Issue 3 | Thursday, 28 November 2019
An NZME custom publication
Health Future Central Focus
How to survive the holiday season w
Is gaming turning your son into a vampire?
Physio, chiro, osteo What you might not know
Informs. Inspires. Educates. | healthcentral.nz/category/futurefocus
2 | Thursday, 28 November 2019
Contents 3
How to survive the holiday season
4
Superfoods to the rescue
5
Young men failing to launch: Is too much gaming creating vampires?
8
Navigating New Zealand’s dental care
12
Recognising depression
13
Physiotherapy, chiropractic and osteopathy: what you might not know
16
It IS easy (and healthy) being green
Do you love writing health and education content? We're looking for an editor for HealthCentral and EducationCentral based in Wellington. Is this you? For more details email: nikki.verbeet@nzme.co.nz
healthcentral.nz/category/futurefocus
The best and the worst of times ’Tis the season to be jolly, goes the jaunty Christmas carol. And the Christmas holiday period really can be a very jolly time – the best of times. It can also be the worst of times. We’re all looking forward to a good break and a chance to spend time with friends and family, but shopping and social demands, financial concerns, as well as fatigue and general overindulgence can take their toll. A decrease in physical exercise is also commonplace, and not just in adults. More and more young people are spending their summer breaks, and indeed, all their spare time, gaming in their rooms. In this issue, Jody Hopkinson reports on this increasing phenomenon and what to do if this is affecting your teenager’s life. One thing’s for sure though, our personal health doesn’t take a summer break and we need to continue to manage our wellbeing throughout, especially if we are teetering on the brink of ill health. If we drink a lot normally, we usually end up drinking a lot more during the lead-up to
Christmas. Check out our quiz to see if the way you are drinking is negatively impacting on you and those around you. Christmas can also be a sad and lonely time for many people, with many emotions that have been pushed down during the year, such as those involving relationship or bereavement losses, returning to the surface. But when does unhappiness become depression? We offer a simple guide on how to recognise the signs. It's not all doom and gloom though – help is at hand! Ruby Harfield offers tips on how to survive and thrive during the holiday season, Kate O’Malley discusses how ‘superfoods’ really can come to the rescue, and we have some great articles on arming yourself with proactive information that will improve your overall health and set you up for a fun and restorative Christmas break. Christmas should be a time of happiness. And it can be, if we look after ourselves and those around us. Now that’s the real meaning of Christmas. Wishing you and yours a healthy and happy holiday season. Nikki Verbeet
Health Media Specialist
Production Manager
Nikki Verbeet E nikki.verbeet@nzme.co.nz
Aaron Morey E aaron.morey@nzme.co.nz
Nothing is more important than health.
Thursday, 28 November 2019 | 3
healthcentral.nz/category/futurefocus
How to survive the holiday season The holiday season can be full of fun, family, food and friends, but these festivities often lead to some unwanted outcomes, writes Ruby Harfield.
O
verindulging in food and alcohol, a lack of exercise, overspending and other pressures can put a dampener on the whole season. Here are some tips to help you look after your mental and physical health.
Time out from the frenzy The holiday season can be stressful which can negatively impact your mental health but it’s also a perfect time to be focusing on your own and others’ wellbeing. Mental Health Foundation chief executive Shaun Robinson says this time of year is about getting together with people you love and having some time out from the frenzy of the working year. “Christmas does bring a lot of pressures for people. It’s very easy to get caught up in the materialistic and money focus, the need to spend lots of money on presents, food and holidays that won’t necessarily support our mental health and wellbeing. “Think about what’s important at this time, there are lots of things people can do for their wellbeing and the wellbeing of whānau and friends that are not about money.” It can be much easier to be together, connect and be kind to others because there aren’t other time pressures, he says. “It’s a great time to do things that are really positive for your mental health and wellbeing.” Relaxing, spending time in nature, exercising, reading, talking about new topics and having fun with your kids can have a positive impact. “They are things that uplift your wellbeing.” Corporate wellbeing specialist Sarah McGuinness says people should be kind to themselves during this stressful time with work, financial and family pressures. “Really that’s about taking that time to acknowledge that it’s a really challenging time. “Give yourself a break if you can. It’s the one time of year when everything is happening at once.”
Keeping up with the Joneses One big cause of stress during summer is finances with people spending up large so they feel like they’ve celebrated the silly season properly.
It is not a time to start a diet or exercise regime, but if Sorted managing editor Tom Hartmann says you eat or drink too much you will need to continue to be money doesn’t need to be a stress if the right active, she says. planning is done and if people change their focus. “If you overindulge one day, eat sparingly the next. Be “Don’t extend yourself too much, don’t do more selective with what you ‘must’ have and what you can than you can handle. If you spend too much you’re leave. One month of excess feeding will pile on the kilos. not going to feel very good.” “Ease up on the drink too; remember that alcohol If you put aside some money each week for is packed full of calories.” Christmas during the year it really helps, he says, Robinson says going easy on the food and but if you’ve got to this time of year without doing alcohol will mean you will have a better time that then you need to plan your shopping and and feel better. stick to a list. “It’s not good for your mental “People feel the pressure at this time or physical health to really of year. Try to escape from ‘keeping “It’s not trash yourself throughout the up with the Joneses’.” Christmas and holiday season.” good for your People think that others are Wham says this time of year spending more than they actually mental or physical can also be a good time to are, so tend to feel the need to try new foods or new recipes health to really trash overextend themselves. Gift because people usually have options to help with financial yourself throughout a bit more time or motivation stress can include secret Santa the Christmas and and there are great seasonal for large families, money (so you vegetables. don’t get caught up in buying holiday season.” “It’s a good opportunity to extra), using rewards points or start trying a few things like making something yourself. making your own hummus; there If you are going to have to get into are also amazing seasonal vegetables debt at this time of year, remember that if you want to try vegetarian options. Make credit cards and buy-now pay-later schemes it fun and interesting.” often have administration costs, deposits and interests so may not be a good deal, he says. Keep the building blocks going “Don’t get too many at the same time; before you Because the holidays provide a break from know it they can become quite unmanageable.” people’s normal lives, they tend to forget to keep up Eat, drink and be wary with their routines. Corporate wellbeing specialist Sarah McGuinness Christmas feasts, celebrations, holidays and work says people need to get enough sleep, drink parties can be full of delicious food and drink that enough water and maintain regular exercise. can be hard to resist. “Keep the building blocks going. Try to do what Massey University School of Sport, Exercise and you can and keep grounded, even if it’s just a walk Nutrition associate professor and dietician Carol around the block.” Wham says it is important for people to eat, drink Wham says exercising every day is important and be wary over the holiday season. – swimming, walking, playing cricket, it doesn’t “It’s pretty easy to overindulge at this time matter what it is, but just do something each day. because of the social importance of this time of This is something that’s quite easy to do in New year. Zealand with it being summer and there being “Just be careful not to overeat and over drink … bush, beach and rivers nearby, she says. concentrate on keeping your weight stable.”
