Am I too old to get in shape?

No, it’s possible to improve your physical stamina, strength and balance well into your 90s!

No one ever believes this information in part because we have a biases about what’s possible and we don’t know many fit 90 year-olds. I want to share with you some examples.

• Edith Murway-Traina is 99 years old and can dead lift 150 pounds and holds the Guinness World Record for her age group. She started weight lifting at 91 – apparently, your never to young to start!

• George Corones of Australia swam 50 meter in 56 minutes and 12 seconds when he was 99 years old.

• Mary Davison, at 77 years of age, has completed Appalachian, Continental Divide, and Pacific Crest trails, and is now adding the 6,800-mile American Discovery Trail.

99-year-old power lifter Edith Murway lifts 150 pounds & earns Guinness World Record

I tell people all the time that after the age of 40, we all need to start investing in maintaining our muscle mass, balance, endurance, and metabolic fitness. When we maintain our bodies, we maintain our brains.

The key is finding something you enjoy & want to pursue.

If you’re a bit out of shape, I generally recommend starting with power ups:

1. Find 3-5 movement practices you can do easily at home.  You can start this today. I chose some videos from Physical Therapist Dr. Jo because I think she has some great safe exercises. You can explore her Youtube channel to find guides for:

• Chair squats

• Core

• Foot alphabets

• Balance

• Stretching

Since my motor vehicle accident in 2014, I have been using the Power-Up system to heal. I find five to ten minutes throughout the day to do 2-4 sets of an exercise that I’ve decided to work on or that a physical therapist has assigned. If I find additional time slot, I do the exercise again or a different one.

2. The next step is to start building your walking endurance. I find that when people are averaging 5000 steps per day they start feeling better in their brains and bodies. When this becomes a continuous practice, many people report feeling worse if they miss a day of movement. (But this, on its own, isn’t going to maintain your body systems of muscle, balance, and metabolic resilience.) 

3. What to do if you don’t want to do these or they seem too boring to do? I suggest using post-it notes to list all the ways you could possibly move your body, and then put them on a wall. Do this for a month. Every time you hear of someone doing something interesting or learn of a new possibility in your area, write it down on a post-it and leave it on the wall. You’re just collecting ideas in this step, and letting them stew.

After some time has gone by. Choose three that you might try at lease 3 to 5 times per day. Our brains tend to reject new things, so we have to do them a few times before we can decide “yes” or “no”.

Remember – it’s not what you’re doing this week or this month. It’s that you are creating the start of a program that will maintain or improve your energy & mental clarity this year.

If you’re having problems getting started or have injuries, I suggest finding a physical therapist to work with. I used to get stuck in the cycle of signing up for fitness classes and then avoiding them because I was either not fit enough to do them or I would get minor injuries that would take a week to heal. Then I started working with a physical therapist, who I told my goal was to be able to do 10 pushups, 10 squats and a 30 second plank. He assessed my deficits and is helping me build the muscles to be able to do that. It’s a realistic and healthy goal for my current fitness level.

What is realistic & healthy for your current fitness level?

It’s better to start where you’re AT then where you want to be.

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Check out these two related articles and studies:

(1) EatingWell recently posted an article about the benefits of Micro Workouts, or what they call “Exercise Snacks” and we call Power-Ups. These include activities that are challenging enough to jack up your heart rate, but only for a minute or less at a time—such as 20 seconds of squat jumps, stair climbing, burpees or a fast 60-second run down your block.

“Increasing your cardiorespiratory fitness can lower your risk of type 2 diabetes and heart disease.” — Dr. Martin Gibala

Read the full article here.

(2) The University Clinic for Psychiatry and Psychotherapy at Ruhr-Universität Bochum (RUB) at the Ostwestfalen-Lippe campus recently published a study (9 June 2021 in the journal Frontiers in Psychiatry) that shows the dual beneficial effect of physical activity in depression.

One of the key findings is that exercise – or movement – is an effective way to promote motivation and togetherness.

This study showed that the brain’s ability to change is lower in people with depression. Following the program with physical activity, this ability to change increased significantly. At the same time, depressive symptoms decreased in the group.  

