Spotlight on the liver

The liver is such an amazing organ. It is the largest organ within the body, can re-generate itself and is responsible for as many as 500 critical functions and metabolic processes essential for life. It contains around 10% of the bodies blood and pumps around 1.4 litres through every minute (1). It has two blood supplies, one via the hepatic portal vein, which carries nutrient rich blood from the entire digestive tract, and the other via the hepatic artery, which carries oxygenated blood from the lungs. It is a vital component of the digestive system.
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Liver functions

liver anatomyAmongst many important functions, the principle role of the liver, broadly,  is to remove toxins from the body, process nutrients from the digestive tract and help regulate body metabolism. Some specific liver functions include:

 

 

 

Instant energy – The liver converts carbohydrates into glucose which is an instant source of energy for the body. If blood glucose levels are optimum, the liver converts glucose into glycogen for energy stores.

Makes bile – Bile that is made by the liver helps with the digestion and intestinal absorption of fats and fat soluble vitamins A, D, E and K.

Detoxification – The liver filters harmful substances and then removes them  via the kidneys as urea and small intestines as faeces.

Cholesterol – It produces cholesterol and special proteins that carry fats throughout the body.

Protein synthesis – It makes blood clotting proteins and proteins for blood plasma.

Recycling blood cells – It breaks down red blood cells and is able to reuse their constituents. (234)

 

Liver disease

Between 2010 and 2012, liver disease was the 11th leading cause of premature death in Australia. More than 2 in 3 of these were male (69%). Interestingly, the premature death rate from liver disease decreased by a massive 48% between 1982 and 2012. This drop is mostly attributed to advances in disease management including lifestyle changes and an increase of hospitalisation for alcoholic liver failure. As the old adage goes ‘prevention is better than a cure’ and in the instance of liver disease, it rings true. Along with genetic predisposition, lifestyle choices are a major contributing factor towards developing many preliminary liver diseases that can lead to life threatening conditions (5).

Non_Alcoholic_Fatty_Liver_DiseaseAlcoholic Fatty Liver Disease – Excessive consumption of alcohol “more than 2 drinks a day for women and more than 3 drinks per day for men” (6), can cause damage to liver cells reducing its ability to break down fats and so fatty liver begins to develop. Further consumption of excessive alcohol progresses fatty liver to alcoholic hepatitis causing inflammation and scarring. At this stage, abstinence can reverse the disease and stop further scaring. Continuation of excessive alcohol consumption can lead to alcoholic cirrhosis, the most advanced form of liver disease and cannot be reversed by abstinence! (7)

Non Alcoholic Fatty Liver Disease (NAFLD) – This is the development of fatty liver outside of alcohol consumption. Generally, it is thought that the liver’s ability to process excess triglycerides causes fats to deposit within liver cells. Causes may range from overweight -obesity, high blood triglycerides, high cholesterol, diabetes, rapid weight loss, starvation, protein malnutrition, enteral or parenteral feeding and genetic predisposition. Progression of NAFLD leads to liver swelling and scaring called Nonalcoholic Steatohepatitis (NASH) and without treatment can lead to cirrhosis and cancer. There are no medical treatments for NAFLD. Positive results in reducing NAFLD come from lifestyle changes including good nutrition from eating a healthy diet and getting regular exercise (678).  Just another example of giving your body the materials it needs to heal itself! People who are obese should aim for a progressive and controlled loss of weight. Diabetics with high blood lipid levels should control their blood sugars.

Viral hepatitis A, B and C – Viral hepatitis is usually a short term viral infection but can become chronic and cause serious health problems and even be life threatening. The varying forms of the hepatitis virus can be contracted by ingesting infected foods to exposure through contaminated blood and body fluids. Apart from immunisation, there are no acute treatments for the hepatitis virus. The best you can do is to maintain a healthy functioning liver by eating a nutritious and healthy diet as well as getting regular exercise. Exclude any toxins in the diet like alcohol, cigarettes or recreational drugs to reduce the workload on the liver.

Other forms – Genetic predisposition are thought to cause liver disease such as hemochromatosis, wilson disease, tyrosinemia, alpha 1 antitrypsin deficiency and Glycogen storage disease. Autoimmune disorders also attribute to liver disease such as primary biliary cholangitis (PBC), primary schlerosing cholangitis (PSC) and autoimmune hepatitis. All of these forms of liver disease are outside of lifestyle causation.

