laptop and stethoscope
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laptop and stethoscopeThirteen years ago I had a panic attack after finishing my last shift as a hospital doctor. I was hyperventilating and shaking. For a few minutes I wondered how I was going to survive without that familiar yet suffocating yoke around my neck that I had been carrying – no, not my stethoscope, but my career as a medical doctor. Then I pulled myself together – and I have never looked back since.

I had spent six years in medical school and three years as a junior doctor. I had witnessed dreadful things, distressing things, without any support from senior doctors. I felt like I was on a conveyor belt to Hell. Something seemed to be missing but I didn’t know what it was. So I enrolled in a Chinese Medicine Bachelor Degree and did not apply for a new job the following year. I sat in lectures about Yin and Yang and learned about the different types of Qi. I spent one year just learning about the hundreds of acupuncture points on the body. I learned about herbs that warmed, herbs that dispelled damp, herbs that invigorated Qi. I had become a Sinophile during medical school, in an attempt to discover my cultural “roots”. Studying Chinese Medicine seemed to be an obvious extension of my journey.

At first it was exotic, but then I began to see the parallels between Chinese and Western medicine. I learned about the influences of the five emotions on the body – especially anger and “over-thinking”. Chinese Medicine taught me to appreciate the impact of lifestyle on health. I also had an introduction to nutrition – a naturopath gave us lectures on vitamins, minerals and wholefoods. I was amazed. Nutrition in hospitals boiled down to serving bacon and eggs for oncology patients, and Sustagen to thin patients.

Gratuitous bacon meme... I couldn't resist ;)
Gratuitous bacon meme… I couldn’t resist ;)

I realised how unwell I was. I was plagued with hay fever symptoms, constant sinusitis, back pain, insomnia, constipation. My diet was terrible and I did no exercise. But gradually, with the dawning of a realisation that I should be taking better care of my health, and the blessing of free time – not needing to work 15 hour shifts several times a week – I started doing more exercise and improving what I ate. I started running. I slowly gave up junk food. My hay fever improved.

But I couldn’t leave Western Medicine behind. I felt there was something I hadn’t finished. I was accepted as a GP trainee after graduating from Chinese Medicine. Two years later, after obtaining my Fellowship, I joined an integrative GP clinic and I am still there, eight years on.

I’ve been on a journey to discover the answers to true wellbeing since I diverted from Western Medicine. Since then I’ve learned so much about nutrition, lifestyle, and the mind-body connection and how to use it. Taking a different tangent opened up my eyes to new paradigms. It was startling. I learned that there was more to medicine than prescriptions. I learned that every human being is a complex and unique creature, and that curing and preventing disease often required more than a drug order. I also learned that there were many situations where drugs saved lives and prevented complications. My job is to know what the situation calls for. I’ve returned to Western Medicine with a new set of eyes.

Now I find I’m moving away from acupuncture because it’s a passive treatment. I still use it in practice and am passionate about establishing rigorous evidence around its’ possible effectiveness. But I believe that active lifestyle changes will make the biggest impact on health in the “worried well” that consult me. Time and time again my advice is to eat less sugar, do more exercise, meditate, practise positive self-talk, go to bed at the same time every night. If patients did these religiously they would rarely need to see me. The other problems are easily fixed – the ones that require a prescription.

I consider myself very fortunate to have a career in Western Medicine. I took a roundabout way back to medicine, but I certainly haven’t ended up in the same place – or perhaps the same place, but with a new vision. If I hadn’t left for a little while, I may not have discovered my vocation – to teach and inspire others to find the answers to health and happiness. (One of the ancient definitions of “doctor” is “someone who teaches“). Inspiration implies I have to be a somewhat healthy role model myself. Now I spend my days and nights learning about health and wellbeing – about healing and nurturing the body, heart, mind and spirit. It’s an amazing and privileged journey and I intend to share it with everyone who wants to come along with me. :)

Photo credit: http://farm7.static.flickr.com/6079/6123892769_9fd6451484.jpg

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By Ragesoss (Own work) [CC-BY-SA-3.0-2.5-2.0-1.0 (http://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons

By Ragesoss (Own work) [CC-BY-SA-3.0-2.5-2.0-1.0 (http://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons
By Ragesoss (Own work) [CC-BY-SA-3.0-2.5-2.0-1.0 (http://creativecommons.org/licenses/by-sa/3.0) or GFDL (http://www.gnu.org/copyleft/fdl.html)], via Wikimedia Commons
Do you use complementary medicines? If so you’re not alone – two thirds of the Australian population reported use of complementary medicines and therapies such as clinical nutrition, naturopathy, chiropractic, herbal medicine and acupuncture. But do you know how safe your CM is? What are the possible side effects and the interactions with other supplements or medications? (For example, did you know that St John’s Wort interacts with the contraceptive pill and has led to contraceptive failures – i.e. unwanted pregnancies?)

Access to reliable information can be difficult, as the Web is swamped with websites of widely varying quality, and many of these “information sources” have a vested financial interest.

