Coffman Integrative Nutrition - Newsletter (blog page)

Issue 136: Navigating the Rapids

Thu, 20 Mar 2025 04:00:00 GMT

Sometimes, I describe life as an accordion—there are moments when it squeezes in tightly, pressing out every last breath of air, and then the music changes. It expands again, creating space and filling it with new possibilities.

Other times, life feels like canoeing down a river. Sometimes the current is steady and smooth, carrying us forward effortlessly. But then come the rapids—demanding, relentless, requiring all our focus and energy just to stay afloat.

Lately, I’ve been in the thick of those rapids. My days have been full — full of meaningful work, deep commitments, and personal challenges. Between serving my clients (old and new), studying for the National Board of Health and Wellness Coaches exam (a rigorous 4.5-hour examination), and managing personal responsibilities, I’ve had little time to pause.

And let me tell you, I am ready for smoother waters.

That being said, I wouldn’t trade the fullness of my days. I love working closely with my clients and witnessing their growth. I feel more prepared and skilled as a coach with everything I’ve studied. And I feel incredibly fortunate to have a life filled with people and activities that matter to me.

But here’s the truth: Not everything is sunshine and light.

Some days are hard. Some are emotional, frustrating, or just plain exhausting.

This season has looked me square in the eyes and said: It’s time to walk the talk.

It’s easy to prioritize self-care when life is calm. But what about when we’re navigating the rapids? When time is tight, and the workdays stretch into the night? When life demands so much that we feel like we’re running on empty?

That’s when intentional choices matter most.
We can do this.

In Wellness, Mary Virginia

Navigating Busy Seasons with Intention

Below are some of the habits and mindsets I lean on to cultivate wellness — even in my busiest seasons. My hope is that something here resonates with you and sparks an idea for your own life.

👉 Reframe obligations as choices.
It’s easy to feel like we have to do everything. But the truth is, we don’t. We choose. Shifting from "I have to" to "I choose to" can transform even difficult tasks into meaningful ones. Purpose and meaning are my paddles in the rapids.

👉 Give myself grace and space.
Not everything has to fit into today. Some things can wait. And that’s okay.

👉 Prioritize sleep.
No negotiation. It’s foundational to my energy, focus, and overall well-being.

👉 Eat nourishing meals (and snacks!)
Food is more than fuel — it’s a necessary pause in my day, a moment to reset, recharge, and reconnect.

👉 Move my body.
Movement is my reset button. After hours at my desk, my body needs to unwind.

👉 Spend time in nature.
Fresh air, forward movement, and a shift in scenery help reorient me to the positive.

👉 Create small moments of pause.
Even brief breaks—stepping outside, taking deep breaths, watching the sky — can refresh my mind. I also: don’t work after dinner, watch a show I enjoy, and read before bed.

👉 Stay connected.
I make time for my people — even when life feels too busy. The way a short call, a walk, or a dinner with friends rejuvenates me is a revelation.

👉 Celebrate the small victories.
My spouse coined the term: Triumph Living, and I love it. Every day is filled with small wins:
✔ Remembered to buy toothpaste? Victory!
✔ Had a great conversation with a stranger? Triumph!
✔ Found a parking spot close to my appointment? Fists in the air!

No victory is too small to celebrate.

How Do You Keep Your Canoe Upright?
📩 What helps you feel whole and well?
🌊 How do you stay afloat during life’s rapids?
🎉 How do you celebrate your small (or big) triumphs?
Send me an email or make a comment below — I truly love hearing from this community.

Issue 135: Build Unshakeable Stress Resilience

Thu, 27 Feb 2025 05:00:00 GMT

I had a great opportunity to speak to the Atlanta chapter of the Princeton Women’s Network recently. We chose as my topic Stress Resilience: The Mind-Body Connection. Writing that presentation got me thinking about habit, ritual, rhythm, and flow as elements of stress resilience.

Come join me in this conversation. I’d love to hear how you use these elements to support your own health and wellbeing!

In Wellness, Mary Virginia

Over the millennia, our bodies evolved to toggle between protective mechanisms and healing mechanisms. The body-mind is enmeshed in tightly designed programming to seek, support, protect, and defend our health and safety.

Whenever there is a threat, regardless of whether it is a physical, health, emotional, or psychological threat, the body is designed to respond with a singular focus on surviving it. This is called the stress response. And boy! When some car runs a red light and we’re able to maneuver our own vehicle out of the way in a split second, we’re so happy that we have an automatic protection system!

However, when we become chronically stressed, perhaps because of a traumatic experience, a health situation, or maybe because of daily demands, we begin to burn out and our physical and mental health suffer.

The Stress Response

When you think about it, there’s a lot that your body does without your conscious awareness. Among them are physiological processes that are kept running by what’s called the autonomic nervous system. Autonomic means the same thing as automatic. This nervous system automatically assures these major processes keep happening while you don’t even notice:

Heartbeat
Blood Pressure
Tear Production
Blinking
Sexual Arousal
Breathing
Digestion
Saliva Production
Waking Up/Getting Sleepy
Urination/Defecation

The autonomic nervous system is made up of three components:

Sympathetic Nervous System: stimulating, energizing.
Parasympathetic Nervous System: calming, renewing; supportive of digestion, elimination, and procreation.
Enteric “Gut” Nervous System: digestion, elimination, immune response, mood.

These nervous systems, together with the cardiac (heart’s) nervous system, collect data from the body and send it up to the brain. The brain interprets the message, forms a story to define it, assigns it meaning, and then sends messages back down into the body about what it should be doing. Mind you, all of this happens in a split second.

Remember, we’re toggling between protection and healing all day every day. The story and meaning assigned by the brain reflect how the body communicates either danger or safety up through the vagus nerve. The brain dictates next steps based on the story and the meaning. That is, does the body still need to be protected? Or are we safe?

We love the sympathetic nervous system! It stimulates cortisol production as morning arrives so that we wake up and have energy to start our day. That stimulation contributes to clear thinking, focus/attention, and generally helps keep us engaged into the afternoon.

The sympathetic nervous system, though, is also thought of as the “fight or flight” nervous system. If any part of the body feels under threat for any reason, the bold, fierce, protective sympathetic response leaps instantly into action to help us think clearly and move fast. Adrenaline is fast to be released and quick to be metabolized. Cortisol, on the other hand, is slow on both counts. It lingers in the system for hours, keeping us on edge and alert to danger.

But you know what the body doesn’t need when it’s in danger?
Distractions like feeling sexy or hungry or having to go to the bathroom, or, you know, being sleepy. The sympathetic nervous system messes with these automatic functions when it’s triggered to protect you.

Here’s the Catch
I’m describing this like the threat is a saber toothed tiger in the woods. But your body doesn’t distinguish between threats, whether physical, emotional/psychological, health/illness, overwhelm, losses, etc. It doesn’t know that you’re “just” having a bad day or that you lost your job or got in an argument with your significant other. It only has one action to save you from danger: the stress response.

That persistent overstimulation sometimes goes by another name: anxiety.

And when you feel so overwhelmed that you become absolutely bound, unable to fight or flee? You freeze (or flop). Another name for this is depression.

How about when our stimulating cortisol levels remain high, but we’re completely worn out from being “on” and not sleeping? We’re wired and tired. Absolutely buzzing and frazzled. This is when we get brain fog, memory issues, irritability, lack of focus, extra distractibility, mood swings, etc. etc.

Our bodies eventually let us know it’s been too much for too long: heart issues, blood sugar and cholesterol dysregulation, weight gain, insomnia, illnesses, nutrient depletions…even cancer.

Resilience

Resilience is built when our bodies spend more time feeling safe, even choosing that feeling of safety as a coping strategy during hard times. In terms of our autonomic nervous systems, this means fostering and nourishing our parasympathetic nervous system response. It doesn’t mean we get rid of stress, but that we have greater capacity in the face of hard things.

The parasympathetic nervous system is also known as the “rest, digest, and procreate” system. I like to think of it as “rest, digest, and renewal.” Quality sleep, good digestion, clear thinking, creativity, thoughtful decision-making, not getting sick (or recovering fast), normal hunger patterns, stable mood, … everything continues to function (even if it’s sometimes toggling into protection).

The American Psychological Association defines resilience this way:

“Resilience is the process and outcome of successfully adapting to difficult or challenging life experiences, especially through mental, emotional, and behavioral flexibility and adjustment to external and internal demands.” Adapted from the APA Dictionary of Psychology.

Essentially, how we engage with the world, the resources we access, and the skills we cultivate and practice can successfully bolster our resilience.

Intuitive Living

Let’s look at some of the daily resources and skills that can support your resilience.

Food & Meals
If you are interested in exploring a nutrient dense food plan, click here for my Food Freedom newsletter.

Build habits and rituals around food that can support your body to stay stable and feel safe via cellular, biochemical, and metabolic resilience. Things like: routine meals at regular meal times. Combine a protein, fat, and complex carb to create time release energy. Prevent physiological stress by fasting overnight for no more than 12-14 hours. Eat mindfully so that you can be fully present and enhance digestion (good digestion signals safety to the brain). And nourish relationships by sharing meals.

Movement
Movement has so many benefits, including directing the body to create healthier new cells as old ones experience programmed cell death. I can’t capture it all here. Still, with it you will develop biochemical, emotional, psychological, and physical resilience as well as expand mood stability. That said, remember to build in rest days for full recovery! Here are a couple of ways movement builds resilience:

Increases Brain Derived Neurotrophic Factor (BDNF)
The “Miracle Grow” of the brain. Enhances neuroplasticity, cognition, & learning & memory; increases the expression of pro-survival genes; regulates glucose & energy metabolism; increases neuronal communication; low BDNF is found in neurodegenerative diseases.

