Optimum Nutrition - Spring 2020 PREVIEW

2 OPTIMUM NUTRITION | SPRING 2020

THIS ISSUE
8
Are you in time with your inner rhythm?
Louise Wates finds out about the so-called ‘body clock’ and why it is important for everything that we do
12
34
It isn’t all downhill!
We find out why age-related disease
is not inevitable and how nutrition and
lifestyle can improve our chances for a
healthier older age
25 Little lives
Recent research reveals why soothers
could be disrupting our children’s sleep,
and how the impact of a sleepless night
goes beyond the next morning
Different strokes
CBD oil can be found in drops, to capsules,
to a morning coffee. But should we all be
using it? Alice Ball finds out about this
new and growing market
46 All about
Faecal transplants are the go-to treatment
for Clostridium difficile infection, but can
they be used for any other conditions?
Elettra Scrivo writes
Contents
16 Interview
Dr Jenny Goodman talks to us about her
new book Staying Alive in Toxic Times and
why all chemicals should be tested for
their impact on human health
28
Little lives
Intergenerational socialising boosts
children’s learning and emotional
development, and health and happiness in
seniors, writes Catherine Morgan
40 World cuisine
Owner of Caribbean restaurant Caribe’,
Keshia Sakarah talks to us about the
flavours and colours of food from Trinidad
— and shares a recipe, too
20
48 Move it 50
Nursing her own injury, Giulia Basana
finds out about exercise-induced knee
injuries and why putting your feet up may
be the best route to recovery
42
Research update
A roundup of recent research into
domestic chemicals and their impact on
health; on p.22 why research into allergies
suggests it is time to junk the junk food
30
On your plate
Three easy and mouth-watering recipes
from The 28-Day Pegan Diet, by food writer
Isabel Minunni and nutritionist Aimee
McNew
Food fact file
Whilst we are told that fresh fruit and
vegetables are the basis for a healthy diet,
they are not always available. We find out
about the benefits of frozen produce
Graduate story
Kate Cook tells us how a desire to do a
‘little’ course in nutrition led to a new
career running workshops and corporate
wellness programmes
04 Comment / news | 26 Kids’ pages | 45 Book therapy
37 Product news | 38 Kitchen chemistry | 39 In season
SPRING 2020 | OPTIMUM NUTRITION
3

FEATURE
On 29 March, the clocks went forward for British Summer
Time — a simple, annual change that can leave many of us
feeling out of sorts. Louise Wates finds out why our natural
circadian rhythms are so important for health and wellbeing
8 OPTIMUM NUTRITION | SPRING 2020

