How to ensure your child gets the best gut flora.

Beautiful pregnant woman relaxing on grass
Most people think that a baby gets its gut flora during delivery and that C section means they don’t acquire the same beneficial flora. Actually a baby can develop gut flora up to about age four and there are a number of factors that can affect it.

First up it seems that the uterus is not sterile and there is already some gut flora distributed in utero. So if you already have a child with allergies, or you have them, make sure during your pregnancy that you supplement with a good range of probiotics or consume fermented foods regularly but at a minimum for at least two months prior to the delivery.

Spoon Of Yogurt With Blueberries On Top

Breast feeding also passes useful flora to the baby and you don’t really need to breastfeed for that long to see a significant benefit. Solely breast feeding to 4 months was shown by a large scale South Australia study to reduce allergies by at least 25%. I know its often challenging breast feeding and if you have difficulties its really worth speaking with either the nurses at the Early Childhood Centres or the Nursing Mother’s Association, both sources of invaluable support.

If you end up having intervention like a C section or you can’t breastfeed , it may be useful to add a specific probiotic for children, as well.

Minimising antibiotic use during the first few years is also an important way to ensure a stable and resilient gut flora. Homeopathic medicines can make a great alternative treatment for children during the early stages of illness. I often use a combination called ABC mix for parents to assist with fevers and ear infections. ABC mix is three homeopathic medicines known as Aconite, Belladonna and Chamomila and can be a good combination to use with mild fevers or ear pain.

Christine Pope is a homeopath and nutritionist based at St Ives at Elemental Health. She is also Head of Nutrition at Nature Care College at St Leonards. She runs regular workshops on health related topics at her practice and her next workshop is on “Managing Stress” on July 15 with Coach, Cheryl Alderman .

Are probiotics worth the money?

Spoon Of Yogurt With Blueberries On Top

Probiotics seem to one area where even doctors and pharamacists seem to be comfortable recommending that patients take a probiotic with or after an antibiotic. However regular probiotics can help you avoid the need for the antibiotics in the first place.

The Cochrane Collection, which is the gold standard of scientific research, has reviewed 14 clinical trials on probiotics involving over 3454 people. Overall they concluded that probiotics reduced the risk of developing upper respiratory tract infections and reduced the need for antibiotics. Nice to have the scientific evidence however I know from my own practice that a good general preventative through winter is a daily probiotic plus Vitamin C, particularly if your children are in daycare.

Home Made Cultured Or Fermented Vegetables

Probiotics for the whole family may be an expensive option (although getting sick is often more expensive) and some other great ways to include a good range of gut bacteria are to introduce fermented foods. This can be through a good quality yoghurt without a lot of sugar and additives or through regular consumption of fermented vegetables such as kim chi and sauerkraut. If you are interested in making your own fermented foods there are a number of people running workshops – have a look at Georgia at Stirring Change on facebook or Pinkfarm. The ladies at Pinkfarm even provide lists of people with starter cultures who are happy to share.

There are quite a few different strains of probiotics and we are just beginning to understand all the different roles that they can play in terms of keeping our immune system strong as well as in supporting effective digestion. The advantage in using foods is that often there are up to 50 strains or good bacteria in keffir whereas a commercial probiotic will only have a few strains.

There are several strains that we know are useful in the gut and often because they help crowd out problematic strains, such as candida. Some strains are known to be anti-inflammatory such as the lactobacillus plantarum which is often recommended to people with IBS. The predominant strain researched in the Cochrane collection was lactobacillus rhamnosus. If you do have more specialised health problems you may need advice on tailoring the strains to suit your particular needs.

Christine Pope is a nutritionist and homeopath who practices at Elemental Health at St Ives. She can be contacted on (02) 8084 0081. If you are looking for practitioners in other areas of Australia have a look at the metagenics website which lists practitioners who are experienced at working with probiotics and natural medicine.

How to avoid the medicare $7 co-payment.

Health food ingredients in white porcelain bowls over papyrus ba

The Federal Budget had a few surprises in it however overall for many families your cost of living will increase. Whether its the 2% debt levy, loss of the Family Tax Benefit or the $7 co-payment that will be introduced if they get it through the senate

One of the best things you can do to reduce your cost of living is to look after your health. Fewer visits to the GP means fewer co-payments and also fewer hours you spend waiting and waiting!
I always remember as a new mum panicking when my children were sick. One of the things I try to get mum’s confident about when I run my homeopathic first aid course is when they can treat something themselves and when they should get straight to the GP. For example in a small child if the temperature is over 39.5c and they are floppy or disorientated seek medical attention as soon as possible.

