Healthy Eating & Nutrition Blog

Welcome to Health Takes Guts® Check back frequently for advice on healthy nutrition and therapeutic diet plans, delicious recipes and other cutting-edge functional medicine nutrition news. Dianne Rishikof, MS, RDN, LDN, IFNCP, & CEO, has special programs for Registered Dietitians (RDs) with mentoring, resources and course offerings.



Why you aren't losing weight

9 reasons you aren’t losing weight

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Weight loss is tough. Keeping weight loss off, is even tougher. A question I get asked time and time again is: why aren’t I losing weight? The person asking is dieting and exercising and the scale won’t budge. So here are my answers:

  1. You are eating too much.

Maybe you are eating more than you think. Calories hide everywhere and add up real fast. Plus, it is convenient to ‘forget’ about that pint of ice cream that we had the other night. A food diary, kept honestly, and analyzed by a professional (app or person) might help.

  1. You are not eating enough.

You read that right. This happens more than #1. People are eating 1200 calories (or less!) a day, and that simply isn’t enough to operate a grown body. Your body needs fuel. Your metabolism slows down and you go into a primal starvation mode. Eat at least 1500 calories a day (more if you are a bigger person).

  1. You dieted too much in the past

You tried every diet under the sun and yoyo-ed yourself dizzy. And now your metabolism is messed up, unfortunately. A sustainable healthy diet is better than any short-term fad any day.

  1. Your blood sugar is out of whack.

You are eating too many sugars and processed carbs, perhaps. Your insulin is high (from a lack of exercise or a lifetime of eating too many sugars and carbs). When you eat sugar or processed starch, it goes out of your gut and into your blood stream quickly. This causes a large amount of insulin to be pumped out and now the calories get pushed into your fat cells (that is insulin’s job). Meanwhile you are hungry again. Plus, the insulin stays around and pushes anything else you eat into your fat cells. When insulin is high, you are in fat storage mode not fat release mode.

  1. Your sex hormones are off

Hate to say it, but as we women age, our estrogen goes down and so does our metabolism. Sometimes progesterone and testosterone are out of range too. All these can affect weight. Little known fact: estrogen and the gut are intricately related. Check out my eBook for more details.

  1. Your thyroid is running low

Testing thyroid hormones is one of the first things I think of when someone comes to me and isn’t losing weight. Hypothyroidism or Hashimoto’s (the autoimmune version of hypothyroidism) mean your thyroid hormones are low, slowing down your metabolism and making weight gain common (and weight loss very hard).

  1. You’re are stressed out

Cortisol, the main stress hormone, is high and it’s messing with your calorie usage and storage. Let’s face it, we are all stressed. And while adrenaline goes away after that meeting with your boss or fight with your spouse, cortisol sticks around. And if you are stressed day in and day out (like many of us) then your cortisol is chronically high. This not only causes weight issues, but many health problems as well. (addressed in my eBook)

  1. Genetics suck

I’ve said it before and I’ll say it again: genes are not your fate. It doesn’t matter if diseases run in your family, diet and other lifestyle factors play a bigger role in your health. However, genetics can be a factor too. I perform a genetics test on patients and we find out that yes, they don’t respond to cardio exercise by losing weight or they need more carbs and less fat to lose weight (or vice versa), or their genes just are stacked against them in all the weight loss areas.

  1. Your gut is unbalanced.

Research study after research study ties being overweight to the microbiome. If you want more information on the gut and the microbiome, read past blog articles and read my ebook.

If one of these factors is applicable to you, I suggest addressing it. Eat more, eat less, get your hormones checked, practice stress management, and fix your gut. Get an assessment done by an expert. I recommend reading my eBook that addresses these topics.

And what is the sustainable diet I recommend? Dropping the sugar and processed food. By doing so, you get rid of the empty calories, the insulin stimulating carbs, and the inflammatory foods, and the gut disrupting foods. Eat whole real foods. A sweet potato instead of bread. More fruits and veggies. You can do it! And it’s the best thing for you, in every way.

 

 

 

“I am NOT fine!”

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I hear the same story 10 times a day.

Exhausted patient walks into her doctor’s office. She says “Doctor, I don’t feel well. I am in pain. I am too tired to get through the day and enjoy my life. I am bloated, constipated, and can’t lose weight”

The doctor responds, “All your tests are normal, there’s nothing wrong with you.”

“I am NOT fine! Something is definitely wrong. Please help me, I am at the end of my rope.”

