Getting enough protein as a vegetarian or vegan

This video talks about how vegetarians and vegans can get enough protein and be at their best.

• 0:00 Intro

• 0:21 How much protein do I need? (here’s a link to the Huberman Lab podcast referenced)

• 1:39 Challenges with getting enough protein

• 4:43 Sources of protein

• 6:37 Protein powders

• 7:10 Sample menu

• 8:22 Glucose curves with different types of food

• 9:16 Continuous Glucose Monitors as a tool

We're working on creating short educational videos this year and would love your feedback and topic suggestions!

Continuous Glucose Monitors and Mood

This video talks about how glucose levels impact mood, focus, and fatigue - and shows an example of what hypoglycemia looks like on a continuous glucose monitor. Learn more at KristenAllott.com

We're working on short videos this year and would love your feedback and suggestions for topics!

Once Upon a Time There Was a Whirlwind Named Jane . . .

or Making a Plan to withdraw from Antidepressants

Jane markets software development.  She is a 35-year old “got it together” professional woman.  At least, that’s the way it seems on the outside.  As a networking master, success flows easily for Jane — so easily, that she runs on “automatic” most days.

It’s those early morning mental gymnastic sessions that are driving her nuts!  Months of waking up at 3:00 AM with her mind racing in all directions, from setting appointments with prospective clients that she has been wanting to see for two years to questioning if she wants to have Sam’s babies or not. . .  Jane is beginning to believe that Sam and she have a future together. . .  She used last week’s early wake ups to work through the fact that she and Sam more than like each other and have a chance of creating a long-term relationship. . . 

"Should I be thinking about children when I have a wild obsession with Doritos and dirty martinis?. . .Could that be why I’m gaining weight? . . . I’ll talk to Sam about this tonight.  We’re meeting at the Matador in Ballard for. . . Well . . . it began in my 20’s.   I was a vegetarian . . . About that same time I began taking antidepressants . . . I’ve never been without them . . . Well, for not  more than three weeks since then. . . Could . . . Maybe . . . Hold it!  Hold all those thoughts.  And, hold this thought, too:  I’ve got to get myself together."

For Jane, getting herself together means scheduling a yearly physical with her primary care physician, checking in with her therapist, and taking care of some unfinished matters that she has let ride for too long, like getting off the anti-depressant.         

Several weeks later, Jane’s primary care physician encouraged her to consider seriously dieting because of the history of diabetes in her family.  In the same week, her mental health professional referred Jane to Dynamic Paths to assist her in getting off of antidepressant medications.  While taking the medications, Jane notices she gains weight and she experiences decreasing sex drive.  Over the last few years, she has tried unsuccessfully to stop taking the antidepressants several times.  The time seems right to tackle this issue again, given the positive nature of her relationship with Sam and the momentum building in Jane’s “getting it together campaign”.

Jane read the Dynamic Paths’ website, noted the various services, and spoke to Dr. Allott by phone.  She found out that Dr. Allott and Heather Brummer provide similar assessments and client education in the beginning.  So, Jane decided to set an appointment with Heather, who sees clients after work several evenings a week. 

“I actually liked the idea of two people reading my screening results and thinking about me.  Besides, my initial costs will be a little less when I see Heather Brummer and more within my “getting it together budget.”

Heather and Jane worked together for three appointments and, after some simple dietary changes, Jane was sleeping through the night.  She began to notice she had more energy as well. 

"Is the 'getting-it-together campaign' working?  she pondered. Well. . .  yeah.  I can tell I’m changing and that is encouraging. Yeah, I’m even willing to do a little more in the way of exercising — but, just a little.”

At the end of her third appointment, Heather provided a lab slip from Dr. Allott.  Heather explained that Dr. Allott wanted to be sure that Jane’s body was absorbing nutrients with the new diet changes. “The lab work will allow us to answer this question,”  Heather stated, “Do you have sufficient nutrients for making dopamine and serotonin before starting the weaning-off process from the antidepressant medication?”

Jane’s next appointment was with Dr. Allott to receive results of the blood work.  Now, it was Kristen Allott who spelled out how Jane’s nutrient deficiencies have contributed to her overall fatigue and long-term depression.  In that visit, Dr. Allott asked permission to call Jane’s referring therapist to share the laboratory findings, which confirmed the mental health professional’s intuitions that Jane would need physical as well as emotional support to reach her “getting it together” goals.

Then, Jane returned again to the convenient evening appointments with Heather Brummer, and together they implemented the plan to strengthen Jane’s body.  Jane continued to see her therapist to explore the idea of marrying Sam and having children as well as for support as she learned to managed her broader range of emotions during the withdrawal from her antidepressant medication.

This time — with nutritional support, practical steps, and additional encouragement from Heather Brummer and Dr. Allott — Jane succeeded in reaching her health goals and now she is open for whatever comes next in her life.

The League of Extraordinary People: A Conversation with Alfred White, focused on BIPOC community Experiences

Using Whole Foods Nutrition to Address the Anxieties that Arise from Trauma and Racism

For Mental Health Awareness Month, Psychotherapist Alfred White discusses how to heal from trauma, adversity and chronic stress with Dr. Kristen Allott, naturopathic physician, speaker and pioneering mental health advocate.

Watch the video on the The League of Extraordinary People Facebook page

My New Favorite Book to Increase Anxiety Tolerance: “Breath” by James Nestor

I am so excited about a new book, Breath: The New Science of a Lost Art, by James Nestor.

