Is stress slowly killing us?

Having some stress is normal. It keeps our body alert, gives us energy, and helps us avoid danger. Stress starts to become negative when we face continual challenges and experience little relief in between. Continual stress starts to wear on our body and may play a larger role on our health than we once thought.

When we experience stress adrenaline is released into the bloodstream. This hormone increases your heart rate and blood pressure. On occasion this release is healthy, but frequent release could lead to health problems such as chronic high blood pressure, abnormal heart beats, and heart disease.

The hormone cortisol is also released into the bloodstream. This hormone increases the release of glucose into the blood for quick energy and tissue repair. Cortisol also inhibits functions that would not be essential in a fight-or-flight situation such as the immune system, digestive system, and reproductive system. This hormone also interacts with the brain, altering mood. It is believed excess release of cortisol could lead to changes in metabolism, lower immunity, and infertility. 

A study released this week from UC San Francisco followed 61 women for 1 year, half of whom where chronically stressed. Measurements of participant’s waistlines and fat distribution were assessed, and labs were drawn to identify insulin resistance, levels of stress hormones, and oxidative damage. Over the course of the year the women reported their intake of high sugar and high fat foods. The findings showed participants who were chronically stressed consumed similar amounts of high sugar, high fat foods but had significantly larger waistlines, higher oxidative damage, and more insulin resistance than lower stressed participants. This placed the stressed participants at higher health risk for heart disease and diabetes than unstressed participants who consumed the same amount of unhealthy food.

The study highlights the fact that weight gain and weight loss may not be as simple as calories in versus calories out. In previous animal studies fat cells grew faster in response to junk food under chronically stressed environments; this study suggests a similar metabolic response in humans.

How can we combat the inevitable chronic stress many of us face due to our jobs and living situations?

We need to develop a new attitude to problem solve and learn how to find solutions to limit the amount of stress we experience. We need to learn how to be flexible and “pick our battles”. We also need to learn to set limits and figure out when we need to say “No”.

We need to take care of ourselves. Eat health foods and avoid the junk; high sugar snacks and caffeine may be quick fixes but are not long term solutions to the problem. Start exercising to release “feel good” endorphins, relax tense muscles, improve your mood, and strengthen the cardiovascular system. Get enough sleep to be well rested and help your body recover from the stress you are under. Studies show lack of sleep can also increase the secretion of stress hormones in the body.

We need to relax more. Take deep breaths to slow the heart, stretch, and massage muscles to reduce tension. Take time to do something you enjoy and get away from the stressful environment. Stay away from unhealthy expressions of stress relief such as drinking too much alcohol, smoking, or overeating.   

We need to talk it out. Talk to trusted family and friends about your stress. Venting can be very cathartic and new perspectives and suggestions from others could help find new solutions you hadn’t considered. Also know when to consult a professional and your physician to learn better coping strategies and manage your health proactively.  

Post Workout Recovery

Post Workout Recovery
Criticality of Nutrient Distribution and Timing

Your workout isn’t finished until you refuel

Research supports during the 20-30 minutes immediately following a workout your body is most receptive to muscle glycogen and protein synthesis. Glycogen is a type of carbohydrate stored in your muscles and in your liver. During exercise glycogen stores are used for energy and muscles breakdown from stress. Consuming a post workout snack replenishes glycogen stores, supports the restoration and building of muscle tissue, reduces post exercise fatigue, and aids in faster recovery.

Research supports a 3:1 or 4:1 ratio of carbohydrates to protein is most effective in replenishing glycogen stores as well as increases the rate of protein synthesis. Consuming high protein snacks immediately post workout with little amounts of carbohydrates is not as effective for muscle tissue development. Alternatively consuming a snack mostly of carbs and very little protein is not as effective for muscle glycogen replenishment.

All sugar is not the same

Healthy balanced diets for athletes and nonathletes include limiting refined sugars. Processed foods, candy, and desserts are filled with sugar we want to avoid; for this reason sugar has a bad reputation. When it comes to increasing athletic performance sugar can be very effective and aid in workout recovery. Simple sugars such as glucose and fructose are rapidly absorbed and become excellent fuel sources during exercise. Post exercise, glucose especially, is quick to replenish depleted glycogen stores and reduce post exercise fatigue. Selecting natural sources of simple sugars, such as fruit, is recommended over candy or desserts.

