Happy Foods ... is there such a thing?

I bang on a lot about the connection between our general health and well-being and the health of our gut microbiome (or the gut bacterial eco-system, as I like to call it).

Here is an excellent podcast which covers both the above and the link between foods and anxiety, depression and mood disturbances.

Happy listening...

Breakfast - the most important meal of the day?

If, like me, you were brought up to believe that eating three square meals a day was important for good health, then the veritable deluge of studies and research coming through that address issues such as fasting (to lose weight, to improve health, to cope with treatment for disease) and when we eat is quite a shock. After all, over the years eating for weight loss and health improvements has never really addressed the when, but only the what and the how much.




Here's another article about breakfast (in this case written in the context of type 2 diabetes) and whether we should - from time to time or all the time - skip it. But wait! Is the old saying - 'breakfast like a king, lunch like a prince and dine like a pauper' now wrong?

Well, it's a complicated subject. Have a read and see if it could work for you. It certainly is important not to blindly believe all we were told those years ago.

I've certainly found that fasting on two days a week (a la Michael Mosley) helps my energy levels, and that missing breakfast often leaves me feeling sharper and more alert during the morning (I eat well later though!).

Perhaps the key takeaway (excuse the pun) is that the body may benefit more from variability than we previously thought. 




Auto-immune disease - a 'cocktail' of self-help approaches

The following ideas should help your body start to heal from most auto-immune disease, and cope with the medicines used to treat your disease. These ideas are grounded in good evidence based science.

If you have any form of auto-immune disease, you need to be doing most of these ALL the time, and all of them some of the time.

  1. Get your gut microbiome happier and more balanced. Research it - especially the role of intermittent or regular fasting at helping the gut bacterial system and the linked immune / inflammation regulation system - there's so much information and evidence for it now - and take steps to influence it positively!
  2. Sleep - poor sleep screws up the immune system. Do what ever you can to improve the quality and quantity of your sleep.  For example.
  3. Be happy - if you have any grumbles or angers or emotional problems from the past - deal with them! For example, counselling.
  4. Vitamin B complex, Omega 3 fatty acids and Magnesium. A combination of the different B vitamins are vital for nerve function, and a high quality fish oil (2000-3000 mg) is vital for managing inflammation. Both DAILY. Low levels of magnesium are remarkably common in the western world.
  5. Avoid, apart from occasional exceptions, the negative foods like shop bought wheat bread, lots of pasta, morning cereals, and of course refined sugar.
  6. A healthy start to the day - Nutribullet blenders are excellent. Along with the greens, banana and berries they recommend you use as a core constituent of your smoothie, add the following: a clove of garlic, some fresh ginger, some fresh turmeric and - importantly - some avocado (for their healthy fats), nuts (esp. almond or walnut) and seeds (esp. flaxseeds). Perhaps not every day of the week but certainly 5 out of the 7.
  7. Don't drink much at all, and definitely not on consecutive days.
  8. Learn to meditate for a bit each day - this app, for example, is excellent.
  9. Regular cardio exercise (testing your limits) that gets you hot and sweaty. However, research this if you have MS.
  10. Regular yoga (good for sleep and your immune system).
  11. Breathing exercises. Practice and practice until you are a very good breather. For example, be able to hold your breath on a full set of lungs for at least 75 seconds, and on a completely empty set of lungs for at least 30 seconds.

If you asked me 'what of the above are the most important?'. Well, I would answer 'always do 1, 2, 3, 8 and 11'. But the others really help too.

Aspirin - that old but still remarkable drug

With the usual and important proviso that you should always chat to a GP before stopping or starting aspirin (for anything other than short term pain relief); this article is an interesting guide to how it is currently thought about and used in a wide variety of situations.



Don't rush into anything though...



The new field of neuro-immunology

As you are no doubt aware, the immune system has many ways in which it causes problems for us humans, rather than the bacteria, viruses etc. it should be focusing on.

We call this 'auto-immune' disease. Depending on the area affected, auto-immune disorders get different names (for example, rheumatoid disease affecting joints, psoriasis affecting skin, and so on) but it is all the same basic issue.

Traditionally, when it comes to the mind and psychological or psychiatric disorders, the assumption has always been that the disorder is localised in the brain itself, with or without 'stress' or adverse life experiences as a cause or trigger.

The idea that the immune system could attack or interfere with the brain enough to cause depression, or psychosis (for example) has not really been recognized except in the last 5 years or so.

Listen to this excellent podcast from the BBC for some more information.




