Archive for December, 2018

Carbohydrate tolerance is a gray area. The amount of carbohydrates that works for one person’s metabolism doesn’t always serve another’s. In the past decade, I’ve seen a growing number of patients who for years have limited sugary foods and swapped out refined carbohydrates for whole grain products, sweet potatoes, and fresh fruit. Yet they are overweight or have surges of fatigue, foggy-headedness, or cravings. Sometimes they don’t carry any extra pounds but have worryingly high levels of blood sugar. It’s not unusual for these issues to come on late in life; their response to a diet they used to do well on has suddenly shifted.

Why this happens is a topic of robust debate in nutritional circles. It’s likely a combination of factors: a genetic predisposition combined with a sedentary, stressful, and sleep-deprived lifestyle; decades of processed foods and medications that have altered the microbiome; or even (unfortunately) overconsuming the healthy-seeming multigrain breads, bananas, and beans, which all turn to sugar in the blood. All this can lower your personal “set point” for tolerating carbohydrates so that your blood sugars don’t fall back to normal within two hours of eating as they should. Instead, they stay elevated, going beyond what the cells can handle, and eventually this triggers a chain of effects that lead to insulin resistance, the precursor to high blood pressure, heart disease, diabetes, obesity, possibly Alzheimer’s disease, and even some cancers. The 2017 National Diabetes Statistics report found that an estimated 50 percent of Americans have either diabetes or pre-diabetes and that many are unaware of this fact.

Taking your blood sugar seriously is nothing to sneeze at. When carb intolerance is at play, your body is telling you to get stricter with your intake. To follow a low-carb diet, nix all sugars and reduce complex carbs dramatically, replacing them with plenty of nonstarchy vegetables and generous amounts of fat. In addition, take sleep seriously, work on repairing the gut, and increase the amount of movement you do. The low-carb diet, along with these other fundamental improvements, can often help restore order where there was previously metabolic chaos. To catalyze real metabolic change in cases of significant weight gain or diabetes, it may be warranted to take the low-carb approach to its ultimate extreme: the ketogenic protocol.

There is another, more accurate way to learn your personal carb set point. Use a glucose monitor to measure the impact of a range of carbohydrate-rich foods on your blood sugar. Twice after eating, at the one-hour and two-hour marks, you can get snapshots of how your body metabolizes starches like grains, beans, and potatoes. If this level of detective work speaks to you, try the protocol outlined in Robb Wolf’s book Wired to Eat. His program of dietary change, basic blood work, and a seven-day carb test can help you zero in on your set point and your level of insulin resistance.

Photo: Jackelin Slack

So are you carbohydrate intolerant? Start by answering these questions.

  1. Are you overweight?
  2. Do you feel fatigued much of the time, especially after eating a carb-heavy meal?
  3. Do you lead a largely sedentary life?
  4. Do you feel like your appetite is out of control?
  5. Do you frequently crave sweets or starchy foods like bread, pasta, potatoes, or beans?
  6. Do you feel lightheaded and dizzy when you get hungry?
  7. Is your blood sugar in the upper ranges of “normal” or beyond?
  8. Are you struggling with brain fog, anxiety, depression, skin problems, joint pain, aching muscles, hormonal issues, and/or sleep problems?
  9. Optional: If you’ve had blood work done recently, look at your hemoglobin A1c levels. This provides a snapshot of your average blood sugar levels over the last three months. Has your diet been clear of sugary foods, yet the number is still above 5.5?

If you answered yes to one or more questions, try 14 days of cutting out of your diet all grains, legumes (beans and peas), starchy vegetables (carrots, corn, potatoes, squash, sweet potatoes, yams), and fruit. (In case it’s not obvious, sugary foods; natural sweeteners like honey, maple syrup, and agave; and most packaged drinks should be removed completely.) After day 14, revisit questions 2, 5, 6, and 8. If you have experienced a marked change in your symptoms, you may have discovered your own carbohydrate intolerance.

So I’m carb intolerant: Now what?

Take heart! Healthy low-carb diets can improve blood pressure and help you lose weight, have fewer sugar cravings, and feel less driven by hunger. Skin and digestion often improve, as well as triglycerides (a form of blood lipids) and blood sugar and insulin markers.

Follow all the advice in this section—then tweak your diet slightly using the suggestions that follow:

  1. No sugars or refined carbohydrates. Increase the amount of leafy and cruciferous vegetables at each meal, and dramatically or completely decrease complex carbs like starchy vegetables; grains, beans, and legumes; and “pseudo-grains” like quinoa and buckwheat. Maximum two or three portions of these complex carbs per week.
  2. Be more generous than you think you should be with “good” fats like avocados and extra-virgin olive oil.
  3. Limit dairy: It’s high in carbs.
  4. Eat low-sugar fresh or frozen fruit only: fresh berries, citrus fruits, green apples, maximum two or three times a week.
  5. Go very light on the alcohol: And if you do drink, go for the lowest-carb options. Pure spirits like whiskey, vodka, and tequila are carb-free, and dry wine is better than beer. Avoid sweet drinks and mixers, which may contain a lot of sugar.
  6. Pay attention to the effects of starchy foods when you eat them.

Your tolerance can rise and fall depending on how much you exercised, how well you slept, how stressed you are, and so on. There’s nothing a doctor can give you that is more valuable than this personal awareness. If you find that you handle whole-food complex carbs quite well, I still advise that you keep them to a reasonable amount, picking from the low- and medium-count foods described above. If you are using carb-counting devices, know this: Conventional dietary recommendations suggest a limit of 225 grams per day. That’s too high: Stay under 150 grams a day maximum, and preferably under 100 grams.

Source: https://www.mindbodygreen.com/articles/are-you-carbohydrate-intolerant

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Image by Leandro Crespi / Stocksy

When it comes to keeping your pearly whites, well, pearly white, you probably think you know the drill. Foods like tomatoes, coffee, and wine are notorious for staining teeth while products like brightening toothpaste and white strips claim to reverse it (and so the cycle continues).

