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Recipes for the Holiday Season

In preparation for the festive season, author of ‘Eat Well to Age Well’ Beverley Jarvis has provided two delicious recipes so your loved ones can enjoy something different and nutritious this Christmas!

Christmas Salad

Spinach is a good source of magnesium, potassium, and iron, as well as vitamin A. Kiwi fruit are an excellent source of vitamin C and fibre.

  • 150 g young spinach leaves, stalks removed
  • 3 tomatoes, chopped
  • 1 large carrot, grated
  • 8 dried apricots, or 2 satsumas, chopped
  • 2 red-skinned eating apples (Cox’s or Pink Lady varieties are nice), cored and chopped
  • Juice ½ lemon
  • 1 kiwi fruit, thinly sliced
  • 50 g pecan nuts, chopped

For the dressing:

  • 2 tsp lemon juice
  • 4 tbsp olive oil
  • 2 tbsp cider vinegar
  • 4 tsp runny honey
  • 2 tsp Dijon or granary mustard
  • Salt and pepper
  1. In a small bowl, toss the prepared chopped apples in the lemon juice.
  2. To prepare the dressing, put all the ingredients for the dressing into a screw-top jar, screw the lid on tightly and shake to form an emulsion.
  3. Prepare the salad. Put the spinach into a large salad bowl, add the chopped apple and lemon juice and top with the tomatoes, carrots, dried apricots/chopped satsumas, and kiwi fruit.
  4. Drizzle the prepared dressing over the salad and toss together. Serve immediately, sprinkled with the pecan nuts.

 

Festive Salmon

Easy to put together and speedy to cook, this pretty salmon dish and the accompanying salad make a delicious meal to serve on Christmas Eve and are also ideal for the Boxing Day buffet table.

Salmon is a good source of protein, omega-3 fatty acids, magnesium and potassium, also providing 6% of your RDI for vitamin C, 53% of vitamin B12 and 30% of vitamin B6.

  • Spray oil
  • 1 x 1½ kg salmon side, skin on
  • 1 red pepper, chopped
  • 4 spring onions, red variety if possible, sliced
  • 1 fennel bulb, chopped
  • Juice 1 satsuma
  • 1 large chilli, de-seeded and chopped
  • 1 small bunch coriander, chopped
  • 1 tbsp sesame oil
  • 2 tsp olive oil
  • Salt and pepper
  • 2 lemons, in wedges
  1. Preheat the oven to 200C (180C fan), Gas 6.
  2. Line a large roasting tin with non-stick liner or tin foil and spray with a few sprays of spray oil.
  3. Blot the salmon dry with absorbent kitchen paper, then lay it in the roasting tin, skin side down.
  4. Put the red pepper, spring onions and fennel, into a large mixing bowl. Add the satsuma juice, chopped chilli, coriander, sesame oil, olive oil and a light seasoning of salt and pepper and mix well to combine.
  5. Top the salmon with the prepared vegetable mixture, spooning it over evenly. Add the lemon wedges, arranging them evenly round the edge of the salmon. Spray all over with about 6 sprays of spray oil.
  6. Roast in the oven for 25-30 minutes, until the salmon is cooked to your liking and the lemon wedges are lightly charred.
  7. Transfer to a large oval platter, using fish slices. Serve hot or cold.

 

For more delicious recipes, check out ‘Eat Well to Age Well’ by Beverley Jarvis which has over 75 delicious recipes to inspire her super-ager peers to eat well, with all the nutrients that are increasingly needed as we get older.

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Celebrating the Season of Giving at Hammersmith Health Books

The festive period is upon us and we want to celebrate the season of giving in true Hammersmith Health Books fashion by giving you an exclusive discount. For the ’12 Days of Christmas’, we have been reflecting on the range of amazing and insightful books released by our expert authors during 2022, as well as giving an exclusive sneak peek onto what you can expect in January 2023…

To celebrate the 12 Days of Christmas with our 2022 releases, we’re giving you 20% off the following books – just use the code CHRISTMAS12 at checkout.

 

 

Blind Trust – Dr Klaus Rose

This insightful read shows the key differences between clinically-directed and administratively-directed research, what will potentially benefit or harm children and how the law needs to change so that true advances can be made.⁠

 

 

 

 

 

 

 

Green Mother – Dr Sarah Myhill and Michelle McCullagh

Released back in January, ‘Green Mother’ by provides a paleo-ketogenic guide to motherhood. With beautiful illustrations and insightful case histories, this is a no-nonsense guide to pregnancy and child rearing like no other.

 

 

 

 

 

 

 

Eat Well to Age Well – Beverley Jarvis

Experienced cookery teacher and writer Beverley Jarvis has put together this book of 75+ delicious recipes to inspire her super-ager peers to eat well, with all the nutrients that are increasingly needed as we get older.

 

 

 

 

 

 

 

Eating Plant Based – Dr Shireen Kassam and Dr Zahra Kassam

This expert guide provides us with a wonderful insight into the plant-based world and the scientific background to tackle the misconceptions on what is considered a “healthy diet”.

