Want to lose weight? Exercise and eat healthy.

More energy? Simple, eat right and exercise. 

What about reducing the risk of chronic disease? Duh! Move your body daily and increase your veggies. 

The starting point for most health professionals when it comes to helping their clients achieve goals is nutrition and exercise. Two absolutely foundational pieces of the health puzzle. But did you know there are other areas you could address that can in some cases, have just as much of an impact on our clients overall health as a change in activity and nutritional intake?

Let’s explore the uncommon areas of your clients’ lifestyle you might be leaving on the table in your consultation room and how to address these in your next session. 

Environment 

Assessing your client’s indoor places and outdoor spaces.

Why?

Because dampness in a home can cause molds harmful for health and clutter can restrict air flow, causing build up of dust and other allergens. In the outdoor setting, particularly if you live in a city or built up area, you have to consider air pollution which can contribute to heart disease and respiratory conditions such as Asthma, as well as noise and light pollution which can interfere with circadian rhythms and sleep cycles.

What can you do as a health professional?

Assess your clients’ indoor and outdoor environment to see if there are any potential stressors or factors that could be influencing their quality of life. Recommend frequent bouts in nature for those who live in built up areas and support the reduction of light and noise pollution to improve down time and sleep patterns.

Seek to increase your understanding around environmental issues relating to health so that you can better support your clients to make changes to their environment.  

Work

83% of US workers suffer from work-related stress, with 25% saying their job is the number one stressor in their lives. For many it is work that is the cause of poor health habits and the frustration for many health practitioners as it gets in the way of positive behaviour change. Whilst it may seem like the only solution you can provide to your clients is for them to ‘leave their job’. There are many things you can do to help reduce stress at work and actually use it as a place to practice healthy habits.

• Feeling a sense of purpose

When was the last time you sat with your client to discuss their deeper why? Working with clients on finding a sense of purpose can be a powerful way to increase motivation and increase feelings of both physical and mental wellbeing. When they are able to tie this sense of purpose into the work they do, it may help to reduce stress associated with their job, or it might just show them that what they are currently doing is not right for them. Either way it can open a positive conversation to take action on improving their feelings around the work they do.

• Becoming aware of natural strengths

Some of the major contributors to work stress are; poor team cohesion, lack of clarity, insufficient support and poor management/communication. Whilst you may not be able to control the work environment when it comes to management, you can support your client in ‘controlling the controllables’ by increasing awareness of their natural communication styles vs others to help foster better relationships and communication pathways. As well as creating more awareness around their natural strengths (and weaknesses) so that they can meet daily tasks with greater feelings of self-efficacy and clarity.

• Planning and Time-management

Gaining an understanding of your clients typical day at work can help you when it comes to setting realistic and achievable health goals that can work into the demands of the work environment. Supporting your client to plan these health goals into their working day and keeping them accountable to them may also naturally start to help create more structure and routine in other areas of their work schedule as they aim to add new healthy habits into their to-do list.

Workplace wellness has become a hot topic due to the significant risks associated with both physical and mental health. As a practitioner it is important that you have the tools to support people in all walks of life.

Social 

Wide-ranging research suggests that strong social ties are linked to a longer life. In contrast, loneliness and social isolation are linked to poorer health, depression, and increased risk of early death.

As a result, assessing a client’s social life and relationships should be as high up the list as looking through a diet diary or exercise history. Does your client spend quality time with friends, family members/loved ones? Are there any relationships that are currently causing stress? Does your client feel loneliness or isolation?

If diving deeper into relationships is not within your skillset or scope of practice, seek out a strong referral network with a psychologist or counselor, so that when you do begin to assess the social aspects of a person’s life, you can safely support your client by referring them to an expert to help deal with any deeper issues should they arise. 

Remember, ALL aspects of the environment can influence gene expression and consequently affect health. Just because a person is exercising regularly and eating healthy does not mean your work is done. Sleep, work, stress, social life, the environment all have important roles to play in the overall health picture. It is your duty as a health professional to understand the bigger picture of your clients lifestyle to formulate a personalized and integrative health program, which can and should of course involve other expert practitioners within your network to support as needed.

This is the future of client-centered, precision health care.

Want to learn more about assessing and managing these areas of your clients lifestyle AND join a network of health, fitness and medical professionals who practice with precision? 

Enroll in the PHA Level Course, details on the next intake can be found here

What if you’ve been doing fitness bootcamps and your body would thrive on pilates instead?

