Our daily circadian rhythms allow us to function optimally in a dynamic world, adjusting our biology and sleep-wake cycles to the meet demands imposed by our environment and lifestyle habits. (1)

Between 33-45% of the Australian population experience sleep disturbances. (2)
In addition to governing sleep-wake cycles, circadian clocks are integrated into all biological processes at a molecular level. Circadian rhythms are fundamental biological imperatives, which govern every aspect of health. (1,3)

When challenged by environmental stressors, dysphasic sleep patterns or unhealthy eating behaviors, circadian clocks can become misaligned, affecting not just sleep patterns, but leading to wide-ranging health conditions. (3)
​In addition to insomnia, circadian dysfunction has been associated with cardiometabolic disorders, glucose dysregulation, neuroinflammation, mood disorders and an increased risk of breast cancer. (1,3)
 
Circadian Reboot Support
Evidence-based approaches known to improve circadian health include the timing of light exposure, chrononutrition and many other factors: (1,3-5)

• Get as much natural morning light as possible and reduce light exposure during the evening
• Exercise, ideally during the day and not at night
• Define a sleep routine which includes relaxation and mindfulness
• Make time to step back from stressful situations and reduce pressure
• Reduce electronic devices and stimulating surroundings, at least 30 minutes prior to bedtime
• Chrononutrition: Concentrate food intake in the first and middle parts of the day
• Follow a whole food Mediterranean style diet, known to improve overall circadian health
• If napping, ensure it is no longer than 20 minutes and not within 6 hrs. of bedtime
• Avoid stimulants such as caffeine and things known to reduce sleep quality, such as alcohol.

 
4 Key Herbs for Healthy Sleep Patterns
Herbal medicines can be extremely beneficial in a clinical setting for improving sleep patterns and helping to reset sleep-wake cycles, which is essential for circadian health. For example:

• Californian poppy (Eschscholzia californica) supplementation helps normalise sleep patterns with no evidence of carry over effects or addiction. (6,7)
• Lavender (Lavandula angustifolia) improves sleep quality and shortens sleep onset by up to 80% in some clinical studies. (8,9)
• Passionflower (Passiflora incarnata) has been traditionally used for the treatment of insomnia, nervousness and anxiety. It works by improving melatonin production and supporting GABA activity. (7,10)
• Ziziphus (Ziziphus jujube) improves sleep quality, prolonging sleep time and increasing NREM sleep. It contains active constituents which are naturally sedative, by improving GABA-energic activity within the brain. (7)

 
Circadian rhythm dysfunction requires ongoing dietary and lifestyle support, including changing both day and nighttime habits to create new sustainable routines, which support a circadian health.
 
References:

1. Foster, R. G. (2020). Sleep, circadian rhythms and health. Interface Focus, 10(3), 20190098. doi:10.1098/rsfs.2019.0098 
2. Adams, R., Appleton, S., Taylor, A., McEvoy, D., & Antic, N. (2016). Report to the sleep health foundation 2016 sleep health survey of Australian adults. The Adelaide Institute for Sleep Health.
3. Abbott, S. M., Malkani, R., & Zee, P. C. (2018). Circadian disruption and human health: a bidirectional relationship. European Journal of Neuroscience. doi:10.1111/ejn.14298 
4. Zheng, D., Ratiner, K., & Elinav, E. (2020). Circadian Influences of Diet on the Microbiome and Immunity. Trends in Immunology. doi:10.1016/j.it.2020.04.005 
5. Zuraikat, F. M., Makarem, N., St-Onge, M.-P., Xi, H., Akkapeddi, A., & Aggarwal, B. (2020). A Mediterranean Dietary Pattern Predicts Better Sleep Quality in US Women from the American Heart Association Go Red for Women Strategically Focused Research Network. Nutrients, 12(9), 2830. doi:10.3390/nu12092830 
6. Schafer HL, Schafer W, Schneider W, Elstner EF. Sedative action of extract combination of Eschscholtzia californica and Corydalis cava. Arzneim Forsch Drug Res 1995; 45: 124-26.
7. Bruni, O., Ferini-Strambi, L., Giacomoni, E., & Pellegrino, P. (2021). Herbal Remedies and Their Possible Effect on the GABAergic System and Sleep. Nutrients, 13(2), 530. https://sci-hub.do/https://doi.org/10.3390/nu13020530
8. Kasper, S., Anghelescu, I., & Dienel, A. (2015). Efficacy of orally administered Silexan in patients with anxiety-related restlessness and disturbed sleep–A randomized, placebo-controlled trial. European neuropsychopharmacology, 25(11), 1960-1967.
9. Chen SL, Chen CH. (2015). Effects of Lavender Tea on Fatigue, Depression, and Maternal-Infant Attachment in Sleep-Disturbed Postnatal Women.Worldviews Evid Based Nurs. 12 (6):370-9.
10. Appel, K., et al. (2011). Modulation of the gamma-aminobutyric acid (GABA) system by Passiflora incarnata L. Phytother Res, 2011. 25(6): p. 838-43.

