Updates, Changes, Moving Forward & Fake it Till You Become It

Hello and happy holidays to any and all of you that check out Health 411. Just dropping by to let you know some exciting things are in the works for Health 411; so no, I've not forgotten about this resource, in fact, I'm working on developing and expanding Health 411, so stay tuned in the new year for access to my recipes, updated nutrition information and much more!

As for what I've been up to over the last 2 months, I've been teaching a wonderful course called craving change. The course helps us take a very close look into our personal relationships with food and why it can be challenging to make healthy choices and changes. When it comes to leading a group of people, I can become nervous at times. On one of my typical TED talk nights (I love TED talks), I stumbled upon a talk by Amy Cuddy discussing the power of body language and how it shapes who we are. Before each workshop I kept this talk in mind and it helped me remain confident in myself. Her suggestions are simple and easy to follow. Try it out and let me know how it goes!

Decrease Your Dementia Risk

Being in preventative health care, us dietitians are always thinking about how to prevent diabetes, heart diseases, stroke.. and today dementia was on my mind. My husband and I have joked about being 85+ years old together and dealing with inevitable dementia that comes with age. When I consider this seriously, it’s not a joke at all. To have impaired memory, mood fluctuations, possible hallucinations, tremors, dis-inhibition, personality change, and/or language difficulties sounds like an emotional, confusing, heart-wrenching process. There are many types of dementia; not every person with dementia will experience all of the symptoms listed above since certain symptoms correlate with certain types of dementia.

Curious about how to decrease your risk or delay the development of dementia? Take a look at some of the research below:

• Challenge your brain. Education may protect you against dementia later in life. Some theories suggest that those with higher levels of education create more complex connections and efficient networks in the brain which can compensate for dementia-relate damage. Others say that those with higher education have higher socioeconomic status and can afford a healthier lifestyle, are exposed to less toxins, and have greater access to healthcare. While some say “use it or lose it” and that lifelong brain activity may be needed to prevent cognitive decline.
• Get support to deal with depression. Those with depression may have increased risks of dementia later in life. Speak with your doctor to see what type of support is available to you.
• Stop Smoking. It damages blood vessels, increases heart disease risk, decreases life expectancy. Yes it is an addiction. Yes it will take many tries to quit. So don't forget to utilize your healthcare team and government funded smoking cessation programs for the public.
• Watch those drinks: alcohol abuse has a deleterious effect on the brain as it damages neurons and decreases cerebral volume. It also leads to liver tissue death and increases risk of heart disease and certain cancers. Alcohol in moderation e.g. 1-2 drinks/ day may have some health benefit in lowering heart disease and Alzheimer dementia risk, but further research is needed.
• Physical activity improves blood flow through large and small blood vessels to the brain, can help decrease blood pressure, decrease insulin resistance and improve blood sugars, increase HDL (cholesterol that protects the heart), increases neurogenesis (formation of neurons in brain), and can reduce the loss of neurons in certain parts of the brain. Some studies suggest that high physical activity may decrease Alzheimers and vascular dementia risks by 40%. 
• A Mediterranean style diet high in whole grains, fruits, fish, legumes, nuts & seeds, and vegetables, has been associated with reduced risk of heart disease, type 2 diabetes, some forms of cancer and overall death. When people are deficient in Vitamin B12 or folate, homocysteine levels rise. High homocysteine levels could be related to nerve cell death and may increase risks of brain injury. It is unclear if Vitamin B supplementation decreases risk of dementia but it may be beneficial in those patients who are deficient. 
• Manage your high blood pressure (hypertension). Studies show that high blood pressure is related to lower brain volume. It can lead to cell damage in the brain as well as an accumulation of protein which could lead to Alzheimers dementia. Hypertension in midlife, is associated with an increased risk of any late-life dementia. Manage your high blood pressure through dealing with stress, not smoking, limiting alcohol intake, physical activity and assessing your sodium intake.
• Having diabetes later in life is associated with increased risks of all types of dementia, especially vascular dementia. Learning how to keep your blood sugars in target ranges using high fiber foods, lean protein, physical activity and stress management may save you from more than just common complications of diabetes.

There you have it, an array of ideas on how to decrease your dementia risk. Now it's up to you to decide which one you start with!

