Categories Advice, Exercise, Health, Nutrition, Sleep, Stress

Self Care: Necessity, not luxury

I have been seeing a trend in my practice lately. Clients come into a program with the best of intentions – to focus on their health, heal their bodies, and put themselves first for a change, only to get sucked back into life’s harsh realities that zap their motivation and plan. They reschedule or cancel visits and put their wellness goals on the backburner. I see it over and over, and I understand because at times in my life I have done the same. My father died in September. The weeks preceding his death were anguishing. I didn’t go to the gym and at times I skipped meals. I didn’t sleep. It’s easy to de-prioritize yourself when you are juggling a hectic work schedule, kids, aging parents, or caring for a friend or loved one. The list goes on an on.

Life will always present us with these challenges. This I know for sure. But self-care can really save us in times like these. Fueling our bodies with nourishing food, moving our bodies with some form of physical activity, deep breathing for stress reduction, and of course getting some much needed rest.

Self-care is a necessity, not a luxury. It’s like the instructions the flight crew gives you on an airplane prior to take off – in the event of an emergency, put YOUR oxygen mask on before helping others with theirs. It is ok to prioritize your needs first. This is not an act of selfishness. This is an act of self-love and self-worth.  It is a demonstration of your love for those around you. Because when you give yourself these gifts, you become the best version of YOU.

So don’t feel bad about scheduling your nutrition visit, or going to the gym, or taking the extra time to cook some healthy meals for yourself, or simply taking a break. You are worth every bit of that time.

As a reminder, I do offer virtual counseling. Simply login from a tablet, smart phone, computer or other Wifi connected device. Virtual visits are an easy and convenient way to continue with your sessions without requiring the time to make a trip to the office. And if you are like most of my clients and getting pulled in multiple directions, time is everything.

To schedule a virtual nutrition session, click here.

Photo by Allie Smith on Unsplash

Categories Advice, Food, Gut Health, Nutrition, Sleep, Stress

Nutrition for Chronic Fatigue Syndrome: 10 Steps to Improve Your Energy

Chronic fatigue syndrome (CFS) or Myalgic Encephalomyelitis (ME) affects millions of individuals each year.  It is generally defined as extreme fatigue that lasts for six months or more and does not improve with sleep or rest.

Individuals suffering from CFS may find it difficult to participate or engage in physical activity, and may struggle with concentration, memory, or the completion of mental tasks.

While no laboratory test will diagnose CFS, there are a few theories about what contributes to it. Certain viruses, hormone imbalances, a compromised immune system, as well as high levels of chronic stress are all possible considerations.

Additional factors that can contribute to CFS include:

  • Food allergies /sensitivities
  • Celiac / Non-Celiac gluten sensitivity
  • Hypothyroid / Hashimotos
  • Insulin Resistance
  • IBD
  • Candida
  • Oxidative stress / cell damage
  • Certain medications
  • Nutrient deficiencies
  • Intestinal permeability / Leaky gut)
  • HPA Axis dysregulation / adrenal fatigue)
  • Impaired sleep
  • An imbalance in energy demand vs energy expenditure

Although there is no definitive treatment for CFS, many individuals are able to find relief through diet modification, gut healing, and supplementation. One key factor to consider is mitochondrial support.

The mitochondria are the main energy source or “powerhouse” of the cells. They are found throughout the body. When they are damaged, less energy is produced. By targeting and supporting the mitochondria, individuals often find that higher energy levels can result.   

For those suffering from CFS, it is important to evaluate nutrient insufficiencies related to mitochondrial damage and replete if necessary. A micronutrient test is a great place to start.

The following nutrients are often associated with fatigue and CFS:

  • Iron
  • Copper
  • B Vitamins (especially B12)
  • Vitamin D
  • L-Carnitine
  • Fatty Acids
  • CoQ10
  • Magnesium
  • Potassium
  • Chromium
  • Vitamin A
  • Vitamin E
  • Vitamin C
  • Zinc
  • Glutamine
  • Choline

To help promote restful sleep and provide additional support, the following supplements have shown beneficial effects:

  • L-Theanine – Found in foods like green tea, L-theanine supports healthy sleep.
  • Melatonin – A naturally occurring hormone, Melatonin supports restful sleep and supports mitochondria homeostatis
  • Magnesium – This amazing mineral has many purposes. Magnesium promotes restful sleep, healthy gut motility, stress reduction and is a natural muscle relaxer. If you want to sleep well, include magnesium rich foods to your diet and either an oral or topical magnesium supplement.
  • Rhodiola rosea – A natural adaptogen, Rhodiola has been shown to improve energy levels in those who suffer from CFS.