Read the full article here.

Did you do MORE of something to get through COVID?

A lot had to stop to get through COVID: going to the office, hanging with friends, traveling to new cities, and going concerts, movies, restaurants... All of these activities are connected to dopamine, the neurotransmitter that lights up when we anticipate things in our future. Additionally, dopamine will drive us to seek MORE of that thing that is out of our reach so we can have it more consistently. When we stopped doing things outside our homes, we needed to fill that space with high dopamine activities within our homes.

Now that COVID is shifting to allow us to go back to some of our old activities, our brains may not want to give up our new activities that feel as comforting as a best friend. When it’s hard for me to change a behavior, an activity, or the use of substance, even though I think that I should, I name it as an addictive behavior held in place by a dopamine neuro-net that needs retrained. Coping with COVID-driven isolation has been the perfect set up for developing many formal and informal addictions. Perhaps you or someone you know has gotten caught in the dopamine pattern of “more” and “do it again” during COVID in a way that is now longer comfortable?

This could be alcohol or drugs, but it also could be more of other sticky behaviors such as:

• Eating more ice cream

• Watching more Netflix

• Scrolling more through political commentary

• Surfing more on Youtube

• Sleeping more than 9 hours a day

• Reading more books

• Connecting to people more in virtual games

• Reclining on the couch more

Again, none of these are bad in and of themselves – it’s when you begin to recognize that you’re no longer comfortable with the time, frequency or amount of whatever the behavior has become. Remember, when dopamine is driving behavior, it just wants more time, frequency or amount.

When we do a behavior over and over again, we create a neuro-net that demands that that the pattern continue. I often tell a story about how I watched People’s Court for four years at lunch time and when my TV died my brain wanted to go watch more People’s Court at my friend Taryn’s house at lunch. I knew that dopamine wanted MORE. Really, after four years I had seen every possible way people can have a disagreement. I personally didn’t care for more People’s Court, but may brain had decided that it was necessary to have more and was going to find a way to get it even if it meant breaking into my best friend’s home to watch TV. It was just a casual habit that now sought to control my behavior.

Is there something that you are doing MORE of, that may now be preventing you from moving forward in this new (post-COVID) era?

For me, my husband and I started playing a card game at night before bed, which helps us get off screens before going to bed (which helps my sleep). After 19 months of this game, my brain just wants to play more Star Realms. I have noticed that if we don’t play there is a little thought that we have to play in order to go to bed. This, of course, is not true; this is just dopamine wanting more. We’ve started looking for another game to play that is just as interesting, but I know that I’ll have to play it at least 5-7 times before my brain will accept it. Until then, my brain’s reaction is, “This is a dumb game, let’s play Star Realms”.

I’m also trying to be more social on weekend evenings. Both my husband and I spend a lot of time with people virtually. I’m making time to socialize with friends during the time that I previously dedicated to Star Realms when socializing was limited. I know from working with people who are in recovery for substance and process addictions that I will need at least 3 or 4 things to choose from to do in the evenings, to keep me from going back to Star Realms as my evening solution. So, in addition to meeting up with friends, I’m including options for myself to read a book, stretch, call a friend, or go for a walk in the summer late evenings. The key is that they not only have to be on my list of ideas, but that I have to DO them in the evenings.

Regardless of what your dopamine-driven behavior might be, is there something you want to diversify away from in order to create space for other activities that support what is really important to you?

If you would like to read about dopamine I would recommend Dopamine: The Molecule of More: How a Single Chemical in Your Brain Drives Love, Sex, and Creativity―and Will Determine the Fate of the Human Race by Daniel Z. Lieberman and Michael E. Long

If you want to change your behavior on something small or large. I would suggest staying in your responsive brain. Check out more of our resources related to addictions and recovery.

Suicidal Behaviors Linked to Steroid Treatments

The research study that I am highlighting this month is especially for mental health professionals who follow my newsletters.  It may explain in part why your patients may do very well and then suddenly they are more depressed or suicidal.  The summary, which follows, discusses how glucocorticoid (steroid) therapy can increase depression and suicidal ideation in your clients.