FEATURE
W
hen our ancestors discovered
fire, did teen cave people refuse
to go to their animal skin blanket
and adults start staying up late just to
binge watch pictures in the flames?
Maybe not, but as a species we do tend to
fight with Mother Nature.
Yet increasingly, research indicates that
although we can take the person out of
the cave, we can’t take the cave out of
the person. Even for so-called ‘night owls’
there is an inner early human in all of us
with a biological clock that is hard-wired
to the rhythms of the day. One study
looking at neural signatures of sleep has
hypothesised that they may have evolved
at least 450 million years ago, long before
our ancestors crawled out of the ocean. 1
And it appears that going against this
biological clock could be fuelling much of
the health problems that we see today.
This may be hard to swallow, especially
for those who happily follow irregular
bedtimes or mealtimes. Yet increasingly,
experts warn that ignoring our circadian
rhythms may contribute to a range of
diseases such as obesity, type 2 diabetes,
fatty liver disease, depression, anxiety, and
even Alzheimer’s.
Consultant neurologist and sleep
consultant Dr Guy Leschziner told
Optimum Nutrition: “For most people, there
is a clear circadian rhythm, a 24 hour cycle
defined by an area of the brain called the
suprachiasmatic nucleus. But this master
clock coordinates circadian rhythms in all
other organs in the body, and when there
is misalignment between our behaviour
and other physiological processes, there
is evidence that this results in physical
harms, including metabolic issues, immune
dysregulation and even increasing the risk
of cancer.”
This is bad news for shift workers. “Shift
work disorder has even been listed as a
possible carcinogen by the World Health
Organization,” he says. “So it is likely that
fighting against your intrinsic circadian
rhythm is deeply unhealthy.”
The interest in body clock and health
has developed into a whole area of
research called chronobiology. One
recent study even suggested that after
surgery, giving anti-inflammatories in
the morning and analgesic painkillers
in the evening works better with the
body’s circadian rhythm. 2 This is because
inflammation, which is important to the
healing process, signals for cells to repair
tissue. It was hypothesised that giving
anti-inflammatories at night, when the
healing is underway, would interfere with
this process. When researchers compared
bone healing in two different groups
of mice, it was found that mice given
anti-inflammatories in the morning and
analgesics at night, as opposed to antiinflammatories
round the clock, recovered
from the pain of the injury, and regained
bone strength more quickly and more fully.
Circadian rhythm
Although we usually speak of a single
‘body clock’, it has been suggested that
different organs have their own circadian
rhythm. Research last year on mice even
suggested that some of these circadian
clocks may work independently of the
brain. After shutting down the entire
circadian clock before jump starting those
for the liver and skin, scientists found
that these circadian clocks responded
to light independent of the brain. 3,4 In
other research, it was found that a type of
immune cell helps to keep time in the gut;
potentially explaining why disruption to
eating patterns can cause gastrointestinal
problems. 5
It perhaps even seems logical that
different parts of the body should have
their own rhythm — because the body
cannot do everything all at the same
time. For instance, we can’t eat, exercise
and defecate all at the same time — or
if we can, we probably shouldn’t. This is
because the body focuses resources on
the task in hand; if we are feeling anxious
we are unlikely to be wondering what to
have for lunch. This is because whilst we
are in fight or flight mode, the digestive
system temporarily shuts up shop — it
would be hard to eat whilst running from a
sabretooth tiger.
Hormones are important for this. Before
we wake up, our so-called ‘stress’ hormone
cortisol rises and peaks, enabling us to
start the day by drawing on stored energy
so that we don’t have to function on empty.
This is triggered by daylight; and at the end
of the day, reduced light triggers secretion
of a hormone called melatonin, which
makes us sleepy.
Response to light
According to a recent study of cells
taken from the eyes of deceased human
donors, three types of cells (which
are not involved in sight) responded
when exposed to light; 6 firing after just
a 30-second pulse of light. When the
light was turned off, some of the cells
took several seconds to stop firing. The
discovery is thought to explain why some
blind people have a body clock that follows
a day-night cycle even though they cannot
see. It also demonstrates how light is a
stimulant to the human body at a cellular
level.
The importance of sleep
Good quality sleep — something many of
us are short on — is vital to the circadian
rhythm. During sleep, the body undergoes
a range of housekeeping chores, healing
and repairing. For example, one study
published this year 7 reports that a type of
collagen that is important to connective
tissue is broken down and replenished
during sleep. So when we don’t get
enough sleep, the body doesn’t get to
carry out all its tasks efficiently.
Also, at the very least, it is known
that tiredness makes us crave highcalorie
foods, which are then processed
differently. More nutrients eaten when
tired end up being stored as fat, so even
if we eat the same foods as when rested,
we are more likely to gain weight. This is
why some experts recommend that we try
to sleep and eat according to those ancient
rhythms; getting as much daylight as
possible during the day, quality darkness at
night, and avoiding eating when our bodies
are preparing for sleep.
Late night eating has also been
associated with poorer health long-term. In
one small study of 112 women, presented at
the American Heart Association’s (AHA)
Scientific Sessions in November 2019, it
was reported that women who ate a higher
proportion of their daily calorie intake later
in the evening were more likely to be at
greater risk for cardiovascular disease. The
AHA said that each one per cent increase
in calories consumed in the evening
increased the likelihood of higher blood
pressure and body mass index, and poorer
long-term control of blood sugar.
In an AHA statement, lead study author
Nour Makarem, PhD, said: “So far, lifestyle
approaches to prevent heart disease have
focused on what we eat and how much
we eat. These preliminary results indicate
that intentional eating that is mindful of
the timing and proportion of calories in
evening meals may represent a simple,
modifiable behaviour that can help lower
heart disease risk.”
Diet, dopamine and disruption
Whilst artificial light and a wealth of
distractions act to disrupt our circadian
rhythm, what we eat can also play a
“...intentional eating that is mindful of the timing and proportion
of calories in evening meals may represent a simple, modifiable
behaviour that can help lower heart disease risk”
SPRING 2020 | OPTIMUM NUTRITION
9

INTERVIEW
Staying Alive in Toxic Times:
meet the doctor who says the
modern world is making us ill
MAIN AUTHOR PHOTO (c) Liz Seabrook
Dr Jenny Goodman talks to Louise Wates about why she was driven to write a book on the
chemicals that surround us, and how lifestyle can help to reduce their impact on health
16 OPTIMUM NUTRITION | SPRING 2020

