Category Archives: Other

Not settling

Hi everyone!

Times have been wild since I have last written. I have been working at the same primary care medical practice, went backpacking solo through Argentina, Bolivia, and Peru, completed a part time post-bachelors program, and have been experimenting with some other projects and goals. ;)

My two year anniversary at the practice is coming up soon, and I have been thinking a lot about what I have learned. My role has been something similar to a health coach, and I have worked with patients with a wide variety of conditions, goals, and personalities. These are people that are both just like you, and not at all, coming from every stage and experience of life.

I am fortunate to be able to get to know patients on a very personal level. I learn their stories, understand their environment, and listen to their struggles, triumphs and goals. This is one side of the equation of their reality. The other side is genetics and epigenetics (the nature in nature vs. nurture). All of these factors converge into a complex web that determines their health and disease state at the present moment.

You cannot know 95% of these things when you look at a person on the street or meet them at an event. It would be hard to know most of this stuff even if you had been known them for years, unless you have a medical background and ask a lot of personal questions… Being able to see how each side of a person, including their genetic and environmental history, lifestyle choices, motivators and challenges, interrelates with their medical pathophysiology has increased my compassion for others and understanding of the amount of power that people actually have to change.

It isn’t just medical conditions that have complex roots; it is every aspect of a person. Their personality, quirks, habits, and choices are all influenced by a multitude of factors. For example…

  • Mood disturbances and mental disorders are tied to neurotransmitter imbalances in the brain, which could be genetic, environmental, chemical, or even nutrition related (not adequate intake of necessary precursors)
  • People have varying levels of pain perception and stress tolerance due to stress exposure in utero
  • Overweight people may be more susceptible to overeating due to low dopamine or altered gut bacteria (ex: h. pylori in excess results in stomach ulcers, but a deficiency leads to a lack of leptin, which is responsible for satiety)
  • Sexual orientation and gender identity is influenced by the hormonal exposure in utero (and theoretically there are external factors that can alter this hormonal environment)
  • It is theorized that some mental issues, including chronic anxiety and poor self esteem, are related to lack of parental attachment in early life
  • Our diets play massive roles in our mood, energy level, sleep, immunity, health, weight, and daily choices. And our diets are massively influenced by our geography, early life experiences, parenting, and socioeconomic past and status.
  • Habitual drug or alcohol use can create a cycle involving neurotransmitters that makes it very difficult to break free of (but also- what spurred the first use? )

I think recognition of the influential unknowns also has huge implications for how we interpret and interact with others. With the understanding that each individual is the outcome of an extremely complex web of factors and events, we can have a bit more compassion for our fellow human beings . We are constantly being influenced and changing, and we can’t know what all of those factors are for ourselves (let alone others). More compassion from the acceptance of our ignorance and the complexity of nature v. nurture interactions, in combination with efforts to change what we aren’t content with, could bring about some seriously positive change in the world. Instead of judging other people (and ourselves!), we should try to be more accepting, while empowering others to make the changes they desire.

I have emphasized the complex roots of personalities and medical conditions in order to bring about compassion, not hopelessness. Most days, I hear someone somewhere saying that they have ‘always been’ a certain way. Whether it’s being overweight, anxious, depressed, or whatever, they appear resigned to this particular trait. It seems logical to me that the best way to change something is to get to the root of the problem, and so I have tried to trace back to the start of a certain problem, habit, or quality. Things quickly turn very murky, as there is not usually one answer.

What I have realized though, is that it does not matter.  There are countless elements that influence who we are that we cannot change. While you can’t change your early life development, genetics, or what others do to you, you can change what you do and how you think. After all, our bodies are made of the foods we eat, and our personas are made of  our actions, words, emotions and thoughts. We do not need to feel resigned to our condition. There are so many things (mental, physical, emotional, personality traits, habits, spiritual) that we can change and the tools are great and varying:

  • Sleep
  • Diet
  • Addressing medical conditions properly, proper medications
  • Probiotics (this can be complicated, different strains do many different things)
  • Supplements, herbs (with medical advising)
  • Therapy of all types
  • Cognitive Behavioral Therapy
  • Mindfulness Based Stress Reduction
  • Meditation
  • Yoga, Tai Chi
  • Introspection, brain storming, goal setting and planning
  • Calendars and list making
  • Positive self talk, positive affirmations
  • Regular reminding self of values
  • Life coaches, health coaches, career coaches, advisors
  • Education, books, reading, studies

In summary, you are awesome. People are complicated with incredibly different life situations. Better to have compassion than pass judgement on others, and  focus on making the changes you wish to seek in yourself – because you can. I hope you all have an awesome Friday and weekend!

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me, the salt flats in Bolivia 

 

 

Things I have learned these last 9 months in San Francisco… Part 1

Hi world. I have been gone so long, essentially since moving to San Francisco, and yet I have thought about this space every day. I have been learning and doing so much in the time that has passed. I can only hope I have grown a fraction as much as I feel I have learned.