I’m writing an article on GPs communicating with their patients about complementary medicine use, and have collated a list of reliable, evidence-based and up-to-date sources of information on CM safety and effectiveness. As a general rule, I recommend sites that use appropriate scientific evidence and are independent (e.g. not sponsored by a herbal supplement company). I’m sharing these with you for your knowledge and use, and perhaps you could bring these to the attention of your GP or family physician too :)

Reliable sources of information on complementary medicine

The National Institutes of Health in the USA have compiled a wonderful site called Medline Plus where you can look up the safety and effectiveness of conventional and complementary medicines.

For evidence-based information on CM treatments like chiropractic, check out the NIH’s Complementary and Alternative Medicine site.

The Integrative Medicine Centre at the Memorial Sloan Kettering Cancer Center provides evidence-based information on a comprehensive range of herbs.

The University of Maryland Medical Centre has a long history of providing excellent information on complementary medicines. Here you will find detailed information on treatment of common medical conditions (including conventional treatment and lifestyle changes) as well as advice on herb and supplement use.

The Linus Pauling Research Institute at the University of Oregon provides a comprehensive review of the evidence for micronutrients (Vitamins, Minerals and phytochemicals).

 

Don’t forget to always tell your GP or family doctor about your complementary medicine use, and always check the dosage and safety of the medicines you are using.

 

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food

I have a confession to make. I have high cholesterol levels. It’s probably genetic, but I did manage to get it to normal levels on several occasions after changing my diet. Unfortunately I have a strong family history of heart disease, so I need to be extra cautious with my heart health.

Anyhow, monitoring my cholesterol levels fell by the wayside with two babies in succession. With my second baby now almost 15 months, I thought it was time to see what those levels were doing. I also wanted to find out how much of an impact exercise makes on cholesterol. I did my test the week after my 15K race and had been running 20-25 km every week for about 6 weeks. I thought my diet was ok, pretty good really, compared to the average Joe’s. Little processed food, lots of vegetables.

One of the perks of being a GP is that you can check your own blood test results before you see your own GP. I log on the evening of having my blood test and see that my cholesterol levels have skyrocketed! The highest they’ve ever been! This made me quite grumpy initially, to be sure. How could this be! For a while, I was in denial and making the excuses that I hear constantly from patients.

I’m a healthy person. I eat well. I don’t eat biscuits or cakes. I take the fat off all meat. I don’t know what else I can change. I do all the right things. I exercise. My diet is really healthy. This is so unfair! My husband/friend eats crap and has no problems with cholesterol/weight/blood sugar. I am a healthy person, dammit!! (cue apoplectic fit).

The thing is, your body doesn’t lie. The weighing scales, cholesterol tests, diabetes tests. You can lie to yourself all you like, but the definition of insanity is doing the same thing repeatedly and expecting different results. If you’re not happy with the way things are going, something about your lifestyle has to change, no matter how great you think you are doing now. This is where journalling your diet and activity levels can be very insightful.

foodSo I faced the facts. Reasons why my cholesterol levels are high again (and proof that being physically active does not mitigate a poor diet):

  1. Eggs. Lots of them. I developed an egg addiction after my daughter outgrew her egg allergy. I had missed eggs so much that I am now in a two-egg a day habit. I read all the stuff about how eggs aren’t as bad for cholesterol as doctors used to think. But I have a suspicion they weren’t talking about fourteen eggs a week. Or more.
  2. Red meat. Too much for my small frame. You know how they say eat an amount the size of your palm? I think I was eating the size of three palms.
  3. Getting lazy with my diet because of my race. In the week before my diet I had cake at morning tea, because I wanted to “carb up”. I had pasta with a cream sauce. And ice cream. And Easter biscuits. Hot chips after the race. Creamy pasta again after the race.

dietMy heart attack risk is actually less than 1% at the moment, mainly because of my relatively young age, and I don’t have any other risk factors apart from family history and cholesterol. Some argue that cholesterol levels may not actually be linked to heart disease at all. I’m not going to be a guinea pig and wait for them to tell me they got it wrong. If there’s a link, I’ll do whatever I can to change. It’s my insurance policy.

So I’m going to adopt a Mediterranean lifestyle. No, not eating lots of pasta, but the diet of Cretan peasants that is linked to low levels of heart disease (and high levels of satisfaction!) I found a great article on the Mediterranean diet which summarises the “Ten Commandments” really well. I can see this extending to a lot of cuisines such as Indian, Moroccan and Mexican. I’ll be on the hunt for family-friendly recipes that can be prepared in less than 20 minutes. Recipes welcome!! Hooray for the wine with meals thing, I say!!

The Mediterranean Diet

 

 

 

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http://pixabay.com/en/chocolate-melt-milk-brown-food-1934/

My friends, I copped some serious flak from my last post on giving up bacon. Talk about shooting the messenger! In response to that, and also in acknowledgement of the impending arrival of the Easter Bunny, I give you herewith an honest, evidence-based post on why you should eat chocolate. And no, I am not sponsored by Lindt, though by golly that is an AWESOME idea! The Healthy Doctor selling chocolate!

