Is this the Diet for Me? Is it for you?

Intention

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There is a lot of information on the internet and from our friends and family about new diets to try. There are systems such as weight watchers, Nutrisystem, and 30/10. There are diets that tend to be based on values: vegetation, vegan, and paleo. There are also styles of diet, like the Mediterranean Diet and DASH; and there are diets based on convenience. Then we also factor in things like culture, economics, family traditions, personal preferences, personal health history, time in life, gender, exercise pattern and age. How do we know what is “right” for us?

So from the start, we can say that every diet is personal to the individual. What works for us when we’re 20 years old may not work for us when we have kids, a different job, or a change in where we live. “Diet” is not a box we stay in for life, it’s a dynamic choice that we make every day.

I want to start a discussion on how to know if your diet is working for you and if you make a change in your diet, how (and when) do you know that it’s a going to work for you.

One step that people often miss is considering their intention for your diet. It seems so obvious, but we actually use our diet for lots of things: to nourish our ourselves, for entertainment, to connect to family and friends, to drug ourselves in to a sugar coma, to manage our emotions, to celebrate. If we change our diet, we may be trying to change our intention about what our diet will do for us.

I believe the main goal of any diet, 80% of the time, should be nourishment, and to provide long-term and short-term health and mental clarity. Then, 20% is for celebration and connection. It’s natural to use food to manage our emotions - it works so well - but we should be working to diversify our options to self soothe.

What does it mean to have a diet that nourishes our bodies? It’s important to protect our power supply. This means that we need to meet our basic nutritional needs: Are we getting enough amino acid/protein, fats, carbohydrates, fiber, vitamins and minerals, and – importantly - is there diversity in what we’re eating?

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When we make changes to our diets, we should have a sense of how the nutrient content might also be changing, and how the body will respond to that change. Our bodies work hard to maintain homeostasis. If we cut our calories, the body’s natural response is to slow the metabolic rate. This is why quick weight loss diets fail: cutting significantly back on calories signals that there is famine (which means we need to hold on to our fat stores), and it also exposes our brains to stress hormones which makes us anxious, irritable or not present to our daily lives, particularly if we have a history of trauma.

Social Interactions

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Eating food together is an ancient way of interacting. Depending on our jobs, families, and economics, we have more or less ability to be in control of what we eat. When we are changing our diets, we need to consider the impact our new diet will have on our ability to engage in social events. We also need to understand and be prepared to advocate for our dietary needs. Another way of thinking about this is how we can be responsible for our own choices, so that other don’t have to guess at what we need. We also need to have clear plans in place to handle holidays and special events, so that we can still enjoy the social aspects without having our diets derailed.

Personal History

In my clinical office, I often work with individuals who have significant trauma histories in their childhoods. An amazing study on the impact of Adverse Childhood Events (ACEs) shows that individuals who have had a number of traumatic events in childhood are at risk for chronic diseases such as diabetes, cardiovascular disease and obesity. These disease risks can be lowered by our diet choices in adulthood. It’s helpful for individuals with trauma histories to have clear intentions for their diets. Restrictive diets rarely work, because the restrictions often get tangled up with feelings of being deprived. Instead, changing to a diet where they notice that they feel better (in their bodies and minds), and occasionally testing if a new routine is helpful, seems to be more effective because part of recovering from trauma is choice. Being forced - even by one’s own self - is just another trauma.

Shallow end, Deep end

Some people wade into pools from the shallow end and some just jump into the deep end. Generally, if you are going to jump all in to a radical diet change it is worth having some outside support, or a way of reflecting back an accurate picture of how the change in diet is affecting you.

What skills do you need to change your diet? How do you know if it’s working for you, and when should you check back in with yourself to be sure that it continues to meet your intentions? What if your needs or intentions change?

This will be the focus of September's Connectors Group webinar - register now to join the conversation.

Not Hungry in the Morning?

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You or someone you know may not be eating breakfast. "I’m just not hungry." Or you have breakfast when you get to work – 2 hours later. Just to be clear, breakfast is the meal that breaks the sleep fast, and your body expects to receive food within one hour of waking. 

Why would someone not be hungry in the morning? It’s not because you ate a big meal in the evening. I know when I have my Thanksgiving meal at noon; I am hungry again before bed. 

So why don’t you feel hungry when you wake up? If your glucose (brain fuel) level dropped too low while you were sleeping, your liver would have already received the signal to deliver a cocktail of hormones that tells the body to make fuel for the brain – and part of the cocktail is adrenaline. When adrenaline is in the system, we tend not to feel hungry. Historically, adrenaline signaled that someone or something was trying to hurt us and we should run; running and eating are not tightly wired together. 

Clinically, the short-term consequences of skipping breakfast happen about 8 hours later. You might be fatigued, and your lizard brain takes charge. This increases the likelihood that you will overeat, have more alcohol before or at dinner than planned, and have passive evenings.

