Curing Disease Through Nutrition with Best Selling Author Dr Karen Coates

Felicity Cohen: Hello, I’m Felicity Cohen. I’m so excited to introduce you to my Wellness Warriors podcast. For over 20 years, I’ve been a passionate advocate for helping thousands of Australians find solutions to treating obesity and health-related complications, through surgical intervention and holistic managed care.

My podcast is dedicated to all the people past, present, and future who have helped shape my journey and continue to inspire me to work consistently to achieve a healthier Australia in both adults and future generations. I hope you enjoy it. Good morning, Dr. Karen Coates, thank you so much for joining me on my Wellness Warriors podcast.

And it’s an absolute pleasure to welcome you here. You’ve had the most incredible career here on the Gold Coast spanning a number of years, and I’d just like to go back to when you were first a GP. And at what point in your career did you start to think about things that might not have been within the traditional scope of the normal general practitioners lifestyle.

Dr Karen Coates: It goes way back to when I first started in general practice in a little country town called Queanbeyan and New South Wales. And I had a very, very standard general practice at that stage. I was doing obstetrics, so I was delivering babies, I was attending the emergency at the local hospital and it was very, very much mainstream and I had a couple of

incidents with patients where my, my mind was open to the possibility that there was other ways of doing some things that I just assumed was related to medication. And one in particular, a woman who came in, complained about the symptoms of bladder urgency. And I thought she had a urinary tract infection.

So I set off her urine, and when the results came across my doorstep, it confirmed what I suspected. She had a bacterial infection on the bottom of the piece of paper, of her results with a list of antibodies. That would guaranteed cure her infection. And so I rang her up and I said to her, “Lynn, you’ve got a bladder infection.

When would you like to come and collect your prescription for antibiotics?” And there was this pause on the end of the line. And she was a very, very brave woman who had the courage to say no to a doctor back then. And it didn’t happen very often. “No, thank you, Karen. Just needed to know that that’s what I was dealing with.

I’m off to my Chinese herbalist to manage the problem.” Yeah. Of course my medical mind, my very, very mainstream mind thought, oh my gosh, that’s a terrible decision here. And I knew I had to keep her safe from that decision, but I also had to respect her ability to choose. So I said to her, I said, well finally, and even though it wasn’t, “when you finished curing your infection, can you please provide me with another sample of your urine so I can make sure that it’s gone?

How long do you think it’s going to take you?” And the reply came back, two to three weeks. I thought to myself quietly, okay, all bets are on here. I forgot about them for about three weeks and then all of a sudden her urine container, her sample reappeared in my office. And a little note from Lynn saying, “here’s my sample

as promised Dr. Karen, I feel fine.” Anyway. So I took the lid off and had a sniff because doctors do that to determine the health of the patient, sent it off to the local pathologist. And when her result came back, it really started to rock my world and that mainstream approach to urinary tract infections, because in my mainstream model, in my mind, she had three options, take the antibiotics, guaranteed a cure, choose not to,

and she would either live with the infection forever, or she’d be so sick with it that she’d be carted off to the local hospital and I’d be called to actually put that antibiotic through her vein. And what I had in front of me with that second sample of urine was a perfectly healthy sample with no sign of any infection.

So she managed to do what I would describe back then as a medical miracle. And because I was so interested in how she did it, I rang her and congratulated her on her result and asked for the name and number of her Chinese herbalist, because I wanted to know what they’d done. And that basically started a conversation that went on first several years in that little country town called Queanbeyan.

And I started to see that there was another way of doing things, short of reaching immediately for that prescription pad.

Felicity Cohen: So that must have been that first trigger you to start exploring the whole concept of integrative medicine. And I think when a lot of people think integrative medicine, what does that actually mean?

And how are we working together with traditional mainstream medical practice, but also looking at incorporating other new modalities to try and treat patients.

Dr Karen Coates: I think what integrative medicine is, is it’s choosing the best out of both worlds, but being mindful that as a medical doctor, I have to stay in evidence.