“You’re fine. Goodbye.” (appointment over)

This is the general experience of so many people. Too many people-because let’s face it one person being dismissed like this is one too many. This country is full of these chronically un-well people. They aren’t sick enough to be diagnosed with a serious disease, but they are not well. (Even the ones who do have diseases get a prescription, not a resolution to their problem.) There seems to be this pattern in conventional medicine where doctors live in their bubble, prescribing what they know, for the body part they specialize in. There isn’t any investigation as to what the root cause of the problem is or what is going on in the rest of the body.

Even though I hear this story, over and over every day from my clients, it never fails to surprise me.  Luckily for my clients, they have trusted their instincts and taken matters into their own hands. They look elsewhere for help. They find me. I dig deep to find out what is causing their symptoms. I take their concerns seriously and we join together to fight the problem as a team.

If you want to learn what are the root causes of most problems and how to fix them, I have put it all in my ebook: Health Takes Guts. Your Comprehensive Guide to Eliminating Digestive Issues, Anxiety, and Fatigue.

Health Takes Guts®: Your Comprehensive Guide to Eliminating Digestive Issues, Anxiety, and Fatigue

For people who want to feel WELL

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I am excited to announce the launch of my new E-book! I have poured all my passion and knowledge for helping people who are struggling to get well, into this book.

Take a look inside:

Health Takes Guts®: Your Comprehensive Guide to Eliminating Digestive Issues, Anxiety, and Fatigue

For more information about the book, and how you’ll benefit from it, click here.

Comments from readers:

“I loved the book! It gave me hope that there was a solution, and that I didn’t have to just miss out on some favorite foods forever! That is what I thought you had to do, if you found that something was causing problems… I never thought that they might be causing a problem because of ANOTHER problem, that could be solved! Correct the underlying problem-brilliant!”

“I love that the book kept the perspective of the reader at all times. I felt held there and not alone. A lot of books I’ve read lately, seem to imply that the process is linear, where in actuality, it seems more web like. I appreciate the tools I now have, to sort through this process.”

“Dianne does a fabulous job of explaining complicated medical processes in understandable ways. As a reader, you are never once confused.”

Patient testimonials after completing the protocol described in the book:

“Now, at 40, I feel better than I did in my 20s. My sleep habits are healthy, my energy is up, and my mind is clear! I hadn’t even realized how much I was dragging myself through my days until I didn’t have to anymore.”

“I have had these digestive problems my whole life and was told by doctors there was nothing I could do about it. I took Dianne’s advice and I feel great. It’s a miracle. I can’t believe it!”

“My gut is doing awesome since following your protocol. Thank you so much again and again.”

“In what felt like a remarkably short period of time, I’ve managed to improve my gut health significantly and I’m no longer flattened by constant fatigue.”

Click here for a full symptom list, and to get your copy.

5 Health Hacks from Professionals That Will Help Maintain a Healthy Gut

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A healthy gut is an indispensable component of good health, with Dr. Mark Liponis pointing to new studies showing how critical it is to wellbeing. Specifically, the microbiome in your gut, which we discussed previously in ‘The Great and Powerful Microbiome‘ can affect, among others, your emotions, behavior, mood, cardiovascular function, metabolism, and appetite.

Maintaining a healthy gut, though, can be quite a challenge, but it is something that you can overcome if you follow these 5 health hacks:

Eat Fiber-Rich Food

Men’s Journal contributor Joseph Hooper and nutritionist Kathie Madonna Swift collaborated on ‘The Swift Diet’ which outlined pointers for healthy microbiome, which, when healthy, can keep you lean, reduce muscle and joint pain, and clear the skin. One practical way to keep them healthy is to load up on fiber by eating lots of veggies, fruits, and legumes. Lack of fiber can make your gut go haywire, with bad bugs, parasites, and fungi entering rather easily. Worse, they can leak into the bloodstream, which can then cause inflammation everywhere and even insulin resistance.

Watch What You Eat

Unhealthy eating is a problem, and poker pro Sorel Mizzi admitted that much in an interview with PartyPoker. “I used to eat anything and everything,” confessed the successful poker pro as he looked back on those days when he used to order Pho at 3 in the morning. But those days, said Mizzi, are long gone, as he is now more mindful of the food he eats. In fact, he considers eating healthy, along with regular exercise, as a natural drug that keeps him in the pink of health. Mizzi never mentioned his exact diet in the aforementioned interview, but it is safe to surmise that he avoids too much fat and sugar, both of which can harm your gut in a variety of ways. Constant sugar overloads will make it harder for your body to burn calories. Even worse, they can cause a spike in blood sugar levels, which can lead to type-2 diabetes. Lots of fat, on the other hand, can damage the gut lining, and thus allow undesirable chemicals released by certain bacteria to seep into the bloodstream. Once this happens, you will experience inflammation in various parts of your body.