Finally, look for ways to modify your lifestyle in order to replete your energy stores. I recommend these tips:

  1. Improve your diet – reduce intake of white sugar and highly processed foods. Adopt a whole foods diet with a high intake of fruits, vegetables, lean proteins that include organic poultry, wild caught fish or grass-fed beef and non-GMO whole grains. In addition consider the following types of foods that will supply your body with melatonin, tryptophan (a precursor to melatonin), magnesium, and choline.
    • Eggs
    • Fish  
    • Pistachios
    • Cow’s milk
    • Oats
    • Mushrooms
    • Cherries
    • Black and red rice
    • Poultry (Chicken, turkey)
    • Cheese
    • Seeds (pumpkin, sesame, sunflower)
    • Nuts (Almonds, cashews)
    • Peanuts/Peanut butter
    • Spinach
    • Soy milk
    • Beans (black beans, kidney beans, lima beans)
    • Edamame
    • Avocado
    • Potato
    • Brown rice
    • Oatmeal
    • Wheat germ
    • Brussels sprouts
    • Liver
  2. Identify food sensitivities and intolerances. Work with a qualified dietitian to identify any potential foods that are antagonizing your symptoms. Do a trial elimination with a food journal and analyze your results.
  3. Balance your plate with the correct ratios of complex carbohydrates, proteins, and fats to stabilize blood sugar and promote energy balance. Include protein at every meal.
  4. Be sure to incorporate enough calories to support activity and energy output. If calories are too low to support your level of activity, fatigue will result. Remember that food provides your body with energy and fuel.
  5. Identify sources of inflammation including environmental toxins, and work to reduce them.
  6. Identify nutritional deficiencies especially if taking certain medications such as acid suppressing mediations, lipid lowering, oral contraceptives, anticonvulsants, loop diuretics, and anti-hypertensives. I recommend a Spectracell Micronutrient test.
  7. Strengthen and heal the gut. In addition to removing inflammatory foods, incorporate a probiotic supplement that contains Bifidobacterium infantis, F. prausnitzii, and L. acidophilus.
  8. Improve sleep; Increase daytime light exposure and reduce exposure to blue light / screens especially at night. Strive for 7-9 hours of sleep per night. Consistency is key.
  9. Reduce stress. Consider deep breathing exercises, daily meditation, delegating tasks, asking for help, being out in nature, laughter, journaling, and seeking out a licensed counselor when needed.
  10. Begin a steady exercise program. Aim for a minimum of 30 minutes per day of cardiovascular exercise.

For more tips like these to or schedule a consultation with me personally, contact me here.

Photo by Abbie Bernet on Unsplash

References:

https://www.cdc.gov/me-cfs/index.html

https://www.health.harvard.edu/a_to_z/chronic-fatigue-syndrome-a-to-z

https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/symptoms-causes/syc-20360490

https://www.karger.com/Article/FullText/457918

http://info.spectracell.com/bid/54668/Vitamin-B12-Function-Deficiency-Symptoms-and-Repletion

https://www.ncbi.nlm.nih.gov/pubmed/28219059

https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/

Ferreira, S. 2018. A dietitian’s guide to assessing and treating fatigue.

https://www.spectracell.com

Categories Advice, Health, How To, Nutrition, Sleep, Stress, Weight Loss

8 Steps to Better Sleep

Ahh, sleep. How many of us out there wish we could get more of it? We know we should be aiming for 8 hours per night, but an estimated 33% of the population falls short of that goal. Hectic schedules, chronic stress, anxiety, excessive screen time, and alcohol consumption can all contribute to regular amounts of sleep deprivation.

Poor sleep leads to poor health outcomes. According to the CDC, individuals who achieve less than 7 hours of consistent sleep per night – meaning you fall asleep easily and stay asleep – are at a higher risk for weight gain, obesity, insulin resistance, pre-diabetes, diabetes, anxiety, depression, heart disease, stroke, asthma, and cancer.

So what can you do to improve your sleep? Here are 8 quick and easy steps to show you how.