Ok, I will admit that I am a little late to the party for the importance of breathing. Not that I was against breathing. I enjoy doing it every 5 to 10 seconds, but it has never been a therapy that I emphasize.

I’ve seen two challenges with breathing practices:

1. In the past, it has always been presented as either a mindfulness practice or an ecstatic practice. In these trainings, no one explained how to breathe in general.

2. When I explained to breathing practitioners that breathing practices increased anxiety in my patients with histories of trauma, no one had an explanation and they recommended that my patients ‘just hang in there'. 

The challenge that people with complex trauma share is that focusing on slowing or controlling their breathing can create more anxiety, and then they feel like they are "failing" at breathing. Instead of a breathing practice,

Instead, I often have my patients name 3-5 colors that they can see around them. This allows the prefrontal cortex and the visual cortex to sit on the amygdala and slow the inner dialog, effectively lowering their anxiety. I thought that naming colors was the same neurological idea of breathing - just a different modality. Plus, I like being able to explain the neurophysiology: vision is at least 30% of our brain.

As a student of psychophysiology, I keep lists of physiology that cause mental health symptoms. When thinking about what can create the physical sensation of fear, independent from present or past emotional causes, I think about:

1. The amygdala being activated by the adrenaline released when the body needs to increase glucose, such as in hypoglycemia.

2. Nutrient deficiencies, such as protein, iron, and B vitamins. 

3. The Vegas Nerve being mechanical pinched at the first and second cervical vertebrae (See Stanley Rosenburg's Book: Accessing the Healing Power of the Vagus Nerve: Self-Help Exercises for Anxiety, Depression, Trauma, and Autism.)

Now, I have a fourth item on my list: Carbon dioxide intolerance caused by survival breathing. 

After reading Breath, I now think very differently about breathing as a tool for healing anxiety. James discusses how people can develop a narrow window of tolerance to carbon dioxide. He shares an example where a woman had no functional amygdala – so no fear responses to spiders, snakes, dangerous people... However, when she inhaled an air mixture with an increased carbon dioxide content, she had a full blow panic attack, and would NOT repeat the experiment.

What I had not appreciated, until reading this book, is that we have chemoreceptors in our brain and in our arteries that are monitoring for carbon dioxide and pH. As carbon dioxide builds up in our bloodstream, it triggers anxiety – sometimes high enough to create a full-blown panic attack.

But, if we don't have enough carbon dioxide in our systems, we can't properly oxygenate our bodies. With breathing patterns that keep carbon dioxide low, our tissues (muscles, digestive system, and brain) suffer from low oxygen states. We can develop fatigue, insomnia, sleep apnea, hypertension, cardiovascular disease, depression, anxiety, inflammation, auto-immune disease and have a weakened immune system. To be physically and mentally healthy, we need to have a range of carbon dioxide that we can tolerate. Studies indicate that people with anxiety have a very narrow range of carbon dioxide levels that they can handle (see links below). 

When we breathe through our mouths, we bring 20% less oxygen into our lungs. Breathing through our noses prepares the oxygen to be absorbed by the lungs into the red blood cells by removing bacteria, viruses, and particulates, increasing the humidity, and slowing the velocity of the molecules so that they can be absorbed into the capillaries carrying the red blood cells.

We need carbon dioxide present in the capillaries of the lungs so that it can exchange places with the oxygen in red blood cells. When we are intolerant of variations in carbon dioxide levels, we tend to breathe through our mouths. This lowers the carbon dioxide levels in our lungs and thereby lowers our oxygen absorption capacity. When we have lower oxygen levels in our bodies, we increase our bodies' stress, which increases our stress-related diseases. 

However, what I was seeing when my patients focused on slowing their breathing was the impact of the increased levels carbon dioxide in their bloodstreams, causing an increased physical sense of anxiety (anxiety not caused by what is externally around them).

Now that I understand the physiological mechanism through which carbon dioxide can increase anxiety, I can more closely screen patients for behaviors that indicate that they may be avoiding the sensation anxiety created by carbon dioxide intolerance. These include: 

• Mouth breathing, while awake or while sleeping

• Poor forward posture, often created by sitting in front of the computer

• Hyperventilation (respiratory rates greater than 10 breaths per minute)

For the people with complex trauma, who often refuse to consider breathing techniques for their anxiety, I now start by explaining that they are not failing at breathing, but rather that they need to develop a slightly larger range of carbon dioxide tolerance. And that when they can tolerate more carbon dioxide, more oxygen will be available to their body, which will help them have more energy and mental clarity. Their brains will begin to wire in that higher levels of carbon dioxide is safe. 

You might be wondering why we, as a species, are so hyper-vigilant to carbon dioxide when it’s so helpful in oxygenating our bodies. The carbon dioxide receptor is one of the oldest receptors found in most life forms. The earliest life forms on the planet were more concerned about getting into a space that was low in oxygen and high in carbon dioxide. This was a safety mechanism to stay alive, which was helpful in the past but not so helpful in our modern life.

Here are the steps that I am using to work with my patients around carbon dioxide intolerance;

1. Ask them to observe if they breathe through their mouths or noses. Times to observe are at work (particularly when working on a keyboard), watching screens, sleeping, and working out.