Mood
Increases blood circulation to take oxygen and nutrients to the brain; increases mood chemicals, including endorphins, serotonin, dopamine, and acetylcholine (which supports memory formation).

Eustress
“Good stress.” Appropriate stress on the body through movement inspires it to build muscle, bone, and energy-producing mitochondria. The outcome of eustress is growth rather than depletion. Incidentally, intellectual eustress does the same for knowledge and the brain.

Sleep
Rituals and routines around evening and bedtime boost physiological resilience, which translates into psychological and emotional resilience. By honoring your circadian rhythm and the processes that happen only during sleep, you will enhance the clearing out of pathway-clogging metabolic waste and the repair, renewal, and rejuvenation of DNA, mitochondria, cells, and tissues.

Cortisol rises with the morning for wakefulness, then diminishes as melatonin begins to rise in the late afternoon/early evening for sleep. These habits allow you to become aware of your own circadian rhythm and take full advantage of it.

Nighttime Rituals and Routines
Do not work after dinner to allow your body to release the day and lean into the relaxing evening and night. Choose calming, attractive activities: reading, tv show, play a game, conversation. Rituals and routines train your body to expect and embrace sleep.

Lighting
Choose as dim a light as is comfortable for the activities you choose in the evening.

Bedtime
No screens of any kind 1 hour before lights out. Read, soft music, light stretching, Keep a bedtime routine. Go to bed at about the same time every night, even on weekends. Again, you are training your body to anticipate letting go of the day and sleeping.

Morning
Upon waking, get outside for 5 minutes or longer to take in morning sunlight. Don’t look straight at the sun! But do look toward it. Morning and late afternoon light trigger the pineal gland to coordinate daytime wakefulness and nighttime sleepiness. Bonus if you enjoy it while taking a walk.

Presence Practices
Presence practices create cascading mental and physical health benefits: mood, immunity, endocrine (hormone) system, nervous systems, and every part of you with which they interact.

They increase heart rate variability (HRV), which helps improve cardiovascular health, blood pressure, blood glucose/diabetes markers, immune function, and more. A high HRV has been found to improve behavioral flexibility and emotional resilience.

If you want to pull all the practices together to create the most profound stress resilience, engage in presence practices. Practice them away from your most stressful situations to train your body to be instantly responsive to them when you need them most. Here are some examples:

Breath Work
Breath work such as 4-5-6 Breathing or Box Breathing. We only breathe deeply when we are safe. Regulated deep breathing not only oxygenates your system, but it engages the stretch receptors of your lungs. The vagus nerve captures that stretch sensation and communicates safety to the brain.

Meditation, Yoga
Try the free Medito app for meditation or Yoga with Adriene. These practices increase HRV and incorporate breath work.

HeartMath
Read about the amazing benefits of HeartMath here.

Social Time
Being with others with whom you feel relaxed, who listen to you, who engage with true interest, and who make you laugh increases HRV, which is why you feel better and calmer after being with them. Build pleasant social relationships into your days and weeks.

Stress Resilience is Yours for the Taking

While stress is going to be a part of our lives, we can build resilience to it for free. We will be most successful when we take a multifaceted approach. Nourish your whole self by establishing patterns and rhythms to your life. Your body will come to anticipate these different forms of nourishment, and you will find yourself sensing intuitively what will bolster and replenish your resilience.

Believe me, after establishing these practices, one day you’ll be in a hard situation, and you’ll intuitively begin to move slowly with intention, breathe deeply, and take a pause to absorb the information. This will allow you to decide how to proceed in a way that serves you best. You’ll be strong and capable. And it will feel great.

“To everything there is a season,
and a time to every purpose under the heaven.”

With apologies to Solomon in Ecclesiastes 3:1-8 (King James Version) and also to The Byrds, I have crafted a reframed poem to illuminate how to build resilience:

A time to eat, a time to refrain from eating.
A time to move, a time to rest.
A time to connect socially, a time to retreat.
A time to work, a time to be quiet and reflect.
A time to awaken, a time to sleep.

When we listen to the intuitive wisdom of our bodies, we automatically fall into rituals and habits that form a healing rhythm to our days.

Issue 134: ADHD Nutrition & Lifestyle: What to Include Next

Thu, 06 Feb 2025 05:00:00 GMT

This is our closing issue on our ADHD series. After this you’ll have an arsenal of information to support you in your ADHD journey!

This week I touch on food, supplements, and lifestyle practices. Please know that this is meant to be a glimpse into this world rather than a full illumination. Lifestyle practices alone could take a whole book! Nevertheless, my main goal is to empower you with these tools so your daily life becomes a bit easier and your symptoms feel far less distracting.

If something in this series sparks a question or you’d like to explore how these tools might fit into your life, I’d love to chat. You can always reply to this newsletter, or you can set up a free 1:1 call with me here to learn more about how I work. Or just hop right in and schedule your intake appointment with me here!

In Wellness, Mary Virginia

In this issue we’re diving into interventions that make a measurable difference in ADHD symptoms. I start by touching on medication since that is the most common medical approach. Then I will take you to the three pillars of functional integrative nutrition: food, supplemental and herbal nutrients, and lifestyle practices. These weave together to play a crucial role in managing symptoms and optimizing brain function. While no single approach is a cure-all, combining these strategies with intention can create a strong foundation for focus, clarity, calm and overall wellbeing.

Medication

ADHD meds seem like a great place to start since most people are familiar with them. Prescription medication is outside my scope of practice, but there are some thoughts I like to share to support my clients.

Whether or not to utilize stimulant medications is a discussion to have with a licensed medical professional who understands ADHD. Weigh the pros and cons based on the person and the circumstances. The right medication at the right dose can be an incredible boon for the right candidates. Among other things, using it can allow the person the focus and clarity to establish new habits of being that rewire the brain. Those practices ultimately might allow for meds to be reduced or needed less often.

Please be aware that stimulant medications can suppress appetite, but that doesn’t make eating and food any less important. If you are struggling with food choice overwhelm, prepping and cooking, eating enough or often enough … please reach out to a qualified CNS who can support you to build a realistic and sustainable food plan that can comfortably nourish you!

Foods

As you’ve seen from me time and time again, a food plan must be personalized. That said, there are foods that are common to most ADHD recommendations. Here you go:

Eat Regular Meals
It’s easy to forget to eat when you have ADHD! Set a timer so that you don’t go longer than 3 or so hours between eating. That includes snacking! Not only do your cells need nutrients, your brain needs glucose to function. Add on that it’s a great, planned break from potentially energy-depleting lack of focus or hyperfocus!

When you go without food for too long or you use up your energy, your brain and body will begin to bug you for easy, quick fuel. That’s when the cravings for simple sugars pop up - your brain is jonesing for glucose. And surprise! Processed foods and sugary treats really do work to trigger the reward/focus mechanisms and you feel better - but only for a short time before you crash. Regular meals set you up for both feeding the brain and avoiding the crash that comes with easy sugary treats.

Keep It Simple
The ADHD brain can become easily overwhelmed. Lots of energy is spent processing information, managing emotions, and trying to keep details organized. Sidestep food overwhelm by choosing easy meals you enjoy and that soothe your senses. For example, snacks might include cheese sticks and crackers, apple and peanut butter, hard boiled eggs with a salt sprinkle, or a creamy, customizable smoothie. Main meals can be built around easily microwaved or steamed frozen vegetables and proteins, or prepared foods that can be paired with fresh vegetables, fruit, and proteins. Put foods that nourish your body up front on shelves and in the doors of the fridge so you see (and choose) them first.

Include a Protein and a Carb Every Time You Eat
You see those snacks above? They all include protein. Protein covers several bases. First, it provides the building blocks for good mood and good focus neurochemicals. Second, it also offers up the building blocks for every enzyme, tissue, and biochemical process, which helps keep your body from feeling stressed and depleted. Third, because it takes longer to digest fully, it slows down the absorption of the sugars from carbs so you have a steady drip of time-release energy. Proteins can be meats, poultry, fish/shellfish, eggs, beans/legumes (pair with a grain to make a complete protein), and nuts and seeds & their butters.

As mentioned, brains strongly prefer glucose as their energy source, and glucose comes from carbs. So eat your carbs so your brain can relax and do its thing. Whole grains (including popcorn!), starchy and non-starchy veg, fruit, and beans/legumes all contain carbs (and, incidentally, fiber!).

Brain Supportive DHA and EPA
Wild caught fatty fish (e.g. salmon, mackerel, sardines), grass fed beef, pastured poultry, nuts, seeds, extra virgin olive oil, avocados and avocado oil are some choices rich in brain supportive fatty acids.

Fats are needed to build the coating for your neurons, called the myelin sheath. Myelination makes brain processes flow more smoothly and faster, enhancing cognition, focus, and memory. These all include omega-3 fatty acids, too, which cool inflammation in both brain and body. (Neuroinflammation worsens ADHD symptoms).

Eat Fiber!
Lots to love about fiber! It feeds the “good” bacteria in your gut that make short chain fatty acids (SFA). SFA’s communicate to your nervous system to make more happy mood & focus chemicals. They also nourish and heal the gut lining and support your immune system. Before that, fiber traps and removes toxins that can stimulate brain fog while making your stool comfortable and easy to pass. Whole grains, whole vegetables (esp. cruciferous veg like broccoli, cauliflower, and cabbage), whole fruit, beans/legumes, nuts, seeds.

