Achieving Optimal

Physical Health

www.healthandnutrition.com.au

PPN Locations Frankston, Langwarrin, Mornington, Rosebud, Sorrento and Somerville

Presenter - Kate Save Accredited Practising Dietitian, Exercise Physiologist and Diabetes Educator

Overview

Understanding our Nutritional Needs

Obesity and Chronic Inflammation

The Hype around Fad Diets

Which Diet Works Best?

The Gut-brain Link

Rapid Weight Loss Vs Slow Continuous Weight Loss

Exercise Techniques (HIIT vs MICE)

Exercise and Ageing

Activity 24hr Food Recall

Understanding our Nutritional Needs

Fats

Essential Fatty Acids

Protein

Essential Amino Acids-

Carbohydrates

Provides short-term energy supply and dietary fibre but there is no minimal requirement due to gluconeogenesis*

Vitamins and Minerals

Varied essential roles for total body functioning

Water

Solvent for nutrients and waste

*Westman EC. Is dietary carbohydrate essential for human nutrition? Am J Clin Nutr. 2002;75:951954.

Obesity Epidemic

Overweight and Obesity = major risk factor

for Chronic Disease.

Overweight and Obesity hampers the

ability to control/manage chronic

disorders.

ABS stats in 2011-2012* -

1 in 4 Australian Children are overweight or

obese (25%).

Almost 2 in 3 Australian adults (63%).

Overweight and Obesity is the 2nd highest

contributor to burden of disease after

dietary risks, and smoking is the 3rd highest.

*http://www.aihw.gov.au/overweight-and-obesity/

Chronic Inflammation, Abdominal

Adiposity and Chronic Disease

*Picard F, Carter S, Caron A, Richard D. Role of leptin resistance in the development of obesity in older patients. Clin

Interv Aging [Internet]. 2013

*Greenberg AObin M. Obesity and the role of adipose tissue in inflammation and metabolism. The American Journal of

Clinical Nutrition [Internet]. 2006

Chronic inflammation is a dangerous

metabolic condition occurring as a result

of adipose tissue cells expanding and

releasing a variety of pro-inflammatory

markers.*

Chronic inflammation can result in

diseases such as diabetes mellitus,

insulin resistance or cardiovascular

disease due to overexposure and

accumulation of pro-inflammatory

markers.*

The Dangers of Obesity

What is the Modern Day

Solution to Obesity?

Fad Diets

Paleo No Grains or Dairy,

Cave-Man Style

Low Fat General weight loss

High Carb - Sports Nutrition

Atkins High Fat/Protein and

Low Carb

Ketogenic Diets Very Low Carb

- Rapid Weight Loss, Metabolic

and other Medical Conditions

High Protein Body Builders

Review of the Paleo Diet

Based on assumed eating habits of our ancestors in the Palaeolithic period (2.5 million and

10,000 years ago) before advent of agriculture and industry

Paleo Diet Pros and Cons

Pros

Encourages consumption of fruit, vegetables, lean proteins

Cons

Excludes two whole food groups no dairy or grain foods

There was no one Paleolithic population*

Humans ate due to availability of food not choice

Main issues are compliance, palatability and cost

Some short term studies show benefits including increased

satiety, improvements in body weight, waist circumference,

blood glucose and insulin, blood pressure and lipid profiles.*

Short, underpowered, heterogeneous studies

Slides reproduced with permission from Dr Tim Crowe of Deakin University and blog site www.thinkingnutrition.com.au *Jnsson T et al. Cardiovascular Diabetology 2009;8:35

*Mellberg C et al. Eur J Clin Nutr 2014;68:350-7

Caveman Recipes?

Slides reproduced with permission from Dr Tim Crowe of Deakin University and blog site www.thinkingnutrition.com.au

Low Carb Diets

Exponentially expanding list of low carb

diets

Food choices change depending on

degree of CHO restriction

Can just limit carbohydrates (~40% of

energy), restrict to a set level e.g. 25%

of energy or

Recent Low Carb Study

115 obese adults with T2DM randomised for 24 wk to hypocaloric low-carb (14%

CHO,

7 Diets Study

Systematic review and meta-analysis of 20

RCTs of 7 different diets followed for >6

months.*

Low-CHO, low-GI, Mediterranean, and high

protein diets all effective in < HbA1c by 0.12-0.5 percentage points with Mediterranean diet showing largest effect

size.*

Dietary behaviours and choices are often

personal, and it is usually more realistic for a

dietary modification to be individualized

rather than to use a one-size-fits-all

approach for each person.