Before I go on I must insert a disclaimer. The following information is general medical advice only (to eat chocolate). Some of the research studies and reviews quoted have been funded by large food corporations (big vested interest there obviously!)  Chocolate has calories, and calorie excess turns into excess fat. Chocolate is usually accompanied by lots of sugar. Chocolate can also cause a disorder well-known to Emergency Departments, aka “Easter Tummy” (abdominal pain from consuming too many Easter eggs). Eating chocolate can also induce feelings of guilt, especially in females who are practising dietary restriction (hmm sound familiar?!) And advice from my dentist is that chocolate is really, really bad for your teeth. So please consult your physician before planning to eat copious amounts of chocolate (which I do not recommend!) and brush your teeth after chocolate! Now we’ve got the business part out of the way, let’s examine the ways in which chocolate improves your health.

http://pixabay.com/en/chocolate-melt-milk-brown-food-1934/
http://pixabay.com/en/chocolate-melt-milk-brown-food-1934/

Chocolate is good for your heart.

Breaking news: Chocolate reduces heart disease risk by a whopping 50%. Chocolate appears to do wonders for the human heart. It reduces unhealthy cholesterol levels, makes blood thinner and less sticky, reduces blood pressure, reduces oxidative stress and inflammation. I really feel I do not need to go on further, but it gets better. Keep reading.

Chocolate may prevent cancer.

Researchers think this may never really be proven, and there are two studies that show an association between cocoa intake and cancer, but other studies suggest that chocolate probably has an anti-cancer effect. However, proving this would involve large trials over many years where some people get to eat chocolate every day…. Something tells me they wouldn’t have too much trouble recruiting for this kind of study!!!

Some studies suggest chocolate may improve mood and cognitive function.

This is not a consistent effect, although testing mood and cognitive function in a laboratory is difficult. But the active compounds in chocolate (including caffeine) are thought to boost mood and ability to think. Interestingly, the effects of chocolate include having effects on receptors in the brain that are similar to the ones activated by psychoactive drugs like marijuana.

Cocoa comes from a bean and contains lots of vitamins and minerals.

I don’t think I need to say much more.

And now… My favourite chocolate cake recipes

I love baking. I’ve been baking chocolate cakes for more than twenty years. Here are some of my favourites. Some of them healthier than others. All of them absolutely divine. I believe in enjoying food, real food. I especially love it when a food can be both healthy and yumbelicious. So this Easter, whip up a chocolate cake or two, and enjoy in moderation :)

Nigella’s Nutella Cake

nigellanutellacakeI am a huge fan of Nigella. And Nutella. Now, let’s be honest, Nutella is not good for you. And it contains palm oil, which is not orang-utan friendly. (You can find hazelnut spread without palm oil in Aldi. I haven’t tried it yet but will do when we run out!)

This is the cake to end all cakes. If today was my last day on Earth, this cake would probably make it onto the dessert list. Absolutely, totally, unbelievably, indulgently, divine.

Neil Perry’s chocolate cake

neilperry

Good old Neil Perry has a way with the classics. Have you tried his heart-stopping macaroni cheese? This chocolate cake basically butter, eggs and sugar. Oh, and a bit of Frangelico. It’s dense, rich and sensuous. He serves it with whipped cream. Which it really doesn’t need. But please yourself :)

“Magic Bean” cake

This recipe is from the Thermomix Australia community website. It is one of the top recipes of all time. You can easily convert it if you don’t have a Thermie – you simply have to puree or blend the beans, and beat the butter and sugar and eggs as per usual. I halved the amount of sugar and it tasted absolutely delicious. I also substituted coconut oil for the butter. The result is amazing, and it is a high protein, low GI cake to boot, with heaps of benefits from the legumes used instead of flour. Must be tried to be believed – and do smother it in a chocolate ganache (made with melted dark chocolate and cream/coconut cream).

I hope everyone has a safe and Happy Easter!

 

 

 

 

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By aussiegall from sydney, Australia (30 Days of Gratitude- Day 15  Uploaded by russavia) [CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons
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Being a mum is a wonderful thing, but unfortunately it also seems to be associated with weight gain. This happens both during pregnancy and afterwards. Weight tends to accumulate with each new baby. Being overweight leads to chronic problems such as high cholesterol, high blood pressure, diabetes, heart disease, and is a risk factor for certain cancers such as breast and ovarian cancer. And while I feel that all women should be aiming for a healthy body image, for many of us our self esteem is linked to how close we feel to what our ideal lifestyle and weight should be. We may not need to fit into the prescribed “healthy weight range” for all women, but any weight loss will significantly improve health outcomes – and give you a huge self-esteem boost because you did it.

Having been a mum for a while and struggled with post-partum weight loss myself, I know some of the traps we easily fall into. These mostly have to do with the change in diet when you become a mother – large reviews of the evidence on postpartum weight loss point to diet and exercise being the key factors to weight loss – not exercise alone. If any of these apply to you, try changing them for a healthier weight, lifestyle and example to your kids.

But to start with, the research shows that the best way to prevent weight gain after pregnancy is to prevent weight gain during pregnancy. This is much easier to say than do – pregnancy has a way of weakening your resolve, pummelling you into a blubbering mess that only chocolate ice-cream can revive. But if you are pregnant now, or planning another pregnancy, keep this in mind, and try not to listen to everyone urging you to finish another muffin because “you’re eating for two now!” Really, you’re not (it’s more like eating for 1.2). But I know and can empathise with the reality of it.

