Category Archives: Lifestyle

Evolution of Reading

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Most of you are incapable of reading this post attentively from start to finish. In fact, you will probably just skim the first paragraph, then quickly scroll down, your eyes will skip to the text in bold for a fraction of a second, then you will hover of the picture, and then, convincing yourself that you got the general gist, you will speed off to click on the next tab on your screen.

photoYep, this is the stunning conclusion that Nicholas Carr comes to in his book ‘The Shallows: What the Internet is Doing to Our Brains’. One damning fact at a time he builds a case proving that the Internet is not just a mindless database of knowledge, passively waiting to be accessed and researched. It is an active medium which has the ability to change the very way we think, structure our ideas, the way we learn and the way we communicate.

Hang on, you say. Isn’t that taking this whole ancestral thing a little too far? Am I firmly on the path of giving up on smartphone and flush toilets to live in a hippie paleo commune on a Pacific island, farm coconuts and wipe with a leaf? (in the words of the timeless King Julien: ‘Who wipes??’). Bear with me for a little while.

I used to be an avid reader. I discovered books at a tender age of 3 and started reading ferociously. My mother used to joke that I swallowed books whole and it was not that far from the truth. Written (or rather printed) word had such power of me that when I did not have a fresh fiction text I would read an encyclopaedia. Fiction had the ability to keep me enthralled to the point of danger. I distinctly remember the night when I was supposed to “watch over the stove” while my mother went to see our neighbour. The 8 year old me was engrossed in “Jane Eyre” and only vaguely registered my Mum’s screams at the room full of smoke and the stove on fire on her return. I was in another world, oblivious.

My eyesight started failing early. Blaming my reading obsession, my parents waged war on books, sneaking up on me in the middle of the night (and taking away the torch from underneath my pillow), locking the crime book cupboards when I needed to study, even checking my school bag in the morning for stealthy novels between textbooks.

I continued to read books when I came to Australia but the love somewhat lessened. The language barrier made it more exhausting initially, then I didn’t really know any good authors, and then I needed to work and study. Fiction reading became a rare indulgence. Non-fiction reading was a necessary chore.

In my first degree I owned a little laptop which I used purely for document editing purposes. My knowledge base was still acquired from a printed text. The massive (and expensive) tomes on microbiology, biochemistry, anatomy and physiology were covered in multi-coloured bookmarks with text underlined in pencil. (Yes, in case you haven’t figured it out, I am a nerd). I memorised anatomy structures by drawing them with pencils (multi-coloured, of course) and writing sheets and sheets of text next to the diagrams. I still remember what a writer’s cramp feels like although I haven’t had it for years.

My computer use stepped up a level in medical school. Buying textbooks for a huge variety of subjects was not feasible plus the underground student online book share was supplying me well. I struggled initially reading textbooks online. My eyes would get tired quicker, attention waver at the slightest provocation, I missed my coloured pencils and bookmarks, I missed being able to curl up on the couch with a cup of tea.

At least this last problem was resolved when I got an iPad. Man, I love(d) this thing. My own personal window to everywhere. Not a bulky laptop with a charger, 5 minutes wind up time and somewhat disturbing warmth radiating to my groin. Coupled with a snazzy blood-red cover, this thing was the shiz.

Word processing to emails, to world wide web, to online learning, to blogging, to social media – I am amazed at how quickly my reading and Internet habits changed. I have found the world of Ancestral Health, although the search was initially triggered by a book (Gary Taubes ‘Good Calories Bad Calories’), this world would be unknown to me if it was not for blogs and social media. I have so much to be grateful for: meeting like minds like Dallas and Melissa, and being able to take our combined knowledge to the people in my part of the world. Heck, I would have never met this awesome guy if it wasn’t for the Internet.

However, recently I have been noticing some things that started to concern me. Far from being engrossed by books, I have become inattentive and distractable. Instead of looking forward to a blissful escape, picking up an old-fashioned printed book seems a chore to my concentration. When I click on a new promising link posted by someone on Twitter I skim it quickly. If scrolling down reveals a huge document I get inwardly annoyed. Frequently I get caught in the comments to the blog post, rather than the blog post itself, clicking on more links and letting my opened tabs multiply. My reading in general has become less reflective and more reactive. My interaction with those “like minds” has reduced to 140 character snippets, not the long intellectual discussions.

As for research, it’s getting harder and harder. One search on Pubmed opens you to a spiderweb of articles. One wrong turn, one wrong click – and you are caught in a labyrinth. My innate curiosity encouraged by an easy availability of information leads me away to the point where I forget what it is that I was looking for in the first place. The sheer volume of information is overwhelming. Every study on the benefits of fibre is counteracted by the study deeming it useless. If I feel lost and confused at times, what of the people who rely on popular media for their health advice?

And there is the interwebz conflicts. You never have as many opponents in your real life as you will have on the Internet. When every snippet is available for judgement, when people do not know you as a person, when your printed word is not accompanied by your tone or body language, it is all too easy to wilfully/accidentally misinterpret and cast your vote. I watch the deterioration of a healthy discussion on Facebook into crazytown bitchfest and want to go away to that Pacific island. The reality is, you wouldn’t say half of this to a person to their face, but the ability to instantly type up a knee-jerk reaction in a witty response is hard to pass.

My escape plan

My escape plan

‘The Shallows’ could not have come at a better time for me. Exhausted from meaningless internet jibes, wary of loss of own concentration and feeling the lack of intellectual stimulation, I wanted to understand what was happening. I don’t blame the Internet (neither does the author). I merely concede that to sharpen the signal I need to reduce the noise. I already keep my Twitter account private but I think it is time to take a holiday altogether. I would like to close the comments on this blog. Not because I don’t value my readers or their opinions – far from it. But I would like to concentrate my time and energy on the work that requires a 100% of me. For those who would like to stay in contact – feel free to email me. Those whose opinions I value and cherish (you know who you are) I want to stay more connected, I want to give our interaction more than just a cursory glance on my phone screen. Let’s chat, let’s exchange papers, let’s Skype. Let’s use this powerful force to what it can be – bringing minds and passions together. I am done with wasting time on anything less than that.

The weight loss conundrum

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Disclaimer: this post expresses my personal opinions. Fancy that. On my personal blog too. And guess what, this opinion may even be different to yours. You can let me know if you agree or disagree with the views expressed here. You might even go as far as to tell me that I am wrong. I may or may not care about that. Enjoy reading.

