Speaker 1: Do you spend a lot of time focused on being healthy?
Speaker 1: Would you never ever skip a workout or indulge in
Speaker 1: high calorie food without feeling incredibly guilty? Do you spend
Speaker 1: a lot of time thinking about what you're going to
Speaker 1: eat and cook and even avoid going out to dinner
Speaker 1: for fear of eating the wrong thing? What do you
Speaker 1: try and eat as a little as possible to keep
Speaker 1: your weight down and then only finding yourself starving and
Speaker 1: then overeating later. The quest to be healthy can become
Speaker 1: an obsession, and on today's episode, we discussed the presentation
Speaker 1: of all thorexia and the signs that trying to be
Speaker 1: healthy may have gone a little bit too far. Hi,
Speaker 1: I'm Susie Burrow and on Leah Lord and as two
Speaker 1: of us traders leading dieticians who specialize in evidence based nutrition,
Speaker 1: we bring you the Nutrition Couch podcast, a bi weekly
Speaker 1: chat on everything that is new in the world of food,
Speaker 1: diets and nutrition, as well as authorexia. Today we look
Speaker 1: at a new way of eating called sequential eating, which
Speaker 1: actually has some evidence to back it for the right person.
Speaker 1: And our listener question is all about colds and flu
Speaker 1: season and what are the supplements we can try to
Speaker 1: help you recover quickly if you've been sick. But first
Speaker 1: of all, Yat, I know you've been a little bit
Speaker 1: sleep deprived because baby Meya is getting some teeth. How
Speaker 1: is that going?
Speaker 2: Oh my dream baby?
Speaker 3: He used to sleep seven hours overnight.
Speaker 2: It's no more season.
Speaker 3: She was so good from about eight weeks old. She's
Speaker 3: sort of ate until about four months. Eight weeks till
Speaker 3: about four months she'd do six seven hour block overnight.
Speaker 2: It was amazing.
Speaker 3: Or sometimes we just dream feed her a little bit
Speaker 3: around either eleven PM or sort of one am, and
Speaker 3: then she's sleep right through to sort of five five thirty,
Speaker 3: which is amazing. But lately we've just had accommodation of
Speaker 3: sickness in our household. We've all picked up colds somehow
Speaker 3: touch Wood. We've still managed to avoid COVID. We've done
Speaker 3: seven routes between David and I, so it's definitely not COVID.
Speaker 3: It's just a nasty cold that's going around. Everyone at
Speaker 3: the moment just seems to have some sort of cold
Speaker 3: or flu or bug or you know, COVID's still out
Speaker 3: there as well, So there's just been a lot of
Speaker 3: sickness around like this. So we've had that in the
Speaker 3: household plus meters, had some teeth, and she's just been
Speaker 3: a little bit out of sorts lately. So the last
Speaker 3: couple of nights, you know, she's barely done an hour
Speaker 3: one to two hour blocks. Nor she'll do a good
Speaker 3: three four five hour block and then we'll get up feeder,
Speaker 3: she'll do another two three hours feet and then she
Speaker 3: might go back down for an hour or so and
Speaker 3: a good day.
Speaker 2: You know, we get to sleep until sort of six
Speaker 2: or so.
Speaker 3: But at the moment, it's been you know, we put
Speaker 3: her down at seven, we dream feed her at nine
Speaker 3: or ten, and then she's up at midnight. Then she's
Speaker 3: up again at one thirty. Then she's up again at three.
Speaker 3: And I think the other morning I took her out
Speaker 3: because David had to go on to work, maybe about
Speaker 3: five am or five thirty or something, and oh, I
Speaker 3: was just exhausted. I condouty, keep my eyes out. So
Speaker 3: any other mum is going through it at the moment,
Speaker 3: we're in this together. She's she's cut her first two
Speaker 3: bottom teeth, so I think the tea things sort of
Speaker 3: stopped now at the moment, I think it's more just
Speaker 3: she's just I don't know a little bit out of
Speaker 3: thoughts unsettled. She might have picked up a little bug
Speaker 3: or a little virus. I'm not really sure what's going on.
Speaker 2: But we'll come through.
Speaker 3: We'll come out the other end, Susie, you will.
Speaker 2: Because you know.
Speaker 1: The funny thing is, And I was just talking to Bronti,
Speaker 1: who looks after all of my and our Instagram images. Actually,
Speaker 1: so I shout out a big shout out to Bronti,
Speaker 1: who really helps us on the nutrition couch. Her little
Speaker 1: baby Emmy is just six weeks old, and she was
Speaker 1: I went to see her for the first time, and
Speaker 1: she was talking about out how good a baby she is,
Speaker 1: and I said, you should really just tone that right down,
Speaker 1: just because in my experience, everyone has a turn for
Speaker 1: one of a better term hell with young children. But
Speaker 1: my advice to everybody and all the parents out there listening.
Speaker 1: I can't even remember the time. All I remember is
Speaker 1: just a haze. I couldn't tell you when teething was
Speaker 1: or when it was bad, other than there were some
Speaker 1: really bad times and there were some times it were fine.
Speaker 1: But for some reason you just seem to forget it all.
Speaker 1: So that's the good news. You'll get through and you
Speaker 1: won't remember how bad it is. So everyone has their
Speaker 1: turn with it and you'll come through. And you know,
Speaker 1: like I said, mother, the boys now they're so tired
Speaker 1: at school, have very little drama with them, so you'll
Speaker 1: be right. Hang in there, hang in there.
Speaker 3: Yeah, I'm just gonna wait till they what five or six,
Speaker 3: and it will come good.
Speaker 1: Oh you know, I actually think once they go to
Speaker 1: like toilet chrained, I think three four even, they're pretty good.
Speaker 3: Yeah.
Speaker 1: So yeah, certainly it's a tough time, but you will
Speaker 1: get through and you're fit, healthy, so you'll be right.