Now let’s have a good honest look at some of the traps we fall into:

1. Breastfeeding does not equal magical weight loss.

By Petr Kratochvil [Public domain], via Wikimedia Commons
By Petr Kratochvil [Public domain], via Wikimedia Commons
We’re lulled into a false sense of confidence with this one. Reviews of the evidence have shown inconsistent results. In some studies, breastfeeding appears to result in some weight loss. In others, no weight loss (compared with non-breastfeeding women) occurs. Researchers have suggested that some breastfeeding women may consume more calories than are needed for breastfeeding. Additionally, the post-partum period is also associated with a decreased metabolic rate (contrary to popular belief). But us mums still fool ourselves, thinking “I deserve this second piece of chocolate cake! I’m turning fat into milk after all!” Well that was me, anyway, after my second baby.

It’s difficult to get an estimation of how many extra calories are needed while breastfeeding. The truth probably is that we need few extra calories – our bodies are supposed to be turning existing fat into milk. (You know, those extra kilos you gained during pregnancy… they’re there for a good reason!) Also, just because you were ravenously hungry when you were feeding 8 times a day at 6 weeks does not mean you need the same calories when you’re doing two feeds a day at 8 months.

So, if you’re using breastfeeding as an excuse and are frustrated that the kilos aren’t magically melting away…perhaps it’s time to put that myth (and those cookies) away.

2. Stop serving comfort food.

{Information |Description=Home made macaroni and cheese, with some dried herbs and grounded pepper. |Source=own work |Date=2007-04-19 |Author=Antilived |Permission= |other_versions= }}
{Information |Description=Home made macaroni and cheese, with some dried herbs and grounded pepper. |Source=own work |Date=2007-04-19 |Author=Antilived |Permission= |other_versions= }}

Having a toddler often means your weekly diet suddenly consists of mac and cheese, spaghetti bolognaise, shepherd’s pie, mashed potato, fried noodles and fried rice… in fact anything that will tempt your fussy eater. Have you fallen into a bit of a “comfort food” habit? Start branching out and serving healthier food that doesn’t involve calorie-laden cheese sauce. Many toddlers also enjoy grilled fish or chicken, steamed vegies, vegie soups and stirfries. Save the comfort food for a weekly meal and revamp your diet.

3. Stop baking.

By aussiegall from sydney, Australia (30 Days of Gratitude- Day 15  Uploaded by russavia) [CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons
By aussiegall from sydney, Australia (30 Days of Gratitude- Day 15 Uploaded by russavia) [CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons
Somehow, when you’re a mum, baking becomes one of your pastimes. It’s fun to make cookies and muffins with your toddlers, and there are those cupcakes for playgroup meetings. At one stage we were churning out a batch of cupcakes once a week! If you’ve fallen into the habit of constant baking (and eating), try to source some lower calorie recipes (skip the icing on the cupcakes for example), put a brake on the baking for now, or bring healthier morning tea treats instead like fruit salad or veg crudites and hommous. (Seriously, hommous is totally yummy – especially drizzled with a fiery chilli sauce!)

4. Stop finishing your children’s leftovers.

You get the drift… Kids don’t finish their meals, so instead of scraping away the leftovers into the bin, you feel compelled to eat them. Don’t. Serve smaller meals to start with, so they don’t feel overwhelmed, and you don’t have to eat the scraps.

5. Make it count.

How could wearing legwarmers NOT make you want to exercise??
How could wearing legwarmers NOT make you want to exercise??

Exercise, that is. I walked for 45 minutes the other day. It was my cross-training day – a day to do something to maintain aerobic fitness but to avoid injury – something other than running, that is. It was a brisk walk but I burned 128 calories. If I had done 20 minutes of running, or high-intensity interval training, I would have burned closer to 200 calories or more, and in half the time. We’re all busy people. Let’s make our exercise time work. Bump up the intensity of what you’re doing and watch those kilos burn themselves! My weight loss certainly kick-started once I started doing HIIT!

6. You’re not too tired.

Feeling exhausted? Too tired to exercise? Is that keeping you from doing any form of regular exercise? It’s tough being a mum with all the responsibilities that we have to attend to. But the truth is, exercise can actually make you less tired. It’s been shown to be effective for treating fatigue. At the very least, it won’t make you any less tired than you are now. If you’re not doing any exercise now, start with something small – a brisk half hour walk a few times a week, and you’ll find that your energy levels will probably improve rather than deteriorate. Many mothers run busy households and manage to fit in a lot of exercise into their week without compromising their energy levels. Don’t let this hold you back! You can do it!

7. Sort out sleep issues.

http://www.huggies.com.au/baby-care/sleep/
http://www.huggies.com.au/baby-care/sleep/

Ahhh sleep, the holy grail of mamas! Who ever thought eight hours of uninterrupted sleep would be such a luxury! Researchers now know that there is a definite link between poor sleep and weight gain. This is thought to be due to physiological and hormonal changes related to sleep deprivation. Obviously sleep deprivation is to be expected in the early months of babyhood. But if you’re struggling with severe sleep deprivation with older babies or toddlers, seek some help. Solving sleep problems isn’t easy, and it depends on your personal philosophy, but if you’re not winning, find out what you could be doing to ensure a little bit more sleep. Speak to your child health nurse or GP, call a sleep school, or read some books. Decide on a method and stick to it. Consistency with night time routines has been found to be one of the key factors to ensuring a good nights sleep for all – more so than the method itself. Chopping and changing doesn’t do any child or parent any good in the long run. And if you’re anything like me and in the habit of staying up too late to get more “me” time after the kids go to sleep – try going to bed half an hour earlier and catch up on your sleep debt. I was amazed the difference this made to my energy levels.

