CNHC update for Camclub enews: May 2014
Physical and mental stress can compromise immune response
How Can You Improve Your Digestion?

CNHC update for Camclub enews: May 2014

• CNHC’s revised Code of Conduct, Ethics and Performance
CNHC has now published its revised Code of Conduct, Ethics and Performance and a hard copy is being posted to all registrants.

The new Code will come into effect on 1 June 2014 and will replace the previous Code which has been in effect since 2008 when CNHC was established.

If you are CNHC registered make sure you read the new Code and become familiar with its contents. You will notice that it is longer than the previous Code but please don’t be daunted by this as it is now full of guidance and useful information to help you to comply with the standards.

You can see the new Code on our website by clicking through to Publications / Code of Conduct for Registrants here: CNHC Code of Conduct, Ethics and Performance.

• CNHC at AVR conference

In February the CNHC team attended the first conference for holders of Accredited Voluntary Registers (AVRs). We were delighted that seven of our CNHC Local Champions were also able to attend along with two CNHC Board members, Wendy Harris and Patricia Mowll.

The event was organised by accrediting body the Professional Standards Authority for Health and Social Care (PSA) and was the first of its kind, bringing together AVRs to share good practice.

CNHC’s Local Champions were keen to find out more about what the AVR scheme means to practitioners and how best to continue to promote CNHC registration for the benefit of public, employers and commissioners.

The day was chaired by Professional Standards Authority Chair, Baroness Jill Pitkealthley. PSA’s Chief Executive, Harry Cayton described how the scheme is developing from PSA’s perspective and sought the views of those attending about how it could be taken forward. Other speakers included Dean Royles, Chief Executive of NHS Employers, Dan Moore from the Office of Fair Trading and Dr Katherine Rake, Chief Executive of Healthwatch England.

Below you can see some of CNHC’s Local Champions with PSA Chief Executive, Harry Cayton and Chair, Baroness Pitkeathley.

Left to Right: James Stobbart, Ruth Souhamy, Mo Ferrington, Harry Cayton (PSA CEO), Baroness Pitkeathley (PSA Chair), John Hutchings, Jane Giddings, Jay Chandarana

For further information about what CNHC’s AVR accreditation means for registrants and the public, you can see the details on our website here: CNHC’s Accredited Voluntary Register or the PSA video clips on CNHC’s facebook page here: .

• CPD random sampling reminder

From May 2014 on an annual basis we will be asking a random sample of 5% of CNHC registrants to send us copies of their insurance certificate and CPD log.

If you are selected in May you will be contacted direct and asked to send your CPD log and insurance certificate. Please do not send these documents to us unless you receive that request.

The full details of the policy and process for the sampling are set out on the link below. Please do click onto this and read the policy because if you are included in the sample, failure to comply could affect your registration. Policy in respect of requirement to provide copies of insurance certificate and CPD log.

For further details about CNHC’s CPD policy please see our website here: CNHC CPD Policy

If you have any questions please contact us at info@cnhc.org.uk

For further information about the CNHC and how to register or renew call 020 3178 2199, email info@cnhc.org.uk or visit


Physical and mental stress can compromise immune response

Dr. Peter Koeppel, Pro Bio Ltd, Switzerland

Stress is a worldwide challenge to health and can come from both physical and emotional sources (1). Sometimes it comes from extreme conditions like poverty, starvation, persecution, or war. It can also be the result of caring for a sick family member, the loss of a loved one, troubled relationships or being in an occupation that involves a high level of responsibility or danger. Heavy workloads and the challenges of balancing professional and family life are increasingly common factors.

Stress affects the hormone cortisol which is produced by the adrenal glands. In small quantities cortisol is helpful. It is anti-inflammatory, speeds tissue repair and controls excess immune cell production. However, continued stress raises cortisol levels beyond healthy levels and slows the production of “good” prostaglandins. These good prostaglandins lower blood pressure, support immune function, improve nerve function, dilate blood vessels, inhibit “thick” blood and are anti-inflammatory. Low levels of good prostaglandin have the opposite effect in that it causes inflammation, immune suppression, stomach acidity and irregular heart rhythm. (2,3,4,5,6,7,8).

Even healthy people with a balanced immune system can go through phases of suboptimal immune function due to situations of overexertion, stress and exhaustion, which make them more vulnerable to infections. In Switzerland, for example, a new survey revealed that 50% of young people suffer from stress.

