Getting enough protein as a vegetarian or vegan

This video talks about how vegetarians and vegans can get enough protein and be at their best.

• 0:00 Intro

• 0:21 How much protein do I need? (here’s a link to the Huberman Lab podcast referenced)

• 1:39 Challenges with getting enough protein

• 4:43 Sources of protein

• 6:37 Protein powders

• 7:10 Sample menu

• 8:22 Glucose curves with different types of food

• 9:16 Continuous Glucose Monitors as a tool

We're working on creating short educational videos this year and would love your feedback and topic suggestions!

Continuous Glucose Monitors and Mood

This video talks about how glucose levels impact mood, focus, and fatigue - and shows an example of what hypoglycemia looks like on a continuous glucose monitor. Learn more at KristenAllott.com

We're working on short videos this year and would love your feedback and suggestions for topics!

My New Favorite Book to Increase Anxiety Tolerance: “Breath” by James Nestor

I am so excited about a new book, Breath: The New Science of a Lost Art, by James Nestor.

Ok, I will admit that I am a little late to the party for the importance of breathing. Not that I was against breathing. I enjoy doing it every 5 to 10 seconds, but it has never been a therapy that I emphasize.

I’ve seen two challenges with breathing practices:

1. In the past, it has always been presented as either a mindfulness practice or an ecstatic practice. In these trainings, no one explained how to breathe in general.

2. When I explained to breathing practitioners that breathing practices increased anxiety in my patients with histories of trauma, no one had an explanation and they recommended that my patients ‘just hang in there'. 

The challenge that people with complex trauma share is that focusing on slowing or controlling their breathing can create more anxiety, and then they feel like they are "failing" at breathing. Instead of a breathing practice,

Instead, I often have my patients name 3-5 colors that they can see around them. This allows the prefrontal cortex and the visual cortex to sit on the amygdala and slow the inner dialog, effectively lowering their anxiety. I thought that naming colors was the same neurological idea of breathing - just a different modality. Plus, I like being able to explain the neurophysiology: vision is at least 30% of our brain.

As a student of psychophysiology, I keep lists of physiology that cause mental health symptoms. When thinking about what can create the physical sensation of fear, independent from present or past emotional causes, I think about:

1. The amygdala being activated by the adrenaline released when the body needs to increase glucose, such as in hypoglycemia.

2. Nutrient deficiencies, such as protein, iron, and B vitamins. 

3. The Vegas Nerve being mechanical pinched at the first and second cervical vertebrae (See Stanley Rosenburg's Book: Accessing the Healing Power of the Vagus Nerve: Self-Help Exercises for Anxiety, Depression, Trauma, and Autism.)

Now, I have a fourth item on my list: Carbon dioxide intolerance caused by survival breathing. 

After reading Breath, I now think very differently about breathing as a tool for healing anxiety. James discusses how people can develop a narrow window of tolerance to carbon dioxide. He shares an example where a woman had no functional amygdala – so no fear responses to spiders, snakes, dangerous people... However, when she inhaled an air mixture with an increased carbon dioxide content, she had a full blow panic attack, and would NOT repeat the experiment.

What I had not appreciated, until reading this book, is that we have chemoreceptors in our brain and in our arteries that are monitoring for carbon dioxide and pH. As carbon dioxide builds up in our bloodstream, it triggers anxiety – sometimes high enough to create a full-blown panic attack.

But, if we don't have enough carbon dioxide in our systems, we can't properly oxygenate our bodies. With breathing patterns that keep carbon dioxide low, our tissues (muscles, digestive system, and brain) suffer from low oxygen states. We can develop fatigue, insomnia, sleep apnea, hypertension, cardiovascular disease, depression, anxiety, inflammation, auto-immune disease and have a weakened immune system. To be physically and mentally healthy, we need to have a range of carbon dioxide that we can tolerate. Studies indicate that people with anxiety have a very narrow range of carbon dioxide levels that they can handle (see links below). 

When we breathe through our mouths, we bring 20% less oxygen into our lungs. Breathing through our noses prepares the oxygen to be absorbed by the lungs into the red blood cells by removing bacteria, viruses, and particulates, increasing the humidity, and slowing the velocity of the molecules so that they can be absorbed into the capillaries carrying the red blood cells.

We need carbon dioxide present in the capillaries of the lungs so that it can exchange places with the oxygen in red blood cells. When we are intolerant of variations in carbon dioxide levels, we tend to breathe through our mouths. This lowers the carbon dioxide levels in our lungs and thereby lowers our oxygen absorption capacity. When we have lower oxygen levels in our bodies, we increase our bodies' stress, which increases our stress-related diseases. 