Your liver is your bodies battery. It stores and releases energy when you need it. It plays an essential role converting food into chemicals that are needed for life. Good nutrition plays a vital roll for optimal liver function and health. A well balanced diet that includes all vital food groups, and limits toxins,  is your liver’s best defence against preventable disease. Alongside regular exercise, good nutrition can also reverse some forms of liver disease. Guidelines for healthy eating can be found at eatforhealth.

 

 

 

 

 

 

 

 

Pre-diabetes. Your fast track to full blown diabetes mellitus!

I work in a hospital and see first hand the grim realities of what diabetes mellitus can do to our bodies. One particular patient in recent weeks, a young man just 35 years of age, had his left leg amputated just below the knee and lost a few toes on the other side. Diabetes can cause peripheral artery disease (PAD) which is the narrowing of blood vessels that deliver oxygenated blood to the limbs. Combined with peripheral neuropathy (nerve damage), small wounds can go unnoticed and become infectious without the ability to repair or heal. Tissue begins to die and become gangrenous, infection spreads to bone and the only way to stop it is to amputate (1). Suddenly, all of those poor lifestyle choices come to a head in a very bad and life changing way.

Diabetes Australia reports that 4,400 people are loosing limbs as a direct result of diabetes mellitus each year and that number is growing (2). 2 million Australian’s have pre-diabetes and are within the high risk category of developing full blown diabetes mellitus (3). Here is a link that opens a diabetes risk calculator provided by Diabetes Australia Diabetes risk calculator.

Pre-diabetes, as the name suggests, is a condition defined by having higher than normal blood glucose that does not quite reach the higher level required for diabetes diagnosis. The chart below illustrates the three tests available for the diagnosis of pre-diabetes and diabetes mellitus.

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  • The A1c test measures glucose that is attached to hemoglobin over a two month period as this is the average life span of a red blood cell. The results are expressed as a percentage where less than 5.7% is normal, between 5.7% – 6.4% is pre-diabetic and above 6.5% is diabetic.
  • The fasting plasma glucose (FPG) test requires a fasting of 8 hours or more before taking blood to measure blood glucose levels. The results are measured in milligrams per decilitre (mg/dl) where less than 100 mg/dl is normal, between 100 mg/dl – 125 mg/dl is pre-diabetic and 126 mg/dl is diabetic.
  • The oral glucose tolerance test (OGTT) checks blood glucose before drinking a glucose drink. The blood glucose level is checked again 2 hours after the drink to measure the body’s response. Less than 140 ml/dl is normal, between 140 mg/dl – 199 mg/dl is pre-diabetic and over 200 mg/dl is diabetic (4).

Pre-diabetes is usually asymptomatic and as a result, most people do not know they have it. Symptoms like excessive thirst and urination, tiredness, hunger, cuts that heal slowly, skin infections, blurred vision and mood swings will usually only become present once diabetes has developed, and by that time it’s too late.

Evidence from large scale randomised control trials show that the development of type 2 diabetes from pre-diabetes can be prevented or delayed by up to 58 percent of cases by embracing a few lifestyle and physiological changes (5).

  • Exercise regularly
  • Maintain a healthy weight
  • Eat a healthy diet
  • Manage cholesterol
  • Manage blood pressure
  • Not smoking

These lifestyle changes may be easier for some to manage, but surely the prospect of staving off type 2 diabetes is well worth the effort? Your ability to metabolise energy from all types of foods efficiently is nothing short of amazing. Often, it is taken for granted like most other things in life, until it is gone..

 

 

 

 

 

Can nutrition help relieve anxiety?