For more than 200,000 years, humans were foragers, consuming large amounts of fibrous plant material and evolving with gut microbiota which was well-adapted to utilise this ancestral diet. (1)
 
During industrialisation however, the gut microbiota was subjected to numerous insults, leading to two significant and detrimental changes:

1. A loss of diversity. Researchers confirm the compounded effects of reduced microbiota-accessible fibres, chlorinated water, antibiotics and other environmental pressures, has led to a loss of more than half the microbial diversity found in traditional populations. (2)
 
2. A microbiome and human genome miss-match. New research suggests our gut microbiota is rapidly evolving in an attempt to cope the industrialised diet. This rapid adaptation is in stark contrast to the much more slowly evolving human genome. The result is an incompatibility between adapted gut microbiota and human hosts. (1)
The combination of loss of diversity and incompatible microbiota, scientists suspect is a significant driver in the emergence of chronic conditions such as: (1,2)
 

• mood disorders
• immune dysfunction
• chronic inflammation
• obesity

 
How can we create more compatible and resilient microbial ecosystems?
 
Specific probiotics strains derived from minimally disturbed traditional communities, may hold the key. Research suggests unique strains are capable of remodelling industrialised microbiota, to become more compatible with our human genome and improve microbial diversity. (1,3)
 
In conjunction with healthy dietary changes, restoration of our gut microbiome may promise improved immune health, metabolic balance and a reduction in mood disorders. (1-4)

References:

1. Sonnenburg, J. L., & Sonnenburg, E. D. (2019). Vulnerability of the industrialized microbiota. Science, 366(6464), eaaw9255. doi:10.1126/science.aaw9255
2. Bello, M. G. D., Knight, R., Gilbert, J. A., & Blaser, M. J. (2018). Preserving microbial diversity. Science, 362(6410), 33–34. doi:10.1126/science.aau8816
3. He, B., et al. (2019). Lactobacillus reuteri Reduces the Severity of Experimental Autoimmune Encephalomyelitis in Mice by Modulating Gut Microbiota. Frontiers in immunology, 10, 385. doi:10.3389/fimmu.2019.00385
4. Laitinen, K., & Mokkala, K. (2019). Overall dietary quality relates to gut microbiota diversity and abundance. International journal of molecular sciences, 20(8), 1835. doi.org/10.3390/ijms20081835

The bi-directional connection between the gut and brain is well established, however researchers now believe the role microbiota plays in our perception, mood and behaviour has been significantly underestimated. (1)
 
Gut-brain axis interactions have been linked to changes in stress and anxiety behaviours, the sleep–wake cycle, sexual behaviour, perception of fear and loneliness, food cravings, social connection, even odour and attraction. (2,3)

Microbiota are capable of producing neuroactive molecules which strongly influence the autonomic nervous system via enteric neurons. They act by hijacking the vagus nerve, the neural axis between the gut and the brain. (1)

Evidence suggests gastrointestinal microbiota may be under selective pressure to manipulate host behaviour in order to increase their survival and fitness. (1)
 
For example, gut microbes are capable of altering our mood and feeding behaviour by: (1,3)

• Altering the dopamine-reward system, to generate cravings for foods they require, or foods that suppress their competitors.
• Changing neuropeptide signalling to induce dysphoria until we eat foods that enhance their fitness.
• During starvation, production of neurotransmitters such as GABA, reducing inhibitions, altering facial expressions and making us appear more socially attractive thereby increasing chances of finding food within the group.

