Vicky is a dietitian from Melbourne and shares her insight on inflammatory diets. Long term inflammation can lead to recurring injuries, reduced performance and lack of recovery. We cover: What the consequences are of an inflammatory diet What are the 'big 3' culprits for inflammation The evidence for high sugar, fat, salt diets Omega 3 vs omega 6 The effects of a diary free diet Find Vicky's social media accounts below: https://eatplaythrive.com.au/ https://www.facebook.com/eatplaythrive https://www.instagram.com/eat_play_thrive/ To follow the podcast joint the facebook group Becoming a smarter runner click on the link: https://www.facebook.com/groups/833137020455347/?ref=group_header To find Brodie on instagram head to: https://www.instagram.com/brodie.sharpe/ To work with Brodie Sharpe at The Running Breakthrough Clinic visit: https://breakthroughrunning.physio/
Expand your running knowledge, identify running misconceptions and become a faster, healthier, SMARTER runner. Let Brodie Sharpe become your new running guide as he teaches you powerful injury insights from his many years as a physiotherapist while also interviewing the best running gurus in the world. This is ideal for injured runners & runners looking for injury prevention and elevated performance. So, take full advantage by starting at season 1 where Brodie teaches you THE TOP PRINCIPLES TO OVERCOME ANY RUNNING INJURY and let’s begin your run smarter journey.
:
Today we're talking about inflammatory diets impacting your running with Vicky Couriel. Welcome to the Run Smarter podcast, the podcast helping you overcome your current and future running injuries by educating and transforming you into a healthier, stronger, and smarter runner. My name is Brodie Sharp. I am the guy to reach out to when you've finally decided enough is enough with your persistent running injuries. I'm a physiotherapist, the owner of the Breakthrough Running Clinic. and your podcast host. I'm excited to bring you today's lesson and to add to your ever-growing running knowledge. Let's work together to overcome your running injuries, getting you to that starting line and finishing strong. So let's take it away. message out there for today's episode. I asked people on Twitter, I asked people on Facebook what their questions were to ask Vicky and I'm so happy that a lot of you guys reached out and had some curiosities around diet. I managed to cover a lot of the topics that were asked but there was heaps of topics around inflammatory diets, a lot around tendinopathies when it comes to diet and a couple around marathon recovery and got to Vicky and had all these questions for her, prepped her for a couple of questions, and she replied with, look, some of these topics are now worth an hour of discussion anyway. I'd rather not superficially scratch the surfaces. I'd rather find a topic that we wanna go deep on so that it's fully understood. You guys grasp the concept of it and it's a practical takeaway and... We can save the topics for another time or you can contact us. So we discussed around inflammatory diets today. I want to say thanks to Georgina for asking her question around inflammatory diets and what foods are recommended. Stacey as well, wanted to ask what sort of food to add or avoid when it comes to inflammation. We had Sam talking about, or asking the question about dairy free diets and Vanessa asking about foods to avoid for joint pain. Julia asking about increased risk factors for tendinopathy around diet. My boy Dave McKay asked about like some dietary recommendations for tendinopathy sufferers. Jen asked about gelatin. Stacey again asked about fish oil tablets and then Robin at the end asking about marathon recovery tips and diet for marathon recovery. Thanks to everyone. I didn't get to have a shout out during the episode, so I thought I'd do it here in the intro. Unfortunately, we didn't cover a lot around tendinopathy, but inflammatory diets in general will impact the tendons themselves or impact the likelihood of injury, so. that was one of the major topics that didn't get discussed today and I tried to cover as much else as I could. I tried to answer all your questions as best as I could within the interview and tried to make it through a bit more of a conversational free flowing topic rather than disrupting the flow with question and answer time. And I think we covered it really well. We've discussed so much in this episode. Vicky was great. breaking down complex topics and making it a bit more simplistic. And I was writing down a lot through this. I was learning a lot. And we mainly settled on the whole inflammatory diet that can apply to anyone and apply to any runner when it comes to performance, when it comes to injury likelihood, and also when it comes to things like recovery. So it applies to everyone. That's why we chose this topic. Vicki's super passionate about it. If you have any other questions, or maybe a question that wasn't necessarily addressed, Vicky's happy to be contacting you can ask her and maybe if I ask nicely we can get her to come back on to discuss a few more others if you have any other questions or if you have any other feedback or topics that want to be discussed but I had a great time chatting to her. Let's bring her on now and start the interview. Uh let's start with what you do with your general day-to-day as a dietitian. Yeah, so, you know, my focus is on real food, low carb nutrition. And so people really sort of seek me out for the purpose of changing their diet to that sort of structure. And that might be for all sorts of different reasons. And I'm either consulting one on one, but a large majority of my work is, is my program that I run. It's a six week program that helps people establish a lower carbohydrate real food diet. And so there's lots of support in that program. So I'm online all the time, answering questions and helping people navigate through that process. So that's the majority of my work. I also am involved, my husband and I run a business, Eat Play Thrive, nutrition is the one component, but we have a lot of exercise classes. We were running those studios face to face, but now we run them online. So I take a few of those. and just get involved with the business side of things as well. So that's my day in a nutshell. Right. And the ones that sign up for this six-week program, are they a certain demographic commonly or are they trying to achieve a similar goal? I guess it's more a similar goal. So these people are wanting to establish a low-carb lifestyle rather than just coming in and doing a six-week program and... having a before and after picture. It's not like that at all. It's rather about learning how to incorporate low-carb into your life. And that might be for a variety of reasons. You know, it might just