Tuesday, February 25, 2014

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

Wednesday, February 12, 2014

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:

Monday, February 3, 2014

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