It’s summer (hurrah!) and this season’s theme at West Norwood Therapies is water.  I have been exploring water and the human body and why hydration is so critical.
 
Water is essential for life and for our bodies to function optimally.  On average water makes up around 60% of body weight in men and 50-55% in women (this can vary depending on age and body composition).
 
Drinking enough water each day is essential for the function of all the cells in the body, it helps us to: regulate body temperature, keep eyes and joints lubricated, helping to rid waste and transport nutrients, helps convert food into energy, protects the nervous system, prevents infection, and keeps organs functioning properly.
 
Some organs contain much more water than others and I found it staggering to learn that the brain and kidneys possess the highest percentage of water: a whopping 80-85%, followed by the heart and lungs 75-80%, muscles, the liver and skin are 70-75%, blood is 50%, bones are 20-25% and lastly teeth at 8-10%.   This helps to put into context how dehydration can have so many symptoms and consequences.
 
The current UK recommendation is to drink 6-8 glasses of fluid per day, more specific recommendations about the quantity needed at different ages are shown below:
(provided by the European Food Safety Authority (EFSA):

The EFSA assume that 20% of fluid intake comes from food and 80% comes from drinks.
It is also important to note that doing strenuous activity or living in hotter or more humid climates may need more than the above.
 
The body works hard to find balance and drinking too little or too much water can have severe consequences.  The warning signs of dehydration include:

• Feeling thirsty or lightheaded
• A dry mouth
• Headache, delirium
• Tiredness (fatigue)
• Having dark coloured, strong-smelling urine
• Passing urine less often than usual (less than 3 or 4 times a day)
• High heart rate and low blood pressure
• Muscle cramps
• Constipation

 
As mentioned above the brain contains 85% water, dehydration can also impact on cognitive function with difficulty in concentrating, impacting mood making us prone to feeling angry, anxious, and irritated.
 
It’s important to note that on the flip side at the extreme end of consuming too much water, can lead to hyponatraemia, a very serious condition that causes extremely low sodium levels in the blood.
 
It is more common for people to suffer with the symptoms of dehydration.
 
The best way to avoid dehydration is to keep track of how much fluid you drink and drink water throughout the day.  It’s ideal to avoid excessive caffeine drinks as they have a diuretic effect on the body, as does alcohol.  Of course, I am not staying to cut them out but to just be mindful of intake and ensure you’re having an adequate water intake too.
 
If you have been unwell with a fever or diarrhoea, playing sports or have been sweating a lot in high temperatures: drinking coconut water or a sports drink or rehydration drink can help to replenish your electrolytes and essential salts and minerals.
 
Swap sugary drinks for sugar-free or no added sugar and dilute squash drinks to reduce the sugar content.
 
If you don’t like the taste of water you can try sparkling water or try adding a slice of lemon or lime, some berries or cucumber.

At a recent party on a chilly evening in the garden I asked a friend in a strappy dress if she was warm enough, she lightly replied “Oh, yes, I have my own personal weather system”. Made me chuckle but menopause is no laughing matter. Some women sail through but for others the symptoms can be unbearable and debilitating and can take a huge toll on just about every aspect of life.  It can be a time when women feel at a loss with the changes that are happening to them, bewildered by them.  Getting the balance between seeing them as a medical issue and a transformative time of adjustment can be helpful in easing women through this phase of life with greater serenity and joy, with a combined approach offering great benefits.
 
Among the most common symptoms are hot flushes, night sweats, mood changes, tiredness, vaginal discomfort, loss of libido and brain fog, but it affects women very differently and you may experience a range of other physical, mental and emotional symptoms. They can start as women enter the perimenopausal phase, often in their mid 40s, sometimes earlier, usually but not always accompanied by changes in their menstrual cycle.
 
From a medical perspective getting diagnosed is the first step to understanding the changes you are going through and finding solutions that suit you, including HRT.  The options can be simple with far reaching benefits. Finding the right choices for you will not only help you to feel better but importantly also help to protect your future health, particularly cardiovascular and bone health.
 
From a lifestyle perspective nutrition, exercise, sleep, relaxation and strong social and emotional connections provide the foundations for your wellbeing, regardless of whether or not you take HRT. Acupuncture can also play a supportive role in helping women ease through the transition, connecting mind with body, with proven benefits for some of the associated symptoms including hot flushes, low mood and anxiety, poor sleep, aches and pain.
 
I have included a link to a resource with a wealth of info at the end, including medical, lifestyle, social and political info. Now, for an overview of exercise and then a brief focus on swimming, our topic for this summer newsletter, in relation to menopause.
 