Green Tea
Not only is it yummy and comes in a variety of flavors (who doesn’t love variety?), green tea contains both caffeine and L-theanine, which when taken together can improve symptoms of ADHD.

Dark Chocolate, Cocoa, Cacao
I’ll bet you didn’t see this one coming! Rich in magnesium, these forms of chocolate also carry flavonoids that improve blood flow to the brain. Fresh supplies of oxygen and nutrient rich blood improved brain processes like cognition and focus.

What to Avoid
Synthetic food dyes have been implicated in ADHD symptoms. You can read more about it in this article from Berkeley Public Health and this one in ADDitude magazine.

Additionally, many people feel better without gluten, dairy, and/or sometimes soy. Mostly, it’s good to observe how your body feels with certain foods and shape your choices to those that make you feel good. As your nutritionist, I recommend that you not remove foods unless necessary. It’s worth a trial removal/reintro to understand how your individual body responds.

Overall you’re looking to create an environment inside your body that makes you feel calm and nourished. That means reducing inflammation (eat the rainbow of vegetables!), supporting it with nutritional building blocks, and providing regular energy.

Nutritional and Herbal Supplements

Lots of families who live with ADHD have tried myriad supplements. However, there are still more folks who live with ADHD who are not aware that improving nutritional status and supporting biochemical pathways with supplemental nutrients and herbs can really change the landscape of their experience. It’s important, though, not to be haphazard about it.

Key to the successful use of supplements is that the choice and doses of nutritional supplements are always tailored to your specific signs, symptoms, lab values, and genetic makeup. They are also influenced by your current food habits and preferences, which determine whether you can achieve the nutritional goals without a supplement (certainly preferable than another supplement to swallow!).

There are several individual and combo products that improve focus/attention, calm overstimulation, and support cognition and memory. Again, it depends on your unique situation. Some of what I might recommend includes:

Zinc, Magnesium, Vitamin B6, and/or Vitamin D
Other specific nutrients depending on the assessment
Pycnogenol
OPC’s
Tyrosine and tryptophan (precursors of dopamine and serotonin)
Green tea extract
Essential fatty acids
Specific probiotics
Calming herbs: e.g. ashwagandha, Holy basil, Lemon balm
Nutritional lithium (microdosing from 1mg to 20mg)
BDNF Essentials by Researched Nutritionals
And others

Be aware, also, that certain supplements can interact poorly with medication. Please work with a qualified nutrition professional before pursuing supplementation.

Lifestyle Practices

Perhaps most surprising to my clients, lifestyle practices quite literally affect your biochemical and genetic expression. How you live your life can actually change your metabolism, how you digest and absorb nutrients from food, and - attention please! - rewire your brain.

Each one of these and many more could have its own newsletter, and in fact I have covered some of them already (look for them here), but I will just list them for now. Please respond to this email if you’d like to talk about any of them!

Coaching! You can learn about and apply structures and behaviors that suit your way of being in the world and help you to function effectively in work and life. Check out Impact Parents and/or a Sanity Session, which offer the gold standard for this work.
Stimulate the vagus nerve and engage the parasympathetic nervous system, both of which rewire the brain to turn on executive function. Effectively enhance clarity, concentration, cognition, and focus, reduce distraction, calm overstimulation, improve mood, refine decision making, and more benefits - all without drugs.
- Vagus nerve stimulation practices.
- Meditation. Try the free Medito app or look at the Mindful website, purchase the Calm app or Headspace.
- HeartMath. Loads of research on the outcomes of HeartMath specifically for ADHD and neurodiversity.
- Breath work. There are so, so many to be found on YouTube.
Sleep quality and quantity: critical for clearing out metabolic detritus that clogs up the brain.
Time in nature - even a walk through your neighborhood.
Movement/exercise: increases brain derived neurotrophic factor (BDNF), the “Miracle Grow” of the brain.
Chiropractic work.
Therapeutic massage.
Therapies: cognitive behavioral therapy (CBT): dialectical behavioral therapy (DBT); somatic experiencing; EMDR, many others.
Various practices that enhance focus and motivation (per the Huberman Lab podcast), such as cold exposure, specific forms of meditation, binaural beats, and visual gaze training. I have used these myself, and they are indeed effective as advertised.
- I’d be intrigued to know if you try binaural beats for focus and attention. I have found they really work to reduce anxiety or calm the mind for sleep. You can find loads of options on Spotify. Just search “binaural beats” and your goal, such as “focus” or “anxiety.”

And That's a Wrap on ADHD

It has truly been a pleasure to share this three-part series with you - breaking down the complexities of ADHD, digging into how to explore your unique processes, and sharing practical strategies to help you find your own path to feeling balanced.

If something in this series resonated with you, shaped a new perspective, or left you with lingering questions, I’d love to hear from you! Reply below with your thoughts, experiences, or anything you’d like me to cover in the future, or email me at info@coffmanintegrativenutrition.com. Your feedback helps shape what comes next, and I always enjoy learning from your insights.

Thank you for being part of this conversation! Stay tuned for more Inner Workings' health and wellness deep dives!

Issue 133: Your ADHD Blueprint

Thu, 23 Jan 2025 05:00:00 GMT

Welcome back! I hope you enjoyed the last issue’s introduction to ADHD and root causes. If you haven’t read it yet, you can find it here.

The ADHD brain is fascinating and full of unique strengths and advantages. However, its neurodivergent wiring can also make life feel overwhelming and frustrating at times, especially when it comes to managing distractions, calming feelings of overstimulation, and finding effective strategies for day-to-day life.

This week we are exploring assessments to understand what is happening inside the body. Nutrient status, blood sugar balance, neurotransmitters, and even digestion and the microbiome - and more! - can trigger or worsen symptoms of ADHD.

In Wellness, Mary Virginia

Where to Begin On Your ADHD Journey

First things first:
Test and assess, don’t guess!

Your first step will be to find a reliable psychologist, psychiatrist, or other appropriate ADHD-informed practitioner who is trained in ADHD diagnosis and other brain/psychological conditions.

Remember to trust yourself and your experience during this process! Be open and clear about your symptoms. Seek a practitioner who listens actively during your work together.

It's important to pursue a proper diagnosis to determine whether the symptoms you see are actually ADHD or some other issue, or perhaps even a complex presentation of several conditions. We can’t just assume it’s ADHD (or only ADHD) even if the symptoms seem to match up pretty closely.

After this, we can explore the underlying factors so you and your care team can define what interventions will work best for you, from medication to food/nutrients to lifestyle patterns.

Getting the Full Picture: Let’s Get Clinical

One of the coolest things about the nutrition care process is that my clients discover how much their daily food and lifestyle choices affect how their bodies and brains function. It’s really empowering! As the expert of yourself, you have the privilege of using this information to experiment and find out what works best for you.

The exploration we do in a nutrition clinic illuminates both how your unique body is natively designed to interact with the world around you (your genes) and how it is actually functioning right now.

Our discoveries are made through a structured process of lab tests, taking a look at the signs from your body, and learning more details about your symptoms. These assessments altogether show us what’s working well and what parts of you need more support - everything from your genetic pathways to your digestion to your stress response. Out of this data blossom personalized options for rebuilding wellbeing.

Most of all, realize that there is no one-size-fits-all approach to interventions. Each person comes with a unique biochemistry, environment, family life, co-existing conditions (I refer you to Volume 132 again), and more.

Standard Blood Work

These are blood tests that you (or I, with your permission) can request from your doctor. They give us information on your nutrient status for things like protein, electrolytes, vitamins, and minerals and on your metabolic health and energy production, e.g. blood glucose, cholesterol, and thyroid health.

Every cell in our body requires nutrients to function. Our energy is produced because of a series of nutrients we get from our food + oxygen. Our body is built out of protein and minerals. Our brains and nervous systems must have amino acids, electrolytes, and B vitamins, but also iron, magnesium, vitamin C, and more. When I look at standard blood work, I see a whole world of your nutritional status.

And just like it sounds, standard blood work gives the best information when we get it at least annually. We will determine which tests are most useful for you when we take your health history. Here’s a list: please know that I just touch on some of what we get from them.

Complete Blood Panel with Differential (CBC with Immune Markers)
A marker for iron, B vitamins, hydration, immune response, and more.

Comprehensive Metabolic Panel (CMP)
A marker for glucose (blood sugar), sodium, potassium, calcium, proteins, liver and kidney function, and the acidity of your blood.

Lipid panel
Cholesterol markers and triglycerides (blood glucose, thyroid, stress, and hormone related).

Homocysteine
A marker for B vitamin and choline status; influences the body’s master antioxidant/detoxification; affects the heart and blood clotting.

Hemoglobin A1c, Glycomark
Blood glucose measurements: amount over time and spikes/dips.

Insulin, C-Peptide
Insulin measurements; how the body addresses elevated blood glucose.

Thyroid Panel
TSH, Free T4, Free T3; energy production; metabolism of food; growth; physical and brain development.

Iron Panel
We can look first at hemoglobin, hematocrit, and RDW for iron status; iron is necessary to transport oxygen to make energy. Also used to fight infection.

Magnesium
Over 600 biological processes need magnesium!

Folate
Blood cell production; DNA repair; cell division; neurotransmitter synthesis (and more). Can assess somewhat from the CBC in MCV, MCH, MCHC, and RDW, too.

Vitamin B12
DNA synthesis; blood cell production; nerve function; turning food to energy.
Can assess somewhat from the CBC in MCV, MCH, MCHC, and RDW, too.

Vitamin B6
Genes and genetic pathways related to mood, focus, melatonin synthesis, and brain development require B6.

Celiac Disease Testing
Celiac disease can interfere with the absorption of nutrients as gluten creates inflammation that damages the lining of the digestive tract.