Phew. Now that we got that out of the way let’s talk weight loss. Everyone on the internet knows that the best way to get traffic is to tag your pearls of wisdom  “weight loss tips” and “Jessica Biel’s diet secrets”. I have neither. Sorry. But this post was mostly brought on by the frustration that the topic of losing body mass is still a priority not just in conventional women’s magazines but in ancestral health community.

You know the one: “Yes, I’ve given up grains because Robb Wolf told me to, I don’t eat refined carbs after reading Gary Taubes, I stopped sugar after watching that Lustig’s video and I force down a tablespoon of fermented cod liver oil since attending Weston A.Price conference. I feel great but… How do I lose another 10kgs?”

And of course there is no shortage of available experts on the interwebz:
- eat less carbs
- eat more safe starches
- introduce interval training
- stop HIIT to salvage your burned out adrenals
- eat sauerkraut for healthy gut
- calories don’t matter
- calories matter
- start IF
- use FitDay to track your daily intake
et cetera.

It’s all very sad.

In the meantime the average long term success of most weight loss strategies is around 1%. Yeah, sure, most people do it wrong. They choose the wrong diet (Lemon Detox, anyone?), they choose the worst possible exercise (if you are a female with a cup size C and above, for god’s sake stop running). And they just don’t have the willpower that the new dieter has (sarcasm font). Because the new dieter knows that he/she will be different. I will be in that 1% who does it right and stays skinny ever after. The End.

There are numerous reasons why weight loss strategies fail. And there are numerous reasons why they succeed. Temporarily. You can lose weight in literally thousands of different ways: Paleo, low fat, low carb, low calorie, ketogenic, vegetarian, aerobic exercise, HIIT, IF, bariatric surgery, liposuction…

That’s why the to and fro arguments on which approach is better for weight loss is kinda pointless. YES! YOU CAN LOSE WEIGHT EATING MARS BARS AND DRINKING COKE! (feel free to leave this page at this point and celebrate).

We have this love and hate relationship with a number that determines our body mass. Lily Allen famously said: “And everything’s cool as long as I’m getting thinner”. There is another number that we have become very preoccupied with in the last few decades: serum cholesterol. Chasing that number (down) is the name of the game, mostly by pharmacological means. Of course, you could tilt this snow globe upside down and decide that the number per se is not very meaningful and in fact represents some other pathological process in the body. Ideally you would choose an intervention that both addresses the cause of the problem and pushes that number in the direction you want. A nutrient-rich diet free of processed junk and pro-inflammatory toxins accompanied by reasonable physical activity is likely to address the chronic inflammatory state that leads to dyslipidaemia and therefore drop the dreaded cholesterol numbers down and please your conscientious doctor.

But sometimes it doesn’t get you to the magic 5.5 mmols that your doctor wants to see. Just like your 6 month foray into the Paleo diet fails to get you to that elusive number that determines your weight, size and consequently happiness. Time to go on PaleoHacks and shout for help.

I am not having a go at the desire to be slimmer. Sure, I wouldn’t mind losing a few kgs. I also wouldn’t mind losing my freckles or having bigger hands (it sucks trying to find surgical gloves that fit). Neither affects my sense of self worth.

So for what it’s worth, these are my ideas in relation to weight loss (note, doesn’t say FOR weight loss):

I am overweight? Oh thank you, kind sir, I wish I knew this earlier! Let me just switch to a healthy diet and start running.

1. If your primary focus is weight loss you are already behind the eighth ball. If being skinny was a powerful motivator we wouldn’t have 2/3rds of Western world overweight or obese. Wanting to lose weight tends to screw with people’s heads even with the best foundation: they start stressing (excess cortisol=bad), they start reducing/counting/starving/hating their bland food/exercising at 5am and generally stop listening to the bodies.

Things are quite different when you eat to nourish every cell in your body. Shift your focus to wellness and flip the switch.

1a Unless you have congestive heart failure or chronic kidney disease, chuck your scales. Like now. Get up and throw them in the bin.

2. Start with having a nutrient-rich diet and get rid of junk. Use whatever framework takes your fancy: Paleo, primal, perfect health diet, whole30, Mediterranean, vegetarian (gasp! ). Minimize the “healthy” versions of unhealthy food, you don’t want any food holding you emotionally hostage.

Until you have that down pat, forget the words “Do you have these pants in a smaller size?”

3. Find a regular consistent physical activity you enjoy. I know exercise is supposed to be about torture. That’s ok if you enjoy torture, no judgement here. Do something you can see yourself doing regularly in a year. Or five.

3a. Do not ramp up the volume/intensity of the said activity to accelerate weight loss beyond the level you see yourself comfortably doing long term. Did I hear you say “bootcamp”? Pfft.

4. You cannot fix self esteem issues with weight loss. The two have very little to do with each other.

4a. In the same vein, having weight loss as a dangling carrot in the future can derail your enjoyment of today. Don’t put off activities, clothes or happiness until you get thinner. See point 1.

5. It seems that the thoughts of weight loss frequently return when people are still longing for a six pack in spite of measurable improvements in their physical and mental health. This is where we hit a little snag.

Let’s say you start off in the obese category. Up to a certain point weight loss and health gains go together. Then you reach a state where your body is happy, healthy and well-nourished. To lose more subcutaneous fat from this point will not gain any further health benefit. In fact, you may dip down into negative territory. If you are body builder, dancer, gymnast or any athlete dependent on low body mass this is the risk you have to take. If you are a suburban mother of 2, disappointed she doesn’t look like her graduation photo any longer, you may be playing a dangerous game. If you still choose to continue down this path that’s cool. Your choice. It’s way harder to shift the happy-healthy weight so you may have to pull out all stops. Some of those deviate even further from the path to long term health and wellness. Obviously if you are naturally lean and small you have to flip this scenario 180 degrees. Getting massive past the point of diminishing returns may not be optimal for your body either.

When I see an obese patient I do not have an overwhelming desire to help them lose fat. To me their weight is nothing more but an external manifestation of serious internal issues.  I worry about their risk of heart disease, diabetes, Alzheimer’s and autoimmune conditions. I feel the same level of concerns for the skinny-fat: normal BMI with little muscle and obvious visceral adiposity.

Incredibly sexist and quite offensive to naturally thin women. However we don’t think twice when the ads are turned the other way around.

For a health-conscious and somewhat rebellious community we are still remarkably superficial and eager to conform to the current body image stereotype.