8. Ditto for stress.

Feeling stressed raises the level of cortisol in the blood – a hormone that promotes weight gain and diabetes. If you’re constantly feeling overwhelmed, depressed or anxious about your life, talk to someone, ideally your GP/family physician, and seek help. Being a parent can be an incredibly stressful experience, so don’t be too proud to admit that you’re not coping as well as you think you should be.

9. Watch your cafe habit.

By Josiah Mackenzie from San Francisco, USA [CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons
By Josiah Mackenzie from San Francisco, USA [CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons
Us mums hang out in a cafes a little bit. It’s our way of coping with caring for small children, dealing with sleepless nights, bonding with our fellow mamas, and generally making life a little bit more enjoyable. But cafes can be a trap for mamas trying to lose weight – a regular chai latte and muffin/cake habit can pile on the kilos unknowingly. You can reduce the kilo creep from cafe habits by going for pram walk with your friends instead, sharing treats, or skipping them altogether (and being judicious with your beverages – a large chai latte can add a whopping 335 calories to your daily intake. Stick to green tea instead, which has no calories and is thought to burn fat!)

10. Stop using food as a reward.

When we were going through toilet training, we rewarded Star with marshmallows if she successfully weed or poo-ed in the potty. You can guess what happened – I ended up sneaking a few here and there. Using food as a reward for children has a double whammy of repercussions – on them and on you!

 

You know all the talk about being a mummy means setting good habits for your children. If you’re having trouble with weight, would it help to re-examine this and walk the walk (literally and figuratively?) Aim for a slow and steady weight loss and a lifestyle change, not a diet. Journalling your calories for a few days can really help set you on the right track. Eat mindfully, eat for pleasure as well as health, and make exercise part of your routine. Here’s to a healthier, lighter and happier you :) You deserve it, mama!

http://young-wild-and-fit.blogspot.com.au/2012/07/motivational-weight-loss-health.html
http://young-wild-and-fit.blogspot.com.au/2012/07/motivational-weight-loss-health.html

 

 

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kevin bacon meme

So we made home-made burgers the other night. Neil Perry style. We used lean free-range mince, a bit of salt, olive oil, and topped the burger patty with cheese, bacon, lettuce and tomato. As I chomped away, mentally congratulating myself for making a “healthier” hamburger (as opposed to, say, McDonald’s) I started wondering if this was actually true. Was my burger “healthy” or a pathway to cancer and heart disease?

I did a bit of reading, and found out that, contrary to popular belief, recent large reviews confirm that unprocessed red meat is not associated with a greatly increased risk of heart disease. Neither is saturated fat, apparently. It seems that at the most, red meat increases heart disease risk to a smaller degree than previously thought. However, the problem was that piece of bacon on top of my burger. The bacon apparently led to heart disease, cancers, and generally increased risk of death.

the-most-interesting-man-in-the-world-meme-generator-i-don-t-always-eat-bacon-but-when-i-do-i-put-extra-bacon-on-my-bacon-1238c9Now, I love bacon. I don’t have it very often, but I really do love bacon. So does my whole family. My daughter, a notoriously picky eater, could exist on bacon if we were on a desert island. As most people are, I’m a bit selective with my nutrition. I’ll eat heaps of vegetables, cut down on saturated fat, all that stuff. But when I do occasionally grill my bacon, I use the old “everything in moderation! Life is short!” adage. We also eat sausages (another favourite with the little ones, hmm…) and sometimes have pepperoni or salami on pizzas. We’ll use chorizo in paellas. I enjoy sausages at a barbecue.

Sadly, now my “ignorance is bliss” period has come to a sobering end. The party’s over. The evidence was too compelling – a substantial increase in heart disease and cancer risk is noted with processed meats. That means all that yummy stuff from delis, the convenient stuff. Ham, sausages, bacon, hot dogs. Gone. It seems that even a very small amount regularly is harmful. Experts aren’t sure exactly why, but it appears something in the processing makes the meat harmful – the salt, the added preservatives and nitrites.

bacon kidThe evidence is less clear with unprocessed red meat. It is still associated with bowel and other gastrointestinal cancers, especially if cooked at high heat. Apparently barbecued red meat is the worst culprit. I’m not sure about stirfries and stews or meat in a bolognaise sauce. I guess that kind of meat doesn’t turn black, which the experts say is carcinogenic. I read an article about rosemary helping to cut down the cancer risk. Certainly increasing vegetable intake is a great idea. As is eating a Mediterranean diet – lots of vegetables, legumes, wholegrains, fish, olive oil, moderation in dairy and red meat intake.

