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Optimal with Dr Liz

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Optimal with Dr Liz

Optimal with Dr Liz

A bespoke, science-led retreat for midlife renewal.

Combining nutrition, movement, and meaningful travel - guided by science, soul, and strategy. 🌿

30/04/2026

I’ve been asked a lot recently about bowel (colon) cancer - particularly what we can actually do to reduce risk.

It’s an important question, and the answer is nuanced.

Most bowel cancer isn’t purely genetic. It develops over time through an interaction between biology, environment, and lifestyle - with the gut playing a central role.
I often describe the gut as an ecosystem.

What we eat doesn’t just nourish us. It also feeds the microbes that influence inflammation, metabolism, and the integrity of the bowel lining.

Rather than thinking in extremes, I find it more useful to focus on a few key levers:
➡️ Fibre intake: aim for ~30g per day from vegetables, legumes, whole grains, nuts, seeds and fruit
➡️ Processed meat: minimise where possible (bacon, sausages, deli meats)
➡️ Red meat: moderate rather than eliminate
➡️ Diet diversity: a wider range of plant foods supports a more resilient gut ecosystem

These are relatively simple shifts, but they have meaningful biological effects. They support beneficial gut microbes, improve intestinal transit time, and promote the production of metabolites that help protect the bowel lining.

Importantly, these same levers extend well beyond colon cancer.

They are also associated with:
➡️ improved metabolic health
➡️ reduced systemic inflammation
➡️ better cardiovascular outcomes
➡️ lower risk of several chronic diseases

So this isn’t only about preventing one condition.

It’s about creating a physiological environment that supports long-term health.
Of course, risk is never entirely within our control. Even people doing many things well can still develop cancer.

But we can influence the terrain.

And alongside lifestyle patterns, screening and early detection remain critical.
Small, consistent shifts - sustained over time - matter.

(If you're interested in how different foods shape the gut ecosystem, I often refer people to the Gut Map as a useful framework for thinking about dietary diversity. Link in comments👇)

28/04/2026

A recent Australian study in older women (~75 years) found that higher protein intake was associated with substantially lower odds of frailty.

The sweet spot?
Around 1.1–1.6 g/kg/day - notably higher than some of the older recommendations of 0.8g/kg/d - although many specialised guidelines are recommending 1-1.5g/kg/d of protein in older adults (in context of a varied diet).

What stood out wasn’t just the amount, but the mix.
Both plant and animal protein contributed, with plant protein showing particularly consistent associations. Benefits also plateaued, reinforcing that more isn’t always better.

Frailty isn’t just about muscle.
It reflects decline across multiple systems = physical, metabolic, and cognitive.
Protein plays a central role, but so does the broader dietary pattern.

Plant sources bring fibre, micronutrients and vascular benefits. Animal sources provide amino acid density and efficiency for muscle synthesis. The combination appears more important than the debate.

For practice, this reinforces a few simple points:
➡️ aim for higher protein intakes in older adults
➡️ include both plant and animal sources
➡️ pair with resistance training

This is cross-sectional, so not causal. It’s also possible that those who are more robust, mobile, and well are simply eating more protein (rather than protein driving the difference). Likely, it’s a bit of both - a reinforcing loop between nutrition, strength, and overall capacity.

In ageing, the goal isn’t just avoiding disease. It’s preserving capability and optimising quality of life.

[📝 Article reference:
Association between protein intake from animal and plant sources and the presence of frailty in community-dwelling Australian women]

23/04/2026

To my research colleagues and collaborators, I’m currently guest editing a Special Issue of Current Oncology on “Nutritional Support in Oncology: Evidence and Practice”, and I would be delighted to see contributions from colleagues working in this space.

The role of nutrition in cancer care is now well established in the evidence base. What the field increasingly needs is stronger work on how that evidence translates into real-world practice - across screening, intervention, survivorship, and models of care.

This Special Issue is focused on exactly that bridge: moving from evidence to implementation in oncology nutrition.

We welcome contributions from researchers working in areas such as:

➡️ oncology nutrition and malnutrition
➡️ cancer cachexia and metabolic changes
➡️ body composition and nutritional risk
➡️ nutrition interventions during and after treatment
➡️ survivorship and supportive care
➡️ implementation of nutrition within clinical oncology pathways

Original research, reviews, and short communications are all welcome.

If you are working in this space and considering submitting research or a review, I would be very pleased to hear from you.

Submissions are open until 31 December 2026.

🔗 Details here: https://www.mdpi.com/journal/curroncol/special_issues/1ITWS68745

Looking forward to seeing the next wave of research advancing nutritional care in oncology.