We do too much sitting. Even when sitting 'properly' there are downsides (weaker muscles, vascular pooling, stretched ligaments, poorer digestion). It's even worse when we don't sit properly. But, leaving aside the obvious point that we need to minimise total time spent sitting, and take regular mini breaks when we are sitting, what else should we bear in mind?

It's possible to sit properly in two quite different ways. These are active versus passive sitting.

When we sit actively, we use our back muscles to hold ourselves upright. We don't use the back of the chair to support our back. See the example of the kneeling chair below.




Note that you can replicate some of the good effects of a kneeling chair while using a conventional chair by sliding your bottom towards the front of the chair, having your feet behind you, resting on your toes, and your knees pointing down at an angle (this stops slumping). See the picture below for an example of this.

Proper active sitting - I could criticise the fact that the knees are NOT pointing down enough but at least it's in the right direction!

Proper active sitting - I could criticise the fact that the knees are NOT pointing down enough but at least it's in the right direction!

Advantages? Our back muscles don't get lazy and we can sway back and forward in the chair, keeping things moving.

Disadvantages? Prolonged sitting like this can get tiring, precisely because we are using our muscles! Also, kneeling chairs will gradually compress the knees, so you'll need a break after a while from that feeling.

When we sit passively, in a proper way, we rest our back against the back of the chair. See this picture below.

This is passive sitting. Not the best picture, but her upper back is also resting against the chair (this is important).

This is passive sitting. Not the best picture, but her upper back is also resting against the chair (this is important).


Advantages? We are nice and relaxed - it isn't tiring in that sense. A very good chair allows us to do this properly, but we must use the chair properly to take advantage of this (especially we must have our bottom right back against the chair, and we mustn't lean forward with our upper back).

Disadvantages? Our spinal muscles get lazy and weak from excessive sitting and we are very static and still compared to active sitting.

The worst sitting position?

Simple! The in-between proper active and proper passive sitting where you are doing neither correctly! Avoid like the plague, especially if you have a disc problem. See the picture below. There are no advantages to this type of sitting, and major problems can occur.

Ouch! Especially if you have a disc problem. 

Ouch! Especially if you have a disc problem. 


Effects of a bad desk / chair / computer set-up?

Even with the best of intentions a bad 'ergonomic' set-up can hamper us from sitting properly (either actively or passively). A bit of lateral thinking, advice and sometimes new equipment can often sort these problems out. Especially, bad ergonomics that encourage you to slump, like the lady above, must be sorted out.

Effects of a badly working or too-weak back?

Interestingly (and often un-appreciated), if you have a back problem then sitting can aggravate and compound the problem. Best to sort out your problem with an osteopath and make sure the spine itself is basically working OK, or - if it is just spinal muscle weakness - work on strengthening these muscles.

Summary / Advice

Ideally? If you have to sit a lot, get both types of chairs (a conventional chair and a kneeling chair) and mix and match between the two, using them properly. If you can only use a conventional chair, consciously alternate between proper active and proper passive sitting on a regular basis. Obvious point - if at the end of a long day sitting, you feel achy and sore - do something about it!


If you do have an active disc problem, then I am a fan of the kind of reclined sitting shown below. It's not ideal in many ways, but it can take the strain off the injured disc.

Not ideal - but good for discs

Not ideal - but good for discs

MRI's and low back pain - when to do them?

This is a quick video on the hip hinge movement and basic instruction for the Kettlebell Deadlift, by Owen Evans.

Here is a copy of a letter I sent to a patient that summarizes the issues. He had just had a private MRI done because he was concerned about some recent low back ache, and then called me up to ask a) what I thought of the radiologist's report and b) should he have bothered having it done in the first place!

Peter, one point of MRI's for the spine is to find pathology (e.g. tumours or fractures) - icky stuff - there is no indication here of anything like that.

Another is to find evidence of significant, unexpectedly large (adjusted for your age) degenerative change in the spine; of the disc, the facet joints etc. Yours seems normal for age. We all get wear and tear in 50's and 60's.

Another is to find evidence of structural or developmental anomalies (e.g. you have an extra verterbra, or a missing x or y). No evidence of that.

Finally, the last point of the MR is to see evidence of something that is causing the pain. In the absence of pathology this is remarkably difficult to do. Perhaps the most reliable case is where the patient has sciatica, and the scan shows evidence of a nerve root being impinged or squashed. Providing the actual nerve root in the scan does correlate with the patient's symptoms, this gives surgeons some comfort if they are planning to operate.

