Can you fight your genes? The importance of healthy lifestyle factors in gene expression.

Genetics. It is a hot topic right now. Well, it has been a hot topic for quite some time, ever since the human gemone project was completed in 2003. We now have the ability to look at someone’s unique DNA and assess risk for a host of health conditions. In many cases, we do not even fully understand the impact of DNA aberrations as many abnormalities have not yet been well studied.

Genetics is also very hot in the nutrition world right now. Why? Because we now have advanced testing that can give us specific information related to how a person’s body responds to various inputs: diet, stress and the environment. We are also uncovering specific genes related to body weight, blood sugar control, brain health, autoimmune conditions, etc. 23andme.com, which you have likely heard of, is one of the leading companies in this arena right now providing raw genetic data to clients across the country.

While this information is useful (and believe me, it can be really, really useful), there is also the danger of believing our genes determine our destiny. It is a common belief that if you have genes for obesity, for example, that at some point you will become obese. That same can be said for alzheimers disease or celiac disease. The thinking is that if your genes point you in any one of these directions, there is nothing you can do to avoid the progression. Might as well eat that doughnut and sit on the couch a little longer because at the end of the day, what can you do to stop it?

Thankfully, that is not true! Lifestyle choices DO matter, and they matter critically when it comes to gene expression. The key point is this: just because you have “bad” genes does not mean that they will express. Take the person with genes for celiac disease. There are actually many people who have those genes and yet never get the disease. How can that be?

Well, in celiac disease, according to Dr. Alessio Fasano, you need three things for the celiac gene to turn “on.” You need to have the gene, obviously. You need to have gluten in the diet. And you need to have an environmental trigger. Ah, an outside trigger! That is one of the key ways genes express. Take a moment and think about what an outside or environmental trigger might be……..

Yep, likely you named a few. How about emotional stress? Physical stress (extremely hard labor, over-exercising)? Poor diet? Substance abuse? Illness? Fatigue/lack of sleep? Toxins?

That brings me to the latest study I read that hit home on this very fact. Lifestyle influences genes. Your genes do not determine your destiny….. necessarily.

The study, conducted in the UK, looked at genetic data and self-reported lifestyle choices from over 360,000 middle-aged subjects. Their primary interest was to see how various lifestyle factors affected the risk for obesity in people with genetic markers predisposing them to excess weight.1

When they analyzed their data, three points stood out. Those with a lower socioeconomic status showed an increased risk for obesity. Presumably this is due to poorer diet choices, increased stress, and other factors related to being low-income. Those with regular exercise showed a significant decrease in their risk for obesity, as well as those subjects with regular alcohol consumption. While clearly more studies need to be done, we can definitely start to see that certain lifestyle choices play a role in how genes express.

What is the take home message then? Drink more alcohol? No, sorry, this is not an article sponsored by Smirnoff. The main message is this: consider your lifestyle choices more than your genes.

Think of it like this, as I learned in a recent webinar by Dr. Ben Lynch. “Bad” genes suggest susceptibility, not cause. Knowing your genes allows you to understand where you are susceptible, but it does necessarily determine your fate. So, as much as you can, take your health into your own hands.

Don’t let anyone tell you diet doesn’t matter. Don’t let anyone tell you exercise doesn’t matter. Don’t let anyone tell you stress doesn’t matter. It all matters. Obviously no one can achieve perfection in any of these areas, but do what you can. It not only makes you feel better, but your genes feel better too!

If your lifestyle just isn’t up to par and you feel lost, please reach out! That is what dietitians are for! The focus of my job is food and healthy lifestyle and I have LOTS of pertinent information to share. Drop me a line!

1. https://www.sciencedaily.com/releases/2017/09/170906103749.htm

Hitting Home the Importance of Fiber

I know, you probably think you have heard enough about fiber over the years. Well guess what, you haven’t. We certainly talk a lot about fiber but Americans continue to eat less than is recommended. The average American maybe eats 15g of fiber per day, and we are supposed to get at least 25-38g (female vs male) in a 24-hr period. That might even be conservative given that fiber intake in other cultures can reach levels much higher.

Previously we have always hyped up fiber for its benefits in weight control, heart health, and digestion. It helps to keep us full, which decreases overall caloric intake, and fiber is associated with improved cholesterol and blood pressure. Fiber also bulks up stools and helps keep us regular. Clearly, it is an essential part of our diet.

But its importance is becoming even clearer as we delve deeper into the studies on the complex system of microbes living in our digestive tract, the “microbiome” as we call it. Study after study is showing that the type of microbes living within us either contribute to good health or detract from it, and studies also show that the types of foods we consume, particularly fiber, play a huge role in determining its overall influence.

For example, a recent study came out showing that walnuts might help support healthy flora in the gut.1 Rats given diets supplemented with walnuts showed an increase in the diversity of bacterial species in their guts over the non-supplemented animals. Walnuts acted as a pre-biotic food, feeding the beneficial bacteria and helping their colonies increase. While we have many known prebiotic foods already (I have handouts on these!), walnuts, at least to my knowledge, have never been on that list. Better get to adding it!

So yay, walnuts are good. But the thing is, as more of these studies are done, I think we will find that all fibrous foods are prebiotic to various extents. In fact, diversity of fiber is probably the key to optimal diversity of gut microbes. These one-off studies, while helpful no doubt, are to many people a simple suggestion to add a few more walnuts here or there, or whatever food the researchers are reporting on that week.