There are some simple ways to improve your health and making these changes could help reduce the number of times you have to shell out for the co-payment. These include;

1) Eat well – lots of fresh fruit and vegetables (still not GST on those) and small amounts of lean protein.

2) Add good sources of probiotics – it could be a supplement or fermented foods such as yoghurt, kim chi, sauerkraut or keffir (much cheaper options). Good gut bacteria are your first line of defence for your immune system.

3) Exercise – you don’t need to join a gym just put the baby in the stroller or take the kids to the park and walk for half an hour a day – your stress levels will reduce and you will be less prone to infections.

4) Learn more about first aid through St John’s or do my Homeopathic First Aid Course. Its much easier to make a decision about health if you know when you should panic!

Christine Pope is a homeopath and nutritionist based at Elemental Health, St Ives. She is also head of nutrition at Nature Care College where she supervises nutrition clinic and lectures in Homeopathy. She can be contacted for appointments on 8084 0081.

Research – can we research natural medicine?

A recent blog talked about how easy it was to poke holes in research so with this one I will look at some of the challenges when you are researching natural medicine interventions, such as homeopathy.

First up most clinical trials are set up on the basis of giving a patient one treatment and seeing how it compares to another or to placebo. Most of the time in natural medicine we don’t just give one thing so that does make it difficult to see how a more complex treatment works.

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The first part of a consultation is really listening to your client for 45 minutes to an hour, depending on how long that initial consultation takes. Think about the value of really being heard for up to an hour. This process gives the practitioner time to think about how the whole person is affected by what is happening to them and what may need treatment. Sometimes I find in that time the solutions become clear to the patient and just that process alone can be invaluable in helping them heal.

How do we measure this?  There are tools in which natural medicines such as homeopathy perform quite well .  Valid forms of evidence  including case studies, patient reports of satisfaction , quality of life and observational studies. Here, homeopathy does much better than in Randomised Controlled Trials.

One of the largest observational studies was undertaken by the National Health Service in the UK. It involved a total of 6544 consecutive follow-up patients who were given outcome scores. The patients were all using homeopathic treatment for chronic diseases. Of the patients 70.7% reported positive health changes, with 50.7% recording their improvement as better or much better (1). A similar study undertaken at an Italian hospital in Lucca also showed 74% of patients reporting improvement with the most common conditions being respiratory, dermatological and gastrointestinal.

Isn’t this a better way to assess the value of a treatment like homeopathy?  A research tool which looks at the outcomes for the patient in terms of quality of life and improvement in their health.

 

 

(1) Spence DS1, Thompson EA, Barron SJ., J Altern Complement Med. 2005 Oct;11(5):793-8., Homeopathic treatment for chronic disease : a 6 year University- Hospital  outpatient observational study.

What the hell is bioimpendence analysis??

What the hell is bioimpendence analysis??

In the last blog I mentioned that I was at a seminar where everyone else had these amazing bioimpedence analysis results and mine were to put it nicely very average!

So what is bioimpedence analysis and how is it useful to you in finding out about your health?

Bioimpedence analysis was originally developed to monitor patients who were recovering from surgery in hospitals. Bioimpedence analysis measures fat mass, muscle mass and inflammation. It does this by running a low level electric current through two points on the feet and hands and assessing how long it takes for the current to reach the points and return. The test itself only takes a few minutes however you also need a persons height, weight, wrist circumference and waist measurement to flesh out the parameters.

By measuring these parameters you can start with a baseline of where someone’s health is at and also measure changes over time. Its really useful with weight loss as people often get frustrated saying well I only lost a kilo and I was doing all this exercise. You can actually see with bioimpedence analysis that they have actually lost 2kg of fat and gained a kilo of muscle – which really helps with motivation. Also muscle burns more energy so often I start by getting people to work on building more muscle to really help them burn kilojoules.

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One of the areas I really focus on in practice however is ATM and ATM energy. ATM is active tissue mass or muscle mass in the body. ATM energy is how much energy your muscle mass is producing and this can be really variable. In the picture above the client is showing as having about 4kg less muscle than is adequate for their frame.  If you think of this as being the size of their battery then the battery is too small so even with a good level of energy they may feel more fatigued.