Speaker 1: The Queensland cold, I reckon, that's hurting you. It's Brisbane's cold.
Speaker 2: Oh, I know, it really has.
Speaker 3: Like we've had some mornings that are seven, you know,
Speaker 3: six seven, eight degrees and I'm just thinking, this isn't
Speaker 3: the reason that I live in Brisbane.
Speaker 2: I live you for the warm weather exactly.
Speaker 1: And I agree, it's been really cold up there, so
Speaker 1: that's not acceptable at any level.
Speaker 2: So I'm heading up there soon, so better warm up anyway.
Speaker 1: And moving on today, we're a little bit excited actually
Speaker 1: because we found a few headlines that we thought, oh,
Speaker 1: we haven't talked about that, and there's very few nutrition
Speaker 1: headlines that come through on my phone that I sort
Speaker 1: of think, oh, that's interesting, because obviously I've worked a
Speaker 1: really long time, I've heard a lot of it before.
Speaker 1: If anything, I probably am a bit jaded. But last
Speaker 1: night I was scrolling Twitter at a time I really
Speaker 1: shouldn't have been, and I saw this reference to a
Speaker 1: new passion of eating called food sequencing, And I have
Speaker 1: never heard of this before, And when I took a
Speaker 1: little deep dive, apparently it's out there and there's a
Speaker 1: couple of key articles on it when was published on
Speaker 1: The Conversation, which is quite a reputable online evidence based publication.
Speaker 1: And to put it in the most basic of terms,
Speaker 1: it is we wouldn't call it food combining because that's
Speaker 1: separate altogether. But it's basically looking at the macronutrient or
Speaker 1: breakdown of the foods we eat. So, for example, saying
Speaker 1: a meal will have a mix of protein rich foods,
Speaker 1: carbohydrate rich foods, low energy density foods, so salads and vegetables,
Speaker 1: and then things like your start sheet carbohydrates. And the
Speaker 1: theory is for people who are more sensitive to fluctuations
Speaker 1: in glucose levels, so perhaps those with hyperglycemia or insulin
Speaker 1: resistance or pre diabetes, people who really suffer from that
Speaker 1: peak and then the drop where they get really craving
Speaker 1: and times overeat. The argument is if you eat what
Speaker 1: we would call the low energy density foods first, so
Speaker 1: salads or soup, follow that with the protein rich foods
Speaker 1: I say, the chicken or the meat or the dairy
Speaker 1: part of the meal, and then finish with any starchy carbohydrates,
Speaker 1: that any peak in glucose levels will be flattened and
Speaker 1: leave you less prone to energy fluctuations and cravings, which
Speaker 1: is better for glucose regulation long term. Now, as I said,
Speaker 1: it's not that it's new science as such, because we
Speaker 1: know roughly that that is the way scientifically food will
Speaker 1: break down. You know, a few food combine or have
Speaker 1: protein with carbohydrate, it will help to control glucose levels.
Speaker 1: But this is the first time I've seen it referred
Speaker 1: to as a movement around going out of your way to.
Speaker 2: Eat in this order.
Speaker 1: So you know, if you think back to plates of food,
Speaker 1: some people will save their meat to laughs because it's
Speaker 1: the best bid or whatever the preference. Whereas this is
Speaker 1: talking about it in terms of what's best for digestion
Speaker 1: and specifically glucose regulation, and there is some studies looking
Speaker 1: at it, which to me was really quite surprising. So
Speaker 1: in one study they were looking at participants consuming a
Speaker 1: way protein based shake thirty minutes before a meal that
Speaker 1: had potato in it with the goal of slowing gastric
Speaker 1: emptying and helping bloo glucose levels be controlled. And there
Speaker 1: was evidence to show this really did help reduce glucose
Speaker 1: spikes and the experience of that. So I thought, how interesting, because,
Speaker 1: as I said, in all the years I've worked in practice,
Speaker 1: I've never heard it. And I thought, well, it's really
Speaker 1: quite novel and really interesting, and I don't know if
Speaker 1: I'll try it with clients or not, but I thought
Speaker 1: it was certainly worthy of a discussion, particularly for people
Speaker 1: who really struggle with those highs and lows through the afternoon,
Speaker 1: suggestive of perhaps some insulin issues or crimium deficiency, which
Speaker 1: can absolutely be associated with hyperglycemia, which is where you
Speaker 1: get really lo glucose levels and feel almost shaky.
Speaker 2: So what do you think.
Speaker 1: Have you heard of it?
Speaker 3: You say it before, No, I haven't, but I did
Speaker 3: a bit of read when you sent the headline through
Speaker 3: and I thought, well, it's very interesting, but if we're
Speaker 3: being honest, there's not a whole lot of research behind it,
Speaker 3: and it really is, you know, for a more diabetic
Speaker 3: or a pre diabetic population that I think would be
Speaker 3: the most beteficial. I think if you're a fit, healthy
Speaker 3: person who's just generally aiming for you know, health in
Speaker 3: their lifestyle, I don't really think it's going to be
Speaker 3: that beneficial. Because there was another small study that tested
Speaker 3: five different meal sequences. So you know, some participants ate
Speaker 3: the carbs first, some participants ate the protein first, some
Speaker 3: participants ate the veggies first, and they all had to
Speaker 3: eat their meal within fifteen minutes, so the timing of
Speaker 3: the meal was factored in as well. And of those
Speaker 3: five different meal sequences, none of those sequences actually made
Speaker 3: a difference to the overall spike in blood glue coase levels,
Speaker 3: whether they their veggies first, their meat first, their rice first.
Speaker 3: So I thought that was interesting. So there's not a
Speaker 3: whole amount of evidence behind it. But if you are
Speaker 3: somebody who really does struggle with those big spikes in
Speaker 3: their glucose levels or struggles to get their blood glucose readings,
Speaker 3: you know more stable, it probably is something that's worth
Speaker 3: a trial. It's definitely not going to hurt you. But
Speaker 3: I do feel like sensible nutrition goes hand in hand.