In reality, the take home message is that we need lots of fiber, every day, from whole foods sources, and we need to get rid of the non-fibrous, nutrient-empty foods that clog up our diet. A handful of walnuts in addition to your morning bagel and venti coffee is not going to cut it. We need to be intentional about the choices we make and ensure our meals are full of diversity and fiber.

What does this look like? I think that is the biggest hurdle for most. The grocery stores are not exactly helpful in this area as they seek to entice us with processed and “convenient” options, most of which are extremely low in fiber. Meals still can be quick, but you have to think ahead and make careful choices. To get you started, here are a few ideas:

Breakfast:

1. Yogurt bowl: Grass fed Greek yogurt with ¼ cup granola, 1 tbsp flax seed, 1 tbsp hemp hearts, ½ cup blueberries, ¼ cup chopped walnuts, 1 tbsp honey
2. Oatmeal: ¾ cup oatmeal with 1 tbsp flax seed, 1 tbsp hemp hearts, ½ cup berries, ¼ cup chopped walnuts or other nut, 1 tbsp honey or maple syrup. Alternatively, instead of oats, use cooked quinoa as your base and add same ingredients.
3. Egg scramble: 2 eggs, 1 cup diced mixed veggies, ¼ cup grated cheese, ½ banana on the side
4. Toast & Fruit: Piece of whole grain toast with 1 tbsp almond butter with apple slices or other fruit
5. Chia seed “pudding”: Chia seeds soaked in coconut milk, then add ingredients just as you would with the yogurt bowl
6. Breakfast smoothie: Milk of your choice, protein powder, frozen berries, 1 tbsp flax or chia, handful of spinach or kale, sweetener if needed (try stevia)
7. Egg “hash:” Take cooked kasha groats and top with egg cooked sunny side up, add black beans or baked sweet potato on the side.

Lunch/Dinner:

1. Sandwich: High fiber whole wheat bread with deli meat or PB&J.
2. Wrap: Whole wheat or gluten-free tortilla w/ hummus, leafy greens, deli meat
3. Soups: chicken/veggie, bean soup, etc
4. Stir-fries over quinoa or brown rice
5. Pasta using whole wheat noodles and meat/veggie sauce
6. Curries

Snacks:

1. Piece of fruit with handful of nuts
2. High fiber protein or granola bar
3. Kale chips
4. Homemade whole wheat or bran muffins
5. Veggies dipped in hummus or bean dip

See? So many options besides cereal or the morning pastry. A million more ideas instead of hamburgers or grab n’ go sandwich on white bread. You just have to be intentional. No, most often you cannot simply walk into a store or restaurant and find one of these options on your way into work. You have to plan ahead and do a little prep in advance.

Remember, health doesn’t just happen. You have to work at it. Anyone training their body for an athletic event knows this. It’s the same with your diet. YOU have to make it happen. So no more excuses about not having time or not being to find these things at your local Starbucks, ok?

Go to the grocery store after work and have these ideas ready to go. Pack along a cooler or other mode of food transport so you can take these things with you. Do not let others dictate what you eat for sake of convenience. Make it happen! Your body (and especially your gut microbes) will thank you.

1. https://www.sciencedaily.com/releases/2017/07/170728100832.htm

More Harm than Good? The Health Risks of Proton Pump Inhibitors

proton pump inhibitorAre you one of the millions of Americans currently taking a proton pump inhibitor (PPI) medication? If so, please read on. There are many health concerns coming to light regarding the use of PPIs, including this recent study (see link below), suggesting an increased risk of death with long term use. Yikes! It may be time to talk with your doctor to see if continuing with such a medication may cause more harm than good.

As you are likely aware already, PPIs are commonly prescribed for digestive concerns such as acid reflux (GERD) and ulcers. Common brand names include Prilosec (Omeprazole), Protonix (Pantoprazole), Prevacid (Lansoprazole), among many others. Their primary goal is to reduce the secretion of stomach acid, thereby decreasing GERD and/or allowing ulcerative tissue to heal. Once symptoms subside, the medication is intended to be gradually discontinued.

How do PPIs work? Well, the lining of your stomach contains cells called parietal cells. These cells, through a cascade of enzymatic reactions, make hydrogen ions. These hydrogen ions are then secreted into the stomach where they help form a mixture of hydrochloric acid, potassium chloride, and sodium chloride, aka stomach acid.  PPIs do their job by inactivating this enzyme sequence, hence far less hydrogen ions are pushed out into the stomach. The end result is less production of stomach acid. Less stomach acid means less reflux and less irritation of ulcers. Seems like a perfect solution.

But the problem is………we actually need stomach acid. Long term suppression can lead to a cascade of other health complications.

For starters, stomach acid helps break down proteins, a process called proteolysis. I think we all agree getting enough protein is important, and the acidity of our stomach helps make sure we can utilize what we eat.

Secondly, HCL helps improve the absorption of several key vitamins and minerals that our bodies need. Without stomach acid, many of these nutrients cannot be unbound from their protein carriers and/or transformed into their absorbable form; therefore absorption is impaired. Some of these include calcium, iron, magnesium, and B12.

Thirdly, HCL in the stomach acts as an important protective barrier against unwanted bacteria and helps maintain healthy flora in the intestines. Studies have found that PPI users have an increased risk for C Diff, Listeria, Salmonella, and other pathogenic bacteria which can not only cause illness but also long-term imbalances in the intestinal microbiome.