 

 

 

 

 

 

 

Paleo-Ketogenic: the WHY and the HOW – Dr Sarah Myhill and Craig Robinson

This is a comprehensive guide that discusses the reasons for how and why a Paleo-Ketogenic diet is healthy, sustainable and affordable and arguably, evolutionary correct. It holds a variety of delicious, low-carb, whole-food recipes that provide all the high-level nutrients for the right balance.

 

 

 

 

 

 

Living PCOS Free – Rohini Bajekal and Dr Nitu Bajekal

This book brings together expert information and advice about PCOS, which is one of the most common endocrine disorders worldwide affecting at least one in 10 women or anyone assigned female at birth. This book aims to give those going through PCOS an insightful and inspirational guide. ⁠

 

 

 

 

 

 

Yoga for Cancer: The A-Z of C – Vicky Fox

This incredible book shares expert advice on how to alleviate the side effects of a cancer diagnosis through the practice of yoga.⁠ You don’t need to read it from cover to cover – you are able to find a specific symptom or side effect by searching in alphabetical order.

 

 

 

 

 

 

 

Plant-Based Nutrition in Clinical Practice – Dr Shireen Kassam, Dr Zahra Kassam and Lisa Simon RD

Written and edited by healthcare professionals from the UK, US, Canada and Australia, this educational textbook presents the uses, benefits and practical application of a plant-based diet to support patient care, disease prevention and management.⁠

 

 

 

 

 

 

Transforming Trauma – Dr Heather Herington

This insightful book shows how a pharmaceutical-free approach can enable survivors to regain control of their lives by returning the body’s biochemistry to balance with natural medicine (lifestyle, nutrition, homoeopathy and botanicals). ⁠

 

 

 

 

 

The Fatigue Book – Lydia Rolley

A practical guide to managing chronic fatigue in order to enable recovery at a pace that works for the individual. It outlines proven fatigue management tips and is suitable for people of all ages affected by either Long COVID or CFS/ME, and for their family and friends.

 

 

 

 

You can enjoy 20% off all of these expertly written books by using the code CHRISTMAS12 at checkout. But the surprises don’t stop there…

We’re excited to tease the newest books being released by Hammersmith Health Books this coming January:

 

 

Honey Sapiens – Mike McInnes

This book looks at central importance of the enzyme glutamine synthetase and how this is degraded by refined sugars, a key factor in memory loss, dementia and neurocognitive problems in the young and old and in utero. He explains this causal pattern and the solutions including the unrivalled part honey can play.

 

 

 

 

 

The Underactive Thyroid – Dr Sarah Myhill and Craig Robinson

This new book is a practical guide to the causes, consequences, signs & symptoms of hypothyroidism, how to spot you have it and how to overcome it yourself on an individualised basis.

 

 

 

Merry Christmas and Happy Holidays from the team here at Hammersmith Health Books!

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Grief Awareness Week – Knowing when the time has come…

In recognition of Grief Awareness Week, it seems fitting to share an extract from When The Time Comes: Stories from the end of life. A recent experience with a relative who had suffered a catastrophic stroke put this extract very much in mind – the messages we received from the hospital were so conflicting we did not know whether to prepare for a peaceful death or to put all our energies into sorting out a care package and expecting to bring the patient home. Time that could have been spent saying good-bye and grieving was spent needlessly on high-stress chasing after unavailable services. As this piece describes, health professionals are familiar with the ‘dying trajectory’ and the ‘inevitable progression’ of failing health, but those outside the system are generally not and are often shocked by knowledge that clinicians have been taking for granted, as Henry, husband of dying Helen, is in this real-life story: 

From Chapter 6: Not coming home 

I do not believe Henry had ever been told that the repeat hospitalisations where his wife gradually deteriorated after each discharge were a sign that she was on the dying trajectory. Every shift I had that week I made sure I was allocated to Helen’s room. I knew her dying journey had started but wanted her so badly to get better, not only for her sake but for Henry’s too as he often said that if Helen was not home with him on the farm he would not know what to do with himself. I guess this would have been a perfect time to explain to him that she had passed the point of no return, but it was not my role to do that, nor that of the medical student helping us. And if the specialists whose role it was had already mentioned it to Henry, the news did not appear to have sunk in. 

Helen’s condition began to deteriorate quickly over the following days. Henry sat patiently in the room for long hours stroking her head and her hand, looking up in anticipation when any clinician walked past as if waiting for good news each day, wishing for confirmation that Helen would soon be up on her feet and coming home. I overheard him speaking to her and telling other staff that when she was able to come home he would organise help for the two of them. I felt he possibly believed that if he accepted help from their town’s aged-care services, Helen could come back with him sooner. This was not the case, however, as she was too unwell to leave the ward. 

