Categories Advice, Health, Nutrition, Weight Loss

Things like this really fire me up!

Really??!! Would you want to get nutrition advice from these guys?? I wouldn’t.

When I see crap like this I get so frustrated!

Would you get medical advice from a random salesperson at the local shopping mall? What about legal advice or tax advice? Nope. You’re smart enough to know that seeking advice on these topics from anyone other than a licensed professional could be a huge mistake and cause you potential harm.

Why should nutrition advice be any different?

I love the field of nutrition, and I love my job as a dietitian. It was a second career choice for me, and it was one of the best decisions I ever made. But you know what? It was HARD WORK getting here.

It took me years in school learning about nutrition, anatomy, biology, biochemistry, metabolism, clinical nutrition therapy, psychology, and the art of counseling. Not to mention a year of internship in a variety of settings including a top-notch hospital in Philadelphia, plus a rigorous exam that I studied for and stressed over for months.

Why is the process of becoming a dietitian so demanding?

Because as dietitians we dedicate our lives to the field of nutrition. We believe in food as medicine. We want to help others live their best life. Dietitians truly care.

I know there is a lot of controversial nutrition information out there. So much that it can make your head spin and be completely overwhelming.  There will always be a new diet trend, a new shake, a new pill, and a new promise. But know this…invest your time, your health, and your money in someone who takes nutrition recommendations seriously.  Someone who knows the facts.  Someone who cares as much about your health as you do.

I mean it when I say that. I care about you and I want to help. When you are struggling I am here to help you sort it out. When you are overwhelmed, I am here to make things easier. When you are feeling defeated, I am here to pick you up. And when you celebrate your victories, I celebrate with you.

So don’t fall for the snake oil salesman. Get your nutrition advice from an expert. Don’t settle for anything less.  You are SO worth it.

March is National Nutrition Month. Celebrate with me by giving yourself the gift of health. Book your session today by clicking here.

Categories Hormones, Exercise, Nutrition, Protein, Weight Loss

Thyroid: Is it to blame for your weight gain and fatigue?

Are you constantly struggling to lose weight even though you eat right, exercise regularly, and get plenty of sleep? If so, the reason could be your thyroid.

The thyroid is a butterfly shaped gland located in the neck. It is a major gland of the endocrine system and affects nearly every organ in the body.

Your thyroid helps to regulate the following:

  • Metabolism (How the body burns and stores carbs, fats, and proteins)
  • Body temperature
  • Calcium Balance
  • Heart rate and cellular oxygenation
  • Hormone balance including depression and anxiety

One of the most common types of thyroid disorder is an underactive thyroid. This is known as hypothyroidism. According to the American Thyroid Association:

Hypothyroidism means that the thyroid gland can’t make enough thyroid hormone to keep the body running normally. People are hypothyroid if they have too little thyroid hormone in the blood. Common causes are autoimmune disease, such as Hashimoto’s thyroiditis, surgical removal of the thyroid, and radiation treatment.”

Since your thyroid helps to regulate your metabolism, an underactive thyroid can cause a slower metabolism and in some cases make it to come to a complete standstill. Individuals with hypothyroidism may find it extremely difficult to lose weight, no matter how healthy they eat and how often they exercise.

In addition to weight gain and difficulty losing weight, other signs of hypothyroidism include:

  • Fatigue
  • Anxiety / depression
  • Intolerance to cold
  • Goiter
  • Elevated cholesterol (LDL)
  • Constipation
  • Food sensitivities
  • Thinning hair
  • Dry brittle nails
  • Low libido
  • Brain fog/memory loss
  • Thinning outer eyebrow
  • Micronutrient deficiencies
  • Impaired methylation
  • Muscle weakness
  • Numbness in the fingers or hands
  • Headaches
  • Menstrual irregularities

Knowing Your Numbers:

Have you had your thyroid tested and been told it’s “normal” even though you are still feeling lousy? How frustrating! While your numbers may be in the normal range according to a lab company, they may not be optimal. Optimal means you are feeling well. Or, more commonly, not all of your thyroid numbers may have even been tested.

One of the most comprehensive ways to determine if your thyroid is functioning at its best, is a have your doctor run a full thyroid panel. A full thyroid panel will look a variety of thyroid numbers, not just your TSH. It will give you a lot more information about your thyroid, including a test for thyroid autoimmune disease such as Hashimoto’s or Grave’s.

A full thyroid panel should include:

  • TSH
  • Free T4
  • Free T3
  • Reverse T3
  • Thyroid Peroxidase Antibodies (TPOAb)
  • Thyroglobulin Antibodies (TgAb)

If you have only had your TSH or T4 tested, and are still experiencing symptoms, it may be time to talk to your doctor or endocrinologist about further testing.