Additional Assessments

Assessments can also include hormonal status, such as whether the client is in perimenopause or menopause or struggling with too much/little estrogen or testosterone.

Separately, it’s typically very helpful to have environmental allergy testing and to do an assessment for food allergies. The histamine increase related to allergy, including food allergy and sensitivities, can make ADHD symptoms markedly worse.

Let’s Get Functional, Functional!

Functional testing literally means that we are assessing how your body is functioning! These are a series of specialized tests that give a more nuanced picture of what’s happening that may be disrupting the flow of your physiological and biological systems and contributing to your symptoms. For example, we can look at your gut microbiome in a stool panel, or determine how well you are making and metabolizing your mood and focus/attention neurotransmitters via an organic acids test.

Stool Panel
Assess digestive health and food metabolism (Tiny Health; GI MAP; GI360, others).
A referral to a gastroenterologist might also be considered, depending on the GI symptoms.

Organic Acids Test
This in part assesses nutrient status, neurotransmitter metabolism, HPHPA (which can interfere with dopamine metabolism), and candida/yeast (Mosaic, Diagnostic Solutions, Genova, others).

Mold Testing
I’m most familiar with Mosaic.

Hair Testing for Heavy Metals
Heavy metals in the body can bind nutrients and bind to receptors on cells, wreaking havoc with health (High lead can lead to ADHD symptoms).

Consider Genetic Testing

Genetic testing provides information on your genetic blueprint and evaluates risk. Risk, however, is not the same as outcome! Epigenetics is the influence of the environment on gene expression, and this is why all genetic information must be evaluated along with lab tests and clinical assessments.

Since ADHD is highly influenced by dopamine status, it’s interesting to see how the body is natively designed to synthesize and metabolize dopamine and dopamine receptors on neurons. This includes dopamine related genes, plus MTHFR, COMT, and others.

3X4 Genetics provides nutrigenetics/nutrigenomics testing to understand how your body interacts with nutrients and which biochemical pathways might benefit from additional nutritional and lifestyle practice support.
I order the 3X4 Genetics test for my client. When the kit arrives, the client registers it and includes my practitioner code: MCOF001. That way I will receive the results and will be able to interpret them in the full context of my clients health status.

Full Clinical Functional Evaluation

And finally, there is what we learn from detailed clinical forms and our conversations with each other! My own forms gather a ton of information, and I have been told many times by clients that they had not considered their constellation of symptoms and timeline of health and life experiences so fully before this.

We connect a lot of dots that let us get started in shaping our next steps.

Comprehensive Medical and Social History
This includes all medication, recent blood work or other testing, and diagnoses, and also your life experiences.

Nutrition Focused Physical Exam
It’s amazing what our bodies tell us about our health and nutrient status by what we see just looking at each part of them.

Detailed Review of Food Choices and Current Supplements
Not just what you eat, but also how you eat it, your food environment, likes/dislikes, cultural considerations, etc.

Lifestyle Choices and Behaviors
Sleep, movement, time in nature and sun, relationships, stress, hobbies/pleasures, mindfulness/faith practices, environmental components, etc.

But Wait, There’s More!

Delving into how to support those with ADHD to function with more joy and success in their worlds has been eye opening even for me. It’s a rich fabric of opportunities to understand and to support the ADHD brain and body.

So come back for the next issue! I’m going to detail evidence-based interventions that truly make a difference to make the daily life of someone with ADHD easier and more pleasant.

Issue 132: ADHD Deep Dive: Symptoms, Causes, Hidden Links

Thu, 09 Jan 2025 05:00:00 GMT

Welcome to 2025! I hope you had the most wonderful holidays, including some time to rest! We all need a minute to regroup after being completely out of routine for a couple of weeks.

This special Inner Workings double issue is dedicated to ADHD, its symptoms, root causes, and nutritional and integrative interventions. We have something for everyone, whether you experience life through an ADHD lens or support others on their journey. It’s been fun to bring all of this info together in one place!

Today’s first half discusses the definition and symptoms of ADHD, who is diagnosed with it (some surprises here!), common co-occurring diagnoses, and key underlying root contributors. Our next issue in two weeks will present nutritional and lifestyle interventions that really work to ameliorate the symptoms.

This is a complex topic, and I hope that you will reach out to me with your questions or thoughts.

In Wellness, Mary Virginia

I’ve received a lot of education on supporting adults with ADHD. For these tandem articles on ADHD, I have drawn from research, my trainings with Dr. James Greenblatt and Camille Freeman DCN, MS, RH (AHG), LN and from the deep dive podcast ADHD and How to Improve Focus by Andrew Huberman (The Huberman Lab).

What is ADHD?

Attention Deficit/Hyperactivity Disorder is a type of neurodivergent (vs typical) brain wiring that results in challenges in activities of daily living. Importantly, the person with ADHD is not being willful: this is really how their brain works. Any combination of the following symptoms might show up in an individual with ADHD:

Trouble with maintaining attention/focus, aka easily distracted or difficulty staying on task.
Moving constantly and/or talking incessantly.
Impulse control, or difficulty restraining themselves from doing or saying something, interrupting, or standing in line.
Hyperfocus (interruptions are met with frustration or anger).
Attentional blinks, aka attention dips out briefly and returns. The person might have to use context clues to catch up to current events, and they might miss the info in that span of time altogether.
Challenges with time perception/time blindness, aka run late, procrastinate, be motivated by deadlines.
Issues with spatial perception, e.g. “pile” method of filing, but can’t find anything.
Troubles with working memory in the moment (though can be good at remembering past events).
Typically emotionally delayed compared to peers (children).
Sometimes have physical balance or coordination issues.
Often a night owl.

An important point is that those with ADHD can certainly learn new skills, but may not have the necessary focus or connectivity to apply them well. Renowned psychiatrist James Greenblatt notes that ADHD is a “performance disorder, not a skill disorder.” Nor is it an intellectual disorder, even if it interferes with academic performance. Having some combination of these symptoms can make it tough to participate at school or work, and they can be difficult for relationships and carrying out duties.

ADHD hits hard on executive function, the parts of the brain that provide organizational structure and time management along with task completion.

Those with ADHD brains are often intuitive, creative, and quick, and they can have amazing native intelligence. Any given experience for those with ADHD is often wired to emotion. It barely touches or skips past the brain’s executive function areas and goes straight to the emotional/limbic part, which is very close to our primary site of memory storage.

Seeing and processing the world through a unique lens inspires different connections than neurotypical folks. Many remarkable inventors, artists, comedians, and entrepreneurs have had ADHD, but also lawyers, doctors, and business people.

That said, it can interfere enough that even the brightest people sometimes can’t get traction in work or relationships. They struggle to integrate diverse sources of information, and have difficulty imposing useful structures, boundaries, and patterns where needed.

My own experience with ADHD is that there is a spectrum, from somewhat neurodivergent to highly impaired. Regardless, it’s not formally ADHD unless it is diagnosed.

How is ADHD diagnosed?

ADHD is diagnosed when a trained provider clinically confirms 6 or more symptoms in one or more of the domains below in a child <17 years old, or 5 or more in an adult >17 years old.

Hyperactivity/Impulsivity.
Inattention.
Combined Type (some of both of the above).

Formally, per the DSM-V (the diagnostic manual on mental health used by clinicians. Read about it here), to be diagnosed with ADHD, symptoms must exist before age 12 in two or more settings (e.g. home and school) and interfere with daily living. As the DSM is always evolving, I’m curious about whether this age qualification will change over time.

While most of us will experience some symptoms that are like those of ADHD, they may be the result of our behaviors (e.g. cell phone use/scrolling or lack of sleep) or other root causes (e.g. traumatic brain injury) and not true ADHD.

Who is diagnosed with ADHD?

Research is only recently evolving out of the realm of white males, and this is super important. For example, children of color, especially boys, are more likely to be diagnosed with Oppositional Defiant Disorder, where white children receive the ADHD diagnosis more often - but they present with the same symptoms. Updated research inspires more accurate diagnoses, allowing more appropriate interventions. The new research is also resulting in some diagnoses being made later in life.

There has been an overall increase of one million diagnoses of ADHD since 2016.

Children
These days 5-10% of U.S. kids ages 3-17 are diagnosed with ADHD, and 40-60% of those children maintain it into adulthood.

Adults
75% of adults now diagnosed did not have the diagnosis as a child. Only 11% of adults are receiving treatment for it.

Girls and Women
Girls and women typically present with distractibility and Inattentive Type vs Hyperactive, and this can cause their diagnosis to be missed altogether. It can make them feel stupid where they are actually just wired differently. Therefore, girls and women will establish coping strategies that mask their symptoms and allow them to be successful in spite of the struggle. But the struggle is real.

To this point, here’s one surprise category of individuals that experience ADHD symptoms at an elevated rate: perimenopausal and menopausal women. In my clinic and by the reports of my colleagues, women often report a spike in symptoms of ADHD that can be prominent enough to warrant a new diagnosis. This is a result of the drop in estrogen that has a modulating effect on the brain areas of focus/attention, reward, motivation, and executive function. Likely these women have had ADHD their whole lives, but it was only in menopause that they no longer felt they could manage it well.

Co-Occurring Conditions

Children and adults with ADHD might experience co-occurring brain and mental health conditions (also called co-morbid). For me, the overlap between Autism Spectrum Disorder (ASD) and ADHD is especially fascinating. Not surprisingly given the challenges and brain wiring, anxiety and ADHD often walk hand in hand. Remember that 40-60% of children with ADHD maintain it into adulthood, and what you see in childhood will filter into adulthood. Here are the most prominent co-occurring diagnoses:

What are the roots of ADHD?