 
The latest research suggests specific probiotic strains can therapeutically remodel the human gut microbiota, balancing the complex bi-directional interplay between the gut and nervous system. (4) Potential benefits of therapeutic remodelling of gut microbiota include reductions in stress and anxiety, improved mood, a stronger drive towards healthy eating patterns and improved social connection. (1,3,4)
References:
1. Alcock, J., Maley, C. C., & Aktipis, C. A. (2014). Is eating behavior manipulated by the gastrointestinal microbiota? Evolutionary pressures and potential mechanisms. Bioessays, 36(10), 940-949.
2.  Karsas, M., Lamb, G., & Green, R. J. (2018). The immunology of mind control–exploring the relationship between the microbiome and the brain-part 1. Current Allergy & Clinical Immunology, 31(2), 103-109.
3. Karsas, M., Lamb, G., & Green, R. J. (2019). The immunology of mind control: exploring the relationship between the microbiome and the brain (part II). Current Allergy & Clinical Immunology, 32(1), 50-57.
4. Martin, C. R., Osadchiy, V., Kalani, A., & Mayer, E. A. (2018). The Brain-Gut-Microbiome Axis. Cellular and Molecular Gastroenterology and Hepatology, 6(2), 133–148. 

Could folate and B12 affect cellular ageing?
Nutrients such as folate and vitamin B12 are essential for healthy metabolic processes and well known for reducing oxidative stress.  New research however, is targeting these nutrients for their role in the prevention of cellular ageing by influencing telomere length.
 
Telomeres cap the ends of chromosomes, preserving genome stability and making sure healthy cellular replication occurs. Telomeres naturally shorten during each cell division until they become too short to replicate causing accelerated cellular ageing and associated age-related diseases.
 
Telomere shortening can be partially rescued by telomerase, as enzyme which adds nucleotides to the ends of the chromosomes preserving their integrity.  Research also points to specific nutrients promoting telomere optimisation, by reducing oxidative stress and ‘wear and tear’. Folate and vitamin B12 are of particular interest because they influence nucleotide synthesis and DNA stability.
 
According to a recent 2019 study on 5581 adults, folate and vitamin B12 improved telomere structure and function and therefore biologic ageing.

Several other studies have concluded that diet and lifestyle strongly influence cellular ageing. Specifically, more alkaline diets higher in vegetables, fruits and lower consumption of red meat or processed meat and sweetened soft drinks were associated with telomere length.

References:
Lee, J. Y., Jun, N. R., Yoon, D., Shin, C., & Baik, I. (2015). Association between dietary patterns in the remote past and telomere length. European journal of clinical nutrition, 69(9), 1048-1052.
Boccardi, V., Paolisso, G., and Mecocci, P. (2016). Nutrition and lifestyle in healthy ageing: the telomerase challenge. Ageing, 8(1), 12–15. doi:10.18632/ageing.100886
Tucker, L. A. (2019). Serum and Dietary Folate and Vitamin B12 Levels Account for Differences in Cellular Aging: Evidence Based on Telomere Findings in 5581 U.S. Adults. Oxidative Medicine and Cellular Longevity, 2019, 1–10. doi:10.1155/2019/4358717 

​Recent media attention has uncovered a smoldering divide between the general public and health practitioners alike. The topic of plant-based diets vs the meat-eating population and the question of protein. How much do we actually need?
High protein foods and beverages are arguably the fastest growing sectors in the health food market both locally and globally. However critical discourses on protein, suggest there is has been a mythologization of protein perpetuated by the food industry, which according to the Chen (2019) paper, is a myth.
‘Research shows that consumers (and practitioners) believe high protein food has a positive impact on physical performance and body composition, despite the lack of evidence.’

