Gerry’s Tips for Freedom Day and beyond!

I posted a recent blog regarding the positive and negative effects that the long pandemic lockdown has had on the population, with a view to begin discussing some of the positive things we can all start engaging with in relation to the forthcoming release of lockdown to support or improve our mental and physical well-being.

I think we all have individual stories to tell, regarding the good and not so good bits about the lockdown which has resulted in a significant change of life for many people.

There is no doubt the situation has had a positive effect on some people as expressed in my blog above.

However, in my experience and talking to many of my patients, there are a substantial amount of people where it’s had a negative effect, on them personally, their families, their jobs and businesses and their overall well-being (even if they have no experience of infection of COVID-19 themselves or their immediate family and friends).

The behaviours or habits that we develop have a positive or negative effect on our physiology which translates into a positive or negative effect on our mental and physical well-being.

 

So, what are the obvious behaviours (things most people know about) that might negatively affect our well-being?

Drinking more alcohol

Smokers smoking more cigarettes

The distractions of working from home (WFH), children, noise, partner, personal space and other distractions

Recreational drug use

Not doing as much exercise

General lack of movement given the sedentary nature of most people working from home

Doing too much exercise (I’ve seen many patients getting injured doing celebrity online exercise classes)

24/7 with our partners and children, as much as we love them, it can often become overwhelming.

Overeating and putting on weight

And what are the less obvious behaviours that might negatively affect us

Snacking in between meals, mostly because we are bored or have the opportunity (or you are incorrectly thinking it’s good for you!)

Comfort eating (because our mental health has been affected in so many ways)

Over doing the social media

Watching too many films

Postural effects from sitting on unsupported chairs, inappropriate desks and working on laptops whilst WFH.

Not adopting a healthy routine, such as getting up late or going to bed late

Minimal social interaction (humans are primarily social animals)

The dominant emotion of fear (constant negative and worrying news regarding the virus vaccines etc)

Disordered breathing patterns (around 70% of the population)

What would be my 5 top recommendations as we come out of lockdown to build and enjoy our new sense of freedom?

  • A graduated return to exercise/sport and movement
  • Concentrate on eating a proper breakfast, lunch and dinner and try your best not to snack in between meals, this will also help you adopt a better routine to fit in other activities during the day.
  • Pay attention and learn a more relaxed pattern of breathing
  • If you’re drinking too much alcohol, have a week completely away from alcohol, if you’re adopting the above three strategies this will make it a lot easier. When you return to alcohol, you’ll find that you’ll drink less.
  • Stop watching the news, we are living in a fear based, risk averse society and I’m not surprised there is so much anxiety around, this is seriously detrimental to our well-being. We need to learn that we can’t control everything, just concentrate on the things that are within our control, you will feel better.

How can we check and determine the level of stress that we have accumulated during the pandemic?

That’s a difficult question as most people will not really have had a starting point that will give them any meaningful measure, apart from what they are experiencing and feeling perhaps in terms of symptoms.

The problem with symptoms is we often have preconceived ideas as to where the symptoms are coming from.

Stress is a controversial word, many patients when I ask about stress, initially tell me they are not stressed or at least no more stressed than usual. I think for many people stress seems to be synonymous with psychological symptoms or feelings.

For me stress is more about the physiological responses of your body, as a reaction to the things that we are doing, all that is going on around us and how we cope, both mentally and physically.

Therefore, a good question is how can we actually measure our levels of stress?

I tend to use heart rate variability (HRV), a non-invasive way of measuring the stress response using a heart rate monitor. There are various ways of measuring heart rate variability and various calculations. My favourite way and in my opinion the most useful, is using respiratory sinus arrhythmia RSA or breathing heart wave. As we breathe in our pulse goes up, this is because this is a sympathetic or stress nervous system response and as we breathe out our pulse goes down, because this is a parasympathetic or relaxation nervous system response. Whilst I measure it in real time and the graphs actually give me good information, there will also be a number, essentially the variability between the pulse as you breathe in and pulse as you breathe out. The higher the heart rate variability the better flexibility within autonomic nervous system (subconscious nervous system) which is controlling many different systems within our mind and body. The range is generally 0 to 40, it does decrease with age. A common reading in many of my patients is 5 and they’re trying to tell me they’re not stressed!