2. Ask them to focus on lightly closing their mouths when they can. This mindfulness practice will help them be aware of how they breath. When doing this, the patient might notice that they naturally breathe more deeply, using their whole rib cage. Suggesting that they place one hand on their chest and one hand on their belly is another way to help them see what muscles create their inhalation and exhalation. They might notice that they yawn more. I encourage focusing on their breath for at least 3 days, paying attention to what happens to their levels of energy and mental clarity. If they get anxious, they can breathe through their mouths for a time and then go back to breathing through their nose. 

3. Even if they have a stuffy nose, still encourage them to try breathing through their noses. James Nestor, who suffered from allergies, a deviated septum, and often developed pneumonia, found that learning to breath through his nose actually improved these symptoms.

4. Ask if they are willing to lightly tape their mouths shut while sleeping, using a small piece of medical tape or KT tape – about the size of a postage stamp. It’s still easy to open their mouths if they need to, but it’s enough to remind them to keep their mouths shut and to breath through their noses. This decreases snoring and mild sleep apnea, and increases the oxygenation of their tissues.

5. Ask them to try keeping their mouths shut when working out. This will likely be uncomfortable at first, but if they persevere it can increase performance, endurance and recovery.

6. Lastly, ask them to think of breathing as a moment-to-moment practice that can take a lifetime to truly appreciate.  

I hope this summary is helpful to you. Please feel free to email your questions. Your curiosity helps me learn to articulate the science in a usable fashion. Also feel free to share your own stories of breathing by commenting on this post below.

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Related references:

• Here a podcast interview with James Nestor, “How to Fix Your Breathing to Improve Your Health,” at Art of Manliness Podcast with Brett McKay #638 (46 minutes).

• I listened to Breath on Audible. It was a fun book to listen with lots of stories and listening always make the science easier to hear for me. 

• Scientific Papers:

  • “Panic Attacks as a Problem of pH” by By Richard Maddock, May 18, 2010 in Scientific American

  • “The physiological effects of slow breathing in the healthy human”. by MA Russo, Santarelli DM, and O'Rourke D. in Breathe (Sheff). 2017;13(4):298-309.

Key Labs To Rule Out Physical Causes Of Anxiety, Depression and Fatigue

I am so excited to be a part of Dr. Mariza Snyder's podcast, Essentially You. Mariza has spent the last 2 years creating something incredibly valuable to help reinvent your health with safer, more effective natural solutions and powerful lifestyle changes.

As you know, I believe that lab testing is the way to get the inside scoop on what’s really going on in your body and what could be causing your symptoms.

For so long, anxiety, depression, and fatigue have been completely separated from your nutrition, hormones, and physical health. But by understanding what’s going on under the surface, you can take simple steps to heal your mind and body and restore your energy.

Having the right nutrients and balance of hormones in your body can create a mental, physical, and emotional shift that will help you get back to your energized self faster.

Tune in to this episode today to hear me and Mariza talk about exactly what labs to request, how to interpret them, and which nutrients you can start adding to your routines today to experience relief!

Here’s a short video of what you’ll hear on the podcast!

I’m honored to be part of Essentially You!

What can be learned in therapy, with Dr. Jane Tornatore

The Connectors Group
When I work with an individual on improving their energy and mental clarity while also addressing other mental and physical health challenges, I often ask if they have done therapy and, if so, what they learned from it.

Often the response is that they told someone their story of childhood, loss, challenges... This, of course, is important, but what did they learn?

For myself, I has seen several therapists over time. With each therapist, I was mostly unclear about what I was learning at the time; I just wanted to feel better. In retrospect, I can see that I was learning:

• to tell my story and not edit out the uncomfortable moments

• how to have an observational self that is not the internal critic

• how to trust myself and trust others

• how to set boundaries for myself and others

• how to learn from my mistakes

• how to talk small steps forward, rather than try to leap into what I have not experienced before

• how to have hope

Recently, I was talking to my friend and colleague Dr. Jane Tornatore, who is one of the therapists that I refer out to when someone is struggling and is looking for more than “just talking” about what’s going on. I realized that part of why I enjoy referring to Jane is that she’s clear about what skills people need to learn to help their brains better integrate their experiences. Neuroscience supports that it’s this integration that helps people feel more stable and engaged in their lives.

This is a recording of the live webinar with Dr. Jane Tornatore, Dr. Kristen Allott, and Natasha Duarte..

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Meet Dr. Jane Tornatore:

Dr. Jane Tornatore is a therapist, speaker and author based in Seattle, WA. She has been in private practice for 15 years. Her style incorporates compassion, curiosity, deep listening, and heartfelt optimism, along with powerful shots of playfulness. Jane has dedicated her career and her life to helping people love themselves and have self-compassion. She received a Master’s degree at the University of Illinois, and a PhD at the University of Minnesota. Before going into private practice, she spent two decades working in the field of Alzheimer’s, including research and working for the Alzheimer’s Association. She has authored over 20 articles and just published a book—Everything is Perfect, Just Not ME! A Roadmap for Self-Acceptance. Learn more about Jane at: doctortornatore.com

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The Connectors Group consists of a wide range of individuals who are in positions to help other people navigate their lives better: mental health therapists, executive coaches, psychiatric nurse practitioners, supervisors and project managers, lawyers, teachers, and community organizers.

