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Long Covid – What do we know so far?

Who is it effecting?

It can affect anyone even those with mild/ asymptomatic symptoms.

In the UK the main age group its effecting is the 30-55 and 5:1 are women.

Many already have underlying health conditions and its effecting this group up to 40 times more: – conditions such as diabetes and metabolic syndrome, Inflammatory conditions, Atopic disease, Auto Immune disease.  In addition, those that have high stress lifestyles (amateur athletes, high income/pressure jobs/ balancing too much – this group many describes themselves as healthy before Covid).

Main symptoms

  1. Fatigue
  2. Breathlessness
  3. Headache
  4. Non-specific neurological symptoms
  5. Heart Palpitations or irregularities
  6. Digestive disturbances

All medical tests and normally normal

NICE:-  Are currently engaged  in defining symptom ‘clusters’ , NHS approach likely to be focused on:-

  1. After effects of intensive care
  2. Lasting organ damage
  3. Symptoms that vary around the body
  4. Post Viral fatigue

What a nutritional therapist can help with

Nutritional therapists will primarily deal with those in group 4 – Post Viral fatigue, looking at diet and any nutritional deficiencies that may be there.  Post Viral fatigue is one area that normally requires supplemental nutritional  support initially together with lifestyle adaptations.

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Supplement Labelling

In the UK, food supplements are required to be regulated as foods and are subject to the provisions of general food law.

There are over 2 million people in the UK with some form of food allergy.

Under the Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA)The Federal Drug Administration (FDA) in the USA requires allergen labelling limited to eight food groups – Milk, Eggs, Fish, Crustacean shellfish, Tree nuts, Peanuts, Wheat and Soybeans

This act differs from the EU Food information for Consumers Regulation which requires fourteen food groups to be listed – celery, cereals containing gluten, crustaceans, eggs, fish, lupin, milk, molluscs, mustard, tree nuts, peanuts, sesame seeds, soybeans, sulphur dioxide and sulphites (if they are at a concentration of more than ten parts per million).

The danger arises with many individuals now purchasing supplements via e-bay or Amazon. In simple terms Celery and products thereof, Mustard and products thereof, Sesame seeds and products thereof, required to be listed in the EU/UK are NOT required to be listed on supplements from the USA. 

Practitioners must supply or recommend only products legally appropriate for sale in the UK. One of necessities for a product to be legally sold in the UK is that it complies with EU requirements for labelling. Susan uses Natural Dispensary to supply all her clients, to ensure that all products comply with regulations.

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Food Intolerance tests

Because IgG blood tests have not been proven to identify food sensitivities or allergies, there is a lack of evidence to support making changes based on their findings. The restrictions suggested by IgG test results may lead you to unnecessarily avoid healthy foods. Or, they may prompt individuals with food allergies to include foods that could be harmful to them.

Professional organizations that specialize in the treatment of food allergies, do not recommend IgG testing due to the lack of evidence for this use.

Susan uses the elimination and challenge method to look at any possible food intolerances.

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Vitamin D and COVID-19

Vitamin D has been hitting the news for a few years now, as more and more research shows that those living in the northern hemisphere are more at risk of deficiencies especially during winter.

Normal levels of vitamin D mean that your body’s ability to regulate essential chemicals for healthy bones, teeth, muscles and organs is properly aided by vitamin D.

Vitamin D helps your body absorb calcium. If you don’t get enough vitamin D you might feel tired, get sick often, have weak bones and muscle pain, and feel anxious or depressed.

Your body is able to make all the vitamin D you need when your skin is exposed to sunlight. But when sunlight exposure is low during autumn and winter, it’s really common for your vitamin D levels to drop — putting you at risk of developing a deficiency.

You can get vitamin D from foods like oily fish, liver, egg yolks, and fortified food but it’s hard to get enough this way.

You might also be at an increased risk of developing vitamin D deficiency if you:

  • are vegan or vegetarian
  • have darker skin
  • are elderly
  • always wear sunscreen
  • stay indoors a lot
  • cover up most of your skin outdoors

What are the most common symptoms?

