Lifestyle Nutrition

Eat Well & Thrive

Continuing Education

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The link between obesity and eating out

Posted on September 7, 2018 at 1:05 PM Comments comments (0)

The more you eat out, the more likely you are to be overweight, say obesity experts who have studied the link between eating out and obesity, which are both on the rise.

A third of the calories Americans eat come from restaurants, including fast-food franchises, deli and take out, which is almost double what it was 30 years ago, according to the U.S. Department of Agriculture. For the average consumer, eating one meal away from home each week translates to roughly two extra pounds a year. More than half of adults eat out two or more times a week, and 12 percent eat out more than seven times a week. As a result, the pounds are adding up.

Why do Americans choose to eat out? They cite that they have less time for cooking, longer commutes, more households where both adults work, poorer cooking skills and many more options for meals out. How many more calories a person consumes out depends on the meal. A consumer's weight also plays into how many calories they consume while eating out. For the overweight/ obese individuals, an away-from-home meal added on average 1200 calories a day versus similar food group meals portioned and prepared with health in mind.

Wrong kind of calories

Eating out tends to pack on the pounds more than dining at home. Portion sizes are larger, and restaurant foods tend to be higher in sodium, fats and calories and those calories tend to be the kind that promotes obesity. Foods can be fat promoting or fat fighting and the nutrition scientists all agreed that eating any meal out is more likely to be a fat storage promoter.

"The calories we eat out, for a variety of hormonal and metabolic reasons actually cause more weight gain," said the director of research and education for Florida Hospital Celebration Health's metabolic medicine and surgery institute. Obesity-promoting foods include fat and sodium laden meats, sugar, high-fructose corn syrup, processed grains and trans fats; all cheap ways that restaurants add flavor. These foods lead to changes in blood sugar that cause cells to store food energy rather than burn it. On average, a commercially prepared breakfast provides fewer fiber rich choices, while most dinners away from home include vegetables that are prepared with extra fats and more starch options; according to the USDA economic researchers. The study also noted that restaurant diners eat less well. One meal out typically lowers overall diet quality enough to shift the average adult's diet from fair to poor on the Healthy Eating Index. The index is the tool the USDA uses to measure diet quality. When people eat out they tend to make poorer nutritional choices partly because people often associate eating out as a special occasion, or a time to splurge even if eating out has become a routine.

Paying with their health

As Americans have looked to restaurants to deliver them from cooking, commercially prepared choices have gotten savvier in luring customers. One way is by super-sizing portions, which appeals to America's appetite. For example, a bagel 20 years ago averaged three inches in diameter and had 140 calories. Today's bagels average six inches and contain 250 to 550 calories. Studies repeatedly have shown that consumers eat more when portions are larger. Of course, eating at home most of the time is the most likely solution while eating at home doesn't always equal eating healthy, it increases the odds. When you cook for yourself, you have more control.

Take Responsibility: When all is said and done you must take responsibility for your own health and wellness. Restaurants provide a great service, but in the end, you need to make decisions based on the importance you assign to your health and weight management goals. Bottom Line: Limit eating out to an occasional treat, not as a consistent lifestyle choice. “It is not what we do every once in a while that defines us, but rather what we do consistently.”

These are the resources that provided this information and shaped my opinion: Florida Hospital Celebration Health's metabolic medicine and surgery institute, USDA, Overeating in America: association between restaurant food consumption and body fatness in healthy adult men and women ages 19 to 80. Obes Res 1999;7:564–71.2010 Am J Epidemiol. 2003 Jul 1; 158(1):85-92.

Energy Drinks; are they a safe pick me up?

Posted on September 7, 2018 at 1:00 PM Comments comments (0)

A study published in the Journal of the American Medical Association confirms that energy drinks can raise your cardio-vascular health risks. Increased heart rate and blood pressure appears to be the foundational adverse effects. Dehydration can directly exacerbate this risk and energy drinks do not hydrate, in fact, they tend to be dehydrating.

So while an energy drink seems to help with your energy slumps, they really just temporarily mask the symptoms of fatigue and actually foster ongoing fatigue by fostering your system to cycle exalts and crashes. This cycling has been shown to decrease the immune system, which in turn makes us more susceptible to mental exhaustion and illness. Mental and physical exhaustion elicits certain hormones, some of which signal the evolutionary signal of hunger, seeking to replenish energy producing dietary tools to keep us afoot and therefore not easy prey for a saber tooth tiger’s snack.

What are those evolutionary hunger hormones? Well, let me introduce you to your hunger hormones, leptin and ghrelin. Leptin is a hormone, made by fat cells, that decreases your appetite. Ghrelin is a hormone that increases appetite, and also plays a role in body weight. Ghrelin, the appetite increaser, is released primarily in the stomach and is thought to signal hunger to the brain. Researchers have suggested that ghrelin levels play a big role in determining how quickly hunger comes back after we eat. But Leptin is supposed to be lower when you're thin (so your hunger is less suppressed) and higher when you're overweight (so your appetite is decreased by signaling satiety) that’s the normal evolutionary survival way it is programed to work. Too thin: suppress the hormone that signals you are full and if you are too heavy, increase the hormone that tells signals you are full. Perfect right? Not so; there is good evidence to support what I have been saying for years; Evolution has not caught up with modern man; i.e. that we have grocery stores and restaurants on every corner and enough money to fill our bellies without hitting a rabbit in the head or gathering berries. A recent study from University of California at San Francisco concluded that when someone practices dietary/lifestyle habits that produce chronic “sugar roller coaster rides” their body’s build up a resistance to the appetite suppressing hormone, Leptin, over time.

So while the energy drink question is always - “Is it OK to drink these to avoid the daily dip in energy?” The real question should be “What is the underlying cause(s) of your energy slumps?”

