Among others, April is Stress Awareness Month! You can read about building stress resilience here. Nevertheless, I’m sticking with March’s National Nutrition Month for one more newsletter. You know well that I advocate for food freedom and authentic health. Choosing foods that will nourish us the way our own body-mind wants to be nourished becomes easier when we know the full landscape of food choices. We can shape our meals when we understand what components to aim to include in a meal. Knowledge is power. Here is some straight talk about the most physiologically/biochemically health-promoting (and yummy!) foods to help you expand your choices. Just Say No to Diets Let’s all agree that the word “diet” has become fraught. I prefer calling it a “food plan” instead, which is just so much less limiting. We’re not in the business of restriction or deprivation. Instead, let’s add foods in. With that in mind, what’s the best food plan for you? The one you find most accessible, tastiest, and provides the benefits you seek! Stop for a moment, maybe even take some notes: what benefits do you hope to receive from what you eat? What follows is a guide, not a set of rules. Seek out variety to meet the pleasures and needs of your different daily activities and what your body requests. Variety is not just the spice of life, it promotes health. Use this information to nourish yourself. It bears repeating that you get to choose what works best for your own body and preferences. What is Nutrient Dense Food? Broadly speaking, the most nutrient-dense foods can be found either 1) in their most whole form, or 2) are processed using traditional methods. Think of it this way: whole foods don’t have a chance for the nutrients to escape, like an unopened box. Traditional processing leaves the nutrients intact and can even make some nutrients more available for our bodies to use. Olives are an example. You can eat the whole olive, or the olive can be mashed and puréed in order to squeeze out the oil to use in meals and cooking. Both forms are nutrient dense. Raw or Cooked? I thought I’d toss this in (like a salad?) because I hear comments that raw veggies and fruit are better for you. However, it really depends on the dish and the goal whether to have them raw or cooked. There are health benefits to both, so mix it up. Cooking makes most foods more digestible by breaking down the fiber, protein, or carbohydrates (fats stay about the same). In some cases, it also enhances the nutrient value and/or the flavor. Let’s use apples as an example. You can eat an intact apple right off the tree. Or you can slice it, cook it with cinnamon, nutmeg, and a little water, then mash it to make applesauce. They both offer strong nutritional benefits. Raw apples contain vitamin C, potassium, fiber, a smidge of protein, antioxidants such as quercetin, catechin, and chlorogenic acid, plus myriad phytonutrients. Upon cooking an apple, the vitamin C is destroyed (heat degrades vitamin C), but gut-healing pectin is released and the broken down fiber is easier on the stomach and intestinal tract. This is why apple sauce is recommended when someone has a stomach bug. Tomatoes are another example. When cooked, tomatoes concentrate cancer fighting nutrients like lycopene. They are rich in vitamins, minerals, antioxidants, and phytonutrients both raw and cooked, so eat them both ways (any Brooklyn 911 fans out there?). Mediterranean Food Plan Who hasn’t heard of the Mediterranean Food Plan? It’s everywhere, and for good reason. It’s delicious and the best researched combination of foods in relation to both physical and mental health. A point I make to all of my clients is that you don’t have to eat like folks in the Mediterranean to choose this food plan. Any flavor profile from around the world can be used with the elements below. And because of the variety in the plan, it’s easy to mix up tasty meals. What does it include? Vegetables & Fruit This rainbow of colorful foods provide fiber, antioxidants, anti-inflammatory molecules, detoxification support, vitamins and minerals, and colorful disease-fighting phytonutrients. Big focus on leafy greens, cruciferous vegetables, sweet potatoes, beets, and berries. Fiber Feeds our beneficial gut bacteria, keeps our bowels moving (out with the old, in with the new), and binds cholesterol, old hormones, and toxins for removal. Found in vegetables, fruit, and whole grains Protein Sources support balanced blood sugar, mood and neurochemicals, tissue building and repair, and the synthesis of every single enzyme. Read details on protein here. Healthy Fats Healthy fats contribute to healthy brains, cellular structure, are anti-microbial and anti-inflammatory, and carry nutrients from the foods where they were sourced. Fat/oil must be present for our bodies to absorb fat soluble vitamins A, D, E, and K. Big focus on extra virgin olive oil, avocado oil/avocados, nuts/seeds & their butters, wild caught fatty fish, small amounts of butter and coconut oil. Fermented and Probiotic-Rich Foods: See the list below. Herbs, Spices, Teas, and Traditionally Harvested Salt (Celtic Sea or Himalayan Pink) All assure delicious flavor while carrying a variety of micronutrients and trace minerals, and they provide digestive support, healing qualities, and more. These are little powerhouses of nutrition. Adequate Fluid Intake Washes out toxins and metabolic waste in urine, softens our stool for easy passage, pads our joints, moistens our eyes, and more. Big focus on water, herbal teas (and some caffeinated), soups, a little coffee. Probiotic-Rich Foods “Probiotic” is as it sounds: Pro = for us; biotic = bacteria. These health-promoting foods have been part of every culture around the world. This is partly because traditional preparation methods that ferment foods extend the life of the food. It also often makes it safer to eat, boosts nutritional value, and adds flavor. The benefits of probiotic-rich foods include digestive, metabolic, and mental health. Since this is a “what to eat” article, let your curiosity lead you to this article, which offers a deeper dive into the different probiotic foods. If you consume them daily in food, you can pretty much skip the probiotic pill. Recommendation: consume at least one serving daily. Start with a small amount and increase it as your body adjusts. These are some options:
What’s So Special About All These Foods? This food plan shifts our plates to being more inclusive of plants with smaller amounts of animal proteins than many Americans eat. Certain carbohydrates (veggies, fruit, and traditionally prepared foods made with grains) and healthy oils and fats hold respected positions. All of these foods are in balance with each other. Find these categories with examples laid out by the Institute for Functional Medicine: here for omnivores and here for vegetarians. How Do I Combine All of These Things to Get the Benefits? Click here for my edited version of the Harvard Healthy Eating Plate. This gives a visual for the general composition of a meal that research shows supports good health from a classical medical viewpoint. Your labs typically will begin to reflect the benefits if you mostly follow this guide. Please remember the critical difference between serving size and portion size (scroll to the bottom of this article on protein to read about it)! Honor Your Hunger Each time you eat, choose a combination of foods that includes a protein, carbohydrate, and fat. Not only will the meal or snack be more satisfying, but you will receive the time-release energy of this fuel entering your bloodstream gradually and steadily. Whether you are working and need a clear brain or working out and want your muscles to respond, you’ll feel the benefits. Typically eat three meals a day about 3-4 hours apart, and include a snack whenever it feels right for you. Be responsive to your hunger cues. A gentle, non-intrusive hunger may feel comfortable, even pleasant, and it’s a reminder that your body is notifying you that nourishment will be necessary soon. Hunger that results in fatigue, brain fog, mood swings, headaches, and other symptoms is your body asking desperately for food. My recommendation is simple: If you are hungry, eat. When you are responsive to your hunger cues, you will get into a rhythm of eating neither too much nor too little for your needs. Three Thoughts to Hold Onto