This admission was unlike any previous one. Helen probably sensed this because after a few days she had undergone assessment by the intensive care team, plus chest X-rays, and IV fluids and oxygen were running at all times. All of these were new to her. Henry, however, continued querying us about why Helen was not getting better, although staff had explained repeatedly that she had a serious infection which was not easy to control given the chronic illness affecting her lungs. Looking back I do not know if Henry truly understood Helen’s condition, but nobody seemed to go a step further in detailing the potential outcome in light of the lack of response to treatment. It was not a conspiracy of silence, just the clinical inertia of giving the treatments doctors are trained to deliver, or perhaps fear of taking Henry’s last bit of hope away. In either case, Henry was none the wiser. 

One evening shift I was with Helen and her condition was deteriorating further. She was now not talking in sentences and was becoming very drowsy, her eyes closed most of the time I was with her. Higher oxygen was given, medications were changed and drips of all sorts were again connected. She was too weak to eat and Henry was becoming very distressed at this. He could not understand why she was not hungry. Despite reassurance that she was indeed not feeling hungry, I had found him force-feeding her once, begging her to accept food while shedding silent tears. Of course I understood that Henry was doing this out of love and wasn’t able to accept at this point that Helen’s body was shutting down. An emergency medical call was placed during the night when Henry had stayed. When the junior doctor arrived on the ward it was evident to nursing staff and the doctor that Helen was actively dying. Henry became very distressed and agitated to hear there was nothing more that could be done from a medical point of view. However, after discussion that night, it was decided to continue with medications until Helen’s specialist could review and organise a meeting with Henry in the morning. Neither the nurses nor the medical student were in a position to have definitive words with Henry, as informing the patient’s husband was – and is – the specialist’s role. 

I came back to work after two days and Helen was still on my ward. Henry told me that he had had a meeting with her doctor who had explained her condition and it was decided that she would be made as comfortable as possible while the condition ran its course. Henry was teary and withdrawn throughout my whole shift. He was becoming increasingly frustrated at the doctors and could not understand why Helen was not recovering from this lung infection. ‘It was just two weeks ago, after her other hospitalisation, we were sitting at the farm having cups of tea and laughing as we remembered stories of the kids. Why was this cough any different?’ he kept asking. ‘Helen never told me that this cough was any more serious than the last. She has been sick many times this last year for the same reason and she has always come home.’ He was also very distressed that Helen might be in pain as her breathing had changed, but she was unable to talk so, ‘How would anyone know?’ he would often say. 

He did not know how she could be dying. This dying trajectory, with repeat hospital admissions, had been long and, while commonly witnessed by clinicians, was unrecognised by the husband. I am unsure if the clinicians managing her in previous admissions had mentioned to him the inevitable progression, but I was painfully aware of the looming prognosis that he could not yet grasp, two days after being told of the imminent outcome. Henry had only a very short time to come to grips with Helen’s condition and the devastating news that all active treatments would be suspended. The doctors had looked him in the eye and reassured him that she would not suffer, they had been honest with him about the irreversibility of it all and made sure he did not have false hope for a miracle; they gave him time to absorb the shocking reality and offered to answer any questions about the dying process, but Henry had no questions. He slowly swallowed his tears and accepted the fact that Helen was not coming home. Not this time. Not ever. 

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Preparing for a Vegan Christmas

VGEAN

Blog written by Sandra Hood, author of ‘Feeding Your Vegan Child’

Christmas always takes me by surprise. I think I’m organised and then I find I have less than a week to finish my shopping and write Christmas cards. So, this year I have started planning who I am sending cards and letters to and to whom I am giving gifts. Even if you do not celebrate Christmas, it is the perfect time to spend with loved ones away from the hustle and bustle of everyday life. The majority of shops are closed, there is less traffic on the roads and it is generally quieter. Make the most of it!

Lots of my friends and family are feeling the pinch this year. I have, therefore, decided to give homemade Christmas hampers containing ‘useful’ gifts. The hampers are made from empty boxes covered with an assortment of old Christmas and birthday cards and glazed with glue. In completing this task it made me realise how many cards have pictures of animals and nature, and how humans get great pleasure from the natural world. Children’s Christmas gifts, whether they are games or toys, are often in the image of some animal or other. Why is it that many people still don’t make the link between loving animals and eating them? Anyway, I’m going off on a tangent. This is what I am going to include in the hamper:

Home-made crackers – you always need something noisy for Christmas. These are quite quick and simple to make and can be a lovely gift if you put something particularly special inside. There are lots of great videos around on how to make crackers.

Cookies – I’ve been saving my jam jars and will fill these with mini ginger cookies*. These always go down a treat and I wish I had included this quick and easy recipe in my book.

Candles – A must if we get the power cuts predicted! I’ve managed to pick up all different shapes and sizes from charity shops.

Dried apple rings – I’ve got a dehydrator and it has come into its own this year as I have managed to get lots of free apples from friends and family. When you dehydrate fruit and vegetables the flavours are concentrated, they seem like a different food. Tomatoes and apples are particular favourites of mine.