Kick your energy level up a notch with these tips. You won't feel wired when it’s time to wind down, either

Start Your Day with a good Fiber source

This is the meal that sets the stage for the entire day. Studies show that breakfast helps keep you alert starts your metabolism for the day and keeps you satisfied until your morning snack time.

The type of breakfast you choose can mean the difference between feeling sluggish or full steam ahead. Think of food as your fuel. Remember what your learned about dietary bio-chemistry. You need to make your daily carbohydrate macronutrient choices around 50-55% since your body only lives on carbohydrates; but both fiber and protein keep your sugar load steady. Make sure each meal/snack provides both. This is a strategy that keeps your tummy feeling fuller longer and your blood sugar steady. By contrast, when you eat high sugar choices; ex: pasta- your sugar spikes, then drops a short time later, leading to an energy crash. For a power-packed morning meal, a good example could be: Egg and high fiber toast or pita pocket with a side of low sugar yogurt and berries or other fruit. For variety, alternate with a high fiber cereal, such as Fiber One Original, 1 oz of raw nuts and berries or other fruit.

Take Lots of Short Breaks

This can make you more productive by helping you avoid burnout. You have imprinted the feelings of hunger and fatigue in your body so be patient and its okay to take a few minutes to refresh. There was some good research published by the Louisiana State University that found taking several short breaks throughout the day was better than naps or rests over 20 minutes long.

Snack Right

Is your stomach growling? Stop – think are you really hungry or is this phantom hunger? Phantom hunger can be from, dehydration, stress, inactivity, boredom or dramatic swings in blood sugar levels. Your body is signaling destress; adding in more food just feeds the downward cycle related to obesity. Don’t just dash to your refrigerator or nearby restaurant. Most phantom hunger choices will raise your blood sugar for a short-lived boost, and then leave you feeling drowsy and still hungry for the rest of the day. Take a quick walk to move oxygen into your cells. Drink a glass of water or your fresh juice recipe to replenish hydration. If you are traveling when the arms of Morpheus embraces you and that hunger monster will not be denied- eat an Extend bar slowing with water or better yet- plan ahead and pack a snack from home. These can be very simple like apple slices with peanut butter, fiber one trail mix or low fat crackers with a portable cheese like string cheese

Get Moving

There’s a good reason to “get up and go” when you are feeling tired. Take a few minutes to walk around. A 10-minute walk provides more energy than eating a candy bar, a study from the Journal of Personality and Social Psychology found. Get up and walk every hour or two. This kind of mindfulness can help you address phantom hunger in addition to assisting in any needed weight loss. Being overweight is a prominent culprit in experiences lower energy levels.

Stress; overt or internal

Everybody has some pressure in their lives and chasing life to the point of consistently be overbooked can cause anxiety, sleep loss, overeating, and/or exhaustion. Exercise, sleep and reducing stress are important in fighting fatigue. But nutrition is the dominant area of lifestyle that can affect energy levels throughout the day.


Being hydrated is an easy and inexpensive way to increase energy levels. You don't need vitamin water or sports drinks; they only add extra unneeded calories. Keep a fresh water source with you at all times and drink throughout the day. Add lemons, limes or oranges for taste variety.


Posted on April 15, 2018 at 1:55 PM Comments comments (5)

This information is solely provided to assist you in a conversation with your physician. Consult your physician regarding the applicability of any information provided to your symptoms or medical condition. Only your physician is qualified to determine what is right for you and your specific health concerns

Let’s begin with “What is cholesterol?”

Cholesterol itself is a waxy, fat-like substance that is primarily made by the liver, although some comes from the diet. It is an essential component of cell membranes and is used by the body to produce hormones and vitamin D. Cholesterol is carried through the bloodstream attached to two different categories of lipoproteins: low-density lipoproteins (LDL) and high-density lipoproteins (HDL). LDL is commonly known as the “bad or Lousy cholesterol” because it transports cholesterol from the liver throughout the body, and potentially allows it to hang out in your artery walls. HDL, known as the “good cholesterol or Healthy” picks up cholesterol from the blood and delivers it to cells that use it, or takes it back to the liver to be recycled or eliminated from the body – now the latter is what a well-behaved body is supposed to do!

How much cholesterol do we need?

Most of the 1,000 milligrams of cholesterol that your body needs to function each day, according to the American Heart Association, is manufactured in the liver of a well-functioning body- About 75%. Only around 25 percent comes from the cholesterol you eat. If you eat a well composed diet, your liver manufactures just as much cholesterol to supply your cells with what they need. But if your liver makes too much cholesterol, which can be an inherited problem and/ or if you take in too many calories, especially in the form of certain fats and sugar, your cholesterol levels rise as your liver converts extra sugar to fat. This new research syncs with decades of data on how sugar causes insulin resistance, high triglycerides, lower HDL (good) cholesterol and dangerous small LDL (bad) cholesterol. It also triggers the inflammation we now know is at the root of heart disease.

Conflicting information- What’s the truth?

We still have some differing views, so controversy over whether high cholesterol is in itself a cause of heart disease (the lipid hypothesis), or a symptom of an inflammatory condition that is the true cause of heart disease (the inflammation hypothesis) continues to be debated. According to the latter theory, chronically high levels of inflammation creates small lesions (like a scrape) on arterial walls; the body sends LDL to heal those lesions (like a bandage) but it ultimately accumulates and oxidizes, causing blockages. From this perspective, the best lifestyle approach to lower cardiovascular disease risk is to lower inflammation in the body rather than simply LDL levels.