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Last newsletter I highlighted the necessity of embracing our bodies with affection and care in order to blossom into authentic health. Nevertheless, during this 2024 National Nutrition Month, I recognize that there is a lot of misinformation out in the world about food. How are you supposed to listen to your body about food choices when the media makes those choices so confusing? Ready for some clarity? Read on. There are gobs of misunderstandings and old information about food and nutrition, and I can’t possibly hit them all here. I chose the topics below because they are ones I hear about most often from clients, family, and friends. I truly would love for you to send me questions about where you are confused so I can answer them! So, I’m sure a bunch of you wonder, “What is gluten, anyway? I heard it’s bad for me!” Is sugar really the devil in granulated form? Raise your hand if you are still confused about eggs, fats, and cholesterol! Let’s go find out! To Gluten Or Not to Gluten? Gluten is a naturally occurring protein found in many grains, especially wheat, barley, and rye. It can show up in products made with elements of these grains, like breads, soy sauce, beer, and, weirdly, some commercial salad dressing (read a list here). Gluten is actually a combo of proteins. It is a binder and creates stretch in dough. We have been eating gluten since we began farming grains for food. Since it assists with making grain-based products more shelf stable, modern processors put more gluten in commercial products than there is in traditionally made ones, like sourdough bread (which has much less). Most people do not have an issue with gluten or grains, or only notice it when consuming a lot over time. But keep reading!! So many of us have inflammation in our digestive tracts that gluten can contribute to health issues, including our digestive problems. When gluten enters the digestive tract, a little chemical called zonulin is released. Most of the time that’s not really a problem. However, zonulin triggers inflammation in the intestines - again, usually not enough to be an issue. There is a single layer of epithelial cells that make up the barrier between the lumen (center) of the intestine and the inside of the body. The junctions between these cells are bound tightly together, forming a wall. When zonulin is present or enough inflammation occurs for other reasons, the junctions become loose, spaces open up, and stuff from the lumen (food particles, bacteria, viruses, etc.) can escape into the bloodstream and contribute to making us allergic or sick. Among the food particles, tiny chains of undigested gluten molecules can travel into the bloodstream. The immune system doesn’t recognize them and really doesn’t like them, and we’re off to the inflammatory races as it tries to get rid of the invader. Most people with autoimmune diseases will feel better without gluten (and no/low dairy) in their meals. So, here’s the deal. 0.586% of Americans suffer from Celiac disease, which is a severe autoimmune disease caused by exposure to gluten. In Celiac disease, the immune system attacks the cells of the intestinal lining, mistaking them for gluten molecules and destroying their ability to digest and absorb critical nutrients from food. Some people have a heightened genetic risk of developing Celiac disease. However, some people develop Celiac disease without that genetic risk and some people with increased genetic risk never develop it. We don’t mess around with gluten when Celiac disease is present. Only complete removal of gluten puts the disease in remission. Guess a primary common thread between developing Celiac disease and gluten sensitivity? Stress on the body from lifestyle factors and/or an existing illness. If you are gluten sensitive (but don’t have an autoimmune disease or Celiac), do you need to remove gluten forever? Maybe not, once you heal your digestion. Then you can experiment with how much and how often. There’s Something About Sugar I will speak heresy now: sugary food can be a true pleasure and has a place in our lives. Sweet is a nice counterpoint after a meal to the bitter, spicy, salty, acid, and/or strongly herbal flavors. Desserts are a festive way to celebrate or share family history. Baking is both a delightful science and a way to show love. Sugary items literally trigger the release of dopamine and energize the cells, giving us motivation and energy simultaneously. Something sugary can remind us of sweet memories or experiences or provide a sweet moment when things otherwise feel kinda rough. It can be delightfully connective - like a grandparent sharing an ice cream cone with a grandchild. Now, do modern corporations and our cultural habits encourage people to eat more sugar and ultra-processed foods (the new phrasing for many commercial grain-based foods) than will leave us well and feeling good? Absolutely. These habits can disconnect us from our bodies and undermine our authentic health. But if you are hangry and can’t get to a solid meal any time soon, a small sweet or processed snack will give your cells the energy they need right now. Ditto for when you’re trying to think something through (ever wanted something crunchy when you’re chewing on a problem?), or even if you’re in the middle of a workout and flagging. Glucose is our body’s preferred fuel, especially our brain cells. A little granola bar or piece of donut could be just the ticket in the moment. That boost from sugar or an ultra-processed food will not carry you the long haul, though, because your cells will burn it quickly and you’ll be back in the same boat. So consume some as desired or required rather than relying on repeated sugary and/or processed foods as your primary fuel. Those will, conversely, leave you undernourished, moody, and hungry. Is sugar going to contribute to poor health? Anything in excess will contribute to poor health. The reason sugar and processed grain-based foods (which are quickly turned into sugars in the body) get such negative press is because they raise blood glucose (BG, a type of sugar). Since blood vessels don’t like having sticky sugars hang around, routinely high BG will go a couple of different directions. After it has been used for energy, excess glucose first will be boxed up for later use by the liver, and the rest will be turned into fat for storage. Over the long haul, cells start turning the sugar away because they are tired of being overwhelmed with it. Insulin is the key that opens the lock to the cell for glucose, and the cell starts blocking the lock. Now the cells are “insulin resistant” and the blood is teeming with glucose. Remember that blood vessels only want to transport the sugar, not host it forever. The reason is that glucose gloms onto red blood cells and other particles floating through the bloodstream. It also damages the blood vessel walls by triggering inflammation (remember, it’s not supposed to stay there, so the immune system comes to try to address the issue). This is how too much sugar over time leads to Type 2 Diabetes, cardiovascular disease, and brain diseases. Some have also noticed that sweets and foods made with refined flours, especially when not eaten with protein and healthy fats, can trigger mood shifts or a level of hyperactivity, an important note for those who have ADHD, anxiety, or related mood disorders. Dysregulated blood sugar can spike and tank your mood, and even contribute to panic attacks and poor sleep. This ties directly to eating intuitively. When we understand what our bodies really need in order to feel well, vibrant, and energetic, we don’t have to deny or restrict ourselves. We can make choices about what to eat and when, and in what amount - sugar and processed, grain-based foods included. You are a unique individual. Know your own body and nourish it accordingly. Now You’re Going to Tell Me That Eggs Won’t Raise My Cholesterol You are correct, my friend. Read the following from this 2022 comprehensive review of research: “A great number of epidemiological studies and meta-analysis indicate that dietary cholesterol is not associated with CVD risk nor with elevated plasma cholesterol concentrations. Clinical interventions in the last 20 years demonstrate that challenges with dietary cholesterol do not increase the biomarkers associated with heart disease risk.” Moreover, eggs are fantastic sources of protein, choline, healthy fats, and some vitamin D, making them terrific contributors to methylation processes and brain health, as well as the delights of brunch. Don’t worry about shrimp or liver, either. So what foods do raise the risk for cardiovascular disease? CVD risk rises with the increase in the consumption of trans fats, saturated fats, omega-6 rich fatty acids, refined grains/ultra-processed foods, and sugars. On the other hand, you’ll see below that some oils and fats are actually deliciously health promoting. It’s all about the amount and frequency of these foods, not about never having them and not about body size. Be aware that physiological stress and a sedentary life are also major risk factors for heart disease. Here are some insights:
So, Can Food Choices Lower Cardiovascular Disease Risk? Yep. Whole oats (which contain cardiovascularly healthy beta-glucans) will trap metabolized cholesterol when it arrives in the stool, and the fiber in whole oats keeps the stool moving so we don’t reabsorb it (which will mess with cholesterol levels). Enjoy the benefits of fiber found in whole grains, vegetables, fruit, beans/legumes, and nuts/seeds. Colorful vegetables and fruit prevent oxidation of our cells and mitochondria and assure proper function of inflammatory pathways. You’ve learned that certain fats/oils are rich in health supportive phytochemicals and anti-inflammatory compounds. Take Home Message Surely I have not answered all of your questions about food and health, but I hope that I alleviated some confusion! I’d really love to hear what else you would like to know.
