Exercise: Is it really less important than diet for weight loss?

exercise, diet, and weight lossI have been hearing for some time now that when it comes to weight loss, exercise is not king. Diet is paramount. I mean, the NY Times said it, so it must be true.1 To be fair, they cited many reputable studies in their report that seem to indicate exercise only goes so far in weight management. The amount you can burn in a single exercise session is easily erased by something as innocent as a second helping of dinner or a favorite sweet treat. Also for many, hunger increases after exercise and leads to overconsumption, thereby erasing or even worsening the calorie deficit they were striving for. I get it. I can see how exercise may not be the key piece in the giant puzzle of weight loss.

That being said, I have always had a nagging suspicion that exercise is more important than we think. We already know it helps for a host of issues other than weight loss, including mood/depression, cardiovascular health/blood pressure, blood glucose regulation, hormone balance, improved immune function, etc. People who exercise, on the whole, are healthier. Period. But I still had this feeling that given the right duration and intensity level, exercise has a key role in weight management.

Then this study popped up online2, giving us new insight into what might be going on with our metabolism when we exercise.

Researchers from Karolinska Institute in Sweden found mechanisms in mice by which exercise counteracted fat storage and decreased inflammation. A compound called kynurenic acid, induced via exercise, was the key.

To understand the big picture, backtrack with me real quick. Preceding this study, in 2014, this same group originally published that kynurenic acid in the brain, produced via exercise, supported improved brain function. Exercise produces a sound mind, they declared.

Building on that, they conducted this recent study where they introduced kynurenic acid orally in mice with the goal to reach all the tissues, not just the brain. These mice, while eating a high-fat diet that promoted obesity and elevated blood glucose, stopped gaining weight and in turn converted more of their white fat to brown fat, which is the type that is more metabolically active. They also had improved blood glucose control despite no change in diet.

The theory is that the kynurenic acid in the fat cells promoted this conversion from white to brown fat, while kynurenic acid in the immune cells enhanced anti-inflammatory properties.

These two factors, the increase in metabolically active fat and decreased inflammation, both assist the body’s ability to burn fat as energy and prevent excessive fat storage.

Sounds promising! Lace up those shoes! But then this begs the question, what type of exercise should we be doing to get this benefit?!? What is the magic formula? Running? Light walking? Pilates? HIIT cardio? Cross Fit? Yoga?

Unfortunately, this study does not lay that out as the kynurenic acid was administered orally rather than induced directly via exercise. A little digging, however, and another paper provided exactly that information: endurance exercise.3

Ah, I knew it! I had a suspicion that the time and intensity of exercise mattered. Quick and dirty workouts have their place, but nothing takes the place of a good ol’ get-your-heart-rate-up-for-a sustained-period-of-time-type workout.

What this study showed was that subjects undergoing sustained cardio, in these cases an hour or longer, produced high levels of kynurenic acid in their muscle tissue within an hour after exercise. Subjects doing exercise that involved shorter bursts of intense energy did not see these benefits.

So there you go. Cardio for the win, right? Well yes, mostly I suppose. I think the key takeaway is to remember cardio is important and has an important role in weight management, but don’t let that cause you to overlook the roles of muscle conditioning, toning and even plyometric-type activities to overall strength and health. Varying up your routine to prevent injury and strengthen your body overall is so important as well!

If you are now thinking about what kind of exercise is safe for you, let me put out a quick disclaimer here. I am no exercise physiologist. I work with food to help people lose weight, however, exercise is such a key piece of that puzzle. Also, I have been an avid exerciser since my early 20’s so I tend to talk about it frequently with my clients. That being said, if you need specific advice as to what is safe and appropriate for you to be doing, please consult with your doctor, a physical therapist, or even a certified trainer to develop a plan. My role is to educate that exercise is important. For tailored guidance, particularly if you have injuries or other limitation, see a professional!*

If you feel ok starting up something on your own, let me put out a quick plug for one of my favorite online workout websites, Fitness Blender.com. For approachable, achievable and FUN workouts, this site is the best. Run by a local Seattle couple, they have FREE online workouts for any fitness level and any length of time you happen to have available. I’ll be honest. We don’t always have time for sustained cardio, do we? These workouts can easily fit in your day, whether you have 15 minutes to spare or an hour.