There are several changes you can make which really help improve energy levels. Start with a healthy well balanced diet high in vegetables and good quality protein. If that doesn’t make enough of a difference then you can look at various supplements including a good quality multi vitamin and magnesium or CoQ10.

If you would like to find out what your bioimpedence analysis results look like I am happy to do a free report for you in my clinic on a Tuesday or Wednesday during May and June, 2014. You just need to book in with reception on 8084 0081 and book in a short nutrition consult for a bioimpedence analysis  (VLA) for 15 minutes.  Ideally you will also make sure you know your height as I can do all the other measurements in clinic.

Is wheat a problem for me (or even worse gluten)?

Bakery Bread on a Wooden Table. Various Bread and Sheaf of WheatYears ago at a seminar I got some really good health advice. It was information that I knew but I really didn’t want to hear. Don’t you hate that?

We were doing bioimpedence analsysis which looks at energy quality, muscle mass, fat mass and inflammation. I was sitting in a group of what seemed like really amazingly healthy naturopaths and chiropractors who were all happily showing off their high energy quality and low fat mass percentages and looking at my own numbers which were not that impressive (and the fat mass percentage is still not great).

What the presenter said was basically “Christine I have never seen anyone with thyroid problems who isn’t better, off gluten.” Now I knew that and I also knew there was coeliac in our family history but this finally motivated me to change my eating habits and it was the best thing I could have done.

First up I stopped feeling like I needed an afternoon nap if I had a sandwhich at lunch time. Secondly I felt like my brain was clearer and better still initially I lost a few kilos which had been hard to shift.

Now I can’t promise the same sort of results if you come off wheat or gluten but it does give you a good picture of the type of problems that wheat or gluten could be creating for you. Fatigue, fuzzy thinking and difficulty losing weight.  What other types of symptoms suggest a problem with wheat? Bloating after eating – the so called wheat belly!

Gluten Free Grains Food - Brown Rice, Millet, Lsa, Buckwheat Fla

 

What alternatives are there to wheat? Do you have to give up your cereal for breakfast, sandwhich for lunch and pasta for dinner?  I hope so because its really way too much grain anyway and it is generally not a good source of nutrition. Alternatives to wheat are many and varied but include quinoa, rice, buckwheat and flours made from almond, tapioca and coconut. Many of these alternatives provide much broader nutrition but again focus on variety and make sure you are eating at least six serves of vegetables a day as well.

Christine Pope is a nutritionist and homeopath based at Elemental Health , St Ives.  She is also Head of Nutrition at Nature Care College at St Leonards.  If you need help with identifying food intolerances make an appointment with her on 8084 0081.

Help – my child can’t have dairy!

 


So I thought after all my blogs on research it was time to get back to food again.

I frequently get people tested for food intolerances and whilst its good to know what the child is reacting to its not always easy to change the diet.

The most common issues I am seeing in clinic at the moment are wheat, dairy and surprisingly egg. So what do you do when you need to cut these foods out and how do you find easy replacements?

In this blog I want to look at dairy. The first thing people freak out about is that cutting out dairy means that the child won’t get enough calcium. Actually they haven’t been getting enough calcium because they couldn’t digest the milk so it probably is better that they remove a food which was affecting them and start having foods then can actually digest.

old wooden typesetter box with 16 samples of assorted legumes: gThere are lots of food sources of calcium – nuts and seeds, green leafy vegetables, legumes such as chickpeas and lentils – you know all those things that kids really love to eat (ok well they might when you cut out the stuff that’s been making them feel average).

Many processed foods use milk or dairy as cheap fill and flavouring , often when you don’t expect it. My children both went down an entire aisle of biscuits trying to find one they could have.  They found just one brand – this was a few years ago and now there are a few more options . Often food that is vegan is quite dairy free friendly since they don’t include anything from animals. Just watch out for words in processed foods like casein, whey and rennet – these are all dairy based.

Usually when I see someone who has to cut our dairy I spend a bit of time focussing on alternatives.  Easily available are soy, almond, coconut and rice milk. Each of these has particular uses and almond and rice milk can also contribute to calcium intake (rice milk 110mg of calcium per glass).  I am not keen to replace a significant intake of dairy a day with a direct substitute as variety in food is really important. However I do find it handy in cooking to always have the substitutes easily available.