Exercise
From perimenopause onwards physical activity can help to prevent muscle loss which occurs naturally as we age, support a healthy weight reducing the risk of chronic disease and improve cardiovascular, respiratory and bone health. Exercise will build strength, support the joints and alleviate the aches and pain, and the mood enhancing benefits of exercise can help in the way we perceive pain. Additionally, it can help with sleep and generally help you to feel better. If you have specific health issues that limit your activity then seek appropriate advice and support.
 
As a guide try to get about 30 minutes of moderate exercise 5 times a week but if you are new to exercise then start light with 10 mins a day and build up gradually.
 
Aim for a combination of exercise each week:

• Aerobic exercises for cardio (dancing, brisk or up-hill walking, jogging, cycling, swimming, water aerobics, tennis, climbing stairs)
• Strengthening exercises for muscles, bones and joints (weight machines, rowing machine, hand-held weights, resistance bands or body weight exercises like yoga, pilates, squats, lunges and press ups).
• Stability and balance exercises (yoga, tai chi and pilates, sitting on an exercise ball, standing on one leg)
• Stretching exercises to maintain flexibility of joints and fascia, maintain range of motion, improve posture and reduce pain (yoga, tai chi and pilates).

Cold water swimming is anecdotally very helpful to relieve hot flushes and some of the other symptoms of menopause.  It has proven stress relieving and anxiety reducing benefits which can last for several days, and also helps immunity.  We are fortunate to have Tooting and Brockwell Park lidos on our doorstep. During the winter especially, they are places with a strong sense of community and camaraderie. If you intend to swim into the winter months then start swimming during the warmer summer and autumn months so that you can gradually acclimatise. As the temperatures cool check out the cold water swimming guides so that you adjust safely and do not overdo your exposure to the cold.

More Information
If you are seeking more information the Balance-Menopause website, set up by menopause specialist Dr Louise Newson, is a good place to start for understanding more about the perimenopause  and menopause and finding support, with an app to track symptoms if you wish.  Their mission is to make menopause support inclusive and accessible to everyone globally, with some extremely useful free resources. If you have symptoms then seek out a menopause trained specialist to confirm diagnosis and guide you through treatment choices - HRT, alternative options and lifestyle advice all have a role to play.

ow important is it to have the right food on your plate?

I usually see a divide amongst my friends and clients when it comes to diet and food.

Some people just eat for the joy of it, not caring much about if they eat a lot of carbs or meat. Whilst other people can be “almost” obsessive about what they eat. May that be superfoods, very specific vegetables and meat, etc.

So what is the correct attitude to diet?

Well, I of course could not give a simple answer to such an important question. Especially as I am not a dietician.
However when it comes to Chinese medicine, we always strife for balance. Walking the middle path.

Sure, it is important to have a varied diet -according to both food energetics, colours, food groups- but I find it much more important to look at how people eat and digest.

In my experience, our mental health and eating habits combined has a much stronger effect on our digestion and general health than the types of food we eat. Do not get me wrong, I am not saying that we should all eat white bread, milk and sugar 3 times a day. I am referring to the fact that if you have a varied intake of vegetables, fruits and meats/nuts, you should not worry too much about whether it is organic or not, or how many superfoods and brown rice you include in your diet.

What is important then?

1. Structure and rythmn
It is generally important to follow a rythmn in our daily life. Structuring our days around our meals and sleep can provide with a healthy l. So we priorities ourselves, our nourishment amongst other responsibilities.

2. Rest
Taking breaks between meals (3-4 hours) gives our digestive system a rest, as opposed to continuous snacking which will overwork our Spleen and Stomach.

3. Focus /mindfulness
Eating should be about the food and our nourishment. The taste, texture, colour, smell of our food should be in the focus of our mind when we eat. Not TV, Netflix, news, daily tasks or plans for the week.
Let’s do ourselves a favour and eat mindfully. Just when we decide on the food we eat, we should apply the same mindfulness during our time of nourishment.

4. 2/3
There is a Chinese saying that you should only fill your belly 2/3 of the way, so there is space for Qi to do the digestion.
Overeating is overtaxing on our digestive system. Finding the correct amount of food that does not leave us hungry, but also doesn’t makes us sleepy is essential.
5. Fluids
It is important to drink plenty of fluids during the day, however it is best to avoid drinking with our meal. If you have a weak digestion, you may find it beneficial to drink digestives 20 minutes prior to your meals. Or if your meal seems to settle in heavy (lots of fats/oils) you may find drinking a (half) shot of clear spirit (I recommend Bison vodka for flavour 😛) also very beneficial.
On a different note. There seem to be a misconception about the amount of fluid we all need to drink. Generally speaking of we want to hydrate ourselves we have to include fluid-ful vegetables in our diet. Soups, curries, tomatoes, courgettes, etc.