What if you have been forcing your clients to follow in your footsteps, when they need something completely different?

The birth of precision health

We all recall the Human Genome Project (HGP) – the much anticipated collaborative effort that is the foundation for research into the treatment of disease known as precision medicine.  Completed in 2003, it was understood that once the genome was mapped we would have the blueprint to our bodies and start the guidebook to our health.

Upon the publishing of the human genome, Francis Collins, Director of the National Human Genome Research Project stated “It’s a history book – a narrative of the journey of our species through time. It’s a shop manual, with an incredibly detailed blueprint for building every human cell. And it’s a transformative textbook of medicine, with insights that will give health care providers immense new powers to treat, prevent and cure disease.”

Precision medicine recognizes that we as individuals are each unique, that accordingly we have different health needs and health risks, and that we will respond differently to various treatments and medications.

The HGP has also provided knowledge that has spawned an array of commercial enterprises dedicated to providing you with your own personalized menu of potential health conditions and inherited risk factors. Most of us have seen ads offering to map our genome – we only need to provide a saliva sample. While this data is interesting, and may rule out certain health concerns while confirming others, it falls short of being able to recommend practical application of the data. It turns out that there is another factor, a factor that moves the information along the spectrum from ‘might be beneficial’ to ‘essential knowledge’.

While our individual genome does represent our own personal blueprint, like any plan, it can be altered. Gene expression, or Epigenetics, speaks to the modification of our genes based on environmental factors. Factors like stress, sleep, diet and nutrition, physical activity and exposure to chemicals can alter the epigenome – the suite of chemical compounds that tells the genome what to do. Without modifying the underlying genes, the epigenome interacts with DNA and changes how genes are expressed. Your epigenome is you.

How does it work?

The normal development of cells is strongly influenced by epigenetic processes. Environment or lifestyle factors combined with nutrition and even diet on its own can cause epigenetic changes that may turn certain genes on or off.  There are two primary mechanisms for this:

1. DNA methylation where proteins attach chemical tags to the bases of the DNA molecule and can then turn genes on or off by affecting interactions between the DNA and other proteins.
2. Histone modification whereby DNA in cells is wrapped around histone proteins that are wound into chromosomes inside the cell nucleus. These and other proteins can interact with each other which determines whether that region of DNA will be used or ignored.

In addition, non-coding RNA and Chromatin-associated proteins are also involved in this process.

Yes, it’s complicated.  But because of this, you have a phenotype – defined as the manifest characteristics of an individual collectively, including anatomical and behavioral traits, that result from both its heredity and its environment. In other words, you are the sum of your epigenome, and you are unique. A fundamental truth of the genome and the epigenome, is that no two are exactly alike. And knowing that, we must acknowledge that one-size-does-NOT-fit all and that, therefore, a personalized approach to health is required. 

Precision health, actually.

“We must recognize the complex network of interconnected physical, hormonal, skeletal, and environmental processes that influence who you are. You are a dynamic being, changing every moment of every day, depending on your environment, your diet, your exercise, and the people you spend time with. For this reason alone, it’s important to recognize that your dietary, fitness, and mental needs will change frequently” explains Matt Riemann, PHA and Shae founder and personalized health expert.

What does it mean for you and your clients?

It means that your genes are not your destiny. It means that you can influence the expression of your genes. It means that you have much more control over your lifelong health than you knew.

We have varying degrees of control over the stressors in our lives, the amount of sleep we get and the toxic chemicals we come into contact with, but with diligence, we can minimize stressors and exposure to harmful substances and maximize sleep and integrate stress relieving and reducing strategies into our lives.

What we do have more consistent control over is our level of activity and exercise regimen and, more relevant here, our nutrition. When we understand that we require a personalized plan and approach, we can leverage these for optimal health.

Enter Nutrigenomics 

Nutrigenomics is the study of the interaction of nutrition and genes. Nutrition research has traditionally focused on the assumption that all individuals have the same nutritional requirements. More recently, great strides have been made in the field of nutrigenomics and studies show that nutrients can alter gene expression. Now we understand that because we are each unique, one person’s superfood can be another’s poison.

This is important news for the prevention and management of chronic disease as the impact of diet on conditions like heart disease, diabetes and obesity has clearly been shown.

And it’s important news for those of us who want to preserve our health and support the health of others. 

So, how do you go from knowledge to application?