4 | Thursday, 28 November 2019
healthcentral.nz/category/futurefocus
Superfoods to the rescue Power-pack your health by ensuring your diet is full of nutrient-dense and readily available ‘superfoods’ that protect against disease and optimise your wellbeing. Kate O’Malley reports.
W
hile scientists and nutritionists agree that there’s no clear, definable ‘superfood’ group, there are some foods that clearly punch above their weight in terms of impact on our health. These superfoods offer high levels of desirable vitamins and minerals or are linked to disease prevention. They are also a source of antioxidants that protect our bodies from cell damage and ward off diseases.
Berries Berries such as raspberries, strawberries, blackberries, blueberries and cranberries are high in vitamins, minerals, fibre and antioxidants. They’re associated with a reduced risk of heart disease, cancer and inflammation. They’re also useful in treating digestive and immune-related disorders.
Dark green leafy vegetables Kale, silverbeet, spinach and other dark green leafy vegetables are packed full of micronutrients such as magnesium, folate, zinc, iron, vitamin C and calcium, as well as fibre. They contain high levels of anti-inflammatory compounds known as carotenoids, which may protect against some forms of cancer.
Garlic Used as a medicine for centuries, garlic is a rich source of manganese, vitamin C, vitamin B6, selenium and fibre. It may be effective in reducing cholesterol and lowering blood pressure, as well as boosting the immune system. Its sulphur compounds may prevent some types of cancer.
Ginger Ginger root contains antioxidants and can help in managing nausea and reducing pain from acute and chronic inflammation. It may also reduce the risk of heart disease, dementia and certain types of cancer.
Nutritionists recommend getting more than your fair share of these nutrientrich foods and balancing your plate with them to promote all-round physical and mental health. Unlike some of the marketing hype around the latest obscure superfood extracted from far-flung soils, it doesn’t need to cost an arm and a leg to ‘eat healthy’. Here are some commonly available ‘superfoods’:
Turmeric
Nuts and seeds
The curcumin in turmeric has powerful antioxidant and antiinflammatory effects and may help prevent cancer, heart disease and diabetes. It could also help wounds to heal and reduce pain.
Rich in fibre, protein and healthy fats, nuts and seeds contain anti-inflammatory and antioxidant properties. They can protect effect against heart disease.
Avocado Avocados are rich in many nutrients including vitamins, minerals, healthy fats and fibre. They are high in monounsaturated fats, particularly oleic acid, which is thought to reduce inflammation. Eating avocados may reduce the risk of heart disease, diabetes and certain types of cancer.
Sweet potato Potassium, vitamins A and C and fibre are some of the health-giving properties of the humble sweet potato. They’re also a great source of carotenoids, protecting against cancer.
Mushrooms Mushrooms contain vitamin A, potassium, antioxidants and fibre. They may play a role in reducing inflammation and preventing some cancers.
Eggs Eggs offer high-quality protein and are rich in B vitamins, vitamin A, choline, selenium, iron and phosphorous. They contain antioxidants that protect vision and eye health.
Pulses Beans, lentils and peas are loaded with B vitamins, minerals, protein and fibre. They offer many health benefits including improved diabetes type 2 management, as well as reduced blood pressure and cholesterol. They can also promote a healthy weight by increasing the feeling of being full.
Salmon It’s one of the best sources of omega-3 fatty acids, which reduce inflammation and have other health benefits. This fish is packed with healthy fats, B vitamins, potassium and selenium. It may lower the risk of heart disease and diabetes and help in weight control.
Seaweed These ocean plants are dense in multiple nutrients including vitamin K, folate, iodine and fibre. They are a source of unique bioactive compounds with antioxidant properties. Some of these compounds may reduce the risk of cancer, heart disease and diabetes.
Kefir and yoghurt Kefir contains protein, calcium, B vitamins, potassium and probiotics. Fermented, probioticrich foods like kefir and yoghurt can reduce cholesterol, blood pressure and improve digestion as well as offer anti-inflammatory properties.
Olive oil It contains high levels of monounsaturated fatty acids and polyphenolic compounds. Olive oil also contains antioxidant vitamins E and K, which can protect against cellular damage. It protects against heart disease and diabetes.
healthcentral.nz/category/futurefocus
Thursday, 28 November 2019 | 5
Young men failing to launch: Is too much gaming creating vampires? With the summer holidays on the horizon, Jody Hopkinson talks to Dion Howard about supporting young people whose gaming habits are negatively impacting on their own and their families’ lives.
E
arlier this year the World Health Organization (WHO) officially recognised “gaming disorder” as a mental health condition. Playing a lot of video games isn’t enough to count as a disorder. According to WHO, gaming disorder is a “pattern of persistent or recurrent gaming behaviour” and a person typically needs to have symptoms for a year in order to be diagnosed with the disorder.
