Less Saturated And Trans Fat Intake Recommended

What should we eat to be healthy?  This is the ultimate question that EVERYONE is trying to answer and nobody really has a good handle on it.

Our diets are getting worse and worse.  We are eating more processed foods, more convenience foods, more sugar and fat and salt.  Our risks of diabetes, heart disease and cancer are climbing.  Our kids are the first generation that has a shorter life expectancy than their parents.

The World Health Organization is intensely interested in these worrisome trends.  They are trying to analyze the confusing array of nutritional research coming out to make recommendations to help people all over the world live longer, healthier lives.

Recently the WHO came out with a report recommending less saturated and trans fat intake in the diet.  The goal is to reduce saturated fat intake to less than 10% of daily total calorie intake, and trans fats to less than 1% of calories.

Saturated fat and trans fats are both largely found in animal foods.  Animal flesh from all species, eggs and dairy are rich sources of both saturated and trans fats.  While many people know to avoid partially hydrogenated vegetable oils which are added to processed foods to make them taste better, surveys suggest that trans fat intake from animal foods is greater than that from industrial sources.

If you’ve been following my blog for any length of time, you know I recommend that the whole-foods plant-based diet is the healthiest diet for humans.  This type of diet has the best research showing reduced heart risk and reduced cancer risk.  It has been shown to decrease diabetes risk (a major risk factor for cardiovascular disease and cancer).  In fact, switching as little as 5% calorie intake from animal protein to plant protein reduced diabetes risk by 20-25%.  This translates to 25 grams of protein from plant sources rather than animal for someone who eats 2000 calories per day.

I get that not too many of my readers are going to switch tomorrow from a Standard American Diet to a whole-foods plant-based diet and never look back.  I’m about progress, not perfection.  Hey, my husband calls me “vegan-ish!”  I avoid animal foods as much as I possibly can but every once in a while I have ice cream or macarons for a treat.

So gradually substituting plant-based meals for ones with meat and dairy will reduce your heart and cancer risk.  Reducing animal foods to have less saturated and trans fat intake in the diet is a good step to take for improving your health.  You’ll feel better, and your body will thank you!

QUESTION: Do you try to reduce animal foods in your diet?

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Spring Exercise Tips

 

spring-into-fitnessHooray!  It’s finally spring!

How many of you out there love to work out outdoors?  I do!  I’m a runner and I’m really excited about getting back outdoors for a jog 🙂

So is there anything special about the springtime exercise transition that you should keep in mind?  Here are 3 spring exercise tips to be aware of.

1.  Dress warmly

It’s really NOT that warm out there yet.  Today’s temperature is in the sixties and I’m comfortable in jeans and a hoodie.  Of course I’m not running, but people tend to overestimate the temperature and UNDERESTIMATE how much clothing they need in the spring.

Layering is key.  You should dress so that you’re comfortable when you start AND so you can take off a layer or two as you warm up.  Also consider it tends to be windy in the spring.  Wind wicks body heat away quickly and can cause you to get cold especially when you’re sweaty.  Respect your body and dress properly!

2.  Train up slow

When you’re transitioning from indoor sport/training to outdoors, remember it’s not a simple switch.  Running on a treadmill or riding a stationary bike is different from road racing.  Hills, wind, traffic, uneven terrain and other factors make outdoor workouts different.

Make sure to decrease your intensity/mileage when you transition to exercising outdoors.  Take it slow!  If you’re training for a road race make sure to give yourself plenty of time for a leisurely and thorough transition.  Fast changes lead to injuries!

3.  Try something new

A new season is a perfect time to try a new sport or fitness activity.  Spend a little time thinking about what the best activities are for the current season.  Jogging and cycling are perfect warm-weather outdoor sports, but there are others too.

Hiking and climbing are popular in northern Ohio especially in the Metroparks.  Horseback riding is perfect for warmer weather (if you have a friend who owns horses or can take classes).  Rowing and sailing will be starting up soon.

