Inflammation: why you’re fat, sick, tired, depressed and in pain… and what to do about it


By vegan naturopath Robyn Chuter.

You may never have stopped to think about it, but every time you become unwell in any way, inflammation plays a key role.

That role is obvious in diseases like arthritis – inflammation of the joints, but perhaps less obvious in, for example, the common cold – major symptoms of which are rhinitis, or inflammation of the nasal passages, and fatigue, which results when inflammatory signals from around the body enter the brain; heart disease – which involves inflammation of the inner lining of the blood vessels; and cancer – which relies on inflammatory processes to grow and spread.

Then there’s the role played by inflammation in obesity – fat cells, especially abdominal fat cells, produce inflammatory chemicals which bring on insulin resistance, making it harder for you to lose weight – and in depression, which is associated with elevated levels of inflammatory chemicals both in the brain itself, and throughout the body.

Furthermore, obesity itself may contribute to depression, and not just because people feel bad about buying their clothes in the plus-size department, but because the inflammation brought on by being overweight affects their brain function (1).

So what’s driving this inflammation, and what can we do about it?

Fuelling the fire of inflammation

Inflammation is a response by the body’s immune system to a perceived threat, such as invading bacteria or viruses. One of the strongest triggers of inflammation is endotoxin, otherwise known as lipolysacccharide, a compound produced by certain types of bacteria. While you might think that exposure to infectious disease would be the primary source of this threat, many animal foods such as pork, turkey, cheese, yoghurt and ice cream contain signficant quantities of endotoxin – and this endotoxin is not destroyed by stomach acid or digestive enzymes (2).

In the study cited above, researchers proved that these endotoxin-containing foods caused human white blood cells to secrete inflammatory chemicals, and

“speculate that the occasional ingestion of meals high in LPS [lipopolysaccharide] and/or BLP [bacterial lipopeptide – another immune-activating compound produced by some bacteria] could promote transient, mild, systemic inflammatory episodes that predispose subjects to the development of atherosclerosis and insulin resistance.”

It’s worth emphasising here that the offending bacterial substances were

“minimal or undetectable in fresh fruit and vegetables.”

This relatively new research adds to the insights gained from previous studies, which found that a single fast food meal containing egg and sausage induced inflammation in the arteries of healthy young people, that persisted for more than 6 hours afterwards (3); while a meal containing animal fat caused inflammation in the lungs of healthy people, leading the researchers to speculate that regular intake of such foods may contribute to chronic inflammatory lung and airway disease, including asthma (4).

Endotoxin isn’t the only dietary culprit in inflammation. A study examining levels of inflammatory markers after intake of different foods found that people who consumed cream experienced not just increased levels of endotoxin, but also of the inflammatory markers NF-kappaB and TNF-alpha. On the other hand, in those given a glucose (sugar) solution to drink, NF-kappaB and TNF-alpha levels rose but endotoxin did not. Neither orange juice nor water caused any rise in inflammatory chemicals (5).

The bottom line here is that the major determinant of inflammation levels in our bodies – which in turn determines our risk of disease – is something completely under our control: our daily food intake. And while consumption of whole, unrefined plant foods is linked to lower risk of inflammation-related disease (6), consumption of animal products and refined carbohydrates has the reverse effect – in spades.

Sins of omission and commission

I often describe the effects of dietary choices to my clients with a tongue-in-cheek reference to the Catholic church’s concepts of sins of omission and sins of commission. Sins of commission are bad things which we know are bad but choose to do anyway, while sins of omission are good things we can and should do but fail to do.

Interestingly, Catholic theologians don’t consider either type to be more ‘sinful’ than the other; both kinds are equally pernicious.

In my analogy, the Western dietary pattern, with its heavy reliance on processed grains, sugar and animal products, and only token amounts of fresh, unprocessed plant foods, leads us to commit both sins of dietary omission and commission:

  • When we fail to consume ample amounts of fruits and vegetables, we omit from our diets the abundance of anti-inflammatory compounds – such as carotenoids and flavonoids – that they contain.
  • And conversely, when we eat eggs, yoghurt, beef, chicken, white bread and soft drinks, we load our bodies up with highly inflammatory substances, and the ‘punishment for our sins’ is the disease processes that eventually result: heart disease, cancer, autoimmune disease, insulin resistance and type 2 diabetes, depression, skin disorders and a host of other nasties.

That’s why I teach my clients that healthy eating is a package deal. It’s not just a matter of eating some token ‘good-for-you’ foods to expiate your dietary guilt (like having some iceberg lettuce on your white-bread cheese-and-ham sandwich); you have to minimise or avoid the ‘bad-for-you’ foods as well.

Fortunately, renouncing your dietary sins need not mean a life without culinary pleasure! Healthy food that fights inflammation is attractive to all the senses, delicious to eat, and imbues your body and mind with vitality and joy – just check out my recipe section! Even better, enrol in my 1-day nutrition intensive, Empowered Eating to learn how to make healthy eating simple and delicious, or join my 6-week nutrition and cooking course.


The Mediterranean diet: sorting fact from fantasy


By vegan naturopath Robyn Chuter.

Everyone who’s interested in diet and health has heard of ‘the Mediterranean diet’. Advocates of this dietary pattern claim that it protects against heart disease, stroke, metabolic syndrome (characterised by excess abdominal fat, blood pressure and/or glucose levels, elevated total cholesterol and decreased HDL cholesterol), many types of cancer, and even asthma, allergies, Parkinson’s disease, Alzheimer’s disease and osteoporosis (1).