Liquid post workout snacks can be consumed fast, aid in rehydration, and may be more portable than solid foods. Based on your preferences solid foods can be equally as effective. Aim for foods rich in glucose, high in glycemic value, and low in fat. The longer the duration and intensity of your workout, the more carbs and protein your body needs. Typically aiming for a 200-300 calorie snack is adequate for most workouts. Low intensity exercise and short duration may only require regular meals to properly refuel stores.

Post Workout Snacks
1 low fat string cheese and 1 apple (122 calories, 20g carbs, 6g protein)
1 cup low fat chocolate milk (170 calories, 25g carbs, 8g protein)
2 oz sliced turkey and 10 crackers (184 calories, 24g carbs, 9g protein)
¼ cup raisins with 1 low fat string cheese (190 calories, 32g carbs, 9g protein)
1 cup cheerios with 1 cup skim milk (191 calories, 34g carbs, 11.5g protein)
1 English muffin, 1 oz turkey, and 2 tbs hummus (219 calories, 30g carbs, 11g protein)
1 cup vegetable lentil soup with 5 crackers (230 calories, 41g carbs, 10g protein)
Smoothie with 1 cup skim milk, 1 tbs peanut butter, ½ banana, and ½ cup strawberries (245 calories, 35.5g carbs, 12g protein)
Low fat fruit flavored Greek yogurt and 1 banana (245 calories, 47g carbs, 15g protein)
1 English muffin, ¼ cup low fat cheese, ½ cup tomato sauce, and 1 cup vegetable soup (320 calories, 52g carbs, 14g protein)
2 waffles, 1/3 cup plain nonfat yogurt and 1 tbs almond butter (334 calories, 36g carbs, 11g protein)
1 plain bagel and 1 hardboiled egg (344 calories, 52g carbs, 16g protein)
¾ cup low fat berry granola with 1 cup low fat plain yogurt (364 calories, 62g carbs, 17g protein)
2 tbs peanut butter, 2 tsp jelly and 2 slices bread (400 calories, 43g carbs, 14g protein)
1 roll, 1 oz turkey, 1oz low fat cheese, spinach, tomato, 8 oz orange juice (400 calories, 67g carbs, 17g protein)

Drink to Good Health: Resveratrol

This polyphenol (a type of plant compound) is an antioxidant that is naturally produced by several plants to provide protection from bacteria and pathogens. Red wine particularly has been touted as an excellent source of resveratrol, however the compound can also be found in blueberries, cocoa powder, cranberries, lingonberries, mulberries, peanuts, pistachios, purple grapes, red grapes, and in the roots of the Japanese knotweed plant.

The highest concentrations of the compound are found on the skin of red grapes making red wine highest in resveratrol. The amount of time the grape skin is fermented impacts the amount of resveratrol within the wine. White wine has less of the compound due to the skin of the grapes being removed earlier. Other factors including grape variety, humidity, and other environmental conditions also impact resveratrol content and the amount can range greatly from year to year. Most red wines contain anywhere between 0.2 to 12.59 mg/L of the compound. Typically organic wines are thought to have higher amounts due to less chemical usage and their need to produce more resveratrol to combat fungus. Pinot noir is fermented the longest with the skin intact which could also increase resveatrol levels. Wines from cooler regions such as Italian sangiovese, Australian shiraz, and French burgundy were found to have higher levels compared to warmer climates such as California, Spain, and South American wines.  

Resveratrol was discovered in 1939 but it was not until 1992 when scientists suggested resveratrol may be the reason for the heart benefits of red wine. The hypothesis was based on the “French Paradox” where high levels of saturated fat intake, smoking, and regular red wine consumption in France resulted in relatively low levels of mortality from coronary heart diseases. This suggested regular red wine consumption may provide protection from heart disease.  