Recent evidence indicates that your sugar load is probably a greater contributor to heart disease than is consumption of saturated fat. While high fat/high sodium may contribute to inflammation; poorly managed sugar loads appear to be the alpha culprit. This suggests that the inflammatory hypothesis may in fact have more validity than the conventional lipid hypothesis. Researchers have identified cholesterol's partner in crime as inflammation; which is simply the flood of white blood cells and chemicals that our immune system unleashes to ward off damage or infection. Cholesterol wouldn't be nearly as dangerous without this process, which is thought to play an essential role in atherosclerosis, the hardening that occurs when low-density lipoprotein (LDL) layers on “too many bandages” in the arteries. When high levels of cholesterol occur in the bloodstream, excess LDL begins to seep into the inner wall of the artery. This triggers an inflammatory response, which actually speeds up the accumulation of cholesterol in the artery wall. This in turn produces more inflammation and now that’s where those flagged labs come from. Eventually the deposited cholesterol hardens into a plaque, which can rupture and lead to the blood clots that cause heart attacks and strokes. Some experts now believe that inflammation is the link between the many diseases and conditions that affect the heart and brain. Just focusing on “sweets” is a flawed mindset. Some food choices may have a high sugar conversion but aren’t thought of as a sugary choice. Here’s how sugar works: Most carbohydrates must break down into glucose before you can absorb them. If you convert more sugar than your body needs, the excess amount is stored in your liver in the form of triglycerides, a type of fat that can cling to artery walls as it travels through the bloodstream. High triglyceride levels contribute to atherosclerosis, the formation of plaque in blood vessels. It also appears to contribute to lowering your high-density lipoprotein, the "good" cholesterol, according to an Emory University study published in the April 2010 issue of "JAMA." People in the study who ate the highest sugar producing foods had the lowest HDL and the highest blood triglyceride levels. People who ate the lowest had the highest HDL and the lowest triglyceride levels. If LDL cholesterol and/or triglycerides are an area of concern, ask about your HDL cholesterol since low HDL cholesterol is also a major risk factor for heart disease;

I was interested in who is practicing from the inflammation point of view

And I found that many “super doctor” endocrinologists were on board. The American College of Endocrinology and The Metabolic Institute of America are fertile ground for comprehensive and unique multiple interventional approaches to the cardio-metabolic high risk patient, preventing and managing obesity, diabetes and cardiovascular disease with a focus on inflammation factors. “Inflammation is the common denominator in nearly all of the diseases we deal with "Heart disease, diabetes, dementia all seem to have links to inappropriate, low-grade, chronic inflammation." Inflammation appears to be aggravated by poor and/or unbalanced diets. Research shows that high-calorie, high-fat meals cause a sudden spike in inflammatory markers because they flood the body with blood glucose and triglycerides. “While we have been told to swap eggs for Cheerios, my research says this is dead wrong. Learn more about “Super Doctors” • http/www.superdoctors

Warrior or Victim?

So yes it may be true that as we age we are more likely to see higher LDL cholesterol scores and yes some families seem to have more incidents of certain diseases. But before we give up, let’s explore if it is possible to reduce bad cholesterol levels and improve the good one? Past research has shown a strong association between obesity and high blood pressure and poor lipid profiles. So if you are overweight, start by losing a little fat. If you are not overweight don’t assume that your pro-active options are inconsequential. It was once assumed that obesity was automatically tied to high LDL cholesterol and triglycerides. However, in a recent subgroup analysis, researchers studied subjects with higher GI impact models that had a BMI in an acceptable range and still have concerns with high triglycerides and LDL cholesterol. So while many patients with these maladies may be overweight or obese; this should not be the overlying suspect for high LDL/low HDL cholesterol and/or high triglycerides. Whether you are overweight or not; consider these natural helpmates as well: Being in charge of what you consume at least        80-90% of the time is a smart strategy. Give due diligence to the nutrition fact of the foods you consume and remember that sugar isn’t just from “sweets”. And while we are focusing on pro-active things: don’t forget that high fats and sodium can also impact inflammation which may impact your cholesterol and triglyceride scores. Think integrative and toss in some consistent exercise/activity to ensure you are doing everything you can to support your health goals.

These are the resources that provided the information that I used in this article and shaped my opinion: Emory University study published in the April 2010 issue of "JAMA •Dr. Yehuda Handelsman •American College of Endocrinology’s• Metabolic Institute of America

Who's Stealing My Hydration?

Posted on September 30, 2017 at 9:35 PM Comments comments (1)


This information is solely provided to assist you in a conversation with your physician. Consult your physician regarding the applicability of any information provided to your symptoms or medical condition. Only your physician is qualified to determine what is right for you and your specific health concerns

                                Who's Stealing My Hydration? 

You drink water, you eat your veggies, sometimes you even have your hydrating juice- but your body is stubborn when it comes to moving your hydration in a positive direction. You go through your list of usual suspects: could it be a medication, am I too hot, too cold or too hormonal? Is my activity too robust or not enough? Maybe it’s my aches and pains or my chronic disease that’s thwarting my hydration. It’s maddening when you struggle to pinpoint your hydration thief without success! Well it might be time to add another culprit to your dehydration list: STRESS!

The link between hydration and stress reduction is well documented. You are more likely to get dehydrated when you’re under stress because your heart rate is up and you’re breathing more heavily, so you’re losing fluid. If you are already dehydrated, your body can’t function properly and that can lead to more physical stress and oh my…your physical stress is often stuffed into that big, ugly bag you tote around called emotional stress. Yes it’s true: all of our organs, including our brains, need water to function properly and the truth is that your body doesn’t discern whether your stress is emotional or physical. One grabs the other and next thing you know your body is spiraling downward and taking your hydration level right along with it! When your stress is up, your body is going to respond with a temper tantrum that can bludgeon you mentally and physically.