Now that you know that you are unique, that your genes are not your destiny, that your phenotype is the current version of you and that you can control your health and well-being, you are probably asking “how”? 

How do you know what’s right for you specifically? And importantly, how can I quantify this in my clients so I can be sure I am giving them the correct advice?

We now know that your genome is not the current expression of you and that we need to go beyond a DNA based diet and into a personalized lifestyle plan for best results. There is one lifestyle platform based on epigenetics designed specifically for health professionals to identify your clients phenotype, determine ideal lifestyle choices for optimal health and deliver recommendations in real time. Likened to ‘Siri for your health’, it makes being healthy simple. It’s ph360’s Shae™ and you can learn more today.

Some people may be surprised, even shocked, to see that ph360/Shae may occasionally recommend animal protein to people despite their personal preference for plant-based proteins. I’m certain there are many vegans and vegetarians out there thinking “How could an advanced science-based program like this promote meat?!”

Well, ph360 uses that science and evidence-based research to personalize a diet specifically to you and your body’s needs. Instead of saying “You are right for this type of diet”, ph360 calculates the pros and cons of all foods to find the diet that is right for you, and that includes all kinds of animal proteins.

To address some of those common misconceptions about plant versus animal proteins, let’s clear the air with some myth-busting facts for everyone.

Myth #1: Animal protein is unhealthy

You may have heard claims that meat consumption isn’t healthy because of its effects on cholesterol (an issue that has now been debunked), and yet others talking about it being bad for triglycerides, obesity, cardiovascular disease and the list goes on. But it’s important to separate the studies that focus on processed foods, (1) deep fried foods, (2) or other unhealthy preparation methods and sources, from those that look at quality organic fish or lean meat. Studies on the occasional poultry, lean meat or fish consumption have found benefits for conditions like dementia (3), cancer (4), cardiovascular disease (5), and many other conditions (6).

Myth #2: As mammals, our diet should be based on our physical form

Meat-eaters will say humans don’t have the large fermentation vats (like cows and rhinoceroses) to process all that fiber. Vegetarians speak of our lack of canine teeth and jaw strength (like dogs and cats) to rip through raw flesh.

Unlike other animals, humans can cook and process the food we consume – even organic whole foods. Whether we’re processing flour, making a smoothie, or even cooking foods like taro and kidney beans to make them palatable and safe to eat, we have developed many ways to integrate a wide variety of foods into our diet. With this fact in mind, comparing ourselves to other animal species simply doesn’t make sense. We are omnivores who process our foods for improved digestion, flavor, texture, variety and even medicinal purposes. Let’s not think about our nutrition like animals but like humans.

Myth #3: We should only eat what our ancient ancestors ate

Let’s not go into a lengthy discussion about the evolutionary perspective of meat-eating to evaluate approaches like the paleo diet or caveman diet because, let’s face it, it’s a somewhat silly argument too. Lives were much shorter in paleolithic times, to the point that we can’t be certain they wouldn’t have been affected by chronic diseases that are also correlated with age. Whether we look at historical trends of physical activity, differing living conditions, or a life span of 20-50 years compared to our 80, there simply are too many assumptions that must be made to establish any argument about longevity and chronic disease when trying to compare us to our ancestors.

Humanity has evolved and adapted to many different and varying situations. It doesn’t matter if you’re looking at the traditional diet of the Okinawa, Andes, Lakota, Hopi, Inuit or other cultures, past meat-eating doesn’t justify a meat-filled diet today and neither does a historically vegetarian population justify a solely plant-based diet.

In fact, our diet should be based on who we are today and what we need for our current lifestyle and metabolic status. ph360 does, in fact, often encourage a reduction of animal proteins, even vegetarianism or veganism for some people…just not everyone.

There could be various reasons why ph360 may encourage some high quality sources of animal protein in the diet. In the next myth-bust we’ll reveal some of these reasons. Keep in mind that not all of these examples will apply to everyone. That’s the whole point with the shift toward personalized health – it’s unique to you. SOME issues will affect SOME people more than others. To be healthy, we just need to do what is right for OUR body. While tailoring a unique food, exercise and lifestyle program to an individual has been time consuming and costly in the past, ph360 can now accomplish this feat in mere seconds.

Myth #4: Everyone can get all the optimal nutrition they need from a vegan diet alone

Studies (7), (8), (9) have shown that although people who avoid meat tend to be more health conscious, vegan and vegetarian diets need to be well planned to obtain nutritional adequacy because it can be easy for nutritional deficiencies to occur when eliminating large food groups. This is especially true for very restrictive diets.