6. 100 steps
Digestion does not stop when we finish eating. On the contrary. It’s fairly important that we rest after a meal for about half an hour. The Chinese has been recommending 100 slow steps after eating. As (slow) walking aids the intestinal movements (peristalsis) and thus digestion.

7. Avoid going to bed on a full stomach
Simple as that, we should not be wasting our energy on digestion whilst we are sleeping. More over, it is most beneficial to have a bigger gap (intermittent fasting) in our day when our digestive system is to rest.

8. Anxiety = IBS
Last but not least, looking after our mental health is perhaps the most important of tasks that we need in order to have a healthy digestion. I’ll talk about this more in detail another time.

So these are only a few points that are in my opinion are just as (if not more) important than the quality of the food we eat.

Thus if you are suffering with any digestive issues, you may find it beneficial to go through this list before you start cutting out your favourite foods.

Of course Acupuncture is an amazing tool to help/reset the digestive system. So if you feel you need some additional support in that regard. Do not hesitate to get in touch.

Happy Eating!

I have always had an interest in cooking wholesome food for both enjoyment and health and am guided away from processed foods by choosing ingredients that ‘ran, swam, flew or grew’ in their most natural state. Like many people I have in recent years leant towards a more heavily plant-based diet with an emphasis on a wide variety of colourful fruit and veg, wholegrains and plant-based protein like lentils, pulses, beans and tofu. However, I do still eat fish and meat, buying far less but of higher quality, higher welfare - by trying to choose largely wild fish and meat that is free-range, grass fed, preferably organic - and using every last bit which brings me to the wonders of bone broth.
 
It has been revered for its potent nutritional and medicinal properties by various cultures across the globe for thousands of years from ancient Greece, throughout Africa and Asia, to the infamous recuperative ‘Jewish Penicillin’.  A South American proverb states ‘Bone Broth will resurrect the dead’. It had a reputation within Chinese Medicine stretching back over 2,500 years for its ability to support digestion and reproductive health – pre-conceptually for both men and women to support egg and sperm health, during pregnancy for mum and baby, and post birth to help mum rebuild her strength.
 
Bone broth is packed with easy to digest gelantinous protein and amino acids from the collagen in cartilage, and minerals such as magnesium, calcium, phosphorus and potassium from the bones, extracted by long slow cooking. Wide ranging potential health benefits include helping to support skin, bone and joint health, soothing gut issues like ulcerative colitis and leaky gut, supporting immune function, helping recovery from upper respiratory infections and it may also help to promote good sleep. The combination of skin, joint and sleep effects likely make it beneficial for women post menopause, a time when increasing protein and reducing carbs can be helpful.
 
We can get a bit caught up about what’s in food and what it is good for. Sometimes it is good just to let go of that and enjoy the wholesomeness because you know in another more intuitive way that it is nourishing. For me bone broth is one of those things. A warm soothing elixir!  It is delicious drunk on its own, makes a great base for soups and stews.
 
For convenience you can buy bone broth ready-made, conveniently packaged and delivered frozen direct from the farm to your door but it is far cheaper and satisfying to make your own.  It cooks for so long that it is more economical on fuel to cook up a big batch so I collect any chicken bones both raw and cooked in the freezer until I have a good supply, supplementing them with some chicken carcass bones from the butchers to fill a stock pot.
 
Chicken Bone Stock Recipe
 
This recipe uses chicken bones and cooks for 4-6 hours.  You could make a fish version substituting the chicken for fish heads and bones usually discarded by the fishmonger so very cheap – use about 1kg per litre of water - and simmer for one hour. Strain through muslin to remove all bones.

You’ll need a large stock pot with a tight fitting lid.
 
Ingredients:

• Good Quality Chicken bones (legs but especially wings and whole carcass are good, preferably organic). Equivalent of 4-5 carcasses.
• Spices for flavour: Your choice of whole peppercorns, fennel seeds, coriander seeds. About 1-2 tsp of each for a large stockpot.
• Vegetables and herbs for flavour: Your choice of celery, carrot, leeks, onion, garlic, parsley and coriander stalks, a few bay leaves and fresh ginger. Peelings and ends are fine.
• Cider vinegar. About 4 tablespoons for a large stock pot.

 
Method:
Optional: Before making the stock you can roast the bones for an hour in the oven until they are golden for a richer flavour.
 