be, which is probably the most common, wanting to lose weight and improve energy levels and that sort of thing. Or it might be sport-specific, wanting to adopt this way of eating as a way of moving away from processed carbohydrates. It might be because there are... type two diabetes, have type two diabetes or other metabolic diseases or an autoimmune disease that they're trying to get under control. So all sorts of different reasons but all trying to establish that long-term approach to a low-carb diet. Okay, I think that might segue us nicely into the whole inflammatory diets and it's gonna be the bulk of the stuff we talk about. Let's... Just start us off with like what is inflammation when it comes to gut health and diet? Yeah, so if we take a greater look at what is inflammation, inflammation is just a response of the immune system to whether it be irritation or injury or infection or whatever it might be. And most of the time when people hear about inflammation, they're like, ooh, such a bad thing, terrible. But as a physio, you would know that inflammation in the acute setting is actually a good thing. So if somebody injures themselves acutely, that inflammation is going to help remove damaged cells and bring things into the environment to create the healing process. So we've got that side of inflammation, but then we have the chronic side of inflammation, and that's where... you know, the nasty stuff comes in. And so chronic inflammation, you know, it's difficult to get, you know, I guess consensus on what it is exactly, but we can look at a range of different markers in a person's body to understand if they are chronically inflamed. There's a whole host of them and some more. are often looked at are things like your C-reactive protein and interleukin 6, those are the two probably that most people would look at. And that is starting to give us an indication that maybe you've got some sort of inflammation in your body going on because of things that you are doing on a consistent basis that is potentially putting your body under stress. So what sort of things do we do on a consistent basis be having an impact and of course diet is the first one that people think about and that is certainly a massive contributor but there's other things as well like exercise, sleep, stress, all of those sorts of things but you know in my area of expertise being diet that's the one that I focus on and how is diet impacting your inflammation and then how is your inflammation impacting your life. whether that be from an injury point of view, from a gut health point of view, from a chronic disease point of view, whatever that might be. So we're not talking necessarily about the food itself causing inflammation. You're talking about any sort of stress response from the body and the diet kind of influencing whether that inflammation is exacerbated or settled down. Is that right? Not exactly. I would say that there are definitely certain foods that increase inflammation. 100%. There are groups of foods that cause an increase in inflammation. And if you are eating those foods regularly, then the chances of you becoming chronically inflamed are dramatically increased. So, yes, there are certain foods that... that regardless of whether you're under stress or not under stress, are going to impact you and your system negatively. Now that might not show up straight away. You might be able to get away with it for years. You know, you might be in your late teens or your twenties and just cruising along and slowly, slowly these in this inflammation is building up and building up. then maybe, you know, like in your mid thirties or so, you get this running injury and then it just doesn't go away. And you try one thing after the next, after the next, after the next and nothing helps. And then you're starting to have to drill back and try and work out, well, what's the cause of this inflammation in the first place? And once we get to the crux of that, then very often we can see improvements in things that... have just seemed to be popping up, but meantime, they've been just slowly, slowly building up over many, many years. Right, so if we just say, I take something like I have a diet that is causing inflammation, what's happening exactly? Because what I'm imagining is like, my body undergoes reaction and say things like, the digestive system actually starts to be inflamed. Is it that? bad as what I'm picturing or is there something else going on, something a bit more subtle? Yeah. So, you know, inflammation can cause a range of things to go on. So when you look at inflammation in one person and compare that to someone else, there might be quite a lot of variations. So, you know, if you went for a blood test, you could look at a range of different markers to understand if you had a level. of inflammation in your body. So some examples of that, you know, leukocytes are white blood cells, so they might be slightly raised. We might have transcription factors that are raised. We might have cytokines that are raised. And the ones that I mentioned at the start, which are most regularly tested for in these sorts of scenarios, would be a CRP, which is a C-reactive protein. and an interleukin 6. So those are things that you could begin testing for and that we have some relatively good evidence and information from research that if these figures are raised, then this is indicating a level of inflammation. Now then there's all the sketchy stuff. When we talk about gut health, it's very sketchy. I mean, nutrition science. in the best of times is very sketchy science. And there's, you know, we can have a whole conversation about why that is. And I'll go into a little bit of that as we go along. But, you know, if we have disrupted gut microbiome, then that can certainly impact on these factors that I've just spoken about that you see in your blood. So the best way to measure that is through a blood test to sort of get an indication whether you are experiencing some level of chronic inflammation. The biggest problem, however, sorry to interrupt, the biggest problem is that it's so different between individuals. So if you're lucky enough to have had a test, say in your early 20s and you've got an idea of what your CRP... was at that time and what your transcription factors were like at that time. And then you're 40 or 50 or whatever and you're feeling like something's not quite right and you have the tests and then you have this longitudinal comparison. That's great because then you can go, well look at this, like my CRP used to sit at one and now it's sitting at six. So yeah, I know that that's a problem but... you know, if you look at the average population, maybe six, well, it would be a problem, but you know, let's say it was three or four, then you'll go, well, maybe, you