Food can be a pleasure in all its iterations. When we have the knowledge we require to meet our own health and wellness goals, we can listen to our body’s intuition and make more confident choices. Last week was Eating Disorders Awareness Week (Feb. 26-March 3). I hope you saw as much excellent informational material on your social media as I did. While I don’t work with those who have active eating disorders (that takes specialized care), in my clinical and personal experience most people live in the confusion of disordered eating. It affects both their joy in life and their health. Body distrust and difficult relationships/misunderstandings with food are common threads that run through my clients’ experience. We talk about these a lot. So many folks don’t realize that authentic health may not look like we’re trained to believe. Please read this one through. There’s a lot of opportunity to reorient our relationship with food and our bodies so that we are healthier all around. One newsletter can’t possibly hit it all, but I’d love to share more with you when we work together. Disordered Eating Disordered Eating (DE) is our focus today, although I encourage you to read the facts about eating disorders in the box at the end. Let’s take a sec to look at what DE is, then we’ll consider some new perspectives. Disordered eating very often mimics health promoting behaviors, causing them to be widely accepted by society, especially when they are associated with weight loss. A few of them actually fall on a spectrum from rationally healthy to verging on an eating disorder. It depends on how they are used and the mindset of the person using them. For example, some people follow a vegetarian or vegan food plan for moral and/or health reasons. Or they exercise rigorously on a daily basis. They feel great and they never unduly restrict or deny themselves food or rest. However, some use these as a way to control their food intake and strive for an ever smaller body. Experts identify these ways of eating as yellow flags for a budding eating disorder, particularly when other mental health issues are present. You can see it in teenagers suffering from anxiety and perfectionism. They might suddenly become vegetarian or vegan as a cloak for controlling food intake or extreme dieting. Others push themselves with exercise. Or both. Diet culture surrounds us in advertisements, social media, magazines, and newspapers. Our heads become full of food rules and body perfectionism. We become completely disconnected from what our bodies tell us they need, and our self-care habits become skewed. Did you know that there is a relatively new eating disorder called orthorexia nervosa? When the behavior becomes extreme, orthorexia is diagnosed in people who are perfectionistic about what foods they will eat - everything must be “clean,” organic, “healthy,” no sugar or refined anything, and consumed at exactly the “right” time of day in the “right” amounts. A similar relationship with exercise can also exist. Crippling guilt and anxiety for choosing something outside of this box interfere with daily living. And heaven help us if your body changes (except to be smaller.) We are also bombarded with images of what bodies “should” look like and social media “what I eat in a day” and “healthy swaps.” We become filled with dissatisfaction with our bodies and our food choices as we compare ourselves to these things. Constant dissatisfaction ≠ joy with life - but someone is out there willing to sell you a solution to your body problems! Fear sells products, and make no mistake: weight loss schemes and “healthy eating” are products. What business model other than a diet plan undermines you by telling you you don’t know what you’re doing, repeatedly fails to deliver a sustainable product, blames the customer for the failure, and builds an empire on it? Body disconnection leaves us feeling untethered. If we eat one cookie, we chastise ourselves because it’s a “bad” food. Either we then restrict ourselves further as a means of trying to regain a sense of control, or we perceive ourselves “giving up” and eat the whole sleeve. We’ve “lost” anyway, so why not? But what I want you to know is that enjoying a pleasurable food is not an either-or proposition. Imagine if we stopped being afraid of our bodies and simply embraced them, as they are, with love and compassion? What if we listened and responded with what would make them truly feel their best? What do you suppose would happen? I’d love to hear your response to this. Diet Culture Diet culture is the leading trigger for disordered eating. The Emily Program is an eating disorder recovery program, and their website provides a list of DE behaviors and how they can tip into eating disorders. Here it is, and I made a few additions:
I want to pause here and assure you that you are absolutely doing the best you can with the information you have, and I completely honor that. When you receive supposedly expert advice on how to be healthy (and what it looks like), and then you are surrounded by a culture that applauds you for working to get healthy regardless of how you do it, you’re going to follow that glimmering path of gold. So why trust me? Because there is a large body of research - formal studies and clinically - which describe that restriction, deprivation, weight cycling, and healthism lead to worse health outcomes, both physically and mentally. These are not the paths to authentic health. Yet, authentic health does exist. Out of Touch Toxic cultural messages about our bodies and our health get all up in our heads. We’re triggered into fight or flight and see our bodies as the enemy. We become disconnected from its messages and requests - the body’s innate wisdom. There’s nothing inherently wrong with making food choices, increasing or decreasing the amount of food, moving our bodies (cleanses are another story!), or even seeking a smaller (or larger!) body. It’s the how and why that undermine our physical and mental health. A key to this whole thing is that our bodies are designed to protect the organism - us. The more we crank down on them to force them into shape, size, or “health,” the more they feel threatened and go into protective mode. Deny it food? It will sense starvation and grab back any lost weight and slow down metabolism. Deplete nutrient stores during heavy workouts without adequate rest and nourishment? It’ll draw minerals from bone and break down muscle to make fuel for energy. Neurotransmitters (mental health) and hormones will be thrown into disarray. And the more we moralize and berate ourselves for food choices, the more we want the food we restrict and deny ourselves. There’s solid evidence for all of this. One very readable source that has collected it in one place is the book Intuitive Eating by Evelyn Tribole and Elyce Resch. In my practice I apply the 10 Principles of Intuitive Eating defined by this book, which have proven benefits for overall health and wellbeing. They coined the term “authentic health.” Getting Back in Touch When we tune in to the body, we can align our behaviors with its true needs. Authentic health and our natural shape and size tend to follow. Ease and a feeling of safety and comfort fall into place. How nice would it be to feel safe with any food and move your body with pleasure so it feels great and works well? This is all available to you. Be gentle with yourself and your body. Intuition and Hearing The Quiet Voice Here are a few mindset practices that I offer to my clients to help them align with their bodies. To be honest, they are more effective when accompanied by coaching. Please try them, though, and as you begin to get the glimmers of hope, pleasure, and authentic health they provide, send me a note to let me know! And remember, these are “practices,” not “perfects.” All Food is Morally Neutral You may be surprised to know that there is no food that is superior or inferior, good or bad. It’s really true! Every food is available and plays a valid role in our choices. Adopt an abundance mindset. When every food is “on the table,” we are able to select what’s truly right for us in the amount that meets our needs at the time we require it. No restriction, no denial - no under eating, no overeating. In fact, we can even choose not to eat, if that’s best for us. Every food remains available to us, so the choice becomes about true nourishment, not loss or hoarding. Practicing an abundance mindset allows us to assess and decide on what will lead us into feeling the way we authentically want to feel. We no longer have to prevent ourselves from eating any food: we can trust ourselves and our bodies to nourish us well. Language Matters The words we use with ourselves help define how we see ourselves and how we move through the world (our choices and behavior). You’ve heard it before: would you talk to a friend using the words you use with yourself? Would your friend remain your friend if you talked to them that way? We draw closer to those for whom we express recognition, kindness, forgiveness, understanding, and compassion. We listen to where they struggle, tell them it’s going to be okay, and nourish them with healing foods, touch, laughter, and connection. Is it any wonder that we achieve our authentic health more readily when we do this for ourselves? Express Curiosity When we’re friendly with someone, we want to know more about them. So here’s a novel idea: express curiosity about your own experience. Ask questions. Really hear the answer. We’ve all had a lot of diet culture noise in our heads, and it can feel a lot easier said than done to hear the soft voices of our bodies. It may take practice, but the practice will pay off. Identify a point of your day when things are reasonably calm. Take three slow, deep breaths. This is a listening practice. Find stillness and silence. Literally ask, “What’s happening, Body? What do you need?” Feel before you label the answer with words. Maybe scan from your scalp to the soles of your feet, inside and outside. Notice what’s going on. If something is tight or hurts, rest your attention on it for a moment or two. Acknowledge without judgment. Just allow it to be true and then move on. You may notice the rising of emotions, thoughts, or unexpected physical sensations. Be curious about what they indicate about what you need. Everything that comes during the practice is information, neither right nor wrong - merely true. That information is what some people call intuition. Curiosity encourages observation, and observation allows awareness to grow. When awareness is present, ‘knowing’ and then compassion begin to blossom. Our true needs can be identified, embraced, and met with love. Cultivate the Pause In this mindfulness exercise we’re interested in expanding the space between a trigger for a behavior and our actual response. That is, instead of having a knee jerk reaction, we make a thoughtful, satisfying choice. Light (awareness) now can enter that open space so we can observe what’s really happening and use that information to make satisfying decisions for ourselves. It’s a more intentional version of expressing curiosity. You can learn more about Cultivate the Pause here. Take Home Message You have the most beautiful body, and it’s working 24/7/365 to protect you. Have you ever seen such love or devotion? It chugs away, constantly making adjustments to keep you alive and safe. But those adjustments can take a toll on your health eventually if you treat your body like an adversary to be beaten into submission. When you align, listen, and respond with compassion and love, your body is able to emerge from the bunker and heal. It knows what to do with proper rest and nourishment, and everything settles into place. Here are some important facts from the National Eating Disorders Association (NEDA):
So much research on human health has to do with pathology, or how we get sick and how to treat that sickness so it goes away. This is good and necessary stuff, but typically I like to ‘choose toward’ rather than ‘run from’ or ‘battle’ things. After all, when we run or battle we are in stress mode - fight or flight. Ironically, stress contributes to most illness. What if we ‘choose toward’ feeling terrific? Valentine’s Day is a holiday intended to make us feel warm and fuzzy (and chocolatey!). Could we pursue those delightful feelings every day? I think we can. Medical science has opened its doors to researching what contributes to health and wellbeing. It mostly began in the early 1970’s when Candace Pert, PhD discovered endorphins. ‘Endorphin’ is a blended word taken from the word ‘endogenous’, meaning manufactured by the body, and morphine. Endorphins are just one of four primary “feel good” chemicals we synthesize that improve how we feel. These four are: dopamine, serotonin, oxytocin, and endorphins. It’s incredible that we are literally designed to elevate our mood and relieve our physical (and mental) pain. What do these four chemicals do? They are all produced in the brain. Oxytocin and endorphins are synthesized in the hypothalamus and released by the pituitary gland into the bloodstream to be carried wherever they are needed. Dopamine and serotonin are made in the brain and across the body, including in the heart’s nervous system and the enteric nervous system (or the “gut brain”).