But the biggest influence on the whiteness of your teeth is actually already in your mouth: the oral microbiome. Much like the all-important gut microbiome, the oral microbiome is a complex microbial community made up of beneficial bacteria and other organisms (six to 10 billion of them, in fact), explains biologic dentist Dr. Gerry Curatola, DDS, author of The Mouth-Body Connection. A healthy oral microbiome helps remineralize teeth, transports oxygen molecules to your gums, carries waste products away from your gums, keeps bad breath at bay, and, yes, influences how white your teeth appear.

How the oral microbiome keeps your teeth white.

It does this in two main ways. First, “when the oral microbiome is healthy, it’s a thin, clear, odorless protective film,” says Curatola. “But when that oral microbiome is out of balance, it’s a thick, sticky, smelly film that you wake up with on your teeth in the morning.” This thick film is stain-absorbing, so your teeth are more prone to the staining effects of what you eat and drink.

The oral microbiome also influences how white your teeth are through its role in maintaining healthy enamel. When the oral microbiome is in balance, “that film is transporting ionic minerals from saliva, like calcium and phosphorus, to the surfaces of your enamel so they re-mineralize,” says Curatola. And thicker, stronger enamel means whiter teeth. “Think of the enamel as a piece of glass that goes over your teeth: The thicker the enamel, the frostier the glass, the whiter your teeth,” he explains.

On the other hand, if you have thin, translucent enamel, the dentin (or the yellow part of the tooth) is closer to the surface, making your teeth appear duller. Ironically, thin enamel also makes your teeth even more sensitive to whitening treatments since the dentin (which is connected to the pulp, where the nerve is) isn’t as protected by the enamel.

How to restore your oral microbiome for whiter teeth.

There are a few ways to restore an out-of-whack oral microbiome for whiter teeth. First, Curatola warns against products that strip the mouth of its good bacteria, like detergent toothpaste and alcohol mouthwash (if it says something like “kills germs” or “kills bacteria,” it’s probably a no-go on his list).

Even some holistic health practices can harm the oral microbiome, like coconut oil pulling and using charcoal toothpaste. Common ingredients in natural toothpastes such as tea tree oil and xylitol also disrupt the balance, so keep an eye out for those. Lifestyle habits also play a role in the health of the oral microbiome. When it comes to nutrition, opt for alkalizing, anti-inflammatory, and antioxidant-rich foods, says Curatola. This helps prevent an acidic environment in the mouth, so acid-loving bacteria that disrupts the oral microbiome won’t be able to thrive.

Exercise is also important since staying active promotes healthy circulation and boosts the immune system, he says. Finally, focus on stress management. “When you’re stressed, your saliva dries up, you grind your teeth, and you do a lot of other unhealthy things [that affect your mouth,]” says Curatola.

In fact, these practices are important for overall wellness, too—limiting toxic chemicals, eating well, exercising, and managing stress have major health payoffs, including rebalancing the oral microbiome. And while the benefits of restoring the good bacteria in your mouth go beyond the surface of your teeth, a whiter, brighter smile is a nice bonus.

Source: https://www.mindbodygreen.com/articles/oral-microbiome-white-teeth

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High cholesterol? Add these healthy foods to your diet to lower your numbers naturally.

Have high cholesterol? You’re not alone. The problem affects some 95 million Americans, according to Centers for Disease Control and Prevention, and has been linked to serious health conditions, from heart disease to diabetes.

Cholesterol is a waxy, fatty substance found in your cells. Your liver makes it naturally, but it’s also found in animal foods like meat and dairy products. Your body needs some cholesterol to function, but getting more than you need, which can happen from eating too many cholesterol-rich foods, causes plaque to form in the arteries that could lead to dangerous blood-flow blockages.

“High cholesterol is a top risk factor for heart attacks, strokes, and poor circulation,” says Omar Ali, MD, intervention cardiologist at Detroit Medical Center Harper University Hospital. Ideally, this is what healthy cholesterol numbers look like, according to the National Institues of Health:

Adult women (age 20+)

  •  Total cholesterol: 125 to 200 mg/dL
  •  LDL cholesterol: Less than 100 mg/dL
  •  HDL cholesterol: 50 mg/dL or higher

Adult men (age 20+)

  •  Total cholesterol: 125 to 200 mg/dL
  •  LDL cholesterol: Less than 100 mg/dL
  •  HDL cholesterol: 40 mg/dL or higher

Medications like statins can help you get there, though most experts recommend trying to make healthy lifestyle changes first. “I always advise people to try and lower their cholesterol through diet and exercise,” says Jennifer Haythe, MD, co-director of the Women’s Center for Cardiovascular Health at New York-Presbyterian.

Cutting back on high-cholesterol foods—like fried foods, sugary desserts, and fatty meats—is a start, but you also need to eat more of the fare that can help lower your cholesterol naturally. Here, 10 picks to add to your grocery list.


Overnight oats with blueberries and bananas, with white and black background

Getting 5 to 10 grams of soluble fiber daily could help lower LDL cholesterol (the “bad” cholesterol that can build up in your arteries) by as much as 11 points, according to the National Lipid Association. The roughage isn’t well absorbed by your intestine, so it binds to cholesterol in the blood and helps remove it from the body, Dr. Haythe explains. And oats are a top source, delivering around 2 grams of soluble fiber per half-cup cooked.

Try it: These tasty overnight oats recipes will save you tons of time during busy mornings. Simply prep them the night before and enjoy a fiber-rich breakfast the next day.