In light of this, it is not surprising that long term use of a potent acid-suppressing medication can have harmful effects in terms of nutrient status and overall digestion. Could the increased risk of death indicated in this recent study be linked to this? Possibly. Certainly causes one to pause and consider.

But there is more. Apart from decreasing stomach acidity and impairing digestion, PPIs have other equally and potentially more dangerous side effects that should not be overlooked.

One recent study found that PPIs interfere with an enzyme that supports nitric oxide (NO) production in the body. NO is an important compound for cardiovascular health; it allows dilation of the arteries and improves blood flow. Reduction in NO may contribute to cardiovascular complications in some people.

Other studies have shown increased damage to the kidneys with long term PPI use. While the mechanism is unclear, PPI use is linked to increased risk for chronic kidney disease and end-state renal disease.

Could these be linked to the increased risk of death found in the aforementioned study? More points to ponder.

The main point is this: PPIs were not intended for long-term use and their use does not come without risk. This recent study simply highlights that there are in fact risks and users need to be aware of these when making their medication decisions.

If you are using PPIs and have been doing so for quite some time, please talk to your doctor. Proton pump inhibitors are just a band-aid for a deeper medical issue. Ask your doctor to help you find the root cause. If they have no solution, talk to an integrative health specialist and keep searching. Take your health care into your own hands. This latest study should be a wake-up call to do just that.

If you and your doctor do decide to wean off the meds and you are curious about other ways to repair your digestion, I would love to talk with you. We can find a way for you to be symptom free…..naturally. Diet is a key component and I have many ideas to share!

What is Functional and Integrative Medicine?

integrative medicineThere are many of us nutrition professionals now aligning ourselves with Integrative Medicine. I consider myself in this group. Maybe you are asking yourself what exactly this is and most importantly, does it really matter?

To answer that question, let’s first address the area of conventional medicine. For some time now modern medicine has sought to treat the presenting symptoms. This might mean treating a fever or a cough, for example, or addressing pain or other discomforts. Sometimes this approach is entirely appropriate, however more often this approach misses the underlying cause and the person is never completely restored to health. Think of lingering health conditions such as acid reflux, chronic fatigue, and headaches, just to name a few. Drugs are often prescribed and the patient is sent on her way, but the symptoms persist if the drugs are discontinued.

Additionally, there is very little discussion with the patient as to how their condition came about. Unfortunately, and not the fault of our doctors, there is limited time available to spend with patients and so remedies must be delivered quickly. Without more in-depth dialogue there is little chance the practitioner even has the opportunity to see below the surface of what is really going on.

From a dietetic perspective, a conventional approach to diet intervention would be something like prescribing the same diet to everyone with the same disease. Everyone with heart disease would get guidance on the exact same heart healthy diet, for example, with no consideration given to their culture, preferences, cooking ability, or genetics. Similarly, a person seeking to lose weight would be advised on the same general diet as another without consideration given to what they’ve tried in the past or an understanding of what foods work or don’t work for them. These would be examples of conventional approaches.

Now let’s flip to the functional side. Functional practitioners are looking less at masking symptoms and more at how the body is functioning as a whole. They are attempting to uncover where the body is malfunctioning and how can we restore it to its normal, healthy state. Symptoms are just clues to lead us towards the underlying cause.

In addition to symptomatic clues and obviously a physical exam, if appropriate, functional medicine practitioners are also looking in-depth at a person’s unique health history to find more clues as to how and why the body is not functioning as it should. This means sitting down with someone for a significant length of time (often 45 min to an hour) and asking a series of pertinent questions to paint a picture of the person before them. What might seem off-topic to the patient is often valuable information to the practitioner, as random side notes about vacations, new pets, change of jobs, or significant loss can give further clues into a person’s current state of health. These are topics rarely discussed in the conventional model.

Additionally, if necessary, laboratory tests can be conducted to give further insight into treatment options. These might include not only standard blood work but also food allergy tests, digestive stool testing, hormone testing, etc.

The goal then, after this information is obtained, is to determine how to best gently nudge the body back into an optimum state. Pharmaceutical options are a last resort as we know these only mask symptoms and leave the original condition unresolved. Potential nutrient deficiencies are often addressed, exercise recommendations may be made, and stress reduction techniques might be employed as well. Some may go further and prescribe other treatment modalities such as massage, acupuncture or chiropractic care to complement their recommendations. Once initiated these treatment plans often need time. Patients do not develop chronic health conditions in a day or even a week. Likewise these treatments need weeks if not month to restore the body to proper function and balance.

So how does this model work for the dietitian? Thankfully, we already have the immense fortune of being able to sit down with someone for a good hour or more to delve into health and diet history. This gives us a solid place to start when it comes to tailored diet advice. While we are not credentialed to prescribe or “treat” per say,  this time allows us to get a full picture, both past and present, of what clients are dealing with; therefore we can devise and educate on an appropriate diet strategy. Often we suggest helpful supplements as well, especially where nutrient deficiencies are apparent. We can also advise on exercise and stress and provide additional referrals when needed.

While both modalities have their place, consider looking into functional medicine, especially if you have chronic conditions that the standard medical model is not effectively addressing. Remember, more medications is not necessarily the answer and in fact can lead to yet more symptoms that require more drugs. Believe me, I have clients in these predicaments and it’s a slippery slope.

So consider seeing a naturopath, a functional dietitian like myself or other holistic care providers for a more thorough look into your condition; or even consider it for another opinion. It just may be the nudge your body needs to finally heal and restore.

Of course, if you have questions or want to talk, please reach out! I have loads of referrals if you are looking for a qualified practitioner to meet your unique needs.