So I need to have evidence backing up. My decision, for example, to treat mild, to moderate depression with St. John’s ward, the herb, rather than Prozac. And my evidence is that there’s a very, very well-designed study that says that if I give a patient with mild to moderate depression, the herb I’ve got just as much chance of getting them feeling well and buoyant as I have prescribing the medication.

And I probably do less harm by that first off approach, but I’ve also mindful that there are some circumstances where you have to bypass the natural and go straight to the medication because that’s the right decision for that particular clinical scenario in that person.

Felicity Cohen: Can those things sometimes work in combination?

So I’m thinking back to myself personally, many years ago when Dr. James Reed used to work with us, and he was very involved with the Australian college of environmental and nutritional medicine. He was fascinated in the obese patient population with urinary pyro disorder, and he used to treat a lot with all sorts of things, zinc and, other kinds of nutritional type approach to how he would treat patients.

And at that time I was going through a really stressful period and he said to me, I think you should start taking SAMe so, so he put me on that and I’d never had any exposure to that before. And I found it really, really helpful in balancing my moods in helping me cope with the stresses that I was dealing with at the time.

So do you ever see, is there room for those kinds of treatments to also work in combination with something like Prozac, is, are they other prescribed together?

Dr Karen Coates: Absolutely. And I think it’s important for the therapist, whether they be a trained naturopath or an integrative doctor to know when medication is the right pathway and to also know whether there are any interactions with natural products and pharmaceuticals and, I’m constantly surprised at the power of natural medicine to actually provide the end result that the goods with that when we’re, we’re looking at how, how that fits into a mainstream medicine model, I think sometimes doctors forget about basic biochemistry and basic biochemistry

says if you’re zinc deficient, if you’re vitamin D deficient. Then you’re going to impact on your ability to make those beautiful hormones, that support mood and, and reduce anxiety. So if you’re not actually feeding your body and feeding yourselves, then regardless of whether you choose the medicine or the herb, the medication, or the herb, you’re still not going to have optimal results at the end of the day.

So in my world, I think it would be remissive of mainstream doctor, not to look for vitamin D deficiency, zinc deficiency, and iron deficiency in a young woman presenting with mood disorder because those three things have a powerful influence on their ability to make the serotonin, which is their their happy hormone for want of a better word.

Felicity Cohen: So interesting. You know, I think there’s a common misconception, especially in an overweight person when they’re exploring how they’re going to actually achieve a weight loss outcome with the pathway of surgical weight loss, for example, that they’re all of a sudden going to be starved of nutrition. How am I going to be able to absorb successfully all the nutrients that I need to, to survive, to live well, and maybe eventually have children

post being an obese patient. And what they don’t understand is that their absorption is already so compromised. And what we’re starting to see here now in this clinic is the opportunity to use IV nutrient therapy as well to supplement and compliment, but also for correction. There’s a really strong, I think, argument to look at, how do we support patients overall from that whole nutrient profile?

What do you think about using things like IV nutrient therapies? Is that something that you feel is relevant and worth exploring further?

Dr Karen Coates: Yeah, I think you made a good point where we look at people who are struggling to maintain their body weight, are often, even though they’re, they’re not malnourished, they’re micro malnourished, so their macro nutrients are fine there, but plenty of protein, fat, and carbs, but their ability to get those trace minerals in and absorbed and in sufficient

numbers to actually support everything that their body needs. Those micronutrients for is quite compromised. And I think that the role of whether it be, oral supplements or IV supplements is basically you need to fill those nutritional gaps while you’re working on diet and nutrition and absorption in order for the patient to actually get to their goal, whether that be weight loss, or optimal wellness, it doesn’t matter.

So I’m, I’m all for IV nutrients, if we can’t get them through, in that more sort of digestive, nutritional way.

Felicity Cohen: So interesting that this impacts mood disorders or just stable mood and wellbeing, and that we can treat with things like zinc. What other kinds of nutrition can we look at to help someone stabilise their mood?

You know, so often in this patient population, there’s depression and anxiety is so common. It’s high.