And last but not least I will pop in a copy of my book – if they haven’t had the wisdom to have bought a copy! I’m not very good at blowing my own trumpet but it is Christmas after all. I’ve had lovely feedback from vegan families who liked the fact that my book was a small handy guide and not overwhelming. They have also commented that it is a useful guide for adults as a practical overview to check they were meeting their nutritional requirements too.

Finally, please bear in mind my book isn’t just for Christmas! Happy Christmas and I wish you all a very happy and healthy 2023.

Sandra

*Recipe for ginger cookies

  • 115 g (4 oz) margarine
  • 85 g (3 oz) sugar
  • 1 tablespoon golden syrup
  • 115 g (4 oz) self-raising flour
  • 115 g (4 oz) oats
  • Pinch of salt
  • Pinch of bicarbonate of soda
  • 2 tsp dried ginger
  • 2 tsp fresh ginger, grated
  1. Cream margarine, sugar and syrup together.
  2. Add all the other ingredients and mix evenly.
  3. Roll into 12 balls.
  4. Place on a greased baking tray.
  5. Press each ball flat with a fork.
  6. Bake at 175oC/350oF/Gas 4 for 15-20 minutes, or until golden brown.
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Best practices to cope with COPD

COPD

Temperatures have plummeted as the days get shorter and the wind gets colder, and while the move from blistering sun may get some people feeling the festive cheer, for others the winter time can bring about worry and concern. People with respiratory diseases such as COPD can often find themselves shorter of breath and coughing more than usual.

To wrap up a month focused on COPD and raising awareness for the condition, we investigated some of the simple corrective exercises to help COPD patients overcome breathlessness.⁠ The following blog has excerpts from Paul Brice’s book ‘COPD: Innovative Breathing Techniques’, which you can find here.

Learning to de-slump yourself

Preparation

For this exercise, you will need a high-backed chair that is firm and supportive. You will find a sofa or lounge chair will be far too soft to provide any meaningful support to your spine. A dining table chair with arms or a relatively firm office chair is what you will need. If the chair has arms, it may assist you, but if your chair has no arms you can still do the exercise. You will also need a rolled-up towel or a back support of some sort draped over the top of the backrest.

Self-Awareness Preparation

Sit on a chair as you normally would. Position a rolled-up towel or back and listen again to your breathing. Ask yourself the following questions and be more aware of what you are actually doing when you inhale and exhale:

  1. Notice where your head is in relation to your body
  2. Notice how you are holding your shoulders
  3. Think about the pace and speed of your breathing
  4. Recognise how deep your breath is going into your lungs
  5. Think about how satisfying each breath is

How to do the exercise

  1. Sit down on the firm high-backed chair, with your bottom pushed right back into the seat
  2. Ensure that the rolled-up towel or back support pad is positioned below and between your shoulder blades. The rolled-up towel or pad should be big enough for you to feel it push against your ribs, but not so big that you are being toppled forwards
  3. Now try to draw your shoulder blades backwards and downwards, whilst drawing the nape of your neck backwards. The towel or back support will act as a pivot point, allowing your ribs to open up like a fan, and artificially supporting and expanding your chest in the process
  4. When you draw your shoulders backwards and downwards, you may find that your hands will need to fall by your hips or slide back on the arms of your chair. Work with this by putting your hands on your hips if your chair has no arms, or drawing your elbows back if your chair has got arm rests

Read more about how to manage COPD in ‘COPD: Innovative Breathing Techniques’ by Paul Brice, published by Hammersmith Health Books,  and discover how The Brice Method could help you to re-learn how to breathe naturally, with ease and without having to work hard. The best course of treatment for COPD can differ for every person and what works for some may not be as effective for others, so if you are struggling with COPD, make sure to consult your GP.

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Stress Awareness Week

Stress describes what we experience when we are physically, mentally or emotionally under pressure and feeling unable to cope. It activates our fight-or-flight response, with the outpouring of the stress hormones, adrenaline and cortisol. This response may have positive consequences in the short-term as it prompts us to take action, but prolonged stress and the feelings of helplessness that accompany it can have serious effects on our health.

We have compiled some key pieces of advice and top tips from a range of our books on the effects stress can have on our physical and mental wellbeing, as well as how to manage it:

 

‘Curing the Incurable’ – Dr Jerry Thompson

We already know that stress increases the incidence and severity of many diseases. A meta-analysis of nearly 300 studies found that stress lowered immunity. Stress increases inflammation, which in turn increases the risk of cancer. It activates the ‘fight or flight’ response, triggering the sympathetic nervous system, releasing hormones such as adrenaline, noradrenaline and cortisol, and reducing levels of growth hormone. Both adrenaline and noradrenaline block the body’s ability to destroy tumours. One study showed tumours grew 225% faster in stressed mice.

However, it isn’t just that we produce harmful chemicals when under stress. We also produce less of those anabolic hormones essential for healing and repair, as raw materials get diverted to produce more adrenaline and cortisol.