INTERVIEW
F
or those who haven’t seen the
film Dark Waters, there is a scene
in which the main protagonist
Rob Bilot, played by Mark Ruffalo, is found
ripping up carpets and throwing cooking
pans into the rubbish — before his wife,
played by Anne Hathaway, yells at him to
stop. I shan’t ruin it with spoilers, but the
film is based on the real-life story of lawyer
Rob Bilot who spent two decades fighting
one of America’s largest corporations over
the dumping of toxic waste. It was roughly
when I saw the film that I also spoke with
Dr Jenny Goodman. A UK-based doctor
who practises ‘ecological’ medicine,
Goodman is a long way from Hollywood
but her message isn’t too different from
that of Dark Waters. Her book Staying Alive
in Toxic Times: A Seasonal Guide to Lifelong
Health lists and discusses the chemicals
that surround us in everyday life. But unlike
Dark Waters, she also tells us what we can
do to lessen the damage.
The ‘toxic overload’ debate — the
concept that we live in a chemically-loaded
environment that we didn’t evolve for — is
a controversial one. Many experts argue
that toxins are usually at ‘safe’ levels; for
example, pesticide residues on food. The
other side of the debate, however, is that
those pesticide residues, added to all
the other chemicals in our environment,
create an unhealthy cocktail. Pollution
from vehicles, chemicals in food packaging
or plastic bottles, or cigarette smoke are
well known examples. Goodman’s book
includes many more, stating that these
chemicals are making us — or some of us,
at least — sick; triggering health problems
including neurological disturbances,
autoimmune conditions and cancer.
Goodman and I speak on the phone.
As we talk, she occasionally refers to
academic studies so that I can check her
facts. My impression is that she either
has an excellent memory or is superfast
at thumbing through lists of journal
references. It’s also a reminder that despite
the rather (in my opinion) ‘softly softly’
approach cover of her book, Goodman
comes from a science background. She
qualified as a doctor in 1982 but became
disillusioned because medical training
did not tell her how to help prevent
disease. She writes that on the wards,
the profession focused on suppressing
symptoms “using a vast array of drugs”.
(Goodman, p.2) In the 1990s, she
discovered the British Society for Ecological
Medicine (BSEM) — a form of practice also
known as functional medicine — where,
she writes, she encountered other doctors
who were also disillusioned with dishing
out drugs.
Joining BSEM, she says, meant
rethinking some of her training. “I had an
awful lot to unlearn. I was to some extent
still in the conventional mode. I thought
purely in diagnostic terms — you’ve got
disease X or you haven’t,” she says. “And if
your symptoms don’t fit any pattern in my
textbook then you haven’t got a disease,
ergo you must be well. Of course, we know
that isn’t the case. We know there is a vast
spectrum between health and [a named]
illness.”
Many people can be quite ill, she says,
but with symptoms that haven’t quite
made it into the textbooks. She says she
also had to unlearn the notion of aetiology.
“In medical textbooks, under each disease
there is a section called ‘aetiology’ which
means ‘cause’. It’s always a very small
section.
“I had to learn that what conventional
medicine gives as a cause — which is what
is happening in the tissues, in the cells — is
a mechanism, not the cause.”
Another difference between
conventional medicine and how she
practises, she says, is that rather than
saying nothing is wrong, because the
patient’s symptoms don’t fit into a
textbook, she will say ‘I don’t know what
is wrong’ before investigating. Much of
Goodman’s approach involves nutrition
because, she explains, many chemicals
“push” nutrients out of the system.
However, nutrition as medicine is not
largely accepted by the wider medical
...toxins are driving... diseases including: “Acne, addictions, ADHD,
allergies, anxiety, arthritis, asthma, autism and ASD, auto-immune
diseases, cancer, chronic fatigue syndrome/ME, dementia,
depression, diabetes, eczema, endometriosis, fertility problems,
fibroids, hay fever, heart disease, hyperactivity, inflammatory bowel
disease, irritable bowel syndrome, lupus, motor neurone disease,
multiple sclerosis, obesity, Parkinson’s disease, period problems and
PMS, polycystic ovaries, stroke, thyroid problems”
“The gastroenterologist who — if you pardon the pun — poo pooed the
idea of the microbiome is probably dishing out probiotics on the NHS”
profession, and it is unlikely that many
of us would get similar information
from our GPs. This, she says, is because
conventional medicine is “slow to catch
up”. In her book there is the example
of a gastroenterologist who, about six
years ago, told a patient that food made
no difference to the state of their gut.
“The gastroenterologist who — if you
pardon the pun — poo pooed the idea of
the microbiome is probably dishing out
probiotics on the NHS in the six years
since that comment was made,” she says.
“[Medical understanding is] changing
rapidly but of course myself and my
colleagues will never ever get the credit,
because once the mainstream knows it, it’s
like they always knew it.”
Generally, it appears that GPs are
nonplussed when she works with their
patients. Asked how they respond to her
recommendations, she replies: “On the
whole just blank. Research that is known
about in the academic sphere does take
time to trickle down to the clinical world.”
She mentions small intestine bacterial
overgrowth (SIBO) and leaky gut (intestinal
hyperpermeability) as two examples
that have only recently entered into the
consciousness of conventional medicine.
Where Goodman and like-minded
practitioners continue to stand apart
from conventional accepted wisdom is
on the belief that environmental toxins
are driving growing rates of modern
diseases including: “Acne, addictions,
ADHD, allergies, anxiety, arthritis, asthma,
autism and ASD, auto-immune diseases,
cancer, chronic fatigue syndrome/ME,
dementia, depression, diabetes, eczema,
endometriosis, fertility problems, fibroids,
hay fever, heart disease, hyperactivity,
inflammatory bowel disease, irritable
bowel syndrome, lupus, motor neurone
disease, multiple sclerosis, obesity,
Parkinson’s disease, period problems and
PMS, polycystic ovaries, stroke, thyroid
problems.” These diseases, she writes are
“21st century plagues, which were rare or
unknown before the industrial revolution.
They are not inevitable and they are not
primarily about ageing.” (Goodman, p.8)
The fact we are living longer, she
believes, is not to blame. “There’s a lack
of logic in the argument that says thanks
to the wonders of modern medicine we’re
now living long enough to get hideous
diseases,” she says. “Alzheimer described
what he called pre-senile dementia. His
first patient was 51. In your nineties you’re
going to forget people’s names, but in
SPRING 2020 | OPTIMUM NUTRITION
17