Vitamin B12: Unfortunately, B12 is one of those special vitamins primarily found in animal sources. Though it’s possible to get enough B12 from fortified foods (not always great because it’s not natural and can be highly processed), and there are a few vegetable sources of B12 10, most vegans and vegetarians need B12 supplements in their diet (11), (12). Though it may be ok to have a vegan or vegetarian diet for a while or even cleanse without meeting your need for vitamin B12, this lack shouldn’t be prolonged because it’s a very important vitamin for many parts of our health, including mental (13) and cardiovascular (14).

Iron: Although vegetables do contain iron, and both vitamins C and B12 can be used to improve iron absorption, plants contain non-heme iron which is less easily absorbed by the body than heme iron that comes from animal sources (15). Cobalt, zinc, copper, molybdenum, gallic acid, phytates and phenols all interfere with iron absorption so the program is often calculating which are the best sources of bioavailable iron that your body needs (16), (17).

Zinc: Because of their amino acid content (like histidine and methionine), the most bioavailable form of zinc comes from animal sources, while non-heme iron, fiber, tannin and phytic acid (all common in plant sources) impede zinc absorption (16), (17).

Manganese: Tannins, oxalates, phytates, calcium, magnesium, iron, zinc, cobalt and insoluble fiber all hinder manganese absorption (18) so once again, calculations are being made for the best bioavailable sources based on your food preferences, food allergies, etc.

Phosphorous: Though you can find phosphorus in great amounts in many plant sources, the most bioavailable source is from animal protein. Phytic acid reduces bioavailability, while vitamin D (like in fish) promotes its absorption (19). So once again, depending on what your body needs and what the rest of your diet looks like, the calculations are being made for the best sources for you.

Vitamin A: Plant products can contain carotenoids which the body can convert into retinol, though not very efficiently (20). For some people, this conversion is sufficient to meet their needs, while other people need a little more ready-made retinol which comes from animal products.

Creatine: Though creatine isn’t an essential nutrient because the body can produce it from glycine and arginine, this nitrogen-containing compound improves the way protein is synthesized in the body, providing energy and muscle growth. Athletes and bodybuilders are often seeking or needing more than what the body can produce on its own. Dietary creatine, however, is only found in animal products and though our liver and kidneys can produce some creatine, it may not be enough for some people (especially those who exercise intensively and may have depleted levels of phosphocreatine) (21).

Carbohydrate restriction: Some people (for example, those with metabolic syndrome) may need to reduce their daily intake of starch or short-chain carbohydrates, but some vegan and vegetarian diets can be carb-rich (especially ones that aren’t well planned). Though there are ways to maintain a balanced vegan or vegetarian diet, sometimes people struggle to get enough protein (or iron, zinc, B12, etc) without increasing other dietary components as well.

Amino acids: Yes, you can get all the amino acids you need from a diet free of animal protein and this is why many vegans and vegetarians are perfectly healthy with their diet. However, others may find themselves with imbalanced amino acid amounts (22) (ie: too much of one and not enough of another).

This certainly isn’t an exhaustive list because other factors like exercise goals and health conditions can also play a role in the types of protein a person may need. Though vegan and vegetarian diets can be well thought out to prevent potential deficiencies, several arguments can now be used to explain why eliminating all sources of animal products may NOT be ideal for everyone. Vegans, vegetarians and meat-eaters can ALL be healthy with the proper lifestyle and diet choices (23).

Regardless of the dietary recommendations ph360 makes, any animal protein being consumed should always be organically farmed without antibiotics, hormones or other intrusive chemicals. Livestock should be free range, fed with a proper diet, and maintained with ethical standards. Humane approaches to animal husbandry should always be in place, while also utilizing every part of the animal wherever possible. Not only does this increase the quality of the animal protein (and even its fat content), it also enhances the integrity of our farming practices and our relationship with nature.

So whether animal protein, vegetarianism or veganism is the way to go, the key thing here is that health-conscious eating should always consider nutrients, and, more specifically, the right nutrients for you. The nutrients in your foods and how they react and interact with your unique body is paramount to maintaining nutritional balance, and getting a wide variety of whole foods that provides your body the well-balanced nutrition you need, without harmful additives, will see you on the path to true longevity and enhanced quality of life.