So, with a bit of sadness, I am saying goodbye to bacon. Something to be enjoyed only in a very long while. Like, once a year. Maybe on my birthday. Ham at Christmas. It’s been great but I want to live to see my grandchildren. I also want my children to be as healthy as they can be – they’ve got a lot longer on this Earth than I do from this point on. It’s ok. I love vegies and so do my kids. I love lentils. Thanks, bacon, for the good times. Dr Ee, finding the answers to health… Which unfortunately means a life without bacon. Hommous, anyone?

kevin bacon meme

 

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Mizuna greens
Photo: By Flickr user masahiko(Masahiko Satoh) (http://www.flickr.com/photos/masahiko/5122501941/) [CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons

Are you like me – starting to lose motivation whenever the thought of planning for next week’s meals looms? The drudgery of churning out healthy, tasty meals that cater for all tastes in the family while involving some form of vegetable matter can be discouraging to the most motivated of mamas. We all know vegies are important, but most of us still don’t make our five serves a day (one serve is a cup of raw or half a cup of cooked veg), and probably end up eating the same vegies week in week out.

Vegetables need to be a part of our everyday diet because they provide plenty of fibre and essential nutrients. A diet high in vegetables may help reduce cholesterol, some cancers, and heart disease. We were designed as omnivores after all, not carnivores, and our plates are supposed to look like this:

health plate

Having more vegies on your plate has another huge advantage – they are extremely low in calories (in general – avoid potatoes though!) but high in water, fibre and nutrients so you’ll feel fuller and more satisfied on fewer calories. Hello weight loss!

But how do you find inspiration beyond the usual broccoli, peas and carrots? I’ve developed a number of different ways of thinking about vegetables that I must say I don’t apply often enough, but here they are in the hope that they might help you one day!

1. Vegies that are in season

This doesn’t apply if you live in the tropics, obviously, but buying vegies in season has many benefits, including being cheaper and more nutritious. Google for information on your local vegetable seasons, like this Farmer’s Market Guide to seasonal fruits, vegies and herbs in Victoria, Australia.

2. Vegies according to colour

You get the drift – red for tomatoes and capsicums, green for leafies and broccoli and beans, yellow for squash, orange for pumpkin and carrot etc… This way of eating vegies ensures that you are eating a variety of nutrients.

Photo: Andy Wright, www.flickr.com
Photo: Andy Wright, www.flickr.com

3. Vegies according to cuisine

This is one of my favourites. Think stirfries, salads or curries for Asian cuisines, guacamole for Mexican, ratatouille for French etc. Bon appetit!

Moroccan couscous with seven vegetables. Mmm.. Photo: By Beata Gorecka (Own work (own Photo)) [GFDL (http://www.gnu.org/copyleft/fdl.html) or CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0/)], via Wikimedia Commons
Moroccan couscous with seven vegetables. Mmm..
Photo: By Beata Gorecka (Own work (own Photo)) [GFDL (http://www.gnu.org/copyleft/fdl.html) or CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0/)], via Wikimedia Commons
4. Vegies according to way of cooking

Steamed, roast, stirfried, curried, salads, in soups, braised… Choose your cooking method according to the seasons, with hearty soups in winter, and fresh salads in summer.

Nom! This is making me hungry! Photo: By Ginny (ginger chicken  Uploaded by Partyzan_XXI) [CC-BY-SA-2.0 (http://creativecommons.org/licenses/by-sa/2.0)], via Wikimedia Commons
Nom! This is making me hungry!
Photo: By Ginny (ginger chicken Uploaded by Partyzan_XXI) [CC-BY-SA-2.0 (http://creativecommons.org/licenses/by-sa/2.0)], via Wikimedia Commons
5. As a substitute for carbs or meat

I’m still not convinced of this… Although I do adore my lentil bolognaise, (technically lentils are not a vegetable though but you get my drift). Ribbons of zucchini could replace pasta, or bean sprouts could replace noodles. Or maybe just have a mixture so you reduce the carbs (and calories) but don’t starve!

Still not sure about this one... My family was very suspicious!! Photo: http://www.wellbeing.com.au/blog/recipe-zucchini-linguini-with-kangaroo-bolognese-low-carb-low-fat-high-protein/
Still not sure about this one… My family was very suspicious!!
Photo: http://www.wellbeing.com.au/blog/recipe-zucchini-linguini-with-kangaroo-bolognese-low-carb-low-fat-high-protein/

6. Experiment with fancy salads

I’m a bit lazy when it comes to salads – a prewashed mix with slosh of olive oil and balsamic is my quick fix on weekday nights. But why not try a new salad once in a while – like this Orange and Fennel Salad, and feel a little bit special?

7. Try a new vegetable

Go beyond your comfort zone and try new things like okra, or gorgeous mizuna greens, which were a surprising and delicious addition to an udon noodle soup I had in Japan once.

Mizuna greens Photo: By Flickr user masahiko(Masahiko Satoh) (http://www.flickr.com/photos/masahiko/5122501941/) [CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons
Mizuna greens
Photo: By Flickr user masahiko(Masahiko Satoh) (http://www.flickr.com/photos/masahiko/5122501941/) [CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons
8. Seek inspiration from your favourite chef

Just don’t get distracted by Nigella’s dessert recipes (Does that woman ever stop eating cheesecake?!) – try her Crunchy Salad recipe instead.

I hope that got you inspired – and hungry! Please feel free to share your tips and favourite recipes! x

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mem swan and kieser

Recently there was a very public spat between journalist and radio presenter Chrissie Swan and fitness expert and “FITmum” Sharny Kieser. Swan accused Kieser (who wrote a book about how she lost 24kg after having her fourth baby) of being a bully by calling fat people “lazy”. Kieser countered that she felt it should be a priority to have a healthy lifestyle and set a good example to children.