Fatty fish

honey spiced salmon with quinoa

Aim to eat at least two 3.5-ounce servings of fatty fish like salmon, mackerel, tuna, trout, or herring per week, recommends the American Heart Association. The omega-3 fatty acids found in these swimmers can help improve your triglycerides—a type of cholesterol-like fat found in the blood that can cause your arteries to become hard or thick.

Try it: This honey-spiced salmon with quinoa is loaded with protein and fiber—and takes just 35 minutes to make! If tuna is your go-to, try this tuna salad recipe that subs out mayo for protein-rich Greek yogurt.


assorted nuts

Regular consumption of tree nuts like walnutsalmonds, and pistachios is tied to lower levels of total cholesterol, LDL cholesterol and triglycerides, found an American Journal of Clinical Nutrition review of 61 studies. “This is likely because they contain unsaturated fats, omega-3 fatty acids, fiber, vitamin E, and plant sterols,” Dr. Haythe explains. Just watch your portions, since nuts are high in calories. A small handful or two tablespoons of nut butter is all you need, says Dr. Haythe.

Try it: Top your salads, oatmeal, and stir-fry with nuts for extra crunch.

Green tea

Green tea

A Japanese study of more than 40,000 adults found that those who drank more than five cups of green tea daily were 26 percent less likely to die from a heart attack or stroke compared to folks who rarely sipped the stuff. Experts suspect that’s because the grassy brew is rich in catechins, a family of flavonoids that have been shown to thwart the production of cholesterol as well as block it from being absorbed.

Try it: Drink it straight—or amp up the flavor of your brew with this iced lemon and ginger green tea recipe.

Beans and legumes

Cooked legumes and vegetables in a bowl

Having a daily half-cup serving of beans or legumes could lower your LDL cholesterol by an average of 5 percent in just six weeks, according to a review of 26 studies. Like oats, beans are packed with soluble fiber that helps sweep cholesterol out of the bloodstream, Dr. Ali explains. Hummus, anyone?

Try it: Add beans to your tacos, salads, and soups for extra plant-based protein and fiber. You can add your favorites to this vegetable chili for a hearty dinner.

Dark chocolate

dark chocolate

Who says treats can’t also be good for you? In a British study, participants who sipped a cocoa drink twice daily for a month lowered their LDL cholesterol and raised their HDL cholesterol (the “good” cholesterol that helps prevent plaque from building up in your arteries). Chalk it up to dark chocolate’s flavonoids, beneficial compounds that have an antioxidant effect. Just stick with chocolate that’s 70 percent cocoa or higher—it contains more antioxidants and less sugar than the lower percentage stuff.

Try it: Sprinkle a serving of dark chocolate over your oats or eat on its own with a cup of tea as a post-dinner sweet treat.

Safflower oil

Oil pouring and dripping to the spoon

This neutral-flavored oil is rich in phytosterols—cholesterol-blocking plant compounds that could lower your LDL cholesterol by as much as 14 percent, according to the Cleveland Clinic. In fact, regular consumption of safflower oil is tied to lower total cholesterol and LDL cholesterol compared to regular consumption of olive oil, according to a recent Journal of Lipid Research review.

Try it: Safflower oil has a mild flavor and high smoke point, making it easy to cook with. Drizzle over your favorite veggies before roasting or use it in a DIY salad dressing.


Kale Salad

The leafy veggie (along with cousins collard and mustard greens) has been shown to bind to bile acid. What good does that do, exactly? “That helps the liver burn more fat, which in turn lowers cholesterol,” Dr. Ali says. For the biggest benefit, opt for lightly cooked greens over raw ones. Steaming in particular seems to boost bile acid binding, research shows.

Try it: Beyond using kale as a salad base, you can throw it into your stir-frysauté with eggs, or add into soup.


Toast with avocado and cress

Thanks to their fiber and monounsaturated fat, avocados could help lower your total cholesterol by 18 points, your LDL cholesterol by 16 points, and your triglycerides by 27 points, suggests an analysis of 10 studies. The key is using them in place of foods containing less healthy fats, like saturated fat. Think sliced avocado instead of mayo on a sandwich, or diced avocado rather than cheese in a burrito bowl.

Try it: We all love avocado toast and guacamole, but if you want to get creative, they make a creamy (and satiating) base for smoothies.


Red Apple

Having one every day really might help keep the (heart) doctor away. Apples are one of the best sources of pectin, a type of fiber that’s been shown to lower levels of LDL cholesterol. They’re also chock-full of antioxidants like polyphenols, which an Ohio State University study found can help keep LDL cholesterol from oxidizing, which can cause arteries to become inflamed and clogged.

Try it: Enjoy as a snack or whip up a batch of these apple oatmeal muffins for a grab-and-go breakfast in the morning.

Source: https://www.prevention.com/health/a20431093/how-to-lower-cholesterol-naturally-0/

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Image by Chelsea Victoria / Stocksy

How many of us get bound up (literally) when traveling? This time of year we’re all running around and traveling to see our loved ones; we often get so caught up in the moment that we forget our own health, and then what happens? We get the famous holiday constipation and bloat. You know what I’m talking about.

A big part of the problem is that stress levels run a bit higher during this time of year. And then, when all the gifts are purchased and wrapped and travel plans are finalized, you get in an airplane, car, or train and you travel long distances. These can be dehydrating and stressful experiences—and we all know that we’re probably not eating that organic kale salad on our cross-country treks (well, most of us, at least).

So, what do you do to prevent that holiday bloat or to address the constipation you experience when you finally get to your destination? There are a lot of different ways to address constipation, depending on your particular health issues and symptoms. Keep in mind that if you are experiencing a change in bowel habits, seeing blood in your stool, losing weight, or having other concerning symptoms, you need to consult your doctor. Outside of that, here are some quick tips to get things moving!

How to relieve constipation as quickly as possible.