More of these? Yes, please! Many have a misperception that these chemicals either are working in our bodies or aren’t, and that we really don’t have much influence over them unless we take medication. Sometimes medication is necessary, but how great is it that we really can boost them by what we choose to include in our lives? Let’s look at a few accessible lifestyle choices that will reliably support your mood. Food (of course!): What it boosts: serotonin, dopamine. What to choose: Protein (animal and plants), colorful vegetables, fruits, beans/legumes, nuts/seeds, fermented foods, whole grains, extra virgin olive oil & other healthy oils, herbs, spices, Celtic or Himalayan salt. Dairy is optional (if you tolerate it). Hydration. Very low intake of refined foods and sugar. As a guideline, follow this set up for your plate:
Touch What it boosts: endorphins, oxytocin, serotonin. There’s a reason oxytocin is called the “love hormone!” Our bodies ramp up production when we fall in love or have sex (with the right partner!). Sex also triggers endorphins, and the combo of oxytocin and endorphins makes our sense of wellbeing soar! However, any welcome touch will trigger the release of these mood boosters. Think of massage, holding hands, linking arms, gentle non-sexual stroking or rubbing, cuddling, snuggling with our pets, and especially hugging! I can’t help but note that oxytocin is the hormone of trust and relationship, and it’s no surprise that it’s released when we’re touched by or touch someone we care about. Community, positive relationships, and trust underpin emotional and psychological stability. Movement What it boosts: endorphins, oxytocin, serotonin, dopamine. While intense exercise does great stuff for mood balance, research shows that moderate aerobic movement done a few days a week is key to a balanced, positive mood and brain health (focus/attention, cognition, learning, memory, etc.). Bonus - it’s even more effective when doing it out in nature! Need a pick-me-up? Go out for a brisk walk! Movement puts a beneficial stress on muscles and bone and increases blood flow across the body, more effectively carrying nutrients and oxygen to cells. Muscle engagement triggers the brain to synthesize brain derived neurotrophic factor (BDNF), which I have discussed before here, while simultaneously triggering the production of those happy mood chemicals and facilitating their attachment to receptors in both body and brain (read more here). Music What it boosts: endorphins, oxytocin, dopamine. Enjoyable music increases oxytocin, especially when we sing in a group. The social component of this creates connection and relationship, enhancing the effect. Participating in music making - singing, playing an instrument, even drumming on a table - stimulates endorphins and has been shown to improve pain tolerance. Singing and listening to music also engages cranial nerves that communicate with the vagus nerve. We say it “tones” the vagus nerve to stimulate it in this way. A toned vagus nerve increases heart rate variability (read more here), which has a direct impact on our overall sense of wellbeing and resilience. This also triggers the release of dopamine, creating both better mood and improved focus and ability to be fully present. If you’re in a crappy, closed-off mood, put on headphones and turn on music you really love (don’t blow out your eardrums!). Get those good mood chemicals flowing to improve your emotional status, your clarity, and your connections! Meditation What it boosts: endorphins, serotonin, dopamine. Meditation and acupuncture are two of the best researched “alternative” treatments shown to be effective for improving mood, relieving depression and anxiety, and reducing pain. Not coincidentally, meditation also increases heart rate variability. There are a number of free phone apps and videos on YouTube to help you get started. I recorded a basic guided meditation which you can listen to here. Other Evidence-Based Options
We have the tools to “choose toward” feeling well and whole, even when we struggle with mental illness, whether we use them as stand-alone actions or in conjunction with medical care. The positive health cascade from a steady mood goes beyond emotions and psychology to improving disease risk and health outcomes. It can provide far reaching benefits into school, work, and relationships. Please respond to tell me which of these options you have used the most and how you like them! Tip of the Month What is Valentine’s Week without chocolate? Yum!
Dark chocolate offers benefits that range from supporting cardiovascular and bone health to contributing to immune function. Those benefits come from the nutrients found in the fruit of the theobroma cacao tree: aka cacao, or cocoa. Just to cover that, dark chocolate contains: far less sugar and fat solids than milk chocolate; mood-elevating polyphenols; fiber (!); flavonols (increase nitric oxide = better blood flow); antioxidants; and minerals (iron, magnesium, zinc, copper and phosphorus). Since it has a stronger, more bitter flavor, it only takes about 2 ounces for us to feel satisfied. All things in moderation. Here’s the tip: Unsweetened organic cacao nibs are surprisingly delicious - deeply chocolatey, a little naturally sweet, and crunchy. Sprinkle them on unexpected foods, like whole grain oatmeal, plain Greek yogurt, or your protein smoothie, or mix them into whole grain muffins and pancakes. Cacao nibs can give you a nutritious daily Valentine’s treat all year! Once we reach a certain age, blood work becomes standard operating procedure at our annual physicals. Your doctor usually says she’ll follow up if she sees something, and you end up trying to interpret the results on your medical portal. But what does it all mean? Maybe you have a family history of heart disease or diabetes. Maybe you mostly want to stay healthy into old age. The good news is, there's a lot of great data in there to help craft a Nutrition Care Plan that can help you meet your health goals! In this newsletter, I’m laying out what we all need to know about common blood work. Please let me know if this changes your conversation with your doctor or your thoughts on monitoring your own health! I’m always here to support you. And be sure to forward this issue. Everyone needs to understand the importance of these labs. My conversations about blood work with my clients typically go like this: Me: “Please share your most recent blood work with me.” All of my clients: “Which labs do you recommend?” The truth is, most people don’t really understand what different annual labs say about their health. In my work, lab data gives me clarity about where your body needs nutritional support so that cells and systems can function better. I use it to create a nutritional diagnosis that defines my recommendations. The nice thing about standard labs is that doctors want them AND insurance will pay for them. I’m all about saving money! You’ll see below all of the labs I typically request and (briefly) why. Standard Annual Blood Work I always ask to see these labs, which are a standard part of an annual physical: CBC with Differential; CMP; Lipid Panel, vitamin D. Complete Blood Count (CBC) with Differential Red blood cells, white blood cells, hemoglobin, hematocrit, MCV, MCH, MCHC, platelets, and five specific immune cells. Just as it sounds, a CBC gives us information about the size and content our red blood cells (RBC), percentages of white blood cells (WBC), and number of platelets. Ok, but what does this mean for you? RBCs carry oxygen to the cells to make energy. A deficit in B9, B12, and/or iron will result in anemia - and energy across the body will tank. Without energy, the cells can’t do their work well. Too many RBC’s and platelets increases the risk of blot clots and may indicate an underlying illness. This test also gives me a window into whether you’re dehydrated. White blood cells (WBC) give an idea of whether you are fighting an infection or allergies, both of which contribute to inflammation. Inflammation can be found in symptoms as diverse as sinus infections, joint pain, and mental illness. Certain foods and nutrients (e.g. vitamins A and C, zinc, some specific herbs) can help the body fight infection by bolstering the immune system naturally. You’d be amazed at the overlap between allergy and mood disorders. Comprehensive Metabolic Panel (CMP) Fasting blood glucose, calcium, sodium, potassium, CO2, chloride, albumin, globulin, total protein, ALP, ALT, AST, bilirubin, BUN, creatinine. A CMP measures certain blood substances, most of which are nutrients. It spotlights the risk of imbalanced blood glucose, health of the liver and kidneys, protein status, fluid balance, bone/teeth building blocks, electrolytes (esp. important for nerve transmission and fluid status), and overall metabolism. We learn a lot about what your body needs nutritionally based on whether you have a good blood sugar level and adequate other nutrients, like calcium, sodium, potassium, zinc, and protein. We can see what’s happening with your muscle breakdown, hydration, and immune cell building blocks. Lipid Panel LDL, HDL, triglycerides. Also called a cholesterol panel, we find out how your body is carrying fats, proteins, and other nutrients to and from the cells. In simple terms, LDL carries them out to the cells, and HDL picks up the leftovers and takes them back to the liver to be metabolized or repackaged. The health of blood vessels rely on a good lipid balance. Triglycerides partner with blood glucose in my assessment. Glucose (sugar) and triglycerides (a fat) are both used to produce energy in cells. If a person is insulin resistant, both glucose and triglycerides will be elevated in blood measurements. Blood sugar dysregulation will also be reflected in higher LDL (low density lipoprotein), increasing cardiovascular disease risk. Low HDL (high density lipoprotein) will mean that certain particles that need to be returned to the liver don’t have a ride to get there, so they remain in the bloodstream or cells. While total cholesterol is a useful data point for various things, it tells us nothing by itself about the risk of cardiovascular disease. In fact, evidence shows that higher cholesterol within a