It is obvious that if we want to promote healing, then reducing stress becomes a priority. However, there is more to stress than meets the eye. In the study on rats subjected to electrical shocks mentioned in the Introduction, those that learned to avoid the shocks rejected their tumours three times as often as those that couldn’t. What’s more, 20% more of these rats rejected their tumours compared with those rats not subjected to any shocks. Here the stress proved beneficial and adapting to it had a positive survival effect. […] So reducing stress, or adapting to it in a positive way, can enhance our ability to fight a disease.

Many of the mental strategies that survivors have used are based on two simple ideas. Both are backed by a substantial amount of research:

  1. The body goes into healing mode once it becomes relaxed, and conversely healing of the body stops when we are under stress.
  2. Thoughts are creative and can modify health.

‘Eating Plant Based’ – Dr Shireen Kassam and Dr Zahra Kassam

Oxidative stress is an imbalance between the normal cellular processes of oxidation and reduction and is a result of the generation of metabolic products known as ‘reactive oxygen species’ (ROS). Certain ‘stressors’ can lead to increased levels of ROS, including cigarette smoking, medication, pesticides, radiation and also our diet choices. Oxidative stress then leads to the damage of proteins, DNA and cell membranes. The body requires antioxidants to counter the effects of these damaging ROS.

Plant foods contain hundreds of antioxidant compounds and have vastly higher antioxidant content than animal-derived foods. These antioxidants come in two broad categories: carotenoids and bioflavonoids. Both are large groups of structurally related compounds that help plants cope with radiation exposure from sunlight. Studies consistently show that those eating a predominantly plant-based diet have higher levels of antioxidants in the body compared with omnivores so, add more colourful fruit and vegetables into your daily diet as the intake of these anti-inflammatory foods reduces the very hormones that increase our stress levels.

‘Living PCOS Free’ – Rohini Bajekal and Dr Nitu Bajekal

Dr Nitu and Rohini Bajekal, writing in relation to PCOS but with aphttps://www.hammersmithbooks.co.uk/product/living-pcos-free/plication to all aspects of health, make these creative suggestions for managing our stress:

It helps to try and figure out if your stress is acute or chronic. It may be that it is a family member who needs your attention because they are sick, or it may be your relationship, work-related stress and deadlines, or even bullying and harassment. Chronic stress is a prolonged and constant feeling of stress that can negatively affect your health if it goes untreated. By identifying and acknowledging stress triggers, you may feel better equipped to deal with the situation.

[…] Regular exercise improves the feel-good factor and can help reduce anxiety levels. Walking or working out, especially in natural light, can help increase endorphins, also known as the happy hormones. Spending time outdoors in nature has been found to ease stress. […]

Gratitude practices and thinking of a few positive areas that are going well in your life can help relieve stress levels. Yoga, meditation or simple mindfulness and breathing techniques can calm the mind and reduce anxiety levels. Writing your fears or concerns in a diary or journal may help you to see the situation more clearly.

[…] Spending time in nature reduces stress. Studies have found that the Japanese practice of shinrin-yoku, translated as ‘forest bathing’, can lower blood pressure and improve immune function and mental health. Forest bathing involves immersing oneself in nature by mindfully using all five senses.

[…] Affirmations are powerful and positive simple statements that can help us challenge negative thought patterns. They can decrease stress, increase well-being, and make us more open to behaviour change.

‘Ecological Medicine’ – Dr Sarah Myhill and Craig Robinson (Second Edition available Jan 2023)

Life is inevitably stressful, and we all have skeletons in the cupboard. During sleep we relive the events of the day and remember the important things and rationalise the damaging memories. But if sleep is disturbed by adrenaline, then those memories are relived in a hormonally stressful environment, thereby reinforcing them. This is an obvious vicious cycle. The treatment is obvious too – stop adrenalin release at night with the Paleo-Ketogenic diet, thereby blocking any damaging memories that may be lurking.

 

 

 

‘The A-Z of Yoga for Cancer’ – Vicky Fox

 Breathing is key to helping to release anxiety by bringing us into the present moment. When we are conscious of our breathing we are fully in the moment because we can’t breathe in the past and we can’t take a breath in the future. This means we are in this moment with whatever this moment brings. […] There are many tools we can use to help bring us into the moment and it is about finding what works for you. I recommend beginning with a simple wave breathing exercise.

[…] Find a comfortable sitting position where your spine feels long. This maybe in a chair or seated on some cushions on the floor. […] shift from side to side until you feel there is equal weight on both sitting bones. Your spine should feel long, and you should not be shifting forwards or backwards. As you breathe in, sense the wave-like motion of your breathing.

Follow these steps:

                Inhale and sense or feel the wave rising.

                As you exhale, silently say to yourself ‘1’.

                Inhale and sense or feel the wave of breath rising.

                As you exhale, silently say to yourself ‘2’.

                Inhale and sense or feel the wave rising.

                As you exhale silently say ‘3’.

                Inhale and sense or feel the wave rising.

                As you exhale silently say ‘4’.

… and continue in the same way, Incrementally counting upwards to ‘10’ with each exhale and back down again to ‘1’ (this takes about 2 minutes).