There is actually a fair bit of scientific evidence for these claims. The problem is that – thanks largely to the marketing efforts of the olive oil industry, and the personal biases of many writers who have published popular books presenting their spin on the diet – most people think that the key component of the Mediterranean diet is olive oil.

When I advise my clients to cut out all extracted oils, they ask “What about olive oil? Isn’t it heart-healthy? Surely you don’t want me to cut that out!” Yes I do, and here’s why.

‘The Mediterranean diet’ as we understand it today was first characterised and promoted by the American researcher Ancel Keys. He described it as a dietary pattern high in fresh vegetables and fruits, legumes, whole grains, nuts, fish and olive oil; and low in saturated fat-rich animal foods such as dairy products, red meat and eggs.

In his Seven Countries Study, launched in 1958, he found that the inhabitants of the Greek island of Crete – the examplars of the Mediterranean diet – had the lowest rate of heart disease of the 7 populations he studied, despite consuming up to 40% of their calories from fat (mostly from olive oil and fish).

Keys concluded that replacement of saturated fat with unsaturated fat from plant sources, would bring dramatic health benefits (2) – and the Myth of Olive Oil as Heart Disease Preventer was born.

What Keys failed to acknowledge in his initial study was that the Cretans were incredibly physically active (Crete is very mountainous and at that time, most of the people walked everywhere – up to 9 miles a day!) and their overall energy (calorie/kilojoule) intake was low.

But life in modern Crete is dramatically different than in the era when Ancel Keys’ study was performed. Olive oil consumption remains high, but sedentary lifestyle, decreased consumption of fresh produce and higher intake of high-calorie, refined and animal-derived food have come to Crete.

Over 60% of adult Cretans, and 50% of Cretan children, are now overweight and rates of high blood pressure, type 2 diabetes and heart disease have skyrocketed in recent years (3).

A recent study in Crete (4) found that patients with heart disease ate significantly more olive oil than people free of heart disease, making it crystal clear that olive oil holds no magical power to stave off the health-destroying effects of inactivity and poor dietary choices.

Cretans appear to be suffering from the same delusion as Westerners who have jumped on the Mediterranean diet bandwagon – they think they can continue to eat olive oil with impunity, even if they are overweight and sedentary.

The only thing that protected their forebears from the hazards of olive oil consumption was their high activity level and plant-based, low-calorie diet.

What you need to understand is that oils impair endothelial function. What’s endothelial function? It’s the ability of the thin layer of cells that line your blood vessels, to regulate the flow of blood through those vessels, and it’s a strong predictor of your risk of having a heart attack (5). A well-functioning endothelium keeps your blood vessels reasonably dilated, which in turn lowers your blood pressure and ‘smoothes’ the flow of blood.

Endothelial dysfunction results in constricted arteries, raised blood pressure, ‘sticking’ of inflammation-producing white blood cells to the endothelial lining, and turbid blood flow which in turn increase the risk of microscopic injuries to the blood vessels (6). These injuries are ‘patched up’ with cholesterol, like you would patch up a damaged plasterboard wall with Spakfilla.

If the injuries are infrequent, the cholesterol ‘patch’ is soon reabsorbed and the artery wall is repaired with normal, healthy endothelial cells. If there are repeated injuries, the cholesterol patches aren’t reabsorbed, but instead start to form an atherosclerotic plaque, which narrows the lumen of the blood vessel (the hole through which the blood flows), eventually causing symptoms such as angina, erectile dysfunction and chronic low back pain, and increasing the risk of stroke and heart attack.

When you ingest extracted oils and fats, you impair the function of your endothelial cells for several hours (the duration of effect varies with the type of oil) and during this time period, the growth of atherosclerotic plaques accelerates precipitously.

Olive oil dramatically impairs endothelial function (7). On the other hand, nuts do not impair endothelial function in spite of their high fat content, possibly because they contain antioxidants (which decrease the oxidative stress that causes endothelial dysfunction) and arginine (which endothelial cells use to make nitric oxide, a chemical that dilates blood vessels, prevents atherosclerotic plaque from forming on the vessel walls, and keeps blood flow smooth and even by preventing platelets from sticking together)(8).

As cardiologist Robert Vogel, the pioneer of the primary test used to assess endothelial function, concluded (7):

“the beneficial components of the Mediterranean and Lyon Diet Heart Study diets appear to be antioxidant-rich foods, including vegetables, fruits, and their derivatives such as vinegar [and omega 3-rich foods].”

The bottom line: extracting an oil from the nutritional matrix that it is packaged in by nature is asking for trouble. If you want to minimise your risk of cardiovascular disease, enjoy plant foods that are naturally high in fats, such as avocado, nuts and seeds, in moderation, but leave the extracted oils out of your diet. Slim, active people with no cardiovascular risk factors can get away with some consumption of oil, but that doesn’t mean it’s good for them!


Carbohydrates at night help you lose weight!


By vegan naturopath Robyn Chuter.

For years, I’ve been hearing from clients that their personal trainer/nutritionist/astrologer (OK, I made that last one up) told them not to eat ‘carbs’ after 4 pm, or 6 pm, or whatever particular witching hour their self-appointed weight-loss guru nominates, if they want to lose weight.

The popular theory goes that eating a lot of carbohydrate-rich food stimulates excessive insulin release, and that since we’re less active at night than during the day, all that insulin will cause the glucose we absorb from starches to convert to fat. This theory is quoted as gospel truth on gazillions of weight-loss websites… but it turns out it’s completely false.