“They are playing in virtual rooms; they’re doing something with someone else. So when a parent calls, for instance, to come for dinner, they’re being asked to abandon their mates. When you combine that with fierce adolescent male loyalty, it’s a difficult force to counter. “In motivational interviewing, which is a prominent therapy for dealing with substance use – you never shame a person about their substance use, because you want to be able to get an “They end up Far-reaching consequences accurate picture of [it].” Dion Howard is a nurse based In Wellington who works with Dion points to the cultural shaming that has occurred in being 25 and living young men and girls with depression and anxiety. relation to gamers – the overweight Simpsons comic store at home; sometimes He says there are many reasons why some young guy, for example. people end up gaming too much. And for some boys and “They’ve been conflated with geeks. They desperately they are very good at teens who game excessively, the consequences can have want normal social lives and to enjoy gaming as well.” gaming, but they don’t far-reaching effects on their development. He says families and professionals need to figure out “Gaming in and of itself is not anti-social; in fact, it whether the gaming is an addiction or a perpetuating have any social skills, can be a very social thing to do, and adults frequently behaviour, and if it is enabling social isolation and and are not workmisunderstand that. But play enough every day and in the perpetuating anxiety and depression. blink of an eye that boy has spent one or two years mostly in Dion says parents need to take responsibility for what they ready.” their bedroom. gain from gaming too. “Some are living like vampires and become anti-social, “When children are occupied online, families gain peace and withdrawn, very shy and anxious. Often bullying has occurred and so quiet, and the chance to get things done. You can’t wake up when they avoid face-to-face contact. Basically, it can crowd out opportunities they’re 15 and say ‘that’s enough! No more gaming!’ because by then it’s a and challenges that help with maturing – they can miss some of the typical learned behaviour. It’s how they live life.” milestones of their peers, like having a girlfriend or boyfriend, getting a job, flatting. Conversely, Dion warns that the idea of internet gaming addiction can be too “They end up being 25 and living at home; sometimes they are very good at simplistic, and people only seeing what they perceive as wrong about gaming gaming, but they don’t have any social skills, and are not work-ready.” denies the gamer’s enjoyment and the skills they are learning when playing. There are many great benefits to gaming but that misses the point that some “Gamers get identity and validation online too. Often those young people are people aren’t flourishing with it, explains Dion. very good gamers they have a lot of expertise in gaming. And they build strong and “We think of it as “failing to launch”. There are 18, 19, 20 and 21-year-olds still at honest relationships with those with whom they play online.” home who haven’t completed any undergraduate study or started work – and are Simple and difficult advice home all day every day. It creates conflict because the parents come home, and the child hasn’t contributed. So what is the way out of gaming addiction? Dion says the advice is as simple as it “There’s a physical element too. These men aren’t moving and they’re eating is difficult at times to encourage and enforce. two-minute noodles and drinking energy drinks. Then the boys can get bigger than “I’m working with young people with clinical depression or anxiety. We would their parents and sometimes be physically intimidating, which can add to an already frame it as a person having that as a primary problem, and that the way they game uncomfortable mix when conflict occurs.” – the frequency and duration of gaming – keeps him that way. “It helps to see gaming in context. And we all need to set limits early.”
Parental responsibility
He says, just as when you watch a pet training show or shows like Supernanny, it doesn’t take long to realise when dealing with children addicted to gaming that there is a problem in the whole family system. The owner, or in this case the parent/s, also need support to make changes.
6 | Thursday, 28 November 2019
Advertorial
healthcentral.nz/category/futurefocus
Your mouth and the war that rages within The link between probiotics and good gut health are well known, but it’s the benefits of probiotics for oral health and hygiene that has a Dunedin-based tech company making waves on the world stage.
Blis Technologies Chief Executive Brian Watson.
B
lis Technologies is at the forefront of innovation, developing who value the scientific foundation these products are based on. probiotic products that wage war on the billions of invading bad Traditionally, oral health has been the domain of dentists and bacteria trying to take over the natural bacteria of the mouth, dental hygienists. And while their role is still important, being able to teeth and gums. take control and potentially limit those eye-watering bills by taking a It’s common knowledge that bad bacteria can contribute to tooth decay, proactive approach is holding great appeal. gum disease and the dreaded halitosis (bad breath), but it can also have a So could sucking a simple probiotic lozenge be the next big thing in flow on effect to other aspects of our life. health supplements? Brian Watson believes so. “This is an efficient and Blis Technologies Chief Executive Brian Watson says oral health plays a cost-effective way of supporting overall wellness.” key role in overall wellness. If supporting optimal health is key, then sucking a probiotic “The general public would be amazed at what goes on lozenge once a day could also provide an answer to a big inside their mouth. Things like bad breath and gum problem facing New Zealand. disease can be a major problem for some people, but The appalling rates of tooth decay in Kiwi children what’s really alarming is the link between oral health “This is an hit the headlines earlier this year and Watson agrees and the overall well-being of our bodies, including efficient and that a probiotic could have a role in supporting oral heart, circulation and brain function.” Watson describes the mouth as being like a health. cost-effective way battlefield. “If the mouth is the gateway for the human “It’s about getting on the front foot,” Watson of preventing serious body then an oral-targeted probiotic is a first line of says. “The state of children’s oral health in this support for the body’s defences.” health issues and country is a real concern and it would be great if our products could form part of the solution.” improving overall
Oral probiotics a game-changer
wellness.” General probiotics have become commonplace for the International attention health-conscious in recent years, particularly for those Having achieved considerable success already, it’s concerned about gut health. But it’s the lesser known no surprise that this small Kiwi company and its worldoral probiotics that are starting to take-off in the health leading, advanced oral probiotics has attracted the attention of supplement market. international consumers. For Blis Technologies, developing the world’s first advanced oral probiotic Their strains have gained regulatory approval from the powerful Food has been a game-changer. It’s fair to say that their products, developed and and Drug Administration in the United States, the Therapeutic Goods made in Dunedin, are in hot demand. Association in Australia and from Health Canada. Clearing these allBrian Watson believes it’s the science behind the products that sets them important hurdles opens up vast new markets for the innovative Blis apart. “It was Professor John Tagg’s groundbreaking work in the University of Otago Microbiology Department more than 20 years ago that really paved the Technologies. way for what we see today.” “This is an extremely exciting time for us,” enthuses Watson. “There’s “His discovery of specific strains of ‘friendly’ bacteria that are effective in so much potential with oral probiotics, it’s just a case of getting the dealing to bad bacteria in the mouth, led directly to the products we now offer. message out there and letting the science speak for itself.” The fact that Professor Tagg is still very much involved in our laboratory work Blis Technologies offers a range of oral probiotics that can be found online is a reflection of how important the role of science is in everything we do.” at blis.co.nz or at pharmacies nationwide. Always read the label and take as The correlation between the body’s oral immune response and the use directed. Blis Technologies Dunedin. 1947RS of certain probiotics has certainly struck a chord with savvy consumers
8 | Thursday, 28 November 2019
healthcentral.nz/category/futurefocus
Navigating New Zealand’s
dental care
About half of all New Zealanders are missing out on optimal oral healthcare due to the cost of regular dental check-ups.