Information Source:
http://www.alz.co.uk/research/WorldAlzheimerReport2014.pdf

Why We Procrastinate

Have you had a busy summer like me? Have you kept up with your day to day or weekly self-education? Or is there a project you began a few months ago that doesn't seem to be moving forward? We have all been there, that feeling where you know you have to or should do a certain thing, but you just put it off.
This summer my form of procrastination has been with keeping Heath 411 updated. I like to have at least 1 post per month, but a whirlwind of summer weddings, road trips, cooking and cleaning have given me reason to stay away from my laptop! This got me thinking about, why do we procrastinate?
Procrastinating involves postponing, delaying, or putting off an intended course of action. It is wide-spread and has been reported for thousands of years.
Studies on college students show that they spend over one third of their time procrastinating by sleeping, playing or watching TV. Some suggest that there is an involvement of irrationality and self regulatory failure because the task is often delayed despite expecting to be worse off with the delay. Depression has been linked to procrastination due to low energy levels, and lack of interest in previously enjoyable activities. Additionally, it has been suggested that perfectionism, fear of failure, lack of self confidence, lack of certainty of success, or low self-efficacy could be probable causes of procrastination. Decreasing the value of the task also can increase procrastination, especially if we consider it to be boring or attempt the task when energy levels are low.

Ways to decrease procrastination may involve:

• Taking time to understanding reasons, habits, and thoughts that lead to your procrastination. If you're wanting to change these thoughts, practicing positive self-talk may be helpful
• Consider acquiring or improving skills related to the task may help increase self-confidence
• Increasing task difficulty to make the task challenging but achievable may reduce boredom
• Sometimes simply starting the task can create motivation to complete it, instead of expecting to feel motivated in order to begin the task
• Setting short-term, realistic, goals or breaking big tasks down to little ones can increase personal satisfaction each time we achieve a goal
• Take time to identify and write down personal reasons for wanting to reach your goals or complete tasks. These reasons need to be related to what you want for yourself, not what others want for you

For more information on procrastination take a look at Cal Poly's Procrastination Resource for Students and the links below. Now lets go and get some things done!

Information Sources:
http://www.ncbi.nlm.nih.gov/pubmed/17201571
http://sas.calpoly.edu/asc/ssl/procrastination.html

http://success.oregonstate.edu/six-reasons-people-procrastinate

http://www.princeton.edu/mcgraw/library/for-students/avoiding-procrastination/

Curious About Coconut Oil?

I'm sure you've heard all about the potential benefits of coconut oil, but do you know which types are available, which one may be better for your health, and which type you're using?

Let's start with the main types of coconut oil:

• Unrefined or Virgin: extracted from the fruit of fresh mature coconuts without using high temperatures or chemicals. Unrefined coconut oil has phenolic compounds which have been associated with antioxidant and anti-inflammatory properties. It has a light, sweet-nutty coconut flavor and aroma and is ideal for baking or sautéing up to 350°F.
• Refined: made from dried coconut meat that’s often chemically bleached and deodorized. This oil is tasteless and can be used for baking or for medium-high heat sautéing, up to about 425°F.
• Partially Hydrogenated: further processed by manufacturers and often found in commercial baked goods. Hydrogenating the oil transforms some unsaturated fats to trans fats which can increase our LDL ("bad" cholesterol) and decrease HDL ("good" cholesterol). 

One small study looked at obese adults who were on a low calorie diet and were supplemented with 30mL coconut oil daily. Results showed decrease in waist circumference but no statistical change in weight or fat mass. In another observational study, participants with normal cholesterol levels who reported ~30mL intake of coconut oil daily showed increased HDL ("good") cholesterol, but also had an increased in LDL ("bad") cholesterol. Consumption of unsaturated vegetable oils such as olive or canola did not show a similar increase in LDL cholesterol when compared to coconut oil. High LDL has been linked to increased risks of heart disease, however this link is currently being re-analyzed by many in the medical community.

It has been suggested by some that the short and medium chain saturated fats in coconut oil may have health benefits because they can be metabolized quickly, used for energy rapidly, and may play a role in immune function/ infections/ viral conditions. At this time, there is insufficient evidence to support weather or not these health claims are true. Additionally, it is unclear if the lauric acid in coconut oil which raises HDL results in a cardiovascular protective effect or if the raised LDL is harmful to our hearts.

Overall, small amounts of unrefined coconut oil could be part of a healthy diet. It is important to remember that it's rarely just one thing that "causes heart diseases" or rarely do we find a magical oil or pill that cures all that ails us. It's about your lifestyle, your fiber intake, your activity levels, your mood, your sleep and many other things that work together to decrease or increase our risks of heart disease!

Information Sources:
http://www.eatright.org/Public/content.aspx?id=6442477202
http://www.eatrightontario.ca/en/Articles/Fat/I-ve-heard-that-coconut-oil-is-the-best-oil-to-use.aspx#.U7NUX_ldV-h
http://www.ncbi.nlm.nih.gov/pubmed/23674795
http://www.healthcastle.com/nutrition-faceoff-coconut-oil-vs-olive-oil
http://advances.nutrition.org/content/4/3/294.long
http://www.pennutrition.com.ezproxy.library.ubc.ca/KnowledgePathway.aspx?kpid=2878&pqcatid=146&pqid=2946

Snack Attack: 10 Satisfying Snack Ideas You've Got to Try!