ADHD, like many other illnesses, does not have a single root cause. Anyone with the diagnosis will need a complete evaluation to grasp the most likely contributing factors for their unique physiology and biochemistry. This will let the practitioner personalize interventions to be most effective.

That said, common to those who suffer ADHD is that they have fewer dopamine receptors in the brain or may not be producing adequate dopamine at the right time, or both. Dopamine is the neurochemical of motivation, reward, focus, and attention. Interestingly, it’s also involved in physical movement. If it were a symphony conductor, dopamine would be assuring sounds and silences in the right moments of the music. Those with ADHD are hitting the notes and silences at the wrong time, which causes the “music” to become very confusing and out of sync with themselves and the world around them (credit to Andrew Huberman for the metaphor).

The dopamine pathway can be disrupted by a number of things, and various contributors can trigger, worsen, or mimic ADHD symptoms:

Genes: 75% of those with ADHD have one or more genetic variations that increase the risk of having it.
Environmental triggers: toxins, air pollution, lead exposure (even small amounts), prenatal exposure to tobacco, alcohol, and even (possibly) SSRI and SNRI psychotropic drugs.
Neurobiology: an imbalance in catecholamine synthesis and metabolism (dopamine, epinephrine, norepinephrine).
Digestive disorders and/or dysbiosis (an imbalance in the gut microbiome): a contributor, but it’s complicated.
Candida: yeast in the gut and/or elsewhere.
Food and environmental allergies.
Food sensitivities.
Autoimmune disease, most especially Celiac disease.
Thyroid dysfunction.
Additional need for nutrients: essential fatty acids (esp. DHA), iron, fat soluble vitamins A, D, E, K, folate (vitamin B9), other B vitamins, and calcium, magnesium, and other electrolytes.
Sleep disturbances: 70% of kids with ADHD have sleep challenges that may be triggered by delayed circadian rhythms, an overlap with restless legs or sleep apnea, difficulty winding down, emotional dysregulation, or even timing of their stimulant medications.

Stay Tuned!

Now that you know all about ADHD, come back in a couple of weeks when I publish my next Inner Workings! I will discuss assessments. I will follow that with non-medical interventions that can really support those with ADHD to function more successfully in their day to day lives.

Issue 131: A Year of Growth, Wellness, & Connection

Thu, 19 Dec 2024 05:00:00 GMT

Wow! What a year it has been! It has been a huge pleasure to have shared 2024 with you through both Inner Workings and in my clinic.

As we wrap up 2024, I thought it might be fun to have a quick year in review!

In Wellness, Mary Virginia

Inner Workings Newsletter

All told I have written 31 newsletters (counting this one), and 21 of those were in 2024. My first article, titled Nourishing Mind, Body, and Spirit, dropped in July 2023. I take pride in these pieces in part because there’s no AI involved. My writing and research are all mine, and I truly enjoy it.

In January 2024, we kicked off by learning how to Cultivate the Pause to improve your health. We discussed blood work, using food and lifestyle practices to boost mood, nutrition and genetics, the vagus nerve and stress resilience, protein, fats, and carbs, food and cooking safety, and much more. Make sure to go read them again! You’ll find new nuggets every time.

The Inner Workings audience grew by at least a third, and our subscribers have tuned in from all over the place! We’ve seen logins from the U.S., Canada, Sweden, Ukraine, France, Germany, and Greece!

And guess how many times Inner Workings newsletters have been opened? 29,070!

I love writing about what energizes me around integrative nutrition, and, gratefully, y’all seem to like it, too! Here are some of the nice comments you have sent. Thank you for all the amazing feedback!

"This is so comprehensive!! Very clear. The way you frame it makes people feel less alone.” — Tracey W.

“Love the latest. So reassuring and empowering…” — Christine C.

“Loved your article and perspective of DE [disordered eating]. I found this to be a great introduction into a deeper conversion around health.” — Jessica C.

“Your information is amazing. I read every newsletter thoroughly 😁.” — Ann I.

“This is FANTASTIC! One of the most comprehensive descriptions of Polyvagal theory I’ve seen in one place. Bravo! Saving this to share...Great work.” — Rebecca S.

Presentations

I made several presentations in 2024 to a wide variety of groups, everything from Sunday school classes to other professionals to “ask me anything” events. One I particularly enjoyed was to One Lamb, a mental wellness ministry of Peachtree Road United Methodist Church in Atlanta.

"Thank you so much for the terrific presentation you gave yesterday!! I’ve already gotten feedback about how good it is to hear the information you gave being consistent with other trusted sources; you present with ease and warmth helping the audience feel comfortable with asking questions. I am so appreciative of you putting together such a well thought out talk where the audience could participate.” — Ann S.

“Mary Virginia, thank you so much for your time and wisdom and enthusiasm and wonderful presentation this afternoon! Everyone was so engaged and your delivery was exceptional! I learned a lot and was also reminded of content from your visit to our Sunday School class. We are so lucky to get wonderful education from an expert like you who can instruct us on nutrition & wellness.” — Diane M.

Professional Growth

This year I deepened my knowledge through continuing education courses on migraine, depression, Parkinson’s Disease/Neuroinflammation, and ADHD, and reinforced my engagement in trauma-informed practices. A group of us mental health nutritionists met monthly to discuss best practices, and I enjoyed joining other nutrition experts across platforms to learn from them about autism, AuDHD, anxiety, the neuroimmune system and brain health, and other topics.

I also earned a certificate in Health and Wellness Coaching to enhance my clients’ successes (I take the national board exam in March ’25). This builds on my long-held Master of Social Work degree, where I majored in Interpersonal Relations. Behavior change is often a key component to reaching your health goals. Coaching shines a light and clears the path so you can envision your health and wellness goals and utilize your most effective tools to achieve them. Coaching also allows me to bring my integrative nutrition expertise into every state in the country and around the world!

Clinical Successes

The real focus of all of my efforts, though, is directly working with my clients. These are profound relationships in which my clients are able to build toward their own best authentic health and rediscover physical, emotional, and psychological resilience. Each client is a unique individual, and it truly is a pleasure to design a healing plan that meets their singular needs.

“I worked with a specialist who is an expert in the field [of this illness], and she could not do for me what you have.” — S.B.

“Mary Virginia is exceptionally compassionate, understanding, and smart. She grasps the issue and I could not recommend a person more.” — Judy B.

“This work is dramatically life changing...it has increased my sense of safety and trust in my body.” — Name withheld for privacy.

“Thank you. Thank you. Thank you.” — M.P.

Happy Holidays and a Joyful New Year!

That last sentiment above is exactly how I feel about all of you! Thank you, thank you, thank you for joining me on this journey of exploration into how our bodies interact with food, nutrients, and lifestyle practices. It is endlessly interesting to me, and what a delight it is to share this information with you!

Get Ready — Inner Workings is kicking off January with an exciting multi-part series on ADHD you won’t want to miss!

Issue 130: Thanksgiving Food Safety & Storage: Part 2

Thu, 28 Nov 2024 05:00:00 GMT

Happy Thanksgiving! In the midst of our busy-ness, we are called to pause and feel gratitude for all that we have. Wherever we focus our intention is where we will place our attention. One powerful way to cultivate wellness is to pause and see with your heart the many good things in your life. Believe me, there are a surprising number of them.

As for me, I am perpetually grateful to you, my readers and clients! You make me better and inspire me every day. Thank you! Truly.

I sent this out earlier than usual today so you can use it as a reference as you cook. You’ll be reminded of important cooking temperatures, how long food is safe when it’s left out (like on a buffet), handy rules for cleaning up, and what to do with those yummy leftovers. And go remind yourself of the good stuff from last week!

Remember to print out the full comprehensive guide to food safety to keep all year!

In Wellness, Mary Virginia

Preparing the Meal

I don't know about you, but even I sometimes have to check our Joy of Cooking or my cell phone’s browser to remind myself of the temperature that tells me my bird is cooked. No more! We can all refer to my easy reference guide here.

But there’s more to food temps than just the cooking. We need to know how to keep food safe when it sits out for a while, too.

Minimum Safe Internal Temperature During Cooking

Raw chicken, turkey (not stuffed), and other poultry: 165º.
- Test deep in the thickest part of the bird.
Stuffed turkey: stuffing - 165º; breast - 170º; thigh - 175º.
- Note: turkey may be removed from the oven if it has reached 160º-165º if you allow it to sit for 20-45 minutes. The internal temperature will continue to rise about 5º.
Eggs (not served immediately), chopped fish, ground meat/beef patties: 155º for at least 15 seconds.
Eggs (served immediately), fish, beef steak, pork chops, game animals raised commercially: 145º for at least 15 seconds.
Stuffed fish, stuffed meats, stuffed pasta, and all poultry: 165º for at least 15 seconds.
Vegetables, fruits (eaten immediately): 135º
Reheating food in the microwave: 165º, then allow to stand for 2 minutes before eating.

What You Should Know About The Buffet, Long Meals, & The Temperature Danger Zone

This is so important if you have a meal or gathering that lasts for several hours!

Reminder: Keep hot foods hot and cold foods cold.

Cold foods should be kept at 41ºF or below and hot foods kept at 135ºF or above to avoid bacterial growth before serving. Use ice below containers or heat underneath chafing dishes if on a buffet.

Harmful bacteria grow rapidly when food is kept for more than a cumulative total of four hours between 41º and 135º. That obviously includes room temperature.