U
nlike most other healthcare in New Zealand, dental care is not publicly funded, and the cost can deter people from getting treatment. While children and adolescents are entitled to free basic oral health services until they are 18, adults must pay privately for most dental services. The Ministry of Health website says there is no recommended fee structure for private dentists so costs can vary depending on location, specialisations and what equipment is used. Dental Association president Dr Katie Ayers says adults should be getting check-ups every six to 12 months depending on their needs, but many are not. “Around 50 per cent of New Zealanders receive regular dental care. The remainder are sporadic attenders. “In an ideal world, everyone would have access to routine dental care. This would include regular check-ups and cleaning, basic fillings, and removal of teeth when required.”
Cost not the only deterrent While cost is a big deterrent, it is not the only reason that people do not get regular check-ups, she says. “Many New Zealanders report that they don’t attend check-ups as they don’t see the need to; others report that cost is a factor. “We have found that even when the cost barrier is removed, low income adults do not necessarily attend the dentist. “Other barriers to access may include work commitments, transport factors and childcare issues.” University of Otago associate professor of dental public health Dr Jonathan Broadbent says many people are not getting optimal and timely dental care for two reasons: cost and neglect. “One of the most difficult groups is the working poor. They are ineligible for funded/emergency care but would still struggle to pay dental bills. “The second thing that gets in the way of optimal care is neglect; people put off going to the dentist until they get problems.” Often oral health can be managed easily and problems can be fixed cheaply if picked up early. Prolonged dental issues can cause pain, embarrassment, psychological upset and functional limitations as well as costing more, he says.
Oral health link to wellbeing Dr Ayers says poor oral health has also been linked to some types of heart disease, low birth weight and can affect an individual’s ability to eat, sleep, work and socialise. “Of course, the most important aspect in ensuring good dental health is prevention. Dental caries [tooth decay] is a preventable disease, yet it is also the most widespread.”
One of the most difficult groups is the working poor. They are ineligible for funded/emergency care but would still struggle to pay dental bills
Key factors in reducing tooth decay include reducing the frequency of sugar consumption, good oral hygiene practices (including the use of fluoridated toothpaste), and community water fluoridation. Dr Broadbent says that, in general, dental problems are linked to a person’s behaviour or lifestyle. “What a person does or doesn’t do directly relates to oral health. Having tooth decay is directly related to diet and self-care. “Smoking is the main cause of gum disease. Poor oral hygiene and sugar are the main causes of tooth decay.” Optimal dental care starts with prevention but also includes stabilising problems and rehabilitating the mouth, he said.
What is oral health? The World Health Organization defines oral health as “a state of being free from chronic mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal (gum) disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychosocial wellbeing”.
What dental services are publicly funded? The Ministry of Health website states there is a limited range of dental services funded for some adults: y People with disabilities or medical conditions such as mouth cancer may be referred to a hospital for their dental treatment by their usual dental practitioner or GP. y People on low incomes with Community Services Cards may be able to get emergency dental care, such as pain relief or extractions.
The numbers The latest New Zealand Health Survey results (2017/18) show that most people feel like they have good oral health but not all get regular checkups: y 80 per cent of adults reported their oral health to be ‘good, very good or excellent’. y 94 per cent of parents rated their child’s oral health as ‘good, very good or excellent’. y Most children (83 per cent) visited a dental healthcare worker in the past year, up from 76 per cent in 2006/07. y Nearly half of adults (47 per cent) with natural teeth visited a dental healthcare worker in the past year, down from 52 per cent in 2006/07.
Thursday, 28 November 2019 | 9
healthcentral.nz/category/futurefocus
MitoQ: Making
powerful magic for athletes “I don’t get excited about supplements that easily but from my own experience, anecdotally, and subjectively I’m seeing MitoQ can make a difference,” he says.