Dr Karen Coates: Yeah. I think when you look at young women, you’ve got to look at iron and iron deficiency due to heavy periods. For example, magnesium is another player. And when I start to look for magnesium deficiency, even in

traditional and conventional blood tests. I’m surprised at how often I find a low level of what we call red cell magnesium. And that is the test that actually tells me whether you’ve got enough magnesium in the cell where all the action is that that then provides support for your body. So I think that those sorts of nutrients are really

powerful given intravenously, because it almost like provides a kickstart for those biochemical pathways that people need to feel well, and then get the motivation to look at, for example, at things like weight management, the other thing that we know of people who carry extra body fat is that they are mostly, inflamed, more so than people who are carrying a normal body weight and that inflammatory process

will actually chew up more of the micronutrients. So their diet needs to provide more of those at a time when they’re probably trying to calorie and, and food restrict and therefore not even meeting their basic needs from the point of view of those micronutrients, the minerals and the vitamins.

Felicity Cohen: I remember years ago, you mentioned at a talk that I was at, ‘Selenium’, and how important selenium is in your diet.

And I so remember this, stuck with me forever that I should have, five Brazil nuts and that they needed to be from Brazil because the soil is richer in selenium. And we don’t get enough of that here in our, in our soil and the, in the, how, you know, our produce, where it comes from, et cetera. Why was that such an important element and why should we think about selenium as being important in our diet?

Dr Karen Coates: Most of the soils in Australia are selenium deficient, and also boron deficient and a few other little trace minerals, but selenium from the point of view of weight management is a really important player for thyroid support. So even just a little notch down in Europe, your thyroid glands ability to, to basically support an

efficient basal metabolism is going to put you on the back foot when we look at weight management and weight loss. So looking at things like your ID levels and other trace mineral, that’s very, very commonly deficient in today’s world, selenium levels and vitamin D they’re all players that not only support good health, but also thyroid support, which is your, your metabolic system.

Felicity Cohen: And so interesting that you mentioned thyroid. Because, if I think back to, you know, just early conversations with patients 15 years ago, compared to today, for example, the number of people that I speak to who tell me they have a thyroid condition, the diagnosis in under or active, or, you know, hypothyroidism or Hashimoto’s.

I never used to hear the word Hashimoto’s, 15 years ago it was rare. This is something that I hear all the time. It’s so prevalent. What do you think has given rise to such an increase in all of these thyroid and metabolic type conditions?

Dr Karen Coates: I think that the evidence doesn’t really give us many answers to that question.

But if I look at it sort of from a general concept point of view, I think that if we’re not actually nourishing the thyroid cells of our body, our immune system is more likely to be attracted to an unhealthy thyroid cell, tag that as unhealthy and germ like, and then attract your immune system to that cell in order to rid it

from our body, like it was a germ. And so we have this auto-immune almost epidemic in our society and certainly that Hashimoto’s, that inflammation of the thyroid gland leading to a destruction of the actual thyroid itself and an inability to produce its thyroid hormone. Is just on the rise and I see it more commonly in women and I’m seeing it more commonly now than I was a decade ago.

So I think it’s got a lot to do with, not feeding the thyroid well, and some diets are a real problem with that. Particularly with iodine, anybody who’s followed a paleo style diet for a long period of time is almost certainly iodine deficient. And so that’s one of those micronutrients that you really need to pay attention to if you’re,

you’re looking at a, you know, a fairly restrictive diet long-term long term because, all fad diets do have their macro and micronutrient deficiencies associated with them.

Felicity Cohen: Yes. So important to move away from the whole concept of dieting at all. And especially for a fad diets and for us in, in the work that we’re doing here every day, you know, we’re seeing people who’ve tried

absolutely every diet you can possibly even imagine, which is sad, you know, that they should actually go through all that before reaching a point in time where they need to find something that is more stable, and we’ll give them a solution that’s more long-term. I think also for so many people, they think, okay, I’ve got maybe Hashimoto’s or I’ve got type two.

But it’s under control because I’m taking a pill I’m on medication. Where do you think the trap is there and how do we get people to understand that that’s not a good place to stay in?

Dr Karen Coates: I think that there’s a difference between optimal wellness from the point of view of how your body’s behaving and what your blood test results show.