range has health benefits. Most people don’t know that some hormones, like sex hormones, are made from cholesterol. So, for example, as a woman’s estrogen goes down during menopause, she can expect to see her total cholesterol rise. Same for testosterone in both men and women. Research indicates that higher total cholesterol is brain protective as we age. Higher total cholesterol with well balanced other lipids can mean lower health risks in the right situation. Total cholesterol below 150 mg/dL significantly increases the risk of depression, aggression, and suicidality. The upshot is that we need to know the whole picture to understand our true health. Nutrient Testing There’s only one nutrient that I encourage you to have as a standard annual test - vitamin D. Vitamin D is also a hormone that must be present to support other hormones (insulin & glucagon, cortisol, thyroid hormone, sex hormones, hunger and satiety hormones…you name it), the immune system, bone strength, and more. You might need to be willing to self-pay for it because some insurance won’t cover it. I’ll never understand why not! There’s so much research about the health implications of low vitamin D, and other tests don’t capture it. Pro Tip: Aim for results of 40-80 ng/mL. The 30 ng/mL considered to be normal by Labcorp and Quest is based on population baseline health and is too low. Beyond the Annual Labs Iron panel, blood glucose markers, cardiovascular health markers, thyroid panel. Now that we’ve broken down your standard labs, let’s talk about further testing. I often request the following based on signs and symptoms and what I see in the standard labs. You’ll see that these are still “normal” labs that should be covered by insurance (and sometimes aren’t, depending). Iron panel serum iron, total iron binding capacity (TIBC), and iron saturation If I see that there is a risk of iron deficiency anemia I will often request an iron panel. It’s really important not to take an iron supplement unless you know you need it. Too much iron in the body can cause problems with other nutrients and oxidize cells (rust you from the inside!). Blood Glucose Status Imbalanced blood glucose (spikes and dips) messes with our mood, energy levels, nerve transmission, blood vessels, and cardiovascular health. If I want to know more than the fasting blood glucose on the CMP, here’s what I ask for: Hemoglobin A1c measures glucose levels over time. Glycomark measures the quality of glucose over time. A high, steady glycomark, even with elevated blood glucose, is safer than a low glycomark that shows a blood glucose roller coaster ride. Insulin is a hormone that secretes from the pancreas when we eat food and our blood sugar rises. It’s the key that unlocks cells so they let in the glucose, fats, and proteins that are used as fuel for energy. Elevated insulin may mean insulin resistance (the cells have blocked the keyholes because there has been too much insulin trying to use their keys). C-peptide measures insulin over time. Similar to a hemoglobin A1c, the c-peptide shows whether insulin has been persistently elevated. Cardiovascular Health These are informative tests for cardiovascular health that I wish doctors would order annually for those at risk for cardiovascular disease - I explain why next to each lab below. The good news is that you can request any or all of them! LDL-P measures LDL particle size. The standard lipid panel shows a calculated measurement of how many LDL molecules there are (LDL-C), but says nothing about their size. Large fluffy LDL is less likely to cause damage to blood vessels than small hard LDL. LP(a) is a type of LDL (low density lipoprotein). It is stickier than the LDL-C on a lipid panel. Even if your LDL-C is “healthy,” the risk of plaque buildup notably rises when a high percentage of it is LP(a). ApoB (or apolipoprotein B) is a primary component of “non-HDL cholesterol” on a lipid panel. ApoB is a direct measurement of our risk of developing plaque in our blood vessels. Homocysteine is an amino acid that is damaging to arteries when elevated, which increases the risk of blood clots that lead to stroke, heart attack, and other cardiovascular damage. Thyroid Health Thyroid stimulating hormone (TSH), Free T4, Free T3. (Free T4 is the inactive form of thyroid hormone. Free T3 is the active one) Depending on the client’s signs and symptoms, I might request a thyroid panel - another very standard blood test. Thyroid hormone is kind of a master metabolic molecule. Hypothyroid (too little thyroid hormone) or hyperthyroid (too much) will pull other hormones out of balance. Appetite, energy, weight balance, stress response, immune activity, mood (anxiety, focus/attention, depression, brain fog, etc.), and more all lean on that little butterfly shaped thyroid gland at the base of our necks. Requesting Your Labs We all know the challenges of medical insurance. I wish I could make it easier for you! However, it is our right to ask our doctors to order the labs that make sense for us. You may have concerns about particular areas of health or simply want a baseline. Your doctor should share your curiosity, and she can sometimes influence whether insurance will pay for the labs. I recommend that you bookmark this newsletter for future reference. When you go for your annual physical, write down the labs you want that are beyond the normal annual ones (including vitamin D!). Familiarize yourself with the information they provide. Then talk to your doctor about your concerns and interest in ordering them. Doctors should be your partner in supporting your health, and they should be willing to explain the results to you. A Nutritionist’s Interpretation of Blood Work Clearly I am not a doctor and don’t even play one on tv! I am not qualified to make a medical diagnosis. However, my nutrition diagnoses can make a big difference to what’s happening with your health situation.
As a healthcare professional my interpretation of labs lets me do two things:
A key point mostly missing from the medical field is that nutrition interventions are primary health care - for both prevention and treatment. Food and nutrient intake, drug-nutrient interactions, stress, sleep, movement, and more all influence nutrient status, and nutrient status is the foundation of all health. For a long time I have resisted New Year’s resolutions…and nothing has changed! In this issue I present a case for an alternate path. Let me know what you think! Here we are in the third week of January, and a lot of people are beginning to struggle with their New Year’s resolutions. The dictionary definition of a resolution is: “a firm decision to do or not to do something.” Such firm stances can be hard to maintain. They take so much energy, and too often the firm stance doesn’t meet the root contributors to the things you want to be different. Virtually every resolution somehow is related to food choices or lifestyle. “This year I’m going to eat fewer sweets and more vegetables!” or “I’m not going to sit on the sofa all weekend!” or (shudder) “I’m starting a diet!” It might be, “I’m going to clean up my office and keep it that way!” or “Less time on screens!” Or important medical resolutions, like bringing down one’s A1c or blood pressure. Now, I’m obviously a big fan of everyone shaping their choices and behaviors to meet their health and wellness goals. After all, that’s my whole job! Still, I don’t go for rigid rules of living. They tend to either create corrosive restriction and deprivation or we honestly just don’t want to do the thing. How can we expect to maintain positive behaviors with such a negative foundation? Behavior Change is Hard The truth is obvious to everyone right about now: behavior change is hard. Our habits follow an easy, comfortable routine. We get back to “real life” after the holidays and often floop right back into prior patterns. When we realize it, we might feel deep shame, either because of how we see ourselves or how we think others see us. Some of us beat ourselves up with some pretty tough language. “Ugh, I can’t do anything right.” “I already messed up, so just forget it. I give up.” And my least favorite (and inaccurate), “I have no discipline.” Being hard on ourselves only makes it worse; it has a cyclical effect of confirming the words we use. We see ourselves as incapable - or worse. We lose self-trust and self-respect, the very cornerstones of successful behaviors.There’s a whole other way to do this. What if we consider who and how we want to be in the world, and find ways to practice those behaviors bit by bit? What if we tap into our values and authenticity instead of making a “firm decision”? We CAN create sustainable, lasting, satisfying behaviors that match our vision for ourselves. Our health and wellness will blossom when we align with ourselves using forgiveness, compassion, and love. Knowledge is Power Press your two hands flat together and look at them. Imagine the left hand is a trigger for a behavior and the right is your reaction - there’s no space in between. The closer your reaction is to the trigger, the less control you have over it. You lack any choice. Blending STOP (stop; three deep breaths, observe, proceed), with a basic breath meditation, I built a mindfulness tool for my clients: Cultivate the Pause. Cultivate the Pause is a practice that makes space between the trigger and the response so that you can make a decision that aligns with your values and your wishes for yourself. Cultivate the Pause This is a ‘practice,’ not a ‘perfect.’ I always recommend that nervous system regulation practices, vagus nerve stimulation practices, and any type of meditation are best done first during calm times. You are training your body and mind to respond readily to the practice, so that in the middle of a challenging moment it already knows how to engage quickly to your benefit. It doesn’t take very long when you know how. Once you have the rhythm, you’ll be able to dance anywhere! Note that the breath work at the start is important. It engages your parasympathetic “rest and digest” nervous system, also known as the relaxation response. It calms the release of stress hormones and clears the brain. It’s what creates the space for what happens during the pause.
