|
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:
0 Comments
A reader asked me to talk about “the link between the gut biome and mental health/brain function.” Since this is such a key component of my work, I was surprised I had only touched on it along the way and never dug in! Well, Greg, here you go! Thanks for the question! In Wellness, Mary Virginia In functional medicine and nutrition, we take a systems approach to get to the root causes of disease and dysfunction. One of the biggest contributors to all kinds of illness is an unhealthy digestive tract and microbiome (you’ll remember I talked about this here). It’s every bit the same for mental and brain health. Bring this into your own personal life. How is your mood when you have heartburn, indigestion, diarrhea, or constipation? What happens to your energy? Your sleep? Do you find you’re grumpier? More anxious? Do you battle brain fog or forgetfulness? What happens to your ability to focus or process information? I’ll walk you through the connection between inflammation, the gut microbiome, the gut’s nervous system, and brain and mental health. The upshot is that digestive health, mood, and brain health are inextricably intertwined. Immune System About 70% of our immune system can be found lining the walls of our gut. Healthy gut wall barriers and the immune system work to protect us from most of what travels through (viruses, bacteria, random junk, and other pathogens) that could make us sick. A healthy digestive tract maintains a strict gatekeeping process that serves to allow only safe and useful things, like nutrients, inside the body. This is important as the digestive tracts itself starts and ends with access points outside of the body (i.e. the mouth and anus respectively). We’re Looking at You, Inflammation Inflammation is the first step taken by the immune system. The five characteristics are: redness, swelling, heat, and loss of function. Swelling is the part that makes space between cells so that the metaphorical EMT’s can get through. These are chemicals that battle infection and repair damage. The cells of our digestive tract are only one layer deep. They are tightly bound together to keep stuff that’s inside the tube from slipping between them into the bloodstream. They are also covered with a thick protective layer of mucus to keep the cells from being damaged. A poorly maintained digestive tract begins to break down. Cells become fragile. The mucosal layer starts to become thin. So the immune system ramps up inflammation to treat the damage. When that happens, the cells are no longer tightly bound. You may have heard this called “leaky gut.” Molecules that should stay in the digestive tract slip between the cells into the bloodstream. The immune system throughout the body identifies these as invaders, and creates more inflammation. Note also that chronic stress undermines digestion and triggers inflammation. Poor digestion alone creates a continual stress response in the body, which is its own merry-go-round with gut health, mood, and brain health. I wrote about the role of stress resilience and mood here. Blood Brain Barrier Leaky gut also risks a leaky blood brain barrier (BBB), which is the brain’s protective layer. It’s different from the digestive tract, but serves a similar protective purpose and is also only one cell deep. “Invading” molecules travel in the bloodstream from the gut to the BBB, which triggers an immune reaction and a leaky BBB. This allows the cascade of inflammation to reach the brain. Many psychiatric disorders are associated with inflammation in the brain. For example, depression has long been associated with it. An inflamed gut and a compromised microbiome are also contributors to blood sugar dysregulation. Persistent blood sugar dysregulation is a primary foundation of diabetes, heart disease, vascular dementia, and Alzheimer’s disease. It all starts in the gut. An important answer to preventing inflammation in the gut is assuring a healthy gut microbiome. You’ll learn all about that in a bit. But first, let me tie in the nervous systems. Two Brains, One Integrated Response You know about the Central Nervous System (CNS), which consists of the brain and spinal cord. Perhaps you also are aware that the digestive tract has its own nervous system, called the Enteric Nervous System (ENS). It can also be found embedded in the walls along the entire digestive tract. The CNS and the ENS are connected to each other through the vagus nerve (the vagus nerve is so cool! You can read about it here), and that is a primary way that the gut communicates to the brain. What very few people know is that the ENS (gut) almost completely mirrors the CNS (brain) with the neurotransmitters (electrical messengers) it produces. Familiar neurotransmitters are the mood related chemicals called serotonin and dopamine. Low levels of these are associated with depression, agitation, irritation/anger, lack of motivation, sleep disruptions, issues with focus and attention, and more. Here’s the kicker: the ENS produces about 90% of the body’s entire pool of serotonin and an only slightly lower percentage