And you can have the most perfect blood sugar results on the planet and still be at risk of those medical long-term complications of things like type two diabetes. And again, it gets down to those fundamentals of if you’re nourishing your body well, if you’re not moving your body, then you’re really not supposed your body on a genetic level.

And that’s where optimal wellness sits. So I see that a lot. And I think too, when you’re looking at people who have been on calorie restricted diets for a very, very long period of time, that’s one of the big flags with regard to a very slow basal metabolism because your, your body doesn’t know the difference between choosing not to

eat in a day and there being no food in your environment for that day. So there are some people who are far more likely to be pushed into that drought famine war scenario, where their body basically goes into that starvation mode in an effort to allow them to survive the famine that they believe

their body to be in. And that sort of thing is a real problem when we look at long-term weight management, if long-term weight management is calorie restriction, and particularly if that calorie restriction then gives people micro nutrition deficiencies, that then become an internal stress. Yes.

That then drives that whole process of lower basal metabolism, which means you just don’t burn as much calories in your day, as you were, when you were saying in your teens and you didn’t have a weight problem.

Felicity Cohen: So interesting. You touched on pathology. Something that really has struck me in one of your presentations previously also was how to read a pathology report.

I’m so interested to hear your definition and your take on, you know, how, how we should actually interpret pathology. And what does that look like and how did the pathology labs set that standard deviation the norm in terms of how that’s read. Can you give us a bit of a rundown on your take on pathology?

Dr Karen Coates: The, the nutrients, like zinc, for example, and to a certain extent, iron as well. The reference ranges that you see on your pathology paper are determined, not by optimal wellness, but by population averages. And if we step back and say that I know from other studies that most people in Australia are zinc deficient, then when the laboratories take some peoples blood that is coming into the laboratory, on zinc reference testing day, they actually take that blood test away and actually do a level on it, they then, they then averaged out the zinc coming into the laboratory on zinc reference testing day. And that is the midpoint of those reference ranges. And then there’s a mathematical equation of two standard deviations from the mean that determines the low and the high end of that reference range.

But basically that reference range is being determined by people who are zinc deficient and when I look back on what’s happened, for example, to the zinc reference way back when I started in this game in the eighties, the reference range that you would see on a piece of paper for your serums zinc, it would be 15 to 35.

Now it’s 9 to 19. So over the period of those couple of decades, the laboratories picked up the reference ranges and had to move them in order to put the averages and fit them in between those two reference markers on that piece of paper. So now what we find is that people who just creep into the reference range with zinc, for example of 10 back in 1982, would it be clearly zinc deficient.

When the low cutoff mark was 15 and they would have been told even by their mainstream doctor to take zinc supplements. Nowadays, if you creep in and you score 10 you’re in the range, and then you might be that person whose blood is taken in years to come to define the average of the population. And then again, that reference range is picked up and changed yet again.

And we see that happening time and time again, with these really important nutrients that determine long-term health and wellbeing.

Felicity Cohen: How do we challenge that? What are we, that’s a really, it poses so many questions and it does create a problem for us. So what do we do next?

Dr Karen Coates: I think when you’re looking at things like, well, certainly zinc, vitamin D have a look at where the reference ranges are on your piece of paper, but make sure you’re in the top 10%, rather than the, what I’d call the not dead yet end of the range. Where, for example, vitamin D if you hit 40, which is the cutoff on an, on a lot of reference ranges for vitamin D in Australia.

If you hit 40 you’re in range, but all that means is you probably won’t get rickets, which is a terrible deformity of your bones, but then less as a menopausal women, you actually hit 75. You’ll actually be losing bone density at a much greater and rapid rate than women who sit at a hundred for their vitamin D.

So when you’re, you’re looking at optimal, there’s a sweet spot in that reference range. You don’t want too much, but you don’t want too little and you’d need to actually be a little bit more savvy about determining where optimal wellness lies with regard to these nutrients and for vitamin D in my world, unless you hit 90 and you state somewhere between 90 and 150, you’re really not supporting everything that you need vitamin D for your body.

Felicity Cohen: Thank you so much. And I think that’s so relevant and a great lesson for all of us to be really mindful of how we interpret the pathology results. But to also take control of that and take some action and to explore it and to really think it through, optimal well-being obviously being the one thing that all of us would like to achieve for, you know, longevity and living well.