OMG - Those Darn Hormones!


When your hormones don’t hold hands and play nice; well things don’t usually end well.

Let’s start with the adrenal glands. When you’re under stress, your adrenal glands pump out stress hormones. When you are constantly under pressure, eventually your adrenals become exhausted and next thing you know your body has adrenal insufficiency. Here’s where the “holding hands and playing nice comes in”. Your adrenals also produce the hormone aldosterone, which helps regulate your body’s levels of fluid and electrolytes. As your adrenal fatigue progresses they are not “holding hands” and your body’s production of aldosterone drops, triggering dehydration and low electrolyte levels. Cortisol and Adrenaline are hormonal BFF’s. Surges in these hormones can be life-saving during a brief confrontation with marauding, flesh eating zombies but for the overbooked, chronically stressed gal or guy- too much of these hormones can not only make your body resistant to sufficient hydration but have been linked to overweight/obesity concerns as well as a plethora of very scary health risks.

                                   When you feel thirsty, you're already dehydrated!

Stress and Dehydration: Breaking the Cycle

Staying hydrated throughout the day will not magically make your stress triggers disappear. But if you’re already stressed, your body won’t appreciate the additional stress of dehydration adding to its workload. Studies have shown that being just half a liter dehydrated (that’s 1- 16 oz bottle of water), not to mention that person who just stepped on your last nerve, can increase your cortisol levels. Whenever certain people, places and/or times in your life contribute to extra stress - give out a primal scream and then reach for a glass of water. Just getting enough fluids may help your body squirm loose from the clutches of stress.

                                    It's a Vicious Cycle


Stress can cause dehydration, and dehydration can cause stress. You can break this cycle by implementing more hydrating strategies and removing as many of your stressors as possible. When I was terribly overweight, not one of my doctors ever mentioned that I might be chronically dehydrated but my nutritionist pinpointed it almost immediately. I learned that it is normal to confuse thirst for hunger and that when we ignore our body's thirst signals; overtime we become unable to easily recognize them. Constant sugar cravings can be one hidden sign of dehydration. My nutritionist use to say that my body was asking for water, I was just hearing Boston Crème Pie! Digestive ailments, especially acid reflux and allergen responses could be signs of chronic dehydration. With dehydration, histamine levels can increase and your immune system can send out aggressive warriors to pick a fight with pretty much anything traveling through your digestive track. So if your tummy is not happy, it just might be functional not a lack of humor! Stress can result in many of the same responses as dehydration which can confuse your body. (Increased heart rate, depression, nausea, fatigue, and headache are the most common). Taking a good hard look at your lifestyle is important. Are you consistently feeling “overbooked”? Are you so busy taking care of everyone else that you fail to take care of yourself? Are you the “chronic fixer”? Can you remember the last time you did something just for you that was fun and/or relaxing? Do you take time to just be quiet and breathe? If you are chasing life without rest; you just may be increasing your odds of suffering digestive, emotional, hormonal and/or physical diseases that will finally bring you to your knees. While you are contemplating your other lifestyle choices, why not start with the commitment to consistently adhere to balanced eating , work on achieving and maintaining a healthy hydration level and breathe. Anything you can do to diminish the physiological responses of stress is worth the effort!

Tips for Supporting Hydration Each Day

• Be Consistent!

• Carry an ice filled, insulated sports bottle with you and fill it up as needed.

• Keep water on your desk at work. • Limit caffeine • Lower sodium intake

• Include hydrating vegetables and fruits; especially at snack times

• Keep a glass next to your bed. Many of us wake up dehydrated first thing in the morning.

• Sip…Sip. Sip throughout your day. Eight glasses all at once isn’t good for you!

• Give your hydrating juice recipe a try

• Remember to adjust your hydration to accommodate your activity/exercise; especially in warmer weather.

These are the resources that provided the information that I used in this article and shaped my opinion “Dehydration Symptoms.” Mayo Clinic. 2011. (November 22, 2012)“Dehydration.” NHS Choices. 2011. (November 22, 2012

Sitting less and moving more or deliberate exercise: which is the more effective strategy

Posted on May 12, 2017 at 9:15 AM Comments comments (1)

Sitting less and moving more

May be more important than deliberate exercise.

What do we know?

New research reveals that individuals at high risk of developing overweight/obesity related diseases such as type ²diabetes would benefit from being told to sit less and move around more often rather than simply exercising regularly. The experts suggest that reducing sitting time by 90 minutes in total per day could lead to important health benefits. The idea that exercise is good for us is drilled into our brains by the medical community and what I call “those media experts on Good Morning America”. While certain types of exercise can certainly be beneficial, placing too much emphasis on formal exercise may be highlighting the wrong issue and contributing to long term health problems. Research is now telling us that movement rather than exercise has the most positive impact on our weight and overall health.

What do you think the definition of the term Sedentary is?

You may be surprised how the usual, conventional thinking is not supported by what physiology science supports. I can’t tell you how many people I have seen in my practice that begins our initial conversation with “I have no idea of why I am overweight/obese since I exercise!” Typically it goes like this: I go to the gym nearly every day. I work with a personal trainer a couple of days a week. I do “beach boot camp” a couple of times a year. I go Zumba class 3 X per week.

Who is more sedentary: the person who exercises for one hour several times per week or the one who never exercises at all? Conventional wisdom tells you that the second person is sedentary. This, however, is an incomplete picture and may in fact be completely wrong if other factors are considered.

More important than how often you participate in structured exercise is how much you move during your everyday life. Why? Because how much time you spend sitting adversely affects your health far more than how much time you spend doing formal exercise. If you spend hours a day sitting (at a computer, in front of a television, reading, playing video games, etc.), it can negatively impact your health even if you exercise regularly. Basically, regular exercise is not enough to counteract an otherwise sedentary lifestyle.