When you haven’t been able to use the restroom, you want things moving right away. Based on your preferences, there are a few things you could consider. The golden rule is that you should try these remedies out before you travel because everyone reacts differently and you don’t want to be running to the bathroom if you’re experimenting for the first time. You may also want to consult with your doctor before taking anything because they will understand what might work best for you based on your specific health issues. That said, here are a few simple tips to get things moving—STAT:

1. Consider using a magnesium supplement.

Magnesium can help the bowels move a bit better. Ever seen those small bottles of magnesium citrate? Well, there is a reason we use them to help “purge” the bowels. I wouldn’t drink one of those bottles unless I absolutely had to, but taking a supplement in a smaller dose may be helpful.

2. Make some flaxseed tea.

Take 1 to 2 tablespoons of crushed flaxseeds and steep them in 2 cups of water for 10 minutes. Then strain it and drink it throughout the day. It’s a nice, mild stool softener.

3. Try triphala.

Triphala capsules can act as a nice “bowel tonic” if you take it one to two times daily before eating. It is an ayurvedic herb that has been used for ages to help with digestion.

4. Turn to ginger tea or an herbal tincture.

Ginger is also a mild prokinetic, meaning it helps keep things moving forward (it’s also great for nausea).

5. Try one of these over-the-counter remedies.

Established and well-known laxatives such as senna, senna tea, and PEG-3350 (Miralax) can also be useful when you are traveling and need to get things moving. A stool softener like bisacodyl can also be used. If all else fails and you really just have to get things moving right away, there is no shame in using an enema or suppository to help you get the momentum going. Sometimes we have to “get you there before we can keep you there.” That’s one of my favorite mantras. Once you get the momentum going, you can use strategies one through four to keep it going.

How to prevent constipation in the first place.

Hopefully, these tips can help keep you “moving along” during the holidays! Remember, though, one of the best ways to treat a problem is by preventing it from happening in the first place, which brings me to my second set of tips, focused around prevention strategies. Sometimes we still face the problem, and that’s OK. But if you know your body tends to get backed up, try your best to prevent it with these tips:

1. Stay hydrated.

When you are underhydrated and losing more fluid than you’re putting back into your body (from running around and traveling), you can easily get constipated. Make sure you drink plenty of water when traveling to keep your hydration status up.

2. Take a probiotic.

Taking a probiotic can potentially help bolster your immune system when traveling but could also help keep your bowels moving properly. A recent study from 2016 showed how taking a multispecies probiotic could be effective in treating those with constipation predominant IBS.

3. Plan your travel meals.

It can be hard to plan and coordinate your meals when traveling. I’ve been there myself. However, there are certain things you can do to reduce the intake of junk while traveling. You can bring snacks from home (nuts and seeds are a personal favorite of mine). You can also purchase food from the airport or along the way (if traveling by ground) that is healthier for you. You can pretty much find a salad at any restaurant these days. If you’re traveling by car, you can scope out your travel path and plan when you are going to stop based on where certain restaurants or grocery stores are so that you have the ability to make healthier decisions for yourself while traveling.

4. Relax.

I know it’s hard, but you have to relax. The whole point of your trip is to have fun anyway, isn’t it? When we are stressed out, we are telling our gastrointestinal tracts to slow down. Even if you aren’t overtly stressed and pulling your hair out every minute, when there is a low level of stress, your body senses that and the motility, or way the gut squeezes and moves, slows down in anticipation of some major event that is going to happen (but there is no major event; you are just getting ready for a flight at 5 a.m.). It’s a great time to take some deep breaths, do some yoga, or listen to some binaural beats!

Source: https://www.mindbodygreen.com/articles/how-to-treat-constipation-naturally

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This might be a fun month for you, but December’s a rough one for your liver.

Four nogs? Your liver drinks them, too. Extra gravy? Your liver consumes it as well. Half of a jellied-cranberry log? Your liver would have stopped at a third, but you’re in this together, so… The important part is nearly every bite you eat and every drink you down ends up getting managed by the same organ in your body: your liver. Although it’s one of your largest organs, the stuff you do to it this month can overwhelm it and leave you with long-term damage. Which means it has less bandwidth to regulate blood sugar, process cholesterol, and make certain hormones that you need to . . . you know. . . live. Here’s how the wreckage happens and how to avoid it. (Hint: Easy on the nog.)

The first sip of booze…

When you have a drink or two, your liver kicks into gear and performs triage: It transforms the alcohol in your sidecar into harmless water and carbon dioxide, which you then pee out or exhale. It also holds on to anything it can use, like the antioxidants in wine or the carbs in beer. The whole process is a no-brainer for the liver, but the metabolism of alcohol creates fatty acids along the way, which get stored as triglycerides—a kind of cholesterol—until your body can use them up. Typically, if you eat and drink reasonable amounts, it will use them just fine. Until you . . .

alcohol liver health

Have a few more drinks. . .

“If you binge, then binge again, then binge again, your liver gets shocked each time and can’t recover,” says Christopher Koh, M.D., a researcher at the National Institute of Diabetes and Digestive and Kidney Diseases. The more you drink, the more your liver shuffles those triglycerides into the “burn later” pile . . . until the pile is so big that your liver can’t get to the bottom of it. This causes inflammation and eventually kills off liver cells, leaving scar tissue in their place (and can lead to cirrhosis, a problem that’s increasingly affecting 25- to 34-year-olds). Not good. Just three get-togethers a week through the holiday season can initiate inflammation, if each outing involves more than five servings of alcohol in two hours. Not to mention when . . .

Now, some food. A lot of food.