This wave breathing is a form of meditation because meditation is giving your mind something to focus on; here the focus is movement of breath and counting.

 

National Stress Awareness Day (2nd November) is an annual initiative by Rethink Mental Illness which highlights the ways that stress can affect people and what you can do to manage your stress before it becomes a problem. The causes of stress and the best way to manage it can differ for every person and what works for some may not be as effective for others, so if you are struggling to cope with stress, make sure to consult your GP or look on the NHS website for more information.

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Why exercise is good for osteoarthritis

Blog written by Frances Ive, author of ‘One Step Ahead of Osteoarthritis’.

I don’t know about you, but I found that my knees and hands were virtually pain free during the hot summer this year. As soon as the damp started creeping in, so did the swelling and discomfort.

There have been changes going on too in the recommended treatment for osteoarthritis (OA).

After goodness knows how long, a change has also come about. NICE (the National Institute for Health and Care Excellence) has produced draft guidelines advising GPs that the first recommendation they should give for OA is exercise and weight loss, instead of strong painkillers which have been  standard treatment for some time.

My book, One Step Ahead of Osteoarthritis, focuses on taking charge and managing OA, principally with exercise and losing weight, but also diet, complementary therapies, supplements and practical tips.

The bottom line is that you need to stay active and mobile. Losing your mobility is the start of a slippery slope downwards so the goal is to keep moving.

Why exercise is good for you

One reason why keeping active is good for your osteoarthritis is that exercise strengthens muscles, which surround and protect the joints. The other major plus of exercise is that it helps us to lose weight. According to Dr Paul Chrisp, director of the Centre for Guidelines at NICE, ‘There is evidence which shows muscle strengthening and aerobic exercise can have an impact on not just managing the condition, but also providing people with an improved quality of life.’

He also stated, ‘Losing weight can have a significant impact on health outcomes for a range of conditions, but it can also help to reduce joint pain for people with osteoarthritis.’

Many UK surgeons now prefer to ask osteoarthritis patients to lose weight before opting for joint surgery and find that in some cases patients no longer need the operation.

Mobility is essential

Retaining mobility is key to having a better quality of life. Conversely, becoming immobile is life changing and can lead to isolation and loneliness. It’s important to be able to stay independent and get out and about at any age.

Different approach to painkillers

NICE also claims that there is new evidence which shows there is little or no benefit to people’s quality of life, pain or psychological distress from taking strong painkillers. Particularly in the case of strong opioids, there is evidence that they can cause harm in the longer term and become addictive.

So what exercise should we do?

You can do specific exercises for the knees, hips and hands – the most common areas for OA – and you can find diagrams showing how to do these in my book, courtesy of Versus Arthritis, the UK charity. Not only are these helpful but they can be done at home for free, without needing to go to a gym or classes.

It might be that you already have a favourite activity, exercise or sport that you want to continue with. Some people find gardening is enough activity for them and it keeps them mobile.  But most important of all is that you find the type of exercise that most suits you.

Health experts suggest that we should exercise for at least five days a week for around 30 minutes each time.  If you are incapacitated it’s important to build this up at your own pace.

Formal exercise that is helpful

Cycling – great for strengthening muscles around the knees.

Yoga – stretches and flexes muscles and makes the body stronger.

Pilates – improves core muscles, helping to take the strain off your back.

Walking – good for joints as well as heart and lungs.

Swimming – gentle and muscle strengthening.

Tennis – using supports for problem knees and joints, it is brilliant exercise for people of all ages.

Golf – involves plenty of walking so has all round benefits.

Read more about how to manage osteoarthritis and ensure your quality of life in  ‘One Step Ahead of Osteoarthritis’, Frances Ive, published by Hammersmith Health Books,  and discover how you can help yourself to feel better and maintain a good quality of life.

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Plant-Based Nutrition for Mental Health and Wellbeing

In recognition of a month focused on mental health and wellbeing, we investigated the intriguing findings that suggest plant-based diets may help improve mental health. The following blog has excerpts from Dr Shireen Kassam and Dr Zahra Kassam’s book ‘Eating Plant Based’, which you can find here.

Wellbeing and Fruit & Veg

High psychological wellbeing is more than the absence of mental illness. It is a sense that we are functioning well in our life. People with high psychological wellbeing also report feeling capable, well-supported, and satisfied with life and are more likely to live healthier and longer lives. Accumulating data now show that PBDs, or simply increasing fruit and vegetable (FV) consumption, are associated with gains in wellbeing.

 

 

 

 

 

Worldwide Studies

A study that used data on over 45,000 individuals followed over time, found that wellbeing increased in a dose-response fashion with the number of portions of FV consumed or with the frequency of FV consumption. Even modest increases in FV intake had substantive positive effects on wellbeing.

Similarly, a novel 2-week study in New Zealand showed that providing high-quality FV to young adults resulted in short-term improvements in mental wellbeing, specifically vitality, flourishing, and motivation. Consumption of raw FV may also be important in optimising better mental health wellbeing, with a high level of correlation with consumption of carrots, bananas, apples, leafy greens, citrus fruits, fresh berries, cucumber, and kiwi fruit in one study.

