Our microbiota is made up of trillions of tiny organisms called microbes that live in our gut. The gut microbiota is unique to each of us. They not only help digest the food we eat, but also produce molecules that influence our health via the immune system and impact gene expression. Beneficial bacteria prevent the proliferation of other detrimental ones: as in the animal world, where animals and plants compete to gain access to resources, gut bacteria also compete to thrive. The greater bacterial diversity in our gut, the greater chance of staying healthy.
Life stages and gut health:
The complex community of microorganisms inhabiting our intestinal tract fluctuates throughout life stages. Most important changes occur during infancy and old age. Recent research indicates that bacteria are transmitted to the baby from the mother during pregnancy, birth and breastfeeding. This suggests the oral and intestinal microbiota of the mother might affect foetal and infantile health. As we get older our microbial diversity often decline, although it is still unclear whether it is a cause or a consequence of aging.
Lower bacterial diversity and disease:
Research studies show that many diseases are associated with alterations of the microbiota. They suggest that auto-immune-disease, diabetes, obesity, skin problems, inflammatory bowel diseases, asthma and cardio-vascular diseases may be partly caused by an increase in pathogenic microbes (dysbiosis) in our gut.
Contributing factors to dysbiosis are overuse of antibiotics and drugs, highly processed food, pesticides, too much animal protein, sugar, saturated fats and artificial sweeteners, nutrients deficiencies and stress.
Diversity in your diet is key to a balanced gut flora
Diet has a major role in determining which microbes take up residence in our guts. For most people, eating a rainbow of brightly-coloured plant foods on a daily basis, including traditional fermented foods (prebiotic and probiotic food) will be enough to increase gut microbial diversity. Bioactive substances such as polyphenols, plant compounds abundant in the Mediterranean diet, have been associated with improved microbial diversity. The aim is to include foods that feed the friendly bacteria in the gut. These bacteria produce nutrients for colon cells and lead to a healthier digestive tract, improving metabolic health and lowering inflammation.
How do I support my patients in improving their gut diversity?
My interventions are highly individual and depend on my patients’ symptoms, health concerns and lifestyle. Food diaries are a great tool to develop awareness of diet diversity (or lack thereof); I help my patients increase their prebiotic and probiotic food intake providing them with simple recipes and shopping lists and be more mindful when eating.  My aim is to empower them to make informed decisions to improve their health with natural food. I always keep in mind that they may have busy lives with food temptations everywhere so I have to come up with practical and tasty suggestions. Pleasure should always be one of the diet’s component!!   In certain instances, a comprehensive stool analysis may be useful to assess gut function and microbial diversity.

Digestive discomfort can undermine your chances to run your best marathon. Optimum digestive function depends on the composition of the food and fluid ingested, the timing of ingestion before during and after exercise and your stress level. Just as you train your muscles and mind, you can train your gastrointestinal tract to meet the demands of exercise

Do you suffer from?

• Heart burn*
• Acid reflux
• Nausea
• Belching
• Sharp stomach pain & cramps
• Excessive gas and bloating
• Diarrhoea 

The development of heartburn on exercise must always be investigated fully in order to exclude the possibility of cardio-vascular complication even in younger athletes. 
Tips to improve your digestion on your race day

1. Always consume foods and drinks you have tried and tested before: you need to know what nutrition works best for you
2. Test your meals timing to determine the optimum timing for you
3. Have a fluid/ hydration plan
4. Eat a low GI (low GI) diet a few hours before your run
5. Limit high fat food, spicy foods, peppermint, cinnamon and vinegar
6. Limit your intake of high fibre food for 2 days before the race such as beans, lentils, whole grains, peppers, onions, broccoli, cabbage…
7. Avoid milk, caffeinated drinks, citrus juices, carbonated and fermented drinks and do not drink through a straw
8. Eat slowly, making sure you chew your food thoroughly
9. Avoid excess intake of fructose, xylitol and sorbitol, make sure sports drinks are mixed correctly and test your sports drinks and gels for a few weeks before the race 

You probably know if you have irritable bowel syndrome*(IBS) — with symptoms like bloating, gas, distention, constipation, diarrhoea, cramping… They tend to come and go in periods lasting a few days to a few months, often during times of stress or after eating certain foods. These symptoms can often be debilitating and lead to a reduced quality of life.
Five people with IBS would have the same symptoms but each may have different causes, as there are many underlying culprits to the syndrome. Conventional approach tends to merely suppress symptoms but doesn’t address the underlying causes. Exploring what specifically triggers your IBS symptoms is essential to improving your condition.
 