Minimalist shoe review and Sunday primal living

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Sunday posts are not supposed to be sciency right? Having a weekend off is a luxury and I like to treat it as such. Hence I decided to be a lazy tart and sleep in till 7.30am. A vat of coffee, a quick social media catch up and I was out the door to test my new Lucy VivoBarefoots.

I abhor the term “barefoot technology” because it sounds just a gimmicky as ShakeIt weights but I do agree with a concept that walking on 3 cm of very expensive rubber, otherwise known as “conventional sneaker”, is utter nonsense.

VivoBarefoot EvoII in their better days

I never got into Vibrams (I don’t like the idea of rubber between my toes or people jeering in glee as they point to my feet) but I own a pretty nice pair of VivoBarefoot EvoII which I wear to the gym or operating theatres. Which is pretty much the same thing. Their only problem is that they are damn slippery when you leave the safety of the indoor environment, especially if you like jumping on rocks. So to avoid ending up in my own emergency department I normally wear Sketchers. Yeah yeah, I know, don’t judge me.

I really didn’t want slippery soles here

My usual long walk is around 2.5 hrs which takes me down the coast and back, and has a good mix of beach walking, rock hopping, trekking up and down the hills between coves and a few steep sections through the rainforest. The sole of the Lucy is supposed to be ultra thin (3mm) and puncture resistant but it doesn’t feel quite as paper thin as the EvoII, which together with a pretty thick top covering adds to the sturdier feel. The first climb up the rocks went without a slip up but I did slide down a steep path on gravel a couple of times, gracefully landing on my buttocks, although I don’t know whether it was the shoe or my slightly tired quads. The harder top lining started to put a little pressure on my Achilles tendon after 2 hrs but wearing socks helped. The toe cage is wide enough for my narrow foot but if yours is on the wide side you may find it a little constricting.

Terra Plana sizing tends to run small. I normally wear 38 but ordered 39 in these and they were perfect with a sock. Interestingly, I also ordered VivoBarefoot Mary-Janes and they were a bit big in the same size.

Overall, a good walking shoe which feels more like a conventional shoe although does provide the benefit of good proprioception and a light feel.

The rules of the game: get to the other side without touching the sand. GO!

As always, my weekend walk provides me with a few excitements (I am a simple creature and get excited easily). A huge 1.5m goanna decided to leisurely cross my path causing a temporary bladder spasm and a jerky and too-slow reach for the camera. Gotta love Australia.

A young bright gen-Y sitting on a rock overlooking the ocean spreading Nutella on several pieces of white toast. I kid you not.

The usual quick eyes-on-the-sand dash through the nudist beach was again unsuccessful. The happy-in-his-bare-glory gentleman spotted me and jumped out of the bushes to take a lazy stroll towards me. Exhibitionism ain’t nudism.

Fun times.

As I finish off this post I notice that Victoria Prince has also recently written about her hiking adventures. Which makes me think that we have either all run out of science to talk about (unlikely), we are sick and tired of banging our heads against the wall (quite possible) or we are just moving past the obsessive food-will-cure-all-ails mentality. While it indeed starts with food, there is more to health and wellbeing than what you put in your gob.

Also a topic of our recent presentation at Whole9 seminar in Boston, non-nutrition lifestyle factors are starting to become a more prominent feature in this community. Thank heavens for that. At one stage it looked like we were turning into indoor nerds glued to our computers, obsessively arguing over minute details of the latest Pubmed offering, occasionally emerging from the social media dramas to bash our bodies in the variety of HIIT smashfit pursuits. Whaaat? Somebody still doing that? Crazy folks.

 

Rainforest stair sprints. Or walks.

Anyway, the majority of my activities nowadays are slow intensity performed in a glycogen-depleted state (and when Jamie finally writes up his AHS presentation I will have something to reference!). I try to go for 20-30min walk most days before work, fuelled by caffeine and nothing else; do yoga and strength training once or twice a week. Going for longer and more challenging walks on the weekend fits right into this schedule. So that’s my Slow Movement covered.

 

My shadow is not taller than me = vitamin D production

Sun exposure is another area I consider a powerful factor in overall wellbeing. Vitamin D is certainly the shiz nowadays but let’s not forget about other benefits of sun exposure: mood enhancing qualities, pain relief, better sleep, eye and skin health.

And finally, there’s something about the expansive vistas, the sound of the ocean and the smell of the rainforest that we, as humans, have long felt a connection with. We have seen a few studies emerge showing the benefit of being close to nature (Mark Sisson has written a good overview about it. What hasn’t this man written about???). But I like to look at this from another point of view. It’s not that being close to nature is better for us, it’s just our indoor artificially-lit air-conditioned existence is so very bad. Going back to nature is…well, natural. It’s another one of these instances when feeling “low level crap” has become the norm.

 

Well-deserved: scrambled eggs with lox, avocado, duck pate and local vintage cheddar

Hope you can find some restorative activity, sunlight, fresh air, awe-inspiring views and simple pleasures in your Sunday.

As if you need another AHS wrap up post…

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There have been a few wrap up posts on AHS already, some complimentary, some provocative. I will try to add my bit which will be purely my opinion on the event I have been looking forward to since last year and my impressions of it.

For those who are in the dark about what I am on about (gasp!) here is a good “AHS for dummies” round up. Also Beth has put together quite a list of AHS wrap ups for all your evolutionary medicine science and gossip needs.

Boston Gardens

To start with, I went this year in a purely observatory capacity. If you wondering why anyone would endure 24 hr flying time plus layover in 3 cities, here is my main reason. Evolutionary medicine in Australia is still for weird hippies and charlatans, not for Sydney University-trained doctors. Being in a group of passionate people, some including distinguished scientists, medical professionals and clinicians, was gratifying and encouraging.

*And before I get accused of ignoring minorities and lay folk: I see AHS as a primarily academic event designed to open the doors to new hypotheses, share scientific research and help move evolutionary medicine into mainstream consciousness. I think PaleoFX and its organisers, Keith and Michelle Norris, filled the niche of taking theory to practice very efficiently, and if I can ever afford 2 trips to the US a year (poor medical resident here) I would not hesitate to go. I think it’s fantastic that AHS is open to the lay public (let’s face it, the discerning Paleo “lay public” keep everyone on their toes) but I wouldn’t want for the conference to lose its academic edge. And if I ever want a Paleo group hug I will go to a Paleo meet up.*

Recalling my inability to sit through University lectures, I knew I couldn’t attend every talk so I tried to hedge my bets and pick from the program. Some I got right, some I didn’t. A few times, I opted to hear the “big names” only to miss out on a fascinating talk from a less known figure in the other room. I have already marked the ones I would like to download to watch on video.