  1. Strive for a consistent bedtime each night. The more consistent you can be, the better. Your bedtime should allow you to achieve 7-9 hours of sleep per night and ultimately should occur during our prime sleep hours (10pm-7am).
  2. Unplug all electronic devices 2 hours prior to bedtime. The artificial blue light from these devices will lower the hormone melatonin. Melatonin is needed to help you fall asleep. Devices are also a trigger for stress and emotions. Give yourself plenty of downtime in order to ready your body for sleep.
  3. Practice stress relaxation techniques. A warm bath, reading, journaling, listening to soft relaxing music, prayer, meditation, yoga poses, whatever you like. Implement one of these strategies each night as you ready yourself for sleep.
  4. Keep your room dark and cool. Avoid having any devices or electronics near your bed that can emit light. Use room darkening shades if necessary.
  5. If you are a light sleeper, consider using deep breathing or meditation techniques to achieve deep sleep. Another thing that can help is a sound machine that will generate white noise. 
  6. When possible, expose yourself to sunshine or daytime light upon waking either by going outside or opening a window. This will support healthy melatonin levels throughout the day.
  7. Consume dietary sources of Melatonin. These include eggs, fish, pistachios, mushrooms, oats, black rice, organic cow’s milk (if tolerated), green beans, cherries. You can also consider a melatonin supplement.
  8. Eat plenty of magnesium rich foods such as bananas, almonds, spinach, cashews, black beans, peanut butter, and avocado, or take a magnesium supplement if needed. Magnesium can help your body relax and achieve restful sleep throughout the night.

Set a goal to implement these strategies in order to enhance your sleep. Along with proper diet and exercise, quality sleep can help you to significantly improve your health. For more information, contact me here.

Photo by Vladislav Muslakov on Unsplash

Resources:

https://my.clevelandclinic.org/health/articles/12114-causes-of-sleep-problems

https://www.cdc.gov/sleep/data_statistics.html

https://www.cdc.gov/media/releases/2016/p0215-enough-sleep.html

Ferreira, S. (2018). A Dietitian’s Guide to Assessing and Treating Fatigue.

Categories Gut Health, Nutrition, Stress

A Nutritional Approach to GERD

The incidence of Gastroesophageal Reflux Disease (GERD) has dramatically increased over the last few decades. I know I see a lot of it in my practice. This blog post will help you to understand the most common causes of reflux, dietary factors that contribute to symptoms, and some helpful tips for management and prevention.

 

GERD is most often caused by the flow of gastric juices (stomach acid) up the esophagus, which can result in a burning sensation, pain, or discomfort often referred to as heartburn. The condition typically intensifies following a meal and when lying down. While some individuals may suffer from occasional cases of heartburn that are easily resolved with over the counter medications such as antacids, GERD is more of a chronic condition. GERD can place individuals at a higher risk for swallowing difficulties, esophageal inflammation, ulcers, and certain cancers.

GERD is frequently associated with abnormalities or a decrease in pressure of the lower esophageal sphincter (LES). Your LES is a valve that controls the flow of food from your esophagus into your stomach. Normally this valve should close tightly, keeping hydrochloric acid and gastric juices in their rightful place – your stomach – so that they can help you digest your food properly. When the LES is compromised, the valve does not close fully, or it opens too often, and stomach acid will creep up into the esophagus as foods are being digested.

GERD can also be associated with muscle contractions known as gut motility. In a healthy gut, foods are normally pushed through the GI tract from the esophagus into the stomach, from the stomach into the small intestine, and from the small intestine into the colon. However, when the gut is impaired, these contractions can become compromised and cause a disruption in the digestive process.

Another factor to consider is hypochlorhydria or low stomach acid. While it may sound counterintuitive, having too little stomach acid can disrupt natural digestion, causing food to remain in the stomach longer then it should. This can cause major discomfort for many individuals including reflux-like symptoms.

Consuming foods that weaken the LES (see list below), along with increased stress, anxiety, and gut dysfunction, can make the symptoms associated with GERD occur more frequently and at a higher intensity.

 Common causes of GERD include:

Overeating / Obesity (puts pressure on the stomach)

Smoking (relaxes the LES)

Ingestion of the following trigger foods (weakens the LES):

  • Alcohol
  • Soda / Carbonated beverages
  • Coffee / Caffeine
  • Chocolate
  • Fatty / Greasy / Fried foods
  • Spicy foods
  • Acidic foods (tomatoes, orange juice, citrus fruit)
  • Peppermint / spearmint
  • Onions / garlic
  • Sugar

Stress (impairs gut motility)

Use of certain medications (NSAIDS, calcium channel blockers, Bisphosphonates)

Additional considerations include:

  • Bacterial overgrowth such as H. pylori, SIBO or yeast
  • Celiac Disease
  • Hiatal Hernia (stomach pushes up through the diaphragm muscle)
  • Food sensitivities / Allergies
  • Chronic constipation
  • Micronutrient deficiencies (from use of GERD medications) such as zinc, B12

When reviewing this list, you may find that few or many of these items pertain to you. The list of trigger foods is a general one, and not all foods listed will trigger symptoms in all individuals with reflux. But it is important to know which ones exacerbate your particular symptoms and to avoid those whenever possible. This will allow your esophagus to heal and will help to avoid the pain and discomfort associated with this condition.