Perishable food can be left out safely at room temperature for around 2 hours, but not longer. (Only 1 hour if the ambient temperature is 90º or above). Remember that even if you store it properly after this, the time it was left out is part of the cumulative 4 hours mentioned above.

Foods that contain water or are damp are more likely to grow bacteria. Very alkaline (like crackers) and very acidic (like lemons) foods are not hospitable to bacterial growth.

Let’s Talk Leftovers

Remember that this is all about food safety. Just because you put it in the fridge when the meal was over doesn’t make it safe. Here’s how to store and use your leftovers so you can enjoy them for days! And know when to toss them.

Cooling Food

Do not place still hot foods directly in the freezer or refrigerator. Allow them to cool first, stir them so that warm spots will even into cool ones, and then store in fridge or freezer. Otherwise bacteria can grow in the still warm parts of the food and contaminate the whole thing. Everyone else makes this mistake - don’t be everyone else!
Here are some ways to cool food easily:
- Reduce the size of the food product by cutting or dividing. It will cool more quickly and evenly.
- Consider placing it in containers and then put the containers in ice water baths. Stir to mix cooling food into still warm spots until cool enough to place in fridge or freezer.
- Use loose or no covers while cooling to prevent trapping heat.
Cool from 135º to 70º in less than two hours, then 70º to 41º in less than four hours (fridge or freezer).

All the Yummy Food

Good for 3 days if kept properly cooled, stored, and refrigerated.
- If you’re not going to follow the three day boundary (and so many of us don’t 👋 ), then you’ll be especially interested in reheating and when to know when to toss old food (keep reading).
You can reheat leftovers as often as you want - it resets the clock on spoilage! Food can be safe to eat indefinitely! (Although reheating might affect the texture).
- Remember the rules about warming leftovers: Heat on the stove or in the oven to a core temp of at least 165º, or reheat in the microwave to 165º, then allow to stand for 2 minutes before eating.
Good for 4-6 months if frozen (generally).

Eeeeeewwwww - Fungi/Mold, Yeast, and Parasites

Fungi/Mold: Throw out food with mold on it, although you can cut mold off of hard cheeses and still eat them if you cut it at least one inch from the mold.
Yeast: Some can cause food spoilage. Look for bubbles, an alcohol smell or taste, discoloration, or slime.
Parasites: They need a live host to survive. Freezing and heat will kill them.
When in doubt, throw it out.

Cleaning Up

We all want a sparkling kitchen, pots, pans, and dishes once our meal is done. However, we also really don’t want to spread germs and toxic chemicals onto our food with our cleaning supplies.

The first tip was in last week’s newsletter, too, but so many people just don’t quite follow it that it bears repeating.

No Really - Don’t Keep Cleaning Supplies by the Food
Cleaning chemicals and the bugs collected on rags and sponges can transfer to the food via proximity. Don’t reuse washcloths, sponges, and tea towels used during meal prep after the meal. Put them in the wash.

Surprise! Wash Dishes and Containers in This Order
Wash the containers that have held non-animal proteins (vegetable, fruit, bread, etc.) first. Then wash items that have held mixed foods or cooked animal proteins.

Leave the chopping boards and containers that held raw animal proteins until the very last, and put them in the dishwasher if you can (don’t put plastic in the dishwasher, even the lids). Dry and put away items in the drying rack or other clean items beforehand to avoid contaminating them with the raw animal proteins.

Then launder in hot water everything you used for cleaning.

Cleaning the Counter
Never, ever, ever use a cloth or sponge to wipe the counter if it has been used to clean items that touched raw animal proteins. In fact, I suggest having a fresh, dedicated cloth or sponge for wiping the counters.

How to Clean your Sponge
Sanitize and deodorize your sponges and scrub brushes by putting them in the dishwasher. In a pinch, you can microwave your sponge for at least 30 seconds. It won’t smell any better (pee-yew!), but the bugs will die. You can also, frankly, wash the sponge thoroughly with dish soap, friction, and hot water to make it safer to use. Rinse completely.

Hot Tip: You should not use antibacterial soaps, sprays, and cleaners unless you have a true medical reason (even then, only when strictly necessary). Antibacterial soaps and cleaners contribute to antibiotic resistance in our bodies.

Happy Thanksgiving!

While I love to talk food and nutrition, the most important part of gathering around the table is the ancient and profound connection we feel with each other when we share food. Let me encourage you to listen deeply rather than speaking first. Be curious. Ask a question and wait for the answer before deciding what to say next. Share yourself. Be present. Seek to be kind before all else. Experience the warm heart rhythms of others.

It’s so healing.

I wish you all the best now and always.

Issue 129: Thanksgiving Food Safety and Storage: A Comprehensive Guide to a Healthy Holiday, Part 1.

Thu, 21 Nov 2024 05:00:00 GMT

If you are anything like me, you’re revving up for the holiday kickoff next Thursday - Thanksgiving! Many of us are planning not just the Big Feast, but several meals to feed our families as they come to stay with us. Or perhaps you’re supporting the main chef by providing a dish. Regardless, we’re all eager to nourish our people with food and presence.

With all the cooking and parties over the next month or so, it’s a great time to bone up on food safety. Nothing ruins a party like food poisoning!

You’ll want to tag or download this to support you throughout your holidays. Today we talk about food prep safety, and Thanksgiving Day you’ll have a quick primer on important cooking temps, leaving food out during the celebration, and leftovers. These are updated versions of one of my most popular newsletters, and critical information.

Please share Inner Workings or the downloadable guide with others who need to know!

And, as always, I invite your questions!

By the way, ServSafe training taught me the “Big Five” that are easily transmitted by food: Norovirus (what we think of as “food poisoning”), Salmonella, Shigella, E. coli, and Hepatitis A virus. Good to know that you can avoid them by following this guide!

In Wellness, Mary Virginia

First Things First

First, and I’m calling it out because I know how the holidays get: If you are sick yourself with a cold, the flu, COVID, fever, the sniffles, sore throat, cough, digestive issues, etc. — you should not be cooking for anyone else. If the meal is not made to your standard or someone is disappointed because you didn’t make a particular dish, everyone will survive emotionally. I promise.

Sneezes and Coughs
They happen even to people who aren’t sick sometimes. Walk away/point away from the prep area and absolutely cover your mouth and nose.
Wash your hands thoroughly afterward!

Wash Your Hands When Handling Food (and lots of other times!)You think people know about proper hand washing, but even when they know they often don’t do it. Make your sous chefs wash, too.

Soap, very warm water, and 10-15 seconds of friction by rubbing hands together:

As your first step in cooking;
Every single time you use the bathroom, rub your eyes, blow your nose, touch your hair, eat, smoke, move dirty dishes, or touch something that isn’t for the dish you’re making;
Between handling raw animal proteins and handling any other food; and
really any time you are moving from raw animal proteins to anything else.
- Raw animal products contain pathogenic bacteria and other bugs that can infect your other foods, or that others can touch unknowingly on the fridge, oven handle, cell phone - wherever.
Use a clean towel, ideally a paper towel, to dry them.
Don’t touch the faucet handle or bathroom door handle - use your elbow or a paper towel.

Food Storage: Before Cooking

Assuring your food is safe to consume is just as foundational as the food itself. Know how to ID unsafe cans and food, how to store food in the fridge, and how to thaw your turkey and other animal protein.

Did You Know Most Food-Borne Botulism is Caused by Canned Food?
Botulism is a rare, but extremely serious illness caused by any one of three bacteria, most commonly Clostridium botulinum. The toxin it produces can grow in food, wounds, and the intestines of infants. It attacks the nerves and causes difficulty breathing, muscle paralysis, and even death without quick medical treatment. Unfortunately, improperly made or stored home-canned foods are the most common source.

The bacterium’s spores can grow in these environments: low or no oxygen (anaerobic); low acid; low sugar; low salt; a certain temperature range; a certain amount of water.

Note: Botulism doesn’t need oxygen to thrive, and heat kills it. Tune in next week, and keep the Inner Workings downloadable guide for cooking temperatures to keep your food safe.

Throw Out:

Containers that don’t look right, or a container that spurts liquid or foam when you open it.
Store bought canned food with dents, bulges, swollen tops, or leaks.
Any food that looks discolored, moldy, or smells bad.

Refrigerated Storage
Store raw meats and seafood below cooked foods and fruits, vegetables, breads, etc. to prevent any juices dripping on them from above.

Options for Thawing Frozen Foods Safely

In the refrigerator, under 41ºF. Start a few days early for big things like roasts and turkeys!
- Count 24 hours for small birds/roasts, 3 days for a 15lb turkey, longer for bigger ones.
Under running cold water that is 70ºF or lower (not those big meats, though!)
Microwave, but only if you plan to cook it right away.
As part of the cooking process (e.g. frozen vegetables).
Never thaw meat, fish, or poultry at room temperature:
- The center will thaw more slowly than the exterior, and pathogens will grow at room temp. You can’t count on the cold of the interior to protect the exterior.
- People forget to put the food away or cook it timely = pathogens!

Preparing the Meal

Now all the food is out and the cooking begins! Make sure you don’t accidentally introduce nasty little micro-visitors into your dishes.

Wash Vegetables and Fruit
Veg and fruit that have firm exteriors or rinds should be washed with soap, water, and friction and well rinsed.

Why, you ask? Because this will keep you from transferring pathogens from the exterior to the interior, e.g. when cutting citrus fruits or winter squash or peeling potatoes. Be sure to rinse all other fruit and vegetables thoroughly with running water.

Don’t Taste Your Food with the Same Implement You Use to Cook
Use a clean spoon or fork to taste a dish every single time to prevent pathogens from your saliva getting into the homemade cranberry sauce or the mac’n’cheese. Don’t count on the food being hot enough to kill them!