 

Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net

Smart Summer Snacking

healthy snackSummer is just about here….we in Seattle can feel it. It’s been a long winter. Finally the days are longer and we are getting outside. More importantly, many of us are planning trips, outings, picnics, etc. What do these things always involve? FOOD of course!

With all this movement out and about, eating healthfully can be tricky. Many of us end up snacking more than normal as we end up in different environments with less access to our typical go-to foods. The temptation to swing into a gas station mini-mart or fast food becomes all the more tempting. Unfortunately these places rarely have healthy options, and even when they do, who actually buys them? Be honest here.

The key to solve this problem? Planning! Plan, plan, plan. Did I say plan already?  You HAVE to plan ahead. Yeah, maybe it takes the spontaneity out of things, but there are plenty of other opportunities for exciting food adventures besides those you might encounter driving down I-90 or on a 5-hour plane ride. Plan some snacks, pack them with you, and stay healthy and energetic throughout your trip.

What to pack on the road? I’m glad you asked. Here are some simple, car-friendly and flight-friendly options to get you through until your next exciting meal can be enjoyed. These can also make great meal replacements in a pinch when no healthy meal options exist.

Nuts
Nuts are your friend. They pack a good deal of calories, so portion accordingly, but they also have healthy fats, fiber and protein. Pick your favorite and parcel into plastic baggies or just tote the whole darn bag and share with your travel mates.

Dried Fruit
Yeah, I know dried fruit has carbs. They have a lot of carbs. But they also have vitamins, minerals, fiber and antioxidants. If you portion them correctly you do not have to be afraid of dried fruit. It too is your friend and makes a great travel companion. They pair fantastically with nuts or other protein options.

Dried Vegetables/Legumes
Dried vegetables? Indeed, I have been seeing more dried veggie options in the stores these days. From kale chips to crispy beets to baked chickpeas, there are more savory dried options that are travel friendly. While some may contain oils and flavorings that might be less than ideal, we are still doing better than chips, candy and fast food, right?

Bars
Bars can be risky. I always hesitate and clarify when I recommend bars. Many are loaded with sugar and beefed up with cheap protein fillers and poor quality vitamins. That being said, there are actually some decent options out there with high quality ingredients and actual nutrition. What do I look for? First off I check the ingredients. Does the list run 4 lines long and contain many unpronounceable words? Put it back. For me, the less ingredients the better.

Also check the nutrient label. How’s the calorie count? Protein content? Fat? In a perfect world I’m looking for 200kcal or less (could be more if substituting for a meal), 8g of protein or more, and a fat content that does not seem obscene (less than 15g, perhaps?). Then I’m looking for simple, whole foods ingredients that I know are providing my body with nutrients and don’t require the manufacturer to add in a host of artificial vitamins to make sure it’s well balanced. I like to see nuts, seeds, grains, fruit, etc. Some might add whey or plant-based protein to pump up the total protein content, which I am fine with. Avoid soy protein isolate.

Now, there are a bazillion bar options out there and I am no expert on them all. I will list a few options I like here, but do realize this list is by no means exhaustive. If you find a bar that meets your personal criteria and you like it, go for it! Here are a few I’ve found that I will travel with in a pinch. I believe most of these avoid the common allergens as well so great options for those with food restrictions. Check out their sites for ingredients and places to purchase.

Rx Bar
https://www.rxbar.com/

Macro Bars
https://gomacro.com/shop/product-category/macrobarminis/

Epic Bars
https://epicbar.com/

Primal Kitchen
https://www.primalkitchen.com/products/almond-dark-chocolate-bars/

Pro Bar
http://theprobar.com/#2

And if you have the time, make some bars yourself! On my last trip overseas I planned ahead by making a batch of protein balls and packed them in my carry on. They made a great treat when the food cart came around and there were very few options I deemed acceptable to eat. Homemade gourmet for the win!

Hope these ideas help you plan more effectively for fun and sun this summer!

If you have your own go-to travel snack ideas, please share!

 

Image courtesy of SOMMAI at FreeDigitalPhotos.net

What is Pre-Diabetes?

prediabetesMost of us have heard plenty about Type 2 Diabetes. It is a serious condition causing abnormal elevations in blood glucose levels. Type 2 Diabetes now affects over 29 million Americans and is costing the healthcare system over $300 billion annually.

The cause of Type 2 Diabetes is multifactorial. A high BMI with an unhealthy diet is often the main culprit, but genetics may play a role as well.  Over time, diabetes leads to a host of other diseases, which is where the most considerable health damage is done. These include conditions such as neuropathies, heart disease, stroke, infections, and poor wound healing.

In terms of diagnosis, your doctor will sound the diabetes warning bell if you have an HbA1c above 6.5 and a fasting blood sugar over 125. Treatment often begins with drugs (Metformin is usually the first option) and diet and lifestyle recommendations.

But…..now more frequently we are hearing about what is termed Pre-Diabetes. Yikes, another type of diabetes? Well, sort of, but not exactly. Pre-diabetes is basically the beginning stages of blood sugar irregularities.  It is a critical point where we can catch people before they become full diabetic and in many cases even reverse the progression.  It is important that we all get a better understanding of this condition so we can combat the rising rates and healthcare costs of diabetes. To that end  let’s review the definition of pre-diabetes, the associated health risks, and effective preventative measures.