REFERENCES

1. Schulze, M. B., et al. “Processed meat intake and incidence of type 2 diabetes in younger and middle-aged women.” Diabetologia 46.11 (2003): 1465-1473.

2. Balbi, J. C., et al. “Foods and risk of bladder cancer: a case–control study in Uruguay.” European journal of cancer prevention 10.5 (2001): 453-458.

3. Barberger-Gateau, Pascale, et al. “Fish, meat, and risk of dementia: cohort study.” Bmj 325.7370 (2002): 932-933.

4. Vatten, Lars J., Kari Solvoll, and Elin B. Løken. “Frequency of meat and fish intake and risk of breast cancer in a prospective study of 14,500 Norwegian women.” International journal of cancer 46.1 (1990): 12-15.

5. Vincent, S., et al. “Micronutrients, Mediterranean-diet and cardiovascular risk: the RIVAGE study.” Kmetijstvo (Agronomija) (2001).

6. Sofi, Francesco, et al. “Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis.” The American journal of clinical nutrition 92.5 (2010): 1189-1196.

7. Farmer, Bonnie. “Nutritional adequacy of plant-based diets for weight management: observations from the NHANES.” The American journal of clinical nutrition 100.Supplement 1 (2014): 365S-368S.

8. Leblanc, J. Ch, et al. “Nutritional intakes of vegetarian populations in France.” European Journal of Clinical Nutrition 54.5 (2000): 443.

9. Craig, Winston J. “Health effects of vegan diets.” The American journal of clinical nutrition 89.5 (2009): 1627S-1633S.

10. Watanabe, Fumio, et al. “Vitamin B12-containing plant food sources for vegetarians.” Nutrients 6.5 (2014): 1861-1873.

11. Herrmann, Wolfgang, et al. “Vitamin B-12 status, particularly holotranscobalamin II and methylmalonic acid concentrations, and hyperhomocysteinemia in vegetarians.” The American journal of clinical nutrition 78.1 (2003): 131-136.

12. Pawlak, Roman, S. E. Lester, and T. Babatunde. “The prevalence of cobalamin deficiency among vegetarians assessed by serum vitamin B12: a review of literature.” European journal of clinical nutrition 68.5 (2014): 541.

13. Lachner, Christian, Nanette I. Steinle, and William T. Regenold. “The neuropsychiatry of vitamin B12 deficiency in elderly patients.” The Journal of neuropsychiatry and clinical neurosciences 24.1 (2012): 5-15.

14. Mahalle, Namita, et al. “Vitamin B12 deficiency and hyperhomocysteinemia as correlates of cardiovascular risk factors in Indian subjects with coronary artery disease.” Journal of cardiology 61.4 (2013): 289-294.

15. Hurrell, Richard, and Ines Egli. “Iron bioavailability and dietary reference values.” The American journal of clinical nutrition 91.5 (2010): 1461S-1467S.

16. Hunt, Janet R. “Bioavailability of iron, zinc, and other trace minerals from vegetarian diets.” The American Journal of Clinical Nutrition 78.3 (2003): 633S-639S.

17. Welch, R. M., and W. A. House. “Meat factors in animal products that enhance iron and zinc bioavailability: Implications for improving the nutritional quality of seeds and grains.” 1995 Cornell nutrition conference for feed manufacturers. 1995.

18. Kies, Constance. “Manganese bioavailability overview.” 1987. 1-8.

19. Fukagawa, Masafumi, Hirotaka Komaba, and Ken-ichi Miyamoto. “Source matters: from phosphorus load to bioavailability.” Clinical Journal of the American Society of Nephrology 6.2 (2011): 239-240.

20. Solomons, Noel W., and Jesus Bulux. “Plant sources of provitamin A and human nutriture.” Nutrition Reviews 51.7 (1993): 199-204.

21. Venderley, Angela M., and Wayne W. Campbell. “Vegetarian diets: nutritional considerations for athletes” Sports Medicine 36.4 (2006): 293-305.

22. Krajcovicova-Kudlackova, M., K. Babinska, and M. Valachovicova. “Health benefits and risks of plant proteins.” Bratislavske lekarske listy 106.6/7 (2005): 231.

23. Key, Timothy J., Paul N. Appleby, and Magdalena S. Rosell. “Health effects of vegetarian and vegan diets.” Proceedings of the Nutrition Society 65.1 (2006): 35-41