Dr Karen Coates: I think the problem that we have at that, and having been a very, very mainstream medical doctor for a lot of my career is that we’re our job is to diagnose disease and to treat disease. We very rarely have the luxury of spending sufficient time to actually give the message of preventive medicine and lifestyle changes as well.

Most GPs that I’ve ever spoken to would love to have that opportunity. It just doesn’t fit into our medical model where we’re, we’ve got a waiting room full of people that have coughs, colds, flus, asthma attacks, what have you. And we’ve got a time limit on how much time we can spend with each patient when there’s a waiting room full of people and we’re already an hour late.

So I think that if you’re looking at optimal wellness, it often doesn’t find itself in a very, very busy, very conventional general practice, but having said that, if you have a cough, cold, flu, or you’re acutely ill, that’s the place to be. So it’s a matter of choosing the right specialist for your needs. And if you want to look at wellness, you need to either source an integrated doctor who perhaps gives you 40 or 60 minutes of their time or a naturopath rather than expect your GP to be able to set aside that time, to do that preventative health.

Felicity Cohen: A hundred percent agree. And we’re very lucky here, we’ve got two brilliant, awesome, amazing GPs. So very fortunate here in that, in that context. And I think it is so important. So something else that you talk about a lot that I would really like to touch on are sleep, stress and sugar. You know, there are three of the evils or three things that I think that we are all so impacted by first of all, with sleep.

I just wanted to highlight the fact that I see so many people with sleep apneoa, undiagnosed, sleep apneoa, but without a recognised attitude that this is serious and dangerous. And I really want more people to understand the impact of what sleep apneoa really can mean for them if they’re not managing it.

And I also see that with weight loss, we can impact sleep apneoa and quality of sleep so significantly. And the other thing that I see in that is obviously it sets up a cycle of behavior, you know, where I’m sleep deprived, I’m tired, I’m exhausted, I’m going to reach for high energy dense calorie. You know, Coffee, energy drinks, whatever that looks like, whatever evil that looks like to just keep me energized throughout the day and setting off a whole lot of other host of complications.

So yeah, you know, it goes hand in hand with the stress and the sugar.

Dr Karen Coates: And it’s a vicious cycle too, when you don’t sleep well you tend to choose the caffeine to get you through the morning and then to the evening. And with some people, in particularly those who have been dealt a poor genetic card with regard to caffeine metabolism, that one

shot of espresso that they have at nine o’clock in the morning can still be playing habit with sleep 17 hours later because they actually are very, very sluggish and poorly efficient at getting rid of the caffeine. And what are the other things that people don’t realise is that dark chocolate, gram for gram has a huge amount of caffeine in it.

So it’s not only calorie dense, it’s also really, really high in caffeine. And if you look at my preferred option is the 70% dark, 100 grams of that is about one and a half espressos worth of caffeine. So that can really impact on your ability to get a good quality sleep. And it’s going to be worse in people who have inherited those sluggish genes.

So, your caffeine is a real sleep saboteur. And it’s really important that if you’re not sleeping well, you completely eliminate all sources of caffeine from your life until you’ve got that beautiful restorative sleep pattern happening. And there are so many strategies that you can, you can do to support, sleep and herbal strategies as well.

That I think it’s important to actually focus on that and prioritise it. It’s one of what I would call the five foundational pillars of wellbeing. So you’ve got your nourishment, you’ve got movement, you’ve got stress management, you’ve got sleep, and then you’ve got minimising the toxins that you’re exposed to in your life.

And if you don’t get all five of those pillars, right, then you’re not really going to hit that sort of last third of your life and be as well as you possibly can through, into your fifties, sixties, seventies, eighties, and beyond.

Felicity Cohen: Yeah, absolutely. And I mean, for me, I like people to start thinking well beyond their forties and fifties when they’re talking to us, because I feel that a lot of people don’t have that vision of where they’re going to be at 70 plus early enough, you know, and that is pretty cool.