The truth is, though, if you are really serious about shedding that weight for good, regular exercise needs to be a part of your routine.
So yes, do lace up those shoes and get moving because the evidence is clear: exercise, and specifically cardio, supports fat reduction. Of course, you have to watch your diet, too. =)

1. https://www.sciencedaily.com/releases/2018/02/180206140630.htm
2. https://www.nytimes.com/2015/06/16/upshot/to-lose-weight-eating-less-is-far-more-important-than-exercising-more.html
3. https://www.physiology.org/doi/full/10.1152/ajpcell.00053.2016

*Always check with your doctor before starting any new type of exercise program. Should you choose to try something new, always start slow and always be aware of proper form. If in doubt, consult a trainer or teacher to master the fundamentals before increasing intensity. Basically, start low and slow to avoid injury!

Keeping those New Year’s Resolutions Going from January and Beyond…

Ok friends, it’s done and gone! If you were on a “diet” or had other resolutions you were working on in January…..you made it! The first month of 2018 is over. How did you do?

Maybe you have already achieved your stated goal (no alcohol for a month, for example) or maybe you are still working on it (such as weight loss), but either way, the long-term goal is to continue these new healthy habits in some form and sustain that progress through the year.

I know many don’t however. You know how I know? The parking lot at the gym grows suspiciously sparse all throughout February as people slowly lose motivation. Thanks for the parking spot though! And my calendar starts to book up in March, April, and May when well-intentioned resolutions don’t work out and people realize the summer months are closing in.

Don’t waste all that progress you made in January! Lifestyle change that produces lifelong benefits doesn’t just happen in a month. Sure, it helps reset your mind frame and sets new patterns in motion, but the work has to continue over the next months and even years. Here are a few tips to renew that motivation and hopefully help you avoid starting all over from square one again next January.

1. Asses and learn
Assess what you learned over the last month, and jot down what you learned from it. Likely you found out something about yourself that may be useful in planning for the following months. Maybe it was taking on too many changes at once. Maybe it was learning how to process new and unexpected emotions that resulted from changes in diet, exercising or thinking. Or maybe you saw that your lab markers really do respond favorably from healthier habits. Whatever it is, jot it down so that you remember this going into the next month.

2. Never beat yourself up
Do not let perceived failure derail your efforts. So many people let a day or two of backsliding take their entire set of goals off course. The ol’ mantra is “well, I already screwed up, so I might as well go all out.” Avoid this thinking! We all mess up, and that is unavoidable. Learning how to deal with perceived failure and pick yourself back up again is an incredible skill. It’s not easy, but refocus yourself and get right back up. Every day is a new day, thankfully, and a new chance to start over. Every time you do so, you are that much closer to where you want your mind, body and health to be.

3. Visualize
Every once in awhile, take some time to visualize what you see yourself doing, eating or being in January of next year. That time will come quicker than you think, and obviously you don’t want to end up in the same place repeating the same goals once again. Put a motivating picture up if that helps. Have a reminder set on your phone with encouraging words. Remind yourself in regular intervals of where you intend to be which should greatly increase your motivation to up in the daily work to get there.

4. Exercise
This may already be part of your goals, or lifestyle, so if it is, go ahead and ignore! But if not, I include this here because moving your body incredibly supports our mind. If our mind is functioning better, we are in the best state to do what is right for your health. Over and over studies show that exercise improves mood through the release of endorphins, reduces feelings of anxiety and depression and increases energy. These are all things we need to stay on track with new health goals. If our mind is in the wrong place, we face an uphill battle. Now I realize incorporating exercise can be a whole thing in an of itself, but think of it as a mind activity instead and make it something enjoyable. It could be a brisk walk, a Zumba class, or dancing in the living room with your kids. The goal is just to move. Daily.

5. Journal
Writing about your progress weekly can be incredibly helpful as you move towards a new way of living. My most successful clients are typically those that keep a running log of how they are doing week to week so they can not only track progress but pinpoint areas that need some fine-tuning. Often it’s only when we see our week in writing that we can objectively evaluate and make helpful changes that get us closer to our goals. You don’t need to write every day, but at least weekly is useful. You might want to track things like daily food and beverage choices, exercise, feelings/mood, digestive symptoms, etc. Whatever you are trying to change, start tracking it so you can visibly see that progress over time. It can be extremely motivating to keep the momentum going, or it can provide a checkpoint to make changes if things just aren’t progressing as anticipated.