In another longitudinal study of over 12,000 Australian adults, increased FV consumption was predictive of increased happiness, life satisfaction, and wellbeing. The gain was up to 0.24 life-satisfaction points (for an increase of eight portions a day), which is equal in size to the psychological gain of moving from unemployment to employment.36 In a systematic review of 30 studies examining the association between FV consumption and general (broad) mental health in women, a positive influence of FV was seen using measures of wellbeing, quality of life, positive and negative affect, self-esteem, anxiety, distress, depressive symptoms, depression, and suicide.

Wellbeing, Diet and Diabetes

Wellbeing and diet have also been studied in the context of type 2 diabetes. Diabetes has significant co-morbidity with depressive illness, which itself places high demands on the individual’s inner resources. A large longitudinal study of patients with diabetes has shown improved outcomes for 5-year mental health and wellbeing associated with higher intakes of FV and specifically FV-derived dietary fibre and resistant starch, such as that found in cereals and whole grains. A systematic review of 11 controlled trials concluded that a plant-based diet can significantly improve psychological wellbeing and quality of life in people with type 2 diabetes. The studies included were conducted in several different countries suggesting broad clinical applicability. Specifically, PBDs were associated with significant improvement in emotional wellbeing, physical wellbeing, depression, quality of life, general health, pain perception, weight, diabetes control and lipids, compared with several diabetes associations’ official guidelines and other comparator diets.

Nutrition and Mental Health in Children

In children and adolescents, a systematic review of 12 epidemiological studies reported a significant relationship between unhealthy dietary patterns (including higher intake of foods with saturated fat, refined carbohydrates and processed food products) and worse mental health.40 They also observed an association between good quality diet and better mental health. Since mental disorders often begin in youth, the implications are far-reaching.

A worksite-based pilot study using a whole food plant-based diet intervention resulted in significant improvements in the psychological subscale of quality of life, alongside other wellbeing improvements and is an early indicator that such interventions are both feasible and effective.

For more information on plant based diets, you can read Dr Zahra Kassam and Dr Shireen Kassam’s full books ‘Eating Plant Based’ and ‘Plant Based Nutrition in Clinical Practice’ which provides in depth guidance supported by scientific evidence.

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Hammersmith Health Books – As Seen in the Media

The authors at Hammersmith Health Books have had a busy few months speaking in some incredible publications on their specialist topics where they offer some expert advice and guidance.

Here are some of our coverage highlights from the last few months:

Caroline Freedman – ‘Why Spotting it Early is Key for a Curved Spine’ in Women’s Weekly

 

Author of ‘The Scoliosis Handbook’ Caroline Freedman discussed the importance of spotting of spotting a curved spine early in Women’s Weekly. She speaks on why knowing how to spot the signs of scoliosis early can be vital in preventing surgery in later life and reassures that having the condition does not have to hold you back.

 

 

 

Rohini Bajekal – ‘The Power of Plants for PCOS’ in Vegan Food and Living

 

 

 

Rohini Bajekal, author of ‘Living PCOS Free’, was featured in Vegan Food and Living where she spoke about how PCOS is heavily influenced by lifestyle factors and how a plant-based diet can help to manage and alleviate symptoms of the condition.

 

 

 

Vicky Fox – ‘Supporting Students in their A-Z of Side Effects’ in Yoga Magazine

 

 

Vicky Fox, author of ‘The A-Z of Yoga for Cancer’, offered advice to students on how to mitigate the side effects of cancer treatment and discusses the importance of yoga for cancer classes being specially designed to consider the side effects people may be experiencing.

 

 

 

 

Frances Ive – ‘Delicious Ways to End Joint Pain’ in What Doctors Don’t Tell You

 

 

Author of ‘One Step Ahead of Osteoarthritis’ Frances Ive spoke all about the best foods, herbs and recipes to help heal the pain of arthritis in What Doctors Don’t Tell You. Providing some delicious recipes containing the herbs and foods that are scientifically proven to help end pain and swelling.

 

 

 

Martyn Hooper – ‘Research Priorities in Pernicious Anemia’ in BMJ Journals

 

 

Martyn Hooper, author of ‘Five-A-Day Plus One: The Vitamin B12 Cookbook’, had an insightful paper published in BMJ Journals which delves into Pernicious Anemia and discusses the research priorities related to the cause, diagnosis, treatment and management of the condition.⁠ You can read the full paper here.

 

 

 

Lydia Rolley – ‘Tired all the Time?’ in Your Healthy Living

 

 

 

Author of ‘The Fatigue Book’ Lydia Rolley offered a variety of practical advice on how to manage energy levels in Your Healthy Living magazine. She talks all about what can cause unhealthy levels of tiredness as well as the effective lifestyle changes you can introduce to help manage. You can read the full issue here.