Worksheets for Staying in Your Responsive Brain

As we all navigate these uncertain times, remembering that protein-rich food is a tool to help us manage stress is now more important than ever. This will allow us to take in the ever-changing information about COVID-19 and make responsive, proactive choices rather than reactive, fearful ones. It also helps us relate to ourselves and those around us with compassion, understanding that we each have different tolerance levels and abilities to cope with this upheaval in our lives.

With this in mind, we want to (re)share some worksheets and tools that help take the stress out of figuring out how to feed ourselves.

If your anxiety is rising - remember the Lizard Brain Treat: A Lizard Brain Treat is a snack of sugar (a quick fuel) and protein (a longer lasting fuel). You want the quick fuel to get to your brain almost immediately, which will start to reduce the adrenalin causing you to be in your reactive lizard brain. Following this with protein extends the amount of time you’re in your responsive cortex brain, before needing to re-fuel. Our handout has suggestions for Lizard Brain Treats.

Optimizing Your Brain Food Log: We know that what we eat plays a large part in your level of energy and mental clarity, and can help us each be at our best. This worksheet will help you stay focused on managing your anxiety, anger, and depression by tracking your nutrient intake and helping ensure that you are getting protein, carbs, fiber and fat with each meal.

Go-To Meals Worksheet: Having a plan in place so you don’t have to think about what meals to prepare in the moment can be helpful. Having 3 ideas for each meal can help you stay on track with getting enough protein, balanced with carbs, fiber and fat. Use the Go-To Meals handout to list meal ideas that are simple to throw together or ones that you really enjoy preparing. Remember, there are no rules against eating dinner for breakfast and breakfast for dinner! The goal is to have some ideas that you don’t have to think too much about. Pin the completed handout on your fridge for easy access.

For more suggestions and tools, check out the Education Page and subscribe to our Optimizing Brains & Bodies podcast.

Lizard Brain Treats Help You Feel Better Quickly!

A Lizard Brain Treat is a key intervention to help you feel better now.

When you’re feeling on the edge and having a hard time with acute anxiety and worry, it’s hard to remember what you can do in the moment to help yourself.

If you are experiencing any of the below, try a Lizard Brain Treat! Even though you may not feel hungry, fueling your brain will help you reduce your anxiety and symptoms.

1. Are you having a panic attack?

2. Are you uncomfortably anxious or irritated?

3. Are you waking at 3am in the morning, with your mind racing?

4. Are you overly or underly emotional for the situation?

5. Have you not eaten for more than 3 hours?

6. Do you want to feel better in 10-15 minutes?

Lizard Brain Treats

A Lizard Brain Treat is a snack of sugar (a quick fuel) and protein (a longer lasting fuel). You want the quick fuel to get to your brain almost immediately, which will start to reduce the adrenalin causing you to be in your reactive lizard brain. Following this with protein extends the amount of time you’re in your responsive cortex brain, before needing to re-fuel. Choose one quick fuel and one protein from the lists below – or from your favorite foods.

Ideas for Quick Fuels:

• ¼ cup of juice

• 1 piece of hard candy

• ¼ cup of soda

• Honey stick

• 1 tbl of jelly

Ideas for Protein:

• ¼ cup of nuts

• ¼ cup of nuts

• A stick of jerky

• ¼ cup of cottage cheese

• 2 tbl of peanut (or other nut) butter

Combined sources work too (as long as they aren’t sugar-free)!

• ½ cup of a protein shake

• Protein bar

• ½ a PB&J sandwich

Generally speaking, your anxiety will drop by 10-20% within 10-15 minutes.

Download this information as a handout and post it on your fridge or keep it near your desk.

Juice for Anxiety?

A participant in a recent training sent me a follow up email with a question about the Lizard Brain Treat. She gave me permission to share it here.

Hey Kristen, 

 Hope you had a safe travel home.

Thanks again for a great conference!  I have been getting more protein into myself this weekend and am feeling less irritable with my 4 yo daughter, so already showing benefits for the every 3 hour protein plan!  I also walked the half mile to work today vs driving! You have inspired me so much!

I was sharing some the info with my Mental Health colleagues today and they said “juice”? That has way too much sugar, what about fruit and nuts?  I said “Hmmmm, I’m not sure”, and had to look it up. I saw that you recommended just a ¼ cup juice, not a whole bottle…for lizard brain symptoms.  I also have a colleague who has diabetes, and he said, “I can’t have juice, no diabetic should have any juice.”  What words of wisdom do you have for that question?

Sincerely, Molly

Molly -

Thanks for doing the experiments. 

If people object to juice, they don’t have to use juice. I just find it effective in shifting a person’s mood immediately when they have lizard brain symptoms, such as anxiety, irritation, agitation, or early morning waking for 2 hours.

A ¼ cup of juice is not a lot of sugar. Remember, it is not just juice. We are also adding nuts or a protein source, since the juice will be burned quickly. 

I did a quick search:

·      Apple juice has 28 total carbohydrates in one cup, so ¼ cup has 7 grams of total carbohydrates

·      Granulated white sugar for 1 teaspoon is 4.2 grams of total carbohydrates. 

·      Dried cranberries have 26 grams of total carbohydrates in 1/3 cup. 

Note that dried fruit takes longer for the glucose to get to the brain since the sugar has to be released from the fiber.

Some people don’t have the control to drink only a ¼ cup of juice and will drink a full cup or more. This can be a problem. Additionally, sometimes when people are watching their carbohydrates, as with diabetes, it’s easier to eliminate this food category altogether.