Most commonly, I have seen Prednisone prescribed for bronchitis or asthma.  Sometimes steroids are also used for acute flare-ups of autoimmune diseases such as MS.  Although the research did not specifically look at local injections of steroids for joint pain, I have seen a few patients in my office struggling with depression and the deepening of the depression within the three-month window of steroid injection(s) for knee pain.

Let me state again: I am not against the use of medications.  I simply want people to know that they may experience depression or suicidal behaviors as a side effect of this medication.  If they wait it out, those side effects will go away.

In a United Kingdom study over a period of 18 years, researchers assessed 372,000 adult patients who received prescriptions for oral glucocorticoid compared with those patients who did not receive such prescriptions.  This is the largest study to date examining the effects of glucocorticoid treatment on adverse neuropsychiatric outcomes.

Simply put: Glucocorticoids increase the risk of suicidal behavior and neuropsychiatric disorders.

Authors Fardet, Petersen, and Nazareth reported “finding a high incidence of neuropsychiatric adverse events in the first 3 months of treatment with glucocorticoids.  Over all, the incidence was 15.7 per 100 person-years at risk.  For patients on their first course of glucocorticoids, it was 22.2 per 100 person-years at risk.  Older men were at higher risk of delirium, confusion, disorientation, and mania, while younger patients were at higher risk of suicide or suicide attempt.  Patients with previous histories of neuropsychiatric disorders and those treated with higher dosages of glucocorticoids were at greater risk for neuropsychiatric outcomes.”

These research findings should give us all pause.  Physicians must exercise caution in administering these drugs.  All of us have monitoring responsibilities.  Information and education for patients and their families are very important in order to eliminate, as much as is possible, adverse reactions and misinterpretations of side effects.

Get Rid of Icky-Fishy smelling Omega 3 Pills

Most people have heard that fish oil is “good for you”. Yes, it does help with depression, bipolar, ADHD, cardiovascular disease, diabetes, obesity, and dementia. This appears to be scientifically true.  It is so good for us that the company GlaxoSmithKline has convinced the FDA to approve an omega 3 medication called Lovaza for treating high cholesterol, triglycerides, cardiovascular disease, and diabetes.

My concern about omega-3 products centers on the fact that not all fish oils are created equal.  What accounts for the differences?  In a word, it is QUALITY.

Many of my patients come to my office already taking a fish oil product that they picked up at their favorite discount grocery or supplement store.  I can see medically, it is not working.  I ask my new patient: “Have any of the following improved with the use of the omega 3 you are now taking: skin dryness, joint discomfort, mental clarity?  Have your triglyceride scores decreased?  (Healthy scores are below 80.)  Have your HDL scores increased? (Good cholesterol ranges are 50-60.)  Almost always, the answer is “No”.

When I switch the patient over to what I consider a quality omega 3 product and that product is kept in the refrigerator or freezer as I have instructed, my patient’s over all-skin condition, as well as moods, improve.  In addition, after four months, their cholesterol panel scores are in healthier ranges.  Allow me to get a bit more specific in those areas of change for the better.  By “improved,” I mean: Skin is less dry and certainly more supple with fewer breakouts or acne.  Patients’ moods appear more positive, less depressed, and irritated; wide bipolar mood swings are more stable.  The cholesterol panel numbers are moving in a promising direction.

The two products that I ask my patients to use are made either by Nordic Naturals or Carlson.  I suggest they follow the dosage recommended on the bottle.  Both companies are easy to find nationally, and both test for mercury and pesticides.  However, what is important to me is that neither of these companies sells rancid fish oils.  Most other companies can produce very fishy-smelling and tasting omega-3 fish oils.  Both are earmarks of rancidity.  Rancidity is toxic for human bodies and brains, too.

Nordic Naturals and Carlson produce many fish oil products; I recommend that my clients get a basic one and be consistent about the repeated purchasing and taking of the same product.  Although these two companies cannot claim they produce the cheapest omega 3 on the market, they can make a case for the fact that their products are well worth the prices for uniform freshness, pleasant tastes, and less rancidity.