I have had this post (and several others) as a draft for a month now  thinking I would add and improve. I am just going to publish it and do this piece by piece. Baby steps!

Paleo is not the end all cure all to all diseases. I had the idea that going strict paleo could put any Crohn’s or Ulcerative Colitis sufferer into remission, ameliorate most GI issues like reflux, pain, indigestion, and bloating, and get everyone’s blood work going in the right direction. What I have learned is that paleo can do these things for some people, but it cannot completely cure others. Some people do just fine with, or even need, a higher carbohydrate diet and a little rice isn’t going to kill them. Some people actually do benefit from reducing meat consumption if their lipid profile is resiliently out of whack.  However, as I have said before, this is not the majority and saturated fat is not the enemy. For me personally, paleo has rocked my blood work in the best of ways. I went from average-to-fairly-good HDL and LDL numbers to an HLD to LDL ratio that made my doctor say “You must be one of those genetic freaks.” Only I’m not – it has all been diet. Diet truly is the foundation of all health, in my opinion. However, some people can eat paleo till the cows come home and go out to pasture again and still suffer. Which brings me to my next learning.

Our health is just as much in our minds as in our bodies. We truly can think ourselves  sick or in pain. With that, we must be willing to think positively and channel being healthy and happy. No amount of medication, weight loss, supplements,  or exercise is going to make you “better” or “healthy” or “thin”  if you do not truly want to be. This may sound crazy, like why would anyone want to be sick or unhealthy, but it is true. People can take comfort in their conditions. The labels give them license, excuses to keep doing what they have always done. Similarly, people can take comfort in their extra weight and may not truly want to lose it, despite what they say. This is fear. It can be fear of rejection once the weight is gone, fear that they will won’t be happy at their new size, fear of failure.  Sometimes what looks like obesity, diabetes, chronic pain, etc, is really concealed self-hate, depression, anxiety, and addiction. To truly heal oneself, the whole picture must be assessed and treated from all sides. From the inside out, diet and exercise. From the mind to the body, through various types of therapy, meditation, yoga, stress reduction. From the surface of the problem down to the roots.

 

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the journey to summit Mt. Shasta – May 2013

killer bacon broccoli salad.

Hello everyone!

I seem to have a penchant for obnoxiously long domain names, as I have purchased TheInformedHealthNut.com as the new home for this blog!

So much has happened in the last month, I can’t even fathom it. I have now been working in the doctor office for almost two months and have really been enjoying it. Although, I definitely need to go work attire shopping. But with what time?!

Those work flats are not happening anymore, though. I was beginning to experience some foot pain (eek!), so I went to see a new orthopedic doctor here in the city. We determined that it was walking around the city in my work flats and lugging my laptop that was causing the pain. Thus, tennis shoes are now being worn with my work outfits when in public. So fashionable..

Speaking of work clothes, I now get to get paid to wear spandex and knee socks to work! Last night was my first shift at Crunch Fitness on New Montgomery. I will be working there part time as a personal trainer. The vibe is awesome. It is not too frou frou like some gyms in the city, but it is still a nice facility and very high energy. People go there to work out and make changes, not merely see and be seen. I am excited to fill up my schedule with clients and work with them on their fitness and nutrition! If you live in the Bay Area, come see me for a free hour evaluation and work out! One of the trainers asked me to give him a CrossFit style workout for him last night between clients, so I put him through this wretched little number:

5 Rounds For Time

  • 22 wall balls, 20# ball
  • 30 dumbbell snatches (15 per hand), 50# DB
  • 22 box jumps, 24 inches

As far as San Fran living, I have been doing as much as possible. My logic is that if I am going to pay enough in rent to sustain a family of 4 in the Midwest, than I better live the life of four people each month. Activities have included:

attending my first Giant’s game (going to the World Series!!!!) and watching the Blue Angels fly overhead

 Hardly Strictly bluegrass festival

hiking to the beach + exploring the Mission and most of the other ‘hoods

going to the flea market with Natalie + exploring several food and cultural festivals

I have surely bored you all to tears with all my talk of stress fractures, so I am going to sum this up as quickly as possible. At the beginning of October, I got the OK to lifting weights again. Have been loving it. Started to get a bit of foot pain, but not during workouts. Saw a doc and figured it out. Am currently lifting and being cautious. Get to add in some running in November. Get to add in CrossFit style workouts/ lifts in December. Done.