• Place the bones in the stock pot.
• Add spices and vegetables. Veg can just be added for the final hour if you prefer.
• Cover with water (boiling from the kettle is quicker than heating on the hob).
• Add cider vinegar to help extract the minerals from the bones.
• Cover with a tight fitting lid and simmer gently for 4-10 hours (with the extractor fan on unless you like to live in a soup scented sauna!) checking and stirring every now and then to ensure it is still covered with water and not sticking.
• I cook it until the cartilage on the ends of the bones softens and dissolves which usually takes 4 – 5 hours but some people cook it for much longer which will extract more minerals from the bones.
• Strain off all the liquid, discard bones and veg and then reduce it to a manageable quantity.  For 5 carcasses I end up with about 1.5 litres of concentrated broth. You could concentrate is down even more and freeze in ice cube trays.
• Pour into portion sized pots (I use metal Indian thali bowls) and allow to cool. It should have a thick jelly consistency when cold. The fat will rise to the surface which you can then scrape off if you wish, I usually scrape off some but leave some for flavour. Freeze in a suitable container or bag and use as needed. As it is so concentrated you can dilute it as needed.

 
The effort will more than pay off for the ease with which you can prepare a tasty meal or quick warming drink that nourishes you deep to the bone.  Enjoy!

 
What do you have for breakfast? Do you even have breakfast? It’s often a meal that people skip or habitually go for something quick like a cold bowl of cereal or a couple of slices of toast on the go but when the temperatures drop there is nothing like a comforting bowl of porridge to start the day and get the warmth going from the inside. It is quick to prepare, will sustain you all morning and is a gift to your whole digestive system.
 
Try a water-based whole oat porridge, flavoured with a small spoonful of blood-nourishing molasses, and maybe some cinnamon and ground flax seeds.

• Use whole oats to get the benefit of their blood sugar controlling, cholesterol lowering and anti-inflammatory properties.
• Add the molasses at the end of cooking to prevent it sticking.
• If you are prone to feeling the cold then add a couple of generous pinches of cinnamon for extra warmth and flavour.  It is used in traditional Chinese Herbal medicine to aid digestion, warm the channels and improve circulation. Avoid it if your tendency is towards feeling the heat.
• Add in some ground flax seeds for extra Omega-3s.

 
Top with a sprinkling of pumpkin, sunflower and sesame seeds for extra goodness and a couple of spoonfuls of berries. I use frozen summer berries out of season and just warm them gently. For speed, and if you don’t mind a strangely coloured porridge just add them to the porridge towards the end of cooking. I like a splash of milk to finish it off when it’s in the bowl for that that combo of thick porridge and liquid milk. Delicious and nutritious!
 
If you skip breakfast you may find yourself going for less nourishing alternatives as your blood sugar drops. It can precipitate a vicious cycle of sugar spikes, drops and unhealthy snacking.  Starting the day with nourishing breakfast gets your eating habits off to a healthy start and one suggestion to prompt an appetite at breakfast time might be to replace supper with something very light late afternoon or early evening for a night or two, just to kick start a breakfast habit.
 
Finally, try to make time to sit and enjoy your meals, including breakfast. The digestive process begins when we look at the food, anticipate it and the digestive juices start to flow.  And we are more likely to chew our food well, another important part of the digestive process,if we are relaxed and not in a rush.  Good digestion is as much about how we eat as what we eat. 
 
Enjoy!

Welcome to mid-January, the time when the anticipation and excitement of Christmas is over, the days are short and grey, we are often beginning a long ‘term’ of work or education and spring can feel a long way off. This year we are also 2 years into a pandemic that has brough uncertainty, fear, mistrust and pain in abundance. Whatever our personal experience of covid has been to date, the atmosphere around our country – indeed around the world – cannot fail to permeate our own individual world and we may be feeling the residue of this for a time yet.

We have things that can help us, however, and there is hope and peace to be found in amongst any bleakness. These are some things that can help when we feel short on optimism, energy or hope.

Rest. Our bodies need down time, they need to switch off and we can take a leaf out of nature’s book and hunker down in these winter months.

Walks in fresh air. Sometimes going outside is the last thing we feel like doing…but if we can make the step it can really help us feel more alive and at peace.

Music. Music can lift us or it can connect us to the difficult feelings we need to feel. We can create playlists for whatever we want – to dance to, to cry to, to sing along, to remember people and experiences.

Hugging. IF we’re lucky enough to have someone we love nearby then there is little more wonderful than a long embrace. If we are alone we can still hug ourselves – google ‘butterfly hug’ or look for our post from a year ago about this.