The dairy debate continued in the ice-cream parlour

Rating on some memorable talks I saw in no particular order:

1. Dan Lieberman on evolutionary principles. A great talk to open up the symposium and a must-see for anyone as an Evolution 101 refresher. It set a nice tone to the event, steering it away from the romanticised hunter-gatherer image.

2. Dr Peter Attia gave an awesome lecture on cholesterol. This was probably the most sciency talk of the whole seminar and in my opinion the best. I wish I had a lecture like this in medical school! I will definitely re-watch this one on video, this time taking thorough notes. Highly recommend regardless of your knowledge level, you will learn something anyway.

3. Jamie Scott spoke about using evolutionary principles for endurance training. He effectively melted a few brains by stating a strong case for low intensity work performed in glycogen-depleted state. For the crowd largely indoctrinated enthusiastically involved in Crossfit it was a hard sell but I think he got a few converts.

4.  Dr O’Keefe on the effects of prolonged endurance exercise on cardiovascular system. He described exercise-induced cardiomyopathy in ultra-endurance athletes. As a runner himself, his position was a little biased toward running and in my view his recommended dosages (45-60 min 5 times a week) were still too high. Also he didn’t mention the significant degenerative joint effects and chronic inflammation on the body. Overall, the talk was very interesting and definitely something that running-obsessed Americans need to see (OMG, do you, people, do anything else other than run???)

5. Chris Kresser on iron overload. Chris gave a good view of haemachromatosis, its diagnosis, manifestations and treatment. Most of this material had been extensively covered in my medical school lectures (yes, believe it or not, they DO teach us something). I would have liked to hear a theory on the evolutionary explanation of haemachromatosis and Seth Roberts, I think, asked Chris that question but I didn’t gleam much from the response. Worth watching if you think that Paleo is a free pass to eat meat like it’s going out of fashion.

6. J. Stanton on hunger. JS presented very convincing evidence that hunger is a normal physiological response to the lack of nutrients to the cells (who would’ve thunk it, huh?) rather than a massive character flaw possessed universally by the fatties. It was a great complement to his series of posts on hunger (which are excellent to read). JS is, ahem, an unusual personality with a brainpower that makes the rest of us feel like schoolchildren. He was openly critical of the food reward theory during his presentation, however, when we all went out for dinner that night, he was extremely gracious and kept saying that he felt very honoured that people like Stephan (Guyenet) attended his talk. You can read Stephan’s review of this talk here.

7. Dr Terry Wahls gave an inspiring talk about managing own multiple sclerosis with MS. However, I was already familiar with her very excellent TED talk (which you should definitely see if you have been under a rock somewhere) and not sure I got much more out of this presentation.

8. Robb Wolf‘s talk about implementing Paleo diet principles at Reno municipality is inspiring to watch especially if you are interested in public policy and how to bridge the gap between a Paleo community, often seen as alternative and (let’s face it) weird, and real world. Big picture stuff.

9. Dr Emily Deans have a presentation on food and mental health. She gave a good overview of how fructose and trans fats affect us not only metabolically but also psychologically. It was fascinating to see the diametrically opposed views on sugar and mental health: does it make you happy or not?

10. Dr Andreas Eenfeld was a surprise to me. Even though he presented on carbohydrate controversy (yawn) he managed to make it entertaining (yes, really) and light-hearted. I thoroughly enjoyed it.

Watching squirrels was somewhat more entertaining than a safe starch debate

By the way, I think the whole audience was tweeting. It was absolutely surreal to listen to one talk and read tweets from the next room with people raving about the speaker I was missing.

Talks I cannot wait to see on video:

1. Peter Gray on the role play in the development of social and emotional competence. Here is a great example of his work and if I knew he was in the next room I would have dumped Stephan Guyenet in a heartbeat (sorry!)
2. Ubuntu: a paleolithic perspective on human community and health by Frank Foresich
3. Oxidative stress and CHO intolerance by Chris Masterjohn
4. Paleo nutrition and the brain by David Pendergrass.

Overall impression:
It was disappointing to see a few negative posts from attendees, in particular some who felt not included due to their age, appearance, weight, or some other factor. I was not aware of any such tension during the conference, except to note that people were quite naturally gravitating towards their friends and acquaintances, and of course “Paleo celebrities”. I find this community remarkably inclusive but then I am not an idealist and generally do not expect much of people. I certainly would never anticipate Robb Wolf to come up to me and strike up a conversation. Being quite introverted, I spoke to people who approached me or were introduced by others, and relaxed in the courtyard when the crowds got too much.

I would love to come back next year and reconnect with some new and old friends.

A few thanks:
To Ann and Dave Wendell – for making the most of the Aussie-Kiwi rivalry and teasing the hell out of us.
To Victoria Prince – for feeding us home cooked meals, taking us berry picking and showing us the green and luscious part of New Jersey
To J Stanton – for challenging our brain cells and being a very exciting dinner guest
To Jude – for her Aussie accent, sense of humour and constant and inappropriate swearing
To Melissa and Dallas Hartwig – for great conversations, amazing (very well organised!) meals, unwavering support and a hefty dose of inspiration

Many more Twitter names came alive (hey, these people do actually exist) and I fear I’ll miss someone if I start naming them but I enjoyed meeting all of you.

See you all next year.

Musings on a 40 hour week

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Curled up on the couch with a massive cup of coffee, I am wrapping up one of the most horrific weeks since starting work. Having to deal with between 30 and 40 newly admitted patients daily, my pager going off every 5 minutes (god, I hate that sound), I’m on call tonight (please please please do not call me to rechart meds at 2am) and not having seen sunlight since last weekend makes me count the days (14…) till my trip to the US to AHS12.

The tension in the hospital is almost palpable by the end of the week. The conversations are shorter, comments are snarkier and the only smiles you see is when there is the obligatory Friday junk food fest is involved. Somebody is leaving floor 1 for floor 2 so we all have to subject our bodies to a sugar coma to honour this momentous occasion. Maybe this will help us survive the end of the week without killing someone. By the way, in medicine this is not a metaphor.

Child laborers in a coal mine. Source: The History Place photograph of American child labourer from 1908-1912 by Lewis Hine

Let’s talk working hours. I want to know what genius came up with a 40hr working week.  I am not that strong in history but I grew up in the Soviet Russia and the 8 hr day was celebrated a source of pride and a supreme achievement by unions and blue collar workers. The Industrial Revolution of the 18th century had a lot to answer for with explosion of factory-based manufacturing and resulting insane working hours. The British Factory Act of 1833 went soft and regulated child labour, limiting the work day of 14-18 year olds to 12hrs and 9-13 yo to 8 hrs. They were so concerned with kids’ education that they told under 9s to stay at school. In comparison to those conditions my working week seems like a walk in the park. Our civilised society is way more civilised nowadays and we should be grateful, right?