We already reviewed the diagnostic criteria for diabetes. For pre-diabetes, the ranges are just slightly lower. If your fasting blood sugar is running anywhere from 100-125 and your A1c comes back anywhere from 5.7 to 6.4, you will likely be labeled as pre-diabetic. This puts you at significant risk for diabetes within the next 4-10 years unless steps are taken to return your blood sugar to an ideal range.

This is where I would ask, if you happen to have them on hand or online, to go check your labs. Seriously, go check them! See where your fasting blood glucose is at and determine if you’ve had a recent A1c. The reason being? Many doctors are not diagnosing pre-diabetes. Studies have shown we have an under-diagnosis problem in this country when it comes to pre-diabetes. I’ve seen many clients in my office with pre-diabetic numbers and yet no one told them they were pre-diabetic. So yes, go check.

It is so valuable to know this information because pre-diabetes is EASY to treat with diet and lifestyle change. The studies show that diet and lifestyle are the number one way to reduce blood sugar numbers in pre-diabetic patients. Once you progress to full diabetes the chance of returning to normal blood glucose is much, much harder. NOW is the time to take action and correct.

If you are pre-diabetic and want to take steps now to avoid becoming diabietc, here are a few of the researched ways to get those numbers back under control.

DIET
Not surprisingly, diet of course is the primary area to address. From the research we see that that reducing carbohydrates helps immensely, as does decreasing overall calorie intake such that weight loss occurs. When diet and weight loss are tackled together, blood sugar begins going in the right direction as well. What kind of diet you ask? Multiple studies show the Mediterranean diet is a very helpful roadmap for an overall healthy diet. Thankfully multiple books, cookbooks, websites, and blogs have been devoted to this way of eating. Another similar approach is the anti-inflammatory diet. In both cases, think fruits, veggies, lean protein (especially fish), nuts, seeds and legumes…..you get the idea.

WEIGHT LOSS
As alluded to, weight loss is extremely important in normalizing blood glucose levels. In many studies they have found weight loss to be the most important factor in reducing diabetes risk. The theory is that being overweight increases inflammation in the body. Once the weight comes off and the inflammation subsides, blood glucose begins to return to normal. Of course diet is always interwoven with weight loss, so likely the diet plus the decrease in weight is working together. Whatever the cause, include modest weight loss in your plan and you should see results.

EXERCISE
Naturally we cannot talk about diet and weight loss without including exercise. Exercise helps support weight loss which we know improves blood glucose. Apart from helping with the weight, exercise also helps improve insulin sensitivity and increase metabolism, all of which help us clear sugar from the bloodstream more efficiently. It also supports a healthy heart and improves circulation, both of which are negatively impacted by high blood sugar.

DRUGS
In some cases, drugs are employed to help in the pre-diabetic state. If diet and lifestyle changes just aren’t working, or maybe you are at a place where you cannot implement these changes, doctors may prescribe drugs such as Metformin to support healthy blood glucose levels and slow the progression towards diabetes. Of course diet and lifestyle change remains paramount components, but drugs can often work in conjunction with other treatments when necessary.

SUPPLEMENTS
As you are likely well aware, there are many supplements on the market for diabetes. They are often marketed for pre-diabetes as well. Some of the ones you may have heard of include cinnamon, alpha lipoic acid, chromium and Omega 3’s. All of these have shown some promise in various studies conducted. While they can help support improved glycemic control, remember that diet and lifestyle changes are always the most important. Never rely on supplements as your primary means of blood glucose control.  They show modest results at best. Like medications, they can be helpful in conjunction with changes in diet, exercise and weight control.

Hopefully this review gave you a quick glimpse into pre-diabetes and a better understanding of where you stand in terms of blood sugar health. Like I mentioned, always review your labs and be keep tabs of where you are at. While doctors are very knowledgeable, sometimes they miss these early stages of disease where small changes now can lead to big decreases in risk later. Take control of your health and be on top of your numbers.

If you do find that you are pre-diabeteic, one of the best things you can do is talk to a Registered Dietitian! In fact, a recent study conducted found that RD’s were more effective in delivering health information to diabetics than other types of practitioners, resulting in greater improvement in diabetic markers over a 12-month period. What makes our job so great is that we get to sit down with clients one-on-one for up to an hour, really drilling down on each person’s unique diet and situation. We customize the plan to fit the client instead of forcing people to adhere to some standard regimen on a piece of paper. As the research shows, this results in better compliance and bigger changes in blood glucose.

So….along with knowing your numbers, know a dietitian! Get some support if you are looking to navigate new changes in your diet and overall health! That’s what I’m here for.

Are Supplements Necessary?

supplementThere has been a lot of talk regarding the necessity, or not, of vitamin supplementation. Some argue that our poor, inadequate diets require it. Others purport that we glean enough from the variety of foods we eat in addition to fortification of grains, so taking supplements is just a huge waste of money. Who are we to believe?

I get asked this question every day. “Should I be taking a supplement?” My answer? It depends. I agree that not everyone needs a supplement. Our ancestors went without popping pills every day and arguably did ok, in most cases. Maybe this fight against supplementation is warranted. On the other hand, we all know people and specific cases where supplements were extremely helpful. Iron deficiency, B12 deficiencies, and Vitamin C deficiencies are just a few examples. Also those with clearly inadequate diets would, I believe most would agree, benefit from some sort of supplementation.

What is the correct answer then? Again, it depends.  There are so many factors that should go into the decision of whether to take a vitamin or not. Despite what online articles might tell you, it’s not a black or white issue. Let’s walk through the areas I typically assess with clients to determine if supplements are worth considering.