 

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Back Care Awareness Week

Blog written by Caroline Freedman: Personal Trainer and TRX Sports Medicine Suspension Training exercise professional, and author of ‘The Scoliosis Handbook of Safe and Effective Exercises Pre and Post Surgery‘.

Backcare Awareness Week brings an opportunity to check our posture and become aware of how our lifestyle affects our spines.  With back issues affecting many of us at some point in our lives, I feel if we gave more attention to postural alignment and the importance of how to carry, lift, sit and stand from a young age this could lead to improving the nation’s backs and help alleviate some pain and suffering.  The knock on effect would be less absence from work and of course lift a little pressure off the NHS.

There is a lot we can do ourselves to keep our spines healthy.  Becoming aware of how we treat our spines and looking after our bodies makes a huge difference. Little things like picking something up, I was taught by an Alexander Technique Postural teacher many years ago that ‘our bodies are more important than the object we are lifting’.  It’s the way we pick something up that makes the difference. Squat to pick a bag of shopping up off the floor making sure legs are hip width and your hips do not go lower than your knees.  Think about getting help for heavy objects rather than over doing it.  Avoid twisting to pick something up from the back seat of a car.  I have heard so many incidents of people putting their neck out simply by overreaching for something. It’s annoying to have to park up and retrieve a phone that’s slipped down the side of the seat and rolled onto the floor behind you, but it has to be better than wasting time at the physiotherapist and the cost of missing work and recovery.  Be aware of housework and try to use both sides of the body to hoover and mop to avoid a one sided build up of muscles.

Thankfully exercise has become a key part of our lives and resistance training with weights has been proven to help slow down degenerative conditions such as osteoporosis of the spine but there is little point in lifting weights and working out your back muscles (lats, trapezius, rhomboids, erector spinae) if your posture is incorrect to start with. Getting back to basics, below are guidelines from The Scoliosis Handbook for correct starting positions for exercise.  Perfect these and you will find that your technique when performing exercises will become much improved, leading to getting more out of your workouts.

There are obviously spinal conditions that we have little control over.  Traumatic conditions from injury, infection and spinal deformity conditions.  Not everyone will have perfectly straight spines.  One condition that is not regularly checked for in the UK is Scoliosis (curvature of the spine)

Many people that I know discovered the curvature of their spine by mistake and most hadn’t even heard of the term ‘Scoliosis’.  Mine was discovered at 15 in an exercise class by the trainer who’s own daughter had scoliosis.  I had complained about pain but my mother had zero idea what to even look for.  I have had three spinal fusion surgeries.  Caught early, scoliosis can often be improved with a brace.

There are no formal health checks for spotting scoliosis in our children in the UK, but here are some checks I’d recommend you make if you are a parent:

  1. Get your child to stand with their back to you and attempt to touch their toes.
  2. Is the spine straight or the torso veering to one side?
  3. Can you see virtual symmetry?
  4. Do shoulders appear uneven?
  5. Are the centre of the ribs running down the centre of the body?
  6. Is your child complaining of a pulling feeling across one side of the rib cage?
  7. Are the hips balanced?

For further reference and advice contact The Scoliosis Association UK www.sauk.org.uk

POSTURE/ALIGNMENT

HOW TO STAND AND SIT DURING EXERCISE

STARTING POSITION

Suck your abs in. Your pelvis should be tilted slightly forward. If you have movement in your lower spine, do not arch it. Shoulders down, head level and chin tucked in. When standing and exercising, always make sure your knees are slightly bent as this will take the pressure off your lower spine. Do not hyperextend (over- straighten) your elbows or knees.

ALIGNMENT

Always be aware of your body alignment. Head, neck, shoulders, spine, hips, knees, ankles and toes should follow each other. A tip is to look down or check yourself in the mirror. Are your knees pulling together or your toes positioned inwards? Your knees should be front facing or slightly outwards and your toes positioned between 11 am and 1 pm OR 10 am and 2 pm.

LYING DOWN ON YOUR BACK

I was always taught to keep my spine glued to the floor. This has prevented me and my clients from having any pain during exercise. There should be as little space as possible between your spine and the floor. Tilt your pelvis and keep your knees bent with your feet flat on the floor, with a wedge under your lower bottom/upper thighs for support. The wedge takes the pressure off your spine.

To engage your core, imagine drawing your belly button into your spine, scoop your abdominals in and pull your pelvic floor up. You should feel like everything is being sucked in and your pelvis tilted upwards.

If your hair is tied into a ponytail, make sure it is not interfering with the positioning of your head and neck, e.g. chin tilted too far back or forward. The space between your chin and chest should be about the size of an orange – try using one to gauge where the positioning should be – it works. Remember to breathe, in through your nose and out through your mouth, gently and without hyperventilating, in a relaxed manner.

Published by: Hammersmith Books – www.hammersmithbooks.co.uk

Illustrated by: Dunelm Digital – www.dunelmdigital.co.uk

Photos by: Sam Pearce – www.square-image.co.uk

‘Images courtesy of Scoliosis Association UK’