M
itoQ is a type of CoQ10 supplement. CoQ10 is naturally produced by the body to heal our mitochondria. Mitochondria are tiny cellular structures which turn the nutrients in our food into a form our cells can use – they generate 90 percent of our energy. Our mitochondria start to decline from the age of 30 onwards. MitoQ is a form of CoQ10 that can concentrate in the mitochondria therefore healing them. Previously, the focus of development and direction of CoQ10 antioxidant supplements has been to combat disease. But now sportspeople and those who coach them are picking up on how MitoQ improves performance, says Paul. “This substance improves how our mitochondria power our cells. It makes it produce more regardless of what age you are, and what we believe is of potential benefit for athletes of all ages and abilities, is that it can affect your energy levels and how much energy you actually produce.” A colleague recommended MitoQ to Paul. “And so I tried it and experimented with my own training and different dosing and noticed my ability to recovery from training and exercise economy noticeably improved. “As a 47-year-old I found I could recover quicker, and train with higher intensity when required. From a physiological point of view, I was handling more load than normal. An athlete I coach also used MitoQ in his build up to Coast to Coast 2019. We noticed a similar trend towards increased economy and improved recovery.” Paul Cadman’s coaching clinic is called Elevate Coaching. He coaches a broad spectrum of men and women athletes who compete at all levels across a variety of endurance sports. His background as a competitor across a number of sports, coupled with his BBS majoring in Sports Management, Graduate Certificate in Holistic Performance Nutrition and being Ironman University qualified was simultaneously augmented by his corporate work.
“A lot of what I did in my corporate work from Xerox to Lion Breweries involved coaching people on how to perform better in their work.” While working part-time and parenting the family’s son, Paul decided on a change in direction and started coaching. “I liken my coaching to a holistic one-stop shop. If you’re not healthy with high levels of wellbeing your chances of athletic success are diminished.” He updates his blog regularly about everything from the value of beetroot juice in an athlete’s diet to new books on growing your mindset. Paul has been running tests on athletes using the MitoQ at the AUT Millennium laboratory in Albany. “I’ve been running physiological tests so we can understand the make-up of an individual and how they’re performing. We run the tests, put them on MitoQ, get them to follow a six-week training programme and they take the same tests with big improvements in numbers. The increase in the VO2 max tests we’re running … they’re overwhelmingly positive. When other people hear the results they say ‘Come again? Wow, that’s impressive!’ “We don’t quite understand why it makes such a difference so that’s exciting too. It could be that it is increasing the number of mitochondria…we just don’t quite know yet and that’s exciting too.” Paul is now getting some clients to try “acute dosages”. “If a race is coming up, I give them a higher dose for three or four days before a race. We get you up to speed then dial back to a maintenance dose.” Athletes in the United States have cottoned onto the magic that is MitoQ – with Spartan CrossFit among others advocating its use. And currently Auckland University is conducting a study on its efficacy for athletes. Paul says through his clients and networks he is building up a body of evidence and believes MitoQ could benefit far more sportspeople than just endurance athletes. “It could be of benefit to cricketers and rugby players to sportspeople across the board.”
10 | Thursday, 28 November 2019
Advertorial
healthcentral.nz/category/futurefocus
The antioxidant that’s an athlete’s best friend The world-first New Zealand supplement that’s being used globally by athletes and active people to help power their performance.
T
he antioxidant CoQ10 is an endurance athlete’s best friend. It’s made in the body by cell powerhouses (the mitochondria) as part of the energy production process and also helps to protect the body from oxidative stress by building its own resilience. CoQ10 can be found in all cells, including those in muscles, heart and lungs. The problem is that, as we age, levels of CoQ10 can naturally decline by around 10 percent each decade from the age of 30. And that means less power to power your performance. Since around 90 percent of your body’s energy is made in your mitochondria, it stands to reason that if you’re wanting to protect that energy source, you need to start there. Because it can be tricky to get enough CoQ10 from your diet (liver, anyone?), many people, including elite athletes, turn to CoQ10 supplements. The issue here is that the mitochondria have a tough double membrane that doesn’t allow many things to pass through, including regular CoQ10.
Scientific breakthrough In the 1990s a team of scientists at The University of Otago invented a breakthrough form of CoQ10 called MitoQ that was cleverly engineered to be able to pass through the mitochondrial membrane, and take effect within the mitochondria to help boost levels of CoQ10 right where they’re needed, therefore helping with cellular energy.
CoQ10 to the power of 1,000 The world-first cellular supplement MitoQ is increasingly finding fans amongst athletes, from the pro to the semi-pro to the weekend warrior. Containing a form of CoQ10 that’s engineered to be able to get through the mitochondrial membrane, MitoQ is the world’s only supplement able to get inside the mitochondria at significant levels to help power them, and therefore your cells and you. Delivering a low 5mg dose per capsule that’s able to penetrate the mitochondria at levels up to 1,000 times higher than regular CoQ10, MitoQ supports healthy energy levels, endurance, recovery, sleep quality, stress and mood, fatigue, mental focus and overall wellbeing.
Fit fans More and more athletes and active people are discovering that MitoQ supplementation combined with a smart training programme can help with performance benefits. How? By supporting cellular health and energy, it’s possible to increase training intensity and duration, and shorten the recovery periods between, enabling you to make incremental gains. “We have been monitoring our athletes when using MitoQ,” says former triathlete, cyclist and footballer Paul Cadman, now a New Zealand endurance coach.
“They have an ability to absorb both acute and chronic training stress load. They seem to bounce back quickly and get out training again. MitoQ plus clever training equals optimum performance.” MitoQ is also used by celebrity and pro-athlete personal trainer and LA Lakers’ Director of Strength and Endurance Gunnar Peterson; Spartan Obstacle Course pro-racer and American Ninja Warrior Rose Wetzel; World Masters Games Triathlon gold and open swim silver medallist Darragh Walsh; and sponsors Spartan Racing in the US, and the legendary K2 Cycle Classic in the Coromandel, known as the Southern Hemisphere’s toughest one-day cycle challenge. “I take MitoQ because it’s part of my day,” explains Gunnar Peterson. “MitoQ gets into the mitochondria, the energy powerhouse of the cell and does its job better so you can do your job better. “If you’ve heard of CoQ10 and you know what CoQ10 does and how it helps break down free radicals in the body and get rid of them so that there’s less damage being done internally, picture MitoQ as the big brother that is a better quality, a higher level CoQ10 in your body.” For more information, visit Mitoq.com. Always read the label and use as directed. If symptoms persist, see your healthcare professional. MitoQ Ltd, Auckland. TAPS #PP4946
12 | Thursday, 28 November 2019
Recognising
depression We all have times when we feel flat or stressed. But how do we know when unhappiness spirals into clinical depression? Here’s our simple guide to recognising the signs.