*Ajala O et al. Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes Am J Clin Nutr 2013;97:505-516

Intermittent Fasting

Intermittent fasting or Alternate day fasting are dieting techniques which

involve following a reduced-calorie diet for some days of the week, with

normal eating on the other days.

Studies in humans and animals increasingly suggest that intermittent energy

restriction is on par with, or even superior to, continuous energy restriction

with regards to various health benefits.

In a recent study conducted in mice, researchers restricted and fixed the

amount of food in the continuous diet, but for the intermittent diet they

allowed the mice to eat as much as they wanted for fixed periods of time

each week, from one to three days.*

Interestingly, both groups of mice achieved the same weight loss over the 15-

week period, despite the intermittent diet group eating more food.

*Seimon, R., Shi, Y.C., Slack, K., Fernando, H., Nyguen, A.G., Zhang, L., Lin, S., Enriquez, Q.F., Lau, J., Herzog, H., Sainsbury, H., Intermittent Moderate Energy Restriction Improves Weight Loss Efficiency in Diet-Induced Obese MicePLoS One. 2013; 8(6): e66069. Published online 2016 Jan 19. doi: http://dx.doi.org/10.1371/journal.pone.0145157

Intermittent Fasting

Recent reviews of clinical trials in individuals with overweight or obesity

suggest that intermittent severe energy restriction results in equivalent

albeit not superiorweight or fat loss and improvements in cardiovascular

disease risk factors and fasting circulating insulin levels and insulin sensitivity

relative to moderate continuous energy restriction.*

*Seimon RV, Roekenes JA, Zibellini J, Zhu B, Gibson AA, Hills AP, et al. (2015) Do intermittent diets provide physiological benefits over

continuous diets for weight loss? A systematic review of clinical trials. Mol Cell Endocrinol 418: 153172. pmid:26384657 doi:

10.1016/j.mce.2015.09.014

Ketogenic Diets

Ketogenic diets have been shown to be effective, at least in the short to medium

term, as a tool to fight obesity, hyperlipidaemia and some cardiovascular risk

factors.*

The ketogenic diet has proven therapeutic benefits as part of the treatment of

various neurological and neuromuscular diseases.*

Ketogenic diets induce a metabolic condition named physiological ketosis (or

Nutritional Ketosis), to distinguish it from the pathological diabetic ketosis.

*Paoli, A., Ketogenic Diet for Obesity: Friend or Foe?, Int J Environ Res Public Health, 2014 Feb; 11 (2): 2092-2107.Bueno N.B., de Melo I.S., de Oliveira S.L., da Rocha Ataide T. Very-low-carbohydrate ketogenic diet v. Low-fat diet for long-term weight loss: A meta-analysis of

randomised controlled trials. Br. J. Nutr.2013;110:11781187. doi: 10.1017/S0007114513000548.

Diabetic Ketoacidosis is a dangerous condition in which abnormal levels of ketones are produced with inadequate insulin to regulate the flow of fatty acids, causing

production of ketone bodies.

Physiological (Nutritional) Ketosis for weight loss is effective in the range 0.5-1.5mmol/l but more severe ketosis might be required in the management of Chronic

conditions such as Epilepsy where Ketogenic diets have been used therapeutically.*

Ketone testing can be performed with urine dip sticks or Diabetes monitors (Aceto-

acetate Vs B-Hydroxybutyrate)

Physiological Ketosis Vs

Diabetic Ketoacidosis

*Paoli, A., Bianco, A., et al (2013). Long term successful weight loss with a combination biphasic ketogenic Mediterranean diet and Mediterranean diet protocol. Nutrients 5, 5205-521

Ketogenesis

After 3-4 days of fasting or a drastically reduced carbohydrate diet

(below 20 g per day), the bodys glucose reserves become

insufficient for the production of oxaloacetate for normal fat

oxidation in the Krebs cycle and for the supply of glucose to the

central nervous system (CNS).

