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 Nutrition, Advice, Health, How To, Weight Loss

PCOS: TIPS FOR BLOOD SUGAR BALANCE AND WEIGHT LOSS

Polycystic Ovarian Syndrome or PCOS is an endocrine disorder that affects up to 10% of reproductive age women. It is often associated with infertility due to an imbalance of reproductive hormones that affect the ovaries. Many times, women with PCOS are initially misdiagnosed.

PCOS results in higher levels of androgens (male hormones) and insulin in the body.

As a result, women with PCOS may struggle with their weight and are at a higher risk for developing impaired glucose tolerance, Type 2 Diabetes, and metabolic syndrome. Women with PCOS often have additional cardiovascular disorders including hypertension, elevated cholesterol (high triglycerides / low HDL) and elevated blood sugar related to insulin resistance.

The insulin resistance seen in PCOS is somewhat unique. It may occur in women of normal body weight, and it is not always corrected with weight loss. The insulin resistance results from a defect in the actual cell, rather than the impaired ability of insulin to bind to the cell receptor.  Often times, medication such as metformin is prescribed to help with insulin resistance and restore ovulation.

Signs and Symptoms of PCOS include:

  • Infertility / Impaired ovulation
  • Menstrual irregularities / Amenorrhea
  • Hirsutism (unwanted hair growth, such as on the face)
  • Acne
  • Sleep apnea
  • Weight gain / Difficulty losing weight / Obesity
  • Cystic ovaries

Dietary Guidelines

The following are some simple dietary guidelines that can help women with PCOS manage blood sugar and support healthy weight management:

  • Consume small frequent meals within the appropriate calorie range. It’s important to understand that each person’s calorie range is unique. Calories are based on a person’s height ,weight, age, gender, physical activity level, and goals. So, if someone you know is following a 1200 calorie diet (hint – which for most people is WAY too low), this may not be right for you.
  • Consume a high fiber diet. I recommend at least 25g of fiber per day. Foods that contain fiber can be found in many types of healthy complex carbohydrates. These include fruits, vegetables, beans, legumes, and whole grains. Fiber will support digestion, help keep you fuller longer, help to lower cholesterol, and support overall health and weight loss.
  • Choose complex carbohydrates that are low on the glycemic index and will not cause rapid spikes in blood sugar. Complex carbs include fruits, starchy vegetables, beans and legumes, and whole grains.
  • Avoid processed foods and foods with added sugars. Sugar has no nutritional value and will only make matters worse by increasing your caloric intake and cravings.
  • Consume a diet rich in protein. Ideally strive for a diet that is at least 25-30% protein. Choose lean proteins such as poultry, cold water fish, lean cuts of meats (preferably organic or grass fed), eggs, or plant based protein such as miso or tempeh.
  • Avoid skipping meals. This will impair your metabolism and lead to blood sugar crashes that will cause intense cravings for carbohydrates. The exact opposite of what you need to support PCOS and insulin resistance.
  • Consume healthy Omega 3 rich fats such as nuts, seeds, avocados, and olive oil. Fats will help keep you satiated and they will not spike your blood sugar. Unsaturated fats will also support healthy cholesterol levels.
  • Avoid inflammatory foods. Sugar and processed foods are obvious, but sometimes even healthy foods can be inflammatory in certain individuals. This list might look different for everyone, but if you know that certain foods cause an inflammatory reaction in your body then it’s best to avoid them. A common example would be dairy causing lactose intolerance. The idea here is to reduce inflammation not create it. Keeping a detailed food journal and working with a qualified dietitian can help you identify which foods might be inflammatory to you.
  • Consume plenty of anti-inflammatory foods that are rich in nutrients and anti-oxidants. Examples include: Cinnamon, flax, oats, berries, apples, pears, dark leafy greens, ginger, turmeric, fenugreek, and green tea.

Nutritional Supplements:

Studies show that certain nutritional supplements (along with medication) can support fertility, insulin resistance, and weight management issues associated with PCOS.

  • D-chiro-Inositol and D-pinitol or Myo-Inositol– Has shown to improve insulin resistance, dyslipidemia, hypertension, weight loss, androgen lowering, and fertility.
  • Vitamin D3 – Supports proper metabolism of carbohydrates.
  • Chromium – Promotes insulin sensitivity by helping to reduce body fat and increase lean muscle.
  • N-Acetyl Cysteine (NAC) –Has been shown to improve insulin resistance, androgen lowering, dyslipidemia, weight management, menstrual regularity.
  • Magnesium  – Has been shown to improve insulin resistance, improve sleep, lower blood pressure, and support healthy digestion.
  • Cinnamon – Anti-inflammatory and helps to lower blood sugar.
  • Omega 3 Fatty Acids – Helps to reduce inflammation and improve cholesterol levels, lower blood pressure, and improve insulin resistance.
  • Fenugreek –Has been shown to improve insulin resistance.
  • Probiotics – To support overall gut health, mood, and weight management. 