Robust epidemiological studies indicate that a high intake of animal protein, particularly red meat, may increase the risk of age-related diseases. Protein intake is associated with increased IGF-1 and mTOR, substances known to block intrinsic longevity promoting processes in the body.2-4 In fact, research suggests a reduced protein intake may play a critical role in extending longevity and metabolic health.2
On the other hand, research clearly indicates that insufficient protein may be associated with sarcopenia and frailty in elderly populations which is harmful to longevity, suggesting that the time of life may require individualised protein consumption.

How much protein do we need?
Looking at the longest-lived populations and what they ate, may provide valuable insights into understanding our healthspan. The Mediterranean and traditional Okinawan diets for example, ate approx. 9-13% protein, not entirely but largely from plant sources. They also ate a diet very high in alkaline vegetables and fruits.
There is still hot debate and emerging research about the ideal balance of macronutrients, which is only part of the equation when it comes to healthy aging. 

• Chen, A., & Eriksson, G. (2019). The mythologization of protein: a Multimodal Critical Discourse Analysis of snacks packaging. Food, Culture & Society, 1-23.
• Kitada, M., Ogura, Y., Monno, I., & Koya, D. (2019). The impact of dietary protein intake on longevity and metabolic health. EBioMedicine.
• Fung, et al. (2016). Association of animal and plant protein intake with all-cause and cause-specific mortality. JAMA internal medicine, 176(10), 1453-1463
• Levine, M. E., et al. (2014). Low Protein Intake Is Associated with a Major Reduction in IGF-1, Cancer, and Overall Mortality in the 65 and Younger but Not Older Population. Cell Metabolism, 19(3), 407–417.Song, M.,
• Buettner, D., & Skemp, S. (2016). Blue Zones. American Journal of Lifestyle Medicine, 10(5), 318–321.
• Willcox, D. C., Scapagnini, G., & Willcox, B. J. (2014). Healthy aging diets other than the Mediterranean: A focus on the Okinawan diet. Mechanisms of Ageing and Development, 136-137, 148–162.

Endotoxins such as liposaccharides (LPS) are potent inflammatory antigens and are found in the human gut. (1,2) There is however another potent source of endotoxins coming directly from the food we eat.(1,3,4) Evidenced by significant increases in endotoxin concentrations in as little as 30 minutes after consuming a meal and is emerging as a prime suspect in postprandial inflammation. (1,4)
 
Capable of passing through the gut wall and entering systemic circulation, endotoxins cause substantial increases in chronic inflammatory markers such as NF-kB, IL-6 and TNF-a.(1While mild postprandial inflammation is common, it was shown that minimising dietary intake of endotoxins reduced inflammation and improved cardiometabolic markers.(3,5)
​
Which foods contain high levels of endotoxin?

According to Herieka et al (2016), there may be endotoxins in foods generally considered healthy and is highly dependent on food preparation. Pre-packaged and processed foods including minced meat and pre-cut vegetables which are seemingly ‘unspoiled’ and kept refrigerated frequently contain large amounts of endotoxin resulting in chronic inflammation and even endotoxemia.(3)

Some research also suggests certain fats unfavorably alter intestinal permeability, allowing endotoxins from a meal to pass into systemic circulation, however the exact mechanism is still unclear.(1,4,6)
​
Given that inflamm-ageing is associated with changes in digestion, metabolism, our microbiome and inflammatory status, we may need to amend the current anti-inflammatory diets to include ‘fresh is best’.