Hopefully, these quick tips give you a few ideas to continue your New Year’s resolutions into February and far beyond. You have already put in a good 30 days of work…..don’t stop now!

Can Diet Calm an Anxious Mind?

foods to calm your nervesAnxiety. It’s a common ailment. When my clients list their medical history, anxiety is often on the list. It seems to be more prevalent than ever. Maybe we are now recognizing and diagnosing it more often, but it is not uncommon for a person of any age, even children, to report various levels of anxiety.

What is anxiety? Many confuse it with stress, but it’s actually more than that. Whereas stress is the body’s physical response in the moment to a situation, anxiety differs in that the physical response continues far after the situation is over. It is almost as if there is no switch to turn “off.” These physical responses can include increased blood pressure, excessive trembling or sweating, chest pains, insomnia, headaches, nausea, dizziness, muscle tension, constipation and/or diarrhea, indigestion, and even rashes or what feels like allergic reactions. The physical manifestations clearly can be many and may cause harm to one’s body over the long term.

The levels of anxiety can be varied as well. I am not a psychiatrist so I won’t get too far into this, but it can range from general anxiety all the way to obsessive-compulsive disorder (OCD) or post-traumatic stress syndrome (PTSD).

The first step to take if you feel you have anxiety is to talk with a mental health professional. That way you can find out where you are on the spectrum and hopefully even find out where the anxiety is stemming from.

Second, which is where I come in, is supporting your body through this process with proper diet. Studies have shown that specific foods can play a huge part in reducing overall anxiety and improving the body’s ability to cope and recover.

While a healthy, balanced diet is what we typically recommend, let’s break it down into specific foods you can choose to support your brain and mental health.

Foods to Calm Your Nerves

1. Foods high in B Vitamins: Many of the B vitamins are known to help with anxiety and mood. Some great choices include:

  • Green leafy vegetables (at least one large handful of raw greens daily is ideal!) Spinach, kale, chard, collard greens
  • Avocado
  • Citrus fruits
  • Beans, peas, lentils
  • Cruciferous veggies such as broccoli, cauliflower, Brussel sprouts
  • Beets
  • Bananas

2. Foods high in Omega 3 fatty acids: The Omega 3’s (DHA and EPA) we know are very beneficial for the brain and may do wonders for your mood. These are foods such as….

  • Seafood including wild caught salmon, mackerel, sardines, herring and anchovies
  • Plant sources with pre-cursors to DHA and EPA include flax seed, hemp hearts, chia seeds, walnuts
  • High-quality fish oil supplement

3. Fermented foods: Numerous studies have shown that our gut microbes talk to our brain. Crazy, isn’t it? Supporting a healthy gut environment, therefore, is an important consideration for our mental health. Fermented foods include:

  • Cultured dairy products, such as high-quality yogurt (few ingredients, low sugar), kefir, buttermilk, cultured butter
  • Sauerkraut
  • Kimchi
  • Kombucha
  • Pickles and other pickled veggies
  • Miso
  • Tempeh
  • Natto

4. Foods high in antioxidants: Inflammation can definitely put stress on our brains. Fight inflammation with antioxidants and other anti-inflammatory foods. Antioxidants, particularly anthocyanins, can also help increase the body’s production of dopamine.

  • Anthocyanins: blueberries, cherries, grapes, blackberries, pomegranates, red cabbage, purple asparagus
  • Vitamin C foods: Oranges, kiwis, strawberries, pineapple, mango
  • Others: goji berries, dark chocolate, herbs and spices (especially turmeric)!

5. Hydrate!: While not a food, keeping up good fluid intake is so important! Dehydration increases stress on the body which can only exacerbate anxiety. While straight up water is a great choice, teas can also have a very calming effect on the body. Aim for 8 cups per day and even more if sweating excessively.

Foods That May Stress an Already Anxious Mind

While eating more of certain foods can be helpful, we also need to cut out those foods that are increasing stress on your body. These are likely nothing new to you, but they are good reminders!