Speaker 3: Like if you're someone who has diabetes or is pre diabetic,
Speaker 3: if you're sitting at a restaurant waiting field meal and
Speaker 3: sipping on a soft drink or you're sipping on a juice,
Speaker 3: of course that's going to hinder you know, your blood
Speaker 3: sugar levels. But if you're someone who you've ordered a
Speaker 3: really lovely healthy salad and it's got some kinoi in it,
Speaker 3: and it's got some chicken in it, and it's got
Speaker 3: some avocado in it, I think just eating that meal
Speaker 3: as a whole meal is probably absolutely okay. I think
Speaker 3: it really comes down to the amount of foods that
Speaker 3: we're eating as well. For having a huge bowl of
Speaker 3: creamy pasta, yeah, maybe it may be beneficial to have
Speaker 3: a salad first, or have I don't know, some Greek
Speaker 3: yoga or a protein hit before that to really reduce
Speaker 3: the overall spike of the those glue coase levels. So
Speaker 3: although there's not a whole I guess amount of research
Speaker 3: behind it, it is a kind of a cool novel concept.
Speaker 3: You know, there are definitely probably some listeners out there,
Speaker 3: SUSI that do struggle with their sugar level. So I
Speaker 3: do think it's something that if we've got the time,
Speaker 3: I mean, I think it probably shouldn't take you know,
Speaker 3: any more time to eat your meal in a different sequence.
Speaker 3: To me, it probably wouldn't add much to the over
Speaker 3: experience of a meal. I really like to mix things up.
Speaker 3: I like to sort of have the flavors going all
Speaker 3: through to together. I wouldn't like to just eat my
Speaker 3: chicken first and then my potato, then my salads or whatever,
Speaker 3: you know, whatever sequence first. I prefer to eat things
Speaker 3: all together. But I do think it's worth a try
Speaker 3: at home. It's not going to cause any harm and
Speaker 3: it's not going to you know, be negative, I don't
Speaker 3: think for anyone out there. So I think it's well
Speaker 3: worth a trial for alysis at home who do struggle
Speaker 3: with you know, highs and lows in terms of their sugars.
Speaker 1: Well, what are the very basic nutrition guidelines I've always
Speaker 1: recommended for years is always at carbohydrate and protein together,
Speaker 1: because my argument is that you will be kept full
Speaker 1: of for longer, you will have a better profile of nutrients.
Speaker 1: So it's not indirectly exactly this suggested order, but it's
Speaker 1: not dissimilar. But what we do know from volumetrics eating
Speaker 1: is that including a low energy density food before the
Speaker 1: meal or at the start of the meal, whether it's
Speaker 1: a broth type soup or a salad or even a
Speaker 1: plate of vegetables, is that you lead up to one
Speaker 1: hundred calories less per meal basically because it occupies some
Speaker 1: of the stomach and fills you up a little bit,
Speaker 1: same as drinking glass of water before a meal. So
Speaker 1: it's a little bit of an extension of that. But
Speaker 1: I think as a novel aspect, particularly for people who
Speaker 1: really struggle through the afternoon, so those who are at
Speaker 1: really high risk of type two diabetes or no they
Speaker 1: have that real low feeling, it's probably worth a little play.
Speaker 1: It won't hurt. But as I said, I wouldn't be
Speaker 1: mucking around with shakes and things. All I would do
Speaker 1: is say start the meal with some sort of low
Speaker 1: salad or bulk. You know, have then your protein and
Speaker 1: then you know, have any of the carbohydrate more towards
Speaker 1: the end to give that digestion and just see the effect.
Speaker 1: And if you find it works for you, it's a
Speaker 1: strategy that they're won't hurt and if it works fantastic.
Speaker 1: You know, it's not using any strange supplements, so it's
Speaker 1: really just you know, having a little look at physiology
Speaker 1: and seeing how we digest food. And I think it
Speaker 1: also encourages people to really look at the makeup of
Speaker 1: their meal because the feedback I'm giving every daily and
Speaker 1: is where are your salad? Where's your vegetables? Because the
Speaker 1: meals are inevitably too much protein, too much carbohydrate. You know,
Speaker 1: people will have a big serve of chicken or a
Speaker 1: realasmably big serve of meat and then rice or noodles
Speaker 1: in far excess of what should be there. Whereas I
Speaker 1: think if we take the focus back to a salad
Speaker 1: or veggies or soup to start as a bit of
Speaker 1: an entree, it's good for your nutrition in general. And
Speaker 1: then whether you eat the protein or the carb straight
Speaker 1: after each other, I don't think it'll make a massive difference.
Speaker 1: But I think just loading up with that bulk and
Speaker 1: that volume that we all need is a good strategy
Speaker 1: for all of us, and we could all benefit from
Speaker 1: having more veggies in general. And then you know, if
Speaker 1: you want to take it to the extreme if you
Speaker 1: do want, you know, we wouldn't be encouraging people to
Speaker 1: have mashed potato anyway. We'd certainly want a potato in
Speaker 1: a jacket as the recommendation. It comes down to a
Speaker 1: little bit of carbohydrate quality and portion size that you know. Certainly,
Speaker 1: I think that there's a bit of fun in it,
Speaker 1: and if it works for you, it's certainly something to
Speaker 1: have a look at, and metabolically there would be some
Speaker 1: evidence to support it. So yeah, I was quite interested,
Speaker 1: and I think we'll see a few articles on this
Speaker 1: coming through now because we're like something new in the
Speaker 1: tight space and I've never heard of that before. So
Speaker 1: you heard it here first on the Nutrition Couch podcast
Speaker 1: food sequencing and the association with glucose control. So let
Speaker 1: us know your thoughts if you've tried it and if
Speaker 1: it works for you.