Spring is a beautiful time of year, especially in a place that spends so much of the year buried under snow and ice!  Get out there and take advantage of it by taking the show on the road!

QUESTION:  What is your favorite form of exercise in warmer weather?  Are you interested in trying something new this year?

 

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Waist Circumference Predicts Heart Risk

When you step on the scale, do you see a normal weight?  When you check that BMI chart by the scale at the doctor’s office, are you reassured to see your score is under 25?  That means you’re good, right?

Not so fast.  There’s another measurement to take.  Your waist circumference also says a lot about your heart risk.

Carrying body fat around your middle, called abdominal adiposity, is a marker of higher heart risk.  For women, a waist circumference over 35 inches is a risk factor for heart disease.  (That’s assuming she’s not pregnant, of course!)  For men, the threshold is a waist circumference over 40 inches.

A study published recently in the European Heart Journal shared some interesting insights.  The authors analyzed data from almost 300,000 people to see what waist circumference and other measures of “fatness” tell us about heart risk.

They found that there was a linear increase in heart risk with increasing waist circumference.  Also, body fat percentage, waist-to-hip ratio and waist-to-height ratio also gave almost a linear increase in heart risk with increasing values.

BMI did NOT give a good correlation to heart risk.  I’ve always hated the BMI.  It’s stupid and doesn’t account for body composition.  Someone with a lot of muscle, like LeBron James, is NOT obese but you can’t tell that from the BMI.

So when you go to the doctor and he or she measures your weight and height, don’t stop there.  Ask to have them measure your waist circumference too.  Better yet, see if they have a body fat analyzer.  I have a handheld unit in my office that isn’t perfect, but it does give a much better estimate of whether someone is overweight or obese than BMI does.

When I am working on weight loss with patients, I target 30% body fat in women and 25% in men.  That’s just a starting point, people may need a different individualized target.

A third of Americans die of cardiovascular disease, and two thirds of Americans are obese or overweight.  Waist circumference can help determine whether you are at higher risk for a cardiovascular event.

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Food Addiction

Do you struggle with your weight?  Are you obese?  Have you tried again and again to lose weight, and had short-term success but then slip back into old patterns?  Have you lost weight only to find yourself gaining the weight back with interest?

As a physician who enjoys helping people lose weight, I am almost as frustrated as my patients when things aren’t going well.  One thing that makes weight loss particularly difficult is food addiction.

Food addiction is just starting to be recognized as a major underlying factor in overweight and obesity.  Just like alcoholism and drug addiction, there are changes in the brain in some overweight and obese people that make it difficult or impossible for them to lose weight without help.

Researchers at Yale developed a questionnaire, published in 2009, to assess food addiction.  This questionnaire, the Yale Food Addiction Scale, is a 25-question tool that helps dig into symptoms and behaviors of food addiction.

What is addiction?  Psychiatrists and psychologists recognize addiction as a persistent pattern of abnormal behavior that results in significant distress in the patient.  Abnormalities include

  • Tolerance (needing more of the substance in question to get the same effect)
  • Cravings and withdrawal symptoms when not using
  • Consuming larger amounts than intended
  • Unsuccessful attempts to cut down in spite of wanting to cut down or abstain
  • A lot of time spent using or recovering from use
  • Continued use or overuse in spite of known consequences
  • Giving up important activities in order to use

You may already recognize some of these markers in yourself.  I certainly do.  For instance, I have a really bad sweet tooth.  I sometimes find myself eating more sugar than I know is good for me.  If I stop eating sugar, I will have sugar cravings, headaches and body aches.  Sugar is addictive and I know I have withdrawal symptoms if I overuse it for awhile then stop.

The same group that developed the Yale Food Addiction Scale published an article looking at almost 200,000 people, and found that about 25% of people who were overweight or obese met the criteria for food addiction.  Food addiction was more common in women, those over 35 years of age and those with clinically disordered eating, like binge eating, anorexia and bulimia.