Are you skipping meals? No time to eat in the day so you end up snacking or over-eating at night? The best way to prevent over-eating or unhealthy/ uncontrollable snacking at night is to eat at regular intervals throughout the day. If you don't have time to prepare a lunch, why not take some of these fiber and protein packed snacks that won't leave you searching for more food an hour later. Be sure to add these ingredients onto your next grocery list so that you're refrigerator is well stocked!

• Apple, nut butter sandwich. Sprinkle with pumpkin or sunflower seeds for added crunch. If you have a sweet tooth, add raisins, cranberries and cinnamon
• 3/4 cup of plain greek yogurt and frozen berries. Top with your favorite high fiber granola or cereal (4 grams fiber or more per serving) or nuts
• 3-4 Ryita crackers with almond or peanut butter. Add sliced banana, chia or hemp seeds for more flavor and crunch 
• Cherry tomatoes, snap peas, & bell peppers dipped into 2 heaping tablespoons of hummus or home made greek yogurt tzatziki
• Home-made trail mix: 1/4 cup unsalted nuts, 1 tbsp pumpkin seeds, mixed with 1/4 cup dried fruit (e.g. apricots, dried cranberries, cherries, raisins). You can even prepare larger quantities and divide into small bags or containers for the week.
• 1/4 Cup unsalted nuts like almonds, walnuts, or pistachios with your favorite fruit 
• Smoothie with banana, frozen fruit, plain greek yogurt, & 1% or skim milk, water, or 1/4 cup juice. For more fiber and antioxidants blend in a handful of kale or spinach. For more protein and healthy unsaturated fats, blend in a closed handful of nuts, or 1 tbsp of chia, flax, or hemp seeds 
• 4 Ryvita crackers or a whole wheat wrap with salmon, tuna, or egg salad 
• 1/4 Cup cottage cheese with fruit such as orange slices or vegetables like celery 
• 1 Whole wheat pita with mashed pinto or black beans, guacamole and/ or hummus
  
  There you have it, my top 10, protein and fiber filled, dietitian approved snacks that promise to keep your belly full and hopefully limit cravings and over-eating later in the day. Happy snacking!

What About MSG?

Have you ever thought "what is the deal with MSG?" Many of my patients, colleagues and even I try choose foods without MSG, but do you know why you're avoiding it and what it is? If you're a curious soul like me, read on to get some facts about MSG.

Monosodium glutamate is a salt formed from the amino acid glutamate, sodium, and water. It originally was extracted from seaweed kelp by Japanese chemist Ikeda Kikunae.  It is used in our food industry to enhance natural flavors and is often found in soups, crackers, potato chips, casseroles, meat, seafood, prepared pastas, Chinese food, broths, spices/ seasonings, gravy and sauce mixes. Glutamate is used in our bodies to make protein and also naturally occurs in dairy, meats, tomatoes, mushrooms, potatoes, grapes, peas, corn, and cheeses such as Parmesan and Roquefort.

The FDA states that MSG is “generally recognized as safe” (GRAS). However, some people identify themselves as sensitive to MSG and report symptoms of headache/ migraine, facial pressure, burning/ tingling, nausea, flushing, chest pain/ palpitations that appear ~20 minutes after consumption and resolve within 2 hours. If this reaction consistently occurs after MSG ingestion, the best treatment is to read ingredient labels and avoid MSG.

A study conducted in 2008 on 752 healthy Chinese participants looked at MSG intake and body mass index (BMI). The population was from rural China and 82% of participants used MSG powder as seasoning in their cooking. Participants were asked to shake out the amount of MSG they added to their daily cooking onto a scale; weighed amounts were recorded. MSG in soy sauce and restaurant foods were also accounted for. Results showed that those who used greater MSG had higher BMI and were more likely to be overweight than non-MSG users.
A 2014 study that looked at specific DIAR newborn mice who were treated with MSG and without. The BMI and blood sugar levels of MSG treated mice was found to be higher. The MSG mice also showed cholesterol accumulation in the liver. However it is important to remember that injecting MSG into neonatal mice is different than a human consuming small amounts of MSG orally within the food supply.

Alternatively, a 2010 study looked at 1282 participants; MSG intake and body weight were assessed in 2002 and then in 2007. When other food items and dietary patterns were accounted for within statistical analysis, no association between MSG and weight gain was found in the study.