Speaker 3: Definitely, Yeah, I like that. It's a really novel concept.
Speaker 3: But as you sort of hinted it, I really we're
Speaker 3: not really encouraging people to go and have a way
Speaker 3: protein jake thirty minutes before their meal. I just think
Speaker 3: that's a sort of an excessive thing. And that's how
Speaker 3: those were able to sort of standardize the research studies.
Speaker 3: I really do think have the meal that you're going
Speaker 3: to eat and maybe try to sequence out the different
Speaker 3: parts of that that you're going to have at a
Speaker 3: different timing, or you know, have one portion first, the
Speaker 3: next portion after, versus.
Speaker 2: Mixing it all together.
Speaker 3: We're definitely not encouraging adding extra protein to the meal
Speaker 3: because I think a lot of us drains, particularly at
Speaker 3: dinner time, actually too much protein anyway. So I don't
Speaker 3: think adding more protein at the start of the meal
Speaker 3: or thirty minutes before is going to do too much
Speaker 3: from a general health perspective, because we know Ossie's particularly
Speaker 3: red meat, we eat far too much protein. We eat
Speaker 3: far too much red meat, so we definitely don't need
Speaker 3: more necessarily in our diet. So it's a novel little concept,
Speaker 3: and it will be interesting to see if our listeners
Speaker 3: can provide us with any feedback if anyone's given it
Speaker 3: a go. But moving on to our client case study
Speaker 3: of the week, So Susie, this is I would say
Speaker 3: a condition that we've both seen more and more frequently
Speaker 3: within our clinics, particularly in our younger population, particularly in
Speaker 3: our females. So it's the concept of or the clinical
Speaker 3: condition that we would call orthorexia nevosa. By definition, so,
Speaker 3: orthorexia nervosa is basically a disordered eating pattern that's characterized
Speaker 3: by the need or the obsession to eat completely clean
Speaker 3: and completely pure foods to the point that that individual
Speaker 3: or that person then becomes quite obsessive with this way
Speaker 3: of eating in this way of life. So orthorexia nervosa
Speaker 3: is commonly associated with and also social isolation. So if
Speaker 3: you were looking to have an exact definition, authorexia is
Speaker 3: an obsession with eating healthy foods. Basically, that's probably the
Speaker 3: easiest definition, and it is now a diagnosed medical condition
Speaker 3: because you know, years ago, Susie, we had eating disorders
Speaker 3: that were anorexia oversia, we had bolimia. We never had
Speaker 3: a type of eating or a style of eating that
Speaker 3: really was focused on restriction and really focused around healthy foods.
Speaker 2: So I really like.
Speaker 3: That in the past couple of years, we've moved away
Speaker 3: from just saying, well, if you don't have an arexia
Speaker 3: and you don't have binge eating disorder, we don't have
Speaker 3: an eating disorder because we know all bolima as well.
Speaker 2: We know that.
Speaker 3: Even being completely obsessed with quote unquote, clean eating and
Speaker 3: healthy eating can be damaging and detrimental to our health
Speaker 3: long term. So we found an article online and I
Speaker 3: really like the SUSI. It was written by a dietitian,
Speaker 3: and it essentially says, the ten signs that you're healthy
Speaker 3: eating may have gone too far. So I guess a
Speaker 3: red flag or something you might think about if you're
Speaker 3: thinking at home and thinking, oh am I suffering from authorexia?
Speaker 3: Do I need to go and see a psychologist? Should
Speaker 3: I see my doctor? Should I see a dietician? These
Speaker 3: are maybe some red flags or some signs that things
Speaker 3: may have gone a little bit too far despite the
Speaker 3: best intentions. We I don't think anybody sets out to
Speaker 3: have an eating disorder, right, but it sort of just
Speaker 3: develops naturally over time. And for those of us with
Speaker 3: more of that perfectionist personality type and really like we're
Speaker 3: obsessed with being healthier, we fear unhealthy foods. I think
Speaker 3: that's sort of the first red flag. So the number
Speaker 3: one sort of sign that you're healthy eating may have
Speaker 3: gone a bit too far is that you skip social occasions.
Speaker 3: So you're saying, no, I can't come to dinner, No, sorry,
Speaker 3: I can't eat out breakfast because you fear having to
Speaker 3: eat food that you haven't prepared yourself, or you bring
Speaker 3: all of your food to a social occasion, so you
Speaker 3: go to someone's birthday and you take your food in
Speaker 3: a top work container so you can eat that. Second sign,
Speaker 3: your skin is really dull. It's breaking out, your hair's
Speaker 3: bawling out, basically, sort of like vitamin and nutrient deficiencies.
Speaker 3: Number three, if you're a female, if you've lost your
Speaker 3: period or it's very irregular, or if it used to
Speaker 3: be regular and now it's really a regular, or there's
Speaker 3: just changes within your period of cycle all you've lost
Speaker 3: it all together. Number four is you're constantly tied or
Speaker 3: you're constantly feeling very cold. Number five you've got recurrent
Speaker 3: injuries or sicknesses. Number six, you only have a very
Speaker 3: limited range of foods that are quote unquote safe or
Speaker 3: you're able to eat. Number seven, you never ever have cake, chocolate,
Speaker 3: an alcoholic drink, or.
Speaker 2: A sugar drink.
Speaker 3: Number eight, you're exercising for more than about one and
Speaker 3: a half to two hours a day and you're not
Speaker 3: a professional athlete. If you're a professional athlete, sure you
Speaker 3: might have three, four, five, six hours of training a day.
Speaker 3: But if you're just an average person like Susie and I,
Speaker 3: we have jobs, we have families, spending anywhere more than
Speaker 3: about an hour and a half to two hours exercising
Speaker 3: per day could sort of be a sign that you're
Speaker 3: healthy eating and your healthy lifestyle has gone too far.