I tell people who are opposed to juice and are anxious/irritable/early morning waking to try the juice to see if it works. If it works and helps them regain emotional balance or go back to sleep, then we work to find a food that will have an equivalent response. It is different for each person. Here are some of the solutions that have worked: dried cranberries, carrots, honey sticks, 1-2 large smarties.

The Smarties candy is an interesting one. It’s made of dextrose which converts quickly into glucose. The large ones are about the size of a penny.

My goal for the juice is to quickly get some glucose to the brain to turn off the adrenalin that is firing up the lizard brain. Here are some common scenarios where I find ¼ cup of juice (or equivalent) effective.

• Slowing down anxiety and panic attacks

• Irritable teenager who is frustrated

• Waking in the early morning with thoughts racing

• Not hungry in the morning at waking

• Really groggy in the morning at waking

Hopefully that is helpful. Kristen

Tenets for Practice that Put the Client at the Center

I just finished a two-day training in Minnesota. Participants kept coming up to me and saying how much they appreciated my approach. What is that approach? How might it be different than other methods? What does it mean to be client-centered? What is the humanistic approach? Would mindfulness practitioners call this approach mindfulness? I tried to get clearer on what people are experiencing because all I experience is me.

I do have some tenets that I hold on to:

• Don’t try to be smarter than God or Evolution. I embrace the fact that I understand very little of what’s happening for individual. However, I can set up experiments to test for what might be true.

• Trust people to tell you close enough to the truth. Again, I don’t have to know everything. I just have to know what they are willing to try and what they won’t.

• Encourage being inconsistently consistent. Perfection is always a prison. How I have seen people change is to try, stop, make new intension, try again, don’t make it, succeed for a little while, stop, try again, miss, change it up, learn, try, fail, pout, feel anxious, try again, and so it continues. What I have learned most from martial arts is to get up after every fall.

• Willpower resides in our responsive brain. If we are not fed, we are reactive and can’t be responsive. Our anxiety, irritation, and agitation will escalate until we fuel our bodies.

• Human physiology is common to all humans. The details of our choices arise from our past experiences, our current circumstances, and what our holds us back. But the physiology happens for everybody’s body.

• Be curious about how the underlying physiology drives behavior. If someone is living in the complex world of homelessness, they might need to drink soda all day long to feed their pre-frontal cortex so that they can be responsive instead of reactive. Change comes from being responsive to one’s situation. Drinking soda all day is not a sustainable long-term behavior, but it may be what’s needed to get a toe hold on a new path.

• Most of us cannot DO a food program. We make moment to moment decisions about how and what to feed ourselves based on what’s available. Having have some basic knowledge about what will be useful in-the-moment can be empowering and help us gain some understanding of what our possibilities are.

• My job is to witness and to constructively add to people’s lives. Telling people to stop a behavior or to change is akin to suggesting a massive mountain climb. Teaching the skills needed for change and doing experiments along the way so people can begin to feel better in a single moment provides a more sustainable pathway for change.

Most of these tenants are not unique to learning and healing. I think the connection to how physiology impacts and drives our behavior is important and sometimes lost to the drama of life.

The workbook that Natasha and I are writing describes how the physiology of glucose control can impact how we experience all forms of anxiety. I have witnessed that attending to the physiology helps not only anxiety, but other conditions as well: PTDS, OCD, night terrors, 3 am waking, fatigue, depression, ADHD, and others. It also supports effective decision making, creativity, and sustaining energy levels throughout each day.

If you have been using food to help yourself or the people you connect to feel better, we would love to hear how addressing glucose control has positively impacted different behavioral symptoms. How has understanding the ways in which protein and carbohydrates influence behaviors been helpful? Please take this 1-minute survey.

Minimal Metrics for Exercise

In 2018, my blog focused primarily on anxiety. This year I am thinking more about movement and mental health. A good starting place is identifying the minimal metrics for movement and how achieving these metrics can support mental health.

So, I spent some time reviewing the most recent studies for exercise.

What is definitive?

Exercise reduces dementia and reduces all causes of death. For mental health in general, cognitive functioning exercises in studies don’t always show that it is helpful. They have not shown that they decline cognitive functioning. Ok. Exercise dose not always helps to be smarter. But for depression, the research is clear: exercise is an excellent therapy on its own and in conjunction with other therapies. Exercise increases neuroplasticity, improves how the autonomic and endocrine systems respond to stress, improves sleep, improves self-esteem, …the list goes on. So, we can definitely say now that exercise is good for both the brain and body.

How much movement do the studies say is needed?

When people exercise three times a week for 12 to 24 weeks, there is a dramatic reduction of depression, and if the exercise continues, there is a reduction in recurrence. That sounds great! And… those people were selected and paid to be in the studies.

Beyond the studies and in my office

When people can feel that movement improves how they feel, then it becomes a useful tool for treating energy and mental clarity in the moment. I believe that part of treating depression, mental health, pain, and other diseased states, is to provide people with tools that move them towards resilience moment to moment. If a person has a tool that can help them feel better now, today, or later today, we can build experiences that move us away from depression, fatigue, low self-esteem, anxiety, pain, or whatever their points of suffering are. Why does this work? When people can experience change that they are in control of, and learn the value of the process, they have a model of change that can then apply to other things in their life.