Due to conflicting evidence, it is still difficult to clearly determine if MSG leads to weight gain, liver toxicity, increased blood sugar and/ or allergic reactions. A simplified question to ask could be does the use of flavor enhancers lead to more frequent over-eating in our population? If so, how does this affects our choices, health, blood sugar, cholesterol, and weight?

Information Sources:
http://www.hc-sc.gc.ca/fn-an/securit/addit/msg_qa-qr-eng.php
http://www.eatrightontario.ca/en/Articles/Food-allergies-intolerances/The-Truth-about-MSG.aspx#.U4OxP_ldV-g
http://www.fda.gov/food/ingredientspackaginglabeling/foodadditivesingredients/ucm328728.htm
http://www.healthcastle.com/msg.shtml
http://www-ncbi-nlm-nih-gov.ezproxy.library.ubc.ca/pubmed/?term=intermap+study+monosodium+glutamate
http://www-ncbi-nlm-nih-gov.ezproxy.library.ubc.ca/pubmed/20370941
http://www-ncbi-nlm-nih-gov.ezproxy.library.ubc.ca/pubmed/24730643

Green Tea Extract for Weight Loss? Let's Get Some Facts!

Another recent weight loss regime I've been asked about are green tea extract pills. Widely known as a protective antioxidant, over the last few years it has been suggested that green tea (from the Camellia sinensis plant) contains polyphenols called catechins which may play a role in promoting weight loss, decreasing LDL or "bad" cholesterol, preventing inflammation, and preventing heart disease.

In a 2010 study that lasted 8 weeks, 35 obese participants were divided into 3 groups: those who drank 4 cups water/day, those who drank 4 cups green tea/day and those who took 2 capsules of green tea extract daily. Patients who drank green tea or supplemented with green tea extract showed greater weight loss than the group who had water only. Additionally, a 2005 study with Japanese participants who drank oolong tea high in catechins (from green tea extract) showed reduced weight and body fat after 12 weeks when compared to those who drank tea low in catechins. Adversely, a 2014 study which assessed the affect of a weight loss beverage containing green tea extract showed no benefit or additional weight loss in participants who drank the beverage. This study found that participants who were involved in an online 12 week behavior modification course experienced greater weight loss results. The 2013 study by Liu et al., combined the data of 17 studies and found that green tea could reduce fasting blood glucose and hemoglobin A1C levels (average blood glucose over a 3 month span), which may have implications in diabetes management. However it is unclear if these results were related to green tea or green tea extract, which populations would most benefit from the intervention, and what dose would be most effective. It is additionally important to note that some studies have linked supplements containing green tea extract to incidents of hepatotoxicity (toxicity to the liver); These concentrated supplements have not been proven to be safe.

If you're still interested in trying this idea out, I'd recommend the safest source of catechins in their diluted form of a warm, soothing cup of green tea! Don't forget that your daily food choices, activities, family/ friends, and healthcare team can always be utilized to support your weight management goals.

Information Sources:
http://www.ncbi.nlm.nih.gov/pubmed/18691042
http://www.ncbi.nlm.nih.gov/pubmed/20595643
http://ajcn.nutrition.org/content/81/1/122.full
http://www.ncbi.nlm.nih.gov/pubmed/23920353
http://www.ncbi.nlm.nih.gov/pubmed/23803878
http://www.ncbi.nlm.nih.gov/pubmed/23121117
http://www.nlm.nih.gov/medlineplus/druginfo/natural/960.html
http://www.eatright.org/Public/content.aspx?id=6442473527

Mindfulness, Breathing, & Increased Awareness. Could It Be For You?

Depression, stress, and anxiety are quite present in today's society and a range of first-world lifestyle factors may be contributing to their increased prevalence. Today I'm going to focus on two iPhone applications which may help you to relax when feeling anxious, stressed, or sad.

Stop, Breathe, and Think is an application created by a non-profit organization called Tools for Peace. The application asks you to select your mood or specific feelings you may be experiencing at that time and then gives you options of certain mindfulness meditation/ relaxation exercises which may help you feel calm and relaxed. Some sessions are as short as 3 minutes while others can be up to 8 minutes. The application also tracks your progress and how much time you have spent meditating.

Breath2Relax is an application created by the National Center for Telehealth and Technology and focusses on diaphragmatic breathing exercises. The length of inhalation and exhalation can be set by the user along with calming background music.

Both applications share information about mood and stress; Stop, Breathe and Think offers more variety, has attractive visuals and tracks mood and progress, while Breathe2Relax focuses solely on breathing and may be appealing for those who want to specifically set a length of time for their exercise and/or get great relief from deep breathing.