T
hese days it’s everywhere – the D word. Our social media feeds and news bulletins regularly discuss depression. Headlines shout out about another celebrity’s battle with depression. Every few weeks new research highlights concerning statistics about depression. This new willingness to talk about depression both privately and in the public sphere is positive. Shining a light on the problem is a vital step to finding solutions. But, sometimes, it can be hard to identify the difference between going through a tough patch and suffering from clinical depression where help is needed. Depression affects us all differently. However, most health care professionals agree that depression is about persistently feeling down or uninterested in things you’d normally enjoy over a period of weeks or months. If you or a friend or relative have been experiencing a number of the signs and symptoms below, and these have lasted two weeks or more, it’s probably time to talk to someone.
Emotional symptoms Hopelessness Having the sense that there’s no point in anything is one of the most common signs of depression. Feeling negative about everything or that there are no solutions to your problems are key symptoms of depression.
Guilt Blaming yourself for your problems or being over self-critical are frequent aspects of depression. You may go over and over scenarios in your head, finding fault with yourself and exaggerating any of your weaknesses.
Anxiety Depression is often accompanied by anxiety – you may constantly worry about the future or things that happened in the past. Anxiety can translate into nervousness, tenseness or a feeling of dread.
Overwhelmed
Changes in weight
Situations you normally cope with may seem overwhelming. You may feel incapable of carrying out everyday tasks or dealing with social situations.
You may gain a lot of weight suddenly or, alternatively, lose weight suddenly. If you haven’t set out to lose or gain weight, it’s worth investigating whether depression is the cause.
Irritability You may feel easily annoyed and intolerant of others. Small things that don’t go right may particularly annoy you.
Worthlessness It’s common to feel worthless or useless when you’re depressed. You may have trouble remembering anything that you’re good at.
Sadness You may feel tearful and sad all the time. This is different from feeling sad about specific things; for example, grief in bereavement.
Loneliness Feeling alone or isolated or unable to connect with other people is a key feature of depression. You may worry that no one really likes you or that you have nothing to contribute to other people. There are many other feelings you may experience when you’re depressed. Some people experience uncontrolled emotions, with swings between anger, sadness and frustration. Other people report having no feelings, a feeling of numbness.
Physical symptoms
Rapid heart rate, increased sweating and trembling or muscle twitching could be signs of anxiety associated with depression. Your stomach may also be upset. You could have trouble focusing or thinking clearly.
Reduced sex drive A lower than normal interest in sex can be a sign of depression.
Thoughts Depressed thinking focuses on what might go wrong, negative experiences of the past and self-criticism. y “I’m a failure.” y “It’s all my fault.” y “I’m worthless.” y “Life’s not worth living.” y “Nothing good ever happens to me.” y “People will be better off without me.”
Behaviour The following might indicate depression: y Not going out anymore. y Withdrawing from family and friends.
Low energy
y Giving up hobbies.
You could feel exhausted all the time. You may struggle to do basic tasks. You may feel constantly run down.
y Staying in bed longer.
Sleep changes
If you or a loved one have been suffering from any of these signs for two weeks or more, it’s time to get help. The good news is that there are more and more successful ways of treating depression. Start by talking to someone – your doctor or a counsellor.
It’s common to have trouble sleeping and to lie awake worrying about things. Other people find they sleep far more than normal and have trouble waking up.
How severe is it?
Fact file
Mild depression has some impact on your daily life.
y 1 in 7 people will experience depression before they are 24 years old.
Moderate depression has a significant impact on your daily life.
y 1 in 8 men will experience depression.
Severe depression makes it almost impossible to get through daily life.
Physical anxiety
y 1 in 5 women will experience depression. y 1 in 4 New Zealanders will experience anxiety. Source: The NZ Mental Health Survey, 2006
y Increasing use of alcohol or drugs.
Where to get help If you are worried about your or someone else’s mental health, the best place to get help is your GP or local mental health provider. However, if you or someone else is in danger or endangering others, call police immediately on 111. Or if you need to talk to someone else: y
LIFELINE: 0800 543 354 (available 24/7)
y
SUICIDE CRISIS HELPLINE: 0508 828 865 (0508 TAUTOKO) (available 24/7)
y
YOUTHLINE: 0800 376 633
y
NEED TO TALK? Free call or text 1737 (available 24/7)
y
KIDSLINE: 0800 543 754 (available 24/7)
y
WHATSUP: 0800 942 8787 (1pm to 11pm)
y
DEPRESSION HELPLINE: 0800 111 757
healthcentral.nz/category/futurefocus
Thursday, 28 November 2019 | 13
Physiotherapy, chiropractic and osteopathy: what you might not know
From images of a physio rubbing down an All Black, a chiropractor ‘cracking’ bones and an osteopath massaging a back into shape, we have a general idea about what these health practitioners do. But do these ideas still hold? Jody Hopkinson looks at the more nuanced and lesser-known treatments these three quite different practices offer. Pelvic health physiotherapy We rarely talk about problems in your nether regions i.e. “poos, wees and sex” and that needs to change, says Tauranga-based pelvic floor physiotherapist Claire Baker. “We’ll talk about lower back pain problems, but pelvic problems are regarded as ‘just’ affecting pregnant women or the very elderly, rather than the 80 percent of the population they do affect.” At the beginning of her TedX Tauranga talk ‘Common… NOT normal’ Claire explains that when she began studying to be a physio, she had envisaged rubbing down the All Blacks or travelling to the Olympics with a team. But then she had children. While she had what many would call an enviable water birth with no instrumentation, she tore from back to front, and then the importance of the pelvic floor became very real to her. “I knew not to wait and see what might happen in the future and went to physiotherapists about it. I learnt that the health of your pelvic floor
“The silence means we don’t realise that [pelvic issues] are affecting so many of us.”