This is where that important behavior change shapes itself and starts to take hold. You repeatedly choose who and how you want to be. You learn both intellectually and viscerally how to align with your true self. Gradually how you are syncs with who you are. The behaviors that undermine your best self will be crowded out by ones that feel great. And if there is something after all that you have to change with firm resolution, you will know your purpose and have the support and confidence of all that you have built. The more you practice, the more your body will intuitively select the pause when there’s a trigger for a behavior. You don’t have to react using ingrained patterns and with choices that leave you feeling defeated, depleted, and unhappy. In the moment or when you are planning for the future, the pause will give you the space you need to make good decisions - that are right for you - with a clear head. Instead of resolutions this year, let's Cultivate the Pause.
I integrate lifestyle practices into my nutrition recommendations to address the wellbeing of body, mind, and spirit. Two words capture this approach: stress resilience. This issue opens a peephole into profound, lasting stress resilience, habits of being that can serve you well through 2024 and beyond! My source here, Transforming Stress by Doc Childre and Deborah Roma, Ph.D., shows the research behind one of my key tools, HeartMath. As always, please write to me with your thoughts and questions! I love hearing from you. In Wellness, Mary Virginia From ancient times, the heart has been identified as the seat of emotion. You’ve probably used terms like “heartfelt” and “from the heart” in your daily language to describe the warmth of a positive emotion. We also express sentiments like “that hurts my heart.” But did you know that these feelings and sensations are much more than emotion? They are literal communications from the body to the brain - messages of safety and security or those of disconnection and distress. Those communications have everything to do with our thoughts, focus, decision-making, and mood. HeartMath is a healing practice that reorients these communications from the heart to the brain to create focus, clarity, reason, and balanced mood in the face of hard things. Instead of reacting, we respond thoughtfully, from the heart. HeartMath The autonomic nervous system has two branches, sympathetic and parasympathetic, that coordinate to keep us running. Hearts beat, lungs breathe, eyes blink, digestive tract digests, etc. Most of the time we’re not even aware these are happening. One of the few places where we can control how it happens is with our breath. HeartMath accesses breath and harnesses it to our imaginative ability to call forth positive, regenerative emotions based on our experiences. An example is the Heart Lock-In technique. We focus on breath flowing in and out of the heart. We call forth a heartfelt sensation - love, appreciation, care, compassion, or any positive, healing emotion - that we allow to flow with the breath. It’s important to understand that during the practice we want the sensation of the emotion, not the intellectual memory. That is, the practice lives in the heart, not in the head. We measure the results of the practice through heart rate variability (HRV), which I describe below. A high HRV ultimately directs the release of serotonin, dopamine, and hormones, changes the mechanical heart beat, and alters the heart’s electromagnetic field. (If you want a deeper dive, go here.) Moreover, the PENI systems (read about it in my prior newsletter here) begin to function optimally. Voilå - stress resilience. Heart Intelligence The heart communicates emotional status to the brain in four different ways.
Vagus Nerve This is a cranial nerve that originates in the brain and then branches out through the body to touch the throat, the heart and lungs, all of the organs, and the intestinal tract. 80% of the communication through the vagus nerve is from the body - especially the heart - to the brain. It tells the hypothalamus what’s going on so that the brain can direct the right protective or healing response. Coherence, Cognition, Clarity, and Capacity Still yourself for a moment, and then place your hand on your heart. Sense your heartbeat. Feel your breath. What is your emotional state? Can you tell? Emotion travels faster than thought, and the heart’s intuitive intelligence defines our thoughts, actions, and behaviors. HeartMath provides a guide to go deeper, find answers, and generate change.
Imagine repeatedly encountering a difficult person at work. They put you on edge, and you get in such a bad mood. You get snippy and irritable. Or perhaps you’re a student who has trouble focusing, and it gets worse with the pressure of a paper or a midterm. Your grades suffer, which makes you depressed and anxious. Or maybe you’re someone who worries a lot - constantly fretting. You feel like you have to control everything, from other people to what you eat. All of these can be measured in low HRV. HeartMath practices increase our HRV, which enhances our self-awareness, alters our thought processes, and regulates our emotions. It opens our Window of Tolerance so that we can address hard things with clarity and perspective. This doesn’t mean that we don’t feel the difficulty, but we respond thoughtfully rather than with a kneejerk reaction. We can find another way to communicate with the difficult person. We are able to focus and approach the paper or test with calm confidence. Reason and good choices become available so that worry is less compelling. The Stress Factor & Stress Habits One guarantee of existence is that life is challenging! We usually have the same, repeating stress triggers, and we get in the habit of reacting the same ways every time. These are well practiced stress habits! Stress habits commonly show up as irritability, worry, anger, excessiveness, forgetfulness/brain fog, anxiety, depression, fatigue, sleep disturbances, aches and pains, and even illness such as colds and flu. I’ll bet you can feel stress physically in your body: tension, headache, racing heart, shallow breathing, digestive upset, feeling sick…it feels lousy. We can reshape our stress habits to be more healing and productive, though! Thousands of times a second the body communicates sensations and messages through the vagus nerve to the hypothalamus. It directs information to the brain’s cortex (executive function, focus, decision-making), which then sends the now organized data to the amygdala and hippocampus (in the limbic system) for memory storage. The amygdala chooses the tone of stored memories (experiences) based on messaging from the cortex and the heart combined with sensory input - sight, sound, touch, taste, smell. Fascinatingly, “…the cells in the core of the amygdala synchronize to the heartbeat.” Not surprisingly, stress habits install a bypass straight to the amygdala. Imagine the core cells of the amygdala vibrating incoherently! Negative emotions, a closed mind, fear, anxiety, and worry inform the creation of memory and associate it with the sensory experiences that accompany it. Stress habits develop as protective mechanisms to the fear and uncertainty embedded in memory. Stress Response - Hormones and Mood Incoherent HRV is related to the release of stress chemicals, adrenaline and cortisol. Persistent incoherence and the stress response support a downward trend of emotional dysregulation, a closed mindset, and a sense of impossibility. A coherent HRV triggers the release of positive mood chemicals, such as dopamine, DHEA, oxytocin, and BDNF. These lead to stress resilience and a beneficial upward spiral. Illness Stress habits are also significant contributors to preventable lifestyle diseases related to nutritional status, such as Type 2 Diabetes, cholesterol imbalances, cardiovascular disease, high blood pressure, mood disorders, emotional eating, sleep disorders, cancer, dementia, and more. Community Our bodies intertwine the function of three brains to define our quality of life:
Coherence makes us resilient in the face of others’ stress habit-born incoherence. Because the electromagnetic fields of our hearts reach so far into the environment around us, negative emotions and stress habits can be like an easily transmittable virus to others. Those with strong immune systems are better able to ward off illness. Well established coherence protects us from the ‘infection’ of others’ incoherence. Better yet, research studies have demonstrated that our own HRV can be measured in the brain waves of those around us. Therefore, our emotional status literally changes the emotions of those near us. Have you ever entered a room and sensed the mood? That mood is emotional content as expressed by HRV in those folks. By establishing our own coherent HRV before encountering others, we can pass our resilience along to them. The Beat Goes On HeartMath offers a concrete, accessible path to physical and mental health. A practice session can last as long as we choose, and benefits can be felt in as few as 1 to 3 minutes.