Get Your Fill of Probiotics

Registered dietitian and US triathlon coach Kim Schwabenbauer swears by the health benefits of probiotics, which include enhanced recovery from fatigue, a boost in immune function, and yes, a healthy gut, although he won’t guarantee that they will help you become a better athlete. For your daily fill of probiotics, include in your diet some yogurt, kefir, sour pickles, and miso. You can also take probiotics supplements.

Cut Down on or Avoid Gut Irritants

Gut irritants, as the name suggests, can adversely affect your gut’s health and even undo all the positives gleaned from a healthy diet. It is thus imperative that you avoid these gut-impairing products according to health coach and nutritional therapy practitioner Laura Kraber. Antibiotics is number 1 on the list, but it doesn’t mean you shouldn’t take it when the need arises. Other gut irritants include nonsteroidal anti-inflammatory drugs (NSAIDs), alcohol, coffee, birth control pills, gluten, and processed food.

Exercise!

Writing for the Observer, personal trainer Theo Brenner-Roach advocates exercising for a healthy gut. Citing various studies, the Lift Learn Grow founder notes that exercising can increase certain types of bacteria—collectively referred to as “gut flora”—that improve your gut’s overall health. Brenner-Roach particularly cites a study that shows rugby players having a more diverse set of gut flora, which according to researchers, is indicative of the positive impact of exercise on gut health. (For more on the beneficial effects of exercise on your gut, check out the previous post Exercise Affects Gut Bacteria.)

These health hacks are actually quite simple, and if you follow everyone of them, you will be well on your way to having a healthy gut.

IBS vs IBD

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It is a confusing topic. One that comes up a LOT in my world. People don’t know what IBS is or what IBD is or what the difference is. Why would you? I get it. Even health professionals say it wrong. (I have heard trained colleagues call it irritable bowel disease. Not it). So, let’s clear it up!

IBS stands for Irritable Bowel Syndrome. Irritable bowel describes the syndrome of symptoms; bloating, diarrhea, constipation, pain. This is a syndrome not a disease because there is nothing ‘wrong’ with the digestive tract. On all medical tests, people with IBS come up ‘normal’. They don’t have another diagnosis so the doctors call it IBS and send them on their way. Why? Because in conventional medicine, IBS is a group of symptoms for which there is no cause or treatment. (This couldn’t be more wrong. Those of us in the functional medicine world know that there are several causes of IBS, all treatable.) These symptoms might be happening because of an imbalance in the microbiome, damage to the intestinal wall (leaky gut), food sensitivities or intolerances, or a sensitive gut-brain connection (stress and emotions cause the symptoms).

IBD stands for Inflammatory Bowel Disease. These diseases include Crohn’s and Ulcerative Colitis. Crohn’s can affect any part of the digestive tract, but usually the latter part of the small intestine. Colitis is only ever in the colon. People with IBD have visible inflammation and ulcers on the inside of their GI tract. These diseases are auto-immune, where the person’s own immune system is attacking the intestine. The symptoms include pain, bloating, diarrhea, weight loss, fever, and fatigue. The disease shows up on the conventional medicine tests. And the primary conventional treatment is anti-inflammatories and immune suppressants. But the patients all have the same underlying problems as stated above (imbalance in microbiome and leaky gut, etc) in addition to the self-driven inflammation.

Both conditions can be miserable to live with. But both are very treatable and manageable with diet, supplements, and other lifestyle interventions. For more information about how to treat these issues, check out my eBook!

Protect your Heart with Diet

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Did you know that February is American Heart Month? Heart disease is the leading cause of death in the U.S. This celebration aims to help people evaluate their personal heart health and learn how to properly care for their bodies. Today we’ll be exploring some of the risk factors for heart disease, and comparing the risks and benefits of dietary changes vs. prescription medications.

Heart disease is a condition of the blood vessels that causes a process called atherosclerosis, or a “hardening” of the vessels. The affected vessels fill up with plaque, which blocks veins and arteries, causing DVTs, heart attacks or strokes. But at its core, heart disease is the culmination of possible genetic factors and a lifetime of dietary and fitness choices.

Heart Issues and Medications

The top three risk factors for heart disease are high blood pressure, high cholesterol, and type II diabetes. While all three can be influenced by genetics, they correlate highly with weight, diet and exercise habits. Despite this correlation, many people are prescribed medications to treat these conditions and are never asked or ignore suggestions to make proper lifestyle changes. In fact, millions of Americans rely on medications to “solve” their health problem, when simple nutrition could help dramatically.