Excessive stress, either physical or mental, has a detrimental effect on the optimal functioning of the immune system. During a period of stress, the immune cells nearly disappear from the blood due to raised levels of cortisol. The part of the immune system most sensitive to increased cortisol levels are the Natural Killer Cells, a type of white blood cell which is critical to the innate immune system. A non-scientific analogy to this is the collapse of the house of cards after adding just one more card that causes it to fall down.

Figure 1 shows how lifestyle and exercise stresses influence immune status and the risk of infection.

The effect of stress on the immune system is comparable to the effect of exercise on the muscle. An unused muscle will degenerate, a moderately or intense used muscle will strengthen, but very intensive muscle efforts can lead to severe damage of the muscle.

Nucleotides overcome the effects of stress

Nucleotides are the basic molecules that make up DNA and RNA, that therefore play key roles in many biological processes. The requirement for nucleotides increases during times of elevated stress and recovering from major tissue injury, systemic infection or suppressed liver function.

Nucleotides are particularly important for the natural proliferation of the specialised cells that are an integral part of the immune system. When the body is exposed to an antigen (bacteria, virus, toxin etc), it produces an immune response. The response includes the production and proliferation of specialized white blood cells, called lymphocytes that produce specific antibodies that recognise and react with the antigen to render them harmless. In addition to this, one of the body’s biggest physical barriers to the entry of potentially harmful foreign substances is the gut lining of the intestine. The total surface area of an adult’s Intestine is roughly that of a tennis court! This lining has a mucous membrane (mucosa) which includes important immune cells called enterocytes. Maintaining a healthy balance of ‘good’ bacteria in the intestinal tract is also important to help the body maintain a healthy immune system. Although your body produces some of its own nucleotides, the proliferation of all of these cells in the immune system is aided by additional nucleotides from the diet (11,15,17,18).

“From a more holistic point of view, it is interesting that both innate and acquired immunity need rapid and unhindered cell proliferation for proper functionality. Unfortunately, cells of the immune system lack the potential to synthesise nucleotides themselves. Other cells not capable of producing sufficient amounts of nucleotides include gastrointestinal and blood cells. Importantly, nucleotides do not stimulate innate or acquired immunity, but rather provide the resource for unhindered cell proliferation, gene expression, and response to special environmental and physical challenges. Their universal use and fundamental functionality and efficacy in every living organism make nucleotides a valuable management tool for many stress- and health-related conditions.” Ref Function Sports Nutrition magazine, Nucleotides- the building blocks of life, Dr P Koeppel, July/Aug 2011.

It has been found that the application of a nucleotide free diet significantly suppresses cellular immunity (10). In several studies, nucleotide supplementation has been shown to reverse the immunosuppression caused by malnutrition and starvation. A trial with race horses, for instance, revealed that cortisol levels after an anaerobic test was significantly lower in horses fed on a diet supplemented with nucleotides compared to horses fed the non-supplemented diet, while immunity parameters simultaneously improved. In the same trial a significant increase of the liver enzymes was found in the horses supplemented with nucleotides (9).

Until recently, there has been limited available data on nucleotide supplementation on the immunologic effects and on stress parameters in humans. This is an area of research that Pro Bio Ltd, Switzerland, along with Nucleotide Nutrition Ltd, have been pioneering. Pro Bio’s exclusive formulation of purified nucleotides has been shown to lower the formation of cortisol and therefore prevent the decline of the immune system in endurance athletes (12,13,16).

Effects of a nucleotide supplement in trained male subjects on IgA, Cortisol and Lactate after endurance exercise


The aim of this research was to examine the effect of a nucleotide supplement on IgA and Cortisol levels after endurance exercise of young healthy males.


After supplementation of nucleotides, IgA was significantly (p<0.01) higher after exercise in the test persons as compared to those taking a placebo. The pre-exercise level of cortisol was not significantly different (p>0.11). However, after supplementation of nucleotides, cortisol was significantly (p<0.0001) lower after exercise in the test persons as compared to the ones who took a placebo.

There was a greater difference between the changes in the placebo group than there were between the Nucleotide supplement group (p<0.004). This suggests that athletes who ingest the supplement may be able to work at a higher level than non-supplemented athletes, or can undertake the same amount of work as previously without the same levels of blood lactate accumulating post-exercise.

The difference between the changes in lactate post supplementation between

Nucleotide supplement (NuCell) and placebo

Nucleotides help reduce cortisol accumulation and, therefore, reduce stress. Additionally, nucleotide supplementation supports the formation of IgA improving the primary defence of the body and after exercise the level of lactate in the blood is diminished.