However, what I was seeing when my patients focused on slowing their breathing was the impact of the increased levels carbon dioxide in their bloodstreams, causing an increased physical sense of anxiety (anxiety not caused by what is externally around them).

Now that I understand the physiological mechanism through which carbon dioxide can increase anxiety, I can more closely screen patients for behaviors that indicate that they may be avoiding the sensation anxiety created by carbon dioxide intolerance. These include: 

• Mouth breathing, while awake or while sleeping

• Poor forward posture, often created by sitting in front of the computer

• Hyperventilation (respiratory rates greater than 10 breaths per minute)

For the people with complex trauma, who often refuse to consider breathing techniques for their anxiety, I now start by explaining that they are not failing at breathing, but rather that they need to develop a slightly larger range of carbon dioxide tolerance. And that when they can tolerate more carbon dioxide, more oxygen will be available to their body, which will help them have more energy and mental clarity. Their brains will begin to wire in that higher levels of carbon dioxide is safe. 

You might be wondering why we, as a species, are so hyper-vigilant to carbon dioxide when it’s so helpful in oxygenating our bodies. The carbon dioxide receptor is one of the oldest receptors found in most life forms. The earliest life forms on the planet were more concerned about getting into a space that was low in oxygen and high in carbon dioxide. This was a safety mechanism to stay alive, which was helpful in the past but not so helpful in our modern life.

Here are the steps that I am using to work with my patients around carbon dioxide intolerance;

1. Ask them to observe if they breathe through their mouths or noses. Times to observe are at work (particularly when working on a keyboard), watching screens, sleeping, and working out.

2. Ask them to focus on lightly closing their mouths when they can. This mindfulness practice will help them be aware of how they breath. When doing this, the patient might notice that they naturally breathe more deeply, using their whole rib cage. Suggesting that they place one hand on their chest and one hand on their belly is another way to help them see what muscles create their inhalation and exhalation. They might notice that they yawn more. I encourage focusing on their breath for at least 3 days, paying attention to what happens to their levels of energy and mental clarity. If they get anxious, they can breathe through their mouths for a time and then go back to breathing through their nose. 

3. Even if they have a stuffy nose, still encourage them to try breathing through their noses. James Nestor, who suffered from allergies, a deviated septum, and often developed pneumonia, found that learning to breath through his nose actually improved these symptoms.

4. Ask if they are willing to lightly tape their mouths shut while sleeping, using a small piece of medical tape or KT tape – about the size of a postage stamp. It’s still easy to open their mouths if they need to, but it’s enough to remind them to keep their mouths shut and to breath through their noses. This decreases snoring and mild sleep apnea, and increases the oxygenation of their tissues.

5. Ask them to try keeping their mouths shut when working out. This will likely be uncomfortable at first, but if they persevere it can increase performance, endurance and recovery.

6. Lastly, ask them to think of breathing as a moment-to-moment practice that can take a lifetime to truly appreciate.  

I hope this summary is helpful to you. Please feel free to email your questions. Your curiosity helps me learn to articulate the science in a usable fashion. Also feel free to share your own stories of breathing by commenting on this post below.

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Related references:

• Here a podcast interview with James Nestor, “How to Fix Your Breathing to Improve Your Health,” at Art of Manliness Podcast with Brett McKay #638 (46 minutes).

• I listened to Breath on Audible. It was a fun book to listen with lots of stories and listening always make the science easier to hear for me. 

• Scientific Papers:

  • “Panic Attacks as a Problem of pH” by By Richard Maddock, May 18, 2010 in Scientific American

  • “The physiological effects of slow breathing in the healthy human”. by MA Russo, Santarelli DM, and O'Rourke D. in Breathe (Sheff). 2017;13(4):298-309.

Lizard Brain Treats Help You Feel Better Quickly!

A Lizard Brain Treat is a key intervention to help you feel better now.

When you’re feeling on the edge and having a hard time with acute anxiety and worry, it’s hard to remember what you can do in the moment to help yourself.

If you are experiencing any of the below, try a Lizard Brain Treat! Even though you may not feel hungry, fueling your brain will help you reduce your anxiety and symptoms.

1. Are you having a panic attack?

2. Are you uncomfortably anxious or irritated?

3. Are you waking at 3am in the morning, with your mind racing?

4. Are you overly or underly emotional for the situation?

5. Have you not eaten for more than 3 hours?

6. Do you want to feel better in 10-15 minutes?

Lizard Brain Treats

A Lizard Brain Treat is a snack of sugar (a quick fuel) and protein (a longer lasting fuel). You want the quick fuel to get to your brain almost immediately, which will start to reduce the adrenalin causing you to be in your reactive lizard brain. Following this with protein extends the amount of time you’re in your responsive cortex brain, before needing to re-fuel. Choose one quick fuel and one protein from the lists below – or from your favorite foods.