Occasionally, I do not recommend that a patient take fish oil.  In cases where the person is on a blood thinner, bruises easily, and/or his or her HDL (good cholesterol) score is above 60, I find not taking an omega 3 more appropriate.

Why waste time, money, and your health in the short and long run on fishy smelling, tasting and often burp-producing fish oil pills?  Now, you have a choice.

Friends Don't Let Friends Drink Diet Sodas

Yes, my title is a take off on an old driving while under the influence of alcohol campaign.  Nonetheless, it just may be an appropriate warning for friends of diet soda drinkers.

Medical researchers in three studies, referenced below, are raising some interesting as well as disturbing findings regarding popular diet sodas.  Findings that struck me as significant include the following:

Drinking at least one diet soda daily increases your risks

• of obesity by 36%;

• of cardiovascular events by 61%;

• of type 2 diabetes by 67%.

Drinking two diet sodas a day increases the likelihood of reduced kidney functions.

Diet soda studies to date have been based on “observational data and have not focused on establishing causality”.  But that doesn’t mean we should dismiss their findings.  Matter of fact, I believe these three articles are calling loudly: “Pay attention!”

• Diet soda and kidney disease

• Diet soda and cardiovascular events

• Diet soda and diabetes and obesity

Tips for Easing Off the Diet Soda Habit:

• If you do drink diet sodas, first take note of why.  Many people do it for the caffeine, “the mouth entertainment”, to break the boredom in meetings, to have something to do with their hands.

• Try taking 2 weeks off.  You may need to replace it with sparking water or green tea. Then, notice how you feel.  Ask yourself questions such as Did the headaches go away?  Is there less muscle skeletal pain?  Have food cravings lessened?

Like breaking all habits, your commitment is key.  Reread those bold facts above and remind yourself that your decision is one based on your vision of a happily healthy you.  Good luck!

Once Upon a Time There Was a Whirlwind Named Jane . . .

or Making a Plan to withdraw from Antidepressants

Jane markets software development.  She is a 35-year old “got it together” professional woman.  At least, that’s the way it seems on the outside.  As a networking master, success flows easily for Jane — so easily, that she runs on “automatic” most days.

It’s those early morning mental gymnastic sessions that are driving her nuts!  Months of waking up at 3:00 AM with her mind racing in all directions, from setting appointments with prospective clients that she has been wanting to see for two years to questioning if she wants to have Sam’s babies or not. . .  Jane is beginning to believe that Sam and she have a future together. . .  She used last week’s early wake ups to work through the fact that she and Sam more than like each other and have a chance of creating a long-term relationship. . . 

"Should I be thinking about children when I have a wild obsession with Doritos and dirty martinis?. . .Could that be why I’m gaining weight? . . . I’ll talk to Sam about this tonight.  We’re meeting at the Matador in Ballard for. . . Well . . . it began in my 20’s.   I was a vegetarian . . . About that same time I began taking antidepressants . . . I’ve never been without them . . . Well, for not  more than three weeks since then. . . Could . . . Maybe . . . Hold it!  Hold all those thoughts.  And, hold this thought, too:  I’ve got to get myself together."

For Jane, getting herself together means scheduling a yearly physical with her primary care physician, checking in with her therapist, and taking care of some unfinished matters that she has let ride for too long, like getting off the anti-depressant.         

Several weeks later, Jane’s primary care physician encouraged her to consider seriously dieting because of the history of diabetes in her family.  In the same week, her mental health professional referred Jane to Dynamic Paths to assist her in getting off of antidepressant medications.  While taking the medications, Jane notices she gains weight and she experiences decreasing sex drive.  Over the last few years, she has tried unsuccessfully to stop taking the antidepressants several times.  The time seems right to tackle this issue again, given the positive nature of her relationship with Sam and the momentum building in Jane’s “getting it together campaign”.

Jane read the Dynamic Paths’ website, noted the various services, and spoke to Dr. Allott by phone.  She found out that Dr. Allott and Heather Brummer provide similar assessments and client education in the beginning.  So, Jane decided to set an appointment with Heather, who sees clients after work several evenings a week. 