Keep Separate Cutting Boards and Containers for Raw and Cooked Foods
Raw meat/animal products and cooked foods must have their own separate cutting board, separate containers/pans/bowls, and separate part of the counter to avoid cross contamination.

Never, ever chop or store other foods (vegetables, fruits, breads, etc. etc.) on a cutting board or in a container that has had raw meat, seafood, or poultry on it. Dedicate their own chopping boards and containers to these (I’ll cut you some slack if the items being chopped will be cooking with the meat or poultry).

Don’t Keep Cleaning Supplies by the Food

Cleaning chemicals and the bugs collected on rags and sponges can transfer to the food.
Don’t reuse washcloths and tea towels used during meal prep after the meal. Put them in the wash.

See my Thanksgiving Day issue for your primer on cooking temperatures, food that’s left out during the meal, and leftovers!

Tip of the Week

A short walk after eating will help you balance your blood sugar, even if it’s just a ten minute stroll up and down the street. This can support you to prevent or manage illnesses related to blood sugar dysregulation, such as Type 2 Diabetes, heart disease, and dementia.

Walk with a friend, your family, or the dog! Listen to a podcast or music! Look up at the trees and the sky and experience the wonder and joy of those blessings you started to notice at the beginning of this newsletter.

Issue 128: Boo! It's Menopause!

Thu, 31 Oct 2024 04:00:00 GMT

Happy Halloween! 🎃👻 Snuggle up with some popcorn and watch a scary movie! Enjoy your candy! (Also, in case you wonder where I stand on candy, watch this from The Nutrition Tea on Instagram. She captures my own thoughts exactly).

My friend Amy and I were talking the other day, and she observed, “I don’t think there’s enough info out there for women. I’d like to hear more about navigating women’s health in your 60’s. What foods help at this time of life?”

It’s a great question! Time for some insights for your 60’s and beyond. And if you think this is just for women of a certain age, think again! Everyone will learn something important from this issue.

In Wellness, Mary Virginia

Women who are in perimenopause and menopause are often blindsided by a bunch of pretty well known symptoms: hot flashes, night sweats, sleep disruptions, mood swings, an increase in headaches, brain fog, and other uncomfortable features of hormonal shifts.

As we move into our late 50’s and 60’s, we might experience other changes. Bones become a bit more porous. We lose strength and muscle. Our hair and skin seem to dry out overnight. Our bodies change shape and begin to deposit padding where we might prefer it not reside.

And then there are those kind of shocking surprises that no one mentioned: Our cholesterol often rises. Our tendons change, putting our hips, knees, and shoulders at risk for pain and injury (check out this article on gluteal tendinopathy). Food doesn’t digest as well. Ears might start to ring with tinnitus. Our heart feels like it beats harder. We develop phobias and anxiety that never existed before. And, irritatingly, sometimes we can’t hold our urine. I suppose the good part is that we don’t have to deal with periods anymore!

The Change

Sometime in our 40’s/early 50’s, estrogen and progesterone levels drop. By the way, this is true for all genders and sexes. Most of us know that these hormones play important roles in reproduction, but we didn’t know they affected so many other aspects of our bodies! I’m not going to give a whole science lesson on this, but here are a few fun facts to understand it better.

Definition of Menopause: The cessation of menstruation for 12 months, not caused by reversible illness, overexercise, inadequate weight, or nutritional depletions.

Cholesterol: The sex hormones DHEA, testosterone, estrogen, and progesterone are made from cholesterol. The liver keeps making cholesterol as we age, but as the ovaries and other tissues decrease in hormone production, cholesterol begins to rise. Notably, a higher total cholesterol as we age appears to be brain protective (the brain is 60% fat and the myelin sheath that protects the neurons of the brain is made from cholesterol).

DHEA (dehydroepiandrosterone) is made in the adrenal glands and is the precursor to all the other sex hormones.

Testosterone is produced by every gender and sex. In those with ovaries, nearly half of available testosterone is made there. In menopause, women can show signs of testosterone deficiency: low energy, increase in fat storage, loss of strength/muscle tone, depression/anxiety, thinning hair, etc. Read more here.

Estrogen is also produced in all sexes: gonads, ovaries, adrenal glands, and fat cells.
In everyone, estrogen is required for sex drive. Low estrogen tanks it.

The Cleveland Clinic writes this about the “non-reproductive function of estrogen”:
“Estrogen regulates important processes in your skeletal, cardiovascular, and central nervous systems that impact your overall health. Estrogen affects:

Cholesterol levels.
Blood sugar levels.
Bone and muscle mass.
Circulation and blood flow.
Collagen production and moisture in your skin.
Brain function, including your ability to focus.”

Estrogen receptors are not just found in reproductive organs and breasts. They are also found in bone, brain, liver, colon, skin, and salivary glands.

Progesterone is a calming hormone. It supports duration and quality of sleep and a balanced mood. Our adrenal glands (think stress response) are a primary producer of progesterone. You can connect the dots about what this means for stress resilience, mood, and sleep during perimenopause and menopause as progesterone levels fall. Read more about progesterone here.

I mean, this part of life sometimes is no joke. It’s time to adapt our choices to our more mature needs!

The New Normal

As our bodies move into the next stage, they do a lot of rearranging and resettling. Luckily, we have nutrition science and clinical experience to support our next steps!

From here on, I’m just going to give you nutrition and some lifestyle tips that will support you feeling your best as you live into your fabulous menopausal status. These will improve both physical and mental health.

HCl, aka Stomach Acid

We produce less stomach acid as we age. Stomach acid is necessary to digest food and absorb nutrients well, especially animal protein and fats. We also need it to kill pathogenic microorganisms we incidentally swallow along the way so we don’t get sick.

Eat these to support appropriate stomach acid:

Lemon water or lemon in tea before and/or with your meals.
Add raw apple cider vinegar to your salad dressings or otherwise use as a condiment, or drink some mixed in water in place of the lemon.
Bitter greens and vegetables, like spinach, kale, collards, mustard greens, and cruciferous vegetables, like arugula, bok choy, broccoli, Brussels sprouts, cabbage, and cauliflower.
Cook with bitter herbs, like chervil, ginger, fenugreek, thyme, marjoram, rosemary, tarragon, sage, oregano, coriander, and turmeric (not a complete list). This looks like a good article about them.

Read more about this Secret Sauce to Good Digestion. Remember, low stomach acid mimics the symptoms of much more rare high stomach acid. Don’t take an acid blocker. See a nutritionist.

Cholesterol/Blood Sugar

I put these two together because spikes and dips or steadily high blood sugar has a profound impact on cholesterol balance, especially LDL and triglycerides.

Eat these foods to support healthy cholesterol and blood vessels, and to keep your blood glucose balanced and your energy steady all day:

Eat your veggies!
Minimum 2 cups (raw) of leafy greens daily and 1 cup of cruciferous veg daily.
Unlimited: Every color of the rainbow of other vegetables. The phytonutrients and fiber of colorful veg help reduce inflammation, LDL, and triglycerides.
1-2 servings of whole grains daily, especially whole grain oatmeal and/or barley. The beta-glucans in these grains trap excess cholesterol in the stool and remove it before it can be reabsorbed into the body.
(Incidentally, these will keep your bowel habits regular, which you also need more right now. Remember: fiber, fiber, fiber!!).
2-3 servings of healthy fats daily.
Protein, complex carbohydrates, healthy fat every time you eat for blood sugar balance and steady energy. Go deep on this here.
Take a 5-10 min walk after you eat.

Bones

Most of the women I know are clear that they need to keep up their calcium to assure strong bones into their older age, but it’s a bit more complicated than most people realize. We need vitamin D to help us absorb calcium and vitamin K to drive the calcium into our bones rather than our soft tissues, like the heart muscle. For this reason I recommend food, not calcium supplements. It’s really easy to get the nutrients we need for bone health.

Eat these foods to get the balance of vitamins D and K and the mineral calcium:

Vitamin D
- Mushrooms
- Egg yolks (always eat the whole egg. So much nutrition!)
- Liver
- Salmon, sardines, tuna, herring, halibut, cod (all wild caught for the most vit. D).
- Fortified milks, non-dairy milks, and orange juice.
- Also, expose skin to midday sun for 5-30 minutes.
Vitamin K
- Check out the leafy greens and cruciferous vegetables list above. No, really! These are such incredible powerhouses of nutrition!
Calcium
- Leafy greens and cruciferous veg - again! Point made, right?
- Dairy products (milk, cheese, yogurt, etc.), non-dairy milks, some fortified orange juice.
  *Note for those who are dairy free: some non-dairy milks are great sources of calcium, such as Califia Farms Complete and Ripple Plant Based Milk. These both have the same or more calcium than cow’s milk and the same amount of protein, plus other nutrients.
Weight lifting reliably strengthens bones. Get a trainer.

Tendons

Collagen is what builds and maintains connective tissues like tendons and other tissues like hair, skin, and nails. And what do you need to make collagen? Vitamin C and protein. If you are eating adequate vitamin C rich foods and protein, I don’t see the need for a collagen powder supplement.

Eat these vitamin C rich foods to support collagen production:

Bell peppers, especially red and green ones.
Oranges and other citrus fruits.
Berries, bananas, kiwi, cantaloupe, mango, and other fruits.
Broccoli, cabbage, cauliflower, kale, spinach, etc. (seeing a trend here?).
Tomatoes and tomato products.

Muscle/Strength

Protein becomes even more essential as we age because all of our tissues need the amino acids to build, repair, and maintain them.