ON YOUR PLATE
Beet chip nachos
with refried lentils
Serves: 4
Isabel and Aimee say:
“These colourful nachos are delicious!”
Ingredients
Beet chips
• 3 beets, preferably in different colours
• 1 tbsp olive oil
• ½ tsp sea salt
• ½ tsp pepper
Refried lentils
• 1 cup lentils (approx. 250 g)
• 4 tbsp olive oil
• 3 tbsp red pepper, minced
• 2 tbsp onion, minced
• 2 garlic cloves, minced
• ½ tsp cumin
• ½ tsp sea salt
• ½ tsp pepper
Toppings
• ½ cup romaine lettuce, chopped
• 1 jalapeño, sliced
• ½ cup salsa
• 2 tsp chives, sliced
• Drizzle of avocado crema (see below for
recipe)
Avocado crema
• 2 ripe avocados
• ¼ cup chopped coriander (cilantro)
• 1 lime, juiced
• 2 tbsp avocado oil
• ¼ tsp sea salt
• ¼ tsp cumin
Method
Preheat oven to 180C/350F/gas 4.
Using a mandoline, thinly slice the
beets. Line a cookie sheet with parchment
paper and brush with olive oil. Place
beets in a single layer onto cookie sheet
and brush beets with remaining oil.
Place in preheated oven and bake for 15
to 20 mins. Remove from the oven and
immediately season with salt and pepper.
Rinse lentils in cold water. Look for
and remove any debris, then drain. Place
lentils in a medium saucepan with enough
water to cover lentils. Heat over mediumhigh
heat and boil lentils until tender,
about 15 to 20 mins.
Heat a frying pan over medium heat.
Coat with oil and cook the onion and
pepper until soft, about 2 mins. Add in
garlic and cook another minute. Season
with cumin, salt and pepper.
Drain the cooked lentils and add them
to the frying pan. With a hand-held potato
masher, mash the lentils until half are
broken up and mashed.
Place all crema ingredients in a blender
and blend until smooth.
Arrange the beet chips on a serving
platter and top with lentils, lettuce,
jalapeño, salsa, chives and a generous
drizzle of avocado crema.
SPRING 2020 | OPTIMUM NUTRITION
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