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?

How to Avoid Spine Pain: Lessons From a Plane Crash

In 1972 an airplane carrying 163 passengers crashed into the everglades. This was a scheduled flight from NYC to Miami. The flight was routine until it began its approach into Miami. Shortly after lowering its landing gear the entire crew in the cockpit became preoccupied on an indicator light.

Normally this light lit up green signaling that the nose landing gear was locked down. It turns out that tiny indicator light only appeared to be off as the bulb was burnt-out. This created a diversion and the crew failed to notice that the autopilot had been inadvertently disconnected, resulting in a loss of altitude and a deadly crash.

Upon review the National Transportation Safety board cited the cause of the crash as “pilot error.” The crew was distracted by the landing gear light and failed to monitor critical instruments tracking their altitude.

By no means am I attempting to make light of this particular story. Instead, the story provides an essential lesson. This was a situation where the big picture was eclipsed by the hyper focus on the indicator light.

Patients will ask what causes joint misalignments, muscle pain and loss of range of motion.

Sometimes there is a simple answer, but most of the time it’s hard to boil it down to one specific cause. Unlike flight 401, the underlying cause of musculoskeletal pain is due to the inverse mistake:

relying on autopilot and not responding to the distress signals.

The demands we put on the musculoskeletal system are unbelievable. From the moment we wake up we are bombarding the system with information and postural requests. We begin to create movement habits to conserve the drain on cognitive energy.

The day begins

Negotiate a safe departure from the bed, shower, cook breakfast, dress the kids, empty the dishwasher, commute to work, sit for 6- 8 hours, back in the car, stop at the gym, take out the recycling, load laundry/fold laundry. I’ll leave out the most of the minutia. Whether you’re standing cock-eyed brushing your teeth or flexing over to tidy up some toys off the floor your muscle and joints are at work. Together the joint, muscles and connective tissue function as kinetic architecture. These movement patterns exist as kinetic images in the brain and make up an individual’s “autopilot coding.”

Eventually, through thousand of iterations, we establish a fixed set of movement patterns. We don’t think much about these patterns and in many ways we rely on this internal autopilot.

Over time a constellation of signs and symptoms emerge. Some examples include:

• Flexing from the torso,

• Slouching while driving

• Loss of trunk rotation

• Lack of hip mobility and independent movement from lumbar spine

• Preference towards forward head posture

• Rocking your pelvis back (posterior tilt) while sitting

• Rock your pelvis forward when standing

• Decrease in sacral flexion and extension

• Prolonged static positions where hips and shoulders are not squared up

• Walking using the lower legs as the primary movers

• Disengaging the core

When looking at the big picture we need take into account load and capacity. Capacity is the ability to do work and the load is the work you do. In all living organisms there is a relationship between structures. The postural problems mentioned above leave you susceptible to tissue damage. The paradox is that pain does not move in lockstep with tissue damage. By the time you are experiencing pain, (absent acute trauma such as rolling your ankle) injury has set in and your body is struggling to meet hose demands

What’s happening from a physiologic standpoint is a cycle of damage, inflammation, and compensation. Diet, sleep, gut health, weight, and immune function add complexity to the cycle of pain and healing, but we’ll save that for another post.

Overuse results from cumulative stress on the muscle, bone, tendon or bursa. This may lead to partial tears, joint instability, and promote non-anatomic joint position.

Periodically it’s beneficial to manually restore awareness and filter out poor mechanical patterns. In an effort to keep the muscles limber and joints healthy we have to rewrite some of the automatic patterns and inadequate muscle coordination.

If left unchecked these postural distortions will become harder to reverse and escalate through every day activities. I would encourage you to cultivate better sensory awareness and connect back to deliberate bodily movement.

This can be done through training conscious movement, adopting spine care, integrating breath and movement, and exercises that activate, strengthen, and balance.

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.