When glucose is depleted, ketone bodies are produced from the

overproduction of acetyl-CoA: acetoacetate (AcAc), -

hydroxybutyric acid (BHB) and acetone.*

Ketogenesis occurs principally in the mitochondrial matrix in the

liver.

A recent study reported that there were no changes in resting

energy expenditure after a Ketogenic diet.*

*Feinman R.D., Fine E.J. Nonequilibrium thermodynamics and energy efficiency in weight loss diets.Theor. Biol. Med.

Model. 2007;4 doi: 10.1186/1742-4682-4-27.

*Paoli A., Grimaldi K., Bianco A., Lodi A., Cenci L., Parmagnani A. Medium term effects of a ketogenic diet and a mediterranean diet on

resting energy expenditure and respiratory ratio. BMC Proc. 2012;6 doi: 10.1186/1753-6561-6-S3-P37.

Ketogenic Diet Weight Loss Effects

Hypothesized Mechanisms of the Ketogenic Diets Weight Loss Effects;

Reduction in appetite due to higher satiety effect of proteins, effects on appetite

control hormones and to a possible direct appetite suppressant action of the

ketone bodies;*

Reduction in lipogenesis and increased lipolysis;*

Greater metabolic efficiency in consuming fats highlighted by the reduction in the

resting respiratory quotient;*

Increased metabolic costs of gluconeogenesis and the thermic effect of proteins.*

*Westerterp-Plantenga M.S., Nieuwenhuizen A., Tome D., Soenen S., Westerterp K.R. Dietary protein, weight loss, and weight maintenance. Annu. Rev. Nutr. 2009;29:2141. doi: 10.1146/annurev-nutr-

080508-141056.

*Veldhorst M., Smeets A., Soenen S., Hochstenbach-Waelen A., Hursel R., Diepvens K., Lejeune M., Luscombe-Marsh N., Westerterp-Plantenga M. Protein-induced satiety: Effects

and mechanisms of different proteins. Physiol. Behav. 2008;94:300307. doi: 10.1016/j.physbeh.2008.01.003.

*Sumithran P., Prendergast L.A., Delbridge E., Purcell K., Shulkes A., Kriketos A., Proietto J. Ketosis and appetite-mediating nutrients and hormones after weight loss. Eur. J. Clin.

Nutr. 2013;67:759764. doi: 10.1038/ejcn.2013.90.

*Johnstone A.M., Horgan G.W., Murison S.D., Bremner D.M., Lobley G.E. Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad

libitum. Amer. J. Clin. Nutr.2008;87:4455.

*Cahill G.F., Jr. Fuel metabolism in starvation. Annu. Rev. Nutr. 2006;26:122. doi: 10.1146/annurev.nutr.26.061505.111258.

*Paoli A., Cenci L., Fancelli M., Parmagnani A., Fratter A., Cucchi A., Bianco A. Ketogenic diet and phytoextracts comparison of the efficacy of mediterranean, zone and tisanoreica

diet on some health risk factors. Agro Food Ind. Hi-Tech. 2010;21:2429.

*Tagliabue A., Bertoli S., Trentani C., Borrelli P., Veggiotti P. Effects of the ketogenic diet on nutritional status, resting energy expenditure, and substrate oxidation in patients

with medically refractory epilepsy: A 6-month prospective observational study. Clin. Nutr. 2012;31:246249. doi: 10.1016/j.clnu.2011.09.012.

*Fine E.J., Feinman R.D. Thermodynamics of weight loss diets. Nutr. Metab. 2004;1 doi: 10.1186/1743-7075-1-15.

Reported initial feelings of lethargy first 3-4 days, but usually followed

by improved energy levels and mood.

Bad 'fruity' breath, caused by the ketone body acetone.

A decreased chance of weight cycling or yoyo-ing seen with other

methods of weight loss (Paoli et al 2013) **When KD is followed by a

longer period of Mediterranean diet.