What are the long-term consequences of skipping breakfast?  When we skip breakfast, we set up a cascade of stress hormones that are working to maintain our fuel supply. The most recent studies suggest that not eating breakfast causes:

  • increased calorie intake during the day,
  • Increased stress/inflammatory hormones, such as cortisol and insulin,
  • increased weight gain and adipose tissue/body fat,
  • increased cholesterol and blood pressure, and 
  • increased cardiovascular disease.

What to do about the fact that you just don’t feel hungry? Typically, a quarter cup of fruit juice or some other quick-acting sugar, such as a teaspoon of honey, will get your body to send the hunger signal within 20 minutes. Then, you can have breakfast. For the people who are not eating because they are jumping out of bed to go to work, try putting a protein shake in the refrigerator the night before so you can grab it on your way out in the morning. If you do this for about a week, you might find that your hunger signal kicks in more easily in the mornings. 

Do you skip breakfast? Try the experiment of starting your day with food that has protein (14-20 grams) + carbs + fiber + fat. This Shortcuts post has some ideas for breakfast. Observe the following changes:

  • less anxiety, irritation, and agitation in the mornings
  • more energy and mental clarity in the day
  • less overdoing intake of sugar, alcohol, or snacking 8 hours after waking
  • better sleep 
  • increased ability to participate in after-work activities that are important to you. 

Tell us about your experience on the Dynamic Paths Facebook page or add a comment to our blog. 

Shortcuts to a Quick Breakfast

  • Ready-to-drink protein shake (Odwalla Protein Shake or Orgain protein shake) with an apple
  • Protein bar: Cliff, Zing, Stinger, or high-protein Kind bars
  • High protein Greek yogurt (Fage, Chobani) with walnuts, almonds or cashews and raisins, an apple or 1/2 a banana
  • Apple, carrot and/or celery with 4 Tbsp of nut or seed butter (almond, cashew, or tahini)
  • Whole eggs: 1-2 scrambled/boiled/fried with a handful of veggies and toast or sweet potato
  • Breakfast burrito with scrambled eggs, veggie sausage or refried beans, a handful of veggies, and cheese
  • Make own protein shake with whey or rice protein powder, dark berries, chocolate powder, coconut milk and water
  •  My favorite –  Dinner!

Share your favorite breakfast ideas by commenting below!

Who's in Charge - Your Brain or Your Mind?

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What is the difference between your brain and your mind? Dr. Dan Siegel has been very helpful by distinguishing the difference in his many books. Here’s how I think about the difference: the brain is the hardware that keeps track of information, repeating behaviors and keeps us alive; the mind is software that can manipulate the information in response to the present moment. The brain is powered by the body and by the input and output about our environment and relationships from our senses. The mind arises from our brain, body, and relationships, and provides the observational self.

I am grateful for everything that my brain automatically takes care of... breathing, brushing my teeth, driving my car home when I am tired, putting clothes on in the mornings. These are habits that support the functioning of my life. Of course, we can have good habits and bad habits. Another way of thinking about behaviors is who is choosing the behavior and for what reason? Is it our brain or is it our mind?

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Let's do an exercise to demonstrate changing a habit that the brain is in charge of: brushing your teeth. Let's imagine that you are going to do whatever it takes to not brush your teeth for three days. You can use breath mints or chew gum, and we can acknowledge that your teeth will not rot in the three days.  Ok, don't stop reading, I know that you are not going to do this exercise. The point is that when the brain is in charge of this behavior, it takes a lot of energy to change that wiring and we will feel uncomfortable in the process.

Many things can get wired in as a brain-habit that we may want our minds to stay in charge of. Food is an example. One day I had a handful of chocolate chips after lunch. Then, it happened another day and another day. Eventually, my brain decided that the rule was handful of chocolate after a meal. Ok, lunch and dinner... sometimes breakfast. I often eat and then leave the house and because what happens together wires together, my brain rule began to ask me if I needed a handful of chocolate chips to leave the house. Sure why not? Ok now my brain is asking for chocolate after every meal and as I prepare to leave the house. At some point, my mind said "Hey, have you noticed that I’m eating chocolate chips 3 to 6 times a day? My brain said " I just need them."

Having a habit hard-wired into your brain means that those wired circuits need to be used and if you stop the behavior your brain make you feel uncomfortable, anxious, or agitated just like you would if you tried to stop brushing your teeth.

Now there is a tug-of-war between my brain and body and my mind. Sometimes my mind says "no chocolate chips," but if I am not paying attention they just get grabbed before I have a chance to decide. I could just decide to not buy chocolate chips but I’ve tried that in the past and I just replace the habit/addiction with something else that’s in the house. 

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When I want to make sure I’m not in a brain rut, I apply the choice of three: when we have three choices, we make better choices (check out the book Brain Rules by John Medina). So, if I need a signal that a meal is done, here are my three choices:

  1. chocolate (but not everyday),
  2. a piece of fruit, or
  3. a moment of silence about the meal, where I relive the meal - particularly if it was a meal that I would like to make more of. By reviewing the meal, I am signaling that is should be remembered and I am increasing gratitude.

