Q&A with Functional Nutritionist Women's Health Expert, Pauline Cox

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Pauline Cox is the founder of Sow and Arrow, which is a low-carb keto store in the UK. Sow and Arrow were the first resellers of Funky Fat Foods in the UK, that’s how we met Pauline. She is also a functional nutritionist, passionate about food and nutrition, and also writes articles about health and well-being, particularly women's wellbeing.

Pauline’s health journey and how Sow and Arrow started.

Pauline's health took a turn for the worst around 13 years ago and ironically, she was working as a health professional at the time, as a physiotherapist. But she felt extremely tired, anemic, had Polycystic Ovarian Syndrome, and had chronic breathlessness, she just felt awful. She realized that despite having two degrees in human science, she knew very little about nutrition and became aware that she hadn't been looking after herself very well from a dietary perspective. Pauline started to learn more about how the foods she was choosing were impacting her mental well-being and her physical well-being as well as her hormones and all the symptoms women have around their menstrual cycle. She was curious to know how just making some changes in her diet as well as her lifestyle would affect her day-to-day life. 

After coming across the work of a lot of very inspirational scientists like Dr. Terry Wool, and J.J. Virgin, she embraced their learnings and went on to study for a Master's in Nutrition and Public Health. She left physiotherapy completely behind and then opened Sow an Arrow. At the same time, she carried on with her second Master's level in integrative medicine as she wanted to go deeper into understanding natural medicines and how we have so much control over our health, our longevity, and our mental and physical well-being. 

Right now there's so much information about what healthy is and what a healthy lifestyle looks like. Is there anything on a physiological level that our body requires? Like a specific amount of macros that our bodies require or that our bodies work best with?

To put it simply, no, because everyone is different. You can have someone who is training every day, running marathons, their protein requirement would be very different from someone that doesn't train at the same level. Another example is, that someone who's very fat adaptive and able to survive on a very low carbohydrate diet and is very adequate at burning fat for fuel would have a very different need to someone who's quite insulin resistant and isn't able to burn fat so effectively. 

Pauline says it's not so much about having the perfect macros, that's very individual-dependent. It's much more about finding whole foods and eating foods that are real, that are not from packets, and that are not highly processed with lots of chemical ingredients or unrecognizable ingredients. We're much better off enjoying food that has brightly colored vegetables and high-quality protein, whether that's eggs for vegetarians or fish for pescatarians, or beef for carnivores. It's more about where your food comes from, as opposed to what that food is. And that's why you can have a very unhealthy vegan diet or you can have a very unhealthy ketogenic diet. It's not so much the diet and lifestyle, it's more about where that food is coming from, whether it's been grown, whether it's been made in a factory, and eating it in a way that your body is accessing the nutrients.

How can we support our bodies and give them the fuel that they need?

Food is more than fuel. Pauline says “food is a gift from mother nature” and that we should appreciate the amazing nature we have around us because as we appreciate planetary health, we can appreciate our health and start to see foods as an extension of us, whether they're plants from the earth, whether they're animals roaming in the fields.

Food is something that builds us. It builds every cell in our body. It restores and revives us.

Having that mindful experience when we're eating and recognizing that we are not just chewing down on something to get fuel, but enjoying the pleasure of knowing that this was grown in the field down the road. You are benefiting from the protein and building muscles, hair, skin, nails, and bones from that protein. 

Protein is an essential component of the diet to make sure that we have the building blocks for the body and the amino acids to build our neurotransmitters, which are: 

• Serotonin, the happy hormone
• Dopamine, which is the motivation hormone
• Melatonin, which is your sleep hormone, which comes from serotonin 

All of these neurotransmitters require amino acids. The whole scaffold of your body is built from amino acids. Protein is a very important component. Healthy fats are also very important for human health, particularly fatty acids that we can't make ourselves. People often are lacking in omega-three fatty acids, these come from wild fish, particularly as a super source of EPA and DHA, which are two forms of omega-three fatty acids. Now you can get plant-based omega-three fatty acids, which are known as ALA. They can convert to some degree to EPA, but the conversions are not so great. There is a very interesting plant called Ahiflower and that has a higher conversion to EPA. Pauline thinks that's a nice source for vegans or people who don't eat a great deal of fish, it's available as a powder, in capsules, and oils. 