Side Effects of a Ketogenic Diet

*Paoli, A., Grimaldi, K., Toniolo, L., Canato, M., Bianco, A., and Fratter, A. (2012). Nutrition and acne: therapeutic potential of ketogenic diets. Skin Pharmacol. Physiol. 25, 111-117

*Sumithran, P., Prendergast, L. A., Delbridge, E., et al. (2013). Ketosis and appetite mediating nutrients and hormones after weight loss. Eur. J. Clin. Nutr. 67, 759-764.

KETO VS

MEDITERRANEAN

Rapid Weight Loss Vs Slow Weight Loss

A study which examined subjects following a VLED ketogenic and non-ketogenic protocol for 6 months, then a Mediterranean diet for 6 months and saw no weight regained after

the 6 months.*

Another study investigated the effect of rate of weight loss using either a LCD 1250kcal/day for 12 weeks (slow weight loss) or VLCD 500kcal/day for 5 weeks

(rapid weight loss), with similar total weight loss, on weight regain in individuals with

overweight and obesity. This was followed by a 4-week weight-stable (WS) period and 9

months follow-up. This study showed that, with similar total weight loss, rate of weight

loss did not affect weight regain. However, %FFML after DI was associated

with weight regain.*

*Paoli, A., Bianco, A., et al (2013). Long term successful weight loss with a combination biphasic ketogenic Mediterranean diet and Mediterranean diet protocol.

Nutrients 5, 5205-521

*Vink RG, Roumans NJ, Arkenbosch LA, Mariman EC, van Baak MA. The effect of rate of weight loss on long-term weight regain in adults with overweight and obesity. Obesity (Silver Spring). 2016 Feb;24(2):321-7. doi: 10.1002/oby.21346.

Rapid Weight Loss Vs Slow Weight Loss

A review of nine randomized control trials, on the topic of very-low-calorie diets (VLCDs) and the long-term weight-maintenance success in the treatment of obesity

showed that there is evidence that a greater initial weight loss using VLCDs with an

active follow-up weight-maintenance program, including behavior therapy,

nutritional education and exercise, improves long-term weight maintenance.

*Saris WH,. Very-low-calorie diets and sustained weight loss., Obes Res. 2001 Nov;9 Suppl 4:295S-301S. DOI: 10.1038/oby.2001.134

Manipulating Protein Intake

Weight-loss diet literature focuses primarily on

manipulations of fat and carbohydrate content.

When assessing the separate and distinct role of

protein manipulations in weight-loss response

the results suggest that a higher-protein diet,

leads to greater appetite suppression and

weight loss, as well as greater decreases in

blood pressure and triglyceride concentrations

without affects on GFR.*

An important follow-up to these findings may be

to investigate the extent to which the food

sources of the protein (for example, plant-

based protein vs animal-based protein) might

influence these results.*

*Gardner CD. Tailoring dietary approaches for weight loss Int J Obesity Suppl 2012;2:S11-S15

*Berryman, C.E. et al. (2016) Diets higher in animal and plant protein are associated with lower adiposity and do not impair kidney function in US

adults.. Am J Clin Nutr,2

Long Term Diet Success

Reduced-calorie diets result in clinically meaningful weight loss regardless of which macronutrients they emphasize according to one of the largest and longest-run weight loss studies ever conducted;*

800 overweight adults randomly allocated to one of four different diets (ranging from high-carbohydrate/low-fat to low-carbohydrate/high-fat) over 2 years.

After six months, the average weight loss was 7% of the initial body weight, with negligible differences between the diets.

Most lost weight was regained, with only half the respondents maintaining their new weight for two years.

*Frank M. Sacks, M.D., George A. Bray, M.D., Vincent J. Carey, Ph.D., Steven R. Smith, M.D., Donna H. Ryan, M.D., Stephen D. Anton, Ph.D., Katherine McManus, M.S., R.D., Catherine M.