What are the main triggers?

• Food sensitivities and allergies
• Malabsorption of a class of carbohydrates
• Gut microbes or bacterial overgrowth
• Poor diet, High fat diet
• Caffeine
• Stress and anxiety
• Increased gut sensitivity

Food sensitivities and allergies
These could be caused by gluten, a protein found in wheat, barley, rye and spelt. Dairy can be problematic as well, as lactose may cause bloating, gas and diarrhoea in some people. Other common food sensitivities may relate to soy, corn and eggs which may cause gut inflammation.
Malabsorption of high FODMAPs food
Some carbohydrates named FODMAPs (Fermentable Oligo-saccharides, Di-saccharides, Mono-saccharides And Polyols) may be problematic for those with IBS. These short-chain carbohydrates are poorly absorbed in the small intestine and rapidly fermented by bacteria in the gut. The production of gas by these bacteria is a major contributor to symptoms.
Gut inflammation and ecosystem imbalances
Many things can make your gut lining erode, including: stress, antibiotics or recurrent courses of anti-inflammatory drugs, intestinal microbial, viral or parasitic infections, poor diet low in fibre and high in sugar and alcohol… . If that lining breaks down, your immune system will be exposed to foreign particles from food and bacteria and other microbes. Imbalance in your gut flora where pathogenic bacteria overwhelms healthy bacteria is also implicated in IBS.
This is precisely why it is so critically important to personalize the approach based on the unique circumstances. By addressing underlying causes, excellent outcomes are possible.
*Always have your symptoms checked by a General Practitioner, although IBS can’t be confirmed with a test, your GP may recommend blood tests, scans, X-rays or other tests in order to rule out any other structural bowel disease.

"Action on Sugar" 2016 survey on high street hot drinks found that a large portion of them contained shocking amounts of sugar. The recommended daily amount of free sugar  for over 11 years old  is 7 teaspoons.

Starbucks White Chocolate Mocha Coconut Venti: 20 teaspoons
Costa Coffee Chai Latte Massima: 20 teaspoons
KFC Mocha: 15 teaspoons
Caffe Nero: Caramellita: 13 teaspoons 
Eat Matcha Latte Big: 11 teaspoons 
Mac Donalds Mocha Large: 11 teaspoons
Greggs Mocha Large: 11 teaspoons
 Some of these drinks may contain naturally occurring milk sugar lactose which is not a free sugar

If you hesitate in a restaurant between starter or pudding, you may need to consider as well your glass of wine… 
Sugar tax on soft drinks is a great initiative to tackle childhood obesity, but do adults know the sugar content of  their alcoholic drinks?
Adults in Europe get more of their calories from alcohol than from sugary drinks; if we want to reduce obesity should consumers not be aware of the calories content of their drinks?
Did you know that:

• 1 pint of beer contains 180 Kcal, the same as a slice of pizza
• 1 large glass of wine contains 200 Kcal, the same as a doughnut
  ​or 4 mini sausage rolls
• 1 vodka tonic contains 120 Kcal
• alcopop contains 140 Kcal

If you want to calculate your alcohol daily calorie intake check this:

​Lack of sleep, disturbed sleep and irregularity in sleep/wake patterns are associated with obesity, sub-optimal glucose metabolism and increased fat storage. In short, when we sleep  less than 7 hours, not only do we tend to choose larger portion sizes, but we also tend to crave more sugary and starchy carbohydrates foods, on average our calorie intake increases by 350kcal to 500kcal/day as our brain finds it harder to control our cravings due to imbalances in our hunger and satiety hormones, at the end of the week this may accumulate to 3500 kcal.
Tips to improve your sleep:
Do:

• 1. Go to bed and get up at the same time each day. 
• 2. Get regular exercise, preferably in the morning. There is good evidence that regular exercise improves restful sleep. This includes stretching and aerobic exercise. 
• 3. Get daily exposure to outdoor light, i/e have a walk at lunchtime.
• 4. Have a dinner rich in tryptophan (i/e egg, turkey, tofu, salmon, cheese, nuts and seeds) combined with carbohydrates (pasta, rice, oats, bread) to boost your serotonin levels
• 5. Keep the temperature in your bedroom on the cool side 
• 6. Keep the bedroom dark to facilitate sleep (this increases production of melatonin (the sleep hormone). 
• 7. Remove electrical devices (radios, cell phones, multiple outlet connectors) from around your head when you sleep. Electromagnetic fields have been found to reduce melatonin levels.
• 8. Turn off television and computer 1 hour before bedtime. This will reduce your blue light exposure. Dim the light of your digital devices if you need to use them before bedtime.
• 9. Use a relaxation exercise just before going to sleep (e.g., muscle relaxation, imagery, massage, warm bath, etc.) or read a book. 

 
Don't:  

• 1. Have caffeine in the evening (coffee, many teas, chocolate, some sodas, etc.) 
• 2. Watch television or  use your tablets in bed. 
• 3. Use alcohol to help you sleep. 
• 4. Go to bed too hungry or too full. 
• 5. Take daytime naps especially after 3.00pm and over 20mn.  

Although certain risks factors for cardiovascular diseases cannot be changed such as family history, ethnicity and age, many others may be reduced and even reversed: high blood pressure, high cholesterol, obesity, Type 2 diabetes, tobacco exposure, sedentary lifestyle…
Diet is one of the key factors that may have an impact on the health of your heart. Adopting a “cardiometabolic diet” rich in dietary fibre, phytonutrients and healthy fats can help you achieve and maintain a healthy weight, reduce LDL cholesterol, hypertension and Type 2 diabetes. The type of food, cooking methods and meal timing all contribute to reduce inflammation, and oxidation which are implicated in atherosclerosis (hardening of the arteries).
The cardiometabolic foods work in synergy to fight off atherosclerosis  while providing an enjoyable and tasty diet rich in fresh and colourful vegetables, fruit, legumes, wholegrains and healthy fats found in fish, olive oil, nuts and seeds.
Whether you are interested in prevention or you already suffer from a heart condition you can start learning about therapeutic food through the Cardiometabolic diet plan.

As autumn settles in and winter is at our door step, we need to make some changes to our diet to support our natural defences against cold and flu:

1. Check your Vitamin D levels:  Although you may have stored Vitamin D from sunshine during the summer, it rapidly declines and even a well-balanced diet is unlikely to provide enough amounts.  The current government guidelines for adults are to take 10mcg of Vitamin D per day during autumn and winter months. If you are unsure ask advice from your nutritionist, GP or dietician and always choose supplements tailored to your age group and condition.
2. Eat good quality protein with each meal to support your energy levels and mood. Protein also helps tackle hunger that may lead to sugar binge. Your protein needs may be increased by stress and infections.
3. Include a large variety of fresh seasonal green and orange vegetables, legumes, fruit, wholegrains, nuts, seeds, seafood, shellfish and lean meat to boost your levels of iron, zinc, Vitamin C, Vitamin E and selenium.
4. Choose warmer and nourishing food such as porridge, soups and slow cook stews. The gut is key to immunity, so supporting digestion is crucial.
5. Cut back on stimulants such as caffeine, alcohol and refined sugar as they have a weakening effect on the immune system.

     6.  Maintain a healthy weight  because inflammation linked to adipose tissue weakens           your immune system making you more prone to infections.