The most common symptoms of vitamin D deficiency include:

  • getting sick often
  • feeling tired
  • aching bones and joints
  • weak bones — increasing your risk of osteoporosis
  • poor wound healing
  • weak muscles
  • depression

There are many companies now offering a private Vitamin D blood tests , and in some instances your GP may be able to provide a test. Even though, there is still debate about how much we actually need, most experts agree that below 25 nmol/L (or 10 ng/ml) is considered deficient.

Some experts argue 25-30 nmol/L in the blood is sufficient, some say over 50 nmol/L is optimal for good bone health for most people, while others again advocate for 75 nmol/L or even higher. Susan looks at levels of 70- 120 for her clients to ensure optimal health.

Recent research by Boston University have shown that individuals with a blood level of 25-hydroxyvitamin D of at least 75 nmol/L, had a significant decreased risk for adverse clinical outcomes including becoming unconscious, hypoxia and death. In addition they had lower blood levels of inflammatory marker ( C- Reactive protein) and higher levels of lymphocytes.

During autumn and winter, Public Health England advises that everyone should consider taking a 10 mcg daily vitamin D supplement from October to March. And if you’re more at-risk, they recommend taking them year round. The recommended doses for at-risk groups include:

  • 8.5-10 mcg daily for breastfed babies from birth to 1 year
  • 10 mcg daily for children aged 1-4 years
  • 10 mcg daily for at-risk adults — for example, if you’re elderly or have darker skin

Suitable products contact Susan if you wish to place an order – Free postage on orders over £25. Prices correct as of 26th Sept 2020 – contact Susan for up to date prices.

These products are chosen at own risk, no advise given without a full assessment.

Lamberts Cod Liver oil Professional range – gives you vitamin D and A and  EPA and DHA. – £14.00 – 180 days supply

Allergy Research Vitamin D3 complete – higher dose suitable for those with a diagnosed vitamin D deficiency, also contains vitamin A and K – £ 27.00 – 60 day supply – Not suitable for those taking blood thinning medications

Biocare – Vitamin D3 –  1000iu – Vegan – £12 – 60 capsules

DLux 4000 Vitamin D Daily Oral Spray 15ml- £9 – Vegetarian

Lamberts Professional Range – Vitamin D3 Drops 20ml – suitable for all the family £8.20

Other vitamins and supplements from Susan’s supplier Natural Dispensary may be added to order, just let her know what you require.

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Zinc Deficiency and Covid-19

Lower levels of plasma Zinc on hospital admission, effected the outcome when admitted with Covid- 19. But before you reach for the Zinc supplements, this is one mineral where less is more. Zinc absorption is higher at lower dosages. Zinc also has many nutrient interactions, Iron, calcium and phosphorus all decreases its absorption levels. Zinc is in many protein rich foods and absorption rates are higher from animal sources than plant sources, those on plant based diets will need to consume a higher amount of zinc to ensure required amount is absorbed. Phytates, which are commonly found in plant foods, reduce zinc absorption, and some researchers have suggested that this increases the zinc needs of vegetarians by up to 50%. Foods high in Zinc include 1/2 a cup of baked beans will provide 26% of daily requirement, Chicken Thigh – 22%, 25g pumpkin seeds – 20%, 1/2 cup chickpeas – 12%. If you wish to look into supplements please contact Susan who can provide some recommendations.

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Which Sugar is best?

Refined sugar is so processed that it has absolutely no nutritional value – no fibre, nutrients, healthy fats or enzymes. In fact, it acts as an “anti-nutrient,” robbing your body of precious minerals like calcium, magnesium and potassium. And as little as 36g of sugar for adults and 18g for children begins to suppress our immune system.⁣

But we have taste buds targeted for ‘sweet’, so we’re obviously designed to want this flavour. Luckily, there are some healthier, natural sweeteners we can use instead.⁣

WHAT ARE NATURAL SWEETENERS?⁣
This may seem obvious, but as more and more dubious products come out claiming to be “natural” sweeteners, I think I should explain more. Natural sweeteners are minimally processed (depending on the quality you purchase) don’t require the use of added chemicals, enzymes or expensive machinery, and still contain minerals and phytonutrients that occur naturally. For instance;⁣