1. The number one factor I assess when determining the need for vitamin supplementation is the client’s current diet. Are they getting a varied diet, supplying a variety of nutrients throughout the day? Or, are they eating the same foods every single day, many of which are nutrient-poor? If the client’s diet is not meeting their needs, of course the first step is to help them correct the issue. Along with better diet, however, supplementation can be helpful in rebuilding nutrient stores in the body. Sometimes we recommend specific nutrients of concern, say calcium, Vitamin D, B vitamins, etc, and other times we go straight to a multivitamin to help cover all the bases. Our goal is to support health through optimal nutrient status, and supplementation, at least in the short term, is one way to help clients achieve that.

2. The next factor I always address is overall health. Are there specific disease states that my increase the need for certain nutrients? Are there potentially genetic factors whereby the client does not use nutrients as optimally as they should, thereby requiring a higher intake to enhance absorption? In these cases, short-term or long-term supplementation at regular or sometimes much higher doses are warranted. Please note that vitamin supplementation for disease conditions or at higher doses than commonly recommended should be evaluated by a medical practitioner before commencing.

For example, some diabetics may be deficient in chromium. Chromium is a micronutrient that works with insulin to help it do its job. Obviously insulin function is very important to a diabetic, hence a diabetic might consider chromium supplementation in their treatment plan.

In terms of genetic issues, one example is someone with the MTHFR mutation, which causes a defect in the enzyme that helps convert folate into methyl-folate. Methyl-folate then goes on to make another product called SAMe via another enzymatic process, which is then used used in hundreds of reactions throughout the body. If someone is not utilizing their folate as they should, symptoms can result. Supplementation can be a huge and necessary help.

3. The third area I address is lab data. Does the client have lab results reflecting overt deficiencies? Often many people don’t even realize they have a deficiency until testing is done to assess. Based on lab data we can pinpoint appropriate supplements that might be necessary in the short-term to correct a nutrient problem before it becomes a major health concern that they do realize.

4. And the last area I assess is general need based on location. I live in the Pacific Northwest. We are chronically Vitamin D deficient. Almost all of my clients should be taking some level of Vitamin D. Iodine is another example. Some parts of the country and in some communities in particular iodine-rich foods are almost non-existent. These groups might benefit from standard supplementation when there are known, widespread deficiencies.


So now that we have a better understanding of how to assess when and where nutrient supplementation might be needed, the next big question I often get is asked is, “Does it matter which brand I take?” The answer to that question is yes!

Quality is a huge concern in the supplement world. That is probably the number one reason supplements in general have a poor reputation. Numerous reports and studies have caught supplement manufacturers lying about the contents of their products or outright deceiving customers on what they even contain.

You may remember this story from a couple of years ago where several herbal products in common retail stores (Target, various drug stores) were tested for authenticity. They found that many of the products they looked at did not even contain the herb listed. In fact, some were filled with common houseplant substances instead of the healing herb they were touting.1  I can see why consumers would be suspicious. (see story link below)

Clearly, you do need to be careful about the products you choose. Unfortunately the choices are overwhelming, even to me! How do you decide?

The easiest answer is to ask your health practitioner what, if any brands, they use or recommend. I personally have my go-to’s that I know are safe and effective. Other practitioners have their trusted products. Typically these are from well-known, established companies with documented testing procedures, quality control measures, etc. Many of these brands are trusted and recommended by doctors, naturopaths, dietitians, and chiropractors. Some can be found at your local supplement store, and others need to be obtained at a natural pharmacy or online. Almost none, just for reference, come from the local drug store (Walgreens, Rite Aid, etc). It’s usually best to buy from a reputable supplement store, and even better to walk in with a specific product in mind, lest you get confused and/or tempted by the multitude of options.

Conclusion? Despite what media reports might say, supplements can be useful. Does it mean you need to run out today and get a general multivitamin just to be safe? Absolutely not. The key above all else is to improve your diet choices for optimal health and then evaluate if further “assistance” is needed. Don’t pay attention to all those latest fads on TV telling you what you need. Eat healthy, listen to your body, and employ the advice of a qualified health practitioner to better assess what supplements would be helpful, if any. You will save yourself a lot of time and, not to mention, a heap of money.

If you are not feeling at your best and wondering if supplementation is something you should consider, or if your medicine cabinet is jammed full of supplements and you are not sure if they are the right ones, reach out! We can do a general assessment to figure out what you need to make sure your body is working at its best.

1. https://www.washingtonpost.com/news/morning-mix/wp/2015/02/03/gnc-target-wal-mart-walgreens-accused-of-selling-fake-herbals/?utm_term=.1618f3899833

Turmeric: Nature’s Wonder Drug….. or Not?

Unless you’ve been living underground, you have likely heard an overwhelming amount of information related to turmeric this past year. Somewhere along the way it was awarded super-spice status and now can be found almost anywhere you look, from supplements, to grocery store products, to even toothpaste!

The benefits of this wonder-spice are mainly anti-inflammatory in nature and for that it has been reported helpful in many diseases such as heart disease, diabetes, depression, and possibly even cancer. In Indian culture they even use it topically to speed wound healing. What can’t this spice do?

Recently, however, a report came out saying that we were duped. Curcumin, the active ingredient in turmeric, has little bioactive activity in the body. The report pointed out few studies showing curcumin itself to have any health benefits, and that in fact the compound often breaks down before it can elicit any sort of positive health impact.1

Oh no! How could we have gone so far astray, especially regarding an ancient spice that has been used for centuries therapeutically in other countries? Is it simply placebo affect?