Given this new understanding of inactivity physiology and the health impacts of sedentary behavior, I would argue that there is now sufficient evidence for health practitioners to expand their thinking beyond “purposeful exercise”. In my opinion, it would be very helpful if PCP’s would feel comfortable engaging their patient’s in this “health” conversation. Especially; this new perspective on the negative health consequences of too much sitting should be seen as a sensible first start for those who are inactive due to motivation and/or limited mobility. Adding in consistent movement along with participation in any purposeful, physical activity the patient is already engaging in is certainly an advantageous partner.

Communicating this new perspective to the public and to policy-makers will require some ingenuity and clear messages that it is neither one nor the other but both. I suggest that too much sitting around need equal emphasis with exercise recommendations. Many people have a poor or limited understanding of what is meant by “sedentary time.” Perhaps the most practical definition of sedentary time for the public could be based on postures such as sitting and lying down. People do not know their minute-by-minute energy expenditure or personal metabolic profile throughout the day, but they do know their posture. When people are sedentary and awake, they sometimes lie down but they usually sit. People sit at work. People sit to eat. People sit in social settings. Thus, public health recommendations about physical inactivity may be best communicated if they use terminology related to posture: “Be aware of your posture throughout the day: sit less, stand more!”

The best solution to being sedentary is to sprinkle “good posture” into our everyday lives with activity. This can be done in a variety of ways:

1. Take phone calls standing up or walking.

2. Use a standing desk if possible or sit on an exercise ball at your desk.

3. Take frequent breaks during your day by getting up and walking around for about 5 minutes every hour

4. Try yoga or Tai Chi stretching movements 2-3 times per day for 2-5 minutes

5. Get up during commercial breaks while you`re watching television.

6. Use the stairs instead of the elevator whenever you have the choice.

7. Park on the far side of the parking lot when you can.

8. Get up and go window shopping rather than browsing online.

9. When you meet with friends, clients or colleagues try to do something that includes more movement and stop making eating the center of these fellowship based activities. I always say: “Time with others should always be about the fellowship not the food!”


This information is solely provided to assist you in a conversation with your physician. Consult your physician regarding the applicability of any information provided to your symptoms or medical condition. Only your physician is qualified to determine what is right for you and your specific health concerns

These are the resources that provided the information that I used in this article and shaped my opinion                                                                                                                                                                                                           

Haskell WL, Lee IM, Pate RR, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116:1081–1093.



Constipation: Let It Go!

Posted on February 5, 2017 at 9:50 AM Comments comments (0)

This information is solely provided to assist you in a conversation with your physician. Consult your physician regarding the applicability of any information provided to your symptoms or medical condition. Only your physician is qualified to determine what is right for you and your specific health concerns


Constipation generally means that you have three or fewer bowel movements a week. But it can also mean straining to have bowel movements or passing stools that are small, hard, and dry.

It is not uncommon to find that changes to your normal routine can cause problems with your digestive system, resulting in constipation. Putting off going to the bathroom when you feel you need to defecate, changes in exercise, and changes in diet. If you get constipated, first take time to go to the bathroom a few times during your day. Without straining or stress, just relax and give your body some time to respond. Usually 10-15 minutes of reading during these times will help your body get back into your normal rhythm. If you have changed your diet to a healthier one then give your body time to adjust to the changes. Eating lots of healthy, high-fiber foods, exercising, and drinking water are adjustments that will bring about health benefits over time.


Check out your medications/supplementation. When you have made dietary changes, the same medications/supplements may contribute to a temporary bout of constipation. Some common medications that can cause constipation are diuretics, antacids (with aluminum and calcium), narcotics, antidepressants, supplements, anticonvulsants, and blood pressure treatments.

Constipation can also be caused by the very medications taken to treat them; laxatives. Americans spend more than $700 million on these constipation treatments annually, but just like some other over-the-counter and prescribed medications, laxatives can become habit-forming. Taking them too often may cause your digestive system to become too dependent on them.


Treatment depends on the cause, but could include: •Removal of the impacted feces – which may involve enemas, stool softeners and a short-term course of laxatives.

•Dietary changes – such as increasing the amount of fiber in the daily diet. Physicians generally recommend about 30g of fiber every day for patients that present with chronic constipation. Good sources of fiber include high fiber cereals, fruits, vegetables and legumes. The intake of foods such as cow's milk, cheese, white rice, white flour products and red meat should be lessened because they tend to contribute to constipation.

•More fluids – liquids help to plump out feces. However, it is important to restrict the intake of diuretic drinks such as tea, coffee and alcohol. Water works best until constipation is remedied.

•Fiber supplements – these may be helpful in addition to the patient including more fresh fruits or vegetables in their daily diet. If fiber has been low, boosting fiber too quickly via fiber supplements could possibly aggravate or cause constipation, so begin with small doses of fiber supplement to ease the transition.

•Exercise – one of the many benefits of regular exercise is improved bowel motility. Ideally, exercise should be taken every day for about 30 minutes. People with a condition that affects mobility need to be as active as possible each day, as every little bit of regular exercise helps.

•Laxatives – there are two main types: bowel stimulants and bulking agents (stool softeners) that increase the water content of the stool. Bowel stimulants increase bowel contractions, but may cause cramps. ·Dried fruit such as apricots, figs and prunes help. Dried fruits contain soluble fiber and in the stomach this turns to a gel that binds with other digestible material, softening stools.


Resource: American Journal of Gastroenterology.


Toxic Stress

Posted on March 30, 2016 at 12:05 AM Comments comments (0)


While we try to work on strategies to address specific stress triggers, beware that it is not an easy task to reprogram your psyche.