know, that that's sort of, okay. Most doctors would say, well, that's okay, but maybe it's not okay for you. So it's pretty complicated. And I guess at the end of the day, it's sort of listening to your own body and trying to identify things that are not quite right for you. Um, Did you used to be full of energy and now you're just flat and tired all the time? Is your skin really dull? Do you suffer from hay fever and you never did previously? Just little things, are you getting sick all the time? All of those sorts of things could be indication that you are experiencing this chronically inflamed state. Like I say, with everyone being quite different, it's good to, I guess, gather the more data you gather and have snapshots over different periods of time. That's when you can start to interpret the, the findings and the blood tests a bit more accurately, as opposed to just taking one snapshot in time and seeing how you compare to your age group or your gender or your demographic and, um, interpreting it that way. Cause like you're saying, everyone's a bit different. So would you recommend getting blood tests every year or so and storing that information? Yeah, look, I don't think when you're younger that you need to do it as regularly as once a year. Maybe, I don't know, there's no real amount of time but if you had it done say in your early 20s or so and there was absolutely nothing wrong, then you could even wait 10 years before you had another one. At least you've then got a baseline figure. I think once you get a little bit older, like you reach your 40s, then you probably want to start doing it every couple of years, unless something is wrong. Then you want to follow that up at more regular intervals. Okay. But getting a good baseline when you're asymptomatic and you're feeling good, you're sleeping good, good stress levels. And that's when you want to get that baseline measurement that way in the future, when something does arise and you are getting stressed or you are getting some sort of symptoms, you want to have that baseline comparison. Yes, exactly. And if you can find a good doctor who knows all those little things that you want to test at that point, then that's really helpful as well. Okay. And is it okay, you kind of mentioned the acute inflammation and let's just say we do have an acute inflammation due to diet or if you're eating something you're not used to and you do have a reaction. Is that okay for that process just to undergo and you sort of overcome it quite quickly or is there any lasting effects? Yeah, I think probably when it comes to diet, we don't really, you know, we can't really apply that acute inflammatory response. Like it's more to an injury or to an irritation on your skin or something like that is when an acute response is going to be positive. When it comes to diet, As soon as you introduce something into your body that we are not really physiologically made up to deal with, we are going to create an inflammatory response that is not desirable and that could therefore result if we kept on doing it, if we kept eating those things, to something that becomes chronic. So I think in the context of diet, there's not really... and a good acute situation. Okay. And if we delve into the chronic nature that is inflammation and inflammatory diets, what are the long-term consequences and what's exactly happening there? Yeah, so the long-term consequences are the development of chronic lifestyle disease. And you know, we think, well, what's that? What fits underneath that? And pretty much everything that us modern humans are suffering from fits underneath this heading of chronic lifestyle disease. So we're talking about heart disease and we're talking about raised blood pressure and diabetes. And we're talking about things like fibrobiology and chronic fatigue and autoimmune disorders. All of these things. You're increasing your risk of developing if you are in a chronically inflamed state. And how would we know if we are in that state if we haven't got blood tests? Are there any signs and symptoms we can look out for? Yeah, certainly. Like the things that I mentioned before, just feeling like you are tired all the time. a symptom of this, I guess, or a sign that something's not quite right. Like if you feel like you haven't really changed anything, your sleep patterns are still okay, but you just feel like you're washed out and maybe you're not recovering. If you do exercise, you're not recovering well from your sessions, you just hit the slump, like you could lie down for a nana nap at any time of day and just really fall into quite a deep sleep. All of those things. You might, as an athlete, probably one of the best signs is that you just keep having these niggling injuries that don't go away, that all that you find really difficult to get rid of. So having to go into medications, strong anti-inflammatories might not even be helping. You might not be recovering well from sessions, so you might do like a really high intensity, hard session, and then for three or four days afterwards, you just feel like you can't go out and train or do anything properly. So all of those sorts of things are probably signs that you should be investigating further or giving you an idea that you probably have an underlying level of inflammation. I think it sort of wakes everyone up when we're talking about reoccurring injuries and. decreased recovery and decreased performance. Listen, like all the listeners here will be runners and that might strike true for a lot of people and some might think, you know, maybe I have a inflammatory diet issue. Is it different for everyone? Is there some common inflammatory diets or is everyone different? No, there are definitely common foods. So there's certain foods. I have the big three. that I say will cause inflammation in everyone. And those three sugar, you know, pure cane sugar. The second one is processed oils. So these are all your horrible oils, you know, vegetable oils, canola oil and grape seed oil and sunflower and safflower oils, those ones. And then the third one are refined carbohydrates. Unfortunately for athletes, often the sugar and the refined carbohydrates are quite a big part of their diet because most athletes are fueling themselves using carbohydrates and therefore they're having things like gels and sports drinks and excess amounts of carbohydrates to get through training sessions and to get through events. But what is this doing from an inflammatory point of view? And this is where people need to sit up and think about how they could possibly modify things so that they can look after their health, prevent these ongoing issues that they might be having with energy or injuries, but also continue to train. at a good enough level without having to