1. Erridge, C., Attina, T., Spickett, C. M., & Webb, D. J. (2007). A high-fat meal induces low-grade endotoxemia: evidence of a novel mechanism of postprandial inflammation. The American Journal of Clinical Nutrition, 86(5), 1286–1292. doi:10.1093/ajcn/86.5.1286 
2. Kim, K. A., Jeong, J. J., Yoo, S. Y., & Kim, D. H. (2016). Gut microbiota lipopolysaccharide accelerates inflamm-aging in mice. BMC microbiology, 16, 9. doi:10.1186/s12866-016-0625-7
3. Herieka, M., Faraj, T. A., & Erridge, C. (2016). Reduced dietary intake of pro-inflammatory Toll-like receptor stimulants favourably modifies markers of cardiometabolic risk in healthy men. Nutrition, Metabolism and Cardiovascular Diseases, 26(3), 194-200.
4. Erridge, C. (2011). The capacity of foodstuffs to induce innate immune activation of human monocytes in vitro is dependent on food content of stimulants of Toll-like receptors 2 and 4. British journal of nutrition, 105(1), 15-23.
5. Wassenaar, T. M., & Zimmermann, K. (2018). Lipopolysaccharides in Food, Food Supplements, and Probiotics: Should We be Worried?. European journal of microbiology & immunology, 8(3), 63–69. doi:10.1556/1886.2018.00017
6. Boutagy, N. E., McMillan, R. P., Frisard, M. I., & Hulver, M. W. (2016). Metabolic endotoxemia with obesity: Is it real and is it relevant? Biochimie, 124, 11–20. doi:10.1016/j.biochi.2015.06.020 

Recent research into circadian rhythms shows that the time of day when food is
ingested influences nutrient absorption, assimilation and utilisation. This had led to a dramatic increase in research into the possible benefits of time-restricted eating (TRE). TRE suggests benefits in narrowing the time-window for eating and raises the question whether the largest meal is best consumed at the beginning or end of the day.
 
‘When we eat may be as important as what we eat.’
 
Humans evolved with cyclic periods of fasting and feeding. These adapted temporal rhythms act at the cellular level switching between nutrient utilisation and storage. Fasting-feeding cycles are known to acutely activate nutrient-sensing pathways in what is termed the ‘molecular clock’.
 
The circadian molecular clock ensures that gene expression and appropriate pathways that help assimilate nutrients begin to rise in anticipation of feeding, so the body can handle the rush of nutrients in an optimal way and maintain nutrient balance.
 
Circadian fasting-feeding cycles affect metabolism

The time of day wen food is ingested exerts a powerful influence on metabolic health including:

• body composition and size
• hunger and satiety
• liver health
• blood sugar and cholesterol
• neuroendocrine function
• the gut microbiome
• heart function
• inflammation
• sleep

 
A current hotly debated topic is what time of the day should the largest meal be consumed. It is well established that after eating, blood glucose remains higher in the evening than in the morning. This research been put to the test with human clinical trials, to once and for all answer these common questions:

• Is it better to consume the main meal in the first or last half of the day?
• Is it safe to skip breakfast, lunch or dinner?

 
According to researcher Chaix (2019), restricting the time of food access for example to an 8-10 hour window during the day, not only reduces obesity, but activates multiple longevity factors, which may help halt chronic disease.  Studies where the majority of food is consumed in the first half of the day and less in the second half of the day, reduced inflammation, improved blood sugar control and produced better weight loss and reductions in hunger. In fact, research suggest, breakfast skipping may have detrimental health effects and lead to late night binge-eating.
 
For those wanting to reduce their weight and improve metabolic and hormonal health, a personalised time-restricted eating program from a health-care professional may offer an efficient and easy way to maintain a healthy weight and improve longevity.
 
Bibliography:
Chaix, A., Manoogian, E. N. C., Melkani, G. C., & Panda, S. (2019). Time-Restricted Eating to Prevent and Manage Chronic Metabolic Diseases. Annual Review of Nutrition, 39(1). 
Jakubowicz, D., Barnea, M., Wainstein, J., & Froy, O. (2013). High Caloric intake at breakfast vs. dinner differentially influences weight loss of overweight and obese women. Obesity, 21(12), 2504–2512.
Laermans, J., & Depoortere, I. (2016). Chronobesity: role of the circadian system in the obesity epidemic. Obesity reviews, 17(2), 108-125