You don’t even have to drink alcohol to mess up your liver. Seasonal foods (you know, with saturated fat, refined carbs, or processed red meat) combined with holiday-associated weight gain can lead to nonalcoholic fatty liver disease (NAFLD). “It’s estimated that up to 30 percent of the U. S. population has NAFLD, and there aren’t symptoms, so people usually don’t know and aren’t doing anything to reverse it,” says Mazen Noureddin, M.D., director of the Fatty Liver Disease Program at Cedars-Sinai. Meanwhile, that fat is wreaking the same havoc alcohol does—inflammation and eventual scarring—without the libations. NAFLD could develop in as little as six weeks if you really overdo it.

holiday food liver health

How to hit “restore”

Your liver can actually regenerate—if you stop beating it down. You don’t need an activated-charcoal smoothie or a beet-juice detox cleanse to do it. Your liver naturally gets itself back in working order if you move the heck out of its way. A month or so without a drop of alcohol (no beer during the game, no wine at the client dinner) can reduce the fat storage in the liver and help tame inflammation. You can undo some of the fat that causes NAFLD by cleaning up your diet and cutting portion size: Losing 5 percent of your weight can reduce fat in your liver by up to 30 percent.

Source: https://www.prevention.com/health/a25619220/food-alcohol-effects-liver-damage/

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Ever wonder why you’re so inexplicably tired during what is supposed to be the most relaxing time of the year? Well, the holidays can certainly be exhausting. Running around, buying and wrapping gifts, planning parties, and traveling…whew…even thinking about it can be exhausting! Outside of physical exhaustion from running around, there are a bunch of things happening in the background that—without you even realizing it—can be contributing to your low energy levels.

Your energy levels greatly depend on the bacteria in your gut.

The gut microbiome is the ecosystem of trillions of bacteria and other microorganisms that live inside of our gastrointestinal tracts. These microbes have a wide variety of functions and capabilities, and one of the things we have seen them do is help regulate our metabolism. If we eat plenty of vegetables, fruits, and other fiber sources, we tend to have a more diverse and resilient gut microbiome. At the same time, we know that these foods are healthier for us because they help stabilize our insulin surges and metabolism. In fact, certain gut microbes have the potential to diminish insulin resistance and metabolic and cardiovascular disorders, but we have to cultivate that inner garden to allow that to happen.

On the flip side, certain foods (we’re looking at you, simple carbs and sugars) can allow unfavorable bacteria to flourish and diminish our gut bacterial diversity. Not to mention, the energy high from the dopamine surge you get from these sugars and simple carbohydrates will only get you so far. Once your body figures out what to do with all that sugar and packages it away inside your cells, you will be looking for a way to keep that energy “high” up, and you may start to crave other things that give you the same feeling quickly because you will get cranky and tired otherwise. This is where the vicious cycle begins and where the gut microbiome gets thrown off kilter.

Caffeine, alcohol, and portion control are also major players in your holiday fatigue.

Some of us may turn to caffeine sources to keep the energy levels higher. We know that coffee, for example, has a stimulating effect and also has a number of health benefits in the proper context. However, one study suggested that it may also contribute to insulin resistancein the setting of a high-fat diet. So, you can see how a variety of things can have an additive effect on your health and gut microbiome and thus your energy levels.

During the holiday season, cocktails are usually also freely flowing. Excessive alcohol intake can be a poison to the gut microbiome and can affect our metabolism as well. We all know that sleep quality is not the same when alcohol is part of the equation. What we don’t always appreciate is that our circadian clock influences our metabolism and that the gut microbiome is involved in that process as well. When we throw one element off, the others can go along with it as well.

Additionally, while those delicious and heavy holiday meals seem attractive, overeating and overindulging can translate to higher fatigue levels as well because it is felt that insulin resistance can alter tryptophan metabolism and contribute to mood alterations and fatigue in certain populations. This could mean that when you have big surges of insulin in response to the heavy meals, it might feel good at first, but your metabolism and gut microbiome are really not happy, and that feeling of fatigue and sleepiness you have after eating is just a sign of just that.

So, while we all want to enjoy the holidays and have a good time with family and friends, we also should keep in mind that if we are full of energy and excitement, we are likely to have more fun than if we are sleepy and tired all the time! Protecting our gut microbiomes by eating healthy foods as much as possible, watching portion sizes, and not overindulging in alcohol, caffeine, and other sweet treats can protect our metabolism and give us increased energy levels so we can enjoy our holidays on a much bigger level.

Source: https://www.mindbodygreen.com/articles/why-youre-so-tired-over-the-holidays

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Letting go of perfection is priority number one.

There seem to be two versions of the holidays: One portrays this time of year as the happiest, while the second is a whirlwind of strained budgets and family fights. Nearly 70% of us are stressed during the season, according to the American Psychological Association. “The holidays bring together almost all of our pressures into one short period of time,” says Tarane Sondoozi, Psy.D., a psychologist serving as an employee assistance provider at Scripps Health in San Diego. But it is possible to sidestep the stress— you just need real-world solutions, and you’ll find them here.

Trying to do it all

It’s become more difficult to write off the idyllic holiday as unrealistic when social media delivers us photos of friends’ and bloggers’ seemingly impeccable celebrations. In fact, one survey found that 44% of people strive for holiday perfection, and 32% end up disappointed.

Holiday stress strategy: Start breaking some traditions. “When it comes to decorating, giving gifts, and upholding traditions, women in particular often feel like they have to do everything,” says Pamela Regan, Ph.D., a psychology professor at California State University, Los Angeles. But do you? Keep your most cherished traditions, like caroling or cooking latkes, and simplify the rest. “Creating newer, easier traditions takes the pressure off of how things should be,” says Regan. Decorate the living room rather than the whole house, and invite close friends over for tea rather than hosting a party. You never know which new customs will stick around for generations to come.

A mile-long gift list

There’s so much stress around gift-giving: finding the perfect presents for family, plus the murky gray areas—what should you give your daughter’s dance teacher? Should all of your neighbors get a present?

When eBay researchers strapped biometric devices to 100 people as they shopped for holiday gifts, the participants’ heart rates jumped 33% and they felt fatigued after 32 minutes. It’s no wonder a Pew Research Center survey found that only 1% of Americans list shopping as their favorite holiday activity.

