Hypothalamic Amenorrhea and How To Exercise

I get asked this question A LOT. Especially since Sarah Wilson kindly posted my story on her blog. I think, inherently, we are all a little voyeuristic. A little pervy. Wanting to know the intricate details of other peoples’ lives. Or perhaps we just want a little guidance or confirmation that we are doing the right thing. Either way, I have decided to share how I approached exercise as I was healing from hypothalamic amenorrhea.

Peeping Toms in Tokyo, 1951. Image via pinterest by sahua d

First, know this: hypothalamic amenorrhea (also referred to as the Female Athlete Triad) is often a result of over-exercising and/or under-eating, which leads to an overall negative energy balance for an extended period of time. The body senses that you are, essentially, starving and says “Righteo, no energy for reproduction, then” and bids farewell to your monthly lady holiday.

So, taking this into account, you can see that exercise is perhaps contraindicated in the treatment of hypothalamic amenorrhea. Right? Right! 

Chronic exercise = no good. BUT movement = good!

Prior to actually deciding to do something about my infertile situation, this is what my exercise looked like: 

• Monday: Body Attack (1hr) followed by Body Pump (1hr). I might have walked ~1/2 -1hr too
• Tuesday: Maybe a walk, maybe a weights session (maybe both), maybe a cardio session
• Wednesday: Body Attack (1hr)
• Thursday: Body Step (1hr), ½-1hr walk
• Friday: Body Attack (1hr), weights (1hr)
• Saturday: Body Step (1hr) – every second Saturday
• Sunday: Body Step (1hr)

Holy crap. I am exhausted just looking at all of that! So much time wasted in the gym! Granted, it was my job, which made it more “legitimate”, I suppose, albeit no less damaging to my health and fertility.

I realised that this was unsustainable and would leave me in my infertile state if I were to continue. 

Yes, thank you for your wisdom, Albert. For a while, I was insane. I thought I could just throw herbs and vitamins at the situation and it would sort itself out. But, after spending thousands of dollars (literally), I realised this approach was no bueno. So here is what I did…

I progressed quite gradually, and it helped that it coincided with my dietetics placement, so I had an excuse to no longer teach a lot of my classes.

Stage 1

• Monday: Body Pump
• Tuesday: Walk
• Wednesday: Weights (functional training 1hr)
• Thursday: Yoga
• Friday: Weights (functional training 1hr)
• Saturday: Body Step (every 2^nd weekend)
• Sunday: Body Step

 A considerable change, but probably not enough. Cue stage 2.

Stage 2

• Monday: Body Pump
• Tuesday: Walk/yoga
• Wednesday: Weights (8 minutes – YES, you read right EIGHT minutes – 8 sets of 3 clean and presses; sets 1 min apart)
• Thursday: Walk/yoga
• Friday: Walk/yoga, maybe a Tabata session (4mins of cardio)
• Saturday: REST
• Sunday: REST

Although it was tough (mentally), I stuck to this routine for quite some time (until my period returned), gradually adding in more yoga (vinyasa/yin/hatha NOT bikram/ashtanga) and taking out the Body Pump. As I have previously mentioned, I found the yoga incredibly beneficial to the healing process as it allowed me to focus more on my body’s ability, rather than its aesthetics.

So, now that my cycle is getting back on track, how do I exercise? Well, it depends. I try and get outside as much as possible for a gentle walk/hike, as I now live in the nature-lover’s playground:

Image by Lake Wanaka Tourism

But if it is raining outside, and I feel really good, and my stress levels are low, my week might look like this:

• Monday: Weights (1hr - 10 min mobility warm up, 30 min weights, 20 min stretch/yoga)
• Tuesday: 1hr yoga
• Wednesday: Body Pump
• Thursday: Tabata
• Friday: 1hr yoga
• Saturday: Hopefully the rain has stopped by now and I can go for a hike!
• Sunday: Rest

Note: I do at least 30 minutes of yoga every day in the morning. It grounds me and sets me up for an awesome day.

Now please note, this was MY journey. This gives you a general idea of what worked for me. It may or may not work for you. Listen to your body. If you have exercise/stress/lack of food-induced amenorrhea, then you probably need to pull right back on the exercise to start with, then take baby steps along the way, depending on how everything is tracking along.