Addiction is a complicated topic and I could write for days about it.  A VERY over-simplified explanation of addiction is that the reward centers of the brain have low levels of dopamine, the pleasure hormone.  Using the drug of choice (opiates, food, sex, sugar, etc) raises dopamine levels in these areas.  Also, these substances interact with the endogenous opioid (endorphin) systems, giving a morphine-like “high.”

Taken together, the presence of the “high” with use and low dopamine levels without use make it very difficult to resist the urge to overeat and very difficult to stop overeating once started.

Do some foods trigger food addiction more than others?  Well sure, nobody really binges on green beans and broccoli, right?  So called “highly palatable” foods are much more likely to trigger overeating.  The food industry knows this, and adds saturated fat, salt and sugar to processed foods to create this super-tasty addiction trigger.  Chips, cookies, candy, soda, cheeseburgers, French fries, white bread and ice cream are examples of foods likely to trigger an addiction response and binge eating behavior.

My personal belief is that weight loss is much harder than dealing with alcoholism, smoking, even heroin addiction.  You can’t just not eat, right?  However, when you understand what foods and situations trigger addiction, you can avoid them like an alcoholic avoids beer and stays out of bars.

What about people who are motivated to kick their food addiction for good?  What is available to help them?  There are twelve-step programs for food addicts, similar to Alcoholics Anonymous.  One such program is Food Addicts In Recovery Anonymous.  (I have no experience with this program, I just know it exists.)  And like alcoholism and opiate addiction, medications can help.

There is a medication called Contrave which has been shown to promote weight loss.  When you understand food addiction, it’s easy to see how Contrave would be helpful.  Contrave is a combination of bupropion, which raises dopamine levels, and naltrexone, which blocks the endorphin response.

Bupropion, an antidepressant, is well known to help people quit smoking and is the only antidepressant that promotes weight loss.  Raising dopamine levels decreases the need to eat, or smoke, or do other things to raise these levels in the brain.  Naltrexone blocks the “high” from drinking alcohol, using opiates like heroin, or binge eating.

While Contrave is very expensive and only rarely covered by insurance, both bupropion and naltrexone are available in generics and are inexpensive to purchase if not covered.  GoodRx.com can give you an idea what prices would be like near you.

If you believe you may be a food addict, please print and fill out the Yale Food Addiction Scale and take it to your doctor.  You can also print out the scoring instructions, it’s a little tricky to score.  This will help your doctor help you.

Like many similar problems, a combination of medication and counseling is going to be the most effective way to deal with food addiction.  If you are overweight or obese and feel out of control with respect to your eating, don’t give up!  See your doctor and ask for help.  If he or she isn’t comfortable diagnosing and treating food addiction ask for a referral to a bariatric center near you.

Like alcoholism and opiate addiction, food addiction can impact every part of your life.  It can alienate you from friends and family, and can even take your life.  Proper treatment starts with recognizing the problem and asking for help.

QUESTION: Do you or someone you love have a food addiction?  Will you do something differently based on the information in this post?

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Boo! Healthy Halloween Treats For You!

Happy Halloween everybody!  I LOVE Halloween 🙂  Costumes and boisterous kids and, yes, treats.  If you come in to the office on Halloween you’ll see that my office really gets into the spirit.  Nope, I’m not going to tell you what my costume is.  Maybe I’ll post a pic on my Facebook page on Tuesday 🙂

The downside of Halloween is that it starts the snack-food feeding frenzy that doesn’t end until New Year’s Day.  It’s a constant parade of sweets and treats for the next two months.  VERY difficult for those of us who are conscious of our weight and our health.

Fear not!  There are plenty of healthy Halloween treats available!  Here are a few ideas of how to help your kids (and your neighbors) have a happy healthy Halloween!

1.  Dark chocolate:  Dark chocolate is MUCH better for you than milk chocolate.  It has more antioxidants and helps lower cholesterol and blood pressure.