Ideas for Quick Fuels:

• ¼ cup of juice

• 1 piece of hard candy

• ¼ cup of soda

• Honey stick

• 1 tbl of jelly

Ideas for Protein:

• ¼ cup of nuts

• ¼ cup of nuts

• A stick of jerky

• ¼ cup of cottage cheese

• 2 tbl of peanut (or other nut) butter

Combined sources work too (as long as they aren’t sugar-free)!

• ½ cup of a protein shake

• Protein bar

• ½ a PB&J sandwich

Generally speaking, your anxiety will drop by 10-20% within 10-15 minutes.

Download this information as a handout and post it on your fridge or keep it near your desk.

Juice for Anxiety?

A participant in a recent training sent me a follow up email with a question about the Lizard Brain Treat. She gave me permission to share it here.

Hey Kristen, 

 Hope you had a safe travel home.

Thanks again for a great conference!  I have been getting more protein into myself this weekend and am feeling less irritable with my 4 yo daughter, so already showing benefits for the every 3 hour protein plan!  I also walked the half mile to work today vs driving! You have inspired me so much!

I was sharing some the info with my Mental Health colleagues today and they said “juice”? That has way too much sugar, what about fruit and nuts?  I said “Hmmmm, I’m not sure”, and had to look it up. I saw that you recommended just a ¼ cup juice, not a whole bottle…for lizard brain symptoms.  I also have a colleague who has diabetes, and he said, “I can’t have juice, no diabetic should have any juice.”  What words of wisdom do you have for that question?

Sincerely, Molly

Molly -

Thanks for doing the experiments. 

If people object to juice, they don’t have to use juice. I just find it effective in shifting a person’s mood immediately when they have lizard brain symptoms, such as anxiety, irritation, agitation, or early morning waking for 2 hours.

A ¼ cup of juice is not a lot of sugar. Remember, it is not just juice. We are also adding nuts or a protein source, since the juice will be burned quickly. 

I did a quick search:

·      Apple juice has 28 total carbohydrates in one cup, so ¼ cup has 7 grams of total carbohydrates

·      Granulated white sugar for 1 teaspoon is 4.2 grams of total carbohydrates. 

·      Dried cranberries have 26 grams of total carbohydrates in 1/3 cup. 

Note that dried fruit takes longer for the glucose to get to the brain since the sugar has to be released from the fiber.

Some people don’t have the control to drink only a ¼ cup of juice and will drink a full cup or more. This can be a problem. Additionally, sometimes when people are watching their carbohydrates, as with diabetes, it’s easier to eliminate this food category altogether.

I tell people who are opposed to juice and are anxious/irritable/early morning waking to try the juice to see if it works. If it works and helps them regain emotional balance or go back to sleep, then we work to find a food that will have an equivalent response. It is different for each person. Here are some of the solutions that have worked: dried cranberries, carrots, honey sticks, 1-2 large smarties.

The Smarties candy is an interesting one. It’s made of dextrose which converts quickly into glucose. The large ones are about the size of a penny.

My goal for the juice is to quickly get some glucose to the brain to turn off the adrenalin that is firing up the lizard brain. Here are some common scenarios where I find ¼ cup of juice (or equivalent) effective.

• Slowing down anxiety and panic attacks

• Irritable teenager who is frustrated

• Waking in the early morning with thoughts racing

• Not hungry in the morning at waking

• Really groggy in the morning at waking

Hopefully that is helpful. Kristen

Fuel for Thoughts: Panic Attacks in High Functioning People

Have you ever known someone who seemly had it all together? And then, she or he seemed to spiral downward with anxiety and depression, even though it seemed out of character. Brad Stulburg, a published author on productivity and performance, recently published an article on his experience with anxiety and panic attacks. I have been following his blog lately because he encourages mindfulness, sleep, and exercise for executives. His anxiety and panic attacks are completely new phenomena to him. He writes candidly about the impact this had on his life and his advice toward the path out.

I was intrigued when Brad shared about the day of his first panic attack: his hadn’t fed his body well during the day, and after exercise he had an alcoholic drink and snacked on potatoes chips. We’ve all done it. You meet some friends at a bar for a drink after a long day and there is no real food available. This combination set up the event of his hypoglycemia (low blood glucose for the brain) and - in my opinion - a shot of adrenaline that was at a survival dose rather than risk taking/excitement dose.