Following the 1992 study, hundreds of reports have promoted the health benefits of resveratrol. The majority of studies have been conducted in test tubes or with animals. Several have been conducted on humans but these were not long term studies and have not shown significant evidence of resveratrols health benefits. Mouse studies have indicated activation of one gene that helps protect the body against side effects of obesity and diseases of aging. It is thought resveratrol may prevent heart disease by reducing inflammation, preventing the oxidation of LDL cholesterol, and preventing platelets from sticking together and forming clots. It is believes resveratrol may prevent cancer by reducing the spread of cancer cells. For Alzheimer’s disease resveratrol may protect nerves from damage. Resveratrol may also help prevent against insulin resistance, a precursor to diabetes.

Moderate alcohol consumption has been shown to reduce heart disease risk by 20-30%. Some studies have shown wine drinkers to have lower risks than people consuming beer or liquor; however other studies found no difference. It is not yet clear if polyphenols, such as resveratrol, in red wine have the most beneficial impact on reducing heart disease risk. Due to the limited studies in humans we are unable to confirm health benefits of resveratrol at this time.

Manufacturers have capitalized on selling resveratrol as a supplement, and while it is generally considered safe, the long term side effects have not been studied. Resveratrol does have estrogen like properties, similar to soy, and should not be taken by pregnant or breastfeeding women. It is also recommended children and adolescents under 18 not take the supplement as the effects on development are unknown. People on certain medications such as anticoagulents (Warfarin), antiplatelet drugs (Plavix, Persantine), and NSAIDs (aspirin, ibuprofen) are also advised not to take resveratrol supplements. Until more is known regarding the estrogen like properties of resveratrol, women at risk or with a history of estrogen-sensitive cancers should also avoid supplements.

In addition to resveratrol, red wine contains other polyphenol compounds and anthocyanins which have beneficial antioxidant properties. Until more research ensures the efficacy and safety of supplements my opinion is to consume these compounds from natural sources so they can work together in synergy with other phytochemicals.

 

The Goji Berry

Eat it raw, dried, cooked, or as juice; this bright reddish-orange berry has a mild sweet, sour, and tangy taste when dried, and has a chewy texture similar to a very dry raisin. Ancient Chinese medicine used goji berries for longevity and immunity. Today the goji berry has earned the reputation of being a super fruit thanks to its nutrient value. The berry contains various phytochemicals, phenolic pigments, calcium, vitamin C, selenium, riboflavin, beta-carotene, and zeaxanthin. These vitamins, minerals, and antioxidant compounds have led the way for preliminary medical research to identify possible healing powers within the goji berry. It is important to note at this time due to limited clinical trials no health claims have been substantiated and consumers should be aware of this when reading advertisements. 

Published studies have speculated from animal models and human pilot studies that goji berries may inhibit some forms of cancer, prevent oxidative stress, protect against retinal damage secondary to ischemia, and prevent against cardiovascular and inflammatory diseases. From my research it appears only two published studies have tested goji on humans, one published in 1994 found people with cancer did respond better to treatment when goji was added into their diet.

When it comes to eyesight the antioxidant zeaxanthin found in goji berries absorbs blue light and protects the retina of the eye. Several studies show consuming foods rich in zeaxanthin may reduce the risk of macular degeneration. This compound is also found in paprika, corn, and saffron.
For most people eating goji berries along with other fruits and vegetables is an excellent was to add nutrients, antioxidants, and phytochemicals into their diet. Since research is ongoing and nothing is conclusive just yet I would recommend not “overdoing it” with the goji crazy, but certainly adding some goji into your diet can be part of a healthy lifestyle.

Goji berries can interact with some medications, particularly with the way they are metabolized in the liver. Taking goji with anticoagulants (especially warfarin) by increasing bleeding risk, drugs for diabetes by causing drops in blood suagr, and drugs for hypertension by causing your blood pressure to go too low. Goji can also stimulate the uterus and should not be used when pregnant or breastfeeding. Most interactions were seen in people consuming 3-4 cups of juice daily or 6-18g berries daily.

Coo-coo for Coconuts

Coconut oil is the latest “super-good-for-you” food claiming to improve cholesterol, regulate blood sugar levels, increase metabolism aiding in weight loss, and fight off  infection.

For years every major health organization advised consumers to avoid high consumption of coconut oil due to it being high in saturated fat. Today we are hearing the type of saturated fat in coconut may not be harmful to our health.