Of course there are times when medication is unavoidable. But if possible, it should be a last resort, not the first pit stop. Here’s why: medications don’t teach people how to care for their bodies every day, and they can have dangerous side effects. For example, the blood thinner Pradaxa, often given to patients with high cholesterol, definitely does its job and can help prevent blood clots. On the other hand, it also carries the harrowing possibility of deadly bleeding from even a minor cut or injury.

The same goes for other medications. Statins are drugs that lower your LDL (the “bad” cholesterol), but they can also cause liver damage and memory loss. For diabetics, the medication metformin helps the body to use insulin more efficiently by improving the sensitivity of body tissues. In some cases, however, it may cause a serious, fatal condition called lactic acidosis in which lactic acid builds up in the blood. In contrast, a shift in nutrition can help naturally lower your LDL, manage your hypertension and help those with prediabetes from getting full-blown type II diabetes, without any serious dangers. A nutritious lifestyle is a wholly positive shift, and it will help you develop better habits for life.

Nutritious Solutions for Heart Health

Every person’s nutrition needs are different. For example, a person with celiac disease can thrive on a gluten-free diet, while a person with irritable bowel syndrome may need a more personalized diet based on the low-FODMAP diet plan. The same goes for heart health. Generally speaking, avoiding trans fats, sugar-filled snacks and processed products is a great first step. From there, it’s important to consider the needs of your specific condition.

Individuals with high cholesterol need to focus on foods that let them lower the LDL in their blood. While trans fats should be avoided, polyunsaturated fats directly lower LDL and should be included. You’ll also want to make sure to eat plenty of foods high in soluble fibers, like fruits, peas, lentils and some bean varieties. Plant sterols and stanols also help hinder the absorption of cholesterol by your body, and can be found in nuts, legumes and whole grains.

For people with high blood pressure, there’s a specific diet plan known as the DASH diet. DASH stands for Dietary Approaches to Stop Hypertension, and it’s easier to follow than most diets because it doesn’t require huge food group restrictions. Rather, the diet encourages the use of a wide range of foods that are rich in potassium, calcium, magnesium, fiber, and protein, and low in sodium. Dieters should make sure to include whole grains, nuts, broccoli, carrots, kale, and lean meats. Research has shown the DASH diet can lower blood pressure in just two weeks.

For diabetics, things are a bit different. It is impossible to manage full-blown Type I or Type II diabetes through diet and exercise alone. If you have diabetes, insulin injections are absolutely essential, and some medications may be required. You should still, of course, be aware of your dietary choices; it’s recommended that diabetics and prediabetics use the glycemic index to avoid blood sugar spikes.

If you’re prediabetic, have a family medical history of diabetes, or other diabetes risk factors, nutrition and lifestyle changes can absolutely help. As with hypertension and high cholesterol, avoiding saturated fats, processed foods and getting a sufficient amount of fiber will be helpful. It’s also important to maintain an appropriate weight, because obesity is a leading risk factor for diabetes.

As with everything, the keys to a healthy heart are communication and smart choices. Always talk to a professional before beginning a new exercise regime or diet. If you’re already on a medication, it’s imperative to talk with your doctor before making major changes, or before stopping the drug. This February, take the time to check in with your body, and listen to what it tells you. It may be time to make some changes for a healthier you!

 

*This is a non-sponsored guest post

woman breathing on the beach

Treatment for PCOS

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Polycystic Ovarian Syndrome (PCOS) is the most common hormonal endocrine disorder in women of childbearing age, affecting approximately 5 million women in the United States.(1,2) It is also the most common cause of ovulatory infertility but research shows that lifestyle changes can help restore ovulation and improve pregnancy rates.(3) High androgens (“male hormones”) like testosterone, high insulin/insulin resistance, and low progesterone are just some of the clinical markers of PCOS.(4) Symptoms include irregular and/or a painful menstrual cycle or no menses, facial hair, acne, infertility, and balding.(5) The term PCOS can be misleading as not all women with PCOS have ovarian cysts. Another common misconception is that all women with PCOS are overweight or obese, however, there are plenty of women (about 20%) with a “normal” BMI who are diagnosed with PCOS.(6) Regardless of BMI, a combination of diet, lifestyle, and supplements should be the primary treatment choices for addressing PCOS.

It is estimated that 50-70% of women with PCOS have insulin resistance(2) so making some simple changes to the diet like eating protein with each meal can help to stabilize blood sugar.  Sleep disturbances and obstructive sleep apnea are also common in women with PCOS and since sleep affects a variety of things including hunger hormones and insulin resistance, making sure to get adequate z’s is an important part of treatment.(7-10) Stress is an equally important factor to address and is even a potential cause of PCOS. Stress can cause the disruption or total loss of menstrual function in women (11) and as we know has an effect on everything else in our lives from what we eat to how much we sleep.