2.  Portion-packs of apple slices, pretzels, raisins, trail mix or nuts.  Make sure to ask if nuts are OK, some children are allergic.

3.  Dried fruit:  Banana chips, freeze-dried strawberries, pineapple, raisins, so many possibilities!  Sweet and MUCH healthier than candy!

4.  Carrot sticks:  Sweet and crunchy, and oh so good for you!  Full of fiber and vitamin A for healthy skin and eyesight.

5.  Popcorn balls:  Also high in fiber, popcorn balls are available at this time of year in factory-sealed packages for trick-or-treaters.

I found an awesome YouTube video from The Vegan View with four different awesome idea for healthy Halloween-themed treats.  These would be great to make with kids.  Check it out!  (And their costumes are so cute!)

Here’s a photo of the most adorable Halloween treats I’ve seen this fall, courtesy of Pinterest!a8947aaa1fb9b9debe8a096ef0561147Make sure you set aside some time to stay active, and eat a healthy meal with the kids before they head out trick-or-treating.  Send the kids out with a SMALL bag and encourage them to take only one piece of candy at each house.  After they get home, consider having them choose their favorites to keep and then have a “candy buy-back” for cash, a gift card, or a special privilege.

Have fun, stay safe, and be healthy!

Question:  Are you planning to take any steps to “limit the damage” to your health this Halloween?  Please share your ideas below!

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You CAN Lose Weight And Keep It Off

As a family doctor and a doctor who enjoys providing medical supervision for weight loss, I have a lot of REALLY big patients.  They struggle with their weight for many reasons, but they all have one thing in common.

My patients have tried and failed to lose weight and keep it off many, MANY times.

As a result, some of them have given up.  One patient actually said that, in so many words.  “I tried to lose weight, but I couldn’t do it, so I gave up.  Now I just eat whatever I want.”  Yikes!

I LOVE helping people lose weight.  It is the highlight of not only my medical practice, but my Shaklee business as well.  Unfortunately, sometimes it’s difficult to get patients to see that yes, you CAN lose weight, there IS a program that will work for you!   Even if you’ve failed before, you can lose weight AND keep it off!

Why do people fail at losing weight?  There are so many reasons!

  • Diets ask people to give up their favorite foods
  • People don’t have time to spend hours per week at the gym
  • People are too busy to cook multiple meals each day and do a lot of food prep
  • What reason would YOU add?

These are all reasons why I’m so excited about a soon-to-be-published research article proving that people who have failed multiple times to lose weight and keep it off CAN lose weight without a restrictive diet and punishing hours-long sessions at the gym.

Let me have Dr. Wayne Wescott, PhD, professor of exercise science at Quincy College in Massachusetts, explain about this research project.

Talking points from the study:

  • Participants had failed at weight loss an average of TEN times
  • The program design was very doable.  A 40-minute exercise program twice per week, incorporating both resistance training and cardio.  Modest calorie restriction only in the first phase, participants could resume their normal diet in the second phase, just continuing a single protein shake per day.
  • Over 80% of participants completed the initial phase of the program (not too hard or too restrictive)
  • 75% of participants completed the second phase of the program
  • Participants had success!  They lost an average of 14 pounds of fat and added almost 4 pounds of muscle.  That may not sound like a lot for those of us who watch the “lose 10 pounds in your first week or your money back” commercials on TV, but this is healthy, real, sustained weight loss for those who had failed A LOT in the past.

This is the exercise program used in the study.  Each exercise is done in a single set, at a weight where you reach temporary total fatigue between 8 and 12 reps.  This means that you can do 9 reps but not 10, or 10 reps but not 11.  Do the exercises slowly and with control, with proper form.

DISCLAIMER: If you aren’t familiar with resistance exercises, you should invest in a session with a good personal trainer before starting any new exercise program.  Many gyms have trainers available and some gyms provide a free session when you join.

