Where to look if your health is stuck

It’s not unusual for one’s perspective on their personal health to change at different points in his or her life. For some there is indifference, frustration, and reactivity. For others there is clarity, deep involvement, proactivity, and even identity.

Each person has their own “health documentary.” Typically it’s a blend of factors that include your health history, family’s eating habits, psychological health, environmental factors, financial pressures, value systems, and other lifestyle habits.

I want you to pause and think about how you engage with your own health and possibly your family’s health. Do you think about the future of your health? Is it your responsibility or is it a transaction to be had with a doctor at a perfunctory check up? Are you competent enough to embrace your own inner doctor barring some critical situations?

You may be familiar with the term functional medicine. Functional medicine was born out of necessity. It is a systems-based approach that looks to reverse disease by identifying the drivers and causes. This form of personalized medicine is practiced by M.D.’s, D.C’s, D.O’s, Naturopathic doctors and a host of adjunct practitioners. Allopathic or conventional healthcare accels in acute situations and provides disease management. Where it is lacking is disease prevention and health optimization. If you only treat symptoms, people want pills. Show people the root cause and they will demand a fix.

For the most part you do not catch disease. You build it through life exposure, sometimes referred to as the exposome. The exposome is a collection of environmental factors, such as stress and diet, to which an individual is exposed and which can have an effect on health.

Let’s get back to your health. Imagine that you just landed in your body. Time for an appraisal. Can you move well? How do you feel? What’s your emotional and mental state? Is it a fixer-upper or does it require just some basic maintenance?

Perhaps you want to take a closer look at your physiology and chemistry by running predictive lab work. But before you even seek out a doctor, what is in your immediate control? Your lifestyle choices! Let’s touch on a few.

I. Manage stress wisely

Stress is a ubiquitous part of life that affects us all. Stress can have a profound effect on your gut. There is ample evidence that many chronic metabolic diseases start in the gut. Exposure to prolonged stress alters brain-gut interactions, ultimately leading to the development of a broad array of psychological and GI disorders.

II. Focus on nutrition

Food is one of the most effective tools for bringing balance to your body. When we optimize our diets we see improvements in detoxification, energy and metabolic health. We are a society in a chronically fed state. Too much processed foods derail our metabolism. Eating low-carb and the occasional keto cycle can retrain your metabolism and provide a necessary reboot.

III. Intermittent fasting

Our high school biology teachers failed to mention that fasting is not only a evolutionary skill , but also the best way to activate your body’s own “house cleaning” systems. It’s referred to as autophagy and it promotes healthy cell cycles and deep cellular detoxification. When paired with a proper diet it can help balance blood sugar, prune the microbiome, and build metabolic flexibility. Metabolic flexibility means your body can use protein, fats and carbohydrates efficiently.

VI. Exercise

Physical activity has endless possibilities. Research shows that we get the best results when we mix up our routines and change how we stress our bodies.

Fasted- cardio in the morning can help support healthy blood sugar and utilize body fat for fuel. (2-3 times per week)

Post-meal activity can put circulating blood sugar to work. This is 20-40 minute walks a few times a week after lunch or dinner.

High intensity interval training (HIIT) is a great way to work your metabolic machinery and increase insulin sensitivity (2 hours per week total)

Strength training you can’t go wrong having a higher proportion of muscle to fat mass ratio. Free weights, body weight, resistance bands all work well. (3 X per week 20-30 mins)

This article does not provide medical advice. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment.

Behavior Change - Rocket Powered Healing

We live in a fast-paced demanding world. It’s not unusual for us to create habits and even routines that help with the decision fatigue and a constant barrage of responsibilities. Some of these habits are by design and others just a default pattern. In some ways we are in “self preservation” mode.

Let me ask you – How many minutes per year do you spend on “habit change,” or “decision making.” It’s not really something we ponder, but maybe we should. Why? I’d argue that if we don’t we are more likely to go on cruise control and allow subconscious programming to guide our current behaviors. That inner pilot light that’s helping us close the gap on our goals, assess our progress, and change our behaviors grows silent.

So what do we have to do to enhance that inner voice and position ourselves to choose better behaviors? Dan Ariely, is a psychologist that uses a rocket analogy. It’s simple yet profound. Dan’s point is that we must change our environment in a way that reduces friction to make a desired behavior more attainable. Just as a rocket is designed with aerodynamics in mind people can minimize different types of resistance. Once friction has been reduced the rocket needs as much fuel as possible. Fuel in behavioral change is the motivation/energy or incentivizing factors.