“I actually liked the idea of two people reading my screening results and thinking about me.  Besides, my initial costs will be a little less when I see Heather Brummer and more within my “getting it together budget.”

Heather and Jane worked together for three appointments and, after some simple dietary changes, Jane was sleeping through the night.  She began to notice she had more energy as well. 

"Is the 'getting-it-together campaign' working?  she pondered. Well. . .  yeah.  I can tell I’m changing and that is encouraging. Yeah, I’m even willing to do a little more in the way of exercising — but, just a little.”

At the end of her third appointment, Heather provided a lab slip from Dr. Allott.  Heather explained that Dr. Allott wanted to be sure that Jane’s body was absorbing nutrients with the new diet changes. “The lab work will allow us to answer this question,”  Heather stated, “Do you have sufficient nutrients for making dopamine and serotonin before starting the weaning-off process from the antidepressant medication?”

Jane’s next appointment was with Dr. Allott to receive results of the blood work.  Now, it was Kristen Allott who spelled out how Jane’s nutrient deficiencies have contributed to her overall fatigue and long-term depression.  In that visit, Dr. Allott asked permission to call Jane’s referring therapist to share the laboratory findings, which confirmed the mental health professional’s intuitions that Jane would need physical as well as emotional support to reach her “getting it together” goals.

Then, Jane returned again to the convenient evening appointments with Heather Brummer, and together they implemented the plan to strengthen Jane’s body.  Jane continued to see her therapist to explore the idea of marrying Sam and having children as well as for support as she learned to managed her broader range of emotions during the withdrawal from her antidepressant medication.

This time — with nutritional support, practical steps, and additional encouragement from Heather Brummer and Dr. Allott — Jane succeeded in reaching her health goals and now she is open for whatever comes next in her life.

Pharmacogenetics Testing

In case you have not met pharmacogenetics testing, may I introduce you? It is a testing tool that takes the guesswork out of prescribing medicines and their appropriate dosages for individual patients.

The screening tool will indicate which medications the patient’s liver can successfully process. A patient with a slow metabolizing liver will need a smaller dosage to successfully reach a therapeutic window; fast metabolizing livers will need larger dosages of medication to reach the therapeutic window. The types of medications and conditions that the genetic information can impact are medications for depression, anxiety, elevated cholesterol, blood thinners (especially warfarin), and cancer.

I’m interested in spreading the word about pharmacogenetics testing and its possibilities because of its power to reduce adverse drug reactions. Approximately 30% of the people I’m seeing in my office these days have spent more than a year trying out various medicines in order to find the most effective ones for treating their symptoms. These searches can be impossibly long and unsuccessful. Pharmacogenetics testing can dramatically shorten the search times for the “just-right” medications and can help prevent adverse drug reactions.

Some of my clients are suffering from unnecessary side effects caused by over-medication. The test can aid in recommending appropriate dosage. Finally, pharmacogenetics testing can predict conflicting side effects, when these types of medications are used in combination with other prescriptions.

A 55-year old executive with depression tried out most available antidepressants over a period of three years. He felt extremely frustrated and declared: “I just can’t—no, I won’t continue using those medications.” He experienced being “physically uncomfortable, clumsy, and mentally foggy.”

The pharmacogenetics testing revealed that he had a slow metabolizing liver. Therefore, for success, he needed to be taking much smaller medication doses. Making those adjustments can be handled fairly painlessly and quickly.

The people who should consider pharmacogenetics testing are individuals who have had adverse reactions to medications and/or who have not had good success treating mental health conditions despite multiple attempts.

In your areas around the country, ask providers near you if they do pharmacogenetics testing. Or inquire if the provider knows anyone that does this type of testing.

The procedure is very simple: a doctor swabs the inside of patient’s cheeks and sends the swabs to a lab for genetic testing. Depending on the patient’s insurance, the screening may cost 0-$400 dollars. Medicare actually pays for the screening because it has been shown to be a cost reducer. It is certainly worth investigating if it provides life-long data that will benefit you and/or your patients.

Lemon Coconut Protein Balls

lemon coconut protein balls

1/4 C vanilla protein powder
1/2 C coconut flakes
2 Tbl lemon juice
lemon zest from 1 lemon
2 Tbl honey (or other sweetener).