Holiday stress strategyOrganize your shopping into manageable categories. To make it less overwhelming, sort through who you’re buying gifts for and research what you’d like to get each person before leaving the house, says Sara Skirboll, a shopping and trends expert for RetailMeNot. Next, plan three to five different shopping outings rather than one long day of spending. “Visit the mall one afternoon and get everything you need there, hit a boutique store another day, and then plan to spend, say, three different shopping sessions online,” Skirboll says. This way, you can tackle your gift list without feeling exasperated and unorganized by the end of a long day (and, as an extra perk, you’ll have fewer bags to carry!).

And no matter where you end up shopping, prep yourself for the chaos you’ll encounter. “You may need to remind yourself that this time of year requires a little extra patience,” says Scott Bea, Psy.D., a practitioner of cognitive-behavioral psychotherapy at the Cleveland Clinic. “Try to observe others without judgment, and know that everyone else is out there for the same reason you are—to have a happy holiday.”

Your budget is stretched

Once you’ve organized your shopping strategy, the next step is paying for all those gifts—not to mention all the decorations, food, and travel costs that come with the season. One Coinstar survey of 2,000 Americans found that 65% of people set a holiday budget, but 77% expect to exceed that budget. That’s stress waiting to happen.

Holiday stress strategyGently reshape expectations. That means your own and other people’s. Determine ahead of time how much you’ll spend on each person you’re giving a gift to, says Skirboll. “With groups of friends, you can suggest a gift exchange in which every person draws a name and gives a gift only to that person,” she says. “And remember, homemade presents are often more cherished than store-bought ones, and much less expensive.” (See right for easy ideas.) When it comes to your children’s wish lists, if what they want is too expensive, be caring but honest about it. This can be a good lesson for them in managing expectations. You can also use this as an opportunity to highlight the spirit of the season by helping them make small gifts for others, Skirboll suggests.

To cut down on travel expenses, consider flying on Christmas Eve, Christmas Day, or New Year’s Eve; since most people travel before or after these days, lower demand means airfare discounts. You may also save by renting a car through Costco—its travel site generally has better deals than you’ll find at the airport.

An overpacked schedule

Not only do you have a ton to do, but you’re likely trying to do it all at once. “Your mental health is like a bank account,” says Lisa Hardesty, Ph.D., a clinical psychologist with Mayo Clinic Health System. “This time of year, most people have too many withdrawals that stretch us thin.”

Holiday stress strategy: Finally practice mindfulness. You’ll actually feel more efficient if you do: Research shows that multitasking can reduce productivity by 40%. See below to get started, and give yourself permission to find time for yourself if there’s still too much to do. Sondoozi recommends letting your loved ones down gently by declining requests while offering a more manageable alternative. For instance: “I’m touched you wanted to include me at your party, but this weekend is packed for me. What if we celebrate by walking around the lake next week with hot cocoa?” If you can’t fit everything in, send a handwritten note or a bottle of wine ahead of time to let the hosts know you’re still thinking of them.


Perhaps you’re not close with your family or you still feel the aching absence of your mother, who passed away.

Holiday stress strategy: Find time to volunteer. A study in the Journals of Gerontologyfound that recent widows who started volunteering at least two hours per week lowered their feelings of isolation to a level similar to married people who volunteered. “Taking time to help others gets you out of the house, provides a shift in perspective, and forces you to interact with others,” says Adam Fried, Ph.D., a clinical psychologist based in Phoenix.

In fact, simply lending a hand to a relative, friend, or even a stranger has its benefits, and research shows it can mitigate the impact of stress. Reach out and ask someone if he or she could use help or company—or simply invite the person to your own celebrations. Most people don’t make their loneliness known, but you can be the one to make it better.

Family drama

You have the uncle who shouts about politics across the dinner table, and the cousin who returns every kind gesture with a complaint. Although nearly 90% of Americans plan to spend the holidays with extended family or friends, Consumer Reports data shows that 33% dread political conversations with them and 16% don’t want to host.

Holiday stress strategy: give yourself a new script. Before a family reunion, think about how you’ll answer possible questions, says Regan. This way, you won’t be stunned when you’re hit with an inquiry you’d rather not answer (“Do you think you’ll ever remarry?” “How much did you pay for your new house?”). If things get out of control, put your foot down by saying, “I love you, but let’s not discuss this right now,” recommends Judith Orloff, M.D., a UCLA psychiatrist and author of The Empath’s Survival Guide.

Source: https://www.prevention.com/health/mental-health/a25645186/holiday-stress-management/

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At any given time, two-thirds of American women aged 15 to 49 are using contraception. More of them are turning to I.U.D.’s and implantable devices.

More than 10 percent of women of childbearing age use long-acting reversible contraceptives, like this intrauterine device.CreditCreditiStock/Getty

More than two-thirds of women of childbearing age in the United States use contraceptives, according to a new report by the Centers for Disease Control and Prevention.

Almost all American women turn to contraception at some point in their lives. But at any given time, many may not be using it for various reasons: because they are pregnant or trying to be, for example, or are not sexually active.

In interviews, part of a national survey conducted from 2015 to 2017, women were asked about their use of contraceptives in the current month.

There are 72.2 million women aged 15 to 49 in the United States. Over all, 64.9 percent use some form of contraception, the researchers estimated.

The most common form was female sterilization, reported by 18.6 percent of the women. Almost 6 percent relied on male sterilization, 12.6 percent took oral contraceptives and 8.7 percent used male condoms.

More than 10 percent used long-acting reversible contraceptives, or L.A.R.C.’s — hormone-releasing rods inserted under the skin, or intrauterine devices that prevent implantation of the fertilized egg.