1. Caffeine

Not everyone reacts adversely to caffeine, but if you are one of those who do, caffeine can definitely raise your anxiety level. Try cutting it out for awhile to see how you respond. On a personal note, someone in my own family did this recently and it did wonders for their mood and overall stress level!

2. Sugar

No surprise here, but sugar increases inflammation, raises blood sugar, and overall is harmful for your brain. Dial it back and choose naturally sweetened foods like fruit instead.

3. Gluten

For some, gluten can be very inflammatory and therefore impact your mood and well-being. Try taking a gluten vacation for a couple of weeks and see how you feel.

4. Processed foods, especially fast food

Another no-brainer, but fast food and other highly processed foods are very low in actual nutrition and high in refined carbs, sugars and additives. Ditch the drive-through and seek out healthier alternatives.

5. Artificial sweeteners

A component of many processed foods, I single these out because they may be harmful to our guts and therefore impact brain health. Some of my clients have even reported headaches and other reactions from these sweet additives. Go for the natural sugar if forced to choose but in very small amounts.

6. Avoid any foods you are allergic or sensitive to

Some of you, knowingly or unknowingly, may be suffering from food sensitivity reactions. These reactions cause inflammation which can exacerbate stress and anxiety. If you aren’t sure which foods are causing you problems, an elimination diet can be a good first step. Seek guidance from an RD like myself to help tailor such a plan or dig deeper if the offending foods are elusive. For difficult cases, I like using MRT food sensitivity by Oxford Biomedical for decisive answers (www.nowleap.com).

 
Hopefully, this gives you a few specific food ideas to get started! Again I will reiterate that if you are struggling with anxiety, seek professional help. Don’t do this on your own. Along with expert advice, change up your diet to give your brain the support it needs!

 

Are diets one size fits all? Research suggests not all diets are created equal when it comes to your genes.

weight lossOnce again I’m pondering the research around “diets.” First of all, I hate the word diet. It implies some sort of rigorous eating plan that once completed, will solve all your health problems and somehow miraculously allow you to resume former habits. Or, it alludes to something you hop on/off a couple times per year in hopes of staving off weight gain.

Diet is actually defined as the foods a person or animal habitually eats. In that sense, the way we use diet is all wrong. For most, “diets” have a foreseeable end, whereas a diet in actuality is the way you eat most of the time.

There are numerous “diets” or ways of eating that are being publicized. Who hasn’t heard of the ketogenic diet by now? There is also paleo, Mediterranean, low carb, macrobiotic, vegetarian, vegan, etc.  All of these tout that their plan is the “way” everyone should eat. It can be extremely confusing. It’s like a pick your own adventure of diets.

Naturally, as a dietitian, everyone wants to know what I deem to be the BEST diet. Some are disappointed when I don’t provide a clear and firm response on the matter. You see, the reason I keep pondering various these diets is because I’ve seen through countless client encounters that many diets, as healthy as they might seem, just plain do not work for some people. I have had people come in, desperate for help, because the “healthy” diet they have followed to the “t” is producing no weight loss results, or even worse, causing increased lipid levels and reduced energy. What gives?

Recent research out of Texas A&M may provide some helpful results.1 They showed that that in mice fed various popular diets (Standard American, Ketogenic, Japanese, Atkins, etc ), they all responded differently, some positive and some negative. In other words, some mice showed positive improvements on particular plans while others actually got worse on the very same diet.

The key is genetics. The researchers in this study suspect that genetic variations cause our bodies to respond better or worse to various foods and styles of eating. For example, one mouse in particular did very poorly on the Japanese diet, surprisingly, while the rest stayed in good health. Also, most did poorly on the standard American diet (as expected) but some fared less poorly than others.

The take home message is that clearly, one diet does not fit all. A diet that improves the health of one person might worsen the health of another. So many out there want to promote and sell you the universal “ideal” diet, and yet it is becoming more clear that it does not exist. The role of genetics is only going to continue to become more prominent as we search for answers in the obesity epidemic and for conditions such as heart disease, diabetes, and hypertension.