But how do you actually get someone who is depressed moving?

At my last PESI training in Richmond, VA, I posed this question to the group of around 90. I like to start with the smallest possible metric, in large part because it is doable. And since I am all about being able to feel what’s going on in the body, I first asked everyone to do an experiment. You, the reader, can do the same experiment now.

The Minimal Movement Experiment

1. Check-in and rate your energy level at this moment, using the scale below.

Now stand up. Choose one of the three possible movements that you will do four times. Here is a video of me squatting, marching and flapping my hands, in case you want to see what I am talking about.

• Chair squats – have a chair behind you and sit down as though you are going to take a seat. Just as the chair touches you, stand back up;

• March in place – with your knees coming up as high as it is comfortable; or

• Overhead hand clap – raise both arms in the air and bring your hands together comfortably over your head. Clap your hands together if that sounds like fun.

Remember one of these, just four times.

3.  Sit back down and re-rate your energy level.

The majority of people in my training reported feeling at least 10% better. So, if you were initially at 6 (out of 10), you might now be at 7… in less than 30 seconds! What could you do with 10% more energy? Do you get up to snack or drink coffee at work when you might just need to move your body a little bit to get some energy and mental clarity?

Where can the experiment be done?

Certainly, YOU can do this experiment anywhere: at the office, in the bathroom, when you get off the couch from watching TV. Additionally, you can try this experiment with clients who present with fatigue or who are kinesics learners. I offer it as a mindfulness exercise for people with childhood history of trauma, as a way got them to learn to listen to their bodies. It is a small enough dose that it is unlikely to make fatigue worse. Maybe nothing is noticed, but they tried something new. I also like to give it to my clients as homework (“Since the exercise was helpful in my office, I would like you to try it when you have been sitting for more than three hours.”)

Throughout the year, I will write more about how to use movement as a way to improve energy and mental clarity.

References:

Medina JL, Jacquart J, Smits JAJ. Optimizing the Exercise Prescription for Depression: The Search for Biomarkers of Response. Curr Opin Psychol. 2015;4:43-47. doi:10.1016/j.copsyc.2015.02.003. Link to study.

Belvederi Murri M, Ekkekakis P, Magagnoli M, et al. Physical Exercise in Major Depression: Reducing the Mortality Gap While Improving Clinical Outcomes. Front psychiatry. 2018;9:762. doi:10.3389/fpsyt.2018.00762. Link to Study.

10 Tips For A More Enjoyable Holiday Season

It is never too early to create a plan to build willpower and practice waypower for your holiday eating, especially if your desire is to weather the season feeling your best and without unreasonable weight gain.

These 10 tips may serve as a thoughtful steps through the challenges that come during the most food-seductive time of year.

1. For the months of November, December and January, mark the days on your calendar for “free eating” - a time to enjoy eating whatever you want.

2. When sugar cravings are especially high during the holidays, turn to protein: eat protein every 3 hours.

3. This is the time of year when exercise routines are often disrupted, so plan shorter workouts such as 10 minutes of walking, complete 20 squats, do a 20-count of plank, or 10 sit ups. I like calisthenics because I can break up the exercise routine throughout the day and still receive the benefits.

4. In early December make an appointment for after January 15th to meet with a friend for a walk, see a nutritionist or exercise person of choice and start a new routine. By mid-January you’ll know what your goals are for the New Year and will be open to assistance and ready for action.

5. Include on your gift list a fitness band (a step-tracker, or other similar device) along with time from a tech savvy family member or friend to assist you in setting up the gadget. Fitbit and Jawbone are two programs that I have observed as really excellent, but there are others as well. Don’t forget: walking 10,000 steps a day changes health. This level of movement prevents diabetes, improves the quality of most sleeping and supports positive mental health. Increasing your daily movement will be far easier than you might imagine, when using one of these convenient programs.

6. Commit to eating a protein-rich breakfast daily.

7. Consider purchasing a full spectrum light for where you eat breakfast. It is a less expensive alternative is buying a full spectrum lightbulb for a lamp you already have.

8. Be outside at least 10 minutes a day, even on rainy or cloudy days.

9. Thoroughly enjoy food that you are eating, regardless of what it is. Stop to notice the taste, color, texture, and what you really like about it. Don’t feel guilty; guilt comes with no benefits. Have a plan to get your eating back on track the next day.

10. If you are tired, try a 20- to 40-minute nap.

For more Waypower ideas, check out our Holiday book, Surviving the Holidays, available on Amazon.

What diet types contribute to depression and anxiety?

I am reluctant to write this post. I’m sure I’m going to make a few people mad. In last month’s Connectors Meeting there were questions about how different diet types contribute to mental health concerns. When a person's diet choice restricts food categories, they can find over time that their diet is contributing to increased anxiety and depression. This is because a diet that limits food groups can lead to nutrient deficiencies if health metrics are not carefully monitored through diagnostic labs.

In this post I’ll review some things to watch out for when eating significant amounts of highly processed foods, following vegetarian or vegan diets, and keto/paleo/Atikins types of diets.