  • Leg extensions
  • Leg curls
  • Leg presses
  • Cardio x 6 minutes
  • Chest press
  • Lat pull-down
  • Shoulder press
  • Cardio x 6 minutes
  • Abdominal crunches
  • Lumbar extensions
  • Torso twist
  • Cardio x 6 minutes

Some suggestions for cardio would be the elliptical treadmill, stationary bike, rowing machine, stair-stepper, or a fast walk or a jog on the treadmill.  As long as you get your heart rate up and get a little out of breath, do what you like!

The meal-replacement protein shakes used in the research project were the Shaklee 180 products.  They are easy to use, tasty, and manage hunger well while providing protein, fiber, omega-3 fatty acids and probiotics.  The shakes are supplemented with the branched-chain amino acid leucine to support and preserve muscle mass.  The products are low-glycemic and therefore diabetic friendly and never contain artificial flavors, sweeteners, preservatives or genetically-modified ingredients.  You can see more about the products at this link.

The bottom line is that, even if you have failed at weight loss in the past, you CAN lose weight and you CAN keep the weight off.  Shaklee and Dr. Wescott have proven it!  Please don’t give up!  Email me at drjen@jenniferwurstmd.com and let’s get started 🙂

QUESTION: Have you tried to lose weight and failed in the past?

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The Nutrient We Miss The Most

I spend most of my time (in a professional sense) talking to people about nutrition.  I encourage them to eat right.  To get plenty of fresh fruits and vegetables.  To skip the processed food, junk food and fast food.  To take a good-quality multivitamin.

But most people still skimp on one very important nutrient.  What is it?  What is the nutrient we miss the most?

It’s WATER.

Think about it.  Your body needs about one ounce of water per day for every two pounds of body weight (up to about 100 ounces per day).  For the average person that’s 60-80 ounces of water, or a half gallon or more.

Not coffee, not iced tea, not soda or lemonade.  WATER.

Water helps keep your blood pressure down.  It removes toxins and improves your digestion.  It fights fatigue and keeps your mind sharp.

When you’re a little thirsty, this can be interpreted by the brain in as hunger.  So staying well hydrated helps control appetite and promotes weight loss.

Every organ in your body depends on you staying well hydrated.  From your kidneys to your digestive system to your brain, water is critical for normal function.

So why is it so hard for us to get enough water?  I can’t speak for you, but I know why I have a hard time staying hydrated.

First of all, the most plentiful source of drinking water is the kitchen tap.  And tap water is NASTY.  Have you tasted it lately?  Ew!  It doesn’t help that I know more than is good for my mental health about what is actually in our tap water.  Pesticide runoff, pharmaceuticals, chlorine and other chemicals interact to make me not want to drink straight from the tap (or from the garden hose, but that’s another story…).

Your local water department has water quality reports available for download at their website, for those who use city water.  Cleveland’s water quality report for 2016 is available here, if you’d like to see.

The second problem I have with getting enough water to drink is that when I drink the water I should, I have to pee.  A LOT.  When I’m in the office that’s inconvenient but manageable.  When I’m traveling or pressed for time it becomes difficult for me to get all the water I need.

Honestly, there isn’t a good fix for this problem, I just tell myself to suck it up.  Every time I go, I think of all the toxins being washed away and that makes it easier to just do it.

The last problem my patients report with drinking copious amounts of water is that it’s BORING.  “I don’t like water, it doesn’t taste good.”  Which is silly, because fresh clean water has no taste at all.  It’s clear and cold and wet and refreshing!

What people are telling me when they say they don’t like the way water tastes is that they have trained themselves to expect flavor from everything that goes in their mouth, whether it should have flavor or not.  What I tell them is that their tastebuds may not like it (for now) but their bodies certainly do like water.  In fact, they NEED it, and they do NOT need all the sugar and flavorings and additives in their usual beverage of choice.

So if our tap water is so gross, what water should we be drinking?