If this is all too overwhelming for you, I get it. My hubby (who is a PT and peak performance coach) helped keep me on track. Everyone needs someone. Feel free to shoot me through an email via my website if you would like to book a consultation for some more structured, personalised guidance that will help you get your sexy back.

Final note – as always, be kind to yourself. x

Should we eat more fat? Time Mag says yes!

I’m sure, by now, many of you have seen the recent time magazine cover telling us to “Eat Butter”. In case you missed it, here it is:

You’re probably expecting me to jump around and say “Haha! I told you so!”, while I do a little Irish jig, because, well, I did tell you so a couple of years ago in this post. However, I’m not going to do that. Oh wait, did I just do it? Oops!

What I actually want to do in this post is cover off the key points from the Time article and see how we can apply this and that perhaps we do not need to eat MORE butter. Yes, I am going to play the Devil’s advocate!

OK, let’s dive in. Here are the salient point from the article:

• In the 1980’s, dodgy science reported that high intakes of saturated fat increased your risk of heart disease. The USDA took note, created dietary guidelines that recommended avoiding fat, and subsequently a whole realm of low fat foods were produced
• Fat intake decreased, junky grain-based carb consumption increased, the prevalence of chronic disease (heart disease, diabetes, obesity) was on the rise
• In the mid-1990s, Dr Walter Willet found that if people replaced foods high in saturated fat with carbohydrates, there was no reduction in heart disease. Go figure! More people then started to question the role of fat
• The Mediterranean Diet began to take flight as the heart-healthy diet, with its preponderance of poly and monounsaturated fats (note – these were from nuts, seeds, fish, olives and olive oil NOT refined vegetable/seed oils)
• Arrogant wanker quote of the year** from Dr Robert Eckel, past president of the American Heart Association (AHA) – “When you replace saturated fats with polyunsaturated  and monounsaturated fats, you lower cholesterol. That’s all I need to know”. This kind of closed-minded, egotistical view is what is stifling the health of the world. We need to put our egos aside and be open to new evidence and admitting when we were wrong. This is the nature of science!
• A 2010 meta-analysis (a study of many relevant studies) found that there was no significant evidence of an association between saturated fat and increased risk of heart disease. These findings were further supported by another study this year
• Saturated fat increase LDL cholesterol AND HDL cholesterol, which negates the heart disease risk
• Refined carbs stimulate the production of insulin, which drives fat storage
• Low-carb diets have shown potential in helping with diabetes and obesity
• Increasing meat may have environmental consequences. Read why I disagree HERE (the Allan Savory vid)
• Some experts are concerned that if we spread the message that saturated fat is fine, this may increase unhealthy habits and instead, we should focus on whole, real foods

**Time Magazine did not call this dude an arrogant wanker. That was me being on my soap box 

Now for my thoughts on the situation.

First off, I think it is awesome, and long overdue, that this information is out in mainstream media. And it is only fitting that Time Magazine publish this, considering they were the catalyst for everyone freaking out in the first place with this cover in 1984:

I whole-heartedly agree that we should not avoid saturated fat. The research clearly does not support the thinking that this nutrient increases the risk of heart disease. HOWEVER I think there are a few things we need to be wary of

1. Healthy, “risk-free” saturated fat does not mean party pies, sausage rolls and pop-tarts.

Saturated fat from REAL FOOD is what we are talking about here, peeps, so do not use this research as a license to go and feast at McDonald’s or your local 7/11! Instead, enjoy real-food sources of saturated fat, such as:

• Meat and organs (choose grass-fed, which is also a great source of omega-3 fatty acids)
• Chicken (again, free range and organic is best)
• Egg yolks
• Fish (31% of the fatty acids in salmon are saturated)
• Olives (YES they are actually 13% saturated fat!)
• Nuts (macadamias are highest in saturated fat of all nuts)
• Coconut and coconut products (the main fatty acid, lauric acid, has been shown to increase HDL/”good” cholesterol, and is also the predominant fatty acid in breast milk)
• Dairy products
• Avocado (23.5% of fats are saturated)

Note that those foods that we often associate with being good sources of poly- or mono-unsaturated fats (e.g. salmon, nuts, avocado, olives) are actually also good sources of saturated fat? That is because these fatty acids never exist in isolation! We need to start thinking of WHOLE foods, rather than their individual constituents.