Interventions based on mindfulness and awareness have become increasingly popular. Mindfulness is a state of active, open attention on the present. When we are mindful, we are aware, attentive, and observe our thoughts and feelings from a distance without judgment. It has been associated with enhanced relaxation, attention regulation, emotion regulation, body awareness and cognitive re-evaluation. Multiple 2013 and 2014 studies suggests it may play a role in pain management, irritable bowel syndrome treatment, diminishing cravings, fatigue, and insomnia management (see links below for details). A 2013 study with 56 pre-hypertensive patients showed a greater improvement in participant blood pressure who underwent mindfulness-based stress reduction exercises over an 8 week period. While another small 2013 study showed diaphragmatic breathing and muscle relaxation to promote more weight loss in overweight, Greek women when compared to those who did not receive a stress-management program.

Overall, it is difficult to definitively link mindfulness, meditation, and diaphragmatic breathing to an entire list of positive outcomes since many of the studies conducted involve small groups of people. However, the results seen are often positive; so if you experience stress, anxiety, or mood issues, why not give yourself a few minutes to relax, breathe or become more aware?
Also, if you've used alternative applications that have helped you, I welcome you to please feel free to post in the comments below and share!

Information Sources
http://www.ncbi.nlm.nih.gov/pubmed/24719001
http://www.ncbi.nlm.nih.gov/pubmed/24461370
http://www.ncbi.nlm.nih.gov/pubmed/24239587
http://www.ncbi.nlm.nih.gov/pubmed/24127622
http://www.ncbi.nlm.nih.gov/pubmed/23627835

So You're Thinking About Oil Pulling..

Oil pulling is an Indian folk remedy that has been used traditionally to strengthen teeth, gums, and jaws and to prevent decay, oral malodor, bleeding gums and dryness of throat, and cracked lips. 1-2 teaspoons of sesame, olive, or coconut oil is placed in the mouth and swished around for 15-20 minutes, and then spit out. Some sources suggest that this removes toxins, plaque and bacteria from the oral cavity. A 2009 study involving 20 participants gave half of the participants a chlorhexidine mouthwash and the other half sesame oil. Results showed that both groups had a reduction in plaque and aerobic microorganisms in the mouth. Another 2011 in lab study (in vitro) suggested that sesame oil did not have antimicrobial affects but the process of oil pulling could lead to emulsification and saponification (process that produces soap) which could help clean the oral cavity. To date, most scientific studies involve few participants; positive results in 10 individuals don't necessarily predict what would happen in every person, therefore studies with larger participant numbers are needed.
The Cleaveland clinic suggests that oil pulling may be used as a mouthwash to maintain oral health but is not a replacement standard oral hygiene recommended by your dentist.
Currently there is no scientific evidence to prove that oil pulling improves or cures chronic diseases. However, it is likely a safe to use as a natural mouthwash as long as you're don't forget about that toothbrush and floss!

Information Sources:
http://www.ncbi.nlm.nih.gov/pubmed/21911944
http://www.ncbi.nlm.nih.gov/pubmed/19336860
http://www.ncbi.nlm.nih.gov/pubmed/21525674
http://health.clevelandclinic.org/2014/04/is-oil-pulling-your-best-choice-for-dental-health/

Fast Food? Get Some Fast NFACTS!

Fast-food fast NFACTS? Sounds like a tongue twister! The point of this post is to give you fast, easy access to the nutrition facts of common restaurants. In the previous post I encouraged you to take charge, find out what you are putting in your body and find out what is in the food you are eating. I've taken it a step further and made it even easier by providing links to common fast-food nutrition information. Take a look at the sodium or saturated fat content of that burger you eat every Friday, and maybe, consider trying a different, lower sodium, lower saturated fat, higher fiber or higher protein option next time? If you're ready to make positive health conscious changes, how would you know that you're making better choices without looking at the nutrition facts? You possibly wouldn't.. So click away, become informed, gain knowledge, and make choices based on what you learn.