Benefits include:
The journey to stress resilience is found in the flexibility and adaptability of the heart. It is key to overall wellbeing. As you celebrate and reflect this holiday season, become aware of your own heart’s wisdom. Together let’s build a world of healing, resilience, and connection! We are entering the darkest time of the year for the Northern Hemisphere. It’s no wonder so many religions celebrate light in December! A reader wrote to ask me what to do to get ahead of Seasonal Affective Disorder (SAD). With the time change a month ago, 6pm feels like midnight. It’s cold and sometimes wet. All of this can result in a deep drag on many people’s moods and energy. So let's dive into some effective mood- and energy-boosting strategies! And remember to share this with your friends – let's spread positivity and empower each other to feel our best! Reader Question: “I’ve been having brain fog and seasonal depression. Literally, the day the time changed I immediately felt it kick in. It’s not bad, but I want to get ahead of it - last winter and the one before were really hard.” Light and Dark Our bodies are super attuned to sunlight and darkness. Melatonin rises as darkness comes. Cortisol rises as daylight approaches. Even our gut microbiome responds to circadian rhythms, which affects our digestion. What to do: Morning sunlight: Get up as early as is comfortable to take advantage of the morning light. The light spectrum of morning sunlight triggers a natural uptick of cortisol, the hormone that wakes us up. We also experience an increase of the motivation/mood/focus/reward system neurochemical called dopamine. Dress for the weather and go outside before doing anything else. Walk, jog, or even just stand in the sunlight. Face the sun for a minimum of 5 minutes, and as much as half an hour if it’s cloudy. Now, don’t look straight at it (we don’t want to damage your retinas!), but the goal is for your eyes to take in the sun’s rays. Be in nature as much as your surroundings will allow. If you live in the city, go to a park. Forward movement: One benefit of a walk is that forward movement sends a signal to the brain that we are not stuck. It enables problem solving and a growth mindset. Go any time of day to clear your head and set yourself up for better thinking and mood! Consider taking a cold shower or bath: Cold water running over your head and body for 1-3 minutes (or longer) causes a long lasting surge of dopamine, leading to a day of positive mood, better thinking, and focus. It also improves circulation (sending oxygen to brain, muscles, and joints), reduces bodily inflammation, and boosts your ability to fight infections. Deep breathing: Deep breaths (see Breathwork below) bring oxygen to the brain, which improves cognition, problem solving, focus, and attention. It also helps to align your nervous systems (it’s a vagus nerve stimulant), which reduces stress chemicals, establishes a sense of safety (parasympathetic response), and releases positive mood chemicals. Meditation and breathwork are simultaneously calming and stimulating - great to do before work. Aerobic Exercise: Getting your heart rate up releases endorphins and the “Miracle Gro” brain chemical called ‘brain derived neurotrophic factor’ (BDNF). Do this in the morning if you can, but not later than about 6pm (since it will wake you up). HIIT workouts count. Movement is a well-established mood enhancer, compared in studies to be as effective as antidepressants when utilized routinely. Bedtime Hygiene Bedtime hygiene can make all the difference to the quality of your sleep and your ability to awaken rested, focused, clear headed, and in a positive mood. What to do: Evening natural light: Get outside in late afternoon or dusk. Again, perhaps take a walk. Try to be in nature. The angle and light spectrum of afternoon light/dusk cue our circadian rhythms that it will soon be time to relax and sleep. Circadian patterns are critical for balancing hormones like hunger/satiety hormones, insulin, sex hormones, thyroid hormones, melatonin, etc. Indoor light: Artificial light artificially signals our bodies to release cortisol (remember - the wake up chemical). As evening rolls around, keep indoor light as yellow and warm as you can, and turn on as few lights as you need to function. TV and computers are especially stimulating. The blue light of the screens parallel the blue light of mornings. Go to bed earlier than during the lighter months: Your body craves being in sync with the light/dark cycle. Aim for 7-9 hours of sleep, depending on your needs. Establish a bedtime routine: Put away all screens at least an hour before turning off the light. Remove electronics with screens (yes, even cell phones and Apple Watches) from the bedroom. They have a pesky way of keeping your thoughts turned on, even when the gadgets are off. You won’t need to track your sleep when you are sleeping better! Generally do things in the same order: changing into pjs, face wash, teeth brushing, etc. Read before bed, or listen to gentle music. Limit fluid intake in the couple of hours before bedtime so you aren’t woken up with a full bladder in the middle of the night. If you drink alcohol, keep it to a single drink and have it early in the evening. Alcohol disrupts sleep. Meditation, interestingly, should be left to earlier in the day. It stimulates the brain and will cause wakefulness. Mental Hygiene How we manage our emotions and our thoughts deeply influences our perceptions and even how our bodies function. Importantly, the advice I give here may not be adequate for everyone. Please, please seek out a mental health professional (therapist, psychiatrist) if you are depressed for a week or more. What to do: Self-talk: Reframing is a useful cognitive tool. As negative thoughts impose themselves, step back and examine them. Review the thought (maybe even write it down): Is it true? Is it necessary? Is it kind? Is it helpful? Now reframe your negative thoughts. If they’re useful, then translate them into positive language. If they aren’t, ditch them. Social time: Leave the house and be with others! Even if it’s at the grocery! Socializing via Zoom or FaceTime are also good options. Time with others takes us out of ourselves, is energizing, and expands our perspective. Like walking, it can remind us that we aren’t stuck. Meditation/prayer: These both allow for cognitive reframing and the expansion of perspective, and they are vagus nerve stimulants (creating a balance of calm stimulation). These practices open us to subtle energy and what some call a “higher power” that can be profoundly healing. There are many free apps for guided meditations to get you started. Look into Dan Harris’ Ten Percent Happier podcast and On Being with Krista Tippet. Breathwork: So many options, but try one of these if you’re not familiar:
Food The decrease in energy that comes with SAD inspires an innate desire for foods that our bodies know boost energy. Our bodies and brains prefer glucose as fuel, and that means that we sometimes come to crave sources of glucose-rich carbohydrates, from bread and potatoes to cookies and candy as pick-me-ups. It’s not your imagination, and those cravings aren’t you losing control. It’s ok to eat something sweet every day! How you do it for sure can be managed with awareness and intentionality. Along with the energy shifts, it’s no secret that viruses spread more effectively as we live more indoors. These food suggestions boost both energy and immune function. What to do: Eat a source of protein and healthy fat with every meal and snack: Protein and fat take longer to digest, so they make us feel full longer. They also slow down the absorption of those carbs, creating time-released energy without the blood sugar spikes. Think nuts with fruit, cheese and crackers, hummus and crudité. Even add some almond butter to that ice cream. Choose high fiber foods: Fiber! It’s an unsung macronutrient. It also slows down the absorption of glucose while keeping your bowel habits regular (a huge mood boost) and feeding the mood enhancing “good” bacteria in your gut. Sources: vegetables (esp. cruciferous veg & sweet potatoes), fruit (esp. berries), whole grains (esp. whole oats), beans and legumes, and nuts and seeds (check out chia and flax meal) Colorful vegetables: The vitamins, phytonutrients, and fiber are incredible for your immune system. My top recommendations are leafy greens and cruciferous vegetables. You need 1-2 cups of each of these daily. Overall, aim for 5-7 cups of vegetables a day, and I promise your energy and immune system will thank you. Herbs, spices, and green tea all enhance the benefits! Balance your plate: ¼ protein; ¼ grains, or grains and legumes, or starchy vegetables; ½ colorful vegetables. Add 1-2 portions of fruit (esp. berries) daily. Stay hydrated: About ½ of your body weight (if you said ounces instead of pounds. A 120 lb person would aim for 60oz) daily in fluids (not caffeinated, not alcoholic beverages). Soups, smoothies, and watery fruits count. Water and herbal teas are best. Timing: Generally have your last bite of food 3-4 hours before bedtime. Eat again about 12 hours later. There is no need to go longer than that unless you really, truly feel good doing it. Hunger can mask as headaches, brain fog, low energy, mood swings, and irritability, even if your stomach doesn’t growl. Vitamin D: This is one of those eponymous nutrients that has positive effects all over the body. We absorb vitamin D from the sun, and our kidneys transform it into the active form. In the winter, we obviously get much less. Importantly, people who suffer from depression tend to have levels that are very low - in the single digits or teens. A standard normal measurement is 30 ng/mL or above, but the healthiest people measure between 40 and 80 ng/mL. I like to see my clients at 50 or higher. Vitamin D is needed: to lower inflammation (a marker of depression), boost immune function, balance hormone status (insulin, hunger/satiety hormones, thyroid hormones, etc.), calcium stasis, and bone strength. Supplementing may be necessary: It’s hard to take in enough vitamin D via food, and sunlight is not strong enough in the winter months for the body to produce it. Most people benefit from supplementing with at least 2000 iu of vitamin D daily. Have your level tested, and talk with a nutritionist to know whether you would benefit from a higher dose. You deserve to feel good, no matter what the season. Start incorporating these strategies into your routine today, and see how your energy and mood improve. Share this newsletter with your loved ones! Let's support each other through the season, and don't hesitate to reach out if you have any questions or need further support. I honestly would love to hear about your successes and challenges.