affects the most essential areas of your body, and physiotherapy can, if not fix these issues, help you manage them and subsequently lead a fuller life. I then went on to retrain to help people manage their pelvic floors.” She says keeping “private parts private” is detrimental to our health, with some suffering from faecal leakage, for example, and not even telling their GP because they are so ashamed of a condition actually affecting one in eight New Zealanders. “The silence means we don’t realise that pelvic issues like leaking from your bladder, needing to wipe hundreds of times to feel clean, pelvic floor prolapse where your organs are falling outside your body, or erectile dysfunction are affecting so many of us.” She explains that what we don’t know can hurt us and that the not knowing means people put up with discomfort and pain thinking it’s normal – when it’s common but it’s not normal. >>
14 | Thursday, 28 November 2019
healthcentral.nz/category/futurefocus
The tragedy of pelvic floor issues is that people begin to withdraw from their own lives to manage quite common and manageable issues, says Claire. “People are not going to say, ‘Oh my vulva pain is really playing up today’ or “Yeah, I’d love to play netball, but I’m scared my uterus will fall out on the court” or ‘I would go on a date with you (but I can’t get it up)’.”
“When we’re working on people, we’re not just feeling for the movement within the joint – we’re also assessing the quality of the tissues around the joint. Tissues can feel firm or soft, hot or cold, and these qualities help us to understand the state and nature of an injury.”
Tailored treatment
Spine central to good health
Rather than dividing the body into parts, says Gamblin, osteopaths view the person as a whole and tailor each treatment to each person individually. “Osteopathy is quite unique in that way, because we acknowledge that everything in the person’s body functions together. “For example, somebody might come in with back pain and we also end up treating the foot. We look at their injury history, their levels of stress, their lifestyles… If there is something wrong with your foot, your body will compensate for it elsewhere, whether it be in your hip, your back, or even right up into your head.” Gamblin says osteopaths can work quite gently or quite firmly, and “we all have our preferred style of treating”. “It’s interesting because you can see different osteopaths who will use different approaches, but by using the same osteopathic principles they all have the same goal – to get your body working better.” She says osteopathy is a “hands-on” tradition. “Everything we do, we feel through our hands. Patients can be surprised by what we pick up on! This is also a skill unique to osteopathy, as we develop a fine-tuned sense of touch which is over time.
Fairest reiterates how chiropractic is not “bone crunching”, rather it’s dealing with whatever issue the person presents with, and then empowering the person to get back into the world again. “Generally, we deliver adjustments with hand-activated instruments or with our hands. There are many different ways to adjust a patient depending upon their preferences and requirements. “Many of us do cranial work as part of checking the full spine. We always assess the nervous system, do a physical exam, and inspect the patient’s history when deciding upon the type of care needed. “If the spine works well, then your nervous system will function well. The healthier your nervous system, the more accurate the information it sends to your brain. The more accurate the information your brain has to work with, the healthier you are as a person.”
Comprehensive chiropractic care
Chiropractic care is a whole lot more about adjusting the spine gently and specifically than it is about major manipulations, says Dr Transformative treatment Cassandra Fairest, vice-president of the New Zealand Chiropractors’ Physiotherapy can help people to learn to manage a problem and work Association and the NZCC Alumni Chiropractor of the Year 2018. with it, says Baker; it can be that transformative. “Chiropractors help people reach and maintain greater health “We can help prevent and manage incontinence; resolve and wellbeing through the care of the spine and nervous pelvic pain or pain during sex; do bladder retraining and system. Chiropractors adjust the spine to correct nerve, help with problems during pregnancy.” muscle and joint dysfunction. Assessment and guidance can include a vaginal “We do a five-year, full-time degree covering a huge “If the spine examination and tailored pelvic floor exercises, range of health science subjects from neuro-musculoworks well, education, bladder and diary analysis, and core skeletal anatomy to neuroscience. Not many people then your nervous strengthening. know that we do radiology papers as well, as part of “A big part of this is helping clients get to know the our training, so we are all licensed to take X-rays and to system will body they have NOW. Listen to your body, where it own X-ray machines.” function well.” is at now – not pre-baby, not pre-menopause – and if She says a chiropractor’s strength is in their indepth you have anything that impacts negatively on your life, knowledge and understanding of the nervous system and seek out a pelvic health physiotherapist.” the spine. “I was drawn to chiropractic when my baby couldn’t turn Holistic osteopathy her head one way and was developing a flat head on one side. A GP recommended a chiropractor, who, with incredibly gentle and subtle Osteopathy is quite different. Osteopathy is a form of manual pressure, adjusted my child and she immediately moved her head therapy that looks at the way that different parts of the body are that way. Not only could she turn her neck, but she also seemed more connected, and how they can affect each other. settled and slept better. It changed our lives. Jessica Gamblin, vice-president of Osteopaths New Zealand, is a “I see and hear time and again patients calling what we do a miracle. UK-trained osteopath with her own clinic, Align Osteopaths, based in But for chiropractors we’re often more puzzled when we **itals** don’t** Tauranga. see miraculous things happen with what we do.” “Often people don’t realise how gently we can work,” she says.
