Vegetarian. To be or not to be…

The role of Protein in the body:

The word Protein comes from the Greek word “Proteos” (Πρωταρχικος- Προτερος), meaning “The first one”, “The most important one”. There you have it.

Protein is in fact the body’s most important block. It is made from many combinations of Amino Acid blocks. All of our organs are built from proteins, such as the skin, the muscles, the hair etc. Many hormones are proteins and the immune system, the digestive system and blood rely on proteins in order to work normally.

Amino Acids.

Amino acids are the building blocks of Protein. The body needs about 21 amino acids in order to function properly and therefore they are called “Essential amino acids”. 12 out of the 21 amino acids are synthesized by the body’s biological mechanism but 9 of them cannot be synthesized by the body. These 9 amino acids are: Tryptophan, Isoleucine, Leucine, Lysine, Methionine, Phenylalanine, Valine and Histidine.

These essential amino acids can only be obtained through food. Food sources that contain all of these 9 essential amino acids in one, are called “Complete Protein” or “High quality Protein” foods.

These foods are predominantly animal proteins, including red meat, poultry, seafood, eggs and dairy.

Some variations of Vegetarians:

Vegetarians (or Lacto-Ovo vegetarians): Are those that do not eat meat, poultry or fish, but do eat eggs and dairy products.

Pescatarian (or Pescetarian) : Maintain a vegetarian diet -no meat, no poultry, with the exception of fish or other sea foods such as shrimps, lobster etc.

Pollotarian (Pollovegetarian): Is someone that will not eat read meat or fish but will eat Poultry, such as chicken or turkey.

Vegans: Do not eat meat, poultry, seafood and fish or any products derived from animals, including eggs, milk, honey etc

Raw Vegan / Raw food diet: A raw vegan diet consists of raw foods that have not been heated above 46 degrees Celsius. Raw foodists believe that foods cooked above this temperature have lost a significant amount of their nutritional value and are harmful for the body.

How Vegetarians do it?

Incomplete Protein sources:

Incomplete proteins are the proteins that do not contain all 9 essential amino acids, but they might contain 5 or 6 or even 8 (soy), so they must be combined or supplemented with other proteins. Incomplete Protein sources include:

– Nuts

– Legumes

– Grains

– Vegetables

Combine two or more incomplete proteins and you have a complete protein. For example: Rice and beans, spinach with almonds.

Plant Proteins Vs Animal Proteins:

Humans are omnivores. The human body has been designed in such a way that can have a diet composed of both plants and animal materials. In other words, our body is prepared and well able to consume and digest meat.

Animal proteins are more similar to our proteins, thus the bioavailability (absorption by the gut) is more readily and rapidly than plant proteins, meaning that the amino acids derived from animal based proteins are more readily available for our own protein synthesizing reactions which allows them to operate at full tilt.

Vegetarian diets often include large amounts of cereal grains and legumes, both of which are low in bioavailable nutrients (the nutrients don’t get easily absorbed).

Vegan diets on the other hand, are almost completely devoid of certain nutrients that are crucial for physiological function. Many studies have shown vegetarians and especially vegans to be deficient in B12, Calcium, Iron, Zinc, long-chain fatty acids EPA & DHA and fat soluble vitamins such as A &D.

My position.

As a Dietitian, I believe that complete prοteins are the A and the Ω of a healthy body.

Do I believe that non-vegetarians are better than Vegetarians? No. However, I do believe that people who have made a choice to exclude any kind of animal protein should be aware of the potential dangers. Being a vegetarian is fine as long as there is wisdom and responsibility. Supplementing with vitamins and minerals could be a good idea in order to avoid any deficiencies.

What I do not accept is when food becomes a religion.