Highly Processed Food Diets

Diets high in processed foods have been shown to increase depression and anxiety. These are diets with lots of white foods (bread, rice, potatoes, pasta, muffins, bagels, chips, sweets, fast food). With this diet, when I look at an individual's labs what I typically see are deficiencies in nutrients that help to synthesize dopamine and serotonin. Common deficiencies are protein, B vitamins, magnesium, zinc, omega 3, Vitamin D3, and fiber. Additionally, there is increased inflammation as indicated by elevated C-reactive protein (CRP) levels. Inflammation contributes to depression, fatigue, bipolar, cardiovascular disease, dementia, and diabetes, to name a few concerns. Dr. Felice Jacka provides a whole body of research about the impact of diet on mental health. Here is her seminal paper: Association of Western and traditional diets with depression and anxiety in women.

Vegetarian/Vegan

When I see vegetarians and vegans in my office, they tend to be very anxious individuals and the anxiety often leads to depression. I’m not saying that all vegetarians and vegans struggle with anxiety and depression. Rather, that individuals who are anxious and depressed and vegetarian tend to have higher levels of anxiety and depression due to nutrient deficiencies. Their anxiety is often caused by fluctuations in blood sugar levels because of the low carbohydrate to protein ratio in many of the foods they typically consume.

For example, let’s consider a bean burger. Beans have some protein and some carbohydrates. The bread is all carbohydrates. So this bean burgers contain a lot of carbs and not a lot of protein

Clinically, I have seen anxiety decrease significantly when we assure that they are getting enough protein throughout the day (8 grams per 20 pounds of body weight or at least 65 grams divided throughout the day for anyone over 140 lbs.)

There is a large body of research that suggests vegetarians have better physical health then omnivores. Vegetarians tend to have lower body mass index and cardiovascular disease. However, an Australian study with 9113 participants indicated that vegetarians and vegans have more anxiety and depression then omnivores.

Here are two more studies that may be of interest:

• Vegetarian diet and mental disorders: results from a representative community survey

• Food and Nutrient Intake and Nutritional Status of Finnish Vegans and Non-Vegetarians

For vegetarians, the labs that I carefully look at are total protein, Omega 3, ferritin (iron stores), B vitamins, and Vitamin D3. In my client base, vegetarians and vegans tend to carry less muscle mass and more fat mass.

For vegans, I will also look to see what their primary sources of fats are. The addition of coconut milk and oil can help with fatigue caused by a lack of cholesterol in their diet; consuming enough cholesterol is important because it helps synthesize hormones.

Keto/Paleo/Atkins

I am going to make a “no duh” statement… But it’s one we often forget: Weight does not determine health.

High-fat mass can impact health, but it’s not everything. I’m far more concerned about an individual's ability to be self-compassionate, eat primarily health-sustaining foods, engage in some level of regular movement or exercise, sleep well, and have healthy labs.

I have seen a number of individuals who started on a keto diet (low carbohydrate with high protein and high fat) to lose weight. However, after the initiation phase of just meat and fat, they did not add fruits or veggies back into their diets for years. They explain that primary reason for staying with this phase is because adding back fruits and veggies caused them to gain back the weight they had lost. This is true, because when we do quick weight loss programs it’s hard to not do quick weight gain as well. However, there are some serious health consequences not eating fruits and vegetables.

One of the consequences is that they became very low in B vitamins and Vitamin K. For women following this type of dietary restrictions, they started having heavy menses because their blood was not clotting well. This then also led to iron deficiency, which contributed to their story of depression/fatigue.

Check out these articles:

• Intravenous iron for the treatment of fatigue in non-anemic, premenopausal women with low serum ferritin concentration

• Dietary and supplement treatment of iron deficiency results in improvements in general health and fatigue in Australian women of childbearing age.

In conclusion

Diets that support physical health do not always support mental health. Diets that are low in nutrient dense foods can contribute to mental health concerns through presentation of depression/fatigue and hypoglycemia/anxiety. When someone is considering medications or has tried medicines without the expected positive impact, it’s worth suggesting that they ask their primary care providers for a laboratory workup for fatigue. Going to a naturopathic physician, nutritionist, or acupuncturist to have their diet evaluated for deficiencies that could be contributing to their mental health status is also a good option.

Here are some additional resources:

• Handout: Getting Enough Protein/Optimize Your Brain

• Handout: Getting Enough Protein for Vegetarian and Vegans

• Handout: Fruit and veggie All Stars

• Worksheet: Factors to consider before changing your diet

• Worksheet: Snap Shot of Anxiety

• Blog on labs

• Webpage: Labs & Mental Health: CRP

• Webpage: Labs & Mental Health: Ferritin

Fuel for Thoughts: Panic Attacks in High Functioning People

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.

Do you "sheet cake"?

I laughed pretty hard when I watched Tina Fey's sheet caking skit on SNL's Weekend Update. It perfectly captured the way many of us (at least from time to time) use sugar to calm our anxiety.

The physiology that explains why this works can be found here, but in short: the sugar in sheet cake gives us a readily available glucose source that tells our lizard brains that everything is going to be ok.

What's missing from the skit is the ensuing sugar crash, which can leave us feeling even worse than before.

For a longer-lasting fix to calm anxiety, eat your favorite source of protein first. Then go ahead and indulge in that sheet cake if you still want it. I'm guessing the speed at which you eat - and the quantity you eat - will be less than without the protein. By focusing on adding protein with carbs,  mostly complex carbs but sometimes sheet cakes, you can avoid the sugar hangover and not let the stress of the night before move with you into the next day. 

What's impacting your anxiety?