fill with excess amounts of those three foods. Yeah, and just coming off Easter as well, I think everyone can say they've had their fair amount of sugar. Yes, I'm sure. When you're mentioning- Yeah, go for it, sorry. When you're mentioning things like processed oil, what sort of oils do you recommend when preparing foods? So I'd be recommending more of your naturally occurring oils. So olive oil gets the greatest, biggest tick of approval. And if we're looking at science, it's difficult to get good science in terms of getting meta-analyses or reviews that all point in the same direction when it comes to nutrition. But olive oil is one of those things that gets the tick from every. every source and every research group. So we can definitely go with that one. The other ones that I would be using are things like avocado oil, coconut oil, and animal fats, which people would go, oh my God, what do you mean? Because isn't that high in saturated fat? And yes, it is high in saturated fat, but saturated fat is actually really, really stable. I could have a whole podcast conversation with you about saturated fat and the misinformation and the mis-science that has gone on around this poor nutrient and it really is not as bad as it's been made out to be. And so if people are rather consuming unprocessed saturated fat, they will have a much less likely chance of becoming inflamed as opposed to having... canola oil and safflower and sunflower and grapeseed oil and all of these highly, highly processed inflammatory oils. When you're, I'm very skeptical about like those podcasts I listen to when they're talking about their preaching kind of one diet, but I have listened to Stephen Gundry a couple of times and he loves olive oil. He very highly recommends olive oil and He says on a number of occasions he recommends about a litre of olive oil per week. And it seems very excessive, but I guess it shows the importance that it contains. Yeah, look, there's really a lot of benefit in having good fat in your diet from so many points of view. And olive oil has just got a really good combination of the different types of fats, so it's really high. in your mono unsaturated, it's got some saturated, it's got lower levels of polyunsaturated. It just ticks all the boxes for us. It's unprocessed, it's all good. So if people are scared of using the other oils, although I'd say you should embrace them because variety is absolutely key in your diet, but start with the olive oil and don't be spraying tiny little bits into your pan to cook with. throw a few tablespoons in and get some good gulps of it going into your food. You know, that's what we should be having. Interesting. And the fact that it can be so misinterpreted when you're talking about fats and having a lot of like a high fat diet, because where I sit at the moment with the research I've done is try and limit the amount of sugar as much as you can, have as much good fats as you can. And the fact that when people think of fats, they think of like your body, like, um, at a post tissue kind of fat and like being obese. And they think if they eat a lot of fat, they're going to get fat. But it's actually, if you eat a lot of sugar, then you get fat. And so doesn't that just like blur the lines and become really like, I don't know, like confusing for a lot of people. Absolutely. Look, it is really confusing. Probably the best thing that I heard, and I can't remember who said this, I should, but, um, said, you know, if you're eating fat doesn't make you fat, just like eating green vegetables doesn't turn you green. Like that's the correlation. There is no correlation between the fat that we eat in our diets and the fat that we have on our bodies. However, when we eat large amounts of sugar and when we eat large amounts of carbohydrate, we then cause large amounts insulin to be secreted from our pancreas. And insulin is at the crux of making us fat. If we have high amounts of insulin, so we have an ongoing secretion of insulin or we have a higher baseline level of insulin, this is what makes us fat. Because what is insulin? Insulin, in its most simple form, to describe it to people, is a fat storage hormone. So if you continually eat carbohydrate, which causes an insulin secretion in order to deal with that carbohydrate, you have to secrete insulin when you eat carbohydrate because that's how your body gets it out of the blood and enables you to use it. Well, those high levels of insulin then put you into a state of fat storage. So it's carbohydrate, an excess amount of carbohydrate that's going to make you fat, not fat. I'm glad we went on your recommendation to cover just one topic for the interview because I can understand why we're taking so many different like tangents and covering it on a wide basis. So I'm glad we're doing this and following your recommendation. When I was putting the question out there to my following and the Facebook group, a lot of questions came up around dairy. And if there's any link with inflammation and whether going like really low or no dairy can help with inflammation and sort of running injuries, is there any correlation there? Yeah, it's so interesting because poor old dairy, it really gets the go from people all the time. And You know, the media has a go at dairy often and that it's bad for you. Only cows should be drinking dairy and all of this sort of stuff. And that it's highly inflammatory. I mentioned before about how nutrition research is really a bit of a shambles. And it's a shambles from a number of points of view. But just to give your audience a bit of an idea, there's different levels of evidence when you're looking at any types of studies. But let's just speak about nutrition. So when you're looking at nutrition science, you're trying to find level one evidence. And this level one evidence comes from things called systematic reviews and from meta-analyses. And this is where we've come up, you know, there's been a hypothesis. Dairy causes inflammation, let's say that's the hypothesis, and then it has been tested. And it's been tested over and over and over again in very controlled environments on thousands and thousands and thousands of people. And then we get a result to say yes or no. So there have been 52, and I know this off by heart, because I get asked this question so many times. but there have been 52 systematic reviews of dairy. And the result from every single one of those is that dairy is a strong anti-inflammatory agent, except in people who have a dairy allergy. So, you know, I think that a lot of the reason why people think that dairy is a problem is because on the other side, like a level five, level six sort of evidence is when we have this epidemiological or observational evidence. And what that involves is people basically looking