Conventional treatment and management of GERD often involves:

  • Weight loss (when appropriate)
  • Continual avoidance of trigger foods
  • Eating smaller meals
  • Raising the head of the bed
  • Use of certain medications such as antacids and acid-blocker drugs such as Proton Pump Inhibitors (PPIs)
  • Avoidance of eating within 2-3 hours of lying down or going to bed
  • Avoidance of tight clothing that can put pressure on the LES
  • Avoidance of certain exercises that can put pressure on the LES such as sit-ups, inverted yoga poses, and certain forms of heavy lifting

Additional recommendations that can help include:

  • Slowing down at meals
  • Sitting at meals (avoid standing)
  • Taking smaller bites
  • Chewing food thoroughly. This can actually increase saliva production which can help support the integrity of the esophageal mucosal barrier, which is often impaired in reflux patients.
  • Consume meals that are lower in fat
  • Consume meals that are lower in carbohydrates (to help maintain a healthy weight)
  • Consume fermented foods (to support a healthy microbiome)
  • Avoid consuming large amounts of fluids with meals
  • Begin a routine of gargling at night to stimulate the vagus nerve (supports healthy digestion)
  • Stress reduction / Lifestyle change
  • Regular exercise

There are several types of supplements that can support GERD naturally and can help avoid the harmful side effects of PPIs. These include:

  • Deglycyrrhizinated licorice(DGL)
  • Limonene (extracted from citrus fruit peel)
  • Zinc Carnosine
  • Magnesium Citrate or Glycinate
  • Aloe Vera
  • Slippery Elm
  • Marshmallow
  • Glutamine (to heal)
  • Probiotics (to balance the microbiome)
  • Digestive Enzymes
  • Ginger
  • Iberogast (for motility)

It is always important to work with a qualified healthcare practitioner to receive a proper diagnosis for reflux and to identify the root cause.

In addition, many people find it valuable to work with a dietitian to help control their diet, which will make it easier to manage reflux and its related symptoms.

Common dietary approaches that I recommend in practice:

  • Identify and avoid trigger foods
  • Avoid processed foods and those high in refined sugar that can impair gut integrity and motility
  • Identify and support any nutrient deficiencies
  • Practice the key principles of eating properly (slow down, chew your foods, do not overeat)
  • Dietary support of Hypochlorhydria if present
  • Dietary support of bacterial infections if present
  • Incorporation of fermented foods and probiotics to heal the gut and support your microbiome
  • Stress reduction each day

 

Sources:

Gaby, Alan R., MD. Nutritional Medicine. Alan R. Gaby, M.D., 01/2011. VitalBook file.

Murray, M. T., & Pizzorno, J. (2012). The Encyclopedia of Natural Medicine, 3rd Edition. New York, New York: Atria paperback.

University of Wisconsin School of Medicine and Public Health. An Integrative Approach to GERD (Gastroesophageal Reflux Disease). (2018)

Mullin, G. E., & Swift, K. M. (2011). The Inside Tract: Your good gut guide to great digestive health. New York, New York: Rodale.

https://www.iffgd.org/motility-disorders.html

Rishikof, D. Health Takes Guts Ebook, 2018.

Hyman, M. 7 Steps to Reduce Acid Reflux. 2018.

https://www.mayoclinic.org/diseases-conditions/gerd/expert-answers/heartburn-gerd/faq-20058535

Categories Weight Loss, Exercise, Health, Hormones, Sleep, Stress

Menopause and Weight Gain

Menopause. That notorious phase of life where one is prone to mood changes, fluctuating stress levels, anxiety, hot flashes, insomnia, food cravings and weight gain.

I counsel women about this topic all of the time. What I typically see is someone who is restricting calories, engaging in high intensity cardio multiple times per week, and not losing one pound. One of the most important things I want women to know is that there is A LOT going on behind the scenes during this time that is causing that stubborn weight gain, and much of that may not be your fault. And while a healthy diet and exercise are important, it may take more then that to handle the major fluctuation in hormone levels that can occur.