Another test which I sometimes use (analysed in the laboratory on saliva samples), is an adrenal stress index profile. The adrenal glands, which sit on top of the kidneys, pump out a variety of hormones including adrenaline, noradrenaline and cortisol in response to stress but also another hormone called DHEA, which is a precursor of other hormones and important for stress management.

The test measures DHEA and the diurnal variation of cortisol, which tends to be high in the morning, when we wake up and slopes down towards the end of the day, reaching its lowest levels by the time we go to sleep. This is of course what should happen, in many of my patients we can pick up significant variations in this. The test also measures secretory IgA which is adversely impacted by stress and an important part of the immune system.

Which leads to another important point, whilst everyone is pinning their hopes on the miracle of the vaccines (or not as the case maybe), I think it’s important for people to understand the things that can support their own immune systems and managing stress is a critical one.

What action could we take to help our body recover from stress caused by the pandemic, for example: take specific vitamins, practice breathing exercises, do regular walk, anything else?

Because we are breathing 24 hours a day, and because breathing so influences our physiology both on a mental and physical level, I think, adopting a more relaxed pattern of breathing for me is the number one thing that can help people recover from the stress caused by the pandemic.

If you want further information, you can visit the breathing page on my website, where there is a lot of information including several videos and a series of interviews with my lovely friend and patient Ms Amy Dickson, the award-winning saxophonist.

Key tips for adopting a more relaxed pattern of breathing

Try to learn how to use your diaphragm and to not over-use your upper rib cage. This is not as easy as it seems even people who have heard of the diaphragm and think they’re using it often or not!

Breathe in gently and pause and breathe out a little bit longer and pause and then repeat the cycle. The pause is critical it helps slow our breathing rate down and helps the brain understand that a transition is helpful.

Try to do this for one minute and then later on in the day perhaps two minutes and then just gradually building it up bit by bit, until it becomes a more normal pattern.

Do your best to breathe in through your nose, many people are chronic mouth breathers and to start off it’s useful to start practising breathing in and out through your nose, although later on as it gets easier a gentle long out breath through the mouth can often be fine.

About 70% of my new patients don’t breathe properly and because breathing is predominantly a subconscious activity, they probably don’t know it.

The common themes of dysregulated breathing tend to be:

Shallow breathing conversely some people breathe too deeply

Fast breathing

Not using your diaphragm

Holding your breath and not realising it

One of the tools used to measure breathing behaviour is a non-invasive device called a capnometer.

It can measure a patients CO2 levels, the paradox of CO2 is many patients, because of how they breathe, do not retain enough CO2. Low levels of CO2 compromise oxygen delivery on a cellular level. Oxygen is a major metabolic fuel the drives energy pathways and provides the energy cellular reactions within the body.

Breathing also critically influences pH, the control of acid and alkalinity within the body. pH control is incredibly complicated, breathing is the number one thing which influences this in relation to kidney function which excretes buffering chemicals to help us control it. I tend to raise my eyebrows when I read Sunday magazines about the latest superfood which tends to either alkalise or acidify the body. Whilst certain foods can have a minor effect by far the most important thing to control body pH is actually breathing and kidney function.

As we mentioned earlier the effect on the autonomic nervous system via how we breathe is also critical. Essentially having a longer out breath is conducive to having a more relaxed nervous system. Breathing out is about letting go. Because most people don’t understand the physiology of breathing their belief is that it’s all about the in breath i.e., getting oxygen into the system. Whilst of course oxygen is critical as I’ve explained above CO2 control is also critical and the gentle and longer out breath is really important for balancing the autonomic nervous system.

I think walking and gardening are great exercises. Not only do they make us become more active and are good for a cardiovascular system, but they also tend to be done outside and so have numerous other benefits, sights and sounds and hopefully engaging with nature. It’s good to practice these activities, again trying your best to breathe through your nose not your mouth.

Nutritional supplementation can play their part to complement a balanced and varied diet. I don’t normally tend to give generic advice because I practice individualised medicine and sometimes certain foods and certain supplements are not appropriate for some people. However, most people will tolerate the below suggestions.

Magnesium is a critical mineral and many people in the UK are deficient in it. Whilst part of the issue is the nutritional content of our food has dropped over many years due to intense farming, constant stress provokes the adrenal glands to work overtime and that requires a lot of magnesium, so we simply use up more than we are consuming. It’s a very safe supplement to take, although it’s important to take a form that’s more easily absorbed by humans such as Magnesium Citrate and Chelated Magnesium.