Creativity. Finding ways to express ourselves whether this is to release some dark emotion or create beauty from nothing, connecting to our creativity is connecting to life’s energy.

Meditation. Staying present, being here, everything as it is. Let go of struggle, effort and getting to know your mind and body more intimately, it’s so valuable.

Yoga. If you practice yoga regularly you might be familiar with the space, acceptance and support that yoga can bring.

Talking and sharing. When we feel bleak the most tempting thing can often be to shut down and hide away. And yet there is likely someone near to you feeling the same thing and the connection that can be gained by sharing your experience can be an incredibly warming feeling.

Space and solitude. Just as important as connection with others is connection with ourselves, stepping out of the busyness of life and finding some space to be with ourselves.

Take time out for things you enjoy. It can be tempting to throw yourself into the ‘shoulds’ and zone out the rest of the time, but if we can really let ourselves have the opportunity to find joy and fulfilment in something, whether it is going for a run, dancing in the kitchen or stroking the cat this is important stuff that we would do well to make central rather than peripheral in our lives.

Give up! Some days nothing will help and perhaps what is needed is just to retreat into the murky waters and let yourself do absolutely nothing whatsoever.

Therapies. Last but by no means least, go for a massage! Or for acupuncture, reflexology, reiki, sound therapies or any other therapy that feels good to you, gives you a space where you are looked after and cared for and leaves you feeling rested and revived.

So as we approach ‘blue Monday’ we can keep in mind there are some ideas that can be helpful when life feels less vibrant. And sometimes they can help us remember that spring is just around the corner.

Trying to have babies when it doesn’t just happen easily can be a heart wrenchingly difficult time.  There can be months even years of trying, balancing hope with uncertainty, even at times despair.   Another cycle starts.  Is this going to be your lucky month?
 
When supporting women with fertility I tend to focus treatment on the follicular phase leading up to ovulation, or in the case of IVF through the stimulation phase until egg collection and at embryo transfer.  These are the times that research has shown acupuncture can have a significant influence on live birth rates (Zheng, 2012). Treatments around embryo transfer, when they can be scheduled in without adding extra stress, are also shown to have a beneficial effect on outcomes (Smith, 2019).
 
Ideally, men and women would also have received some preconceptual lifestyle advice during the preceding months, not least of all to support egg and sperm quality as they develop and mature.  Treatment can be aimed at regulating the menstrual cycle, supporting endometrial development and addressing other issues impacting on fertility.  Treatment during the follicular phase will be aimed at supporting the processes that take place throughout the menstrual cycle including the luteal phase but what about treatment during the actual luteal phase or the two-week wait as it is commonly known, which follows ovulation or embryo transfer?
 
How can Acupuncture help?
As I have said, I tend to focus most treatment during the follicular phase but that does not exclude treatment during the luteal phase. It is a time to be cautious with any treatments that could disturb the delicate interplay between the embryo and uterine lining around the time of implantation, but treatments aimed at relaxation and good sleep can be positively beneficial.   It is often an anxious time when every little twinge seems to take on some significance.  An acupuncture treatment can offer a gentle wind down from the intensity of IVF or the pressures of trying naturally, at a time when sound sleep and a feeling of calm may be quite elusive.
 
How can you support yourself during the two week wait?
The preparations you have taken in the preceding months, weeks and days will help to lay the foundations but here are 10 tips to support implantation and help through these two weeks:
 

1. Get plenty of rest and sleep. Try one of these Yoga Nidra exercises for sleep.
2. Eat nourishing anti-inflammatory food. Lots of fresh fruit and veg, good quality protein, nuts and seeds, healthy fats and wholegrains.  
3. Avoid sugar, processed and junk food as much as possible.
4. Include some live fermented foods – yoghurt, sauerkraut, kimchi, kombucha, kefir etc - or take a probiotic.
5. Ease up on strenuous workouts, moderate exercise is fine even beneficial.
6. Avoid excess heat on the abdomen (no hot baths, saunas or hot water bottles on the belly).
7. Avoid googling and trying to second guess the meaning of everything you feel.
8. Take time to sit quietly, and just notice how you feel. Take a few breaths into your belly to help your thoughts settle – longer on the out breath. Notice any sensations you feel in your body, without attaching any significance.  Just notice and let them go.
9. Distract yourself with a few things to look forward to. A catch up with friends, a film, a creative project, a good book.
10. Don’t be tempted to test too early. Wait until the first day of your missed period or until advised by your fertility clinic.

 
Good luck. Remember that even under perfect conditions there is only a 1 in 4 chance of conceiving each month, so it can take a while. Please contact me if you think I may be able to help you.