Giovanna De Angelis Terzaki

The Carbohydrate cycle

Carbohydrates are- in simple terms- sugars and starches. They are absorbed from the digestive tract reasonably quickly, which is the reason why we get a rapid energy boost from a bar of chocolate, pastry etc. A hormone called Insulin is released, which then starts to lower the blood sugar level very quickly . When the sugar level in our blood goes down rapidly, we often feel weak, agitated or lethargic (hypoglycaemia), so we often have another sweet food to boost our sugar level. We might feel better for a while but soon Insulin kicks and we feel weak again and so the cycle goes on.

Most people associate Insulin with Diabetes, in which there is a problem with Insulin production which is true, but actually, Insulin is an essential hormone  in everyone. Insulin has many essential functions in maintaining life, but there is one function that is very important for the dieter. It causes excess carbohydrate to be stored as fat. In other words, it actually stimulates the deposit of fat around our bodies, especially around the waist and hips. Even worse, it actually prevents body fat from being used to provide energy, so the body cannot break down fat if Insulin levels are elevated. If the amount of Insulin released in the body is decreased, the blood glucose (blood sugar) will not plummet so dramatically, so the person does not become weak and irritable and will not feel the need to eat more carbohydrates for energy. Therefore, the body will not deposit the fat on the waist or hips. Even better, if someone lowers the Insulin levels, the body’s mechanisms are actually directed to “burn” fat preferentially. In simple terms, you have then switched on the body’s automatic fat-burning mechanism.

Reduce the refined carbohydrates.

The production of Insulin, is essentially controlled by the carbohydrate intake. Not fats or proteins. So if the consumption of refined carbohydrates is reduced drastically, Insulin levels are reduced as well.

Some people can now see why some previous diets have failed. Many diets recommend a huge amount of carbohydrates, such as cereals, grains,pasta, rice and pulses. Even if someone reduces the calorific intake and actually loses weight, the fat is still stored in the body, as Insulin continues to work. It is not medically possible to lose fat on some of the mainstream diets. Of course, the purpose is not to switch off Insulin completely here, We do need Insulin, but our bodies were not designed and never needed such large quantities of refined carbohydrates.

On the other hand, in”Starvation Diets”, again we lose weight but not much fat. When in starvation mode, the body uses up the energy stores of carbohydrates first (in the form of a substance called Glycogen). However, the body can only store a certain amount of Glycogen and it is usually used within two days. Then, it starts breaking down protein. Too much of protein break down will eventually compromise the Immune system  and the muscle mass.

A good balanced diet excluding refined carbohydrates or even complex carbohydrates for a few weeks and introducing high quality protein, could contribute towards a healthy weight loss.

If any questions or for more information, contact me.

Giovanna De Angelis Terzaki

Depression, Neurotransmitters & Obesity

The relationship between obesity and mental health is complex. There are several theories about how the two are linked. Some, suggest that obesity can lead to common mental health disorders, whilst others say that people with such disorders are more prone to obesity. I say, it all depends on the person and how the person handles a situation/ problem.

The brain uses a number of chemicals as messengers to communicate with other parts of itself and with the nervous system. These chemical messengers are called Neurotransmitters and are received or released by the brain’s nerve cells. Depression. has been linked to problems or imbalances in the brain with regard to the neurotransmitters: Serotonin, Noradrenaline and Dopamine.

Serotonin: Serotonin is a neurotransmitter known for its antidepressant properties. There are Serotonin receptors in the brain as well in the gut (intestines) and blood vessels. Several studies indicate that Serotonin can lower the appetite  and here is where Obesity and depression are linked. Drugs that enhance the brain’s release of Serotonin have shown to help people lose weight.

Dopamine: High levels of Dopamine are associated with increased anger and aggression, but when in balance, Dopamine gives a feeling of relaxation, happiness and pleasure. It is also known to prevent Sodium and water retention.

GABA (Gamma Amino Butyric Acid): Is the anti-stress, anti-anxiety, anti-panic neurotransmitter. Low levels of GABA could affect sleep patterns causing anxiety and stress.