There are two types of coconut oils, hydrogenated coconut oil and virgin coconut oil. Hydrogenated coconut oil is manufactured and contains trans fats which turn good cholesterol into bad cholesterol in your body. Many major health organizations are lobbying to have trans fats removed from all foods. It is important to read food labels on packaged goods to ensure it does not contain trans fats, hydrogenated, or partially hydrogenated oils. Hydrogenated coconut oil is no exception and should not be consumed.

Virgin coconut oil, or regular coconut oil that is not hydrogenated typically means the oil has been unprocessed. Unlike olive oil, there is not an industry standard for the meaning of “virgin”. It is assumed the coconut oil has not been refined or bleached. 1 tablespoon of coconut oil has 120 calories and meets 60% of the maximum amount of saturated fat allowed in a 2000 calorie diet. If you have that with 4 ounces of beef you have exceeded your daily limit. Here is a side by side comparison with 1 tablespoon of olive oil:

 Historically polyunsaturated and monounsaturated fatty acids are considered the “good fats” that prevent heart disease and improve cholesterol levels in the body. Trans fats and saturated fats have been considered the “bad fats” that cause plaque buildup in the arteries and lead to heart disease. The unique feature of coconut oil is that it contains mostly medium-chain triglycerides that may not have a significant effect on cholesterol.

Medium-chain triglycerides are digested rapidly and are broken down immediately. Once in the blood stream they are sent directly to the liver which uses them for energy or stores them as fat. It is thought the rapid speed of digestion leads to increased energy and increases in metabolism helping to promote weight loss.

For all the positive effects we hear about coconut oil we rarely hear the negative or harmful effects. Because medium-chain triglycerides are rapidly delivered to the liver, overconsumption can lead to added stress on your liver and some studies show it may contribute to non-alcoholic fatty liver disease. Ketones are also produced as a byproduct of metabolism and can be a large concern for people with diabetes. Diabetics and people with liver disease are encouraged not to consume medium-chain triglycerides. Other side effects of consumption include nausea, gastric distress, and diarrhea. Coconut oil also contains omega-6 fatty acids that produce a more inflammatory effect on the body while oils containing omega-3 fatty acids produce an anti-inflammatory effect on the body.

Eating too much of anything is unhealthy and something as concentrated in calories as fat can quickly lead to weight gain, increasing risk of cardiovascular disease. When we hear recommendations to “eat more healthy fats” I often see clients take this as an invitation to use copious amounts of oil on everything they eat. A well balanced 2000 calorie diet should include 6 teaspoons of healthy fat daily. 1 teaspoon of oil is equivalent to:

·         1 ½ tsp nut butter

·         2 Tbs avocado

·         6 almonds

·         8 black olives

·         1 Tbs regular salad dressing

·         2 Tbs reduced-fat salad dressing

·         1 Tbs flaxseed

·         1 slice bacon

·         2 Tbs sour cream

As you can see an ounce of almonds and dressing on your salad meets your recommended 6 tsp daily. Remember you will be consuming additional fat in the protein you consume, as well as in other processed foods. When all of this is taken into account you want to end up with consuming about 50-75g of fat overall for the day on a 2000 calorie diet. There is no need to go overboard with covering everything in oil.

The reality is we do not have enough information at this time to know for sure if coconut oil does harm or good for the body. There certainly are better options out there such as olive and canola oil which have been very beneficial in decreasing cholesterol and providing better ratios of omega-3 to omega-6 fatty acids promoting anti-inflammatory effects on the body. Instead of playing roulette with your health it is best not to switch over to the coconut oil trend. I always say everything in moderation…enjoying coconut oil from time to time is not dangerous but making it a steady part of your diet may not be so positive.

Eat to Boost Energy

Food gives us much-needed energy. Just like a car, our body needs fuel to run. It is important to maintain normal blood sugar levels, and the best way to accomplish this is by eating every few hours any never let our “tank” get empty.