21/04/2026

A new BMJ Open paper has prompted discussion about how AI chatbots answer medical questions.

The headline - that around half of responses were considered “problematic” - has understandably raised concern.

But the findings themselves are not particularly surprising. They reinforce a challenge we’ve seen for years: interpreting medical information from sources without clinical context.

We’ve seen it before with “Dr Google”… and even with well-meaning advice from friends or social media.

Information without context can mislead.
Confidence without depth can be risky.

As a researcher, I see access to information as a positive development. More data has the potential to support better and more personalised decisions.

The real challenge lies in how that information is interpreted and applied.

AI doesn’t inherently understand:
👉 nuance
👉 individual context
👉 clinical complexity

Yet it can present answers with striking confidence - even when those answers are incomplete.

This is where the Dunning–Kruger effect comes in: surface-level knowledge can sometimes appear more certain than deeper expertise.

For me, AI is not something to avoid. It is something to use thoughtfully.

It can be a valuable tool, particularly when integrated into a broader health ecosystem alongside clinical care, lived experience, and professional guidance.

As health professionals, our role is becoming more important, not less. Not just to provide information, but to help people interpret it safely and meaningfully.

Because ultimately, good care isn’t about more information.

It’s about understanding what matters to this person, at this time.

16/04/2026

What are ultra-processed foods? It’s a term that’s used frequently - often without clarity.

Here’s what it actually means.

Ultra-processed foods are industrial formulations made primarily from substances extracted or modified from foods, often with little whole food remaining, combined with additives designed to enhance flavour, texture, shelf life, or appearance.

They are engineered products, not simply prepared foods.

Common examples include:

🍟 Packaged snack foods - crisps, biscuits, confectionery
🥤 Soft drinks and energy drinks
🍫 Protein bars and “diet” snacks
🍜 Instant noodles and flavoured sachet meals
🥣 Sweetened breakfast cereals
🌱 Some plant-based meat alternatives
🍱 Ready-to-eat meals with long, complex ingredient lists

💡 A useful rule of thumb: if it’s designed to be eaten straight from the packet and bears little resemblance to something you would cook at home, it’s likely ultra-processed.

Large umbrella reviews consistently associate higher intake of ultra-processed foods, as a dietary pattern, with increased risk of obesity, type 2 diabetes, cardiovascular disease, and poorer mental health outcomes.

This doesn’t mean never eat them.

It does mean being aware of how much of your regular intake comes from that category - and what might be quietly replacing more structurally intact foods.

As with most things in nutrition, the issue isn’t a single ingredient.

It’s pattern, proportion, and frequency.

14/04/2026

I came across this recent paper exploring the immunoregulatory role of probiotics in cancer-associated cachexia 👇

At first glance, it sounds compelling - modulation of the gut microbiota, reduced inflammation, potential effects on muscle loss and weight. However, upon closer examination, most of the evidence remains preclinical, with significant variability in strains, dosing, and outcomes.

What I found most interesting is the suggestion that not all cachexia is the same, and not all microbiomes are the same. There is growing recognition that different “dysbiosis phenotypes” may respond differently to intervention.

From a clinical perspective, we’re not yet at the point of recommending probiotics for cachexia. The heterogeneity makes translation difficult.

For me, this reflects a broader shift in nutrition research, away from one-size-fits-all approaches and towards more phenotype-driven, systems-based thinking.

Understanding the microbiome, immune response and metabolic context may ultimately be just as important as the intervention itself.

Curious to see how this space evolves as we move from mechanism to meaningful clinical application.

09/04/2026

Back into it ✨
Travel always shifts your rhythm… even when you try to hold onto routine, there’s a re-entry phase. That’s normal.

The key?

Make it ridiculously easy to start again.
Lower the bar.
Shorten the session.
Focus on showing up, not performing.
Momentum builds quietly from there.

And honestly… it’s so much easier when you’re surrounded by the right energy.
People who make it feel light, fun, and natural to move your body again.

Today wasn’t about pushing.
It was about returning.
Foundations first. Always.

07/04/2026

Weight is one signal of health.

But it is not the most important one.

Metabolic health reflects how well the body regulates energy — and many of the earliest changes occur internally, long before visible weight change.

This becomes especially relevant in midlife and after cancer treatment, when shifts in glucose regulation, lipid metabolism, and energy stability often begin quietly.

Improving metabolic health does not require perfection.

It requires stable, repeatable patterns across the foundations of physiology: food, movement, sleep, and stress.

See below for a simple explanation of what metabolic health actually means — and what moves the markers that matter.

Save this post if you’d like a simple framework for thinking about metabolic health beyond the scale.