Foods To Include:

To support a healthy thyroid, I recommend a whole foods diet with plenty of lean protein, fruits, vegetables, healthy fats, and complex carbohydrates. Consider organic fruits and vegetables (use the Clean 15/Dirty Dozen list as a guide) meats without antibiotics, dairy without hormones, and non-GMO fermented soy in limited amounts only. Drink plenty of water. Set a goal to drink half of your body weight in ounces each day (For example, a person who weighs 150lbs would drink 75oz in water per day). For weight management, stick to your appropriate calorie range, keep carbs low, and balance with plenty of protein. Aim for 25g of fiber per day minimum.

In addition, be sure to include thyroid supportive foods that are rich in Vitamin D, iron, selenium, iodine, zinc, Omega 3 fatty acids, B12, and anti-inflammatories such as:

  • Lentils
  • Spinach
  • Sardines
  • Tuna
  • Crab
  • Lobster
  • Oysters
  • Eggs
  • Sea salt / Kelp /iodized salt
  • Brazil Nuts – about 2 per day
  • Beans (if tolerated)
  • Dark chocolate (in moderation)
  • Olive oil
  • Almonds
  • Cashews
  • Avocado
  • Sweet potatoes
  • Oats
  • Grass fed beef
  • Poultry
  • Flax seed
  • Pumpkin seed
  • Sesame seed
  • Tumeric

It is also important to include fermented foods to heal the gut such as kefir, sauerkraut, miso, yogurt, fermented vegetables, and Kombucha

Foods to modify:

  • Cruciferous vegetables – Foods such as broccoli, cauliflower, kale, Bok Choy, Brussels sprouts, cabbage, collards, watercress, radishes, arugula, and mustard greens contain goitrogens. In a person with hypothyroid disease, goitrogens can attack the thyroid and produce what is known as a goiter. Let me be clear, you do not need to avoid these foods! You just need to cook them first. Cooking will break down the goitrogenic properties and make them safer for your thyroid.

Foods to limit/avoid:

  • Gluten*
  • Dairy*
  • Millet
  • Soy (in some cases)
  • Coffee – Limit, consume 1-2 hrs after taking medication
  • Added sugars
  • Trans fats
  • Fast food
  • Common food sensitivities should be ruled out
  • Halogens including chlorine and fluoride (can inhibit iodine update)
  • Environmental toxins (Plastics, synthetics, pesticides, xenoestrogens)

*It is important to note that celiac disease, gluten sensitivity, and dairy intolerance should all be ruled out. There is evidence that supports a correlation to thyroid disease and celiac disease. If autoimmune disease is present, there is evidence to support a GFDF diet can help.

Supplements to consider (Not all of these supplements may be needed. Certain supplements should only be considered if you are deficient. I recommend micronutrient testing to determine your needs)

  • Daily Multivitamin
  • Vitamin D3
  • Fish Oil
  • Iron
  • Selenium
  • Vitamin A
  • Vitamin E
  • Zinc
  • Certain Antioxidants

Supplements that may interfere with thyroid medication:

  • Calcium, fiber – If taking, space apart from your thyroid medication
  • Biotin – Can interfere with thyroid tests

Finally, be sure to get plenty of exercise and manage stress. Here are some additional treatment therapies to consider:

http://www.thyroid.org/thyroid-disease-cam/

Resources:

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.

http://www.umm.edu/health/medical/altmed/condition/hypothyroidism

https://my.clevelandclinic.org/health/diseases/8541-thyroid-disease

https://www.thyroid.org/hypothyroidism/

http://www.todaysdietitian.com/newarchives/070112p40.shtml

https://www.eatright.org/food/vitamins-and-supplements/nutrient-rich-foods/the-beginners-guide-to-cruciferous-vegetables

https://www.amymyersmd.com/thethyroidconnection/

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 Gut Health, Health, Weight Loss

Gut Health and Obesity – Is Your Microbiome Making You Fat?

If you are like many of my clients, you may be seeking guidance and recommendations for weight loss. I often teach people about the benefits of eating healthy unprocessed foods, getting the proper amount of exercise, reducing stress, and prioritizing sleep as a means of achieving a healthy weight. But what if you are doing all of those things and still not seeing results? What else should be considered? The answer is: your gut.

“All Disease Begins In the Gut”

These were famous words spoken by Hippocrates thousands of years ago, and they still hold true today.

Our gut contains 100 trillion microorganisms known as our microbiome. This vast and awesome environment consisting mostly of bacteria, houses 70-80% of our immune system. It is also where serotonin is produced. Serotonin is a neurotransmitter that is responsible for regulating mood, behavior, appetite, digestion, sleep, memory, and sexual desire. While we want to strive to have as healthy and diverse of a microbiome as we can, we can easily find ourselves in situations where our microbes will become altered or imbalanced.