Dr Karen Coates: We do that with our financial planning. But if you haven’t got your health moving into your retirement, it doesn’t matter how much money you’ve got. You’re not going to optimally enjoy it because you’re going to be spending more time in doctor’s waiting rooms that on the beach or at the golf club. So I think it’s important for you to really start looking at health and health maintenance as, as early as possible. And I would like that to happen in the twenties. You know, we’re, we’re young people and I’m seeing more and more of that in my practice are coming in and they’re not accepting of that pharmaceutical model that perhaps their parents have fallen victim to, and they don’t want to be put on blood pressure medication in their forties and heart medication in their fifties and diabetic medication at an early age. They want to look at dodging those, those bullets of chronic disease and the earlier you start to do that the more successful you are.

And I had an interesting, very, very early experience with what I would call an obesity genic environment. We know from, from studies on, on obesity, that 70% of it is probably genetically determined, but, and there’s a big but there, those genes become irrelevant unless you are put into an environment that creates obesity.

And when I was, 17, I went to live in the US as an exchange student for 12 months. And over that 12 months, I was as active as I was back here. I was doing competitive training and swimming, but at the end of my 12 months there, I had put on 14 kilos of weight. Even when I was pregnant with my two children, I have never hit that weight ever.

It took me six months of not trying very hard when I came home to, to drop that weight. But it was because I came back to in Australia at that stage, what was it pretty clean diet. And within my family, it was a very clean diet that didn’t involve high sugar, mostly high sugar, high fat, and hellishly processed foods.

So I think it doesn’t really matter what your genetic tendencies are. Some people put them into that high fat, high sugar, high processed food, again, to put on weight quicker, but they will all put on weight given enough time in that diet that basically encourages obesity, encourages weight gain.

Felicity Cohen: So is that the unfortunate trend that you’ve seen you remember a life when in your family that eating clean was fairly normal?

Dr Karen Coates: Eating clean was, was what we did.

And again, it was so starkly in contrast to moving literally out of meat and three veggies and dessert once a week, if we’re lucky into a, an American style diet where they had instant breakfast and pop tarts, which replaced any form of real food. And it was, it was breakfast on the run and your, your breakfast at school was provided free of charge at that time.

And it was all high, high energy food. So I would have a salad, but on that salad, I would have lashings of thousand island dressing. And that would probably be half of my calorie intake. When I look at what I was eating back home in Australia. So in retrospect, it doesn’t surprise me one bit that I put on that weight despite being really, really physically active, but I’ve never, I’ve never had to struggle with weight management because I suppose I learnt those foundations of really good health and, and food choices from a young age.

Felicity Cohen: That really confirms the saying that we hear a lot, that you can’t out train a bad diet.

Dr Karen Coates: Exactly right. And it’s, it’s so, so true. And. With, with a lot of certainly young women that, that have an incredibly good training and quite a balanced training program.

And they move a lot, but they still struggle with their weight. And I think that somewhere along the line, that basal metabolic fire has been turned down a bit in those women. And unless they provide, you know, healthy lifestyle strategies, they’ll, they’ll never actually achieve easy weight management without, you know, paying the price.

Felicity Cohen: One of the other areas of health in women that you’ve done a lot of work in is young women with PCOS. Obviously, you know, we, we see a lot of metabolic diseases and we do see a lot more PCOS, but often in combination with endometriosis and then down the line, your fertility and other issues as well.

Tell me about your story and how you came to drive a program to support women with PCOS?

Dr Karen Coates: Probably came about because of my very, very personal experience with my daughter who I diagnosed PCOS with it, I think she was 14 or 15 and I had the diagnosis in my mind and then confirmed it when she was 18. So I started looking at options that didn’t involve medication because I didn’t want my daughter to go on medication at that age.

And one of the mainstays of turning down those sets of genes that dictate and drive the PCOS picture in medicine is weight management and a good health choices. And I think that one of the things that I encourage young women who have got a diagnosis of PCOS to do is to reframe that particular medical label and to look at what is potentially its genetic origins.

And we know from looking at genomes of our very, very ancient women that are thousands of years old, that the PCOS where set of genes existed very, very early in our, our human life. And so then we asked the question, well, why has it persisted over that, that huge number of decades and generations? And the answer to that is it conferred in advantage of survival at certain stages in our human existence.