Champagne, Ph.D., Louise M. Bishop, M.S., R.D., Nancy Laranjo, B.A., Meryl S. Leboff, M.D., Jennifer C. Rood, Ph.D., Lilian de Jonge, Ph.D., Frank L. Greenway, M.D., Catherine M. Loria,

Ph.D., Eva Obarzanek, Ph.D., and Donald A. Williamson, Ph.D. Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates

N Engl J Med 2009; 360:859-873, February 26, 2009DOI: 10.1056/NEJMoa0804748

Science Vs Reality

In all diet comparison studies,

results are averages some do

better and others worse on each

diet.

Several studies* indicate that

those with insulin resistance may

do better on low-CHO diet vs low-

fat diet (the opposite is also true!)

Tailoring diets to maximise

success.

Genotyping for weight loss

success.

*Gardner CD. Tailoring dietary approaches for weight loss Int J Obesity Suppl 2012;2:S11-S15

*Slides reproduced with permission from Dr Tim Crowe of Deakin University and blog site www.thinkingnutrition.com.au

A Balancing Act

In Australia, 1/3 of daily kilojoules* is from foods of little nutritional value

(discretionary foods) - not ancestral foods, nor foods that any nutrition expert,

regardless of dietary persuasion, would ever recommend

Whole grains and legumes improve health through improved blood lipids, better

blood glucose control and less inflammation (but refined grains to inflammation)

Any diet requires dedication and lifestyle adaptation given that Western foods are

more socially acceptable than whole foods

*Australian Health Survey 2011-2012 www.abs.gov.au/ausstats/abs@.nsf/mf/4364.0.55.007?OpenDocument

The Common Sense Approach..

There is no one size fits all approach for dietary interventions.

Just cutting back on sugary foods/drinks, highly refined carbohydrate sources,

serving size of meals and eating more non-starchy vegetables makes a diet

low-carb and approaches Paleo too but without the stigma of a strict or

limiting diet.

Consider the individuals personal health and goals before making dietary

adjustments and use biochemical measures for safety and anthropometric

measurement's regularly for motivation.

The gut-brain link

Microbes in the gut influence behavior and can alter brain physiology and neurochemistry.

Neural messengers are also produced by these bacteria.

From mice studies, it has been found that:

Stress influences the composition of the gut microbiota and that bidirectional communication between microbiota and the CNS influences stress reactivity.*

Several studies* have shown that microbiota influence behaviour and that immune challenges that influence anxiety- and depressive-like behaviours are associated with alterations in microbiota.

Those who had gut microbiota removed were seen to have cognitive deficits and some autistic like behaviours.

Reconstitution of gut microbiota reduces anxiety-like behaviour.

*Foster, J.A., Neufl, K.M. (2013). Gut-brain axis:how the microbiome influences anxiety and depression. Trends in Neuroscience, 36(5), 305-312.*Carabotti, M., Scirocco, A., Maselli, M. A., & Severi, C. (2015). The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems. Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology, 28(2),

203209.

The Microbiome

The Microbiome is the collection of bacteria living in the gastrointestinal tract

which plays a complex and critical role in our health.

Anti-biotics were once believed to be medicines greatest innovation to

combat disease, but now are considered detrimental to our long term health.

The microbiome is suggested to contain anywhere from 3 to 100 times more

bacteria in the gut than cells in the human body.

A Symbiotic relationship exists with the gut microbiome influencing the

function of the immune, endocrine and nervous systems, which in turn alters

the activity and composition of the bacterial community.*

*Turnbaug, T.J, Ridaura, V.K., Faith, J.J., Rey, F.E., Knight, R., Gordan, J.I., The Effect of Diet on the Human Gut Microbiome: A Metagenomic Analysis in Humanized

Gnotobiotic Mice, Science Translational Medicine 11 Nov 2009:Vol. 1, Issue 6, pp. 6ra14. DOI: 10.1126/scitranslmed.3000322

Microbiome-Immune System Link

The microbiome-immune system link is established shortly after birth, and the developing immune system is then set up for later immune responses due to the microbiomes composition.

Intervention could potentially be achieved using either prebiotics or probiotics and diet.