For these reasons we recommend treatment that focuses on the following 5 factors:

  1. Diet
  2. Sleep
  3. Stress
  4. Supplements
  5. Self-care
  6. The gut

Diet

  • Focus on whole foods with a variety of fresh fruits, veggies, whole grains, beans/legumes, meat, fish, poultry, and oils
  • Limit starchy processed carbohydrates (high amounts increase insulin & trigger inflammation)
  • Have carbohydrates, fat, and protein at each meal to help stabilize blood sugar
  • Aim for 2 cups of fruit and 2 ½ cups of vegetables each day
  • Consume up to 6 ounces a day of whole grains like brown/wild rice, rolled oats, bulgur, and quinoa
  • Include healthy fats like olive oil, olives, avocado, nuts, nut butter, seeds, eggs, and fish
  • Use cinnamon which has been shown to improve insulin resistance and dyslipidemia
  • Add garlic to your diet to reduce total cholesterol and triglycerides, just one clove a day shows improvement! (12)

Sleep

  • Aim for between 7-9 hours a night (If you don’t feel rested with 7, you may need more.)
  • Choose a relaxing bedtime routine and aim to turn off electronics 30 minutes to one hour before you go to bed
  • If you have a hard time falling asleep consider taking a supplement like magnesium glycinate

Stress

  • Take 5 deep breaths when you feel stressed to remind yourself that you’re okay!
  • Take some time, even a few minutes, to practice yoga poses
  • Make a list of what needs to be done so you don’t have to think about it
  • Keep areas free of clutter to calm the mind

Supplements (5, 13-15)

  • D-chiro-inositol (DCI) & Myo-inositol (MYO) – helps with: Ovulation, insulin resistance, dyslipidemia, androgen lowering, hypertension
  • N-Acetylcysteine (NAC) – helps with: Insulin resistance, infertility, inflammation, androgen-lowering, dyslipidemia, bronchitis, & immune support
  • Chromium Picolinate – helps with: improving glucose and insulin
  • Cinnamon Cassia – helps with: decreasing HbA1c and fasting glucose
  • Fish oil – helps with: Anti-inflammatory, dyslipidemia, hypertension, depression, androgen lowering, infertility, insulin resistance, Fatty Liver Disease
  • Magnesium, Vitamin D, and B12 – helps with: insulin resistance, infertility, dyslipidemia
  • Various herbs such as licorice, chasteberry, and milk thistle have been effective in the treatment of PCOS.
  • Many of these supplements can be found on my online dispensary

Self-care (16, 17)

  • Make the time to acknowledge your needs
  • Examples include taking a bath, sipping a hot cup of tea, or going shopping
  • Self-care is shown to improve health outcomes
  • Mindfulness, bringing one’s attention to the present moment, can help with all of these components and has been shown to improve outcomes in women with PCOS.(18,19)

The Gut (20,21)

The research on the gut and PCOS is strong and growing more astounding by the month. An unbalanced microbiome is the root cause of most hormonal issues. And fixing the gut is an evidenced-based solution for PCOS. For more on how PCOS and the gut are related and how to fix your gut, check out my eBook!

Every person is different and will need an individualized plan which is why working with a registered dietitian nutritionist who understands your needs and specializes in PCOS is so important.  Remember, it is our patterns over time that impact our health so don’t feel pressured to make all of these changes at once.  Making changes to an already busy life is stressful in and of itself so pick one of the five factors to start with and focus on that! For more information and help, read my eBook.