at a population of people and they go, okay, this population is a really unhealthy population. What are they eating or what are they not eating? And they... have a look at those things and they draw different ideas out and they build hypotheses. Now, many of the hypotheses that have been built from observational or epidemiological studies have been that dairy is in fact inflammatory. But people then don't follow that up to look at the level one evidence to where they've taken the hypothesis and actually done something with it. So the only people who need to be worried that dairy is going to cause inflammation are people who have a real intolerance or an allergy. And I just want to clarify that dairy, we have rubbish dairy on our shelves. We have processed, highly processed cheese, like this plastic fantastic, tariff not fantastic at all, terrible stuff and like just crap. dairy, but then we have really good dairy. And what we're talking about here and what has been involved in these clinical trials is good dairy, you know, whole unprocessed dairy. So that's what I'm referring to as being anti-inflammatory. Okay. And you're more referring to people like cherry picking evidence when it comes to suiting their own narrative. When you said there's 52 systematic reviews, are you talking about like 52 studies or actually 52 systematic reviews that have looked at this one topic? Yes, 52 reviews that have looked at this one topic. So that means there've been many, many more clinical trials. Wow. Yeah, it's huge. Yeah. And so those... Like somebody else who knows research will say, Oh, well... who was the research funded by and blah, blah. And that is a big issue in nutrition research, who has the research been funded? Because most of the funding for nutrition research is coming from food industry and pharmaceutical industry. So, and sometimes then you've got the dairy industry who is funding a clinical trial and... Surprise, surprise, what do we see in those trials? So we need to be cautious about all these little things. But when we do look at the systematic reviews, hopefully we do cancel out all those conflicting things to a degree. And that's why you have to actually read the whole systematic review and it gets quite time consuming because you can not only do they have to compile all the available evidence, sift through all that evidence and find out which studies are heavily weighted, which ones are poorly designed, and then come up with an interpretation of all of those. And so their biases can be slightly skewed based on who's funding or who they are, whether there's motivations behind it in terms of how they skew that interpretation. And so I think reading it yourself and making your own interpretation. is very, very time consuming, but that's where you find the most unbiased narrative, you could say. Absolutely. That's exactly right. Yeah. It's an interesting topic. And I actually never thought of looking at the, like who's funding it and that kind of thing. I hope it's not as prominent in the physio world. I don't think there's a whole lot of people backing certain narratives in terms of the lecturers and stuff that design these studies, hopefully not. But, um, yeah, it's very interesting. And that's, I guess that's why it's so, um, confusing for people to try and interpret because they hear, I literally hear a strong evidence for one side and then a strong evidence for the other. And I wanted to touch base on when you were talking about, uh, it's beneficial or anti-inflammatory component to dairy, unless you have an allergy or a high intolerance. Have you found that it's like people who do have allergies, is it quite common in the general population? So it does, it varies in population groups. So we know if you have an Asian, if you have an Asian blood in you, the Asian population has a far greater level of intolerance and allergies to dairy, whereas people with the European, origin have far less. So probably the best or your African and African-Americans tend to have higher. So one of the biggest clues is looking at where you come from and then also looking at your family. So if mum or dad or grandparents or someone who has been suffering has suffered issues with dairy, then you might have some sort of underlying probability towards that as well. So looking at your family history is probably the best way to start understanding if you could have a tendency towards that. Okay. And if you're in this population that don't respond well to the dietary components, will the symptoms be obvious or will they be sometimes like too mild and it's not until you actually get tested that you find the answer? Yeah, sometimes the symptoms can be very non-specific and then you might have a tolerance level. So, you might go through most of the time and not have symptoms at all. And then for some reason, you consume a bit more than usual over a period of time and then symptoms pop up. And then what the symptoms might be could be so different from one person to the next. Some might get those specific sort of dietary symptoms like abdominal cramping and bloating and diarrhea or constipation, whereas others it might be really, you know, it might be something like hay fever or it might be a rash on your skin or yeah, those sort of symptoms. So, you know, it can vary significantly. And really the only way to, like you can go and have a lactose tolerance test, but that's not going to give you all the answers because that's just looking at the carbohydrate component of dairy. So you could have an intolerance to the protein component of dairy and that's not going to come up at all on a lactose tolerance test. So you'd really have to remove, the way that you would do it is that you'd remove dairy from your diet for a period of time. And usually that period of time is roughly about a month or so. So absolutely zero dairy. And you in order to do that, you'd really have to be conscious that you've read absolutely everything you're ever eating and there's no dairy whatsoever coming into your diet. And then after that period of time, you would reintroduce it and then you would go through a process of reintroducing it to see if symptoms did build up and if they built up quickly or slowly and you could sort of. work things out from that point. Okay. So there's no like blood test or anything that is definitive. No, there's not. Damn. Damn, damn. Nothing in nutrition is as simple as that. Yeah. Okay. Yeah. I want to backtrack a couple of steps. You did mention the big three when it comes to inflammation, that being sugar, processed oil, and then refined carbs. And you said that is... the big inflammatory factors that everyone is involved. Are there any common culprits that doesn't affect everyone, but can affect most people? outside of those