Bottled water?  No, that’s not a good choice.  For one thing, it’s expensive.  It also puts tons of unnecessary plastic in the landfill and isn’t necessarily cleaner or safer than drinking tap water.  Often we don’t know where the water comes from or what testing was done.

My choice for lots of fresh, clean drinking water is Shaklee’s tabletop pitcher filter.  It is certified to remove lead (most tabletop pitcher filters, including Brita and Pur, are not) and has a replaceable carbon filter so that everything else is reused.

Do you have a water filter at home?  You can check the Water Quality Association’s website to see what your filter is proven to remove from the water you drink.

And it’s CHEAP!  Just did a price check on Deer Park spring water at Giant Eagle.  Buying bottled water (this brand, anyway), costs $2.25 per gallon and leaves you with lots of plastic bottles to deal with.  Shaklee’s Year of Get Clean Water costs just 52 cents per gallon.  And after the initial investment of the reusable plastic pitcher, replacing the carbon filters gives you clean, fresh water for only 25 cents per gallon.

So what are you going to do about your hydration problem?  For me, there’s only one choice.  Saving money, drinking fresh clean water, and avoiding putting unnecessary plastic in the landfill is a win-win situation!

QUESTION: Do you drink enough water?  How do you get your drinking water?

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Summer Is A Great Time To Lose Weight

Hello from Cincinnati!  We are traveling this week, on our way home from a great week away.  We spent several days in Gatlinburg, TN and are moseying home, refreshed and ready to get back to work.

This afternoon we went to church at a positively ancient and very well-known church in Mt. Adams, Holy Cross – Immaculata.  I can’t believe I grew up in Cincinnati and had never visited this beautiful old church on the top of Mt. Adams.  If you’re Catholic and visit Cincinnati, please go see it!

The pastor, Father Leonard, gave a lovely homily in which he very humbly reviewed his first year as pastor and numbered some of his goals for the next year.  I had to laugh a little when he mentioned a personal goal – to lose weight!  I know lots of people who would put that one on the list of their own goals to tackle 🙂

That ties in very well to my topic for this week.  I know a lot of my patients and Shaklee family members who make a huge push for weight loss after the New Year.  That goal gets legs and becomes almost desperate as the summer gets closer.  People want to get that “swimsuit body.”  If they are not where they want to be weight-wise by the time their kids get out of school, they are prone to giving up.

This week I want to give you 3 good reasons why summertime is a great time to keep working towards that weight loss goal!  Summer is a great time to lose weight!

Fresh Seasonal Produce

There is so much healthy fresh seasonal fruit and vegetables that are available this time of year!  Those of us who are focusing on eating healthy can positively gorge ourselves on healthy foods that are bursting with summertime goodness.  Curious about what is in season?  Find a local farmer’s market, feast your eyes and satisfy your tastebuds with just-picked produce that taste like heaven.

You might consider joining a CSA, a popular program with a number of local farms where you pay ahead of time for a share of the season’s crop.  Most CSA shares are sized to provide a weekly supply of produce to feed a family of four.  Every year I keep eyeing Greenfield Berry Farm’s CSA, but I’m worried I won’t use it all and haven’t found anyone to share it with.

Beautiful Weather

Go walk!  Run!  Chase your kids around the yard!  Dust off and oil up your bikes and go for a ride.

Summer weather means you can be active outside and aren’t limited to the things you can do in the confines of a gym or field house.  From frisbee to pick-up softball, there are so many things you can do outside to get some exercise.

Take your kids to the park and make it a family adventure.  Go hiking in the Cuyahoga Valley National Park, or take the Bike-and-Ride for a longer excursion on the Towpath.

Less Clothes

Now be honest.  Why do you want to lose weight?  I’m going to encourage you to think of your body’s HEALTH rather than how it LOOKS, but I’m aware that most people (women in particular) also want to look better.