• Arby's  www.arbys.ca/pdf/CanadaNutrition2010.pdf
• A&W  http://www.awrestaurants.com/A&W_Nutritional_Information.pdf
• Booster Juice  http://boosterjuice.com/products/menu
• Burger King  http://www.bk.com/en/us/menu-nutrition/index.html
• Dairy Queen  http://www.dairyqueen.com/us-en/Company/Nutrition/?localechange=1&
• Extreme Pita  http://www.extremepitast.ca/public/Nutritional%20Guide.html
• IHOP  http://www.ihop.com/-/media/ihop/PDFs/nutritionalinformation.ashx
• KFC  http://www.kfc.ca/en/assets/pdf/KFC11834_NutritionalChart_Eng.pdf
• Little Caesars  http://www.littlecaesars.ca/OurMenu/Info/Nutrition.aspx
• McDonalds  http://www1.mcdonalds.ca/NutritionCalculator/NutritionFactsEN.pdf
• Milestones  http://www.milestonesrestaurants.com/nutrition_selector.php
• Montana's  http://www.montanas.ca/pdf/nutritionals.pdf
• Olive Garden  http://www.olivegarden.com/Menu/Nutrition/
• Papa John's  http://order.papajohns.com/nutrition.html
• Pizza Hut  http://www.pizzahut.ca/Nutrition.aspx
• Red Robin  http://redrobincanada.com/home/nutritional-information.aspx
• Starbucks  http://www.starbucks.ca/menu/nutrition-info
• Subway  http://www.subway.com/nutrition/nutritionlist.aspx
• Swiss Chalet https://www.swisschalet.com/nutrition-allergies
• Taco Bell  http://www.tacobell.com/nutrition/information
• The Keg  http://www.kegsteakhouse.com/en/nutritional-charts/
• Tim Horton's  http://www.timhortons.com/ca/en/menu/menu-info.html
• Wendy's  http://www.wendys.ca/food/Nutrition.jsp

Fast Food, Convenience, & Our Developed World

Fast food... it's convenient, it's easy, it's everywhere around you. As soon as you leave your home or as soon as you get walking or driving to work, you'll surely be exposed to some sort of advertising for a fast food or restaurant meal. 2 for 1 lunches, buffets, 1/2 off Tuesdays, happy hour... Have you been so easily manipulated by this "money saving" or "value" meal that you've forgotten about the actual nutrition value of the meal? We all have likely have fallen for such marketing strategies, I know I've purchased at least 1 Groupon for a 50% off restaurant meal over the last month.

But do these companies care about your health? No, not necessarily. What they do care about is money, and how you spend yours. So my next question is who cares about your health? If they don't and you don't, what's happening to you body? Your blood pressure? Your heart? Your blood sugar? What is in the food you eat? Do you know? Do you ever ask? So again, if they don't care about your health, and you don't, who is taking responsibility of your health and your choices?

I encourage you to take control. Eat out and enjoy it, but know what is in your food. Ask the waitress how your meal is cooked, in what type of oil? What type of seasonings are used? How is the sauce prepared? Can you have your sauce on the side? Is there a whole wheat or whole grain option instead of a white flour based option? Is your coffee made with whole milk? Can you have skim milk? Ask for the nutrition facts. "The what" you say? The nutrition facts! Most fast food chains have paper copies of the nutrition information of their meals available and many restaurants also offer this information if you ask for it. This information is rarely voluntarily offered, so know that you can ask! Many restaurants and fast food chains also provide detailed nutrition information online; checking this out before you meet your friends for supper may decrease any social awkwardness you may feel if asking questions about your meal.

However, my next question is: why should we feel awkward about wanting to know more about our food? Did you know that most fast food meals have over 1000mg of sodium and 22% of restaurant meals have more than 2300mg of sodium; Between the ages of 9-50 years old, we only need 1500-2200mg per day. Long-term high sodium intake can increase risks of high blood pressure, chronic kidney disease, heart attack and stroke. In addition to high sodium, fast food is often high in saturated fat. This fat can increase our LDL or "bad" cholesterol and increase risks of heart attack and stroke. So I ask, is it worth not knowing what is in your food because it seems inconvenient or it may feel awkward asking a few questions?

The choice is always yours. I encourage you to empower, educate, and care for yourself. Ask questions, share the answers with your loved ones, and make positive choices for yourself and your family.


Information Sources:
http://journal.cpha.ca/index.php/cjph/article/view/3683

http://www.hc-sc.gc.ca/fn-an/nutrition/sodium/index-eng.php

Is Anxiety Getting In Your Way?

The goal for today's post is definitely not to open up a can of worms, seeing as we could discuss anxiety and its associated disorders for hours! Also, I'd like to be the first to clarify that I am no expert in counseling patients for anxiety disorders; I'm a registered dietitian, not a counselor, but I do deal with patients on a daily basis who are struggling with anxiety, stress and depression. With that in mind, I'd like to provide a brief outline of what anxiety is, symptoms associated with anxiety, and what methods can be successful in treating anxiety.