As your ovaries begin to decline in estrogen production, your body will try to compensate by producing estrogen in other ways. One way is through your fat cells. This is why it is so common for women to gain weight (especially in their abdomen) during menopause. Those fat cells are trying to produce and hold on to estrogen. Your body will make it much harder to lose fat then it will to gain it.

In addition, your adrenal glands (which regulate the stress hormone cortisol) will also try to support your declining sex hormones, essentially working overtime to help your body regulate itself. This is a problem because cortisol can then become out of balance, and run high or low at the wrong times. Normally, cortisol should be highest in the morning upon waking, giving us energy to start our day. Throughout the course of the day, cortisol should gradually decline and be at its lowest as we prepare for sleep. When cortisol becomes imbalanced, it can end up running high at night (causing insomnia) or low in the morning (causing fatigue). Or sometimes, cortisol will run high all day long. When this happens, it can cause your blood sugar to chronically run high, which can lead to increased appetite, food cravings, weight gain, and insulin resistance. Cortisol also plays a role in causing symptoms like hot flashes and night sweats.

So what’s a woman to do?

The following strategies can help…

Balance your plate

The first thing I typically recommend is to balance your blood sugar with plenty of high fiber non-starchy vegetables, complex carbs, lean protein, and healthy fats. Complex carbs include fruit, starchy vegetables, beans, legumes, and high fiber grains such as quinoa. For protein, I like to recommend wild caught fish, free range chicken or turkey, and grass fed beef. Healthy fats would include olive oil, grass fed butter, ghee, coconut oil, nuts and nut butters, seeds, and avocado.

Do not deprive yourself of calories

It’s important to note that while we are normally inclined to limit calories in order to lose weight, in times of stress we actually want to be cautious about going too low. When this happens, it can actually cause additional stress on your body. That’s why it’s important to fuel your body with the right amount of calories to support its needs. Calorie needs differ for each individual. Know your minimal calorie range (I can help you with that) and stick to it. Do not over restrict yourself.

Stick to a meal schedule

Eat small meals throughout the day, and avoid going long stretches of time without eating. I usually recommend fueling your body every 3-4 hours. This will help to stabilize blood sugar and optimize your energy levels.

Limit or avoid caffeine and alcohol

Caffeine and alcohol can raise cortisol, increase hot flashes and night sweats, and impair sleep. Many women report a reduction in symptoms when they reduce or eliminate these from their diet.

Exercise

Exercise on the regular, and include strength training. Strength training will help burn fat and build muscle, which is known to decline as we age. It will also help to slow down the onset of osteoporosis, which women are at risk of during menopause because of the direct relationship between estrogen and bone health. Avoid frequent amounts of intense exercise. This can actually raise cortisol levels which will make it harder to lose weight. Have variety in your workouts, such as strength training 2-3x per week, cardio 2-3x per week, and low impact exercise such as walking or yoga 1-2x per week to really balance things out.

Focus on Stress Reduction

Manage your stress! Deep breathing, yoga, laughing, being outdoors, and simply taking time for yourself are all things that can help support your adrenals and lower cortisol levels. You can also incorporate supplements such as Vitamin C or B vitamins to help reduce stress. Adaptogenic herbs such as Ashwaganda, Holy Basil, Rhodiola, Lemon Balm, or Valerian can be especially helpful, but I recommend starting with these in the form of a tea versus a supplement, unless you’ve taken a cortisol hormone test and know what your specific levels are throughout the day. Work with a qualified health practitioner to learn more.

Prioritize your sleep

Adapt a healthy sleep routine and stick to it. Turn off electronic devices after 10pm, keep your bedroom cool and dark, and practice healthy sleep habits such as reading or meditating to help clear your mind and prepare you for restful sleep. The ultimate goal is 7-9 hours of uninterrupted sleep per night.

Acupuncture

Consider complementary therapies such as acupuncture to help with stress and hormone balance.

Hormone Replacement

Talk to your doctor about hormone replacement therapies such as compounded bio-identical hormones. Your doctor will be able to discuss options and help you determine if this is something right for you.

Finally, recognize that this is a journey and that it may take time to see your body respond to some of these changes. Set goals, stay consistent, and be patient.

For more ideas on how you can manage menopause and weight gain, contact me here

Photo by Jennifer Burk on Unsplash