Speaker 3: Sign Number nine is that people are constantly commenting on
Speaker 3: how thin you look or how much weight that you've
Speaker 3: lost recently. And number ten is that you're not happy
Speaker 3: with your body no matter what you do, no matter
Speaker 3: how much you weigh, no matter how much you eat
Speaker 3: or how much you exercise, You've always constantly feeling like
Speaker 3: you can do more, you should do more, you should
Speaker 3: look differently. So those are sort of ten signs that
Speaker 3: maybe things have gone a little bit too far and
Speaker 3: there's a little bit of this obsession with health that
Speaker 3: may have gone towards more of an unhelpful place.
Speaker 2: Put it that way.
Speaker 3: So, have you seen many clients with orthorexia recently?
Speaker 2: I've seen it.
Speaker 1: I've seen a handful, And I'll describe a couple of
Speaker 1: the key clinical presentations, and I think we should really
Speaker 1: stress that when it comes to clinical eating disorders. So Anorexinivosa,
Speaker 1: Bolivia Nevosea. There's some very very strict criteria that define that. So,
Speaker 1: for example, anorexics need to have had several months with
Speaker 1: the lack of menstrual cycle, vastly different view of their body,
Speaker 1: avoidance of food, extremely low body weight be in my
Speaker 1: below seventeen point five.
Speaker 2: Yeah, I think so.
Speaker 1: So there's a lot of very specific clinical indicators of
Speaker 1: those diagnosable clinical conditions. So the thing with authorexia it
Speaker 1: kind of sits in between because often the present is
Speaker 1: they're not significantly underweight, but there's a real obsession and
Speaker 1: a rigidity around it, and my experience it's often misplaced
Speaker 1: anxiety that comes out in controlled or obsessive food and
Speaker 1: eating behavior and exercise behavior. So a classic presentation would
Speaker 1: be a typically young, sort of twenty thirty year old
Speaker 1: female who is slim and fit and healthy but wants
Speaker 1: to be slimmer, wants to lose that final two to
Speaker 1: three kilos, which is debatable if it's there. They're already training,
Speaker 1: often multiple sessions a day, so this is often my goal,
Speaker 1: well not often because I don't want to put everybody
Speaker 1: in that group, but these are goals who perhaps will
Speaker 1: do a CrossFit early five am every day and then
Speaker 1: come and train again in the afternoon, plus doing their steps,
Speaker 1: and then on a really tight calorie restriction, so eating
Speaker 1: eight hundred one thousand calories, so chronically calorie deprived and
Speaker 1: not ticking the box, and a number of their key nutrients.
Speaker 2: Very tired.
Speaker 1: Sometimes they're binging on alcohol or or food because they're
Speaker 1: feeling so restrained. So there's a few key markers of it.
Speaker 1: One is a rigidity around diet and exercise, very focused
Speaker 1: on clean eating, so quite rigid in the patterns of eating,
Speaker 1: so every day, say way, protein shake, every day, this much.
Speaker 1: It's so very very strict with their self prescribed diet
Speaker 1: and often quite unhappy, you know, low mood and stressed
Speaker 1: and perfectionistic characteristics and anxiety in many cases. So it's
Speaker 1: more it's a slippery slope, isn't it, Because sometimes we
Speaker 1: start with healthy eating behavior and then we think more
Speaker 1: is better. And as we've discussed before, it's not a competition.
Speaker 1: You can't win the prize for being the healthiest eater.
Speaker 1: And even if you do, even if you tick the
Speaker 1: box on the healthiest eating, it doesn't guarantee any outcome.
Speaker 1: You know, the physiology and the body is a lot
Speaker 1: more complicated than that, so it's a complex issue. Certainly,
Speaker 1: in many cases, I would say it's not only a
Speaker 1: dietary presentation. Often the referral is going back to GPS
Speaker 1: or psychologists to work on the underlying driver, which is
Speaker 1: often some psychology or anxiety or stress or trauma that's
Speaker 1: driving that more obsessive behavior. So certainly alone not a
Speaker 1: nutrition problem, but I think it also can present with
Speaker 1: teenage girls who start to eat healthy and become more
Speaker 1: and more obsessed moving through those school years. So they
Speaker 1: are all little markers for parents listening with teenage girls
Speaker 1: who sort of tend to be a bit obsessive, become
Speaker 1: very body conscious, going to the gym more and more frequently,
Speaker 1: because yeah, it's a slippery slope to full blown eating
Speaker 1: disorder and becoming quite clinically underweight and doing damage to
Speaker 1: the body and resulting in things like stress factors as
Speaker 1: a result of chronically localcium intake and impacts on metabolic
Speaker 1: rate because of chronically low So there are a few
Speaker 1: signs of it, and it does absolutely present, and you
Speaker 1: can really benefit from some nutrition therapy around hitting baseline
Speaker 1: calorie requirements and nutrient targets as a minimum, not overtraining
Speaker 1: and underfuel, which is common. You know, if I'm seeing
Speaker 1: someone doing more than a couple of hours of intense
Speaker 1: exercise and they're not elite athletes, I'd be sort of
Speaker 1: questioning the driver for that, and certainly looking at things
Speaker 1: like the bloods and nutrient deficiencies, things like B twelve iron,
Speaker 1: zinc can all be impacted thyroid long term, and of
Speaker 1: course mood. You know, we know that mental health issues
Speaker 1: are so prevalent. We know that its getting to the
Speaker 1: right practitioner and the right support around it, which we've
Speaker 1: spoken about before.
Speaker 2: Nutrition can be a big part of that intervention.
Speaker 1: That's some support, you know, a really good therapist, psychologists
Speaker 1: to manage some of those other drivers can be a
Speaker 1: really big important part of it. So I like that
Speaker 1: checklist because I think it's just a reminder when things
Speaker 1: get taken a little bit too far, and yeah, it's
Speaker 1: just the pre slope to full blown so disordered eating.