three? Yeah, outside of the big three that might be causing inflammation in some people, but not all, but some people that might be quite having a big impact. Want to look at it? Not in my experience. So, you know, I always try and explain it to my patients. You know, if you've got... if you take away those big three culprits or reduce them significantly, and the way to do that really is to just limit or remove processed food from your diet. As soon as you do that, you have significantly reduced or even removed all of those three from your diet. And if you do that for a period of time, and usually a good three to six months of being quite strict about that, I would say roughly 95% of my patients would then no longer have issues. That's good. I think that clears the... Yeah, sorry? I think like you say, if there's no other... if we're sticking to the big three and they are the big three, then I think it makes it a bit clearer for people as well. And it's good that it's like the lines aren't as blurred. No, that's exactly it. People often want to jump onto the little things. And if you haven't dealt with the big stuff first, the big three here, then the little things are really not gonna make a difference for you. You know, like people go, okay, well, I know that omega-3 is anti-inflammatory, so why not just, I'll just add some of that to my diet. That would reduce my inflammation. Well, if you haven't dealt with the reduction of omega-6s by taking away or reducing those vegetable oils, processed oils, the omega-3 is not going to do anything for you. But if you have removed those three and now you just want the cherry on top stuff, then you could do that stuff. Then you could take an omega-3 supplement and then you might add a bit of turmeric to your curries. And then you might, you know, those little other things which we have a little bit of good research about. Omega 3 we have a stack of good research about, but you know, it's those little ones that we can then add on just to get, to really optimize, but we have to deal with the big stuff first. Yeah, you need a really good foundation before you can stack little one percenters on top of that. And what can we say about Omega 3s at the moment? What can we conclude with the evidence and how much we need to take, or does it benefit everyone? Yeah, look, To give you a brief explanation, so omega-3 is a polyunsaturated fat, and its sort of partner in crime is omega-6. So we have omega-3, which is anti-inflammatory, and then we have omega-6, which is pro-inflammatory. Now, we need a good balance of these two in our bodies. Ideally, we should have a ratio of one to one. Like if you took a biopsy of fat from somebody's body, you could tell exactly what type of ratios of fat they were eating in their diet. So if their diet was 40% monounsaturated, 40% saturated, 20% poly, like we would be able to see exactly that. So our fat in our body is the same representation of the types of fat. that we eat in our diet. So we should be seeing a one-to-one ratio of omega-3 and omega-6. Now, if you go back like 100 years, about 80 years or so, biopsies then were showing this one-to-one ratio. So we were all good. We had these pro-inflammatory markers from the omega-6 to deal with the acute situations that we've spoken about. But we also had the omega-3s to balance that out so that we didn't develop chronic inflammation. But right now, when we are taking biopsies of fat from people who live in Western societies like Australia, well, we are seeing a very different picture. In fact, we're seeing roughly 20 times at least, 20 times more omega-6 to omega-3. So we've got 20 times more pro-inflammatory fat in our body than we do anti-inflammatory. So if you just said, okay, well, to sort this out, I'm gonna take some omega-3s to boost my omega-3 levels, well, you might then be able to get that ratio to like 18 to one or 15 to one. If you didn't address the reduction of omega-6 in your diet, you're not really, you know, those omega-3s that you're taking are not really having much of an impact. But if you got rid of these processed oils and now you have this significant reduction of omega-6s and then you put some extra omega-3s back in, well then we can start bringing that ratio back to where it needs to be. So in terms of an exact amount or anything like that, there probably isn't an exact amount to specify, but rather the process of trying to get those ratios back to a desirable level. Yeah, it's kind of like balancing the equation a little bit. Yeah, so I guess, is there ways to test like what your balance is? Yes, certainly. You can have a blood test. Yes. Yeah. All right. So you can test these, you could have a blood test and get an indication of your, um, Omega three and Omega six levels in your body and what your ratios are. Yep. You can certainly have that done. Yeah. Cool. So the, I guess to summarize that there's no point like trying to, you know, fight this uphill battle of. getting in all these anti-inflammatory stuff, if you're building your body full of these pro-inflammatory stuff, and they're just becoming way too overwhelmed, you might as well try and fight the battle from the other, flip the other equations, try and eliminate as much pro-inflammatory stuff if you can, rather than supplementing little anti-inflammation here and there. Exactly, that's exactly right. and the pro-inflammatories mainly come from the processed oil, or does it come from sugars and refined carbs as well? Yeah, so in this, you know, in this just example of the omegas, it comes from the processed oils. And, you know, just to let your audience know, you know, a lot of people say, oh, I don't use any of those oils, but if you are eating any packaged processed food, you know dips and sauces and supermarket bread and all of that stuff these processed oils are there they're in there they're hidden just like sugar is hidden in everything these processed oils are hidden in everything. But in terms of increasing inflammation certainly your sugars and people will first point a finger towards fructose and fructose certainly has a really big impact on our liver. and increasing inflammation. It takes a very similar sort of route in our body, physiologically, to ethanol. So, you know, a lot of people develop fatty liver disease, which we used to call alcoholic fatty liver disease. But now we see all these people who don't drink alcohol with the same symptoms, and it's because of sugar fructose. But then we also have the other side of sugar, which is glucose, which in itself, has issues related to excess consumption. Right and there's a couple of other questions, not too sure how to combine them all rather than just jumping around here and there. When you're talking about specific foods, one of the things that I wanted to ask