In one experiment, researchers transplanted the human microbiome into germ-free mice (animals that have no gut bacteria) in order to study it in a controlled setting. They found that, by changing the carbohydrate and fat content of the mices food, they could alter basic cellular functions and gene expression in the microbiome.*

*Turnbaug, T.J, Ridaura, V.K., Faith, J.J., Rey, F.E., Knight, R., Gordan, J.I., The Effect of Diet on the Human Gut Microbiome: A Metagenomic Analysis in Humanized

Gnotobiotic Mice, Science Translational Medicine 11 Nov 2009:Vol. 1, Issue 6, pp. 6ra14. DOI: 10.1126/scitranslmed.3000322

Microbiome, Diet and Gene Expression

Nutrient and energy harvest from food influenced by the gut bacteria.

Switching from a low-fat, plant polysacchariderich diet to a high-fat, high-sugar

Western diet shifted the structure of the microbiota within a single day and

altered microbiome gene expression.*

Humanized mice fed the Western diet also have increased adiposity; this trait is

transmissible via microbiota transplantation.*

*Turnbaug, T.J, Ridaura, V.K., Faith, J.J., Rey, F.E., Knight, R., Gordan, J.I., The Effect of Diet on the Human Gut Microbiome: A Metagenomic Analysis in Humanized Gnotobiotic Mice, Science

Translational Medicine 11 Nov 2009:Vol. 1, Issue 6, pp. 6ra14. DOI: 10.1126/scitranslmed.3000322

Experiment from Professor of Genetic Epidemiology, Dr Tim

Spector (The Diet Myth*) on his son Tim;

McDonalds for ten days (Big Mac or Chicken nuggets,

plus fries and Coke) plus allowed beer and crisps in the

evening.

Fecal samples collected before, during and after his 10

day diet.

Toms microbiome changed significantly - Firmicutes

were replaced with Bacteroidetes as the dominant type,

while friendly bifidobacteria that suppress inflammation

halved, species diversity was reduced by nearly 40% as an

estimated 1,400 species were eradicated.

The changes persisted and even two weeks after the diet

his microbes had not recovered.

Fast Food Experiment

*Spector, Dr Tim., The Diet Myth: The Real Science Behind What We Eat. (2015), Weidenfeld and Nicholson, UK. http://www.tim-spector.co.uk/

Junk Food Binges A Rat Study in 2015* compared dietary habits;

Group 1 - Continuous access to a healthy diet

Group 2 Continuous access to junk food (cake, biscuits, meat pies, dim sim, chips)

Group 3 - Cycled between the two diets healthy for four days and junk for three over 16 weeks.

Results;

Cycled rats showed large swings in food intake, consuming 30% more energy than those maintained on the healthy diet only.

When cycled rats switched back to a healthy diet, they consumed half as much nutritious food as those maintained on a healthy diet only.

At the end of the study, the cycled rats had gained less weight than rats consuming junk diet continuously, but were still 18% heavier than rats on a healthy diet only.

Their measures of key metabolic hormones (leptin and insulin) were in-between the rates for rats fed junk or healthy food.

However, the gut biota profiles showed a different pattern any exposure to the junk food was sufficient to shift the gut biota profile.

*Lecomte V, Kaakoush NO, Maloney CA, Raipuria M, Huinao KD, Mitchell HM, et al. (2015) Changes in Gut Microbiota in Rats Fed a High Fat Diet

Correlate with Obesity-Associated Metabolic Parameters. PLoS ONE 10(5): e0126931. doi:10.1371/journal.pone.0126931

The Second Brain and Stress Response

The second brain or mini-brain refers to the enteric nervous system

whose neurons surround the whole GI tract.

Information flows back and forth continuously between the brain and

the gut via the Gut-Brain Axis using more than 30 neurotransmitters

(most biochemically-identical to those found in the brain).