Anxiety disordersanxiety grip many of us on a day to day basis. Anxiety does not discriminate. It can effect people from all walks of life and at any age. Grappling with any of the six main types of anxiety, including generalised anxiety disorder (GAD), panic disorder, phobic disorders, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD) and separation anxiety disorder, can leave a person with a great sense of isolation, helplessness and completely drained of energy. 45% of all Australians will experience a mental health condition in their lifetime. In the space of a year, over 2 million Australians will experience a form of anxiety disorder (1). I have a person close to me experiencing heavy generalised anxiety and so have decided to research the possibilities of therapeutic nutrition in regards to treating the biological and biochemical factors that may relate to anxiety disorders.

gut brainAnxiety is believed to be caused by a combination of biological, psychological and environmental factors. Nutrition influences all our bodies metabolic processes which can alter the brain’s biochemistry. So what we eat, can effect the biological and psychological constructs of anxiety. Specifically, an imbalance of neurotransmitters (chemical messengers in the brain) may contribute to anxiety. Notably, serotonin, dopamine, epinephrine and the stress hormone cortisol (2). It is also interesting to note, in regards to nutrition and anxiety, that research and discoveries in the past century on the role of the enteric nervous system (ENS) are making connections to the gut and human emotions. Despite early discoveries, interest in the ‘gut brain’ fell until the relatively new field of neurogastroenterology was born in the 1990’s. We now know that 90% of information passed between the gut and the brain, via the vagus nerve, actually travels from the gut to the brain (3). Certainly brings truth to the question ‘What does your gut say?’.

There are some basic rules relating to diet that can help manage and relieve anxiety in any form. Reducing or eliminating caffeine from the diet will help reduce blood levels of the stress hormone cortisol. Reducing or eliminating alcohol from the diet can help regulate normal levels of neurotransmitters like serotonin. Managing blood sugar levels throughout the day by eating more nutrient dense whole foods like fruits, vegetables, nuts, seeds and lean meats and less calorie dense foods like processed carbohydrates, take-away foods and soft drinks can help alleviate anxiety symptoms. Hypoglycemia (low blood sugar) shares many similar symptoms as anxiety including accelerated heart rate, trembling, light-headedness, sweating and nausea that could be the catalyst that triggers an anxiety attack.

Here are some specific foods that may help reduce anxiety and some reasoning behind them.

Whole Proteins like beef, fish, poultry, eggs and dairy products contain tryptophan amino acid which is the precursor for serotonin (Happiness). The insulin hormone is needed to transport it to the brain for a serotonin boost and so carbohydrates play a role here. These proteins also contain tyrosine amino acid which is the major building block for dopamine (Motivation). Tyrosine can also be found in avocado, leafy green vegetables, beets, oatmeal, nuts and seeds. Choline is the precursor for acetylcholine (memory and learning) and can be sourced from shrimps, scallops, eggs and dairy. Gamma- aminobutyric acid (GABA-natures ‘valium’) has several precursors including glucose and several amino acids. Some of the best foods for increasing GABA include banana’sbroccoli, brown rice, citrus fruits, fish, lentils, nuts, oats, spinach and whole grains (4).

I am convinced that diet can play a pivotal role in the treatment of all the different types of anxiety disorders. Combined with  addressing the environmental and psychological contributors, diet could definitely assist in creating more positive outcomes for people, enabling them to live a happier and more fulfilling life.

  

antioxidants“Contains antioxidants!” One of the most widely used claims these days, for foods that have great health benefits. I have, for some time now,  had a general idea of the reasoning behind the benefits of including foods that are high in antioxidants in our diets, but I have never really convincingly understood. I thought it was about time I looked at it a little closer to see what all the fuss and claiming is about.

So, why do our bodies need antioxidants? To help neutralise free radicals of course! Sounds like something out of a sixties political thriller. So lets break those two components down.

Free radicals are molecules that contain unpaired electrons in an atomic orbital. These molecules become unstable and reactive by either donating to, or accepting electrons from other molecules behaving like oxidants (hydroxyl, nitric oxide radical, peroxynitrite radical) . This process can damage biologically relevant molecules such as DNA, proteins, carbohydrates and lipids, and become the catalyst for many human diseases like cancer, diabetes and inflammation. When free radicals overwhelm the bodies ability to regulate them, they create a condition known as  ‘oxidative stress’.

