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Or more importantly, how to determine your ideal diet


ADRENAL FATIGUE AND WEIGHT GAIN
In Australia overweight and obesity rates are increasing with nearly 2 in 3 (63%) adults, and more frighteningly – 1 in 4 (28%) children considered overweight or obese1. Type 2 diabetes, the result of poor diet and lifestyle choices is the fastest growing of all chronic diseases. Stress and the role of glucocorticoids (cortisol) have been linked to abdominal obesity (central obesity) which is the most damaging form of obesity as it’s associated with heart disease, hypertension, insulin resistance and type 2 diabetes. In measuring cortisol levels, the DUTCH test is the only method of measuring free and total cortisol levels in the one test. This can be crucial when addressing cases of weight gain and obesity caused by the stress response and HPA axis dysregulation2.

Stress and HPA axis dysregulation are considered to be major factors in obesity driven chronic diseases. Unstable blood sugar and the stress response are central in the development of type 2 diabetes. In Australia, type 2 diabetes is the fastest growing of all chronic diseases. This type of diabetes is often due to lifestyle and nutrition choices. Our programs include insulin sensitizing nutrients which results in improved glucose control, thereby decreasing the risk of developing type 2 diabetes and aid in weight loss3.

The majority of my patients have multiple health complaints such as fatigue, weight gain with depression or anxiety. Many of my patients are eating what would be considered a healthy diet and exercising frequently yet still gaining weight, they’re often confused and frustrated by their lack of progress. Our goal is to provide each of our patients with a personalized nutrition plan based upon your own unique physiology.
Fad diets that restrict calories and necessary nutrients in the aim to achieve weight loss can be extremely dangerous for your long-term health. The problem with calorie restriction and the reason most people who are yo-yo dieters actually gain weight in the long term is the damage to their metabolism that results from calorie restrictive diets4. The OAT test is a comprehensive snapshot of your metabolism, allowing for a more tailored approach to improving your metabolic health and may also help you to lose weight more efficiently5-7.

Unfortunately, there is much misinformation concerning nutrition and what constitutes a healthy diet. The focus should be on achieving health not just weight loss, a staggering 90% of adults don’t eat the recommended serves of vegetables per day, 77% aren’t meeting the requirements for fruit intake and approximately one third of our total daily energy requirements are coming from junk food, including alcohol8.

Many people struggle with food and alcohol addiction, using substances like sugar or alcohol to regulate their mood by momentarily boosting serotonin. Certain amino acids can help support neurotransmitter levels, decreasing sugar cravings and binge eating. These amino acid supplements have been shown to help with cravings, and support weight loss9.

PERSONALIZED NUTRITION
The single most commonly asked question I get in practice is “what is the ideal diet for me”. There is no perfect ‘one size fits all’ diet. However, there are a few basics that you should be aware of. Plant based or vegan diets have been shown in numerous studies to have better health outcomes including; 

- Weight loss10
- Increased Energy11
- Decreased incidence of type 2 diabetes11
- Improved cardiovascular health12

What I believe to be the most compelling evidence around plant-based diets is the fact that a vegan diet is the only diet proven through scientific studies to reverse heart disease12. The issue of vitamin B12 deficiency is a topic that’s often mentioned when discussing vegan diets. Studies have shown that B12 is best absorbed from fortified foods and supplements not meat from the diet13. Vitamin B12 deficiency can exist in meat eaters or vegans alike. Due to the declining quality of our soil its recommended that most people supplement to avoid developing a deficiency, not just vegetarians or vegans.

Food allergies and sensitivities should be tested for and known allergens then excluded from your diet. This will allow for healthy digestion, assimilation and absorption of nutrients. Many people have subclinical food sensitivities which often go unnoticed. Ironically, the foods people often crave are the ones they have sensitivities to. The page on food allergy testing will provide you a more in-depth discussion on the topic.

Nutrigenomics is the study of how different foods can interact with certain genes to increase the risk of chronic conditions such as type 2 diabetes, obesity and heart disease. This is another reason why personalized nutrition is so important. It’s often the interplay between diet and genetics that can make such a profound impact on your health.

Proteomics via MALD-TOF Ms has allowed for the identification of different types of bacteria within our digestive system, also known as the human microbiome. Research into certain bacteria has proven to be clinically relevant;

1. Akkermansia muciniphila: Our stool testing can measure the abundance of this bacteria which has been linked to metabolic syndrome and obesity. Increasing levels of this certain bacteria in human studies resulted in weight loss14

2. Parabacteroides distasonis:  Human studies have shown that a higher abundance of this bacteria has implications for type 2 diabetes due to a higher post meal blood sugar response15. This discovery may make the traditional Glycaemic Index method of classifying certain foods obsolete, as it’s often the bacteria which determines your blood sugar response to food, not just the food itself.

3. Firmicutes/Bacteroidetes ratio: An increase in this ratio has been observed in obese people and decreases with weight loss16.


REFERENCES

1. Australian Government: Australia’s health 2018. Australian Institute of Health and Welfare.
 
2. Rask, E. et al (2001) Tissue specific dysregulation of cortisol metabolism in human obesity. The Journal of Clinical Endocrinology & Metabolism. 86(3) 1418-1421

3. guilliams hpa axis book

4. Rosenbaum, M., Leibel, R.L. (2010) Adaptive thermogenesis in humans. Int J Obes. 34(01) 1-155. Metabolomics: An emerging but powerful tool for precision medicine. Clish (2015) Cold Spring Harb Mol Case Stud 1: a000588 6. Barshop, B.A. (2004) Metabolomic approaches to mitochondrial disease/ correlation of urine organic acids. Mitochondrion 4(2004): 521-527

7. Tsoukala, D. et al (2017) Application of metabolomics- Focus on the quantification of organic acids in healthy adults. Int J Molecular Medicine 40: 112-120

8. Australian Government: Nutrition across the life stages. Australian Institute of Health and Welfare (2018).

9. Birdsall, T.C (1998) 5-Hydroxytryptophan: A Clinically Effective Serotonin Precursor. Alternative Medicine Review. 3(4) 271-280

10. Turner-McGrievy, G. et al (2017) A plant-based diet for overweight and obesity prevention and treatment. Journal of Geriatric Cardiology. 14:369-374

11. Tuso, P.J. et al (2013) Nutritional Update for Physicians: Plant-Based Diets. The Permanente Journal. 17(2) 61-66

12. Kahleova, H. et al (2018) Vegetarian Dietary Patterns and Cardiovascular Diseases. Progress in Cardiovascular Diseases. 61(2018) 54-61

13. Tucker, K.L. et al (2000) Plasma vitamin B-12 concentrations relate to intake source in the Framingham Offspring Study. Am J Clin Nutr. 71:514-522

14. Depommier, C. et al (2019) Supplementation with Akkermansia muciniphila in overweight and obese human volunteers: a proof-of-concept exploratory study. Nat Med 25(7) 1096-1103

15. Zeevi, D. et al (2015) Personalized Nutrition by Prediction of Glycemic Responses. Cell 163. 1079-1094

16. Koliada, A. et al (2017) Association between body mass index and Firmicutes/Bacteroidetes ratio in an adult Ukrainian population. BMC Microbiology. 17:120. 1-6
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Dr. Adrian Clegg

When I began practicing eighteen years ago, people suffering from multiple debilitating conditions had few places to turn to receive the care they needed to get better. As the years have gone by, I began to realise that more and more people were suffering with chronic health problems—feeling tired, depressed, gaining weight, experiencing digestive problems, allergies and a host of hormone issues.

Over the years I have worked with 1000’s of people to help them overcome chronic health conditions using Functional Medicine and AO.
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