And when I look at those young women who have high androgens, high male hormones and the ability to store fat very easily. They’re basically the warrior women who in times of long-term drought, famine, and war, were the last women standing as strong women who weren’t falling pregnant at bad environmental times, so that when good times happened, they were the ones that had the babies and passed their genes on to future generations. And I think that if we take that model and reframe PCOS is okay, it was a really helpful set of genes to have back then. How can we apply that and change our lifestyle to suit a more obese, agentic life that we have now. And that involves, again, a mindful approach to all of those pillars, nourishment very, very important with the processed foods too, to cut out any processed sugars with that.

And for those women, it’s a, a higher protein and lower carb, but not a no carb diet. We need our beautiful fruits and our berries, because if we don’t have those beautiful sugars coming into our diet, we don’t feed the good guys of our bowels. And that then sets off a domino of poor health that’s related to gut.

So PCOS is a very complex disorder, but the, the diet and weight management is probably the first, first layer that you need to submit in order to take control of those PCOS symptoms and, and truly maintain both health, wellbeing, and fertility into later life.

Felicity Cohen: Excellent.

Thank you so much. And I, you know, I see so many of these women who, struggle to fall pregnant and you know, many of them also due to their weight, they can’t get onto IVF programs.

Being able to help them is just such a joy. And it’s, you know, it’s wonderful to see them actually get good outcomes and to eventually be able to fall pregnant and have healthy, healthy pregnancies and, and carry to full term as well.

Dr Karen Coates: Exactly. And I think that, that it holds true. I had one patient who I remember very well.

She was a country woman and she desperately wanted a child, but she weighed in at 180 kilos. And at that stage, she was actually not allowed to have a lapband surgery because of her weight. So she was told to go away and lose weight before they’d actually et cetera. I was shocked really, really hard to, yeah, but I, I worked with her for 12 months.

We got 50 kilos off herand she fell pregnant naturally. She had a natural conception when she was down and certainly it’s still a high-ish BMI, but she she’d lost a significant amount of weight, which allowed her fertility to, to shine and then to conceive naturally. So it’s a long-term work process when we’re looking at PCOS in that circumstance.

Felicity Cohen: Definitely. Do you have a preference for a certain style of eating? We know that the Mediterranean diets a very popular way of eating or a style of eating, do you have a personal preference for something that you believe really encourages optimum wellbeing?

Dr Karen Coates: I think the first thing I would look at is where is your ancestral heritage from.

So an ancestral area of perhaps European and UK would be ideally suited to a Mediterranean diet, but I wouldn’t be giving that advice to somebody who had an Asian background. You know, they have a completely different, traditional diet. And it’s important to acknowledge that because their genes are set up to deal with food in a different way.

And their microbiome is quite different when you’re looking at people who have basically originated from Asia versus UK versus South America. And I know that we’ve had some interesting time with South American dietitians who have come out and tried to basically increase, legumes and beans to an Australian palate, and basically only caused distress because the gut, our microbiome is just not set up to, to deal with a high legume, high bean diet.

So I think that’s important is to look at what your country of origin looking ancestrally, where you’ve come from and to try and take the best of those sorts of approaches out of it. When we look at what diet is best there’s, a lot of information on, eat right for your genes rather than eat right for your blood type, if I can put it that way. So I think, the fact that most of us in Australia have an Anglo Saxon origin that Mediterranean style diet has huge evidence and research to say that that’s a very, very anti-inflammatory healthy diet to be on. If we’re looking at general advice and very specific advice.

I asked people who want to manage their weight and optimise their nutrition to get out the old kitchen scales and to weigh up at least 650 grams of green vegetables a day and make sure they eat that each day.

Felicity Cohen: 650 grams?

Dr Karen Coates: Correct.

Felicity Cohen: That sounds like a lot.