Eat these protein-rich foods to support muscles and strength:

Poultry, beef, lamb, shellfish, fish, eggs - as close to grass fed/pasture raised/wild as you can.
Beans/legumes paired with a whole grain to make a complete protein.
Tofu, tempeh.
Nuts and seeds, esp. pumpkin, sunflower, walnuts, almonds, pistachios.
Dairy, such as Greek yogurt and cheese, if you tolerate it.

Increase the amount you move your body to 150 minutes of moderate exercise a week or 75 minutes of vigorous exercise a week. Mix up aerobic workouts (like walking, jogging, dancing, biking, etc.) with weight bearing exercises like weight lifting and movement that uses your own body weight, like yoga.

Sleep

Adequate sleep is critical for every function of your body. It washes metabolic breakdown products from your brain and repairs and rejuvenates your cells. Try these to enhance your sleep:

Move your body! Regular exercise supports quality sleep.
Expose your eyes to morning sun for 5-10 minutes. Morning sun triggers the wakeful hormone cortisol in the morning and the sleep hormone melatonin at night.
Take a hot bath before bed with epsom salts, which are rich in magnesium.
Take a magnesium glycinate supplement, 200-400mg nightly. Start low and gradually increase. Glycine is calming and magnesium relaxes tight muscles.

Live Your Best Life

Menopause and our 60’s can actually be a really great time for our bodies! We will certainly take stock of how the life we have lived is showing up in what our bodies are doing and our health status. But we are not static. Our health future is not a given. We have neuroplasticity in our brains long into our old age, which means we can learn new things, take on different perspectives, and rise to new challenges. We are adventurers!

Our bodies are showing us that they are in a new phase, and in new phases they will change. This is normal and to be expected. We are not losing some mysterious game by having a rounder middle, and there’s absolutely nothing true about healthy older people naturally losing our memory.

Step into this evolving iteration of yourself. Embrace it, nourish it, love and admire it. Change is the only given. Decide what you want your future to be, and go for it!

Issue 127: What is Clinical Nutrition?

Tue, 22 Oct 2024 20:11:31 GMT

It occurred to me that I share a lot of information about nutrition, the body, and integrative healing practices in Inner Workings, and yet my readers may not know how I got started or much about my clinic. Let me introduce myself!

In Wellness, Mary Virginia

Who I Am

Hello! I’m Mary Virginia. 😀 I am a clinical integrative nutritionist who owns Coffman Integrative Nutrition. My areas of expertise include mental health nutrition (especially anxiety, depression, ADHD), brain health, gut health, metabolic health, thyroid health, and stress resilience.

Many years ago I had my first baby, and I nursed her. As she grew and began to eat solid foods, it occurred to me that if breast milk was important for her growing body, then surely the rest of the food I chose for her was also important. Thus was born my first fascination with nutrition and health.

Later my third child developed chronic sinus infections as an offshoot of H1N1 (bird flu). As the one year anniversary of her monthly antibiotics approached, the importance of gut health was starting to be all over the news. I was beside myself that her microbiome was continually being wiped out and she would suffer long term health consequences.

That’s what really kicked off my research, and boy did I learn a lot on my own about the effects of nutrition on the body! My reading opened my eyes to gut health and inflammation and how they interact with mental health. I was hooked. This information built on my Master of Social Work, where I majored in Interpersonal Relations (i.e. therapy). Moreover, I was able to help her overcome those awful sinus infections. 🥳

I elected to pursue a Master of Science in Human Nutrition, earned the Certified Nutrition Specialist designation, and here I am now with my own clinical practice in Atlanta, Georgia!

What I Do

What many don’t really realize is that clinical nutrition is health care, not a sideline alternative path to health. It’s an expansion of standard care that uses the body itself to heal.

In fact, much of Western medicine is “disease care.” You get sick, and medicine is applied to stop the specific sickness. This is really important, and I am grateful for the advances in medicine that help so many people heal. However, it’s narrow in scope and often creates a domino effect of other illnesses.

Clinical integrative nutrition, also called functional nutrition, uses a different lens than seeing just a small fraction of the body. We really practice “health care.” That is, we identify the root contributors to your body’s illnesses, observe all the systems of your body and the environments that influence them, and then align with your body’s own healing mechanisms. This does not necessarily exclude medication, although it often turns out that medication is not necessary or is reduced. Certified Nutrition Specialists (CNS) coordinate with our clients’ doctors so that they really experience the fullest possible care.

My work takes a multidisciplinary approach. I use food, supplements, lifestyle choices, and coaching (behavior and mindset/perspective shifts) to support my clients in both prevention of illness and healing from being sick. I practice medical nutrition therapy (in states where I am legally allowed to practice), which uses these methods to manage and heal from chronic health conditions, such as autoimmune diseases, metabolic illness, digestive health issues, and emotional dysregulation.

Pointedly, my clients are all individuals with unique life experiences and preferences. I provide personalized nutrition and coaching care so that my recommended interventions feel authentic and accessible to my clients.

Doctors Don’t Talk About This

What I have learned is that many symptoms are manifestations of underlying dysfunctions that we can address.

For example, there is an ongoing conversation in America about people in larger bodies. Being in a higher weight body is described by itself as an illness. However, it’s typically not, even if reducing weight appears to solve health issues. Weight status is the cart, not the horse. I see weight increase as only one symptom of one or more root cause: hormone shifts, the gut microbiome/digestion, metabolic issues, medication, fatigue tied to autoimmunity, mental health status, stress, generational or personal trauma, mindset, genetic predisposition, sleep deprivation, behaviors tied to any of these, or other things. It’s a data point, but it’s not an end in itself.

Anxiety and depression are at epidemic levels now. While the conversations about environmental triggers (e.g. cell phones, social media) are worthy and salient, I can identify a number of points of dysregulation in the body that can be treated with great success. For example, people who are low in vitamin B6 and zinc are more prone to panic attacks. High stress depletes certain B vitamins and indicates a need for higher antioxidant intake, such as vitamin C and colorful, phytonutrient-rich foods. I wrote a whole article on the vagus nerve and nervous system regulation because of its importance to mood, focus, and cognition. Hypothyroid has an impact not just on metabolism, but also on mood and digestion. Cortisol rises or dips at the wrong time of day will create persistent over- or under-stimulation and symptoms of anxiety or depression, including overstimulation or fatigue. ADHD and anxiety have a strong Venn diagram of symptom overlap. Allergies (food and environmental) trigger anxiety and depression symptoms. There is a loop between poor digestion, nervous system dysregulation, and anxiety that we label Irritable Bowel Syndrome. And the gut microbiome is a key player in mood status and brain health. I address all of these and other root causes, and my clients report feeling so much more even keeled and well.

Genes are one of the most fascinating contributors to health status. I use a test by 3X4 Genetics that identifies your individual genetic blueprint on how your body is designed to interact with nutrients and lifestyle, such as exercise. Knowing your genes means that we can craft an integrative nutrition care plan that is specifically tailored to allow your body to function optimally. We can lower risks for potential future health problems and support you now to have your best health and energy.

Picture Yourself in Session With Me

Our first clinical session is a comprehensive intake. Before our 90 minute session, I will send you several forms to complete:

Health & Social History (Intake Questionnaire)
Nutrition Focused Physical Exam
Medical Symptom Questionnaire
Wellness Questionnaire
HIPAA Notice of Privacy Practice
Release of Protected Health Information

I also request that you upload your most recent lab results and provide any unique information that lets me understand your situation better. As part of this initial evaluation, I will review your medications for drug-nutrient interactions and delve into what your signs and symptoms indicate about your nutritional status.

We meet for a long initial session because I really want to know your story and your experience. Between the data on your forms and our conversation, I develop a timeline of your illness or health status and define the triggers and mediators that influence it. This is your body, and you are the expert of it. I will reflect back what I hear from you to confirm that I fully understand.

At the end of it I might make initial recommendations or lay out the first steps of the path that will move you toward better health. For example, it might be wise to pursue more data, such as updated standard blood work or functional testing, which might be a stool panel, a urine test called an organic acids test, or other specialized tests, such as 3X4 Genetics.

Follow-up sessions are designed to move you toward the health outcome you envision. Typically we will meet for an hour. This time might include my interpretation of labs and root causes of symptoms, education on food plans and choices, recommendations for supplements and my reasoning for offering them, education on the relationship between different bodily systems, presentations on the influence on your health of sleep, movement, time in nature, the vagus nerve, circadian rhythm, and more, and/or training in lifestyle practices that will support your body’s optimal functioning. This is also a time when you can ask questions, bring up new information, or participate in coaching to help you decide how to proceed.

May I Ask a Favor?

Inner Workings goes out to all of my former and current clients, as well as people simply interested in the role of nutrition and behavior choices on our health. It is humbling to work with such amazing people! I truly have the best job in the world and I am grateful for each of you.

Along those lines, I have a couple of favors to ask:

I’m seeking some positive Google reviews to help boost my business. I love my work, and this is a great way for me to attract clients! If you have worked with me in any capacity (nutrition or coaching), or even if you just read Inner Workings, it would mean a lot to me to have you reflect on it. No pressure and no worries if writing a review is not your cup of tea.
I really want to write about what interests you! I’d love to do an Inner Workings dedicated to a bunch of your questions (Ask the Nutritionist style) or doing a deep dive into something you’ve wanted to understand better.
Please write to me with your questions!
I suspect you might not know that I do paid speaking engagements, especially anything related to nutrition, mental wellness, or stress resilience. Please feel free to refer me to your organization, or share a contact with me so that I can reach out to them. Let me know if I can use your name!