Diet-induced reduction of oxidative stress – effect of a nucleotide supplement

Oxidative stress is known to induce genotoxic effects on immune cells. Since nucleotides play a role as immunomodulatory nutrients, their role in the prevention of effects of oxidative stress formation could be of interest.

The aim of the study was to evaluate the effect of nucleotide supplementation on the oxidative stress induced by a high proportion of dietary polyunsaturated fatty acids (PUFAs).

Oxidative Stress / Free Radicals / Cell repair

Stress leaves its marks even on the cellular level. One of the damaging mediators of stress on the cellular level is known as Free Radicals. These molecules are natural side products of metabolism and are even produced by just breathing. Free radicals are aggressive and highly reactive oxygen compounds. An increased production of free radicals can lead to serious damage on protective cell membranes, on important fats or proteins and on DNA . Oxidative stress, therefore, promotes early aging, the development of tumors, arthrosclerosis, cardio-vascular diseases, Alzheimer’s disease and eye cataracts. Increased free radicals are, therefore, the enemy of healthy cells and can lead to variable and severe damage to the body.

Free radicals are only damaging if they are produced in excess or if the antioxidative protection fails or is overextended. Increased production of free radicals has been attributed to cigarette smoking, high UV irradiation, excessive mental or physical stress and exposure to heavy metals. They are also detected in athletes after excessive training (high oxygen turnover). Because free radicals also occur naturally in a healthy metabolism, the organism protects itself by virtue of antioxidants and cell repair mechanisms.

Effects of a nucleotide supplement on oxidative stress
Introduction: Oxidative stress is known to induce genotoxic effects upon immune cells. Since nucleotides play a role as immunomodulatory nutrients, their role in the prevention of effects of oxidative stress formation could be of interest. Therefore, nucleotides could play an important role in the prevention of the negative effects of oxidative stress.

The aim of the study was to evaluate the effect of nucleotide supplementation on oxidative stress induced by a high proportion of dietary polyunsaturated fatty acids (PUFAs).

The oxidative stress, induced by high doses of polyunsaturated fatty acids, was quantified at the beginning and end of 21 days of supplementation of PUFAs by the “Comet-test”, which measures the damage to the DNA of white blood cells. The DNA is isolated and exposed to electrophoresis. An intact, non-damaged DNA stays at the point of application. The DNA is cracked in smaller parts by oxygen radicals. The smaller DNA Parts can migrate in the electric field and form a tail. The more damage that occurs in the DNA, the longer the tail.

Results: In the control group, 4% of the lymphocytes showed damaged DNA. In the group with PUFAs, alone, 15% of the lymphocytes had damaged DNA. If nucleotides were applied together with the PUFAs, the amount of lymphocytes with damaged DNA was, again, only 4%.

Conclusion: These results show that the application of nucleotides can reverse the damage of the DNA. Nucleotides are, therefore, a very important food supplement to sustain the repair mechanisms in the body with primary importance to the efficient function of the immune system.

Nucleotides support the protection of the body against the damaging effects of oxygen radials and help to lower the negative effect of stress.

The research behind NuCell®IM has been conducted to show that a specialised combination of vitamins, amino acids and nucleotides can enable generally healthy sports men and women to support their immune (shown in Figure 2) and hormonal responses during times of heavy demand (12,13,25).

The vitamins and nutrients contained in NuCell®IM also have a role in the process of cell division and regeneration, protecting cells from oxidative stress and contributing to iron absorption and normal red blood cell formation. In recognition of the need for sports men and women to be able to choose sports supplements that are free from prohibited substances, NuCell®IM is registered and tested through the HFL Sports Science Informed-Sport prohibited substances testing programme.


1. Seyle H (1975). The stress of life New York, McGraw-Hill.

2. Biondi M (2001). Effects of stress on Immune function: an overview. In Ader R et al. Psychoneuroimmunology. San Diego (CA): Academic press.

3. Avitsur R et al (2001). Social stress induces glucocorticoid resistance in subordinate animals. Horm Behav. 39.

4. Avitsur R et al (2009). Social Interactions, Stress, and Immunity. Immunol Allergy Clin N Am. 29.

5. Miller GE et al (2002). Chronic psychological stress and the regulation of pro-inflammatory cytokines. Health Psychology. 21.