Well, actually, who says that a 40hr week is evolutionary appropriate at all? In 1966 an anthropologist by the name of Marshall Sahlins wrote “Notes on the Original Affluent Society” in which he described the lifestyle of modern and ancient hunter-gatherers, estimating their work day to be between 3-5 hrs to the total of 14-20hr working week. Closer to home, Jamie Scott wrote a nice report on the lifestyle of Vanuatu and he also mentioned that the villagers there seemed to have a lot more leisure and play time.

Now I am far from an expert on anthropology and by no means advocate discarding our society, culture and coffee machines to go live in the bush and eat ‘roos or whatever you can catch in your part of the world. But, dayam, a 20hr week sounds way more attractive than a 70 hr limit for hospital doctors recommended by the Australian Medical Association (which is successfully circumvented by hospitals and doctors themselves).

For those interested in an overview of the working conditions of Aussie doctors-in-training (or hospital residents and registrars) read this report on safe working hours from Andrew Lewis, an industrial relations advisor for AMA. Good thing they got a non-doctor to write it. Because doctors are masters at bitching about  their lack of sleep, nutritious food and any resemblance of personal life. However, that whining tends to come with a whiff of hidden pride. The expectations of our seniors (“back in my days we slept in the elevators”), peers and patients make this screwed up lifestyle “a rite of passage.”

Of course, doctors and nurses don’t have a monopoly on insane working conditions. But the media prefers juicy stories of sleepy surgeons armed with a scalpel than  tired cranky lawyers (armed with a Monblanc pen?). The talk inevitably becomes a tad hysterical as it turns to the risk to the community: “jeopardising patients’ safety… Impaired judgement…”  Fair enough, I say. I’d be worried too if I knew that a guy who is about to do a lumbar puncture on my daughter has been working for the last 17hrs. Apparently being awake (not just working, but AWAKE) for 18 hrs is comparable to a blood alcohol level of 0.05. Cool, I can come to work after a bottle of Shiraz and nobody will notice anything different.

Still, forgive me if I am more interested how this lifestyle is affecting my body and my mind. We all know it’s bad but how bad? Can you suck it up for a few years and hope to repair the damage when you have the money to afford holidays in the Pacific and a personal chef? Or is it something that we can mitigate by sleeping in till 8am on the weekend (oh, the luxury!)?

Not a place to be when you are stressed…

Here are some studies that I personally found quite interesting.

1. Acute sleep deprivation resulted in increased hunger and the activation of anterior cingulate gyrus reflected hedonic stimuli in the absence of fasting blood glucose changes. In other words, if you are sleep deprived, those cookies in the jar will call your name with an irresistible siren song.
http://www.ncbi.nlm.nih.gov/pubmed/22259064?dopt=Abstract

2. Adults working more than 40hrs a week were 5 times more likely to have suboptimal glycemic control as measured by HbA1C >= 7% than those who worked 20hrs or under. So if your diabetic or pre-diabetic your working hours alone will make your doctor frown and reach for the script pad.
http://www.ncbi.nlm.nih.gov/pubmed/21246586?dopt=Citation

3. An observational study of nearly 17000 Australian full time workers looked at the relationship between working hours and increased BMI. They found that the relationship between long hours and obesity seemed to be mediated by the lack of sleep. This might make you think that it is possible to mitigate the effects of long hours by just increasing your sleep time however…


http://www.ncbi.nlm.nih.gov/pubmed/20734126?dopt=Citation

4. …a study of Japanese white collar workers found that longer working hours had a negative effect on total sleep hours, sleep efficiency and daytime dysfunction. The effect was noticeable at 50hrs a week and the more hours they worked the worse their sleep quality was rated.


http://www.ncbi.nlm.nih.gov/pubmed/20561174?dopt=Citation

Just a note, the whole patronising “Just sleep more” really tends to push my buttons. It’s a bit like “Just eat less and move more” in its sheer unhelpfulness. Do we really think that those poor buggers who lie in bed for hours struggling to nod off because they like it? You can’t get that deep recovery sleep by willpower alone. Try telling any doctor on call that they should stop tossing and turning and get back to their restorative snooze… with a pager next to their ear.

5. Markers of oxidative stress were increased after a 16hr shift in medical residents and an 8 hr shift non-healthcare workers (so once again, you don’t get a free pass if you are in another field).
http://www.ncbi.nlm.nih.gov/pubmed/20811270?dopt=Citation

6. Psychological stress has been found to cause very real physiological phenomena contributing to many diseases. This excellent review of the role of stress in the gut disorders concluded:
http://www.jpp.krakow.pl/journal/archive/12_11/pdf/591_12_11_article.pdf

From Konturek et al ” Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options”

“1) exposure to stress (especially chronic stress) is a major risk factor in the pathogenesis of different diseases of gastrointestinal tract including gastroesophageal reflux disease (GERD), peptic ulcer, functional dyspepsia, inflammatory bowel disease (IBD), irritable bowel disease (IBS), and other functional disorders of GI tract;

2) the dysregulation of brain-gut-axis plays a central role in the pathogenesis of stress- induced diseases;  

3) Stress increases intestinal permeability, visceral sensitivity, alteration in GI-motility and leads to profound mast cell activation resulting in release of many proinflammatory mediators“

These articles are just a few in a sea of plenty. The scientific evidence is pretty conclusive and pretty overwhelming. Long hours = bad, psychological stress = very bad, lack of sleep = very very bad.

So it’s kind of bewildering that we choose to bury our heads in the sand and carry on with a stiff upper lip. Good luck repairing your leaky gut and undoing the oxidative damage with your superhuman willpower. I’m not suggesting that you should give up your career and go all hippie, greeting sunrise in the nude and weaving loin cloths out of bush plants. Sometimes the acknowledgment that this is not just in your head, but in your gut, your nervous, endocrine, immune and cardiovascular systems, can go a long way.