Endurance Focused Lifting Workout

5 sets of:

  • 20 backsquats, 95#
  • 12 military presses, 45#

4 sets of: 

  • 20 deadlifts, 115#
  • 15 lateral DB raises, 10#

Between my two jobs, I now work from 10:3o am to 9 pm with a break to work out in there. Thus, I have to bring both my lunch and dinner with me each day. This is going to make recipe posts more difficult, but hopefully it will be a great way to learn how to make portable meals that are suitable for work  that are actually tasty and healthy. Expect that in the near future! A recent fave…

Addictive Bacon Broccoli Salad

Recipe: Serves 2 as a side

  • 3 cups raw broccoli, chopped
  • 2-3 slices of bacon
  • 3 tbsp sweet onion, finely diced
  • 3 tbsp light mayo
  • 1 tbsp greek yogurt
  • 1 tbsp honey
  • 2 tsp apple cider vinegar
  • 2 tbsp raisins
  • salt, to taste

Directions – Cook the bacon in the microwave for 2 or 3 minutes, until very crispy. Lay on a paper towel to drain. Once cooled, crumble into bits. Combine the broccoli, bacon bits, diced onion, mayo, Greek yogurt, honey, apple cider vinegar, raisins, and salt in a bowl. Mix well. Taste and adjust to personal preference. Enjoy!

How to speed up stress fracture recovery

So, you got yourself a stress fracture. You probably found this blog post because you have been put into a boot or cast, can’t play your beloved sport, and are feeling thoroughly depressed. While being injured really sucks, there are things you can do to heal yourself both physically and mentally.

Keep in mind that a stress fracture is exactly as the name implies. It is not a bone that has been broken into pieces, but is fractured partially through. This may not be a clean cut, but may also be surrounded by micro-fractures. Think of the bone as now being extra porous, like a pumous stone. What your body must do to heal the fracture is fill in the cuts and pores and re-inforce the area by making an extra thick “collar” of bone matrix around the damaged areas. Stress fractures usually cannot be scene on X-rays until the collar has begun to be formed, after around 2-3 weeks. In order to heal the bone, your body obviously needs more of what bone is made of:

  • hydroxyapatite (made of calcium and phosphorous)
  • collagen (made of protein, especially the amino acids proline and glysine)
  • calcium carbonate
  • growth factors, like glycosaminoglycans, osteocalcin, osteopontin

the fuzzy part is the “collar

Before we talk about healing, I want to emphasize that a) I am not a doctor and you should consult yours before considering any of this advice and b) that unless you are in pain and really, really want to take over the counter anti-inflammatory drugs:

Avoid taking NSAIDS (Aspirin, Ibuprofen) at all costs during the healing process.

NSAIDS reduce pain by reducing inflammation. They achieve this by shutting down the COX-2 (cyclooxygenase) enzyme. While COX2 is responsible for the pain and inflammation, it is also the beginning of a long chain of events and enzymes that lead to healing. Inflammation, after all, is the flooding of an area with blood and cells to repair the damage. Shutting down COX2 = slowing down the healing process. 

Physical Healing

  • Bone Broths. In my opinion, the best way to provide your body with what it needs to repair bone and possibly up-regulate the enzymes responsible for bone growth and repair is to eat bones. What could be a better, more complete source of everything you need to heal? To make a bone broth, use the leftover carcass and bones from a chicken or roast. Place in a pot and cover with water and add 1 tbsp of vinegar. Bring to a boil and reduce the heat to a low simmer. Cover and let simmer for 12-24 hours. You will likely need to add more water if it gets too low.
  • Calcium Magnesium supplement. Calcium and magnesium should ideally be taken together, which can easily be done in a single supplement. Plus, magnesium can offset the constipating effect that calcium supplements can sometimes have.
  • Vitamin D3, A, K2 supplement. These three nutrients act synergistically together, meaning they are far more powerful together than they are individually. Personally, I used this one. Also, Vitamin D can help fight the depression that may come with being injured. It certainly helped me!
  • Horsetail. I purchased a horsetail tincture simply based on anecdotal evidence and one study done on rats that showed increased stress fracture healing due to its high silica content. Silica dioxide is found in bones and is major part of collagen. I gave myself a dose 1-3x per day. I purchased this one.
  • Milk Thistle Complex. I also purchased this supplement, which is typically used as a liver detoxifier, based on one study done on rats that showed increased fracture healing due to its silymarin content.
  • Homemade, raw yogurt. Raw, cultured yogurt is an awesome source of very bio-available calcium. Here is my post on how to make it yourself!
  • Plenty of protein and calories.  Whenever your body is repairing tissues or fighting off an illness, your protein needs are increased. All of the repairing and immune cells (as well as all cells) are made of protein, and you will need these in greater numbers than usual. Also, do not try to diet while in recovery. I don’t have a scientific study for this, but our hormones tend to act globally on the body. If you are in starvation mode, you are going to be catabolic (which means the state of breaking down tissues like fat and muscle). When you need to repair a bone, it makes sense to avoid catabolism and try to ere on the side of anabolism. You don’t need to stuff your face, but this isn’t the time to drastically cut calories or protein intake, despite the necessary decrease in activity. Just try to make the vast majority of your diet healthful, nutrient dense foods.
  • A safe level of activity. This completely depends on your stress fracture/s, current level of mobility and fitness, and doctor’s orders. In my case, being completely immobile was thought to be not ideal. Light weight-bearing activity can increase blood flow and help send the signal to the body that part of the body needs to be healed. I was able to partake in swimming, limited walking, and some safe exercises (abs, bench press, etc). However, I had to emphasize rest and avoid running, lifting, and CrossFit for 3 months. Well, hopefully… the “final” doc appointment is on Friday!
  • Get some sleep and avoid alcohol. Deep tissue healing occurs during deep sleep, so it is very important to make sleeping a priority. Alcohol also shuts down the healing process while it is in your system, so if you must drink, limit yourself to special occasions.