There are these very interesting foods that we come across that can optimize human health, for example, macronutrients, fats, and healthy fats. Then we have proteins and carbohydrates from fiber, berries, dark berries, and a few root vegetables. 

For macronutrients, you can sometimes find people have a subclinical deficiency, especially magnesium and it particularly happens in women, it often tends to get highlighted because of the menstrual cycle. Women can experience more PMS such as cramping, fatigue, irritability, and insomnia, and that carries through into perimenopausal symptoms and menopausal symptoms. 

Pauline mentions that magnesium tends to be a nutrient that several individuals are deficient in because of the depleted soils. She says we're not necessarily eating a lot of magnesium in our diet and, if you are, you’re not absorbing it because your stomach acidity is not so great. If you are eating lots of sugar, if you’re chronically stressed or if you take a lot of medications, chances are you’re depleted in magnesium. So there are some situations where we are constantly battling against this depletion and trying to top up, but not always getting enough. 

Can you explain what functional foods are?

Most foods have nutritional benefits, particularly natural foods, and processed foods, not so much, but functional foods have additional health benefits to an individual. Some of Pauline’s favorite functional foods are fermented foods, like kimchi, and sauerkraut. These fermented foods contain probiotics which help restore the microbiome. 

Sauerkraut is a really simple functional food that adds incredible benefits to your body, your mental wellbeing, as well as your physical well-being through the gut and proliferating beneficial bacteria in the gut, because the actual Salcrowd itself, the cabbage, serves as a source of food for the bacteria and the food for the bacteria to live on. The lactic acid within the sauerkraut also gets transformed into a very potent antioxidant. 

On the other hand, for functional spices, some examples are turmeric, cinnamon, ginger, seeds, chia seeds, flax seed berries, dark berries, like blueberries, and C Buckthorn. These are all foods that have particularly high antioxidant levels or some kind of interaction with our gut microbiome.

What would be your biggest tip for people who wanna start including these healthy foods into their lifestyle?

Pauline thinks a smoothie is a very good idea, she has one every morning. This is what it looks like: 

• A large ripe avocado, which is full of fiber, magnesium, and healthy fats. 
• Some unsweetened nut milk and all sorts of fun and functional foods.
• A bone broth powder.
• Sometimes she adds collagen or colostrum. 
• Cocoa powder. 
• Mushroom (lion's mane).
• CEPS
• Black tahini, which is super rich in antioxidants, is exceptionally high in antioxidants. And in traditional Chinese medicine, they believe that this has very anti-aging. It's very high in melanin, so it's very good for the pigments in your skin, keeping away gray hair. 
• A bag of frozen berries. Red or blackberry, blueberry, raspberry. A mixture of dark berries. 
• Nut butter 
• Probiotics. 
• A zinc capsule, that's the opportunity to kind of add in some extra supplement-wise. 

After she has added all that, she blitzes it up for a few minutes and then drinks it. Then, she stops eating always by six so she can get a long fast through to her eight o'clock smoothie.

When did you start doing intermittent fasting and how have you felt whilst doing it? 

Pauline has been doing intermittent fasting for about five years. She thinks it's a very powerful tool, particularly for balancing blood sugars, optimizing insulin sensitivity, increasing ketosis, and increasing healing autophagy, which is where your cells are going through this kind of regenerative mopping-up phase. It's great for good sleep, good quality of sleep gives you a digestive system rest. 

Pauline always stops eating by six. She fasts from six o'clock to eight o'clock of the next day, which is about a 14-hour fast, that's the minimum she'll do, sometimes longer, 16 to 18 hours. She says it’s good to do it overnight but leading up to bedtime three, or four hours before bed, not eating is also really beneficial for your digestive system. It's great for your gut health. As she mentioned, it's really good for your blood sugars and it helps with waking up in the morning, having great clarity of thought, and great energy.  