Speaker 1: You know, inevitably well can lead to eating disorders and
Speaker 1: they very serious, so you know, worth of a discussion,
Speaker 1: particularly for as I see most commonly that the overtrainers
Speaker 1: and underfuelers.
Speaker 3: Absolutely, and I just thought of two more off the
Speaker 3: top of my head. Susie really being obsessed sid with
Speaker 3: like ingredient less and nutrition labels. Of course, in the
Speaker 3: Nutrition Couch we recommend people spend some time reading the
Speaker 3: ingredient lists and reading the nutrition labels. Of course, we
Speaker 3: always want to find those healthy eruptions. But when it
Speaker 3: comes to soul foods, when it comes to a celebration,
Speaker 3: when it comes to eating at at a restaurant, if
Speaker 3: places use palm oil, if places use sugar in cake,
Speaker 3: if people you know, want to have a glass of
Speaker 3: champagne with their dinner, all those things are absolutely okay
Speaker 3: in you know, small amounts or in moderate portion sizes.
Speaker 3: So it's not to say that if we go to
Speaker 3: a restaurant and we ask, you know what type of
Speaker 3: oil the chef uses and we say, well, I'm not
Speaker 3: eating that.
Speaker 2: I couldn't possibly eat that.
Speaker 3: Or if we say, oh, what's in this dessert and
Speaker 3: they say it's got you know, sugar, and you ask
Speaker 3: is it white refined sugar? Then you say there's no
Speaker 3: way I could put that food into my body. There's
Speaker 3: sort of some signs and symptoms, and we become very
Speaker 3: obsessive with checking every single ingredient that goes into our
Speaker 3: food and every single ingredient on our nutrition labels as well.
Speaker 3: So that's probably a big one for me where I've
Speaker 3: had a few clients who have absolutely black or white
Speaker 3: with different ingredients in different nutrients in the foods and
Speaker 3: iolutely won't eat this. And fair enough, if there's an
Speaker 3: ethical or a personal view of it, you know, say
Speaker 3: you might be plant based, so you might be vegan,
Speaker 3: that's absolutely okay. That's you know, a whole other area
Speaker 3: in it stuff. If you don't want to eat animal products,
Speaker 3: that's absolutely okay. But if you're avoiding an ingredient and
Speaker 3: avoiding it something in a food because you just feel
Speaker 3: that it's completely unhealthy, there's just a fine line between that,
Speaker 3: isn't There susa a fine line between you know, wanting
Speaker 3: to choose better products and then being almost fearful of
Speaker 3: eating certain ingredients. Of course, we're not saying you should
Speaker 3: eat soft foods regularly all of the time, but it's
Speaker 3: absolutely okay to have some you know, white refined sugar
Speaker 3: in a birthday cake if it's somebody's birthday it's a
Speaker 3: bit of a celebration or something like that. So I
Speaker 3: really think that obsessiveness around the ingredient list and very
Speaker 3: black or white in terms of the foods that you
Speaker 3: will and won't eat is a big sign. And the
Speaker 3: other one is really, I mean, the most common sign
Speaker 3: of orthorex here, I think Susie is that it negatively
Speaker 3: affects your life. So it's causing you, you know, more stress,
Speaker 3: more anxiety. It's socially isolating you. You've got your friends
Speaker 3: and your family really worried about you, asking lots of questions,
Speaker 3: are you doing okay? Perhaps they're suggesting that you should
Speaker 3: talk to somebody. I think really the biggest sign is
Speaker 3: that it's negatively impacting your life in some way. If
Speaker 3: you're canceling plans with your family, or you running late
Speaker 3: to work because you had to spend an extra you know,
Speaker 3: twenty minutes out on your run, those sorts of things
Speaker 3: are negatively impacting your life, and I really do think
Speaker 3: that it's time to take a step back and sort
Speaker 3: of go and chat to a professional. And probably the
Speaker 3: top line professional when it comes to something like orthorexia
Speaker 3: would be a psychologist. So absolutely that's the first point
Speaker 3: of call we'd recommend, although you know, having a chat
Speaker 3: to your dietician or having a chat to your doctor
Speaker 3: of course is a good idea as well, but for
Speaker 3: I think the majority of people suffering from orthorexia, it
Speaker 3: really would be a psychologist that is able to help
Speaker 3: them probably the most.
Speaker 1: And I think the other one I see a lot
Speaker 1: is obsessive calorie counting and monitoring on something like my
Speaker 1: fitness power, where there's just streams and streams of data
Speaker 1: and over analysis. And what always strikes me is that
Speaker 1: those monitoring apps, they're great, but they're also a bit inaccurate.
Speaker 1: You know, it's probably twenty percent in accuracy, So people
Speaker 1: who are really focused on those numbers and thinking, oh,
Speaker 1: I eight five more grams of carb today, when really
Speaker 1: it's probably an error margin anyway for any food that's
Speaker 1: in there. So that's another warning sign for me. When
Speaker 1: people obsessively calorie count with no end in sight for
Speaker 1: no other reason than just to feel in control, that
Speaker 1: can be a sign that, you know, focusing a little
Speaker 1: bit too much, and it particularly getting into headspaced hunger
Speaker 1: rather than what your body is telling you and overriding
Speaker 1: things like fatigue and training regardless and ignoring sort of
Speaker 1: physiological signs and then cognitively controlling things. So yeah, I
Speaker 1: think there might sort of risk groups. It's the young
Speaker 1: women and then also the girls' teenage girls who go
Speaker 1: through sometimes that focus on what they're eating and doing
Speaker 1: exercise wise, so it can be a real concern for parents.