Mental Healing

Assuming you got the stress fracture because you were doing too much of an activity, you probably love whatever it is you were doing. Not being able to play your sport or do your thing can leave a painful void in your daily life, which is a major emotional hit. Instead, it is helpful to see your injury as an awesome opportunity to improve other areas of your life. Use the time that you would have been doing that activity to do something else that is productive and beneficial to yourself and/or others.

  • Be thankful. Be thankful that the injury wasn’t more serious and for what you do have. Start a gratitude journal and try to truly appreciate the fact that your stress fracture is temporary. Not all things are.
  • Volunteer! This was the best thing I did while recovering. Volunteering is not only a great distraction but also very fulfilling.  I volunteered a little bit feeding the homeless, which I enjoyed, but I fell in love with my second volunteer position because it more related to my passions. Once a week, I got to teach kids ages 6-14 at an after school program in the projects of Sacramento. I could choose any topic I wanted, so clearly I chose nutrition! We went over the food group basics, vitamin and mineral functions, sugar and its effects, and how to read food labels. Chobani even sent me over a free, giant case of Greek yogurt for the kids to try! I miss my kids!
  • Take up a new hobby or dive into your current ones. I had been thinking about giving clinical research a try, so I started interning at a research hospital for a couple months to see if it was something I would want to go into as a career. As it turns out, I’m not that into clinical research. I’d rather read the results ;)

Hand-tweezing human fat cells out of the fascia.

  • Read! Read whatever you love. Learn a new language. Get NASM certified to be a personal trainer.

Ironically, right around the time I got diagnosed with my two 2nd metatarsal stress fractures, Sun Chlorella sent me a box of Infuse Your Mood Tea to try. The tea comes from the eleuthero plant and is supposed to help improve moods and calm the body and mind. I am not usually an herbal tea fan since I like sweet, fruity teas, but the taste was pleasant and earthy. I didn’t notice a difference in my mood, but it certainly didn’t hurt! Tea can be a nice calming ritual before bed, and Infuse Your Mood is caffeine free.

I hope you all find this information helpful. If anyone has any additional tips or insights, please leave a comment! Happy healing. :)

Aside

My blog is typically me putting my best face forward. I avoid complaining and revealing my negative emotions. Not because I want to fool anyone into thinking I am always happy and perfect, but because writing positive posts makes me … Continue reading

a week of paleo + crossfit

A week has already flown by since my big paleo post! If you haven’t actually read it, and I know it is quite long, I definitely encourage you to give it a go. I spent ample time researching and made a point to only use the most properly executed studies so that you could get the facts. I spent this last week enjoying life before summer school, visiting friends, doing CrossFit, and eating strict paleo.
me and Dina <3
Congrats Carlyn! 

How did paleo go?

For the most part, I liked it and found it quite easy. This is really only because I have never liked beans and hardly liked grains. I know that sounds like BS, but I have always just wanted more of the things that you put on grains. Pass me a bowl of curry or spaghetti sauce and give me the cheese off your pizza, please. The rest is just flavor-diluting fluff. Honestly, I had been forcing myself to eat more grains like brown rice and quinoa in the last couple years because I figured they were good for me. However, I truly did miss my whole wheat waffles and dairy. I missed whipping cream in my morning coffee. Coconut creamer basically just ruined the experience of my beloved caffeine elixir. And ice cream! Don’t even get me started.

How did paleo feel?

Paleo felt great, but to be honest, it didn’t feel very different from how I usually eat, which is very little grains and no beans anyway. I actually felt a little more stressed out because I was having to watch what I eat more and avoid dairy. It also seemed like my digestion was slightly slowed at times, perhaps due to the lack of probiotics. I am so accustomed to eating yogurt every day! Then again, it could have just been the extremely filling foods I was eating more of. Eating lots of protein, veggies, fats and nuts, and some fruit makes me feel light but satisfied all the time. I almost always feel awesome and have a steady flow of energy throughout the day. My digestion is bangin’ and my hunger comes at times that make sense. Eating paleo makes me feel comfortably full and satisfied for long periods of time. Some meals kept my hunger at bay for over 5 hours! In my book, paleo is the way to go.

So, now what? 