Imperfect Day

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When people embark on a new venture, like a new nutrition program, they do not expect to fail. Full of vigour and enthusiasm, they feel ready to improve their diet, exercise and lifestyle. But if you ask them how they imagine their new life, almost inevitably you will get a picture of a PERFECT day. The day where they bounced out of bed early to go for workout (or at the very least, an energising walk), had all their meals prepared for the day, felt perfectly satisfied and full after each one, managed their work stress, astonished their work colleagues with own weight loss and vitality, had enough energy to attempt a deadlift PB in the evening, spent quality time with their family, browsed through at least 20 Paleo blogs, meditated, mastered a homemade jerky recipe and had a restoring 8 hour sleep undisturbed by blue light.

Nobody wants to think that one day they will want to throw their alarm clock across the room in the morning. Or that their work pressures will pile up over the course of the day culminating in a massive verbal punch up with a co-worker. Or that they will have a fight with their boyfriend and the thought of a pity party for one, complete with a tub of ice-cream and Lindt chocolate balls (ahem), seems like a perfectly reasonable idea.

Because that would be failure. And it wouldn’t happen. And, anyway, if it did, you would know exactly how to deal with it. Sure, 99.99% of people in your situation, would crumble and lose the plot. But you are different. You are SPECIAL. You have superhuman willpower, steely determination and you totally mean it this time.

Sorry to break it to you, a unique snowflake you are not.

But I was soooo strong…

Reality will bite you on the arse just like everyone else. Human physiology trumps willpower every single time. If you are working shift work, don’t expect to have energy for daily WODs. If you are stressed at work, don’t marvel at your increased appetite, and for God’s sake, don’t hover around a muffin platter. One of you is going to lose, and it ain’t gonna be the muffins.

So my new theory is, prepare for a IMPERFECT day. Think of everything that can go wrong (yes, I know, it’s a bit morbid) and work out a strategy of how you are going to overcome it, minimize it or at least mitigate the damage.

Here are a few of my strategies:

1. Too tired to cook healthy food at night -> Do a massive cook up prep with cut up veggies and pre-cooked meats Melissa Joulwan style on Sundays
2. No motivation to work out -> go for a long walk on uneven terrain, accelerate on a few stairs and recover in the open air
3. Fatigue/stress/frustration building in the afternoon -> take a 5 mins break outside, preferably on the open air, and take 20 deep breaths with your eyes closed
4. Cold/sore throat/cough/fever -> (I can’t believe I have to write this) please do not go to the gym. If energy levels are still ok, go for a short walk. If feeling tired, go home and curl up on the couch. Please.
5. Everything went wrong for you today, personal life in shambles, work has been shit, you want to cry, watch soppy movies and eat chocolate -> cry, watch soppy movies and eat the best goddam chocolate you can lay your hands on.


 

The health of health professionals or How to burn out while doing everything right

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So you may or may not have noticed that I have not been blogging. As it turns out, being a hospital resident is a bit more than just a full time job (the understatement of the century). Besides, being on a busy surgical team played right into my ADHD tendencies: brief ward rounds (“Morning, how is your pain? Have you opened your bowels? Any nausea or vomiting? You are doing great, see you tomorrow morning”) and suddenly anything over 140 characters of writing seems impossibly long.  But now that I am back on the ward and have to ACTUALLY TALK to patients, I am finding my brain starting to slow down from the hectic pace of the last few months.

Something that I have become increasingly acquainted with in the last few months is the health habits and the lifestyle of my esteemed colleagues and other health professionals. And let me tell you health has nothing to do with  it.

Educating people on healthy diet and lifestyle choice is widely considered a panacea for the today’s obesity woes. Those poor Mums buying McCrap for their muffin-topped offspring just don’t know that this is not particularly good for them. Let’s horrify them with the consequences of not eating broccoli and the world will be right again, yes?

The same logic will tell you that healthcare professionals should be the healthiest people on the planet, right? The combination of a higher socio-economic status and specific education in disease prevention should almost guarantee them svelte figures, long life and no chronic disease struggles.

Health professionals KNOW better and they can AFFORD better. Is that the reality?

Here are real-life conversations I have had in the hospital with doctors, nurses, physios, etc. in the last few months:

- I am always tired, every day, I don’t know what’s wrong with me. I don’t even feel like training today. – How often do you train? – (puzzled look) Every day.

- (in a hospital cafeteria) I’ll have a banana bread and a skim extra large latte. No, no butter of course.

- I am doing a double shift today. It’s a shame the cafeteria closes at 6.30pm. I really need a few more coffees to last me to midnight.

- (11pm) Oooh, l just can’t say no to baked treats on a night shift.

- I really need to exercise more. I tried going to the gym after my night shift at 7am but I just can’t make myself do it. I am so naughty.

- I don’t know why I am always so cold. I might ask to have my croissant warmed up.

-I was good yesterday and had a salad for lunch and salmon for dinner. But for some reason I really crave sweets today. I’ll just have this TimTam and then I can always go for a run after work.

- Whose birthday cake is it? I thought Ann was yesterday? Ah, that was Michelle’s. Yum. Did I tell you that I started buying Flora ProActive for my husband because his cholesterol is through the roof? And he still has bacon and eggs for breakfast!

- I always put exercise as my number one priority before sleep. After I finish my night shift at 7am, I have a 2 hour nap and then go to the gym. If I don’t go to the gym I feel lethargic and cranky. Although recently I went to my GP complaining of increased breathlessness. Turns out I am really anaemic.

(This last conversation left me with my jaw dropped to the ground. And probably served as the catalyst to writing this blog post. Thank you, Sarah. )

Get your butt up and go for a run, you lazy sod. (Julia Fullerton-Batten/Getty Images)

Probably a repeat of conversations you hear at any office, workplace, any water cooler and tearoom. What strikes me every day,  apart from the obvious natural fat-phobia (which is nothing new), is the ridiculous amount pressure these people put themselves under.

It is understandable that seeing sick patients riddled with chronic disease makes us determined NOT to end up like them. We are more aware (=more paranoid?). Most health professionals go about it by reducing junk food. Sure, you find lots of “healthy” baked treats on the wards, homemade cakes making a resurgence in light of Masterchef and everyone is suddenly a gourmand. But to be fair, you won’t find many doctors in a line at KFC.

The next thing to be screwed up tight is exercise. And when health professionals get into it, they don’t hold back. Triathlons, marathons, bike rides before dawn, fitness classes at 6am. Exercise has become part of our healthy identity. The number of hours in the gym is the matter of competition, sports injuries are a badge of honour.

I don’t know at what point we have decided that exercise is going to solve our problems? Our lack of sleep, horrific work hours, shift work, mental stress, lack of sunlight, excess stimulants, daily exposure to pathogens, indoor lifestyle and, frequently, disconnect from nature and natural environment. Is exercise a cure-all or is it really a punishment that we impose on ourselves for failure to address other issues?