The use of L.A.R.C.’s has increased rapidly in recent years, according to the lead author of the report, Kimberly Daniels, a statistician with the C.D.C. From 2011 to 2015, 8 percent of women were using them, compared with 11.3 percent in the 2015 to 2017 period.

Among women aged 15 to 19, 37.2 percent were using contraceptives. The rate increased with age: 61.9 percent of women in their twenties, 72 percent of those in their thirties and 73.7 percent in their forties.

The use of oral contraceptives generally decreased with age: 16.6 percent of 15- to 19-year-olds said they used the pill, and 19.5 percent of women in their twenties; but just 11 percent of those in their thirties and 5.1 percent in their forties.

“It’s interesting to see that among these 72 million women, almost half their contraceptive use is covered by L.A.R.C.’s, female sterilization, the pill and the condom,” Dr. Daniels said.

Almost 4 percent of women depended on withdrawal before ejaculation, and small percentages used other forms of contraception — morning-after pills, female condoms, foam, cervical caps, diaphragms, sponges, suppositories, jellies or periodic abstinence.

There were no differences in contraceptive use by level of education, but there were by race. Some 59.9 percent of black women used contraceptives, compared with 67 percent of whites and 64 percent of Hispanics.

Source: https://www.nytimes.com/2018/12/21/health/women-contraceptives.html

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One bright spot is breast cancer survival, the report finds.

American women are still struggling to get good health care compared to women in other advanced nations, a new study finds.

U.S. women are sicker, spend more on medical bills, have to work harder to get good care and are far more likely to die in pregnancy and childbirth than women in other rich nations, the report out Wednesday from the Commonwealth Fund finds.

The only areas where the U.S. comes out ahead? Women are less likely to die of breast cancer here, and have better access to medical specialists.

But in most other measures, the U.S. falls short when compared to 10 other wealthy countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and Britain.

The Commonwealth Fund’s Sara Collins, who helped write the report, said the aim was to see if the 2010 Affordable Care Act had made a difference for women’s health. “We wanted to take an assessment of where women are on health care and, particularly, insurance coverage,” Collins said.

And compared to 2009, when 16 percent of Americans had no health insurance, now just 8.8 percent of Americans go without a way to help pay medical bills.

“Women are indisputably in a better place than they were in 2009,” Collins told NBC News.

But the benefits of the Affordable Care Act — expanded health insurance coverage, rules that stop health insurers from charging women more, rules forcing insurers to cover pre-existing conditions, and coverage guarantees — have done little to narrow gaps between American women and women in other rich nations.

Compared to the 10 other wealthy countries, the U.S. still has the highest rate of maternal mortality. The U.S. maternal mortality rate is 14 deaths out of every 100,000 women who give birth, according to statistics from UNICEF. That’s comparable to the rate in Uruguay, where the maternal mortality rate is 15 per 100,000, and Turkey, where it’s 16 per 100,000.

“Women in the U.S. had the highest rate of maternal mortality because of complications from pregnancy or childbirth; women in Sweden and Norway had among the lowest rates,” the report reads.

“High rates of caesarean sections, lack of prenatal care, and increased rates of obesity, diabetes and heart disease may be contributing factors to the high rate in the U.S.”

The report gets at some of the possible reasons: close to 40 percent of women say they’ve taken a pass on health care because of cost.

“This is the highest rate among the 11 countries in our analysis,” the report reads. Just 5 percent of British women said they skipped care because of cost.

The Commonwealth team surveyed 9,254 women aged 18 to 64 in the 11 countries, and also used health data from the Organization for Economic Cooperation and Development, as well as UNICEF’s maternal deaths database.

More than a quarter of U.S. women said they spent $2,000 or more of their own money for medical treatment. That compares to 2 percent of women in Britain, Sweden and the Netherlands. Only in Switzerland did more women — 28 percent — spend more.

And 44 percent of American women complained about trouble with medical bills. That includes being unable to pay a bill, struggling to pay, arguments over bills or having to pay more than expected. That compared to 35 percent of women in France and 2 percent in Britain.

American women are also sicker, in general. In the U.S., 20 percent of women have two or more chronic conditions, such as diabetes, asthma or heart disease. That’s the highest rate out of the 11 countries. In Canada, 16 percent of women have two or more chronic conditions; in Germany, just 7 percent do.

And Americans spend more to get less. The latest federal health care spending report shows the U.S. spends $10,739 per person on health care, more than any other country and about twice the average for developed countries.

“Women are indisputably in a better place than they were in 2009.”

The team did tease out some benefits. They looked at breast cancer in particular and found women in the U.S. are more likely to get mammograms and are more likely to survive breast cancer than women in other countries. Women in the U.S. had among the lowest rates of breast cancer–related deaths, after Norway, Sweden, and Australia. Women in the Netherlands and Germany had the highest rates.

“Breast cancer survival is a bright spot,” Collins said.

American women are unhappy with their health care. Just 24 percent of U.S. women said their medical care was excellent or very good, by far the lowest percentage. More than 60 percent of British women said their care was very good or excellent; 61 percent of Swiss women did and 59 percent of Australian women did.

The U.S. is the only country among the 11 that does not have a system of universal health care coverage, either through a national insurance system or a law requiring everyone to have health insurance. But Collins said it would be possible to improve the health outlook for women without moving to a European or Canadian-style health system.

“There are ways to do this,” Collins said.

“All states should expand Medicaid without restrictions that limit enrollment.” Currently, 37 states have expanded Medicaid to more people, or plan to, while 14 states have not. Arkansas, Kentucky, New Hampshire and Indiana either have or plan to impose work requirements for Medicaid.

Providing federal support to help more people pay their health insurance premiums would also help, Collins said.

“There is just a long list of small changes that could be made to the ACA,” she said. “We don’t need to throw out the law and start again. There are small, relatively low-cost changes that Congress could tackle.”