In addition to implementing dietary strategies I recommend getting plenty of exercise. Engage in cardiovascular activity 3-4x per week and weight bearing exercise at least 2-3x per week such as strength training in order to reduce body fat and build muscle.

In my practice I work with women all the time who are struggling with PCOS and weight management. If you are seeking guidance and support for PCOS, you can contact me here. I would love to work with you.

References:

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

Nutrition Care Manual Polycystic Ovarian Syndrome / eatright.org

https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome

Grassi, A. (2013). PCOS; the Dietitian’s Guide (2nd ed., Vol. 1)

Categories Weight Loss, Food, Health, How To, Nutrition

Intermittent Fasting – Is it right for you?

If you are like most people, you’ve heard the buzz about Intermittent Fasting (IF), and you’ve probably wondered if it’s something you should consider. Maybe you’re even confused about how it works or whether or not you’re already doing it. After all, don’t we fast every night when we sleep? I’ve been getting asked a lot of questions about fasting recently so I thought it would be a valuable topic to discuss.

Let’s begin with defining what IF is.

The concept of fasting has been around for centuries, and originated in different cultures due to certain religious practices. Traditional fasting is defined as the abstinence of food or drink. Intermittent fasting is a modified version of a traditional fast. It is defined as a period of time in which you cycle between a period of fasting and eating.

There are different variations to the fasting cycle. Some of the most common ones are:

  • Alternate day fasting (5/2)– This is a cycle in which a person will eat a normal diet for five days and then fast for two days. During the two days, you don’t fast completely, but you severely limit calories. So that might look something like this: Breakfast – Fast, Lunch – Fast, Dinner – 500 calories or less.
  • Complete fasting – This is a fully restricted fast that can last up to an entire day. The other days of the week a normal diet is consumed.
  • Time restricted feeding – This is probably the most popular type of IF. This involves fasting within a certain number of hours per day, and eating within the remaining timeframe. The most common is 12/12 (eating all meals within a 12 hour window and fasting for 12 hours) or 16/8 (eating all meals within an 8 hour window and fasting for 16 hours). The cycle can be repeated as often as you prefer – either every day or just a couple of days per week.

Benefits

Recent studies have reported several benefits to IF. IF has been shown to:

  • Assist in alleviating digestive disorders (IBS, SIBO) 
  • Improve insulin resistance and blood sugar balance
  • Support weight loss
  • Slow the growth of certain diseases such as Type 2 Diabetes, cancer, metabolic syndrome, cardiovascular disease, and obesity
  • Lower inflammatory markers
  • Improve longevity
  • Support cognitive function
  • Improve circadian rhythm (the body’s natural sleep/wake cycle)

Some of the most interesting research has been done in the area of weight loss, cardiac health, and the microbiome.

Weight Loss

The idea behind IF supporting weight loss is due to the notion that IF promotes calorie restriction and a temporary increase in resting energy expenditure. In addition, fasting has been shown to support a decrease in fat mass while allowing the body to maintain muscle mass. The theory behind these findings is that during a fasting period, fatty acids are released from fat cells and enter the liver where they are converted to ketones and used for energy and neurons. However, to date this idea has only been studied in animals, so more studies are needed to determine if it applies to humans as well. Other studies have shown that fasting allowed for a greater loss in abdominal fat and overall fat mass.

Cardiac Health

Alternate day fasting has been shown to have a significant reduction in triglycerides, LDL particle size, inflammatory markers such as CRP and may prove to be a viable option for those who are overweight or obese and suffering from cardiovascular disease.  

Another study found that participants who engaged in time restricted eating (16/8), resulted in a 3% decrease in body weight as well as reduction in blood pressure. The researchers concluded that this type of fasting allowed for weight loss without calorie counting. This type of diet is less restrictive then complete and alternate day fasting and may be easier in terms of compliance.

The Microbiome

Studies have shown that a diverse and healthy gut can be beneficial to maintaining a healthy weight. In certain cases, obese individuals have been found to have higher levels of harmful bacteria in gut, and low diversity of good bacteria. In addition, we are now learning that the gut has its own circadian rhythm. Chronically disrupted circadian rhythm may affect GI function and impair metabolism. Obesity or weight gain can be impacted by circadian rhythm in our microbiome. The microbiome in obese patients require a greater amount of energy, and imbalances can lead to chronic inflammation, dysbiosis, and intestinal permeability all of which can contribute to obesity.

How does fasting come into play? Fasting promotes gut rest, allowing the Migrating Motor Complex (MMC) to work optimally, sweeping debris from the small intestine into the colon and allowing proper digestion and absorption. This can be highly beneficial to those suffering from certain GI disorders and optimizes the ability to have a healthy well functioning gut.