Sometimes I use other what we call stress adaptations such as Siberian Ginseng and Ashwaganda, these are both herbs partly targeting adrenal support to help manage stress.

L Theanine, is an amino acid, I will sometimes recommend this again for stress, particularly if patients are having difficulty sleeping.

L Theanine is one of the functional ingredients in my new range of functional drinks. I am also using L Theanine in my calming drink, Gerry’s Night-Time, in conjunction with magnesium and a host of other functional nutrients including CBD.

I’m also using L Theanine and Siberian Ginseng in my uplifting drink, Gerry’s Daytime, in conjunction with a host of other functional nutrients.

Watch this space!

 How to determine whether we have been eating properly during the lockdown? Perhaps we eat too much? Are there any quick fixes in our eating habits? 

 What food could quickly reduce stress level in our bodies? And what food or products could improve the quality of our sleep?

There is no doubt that many people have been in eating and drinking more during lockdown. The most obvious sign is probably that they have increased weight. The UK unfortunately is the most obese country in Europe. Given obesity is such a high-risk factor for developing severe COVID 19, I think people need to give serious consideration to adopting a healthier diet not only to manage their weight but to improve their physiology. Increased fat deposition (increased body weight) causes numerous physiological changes of which, probably one of the most important, is an increase in systemic inflammation. An increase in the number and size of the fat cells provokes a response in inflammatory cytokines, chemicals that provoke systemic inflammation. You have probably heard of the cytokine storm which has come to prominence in media regarding the severity of COVID-19 symptoms.

One of the worst habits for this is continual grazing. If whatever you eat for breakfast is good enough, and by the way breakfast is considered to be the most important metabolic meal, you should not be hungry until lunchtime. If you are, you are what we call glucose dysregulated.

If what do you eat for lunch is good enough you should not be hungry until dinner.

We lose most weight when we sleep not when we do exercise! So, a good sleep pattern is critical for weight management it’s not just about eating.

We tend to suggest that patients should not eat after 9 pm, it takes at least a couple of hours for food to go through from the stomach into the small and then into the large intestine. If we are using a lot of our body energy through digestive processes, we can’t utilise this energy to burn fat during our sleep. There are numerous articles on good sleep hygiene out there and I think we need to remember that sleep is simply a pattern. Even when we are in a situation of sleep disturbance which can be situational or chronic and long-term. Adopting good sleep hygiene is an important part of relearning a good-relaxed pattern of sleeping.

One of the problems is that when we go to sleep, the subconscious comes out to play and all the things that we are generally worrying about in life, both consciously and subconsciously can be a problem to the extent it can wake people up.

Therefore, if you are going to think about it in a more holistic way, adopting a more relaxed breathing pattern can be really helpful to having good quality sleep.

By the way, when I lecture nutritionists, I always mention breathing. When you’re looking at the neurological control of the digestive system, it is under the parasympathetic or relaxation nervous system control. So many of the functional gut problems that we see, can really be rectified simply by diaphragmatic and relax breathing patterns, never mind changing the food people are eating.

Each meal should consist of good quality dietary protein adequate dietary fat and low glycaemic load carbohydrates predominantly vegetables.

Never mind the COVID-19 pandemic, there is a pandemic of confusion in the general population in relation to what they actually think is good for them to eat. Many people assume if they’re not eating fast food all day, they must have a good diet.

The old adage having a balanced varied diet is critical to health is something I adhere to. What this means in practice is not eating the same thing day after day. So, if you eat for example the same breakfast day after day that is not a balanced or varied diet.

The food we eat provides us with a variety of macro and micro-nutrients and dietary fibre, all critical for our physiology.

It is thought that some foods tend up regulate our stress nervous system or down regulate or stress nervous system.

We can help calm down our nervous system by reducing the following:

Processed meats (which are high in nitrates)

Cows’ milk dairy, milk yoghurt and cheese (sheep and goats are probably better)

Too many eggs

Refined carbohydrates, especially wheat (this is not the same as avoiding gluten, which I think far too many people unnecessarily do)

Fruit juices (which are simply very high in sugar)

If you want further information, you can download at my iBook

It contains a wealth of health information, a lot of it focused on nutrition and following the principles of Metabolic Balance which was a nutritional program developed in Germany by an internal medicine Doctor also a PhD in nutrition. It also contains 10 HD videos of me preparing and cooking meals such as five different breakfast choices and five different lunch/dinner choices, many of my patients find this amusing!