Studies show people who Eat Breakfast have a better mood, have more energy throughout the day, overeat less at night, and are less likely to be overweight. After an overnight fast eating breakfast supplies your body with fuel and signals your metabolism to start burning energy efficiently. Eating a 300-400 calorie nutrient rich breakfast balanced with fiber and protein will help provide a steady stream of energy. This will keep you satisfied longer than a sugary breakfast filled with empty calories. Try:

·         Whole wheat English muffin with 1 tbs peanut butter topped with sliced banana

·         Nonfat Greek yogurt topped with 1/3 cup low-fat granola and ¾ cup blueberries

·         1 egg and 2 egg whites mixed with spinach and tomato with 2 slices whole wheat toast

·         1 cup whole grain cereal with 1 cup nonfat milk, 2 tbs walnuts, and 1 cup sliced melon

·         2 frozen whole grain waffles topped with ½ cup nonfat yogurt, 1 tbs slivered almonds, and 1 cup fresh raspberries

Enjoy a Power Snack by eating between each meal. Studies show eating large quantities of food stimulates increased insulin production and deposition of fat. Eating less more often, through smaller meals and snacks every 3-4 hours encourages your metabolism to consistently burn calories, your blood sugar levels to remain stable, and you to stay well energized. Just like breakfast, combine fiber with protein to provide a nutrient dense power snack. Try:

·         1 oz low fat cheese and 1 medium apple

·         1 cup baby carrots and 2 tbs hummus

·         23 almonds

·         Single serve low fat yogurt with ¾ cup berries

·         2 rice cakes with 1 tbs peanut butter and ½ banana

Maintaining consistent energy is established through keeping blood sugar balanced. Eating more whole grains and less sugar helps allow a slow and steady release of carbohydrates into the bloodstream. When we eat sweet foods or refined carbs, such as cookies, candy, or white rice, we get a spike in blood sugar and an initial burst of energy which is followed by a rapid drop in blood sugar. We then have feelings of fatigue and may start eating more to compensate for our drop in energy. If we do this enough times in a day, we feel exhausted by the evening. Studies also show people who eat whole grains can lower their cholesterol levels, manage their diabetes better, and are less likely to be overweight. Try:

·         Brown rice

·         Popcorn

·         Oatmeal

·         Any grain that starts with “whole”

·         Quinoa

Dehydration can deplete our energy levels and lower our metabolism. Drink water throughout the day to stay well hydrated, remembering thirst is not a good indicator of hydration status. Most people need about 8-10 cups of fluid daily. Water is the best but other fluids count towards that total too. Keep in mind caffeine may be a quick pick-me-up but once the caffeine wears off, where will your energy levels be? Drinking caffeine and alcohol later in the day can also affect your quality of sleep. Get enough sleep to restore your energy levels and promote greater health. Studies show lack of sleep contributes to weight gain, increased risk of cardiovascular disease, increased rates of depression, aging, accidents, and forgetfulness.

Magnesium supports over 300 enzymatic reactions within the body and plays a significant role in how our body produces energy. Magnesium is the most common nutrient deficiencies in the United States…along with calcium and vitamins A, C, D, and E. Food high in fiber are generally high in magnesium as well. Men need about 420mg daily; women need about 320mg daily. Try:

·         Dark Leafy Greens: Spinach, Swiss chard, Kale

·         Nuts and Seeds: Pumpkin, Sesame, Brazil Nuts, Almonds, Cashews, Pine Nuts

·         Fish: Mackerel, Pollock, Tuna

·         Beans and Lentils: Soybeans, White beans, French beans, Black-eyed peas

·         Whole Grains: Brown Rice, Quinoa, Millet, Bulgur, Buckwheat, Wild Rice

Treat yourself to a piece of Dark Chocolate to fight off fatigue. Dark chocolate comprised of at least 70% cocoa contains a significant amount of flavanols which have been linked to lowering blood pressure, decreasing LDL cholesterol oxidation, increasing insulin sensitivity, decreasing inflammation, and reducing fatigue. Researchers believe chocolate may increase serotonin levels in the brain helping to regulate mood and sleep which helps alleviate chronic fatigue. One study also showed increased blood flow to the brain for 2-3 hours after consumption which may increase alertness and cognitive skills.

Food is fuel and picking the right nutrients at the right time gives you optimal energy throughout the day.