2. Carbohydrates are not the devil

Image by Fonda LaShay, via pinterest

When the original research came out regarding fat causing heart disease and making us fat, we all went gung-ho and took the stance of “the less fat we can have in our diet, the better”.  We know this is not true. We need fats for the optimal functioning of a number of bodily processes, such as hormone production, health bone metabolism, cell membrane integrity, satiety, immune health and more.

What concerns me is that people will take the “low-fat=no-fat” attitude and apply it to carbohydrates, going extremely low carb, or cutting them out altogether. While this may be beneficial for some (such as those suffering from epilepsy, pre-diabetes or un-medicated diabetes, or even obesity), this does not mean it is the best choice for everyone. I made the mistake of going too low-carb for too long. Learn from my mistakes and be mindful that you need carbs for a few things:

• Carbohydrates feed the good bacteria in our digestive system. If we go too low carb, they can be starved, creating dysbiosis and digestive problems
• Carbohydrates provide bulk to the stool to help with passing a bowel motion, and we are all aiming for the perfect poop, right?
• Carbohydrates help with the conversion of the inactive (T4) to the active (T3) form of thyroid hormone, thus helping fuel metabolism. Go too low carb and you may find yourself in a bit of a weight pickle as your thyroid stops working as it should
• Carbohydrates prevent the body from relying on the adrenal glands and cortisol to keep blood sugar levels in balance, thereby limiting the likelihood of adrenal fatigue
• Carbohydrates help to refuel muscle glycogen stores after an intense workout, and prevent the breakdown if muscle

There are more, but I think you get the point. Carbs can be useful. How much you need is dependent on your lifestyle and individual situation. If you are active and/or stressed, you may need slightly more. If you are sedentary and/or chilled out, maybe a little less will suit. Play around with it and see how you feel!

All in all, I recommend that you avoid low-fat junky “foods” and not fear fat, while also being mindful that some carbohydrate-rich foods (such as sweet potato, potato, parsnip, beetroot, rice, a little fruit and even quinoa or legumes, if tolerated) are also great sources of vitamins, minerals and antioxidants, and can help our body to function at its peak. Do I think they should be the bulk of our diet? No. But they should not be demonised, either.

Moral to the story – eat real food. If it needs an ingredients label, or if you don’t know what all of the ingredients are, don’t eat it. Simple. Don’t get caught up in the minutia – life is too short!

What are your thoughts on this whole dealio?

Paleo Pumpkin-Pie Pancakes

Yes, I like alliteration. Rolls of the tongue, doesn’t it?

PANCAKES! Who doesn’t love them, seriously? You say Sunday morning. I say pancakes. They just work. Any day, any time, really. But unfortunately, most pancakes are full of sugar, and gluten and junk. Especially the Shake ‘n’ Bake kind and yes, even the gluten free variety. (Note to self gluten-free processed foods are not healthy, just because they do not have gluten in them).

I like to experiment with recipes. Sometimes they are complete failure. Other times a huge success. The recipe I am going to share with you, my lovely friends, was a huge success. Otherwise I wouldn’t share it, would I? It probably wouldn’t even go on Instagram because, as everyone knows, you only put the highlights of your life on Instagram.

Anyway, enough jibber jabber (that didn't even get spell-checks. Seriously?).  Give these yummy Paleo pumpkin (yes there is a vegetable hiding in there) pie pancakes a whirl. I am pretty sure even the little ones (meaning kids) would like these. Handy tip: roast the pumpkin the night before in coconut oil.  Roast some other veggies for your dinner that night, while you’re at it. Why not?

Paleo Pumpkin Pie Pancakes

They taste better than they look. Promise.

Ingredients

• ½ cup mashed pumpkin (roast the night before)
• 2 eggs, whisked
• ½-1tsp cinnamon (I have super strong cinnamon at them moment)
• ¼ tsp nutmeg
• ¼-1/2 tsp all spice
• ¼ tsp ginger powder
• ¼ tsp baking soda
• Coconut oil/butter to cook in
• Splash coconut water (or plain water, but coconut will be sweeter)

How to

1. Heat oil/butter in a frying pan over medium-high heat
2. Mix all ingredients, except coconut water, in a mixing bowl until smooth
3. Add a splash of coconut water to thin out the consistency a little
4. Add dollops of mixture to the pan once it is hot, allowing to cook lightly (2-3mins) on one side, then flip and repeat
5. Serve with whatever your heart desires. Mine desired sunflower seeds and coconut flakes. A little full fat yoghurt and some berries would probably be quite nice, too
6. ENJOY!