Agave — NOT NATURAL⁣
Rice Bran Syrup — NOT NATURAL⁣
Sugar Alcohols (like xylitol or erythritol) — NOT NATURAL⁣
Stevia Leaf Powder — NATURAL⁣
Maple Syrup — NATURAL⁣
Raw Honey — NATURAL⁣
Rapadura Sugar — NATURAL⁣
Organic Dates — NATURAL⁣

These natural sweeteners nourish the body instead of deplete it.⁣

RAW, LOCAL HONEY⁣
contains antimicrobial properties, enzymes, antioxidants, vitamins B1, B2, B3, B5, B6, calcium, iron, magnesium, phosphate, potassium. It also soothes sore throats, coughs, and respiratory conditions.⁣

DATES⁣
are naturally loaded with potassium, copper, iron, manganese, Vitamin B6 and magnesium. You can also ferment them to make them even lower in sugar, full of probiotics and easier to digest (recipe/ instructions are on my website).⁣

STEVIA⁣
doesn’t affect blood sugar levels, doesn’t feed Candida or pathogens in the gut, or set you up for sugar/ carbohydrate cravings. When purchasing stevia, find one that is pure, as so many contain fillers like maltodextrin, flavours, lactose, glycerin and alcohol.⁣

MAPLE SYRUP⁣
is an excellent source of manganese, zinc and other antioxidants. Be sure you purchase pure, organic maple syrup as many commercial brands use formaldehyde in processing.⁣

What’s your favourite natural sweetener?

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Mediterranean diet

Susan has returned from a lovely week in Crete, the original home of the Mediterranean diet, this diet has been researched for many years and has shown many positive effects for health.

For thousands of years Cretans have eaten only what their land produced – which was lots of fruits, vegetables, olives, whole grains and pulses.  Cretans consume a great deal of olive oil, significantly more than any other Mediterranean people and they don’t use any other type of oil. Todays diet can not be exactly replicated since lifestyles have changed since the 1950’s.

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Fat makes up about 35%-40% of daily calories in the Cretan diet. Cretans get their fat from olive oil and olives instead of butter, meat and other oils .

Cretans ate more fruit than any of the other Mediterranean countries and much more than other countries in the study

The average Cretan consumed 9-12 servings of fruits and vegetables each day compared to the current USDA recommendations of about 4.5 servings combined. Wild Greens were popular during the study but are very hard to find now.

The main grains consumed were the whole grains barley and wheat in the form of bread, rolls and rusk. Bread was typically made from all barley or a combination of barley and wheat, rusks from a barley and wheat mixture, Bread was eaten daily (usually with lots of olive oil).

Pulses – Were consumed about 3 times per week

Nuts – Nuts consumed in Crete are most often almonds, hazelnuts, chestnuts and walnuts.

Eggs – While eggs were not a huge part of the Cretan diet, they did consume 2-3 eggs a week. The biggest difference is that the chickens that produced the eggs were all free-range chickens that instead of eating grains like chickens in the US, lived on figs, grasses, insects, worms and purslane. This not only made the chickens healthier, but meant that the eggs are excellent sources of omega-3 fatty acids

Fish and chicken is eaten a few times a week with red meat saved for special occasions.

Food is flavoured with lots of herbs, all vegetables we ate were flavoured with herbs, as with the fish. Meat portions were small, and lots of vegetable were available – The hotel made the tastiest courgette Ive ever tasted, and tomato grown in the sun tastes so different than ones grown in a green house.

Susan was there for only 6 days, having a breakfast of Greek Yoghurt and fruit, followed by a small meat free cooked breakfast. Evening meal always started with a large selection of salad, with some feta cheese. Main meal fish and vegetables and potato cooked in olive oil, since she was on holiday she did try the delicious deserts. Midday snack my sons favourite, frozen greek yoghurt with strawberries and kiwi (highly recommend Andriani’s Homemade Ice and Frozen Yoghurt) and came back 1llb lighter, I never went hungry and felt really nourished. Susan will certainly will be eating this way more at home.