References

  1. How many people are affected or at risk for PCOS?. Nichdnihgov. 2017. Available at: https://www.nichd.nih.gov/health/topics/PCOS/conditioninfo/Pages/risk.aspx. Accessed November 7, 2017.
  2. Grassi A. 30 INTERESTING FACTS ABOUT PCOS. PCOS Nutrition. 2017. Available at: http://www.pcosnutrition.com/facts/. Accessed November 7, 2017.
  3. LEGRO R. Pregnancy Considerations in Women With Polycystic Ovary Syndrome. Clinical Obstetrics and Gynecology. 2007;50(1):295-304. doi:10.1097/grf.0b013e31803057ed.
  4. Sirmans S, Pate K. Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clinical Epidemiology. 2013:1. doi:10.2147/clep.s37559.
  5. Grassi A. Popular Supplements For PCOS. https://docs.google.com/file/d/0B-1AdyQf8ICwTXAtdzJLc0RXT1k/edit; 2017.
  6. Marshall J, Dunaif A. All Women With PCOS Should Be Treated For Insulin Resistance. Fertility and Sterility. 2012;97(1):18-22. doi:10.1016/j.fertnstert.2011.11.036.
  7. Moran L, March W, Whitrow M, Giles L, Davies M, Moore V. Sleep disturbances in a community-based sample of women with polycystic ovary syndrome. Human Reproduction. 2014;30(2):466-472. doi:10.1093/humrep/deu318.
  8. Helvaci N, Karabulut E, Demir A, Yildiz B. Polycystic ovary syndrome and the risk of obstructive sleep apnea: a meta-analysis and review of the literature. Endocrine Connections. 2017;6(7):437-445. doi:10.1530/ec-17-0129.
  9. Donga E, van Dijk M, van Dijk J et al. A Single Night of Partial Sleep Deprivation Induces Insulin Resistance in Multiple Metabolic Pathways in Healthy Subjects. Endocrinology. 2010;151(5):2399-2399. doi:10.1210/endo.151.5.9998.
  10. Why Is Sleep Important?. Nhlbinihgov. 2017. Available at: https://www.nhlbi.nih.gov/health/health-topics/topics/sdd/why. Accessed November 7, 2017.
  11. Berga S, Loucks T. Stress Induced Anovulation. Emory University School of Medicine; 2007. Available at: http://booksite.elsevier.com/brochures/stress/PDFs/berga.pdf. Accessed November 7, 2017.
  12. Zeng T, Guo F, Zhang C, Song F, Zhao X, Xie K. A meta-analysis of randomized, double-blind, placebo-controlled trials for the effects of garlic on serum lipid profiles. Journal of the Science of Food and Agriculture. 2012;92(9):1892-1902. doi:10.1002/jsfa.5557.
  13. Regidor P, Schindler A. Myoinositol as a Safe and Alternative Approach in the Treatment of Infertile PCOS Women: A German Observational Study. International Journal of Endocrinology. 2016;2016:1-5. doi:10.1155/2016/9537632.
  14. Grassi A. THE 4 BEST SUPPLEMENTS FOR FERTILITY. PCOS Nutrition. 2017. Available at: http://www.pcosnutrition.com/4-best-supplements-fertility/. Accessed November 7, 2017.
  15. Goswami P, Khale A, Ogale S. Natural Remedies for Polycystic Ovarian Syndrome (PCOS) : A Review.IntJPharmPhytopharmacolRes. 2012;1(6):396-402.
  16. Lorig K, Sobel D, Laurent D, Hobbs M. Effect of a self-management program on patients with chronic disease. Effective Clinical Practice : ECP. 2001;4(6):256-262. doi:11769298.
  17. Adams R. Improving health outcomes with better patient understanding and education. Risk Management and Healthcare Policy. 2010:61. doi:10.2147/rmhp.s7500.
  18. Stefanaki C, Bacopoulou F, Livadas S et al. Impact of a mindfulness stress management program on stress, anxiety, depression and quality of life in women with polycystic ovary syndrome: a randomized controlled trial. Stress. 2014;18(1):57-66. doi:10.3109/10253890.2014.974030.
  19. Raja-Khan N, Agito K, Shah J et al. Mindfulness-based stress reduction for overweight/obese women with and without polycystic ovary syndrome: Design and methods of a pilot randomized controlled trial.Contemporary Clinical Trials. 2015;41:287-297. doi:10.1016/j.cct.2015.01.021.
  20. Association between Polycystic Ovary Syndrome and Gut Microbiota.Guo Y1, Qi Y1, Yang X1, Zhao L1, Wen S1, Liu Y1, Tang L1.
  21. Dysbiosis of Gut Microbiota (DOGMA)–a novel theory for the development of Polycystic Ovarian Syndrome.Tremellen K1, Pearce K.

 

*This is a non-sponsored post written by Crystal Longo Savoy

Nutrition and Eye Health

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Infographic credit: https://www.focusclinics.com/blog/dont-turn-blind-eye-superfoods/

There are many reasons to maintain good nutrition and a regular exercise routine. It can help you manage your weight, lower your blood pressure and cholesterol, prevent disease, reduce the risk of cancer, improve mental health and well-being, and keep you fighting fit and feeling younger for longer. But what many people don’t realize is that good diet and exercise can also help with overall eye health and to keep your vision sharp.

Almost everything we do with our bodies (what we put in and what we put out) affects our eyesight and eye health, so ensuring that we eat healthily and exercise regularly is essential.

The Importance of Nutrition

Foods that can boost your eye health include fish and other things rich in omega-3 fatty acids, leafy greens and pigmented veggies packed with lutein and zeaxanthin, whole grains with a low glycemic index (GI), citrus fruits and berries with vitamin C, and any foods that contain vitamin E, zinc and niacin.