When I am leaving the house, I try not be on the phone, and to stop to see if I have everything. I found that the chocolate grab also helped slow me down so that my brain had time to remind me that I forgot to something. So stopping to review and breathe is also helpful and it gives me time to ask myself "do I have everything?"  I have not created three options here because the brain has about 7 slots to juggle everything making one of three choices when I know I am in a rush will just assure that I leave more thing I need at home, so I just try to be mindful about leaving.

Meals and exercise are good opportunities to slow down, where we can practice being mindful of our choices rather than run by brain-driven rituals. Having 3 options that we try and cover each week will also increase the variety of nutrients that we eat or the ways we move our bodies; making sure we don’t get bored has the added benefit of preventing burnout on any particular food or exercise.

One of the things you’ll notice is that I treat my brain and my body as if they are good friends who are always traveling with me. They each have their individual jobs but none of us get to dominate the discussion.

I wonder if anyone else has a committee? How do you experience your brain and mind?  Feedback on this article is welcome

Short Cuts: Ways to keep your mind in charge of your brain

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We all need routine to make our busy lives efficient. We need to put things on autopilot to function. But sometimes we become too efficient. Part of what governs what the brain does is “what happens together wires together”. As the behavior happens hundreds to thousands of times, it becomes a brain-habit and we feel uncomfortable if we deviate from it.

Examples of this are: We eat the same thing for breakfast every day, we always watch a show at 7pm, we have alcohol with every dinner, we do only one form of exercise… However, if we maintain three options for any given activity, we are more likely to vary our choices and not get bored and stop or consistently turn to addictive foods, screens, or substance.

So what are your three go-to options for breakfast, lunch, snacks, dinner, before bed activities, and ways of moving your body?

To help you with the meal and snack options, we have handouts for omnivores and for vegetarians.

Food of the Month: Blueberries

"Eat fresh non-sprayed dark berries, such as blueberries."

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Traditional medicine (medicine older than the last 100 years) says dark berries, such as blueberries, are good for lots of conditions: vision, prevention of varicose veins, improvement of memory, slow the progression of heart disease, diabetes, and prevention of urinary tract infections, to name a few.

When I started naturopathic medical school, more than 20 years ago, the pushback to traditional medical statements about one fruit helping so much was How can one small fruit do so much? My response was the same as for any medication: It’s what’s in it.  Why would a pill be more powerful than what our body has consumed for thousands of years? 

Now we know a lot more about blueberries and if you search Pubmed, you’ll see that they are starting to be treated as a medicine. Blueberries are full of compounds that help with inflammation, help with glucose control, prevent the breakdown of acetylcholine (a neurotransmitter that helps us see colors and objects in our imagination), prevent cancer... the list continues. The World's Healthiest Foods website has a great description of the science if you are interested..

Many people are talking to me about memory; blueberries and other dark berries have been my go-to medicine to help.  A quick look through Pubmed found an article about a study where the treatment group got blueberry juice 2 weeks before receiving general anesthesia and the control group did not. It was found the group who drank the blueberry juice had better attention and memory after receiving general anesthesia than the control group.

Ok good to remember for our next planned surgery, but there are other places where chemicals affect our brain. Blueberries help protect us in any place where we are exposed to volatile chemicals: panting a house, being in a home with chemical air fresheners, working on machinery, being in an area with forest fires… If you can smell it and it’s annoying to you, you can try some yummy blueberries. And there a good treat to improve your memory in general.

My favorite ways of eating blueberries:

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By themselves: First, make sure they are organic or non-sprayed. The pesticides are not helpful because these are some of the chemicals you are trying to avoid. Second, wash with cold water. Third, pick them up and place in your mouth. Yum!

In yogurt: Mix together plain, full-fat greek yogurt, almond extract and vanilla extract to taste, pecans, blueberries.

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In any salad!

It’s also interesting to notice if blueberries count as a carbohydrate for you. It is ok if it doesn’t, you have to consider your whole health and where you are on the spectrum of need for sweet taste. But can it be enough carbs for a salad or the yogurt? For me, some days they are and some days they are not.

Fuel for Thoughts: CrazyWise and Connection

The other night I went to a showing of CrazyWise, the documentary by Phil Borges and Kevin Tomlinson. They examined the question of why the recovery rate for mental illness in industrial countries is one third, and in developing countries two thirds? Think about that for a moment. All our medications and skilled providers plus billions of dollars is not working!

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Often what we see in the US as mental illness, such as depression, anxiety, or hearing voices, is seen as a calling in other countries - an experience to learn more about yourself. It might mean that you will become a healer because to understand yourself you have to understand the fundamental nature of being human. Within the countries with higher recovery success rates, the people in the person's community will connect with them. Again, let’s think about this for a moment, when a person is struggling their community comes together or someone experienced wants to be curious with that person about what they might need to understand about their self.  They offer connection and compassion.