It is estimated that 50 per cent of dopamine and 95 per cent of the

serotonin in the body is found within the GI tract.*

Researchers have shown that the presence or absence of microbes in

young mice affects the sensitivity of the hypothalamic-pituitary-

adrenal (HPA) axis a key pathway in the bodys stress response

system.*

*Bercik, P., Park, A. J., Sinclair, D., Khoshdel, A., Lu, J., Huang, X., Deng, Y., Blennerhassett, P. A., Fahnestock, M., Moine, D., Berger, B., Huizinga, J. D.,

Kunze, W., McLean, P. G., Bergonzelli, G. E., Collins, S. M. and Verdu, E. F. (2011), The anxiolytic effect of Bifidobacterium longum NCC3001 involves

vagal pathways for gutbrain communication. Neurogastroenterology & Motility, 23: 11321139. doi:10.1111/j.1365-2982.2011.01796.x

*Barrett, E., Ross, R.P., O'Toole, P.W., Fitzgerald, G.F. and Stanton, C. (2012), -Aminobutyric acid production by culturable bacteria from the human

intestine. J Appl Microbiol, 113: 411417. doi:10.1111/j.1365-2672.2012.05344.x

Examples of Bacterial Messaging

Type of Bacteria Neural Messenger

Bacillus Dopamine, norepinephrine

Bifido-bacterium Gamma-aminobutyric acid (GABA)

Enterococcus Serotonin

Escherichia Norepinephrine, serotonin

Lactobacillus Acetylcholine, GABA

Streptococcus Serotonin

*T. G. Dinan et al. Collective unconscious: How gut microbes shape human behavior. Journal of Psychiatric Research. Vol. 63, April 2015.

doi: 10.1016/j.jpsychires.2015.02.021.

Anxiety and Probiotics

Gut bacteria plays an essential role in neuronal growth. As bacteria

colonise the gut in the days following birth a sensitive period for brain

development poor establishment of the microbiome may potentially

lend to the occurrence of anxiety-based disorders.*

In 2011, researchers in Ireland discovered that mice treated with the

common probiotic bacterium Lactobacillus rhamnosus had reduced

stress hormone and anxiety related behaviours.*

L. rhamnosus was later found to influence gamma-Aminobutyric acid

(GABA), the primary central nervous system inhibitory neurotransmitter

involved in regulating countless processes.

GABA or GABA receptors are associated with the development

of anxiety and depression.

*Science News, Belly bacteria boss the brain, August 29th, 2011

*Hanns Mhler, The GABA system in anxiety and depression and its therapeutic potential, Neuropharmacology, Volume 62, Issue 1,

January 2012, Pages 42-53, ISSN 0028-3908,

http://dx.doi.org/10.1016/j.neuropharm.2011.08.040.(http://www.sciencedirect.com/science/article/pii/S002839081100373X)

*http://allergiesandyourgut.com/wp-content/uploads/2015/01/prebiotics-and-probiotics-41-638.jpg

Prebiotics

A type of fibre which must pass through the GI tract undigested and stimulate

the growth and/or activity of certain good bacteria in the large intestine.

Prebiotics include fructans and galacto-oligosachairdes (GOS).

Vegetables

Jerusalem artichokes, chicory, garlic, onion,

leek, shallots, spring onion, asparagus,

beetroot, fennel bulb, green peas, snow

peas, sweetcorn, savoy cabbage

LegumesChickpeas, lentils, red kidney beans, baked

beans, soybeans

Fruit

Custard apples, nectarines, white peaches,

persimmon, tamarillo, watermelon,

rambutan, grapefruit, pomegranate. Dried

fruit (eg. dates, figs)

Bread / cereals / snacksBarley, rye bread, rye crackers, pasta,

gnocchi, couscous, wheat bran, wheat

bread, oats

Nuts and seeds Cashews, pistachio nuts

Other Human breast milk

Resistant starch

Resistant starch is defined as the total amount of starch and the products of

starch degradation that resists digestion in the small intestine of healthy

people.*

Starches that resist small intestinal breakdown are fermented by the resident

bacteria in the large intestine, producing a variety of end products including

short chain fatty acids (SCFA) that in turn provide a range of physiological

benefits.*

*Ahmed R & others. 2000. Fermentation of dietary starch in humans. Am J Gastroenterol 95(4):1017-20.

*Food Standards Australia New Zealand (FSANZ). 2011. Report of Consultation on Nutrient Reference Values in the Australia New Zealand

Food Standards Code a potential revision.

Summary of the Gut Microbiota

Bacteria play an important role in the communication between the gut and

the brain impacting immunity, mental illness (autism/anxiety/depression),

obesity and chronic disease.