Food Intolerance, What is Real and What is Not

It seems like everyone is gluten free these days. Is gluten bad for us? What about wheat and other grains? I’ve heard of food sensitivity blood tests…should I get tested? Every day I have 1 or 2 patients ask me these same questions. It is time to set the record straight…

Food intolerance is real. Foods that irritate your body and cannot be properly digested are a food intolerance. They range from person to person, with symptoms mild to severe. Nausea, stomach pain, diarrhea, vomiting, gas, bloating, cramps, heartburn, headache, irritability, and nervousness are the most common signs someone has a food insensitivity/intolerance.

Food allergies are not as common but symptoms can be similar. The largest difference is that food allergies involve the immune system and are life threatening. The body produces immunoglobulin E (IgE) which circulates throughout the blood and releases histamines once exposed to an allergen. People with allergies may begin to feel itchy, experience gi distress, or even have difficulty breathing. If you have a true food allergy, having a blood test will reveal IgE antibodies. It is very important for people with food allergies to avoid foods that they are allergic to.

Food intolerance does not involve the immune system and are not life threatening. People with food intolerance may need to avoid trigger food to prevent the unwanted symptoms they experience. There are many different food substances that cause intolerance; the most common are lactose, preservatives and additives, tyramine, and gluten. In recent years food sensitivity blood tests have surfaced claiming to identify food intolerance and help you avoid your trigger foods. 

Are food sensitivity blood tests valid?

Food sensitivity/intolerance tests seek out the presence of IgG and IgA antibodies to identify reactions to various foods. Some people who receive test results and eliminate identified foods do believe the test helped them. The American Academy of Allergy, Asthma, and Immunology’s position is that the tests do not have clinical relevance, are not validated, lack sufficient quality control, and should not be performed. These blood tests produce an unacceptably high false positive rate and are not accurate enough to diagnose food intolerance. Also the presence of IgG antibodies to foods may not necessarily mean intolerance but could be related to foods you eat often or ate recently. Research also shows elevated IgG antibodies have been related to childhood allergies that were outgrown as a child becomes an adult (such as an egg allergy), indicating increased tolerance to the food not an increased intolerance.

At this time the best method of identifying food intolerance is through an elimination diet. This diet removes foods and slowly reintroduces them one at a time over several weeks while keeping close track of your symptoms. A dietitian can help assist you with an elimination diet to help ensure your success.

The bottom line is food sensitivity testing may have worked for some people, but the evidence-based research backing up the findings are not there. If you have received test results and have eliminated foods based solely on this recommendation, you may try slowly adding back in these foods and see if you experience any side effects. If you are currently suffering from food intolerance and you do not know which foods are causing you distress, working with an allergist and dietitian and trying an elimination diet may help bring you relief.

What about gluten?  

Gluten is a protein found in wheat, rye, and barley responsible for triggering an immune response in about 1% of the American population who suffers from a condition called Celiac Disease. Symptoms include diarrhea, anemia, pain, skin rash, and malabsorption. People with Celiac Disease must avoid gluten to prevent nutritional deficiencies. Some people may suffer from an intolerance to gluten, which does not trigger an immune response, and avoiding foods with gluten may help them feel better.

Gluten is deemed safe to consume and there is no reason to avoid it unless you experience symptoms and avoiding gluten resolves your discomfort. Currently gluten-free products are booming and many people perceive a gluten-free lifestyle to be healthier-this is not always the case. Many whole grains that contain gluten are rich in vitamins, minerals, and fiber that gluten free products may be lacking. Also gluten free products may be higher in fat, sugar, and salt to improve taste. The bottom line is avoiding gluten does not make you any healthier than eating gluten. The majority of people tolerate gluten and it is safe to eat. Some people may experience intolerance and avoiding gluten helps relieve their symptoms. 

What about wheat and other grains?

Wheat is one of the most common allergies among children. It involves an immune response and production of antibodies after exposure to several different proteins found in wheat. With Celiac Disease only one protein, gluten, causes an immune response. Avoiding wheat is essential for people with wheat allergies, particularly hidden sources of wheat such as in condiments and beer. Intolerance to wheat and other grains does exist, and just like other intolerance's it does not trigger an immune response. Starting an elimination diet to pinpoint what specifically is causing your symptoms is the most effective way to manage food intolerance.

Food allergies and food intolerance can be difficult to manage. Working with your registered dietitian to find a well balanced diet that works for you can help. Grains are an excellent source of nutrients and energy; they belong in every healthy diet in moderation.