Part of the problem in the western world is that we are in denial about the prevalence of Adverse Childhood Events (ACE). In some communities, it's above 50%. An adverse childhood event is an event that is beyond the comprehension of a child (abuse, neglect, divorce, illness, addiction). Really these are beyond the comprehension of adults as well, but for children, it threatens their nervous system in a way that can set a person up for mental illness, addictions, and physical health challenges such as diabetes, obesity, and cardiovascular disease.

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What I loved about CrazyWise is that the movie is not saying that medications are bad. They are suggesting that the path forward is connection. Rather than labeling someone in crisis as ill, let’s think about how to get that individual more connected. Evidence-based studies are showing that community helps with addictions, psychotic episodes, homelessness, depression, anxiety, and the list continues.

The path away from mental illness is connection: how we each connect to our bodies, ourselves, other people, and nature.

As an experiment, think about what your connections are. Can you draw a map of your connections? Maybe a thin line for loose connections and a think line for strong connections. Are they all people? What about animals, plants, places, food, activities, art, crafts, books, communities... Where do you put our energy and where do you receive our energy?

Short Cuts: Artichoke Recipe Ideas

Here are my favorite quick and easy artichoke recipes:

Super quick: 1 can artichokes, in water (from Trader Joe's for the discount). Drain. Eat!

A slightly longer shortcut, toss together the following.

  • 1 can of water-packed artichokes, drained
  • Fresh squeezed lemon juice, to taste
  • 1-2 TBS of olive oil
  • Salt and pepper to taste

Option 1: add chopped garlic in with the lemon and olive oil

Option2: instead of olive oil, mix the lemon juice, salt and pepper into a cup of greek yogurt then toss with the artichoke hearts. Snipped scallions optional.

Salad Idea:

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  • 1  can of water-packed artichokes, drained
  • 1 can of garbanzo beans or white beans, drained
  • 1 jar of fire roasted red peppers,drained drained
  • Olives
  • Feta
  • Place artichoke mix on a bed of arugula

Food of the Month: Artichokes

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When I am talking to people who say they dislike veggies, I always ask are there a few that they like. If they can’t think of any, I start naming veggies that they might like. 

I usually start with artichokes. Most people, but not all, like artichokes. Usually, the expense comes up. “Well, they are over $4 per can at the market.” Yes, and at Trader Joe's, artichokes canned in water are less than $3 per can and they will not rot in a week. How many veggies have gone to waste by not eating them in time? Fresh is better, of course. But we are looking to do a little better than what we we're currently doing and trying to create sustainable behavior.

Plus they are super healthy for you. I like them in terms of helping with energy and mental clarity for a number of reasons:

First, they are high in antioxidants such as Vitamin C and A.

Next, they are great for our liver in that they help the liver produce bile. Bile helps our us absorb fat soluble vitamins such as A, D, E, and K. Bile also helps kill bacteria that is on our food and neutralize the acid from our stomach so that it does not injure our small intestine.

Lastly, and back to food and mood, artichokes are high in fiber. Fiber is one of the mechanisms that help with glucose control. However, there seem to be other mechanisms at work because they're more effective at this than can be accounted for by the amount of fiber. Probably because it supports the liver.

The take-home message is to put canned artichokes in the kitchen cabinet for when you are in a rush and won't otherwise get your veggies in.

Here's a study about artichokes for further reading.

Fuel for Thoughts: Preventing Night Terrors

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For years, I had a consistent dream of a bear chasing me. I would wake with my heart racing. I didn’t want to go back to sleep for fear of the bear returning.

How do I fix a problem when I am not even conscious for the event? I started to look for patterns.

I noticed that when I went out with friends and had a drink with dinner, the bear would predictably visit. I noticed that when I had a late dinner with lots of protein and no alcohol, the bear was absent. I moved into a new apartment in the summer and it was hot, so I left the bedroom door open for a cross breeze. No bear. It cooled down and I closed the bedroom door while I slept…bear. Open door, less likely bear. I started a list of what seemed to make a difference. Open door, protein at night, limit alcohol at night: the bear dream was more manageable.

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I started seeing a therapist to address some anxiety about being dyslexic and in medical school. When my therapist showed me how turn into my anxiety instead of trying to ignore it or avoid it, my dream changed. One night, instead of running from the bear, I turned to face it and said “What?!” The bear just stopped and sat down in front of me. I had a sense that I had found a new best friend. Now, I can trust my anxiety to tell me when something is off, and I can look with curiosity until I understand my discomfort.

Later as I started to study the physiology of mental health and how the brain works, I could see why my observations helped. Not getting random hits of adrenaline due to dropping blood glucose from alcohol or not eating protein is helpful.

We all have ancient brains that will scan our environment for safety and make sure we are not being approach by lions (or bears). We all need to figure out what our bodies and brains need to feel safe., especially while asleep.  Nightmares and night waking are a chance to listen deeply for what we need, observe our patterns, and do experiments to learn more about what the body and brain need. Please read the Short Cuts post for more ideas about how to improve sleep. 