Is your current diet not providing the results you had hoped? The good news is that there is a “right” diet out there for you. Maybe you need to stay more consistent with the one you are on, or maybe you need to change gears entirely. If you are unsure which way to go, consult a professional like myself to provide some guidance on steps forward. While we can’t know for sure which diet will be the golden ticket, we certainly can provide some objective advice to point you (hopefully!) in the right direction.

Last point. If you have failed at weight loss in the past despite carefully following popular diet plans that show amazing results for others, don’t count yourself a failure. Look at this research as hope. It validates that it may not be your efforts that have failed but that type of diet doesn’t work with your genetics. Keep exploring and keep trying!

https://www.sciencedaily.com/releases/2017/11/171130170236.htm

‘Tis the Time for Mindful Eating: Danielle’s 5 Key Tips to Surviving the Holiday Food Deluge

Oh yeah, here they come again, the holidays! It’s funny because it is a time we all look forward to and yet there is still this dread …. the dread of weeks of overeating and the unavoidable weight gain. For many it’s quite predictable. In fact, the average American gains 7-10 pounds during the months of November and December. But really, who can resist all those delectable holiday treats?

Many, on the other hand, never gain an extra pound over the holidays. I am usually one of those. “That’s because you are a dietitian and never enjoy food anyways” you say. “No way!” is what I say. I enjoy lots of foods. Lots of foods in moderation. “Ugh, the moderation word. So overused.” Yeah, I agree. But to a large extend it’s true. You can enjoy a wide variety of foods if you keep it in moderation. Over-indulge? No. Indulge a little? Yes.

Now, you might be already thinking, well that’s no fun. What’s the holidays if you can’t eat until your stomach is about to rip in two and you need to take an extended siesta on your grandfather’s lazy boy? I hear you. We all have traditions that we come to expect and almost crave during this time of year. For so many, over eating is one of them. As mentioned, we dread this season of overeating, but we also expect it and do it anyways. It’s like an unbreakable vicious cycle. How do we get out of candy land hell!

One of the first steps is to recognize the problem! The problem is that when we overeat, we constantly over-ride our natural hunger/fullness cues which eventually leads to dysfunction, to the point we can’t even tell when we are hungry and full anymore. We start to eat for pleasure or pain instead of physical need. This causes us to eat frequently and in portions much larger than we need.

What to do? This is where some basic mindful eating tips can come in super helpful. It may not change your life immediately, but trust me, over weeks and months you will slowly be more in tune with yourself and better able to nourish your body with what it needs, not with what your cravings tell you it wants.

Danielle’s 5 tips for surviving the holiday food deluge:

1. Recognize your weakness areas and where they are encountered.

Recognition is always the first step, isn’t it? You have to assess where your problem areas lie.  Is it sugar? All carbs? Salt? Large portions in general?  All of the above? Does the problem occur in the workplace? At home? At family gatherings? Late at night alone? All of the above. Think through the foods you just can’t stop eating and where you find them throughout the day. Write it down.

2. Make a daily and weekly plan.

Remember, most of the gradual weight gain comes from slight but cumulative overeating all through the holidays, not just on Thanksgiving and Christmas day. Make a plan for yourself so you have a rough idea of what you want to eat from day to day and stick to it. Having a plan liberates the mind to think about other more important things and even frees it from considering cravings, especially when you know, according to your “plan,” that they are not an option.

*If you need help making a plan for the holidays, come see me for ideas!

Going along with that, keep a diet journal as you go. Writing down what you eat, at least for a short period of time, increases your mindfulness around what you are eating and helps avoid random snacking. When you are forced to think more about what you eat, you tend to make better choices. So put pen to paper (or finger to phone) and keep track for a couple of weeks during the holidays.

3. DO NOT avoid all your favorite foods. That is probably the worst thing you can do, especially as you start something new. In my experience the more forbidden a food is, the more you want it. What I say is that all foods are allowed, but portions are controlled. That is the key. Make sure you enter it into the plan and stick to a defined portion. *Don’t forget, usually the first 1-3 bites of any food are the most satisfying. The word is enjoy, enjoy, enjoy. Enjoy the hell out of each bite. When that uber enjoyment ends, put down the fork. Save the rest for another day. I know it’s hard, but try it!