Sources of free radicals

  • Inflammation
  • Exercise
  • Mitochondria
  • cigarette smoke
  • radiation
  • certain drugs/pesticides

antioxidants 3Antioxidant’s are molecules that are stable enough to donate an electron to an unstable free radical molecule which can help neutralise the free radicals chain reaction effect on other stable molecules. Interestingly, some antioxidants like glutathione, ubiquinol and uric acid are produced by the body during normal metabolism. Other lighter antioxidants can be sourced from micro-nutrients through diet. These include vitamin E (avocado, nuts, seeds, vegetable oils), vitamin C (oranges, kiwi fruit, broccoli, spinach)and B-carotine (pumpkin, apricot, carrot, mango) to name a few. (Lobo et al 2010)

Learning that the body produces its own forms of antioxidants suggests that they are crucial to our health and well being. It is well documented that antioxidants do in fact neutralise disease causing free radicals. Although, it seems, there is still allot of extensive research to be done regarding the benefits of dietary antioxidants, the evidence so far would suggest to include foods high in a range of antioxidants as preventative medicine. (As always, consult your health professional before making decisions on any treatments)

 

 

Why so antioxidant?

Want to live forever?

Longevity. Its what almost all of us a striving for right? Massive amounts of money is spent on develimagesoping anti-ageing products year in, year out, and the masses pour in to buy them. A new product almost daily claiming to be better than the last. What does that say about their previous products? were they actually no good? Personally, I have never bought into media hyped products that claim to reverse time. I am a cynic and prefer to rely on scientific evidence before making any decisions about the validity of any claims.

I was doing some research on the benefits of certain vitamins and came across an article writtenimages-1 by Dr Mercola about one very interesting and exciting benefit deriving from vitamin B12, Folate, Zinc, vitamin D, Omega-3, vitamin C and vitamin E. Research has found that each of these nutrients have positive effects on preserving and possibly even increasing the length of a chromosomes telomeres. Telomeres are regions at the ends of a chromosome that serve as protection against deterioration and fusion with other chromosomes. They become shorter over time because they cannot replicate completely during cell division.They continue shortening until they become so short, that cell division ceases completely. Then we die. Scientists say that telomeres are the closest thing we have to a body clock. There may also be links with low telomere lengths to common diseases like cancer, liver disease, type 2 diabetes and decreased immune response to name a few. It is an emerging science and one that I will be following.

So how do some of the nutrients mentioned earlier help preserve or even possibly lengthen telomeres?

  • Vitamin D can inhibit your body’s inflammatory response, which in turn can slow the replication of leukocytes (white blood cells). As leukocyte telomere lengths will decrease more rapidly due to a more rapid turn-over in chronic inflammatory conditions, any inhibition will slow this replication process and preserve the leukocyte telomere lengths, and in-so doing, possibly staving off chronic disease. Responsible exposure to sunlight should give you enough vitamin D.
  • Folate (B9) helps maintain DNA and RNA integrity and helps facilitate methylation (Control for gene expression). Both influence telomere length. Good sources of folate are dark green vegetables and dried legumes such as chickpeas, beans and lentils.
  • Vitamin B12 is important for DNA synthesis and ensures structural stability to regions of the chromosome. It also plays a critical role in regulating DNA methylation. Good sources of vitamin B12 are from animal products like meat, liver, milk, eggs, shellfish. Vegans must source their B12 from fortified products.
  • Omega-3, according to Dr William Harris, omega-3 fatty acids play a role in activating telormerace (the process of telomere synthesis through an enzyme) which has apparently been shown to actively reverse telomere shortening. Good sources of omega-3 are cold water fish like sardine and salmon, flaxseeds, chia seeds, leafy greens and beans.

Nutrients appear to influence the activity of telomerace which directly effects telomere length. It has been well published that telomere length is related to genomic stability, prevention of DNA damage and regulation of cellular ageing.

If the science is correct, imagine being able to reverse ageing, stop it or even just slow it down enough to properly enjoy this beautiful world of ours! I’m thinking I would like at least another fifty years on top of the average life expectancy.

Learning about nutrition

In late 2014 I decided to take the plunge into a new career pathway. My interest in nutrition and how it effects the body in both positive and negative ways became my new focus. I enrolled in a Cert IV in Allied Health Assistance specialising in Nutrition and Dietetics and secured an entry level job in food services within an aged care facility. Today, I have recently completed the certificate and have been working for the past twelve months in a private hospital’s food services department. My placement for the certificate took place in another private hospital working under dietitians and speech pathologists. To say this was an amazing experience would be a great understatement! The experiences I have gained over the past two years working directly with people who are effected by poor nutrition choices and those that require therapeutic diets, have strengthened my resolve to continue on this new career pathway.

The main reason for this blog (and I’m sure the reasons may morph and change over time as my blogging experience grows) is to continue researching and discovering the effects, and therapeutic properties of nutrients. The blog will provide a platform to gather the information I find and hopefully provide some objective and informative reading.