I plan on continuing to eat mostly paleo, but with some quality dairy. I think I will have grass fed, whole, preferably raw, cream, yogurt, butter, and cheese whenever I crave them. And occasionally ice cream because a life without ice cream is no life at all! Grains will be mostly reserved for special occasions. Like wedding cake. Mmmm.
And because I can’t find my dang camera cord anywhere, I will have to leave you with many workouts instead of a recipe…
Monday
5 founds for time
  • 12 deadlifts, 115 lbs
  • 20 pull ups
  • 12 clean and jerks, 50 lbs
  • 20 knees to elbows
Tuesday
5 rounds for time
  • 22 kettlebell swings, 25 lbs
  • 22 box jumps, 24 inch box
  • 400m run
  • 22 burpees
  • 22 wall balls, 14 lb ball
Wednesday
5 rounds for time
  • 10 tire flips
  • 5 bleacher runs
  • 10 wall climbers
little guy just chilled while I ran those damn steps
Thursday
21-15-9
Deadlifts, 125 lbs
Thrusters, 65 lbs
Friday
50-40-30-20-10 reps for time
  • Wall balls, 14 lb ball
  • Box jumps, 24 inches
  • Kettlebell swings, 20 lbs
THIS WAS SO HARD.
spent.
Saturday
5 rounds for time
  • 800 m run
  • 15 overhead squats, 55 lbs
Sunday AM (I did this with my friend Zoe at her favorite gym in Marin)
3 rounds for time
  • 800 m run
  • 50 back extensions
  • 50 situps
  • 50 kettle bell swings (20 lb)
Sunday PM (I couldn’t skip actual CrossFit no matter how tired I was!)

6 rounds for time

  • 600m run
  • 11 pull ups
  • 11 lunges with 8 kg kettle bell per hand
  • 11 thrusters with 8 kg kettle bell per hand
Monday = REST DAY, FINALLY!
Today = I have CrossFit tonight at 9pm!

As always, thank you for reading! And if you are giving paleo a try, let me know how it is going!! 

 

NuNaturals Stevia Giveaway!

Welcome to the NuNaturals Stevia Giveaway! I am really excited about this giveaway because stevia is the only non-caloric sweetener I am down with. Aspartame, acesulfame K, sucralose, and all that other junk is bad. Half of them are banned in Europe, and yet America doesn’t seem to care about the studies that link them to cancer. Not to mention they make you bloat like a mother no other. Certain sugar alcohols do appear to be relatively harmless, but as far as low calorie sweeteners go, stevia is currently the best bet. It is a natural plant extract from the rebiana plant. In fact, one of my friends grows stevia and puts the leaves in her tea! Extracting the compounds from the leaves makes stevia extract far more potent and sweet, which is why it is so useful for cooking.

In my last post, I said there is no one thing that I say no to, and that is true. However, the number one thing in my diet that I do try to minimize as much as possible is

refined sugar.

Sugar is not your friend. It raises insulin levels which will increase fat storage, cause a spike and drop in energy, and mess with your other hormones, which can lead to far more serious conditions than an energy slump. On top of that, your body does not need refined sugar. All carbohydrates are composed of glucose (sugar) molecules, and your body is completely competent at breaking down the carbohydrates down into those units. Also, our bodies can convert dietary protein into carbohydrates when we need them, so carbohydrates themselves are necessary, but we do not need that much.

In this giveaway, 4 readers will win:

1 bottle of Lemon liquid stevia, 1 bottle of Orange liquid stevia, 1 bottle of Vanilla liquid stevia, and 1 box of stevia powder packets

Also, if anyone wants to order NuNaturals prodcuts online, you can use this code to get 15% off! Code: BLG0612. The code expires June 30th and there is free shipping on orders over 35$!

How to enter:

leave a comment for each of the following…

1 entry for a recipe or informational post you would like me to blog

1 entry for tweeting this giveaway link with an @NuNaturals and @wholewheatrbust

2 entries for re-blogging this giveaway

2 entries for Facebooking this giveaway

1 entry for a link to your favorite recipe

The winners will be announced on Wednesday, June 13th!

I use the vanilla stevia in my plain greek yogurt to make it delicious and in most of my baked goods. As for the lemon and orange flavored stevia bottles, I mainly use them for drinks, but there are several muffin recipes on this blog that utilize lemon and orange flavors. Here is some inspiration:

Refreshing, Sugar Free Lemonade

  • 2 handfuls ice
  • grated lemon zest from 1 lemon
  • juice from 1 lemon
  • 1 dropper lemon stevia
  • 2-3 cups water, to taste
  • optional: handful frozen blueberries

Directions – Combine all the ingredients in a tall glass or pitcher and stir! Enjoy.

Orange Coriander Oat Bran Muffins

Adapted from Cake Batter and Bowl

Recipe: Makes 8-12 muffins

Dry ingredients -

  • 1 1/4 cup oat bran
  • 3/4 cup white whole wheat flour
  • 1 1/2 tbsp coriander
  • 1 1/2 tsp baking powder
  • 1/4 tsp salt
  • handful raisins

Wet ingredients -

  • 2 droppers NuNaturals Orange liquid stevia (or 1/4 cup more sugar)
  • 1/4 cup brown sugar
  • the zest of one small orange
  • the juice of two oranges (about 2/3 cup)
  • 1/4 cup coconut oil, melted
  • 2 tbsp molasses
  • 1 egg

Toppings -

  • sprinkle rolled oats
  • sprinkle of sunflower seeds
  • shake of cinnamon

Directions – Combine the dry ingredients in a bowl and the wet in a separate bowl. Mix. Pour the wet over the dry and mix with a spatula until just combined. Pour into a baking muffin tin. Sprinkle rolled oats, sunflower seeds, and cinnamon on top. Bake at 350 degrees for 18 minutes.