4. Keep up your physical activity! I can’t even tell you how many people let go of their exercise routines during this time because they are “too busy.” Oh no. That is not acceptable. We all have extra things we add to our daily itineraries because of holiday stuff, but slacking off on exercise is not one we can cut. Decreasing exercise can increase your risk for depression (especially if you are prone to it), decrease your willpower around food portions, and of course only add extra calories to your day because your aren’t burning those bad boys off. In fact, my advice is to INCREASE your exercise during the holidays! Make November and December your fittest months. You will not be regretting that come January when everyone else is hauling their sorry arse back to the gym!

5. Always load up on fruits and veggies.

Basically when in doubt, choose fruit and veg. These beauties are chocked full of vitamins, minerals, fiber and antioxidants ….all the things you need to counter act any unhealthy choices encountered over the holiday months. You are going to feel a lot better, and gain less weight, if you fill your plate with produce at each and every meal.

Bonus tip: Relieve stress however you can! Stress always makes eating worse (not to mention ruins our holiday spirit). Before the holidays hit, think thru right now what helps you melt away stress and make a plan to DO those things regularly. Read a book? Get together with a friend? Meditate or deep breathing? Yoga? A quick getaway? If the holidays stress you out, counteract it this year and get stress-relieving activities on the schedule!

Remember these tips as you move through these next weeks and months, and best of luck as you navigate another wonderful holiday season!

As always, if you need help with any of the above, please come talk to me! I’d love to help you make a holiday plan to make this time your healthiest yet!

Image courtesy of Serge Bertasius Photography at FreeDigitalPhotos.net

Skipping breakfast hardens your arteries? More reasons to charge up in the morning with a healthy (and preferably potassium-rich) meal!

According to a recent study in the Journal of the American College of Cardiology, those who skip breakfast are more likely to experience atherosclerosis, aka hardening of the arteries, than those who ate a daily, healthy meal in the morning. 1

The connection, it appears, is that those who are breakfast skippers tend to have more unhealthy diets and lifestyles than those who don’t. They found in the study that overall, those who opt to skip breakfast had poorer diets, were more likely to have high blood pressure or be overweight, and were more likely to smoke or consume alcohol in excess. All of these factors lead to an increased risk for atherosclerosis. Lack of breakfast is not the cause, per se, but an indicator of other health habits.

Now, when I read the study synopsis I was suddenly reminded of another study I recently perused. It linked low potassium intake with hardening of the arteries.2 I got to thinking. Does lack of a morning meal also mean less nutrient intake overall, and therefore decreased intake of critical nutrients for heart health?

Think about it. If you are skipping an entire meal, one that for most provides roughly one quarter to one third of a person’s daily calories and nutrients, wouldn’t this eventually have an impact on nutrient status (particularly potassium) and therefore one’s heart?

The daily recommended intake for potassium is 4,700 mg per day. This is easily achieved if the diet is full of fruits, vegetables, legumes, and dairy. This is hard to achieve if one lives on processed foods and is skipping meals. It seems, therefore, that skipping an important meal, one that has the potential to provide a good dose of nutrition, could be a serious problem. Now, if a person is very diligent with their diet the rest of the day and makes up those nutrients elsewhere, clearly this is less likely to be a problem. But let’s be honest: that is not most of us.

So while we thought the great breakfast debate had died down, evidently it has not. Here we have yet another reason to start your day off right. Eat your breakfast, and make sure it is healthy….for your heart’s sake.

Now that begs the question: what constitutes a healthy breakfast? Let’s dive into some potassium rich breakfast ideas to get you going in the morning:

  • Sweet potato hash and eggs
  • Greek yogurt with fruit and nuts
  • Protein shakes:
    • Add banana and/or berries
    • Add avocado
    • Mix with coconut water for a super potassium boost
  • Egg scramble with spinach, broccoli and onions
  • Avocado toast
  • Smoked salmon or lox on toast w/ fruit on the side (cantaloupe is a great choice!)

Hope those ideas get you started! Just remember, starting your morning with healthy foods straight away sets you up for a day of healthy eating. So eat something, even it is small, and get your day off to a good start. Your heart will thank you.

  1. https://www.sciencedaily.com/releases/2017/10/171002145635.htm
  2. https://www.sciencedaily.com/releases/2017/10/171005102712.htm

 

Image courtesy of KEKO64 at FreeDigitalPhotos.net

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