​It is well established that a healthy dietary pattern is associated with optimal wellbeing and disease risk reduction. To guide the public towards better health, certain dietary plans are now recommended worldwide, such as the traditional Mediterranean diet and The Dietary Approaches to Stop Hypertension (DASH) Diet (modified).(1) These diets, along with the popular Paleo diet, vary slightly in their components; however, the commonality with these, is achieving a balance between the intake of fruit and vegetables and animal protein.
These diets attribute their health benefits mostly to the increase in nutrients, such as vitamins, minerals and fibre etc., which are needed for biochemical and metabolic processes. However, there is another major physiological effect of these foods that is often overlooked and not included in standard guidelines—the effect on acid-alkaline balance. 

The importance of acid-alkaline balance
Every part of the body needs different levels of acidity and alkalinity for the function of important physiological roles. The balance between alkalinity and acidity and is often termed pH balance, as pH is the measure of hydrogen ions (pH = potential hydrogen), which are acidic. This scale is measured numerically in which the value 7.0 is neutral, below 7.0 is acidic, and above 7.0 is alkaline.
Controlling extracellular pH in the correct range is critical for metabolic homeostasis.(2) For example, research shows that even small changes in the pH levels towards acidity can lead to increased bone breakdown and reduced bone rebuilding.(3) These small changes in pH are termed chronic low-grade or latent acidosis and although it is not as severe as metabolic acidosis (where there is a considerable decrease in blood pH), latent acidosis is more common and can have severe and long-term detrimental effects on health.(4,5)

The effects of chronic low-grade acidosis
If acid production increases more than the body can excrete (primarily via the kidneys), even healthy people are affected by chronic-low grade acidosis.(6) Also, simply ageing has an impact as the glomerular filtration rate of the kidneys decreases by 50% from ages 20 to 80 years. This limits the kidney’s ability to excrete the excess acid produced endogenously during metabolism and from a dietary acid load.(7) Conversely, excess acid from the diet can damage the kidneys, even in children, again reducing acid excretion and increasing tissue acidosis.(8,9)
According to research, the overproduction and accumulation of metabolic acids, a high dietary acid load, and chronic tissue metabolic acidosis may contribute to the development of numerous health issues,2,10 including (2,5,9,10):
·        pain and inflammation
·        fatigue and exhaustion
·        cognitive decline
·        insulin resistance
·        diabetes
·        cardiovascular risk
·        glutathione depletion
·        poor detoxification
·        kidney disease
·        bone demineralisation
·        muscle breakdown
·        gastrointestinal dysfunction
·        developmental issues in children

Chronic low-grade acidosis is often described as diet-induced because a high dietary acid load is a major determinant in the body’s acid-base balance.(11) Conversely, a diet rich in alkalising foods will balance the acid levels and support the body’s acid buffering systems.