Noradreanline (Norepinephrine): Noradrenaline causes several changes in the body. It increases the amount of Oxygen going to the brain -this helps think faster and clearer. Noradrenaline (along with Dopamine), has come to be recognised as a major contributing factor in attention and focus and for lowering blood pressure. Attention, Noradrenaline is not Adrenaline. There is a major difference between these two. Noradrenaline is a neurotransmitter that is produced naturally in the body and manufactured as a drug. Adrenaline, is a hormone produced by the adrenal gland and stimulates the heart rate, dilates blood vessels, air passages and a number of other functions. It is naturally produced when the body is in high-stress or physical exhilarating situations. The term “Fight or Flight” is often used to characterise the circumstances under which Adrenaline is released into the body.

An imbalance of one or more of these neurotransmitters could be a contributing factor towards depression.

In terms of nutrition, it is important to examine whether physical activity is low if or a person has a poor diet in essential nutrients. High protein diet is always beneficial, but in this case, carbohydrates are essential as they help to move Tryptophan to the brain. Tryptophan is an amino acid and when in the body, is converted into Serotonin. Foods rich in Tryptophan: Turkey, Chicken, Egg whites, Pulses, Beef, Tuna and Soya products. Refined carbohydrates such as biscuits, pastry white bread etc, are not recommended. It is best to keep blood glucose stable with the help of protein and complex carbohydrates such as vegetables, wholemeal bread, legumes. Vitamin D is essential so a supplement of Vitamin D or a B Vitamin complex could often be recommended.

Giovanna De Angelis Terzaki

Estrogen Dominance could lead to Obesity

What is Estrogen Dominance:

To begin with, Estrogens are hormones that are important for sexual and reproductive development mainly in women. They are also referred to as “Female sex hormones”. The term Estrogen refers to all of the chemically similar hormones of this group (Estrone, Estradiol, Estriol)

The body maintains a specific balance of estrogens, progesterone and testosterone.

Estrogen dominance, describes a condition where a person can have deficient, normal or excess levels of estrogen, but less or no progesterone to balance its effects in the body.

Excess estrogen in relation to progesterone, could also be received from all sorts of external- environmental factors, called xenoestrogens .

Xenoestrogens are fat-soluble and non-biodegradable in nature. A major source of xenoestrogens are pesticides, detergents, cosmetics and food cans.

Factors that could contribute towards the development of this condition are:

Diet: A poor diet in beneficial bacteria and fibre could compromise the health of the intestine. The gut integrity is of vital importance as it allows the body to absorb and digest all the necessary nutrients. If there is not an adequate amount of good bacteria, then intestinal dysbiosis could occur. A condition in which suboptimal bacteria, yeast or parasites colonise the intestines. Bad dietary choices such as sweet and highly processed foods, or antibiotic use could contribute towards Estrogen Dominance.

Excess estrogen molecules are packaged in the liver and sent to the intestines to be eliminated. Some of the “bad bacteria” are able to modify the package so that estrogen is reabsorbed into the blood to continue to act in the body.

Stress: It is also a contributing factor to the development of Estrogen Dominance.

There are several points of interaction with ovarian hormones indicating that estrogens may have a neuroprotective role in relation to stress and glucorticoid secretion and actions in the brain. Any estrogen imbalance could increase stress levels and vice-versa. Dealing with stress on a regular basis, could have an affect on the adrenal glands. This in turn could decrease the amount of produced progesterone causing progesterone deficiency, hence, Estrogen Dominance.

Menopause: Estrogen is the hormone responsible for staving off menopause. As estrogen naturally decreases with age, the onset of menopause occurs, resulting in the completion of menstruation and the end of the reproductive cycle. Estrogen production decreases by about 40% after menopause whereas progesterone decreases to about 1/120 of baseline levels. This could lead to an imbalance between estrogen and progesterone, causing an increase in estrogen activity which could result in Estrogen Dominance.