I felt for both sides of the argument. Firstly, from Kieser point of view: she felt railroaded into a hostile debate about something she had not expecting discussing on air. She was invited to speak about combating morning sickness and cravings. Also, I fully support her belief that health should be a priority. Swan is a woman of considerable influence: if her long hours are impacting on her being able to fit exercise into her week, she could consider a re-jigging of her work week. (I must say I know little about her battle with weight, or her personal circumstances). A healthy lifestyle is something we should all be modelling for our children. Having successful careers or successfully running a household but not balancing this with a lifestyle that promotes health is not success, from my point of view. Our children grow up valuing these pursuits over regular exercise and healthy eating.

However, poor Kieser needed some media skills training. Anything can and will come up in an interview. Kieser needed to be aware that her comments had caused controversy and may be targeted anytime she speaks to the media.

mem swan and kieserI see many overweight patients in clinic. I know that quite a few of them are physically active and eat reasonable diets. Overweight people are not necessarily lazy. However, at some stage earlier in their lives there was an energy imbalance and they consumed more calories than they burned. This may have been in very early childhood and often happens during pregnancy. Their bodies reached a convenient “set point”. Our bodies seem to dislike change – every effort is made to return to the status quo. Of course there are other complex factors as to why they remain overweight, and I am not saying lifestyle changes are not the key to losing weight. I certainly see a lot of overweight people who don’t exercise and admit to loving their daily Cadbury Dairy milk habit. I am simply pointing out that a proportion of overweight people are currently in energy balance but were not previously. Also, someone who appears overweight might have lost 5 kg in the past 6 months. Sure they’re still overweight but they’ve made the difficult switch from energy balance to energy deficit. They’ve managed to burn more calories than what they consume.

It’s very very easy to consume more calories than you burn, if you consider how much sugar and fat is in the “normal Western diet” and the sedentary nature of our lives. I’m not surprised at all that overweight and obesity is now at epidemic levels. Losing weight comes down to a basic equation – consume fewer calories than you burn – but this can be challenging to execute. It’s much easier to prevent weight gain. Weight loss is not impossible but it will involve a complete lifestyle change, almost daily physical activity, and reducing calorie intake. Basically, don’t do what everyone else does if you don’t want to end up a statistic.

Being overweight is a problem beyond social acceptance and appearance. Obesity increases the risk of many chronic conditions, including Polycystic Ovarian Syndrome and its accompanying reduced fertility, complications in pregnancy and labour, diabetes, high blood pressure, high cholesterol, heart disease, strokes and cancers. I always tell my patients that they need to aim first to lose 10% of their body weight. Research shows that by doing this, they will significantly reduce their risk of developing chronic disease. They may still be considered overweight after losing this 10% – but they would have given their health a life-giving boost. This is why overweight people are not necessarily lazy. Not everyone needs to look like Kieser, as inspiring as she is to many mothers.

However, there are enormous benefits from a complete change in lifestyle. I try to focus on this when counselling patients, and seek to “treat” overweight in the context of overall physical health, such as improving blood pressure and cholesterol levels. Losing weight does not involve a short-term diet. It involves eating the right foods, cutting out the crap, and learning to love exercise. Improving fitness and nutrition should be the priorities, not just dropping dress sizes.

 

 

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By FXR (aka Soundz'FX) (originally posted to Flickr as Champagne Supernova) [CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons
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By FXR (aka Soundz'FX) (originally posted to Flickr as Champagne Supernova) [CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons
By FXR (aka Soundz’FX) (originally posted to Flickr as Champagne Supernova) [CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons
I started researching this post for International Women’s Day and uncovered some staggering facts. I knew alcohol raised the risk of breast cancer, but I didn’t know that even two drinks a day increased risk significantly.

Recent large studies revealed some sobering facts about alcohol and breast cancer risk:

  • Women who have as few as three drinks a week have a 15% higher risk of breast cancer.
  • For each additional drink that women have per day, risk of breast cancer increases by an extra 10%. This means if you have one drink per day four days of the week and two drinks three days of the week, your risk of breast cancer increases by 25%.

There are many reasons why this gets me worried.

  1. I’m a family physician/general practitioner. I know about prevention for cancer. Yet I didn’t know that even a modest amount of alcohol raised your risk of breast cancer.
  2. Breast cancer is the most common cancer affecting women.
  3. I enjoy drinking alcohol in moderation. To me it’s a way of relaxing at the end of the day (though in recent times I’ve made a concerted effort not to make this a daily ritual), celebrating milestones, and socialising. I love cocktails with the girls, tall flutes of bubbly, a good Pinot Noir, and a nice refreshing Sauvignon Blanc on warm summer nights.

But the most worrying thing of all is that I believe that the truth about alcohol and breast cancer risk is not publicised enough. This may be because women don’t want to have a conversation about alcohol and breast cancer. We don’t want to face the thought of giving up our wine, vodka or whatever our favourite poison is. Only 12% of women in a recent survey were interested in learning how to reduce their drinking to reduce breast cancer risk.

We’re also told that some red wine is good for health, so we enjoy toasting to this. (I rarely tell my patients that a bit of red wine helps to increase good cholesterol levels, because I know exactly what will happen if I dole out this advice!)