Soy milk works better in savoury dishes – so if you need a little milk for scrambled eggs or a quiche. Rice milk is sweeter and I find substitutes easily into baking muffins or cakes.  Either works well as a substitute for milk on the morning cereal as well.

Coconut milk is a great way to add a creamy flavour to a curry or stew. One of my favourite breakfast dishes is easy chia pudding – which basically is 1 cup of coconut milk to 1/3 cup of chia seeds and half a cup of frozen berries. Stir and leave overnight and top with flaked almonds to serve. Filling and delicious. The chia absorb most of the liquid but still have a nice little crunch to them as well.

Coconut oil and fresh coconutDepending on how intolerant your child is you may need to stop using butter as well – again use some good oils in its place. Olive oil is great to dip bread in or drizzle over vegies and coconut oil has a higher melting point and is good for longer slower cooking. With coconut oil just make sure you use the extra virgin one or it can have quite a strong odour.  Remember fats are important as they help us take up minerals such as calcium so adding a little fat to your steamed vegetables will help with absorbing as many nutrients as possible (and make it taste a lot better).

 

Christine Pope is a practising homeopath and nutritionist based at Elemental Health at St Ives, Sydney. She is also the Head of Nutrition at Nature Care College where she lectures in Homeopathy and supervises Nutrition clinic.

Meta analysis?? Where homeopathy has been shown to work!

 

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Meta analysis – more research jargon I’m sorry but its not really tricky to understand.

Basically a meta analysis can be done when you have a number of studies that look at treatment of the same condition. So if you have a group of clinical trials on childhood diarrhea for example you can then conduct an analysis to see if it was effective across all the groups. This can be useful when the original groups were quite small (a common criticism of natural medicine trials).

There have been seven meta-analysis conducted of homeopathic trials of which six have shown homeopathy to be more useful than placebo. One of the older studies is on childhood diarrhea where there were three studies analysed. Basically what the meta analysis showed was that homeopathy reduced the average duration from 4.1 to 3.3 days as measured by the number of loose stools (1) .  Most people when they have some form of gastro bug are happy for a reduction in the time they spend suffering.

The major homeopathic medicines used in those trials were Podophyllum, Arsenicum album, Sulphur, Chamomilla and Calcarea carbonica – which were used for 78% of cases.

So what other conditions have been shown in meta analysis to be effectively treated by homeopathy? Meta analysis have been conducted for conditions such as allergies, hay fever and upper respiratory tract infections showing homeopathy to be more effective than placebo. Most people who have used homeopathy for those conditions would happily confirm that this is the case.

How do you find out which homeopathic medicine to use to treat acute conditions? I run regular Homeopathic Workshops at my practice in St Ives so come along to a short two hour workshop on May 1 , 2014 from 10-30-12.30  if you are interested. The cost is $99 and you can book in on (02) 8084 0081. Alternatively if you aren’t local  I find the book Homeopathic Self Care a great resource and the author is Reichenberg Ullman – you normally need to order it online from Amazon, but it does cover how to prescribe and up to 70 conditions with self naturopathic suggestions as well.

 

(1)  Jacobs J1Jonas WBJiménez-Pérez MCrothers D., Homeopathy for childhood diarrhea: combined results and metaanalysis from three randomized, controlled clinical trials, Pediatr Infect Dis J. 2003 Mar;22(3):229-34. 

 

Research – is it all lies, lies and damned statistics?

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A recent press release by the National Health and Medical Research Council (NHMRC) stated that where there was evidence to support the use of homeopathy the trials were too small and not well designed. Its kind of damning with faint praise isn’t it?? By the way most of the headlines were a lot less favourable but I read the detail of the report.

So I decided to write about research and try and explain what is contained in the report and perhaps shed a little light on the whole process. I did try and avoid a lot of maths in this discussion but this is going to be a little longer than my usual blog as it covers a fair amount of information.

Research – hierachy and different types

First up there is a hierachy in terms of research evidence in western medicine. At the top of the research hierachy is the randomised controlled trial (RCT) , which is regarded as the gold standard of evidence. Unfortunately it takes a lot of gold to meet the gold standard and it will always be more difficult with natural medicine which can’t really patent its findings to generate the types of revenues that fund this standard of research.

How much of western medicine is based on the gold standard of RCT’s? Surprisingly a lot less than you would think. Back in the 1980’s when the Cochrane Collection was established only 10- 15% of drugs in use had been subject to this research. The rest of the time they relied on long term clinical use (kind of like a lot of natural medicine). That number has at least doubled in part due to the efforts of the Cochrane Collection which is an independent research body promoting the use of evidence based research in clinical decision making.