Discover & share this Toy Story 4 GIF with everyone you know. GIPHY is how you search, share, discover, and create GIFs.

How do we apply this analogy to actually making better choices. Providing information alone or education is not a good recipe to change a behavioral or a pattern. Changing a person’s mind with information is tough whereas changing someone’s behavior with information is a true test.

Instead we need to take it a step further and reduce friction by changing our internal environment and external environment. If that's true we already have a leg up on the rocket because we have more control over our external environment. Last I checked gravity does not fluctuate therefore it's a constant variable for the rocket scientists to overcome.

However, we have control over the people we choose to be with, the food that we eat, the relationships we foster, our attitudes, the dreams we pursue, and how we respond to our circumstances. And because our behaviors are often irrational it’s imperative we attempt to harness health related irrationality.

Similar to the mind our physical body responds to friction and fuel (here fuel is food, sleep, stress, social determinants, and mental attitudes).

Let’s look at 3 conditions people struggle with and then engineer ways to reduce the friction and fuel a sustained change.

LEAKY GUT

What creates friction?

• Processed foods

• Industrial seed oils

• Multiple courses of antibiotics

• Extended use of Antacids, histamine blockers and PPI’s

• Unknown food intolerances

• Bacterial overgrowth

• Overtraining

• Lack of sleep

How to reduce friction?

• Create weekly meal plans

• Allocate time to create a recipe list

• Limit eating out

• Test your gut

• Look to natural remedies

• Try an elimination diet

• Intermittent fasting

• Utilize a prebiotics and probiotic

Fatty Liver

What creates friction?

• Overeating Leaky gut

• Food intolerance

• Poor bile production

• Poor food choice

• Endotoxins from GI tract

• Alcohol in excess

• Nutrient deficiencies

• High blood sugar Medications

• Bad Oils (seeds oils)

How to reduce friction?

• Portion control

• Eat for gut health

• Liver support

• Eat protein fats and some carbs

• Liver blood work

• Use time-restricted eating Intermittent fasting

• Check thyroid health

Blood sugar and cholesterol problems

What creates friction?

• Processed food consumption

• Calorie surplus and high carb diet

• Excess body weight

• Insulin resistance

• Elevated inflammatory markers

• Genetic predisposition

• Lack of activity

• Emotional eating

• Nutrient deficiencies

How to reduce friction?

• Increase insulin sensitivity

• Liver support

• Eat protein fats and some carbs (Nutritional balance)

• Use time-restricted eating

• Check blood glucose with a glucometer after food (1hr & 2hr)

• Check thyroid health

• Get adequate sleep

What fuels these examples of friction?

• Eating out (especially fast food)

• Lack basic cooking skills

• Poor time management

• Not enough social connection

• Poor sleep hygiene

• Inability to cope with stress

• Inadequate amount of downtime

Fuel to minimize friction?

• An unhealthy gut creates problems elsewhere in the body

• Gut problems may weaken your immune tolerance (autoimmune)

• Gut problems may shift hormonal balance (i.e. PCOS, Cancer)

• A dysfunctional gut suppresses our detox pathways

• Leaky gut may interfere with your metabolism

What fuels these example of friction?

• Disconnection from food choice and disease

• Hyper-palatable foods (i.e. potato chips, pizza)

• Ignoring constipation

• Alcohol addiction

• Not enough social connection

• Lack of plants and animal products

• Pill for every ill mentality

• Oblivious to your lipid levels

Fuel to minimize friction?

• We tend underestimate our dietary calories

• Comprised liver leads to inflammation in the joints as well as the brain

• Inflammation is linked to poor liver function

• Liver health is directly connected to disease risk

• A dysfunctional liver impairs our detox pathways

• Liver can be compromised by 90% without a warning signs

What fuels these examples of friction?

• Hyper-palatable foods (i.e. potato chips, pizza)

• Giving in to cravings

• Disregarding weight gain

• Sugary drinks

• Excessive snacking

• Limited information from your doctor

• Relying on basic lipid panels and subpar labs from a annual physical
  
  Fuel to minimize friction?

• Diseases associated with insulin resistance includes obesity, cardiovascular disease, nonalcoholic fatty liver disease, metabolic syndrome, and polycystic ovary syndrome(PCOS)

• Gradual increase of physical activity and energy expenditure

• Liver can be compromised by 90% without a warning signs

• A dysfunctional liver impairs our detox pathways.