In the summertime, you’ve shed the bulky sweatshirts and jeans for more form-fitting clothes, so that means you may have more incentive to say no to the ice cream truck.  Eating healthy and keeping your body lean is a year-round goal, so why not use the fact that you’re seeing more skin in the mirror right now as a reason to double down on your commitment to treat your body right?  Why NOT avoid the treats and junk that are going to sabotage your ability to meet your goal of a leaner, healthier you?

You CAN do it.  And because this weekend is Father’s Day, I’ve got a special offer to help all you dads (and moms too!) get recommitted to your weight loss goals.

Shaklee is offering a special price on the Shaklee 180 Starter Kit, $150 for all you need for your first 2 weeks on the Shaklee 180 weight loss program.  And because we know that 2 weeks is not long enough to meet your goals (although it’s definitely long enough to start to see real results) Shaklee is offering up to $20 in free shipping for any order over $150 in July when you purchase the Shaklee 180 starter kit by June 30.

Summer is a great time to make real progress on your goal of a leaner, healthier you.  I’m excited to offer THE best weight loss program I’ve ever seen at a discounted price to help give you the tools to make it happen.  Order your Shaklee 180 Starter Kit today!

QUESTION: Do you put your weight loss goals on hold over the summer?

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When Fear Blocks Transformation

One of my patients, let’s call her Anne, is massively obese.  She is a very sweet woman with a supportive husband and family.  Her family is well off financially and she is educated.  Why on Earth would she struggle so with her weight?

She has the means to hire the most expensive trainers available.  She could build an entire gym in her own home.  She can buy potions and pills and exercise videos galore.  Why can’t she lose weight?

I’m not sure, not with any real confidence, because we haven’t taken the time to dig into the whys and wherefores.  I’m not a trained counselor, after all, and it’s not something we can really get into in the confines of a 15-minute visit when I also have to address all her medical problems and refill all her medications.

But if I had to venture a guess, I’d say she’s scared.  Terrified, even.  There is something about the PROCESS of weight loss that has her so frightened it is easier for her to stay massively obese than to tackle her weight.  What can we do when fear blocks transformation in your health, your career, your life?

Lately I’ve been doing some reading in the leadership coaching industry in the interest of skilling up my ability to help patients with behavior change.  I AM first and foremost a coach, after all.  I’m not a surgeon to take out appendices or cancerous growths.  My most effective tool is my ability to help patients change their lifestyle to change their health for the better.

One of the most fascinating insights I’ve had in the reading I’ve been doing is the idea that patients resist change not because they don’t want the results but because they’re scared.  They see the goal, they know how to get there, they’ve gotten practical advice and a roadmap that works.  But there is something about the roadmap that scares them to death.

Even though I don’t know what Anne’s fear is, I know there is one.  Something about weight loss triggers her brain’s threat response and makes her completely UNABLE to move beyond that point in her efforts to get healthy.  We can speculate that maybe as a child her parents withheld food as a punishment.  Now anytime she even THINKS she might get hungry that threat response is triggered and she compulsively seeks to eat to reassure herself that she is not that helpless child anymore.

Maybe she has confined herself to the role of a sick person so thoroughly that if she gets healthy she won’t know who she is anymore.  She’s afraid her husband won’t take care of her anymore if she is able to care for herself.  Maybe she’s afraid if she loses weight he’ll want to have sex with her again and there’s a history of sexual abuse in her past buried so deep she can’t bear to remember it.

I don’t want to speculate about my friend Anne.  I would love to have the time to sit down with her and really dig in with her as a willing participant, to figure out what frightens her so.  I KNOW something does, because she tells me she wants to lose weight but we can’t make any headway.  She’s not weak, not weak-willed, and not self-sabotaging.  She’s afraid.

What about you?  What are you doing that you KNOW is hurting your health?  Do you eat the wrong foods when you KNOW which foods will support your body’s health and even know tasty recipes to cook them for yourself and your family.  Do you continue to smoke even though you hate every stupid cigarette you take out of the pack?  Do you find yourself making excuses about exercise even though when you drag yourself to the gym you feel amazing and sleep so much better?