May this winter be a time of self-discovery, inner peace, and renewed energy. Volume 107: Thanksgiving Food Safety and Storage: A Comprehensive Guide to a Healthy Holiday11/23/2023 Happy Thanksgiving! Let the feasting begin! Gratitude abounds! Especially from me to you for being part of Inner Workings. Really. Thank you for being here. You’ll want to tag or print this newsletter to support you throughout the busy holidays! We’re talking about food safety: cross contamination, how long food should stay out at what temperature, and how to store it after feasting - or even day to day. Please share this newsletter with others who need to know! And, as always, I invite your questions. (My husband’s aunt used to store their partially eaten stuffed turkey on top of the fridge for days and days after the meal ended. They’d still eat from it. Don’t do that). 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. 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! 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 are critical:
Sneezes and Coughs
Keep Separate Cutting Boards and Containers for Raw and Cooked Foods
Don’t Keep Cleaning Supplies by the Food
Eeeeeewwwww - Fungi/Mold, Yeast, and Parasites - When to Toss the Food
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.
Wash Vegetables and Fruit
Refrigerated Storage
Options for Thawing Frozen Foods - All of Them
The Temperature Danger Zone for Bacteria to Grow This is so important if you have a buffet that lasts for several hours!
Minimum Safe Internal Temperature During Cooking
Cooling Food
Leftovers
Tip of the Month This newsletter was full of tips already!
My tip this month, then, is to suggest you find ways to connect. Remember that no one is perfect. It’s ok to have different opinions - when you hit them, consciously find commonalities instead. Stuff goes wrong, and that’s ok. Seek out hugs. Play games. Take walks. When you need a break, take it. Ask for help. Join in creating a healing community. Love fully from the heart. Blessings on you and your family by blood and your family by choice, now and always. My work focuses on mental health, gut health, and metabolic health. You already know from reading this newsletter that each one of these influences the others. Not surprisingly, there are lots of nutritional and integrative interventions that can support healing these systems. I address one of them in this newsletter thanks to a reader’s question: fasting. You can’t swing a short stick without hitting a podcast or news article about fasting. The data is pretty compelling - but is it right for everyone? I dig into pros and cons, and also provide viewpoints on fasting that often get left out. Reader's Question: “I would love to know more about fasting. It is promoted strongly by some of my favorite podcast sources, and I appreciate the idea of more "metabolic rest" especially for menopausal women, but I find fasting to be stressful, headache inducing, and maybe not worth the benefits.” Fasting is one of the darlings of the nutrition world. The evidence promises health improvements across the body via a very straightforward, free-to-use route: simply don’t eat periodically for an extended period of time. The research literature supports this intervention. Certain models of intentional fasting have demonstrated routinely improved: blood glucose levels, insulin sensitivity, use of fat for energy, weight management, mitochondrial health/energy production, brain health, and mood; and a decrease in inflammation, cancer cell proliferation, oxidative stress, cardiovascular disease, and mental illness. So much to like, right? I would be remiss in not pointing out that some form of fasting is an ancient ritual in each of the world’s five major religions. Those who participate report a remarkable feeling of lightness and being closer to their higher power. Often this is a water fast, limited food over a day(s), or a dawn to dusk fast, as in Ramadan, and typically it is in combination with prayer and other religious practices. How is fasting done? Just so you are in on the lingo, in the medical and nutrition worlds “fasting” means a period of time of not eating. “Fed” or “feeding” indicates times of consuming food and the post-consumption metabolism of it. So in research, they distinguish between a “fasted state” and a “fed state” for a subject. A “feeding window” indicates how many hours a day are designated as available for food consumption. At the American Nutrition Association summit in October, I heard a compelling presentation by Sebastian Brandhorst, PhD of the Longevity Institute on the role of fasting in healthy aging. Spoiler alert: fasting supports longevity. He defined the primary forms of intentional fasting this way:
Time Restricted Feeding A TRF feeding window can be as narrow as 4 hours to as long as 12. TRF follows circadian light/dark rhythms - eating during the day and not overnight. The last meal is no later than early in the evening, and the next meal is taken sometime after waking the next day. This provides the body time to focus on tending to itself: sweeping out metabolic trash, repairing, rejuvenating, and building, which is what it does during the quiet hours of night and sleep. A second longevity expert, Dr. Kara Fitzgerald, whose life work researches healthy aging using food and lifestyle, points out that the benefits of TRF can be reached with a mere 12 hour stretch of not eating between dinner and breakfast. Finish dinner at 7:00pm, and eat again as early as 7:00am. Voilá! You have done time restricted feeding. Some choose TRF daily, and others insert limited feeding windows a few times a week. It’s a flexible method that can be individualized. Dr. Brandhorst described that there are many benefits to TRF. One is that humans are social, and social factors influence when we eat. TRF days and timing can be chosen by the individual and so can be socially adapted. A key point is that TRF does not restrict calories. The health benefits echo the ones described in my first paragraph, with the bonus elements of an improved quality of life, higher energy, more restful sleep, and lower hunger at bedtime. In short, TRF enhances both lifespan and healthspan. What could go wrong? Going to my reader’s question, TRF, especially with a longer fasting window, can be a trigger for those who have low blood sugar or suffer from migraines. Those who suffer from chronic stress, including the stress and energetic drain of poor sleep, also may feel worse trying TRF. During these times, the body requires more support nutritionally and regular energy inputs. Remember that lengthy periods of fasting or highly calorie restrictive diets can deplete nutrients, even with refeeding. Too short a feeding window can prevent consuming the amount of food/nutrients (both macro- and micronutrients) that our bodies need. If you are already consuming the minimal amount of calories your body needs to function well (a form of mild CR), adding TRF may tip into damaging instead of health promoting. TRF can undermine our health if we don’t start with a foundational food plan that is nutritionally rich. A body that already experiences nutritional deficits will suffer rather than improve, especially as a fasting window is widened. On top of that, most who feel deprived on a fast (especially CR) are more likely to react with a binge - either because their body is desperate for easy energy or because they feel psychologically isolated from the pleasure of food - or both. Pregnant and nursing people should not participate in TRF - or any fasting - due to the need for regular energy and nutrient intake. If you want to try TRF, choose the least limited fasting window of 12 hours and see how it goes. Widen the fasting window gradually (or don’t!) to find your own sweet spot. Remember that TRF does not need to be daily or even weekly, and you don’t need to choose it at all. What else should I know about fasting? There’s one concern I always have about any program that restricts food in any form: could it trigger health issues, a disordered relationship with food, or an eating disorder? The fewest health benefits and the biggest risk comes from extreme calorie restriction (CR). Dr. Brandhorst explained that it does not provide lasting benefits for weight loss or cardiovascular disease. In fact, he rather dryly pointed out that starving animals live longer - unless it’s overdone and they die. Too many commercial weight loss diets involve a form of CR fasting that ultimately results in muscle wasting and nutrient depletions. They are unsustainable and eventually fail those who try them, often triggering new health problems, disordered eating, body distrust, and eating disorders. I suspect this topic is of interest to many, so I will happily explore it more deeply in another newsletter. From my viewpoint, any fasting program has the opportunity to lure the participant into ever more extreme versions of itself, especially with promises of weight loss or the new shiny object - living long past 100. This is a significant disordered eating/eating disorder risk factor especially for tweens, young adults, and - surprise! - middle aged women. Take-Home Message Well managed Time Restricted Feeding can be an incredible way to shape our health for the better.
A key point of any eating plan is tuning in to how it makes your body feel. If it’s not working, become aware of what’s not right for you so that you can make choices that help you feel most well. |
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
March 2024
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