Short Cuts for Improving Sleep

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There is a spectrum of sleep disturbances that can affect us: such as nightmares, anxiety dreams, sleep terrors, fitful sleeping, awake in the early morning for two hours (“3AM Committee Meetings"). If you suffer from having your brain wake you up or sleep through horrible stories, you may have tried various prescription medications only to find that maybe you don’t remember not sleeping well but still feel tired and groggy.

I suggest trying an experiment to prevent hypoglycemia and keep you brain oriented to the safety of today. This might help you reduce your medications or prevent the use of medications.

Let’s create check list of things that are likely to decrease sleep disturbances:

  • Go to bed at about the same time every night and wake at about the same time every morning.
  • Sleep in a relatively quiet space
  • Sleep in relative darkness
  • Turn off screens one hour before bed
  • Have any alcohol and dessert shortly after dinner, not on its own away from a meal
  • Have a consistent ritual to indicate that it is time for sleep (drink a cup of herbal tea, take a bath, read a book, play a game of cards…whatever works for you).
  • Remove screens from the bed room; alarm clocks can replace smart phones.
  • Rule out sleep apnea at a sleep clinic

If the above list is basically being adhered to and sleep disturbances still occur, try the following experiments:

  1. Eat protein before bed, such as a piece of turkey or a couple spoonful’s of cottage cheese. This will stabilize your blood sugar. One cause of sleep disturbances is dropping blood glucose and the resulting sudden release of adrenaline.
  2. Have a Lizard Brain Treat ready: a ¼ cup of juice and one handful of nuts will often help you get back to sleep within 30 minutes rather than 2 hours. For early morning nightmares, if they are consistent, and you wake to go to the bathroom, have the juice and nuts - this will keep your blood glucose up and prevent an adrenaline release by keeping your brain fueled. Try this for at least 5 to 7 days to see if it works.
  3. Work with a therapist to address how you understand anxiety and any past trauma.
  4. Create cues of safety during sleep. The problem and blessing of sleep is that you are not time oriented. In your brain, the past can be present and the future can be worried about. Historic memories can replay past trauma or only parts of past trauma, such as the emotions, the sounds, or the sensations. Creating a sensory experience that your brain can monitor will help indicate that it is the present moment and safety is being sustained through the night can help. This takes a little internal work to overcome what your “rational brain” will say. I have clients who just keep asking “what do I need to feel safe while sleeping?” Some women have put a lock on their bedroom door even though the house is locked and they have a large dog. One person tied a string to the door of the bedroom and to a vase that would break and wake them up. Sometimes it just helps to take a flat sheet and wrap yourself in a cocoon. Playing sounds of the ocean might help.

Sleep patterns are challenging to change because for the most part our conscious observer mind is asleep and is only receiving partial information. So when deciding to do a sleep experiment be sure to try it for at least 5 to 7 days. If the experiment works, try to be consistent for at least 6 months to rewire the new sleep habit.

Eat to Support Sleep

This month we are discussing how to improve sleep. Eating protein before bed can help with nightmares, night terrors and night waking.

But what kind of protein and how much?

If we look at the Optimizing Brains Chart (page 2), we see that 3 ounces (about the size of a deck of cards) of any kind of meat or fish is about 20 grams of protein, which is roughly what a person can absorb and muscle can use in an hour.

For sleep we may not need that much. I suggest starting with 2 ounces (not quite a deck of cards), or 10-12 grams of meat or fish protein. I usually just have people have meat without anything else.  For vegetarian sources, 2 tablespoons of nut butter, or ½ cup of quinoa or cottage cheese often does the trick.

Short Cuts: Use a hand blender to support physical and mental health

The key to eating better is having the right tools to prep food quickly and deliciously. To get my clients to eat more veggies, I often encourage salads. For the busiest individuals, they can buy a package for pre-washed lettuce, add a tomato, a couple of canned artichoke hearts, and ½ avocado, plus a link of sausage cooked over the weekend or a can of skipjack tuna. Add salad dressing and it is good to go.

Making my own salad dressing keeps me from getting bored of salads. One day it is apple cider vinegar, garlic, mustard and olive oil. Another day, it is tahini, apple cider vinegar or lemon, tamari, garlic, graded ginger from a jar, and water. Great with baked cauliflower. Third options is red wine vinegar, olive oil, handful of cilantro, garlic. All of these come together in less than 5 minutes by having a hand blender.

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The short cut that makes the biggest difference for me is using a plug-in hand blender. I tried the cordless blenders and then I never had power when I needed it. I have had the Cuisinart version for years, but you can buy cheaper ones - they all seem to work. What’s awesome about hand blenders is that it takes 3-5 minutes to make the best salad dressing, so quick that you can easily make a different one every time. As a bonus, hand blenders help make great soups in the wintertime too.