An imbalance in our microbiome is known as dysbiosis. Dysbiosis occurs when we have low microbial diversity, an overabundance of bad bacteria vs. good bacteria, or pathogens. Dysbiosis typically results from things like poor diet, stress, certain medications like NSAIDS, chronic infections, and toxins in the environment. Dysbiosis has been linked to many chronic diseases such IBS, depression, anxiety, thyroid disease, and autoimmune conditions and obesity.

But how exactly, does bacteria in our gut contribute to our ability to gain and lose weight? Several obesity studies have shown that specific microbes in the gut alter how we store calories and fats. Studies that compared the microbiome of lean individuals to obese individuals have found that the leaner study participants had a wider variety of microbes that break down plant starches and fiber into shorter molecules that the body can use as energy. Studies have also shown that a diet high in processed foods can lower diversity within the gut. Gut bacteria can also alter how we regulate glucose levels and how we respond to hormones that make us feel hungry or full, both of which can contribute to changes in body weight and metabolism.

Simply put, an imbalance in our microbiome may increase our risk of weight gain and obesity.

How do you know if you are at risk?

Digestive issues such as gas, bloating, constipation, diarrhea, reflux, or IBS are all signs that your microbiome is impaired and out of balance. If you are struggling to lose weight, these issues may be a contributing factor. Other signs of gut impair include fatigue, brain fog, depression and anxiety, frequent colds and infections, and autoimmune disease.

What to do about it

Repair your gut – for many this can start with a quality probiotic. Probiotics help to diversify your flora  and keep your gut functioning at its best. I recommend professional grade probiotic supplements along with glutamine or collagen to help maintain a healthy gut mucosal lining . But if you are experiencing any of the issues mentioned earlier, it could require a more extensive gut protocol that includes additional supplements such as digestive enzymes, HCL, Magnesium, herbal microbials, or reflux supportive supplements such as DGL. This may seem extensive, but keep in mind that many of these might be temporary supplements that are needed to reduce inflammation and put you on the road to better health.

If you are struggling with digestive issues and weight gain, it is worth exploring the topic of gut health and working with a qualified health practitioner such as myself, to develop a gut protocol to get you well. Once your gut is repaired you may find it easier to lose weight and maintain a healthy weight longer.

For more information on gut health and nutrition counseling, contact me here

Categories Food, Health, Nutrition

The Power of Phytonutrients

Phytonutrients are natural compounds in plants that are a powerful tool for building better health. Phytonutrients provide numerous functions, such as providing the body with a rich source of antioxidants, which protect us from oxidative stress. Phytonutrients also stimulate enzymes that help the body get rid of toxins, boost the immune system, improve cardiovascular health, promote healthy estrogen metabolism, and stimulate the death of cancer cells.

The best source of phytonutrients in the diet are fruits and vegetables, along with whole grains, legumes, herbs, spices, nuts, seeds, and teas. Phytonutrients in food come in a variety of colors including red, orange, yellow, green, blue, purple, tan, and white. For optimal health, it is important to eat a variety of colorful foods often.

Remember to strive for at least two servings of vegetables (about half of your plate) at meals, and one serving at snacks. Challenge yourself by aiming for one to two colors per day and choose a variety of fruits and vegetables within those color groups each week. In addition, vary your preparation methods. Enjoy veggies raw or cooked. Try adding colorful fruits to salads, smoothies, or hot cereal. Experiment with different varieties of beans and grains. Add colorful spices to your foods.

Below is a sample list of phytonutrient rich foods by color. Which ones do you enjoy often? Which new ones will you try?

Green – Apple, artichoke, asparagus, avocado, bell peppers, bean sprouts, Bok choy, broccoli, cucumbers, green beans, peas, zucchini

Yellow – Apple, pears, banana, bell pepper, corn, summer squash, pineapple

Orange – Apricots, bell pepper, cantaloupe, carrots, mango, nectarine, oranges, papaya, persimmons, butternut squash, sweet potato, tangerines, turmeric, yams

Red – Apple, kidney beans, beets, bell pepper, cranberries, cherries, pink grapefruit, goji berries, grapes, plums, pomegranate, radishes, raspberries, strawberries, rhubarb, tomato, watermelon

Blue/Purple/Black – Blueberries, blackberries, boysenberries, cabbage, carrots, cauliflower, eggplant, figs, grapes, kale, plums, potatoes, prunes, raisons

White/Tan – Apples, cauliflower, coconut, dates, garlic, ginger, jicama, white beans, lentils, mushrooms, onions, pears, shallots, seeds, grains, black or white tea

Source: Institute Functional Medicine