Stress can mean different things to different people. Some of you will manufacture stress because you thrive on chaos. Some can navigate through extremely challenges events without any outward appearance of being overwhelmed, while others have outward meltdowns over seemingly trivial events. No matter how you deal with or demonstrate your stress to others, here is a reminder that there are negative, biological changes that occur with stress that often leads to excess fat stores. The chronic elevation of the stress hormone cortisol leads to increased intra-abdominal fat, which is linked to increased risks for heart disease, diabetes and cancer. Stress leads to a decline in sex hormones, which can also pack on the pounds. Stress increases lethargy;depression and anxiety. Stress has been cited as an underlying culprit for an increased probability of non-alcoholic fatty liver syndrome, Finally, stress interferes with sleep and poor sleep can result in lower energy or motivation to exercise and care for yourself. Stress can become an integral part of your psyche and behavior.

Living a healthier, more productive life is all about striving for a mind-body balance every day. Yes, life is stressful and stress can be related to negative things and good things alike. For some watching the 6'o'clock news, or a football game where your team is playing like a the 4th floor occupants of the local nursing home can cause the adrenaline to flow and the cortisol to produce fat. For some of us a simple change in our routine can disturb our sleep and often our digestion. That delightful house guest or that weekend visit to family or friends can bring about what I call “good stress.”

Some experts believe that over the last decade we have increased our inactivity and tend to “ingest” way too much negativity via television and other electronic venues. Throughout the USA, 68 percent of adults are either overweight or obese, with the likelihood greater for men (72 percent) than for women (68 percent). Here’s a statistic you may relate to: Over 65 percent of this group listens to and/or watches at least 2 hours of negative news or some sort of disturbing programing or video games every day, and those that did were 77 percent more likely to be overweight or obese.

I love this quote by Charles Darwin because it sums up the mantra of the successful Lifestyle Nutrition member “It’s not the smartest who survive, nor the strongest. It’s those who can adapt who survive.”


How can you support your body's survival code without self-destruction?

First, don't manufacture chaos and crisis. Learn to step back from any situation that makes you feel stressed/or anxious- yes – even those “good stress things we often talked about”. Take a breath, remove yourself from the situation to evaluate the challenge. Are you creating this chaos, are you playing a part in this chaos or are you truly just a bystander within the situation? If this stress is caused by a situations outside of yourself, then is there anything you can do or say to help resolve the issue or are you convinced that you are only a victim of the situation?

We always come back to this simple question: Are you a victim or a champion? Every choice you make and every strategy for a solution depends on how you see yourself in the situation. If you can do nothing to change it, then walk away. If you can offer something constructive and positive to resolve the situation then step up and take charge. Trying to manage other people's lives and/or decisions will leave you exasperated and exhausted. Take responsibility for your actions and allow others to take responsibility for theirs. You need to find smart ways to get by without spending all your energy on self-destructive behavior. Adapting means wrapping your head around a tough reality, and adjusting means creating a strategy to manage the toxic stress in your life that could be truly killing you physically and emotionally.

What can you do to manage Toxic Stress?

Medicate with movement.

Medical studies have shown, one of the best ways to DE-stress mentally and physically is through physical movement. It’s better than a pill and certainly better than numbing yourself with alcohol or food. Any movement is good movement. Bending, stretching, pushing, lifting and walking. No excuses even at work. Quietly get up 5 minutes out of every hour and find that staircase or walk around the building. Bring your lunch to work and during your break go outside and walk after you’ve eaten. This is a no cost, easy way to neutralize the high levels of stress hormone with the endorphins of physical activity.

Pack your lunch and snacks with stress-reducing foods, including combinations of protein and fiber to mediate sugar. Reduced fat peanut butter on a high fiber slice of bread or Metamucil cookie works as does low-fat string cheese with a little fruit, lean protein and veggies.

Limit negativity.

Participate in joyful activities. Dance, Yoga, walk or bike ride ( yes- stationary is good too!) Avoid toxic people and embrace those who prioritize their health high on their lifestyle list. Develop outside interests to distract you from your job stresses. These are some good starting places to cultivate balance in your life.

Establish a support system.

It’s so stress relieving to just have someone there to listen to you when you need to vent about dealing with Illness, work or family issues. Depression, isolation and loneliness lead to self destructive behavior. Reach out and make friends with people who embrace a positive, healthy lifestyle. Distance yourself from those who disrespect and/or sabotage your goals. You teach people how to treat you! If family or friends are not providing what you need to promote a healthier you, let them know the rules have changed.

Negativity invites Toxic Stress-You and your body do not deserve abuse!

Use your head.

Learning how to meditate and to calm down are essential to de-stressing mentally. Go to a quiet place and practice your breathing exercises. Do some gentle yoga stretches, close your eyes and move your brain to a quiet walk on the beach, All of these simple things can help relieve stress.

Get counseling if you need it.

If you’re really having a hard time, seek out counselors (licensed social workers are great) who specialize in stress management. Get the help you need – it may be life-saving.



This information is solely provided to assist you in a conversation with your physician. Consult your physician regarding the applicability of any information provided to your symptoms or medical condition. Only your physician is qualified to determine what is right for you and your specific health concerns

My Lifestyle Nutrition Program has one central purpose. To teach, encourage and support a mental, nutritional, and physical transformation for life.