A recent study compared the outcomes of 78 obese police officers who were put on a low calorie diet containing 20% protein, 30-35% fat and 45-50% carbohydrate. The control group was told to distribute their carbohydrate intake throughout the day, while the experimental group was instructed to eat most of their carbohydrates at night.

The researchers found that, after 6 months of following the dietary plan, the carbohydrate-at-night group had lost substantially more weight, abdominal girth and body fat mass than the control group, despite the two diets containing the same calories and the same proportions of macronutrients.

Furthermore, the carbohydrate-at-night group experienced less hunger and had greater improvements in fasting glucose, average daily insulin concentrations, insulin resistance, cholesterol and the inflammation markers C-reactive protein, tumor necrosis factor-a, and interleukin-6, which are elevated in overweight people, and are linked to an increased risk of heart disease, cancer and depression.

Although you wouldn’t know it from reading popular weight loss books and websites, the idea that carbohydrate-rich foods caused increased insulin secretion was debunked last century, in a study that examined the insulin demand generated by various foods.

Researchers fed 1000 kj portions of a variety of foods to healthy people, and measured the amount of insulin their bodies secreted in response. They found that both protein-rich foods and bakery products (which are high in fat as well as carbohydrate) elicited disproportionately high insulin secretion.

Beef and cheese, for example, raise insulin levels more than pasta!

Even earlier research found that glucose raised insulin secretion only slightly more than an equivalent amount of protein.

The bottom line here is that popular theories of weight loss should never be used as the basis of your weight loss plan. There is no substitute for properly-conducted testing of these theories, no matter how ‘scientific’ their proponents make them out to be.

The scientific literature is, in fact, very clear about what works for sustainable weight loss – a diet based on unrefined plant foods. See my articles Eating meat: the fast track to diabesity, and The Big Fat Protein Swindle for more information and scientific references.


Can you change your genes?


By vegan naturopath Robyn Chuter.

What if you could change your genes, almost as quickly as you change your jeans? What if you could ‘switch off’ genes that cause disease processes, and ‘turn on’ genes that initiate healing processes?

Mention the word ‘genes’ to most people, and what they think of is fixed, immutable carriers of information. The term ‘blueprint’ is often used when discussing genes, as if they provide a very precise set of instructions that only has the possibility of producing one outcome. But the Human Genome Project (1) demonstrated beyond any doubt that this way of thinking about genes is outmoded and inaccurate.

Humans have approximately 20 000-25 000 genes – about the same number as mice and roundworms; not that many more than fruit flies (which have about 14 000 genes); and less than a water flea called Daphnia pulex which, at around 31 000, holds the record for the greatest number of genes in any organism whose genome has been sequenced (2).

We also share 97% of our genes with chimpanzees (3), but are clearly very different to them physically, behaviourally and psychologically. There is simply no way that we can explain the incredible complexity, diversity and adaptability of human beings using the old ‘genes = blueprint’ model.

While there is a small percentage of genes that act all by themselves to produce a particular outcome (for example, the genes that code for eye colour or blood type), this is the exception and not the rule. The majority of genes operate in remarkably complex networks, controlled by genes called transcription factors which themselves operate in complex networks.

And what controls these networks? Influences which scientists call ‘epigenetic factors’: changes in the environment of cells brought about by the level of various nutrients, hormones, neurotransmitters, toxins and so forth.

So if you want to change your genes in a health-promoting way, what should you do? Do what your mother always told you, and eat your fruit and veg. Not just one or two ‘superfoods’, by the way – the greater the diversity of plant foods in your diet, the more genes are influenced in a positive way.

Scientists used to think that fruit and vegies are good for your health because they contain antioxidants such as vitamin C and beta carotene. Antioxidants neutralise free radicals which could otherwise build up and damage DNA – the material our genes are made of – predisposing us to cancer and other diseases. However, human trials of supplementation of individual antioxidants have shown that they don’t protect against cancer, and some can increase the risk of cancer (4). What’s going on?

Well, it’s now known that phytochemicals (compounds that plants make to regulate their own metabolism, only some of which have antioxidant activity) actually increase our cellular defenses by activating those transcription factors I mentioned before. And what that means is that cells can recover their normal function even if their DNA is damaged by free radicals, rather than either dying, becoming dysfunctional, or turning cancerous.

The activation of transcription factors leads to a much longer-lasting protective effect than antioxidants, most of which have a very short half-life in the body.

In regards to dietary variety, a 2010 study (4) showed that adding 3 antioxidant-rich kiwifruit per day to the diet of male smokers with no known health problems, caused changes in the behaviour of 9 genes, 5 of them involved in cellular defence processes. But a dietary portfolio consisting of green tea, dog rose juice, cranberry juice, aronia juice, unsweetened bilberry juice, bilberry jam, bilberries, blackberries, strawberries, raspberries, pomegranate, dark blue grapes, Brussels sprouts, broccoli, red cabbage, kale, blue potatoes, tomatoes, dark chocolate, pecan nuts, sunflower seeds, walnuts, extra virgin olive oil, rosemary, thyme and oregano changed the behaviour of 44 genes, 25 of them involved in cellular defence.

The moral of the story? If you want to activate your ‘good genes’,

  1. Choose a diet centred on a wide variety of fruits and vegetables;
  2. Avoid taking antioxidant supplements that contain isolated nutrients such as beta carotene and vitamin E, and
  3. Don’t waste your money on high-priced ‘superfoods’ such as acai and maqui berry, which are sold on the basis of their high ORAC (antioxidant) score – which is far less protective against disease than activating your own cellular defence mechanisms.