was about salt because we've looked at fats, we've looked at sugars and we've kind of got our good understanding of those but what can we conclude when it comes to salt or like a high salt kind of diet? Yeah. So if we are having, um, a diet that's high in processed foods. So, okay, I'll take this back one step. So the ideal amount of sodium, which is what salt is made up of mainly the ideal amount of sodium that we should be having in our diet per day is about four to five grams. So somewhere between four to five grams, that is ideal. Now, if people are eating the typical Australian diet, and that recommended by Australian dietary guidelines, usually you're getting somewhere around about 12 grams of sodium per day, so more than double. So the recommendations therefore have always been to limit your salt intake to select products that are lower in salt and to not put too much salt in your food when you're cooking or at the table or whatever it be. Now if you are following a processed diet then those recommendations are absolutely correct and you should be trying to bring your salt intake down. However, if you are following a diet free of processed food, so you are cooking from scratch, you're eating whole real foods, nothing's packaged or processed, everything's being made from scratch, then typically your diet is too low in sodium. You end up probably having about one or two grams of sodium per day if you're following that sort of a diet. Now, if you look at risk associated with salt intake, you get this U-shape or J-shaped curve. So you have increased risk if you have too little, then your risk comes down when you reach that four to five grams per day, and then it goes back up on the other side. So if you're having a real food diet and you think, wow, I'm doing all the right things here, I'm having no processed foods, your salt intake could be too low and this could cause issues, especially if you're an athlete, if you're a runner, because... your losses as a runner are going to be increased as well through sweat. And so you would really need to actually be supplementing some salt back into your diet. You'd have to be really conscious of adding salt back into your diet in order to meet the correct amounts. The only people who really need to be... Cautious of adding salt into their diets are people with high blood pressure Who respond to salt now some people have high blood pressure have lots of salt in their diet It doesn't impact their blood pressure, but other people have high salt and it causes their blood pressure to be worse So if you are a salt or sodium responder if you have Low amounts then you're not needing to increase the amounts, but that's a very small percentage of the population. So I hope that's not too complicated, but it really depends on what your diet comprises of as to whether you need to be thinking about reducing your solid intake or actually adding some back in. Yeah. You're doing a really good job of simplifying a complex topic. I understand it can't be as, as easy as it sounds. You did mention though, when it comes to consequences of a runner having low sodium. what's actually happening if the body is low in sodium and why is it risky? So if you're low in sodium, um, well, it can, it can change the whole, um, osmotic, osmolarity of what's going on. So you're drawing water into areas where water should not necessarily be, or drawing it out from areas where it, where it shouldn't be. And the whole balance of things. can become problematic. Now, the symptoms of that might be this extreme fatigue, just absolutely, it's just stuffed, like stuffed all the time, struggling to get out of bed, just that real, real ongoing fatigue, lightheadedness, headachy, even a bit of nausea can accompany low salt levels. But what can happen if is if you don't address those salt levels early on, then you start, other electrolytes in your body will start following the salt. And the big one that people often speak about is magnesium. So once your salt levels are too low, your magnesium is then at risk of leaching out as well and you have a reduction of your. magnesium level and that's when you might start getting cramps. So, um, restless legs at night, muscle cramps at night, or even whilst you're exercising, starting to get more cramping. So this is, it's not just about then supplementing your magnesium. It's about really drilling back and going, okay, do I need to start off with the sodium as well as the magnesium and make sure I'm meeting both of these potassium is a, you know, people jump into potassium as well. It is really complicated and I wouldn't be recommending anybody's supplement with potassium without medical supervision. Wow, okay. And I think when it comes to like as a running population, when you are sweating a lot, just take a mental note that you are losing a lot of salt. And I understand like say in winter who's maybe just recreational and rather just doing short runs. If you then have a look, if maybe the climate changes, or you're doing longer runs, you're definitely sweating more. You need to be conscious of that fact and then pay attention to the salt that is in your diet. When you're talking about low sodium in the blood and that osmotic sort of changes, there are, there's like some very like a severe, like acute things that people, do get like say running marathons if they're not replacing salts and they get this hyponatremia, which I don't know a lot about, but what I've been learning is like the sodium in your blood gets way too low and your blood just has, if you replace it just with like water, then it becomes very, the concentration just gets thrown out of whack and can be very severe. I think it's caused some deaths in the past. It gets like really, really like urgent. kind of medical attention. So I'm conscious of the fact that when I run, like say in winter and I just do 5k, 6k slow jog, I don't really sweat that much or it's just, I guess, evaporated in the air quite quickly as opposed to summer when I am sweating a lot, especially if I go say midday. Should I be conscious of maybe keeping an eye on what salt I am taking in? Look, if your diet is a real food diet and you're not having processed foods, then I say yes, you should be watching your salt intake. And I even get some of my athletes and even people who are not doing any sort of competitive athletics, but maybe just even just lifestyle sort of running or going to the gym or whatever. And I get them to each morning put two teaspoons of salt. into a little saucepan and then make sure by the end of the day that salt has been used up. So there's just little things that you can do if you're on a real food diet to make sure that you are replacing it because two teaspoons might not sound like very much but if you don't really