I got increasingly worried as I visited the prominent Breast Cancer awareness websites in Australia – the Breast Cancer Foundation and Breast Cancer Network. On the “About Breast Cancer” page of the Breast Cancer Foundation, it states that “Research has shown a strong link between alcohol and the risk of developing breast cancer” and then recommends to “try and limit your alcohol intake to no more than two standard drinks a day“.

On the Breast Cancer Network website, there is no mention of alcohol as a risk factor. There is also no mention of other lifestyle factors such as being overweight and not doing exercise, and having an unhealthy diet. Instead, the “About Breast Cancer” page emphasises risk factors that women cannot change, such as increasing age and genetic risk.

Surprisingly, there is no mention of the lifestyle changes that women can make to reduce risk of breast cancer.

When I had a look to see if there were any fundraising events in Australia that highlighted abstinence from alcohol as a risk factor for breast cancer, I found none. Instead I found lots of fun runs, which is fantastic of course, but also morning teas, afternoon teas, cocktail evenings, and even pink chocolates. While it is great to see so many fundraising efforts, surely these events are not in the spirit of increasing awareness about how to prevent breast cancer, because they promote exactly the fun things that unfortunately increase breast cancer risk (calorie-laden foods and alcohol). I did find a Dryathlon in the UK which raises funds for cancer.

chocolate-wine-drine-my-chateau-ecards-someecardsIn recent times, there have been yearly events that promote abstinence, such as Ocsober, Febfast, and Dry July. These support empowering young people through education, helping youth kick addiction, and improving the lives of people living with cancer. I think there should be a similar event for breast cancer. I have been thinking of starting a fundraising event via the Breast Cancer Foundation, but am struggling with a catchy name. Drink Less for your Breasts? Give Up Booze for your Boobs? I’m thinking May would be an ideal month – as this is the month that Mother’s Day falls on in Australia. I’m also thinking I personally need a kick up the butt with this sort of thing. Alcohol is all too often an easy form of relaxation and leisure. I should be putting my money where my mouth is, and fighting the easy habit of reaching for a drink.

The Breast Cancer Organisation page in the USA has excellent articles on changing your lifestyle to reduce your risk of breast cancer. These include maintaining a healthy weight and increasing physical activity. Breast cancer risk has to be taken in context, as there are many factors that affect individual risk. You can find out about your breast cancer risk, and how you can reduce it, by using this risk calculator. I often use this in clinic with my patients, especially if they are worried because of a family history of breast cancer.

So this year I challenge all my fellow drinkers to cut out alcohol for one month. When I come up with a catchy name for a fundraiser, I’ll post about it (suggestions are welcomed!!) In the meantime, I’m going to stick to my 80/20 rule – during the week I will avoid alcohol, and on the weekend I’ll have one or two drinks. Here’s a reminder about standard drink sizes, and I urge everyone to remember that the standard wine pour is usually a lot more than one drink.

StandardDrinksGuide_web2Viva la mocktail – again! Let’s drink (soda water) to our health!

 

 

 

 

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imageIt’s wonderful to work out in front of our children, isn’t it? Setting a good example for health and all? Oh who am I kidding, the truth is my three-year-old is all over me like a rash whenever I start to do anything that remotely resembles a workout! Here is a Mummy (or Daddy) version of a Core-strengthening workout from Runner’s World Magazine. I take no responsibility for injuries sustained while working out with a small child as weight equipment!!

1. Step Downs

(A) Lie on your back with one hand under your lower back. Lift your legs so your thighs are at a 90-degree angle with the floor, and bend both knees to a 90-degree angle. Now let your child balance on your shins. (B) Tighten your lower back so that it doesn’t move up or down, and slowly lower your right foot to within 1 inch of the floor. Keep your right knee bent at a 90-degree angle, and maintain the position of your left leg. Hold your child up with your arms. Hold your right foot 1 inch off the floor for 2 seconds, then return it to the start position next to the left leg. Repeat the same action, but this time lower the left foot. Repeat both sequences three to five times, or as many times as your child will allow you to

2. Prone Stabilizer

(A) Start on your stomach, and raise yourself into a modified pushup position, with all your weight balanced on your forearms and toes. Keep your back as straight as possible as you let your little monkey scramble onto your back. (B) Slowly raise your left leg until it lines up with your back. Hold this position for 4 seconds, then lower the left leg, and repeat for 4 seconds with the right leg. Repeat both sequences three to five times, or until you collapse with exhaustion.

3. Bridge

(A) Lie on your back with your arms beyond your head, and your feet planted on the floor directly below the knees. Now position your munchkin on top of your belly. Press down on your feet, and lift your torso and upper legs until they form a straight line. Your child will probably now pretend you are a slide and proceed to slide down your front. Fun times! (B) With your weight on your shoulders and your feet, slowly extend the right leg by straightening the knee. Be sure to keep your back straight. Hold for 4 seconds, then repeat with the left leg. Repeat both sequences three to five times or until you have had enough of the shenanigans.

Don’t forget to follow this with a nice relaxing stretch. Oh yes that’s right, you’re a parent, who has time for stretching! Pat yourself on the back instead for managing to fit in some core strengthening exercises into your day!

Photo: health.com

 

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