The ruling earlier this month by a federal judge in Texas, who said the ACA is unconstitutional, adds some uncertainty, Collins said. She and many other scholars predict the ruling will be turned back at appeal. “But it throws a lot of confusion into the health care system,” Collins said.

Source: https://www.nbcnews.com/health/health-news/health-u-s-women-still-lags-those-other-rich-countries-n949921

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Landmark legislation headed to the president’s desk would provide millions of dollars to help states determine why women are dying from pregnancy and childbirth at troubling rates. But the bill passed last week by both houses of Congress does not specifically require states to examine whether flawed medical care played a role.

Studies have found that at least half of childbirth-related deaths could have been prevented if health care providers had followed best medical practices to ensure complications were diagnosed and treated quickly and effectively.

Yet a USA TODAY Network investigation in September revealed that state maternal death review committees across the country often avoid scrutinizing medical care that occurred in the days and hours before mothers’ deaths. Many state reports instead focused on  mothers’ lifestyle choices or larger societal problems, such as women being obese, smoking or failing to seek prenatal care or use seat belts.

Bipartisan sponsors and supporters of the legislation said it’s an important first step, which would provide critical resources to ensure all mothers’ deaths are reviewed for all causes. Its language, they noted, would allow the Centers for Disease Control and Prevention to include scrutiny of medical care as a requirement for states to receive a grant.

“It’s impossible to read the text of HR 1318 and conclude that committees will do anything but study every single death and cause – societal, provider error or other – if they want to successfully compete for this funding,” said Angeline Riesterer, communication director for the bill’s sponsor, U.S. Rep. Jaime Herrera Beutler, R-Wash. The bill, she said, calls for review committees to use best practices.

Supporters of the legislation said it’s crucial that delays in diagnoses and failures to treat women for childbirth emergencies are studied by state review committees – alongside societal factors – to identify trends and take action to prevent deaths.

“The key thing here is to not blame the mother,” said Cindy Pearson, executive director of the National Women’s Health Network, a consumer advocacy organization.

As the number of childbirth-related deaths has risen – making the USA the most dangerous place in the developed world to give birth – Pearson said too much blame has been placed on mothers for being older, overweight or having underlying health issues.

“That does not in any way, shape or form explain the differences in rates in our community or racial disparities,” she said.

USA TODAY’s ongoing “Deadly Deliveries” investigation has focused on the role of hospital care in preventable deaths and injuries of mothers. Each year, about 50,000 U.S. women are severely harmed and about 700 die because of complications related to childbirth. African-American moms are three to four times more likely than white moms to die or suffer devastating childbirth injuries, studies found.

YoLanda Mention died after giving birth in 2015 despite warning signs she was at risk of stroke from dangerously high blood pressure. She waited for hours in the emergency room of the hospital where she delivered her baby without receiving treatment. Her case was one of several featured in USA TODAY’s investigation of maternal deaths.
Family photo

At hospitals across the country, USA TODAY exposed doctors and nurses failing to follow nationally promoted best practices that make childbirth safer. Little information is publicly available to women about childbirth complication rates at maternity hospitals in their communities, and many hospitals declined to answer questions about whether they follow safety practices.

The legislation would create a national program to confidentially collect and analyze standardized data on every mother’s death. Its stated goal is to identify ways to reduce the number of deaths and serious injuries. The legislation would provide $12 million in funding in fiscal year 2019 to bolster states with maternal mortality review committees and help create committees in more than a dozen  states that lack them.

“The Preventing Maternal Deaths Act takes an important step forward in putting review teams in place in every state,” said Rep. Diana DeGette, D-Colo., one of the bill’s co-sponsors.

Members of Congress and health care advocates credited news coverage from USA TODAY, ProPublica, NPR and others in getting Congress to pass the legislation.

Rahul Gupta, chief medical and health officer for the March of Dimes, called the bill a “game changer.”

Language in the bill says that for a committee to participate in the program and receive federal funding, it must demonstrate to the CDC that its “methods and processes for data collection and review … use best practices to reliably determine and include all pregnancy-associated deaths and pregnancy-related deaths, regardless of the outcome of the pregnancy.” The legislation would require that committees submit standardized data to the CDC.

Riesterer said it is the legislation’s intent that reviews examine all causes, including issues with the medical care women were provided. She pointed to a model worksheet developed by the CDC for voluntary use by state review committees with fill-in text boxes for contributing factors involving health care providers and facilities.

In a statement, the CDC said that funded review committees “will collect standardized information from all available sources – including medical records and hospital records – for each pregnancy-related death in their jurisdiction. The funded committees would then review this information and provide recommendations for prevention.”

“This legislation is an important first step in what will inevitably be a much broader and ongoing effort,” said Sen. Shelley Moore Capito, R-W.Va., who co-sponsored related legislation in the Senate. “The aim of the bill is to help us, as a country, begin to address maternal mortality rates, to better understand the problem and to draw attention to it – while also ensuring that states still have the flexibility to respond to the specific and unique health needs in their various communities.”

Lisa Hollier, president of the American College of Obstetricians and Gynecologists, said uniformity in how mother’s deaths are reviewed and tracked is key to addressing maternal deaths nationally.

“It’s not untrue that (state committees) could do a better job of investigating and making recommendations for preventing maternal deaths, and that is why the passage of the Preventing Maternal Deaths Act was so critical,” Hollier said.

Some state-to-state differences, she said, can unearth important insights.

“The findings from (committees) will always be somewhat unique because they are based on local data and will reflect the issues of biggest concern for that state,” she said. “Knowledge of local public health issues, such as opioid misuse, smoking, mental health issues, absolutely plays a role in designing programs for preventing maternal deaths and should not be minimized.”

Source: https://eu.usatoday.com/story/news/investigations/deadly-deliveries/2018/12/19/maternal-mortality-rate-bill-targets-chidbirth-deaths/2339750002/

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