But diffuse low back ache is often not caused by damage or wear and tear to structures per se, but is often muscular or inflammatory. Here the scan is unable to identify these causes of pain.

This is one reason why x-rays have been largely dropped for the routine evaluation of low back pain, and why (at least in the NHS) an MR scan was not indicated for your current problem.

So the pain needs dealing with not by docs or surgeons, but by exercise, strengthening of the low back muscles, good sleep, a good bed, avoidance of poor sitting posture, good control of inflammation in the body, good bowel movements (this is surprisingly important) etc.

For example, these exercises done daily are excellent.


Build up slow smooth and strong 15-20 reps per day. Perhaps done half morning half evening

Not straight out of bed, when your back is 'stiffer', but after it has had a chance to loosen up.

Make sure your first two reps are especially slow and good. Technique has to be top notch. Observe the video carefully.

Work up from 10 kg to max 15 kg. Every day!

Link between the gut and the brain/mind - worth a look

This interesting podcast covers the emerging links between gut function (especially the large bowel) and brain function. The idea that some types of depression (for example) may have a gut or immune system cause (we have previously talked about the complex and rich links between the gut and the immune system) would have been laughed at only 10 years ago!



More light (excuse the pun) shed on the sleep / blue light issue

In the same way that excessive blue light hitting the brain during the darker hours before night can inhibit the release of the sleep regulating hormone melatonin (and thus cause sleep problems), so can - during the daylight hours - not getting enough blue light cause a disruption of the night-time sleep cycle.

And a surprising way this can happen, for elderly people, is through the development of cataracts. Cataracts increase the opacity of the lens, and thus - during daylight hours - reduce the amount of blue light reaching the brain.

Solution? Have your cataracts done! Fascinating...




Technology meets snoring!

Finally, the link between a pillow and snoring has been explored in this recent initiative.

We've all been there...

We've all been there...

Basically, a gizmo will hear you snoring, and then make a small balloon inside your pillow gently inflate or deflate, nudging you to move and thus tightening up (at least for a while) your airway. It is a flaccid, relaxed airway that accounts for the bulk of snoring, and this relaxed airway tends to develop after a period of lying still.

This could work, and it might well be available in 2017.





Some news about Nurofen (aka ibuprofen)


Most people don't know that the various Nurofen preparations targeted at different problems actually have exactly the same active ingredients! See this article, where Australian authorities have got a bit fed up with this...

Interesting angle on food combining...


Eggs (free range, ideally organic) are good for you, yes? Especially if you add them to salads which contain caretenoids.

Just shows how what you eat is important in terms of the mix and interaction of the foods, as well as the individual ingredients.

Excellent news!


The good news about eating chocolate rolls on, as the number of 'superfoods' continues to grow. It's great to see that chocolate and cocoa seem to be good for us, though splurging on poor quality milky chocolate surely isn't? I find that the higher quality chocolates with a higher percentage of cocoa and less sugar don't make me want to eat too much of them.

Interesting news about whiplash sufferers and chronic pain


Researchers may be shedding light on why it is that some of those who suffer badly from whiplash, and who don't seem to respond well to normal therapies and rehab, do not get better.

For some of this unfortunate sub-group the problem may be less psychological (there is always a tendency to 'blame' the patient if they don't get better) and more to do with unusual structural changes that develop in traumatised muscles. Worth a read if this is a problem for you.


New drug to treat sciatic leg pain?

A drug hitherto used to treat raised levels of "tumour necrosis factor" in diseases such as rheumatoid arthritis, is being trialled on patients with sciatic leg pain (typically caused by an intervertebral disc injury pressing on a nerve root).

Tumour necrosis factor (TNF)

Tumour necrosis factor (TNF)

At the moment, we only have strong anti-inflammatories (such as diclofenac sodium) or codeine based painkillers to treat the nasty pain of a bad sciatica. Hopefully, this new drug will add an important new option that doctors can offer patients with this unpleasant and very common problem.

And now the diversity of our gut bacteria seems to affect our hormones!

It is fascinating seeing the interaction between the microbiome (the bacterial population) of a large bowel and the function of other systems in the body (immune, endocrine) being explored and gradually better understood. See this recent article.

It is now clear that our traditional way of seeing ourselves us as living organisms that are 'apart' from bacteria, worms and viruses (the way that biology is taught, with the conventional view of the immune system as fighting 'foreign invaders') is completely wrong. 

The reality is that we exist in a much more fluid and shifting way with foreign organisms, some of whom help, some hinder, and some (appear to) do nothing.