A healthy diet also helps you manage your weight, which prevents eye complications that can be caused by type 2 diabetes and obesity.

Don’t Dismiss Superfoods

Eating a well-rounded diet with lots of fruits and vegetables, proteins and good fats is the best way of ensuring good vision for the long term. But it’s also important to pay special attention to some of the ‘superfoods’ that are out there.

Whilst kale may have become a popular smoothie ingredient due to today’s health trends, it really is much more than just a trend.

This infographic above shows the damaging effects of blue light and reveals the top 10 vegetables to help protect your eyes from blue light macular damage. The listed veggies are all packed with high levels of lutein and zeaxanthin. These are both carotenoids that can help to keep the eye’s macula healthy.

The infographic not only reveals the vegetables with the highest levels of carotenoids (with kale, cress, spinach and peas ranking at the top), but it also references a recent Harvard University which revealed data to show that lutein and zeaxanthin rich diets could prevent the risk of macular degeneration by up to 40%.

Food as a treatment for Acne

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I receive this question a lot: Can what I eat cause pimples? The answer is yes. Of course, that isn’t the only thing that causes acne but why not eat to promote the healthy skin you want? Below is a short list of ‘yes’ and ‘no’ foods in regards to acne.

Things to eliminate:

  • Limit foods high in sugar with a high glycemic index (white bread, bagels, sweets), as those may promote the production of certain hormones linked to acne
  • Omega-6 fatty acids (refined vegetable oils, fried foods) are thought to contribute to inflammation
  • In a study comparing people with no or mild acne to those with moderate to severe, the ones with moderate to severe acne reported greater dietary glycemic index, added sugar, total sugar, number of milk servings per day, saturated fat, and trans-fatty acids, and fewer servings of fish per day

Things to include:

  • Low glycemic foods (whole foods, whole grains, legumes, eggs, fish, fruits and vegetables)
  • Certain vitamins and minerals are also crucial to include.
    • vitamin A: sweet potatoes, carrots, dark leafy greens, winter squashes, lettuce, dried apricots, cantaloupe, bell peppers, fish, liver, and tropical fruits.
    • vitamin D: salmon, mackerel, mushrooms, herring, sardines, catfish, tuna, cod liver oil, eggs, sunshine
    • zinc: lamb, pumpkin seeds, grass-fed beef, chickpeas, cocoa powder, cashews, mushrooms, spinach, chicken
    • copper: oysters, raw kale, shiitake mushrooms, sesame seeds, cashew nuts, chickpeas, prunes, avocados,
    • selenium: brazil nuts, oysters, tuna, sunflower seeds, pork, beef, lamb, chicken, turkey, mushrooms, whole grains
    • green tea: a great anti-inflammatory and antioxidant
  • Fish and seafood: May help prevent acne, most likely due to their Omega 3 content.
    • Omega-3 fatty acids: reduce inflammation with foods like nuts(walnuts), fatty fish, and eggs.
  • A good probiotic: anti inflammatory
  • Turmeric: anti inflammatory
  • Tamanu oil may be effective as a topical treatment or as part of a facial cleanser for continuous acne control. It’s anti-inflammatory, antibacterial, and antifungal.

Hope that helps!

There are many supplements, such as turmeric, Omega 3s, and probiotics on my online dispensary.

Why is BILE so important?

2 Replies

When I say bile, you probably think of that awful digestive fluid. Maybe you know what it is and what it does, maybe you don’t. While it seems inconsequential, it is anything but.

Bile is fluid made by the liver and stored in the gallbladder that helps digestion and absorption of fats (and fat soluble vitamins) in the small intestine. That’s the well-known function (in the health community). It turns out, bile does a lot more than that. It is anti-microbial, gets rid of waste in the body, regulates cholesterol homeostasis, and has now been shown to play a role in glucose metabolism.(1,2,3,4) In fact, bile acids are now regarded as important hormones and are emerging as regulators of the gut microbiome.(5,6)

If you know me and my work at all, you know how important the gut microbiome is. Our microbiome is supposed to be primarily in the large intestine. When microbes live and grow in the small intestine a whole host of unpleasant symptoms and consequences arise. This is SIBO, small intestine bacterial overgrowth. So, bile kills microbes in the small intestine (and then the bile gets absorbed before entering the large intestine, leaving the large intestinal microbiome alone). They have done experiments in mice and rats: normal bile, no bacterial overgrowth. Without bile, the mouse gets SIBO. Adding bile acids (as a supplement) back and the SIBO goes away again! (7). In summary, reduced bile acids in the gut are associated with bacterial overgrowth and inflammation.(5) We also know that bile helps to maintain the integrity and health of the gut lining (8).