• Sleep is necessary appropriate metabolic function

You may have noticed some of the overlap and redundancies, but that’s because there is an interplay going on in all these conditions. What’s going on in the gut directly affects the liver and both organs affect the cardiovascular system all the way down to each individual cell.

Leaky gut, fatty liver and blood sugar/cholesterol problems put a tremendous burden on the healthcare system and can subtract years of good health from just about anyone. Don’t fret because lifestyle modification should be the primary focus for treating any of these conditions.

The body is interconnected, complex, but also self healing. For example the The Diabetes Prevention Program and its Outcomes Study (DPP & DPPOS) demonstrated A 7% weight loss reduced the onset of type 2 diabetes (T2DM) by 58%. The best treatment for non-alcoholic fatty liver is weight reduction and correcting leaky gut and restoring immune tolerance can be done through shifts in diet, diagnostic testing, and targeted supplement protocols.

Given the importance of patient participation in healthcare decisions you deserve sufficient time and treatment solutions that require some self-management other than guzzling down a pill. It’s time to move away from the old “ diagnose and adiós” mentality. Never underestimate the changes you can make by learning about your health and assessing your habits. This exciting shift puts you in the driver’s seat of your life.

I’ll leave you with this, we don’t always do what’s in our own best long-term interest. With that in mind what will you do differently? Can you identify areas of friction and find your source of fuel?

Is Your Liver Happy

Here we are a month into 2019 and what we knew about health last year remains pretty much the same.  For the large majority of people we find a “health lane” and stick to it. For one person that may look like high-activity levels 5-6 days of “training” per week, a Whole 30 eating protocol, 5-day work week at the office, and the occasional cocktail outing with friends. On the other end of the spectrum person “x” eats mostly vegetarian, engages in yoga once a week, prefers snuggling with their cat, and enjoys church activities.  

People tend to find their comfort zone and begin habit building from a young age. In many cases adopting practices and ideas from their parents and peer groups. Cue the “my mom and dad had this or that issue, must be my genetic cards,”

However we choose to behave it is altering our bodies and physiology at a cellular level. In some ways, and much like our current healthcare system, these behaviors feel uncoupled from our health trajectories. This is because while some activities (injuries, sleep, caloric consumption, food choice, activity levels etc.) have short-term effects the long-term patterns result in ramifications that trickle out over 5 -20 years before we realize their full effect. Often times it’s very difficult to rule out early stage pathology or disease barring an invasive diagnostic test.

Overtime the body gives back, adapts, based on what has been required of it. As a student of the musculoskeletal system the research is quite clear when it comes to how quickly the neuromuscular complex can refashion itself. The Center for Healthy Aging and the Department of Biomedical Sciences at the University of Copenhagen concluded that it takes two weeks for a young person not using a leg to lose 1/3 of their muscle strength and mass leaving them on par with a person who is 40-50 years their senior.  

Inactivity does not discriminate and affects both young and old. What is more interesting is that after 2 weeks of immobilization participants cycle trained 3-4 times per week for six weeks. This was not enough for them to regain their muscle strength unless they included weight training.

This example demonstrates how quickly the body adapts to inactivity and results in rapid muscle loss.  The real kicker is that it will take you three times the amount of time to regain the lost muscle mass.

 Let’s look at a few examples of disease that require a period of 10-20 years before the disease has fully developed and spill over into other organ systems.  Most people don’t realize that cirrhosis of the liver and the deposition of connective tissue (scarring and fibrosis) requires about 80 grams of ethanol daily for 10- 20 years.  For those wondering what’s 80 grams - there is roughly 14 grams of ethanol in a 12 oz beer.  

More importantly, non-alcoholic fatty liver disease or NAFLD parallels that of obesity and has steadily risen over the last 30 years. NAFLD is projected to become the leading cause of liver related morbidity and mortality within 20 years and a leading indication for liver transplantation in the next few years.

Some researchers are calling diabetes a disease of the liver first. The liver is an important organ especially for energy metabolism and storage. The development of Type 2 Diabetes takes around 5-10 years in adults and can take much less time in children. These are 2 examples of long-term metabolic disorders. Atherosclerosis (think plaque and eventual heart attack) would be another example of inter-related long term metabolic stress that leads to maladaptive changes to an individual’s physiology.

Nutrition in the broader context of caloric intake

If you overload the system with continued doses of  “fuel” whether alcoholic beverages, sugar, or fat/protein for that matter, eventually the body will be unable to effectively process, detoxify and utilize these energy sources. A fatty liver is a signal that it is unable to burn fuel appropriately. A healthy liver ranges from 1-3 % fat and once it is at 5% normal function is on the line.