Hey, let’s face it. Exercise can (and should) be fun: cycling, yoga, surfing, bushwalking, kayaking, weights, rock climbing, having sex. If you need to guilt trip your way into any of those, maybe some other part of the equation is missing.

On the big scale of HEALTH vs DISEASE, where your ideal food intake is on one side and your crappy busy indoor work lifestyle is on the other, where do you think daily exercise is going to go? Will it add to your positive balance and compensate for that last 18 hr shift? Yes? Wrong answer.

Ignoring the pressures of work and lifestyle or hoping to willpower your way through them doesn’t work. Period. Even with the best nutrition strategy (no, a low fat muffin isn’t one of them) and the best intention of maintaining physical activity, you are always playing catch up unless you recognize all other areas of your life that have the ability to derail you.

 

What doesn’t kill us… Thoughts on hormesis.

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Not your average beach

It’s 6AM. The sound of the alarm rudely interrupts my sleep. I reach out and fumble with my phone trying to turn it off. Throwing off the covers I drag myself into the bathroom. The light is too bright and my eyes refuse to open. I blindly turn the shower tap on, take a big breath and jump in… My eyes open wide, shiver runs down the spine, my body shoots upright – the water is freezing cold. I slowly count backwards from 30 while feverishly rubbing myself warm, cursing my mother and my Russian heritage under my breath. After reaching zero, I decide I can stay another 10 breaths. That’s enough. I jump out, dry myself off and look at my reflection in the mirror. The eyes are bright and have a crazy glint in them, the skin looks pink and glowing, stupid grin on my face.

What is this madness???

In Finland the practice of ice-water swimming is called Avantouinti, in Russia its practitioners are named ”morzhi” (“walruses”). The less threatening variation is cold water dousing, an old tradition with roots in asceticism and naturopathic healing, frequently practised with fasting. One of the leaders of the movement in Russia was Porfiry Ivanov, regarded a holy man and a healer to some and heretic to others, born in a small Northern Russian village, not far from where I grew up. Porfiry and his followers believed that if the body can withstand any hardships such as extreme cold and hunger both the body and the spirit will get stronger in the process. “Magical thinking” aside, the idea was not unique to them. The practitioners of ice-water swimming all over the world maintain that exposure to cold improves your immunity and circulation. Footy players use cold baths for recovery, many athletes immerse their tired and injured limbs into icy water. Look up “ice-water swimming” on YouTube or Google and you will find endless shots of scantily clad Norwegians/Finns/Russians/Americans enthusiastically plunging into dark icy waters.

As a little girl in Russia, I watched with fascination as our neighbour, a dainty 40-something lady who worked as a primary school teacher, would go outside in her swimsuit with a bucket of water on a cold winter’s day when average temperatures would plunge to minus 20 Celsius. She stood barefoot on the snow, poured some water over herself then rubbed some snow over her legs, arms and face. Glued to the window, I would follow the 5-minute ritual with a sense of admiration and envy promising myself that one day I will try it.

The [perceived] health benefits of cold water immersion are closely related to the concept of hormesis which originated in toxicology where it described a biphasic dose response. In other words, a substance which a toxic in large doses can be actually beneficial and protective in small doses. In health and medicine it has been defined as “an adaptive response of cells and organisms to a moderate (usually intermittent) stress.”

Many everyday stressors may be described as hormetic: lifting heavy weights once or twice a week stresses your muscles and forces them to adapt to that stimulus by growing bigger and getting stronger.  Increase the stress dose too much and suddenly your muscles go past the tipping point. Instead of the beneficial effect, your hormetic stimulus has turned toxic and your body starts to play catch up in its attempt to recover.

It has been speculated that alcohol might be classified as a hormetic stimulus: a little is good for you, a little more is neutral, a little more still and you are in trouble.  Antioxidants may fall in the same category: a punnet of blueberries stimulates your body’s defense against the free radicals but a concentrated dose taken in a pill form will overwhelm it.

Five minutes in the icy water might be a healthy training stimulus for the immune system which is ready for it.  Ten minutes might be enough to cause a system shutdown in the same person. I don’t like using the word “moderation” because it reeks of food industry hypocrisy giving us permission to eat their junk. But use common sense (yes, I know, common sense doesn’t seem to be very common).

The major benefits to taking a cold shower that I have personally noticed is better cold tolerance. I used to be THAT rugged-up-to-the-nose person at the meeting who always closed the windows and turned the air conditioner off. This has improved dramatically since I started eating primal, and even more so now. Now I’m frequently the only person in the hospital wearing a short sleeve top. Cold shower also does a great job waking me up in the morning, the short surge of adrenaline firing me up before work or exercise.

So how do you get started?

1. Start with a 10-15 seconds of cooler water after a hot shower
2. Do it daily, otherwise you will feel tempted to feel sorry for yourself and look for excuses to avoid it.
3. Gradually reduce the temperature and increase the time under cold water.
4. Do not take too long to “build up to it”. It will NEVER feel comfortable. After 3-4 days of preparation just turn the bloody hot water off!
5. Immerse your head as soon as possible! It carries the greatest effect and makes the rest of the body feel tingly and pleasantly cool.
6. Enjoy the feeling of discomfort. Ok, that just sounded weird. But trust me, you will know what I mean.

Don’t overthink it. If you are searching PubMed for a study on cold water immersion right now, you are overthinking it. Just do it.

How (Not) to Put On Weight During Thanksgiving

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We don’t celebrate Thanksgiving in Australia. We have managed to appropriate most other North American holidays without actually knowing their true meaning (Halloween, anyone?) mainly because we just need another excuse to take a day off and stand around the barbeque with a few drinks discussing world affairs, our bosses and why Demi and Ashton have unfollowed each other on Twitter. For now Thanksgiving is all American. The media and the Internet kindly provide us with a small glimpse into what actually goes on during this festive occasion and a lot of talk happens to be about food. I saw this gem of an article today from Medical News Today, a very respected establishment, offering a few helpful tips on how to avoid being a gluttonous slob over Thanksgiving. I decided to improve on some of their suggestions and now I offer you a guide on

How (Not) to Put On Weight During Thanksgiving.

1. Start stressing out about the celebratory occasion a few days in advance. Try to guess what kind of food will be on the table and estimate the total amount of calories, fat and carbs. Don’t sleep the night before tossing and turning while calculating your calorie budget for the next day.