How a hand blender helps support mental health:

  • When cooking is easier, we do the self-care of feeding ourselves well more often. Eating at home generally offers healthier choices, particularly if we make it ourselves.
  • Ideally we should be eating 5 or more cups of veggies every day to nourish our bodies; Salads generally have 3-5 cups, and we’re more likely to eat them with good-tasting dressings.
  • Cooking for ourselves is a chance to decide if we like something or not. We get to experiment. We set our own standards for the day. We get to practice creativity and how to recover from small failures (by learning which combinations of ingredients we don’t like). Salad dressings are a cheap and recoverable place to start. You can try a new dressing quickly with the hand blender and if you don’t like it, throw it out and try again.
  • Hand blenders cost $20-40 and is a tool for self care.

Again if we are going to cook more, we have to make it easier.

Here is an example of what I am taking about:

Be sure to write in your questions on how to do the self-care for better mental health. Feel free to write anonymously ("I have a friend…")

Food of the Month: Apple Cider Vinegar Decreases Inflammation

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Spring is here! My salads are back. I always feel better when I am eating more salads.

When I was in college I found a book in the library that had a series of questions written to a doctor in the early 1900s and posted in a newspaper. The answer to many of the various problems was to include 1-2 tablespoons for apple cider vinegar in the diet. This is part of how I got started in natural medicine: it made sense to me that diet impacts health because I know that I feel better when I add some acidity (apple cider vinegar, lemon juice, or lime juice) to my diet a few times a week.

I have been poking around PubMed, the free-to-all medical literature search engine, to piece together why apple cider vinegar has been used throughout history for both physical and mental health. This year in the Journal of Food Medicine (see links below), apple cider vinegar has been shown to reduce malondialdehyde levels. Malondialdehye levels are a marker for inflammation. Studies have demonstrated that it is elevated in major depression, social anxiety, ADHD, schizophrenia, and bipolar, as well as cardiovascular disease and diabetes.

Clinically, I use it to help start digestion for various GI challenges. A little cider vinegar in water before a meal increases the gastric acid in the stomach and gets digestion going. I have also had patients use it, along with garlic and ginger, to prevent colds and flus.

But, lets get back to spring salads and using apple cider vinegar.

Braggs Organic Apple Cider Vinegar is the only one that I have found that is both unfiltered and unpasteurized. I also like Trader Joes’ Organic Apple Cider which is unfiltered but pasteurized.

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I love making my own salad dressing because then I know what is in it and I can use olive oil which is better than the oils often used in commercial salad dressing. And I can make any number of salad dressings with lots of different flavors!

Benefits of using apple cider vinegar:

1.      Dressing salads results in eating more veggies.

2.      Mixed with water, it makes a good stomach elixir for digestive problems. Mix 1 tablespoon in 1/8 cup of water before meals. Try this for 5 days to see if gastric reflux decreases and energy and mental clarity increases. Over time it will also help the absorption of iron and B12.

3.      Mixed with water, ginger and honey, it helps slow down or prevent colds. Mix 1-2 tablespoons in a cup of hot water with grated ginger and 1 tablespoon for honey, drink 1-3 times at first symptoms of a cold.

4.      It lessens nigh-time leg cramps. Mix 1 -2 tablespoons in a cup of hot water with grated ginger and 1 tablespoon for honey. Try for one week to see the effects.

Although these seem like a large range of challenges, apple cider vinegar works because it decreases inflammation – a driving force behind these and many other ailments.

Let us know how you use it and how it works for you. 

References:

Fuel for Thoughts: Panic Attacks in High Functioning People

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Have you ever known someone who seemly had it all together? And then, she or he seemed to spiral downward with anxiety and depression, even though it seemed out of character. Brad Stulburg, a published author on productivity and performance, recently published an article on his experience with anxiety and panic attacks. I have been following his blog lately because he encourages mindfulness, sleep, and exercise for executives. His anxiety and panic attacks are completely new phenomena to him. He writes candidly about the impact this had on his life and his advice toward the path out.

I was intrigued when Brad shared about the day of his first panic attack: his hadn’t fed his body well during the day, and after exercise he had an alcoholic drink and snacked on potatoes chips. We’ve all done it. You meet some friends at a bar for a drink after a long day and there is no real food available. This combination set up the event of his hypoglycemia (low blood glucose for the brain) and - in my opinion - a shot of adrenaline that was at a survival dose rather than risk taking/excitement dose.

This combination made his amygdala (the reactive/lizard part of the brain) hyper-sensitized to adrenalin. Emotionally, there was no good story about why his adrenalin hit was so high – no attack, no accident. So his brain is trying to find an emotional meaning for the event, when perhaps it was his physiology that was the driver of the adrenaline.

Exercise + refined carbs + alcohol + normal aging process = big release in insulin + sharp drop in glucose + big release in adrenaline = Anxiety and Panic attacks. 

This day of poor self-care set in motion his reactive brain trying to be in charge of his mind, and he has been working hard ever since to regain and maintain his mental health. This can happen to anyone. His example illustrates the importance of nutrition for taking care of one's body to maintain a stable brain and mind. His courage to share his experience helps us all know that we can return to health.