There is also a chicken and egg dilemma happening. The lack of bile could be causing the microbial overgrowth, but the microbial overgrowth (from another root cause) can break down bile, causing fatty stools.

All of this is discussed further in my eBook!

What affects bile acid production?

● Diet
● Antibiotics
● Various disease states

Symptoms and conditions related to low bile:

● Diarrhea
● Fat maldigestion and malabsorption
● Deficiencies in fat soluble vitamins A,D,E,K
● Interference with absorption of Coenzyme Q10 and beta-carotene
● SIBO
● IBS
● Poor liver function/disease
● Gallbladder removal

Consuming adequate amounts of healthy fats will help to stimulate bile production. For the average adult consuming an estimated 2,000 calories a day that translates to 25-35% of calories from fat or 44-78 grams a day.(9) Of course, the amount and sources will vary by person and individual tolerance to certain foods so always listen to your body and eat was feels good for you. A diet rich in fruits and vegetables is also key to feeding your good bacteria and promoting bile production.

What can you do? How to stimulate bile acid secretion and support a healthy gut:

● Consume adequate amounts of healthy fats like olive oil, eggs, avocado, and fatty fish
● Licorice root extract (10,11)
● Ensure healthy liver function
● Avoid foods that bad bacteria thrive on such as: refined foods and sugars and trans fats
● Consume probiotic foods that contain beneficial bacteria such as kefir/yogurt, greek olives, and other fermented foods
● Consume prebiotic foods that feed the good bacteria such as bananas, garlic, leafy greens and other foods high in fiber (a variety of fruits and vegetables)

How can we help? Nutrition therapy with a Registered Dietitian (who specializes in digestive disorders) is essential:

● Identify the root cause of the problem (what is causing low bile acid production or inadequate function?)
● Identify gut dysbiosis (microbial imbalance)
● Recommend supplements/enzymes to stimulate bile secretion and assist with fat absorption
● Recommend dietary strategies

References:
1. Bile. Wikipedia. 2017. Available at: https://en.wikipedia.org/wiki/Bile.
2. Bile. National Library of Medicine – PubMed Health. 2017. Available at: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022186/.
3. Goel. SIBO and Liver Diseases. BeyondDisease.com. 2015. Available at: http://www.beyonddisease.com/sibo-and-liver-diseases#32.
4. Staels B, Fonseca VA. Bile Acids and Metabolic Regulation: Mechanisms and clinical responses to bile acid sequestration. Diabetes Care. 2009;32(Suppl 2):S237-S245. doi:10.2337/dc09-S355.
5. Distrutti E, Santucci L, Cipriani S et al. Bile acid activated receptors are targets for regulation of integrity of gastrointestinal mucosa. Journal of Gastroenterology. 2015;50(7):707-719. doi:10.1007/s00535-015-1041-8.
6. Houten SM, Watanabe M, Auwerx J. Endocrine functions of bile acids. The EMBO Journal. 2006;25(7):1419-1425. doi:10.1038/sj.emboj.7601049.
7. Lorenzo-Zúñiga V. Oral bile acids reduce bacterial overgrowth, bacterial translocation, and endotoxemia in cirrhotic rats. Hepatology. 2003;37(3):551-557. doi:10.1053/jhep.2003.50116.
8. Fabian T. The Importance of Bile Acids: Part One. Microbiome Mastery. 2016. Available at: https://microbiomemastery.com/importance-bile-acids/.
9. Appendix 7. Nutritional Goals for Age-Sex Groups Based on Dietary Reference Intakes and Dietary Guidelines Recommendations – 2015-2020 Dietary Guidelines – health.gov. Healthgov. 2017. Available at: https://health.gov/dietaryguidelines/2015/guidelines/appendix-7/. Accessed October 26, 2017.
10. Sokol R, Devereaux M, Dahl R, Gumpricht E. “Let There Be Bile”-Understanding Hepatic Injury in Cholestasis. Journal of Pediatric Gastroenterology and Nutrition. 2006;43(Supplement 1):S4-S9. doi:10.1097/01.mpg.0000226384.71859.16.
11. Gumpricht E, Dahl R, Devereaux M, Sokol R. Licorice Compounds Glycyrrhizin and 18β-Glycyrrhetinic Acid Are Potent Modulators of Bile Acid-induced Cytotoxicity in Rat Hepatocytes. Journal of Biological Chemistry. 2005;280(11):10556-10563. doi:10.1074/jbc.m411673200.

*This was a non-sponsored guest post by Crystal Longo Savoy