing so. Unfortunately I still hear from the cancer clients that I have the privilege of working with that their doctors/oncologists state that diet has nothing to do with helping treat cancer and improving their outcomes! This is an unbelievable statement and simply does not make any medical or biochemical sense. Why wouldn’t the food that you consume be the cornerstone of any treatment plan? Food is one of the most powerful medicines known to human kind. It can literally switch genes on and off (nutrigenomics).
A ketogenic approach should not be positioned as a diet, but instead as a medicine. It is not always appropriate for everyone to pursue (even if they wish to do so), especially if there are significant imbalances in the microflora/bacteria (dysbiosis) and permeability (leakiness) of the gut present due to an increased risk of moving toxins (LPS – the ‘exhaust’ of bad bacteria) across the gut barrier into systemic circulation. This is why it is important to work with a suitably qualified practitioner who can guide the client through the process of not only evaluating the suitability of using such an approach, but also personalising the intervention in respect of identifying other imbalances that may also be present, covering areas such as unidentified food sensitivities (which if present will contribute to a heightened inflammatory load on the body), lectin/histamine intolerances, micronutrient imbalances and digestive capacity in association with levels of dysbiosis.
Finally, whilst the above considerations are important, the approach should not stop there. All lifestyle elements should be thoroughly evaluated including but not limited to stress levels, sleep quality, toxic load, electromagnetic field exposure and movement. The therapeutic use of appropriate breathing and body exercises, meditation and near infra-red saunas in combination with cold water exposure are all therapeutic options to consider. This is all about the power of ‘marginal gains’, which we have written about before.
We need less dogma and more integration if we are to start really getting control of this devastating disease. The pieces of the puzzle are all there, we just need to start putting them together.
Diverticula disease includes diverticulosis and diverticulitis. Diverticulosis occurs when small pouches or pockets develop in the colon (the large intestine). This is a very common condition occurring in approximately 1 in 3 over the age of 60 and half of 80 year olds. The majority of individuals will have no symptoms with diverticulosis. Diverticulitis is when these pockets become inflamed. This is when symptoms can manifest, with pain in the lower left side of the abdomen being the most common. Other key symptoms include tenderness of the tummy area, cramping, bloating, constipation/diarrhoea, fever, nausea and vomiting. Approximately 25% of individuals with diverticulitis will go onto develop potentially very serious complications including perforations of the gut wall, obstructions and inflammation of the lining of the abdomen. Medical treatments include antibiotics, pain relief and surgery.
Current mainstream dietary advice to help reduce the risks of diverticula disease is based on limited evidence. Advice includes avoiding nuts and seeds and eating more fibre. So what are the key triggers?
Chronic low-grade inflammation and imbalances in the micro ecology of the gut (dysbiosis) are the most significant triggers of diverticula disease. These are of course connected. For those of you that have been reading this column, this will be of no surprise, as the harmonious balance of bacteria in the gut is a fundamental pillar of well-being.
The evidence base and clinical experience suggest that there is a significant correlation between the presence of Small Intestinal Bacterial Overgrowth (SIBO – a type of dysbiosis) and diverticula disease. SIBO is where the small intestine (the part of the digestive system responsible for absorbing nutrients) is overgrown with bacteria that should not be there. This is a notoriously difficult condition to effectively treat, as unless the key factors that caused SIBO to happen in the first place are resolved, then it will typically return no matter whether Rifaxamin (a special non absorbable antibiotic) or antimicrobials are used.
Imbalances that typically trigger the presence of SIBO include poor digestive capacity (weak stomach acid/bile flow and low digestive enzyme status) and poor motility of the small intestine (the migrating motor complex) due to compromised vagus nerve health (often connected to stress). Probiotic and prebiotic supplementation have both been shown to be beneficial, as has shifting diet towards a whole foods anti-inflammatory approach, reducing stress, exercising, undertaking myofascial therapy and using targeted supplementation.
Parkinson’s Disease (PD) was first described over 200 years ago and is one of the most common progressive neurodegenerative conditions. Whilst there are many different symptoms, the main ones are tremor (shaking), slowness of movement and rigidity/muscle stiffness. Symptoms are caused by the brain losing its ability to produce enough dopamine, which is key to co-ordinating movement.
The evidence base suggests that there are a number of potential factors involved in the development of PD including increased exposure to pesticides/herbicides and toxic metals, elevated levels of iron, digestive system imbalances (constipation is now considered to be a key symptom – often present up to 10 years before diagnosis), Small Intestinal Bacterial Overgrowth (SIBO), Helicobacter pylori infections, increased ‘leakiness’ of the gut lining, nutrient deficiencies and associated mitochondrial dysfunction, gluten related disorders and autoimmunity. One key area of research involves the observed accumulation in the brain of a misfolded protein called alpha-synuclein, which has been shown to accumulate in the gut’s own nervous system years before the diagnosis of PD.
Currently there is no cure for PD, with treatments relying on a combination of medications (which aim to increase dopamine levels – often with significant side effects), exercise and complementary therapies.
The evidence base now strongly suggests that gut health is a key factor in the development of PD. The gut/brain axis is irrefutable with the central nervous system being directly affected by the balance of bacterial species in the gut itself. Multiple studies have shown there to be significant alterations in the bacterial species (dysbiosis) of individuals with PD compared to healthy controls and it has been shown that the use of specific strains of probiotics can provide a marked reduction in key symptoms of PD when compared to placebo.
So the chain of events leading to PD might look something like this: dysbiosis (caused by poor diet/lifestyle/toxic load/stress/parasites) causes an increase in ‘leakiness’ of the gut and the expression and accumulation of misfolded alpha-synuclein, which is then transported from the gut to the brain directly via the vagus nerve. Chronic inflammation and ‘leakiness’ of the gut lining promote body wide inflammation, which in combination with the accumulation of misfolded alpha-synuclein in the brain causes damage to the dopamine producing cells of the brain and hence PD – (NPJ Parkinson’s Disease (2017)).
Maybe the gut holds the keys in respect of unlocking effective preventative and therapeutic interventions for this devastating condition?