Let’s hold up for just one second. For starters, before we go dumping all our turmeric capsules down the toilet, let’s read the article fully. What exactly are they saying?

Pay careful attention to the wording. The author in this article is mainly discussing the inability to successfully create a drug utilizing curcumin. Essentially they are saying we have been unable to isolate this active compound in such a way that has a positive and reproducible affect in the human body. Instead of acting on a target protein as they had hoped, the compound broke down and apparently produced no anti-inflammatory result. The article then goes on to say that we have very few published studies to show any benefits from turmeric, and specifically, curcumin usage, so in their conclusion, the time and money spent on turmeric is worthless.

That is all very interesting, however it is also misleading. First of all, just because they cannot isolate curcumin in a stable form suitable as a drug does not mean that curcumin does not work. The body, as we discover daily, works in mysterious ways. Simply because curcumin does not work on one specific target protein does not mean that it is not producing health benefits by other means.

Secondly, we do in fact have some studies to show beneficial affects. Do a quick search on PubMed and you will see what I mean. Some of these studies use the isolated curcumin, and others use the turmeric whole. Both do have research to show some effectiveness. One study, in fact, showed that turmeric was just as effective as ibuprofen in reducing pain from osteoarthritis.2 That is exciting news if you ask me! In fact there are many studies showing positive outcomes with arthritis patients.

Additionally, there are also many in-vitro and rat studies demonstrating the anti-inflammatory benefits this spice can have. While obviously these results are not always directly relatable or applicable to humans, the take-away is that this compound is very active and holds promise for a wide variety of disease states.

On the whole, based on this one critique, I would not be so fast to discount the powerful effects turmeric can have for our health. Ancient tradition and wisdom aside, there are actually studies showing benefit which should lead us to conclude that turmeric is actually doing something, but maybe not in the precise way we are looking at it currently.

Don’t forget that like with most things in nature, compounds work synergistically. Another reason why food, not supplements and fortification, is paramount for health. For example, we know that the phytochemicals in fruit are more powerful when eaten together in the whole food. When we try to isolate specific phytochemicals to make a pill, we find that the compound is unstable and frankly doesn’t work. But these compounds DO work when ingested in the right form and combination that nature intended.

All that to say, keep up with your turmeric if you find it to be working for you. Consider eating it in the whole form in cooking rather than isolated pill forms. If you do choose a pill, purchase from a reputable company and even consider purchasing the same forms used in the studies. When using the whole spice for the root, combine it with other foods known to enhance the bioavailability such as fats and black pepper.

The use of spices, and especially turmeric, is a great addition to an overall healthy diet. While important to take into consideration, don’t let one detracting article like this completely change your viewpoint just yet.

  1. https://qz.com/883829/a-large-scientific-review-study-shows-that-curcumin-in-turmeric-has-no-medicinal-properties/
  2. https://www.ncbi.nlm.nih.gov/pubmed/19678780

If you need advice on how to get more anti-inflammatory foods and spices in your diet, I’d love to talk! Arrange a time to meet with me and we can get you on a plan to reduce inflammation and get your health back on track.

See below for a few great recipes utilizing this wonder spice to get you started!

Turmeric “Milk”
http://nutritionstripped.com/turmeric-milk/

Slow Cooker Chicken Tikka Masala
http://www.thekitchn.com/recipe-slow-cooker-chicken-tikka-masala-recipes-from-the-kitchn-211284

Turmeric Cauliflower
http://www.simplyrecipes.com/recipes/shahi_cauliflower_curry/

Red Lentil Dahl
http://helloglow.co/healing-turmeric-and-red-lentil-dhal/

 

Image courtesy of smarnad at FreeDigitalPhotos.net

Artificial Sweeteners and our Children’s Health

Recent articles have discussed the growing use of artificial sweeteners among children in the US.  It seems, with the increased understanding of how harmful sugar is to our health, especially in youth, a trend towards artificial sweeteners has begun. But is it safe?

Artificial sweeteners include an array of chemical concoctions including products like aspartame, acesulfame, neotame, saccharin, advantame, and sucralose, among others. The most common plant based option is stevia.

What makes these artificial sweeteners so attractive, not surprisingly, is that they increase the sweetness of a food without the added carbs and calories. To many parents, this seems like an ideal alternative to real sugar, especially given all the advertisements about how these no- and low-calorie sweeteners help people lose weight and balance blood glucose levels. In some cases, the switch isn’t even known to parents. Many products tout lower sugar and calories while failing to point out the swap from real to fake sugars.

Unfortunately, there are many problems with the use of artificial sweeteners in children. If you are a parent, it is imperative that you know this information. Artificial sweeteners are far from safe and may even cause lasting damage to a child’s health. Let’s run through the main concerns so you can make an educated choice on how these sweeteners are used, or not, in your family.