The Plant Gallery Bondi – Sydney Vegan Club Review


by Kym Staton, 20th Jan. 2016

The number of 100% vegan restaurants in Sydney has grown in the last twelve months, with at least three new vegan eateries opening their doors, as well as two restaurants making the historic and un-presedented move of replacing their animal-laden menu with a vegan one!

The newest welcome addition to the Sydney vegan dining scene is of the ultra healthy raw vegan variety, with the much anticipated launch of the intriguingly titled ‘The Plant Gallery’ at Sydney’s beachside health-haven Bondi.


Three years ago The Plant Gallery co-owner David Ortega bought a one-way ticket to Bolivia on the search for new horizons and experiencing a different culture. Little did he know that this would bring about a dramatic new lifestyle direction, as it was here that he met raw-foodist and renowned chef Juan Carlos Miranda Ormena who introduce him to the enormous health benefits of a raw-food vegan diet as well as many of the amazing flavours of Peru. The pair formed a terrific friendship and came up with the goal of opening up a raw-food restaurant back in Australia.

David and Juan Carlos were toying with the idea of calling their restaurant ‘The Plant Gallery’ – as homage to the plant-powered menu – when by chance a venue previously used as an art gallery became vacant. It seemed like a match made in heaven to make use of the existing lighting and picture hanging systems and feature artworks on the walls of their restaurant.

Having the pleasure of a first visit to The Plant Gallery I was impressed that in addition to the food/art synergy, the restaurant includes a number of other innovations.

Walking in you instantly notice the back wall is adorned with indoor plants which create a lovely organic natural backdrop. A tour of the large garden (out back) revealed the already active compost bins – big points for reduced food waste! Great to also hear plans for installing a garden and growing some of their own produce!

The furniture is all made of up-cyled timber which lends warmth and ambience. The centre of the restaurant has a huge communal table which encourages interaction from guests.

Admiring all of these innovations, I almost forgot about the food, but was gobsmacked to see the delights on offer with their sophisticated, artistic dishes described on the menu. Then i noticed another innovation with their convenient ‘TPG experience’, in the bottom right hand corner, where newcomers or those who like a surprise can have the ‘chef’s choice of one entree, one main and one salad’ for two people – such a great idea!

Much of the menu is peruvian inspired – where David and Juan Carlos have taken traditional dishes of Peru and ‘veganised’ as well as raw-ified them to great success!

I started my first The Plant Gallery experience with the mushroom ceviche – which was a fresh and zesty salad of marinated mushrooms, onion and corn in a refreshing lime dressing. The flavours and textures were very enjoyable.


For main course I had the spaghetti humancaina – a rich and very flavoursome journey of zucchini spaghetti in a rich cashew and yellow chilli sauce. The huge cashew parmesan chunks were very tasty.


I finished with a very decadent and gorgeously presented dessert of deconstructed inca berry cheesecake with cashew cheese and orange nut crumble which looked like three sailboats floating on the pacific, and had dreamy flavours to match!

The Plant Gallery’s aim is to put to bed the myth ‘that healthy food can’t taste good’. I can see that the team at this exciting new restaurant have both the passion and skill to do just that with their brilliant new venue and the terrific collaboration of dynamic duo David and Juan Carlos!

Sydney Vegan Club wish you the best of luck with your new endeavour and look forward to having a big tasting-party event at you venue very soon so that we can enjoy the flavours and ambience and culinary joys of you creations as a group.

SVC Vegan packman foodie rating:


Plant-Based Nutrition and Coronary Artery Disease


Dr Caldwell Esselstyn is a force of nature. At 82, he still directs the cardiovascular prevention and reversal program at The Cleveland Clinic Wellness Institute, and travels around the US regularly (hopefully he’ll come to Australia one day!), spreading his message that coronary artery disease is a reversible condition, even when it’s so advanced that mainstream cardiologists have given up on you and sent you home to die.

I’ve covered the key elements of Dr Esselstyn’s heart disease reversal program in my 2014 International PBNHC Round-up video and discussed some of the myths about heart disease that Essy busts in a previous post.

In brief, he teaches his patients to eat a wholefood, plant-based (i.e. vegan) diet with no added oil; no nuts or seeds except a tablespoon of ground flax/linseed each day; no avocado; and no added salt; and with the addition of green leafy vegetables at every meal and snack. You can find all the details in his book Prevent and Reverse Heart Disease, and his wife Ann and daughter Jane have authored several recipe books that teach you how to make this way of eating enjoyable.

But what I really want to discuss in this post is why more people don’t know about his work, and the implications of that ignorance.


Let’s start with a little background. Caldwell Esselstyn has worked at the Cleveland Clinic, one of the most well-known academic hospitals in the US, since 1968. His surgical training was conducted there; he chaired the Clinic’s Breast Cancer Task Force and headed its Section of Thyroid and Parathyroid Surgery; he has served as President of the Staff and as a member of the Board of Governors. He received the Distinguished Alumnus Award from the Cleveland Clinic Alumni Association in 2009.

He has also served as President of the American Association of Endocrine Surgeons, was cited in The Best Doctors in America 1994-1995 for his surgical expertise in the categories of endocrine and breast disease, and is a Fellow of the American College of Cardiology. On top of all that, he is the author or co-author of over 150 publications in peer-reviewed scientific and medical journals.

I’m telling you all of this to make it clear that Dr Esselstyn is not some underqualified nut-job pushing a half-baked theory of his own creation that has never been tested. (There are plenty of contrasts to him in the ‘alternative medicine’ sphere, such as Dr Natasha Campbell-McBride, who makes outrageous claims for her GAPS diet based on either no science at all, or badly outdated science that has since been disproven, and who has never published a single paper in the medical literature to document her approach).