What scares you?  What’s holding you back?  I would love to have you email me at drjen@jenniferwurstmd.com and tell me about it.  I will let you in on a secret – once we address that fear and make a plan to help you feel safe, you will be able to transform your habits, meet your goals and make your life even more amazing than it is now.

I’m a coach, after all.  This is what I do.  I help people transform their health and, by extension their lives.  But I can’t do it alone.  I need you to be brave, be honest and real and raw.  I will not judge you – I make my living dealing with real people and real problems.  Send me an email at drjen@jenniferwurstmd.com and let’s get started!

QUESTION: Would you like to share one of your fears?  I’ll start – I eat too many sweets because they soothe me when I’m stressed (stress = fear).  One of my goals is to find ways to soothe stress that do NOT involve food.  I have good days and bad days with that, like most of us.

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Meal Timing In Fatty Liver Disease

We know that eating too much is unhealthy, right?  WHAT and HOW much you eat is important.  We know that eating too much processed food, drinking soda, and abusing substances like alcohol, tobacco and other drugs is unhealthy.

Well, it seems that WHEN you eat is also important.

There is research suggesting, at least in fatty liver disease, WHEN you eat influences the development of disease.  What is the importance of meal timing in fatty liver disease?

First let’s review what fatty liver disease is.  As discussed at Mayo Clinic’s website, fatty liver disease is a poorly-understood condition where the liver cells have droplets of fat present inside them.  Nonalcoholic Fatty Liver Disease is one of the most common liver conditions in the world, and is unfortunately getting more common.  It is linked to diabetes, high cholesterol, heart disease and the Metabolic Syndrome.  We don’t know for sure what causes it and don’t really have good treatments for it.

Scientists are furiously researching this increasingly common problem to try to identify causes and effective treatments.

Recently at the American Association for the Study of Liver Diseases annual meeting, a study was reported that suggested WHEN we eat influences the development of fatty liver disease.

It was found that skipping breakfast and lunch increased the risk of fatty liver disease by 20% and 73% respectively.  Eating between 10 PM and 4 AM increased the risk of fatty liver disease by 61%.  Eating more of the day’s calories in the morning decreased the risk of fatty liver disease by up to 21%.  Researchers adjusted for total calorie intake, age, gender, alcohol use and taking medications that are hard on the liver.

What recommendations can we give people based on this research?  These findings really reinforce the common-sense recommendations we give people all the time.

  • Eat breakfast every day
  • Eat lunch every day
  • Don’t eat too close to bedtime

What about shift workers?  What about my nurses and others that work the night shift?  It doesn’t seem to matter what time you are awake.  The liver has its own circadian rhythm and it seems that eating in the middle of the night is bad for your liver no matter when you sleep.

Since we know that night-shift workers are at higher risk for obesity and other health problems than those who work and are active during the day, this may be one way to reduce the health risks associated with night shift work. Keeping the calorie intake mirroring how day-shift workers eat may help to mitigate the risks for night shift workers.

For instance, one could eat a large “breakfast” when coming off-shift, a medium-sized “lunch” prior to sleep, a small “dinner” before heading to work, and avoid eating in the middle of the night while working.

Since we don’t have effective treatments for fatty liver disease, the main focus right now is on prevention.  Fatty liver disease is considered a “lifestyle” problem.  The main interventions are lifestyle changes like diet change, avoiding alcohol, and weight loss.

Do you already have fatty liver disease?  In addition to eating healthy and limiting calorie intake, making sure you eat breakfast and lunch daily and avoid eating too late can help make a difference in your liver’s health.

You only get one liver and replacement parts are hard to come by.  Changing when you eat is a fairly simple intervention that seems to be powerful in preventing the damage of fatty liver disease.

QUESTION:  Do you eat breakfast and lunch?  If not, do you think you’ll change your eating patterns based on this research?

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