02/04/2026

Grateful to be part of such a thoughtful international team on this work exploring how COVID-19 has influenced the early identification of malnutrition in cancer care.

At a systems level, the findings are both encouraging and confronting.

There have been some positive shifts. More nutrition screening policies. Greater patient involvement in screening.

But the underlying picture hasn’t changed as much as we might expect.

The same barriers continue to show up: time, staffing, awareness, and system complexity. In some settings, practices have even declined.

I often think of nutrition care as a set of quiet levers within a complex system.

Screening is one of those levers. Simple in theory, but highly dependent on how the system is designed around it.

If the system is strained or fragmented, even strong evidence struggles to translate into practice.

One of the most important insights from this work is that we are still identifying malnutrition too late. Often, once it is visible, it is harder to reverse and further along the trajectory.

The opportunity now is not just more evidence, but better integration - embedding screening into workflows, supporting teams, and leveraging patient-led and digital approaches where appropriate.

Because in cancer care, nutrition is not an add-on. It is part of the infrastructure.

Small shifts in how we identify risk - early, consistently, system-wide - can change outcomes in meaningful ways.

Curious to hear how others are seeing this play out in practice.

31/03/2026

Most people are taught to think about weight.
Very few are helped to understand metabolic health.
These are two different conversations.

Metabolic health is how well your body manages energy - blood glucose, triglycerides, HDL cholesterol, blood pressure, and where fat is stored.

It's regulation.
Not just kilograms.

Research increasingly shows that metabolic health status predicts long-term risk more strongly than BMI alone.

Metabolically unhealthy individuals (regardless of weight) face higher cardiovascular and metabolic risk than those who are metabolically healthy, even at a higher BMI.

In practice:
➡️ Someone in a "normal" weight range can be quietly developing glucose dysregulation, rising triglycerides, or increasing waist circumference.
➡️ Someone carrying more weight (especially if its muscle) can have stable glucose, lipids, and blood pressure - and face a lower risk than expected.

This is especially relevant in midlife and after cancer treatment.

The scale may not move. But energy dips. Blood sugar becomes unpredictable. Waist circumference slowly increases.

These are metabolic signals.

Metabolic health isn't a side metric. It's the core job.
Improving metabolic health doesn’t require a perfect lab result.
It requires stable energy regulation - supported by consistent food patterns, movement, sleep, and stress management.

24/03/2026

Most nutrition conversations focus on the body.
Weight. Metabolic markers. Gut health.

Far fewer address the nervous system - and how directly food patterns shape it.

This isn’t fringe science. The central and autonomic nervous systems depend on a stable supply of nutrients to function.

Amino acids from protein are required to synthesise neurotransmitters such as serotonin and dopamine.
B vitamins, magnesium, zinc, and omega-3 fats support neuronal signalling and stress-response regulation
Stable glucose is the brain’s primary fuel.

When those inputs are erratic → skipped meals, chronically low protein intake, heavy reliance on ultra-processed foods - the effects aren’t just physical.

Mood shifts.
Sleep fragments.
Cognitive clarity dulls.
Stress tolerance narrows.

This matters in everyday life. It matters even more in recovery.

After cancer treatment and in chronic illness, the nervous system often carries a sustained stress load - fatigue, altered sleep, heightened sensitivity.

Poor nutrition doesn’t cause these states, but it can sustain them. Better patterns support steadier energy, mood, and cognition - not as a cure, but as infrastructure for recovery.

The gut–brain axis adds another layer.

Diet shapes the gut ecosystem, and the gut communicates continuously with the brain.

Whole-food, fibre-rich patterns support that communication. Ultra-processed patterns tend to disrupt it.

When appetite, digestion, and mood shift together, that isn’t simply psychological. It’s a physiological loop.

Food doesn’t just fuel the body.
It shapes the environment the nervous system operates in - every day.

19/03/2026

Some of the most meaningful shifts I see in energy, mood, and recovery don't come from adding anything.

They come from quietly removing a few powerful interferers.

Those differ by person:
➡️ ultra-processed snacks that drive appetite spikes and crashes,
➡️ late-night eating disrupting sleep and glucose regulation,
➡️ chronic restriction fuelling rebound cravings

Evidence-based frameworks, from the Australian Dietary Guidelines to oncology nutrition guidance, point consistently in one direction:

👉 Sustainable improvement comes from stable, repeatable patterns.

Not from layering in new fixes.

Health rarely improves through complexity.
It improves through consistency.

So rather than "what else should I add?"
I find a more useful question is:
"What's getting in the way, and what one thing can I repeat consistently?"

Remove what interferes. Repeat what works. Let consistency do the heavy lifting.

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