No, Essy is the real deal – a highly-qualified and well-respected doctor with an impeccable academic pedigree. So why is that the vast majority of people who undertake his program find out about him through friends, relatives or internet searches, rather than being referred to him by their doctors, including cardiologists who work at the Cleveland Clinic and have known of him, and his work, for decades?

Well, as I discovered recently, it turns out that the Cleveland Clinic actually has a policy that no doctors employed by it are permitted to refer patients to Esselstyn’s cardiovascular prevention and reversal program, even though it operates inside the Cleveland Clinic! Ummmm, whaaaat?

It’s simple, really. The average cost for heart bypass surgery in US hospitals is US$117 000, and being a top teaching hospital, the Cleveland Clinic probably charges more than that. The failure rate for this procedure is high (see my article What Bill Clinton’s cardiologist didn’t know (and why you need to know it), so a significant proportion of people will end up back under the surgeon’s knife, or undergoing other invasive procedures. Even if they don’t, they’ll have to come back for regular check-ups and to get their prescriptions updated, ensuring that they become cash cows for the hospital.

In contrast, Essy charges next to nothing to participate in his program, has detailed the entire program in a book that you can buy online for around A$20, and explains how the program works in numerous videos that you can watch for free on Youtube. People who stick strictly to the program are virtually heart-attack-proof, as he has documented in the long-term follow-up studies that he has published, so they have no need to come back to the Cleveland Clinic, or to Essy personally, for any more treatment.

Follow the money, folks. Treating people with surgery, stenting and medication keeps them sick patients for the rest of their lives, which is highly lucrative; while teaching them how to take charge of their health gets them off the medical merry-go-round, saving loads of taxpayers dollars as well as their out-of-pocket costs.

What would you choose – to live the remainder of your life as a cardiac patient, or to get rid of your coronary artery disease and live the remainder of your life in robust health – like Essy himself, who in his 80s maintains a schedule that many 40 year olds couldn’t keep up with?


Plant-based diets for the treatment of Polycystic Ovary Syndrome


By vegan naturopath Robyn Chuter

PCOS is believed to affect up to 1 in 10 women of reproductive age in both Australia and the US. It is the most common cause of female infertility, since women with PCOS either only ovulate occasionally, or not at all.

I have seen many clients with PCOS over my 20 years in practice, which is one of the reasons why I was looking forward to Brie Turner-McGrievy’s presentation on it at the 2015 International Plant-Based Nutrition Healthcare Conference. (The other was that she has published some amazing studies comparing the effectiveness of various diets for weight loss, but more on that a little later…)

Symptoms of PCOS include:

  • Infertility
  • Infrequent, absent, and/or irregular menstrual periods
  • Multiple cysts on the ovaries which can be seen on ultrasound
  • Acne (particularly cystic acne), oily skin, or dandruff
  • Weight gain or obesity, particularly around the waist
  • Pelvic pain
  • Male-pattern baldness or thinning hair
  • Increased facial hair
  • Dark patches of skin
  • Skin tags
  • Anxiety or depression
  • Sleep apnea

Woman with PCOS make too many androgens (‘male hormones’) in their ovaries, so they have elevated levels of these hormone in their blood. In addition they have low concentrations of sex hormone binding globulin (SHBG), a protein which keeps testosterone and estrogen in an inactive ‘storage’ state. Low SHBG translates to higher levels of active testosterone, which contributes to all the symptoms of PCOS, including infertility.

In addition, women with PCOS are insulin-resistant – that is, their cells don’t respond to the signals sent by the hormone insulin, resulting in high levels of glucose and triglycerides in their bloodstreams, and increased fat storage.

As a result of these metabolic abnormalities, women with PCOS have a higher risk of developing several chronic diseases, including:

  • Diabetes
  • Hypertension
  • Some forms of cancer
  • Cardiovascular disease
  • Metabolic Syndrome

The first-line treatment for PCOS is pretty simple, if not necessarily easy: lose weight. The problem, as Turner-McGrievy pointed out, is that up until recently, there had been no studies done to establish the most effective weight loss diet for PCOS sufferers. So she did what any self-respecting nutrition researcher with a history of co-authoring studies with the amazing Dr Neal Barnard, founder of the Physician’s Committee for Responsible Medicine, would do – she decided to run such a study herself.

By way of background, Dr Barnard had found in an earlier study that women suffering from severe period pain had a significantly higher serum SHBG concentration when they were placed on a vegan diet than when they were eating their standard omnivorous diet (remember, women with PCOS have lower than average SHBG).

Then, in later Barnard-led studies that Brie Turner-McGrievy contributed to, an ad libitum (all you can eat) low-fat vegan diet was found to cause significantly more weight loss in overweight, postmenopausal women than the US government-developed National Cholesterol Education Program Step II diet, despite the lack of restrictions on portion size and energy intake in the vegan diet group. Not only were the  participants randomised to the vegan diet considerably lighter after the 14-week study wrapped up; they were far more successful than the ‘standard’ dieters at keeping the weight off, at both 1-year and 2-year follow-up.

The same diet was found to cause significantly more weight loss in type 2 diabetics, along with greater decreases in HbA1c (a measure of long-term blood sugar control), fasting glucose, cholesterol and LDL, than the ‘official’ American Diabetes Association diet – highly relevant to PCOS sufferers due to their increased risk of diabetes.