The Anxiety Disorder Association of Canada states that anxiety disorders are the most common mental health concern in Canada. They define anxiety as "when various symptoms of anxiety create significant distress and some degree of functional impairment in daily living. A person with an anxiety disorder may find it difficult to function in areas of life such as social interactions, family relationships, work or school."
It is important to understand that everyone experiences anxiety at times. Anxiety is our body's common response to real danger during a "fight or flight" situation e.g. roller-coaster ride; running into a bear while camping; the ability to jump out of the way of a moving vehicle; feeling nervous before an interview. When this response is activated in situations where there is no (or limited) actual danger and it gets in the way of everyday activities, this would be a red flag that you may need to seek help from your physician or counselor.
Common symptoms of anxiety include but are not limited to:

• Rapid heart beat; rapid breath
• Chest pain
• Light-headedness
• Headache/ Dizziness
• Muscle tension
• Dry mouth
• Upset stomach- nausea, diarrhea, gas, abdominal discomfort
• Cold and clammy palms
• Numbness or tingling sensation
• Insomnia; fatigue
• Difficulty concentrating or forgetfulness
• Irritability
• Fearfulness
• Self-consciousness
• Difficulty communicating

Anxiety disorders are commonly treated with evidenced based Cognitive Behavioural Therapy (CBT). CBT is a technique that promotes an awareness of how our thought process may contribute to anxiety and encourages a new way of thinking about your problems. It can be done with a therapist, independently, or in group settings. Medications can also be used in conjunction with CBT to help manage symptoms. Anxiety BC states that CBT is "one of the most effective treatments for anxiety and can also effectively treat depression, chronic pain, disordered eating, anger issues, addiction, and low self-esteem."
In addition to CBT, many studies suggest that meditation and relaxation techniques can reduce symptoms of anxiety. Calm breathing exercises involving long deep breaths in through the nose and out of the mouth can help control symptoms in addition to muscle relaxation exercises which involve tensing muscle groups and relaxing them periodically. I often ask my patients to come up with a list of 5-10 activities that bring them joy and relaxation; why don't you try this at home, put that list up somewhere you'll see it and try one of those activities the next time you feel anxious?
Many studies show that even a small amount of physical activity can improve mood and prevent depression. Other techniques may include stretching, listening to music, yoga, having a warm bath or shower, calling a friend, working on a puzzle, regularly getting 6.5-8.5 hours of sleep/night, writing in a journal to recognize thoughts that lead to anxiety, asking yourself if your thoughts are realistic or not and then challenge unrealistic thoughts objectively as if you were not part of the situation (or as if you were like a jury in a court case looking at both sides of a situation).

To learn more about anxiety, CBT, challenging your thoughts, relaxation, and videos check out Anxiety BC.
To learn more about relaxation exercises check out The University of Maryland, NHS Choices, explore online or on YouTube.

If you're struggling with anxiety, try to challenge unrealistic thoughts, find what relaxation techniques work for you and work with your healthcare team!

Information Sources:
http://www.anxietybc.com/
http://ajp.psychiatryonline.org/article.aspx?articleID=168746
http://www.anxietycanada.ca/english/index.php
http://www.ncbi.nlm.nih.gov/pubmed/24559833
http://www.anxietydisordersontario.ca/
http://www.ecentreclinic.org/Depression_Factsheet.pdf
http://umm.edu/programs/sleep/patients/relaxation
http://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/ways-relieve-stress.aspx
http://www.youtube.com/watch?v=EIJQsE8C5Is#aid=P9w4zsv1mvY

The Importance of Hydration

 

Some say 6 cups, other say 8, while others say 9 or 10! So what is all the fuss over water and how much do we need?

The human body is 60-70% water. Without water, humans can live for only a few days. It is important to replenish our fluids because fluid helps to:

• Flush toxins and waste through the body
• Protect and cushion joints and organs
• Carry oxygen and nutrients to the body's cells
• Control body temperature- in order to cool the body in hot climates and during physical activity, the body looses fluid from sweat. If the fluid lost in sweat is not replenished, the body may sweat less to conserve water; an increase in body temperature may then be seen along with electrolyte imbalances, decreased plasma volume which reduces the output of blood from the heart, and reduced blood flow to muscles.
• Regulate blood pressure, blood volume, heart rate. Without enough fluid, the volume of blood in the body can be low; the effects of this can be seen in low blood pressure when the position of the heart (or entire body) is changed. This orthostatic or postural hypotension could have symptoms of lightheadedness after standing, dizziness, instability, blurred vision, vertigo, and/or nausea, and can be prevented with adequate fluid intake.
• Protect the kidneys- when fluid supply in abundant, the kidneys function efficiently to clean the blood and rapidly eliminate waste and excess water. When fluid supply is inadequate, the kidneys must work harder to concentrate the urine; this process utilizes more energy and can wear down renal tissues.
• Prevent constipation when enough fluid and fiber are consumed.
• Possibly prevent headaches and/or migraines caused by intracranial dehydration
• Prevent the formation of stones in the bladder or urinary tract which can cause infections and reduce kidney function