Restless Legs Syndrome

Posted on March 30, 2016 at 12:05 AM Comments comments (1)




This information is solely provided to assist you in a conversation with your physician. Consult your physician regarding the applicability of any information provided to your symptoms or medical condition. Only your physician is qualified to determine what is right for you and your specific health concerns


The specific causes of restless legs syndrome (RLS) are not known. RLS is a neurological disorder characterized by throbbing, pulling, creeping, or other unpleasant sensations in the legs and an uncontrollable, and sometimes overwhelming, urge to move them. Symptoms occur primarily at night when a person is relaxing or at rest and can increase in severity during the night. Moving the legs relieves the discomfort. Patient's report that the sensations range in severity from uncomfortable to irritating to painful. Research is being done in the areas of abnormalities in brain chemicals (neurotransmitters) that help regulate muscle movements, or to abnormalities in the part of the central nervous system that controls automatic movements. The two common conditions linked to RLS are iron-deficiency anemia (low blood count) and peripheral neuropathy (damage to the nerves of the arms and legs, often caused by underlying conditions such as diabetes). A couple of things that might be useful to note and discuss with your physician: Certain medications and hypothyroidism have been discussed as possible culprits that may aggravate symptoms.


A few things that you might find helpful:

Restless legs syndrome, makes it hard to sleep. Your legs may ache, burn, tingle, twitch, or jerk. To get the deep sleep you need, try going to bed a little later and sleeping later in the morning. Those morning hours may be some of your best rest. Going to sleep and waking up at the about the same time every day helps just about everyone sleep better. This strategy may stop a bad cycle where fatigue makes your symptoms worse, and then the twitching and tingling ruins your sleep for another night.

Gentle stretching before bed might help. For a calf stretch, step forward and bend your front leg while keeping your back leg straight, in a small lunge. You can put your hand on a wall for support. Repeat on the other side. Stretching also helps if you've been sitting for a long time.

Reduce caffeine: Caffeine can make your RLS symptoms worse, even hours later. Cut out this stimulant and you may find it easier to fall asleep and stay asleep. If you cut down, keep in mind that caffeine can affect some people for as long as 12 hours.

A warm bath before bedtime relaxes you and makes it easier to fall asleep. So it's probably not surprising that this classic way to wind down also reduces the symptoms of RLS.

Heating pad or ice pack? Go with whatever feels good. Either change in temperature can be soothing.

Moderate exercise during the day pays off with better sleep at night. Walk, jog, lift weights, or find any exercise you enjoy. One study found that exercise led to less leg movement and longer and deeper sleep for people with RLS. Be careful not to overdo it. Intense exercise or working out just before bedtime could make your symptoms worse.

When your legs ache or twitch, moving them may ease those uncomfortable feelings. Sometimes just shaking or moving your legs can help. Choose an aisle seat in a movie theater or airplane so you can get up easily.

Stress makes RLS symptoms worse. Release the tension by taking slow, deep breaths. It also helps to dim the lights and listen to soothing music before you go to bed.

A calf massage before bed might calm your RLS symptoms and help you get to sleep. You can do it yourself or trade mini-massages with a family member. Give your partner a 10-minute shoulder rub, then stretch out for a leg massage and relax deeply.

Yoga combines three remedies that can reduce mild RLS symptoms: stretching, deep breathing, and relaxation. Try a class or video to learn the right posture and pace for each move. Once you know the poses, you can do them on your own.

Discuss any labs you may have had to evaluate your iron. The usual test is a Complete Blood Count. (CBC). The CBC measures many parts of your blood. This test checks your hemoglobin and hematocrit. . Hemoglobin is an iron-rich protein in red blood cells that carries oxygen to the body. Hematocrit is a measure of how much space red blood cells take up in your blood. The CBC also checks the number of red blood cells, white blood cells, and platelets in your blood. Abnormal results may be a sign of infection, a blood disorder, or another condition. Finally, the CBC looks at mean corpuscular volume (MCV). MCV is a measure of the average size of your red blood cells There has been shown a correlation between low levels of iron in their blood and RLS. It makes sense since your body needs iron to make dopamine, a brain chemical that helps control movement.

Discuss any medicine/drug therapy that your doctor may think useful for you and your specific concerns.


Resources:: Practice parameters with an evidence-based systematic review and meta-analyses. Sleep, 35(8): 1039–1062.

Peri Menopause or Menopause?

Posted on February 28, 2016 at 11:10 AM Comments comments (0)

This information is solely provided to assist you in a conversation with your physician. Consult your physician regarding the applicability of any information provided to your symptoms or medical condition. Only your physician is qualified to determine what is right for you and your specific health concerns


Perimenopause, also called the menopausal transition, is the interval in which a woman's body makes a natural shift from more-or-less regular cycles of ovulation and menstruation toward permanent infertility, or menopause. Women start perimenopause at different ages. In your 40s, or even as early as your 30s, you may start noticing the signs. Your periods may become irregular, longer, shorter, heavier or lighter, sometimes more and sometimes less than 28 days apart. You may also experience menopause-like symptoms, such as hot flashes, sleep problems and vaginal dryness. Discuss any treatments available to help ease these symptoms with your physician. Once you've gone through 12 consecutive months without a menstrual period, you've officially reached menopause, and the perimenopause period is over.

Perimenopause or Menopause? Menopause is the time during a woman's life when she stops menstruating. You have not yet reached menopause if you're still having periods, even though they might be irregular or occur only once every few months, according to the Mayo Clinic. After one year of no periods, you can assume you've reached menopause. Symptoms such as night sweats, depression, moodiness, and anxiety and heart palpitations occur during perimenopause. Common changes that occur include sleep disorders, hair loss and the one most women complain of is weight gain. This can also be accompanied by pain and discomfort in various parts of the body. During pre-menopause, more commonly known as perimenopause, weight gain is a universal occurrence among women experiencing natural changes in hormone levels, according to the Mayo Clinic. Perimenopause is the stage leading up to menopause and is accompanied by symptoms and changes most people usually associate with menopause, including weight gain. However, women can take steps to minimize these symptoms and changes, such as following a healthier diet and exercising regularly.