Genes: Estrogen Dominance itself is not a genetically caused condition. However, conditions such as Ovarian cysts, Endometriosis or even obesity are contributors to Estrogen Dominance and these could be hereditary traits

Obesity: Obesity contributes in the development of estrogen dominance, as fat contains enzymes that convert adrenal steroids to estrogen. The higher the fat intake, the higher the conversion of fat to estrogen .

There are many pathways and scenarios that could associate Estrogen Dominance with Obesity. For example one of them could be:

Estrogen Dominance Lack of sleep → Cortisol Imbalance → Adrenal Fatigue → Hypothyroidism → Slow Metabolism → Obesity

It is indicated that the majority of the women dealing with Estrogen Dominance, suffer from sleep disturbances. In addition, compared to men, women are twice as likely to have difficulties in falling asleep or maintaining a good sleep at night. It is documented that estrogen makes women more susceptible to stress, so this could worsen the symptoms of insomnia. The glucocorticoid hormones synthesised upon stimulation of the HPA-Axis, either by stress or pro-inflammatory cytokines that may disrupt the sleep-wake cycle, therefore worsen the existing condition (ED). What happens in Estrogen Dominance is while stimulated HPA-Axis increases cortisol synthesis, it may also decrease progestrone levels in several ways:

a) As cortisol itself is a derivative of progesterone, increase of cortisol synthesis may lead to a decrease of progesterone levels.

b) As cortisol and progesterone have the same affinity both to corticoid and progesterone receptors, cortisol may bind to progesterone receptors. This mechanism could reduce the progesterone levels again,so estrogen dominance occurs.

Several studies confirm that individuals with hormonal imbalances are prone to depression and as a consequence, sleep patterns change and become irregular.

Hormonal imbalances such as estrogen dominance have an impact to the energy levels of the person. It is interesting that the temperature of the body gets affected especially during night sleep (hot flashes) . Alteration of temperature (hot flashes) is a very common symptom in estrogen dominance and causes disruptions of sleep. The person wakes during the night. During sleep, the alternation between rapid eye movement (REM) and Non-REM sleep, is controlled by the hypothalamus, basal fore-brain and brain-stem .What happens is that transitions to wakefulness involve the reactivation of wake promoting neurons, which in turn, inhibit sleep promoting circuit.

On the Sleep and Metabolism mechanism, it is important to mention the role of Leptin and Ghrelin that links sleep with appetite. Appetite is regulated by the interaction between metabolic and hormonal signals and the central nervous system. As the hypothalamus is responsible to maintain a proper regulation of energy homoeostasis, by sensing circulating hormones such as Leptin and Ghrelin.

Leptin is a hormone produced by adipose tissues and inhibits arcuate neurons that co express neuropeptide Y (NPY) and agouti-related peptide (AgRP), activating proopiomelanocortin neurons (POMC). Ghrelin, is an appetite-stimulating hormone that has the opposite effects .

Long story short : One of the symptoms of Estrogen Dominance is hot flashes, especially during sleep that interrupt the normal flow of sleep, hence, the cortisol levels. If cortisol synthesis is increased, then progesterone levels are decreased plus, the adrenals work overtime, including the thyroid- a gland that secretes hormones regulating growth and development through the rate of metabolism. If Thyroid function is compromised due to excess cortisol synthesis could often result in hypothyroidism, meaning that metabolism is slow.

In terms of nutrition, along with a healthy diet , meaning no refined products that contain chemicals that could worsen this condition, a good amount of Ω fats is recommended together with high quality protein and high fibre.

Contact me for advice or information.

Giovanna De Angelis Terzaki

Celiac Disease Vs Gluten Intolerance. Similar but…

Celiac disease is an autoimmune condition, triggered by the consumption of gluten. Gluten Intolerance on the other hand, describes the situation where individuals find it difficult to digest gluten and deal with symptoms of bloated stomach or even weight gain.