In July's Connectors Group we reviewed the Snapshot of Anxiety Assessment handout introduced in June's webinar, , hearing stories of how Connectors have used this tool and answering questions. 

We then discussed my new handout, What Impacts Anxiety (WIA),  a worksheet that captures information about anxiety in a format that helps us see the daily pattern of how the symptoms of anxiety show up in our lives.

The focus of this handout is on learning how meeting the needs of your body, which is the power supply for your brain, impacts energy, anxiety and mental clarity. Since food, sleep, exercise, and our environment impact your body’s ability to create a stable platform for your brain and mind to work, they can be significant drivers to improve fatigue and anxiety.

Further, WIA can be used with other interventions to track improvement of the symptoms of anxiety, such as the introduction of medications, mindfulness, exposure therapy, and observing anxiety levels in different environments or around different people.

The WIA Handout can help you with the people you connect with understand their anxiety better, may they be clients, family members, teenagers and most importantly out selves. 

Connectors Group Discussion: What Impacts Anxiety July 2017

• Introduction: 0-0:21 minutes
• Review of the Snapshot of Anxiety Assessment and Q&A: 0:21-20:28 minutes
• Introduction of the new tool, What Impacts Anxiety: 20:28-34:17 minutes

This webinar is also available as a Podcast.

If you find this blog helpful, please tap on "Like", post comments or consider sharing it. Thank you. 

Snapshot of Anxiety Assessment

In June, the Connectors Group discussed one of the assessments I developed for the book I am writing on Addressing the Physical Causes of Anxiety. The handout Snapshot of Anxiety Assessment reviews how to distinguish anxiety from functional hypoglycemia.

As I discuss different chapters from my book with Connectors, I am very interested in getting your feedback. As you watch the 22 minute excerpt from June's Connectors Group webinar, please let me know what you think, reply to the following questions in the comments section below, or email me.

• How is the Snapshot of Anxiety Assessment helpful?
• What new perspective will this Assessment offer your clients?
• What type of client would this help? Are there clients you would not use this with?
• What are the obstacles to integrating this into your practice?
• How likely are you to use and share the Snapshot of Anxiety Assessment?

Dr. Kristen Allott, June 9, 2017 (22.30 minutes)

1. Introduction: 0-1.11 minutes
2. Part 1: GAD-7: 1.11-3.19 minutes
3. Part 2: Mind – Brain – Body Symptoms: 3.19-6.30 minutes
4. Part 3: Global Symptoms: 6.30-13.00 minutes
5. Part 4: Functional Hypoglycemia Score or the “It’s not in your head – it’s in your body” Score: 13.00-17.37 minutes
6. Identify what’s most important to you about reducing anxiety: 17.37-22.28 minutes

This webinar is also available as a Podcast.

If you find this blog helpful, please tap on "Like", share your comments or consider sharing it. Thank you. 

Estrogen: changing the brain and body from menarche to menopause

In May's Connectors Group webinar, guest speaker Dr. Miranda Marti* of Whole Life Medicine discussed estrogen. Estrogen heralds changes not just in the physical body but in mood and libido. It also has the power to shift focus for relationships and careers, and change the salience of what the brain finds rewarding and reassuring.  For some women, these natural fluctuations of estrogen throughout life are experienced with grace, while other women may find themselves driven wild or to despair. 

Dr. Marti discussed why this occurs and how we can support hormonal changes, whether they be monthly cycles or the perimenopausal transition, with ease. The recorded webinar with slides is provided below in three parts. The full audio is available as a podcast.

In Part 1, Dr. Marti explains:

• How estrogen levels change over a lifespan,
• The different ways in which estrogen and progesterone affect brain function, and
• How estrogen and serotonin-melatonin interact.

Dr. Miranda Marti, May 12th, 2017 (17:04 minutes)

In Part 2, Dr. Marti talks about:

• Estrogen-dominant conditions,
• 5 steps to balance estrogen, and
• Answers questions from participants

Dr. Miranda Marti, May 12th, 2017 (23:34 minutes)

In Part 3, Dr. Marti explains:

• Anxiety and the Vagus Nerve, and the Connection with Urinary Incontinence
• 3 Steps for urinary Incontinence
• And important differences between Vaginal Estrogen vs. Hormone Replacement Therapy

Dr. Miranda Marti, May 12th, 2017 (12:10 minutes)

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*Dr. Miranda Marti is a naturopathic physician and acupuncturist specializing in the connections between women’s health, digestive health (the 2nd brain) and mental health. In addition to her private practice at Whole Life Medicine in Kirkland, WA, she leads wellness groups at a Seattle-based drug and alcohol recovery program and is adjunct faculty for the Bastyr University Health Psychology Department.

Addressing the Physical Causes of Anxiety

In February-March of this year I held a live online 3-part training Addressing the Physical Causes of Anxiety. We work with our anxiety and other people’s anxiety all the time. Anxiety can create challenges at work or within our family. We know what questions to ask about what makes us emotionally anxious; but what if part of the cause of our anxiety or the anxiety of the people around us is physical?

The recorded webinars and handouts from the three sessions is now available:

1. Naming and Taming Anxiety

2. Eating to Reduce Anxiety

3. What to Ask Your Doctor

Everyone who purchases this program will receive updated materials and will be able to interact with me about this content, by email, through 2017.

Based on the key educational points that I review with my individual clients, this content represents a value over $700. Your cost for the full online training package: $150