of dopamine, as well as other lesser known, but important, mood chemicals. That is, it’s your gut that’s keeping your mood steady. Here’s another astonishing example: Parkinson’s disease starts in the gut. It begins with a protein that gets folded wrong in the ENS. Here’s the really wild part: each misfolded protein teaches the next proteins like it to fold the wrong way. The misfolded proteins travel up the vagus nerve into the part of the brain that controls motion, retraining every next protein in the chain reaction to fold and act differently. This is the trigger for Parkinson’s disease. Beneficial Bugs We all agree that we want to encourage a balanced mood and maintain brain health by reducing inflammation and bolstering neurotransmitter production. I see nodding heads in my audience. Luckily, there’s a single strategy that addresses all of this, and it’s all wrapped up in the gut microbiome. Our five pound collection of bacteria and other microbes in our gut microbiome really do a lot for us when we tend to it. People compare it to a garden, and it’s really true. We want to crowd out and “weed” the microbes that are only in it for themselves (selfish beasties) and nourish those that maintain their healthy living space by supporting the health of their human host. Certain types of bacteria are well known for their role in partnering with the immune system and healing the cells, the tight junctions between them, and rebuilding the protective mucosal layer. And what these thrive on is fiber from our food. Well nourished “good” bacteria proliferate (like tribbles. Star Trek fans?), and they produce a critical nutrient for the cells called short chain fatty acids (SCFA). So imagine. Now you have healthy, robust, tightly bound cells in the digestive tract walls. The mucosal layer is constantly maintained (the old, worn out mucus is literally eaten by some bacteria while other bacteria encourage the production of fresh new mucus. It sounds gross, but we really want this). Out of this blossoms a reduction in inflammation in the digestive tract, which leads to less inflammation in the body overall, and the blood brain barrier and brain reap the benefit. Fun Fact: All of this makes a difference to allergy sufferers, too. When you think about it, allergies are just another form of inflammation caused by something the body considers to be an invader. But Wait, There’s More! Short chain fatty acids also transport through the cells to the enteric nervous system, which is the source of those beautiful mood supportive neurotransmitters. The presence of SCFA’s triggers the release of serotonin and dopamine. These actually travel up the vagus nerve, attaching to serotonin and dopamine receptors across the body before reaching the brain (it’s actually a chain reaction of neurotransmitter production, not just some from the gut). Good mood is a full body experience. You know a quick way to deliver short chain fatty acids to the gut? A piece of buttered whole grain toast! Butter contains the SCFA called butyrate. The carbs in the bread give energy to the cells (also a mood booster), and the fiber in the whole grains feed those lovely SCFA-producing bacteria. An Apple a Day… Prebiotic fibers like inulin & pectin are amazing fiber food for beneficial bacteria. When you learned as a child that an apple a day keeps the doctor away, it’s because apples contain pectin (well, and a bunch of vitamins). When we chew the apple thoroughly (or cook it), pectin is released. It lands in the colon and is consumed by the good bacteria of the microbiome. Pectin is found in most fruits and vegetables. Among fruit, apples, peaches, oranges, grapefruits, apricots, lemons, and tomatoes contain the highest concentration. Rich vegetable sources are carrots and potatoes. The best legume source is peas. Inulin is also easy to find. It’s rich in asparagus, bananas, garlic and onions. Other sources include burdock, chicory (used in salads), dandelion root, Jerusalem artichokes, and leeks. The upshot is that fiber and probiotic foods are the darlings of gut health (again, read more here). Variety in food choice leads to better health from every angle, and that includes fiber sources. Choose from a wide range of whole, colorful vegetables, whole grains, whole fruits, legumes, beans, nuts, and seeds. Also look to probiotic-rich food sources, like yogurt, sauerkraut, kimchi, kombucha, and real pickles (not the kind made with vinegar). Anti-Inflammatory and High Fiber All the Way! I have already written about a food plan/guide that supports a healthy overall immune response and digestion, so I will refer you to this article so you can read all about it! And check out the antioxidant and anti-inflammatory roles of phytonutrients in colorful vegetables and fruit in this article.
|
AuthorI am Mary Virginia Coffman (I go by “Mary Virginia”), a clinical nutritionist who focuses on mental health, digestive health, metabolic health, and nervous system regulation. My unique combination of clinical interventions, education, and coaching will help you feel well in body, mind, and spirit. Archives
October 2024
Categories |
RSS Feed