PS. Have you checked out the AHSNZ conference yet? 

Ancient Genes vs Modern World - an event you must attend!

When I first moved to New Zealand, I decided that I was going to make a concerted effort to connect with like-minded practitioners. I wanted to be part of a strong community of health folk. What I didn’t know was how amazing my new-found health-nerd friends would be. Actually, I tell a lie. I had an inkling of their awesomeness. 

Sometimes (often) my images have no relevance to the topic.
I thought this one was pretty cool, though, don't you? 
It's a lizard made out of lime!
Image by Harry Chapin Food Bank via Pinterest

We started off our little NZ adventure in Christchurch. There was a chance, after all, that we would be living there eventually. This also happened to be the home town of one very well known, and very respected, nutritionist by the name of Jamie Scott (who also goes by the name of “That Paleo Guy”).

So I thought I would send him an email. I didn’t expect a response, but I hoped for one. I got one. Almost immediately – welcoming me to the country and an expression of interest to catch up! This was beyond exciting. But wait! There’s more – Jamie’s lady-friend happens to be an amazing doctor (yes – GP, MD whatever you want to call it – she is legit) who is a firm believer in using principles of evolutionary medicine and ancestral health to guide the prevention and management of chronic disease. "She", by the way, is Anastasia Boulais. These crazy cats are so passionate about ancestral health that they started up the very first Ancestral Health Society of New Zealand (AHSNZ), which you can read more about HERE. I am so proud to be involved in this remarkable organization with so many other incredible, like-minded people.

Here's a (relevant) pic of the happy couple (on the right)
with the folks from the Whole 9

After our little tiki-tour around NZ, I had the pleasure of meeting these two inspiring people and, I can tell you, they are freakin’ amazing. Not just because of their knowledge and dedication to spreading the word about ancestral health, but because of how unbelievably kind, considerate and inclusive they are.

Anywho…enough blabbering and butt-kissing. Even more exciting news – AHSNZ is holding its first conference at the end of June (the 29^th, to be exact). The following little blurb is 100% plagiarized from the AHSNZ website:

“Ancient Genes vs. Modern World” explores some of the key mismatches that exist between our physiology, having evolved over millions of years, and the novelty of a modern world that has rapidly changed over the last few decades”

Here’s a little breakdown of what you will be learning about on the day (again, plagiarism is at play):

• “Food for Thought: Nutrition and Brain Health” 
Dr Mikki Williden, PhD.  Senior Lecturer and Researcher, AUT. Auckland
• “Are Health Professionals Too Focused on Health?”
 Brad Norris, Director, Synergy Health. Christchurch
• “Ancestral Health in General Practice: Art, Science or Quackery?”
 Dr Pam Olver, General Practitioner. Wellington
• “The Ancestral Woman in a Modern World: Strong, Sexy and Fertile.”
 Kate Callaghan, Nutritionist. Wanaka (THAT’S ME!!!)
• “I See Weak People: The Under-Appreciated Role of Muscle in Health and Disease”
Jamie Scott, Health Researcher, Synergy Health. Christchurch
• “Sunlight: Friend or Foe? Skin Cancer Controversies”
 Dr Anastasia Boulais, Medical Practitioner. Christchurch
• “Stress in the Modern World”
Aaron Callaghan, Peak Performance Coach. Wanaka (AKA Kate’s hubby)
• “Urban Design and Health: The Spaces in Between”
James Murphy, Nutritionist, Synergy Health. Christchurch
• “Ancestral Principles in Managing Autoimmune Disease”
Julianne Taylor, Nutritionist. Auckland
• EXPERT PANEL: Anti-Fragile in Christchurch: Individual Health Strategies in a Changing City

Exciting right? This conference is the first of its kind in the southern hemisphere – you don’t want to miss it! Plus, you can come and hang out with me. Isn’t that worth the trip in itself (insert winky-face emoticon)?! Oh, and its not just for practitioners and/or Kiwi's. All welcome!

If you’re interested (which you should be) go and save your seat now – tix are only NZ$49 (meaning they are even cheaper for those of you across the ditch). Now THAT is a bargain to be hearing from some of the top experts in the ancestral health community. Hope to see you there!