Judging by the statistics, if you’re an American, chances are you may stand to shed a few pounds. This tradeoff, excessive pounds for improved function, will increase your overall health and longevity. I’ve heard firsthand from patients, friends and family how difficult it can be to shed some weight and how to track progress when the scale seems to stall. Even exercise has its limits if your liver is struggling. Exercise is not a game changer for healthy weight loss as much as it is for maintaining a healthy weight. 

Most of us aren’t having routine blood work that looks at our liver enzymes, and even if you are by the time they are elevated your liver has been under insult for a while. The only way to rule out fatty liver is with a biopsy. Dr. Alan Christianson shares an interesting statistic: in situations where healthy individuals are undergoing testing to provide liver tissue donation 40.2% were found to have fatty liver disease. These are individuals with otherwise healthy blood markers.

Height to waist ratio

How do I know if my liver is strained or how it is handling the cumulative energy load? One of the most important metrics is your waist circumference. Your waist should be less than ½ your height. If it’s larger you may be more likely to have higher triglycerides, lower HDL cholesterol, higher LDL particle size, elevated inflammatory markers, elevated blood pressure, and higher fasting glucose.

If you want to quantify your risk of fatty liver disease Dr. Christianson has a built a calculator (because, as we know, short of a biopsy every other marker is inherently imperfect).

Fatty Liver Index

All you need are some results and some measurements:

The measurements you need:

• Weight in pounds

• Height in inches

• Waist circumference in inches

The blood test results you will need:

• Fasting triglycerides

• Fasting GGT

Unlike your car, your liver doesn’t want to be “topped off” at every meal.  Whenever we eat above and beyond our basal fuel requirements metabolic processes result in elevated free radicals and inflammatory compounds. Energy production is a “dirty process” metabolically speaking and requires the liver to run it’s detoxification pathways.

 Trust me, the body is not trying to carry trapped fat around our midsection. If you give the liver no choice and subject it to fuel overload this will result in high density fat storage, high blood glucose aka pre-diabetes/diabetes type 2, suppressed metabolism, and increased levels of pro-inflammatory adipokines.

In addition to eating nutrient dense meats, dairy, fruits and vegetables, do I take any evidence-based supplements for liver health?

Liver specific support

• N- Acetyl-L - Cysteine: can raise the liver’s protective glutathione

• Milk thistle: shown to protect liver cells and safeguard it from cell death

•  Alpha lipoic acid, Taurine, and Betaine Anhydrous  

• Dandelion tea to enhance bowel secretion and liver function

Health care solutions when you have decided to stop chasing symptoms.

As a Functional Medicine nutritionist, I think like a detective to help my clients understand the "why" behind their "what" (the diagnosis). Sometimes, the "why" can be revealed in a simple conversation; more often, more investigation is needed (various types of functional testing and lab work).

The following is an example of one hunt for the root cause of a client's problem. It was a simple conversation over dinner. Amy showed me the dry itchy patches on her hands, which I recognized as eczema, the "what" or diagnosis. To really help Amy and keep her away from the stereo typical treatment with cortisone cream, I now needed to know the "why."

Me: How long have you had the itchy dry spots?

Amy: A couple of months

Me: Are you prone to UTI’s or yeast infections?

Amy: I had my first yeast infection a month ago.

My thoughts are that two things are happening within a month of each other, both possibly stemming from gut imbalances.

Me: Have you had a round of antibiotics within the last 6 months?

Amy: No

Me: Are you taking birth control pills?

Amy: Yes

Me: For how long?

Amy: 3 months

BINGO! Birth control pills are notorious for altering gut bacteria. We’d found the smoking gun, the "why."

I already knew that Amy had a history of chronic constipation as well as acne. Before starting the pill, she likely had bacterial imbalances and the BC pills triggered the eczema, which always has its origin in the gut.

Since she wasn’t ready to stop the birth control pills, the best path was to find ways to support her gut flora so that together, her acne, constipation, yeast and eczema would subside.

I recommended cutting out all dairy and adding probiotics and non-dairy fermented foods. For further support, I suggested 50 mg B6, in the absorbable form of pyridoxal -5- phosphate as BC pills deplete B6 (a vitamin that influences energy, metabolism and the formation of neurotransmitters, influencing sleep, anxiety and depression). Lastly, I recommended vitamin D to help modulate the immune system.

If these steps do not give us the results we expect to see within a couple months, I’ll recommend a stool test to determine the function of her digestion and to rule out any parasites or pathogenic bacteria.