Dr Karen Coates: It is if you try and do it with lettuce. If you add a little bit of, you know, your cabbage, your cauliflower, your broccoli, broccolini, zucchini, as green foods, you can get there, but there’s a huge research that says that you will live longer, much longer,

if you have that high vegetable intake, regardless of what else you put in your diet. One of the other things that I think is just general advice is that deep fried foods should never be a part of a healthy diet. And we know that because regardless of whether you’re genetically prone to inflammation, if you eat deep fried food today, your inflammatory markers that are measurable on a standard blood test are elevated not only for the hours after that meal, but for the next day and the day after.

So up to 48 hours, we can actually measure inflammation markers that are elevated beyond their normal, just because you had that deep fried bit of fish, that deep fried chicken. The same food that’s baked, doesn’t do that. So it really is a matter of, if you take home two things, increase your vegetables and very much stay clear of that deep fried food.

Felicity Cohen: Amazing.

And I think that’s so interesting to note, you know, country of origin to really analyze best approach to food. When we look at what’s happened in Southeast Asian populations and the introduction of a Western diet, even just looking at, you know, dairy because they’re so often dairy intolerant, and now we see this high incidents of type two diabetes in India, for example, many other Southeast Asian populations where the increase in type two diabetes alone is drastic, you know, and it’s, it’s devastating to see that that’s what’s happened from the introduction of a Western diet. So maybe we all need to rethink looking at our country of origin and appropriate, you know, nutrition.

Dr Karen Coates: Natural, our natural diet. There was a study that came out last week on Tanzanians.

So we’ve got a, an, an African population where they, the researchers actually went in and looked at chronic disease markers and chronic disease incidents in tribes that had a very, very natural existence. So were still growing their own food, eating a traditional diet and moving well. And their relatives that had moved to the city and by definition was starting to get into that processed food, fast food diet.

And within four years of moving from village life to urban life, they had basically the same incidence of type two diabetics as we do in our and our urban life. So it’s, again, a take home message here that really doesn’t matter what genes you’re given. If you stick yourself into a highly processed obesogenic environment, you’re going to suffer from those same lifestyle diseases, like type two diabetes, obesity, heart disease, and cancer.

Regardless of whether, you know, your country of origin.

Felicity Cohen: Amazing. And I mean, for me here, you know, we’re very big on prevention. We’ve touched on that earlier and I think for us it starts with our children. We have a childhood obesity prevention program here, and I just think that is where we really need to work on making sure that the kids are the future and never going to end up here as our patients.

So that that’s really important to us. I could sit and talk to you forever, Karen, thank you so much for being here. My final question that I like to ask all of our guests, what does wellness mean to you?

Dr Karen Coates: Wellness means that regardless of your age, you’re able to get out of bed, move your body the way you want to move it.

Regardless of disabilities, move your body the way you want to move it and have a buoyant, an optimistic approach to whatever lays ahead in your day and to get up the next day and do exactly that. So I think that’s it, if you can do all of those things today, it’s just a matter of being mindful that you need to support your body a little bit more carefully as you age in order to continue to enjoy your day and get the most out of it each and every day you have.

Felicity Cohen: Functional fitness and wellbeing being able to move well so important. And what do you think are some of the barriers that people are dealing with right here and now in terms of having that notion of what functional fitness looks like for the future?

Dr Karen Coates: I think we do too much sitting and I think it’s a matter of finding not time to hit the gym, the time to move your body.

And that can be just getting up and spending a minute, walking around your office or going outside and, you know, hitting the pavement for five minutes, huff and puff, turn around and come back in your lunch hour rather than eating your lunch at your computer desk. So it’s taking the opportunity to move and apply it to your day so that you’re functionally moving a lot more.

Felicity Cohen: Oh, I love

that. It’s a huge occupational, I think, you know, complication of sitting at a desk, but maybe, you know, for me, I might get up and go and do my run in the morning, but not move enough through the day. So that’s a really good lesson for us to learn from you. Thank you. Thank you so much for joining me today.

Dr Karen Coates: You’re welcome Felicity. It’s been a pleasure.

Felicity Cohen: Thank you. Thank you for joining the Wellness Warriors podcast. It’s been a pleasure to have you online with us. If you enjoy the series, please leave your review, subscribe and follow. And we look forward to sharing many more stories with you in the future.