So Turner-McGrievy conceived the Healthy Eating for Reproductive Health (HER Health) study, to compare a low-fat, low-glycaemic index vegan diet with no caloric restriction to a standard, low-calorie diet for weight loss in women with PCOS. With very minimal instruction and 1:1 contact, the women assigned to the vegan diet group still managed to lose significantly more weight than the low-cal dieters at the 3 month mark, as well as having greater improvements in dietary intake at the 6 month mark.

Turner-McGrievy then went on to conduct the New Dietary Interventions to Enhance the Treatments for weight loss (New DIETs) study – a 2-month weight loss intervention with a 4-month follow-up period, which randomised overweight participants to either a vegan, vegetarian, pesco-vegetarian, semi-vegetarian, or omnivorous diet. All the test diets were carefully designed so that they were low in fat and glycaemic index. And the winner was… the vegan diet, which resulted in the loss of 7.5% of initial body weight after 6 months. Interestingly, although participants in all test diet groups lost weight by 2 months, the pesco-vegetarian, semi-vegetarian and omnivorous dieters began regaining weight after that, while those in the vegetarian and vegan diet groups kept losing weight.


The take-home message for women with PCOS is that a low-fat, low-glycaemic index vegan diet is the best way to lose weight, balance hormones and restore insulin sensitivity. This backs up my experience with clients, many of whom have resumed normal menstruation and been able to get pregnant naturally by adopting a wholefood, plant-based diet without added oils and refined carbohydrates. – See more at:

The Universe Within


By vegan naturopath Robyn Chuter

As I see more and more clients with complex, chronic health conditions, I am frequently reminded of Hippocrates’ statement from over 2000 years ago:

All disease begins in the gut.

Now, like a lot of pithy sayings, there will always be some exceptions to the rule, but as researchers delve into the inner workings of the digestive tract, more and more health conditions are turning out to have a significant gut component.

And as Dr Corey Howard explained in his presentation at the 2015 International Plant-Based Nutrition Healthcare Conference, that gut component of disease doesn’t just involve our own, human cells. Here are some startling facts to ponder:

  • Our bodies are comprised of around 37 trillion cells (in numerals, that’s 37 000 000 000 000).
  • The human genome contains approximately 21 000 genes.
  • 1.5% of those genes, or around 300 of them, code for proteins (that is, they contain the instructions for making particular proteins).
  • The remaining 20 700 genes regulate the expression of the 300 that code for proteins.
  • 100 trillion bacteria (that’s 100 000 000 000 000) reside in and on the human body – on our skin, in our nose, ears, lungs, eyeballs, the vagina in females, and of course in our gut.
  • There are more than 9 million unique genes in the human gut bacterial community, or over 400 times the number of human genes.

If you’re feeling a little creeped out by the discovery that you are more ‘bug’ than human, you’re not alone. We have been conditioned to think of bacteria as our mortal enemies, to be eradicated by any means necessary. Think of those advertisements you’ve seen for mouthwashes, kitchen sprays and toilet cleaners that proudly trumpet the claim that they ‘kill 99% of bacteria’. The market for antibacterial hand sanitisers has exploded in recent years, and many parents will beg their GP for an antibiotic if they even suspect that their child has a middle ear infection.

But as researchers delve deeper into the human microbiome and how it affects our physical and mental health, it’s becoming more and more clear that attempting to eradicate bacteria from our bodies and living environments is a Very Bad Idea.

Dr Howard focused his presentation on the gut microbiome, although the composition and function of bacteria that live on and in other parts of our bodies is a fascinating subject in itself.

The probiotic or ‘good bacteria’ that inhabit our intestines carry out several vital functions for us. They:

  • Produce some vitamins, including vitamin K and biotin, which we can absorb and utilise;
  • Synthesise amino acids – the building blocks of protein, which we can also absorb and utilise to build our own body proteins;
  • Carry out biotransformation of bile acids – metabolic waste products that contribute to bowel cancer and gallstones – so that they can be safely removed from the body;
  • Produce short chain fatty acids including butyrate, which decreases intestinal inflammation, heals ‘leaky gut’, modulates the sensitivity of visceral organs and improves intestinal motility (helping to overcome IBS), protects against colorectal cancer, lowers cholesterol and reduces insulin resistance… among many other benefits;
  • Secrete antimicrobial substances which inhibit the growth of ‘bad’ bacteria that can cause intestinal infections, leaky gut and inflammatory conditions including cardiovascular and autoimmune disease.
  • Interact with toll-like receptors, helping the immune system to identify and destroy harmful bacteria while tolerating beneficial bacteria, human cells and normal components of food.
  • Interact with dendritic cells, a type of immune cell, helping to calm them and reduce their production of inflammatory chemicals.

That’s the good news. The bad news is that the delicate balance of the gut microbiome can be thrown out by a host of factors, setting the stage for all manner of ill-health.

  • Babies born by caesarean section are not colonised by the healthy bacteria that a vaginally-delivered baby will encounter on its way through the birth canal. Instead of its mother’s flora, the c-section baby’s gut ends up being populated by bacteria from the air in the operating theatre, and the garments of the doctors and nurses.
  • Breast-fed babies receive probiotic bacteria in their mother’s milk, as well as prebiotic oligosaccharides (carbohydrates that can’t be digested by humans, but feed the gut bacteria instead); while formula-fed babies miss out on both.
  • Antibiotics, whether prescribed for infectious illnesses (most of which are not life-threatening and would resolve spontaneously if left untreated), or consumed in dairy products, eggs and meat from factory-farmed land and marine animals that are routinely fed antibiotics, dramatically reduce the diversity of the gut microbiome and can set the stage for colonisation by pathogens such as Clostridium difficule.
  • A wide range of other drugs, including proton pump inhibitors (acid suppressors such as Losec and Nexium); non-steroidal anti-inflammatories and oral contraceptives, decrease the number of beneficial bacteria inhabiting the gut.

