Tatler Asia Q & A with Katia Demekhina, IMI Nutritional Therapist

Interviewee: Katia Demekhina, Nutritional Therapist
Editor: Amalissa Hall
Title: Style Writer

  1. Tell us about your role. What inspired this career path, and how did your prior experience lead up to this?
    – My own health journey
    – a complete burnout, debilitating anxiety, fatigue, bloating or PMS with no medical explanation for her feelings
    – My past career – knowledge of constraints and stresses many of my HK clients face
  2. When did you learn that nutrition was a key element of women’s menstrual and fertility-related issues?
    – Nutrition is about both food and lifestyle, as both influence the nutritional balance in the body
    – Improper nutrition = stress, inflammation, hormonal imbalances (domino)
    – Appropriate nutrition is essential for the growth and development of brains and bodies, and for building, maintaining, fueling and repairing every cell in every part of our body. Diet and nutrients are also essential when trying to conceive and prepare for pregnancy. Overall, there is strong association between “good diet” (such as Med diet for example) and fertility outcomes.
    – Egg quality plays a critical role in how long it takes to become pregnant. By focusing on nutritional and lifestyle factors we can support egg’s ability to produce energy at critical times, to fuel proper chromosome processing.
  3. How does nutrition help menstrual and fertility issues? What is the connection between the gut and uterus?
    – Not what we eat but what we absorb
    – Estrobolome and estrogen balance
    – We are 10% human –> bacteria shape our ohysiology, biochemical processes etc.
    – Fat mass / energy harvesting
    – Role in implantation, successful pregnancy / miscarriages (microbiota is a continuum of reproductive tract)
    – Role in systemic inflammatory response and immune activation
    – Microbiota changes through menstrual cycle, changes in pregnancy
  4. What are some significant foods/ingredients that promote healing?
    – Macros
    – Remove white refined carbs
    – Protein
    – Eat good fats every day / don’t be scared of fat but eat the right kind –> Nuts and seeds contain healthy fats and a small amount of protein to assist with blood sugar stabilisation throughout the day, as well as providing key nutrients for egg and sperm quality such as zinc. + don’t use veg oils / take out foods + omega:3
    – Remember that our brain is mostly fat and that all cell membranes in the body are made of fat. Our sex hormones are also made of fat.
    – Veg, veg, veg! most people don’t eat enough
    – As oxidative stress is a major mechanism underlying ovarian ageing, vegetables’ ability to protect against oxidative stress is important mechanism to support fertility outcomes. “Eat the rainbow” is a good advice as different colours of veg indicate different antioxidant compounds, which all have specific properties and health benefits. Almost all vegetables are superfoods for fertility.
    – My favourite? Cruciferous veg – broccoli every day (1/2kg broccoli a day can make a big difference to hormone cancer risks such as BC, influences the balance of oestrogens) + sprouts
    – The foods that have the strongest links to improved fertility success rates are vegetables, fruit (esp. berries), whole grains, legumes, fish and olive oil. This is basically the foundation of Med Diet, which emphasizes fish, olive oil, legumes, antioxidant-rich vegetable and nuts and seeds. Such diet has been shown to lower inflammation; and lower inflammation may reduce the risk of miscarriage and infertility.
    – We know from large longitudinal study that women who eat more of the quickly digested carbohydrates that rise blood sugar are 78% more likely to have ovulatory infertility than women who ate slowly digested carbohydrates.
    – Research shows that women with low HbA1c are twice as likely to fall pregnant over six month period compared to women with high but still normal HbA1c levels
  5. What are the most common issues women in Hong Kong face, and what types of treatment do they receive from you?
    – Globally, 14% of women of reproductive age experience irregular or heavy menstrual bleeding, 50% experience PMS symptoms and 90% complain of menstrual pain. 30% of women say that these symptoms affect their daily lives, making them miss school/work or miss out on family time and social activities. In Hong Kong, the prevalence of menstrual problems was reported in 77.9% of adolescents. Among those with dysmenorrhoea, pain was present in more than half of the respondents. Besides dysmenorrhoea, 40% of the adolescents surveyed reported other PMS-type symptoms. Overall, 33.6% of menstruating adolescents reported reduced daily activity because of menorrhagia. While there is no data on older adults, the prevalence of menorrhagia was noted to increase with age
    – PMS: Cravings + Mood swings, short temper, …
    – IBS
    – PCOS
    – Fatigue
    – Sleep
    – Stress – Effectively managing stress is vital in terms of optimum fertility. When we are stressed, our bodies are in survival mode and reproductive processes get “turned off” (as reproduction is not essential to survival when we are running away from a tiger). In survival mode, the body focuses all its energy and nutrients allocation towards the most important organs and systems that help ward off immediate danger, and shuts those that are not essential to the task. Reproduction and digestion are the first to typically get switched off as who needs to digest food or reproduce when we are facing a predator.? This is why living in a state of high alert (and inadequate nourishment is also seen as a stress by the body), our reproductive organs do not receive energy and nutrients they need to function optimally.
  6. Could you explain how you devise a nutrition plan for clients, and what are some examples of the changes in said clients that you’ve seen?
    – By spending time listening to the client and gathering their history, I help identify such root causes of ill-health as nutrition, genetic or acquired predisposition, environmental factors, and behavioural and psychological influences. I then customises a personalised plan to diet, lifestyle and supplements to help your body achieve and maintain optimal health. Katia also uses neuro-linguistic programming techniques to help clients build new habits and an environment that reinforce their healthy future.
    – Give an example of Mandy with anxiety and PMS -> “my period came and I didn’t even expect it as there were no signs”
    – Food and anxiety patterns
    – Veg / vegan clients –> need for supplements
    – Pregnant client with pre-diabetes prior to pregnancy –> all glucose challenges during pregnancy with no issues
  7. What can integrative medicine offer alongside conventional medicine practices?
    – They should always look as complementary
    – …
  8. How would you explain integrative medicine for people who are unsure about it, and why do you think more people are seeking it today?
    – Quick fix solutions are failing
    – People are more aware, esp after covid, of the importance nutrients play in their health
    – We look for root cause rather than plaster the symptoms [functional medicine]
    – Functional vs integrative
    – Functional medicine views the body as an interconnected web-like structure of different systems and functions. Imbalances within these systems can manifest as symptoms or illnesses.
    – individualized, patient-centred, science-based approach that empowers patients and practitioners to work together to address the underlying causes of disease and promote optimal wellness. It requires a detailed understanding of each patient’s genetic, biochemical, and lifestyle factors and leverages that data to direct personalized plans that lead to improved patient outcomes.
  9. What practices in regards to nutrition that our readers can adopt in their daily lives?
    – Look for colour and variety
    – the Hong Kong Health Behaviour Survey revealed that 95.6% consume less than 5 servings of fruit and vegetables per day, 67.7% of adult population – only 1.5 portions of vegetables a day13
    – Hong Kongers still consumed on average only 10 portions of vegetables and 9 portions of fruit a week
    – Meals around protein and veg
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