This combination made his amygdala (the reactive/lizard part of the brain) hyper-sensitized to adrenalin. Emotionally, there was no good story about why his adrenalin hit was so high – no attack, no accident. So his brain is trying to find an emotional meaning for the event, when perhaps it was his physiology that was the driver of the adrenaline.

Exercise + refined carbs + alcohol + normal aging process = big release in insulin + sharp drop in glucose + big release in adrenaline = Anxiety and Panic attacks. 

This day of poor self-care set in motion his reactive brain trying to be in charge of his mind, and he has been working hard ever since to regain and maintain his mental health. This can happen to anyone. His example illustrates the importance of nutrition for taking care of one's body to maintain a stable brain and mind. His courage to share his experience helps us all know that we can return to health.

Question: How can we create food safety nets for ourselves and others? Can we keep protein bars or nuts in our bags? Or throw a box of protein bars into the truck of our teenager? Can we ask to meet at bars that have food? 

Share your thoughts by commenting below.

Preventing CEO Burnout

John, the CEO of a mid-size family company, has been putting in 90-hour workweeks for 11 months.  Between the tight economy, an aggressive new competitor, and several family dramas, his taking a vacation now has been out of the question.  It is hard for John to get to sleep; it is even harder for him to stay asleep, and his brain turns off only after several cocktails before going to bed.  John knows that he can’t continue this pattern, but he doesn’t know how to stop, or frankly, what else to do.

One night recently, he woke up gasping for air.  John and his wife thought that he might be having a heart attack and frantically called 911.  As they waited for the ambulance’s arrival, several heavy thoughts registered in a back corner of John’s mind.  He was simultaneously afraid and relieved:  Afraid . . . This is it!  I’m going to die.  And yes, relieved:  Why, if I were to survive the heart attack, I might actually get a break!

At the ER, the medical team conducted blood tests and monitored his heart.  After several hours, the team informed John that he had experienced a panic attack.  He was given two prescriptions and encouraged to check in with his primary care physician as soon as possible. The first prescription was for four days worth of Clonazepam, a benzodiazepine that immediately quiets the brain, but is very addictive.  Also, the ER doctor prescribed Celexa, an antidepressant that aids in reducing anxiety.

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The experience stunned John.  “I’m not the sort of guy who has panic attacks!”  Then, dozens of other questions came:  What does this mean? . . .  Am I not cut out for this level of leadership? . . .  Am I failing and don’t know it? . . . How can I take care of the company and my family, if I am not a strong leader? . . .

After taking a couple of days off, “due to a family emergency,” John returned to work and to the stress that comes with being a man who has many people depending on him and great responsibilities.  Soon, getting access to another Clonazepam tablet became a daily matter for him - a disturbing and frightening concern because he has seen other family members struggle with addictions to prescription drugs.  He called his family physician whose only suggestion was to take time off.

On Tuesday, May 7, 2013. The Wall Street Journal published Leslie Kwoh’s article “When the CEO Burns Out.” She listed fatigue, resentment, and loneliness as causes for burnout.  She gave examples of well-known companies that have lost valuable leadership, when men and women took vacations and/or left to recover physically and mentally.   As remedies. she suggests time off and medications, as needed.

Wait a minute.  We can do better than that!  CEO and C-suite executives do not burn out.  Their brains and bodies do! These same brains and bodies begin to break down when they are exposed to chronic stress.  A common symptom of CEO breakdown caused by chronic stress is loss of a person’s ability to focus. 

In prudent organizations today, leaders understand that executive brains and their physical well-being are the most important assets of any venture.  Therefore, owners and boards of directors anticipate their organization’s needs; after all, they are used to essential scheduled maintenance on machines.  It’s required for all human assets too!

The idea is a sound one.  Therefore, it doesn’t take long for someone to ask: What should be included in an organization’s prevention plan for executive burnout?  At a minimum plans should include:

 1.    Instilling in your corporate culture the behaviors that increase the body’s ability to cope with stress.  These tenants are eight hours of sleep, 30 minutes of exercise daily, and at least three meals with protein and vegetables per day. 

 2.   Insisting on time away:  Our brains function better when we take time away from complexity and sameness.  Rest, relaxation, and discontinuous time and activities produce fresh perspectives - essential in thinking strategically.

 3.  Scheduling annual physical examinations with primary care physicians for C-suite executives.  Metrics of high blood pressure, high cholesterol, and weight gain are symptoms of a body not handling stress well.

Rather than being surprised and in crisis when an executive must step out or step down, which is extremely costly, why not create a preventive maintenance plan for key executives in your organization?