As Dr Howard explained, if you have acquired imbalances in your gut microbiome that are contributing to digestive discomfort and poor health, just taking probiotics won’t get you well again. You’ll need a total dietary overhaul to remove the substances that derange your microbial colonies (artificial sweeteners, animal products laced with antibiotics, refined carbohydrates) and add in the substances that restore balance (fibre, resistant starch, fermented foods); you need to get off drugs that wreak havoc on your gut flora; quit smoking and excessive drinking; and get regular exercise.

Does all of this sound familiar? The same lifestyle measures which promote the health of your human cells also promote the health of your microbiome… and perhaps that is no coincidence.


The Angiogenesis of Health and Disease


By vegan naturopath Robyn Chuter

One of the presentations I was most looking forward to at the 2014 International Plant-Based Healthcare Nutrition Conference (PBNHC) was the one that Dr William Li, the Medical Director and Co-founder of the Angiogenesis Foundation, was slated to give. Having watched Dr Li’s TED talk, Can we eat to starve cancer?, I was keen to learn more about the effect of angiogenesis. (If you’re thinking right now, ‘What the heck is angiogenesis and why should I even care about it?’, don’t worry, I’ll get to that in a minute.)

Unfortunately, due to a family emergency Dr Li was unable to attend the 2014 conference. So I was excited to see he was back on the conference agenda for this year’s PBNHC, and I’m happy to say that his presentation was every bit as good as I’d hoped for!

First, a brief explanation of angiogenesis: ‘angio’ means blood vessel, and ‘genesis’ means the beginning of something. So angiogenesis is the formation of new blood vessels from existing ones.

You’ve actually experienced angiogenesis multiple times throughout your life, although you probably didn’t realise it. For starters, you wouldn’t exist without the angiogenesis that allowed your mother’s body to develop the placenta which nourished you until you were born. Then, every time you ever grazed your knee or cut yourself, angiogenesis kicked in, allowing granulation tissue to form and wounds to heal. If you’re a woman, you’ve been experiencing angiogenesis once a month since your menstrual periods began.

Those are all normal forms of angiogenesis, necessary for life, health and reproduction. But when angiogenesis goes bad, it can go very, very bad. As Dr Li explained, many common disease processes involve abnormal angiogenesis, including:

  • Cancer – tumours cannot grow to a clinically significant size until they have become angiogenic; but once they do, they can grow 16 000 times their pre-angiogenic size in a matter of just a few weeks.
  • Atherosclerosis – angiogenesis occurs within the cholesterol-laden plaques that grow inside blood vessels, making the plaque more unstable and prone to rupturing and forming a clot that can lead to a heart attack.
  • Obesity – in order for fat deposits to grow, they must develop a network of blood vessels to nourish them. Fat cells send angiogenic signals to neighbouring blood vessels when they become overstuffed with fat, and the new blood vessels secrete growth factors that stimulate immature fat cells to develop and multiply. This creates a vicious circle of fat mass expansion.
  • Psoriasis – uncontrolled angiogenesis contrubites to the formation of psoriatic plaques.
  • Arthritis – the formation of a pannus (an abnormal layer of fibrovascular tissue or granulation tissue) over joint surfaces, causing loss of bone and cartilage, is driven by angiogenesis.
  • Endometriosis – the abnormal growth of uterine lining tissue on other pelvic structures is an expression of aberrant angiogenesis.
  • Kaposi’s sarcoma – this hallmark symptom of AIDS is associated with a herpesvirus that triggers angiogenesis.
  • Alzheimer’s disease – abnormal blood vessels that grow in the brain due to inappropriate angiogenesis release a neurotoxin that kills neurons (brain cells).
  • Macular degeneration – angiogenesis is the driving force in this age-related cause of blindness.
  • Multiple sclerosis – angiogenesis is found in the demyelinating lesions characteristic of MS.
  • Rosacea – both the initial development of this distressing skin condition and its persistent presence involve angiogenesis.

So that’s the bad news about angiogenesis.

The good news is that a host of compounds found in whole plant foods inhibit abnormal angiogenesis (without blocking the normal angiogenesis that we need for wound healing and pregnancy).

Some of the all-star angiogenesis inhibitors that Dr Li highlighted are:

  • Resveratrol, a pigment found in red grapes, peanut skins, pistachios, blueberries, cranberries, cacao and cocoa. In laboratory experiments, resveratrol inhibited angiogenesis in tumours by up to 75%
  • Ellagic acid, found in blackberries, cranberries, pecans, pomegranates, raspberries, strawberries, walnuts, goji berries and grapes.
  • Genistein, found primarily in soy beans and products made from them such as tofu and tempeh.
  • EGCG, found in green tea, which not only inhibits pathological angiogenesis but also mobilises the endothelial progenitor stem cells needed for tissue repair.

Many food compounds and foods inhibit angiogenesis more strongly than anti-angiogenic drugs, according to Dr Li, but without the nasty side effects which include black, tarry stools; bleeding gums; body aches and pains; burning, tingling, numbness, or pain in the hands, arms, feet, or legs; chest pain or discomfort; chills; cloudy urine; and convulsions.

Our food selection and preparation practices can profoundly affect the amount of anti-angiogenic activity that we reap from what we eat and drink.