Can you explain the difference between using fat and glucose for fuel? 

Pauline says we are dual fuel burners, so we're designed to be able to burn two types of fuel, we're designed to be able to forage and then maybe go three or four days while we're “hunting for the wild game” and then we get to eat again.

However, we've done a great job of training ourselves to be chronic carbohydrate consumers. So, eating carbs first thing in the morning, mid lunchtime, lunch time then go for after lunchtime snacks, evening meal, evening snacks... Our blood sugar levels are constantly on this roller coaster they're going up, then just as they're starting to come down we take on another snack, then when they're coming down again it's lunchtime..etc. So our blood sugar levels are constantly being peaked and our bodies become very good at sugar burning that excess sugar that gets stored as fat. 

Pauline explains that once our blood sugar levels go up, the pancreas produces insulin. Insulin's job is to usher the blood sugars out to the bloodstream and into the cells. However, any excess glucose that isn't being used as energy by the cells gets stored as fat, so the fat storage starts to get more and more as our body seeks out more and more sugar, because it's on this constant sugar drive. As we start lowering our blood sugars to a more level point and stop spiking our insulin all the time, because insulin is a fat-storing hormone, our bodies then start turning to their source of fuel, which is stored fat. And that stored fat is broken down by the liver into ketones and those ketones serve as the source of fuel for the brain.

The brain loves ketones for the muscles and the heart. That's why you don't feel that constant hunger because your body is technically eating the fat stored within your own body, this way you don't have that craving, that drive for sugar, for food or for carbs or stud that you have when you've trained yourself to be a sugar burner. There are a lot of olympic sugar burners out there, Pauline was one of them, she was hooked on sugar. As soon as she woke up, she needed to eat, because she felt dizzy and hungry. That's because she was a sugar burner, she never even came close to burning fat because she was always eating. She always carried a snack in her handbag, just in case she got hungry, then she’d have her lunch, then her afternoon snack, then dinner, then her evening snacks with a glass of wine. 

It was constant blood sugar spikes and that was for sure driving her fatigue, poor sleep, mental health issues, hormonal problems, and anemia, which was coming from her gut. 

As soon she ditched the bread and became conscious of her carbohydrate intake (she took hers to under 50 to start with). Then it became more like 30 and now she doesn’t count, she doesn't need to because she’s entirely grain free. She eats a lot of protein and healthy fats, vegetables, and dark berries in the morning. So she doesn’t feel the need to count carbohydrates. She just intuitively understands what her body needs much more now. 

What can we expect from you soon?

Pauline Cox has just finished her second book which is all on women's health and eating for hormonal balance, understanding how women have this really interesting relationship between estrogen and progesterone and how that has such a huge influence over how they’re feeling, how they’re eating, whether they’re gaining weight, losing weight, feeling stressed, feeling exhausted, having insomnia or not sleeping well. 

So it's for women to help understand their bodies better because Pauline thinks we women can’t go through their lives not understanding the impact the sex hormones have on their bodies and emotions. Particularly as they get to perimenopause and menopause how those hormonal shifts affect the emotionally and physically and how they can work with those shifts so they don't find themselves anxious with poor sleep or gaining weight or having hot flushes. Pauline wants to help women know how they can work with their bodies to optimize that transition through diet and lifestyle changes. 

In September, she’s launching an 8-week program called better balance. It's all about balancing our gut microbiome,our emotions and our stress. And that's what that eight-week program is about, the details of which are on her website and there's an early bird discount at the moment, you can put in: betterbalance20, then you’ll get a 20% discount. It's only 120 full prices, 94 for the whole eight weeks. 

Do you know when it's coming out or approximately when?

It's likely to be available to pre-purchase just before Christmas but there’s no fixed date set yet. She will let us know through her Instagram account. You can sign up for her newsletter called “The Low-Carb Blowdown”. Every month she summarizes podcasts, blogs, offers, and any news.  

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