I had written and published two blog posts before finding ‘Blogging U’. So here is my first task under ‘Learning The Fundamentals’. I look forward to sharing with other new wordpress bloggers in ‘First Fridays’? I’d better look at that again 🙂

Salt & Hypertension

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Sodium Chloride (Salt)

Food Standards Australia New Zealand (FSANZ) estimated in June 2015, Australians aged 2 years and over were consuming on average 2,150 mg of sodium per day from an average of 5,500 mg of salt. They also stipulate that around 25% comes from breads and rolls, 21% from meat products and dishes, 17% from cereal products and cereal based dishes and 37% from sauces, cheeses and other foods. Considering that Nutrition Australia recommend an adequate intake of sodium to be 460 – 920 mg of sodium per day from an average of around 2,000 mg of salt, it is clear that Australians are eating too much salt!

Sodium is an essential mineral that the body uses, along with potassium, to balance the correct amount of fluids needed for body homeostasis. Too much sodium over a period of time upsets the balance and can lead to excess fluid retention within the cardiovascular system which is known as hypertension (high blood pressure). Amongst other conditions including heart failure and kidney problems, hypertension can lead to stroke. Constant high blood pressure can damage blood vessel walls leading to bleeding on the brain (hemorrhagic stroke).

From personal experience, I found it easy to lower my salt intake over a period of time. I started by using less and less table salt on my foods at home until I virtually stopped. Only once in a blue moon will I use it in cooking. I am now checking the nutritional data on processed food products and actively avoiding foods too high in salt and sodium and buy salt reduced or no added salt products when I see them. As I said, this happened over a period of time and barley noticed any difference. My pallet has grown used to not consuming allot of salt and is now quite sensitive.

Reducing salt intake to help reduce hypertension, a common risk factor for stroke?.. Too right!  “Live Long”

A stroke too close

A colleague of my wife recently passed from a stroke. It came as a great shock as he was only 44 years young. I’m not sure of weather it was ischaemic or hemorrhagic, but I do know he had a history of hypertension which leads me to lean towards a possible hemorrhagic stroke? It really hit home being so close to our family and got me thinking. This is the very reason I am interested in nutrition and how the food we eat can effect our lives both for better or worse.

There are several simple things we can all do to reduce the development of stroke risk factors during the course of our lives. These include:

  1. Healthy Diet – Include plenty of nutrient rich foods like fruits, vegetables, lean meats and fish. There is a veritable plethora of healthy food recipes to be found on the internet. They can be sourced from peak body web-sites like Nutrition Australia or Dietitians Association of Australia. These days there are supermarkets, grocery stores or fruit and vegetable markets around every corner that sells fresh whole foods in every conceivable variety, colour and shape, so there really aren’t any excuses. A diet of nutrient rich foods like a  variety of fruits and vegetables is going to keep your body at a healthy weight and reduce the intake of cholesterol and sodium, all of which are stroke risk factors. The National Health and Medical Research Council recommendation for sodium intake 460-920 mg/day for an adult to maintain optimal blood pressure at 120/80mmHg (heartfoundation.org).
  2. Exercise – It’s all about calories in and calories out. It is such a basic concept really. Count the calories you are putting into your bodies and ensure you get enough exercise to burn them off each day. Find an activity you enjoy and use that for exercise. Walk, jog, swim, crawl.. what ever it takes to divert from a sedentary lifestyle. 30 min a day is a general guideline.
  3. Monitor Your Blood Pressure – High blood pressure is relatively asymptomatic all the way up to when a catastrophic event occurs like a stroke. It is therefore prudent to have your blood pressure tested regularly to highlight any changes or trends that may need correcting with a therapeutic diet, exercise or medication.

Personally, I’ll be getting my bloods done very soon to check my cholesterol levels and heart health. I’ll check my blood pressure as well. The results will tell me if I’ve been doing all of the above well enough >.< and let me know if there is anything I need to change about my diet to stave off a possible stroke. I owe it not only to myself, but to my wife and four year old son, to ensure I’m around to enjoy a long life together.

Would you know how to recognise a stroke? or what to do in the event of a stroke? You could save a life by using the F.A.S.T test that features on the Stroke Foundation web site.