The most manly dinner ever.

Sometimes when I am studying for exam, I do a post about whatever it is I am learning. Yesterday, I had my last midterm in GI Physiology and the topics ranged from anatomy from the mouth to the small intestine, salivation, swallowing, digestion, and regulation of each, as well as gastritis, GERD, and a few other disorders. The most functional information I learned was

how to stay full for longer!

So, as you probably know, you ingest food through the mouth, it goes down the esophagus, into your stomach, is digested, and then is emptied into the small intestines for absorption. The duodenum is the first portion of the small intestines and has the crazy capacity to sense the pH, tonicity, fat content, macronutrient content, and nutrient density of the ingested food.

For food to be emptied out of the stomach, the particles must be about 1 mm in diameter to get through the pyloric sphincter. This wont occur until it has been broken down by stomach muscle contractions and enzymes. The length of time that it takes to break the food down is increased by:

  • Larger food particles
  •  Harder to break down food
  • Increased size of meal
  • Higher fat content
  • Solid meals rather than liquids. Liquids do not have a break down phase at all, they immediately start emptying from the stomach.

There are some things we we eat that we cant break down at all, like the fiber in fruits, vegetables, and whole grains.  This fiber doesn’t empty out with the rest of the meal, it stays in the stomach until everything else has been cleared. It is then cleared out during Phase 3 of the Migrating Motility Complex (basically the peristalsis that goes on when you are fasting in order to get things movin’).

Furthermore gastric emptying is slowed by:

  • Higher calorie content of the meal. There is a MAX of 200 calories per hour for both solid and liquid meals. That rate can be reduced due to the…
  • Macronutrient content of the meal. Fats empty the slowest, then protein, and carbs are the fastest.

Liquid emptying is a bit weird. It does not have a lag phase where it is digested at all, it just starts emptying out as soon as it gets into the stomach. Furthermore, the rate is proportional to the volume. So if you drink MORE it actually empties FASTER. Isotonic liquids (like water) empty faster than hypertonic liquids (lots of solutes).

So, if you want to stay fuller longer, you can:

  • Eat more fat! This is the biggie. The duodenum is very sensitive to fat content of meals.
  • Eat solid meals rather than smoothies, etc.
  • Get yer protein into each meal.
  • Fiber, fiber, fiber! The fiber in veggies and fruits and whole grains will chill in your stomach for longer than anything else.
  • Snack less and eat larger meals. (This is more of a lifestyle choice and  not a big deal if you don’t prefer it.)
  • Drink liquids before or after meals rather than during.
  • Eat nutrient dense foods! This wasn’t covered in detail, but one of the lectures implied that the upper stomach holds onto nutrient dense foods longer before letting it drop down into the lower stomach for digestion.

With all that in mind, I figured I should post a recipe that is the epitome of a filling meal. Vegetarians are going to hate me but um…. here ya go!

Introducing…

….

….

….

The Meatza.

Recipe: Serves 3

inspired by this recipe

  • 1 lb extra lean ground beef (or you can use ground buffalo, chicken, or turkey)
  • 1 egg
  • 2 tbsp parmesan cheese
  • for the sauce
  • 1 can tomato paste
  • basil
  • oregano
  • thyme
  • garlic powder
  • onion powder
  • salt
  • fresh ground pepper
  • toppings
  • 1 cup shredded cheese (I used Mexican blend)
  • 1 bell pepper, diced
  • 1/2 sweet onion, diced

Preheat the oven to 450 degrees. Combine the meat, cheese, and egg and mix well. Spread the mixture over a baking sheet and press until thin.  Bake for 15 minutes.

While the “crust” is baking, combine the pizza sauce ingredients and adjust the herbs to your preference. Once the crust is done, pat with a paper towel to absorb some grease. Evenly spread the sauce over the top of the crust. Top with the cheese, bell pepper, and onion. Bake for 5 more minutes and then broil until the tips of the veggies are browned, just a couple minutes.

Enjoy!

PS – I went to CrossFit again on Thursday night. I tink I’m in loveee.

Mmmkay, I believe it is time for a Lagunitas IPA. Later, gator.

Skinny celebrity pregnancies: a glimmer of truth

My apologies for the sparse blogging these past few months. Its been on my mind all the time, but I just hadn’t the drive or time to write great posts – and if they aren’t going to be great, I don’t want to waste your time. I have been debating on writing this post for a while, because it’s a bit more personal and very sciencey. If neither of those things interest you, you can skip it and I actually have several recipe posts lined up!