***

2. Start denying yourself food a week prior to the occasion. Every calorie that does not go into your mouth will accumulate in a magical space that you can call on at Thanksgiving dinner.

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3. Alternatively,  make a day before your carb loading day. Surely if you overfill your glycogen stores and calm your nervous system with extra sugar you will have more willpower to walk past the crusty bread platter without collapsing into a heap.

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4. Do go out and exercise in the morning. Preferably do something mind-numbingly repetitive for a couple of hours like a Stairmaster in the gym. Face the wall so that you are forced to watch the screen counting the calories spent. Realising how bloody long it takes to burn each  calorie will make you think twice about shoving more food down your gob.

***

4a Such exercise will have an additional benefit of assisting with your hunger control. Everyone knows that doing long bouts of cardio is a marvelous way to stay sated.

***

5.  Have a breakfast of champions: a bowl of wholegrain cereal full of fibre to make you fill so bloated that you can’t even look at the turkey without letting out a sneaky one. Don’t have a single ounce of fat with your breakfast: your arteries will be swimming with saturated fat in a few hours time. Let’s try to avoid a heart attack at a family party.

Don’t forget your orange juice: freshly squeezed, of course. Do you see those orange bits floating in your glass? That’s more fibre, it will lower the GI of your juice from 250 to a respectable 79 and help you maintain even blood sugar levels for the rest of the day.

***

6. Talking about blood sugar. You will quickly realise after your breakfast that you are ravenously hungry. That’s good. Keep topping up your blood sugar level  every 2-3 hours with such wholesome snacks as bagels with low fat cream cheese, tiny tubs of no fat soy yoghurt with fake chocolate flavour and a few multi-grain cereal bars.

***

7. If you have time just before dinner go for a quick run around the block. Last chance workout!

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8. If you are a guy wear a pair of pants size smaller. Ladies, pull that ridiculously tight, preferably pastel-toned dress out of the back of your wardrobe. Your clothing will serve two purposes: first, being so tight it will make it impossible for you to sit down comfortably at the table without looking like you are about to be cut in half. You will be relegated to standing in the kitchen and eating low calorie finger food. Nothing like spending your Thanksgiving dinner munching on carrot sticks and low-fat low-salt low-calorie cardboard crackers.

Secondly, you will be so mortified about every lump and bump spilling out of your neckline, your sleeves and between the buttons it will be shameful to eat at all. Now is the time to punish yourself severely for all the indiscretions since the last Thanksgiving.

***

9. If you do decide to partake of the gluttonous orgy that is the Thanksgiving dinner eat only the bland and unappetising dishes. Ask the hostess to provide a glass of water, a 100g of steamed unsalted piece of salmon and some salad with low fat dressing on the side. If the hostess is your mother, do not forget to remind her that you have to eat this way because of all the dietary mistakes she made when you were a child.

***

10. Finally, if you find yourself ravenous, cranky and slightly dizzy by the time dessert comes around, don’t worry and give yourself permission to have a piece of each dessert (in moderation, of course. Don’t be stupid and go back for third helpings!).  You only live once. This is a once-a-year family occasion. After all, you can always repair the damage by running a half marathon tomorrow.

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Good luck! You are going to need it!

New Zealand and Paleo friends

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My week away from blogging was not spent in idleness. I spent 8 days in New Zealand, this trip was very productive from the point of view of Paleo, connections and more food for thought for my blog.

New Zealand is a gorgeous country. You get a sense that you are in for something special when you see the majestic mountain ranges sloping into the green water out of the airplane window. Together with Australia it’s one of the few Western countries where you can still drive past cows peacefully grazing on grass of the greenest colour imaginable.

iPhone photos do not do it justice

Visiting Christchurch for the first time was a powerful experience for me. It’s a quaint little city (by Sydney standards) still bearing visible scars of the earthquakes which changed the lives of its inhabitants. The walls of beautiful old churches, like the shadows of former life, standing in the midst of piles of bricks behind safety gates. Giant cracks in the middle of city streets partially filled up with concrete. Big signs urging caution on typical office buildings. Huge shipping containers stacked on top of one another at the bottom of the cliff on the side of a busy road protecting from boulders falling from above. All reminding us that we are all at the mercy of the force more powerful than we can imagine. And no, I’m not religious.

Like many other people around the world, I had wondered why do the people stay? 7000 aftershocks later, why would you not pack up your life and start over somewhere else? Where you wouldn’t have to worry about getting a restaurant table under a chandelier?

Maybe because it’s so utterly beautiful. A place where you can go out on a bike ride along the water edge, climb a steep hill to the coffee place up the top and descent to the luscious valley below. Nice. You can Paleo the hell out of this place.

And they seem to be getting on with their life just fine. Good on them, Kiwis. After flogging the Aussies (and the French, and everyone else) at the Rugby World Cup they have even more reasons for some well-deserved NZ pride. Respect.

I didn’t just travel across the ditch to admire the views. One of the goals of the trip was some Paleo networking, catching up with two of the heavyweights of the Antipodean Paleo community: Jamie Scott, a.k.a. That Paleo Guy, and Julianne Taylor from Paleo & Zone Nutrition Blog.

I cannot express what a relief it is to talk to people who understand you, who read the same studies, who get just as frustrated at the limitations of the conventional diet, health and exercise advice. Jamie played a gracious host in Christchurch and showed me around the city, his favourite cafés and cycling routes. We discussed high fat nutrition for athletes, agreed that #contextmatters when it comes to “safe starches”, shared our mutual plans for the Ancestral Health Symposium in 2012.

Jamie and I, about to tuck into a hearty breakfast

I met the lovely Julianne in Auckland and over our 3 hour lunch we discussed everything from thyroid health to the challenges facing medical professionals, body image pressure and undiagnosed gluten intolerance.

Julianne and I: turns out hair colour is not the only thing we have in common

Auckland, the city of sails (=winds), with its 7 seasons in one day, showed us glimpses of sunshine. The world cup fever has largely subsided however the Kiwis were still happy to remind us, the Aussies, who came out on top. The Auckland part of my trip was closely aligned with fitness industry, especially group fitness, and I will probably talk about my ideas on fitness in another post.

For those who are involved in Paleo/primal lifestyle and education in North America it is probably hard to understand how isolated we can feel on the other side of the globe, with the Internet being our only link to this community. Meeting like-minded people was like a breath of fresh air: no need to moderate your language or be tentative in offering different hypotheses. I came back home feeling recharged and fired up for more learning, sharing and blogging.