Future treatment could include administration of probiotics or faecal

transplant procedures that would modify gut flora community structures.

Exercise and Weight Management

Exercise has a modest, but consistent benefit on body fat reduction

independent of dieting.*

For people who are already overweight, even 60 minutes of physical activity

each day may not be enough to halt weight gain.*

One recent high-quality study*, which looked at the ability of people to hold

onto hard-fought weight loss, found that 12 months after a weight-loss

program ended, people who kept up more than 90 minutes of physical activity

each day lost the most weight.

*Elder, S. J. and Roberts, S. B. (2007), The Effects of Exercise on Food Intake and Body Fatness: A Summary of Published Studies. Nutrition

Reviews, 65: 119. doi:10.1111/j.1753-4887.2007.tb00263.

*Deborah F Tate, Robert W Jeffery, Nancy E Sherwood, and Rena R Wing, Long-term weight losses associated with prescription of higher

physical activity goals. Are higher levels of physical activity protective against weight regain? Am J Clin Nutr April 2007 vol. 85 no. 4 954-959.

Burn It Off !

*http://www.theplaidzebra.com/wp-content/uploads/2016/01/2-junkfood.jpg

High Intensity Interval Training (HIIT)

HIIT = brief periods of intense exercise (>85% VO2peak) interspersed with periods of low-intensity exercise or rest

(1) Long intervals: 3 to 15 minutes at 85%-90 % of VO2peak

(2) Moderate intervals: 1-3 minutes at 95%-100% of VO2peak

(3) Short intervals: 10 seconds-1 minute at 100%-120% of VO2peak

Compared to traditional Moderate Intensity Continuous Exercise (MICE)*

More total time spent performing high-intensity activity

More time-efficient

Number one reason for not completing exercise program is lack of time

Superior effect on VO2 peak and ventilator threshold

Similar effect on left ventricular function and exercise compliance

Improvements in time to exhaustion and anaerobic threshold

Safe

*Gayda M, Ribeiro P.A, Juneau M, Nigam A. (2016). Comparison of different forms of exercise training in patients with cardiac disease: Where does High-Intensity Interval Training fit? Can J Cardiol, 32, 485-494.

*Elliott A.D., Rajopadhyaya K., Bentley D.J., Beltrame J.F., Aromataris E.C. (2015). Interval training versus continuous exercise in patients with coronary artery disease: a meta-analysis. Heart Lung Circ, 24, 149-57.

HIIT vs. MICE - Energy expenditure

50 mins continuous exercise vs. 20 minutes HIIT

No significant difference in 24-hour energy expenditure*

*Skelly, L.E., Andrews, P.C., Gillen, J.B., Martin, B.J., et al. (2014). High-intensity interval exercise induced 24-h energy expenditure similar to traditional endurance exercise despite reduced time commitment. Appl Physiol

Nutr Metab. 39(7):845-8

Exercise and Ageing Exercise has been shown to slow the shortening of telomeres associated with ageing

Telomeres have been shown to be predictive of mortality. Shorter telomeres = shorter life

Women and men who were less physically active in their leisure time had a shorter

Leukocyte Telomere Length (LTL) than their more active peers, regardless of the

age group, BMI, smoking status and, SES and physical activity at work.*

The most active subjects had telomeres the same length as sedentary individuals up

to 10 years younger, on average.*

This difference suggests that inactive subjects may be biologically older by 10 years

compared with more active subjects.

*Cherkas, L.F., Hunkin, J.L., Kato, B.S., et al. (2008). The Association Between Physical Activity in Leisure Time and Leukocyte Telomere Length. Arch Intern Med. 168(2):154-158. .*Loprinzi, P.D., Loenneke, J.P., Blackburn, E.H. (2015). Movement-based behaviors and leukocyte telomere length among US adults. Med Sci Sports Exerc, 46(11):2347-52.

In Summary.

Remember, we are all individuals, therefore, eat a varied diet which is highly

nutritious, but dont eat too much, and exercise regularly!

And remember, we dont know everything about nutrition yet, and we

probably never will.

References

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respiratory ratio. BMC Proc. 2012;6 doi: 10.1186/1753-6561-6-S3-P37.

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