Can how you eat make a difference? Diet plays a crucial role in helping women to maintain a healthy weight during perimenopause. According to the Mayo Clinic, women who gain weight often gain the most weight during perimenopause. Many complain that they make no changes in their diet and exercise regime that had served them quite well until they were visited by the perimenopause/menopause “friend’. So let’s look at what might be the underlying culprits for this Phenomenon. 1. When we feel a little off we are more likely to lean a little heavier on starches. This is the carbohydrate group that connects to our feel good senses in two ways: starches give us a sustained high and often starches are imprinted as a remedy from childhood. Remember when you skinned your knee and got a cookie or felt sad and you got an ice cream cone. Think back about these childhood imprints- Did your parent every offer you vegetables when you were feeling off? Starches are the carbohydrate sub-group more likely to make us fatter. 2. Estrogen and progesterone are hormones. All hormones have been shown to be synergistic with other hormones and the optimal functionality of the human body. Changes in estrogen and progesterone can alter the efficacy of other important hormones such as thyroid and insulin. Even if these hormones remain in the “normal area” on your labs, they may be just off enough to invite a little weight gain. 3. When we are not feeling our best, we can talk ourselves out of being as active as we should be. The older we are the more we need to sit up straight and move our tush! Think of it this way, the more miles you have on your chassis the more effort we need to put into our vehicle to keep it on the road. We need to think sports car not a beat up 2 ton truck! Weight gain at any age is risky and can lead to health problems, but it can especially be problematic for older women. Some women believe that by taking herbs they can thwart the symptoms of perimenopause, including weight gain. Although these dietary additions tout that they may help to reduce symptoms, I am suspect of these claims. Discuss any of these with your physician. All supplements should be considered in the realm of medications with possible risks. The safe and sensible strategy to address any weight gain during perimenopause/menopause is to follow a well-balanced and healthy diet that includes plenty of fresh vegetables and fruits along with moderate exercise and stress management. Importance of Exercise At any age, exercise is important for maintaining overall health. However, people tend to lose more muscle mass as they age. More than ever, it's critical for older women to maintain a regular workout routine that includes aerobic activity, stretching exercises and strength training, according to the Mayo Clinic. Not only does regular exercise help with maintaining a healthier weight, but it also helps to lift your mood and can help women deal with the naturally occurring changes in the body during perimenopause. Hormone Therapy Some women take synthetic or natural hormones, or bioidentical hormones, to help relieve perimenopausal symptoms. However, since every woman is different, it is important to talk to your physician to understand your options and what is best for you and your specific health needs.

References: DS00554 Sept. 16, 2010 © 1998-2012. Mayo Foundation for Medical Education and Research (MFMER).



Every Month Should Be Heart Healthy Month

Posted on February 28, 2016 at 11:05 AM Comments comments (0)

Heart disease is the leading cause of death in men and women, but many women don’t know they are more likely to die of heart disease than breast cancer. No matter if you are a man or women, it is important to be your own best advocate. You know what feels off to your body; after all you are living it. So if you think something is wrong; push for answers. Unfortunately, women may be at a disadvantage when it comes to heart health. They are less likely than men to believe they're having a heart attack and therefore are more likely to put off seeking treatment. In addition, doctors tend to treat women less aggressively after a heart attack.


While there are sometimes specific symptoms; some patients never recognize symptoms as indication(s) of heart attack. Keep this list of the standard 6 symptoms that both men and woman present with but pay attention to your body and don’t let any list of standard symptoms influence your response to heart concerns. The statistics says that 64 percent of women who die suddenly of coronary heart disease had no previous symptoms.


Whether you are male or female, if you feel you might be having symptoms of a heart attack, don't delay dialing 911. The is very good evidence that your most effective window for treatment occurs during the first 60 minutes after symptoms manifest.

Warning signs:

1. Chest discomfort or pressure sensation ▪ 2.Arm discomfort ▪ 3.Shortness of breath

4. Sweating and clammy skin ▪ 5.Nausea ▪ 6.Stomach pain and feelings of indigestion


Aside from these, women are more likely than men to experience unusual fatigue, sleep disturbances, anxiety, dizziness and lightheadedness, as well as throat, jaw and neck discomfort during a heart attack.


What does science say?

Although men and women share many of the same risk factors for heart disease, there are differences in the way the disease treats each gender’s body. Women tend to develop heart disease an average of 10 years later than men, and have a greater chance of dying from the disease. Women have smaller hearts and coronary vessels, which often makes heart surgery difficult. In fact, heart disease is the number one killer of women, so women especially should talk with their doctors about developing a heart health plan.

Even if heart conditions run in your family, these diseases are still 80 percent preventable. Healthy behavior changes like losing weight, increasing exercise, sensible eating habits and keeping your cholesterol in check will help you make tremendous strides towards encouraging good heart health.

While smart lifestyle changes are important; there is no guarantee that your body will never develop heart health concerns. No matter how many marathons you run or yoga classes you take, you may still be at risk for a heart condition. Do your part by taking addressing stress, healthier eating, and existing disease such as high blood pressure and high LDL cholesterol, smoking and alcohol use.

It’s never too late to treat or prevent heart disease. Your lifestyle plays a crucial role in both controlling risk factors and caring for heart disease. Simple behavior changes like those mentioned above plus working with your doctor to keep your entire circulatory system working like a fabulous, flawless machine. Remember; Love your ticker; you can’t live without it!


This information is solely provided to assist you in a conversation with your physician. Consult your physician regarding the applicability of any information provided to your symptoms or medical condition. Only your physician is qualified to determine what is right for you and your specific health concerns

Resources: Harvard Health Publications, American Heart Association