Speaker 1: All right, Ley and Well for our final segment of
Speaker 1: their show. Another pertinent topic at the moment given that
Speaker 1: everyone we know is sick, because we do get a
Speaker 1: lot of questions around supplements, and naturally we are dietitians,
Speaker 1: so we love natural food supplements because we always think
Speaker 1: that they're best. But when we do take a look
Speaker 1: at the evidence around cold and flu, there is a
Speaker 1: handful of supplements with some evidence behind them to support
Speaker 1: either improvements in immune function or reduction in symptoms. So,
Speaker 1: off the top of my head, you know, the ones
Speaker 1: we were asked about was more magnesium. Now, whilst there's
Speaker 1: some evidence to show that there's about ten to fifteen
Speaker 1: percent of Australians who have a low intake of magnesium,
Speaker 1: and magnesium is a nutrient found in leafy green veggies,
Speaker 1: nuts and seeds, whole grains, and often people are relatively
Speaker 1: low because of high requirements and low intake of fresh food.
Speaker 2: And whole grains.
Speaker 1: The truth is there's not a lot of evidence around
Speaker 1: magnesium supplementation and immune function. You know, it's more around
Speaker 1: sleep quality restless legs when you take a look at it.
Speaker 1: But the handful that there is evidence and I know
Speaker 1: this because I had to research it recently for a piece.
Speaker 1: There is some evidence for concentrated garlic supplementation. Now, obviously
Speaker 1: it's ideal to have the garlic in natural form, but
Speaker 1: may not always be overly palatable to down a few
Speaker 1: cloves of garlic each day, so if you prefer to
Speaker 1: take it in a supplementary form. It's been used for
Speaker 1: many years as an anti bacterial and anti microbial supplement
Speaker 1: and so indeed shows improving in immune function. The same
Speaker 1: for olive leaf extract as a high level antioxide. There
Speaker 1: is some evidence for that. Echinata is another one. There
Speaker 1: is a little bit of evidence to help reduce the
Speaker 1: duration of a cold, as is the case with vitamin C.
Speaker 1: So vitamin C at high doses won't stop you getting
Speaker 1: the cold, but it can slightly reduce the.
Speaker 2: Length of it. And zinc.
Speaker 1: Now, zinc is a controversial one because when we take
Speaker 1: a look at some of the data, particularly around COVID,
Speaker 1: high level zinc supplementation in an elemental form was linked
Speaker 1: to reduction in COVID symptoms. But zinc is as a
Speaker 1: nutrient of mineral can be quite dangerous at high doses.
Speaker 1: So it's certainly certainly not when I encourage people to
Speaker 1: routinely supplement. Rather, I would be interested in making sure
Speaker 1: people get enough dietary intake of zinc from lean red
Speaker 1: meat and whole grains and nuts regularly, rather than encouraging
Speaker 1: zinc supplementation without warranting it. But in the cases of
Speaker 1: garlic olivelea extract echination and vitamin C, I wouldn't be
Speaker 1: concerned about supplementing those because there's really no concern about
Speaker 1: overdosing in the same way that you would be concerned
Speaker 1: about something like zinc or iron. So yeah, if you
Speaker 1: don't mind popping a few pills, there is a little
Speaker 1: bit of evidence. Do I take any of them? No,
Speaker 1: I don't take any supplements because I'm just not a
Speaker 1: supplement person. But if some people like them and want to,
Speaker 1: these are the ones that you could potentially spend your
Speaker 1: money on. With a little bit of evidence behind them,
Speaker 1: as opposed to the ones that we normally see, which
Speaker 1: are spriaked all the time. So what are the ones
Speaker 1: we see like the greens, powders, and you know a
Speaker 1: lot of those I think are just money makers. I
Speaker 1: certainly wouldn't be encouraging those. I'd much rather someone has
Speaker 1: a veggie juice. But if you want to pop a
Speaker 1: couple of garlic tablets won't hurt you. So that's where
Speaker 1: the evidence sits. What do you suggest for people when
Speaker 1: they're warding off the colds and flu?
Speaker 3: I personally, I do take a couple of sopholmes. I
Speaker 3: do go hopefully extract and for me, I get my
Speaker 3: vitamin C from food. So I will disclose that I'm
Speaker 3: working with zaspri Kirii fruit at the moment. Did you
Speaker 3: guys know that it is very good, the deliciousess of
Speaker 3: song called variety in particular that we get in Australia,
Speaker 3: But did you guys know that one that qiufruit provides
Speaker 3: one hundred percent of your vitamin C intake a day.
Speaker 3: So whatever my clients go, oh yeah, and I feel
Speaker 3: like I'm coming down with something, I'm going to start
Speaker 3: taking some vitamin C supplement. As a hold up, let's
Speaker 3: just take a kiwi fruit a it can count as
Speaker 3: a bit of a snack. We're getting in a bit
Speaker 3: of a fruit serve. There's some soluble fiber in there. Like,
Speaker 3: we're getting way more benefits than just popping some vitamin
Speaker 3: CE tablets. And it's a lot more cost effective as well.
Speaker 3: So queufruits where it's at. If you struggle with things
Speaker 3: like constipation, lead the skin on, you can actually.
Speaker 2: Eat the skin as well.
Speaker 3: Just give it a good wash, So one qiri for
Speaker 3: it a day, one hundred percent of your vitamin C intake.
Speaker 3: So my little cold and flu bubble is basically a
Speaker 3: qui fruit a day, good quality diets, some good chicken
Speaker 3: and vegetable soup, some olive leaf astrac and I actually
Speaker 3: am a fan of zinc susie because there is actually
Speaker 3: some research behind it, but like you said, I only
Speaker 3: really recommend my clients take it for five to seven days.