Celiac disease is a more complicated condition with more severe symptoms (vomit, diarrhea, intestinal bleeding). Once gluten in the body, the immune system responds by damaging the villi, which allows nutrients from food to get absorbed in the small intestine and then into the blood. Celiac disease is often a genetic disease and usually, it runs in the family.

As any autoimmune condition, there is a higher number of certain antibodies, more specifically tTGA and EMA, which are found in larger amounts in the body. Carrying these so called “Celiac disease genes” it is not certain that a person will necessarily develop the disease. On the other hand, not carrying this specific combination of genes, the possibilities for a person to develop Celiac disease are slim to extremely rare. The HLA category of genes, have different variations allowing each person’s immune system to react to a wide range of foreign invaders. Their main role however, is to provide instructions for making proteins that would benefit the immune system and to distinguish the body’s own proteins from proteins made by foreign invaders. An imbalance of these genes could cause an autoimmune dysfunction, as the body’s proteins are perceived as a threat and the body fights its own body.

In general, the expression of genes in the human body is influenced by the environment. Environment, is not only the internal world but the external too. Factors that could contribute towards the expression of the genes associated to Celiac disease are: Gender, drugs, chemicals, temperature (climate), smoking, stress and lack of sunlight (Vitamin D).

Gluten Intolerance is not an allergy. It is a physical condition in the gut.The reason that more people appear to be unable to digest gluten is because modern diets are low in essential nutrients and this interferes with the body’s ability to suppress immune cells that are supposed to attack harmless proteins such as gluten. Gut dysbiosis is on the rise for a number of reasons. Sugar, alcohol, antibiotics, environmental toxins and other allergens such as GMOs, that contribute to an imbalanced intestinal flora which could lead to gluten intolerance. In terms of nutrition, the only treatment for Celiac disease or even gluten intolerance is a Gluten-Free diet. For most people, this will stop symptoms of intestinal damage. Supplements such as Iron could be necessary in severe cases with intestinal bleeding, vitamin D, plant Polyphenols and Fatty acids.

Giovanna De Angelis Terzaki

Gut Brain Axis and overlapping factors when a chronic disease is present.

The Integrity of the gut is vital as it affects all the major organs in the body and could determine the overall health of a person, both physically and mentally.

When the lining of the intestines loses some of its integrity could lead to “Leaky Gut Syndrome”, which means that partially digested foods get into the bloodstream due to nutrients not being fully absorbed.

There is an important relationship between events that take place in the gut and affect the function of the brain (central nervous system) and how the brain affects the enteric nervous system. This relationship is called “Gut Brain Axis”. In other words, the brain listens to the stomach and the stomach listens to the brain. Very often, IBS patients (Irritable Bowel Syndrome), have an increased incidence of exposure to psychological traumas.

The action of the smooth muscle surrounding the intestines is controlled by the specialised enteric nervous system. This in turn, is connected to the brain by the interconnecting autonomic nervous system. Distension of the gut, triggers nerve fibres in the lining of the gut to transmit signals to the brain. So the psychological spectrum reflects to the gut and vice versa.

In cases where a chronic disorder is present, especially a mental one such as Schizophrenia for example, then the balance in the relationship between the brain and the gut becomes of vital importance. Schizophrenia is a disorder associated with a condition called Pyroluria, which can be described by the abnormal synthesis and metabolism of O2 carrying molecule called Pyrole (or else Hydroxyhemopyrolin 2). Pyroles inhibit nutrients such as Zinc, Vitamin B6 and Ω fat GLA from reaching their target in the body. The patient becomes deficient of these nutrients and Pyroles could cause damage to the brain and eventually interrupt the messages that are supposed to be sent.

This is just a brief example of the Gut Brain Axis when chronic diseases are present in order to highlight the disruption of the whole mechanism.

Healthy diet is important to maintain gut’s integrity and the help of a laboratory test, in order to investigate and have a clear picture of the gut. Tests such as ‘ Intestinal Permeability Assessment’ is often recommended.

Giovanna De Angelis Terzaki