I want to talk about hormones.  I have been debating about going to medical school for quite a while now, with my interest growing at my internship at the fertility center (although I am more interested in the other branch of endocrinology, which is metabolism) and my endocrinology course. I just took the final on Tuesday and realized how in love with it I am. That’s why Im bursting at the seams to talk about female reproductive hormones.

To be blunt, I want this post to convey how the menstrual cycle works, why it is so important to have a regular cycle, the damage that amennorhea can wreak on the female body, and a bit of advice for bringing the body back to a hormonally balanced state.

To understand everything, a little anatomy is needed.

The hypothalamus is a section of the brain, composed of millions of nuclei that communicate with the rest of your body. It has centers that regulate everything, from hunger, to metabolism, to reproductive hormones, to sleeping cycles. Most importantly, when given the proper stimuli, the hypothalamus sends signals to the pituitary gland.

This depicts the hypothalamus connecting to the pituitary gland which sends hormonal signals to the rest of the body. 

The pituitary gland secretes many hormones that travel to tissues in the body and activate them to perform their necessary functions. In the case of reproductive hormones, the hypothalamus sends Gonadotropin Releasing Hormone (GnRH) to the pituitary. This causes the gonadotrope cells in the pituitary gland to secrete Follicle Stimulating Hormone (FSH) and Leutinizing Hormone (LH).

This depicts the hypothalamus connecting to the pituitary gland which then sends hormonal signals to the ovaries. LHRH is referring to GnRH.

The ovaries contain a set amount of oocytes (baby eggs) from the day you are born. At puberty, the hypothalamus begins to send enough GnRH to the pituitary which will secrete more FSH and LH which will travel to the ovaries. Once stimulated by Follicle Stimulating Hormone and Leutinizing Hormone, the oocytes begin to develop and mature further. In the monthly menstrual cycle, this is the Follicular phase. The growing follicles secrete estrogen as they mature. This estrogen causes the uterus to build up a blood lining. The follicle with the most FSH receptors continues to grow, while the others die off. After about two weeks of the follicles growing and secreting estrogen, there is a surge of LH which causes ovulation. This is the egg breaking free from the follicle, which is basically a nice little shell of hormone secreting cells. The egg is now free to hitch hike down the ovaries and try to get inseminated. Meanwhile, the empty follicle shell is transformed into the corpus luteum. This is the luteal phase of the menstrual cycle. The corpus luteum is a package of cells that begins to secrete progesterone, which maintains the lining of the uterus. Over the next two weeks, the corpus luteum secretes progesterone, but if the egg isnt fertilized, the level of progesterone falls and the lining is shed. And the cycle starts over!

Main point: No GnRH = No FSH or LH = No growing follicles or corpus luteum = No estrogen or progesterone = No period, no cycle, no babies. Nada.

And why is this relevant?

There are many things that can shut down the GnRH signal from the hypothalamus and thus cause amenorrhea. A few include..

  • High energy expenditure (like endurance athletes)
  • Stress (cortisol)
  • Melatonin (the sleepy hormone – you would have to take a shit load of this though)
  • Pregnancy and breast feeding
  • Menopause and hormonal disorders like PCOS
  • Certain medications
  • Low leptin levels

What is leptin? Leptin is a hormone that is secreted after meals to tell your brain that you are satisfied and to stop eating. It is also produced as a baseline depending on body fat levels. The more body fat you have, the more leptin. Women with very low body fat do not have enough leptin to signal the brain that they are healthy and thus will not secrete enough GnRH or FSH and LH to begin a menstrual cycle. This can be due to working out too much, not eating enough, or both. Enough body fat means that the body is healthy enough and has enough energy stores to sustain a pregnancy. The body is smart. Its not going to let you grow a fetus if you can’t even afford to not eat for a couple days. Shit happens.

So if you aren’t having a period, you can’t sustain a pregnancy. But if you don’t want to become a mother right now, then it’s no big deal, right?

Wrong.

Having a menses is for more important than just getting preggers. It means you have adequate estrogen, and estrogen is ABSOLUTELY ESSENTIAL for bone growth.

This shows the pathway between the brain, pituitary, ovaries, and bone destruction. 

When estrogen binds to receptors in bones, it stimulates the production of a protein called OsteoProtyGerin (OPG). OPG binds to osteoclasts (cells that break bones down) and prevents them from growing and proliferating. Thus, it has a bone protective effect. Estrogen also stimulates the production of growth hormone, which stimulates the production of IGF1. Both growth hormone and IGF1 contribute to bone growth. They are responsible for bone matrix formation, CALCIUM DEPOSITION, and bone cell proliferation and maturation. Therefore, estrogen is essential to both growing bones and preventing their breakdown. Unfortunately, bone break down is constant – we are constantly remodeling our bones to maintain adequate blood calcium levels. So estrogen is needed throughout our lives – not just for a couple years to grow our bones. Furthermore, it is now suspected that bone density is greatest between the ages of 18-25, so suffering from amenorrhea during these sensitive years could lead to a lifetime of weak bones and related complications.