Speaker 3: So where the research really does sit with zinc is
Speaker 3: that zinc lozenges and it's really important to have the
Speaker 3: lozenge of form so it coats the mouth because a
Speaker 3: lot of the bacteria starts in the mouth, So you
Speaker 3: really don't want to just be taking a supplement. You
Speaker 3: want something to hope the mouth. So lozenge is what
Speaker 3: a lot of the research has really been studied with,
Speaker 3: and it can actually help to decrease the duration and
Speaker 3: the severity of a cold. But of course the amount
Speaker 3: is very very important, So a lot of the research
Speaker 3: really focuses on about seventy five milligrams a day of
Speaker 3: zinc in lazow form. It's a hell of a lot
Speaker 3: of zinc, and actually finding a supplement or a brand
Speaker 3: that has that amount in it is basically non existent,
Speaker 3: like you're going to have to take two through four
Speaker 3: tablets of something. So this is definitely something that we
Speaker 3: would only really recommend for healthy adults.
Speaker 2: You should probably double check with your GP.
Speaker 3: I wouldn't recommend it for pregnant women, wouldn't recommend it
Speaker 3: for breastfeeding, wouldn't recommend it if you've got any other
Speaker 3: sort of health concerns or issues all that sort of thing,
Speaker 3: and very short durations as well. So really where the
Speaker 3: research shows is that you need to take it on
Speaker 3: like day one of a cold. If you're four or five,
Speaker 3: six days into a cold, you've got COVID anything like that.
Speaker 3: It's probably really not going to do any sort of
Speaker 3: impact if you already day in. It really needs to
Speaker 3: be on day one that you first develop those symptoms,
Speaker 3: and then I generally recommend my clients take it as
Speaker 3: sort of anywhere between three to seven days, and we
Speaker 3: cut it off after that. Zinc's not something that I
Speaker 3: would recommend, particularly such a high dose of it. I
Speaker 3: wouldn't recommend just taking it in order to try and
Speaker 3: prevent something, you know, like I have a lot of
Speaker 3: clients who say, oh, well, I've got a big presentation
Speaker 3: coming up at work, I'm just going to take some
Speaker 3: supplements to make sure I don't get sick. A high
Speaker 3: dose amount of zinc isn't something that I'd be recommending
Speaker 3: you take as a preventative zink because where the research
Speaker 3: really does show assis that does help to prevent and
Speaker 3: decrease the duration and the severity of a cold. So
Speaker 3: the research is really around that seventy five milligrams a day,
Speaker 3: So a lot of brands you're going to need multiple
Speaker 3: tablets or multiple lozenges of that. I'm just looking at
Speaker 3: one of the systematic reviews I've pulled up Susie, and
Speaker 3: there were five trials included in this with a total
Speaker 3: daily zinc dose of more than seventy five milligrams. There
Speaker 3: were no sorry, five trials that had a total daily
Speaker 3: dose of less than seventy five milligrams, and all five
Speaker 3: trials found zero effect in terms of the zinc and
Speaker 3: reducing the duration and severity of a cold. But once
Speaker 3: we increase the dose over seventy five milligrams a day,
Speaker 3: there was a forty two percent reduction in the duration
Speaker 3: of a cold. So that's you know, for a lot
Speaker 3: of people, that's really a significant impact. So it is
Speaker 3: something well worth trialing, but I think it has to
Speaker 3: be for a very very short period of time and
Speaker 3: only really in the healthy adult population. I definitely wouldn't
Speaker 3: be giving this to children or teens or anything like
Speaker 3: that because it is such a high dose.
Speaker 1: That's a really good point that the supplement doses for
Speaker 1: children and teens. You know, you can't just extrapolate, and
Speaker 1: I think that's the concern when you're having multiple supplements
Speaker 1: as well, or even using protein powder, is that you
Speaker 1: can be getting nutrients from several sources, which isn't always
Speaker 1: a great idea.
Speaker 2: But I love.
Speaker 1: I think that if I always give kiwis as well,
Speaker 1: like eat a kiwi fruit, like you get to get
Speaker 1: a massive dose, You're a million times better to get
Speaker 1: it from fresh fruits and vegetables, and then you get
Speaker 1: the synergistic effect of all of the antioxidants and nutrients
Speaker 1: in that produce. But I have to be honest, I
Speaker 1: can't do the skin like I don't know, like a kiwifruit,
Speaker 1: like biting into it like an apple like I see
Speaker 1: all these dieticians posting that, and I'm like, oh, I
Speaker 1: don't know.
Speaker 2: I can't do that.
Speaker 1: So it's pretty good blended into like a green juice. Yeah,
Speaker 1: you put it into a smoothie maybe, But I'm a
Speaker 1: big fan. Actually, if I'm feeling a little bit well
Speaker 1: and I have had a bit of throat issues this
Speaker 1: last couple of weeks, I just get a green juice,
Speaker 1: so I downstairs from where I work, I do that.
Speaker 1: I do beetroot, celery, carrot or I do that. I
Speaker 1: think the slim grin at top juice, which I really like,
Speaker 1: is got like cucumber, kale, bit of apple, and it's
Speaker 1: about eighty calories and I just load on the juice.
Speaker 1: You know, mixed veggie and a little bit of fruit.
Speaker 1: That's one of the best ways to get a good
Speaker 1: dose of vitamin see nutrients without Yeah, I just maybe
Speaker 1: I'm too tired. I wouldn't pay all that money. But
Speaker 1: you're right, olive leaf extract does have some evidence towards it,
Speaker 1: so interesting that you take.
Speaker 2: That all right.
Speaker 1: Well, on that note, that brings us to the end
Speaker 1: of the Nutrition Couch for another Sunday. If you haven't
Speaker 1: done so already, please subscribe to have us deliver it
Speaker 1: every Sunday and Wednesday morning. We'd love to hear from
Speaker 1: you on social media. We're getting ready for our tour
Speaker 1: event coming out, which we will announce very soon, so
Speaker 1: keep an eye out on that for dates and locations.
Speaker 2: And ticket sales.
Speaker 1: And we will see you on Wednesday for our regular
Speaker 1: product drop. So keep warm and cold and flu free.
Speaker 2: Catch you guys next week.
Speaker 3: Spet spat stand Steed Stet