Question: How can we create food safety nets for ourselves and others? Can we keep protein bars or nuts in our bags? Or throw a box of protein bars into the truck of our teenager? Can we ask to meet at bars that have food? 

Share your thoughts by commenting below.

Short Cuts: Experiments to feeling better

We often think that feeling better takes a lot of time and energy. This idea is certainly supported and promoted by the weight loss industry! But there is a difference between feeling better today, next week, and weight loss. It’s also important to understand that sustained weight loss is very complicated. However, what if our goal is just to have 10 to 15% more energy and mental clarity? This is very possible right now, with a little experimentation.

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I like doing experiments for my health. It allows me to evaluate if a new behavior is worth continuing and also when to use it most effectively. There are lots of little experiments that can improve how you feel, in as little as 10 minutes or just a few days. And this means you might then have the energy to do more to feel even better.

For example, years ago I discovered that if I exercised in the morning my dyslexic brain worked better. With more experiments I discovered that it takes about 20 minutes of walking or 15 minutes of stretching, weight lifting and balance exercises to see a benefit at the end of the day. When it is beautiful out, I go for a walk; when it is raining I work out in my living room.

Every experiment has to have a definable benefit. Not just “because I should”. For me, when I work out in the morning, I can get my clinical notes done with the patient in the room or in the time before my next patient. When I don’t exercise, I spend 45-60 minutes charting at the end of the day. On my non-clinical days, I spend less time wondering around the internet looking for heartwarming videos and more time on my own passions. It took a month of morning work outs for me to see the correlation. Now that I see it, I can see that the benefit is immediate.

Here is a pdf that outlines some short cuts to feeling better. I invite you to choose one to experiment with. Let me know how it goes, or share your own short cuts, by commenting below.

Food of the Month: Dark Berries

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Dark Berries: Raspberries, Blueberries, Cherries, Blackberries

This month’s theme it about how to help your brain recover more quickly from stress. One of my favorite foods to add to a client’s diet is dark berries. I am not going to get all geeky about the names of the chemicals that help your brain. You can look those up if you need them. What I am going to highlight is some of the great things they do for you when you consume them consistently.

Clinically, clients report better memories and a clearer ability to see in their minds. For example, the color of your car is ______? You can see your car even if the car is not actually in the room that you’re in, right? Eating berries helps the brain visualize concepts colors, and thoughts. Additionally, studies show that dark berries also:

  • improve memory and the connections of nerves in the brain
  • help prevent some cancers and cardiovascular disease
  • are high in fiber, without a lot of carbs
  • are high in antioxidants, which help reduce inflammation and protect cells from oxidative stress damage.

I’m often asked if it’s important to eat only organic berries. Organic assures that they have not been sprayed with pesticides, but some farms are not certified organic but don’t spray. It’s the residual pesticides that you want to avoid, so ask your grocers and if you can’t get non-sprayed berries, be sure to rinse them well before eating.

How much to eat? Fresh or frozen, 1 cup a day is not too much. Dried berries and juices are denser so limiting these forms to ¼ to ½ cup per day is a good rule of thumb. These serving sizes are about 15 to 20 grams of carbs. If you are trying to stabilize your glucose and prevent hypoglycemia, pairing the berries with 1/4 cup of nuts or ½ cup of Greek-style yogurt is a good idea. This will give you a carb to protein ration of 2-3 to 1. 

How to help your brain recover more quickly

Have you ever thought about how important our brain is for getting through our day? Our brain is involved in everything we do: sensing, breathing, thinking, walking, speaking, interacting, choosing… to name a few. Research is showing that movement/exercise is one of the best activities we can do to support and heal our brains. Exercise prevents and improves brain-related diseases such as:

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  • addiction
  • ADHD
  • major depression
  • Alzheimer's disease
  • plus most physical health diseases such as cardiovascular disease, diabetes, and cancers.

When we sit and think all day we are using just a small part of our brains. What if when we are tired and unclear mentally, it is because the part of our brains we have been using at work is just tired and the other parts are just waiting to be used?

I have recently been introduced to this idea. A few years ago, I was in a motor vehicle accident that disrupted my vision and balance. Now, when I over-use those nerves beyond their current capacities, I get symptoms of fatigue, visual changes, nausea, neck pain and tinnitus. For a while, it was recommended that I stop and do nothing when this happens, because everything is related to vision and balance. When I had to spend a long time in a car, for example, it would take days to recover.

Another idea is that I can switch and use non-tired parts of my brain. My Z-health trainer, Jennifer Nerio at TAISO Fitness, has shown me over and over again that if I use other parts of my brain that are not tired my symptoms resolve faster. Now, doing movement on the ground can help me recover in minutes rather than days.

This reminded me that I used this same concept when I was in medical school.  I would study, study, study and when I could not study any more, I would do 10 pushup or sit ups. By doing movement that I was familiar with - most importantly movement that I was not seeking improvement with, I was able to rest the neuro-nets that I was using for studying.  By the end of the set of muscle movement, I could go do more reps of mental movement on gross anatomy.