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The sugar tax

Earlier this year the UK introduced a sugar tax, with the government stating                 ‘The ‘Sugar Tax’ will help to reduce sugar in soft drinks and tackle childhood obesity’  While many companies have reduced their formulas to now be exempt from the tax,  some products are shown as price includes sugar tax, so you would assume that those products in the same store  that don’t have this labelling on are better for you.

One such example is a popular fast food outlet.  One of their frozen drinks has the sugar tax added, it contains Sugar, glucose syrup, dextrose, fructose and lactose.   This drink equates to 37% of an adults daily intake of sugar.   Another drink they sell does not attract the sugar tax since its a frozen fruit smoothie, the sugar is all derived from fruit and lactose in the milk, and whilst this drink has less fat and therefore calories it contains 44% of an adults daily sugar intake.

At the end of the day sugar is sugar, its better for you when taken as a whole fruit since you are then also having the fibre. Over consumption of both glucose and fructose, will lead to weight gain and associated medical conditions.  Sucrose, often referred to as “table sugar”, is composed of one glucose molecule and one fructose molecule joined by chemical bonds. This means equal amounts of glucose and fructose are released into the bloodstream when sucrose is digested.  In Australia  most drinks are sweetened by sucrose from cane sugar, while soft drinks are sweetened with sucrose-rich sugar beet (Europe) or high-fructose corn syrup (US). High-fructose corn syrup is also made up of glucose and fructose, but contains a higher fructose-to-glucose ratio than sucrose.

Do they have different health impacts?

Yes over consumption of fructose has been shown to cause non-alcoholic fatty liver disease, and whilst fruit and vegetables in their natural form contain fructose due to the fibre  when eaten as a whole fruit or vegetable its very difficult to over consume.

High glucose consumption rapidly elevates blood glucose and insulin. This may affect brain function, including mood and fatigue. Because high blood glucose is linked to diabetes, consumption of high-glucose drinks may also raise the risk of diabetes and cardiovascular (heart) disease.

So choosing  a fruit smoothie may not be the best healthy option in terms of sugar.

 

 

 

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Prescription medication, vitamins, supplements and food.

When you take prescription or over-the-counter (OTC) medications, do you take also a vitamin, mineral, or other dietary supplements? Have you considered whether there is any danger in mixing medications and dietary supplements?  It is  widely highlighted that grapefruit juice affects the way your medicines work, especially if you have high blood pressure or arrhythmia (irregular or abnormal heart beat).  It can effect other drugs a swell,  but the severity of the interaction can be different depending on the person, the drug, and the amount of grapefruit juice you drink.

Many drugs are broken down (metabolized) with the help of a vital enzyme called CYP3A4 in the small intestine. Grapefruit juice can block the action of CYP3A4, so instead of being metabolized, more of the drug enters the blood and stays in the body longer. The result: too much drug in your body.

There is now further research that shows that grapefruit juice can also have the opposite effect.  Fexofenadine an anti-histamine, instead of changing metabolism, grapefruit juice can affect proteins in the body known as drug transporters, which help move a drug into our cells for absorption. As a result, less of the drug enters the blood and the drug may not work as well.  Orange Juice and apple juice also have the same effect with this medication so its important to always read the leaflet that comes with your medication.

St. John’s wort can decrease the effectiveness of birth control pills, leading to breakthrough bleeding and an increased risk of unintended pregnancy. It also interacts with anti – depressants, statins, and many others.

Herbs that decrease blood sugar may interact with anti-diabetes drugs to cause blood sugar to drop too far.

Echinacea a popular supplement at this time of year, but there are many interactions, especially with medications that follow the CYP3A4 pathway since these all have  toxic effects on the liver.

There are lots of reports in news that as well as vitamin D being a common deficiency in the UK this is closely followed by magnesium, however magnesium tablets can interact with blood pressure tablets and antibiotics.

The list is not exhaustive,  before you take any medication either prescribed or over the counter , vitamins, supplement or herbs please check for any interactions.  Please also mention all medication, herbs, supplements and vitamins, to medical staff and your nutritionist.

© 2018 – Susan Monk BSc (Hons) Open,  MFNTP.