6. Dantzer R & Kelley KW (1989). Stress and immunity: an integrated view of relationships between the brain and the immune system. Life Sci. 44.

7. Schedloswki M & Schmidt RE (1994). Stress and the immune system. Naturwissenschaften. 83.

8. Avitsur R (2006). Social Interactions, Stress and Immunity. Neurologic Clinics. 24.

9. Art T et al (1994). Cardio-respiratory, haematological and biochemical parameter adjustments to exercise: effect of a probiotic in horses during training. Vet Res. 25.

10. Vasquez-Garibay E et al (2004). Nutritional support with nucleotides addition favors Immune response in severely malnourished infants. Arch Med Res. 35.

11. Van Buren C & Rudolph F (1994). Dietary nucleotides: A conditional requirement. Nutrition. 13.

12. McNaughton L et al (2006). The effect of a nucleotide supplement on salivary IgA and cortisol after moderate endurance exercise. J Sports Med & Phys Fit. 46:84-89. http://nucleotides4health.org/immunity.html

13. McNaughton L et al (2007). The effects of a nucleotide supplement on the immune response to short term, high intensity exercise performance in trained male subjects. J Sports Med & Phys Fit. 47(1):112-119. http://nucleotides4health.org/immunity.html

14. Rezar V et al (2003). Wheat and oat bran effectively reduce oxidative stress induced by high fat diets in pigs. Annals of Nutrition and Metabolism. 47:78-84.

15. Yu IT et al (2002). Role of glutamine and nucleotides in combination on growth, immune respons and FMD antibody titres of weaned pigs. Animal Science. 75:379-385.

16. McCowen KC & Bistrian BR (2003). Immunonutrition: problematic or problem solving? Am J Clin Nutr. 77:764-770.

17. Carver JD (1994). Dietary nucleotides: cellular immune, intestinal and hepatic system effects. J Nutr. 124(1 Suppl):144S-148S.

18. Carver JD (1999). Dietary nucleotides: effects on the immune and gastrointestinal systems. Acta Paediatr Suppl. 88(430):83-88.

19. Olive PL et al (1992). Factors influencing DNA migration from individual cells subjected to gel-electrophoresis. Exp Cell Res. 198:259267.

20. Alessio HM (1993). Exercise-induced oxidative stress. Med Sci Sports Exerc. 25(2):218-224.

21. Alessio HM et al (2000). Generation of reactive oxygen species after exhaustive aerobic and isometric exercise. Med Sci Sports Exerc. 32(9):1576-1581.

22. Niess AM et al (1999). Free radicals and oxidative stress in exercise-immunological aspects. Exerc Immunol Rev. 5:22-56.

23. Kim JD et al (1996). Influence of age, exercise, and dietary restriction on oxidative stress in rats. Aging. 8(2):123-129.

24. Salobir J et al (2005). Effect of nucleotide supplementation on lymphocyte DNA damage induced by dietary oxidative stress in pigs, British society of Animal Science. 81:135-140.

25. Hess JR & Greenberg NA (2012). The role of nucleotides in the immune and gastrointestinal systems: potential clinical applications. Nutr Clin Pract. 27(2):281-294.

About the Author
Dr. Peter Koeppel has a PhD in Biochemistry and Immunology. He was trained in Biochemistry with a special interest in clinical Immunology at the Institute of Virology at the University of Zürich. He then worked as a researcher in osteoarthritis and osteoporosis in a pharmaceutical company in Basel. Since 1989 he has been involved in producing special additives for human nutrition for ProBio Ltd, laterally becoming the managing director of this company in year 2000.

How Can You Improve Your Digestion?

Tummy aches anyone?

More people are beginning to see their physician about digestive health issues. Some suffer from indigestion or heartburn, but more are having chronic problems or being diagnosed with IBS, Crohn’s, and other dyspepsia. Digestive disorders are consistently getting worse. More people are being diagnosed with Irritable Bowel Syndrome (IBS) than ever before, as well as heartburn. In the United States alone, one in four people are diagnosed with some sort of GI Disorder, and over 18 million people worldwide are diagnosed with GERD (Gastroesophageal Reflux Disease)1. 10-20% of all Europeans are now being diagnosed with dyspepsia2. With nearly 8 billion dollars going towards GI drugs1, it is time some changes are made.

Back in the old days……….