The moral of this novel is that if you aren’t having a menses than you are inching closer and closer to osteoporosis and you aren’t at your healthiest state. It is important to go see an endocrinologist and see what’s up! It could be many things, and low body fat is one of the more reversible issues to work with. It doesn’t mean one has to gain tons of weight, stop working out, and eat junk. In fact, weight training helps build bones, so that should always be a part of any weight plan, whether gaining or losing!

In order to prevent bone loss during the weight gain or lifestyle change process, the endocrinologist may prescribe birth control as soon as possible. This is because the synthetic estrogens are still effective at bone synthesis. When I went in to see my endocrinologist, he also said that if I didn’t want to gain weight but I wanted to have kids later on, not to worry, there are drugs for that.

That pissed me off.

But a lightbulb went off. I had always wondered how extremely thin women, like Posh Spice and Nicole Richie had managed to have children despite their skeletor-esq bodies. Turns out, fertility drugs can override the lack of leptin (and body fat) and give you large doses of FSH to stimulate follicle growth. This is just my opinion, but it seems as though that is cheating nature. Furthermore, I worry that could possibly have effects on the child later in life. Again, this is just me playing around with ideas, but there are studies out there that indicate that babies born to mothers who were pregnant during a famine or economic depression were more likely to be overweight or obese later in life. The lack of energy (or folate or something else – I’m not sure) altered the epigenetic markings on the fetus’ DNA and thus made the future men or women more prone (but not doomed) to weight gain and resistance to weight loss. Perhaps having a child via fertility drugs when your weight and energy intake isn’t adequate could have similar effects?…

If you have any questions or want any more details, information, whateva, just send me and email or leave a comment!

Something different

I know it is pretty late for a post, but I wanted to write about something a bit more personal while it is still June 5th. Today, 13 years ago, my dad passed away from lymphoma. I was only 8 years old, so at the time I didn’t comprehend the finality of death. It took years for me to fully internalize what happened. Knowing the definition of death is nothing like the moment you finally understand the concept of eternity. Until that moment in time, the looks of pity and sympathy reveal a sense of bewilderment rather than sadness.

I used to think that crying was the only way to mourn, or the only right way. As I have gotten older, my way of coping with his death has transitioned more from salty tears to reflection and honoring his memory. Of course, tears still come (and always will) but I have learned that there is no right or wrong way to react to the death of a loved one. I always used to worry that I was abnormal for so many things.

It is so normal, almost painfully so, for us to worry that we are abnormal.

Since my father’s death, I have been told time and time again what a loving father, brilliant doctor, hilarious badass, and genuine person he was. I knew him for less time than most of his friends and family, but I cling to my memories like gold vanilla bean gelato and want to share a few of them with you.

As background, he was 6’4 with extremely long legs and an affinity for cowboy boots, blue jeans, and pearl snaps. He liked fast cars, fast boats, and hunting. A real man’s man. (A seemingly dwindling breed?…) He didn’t really know his own strength. I used to get ‘tummy aches’ all the time, almost every night. Whenever I was at dad’s house, I would ask for a tummy rub just like I got at moms. He tried his best, but always ended up pressing a little too hard, and rather than relieving any pain, I usually just felt dinner coming back up. Seltzer and saltines would have to suffice.

Although he couldn’t quite master the belly rub, he was very capable at gentility. For some reason, I always used to get horrendous knots in my hair. Like f*cked up huge. I would wake up in the morning for school, stumble to the bathroom, and discover a hard ball of hair at the nape of my neck the size of a grapefruit. I always just wanted to put it up in a ponytail and ignor it so as to save my tender-headed scalp from the pain of dealing with it, but this was never okay with dad. No daughter of Brian DeDecker was going to go to school looking ragged. I think a part of him wanted to prove that a single father could make his little girl look just as cute as any mom could. He would sit me down on the living room floor armed with a plastic green brush (the kind with those wretched little balls on the end) and a bottle of Johnson and Johnson green apple scented detangler. I think he called it rat spray or something… He would whittle away at the knot until my hair was smooth, but utterly soaked in green apple spray. Finally, a solid 20 minutes later, he would send me off to school with my backpack and lunchbox.

The lunchbox was always a source of entertainment both for me and my classmates. I wasn’t exactly cool in elementary school. Quite the opposite actually. I was a total nerd, socially awkward and always buried in a book. Thank God for my one friend (I love you, Loryn). At lunch, I would open up my purple insulated sack to find enough food to feed my entire row of classmates. There was always a turkey sandwich of sorts, 2 or 3 string cheeses, 2 bags of chips, carrots or apples, and not 1 but 2 chocolate puddings. And probably 5 other things I am forgetting. I never left lunch hungry and usually had surplus left over for trading.

There are many more memories I could share, but I shall leave it at that. I will always wish he were still here, but I am thankful for the time I had with him. One of the best things we can do is to live in a way that honors our loved ones and keep their memory alive. I will post again tomorrow or Tuesday with some recipes. I hope this wasn’t too debbie downer of a post!

Love love.