Before you get to the RCT however there are other forms of research which contribute to the picture , this can include case study reports, in vitro research (cells in a test tube), animal studies and cohort studies, case control studies and clinical use. A case study report is usually a report which can highlight problems with an existing treatment or a way of dealing with a case which yields some new information. Studies on cells in test tubes or animals may be done at the start of research. They are  not considered as reliable as human trials as humans may react differently to animals.

Case control studies try to identify what is different between a group who have developed a condition and those who didn’t. They tend to be more cost effective but not always as reliable as a Cohort study where participants are tracked over a long period of time. Try remembering what you were eating like ten years ago? See? Its really not that easy. A Cohort study that tracks it over time can document what you were eating at different times in your life and see if the group who develop a condition were eating differently or eating more of a particular food group.

How do we design an RCT?

Whilst the RCT is the gold standard its fairly hard to find any RCT that is perfect. Typically an RCT is set up to compare one treatment against another or against placebo. You then recruit a group of people to your trial who need treatment for that condition – therefore you need to make sure they have the type of condition that will respond to your drug. To avoid complications you try to exclude people in the research who have other conditions as well. In the US students are often happy to participate in those trial’s as its a good way to earn some extra money.

So is that group of people you have just recruited to your study the same as the group of people who will ultimately take your drug? Quite often people as they get a little older are on multiple medications and they aren’t as robust as the group of students who did the trial.

So in your analysis you have just looked at the recruitment of participants and already you may not be that happy with the design.

See how easy it is to start to poke holes in the design of any trial and I haven’t even looked at numbers of participants yet?

Size of trial

To determine how many people you need in a trial you need to look at what the size of the treatment effect is and then a calculation is done (called a power calculation) to determine how many participants you need in your trial at the end to be able to see that the treatment effect is actually statistically significant.

This means a bigger group doesn’t add up to better research. It tends to mean that the smaller benefit someone gets from treatment the larger the group you need to show that it was  statistically significant and didn’t just occur by random chance. When newer drugs are being trialled against older drugs you often see only small improvements in the treatment so large scale trials will be needed.

Most natural medicine trials are quite small as funding is usually restricted however there are processes in place to ensure that the size of the group is adequate to measure the treatment effect. The NHMRC was generally negative about the fact that so few of the homeopathic trials had in excess of 500 participants but neglected to explain why that may not be necessary. They completely omitted the explanation of power calculations or whether in fact these indicated that smaller studies were still reliable evidence. Sometimes its not all about size!

Natural Medicine and RCT’s

In the next blog I will look at some of the reasons why natural medicine doesn’t fit well into the world of RCT’s. I was going to cover it here but its already a bit long!! Would love to hear your thoughts so please feel free to comment.

Do you have the right bugs in your gut?

Bacteria

Does everyone you know seem to have a food intolerance, allergy or asthma?  Why is this so much more common than  20 years ago? I remember at school only one child having an asthma puffer but now it seems that schools need to keep a spare in the first aid kit as so many children have asthma.

One of the reasons there are so many allergies is that our “microbiome” or the bacteria in our intestine has changed a lot due to the food we are eating. Candida for example thrives on sugar and the highly refined diet that many people eat feeds it beautifully. Not only does it feed it but candida is smart and basically causes you to crave sugar as well making it harder to treat.

Some recent research on rats found that a common bacteria, E. coli , increased inflammation to gluten (the protein in wheat, barley and rye) , prompting what’s sometimes called a “leaky gut”. However a beneficial bacteria called bifidobacteria protected the intestinal barrier.  Your gut bacteria may influence the immune response to gluten.  How many other intolerances to food are being created by the balance of “good” and “bad” bacteria ? Certainly significant research is being directed at understanding the roles of these bacteria and how they can support your health or undermine it.

An easy way to support good gut health is to include small amounts of fermented food or drinks in your diet. Ideally you need a range of good bacteria as they all seem to have different functions.

Traditional diets always included a form of fermented food to support good gut health as well as ensuring you could extract the maximum in nutrients from your food.  Have a look at keffir, kombucha and other forms of ferments with vegetables such as sauerkraut and kim chi.  Sites such as Pinkfarm and Kitsa’s kitchen on facebook have lots of information about how you can easily incorporate these foods into your diet.