consciously add that back into your food what will happen let's say today you only get you never quite get into the two and then that accumulates over time and very quickly that can lead to issues of deficiency. So it's about consciously just adding it into your day. It doesn't have to be around your run time, just to your meals as you normally eat, just put some salt into your food. Some people say I don't like the saltiness in my food and I get them to just throw some into warm water and chug it down. Take a shot of salt. Pretty much. If people are really low on salt and that's the only way, then that's totally fine to do that. Yeah, but you do need to be conscious of it. Athletes might just need slightly more, but that two teaspoons is really what you should be thinking of trying to get in if you are on a real food diet. If you're eating a processed diet. Don't add any additional soft. Yeah. Good point. Yes. We're going to finish up in a second. Uh, I've got so many like notes I've done. It's gone all over the place, all over my page and I'm, I'm learning heaps. Is there any like key points or key messages that we haven't discussed that you really want to get across to runners? I think, you know, what struck me because I've always taken a real big interest in athletes, being an athlete myself, I wouldn't really call myself an athlete, a wannabe athlete. I've done lots of athletic events. I was a gymnast growing up. That's probably my only real plan to fame, but I've done lots of endurance events, trail running and Ironman Triathlon and that sort of stuff. So I've taken a real interest in athletes along the way. And what really scared me is, that on a whole the athletic population believes that they are healthier. And I think for the most part they probably are. Like, you know, that they're fitter, they're in better shape, they're leaner, all of those sorts of things. However, they also consume a lot more food, a lot more calories in general than the average population. And often the excess calories that they're having is coming from carbohydrate-based food as a way of fueling their performance. And what I've seen in my practice and what I've seen in the athletic world is that the consequences of that long-term are absolutely dire. There are so many Olympic athletes that I've seen that are suffering from different diseases, whether they be obscure diseases or the more common ones, metabolic diseases. But I think as athletes, we often think that we are strong and we are immune to these things. And it's really important that we hone in on our diets, even when we are performing well and we're healthy, and everything is going right. Because most of us are not out there trying to hit world records and win races. We're out there for ourselves, for personal bests, for lifestyle, for the social aspect, for all of those sorts of things. And we wanna keep doing this for as long as we possibly can. And if we don't look after our diet in those early years, and always, most likely, the ability to continue being active is going to be cut short. So... I think for me, it's getting the message out to athletes that there is an alternative way to fuel yourself. You don't have to just load yourself up with carbohydrates. And there's a good way of doing that. It's just being open to something different. And you can have it all, but you just need to take a step back sometimes and realize that you're not invincible. and that these lifestyle diseases, you're just as much risk as the general population in terms of getting them, if not at a greater risk. Yeah, think about the long game. I think with athletes, they can like synthetically or like visibly they think they look quite fit and with a high active lifestyle, they can kind of get away with it in the short term and it looks like they're not doing anything wrong. But if you're, like you said, if you're fueling yourself with the wrong things, It might be coming out as energy as the outcome, but the actual process that you're putting your body through to get that fuel can be more efficient in a healthier way with less dire outcomes. If you really take care of yourself. Um, so that's a really, really good point. And I think anyone can kind of nod their head when they are training for a marathon and they've done their long run of like 30 Ks and then they justify eating a whole cake because they feel like they've deserved it. And. Um, that's, I hear it so often and people actually kind of, some people can put on weight when they're training for a marathon and they just justify food and just want to eat. It's not usually of the healthy variety. They don't feel like that when they've just finished a long run, they feel like they've deserved a bit more. Yeah. So common. Um, so you've got your website, eatplaythrive.com.au and I think it's eat, play, thrive on Facebook. You've got Instagram. Twitter, I've found your Twitter under your name, which I'll add in the links. Can you just have a quick little plug of that six-week program that you're mentioning and where people can find out more? Yeah, sure. So, Eat Play Thrive website, there is a link from there to the six-week program, but you can also just go to a separate website, which is just lowc And there's a free... five day challenge that you can just sign up for and do. There's lots of other free things available there just to get your head around everything I'm talking about. And then there's the six week program, if that's something that you wanted to look further into. And I'll just say that I'm pretty active on Instagram and on Facebook. I haven't actually looked at my Twitter account for a long time, so there's probably not much value there. But the other two there definitely is. Awesome. Vicky, like in a world where there's so many diet gurus and so many varied opinions out there, it's nice to sit down and spend some time talking to someone who is, has the qualifications, but what, and like heavy, like research driven, it's really nice to actually get down on the, the level of people who don't have that full understanding and just like communicating with us and having breaking down really complex. topics and in ways that I can understand and the audience can understand and I can tell that you're very passionate about it, which is good. It draws a lot of attention to people who are listening. So it's been great having you on to break down these complex concepts and it's an interesting topic and yeah, thanks for clearing a lot of things up and spending some time having a chat. Yeah, thank you. Thanks for having me on and yeah, it is my passion topic. I am really passionate about it, so I'm glad that came through. Thanks Vicky, you take care. You can personally work with me at brea Thank you so much once again, and remember, knowledge is power.