  • Broccoli stems, which most people discard, have 2.5 times the anti-angiogenic power of broccoli florets. You can put them in soup, or take my client Dennis’ tip and use them, thinly sliced, as ‘dippers’ for hommous!
  • ‘Dunking’ your teabag instead of letting it just sit in your cup, increases the amount of antiangiogenic compounds in your tea.
  • Simmering tomatoes increases their trans-lycopene (a powerful angiogenesis inhibitor) activity by 50% after 2 minutes, and by 250% after 30 minutes.
  • The Rubygem strawberry cultivated in Queensland has the highest anti-angiogenic activity of all strawberries.
  • Whole wheat has almost double the anti-angiogenic activity of white.
  • Carrot greens have 2.5 times the anti-angiogenesis power of the actual carrot, so buy Dutch carrots and eat them greens and all!

Now can you see why I was so excited about Dr Li’s presentation? Understanding the effects of abnormal angiogenesis, and how to control it through simple dietary choices, gives us enormous power to take charge of our health destiny rather than buy into the popular notion that we are doomed to succumb to ‘age-related’ diseases such as cancer, heart disease, arthritis, dementia and macular degeneration.


Why Plant-Based Nutrition?


By vegan naturopath Robyn Chuter.

Dr Scott Stoll is one of the driving forces of the International Plant-Based Nutrition Healthcare Conference. He and his 2 co-founders, Tom Dunnam and Susan Benigas, hold a grand vision; one that, in fact, was first put into words at the beginning of the 20th century by the brilliant inventor Thomas Edison:

“The doctor of the future will give no medicine but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease.”

Judging by the passion and energy with which Dr Stoll and his colleagues are approaching this gargantuan task, “the future” may come sooner than many of us have feared. Let’s hope so!

Dr Stoll’s presentation at the PBNHC followed directly on Professor T. Colin Campbell’s, which I reported on in last week’s blog, and it elegantly illustrated one of the 6 key principles of nutrition that Campbell outlined:

The nutritional effects of a whole food, plant-based diet (WFPBD) are broad and rapid.

The topic Dr Stoll chose to focus on was vasculopathy – disorders of blood vessels, in all their many forms. You simply can’t understand blood vessel disorders without comprehending the structure and functions of endothelial cells. Endothelial cells, or ECs, are the cells that line our blood vessels. If you laid them end-to-end, they would circle the Earth twice, and laid side-by-side they cover the surface area of 6 tennis courts.

Their major function is to produce the gas nitric oxide, which acts like Teflon on a non-stick pan – it keeps all the components of the blood flowing freely, instead of adhering to the blood vessel wall. When ECs are not functioning correctly, the blood vessel wall becomes more like Velcro, causing blood components to stick to it, and initiating an atherosclerotic plaque.

As Dr Stoll pointed out, the consequences of EC dysfunction are many and varied, and the different names given to all these conditions obscure the common origin that they spring from. For example, EC dysfunction causes:

  • Chronic low back pain. 77% of patients with severe long-term nonspecific low back pain were found to have lumbar and/or middle sacral arteries that were occluded by atherosclerotic plaque (the end result of EC dysfunction).
  • Rotator cuff injury. Almost all sufferers of this painful and frustrating shoulder condition were found to have atherosclerosis in the arteries supplying the bones, tendons and muscles of the shoulder girdle.
  • Erectile dysfunction. Two-thirds of men with clinically significant coronary artery disease also have ED, but the signs and symptoms of ED typically appear 2-3 years before any symptoms of coronary artery disease show up. That’s why urologists are now referring to ED as ‘the canary in the coal mine’.
  • Peripheral vasculopathy. Many sufferers of this condition have a genetic polymorphism called Glu298Asp, which affects the activity of the enzyme that ECs use to synthesises nitric oxide.
  • Diabetic neuropathy. This painful condition, which costs up to US$20 000 per year to manage, is caused by damage to nerves that’s driven largely by EC dysfunction.
  • Alzheimer’s disease. While amyloid plaques have long been the focus of Alzheimer’s research, Dr Stoll described how the ‘2 hit hypothesis’ has largely taken over: Alzheimer’s begins with artery damage, caused by EC dysfunction, and then amyloid beta deposits occur at the site of injury.

So what can we do to prevent or reverse the conditions caused by EC dysfunction? Stop injuring our arteries with:

  • Animal products (which contain EC-damaging saturated and trans fats, advanced glycation end-products [AGEs], and a host of chemical toxins that bioaccumulate up the food chain);
  • Refined carbohydrates and vegetable oils (which induce oxidative stress);
  • Salt (which causes EC damage and arterial stiffness even if it doesn’t raise blood pressure), and of course
  • Cigarette smoking and exposure to secondhand smoke, one of the most potent agents of EC damage yet discovered.

In place of all that toxic food, we should fill our plates with EC-nurturing green leafy vegetables (more on that when I summarise Dr Caldwell Esselstyn’s presentation in a couple of weeks) and other colourful vegetables, fruits, whole grains, legumes, and small amounts of nuts and seeds – especially omega 3-rich seeds such as flax, chia and hemp.

How long does it take to work? In the case of diabetic neuropathy, pain relief can occur in as little as a couple of days – even in diabetics who have been heavily medicated and in terrible pain for years! Switching to a plant-based diet restores endothelial function in the penile artery so rapidly that erectile function can be restored in just weeks. The rewards of going plant-based appear much more rapidly and reliably than any benefits gained from medications… and the only ‘side-effects’ are positive ones such as weight loss, increased energy, more attractive skin, lower cholesterol and blood pressure.