Prior to the massive amount of pharmaceuticals that have entered the market, digestive problems were treated with herbal remedies. People would drink tea steeped with ginger and peppermint. These are both still used to help women handle morning sickness. Avoiding caffeine and drinking chamomile tea are two other things that help those with stomach problems. While herbal remedies help with the symptoms, it is better to learn ways to prevent the digestive problems in the first place.

Stress and digestion

‘The idea that stress may contribute to or exacerbate digestive disorders is not a new one, but there is a growing body of research eliciting the biochemical and physiological relationships involved’ says Erica Gibbon, Nutritional Therapist. Emotional and cognitive centres of the brain are linked with intestinal function via the gut-brain axis, a two-way communication system between the central nervous system (CNS) and the enteric nervous system (ENS) which is embedded in the walls of the digestive tract, often referred to as the ‘second brain. This axis is the route via which environmental exposures such as hunger, stress and emotions effect digestive function.

Physiologically stress manifests as a ‘fight-or-flight’ reaction – in a stressful state our body prepares us to run away from danger or to stay and fight for our lives. In modern times we may be less exposed to physical dangers such as wild animals but psychological stressors are much more prevalent and prone to be longer lasting (e.g. money and relationship worries, pressures of our jobs, expectations of those around us, so many things on our ‘to do list’). In any stressful situation energy is diverted away from the digestive system towards body systems that would normally help to keep us alive in times of danger (the brain and limbs), whether that is appropriate in modern times or not. A cascade of stress hormones such as corticotropin releasing factor, noradrenaline, adrenaline and cortisol are released in the body.

Stress hormones have been shown to affect permeability, inflammation and the perception of pain the gut They may also effect gut dysbiosis which can itself contribute to permeability and pain perception as well as to motility problems such as spasm3. Stress has long been associated with IBS and IBD4.

It makes sense, therefore that stress management techniques may help alleviate some symptoms of digestive distress and a variety of stress management techniques are recognised as a cost effective and non-invasive adjunct therapy that can help patients manage a range of digestive disorders.

Music Digestives? Chewing is important for the digestive process. As it is the first step of breaking down food so that it can be effectively digested and absorbed allowing nutrients to be used by the body properly. Savouring the sight and smell of food also releases digestive enzymes so that the process works as it should’ says Erica. ‘In today’s busy world many people do not take the time to sit down, relax and enjoy their food’.

It has been shown that having music playing while eating will dictate how well you handle your food. For example, those who listen to hard rock while eating, eat faster and end up with heartburn, but those who listen to classical music slow down and relax. Playing of classical music, such as Silence of Peace by John Levine, has been shown to help people chew their food slower, lower the cortisol levels, and help a person enjoy what they are eating. Even Patrick Holford knows about the benefits of Levine’s Alphamusic in creating a happier, healthier self. In 2010, Holford said, “Music can also help you switch off by shifting the brainwave patterns to alpha waves… My favourite Album for this is called Silence of Peace by John B. Levine5.” The more people enjoy their food and eat slower, the more likely we are to see a reduction in the obesity rates, heart disease, and IBS diagnoses6.

Erica Gibbon has a BSc in Nutritional Therapy, is a member of BANT and practices at Linden Tree Health, a nutritional therapy clinic in Southport, Merseyside. She can be contacted at www.Lindentreehealth.com

John Bram Levine, world renowned Alphamusic composer and meditation master. John has been interviewed on BBC TV ’Look East’ and Channel 9 TV Australia showing how his special Alphamusic settles down classes of children, babies and even budgies! Alphamusic of John Levine is used and widely praised by a significant range of biomedical and complementary health professionals. Patrick Holford, the world renowned nutrition expert, personally endorses John Levine’s Alphamusic.
In 2007, Levine’s Alphamusic was heard by the Royals at the Diana Concert at Wembley and calmed crowds at Hyde Park Calling and Live Earth concerts. More at www.silenceofmusic.com


1. International Foundation for Functional Gastroinstestinal Disorders. October 2013.

2. Evaluation and Management of Dyspepsia. March 2010.

3. Konturek P, Brzozowski T, Konturek S. Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. J Physiol Pharmacol. 2011;62(6):591-9.

4. Mawdsley J, Rampton D. Psychological stress in IBD: new insights into pathogenic and therapeutic implications. Gut. 2005;54(10):1481-91.

5. Silence of Peace by John Levine http://www.silenceofmusic.com

6. 10 Steps Happy New You. Dec 2010. Web. http://www.dailymail.co.uk/home/you/article-1340806/Patrick-Holfords-10-steps-happy-new-you.html

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