Instead of giving Amy steroids indefinitely to control her eczema, the conventional method of treating eczema, we’re taking steps to heal her by identifying and treating the root cause.

To read more about gut health and bacteria click here. https://alivingbalance.net/2015/05/invitation-to-a-digestion-party/

Written by: Cindy Dupuie, CN

Edited by: Vicki Ronaldson

www.alivingbalance.net

Emotional Vulnerability: Take care of your body to take care of your mind

Unmitigated stress can hurt your health

Our mind, body, and soul are all interconnected. How we treat our bodies has a major impact on our minds and our soul, and vice versa. It’s important to know how we are contributing to our emotional vulnerability. Life is hard. Emotions are raw and real. It’s important to understand how you may be contributing to your emotional vulnerability.

What is vulnerability?

Vulnerability is the quality or state of being exposed to the possibility of being attacked or harmed, either physically or emotionally. In other words, when we leave a vulnerability unattended, we are opening the door to being physically and emotionally harmed.

Often when we feel emotionally vulnerable, we are in a state of mind called “Emotion Mind”. Emotion Mind is when our emotions run rampant, we engage in mood-dependent behavior and our “emotions get the best of us.” Emotional distress can be reduced by decreasing factors that make us more vulnerable to negative emotions and moods.

To increase your emotional resilience to negative or undesired emotions, think PLEASE.

PL: Treat PhysicaL Illness- Being sick lowers your resistance to negative emotions. The healthier you are, the more likely you’ll be able to regulate your emotions. When you are injured, observe the urge to “just wait it out.” Often times we may think, “I should be able to power through this,” or “it’ll get better on it’s own.” See a doctor, chiropractor, dermatologist, or a specialist when needed. Reflect on what interferes with you attending to your physical illness and work toward problem solving the barriers.

E: Balanced Eating- Focus on eating balanced meals that make you feel good and avoid eating foods that upset your stomach or make you feel lethargic. Be mindful about urges to engage in emotional eating or eating out of boredom. Both eating too much and excessive dieting can increase your vulnerability to Emotion Mind. Research indicates that “self-imposed diets” show negative effects of eating too little. In other words, the more you restrict your food intake, the more likely you are to binge eat or having psychological problems (preoccupation with food/eating, increased emotionality and dysphoria, and distractibility). When you eat balanced and nutritional foods, you are less likely to have emotional control.

A: Avoid Mood Altering Substances: Alcohol and other substances, like certain foods, can lower resistance to negative emotions. Stay off illicit drugs and use alcohol in moderation. All substances, including caffeine and nicotine, increases our emotional vulnerability. Some of us may not feel an increase in emotional vulnerability while under the influence, rather experience Emotion Mind the days after.

S: Balanced Sleep: An increasing amount of research indicates that lack of sleep is related to a wide variety of emotional difficulties. Sleep is often undervalued in our culture. As a society, we are busy and constantly getting things done that we tend to slack on getting to bed at a decent hour. For people who work long hours, are single parents, are taking care of their loved ones, we tend to put sleep on the backburner. Maybe 11pm at night is the only “me” time you have, and you really want to catch up on the show. The thing about sleep is, we can’t “catch up” on it. There is no “making up for lost sleep.” Making sure you get the amount of sleep that feels right for you and your body is one of the most important variables to overall emotional well-being. Some people need 7 hours and other people know 10 hours. It’s also important to maintain a sleep routine, especially if you have difficulty sleeping. How much sleep do you need?

E: Get Exercise: Aerobic exercise, done consistently, is an antidepressant. Not only is exercise great for our our physical health, it’s great for our emotional well-being. Try and get some type of exercise every day. 20-30 minutes of cardio a day can increase emotional resilience. When your body is strong and healthy, you are less likely to slip into Emotion Mind and will feel less vulnerability overall. If you are new to exercising, build mastery. Start with 10 minutes and slowly increase the amount of time. Find a workout that is FUN that you WANT to get up and attend. You are more likely going to engage in physical activity if you are doing something that you look forward to. For some of us, that won’t be going to the gym for 1 hour. It may be running outdoors, spin class, yoga, dance classes, and other group classes (group classes are great for meeting people!)

Today’s guest blogger is Marissa Colangelo. Marissa Colangelo is a Licensed Clinical Social Worker (LCSW) with Compass Behavioral Health, specializing in treating adolescents and adults with emotion dysregulation, primarily personality disorders, anger, depression, impulsivity, substance abuse, and anxiety.