Thursday, 28 November 2019 | 15
healthcentral.nz/category/futurefocus
Physiotherapy
Osteopathy
1. What is physiotherapy?
What is common to all osteopaths is a holistic, patient-centred approach that is governed by the main tenets of osteopathy:
Physiotherapy uses proven techniques to help restore movement and function to anyone affected by an injury, disability or health condition. A physiotherapist uses indepth knowledge of how the body works, combined with hands-on clinical skills, to assess, diagnose and treat patients.
y The body is a unit. y Structure and function are reciprocally interrelated. y The body has capacity for healing/self-repair.
2. It started as a women-only profession Begun in the year 1921, partly as a response to World War I, the first professional association was a women’s physical therapeutic association in America. The New Zealand Physiotherapy Act was passed in 1949 and the national membership organisation (now Physiotherapy New Zealand) established shortly after.
3. There are different types of physiotherapy For example, acupuncture; cardiorespiratory; hand therapy; manual therapy; mental health; neurology; occupational health; older adults; paediatric; pelvic, women’s and men’s health; and sports and exercise.
4. Find a physio Physiotherapy New Zealand (PNZ) is the national membership organisation for physiotherapists. Being a PNZ member reflects a commitment to their high standards of practice and professionalism. You can find a member at physio.org.nz.
5. Physiotherapy is good for vertigo Positional vertigo is when someone is experiencing relatively brief instances of dizziness when they move their head or change physical position. A vestibular system dysfunction in the inner ear, this annoying and unsettling sensation can be successfully treated by physiotherapy.
Chiropractic Chiropractic care began in 1895 in Iowa The inventor of chiropractic care was Daniel David Palmer, who proposed the practice in 1895 in Davenport, Iowa. Palmer believed that spinal adjustment would have a positive ripple effect, helping heal many other parts of the body. Chiropractic is a combination of the Greek words cheiros and praktikos (meaning ‘done by hand’.) Never let your untrained friend ‘adjust’ you Chiropractic isn’t just ‘popping your back’. It’s a scientific process that requires thousands of hours of training. If you have an untrained friend who wants to ’help you out’, they may actually hurt you very badly. In 2001 a man in India developed severe spinal cord and brainstem problems after receiving a neck adjustment from his barber. Adjustments aren’t as easy as they look – leave them to the professionals.
16 | Thursday, 28 November 2019
healthcentral.nz/category/futurefocus
It IS easy (and healthy)
being green
“We help people take that sometimes scary first step, put them in an encouraging environment and then keep in touch with them.”
Green Prescription is a health coaching programme that has been successfully helping New Zealanders get fitter and happier and more connected for more than 20 years – and yet many of us have never even heard of it.
T
he Green Prescription (GRx) is an exercise and wellbeing referral programme. Funded by the DHBs, it is run by regional sports trusts, primary health organisations and Māori health organisations. People are generally referred by their GPs or practitioners like paediatricians, midwives and social workers but people can call and ask to take part off their own bat as well. It begins with a consultation with a GRx worker and then up to six months of fitness classes or workshops and advice around what to eat, with ongoing support via phone and text. It also gives much cheaper entry to gyms and pools owned by councils.
Part of a worldwide response The Green Prescription concept came about as part of a worldwide response to the US Surgeon General’s call for countries to encourage people to do more physical activity. It began in New Zealand in 1998 at the Hillary Commission, driven by Diana O’Neill who led it for the next 21 years under various guises and when it moved to the Ministry of Health. Now retired, Diana O’Neill travelled to various other countries wanting to emulate the success of the green prescriptions here,” explains Deputy Director of Public Health Dr Harriette Carr. “Part of its success has been its ability to adapt to different communities’ needs – some people like oneon-one attention, while others want to be a part of our group. It’s our GPs, nurses and practitioners, as well as our frontline staff delivering the programme on the ground, who are a huge part of the green prescription working so well. Their ability to tailor classes and
activities to their communities’ needs is invaluable. “Over the years, customer surveys have consistently shown that people feel less anxious, healthier and fitter and say they appreciate the holistic nature of the prescription as opposed to only treating an illness or condition with medication. “It’s also holistic in that it not only helps people on a personal level but walking for example – the most popular exercise prescribed on the programme – creates a more sustainable environment and counters climate change. “So the Green Prescription is not ‘you’re overweight, now go for a run and we’ll tick a box’-type programme. It is a highly sophisticated number of nationwide programmes getting whole families off the couch and going on walks together, for example, or young mums at risk of maternal diabetes to do a cooking class together.”
Non-judgmental space One of those delivering the Green Prescription is Ashleigh Baker, the Healthy Lifestyles Manager for Sport Wellington. “Often they can be quite nervous when first referred because a conversation with a doctor about exercise and nutrition is not always an easy thing – that’s why the first appointment is so critical to put them at ease and show that we come from a non-judgmental place. “It’s important we seek to understand what people really want to achieve with their health and wellbeing, rather than tell them what we think they should do, so they feel empowered to take the next steps and on their own terms. When you are told to do something how likely are you to follow up?”
Ashleigh estimates that they see around 3,000 people per year participating in Green Prescription across the wider Wellington region. “I feel very privileged to work in this area. It’s the little things like having a family tell you they now eat dinner together at night, and seeing an increase in a young mum’s self-esteem. “Participation in our programmes feeds into other parts of participants’ lives and helps to build social connection; they might get the opportunity to work with a group when they didn’t want to exercise alone and make friends in the process. “We help people take that sometimes scary first step, put them in an encouraging environment and then keep in touch with them. “I believe a big part of the programme’s success is because they are whanaungatanga-centred, and seek to build strong connections between like-minded people, and back into the community.” Ashleigh says she is very proud to be a part of the programme and if she could expand the programme at all it would be to have more one-onone time with those of us fighting against the odds more than the rest of us. “A lot of people present with very complex lives. If there is one thing I would add to the prescription it would be the ability to work with families with multiple needs such as insecure housing and low wages or no work in a more intensive way. “It’s not a level playing field out there and it would be nice to spend more time with people with more complex needs and lives.”