Diet and acid-base balance
The original ‘healthy’ Palaeolithic diet was made up of 35% meat and 65% plant matter (12); however, the western or ‘modern’ diet now focuses on high-fat, high sugar, red meat, and refined grains, with very little intake of fruit and vegetables. This dietary pattern is linked with serious health conditions but is also highly acidic. (13)
Although diets, like the Mediterranean diet, are healthy, they can often be difficult for many people to follow in a balanced way. Additionally, regardless of the promotion of these diets, global trends in children and adults show an alarming increase in unhealthy foods, an abundance of animal protein, and a severe lack of adequate fruit and vegetable intake.(9,14)
Fruit and vegetables contain high levels of alkalising minerals, such as magnesium, calcium, and potassium, as well as metabolisable anions, including citrate. These anions consume acidic hydrogen ions when they are metabolised and by doing so increase the alkalinity of the body. Citrate bound minerals are also highly effective at neutralising acidosis, as citrate is very alkalising and has high bioavailability. Additionally, plant matter (vegetables and fruits) contains high levels of glutamate, which also consumes acidic hydrogen to help bring the body to a neutral position.(15)
Animal proteins and cereal grains, on the other hand, contain sulphur containing amino acids, which when metabolised produce the highly acidic non-metabolisable anion, sulphate.
In the acid-base balance approach, balance is the key word, with a general recommendation of at least two thirds alkalising foods (mainly vegetables with some fruit) and not more than 1/3 acid forming foods (meats, grains and dairy) at each meal.
Research shows following a moderate protein diet with an increased intake in vegetables and fruit can correct metabolic acidosis and improve numerous health outcomes.
References:
1.      Mozaffarian D. Dietary and policy priorities for cardiovascular disease, diabetes, and obesity: A comprehensive review. Circulation. 2016;133(2):187-225.
2.      Della Guardia L, Thomas MA, Cena H. Insulin sensitivity and glucose homeostasis can be influenced by metabolic acid load. Nutrients. 2018;10(5):618.
3.      Arnett TR. Extracellular ph regulates bone cell function. J Nutr. 2008;138(2):415S-8S.
4.      Pizzorno J, Frassetto LA, Katzinger JJBjon. Diet-induced acidosis: Is it real and clinically relevant? 2010;103(8):1185-94.
5.      Vormann J, Goedecke T. Acid-base homeostasis: Latent acidosis as a cause of chronic diseases. SCHWEIZERISCHE ZEITSCHRIFT FUR GANZHEITS MEDIZIN. 2006;18(5):255.
6.      Hayhoe, R et al., Longitudinal associations of dietary acid-base load and incident fractures in the EPIC-Norfolk cohort. Presented at the3rd International Acid-Base Symposium, Smolenice Castle, Slovak Republic, June 24th-28th 2018
7.      Dawson-Hughes, B. Acid-Base Balance - Implications for bone and muscle. Presented at the 3rd International Acid-Base Symposium, Smolenice Castle, Slovak Republic, June 24th-28th 2018
8.      Passey C. Reducing the dietary acid load: How a more alkaline diet benefits patients with chronic kidney disease. J Ren Nutr. 2017;27(3):151-60.
9.      López M. Potential renal acid load in children with chronic kidney disease. Presented at the 3rd International Acid-Base Symposium, Smolenice Castle, Slovak Republic, June 24th-28th 2018
10.  Gæde J, Nielsen T, Madsen ML, et al. Population-based studies of relationships between dietary acidity load, insulin resistance and incident diabetes in danes. Nutrition journal. 2018;17(1):91
11.  Scialla JJ, Anderson CAM. Dietary acid load: A novel nutritional target in chronic kidney disease? Advances in chronic kidney disease. 2013;20(2):141-9.
12.  Frassetto L, Morris RC, Jr., Sellmeyer DE, et al. Diet, evolution and aging--the pathophysiologic effects of the post-agricultural inversion of the potassium-to-sodium and base-to-chloride ratios in the human diet. Eur J Nutr. 2001;40(5):200-13.
13.  Rysz J, Franczyk B, Ciałkowska-Rysz A, et al. The effect of diet on the survival of patients with chronic kidney disease. Nutrients. 2017;9(5):495.
14.  Tapsell LC. Dietary behaviour changes to improve nutritional quality and health outcomes. Chronic diseases and translational medicine. 2017;3(3):154-8.
15.  Adeva-Andany MM, Fernandez-Fernandez C, Mourino-Bayolo D, et al. Sodium bicarbonate therapy in patients with metabolic acidosis. ScientificWorldJournal. 2014;2014:627673 

The many species of microbes in our gut form a kind of ‘ecosystem’ which helps maintain healthy digestive and metabolic function. However, intestinal flora can become out of balance from antibiotic use, stress, illness or poor dietary choices and when this happens, it can affect our overall vitality and mood.

Being healthy doesn't have to mean missing out on treats but if you or your children have food intolerances or allergies, finding suitable and healthy ‘treat’ alternatives can be tricky. 

One of my children has food intolerances and doesn’t do well on sugar either, so when I tried this chocolate ice-cream recipe, I was so impressed with the creaminess and taste, I just had to share it!

It is dairy-free, gluten-free, sugar-free, egg-free, Paleo friendly and can be made low FODMAPS.