Where can you do cross training for the brain when you are intellectually or emotionally tired, remembering that the movement should be something that feels safe and comfortable?

If you are curious and want to glance through more science about the overlap of cognition, emotions and movement, I suggest the Wikipedia article on the “Neurobiological effects of physical exercise”. If you want to get more in depth, I recommend the book Spark: the revolutionary new science of exercise and the brain. 

On-The-Go Protein Sources

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Sometimes, between meetings or when on the road, I need a protein snack to get me through until I can site down for a meal. If I know I'll be having that meal in an hour or two, something with 8-10 grams of protein is ideal. If it's going to be longer than that, I'll reach for something with closer to 20 grams of protein as a one-off meal replacement.

Protein bars that have between a 1:1 - 3:1 ratio of calculated carbs to protein, are made with real ingredients (meaning I can pronounce and recognize all the words), no artificial sweeteners (manitol, stevia, aspartame), and - for me - no gluten, are ideal. 

Remembering that calculated carbs are total carbs minus fiber, here are some of my favorite protein bars that meet the above criteria*. I have indicated which flavors I like, but note that there are some variations in nutritional values among the different flavors - so don't forget to read the label!

•  Stinger Protein Bars (Mint Almond) - 17 grams calculated carbs, 10 grams protein, less than 2:1 calculated carbs:protein ratio. Gluten free, but not hypoallergenic, Has chocolate! 

•  Zing Bars (Double Nut Brownie) - 14 grams calculated carbs, 10 grams protein, less than 2:1 calculated carbs:protein ratio. Gluten free, soy free. vegan. Has chocolate!

•  Square Bars (Toasted Coconut Crisp) - 21 grams calculated carbs, 10 grams protein, 2:1 calculated carbs:protein ratio. Gluten free, dairy free, soy free but not hypoallergenic.

•  Clif Bars (Chocolate Chip Peanut Crunch) - 34 grams calculated carbs, 10 grams protein, ~ 3:1 calculated carbs:protein ratio. Has chocolate!

•  Clif Builders (Vanilla Almond) - 26 grams calculated carbs, 20 grams protein, close to 1:1 calculated carbs:protein ratio. With 20 grams of protein, this is more of a meal replacement than snack - but you can always break it up into chunks.

•  Rise Protein Bars (Almond Honey) - 16 grams calculated carbs, 20 grams protein, less than 1:1 calculated carbs:protein ratio. With 3 ingredients (almonds, honey whey protein) - this is as simple as it gets! Gluten free, soy free.

•  Kind Protein Bars (Double Dark Chocolate Nut) - 12 grams calculated carbs, 12 grams protein, 1:1 calculated carbs:protein ratio. Has chocolate! 

Other great on-the-go snacks are:

•  Krave Jerky (beef or turkey, flavored or not) - 10-11 grams calculated carbs, 10-11 grams protein, 1:1 calculated carbs:protein ratio,. Some choices are gluten free. Chewable!

 • Trader Joe's Nut Packs- Protein to Carb ratio will vary. Getting the individual packs will limit the unchecked grazing and prevent eating a pound of nuts -- which can be done in a day. 

Post a comment below to share some of your favorite on-the-go protein snacks.

*Note: I am not affiliated with these brands in any way.

Food of the Month: Cashews

Throughout 2018 I am going to highlight a food or product that helps us fuel our brain and body. 

If you don’t know about The World’s Healthiest Foods website, I love it. George Meteljan has done a great job describing the benefits of individual foods and why they are healthy for us. He mostly focuses on physical health. I will add to this and describe why the food also promotes good mental health. 

Cashews 

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If you enjoy cashews, a handful of them as a midday snack is a great fuel to stabilize the brain before you go home to the kids. First, it's a good protein source with almost 8 grams of protein per 1/4 cup. It's also loaded with good (unsaturated) fats which not only help your heart but also help the myelin sheath of your brain. The big bonus to cashews is that they are high in copper and magnesium. I am often thinking about whether an individual is getting the right nutrients to synthesize dopamine and serotonin and both of these minerals are needed for the synthesis of neurotransmitters for our brain. 

Magnesium helps calm, and thus organizes nerve activity; it can help with depression, anxiety and sleep. Copper helps convert dopamine to norepinephrine and serotonin into melatonin. In my office, I check for copper deficiency. People with overt copper deficiency will be able organize chaos and complete tasks (dopamine characteristics), but they don’t get any pleasure out of doing it (low level of norepinephrine). Sometimes they also have problems sleeping.

Since high levels of copper can cause problems for both physical and mental health, if I am going to supplement I do it carefully. I would not recommend supplementing copper without lab work. However, increasing copper through food sources is a different story. When we eat whole foods and have a diversity of foods in our diets, it's challenging to overdose on nutrients. If you don’t like cashews, feel free to eat other nuts as a snack. All of them have a healthier profile than the sugar-carb treats that are so easily shared at work. 

Do you have favorite foods, or foods or products that you're curious about? Post a comment below to let me know what you're interested in learning more about.