Challenges:

  • In multiple studies, compliance was the biggest issues for participants. For those who engaged in a 5/2 alternate day fast, intense hunger on fasting days was the biggest reason for non-compliance.
  • In addition to hunger, other possible side effects are weakness and fatigue.
  • IF is simply not practical for everyone, since the benefits will only occur with a consistent eating/fasting period over time. If your schedule varies throughout the week, IF may not be a viable option for you. 
  • Due to intense hunger encountered during an 8/16 fast, some individuals report consuming higher amounts of food than normal and higher calorie amounts, which could lead to disordered eating patterns, weight gain, and digestive discomfort.
  • Due to lack of studies, we have no evidence to know what this does to a person’s metabolism long term.

IF is NOT recommended for the following individuals:

  • Those with certain conditions such as hypoglycemia, hypotension, advanced Diabetes, and those with high cortisol/adrenal dysregulation
  • Individuals with a history of eating disorders or those at risk of an eating disorder
  • Individuals who are underweight, or are looking to gain weight
  • Pregnant or breast feeding women
  • Children
  • Athletes

The bottom line:

I prefer the idea of a 12/12 fast. Consume a healthy balanced diet within a 12 hour window, and allow for gut rest and calorie restriction within a 12 hour fast. This seems to make the most sense to me, and allow for the most compliance without feelings of deprivation and intense hunger.

It is also important to understand that IF is not an excuse to go crazy and eat whatever you want during the eating portion of the cycle – a common misconception. Individuals should still strive to maintain a healthy balanced diet, full of lean proteins (poultry, fish, eggs, lean pork and grass fed beef), healthy fats, plenty of fruits and vegetables, and complex carbs (starchy veg, whole grains, beans and legumes).  If you are contemplating IF, talk to a qualified health professional to determine if it’s right for you. If you have further questions about IF, contact me here

Categories Nutrition, Advice, Exercise, Food, Health, Weight Loss

Healthy Eating for the Holidays (Part 2) 7 Strategies to Help You Stay On Track

How is it December already? It seems like just yesterday I was enjoying my summer vacation! In any case, it’s here. Are you ready? Do you have a plan? If you’re like most people, you’re feeling overwhelmed.

While this is a joyous time of year, it can also be really stressful. You’re not alone if you find that you’re putting self-prioritization on the back burner and falling off track with healthy eating and exercise.

But it doesn’t have to be this way. A while back I wrote a blog post about how to avoid extra weight gain during the holiday season. In today’s blog, I offer some additional strategies to maintain your health goals and still enjoy a festive holiday season.

Here are 7 additional strategies that I recommend:

  1. Use a food tracker for accountability. This can be really helpful throughout the month as you attend holiday parties that are bound to include those tempting high calorie and high carb apps, desserts, and beverages. I recommend that you track your intake during the days leading up to a party or event, and definitely track the day after. On the day of the party, relax and enjoy. But be sure to get back on track the next day with plenty of lean protein, non-starchy vegetables, complex carbs and healthy fats. Your food tracker will hold you accountable and ensure you’re meeting your needs. I love the app Nutritionix Track and my clients do too.
  2. Set an exercise goal and stick to it. Decide how many times you will exercise or work out in December. Have a friend, personal trainer, or fellow gym goer hold you accountable. Reward yourself with something small when you meet your goal (just don’t reward yourself with food or alcohol). I’m not saying you can exercise your way out of poor eating habits, but it will help you to burn some extra calories, lower stress, and feel great about yourself. Who wouldn’t want that?
  3. Hosting a party or event? Give your favorite recipes a makeover. Replace inflammatory vegetable oils with olive oil or avocado oil. Swap heavy carb and fat based casseroles with simpler options. For example, replace a green bean casserole with green beans sautéed in olive oil and topped with almond slivers; swap mashed potatoes with mashed cauliflower or glazed sweet potatoes with a plain sweet potato topped with cinnamon. Check out my Pinterest page for more ideas.
  4. Adopt a “Maintain Don’t Gain” philosophy. Instead of focusing on losing weight during December, set a goal to maintain your weight. It will lower your stress level and allow you to indulge in moderation.
  5. Ditch the sugary high calorie alcoholic beverages. Many are laden with syrup based mixers that will spike your blood sugar and cause you to crave more sweets. Opt for choices that include sparkling seltzer. It will significantly decrease calories and additives, and it will help to keep you hydrated.
  6. Limit the leftovers, especially desserts. If you are offered leftovers, opt for protein and vegetables. Leave the desserts behind. There will be plenty of those at the party next weekend.
  7. Hitting the buffet? Before getting in line, scope out your options. Seek out the fruit, vegetables, and lean proteins and be sure to fill your plate with those first. Decide which carbs you will enjoy (starchy vegetables are best) and which ones you will forgo. Avoid heavy sauces and fried foods.

Let’s face it, even with the best of intentions life gets in the way. The holidays are no exception. Having a clear-cut plan as you approach this month of celebrations will help you stay on track. Remember that this time of year is about spending time with those you love, and reflection. Stay focused on what really matters, remain positive, and remind yourself that you CAN do this.

 

Interested in learning more about my nutrition counseling services? Contact me 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/