Want to know if you're getting enough?
First check your urine; if it's dark yellow and you're not making much urine through the day, you may not be getting enough fluid flushing through your kidneys. The urine color you're aiming for is light yellow or clear.
Second, ask yourself if your mouth is dry or if you feel thirsty; if the answer to either of those is yes, you may not be drinking enough fluid. Some sources suggest that once you feel thirsty the body is already slightly dehydrated.
Finally, consider how you feel. If you're tired, irritable, feel light headed, have headaches or trouble focusing, it may be a sign you're dehydrated.

How much fluid each person requires is very individual. Anywhere between 6-10 cups/day could be enough for you, but looking at the other signs such as urine color, thirst and mood will help you determine if you're getting enough!

Information Sources:

http://www.dietitians.ca/Your-Health/Nutrition-A-Z/Water.aspx?categoryID=58

http://www.eatrightontario.ca/en/Articles/Water/Facts-on-Fluids---How-to-stay-hydrated#.UvwwcsHn_IU

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908954/
http://www.aafp.org/afp/2003/1215/p2393.html

Using Raspberry Ketones for Weight Loss? You May Want to Read This First!

As a registered dietitian, I understand that millions of people struggle with preventing weight gain and promoting weight loss. One of the newer proposed "magic" weight loss pills on the market is raspberry ketones. This product has been endorsed by Dr. Oz, however, even though Dr. Oz is an actual doctor, this doesn't mean that every claim made on his show is supported by strong evidence. On the positive end, I must admit that the famous MD does note that the product doesn't necessarily guarantee results in everyone and is not a replacement for a healthy lifestyle.
So now it's time I dig into the evidence behind this product so that you can make an educated and informed decision about your health. Raspberry ketones are an aromatic compound that comes from red raspberries. It has been suggested that raspberry ketones can alter lipid/fat metabolism and increase lipid breakdown.
In one study conducted on rats, it was suggested that rats who were fed a high-fat diet and then given raspberry ketone did not show an increase in weight related to their diet, had decreased liver triacylglycerol (fat) content with supplementation (after liver fat had increased with high fat diet), and showed increased hormone-induced lipid breakdown in rat fat cells in the epididymis (male reproductive organ where sperm is stored). Another 2010 study completed on cells in a lab found that raspberry ketones increased lipolysis (fat break-down) and the secretion of adiponectin from fat cells. Adiponectin is a hormone secreted by adipocytes (fat cells) involved in the metabolism of lipids, glucose, and may have anti-inflammatory effects. Low levels of this hormone has been linked to obesity, insulin resistance, and heart disease in humans.
Up to this point, only one study including raspberry ketones has been conducted on humans. However, in this study the supplement included raspberry ketone with caffeine, capsaicin, garlic, ginger and Citrus aurantium; isolated raspberry ketone was not used. 45 obese participants completed 8 weeks of diet and exercise with a raspberry ketone containing supplement or placebo. The placebo group showed beneficial changes in body fat, however the supplemented group had greater loss of weight, fat mass, waist and hip girth, and increased lean body mass. It is important to note that since the supplement was a combination of ingredients, it is difficult to determine if effects seen were only related to raspberry ketone.
It is difficult to conclude that because studies in rats, fat cells in a lab, or in 45 humans show encouraging weight loss results, that the same results would be seen in every person. In addition, little is known about the safety of the long term use of this product in high doses. Some sources suggest it may interact with Coumadin (blood thinner), while other sources suggest that its structure is similar to a stimulant called synephrine which may not be safe for patients with high blood pressure or heart disease. Furthermore, the supplement may contain additional ingredients whose safety has not yet been determined.
At this point in time, as a health-care provider I cannot encourage the use of this product until further research regarding it's effects in humans has been conducted. However, if you still choose to still give it a try, make sure to let your doctor, pharmacist and dietitian know to ensure that you're making a safe decision, and recall that your food choices and physical activity can always support your journey!

Information Sources:
http://www.ncbi.nlm.nih.gov/pubmed/20425690
http://www.sciencedirect.com/science/article/pii/S0024320505001281
http://www.todaysdietitian.com/newarchives/090112p80.shtml
http://www.doctoroz.com/videos/miracle-fat-burner-bottle
http://www.ncbi.nlm.nih.gov/pubmed/23601452
http://www.webmd.com/vitamins-supplements/ingredientmono-1262-RASPBERRY%20KETONE.aspx?activeIngredientId=1262&activeIngredientName=RASPBERRY%20KETONE