  1. On taste: Artificial sweeteners, when used frequently, train a child to expect very sweet foods. On the whole, artificial sweeteners can be anywhere from 180 to 20,000 times sweeter than regular table sugar! If not used in low doses, a child can easily become conditioned to overly sweet foods. Instead of decreasing sugary foods, it may only increase them later in life when they start making food choices for themselves outside of the home.
  1. On weight: In research we see few beneficial effects of artificial sweeteners on weight. Kids, in general, are very attuned to their caloric needs. A decrease in one area usually leads to an increase in another. There are a whole host of other foods included at meals and snacks, and just cutting calories from soda or candy will not make up for a consistently unhealthy diet and lack of physical activity. Touting these lower kcal junk foods is not the answer to our obesity epidemic.
  1. On blood sugar: Artificially sweetened products are often promoted for their beneficial effect on blood sugar. By replacing the sugar, the theory is we should be able to keep our blood sugar more stable and prevent those spikes that can lead to weight gain and obesity. When consumed in small quantities and with a variety of other foods at a meal, the effects might be somewhat positive in that respect. However, when used in excess and at the expense of other more natural carbohydrate foods, the body, it seems, can be “tricked” into thinking there is glucose entering the body. In response, high levels of insulin are released to deal with this onslaught of “sugar.” This can then trigger a hypoglycemic episode where blood sugar goes too low and/or increased hunger signals are sent to get that carb hit the brain is looking for. A harmful cycle can begin in which insulin and glucose levels are not well maintained starting in childhood, and this may eventually lead to insulin resistance and an increased risk for disease, namely diabetes, later in life.
  1. On healthy diet: With this increase in artificial sweeteners comes an obvious fact. We are feeding our kids more processed foods. These processed foods are coming at the expense of natural, whole foods which contain an abundance of nutrition that our growing kids need. Starting at an early age we are teaching out kids to rely on and prefer processed foods to more natural choices. While not necessarily harmful in the short term, many of these foods are nutritionally inadequate for our youth. Even in adults we are seeing poor intake of various nutrients when processed foods comprise a large portion of the diet, and this is likely happening with our kids as well. While meaning well in most cases, many parents are setting their kids up to prefer processed foods with the consequence of potential nutrient deficiencies.

These are the main reasons I strongly hesitate against the use of artificial sweeteners in the diets of our children. Apart from being unnatural, they really just aren’t necessary. They are not the answer to the problems we are seeking to solve. Instead they create risk in terms of adequate nutrient intake and even disease risk later in life.

Parents, instead of resorting to artificial sweeteners, I implore you to do the hard work of teaching your kids to enjoy savory and lesser-sweet foods. It’s hard work no doubt and yes, you end up being the bad guy on many an occasion, but your kids will benefit in the long run. Better yet, start very early on if you still have the chance and set those dietary patterns from the start.

References:

Consumption of low-calorie sweeteners jumps by 200 percent in US children.
https://www.sciencedaily.com/releases/2017/01/170110101625.htm

Artificial sweetener use among children: epidemiology, recommendations, metabolic outcomes, and future directions.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3220878

The problem with sugar-free kids.
http://time.com/the-trouble-with-sugar-free-kids

If you are a parent having a tough time getting your kids to dump the sugar, I’d love to help. Get in contact with me and let’s see if we can get your family on a healthier path. It’s never too late!

 

Is saturated fat good for you?

saturated-fatLikely by now you’ve heard the debate. Is fat, and in particular saturated fat, bad for you or not? In the 80’s and 90’s we made fat the villain and steered our entire country towards a low-fat mentality, but in recent years perceptions have evolved. Studies have come out to contradict previous research that found fat harmful to cardiovascular health. Even more recently we found that some studies were in fact manipulated to spin sugar in a more positive light and lay the health blame squarely on fat. Just a few months ago NPR reported that the sugar industry paid scientists to bias their research so that fat appeared to be the main concern in regards to heart health.1 So, what are we to believe?

Studies still go both ways, but we certainly have a growing collection of research to show that fat does not deserve to be treated as an evil part of our diet. Despite years of shunning fat in favor of carbs and protein, we appear to have reaped zero health benefits. We did not see heart disease risk decrease. We did not see waistlines slim down. Increased consumption of Snackwells and low-fat lattes did not result in the statistics health experts were hoping for.

Now, in fact, a recent Norwegian study suggests that fat, and again in particular saturated fat, is good for us.2 What? How could the research be so polar opposite to our previous understanding?

In the study, the researchers did not simply take subjects, put them on high-fat diets, and observe the results, as many previous studies have done. No, they put people on carefully crafted high fat diets that were rich in unprocessed or lowly processed choices, such as butter, cream and cold pressed oils. These were combined with a decent intake of vegetables and whole grains while simultaneously avoiding white flour and sugar. When compared against cohorts on a high carbohydrate diet, the high fat diet participants showed decreases in fat storage and disease risk, even when the subject’s overall energy intake increased when compared to their previous diet.

This study provides a perfect example of how the entire makeup of the diet, as well as other lifestyle factors, is paramount. Singling out a particular macronutrient to vilify, while newsworthy and income-generating for some, unfortunately, has not benefited public health.

Clearly, cholesterol numbers and other markers for cardiovascular disease are not independently influenced by fat intake. There are many other factors involved: sugar consumption, overall energy intake, genetics, and lifestyle factors (smoking, exercise, stress, etc). By singling out fats alone we miss the bigger picture, and in terms of public health, we put people’s lives at risk by giving them misleading information.

As with most things, the answer is actually very simple. Unfortunately, simple answers do not make great billboards and campaigns. But the truth is this: an overall healthy diet is paramount, NOT exclusion of all fat.

So the next time you think about avoiding that butter on your bread, think twice and reconsider the bread before you demonize the butter. Healthy fats are our friends.

References:

  1. http://www.npr.org/sections/thetwo-way/2016/09/13/493739074/50-years-ago-sugar-industry-quietly-paid-scientists-to-point-blame-at-fat
  2. https://www.sciencedaily.com/releases/2016/12/161202094340.htm