Mix it all together, roll into (about) 6 balls, eat.

Notes:
Why balls instead of bars? They're a fun change, and you don’t have to commit to a whole serving all at once. And they’re great for kids (my nieces accept them as “dessert” and eating 5-6 of something feels like a treat). You can make double or triple the recipe – they store well in the fridge for a few days.

I use whey protein isolate powder. For those into hemp, I could see rolling in some hemp hearts to get a little more protein and crunch…

Once I only had very large coconut flakes on hand and, although I thought they would just crush up, they didn’t so much so I added a little bit of coconut flour to help hold everything together. Also – I go out of my way to buy UN-sweetened coconut flakes (just dried shaved coconut). If someone was using sweetened coconut, which is what is commonly available in grocery stores, I’d recommend tasting before adding any additional sweetener.

I often buy dried lemon zest in bulk from Healthy Living as I don’t always have fresh lemons on hand and I love lemon. I use about 1 Tbl of the dried zest, but this really can be added “to taste”.

I use honey and I add it to taste. I find 1 Tbl is plenty, but that can vary depending on the type of honey. I had some nice dark orange blossom honey and I added less than a tsp because it has such a strong flavor. But I guess it depends on how sweet people are used to having things. I find I like things a lot less sweet than others. And it will also depend on if people are using a protein powder than is pre-sweetened or not (I know a lot have stevia or some other sweeteners already in the powder). So I’d recommend tasting the mix before adding any sweetener. But depending on if or how little you use, you might need to add extra liquid to get the consistency right.

The amount of protein will vary with the product used – what I use is 17 grams per 1/4 cup.

I also make a version of this with chocolate whey protein powder and coconut – omitting the lemon and using a few Tbl of water (or cold coffee or milk or milk substitute) instead of lemon juice. Once I used peanut butter and coconut flour with chocolate protein powder (but I’m guessing almond butter would be healthier…). The peanut butter ones came out a bit stickier, so I wonder about adding oats or some other something – maybe just more coconut (or almond) flour, but I haven’t made them again. They tasted good, but definitely not something to snack on while at a computer!

And once you get a feel for the consistency, anything could be used really. As I type this I’m thinking a dash of nutmeg in the chocolate ones might be nice, or chili pepper for those who like spicy chocolate. Maybe some chopped up dried tart cherries and toasted almond slivers, or dried raspberries, orange instead of lemon, mmm – lime instead of orange… I could go on all day. I think I’ll make some this afternoon and try out some different flavors.

If you try them, let us know what you think!

Too Good to Wait

This recipe comes to us from Joy the Baker at her colorful website: http://joythebaker.com/

Photo from Dreamstime.com

ROASTED WINTER CITRUS

Let’s not wait until next winter!

Preheat the oven to 350 degrees.  Line a baking sheet with parchment paper.

Slice citrus (grapefruit, blood, cara cara or navel oranges, limes, lemons, and/or seedless tangerines) into small wedges.  Try, if you like, a variety of citrus fruits in one roasting.  Drizzle with olive oil and sprinkle with a bit of salt and a touch of sugar.  You might even add a pinch or two of dried herbs, such as Herbs De Provence.

Roast for 18-20 minutes.  Remove from the oven. Allow the fruit to rest for 10 minutes and then serve warm with breakfast eggs or dinner spreads with roasted meats and vegetables.  Please enjoy these surprisingly delicious and complementary flavors.

Favorite YouTube Videos for Health

Ten years ago when I opened my practice in Seattle, there were very few books that I could refer to my patients for reading–save a few nutritional physiology textbooks.  There is still no comprehensive book that I can suggest.  However, there are numerous books that are worth reading for individuals who struggle with anxiety, depression, sugar cravings, and weight gain.

One resource that our society had not developed ten years ago, but have at our fingertips today is YouTube.  I have selected four videos from four different authors worth knowing and reading.  Plan on investing a few minutes with each You Tube or video presentation.  You may find one strikes your interests more than the others.  That’s the place to start reading for valuable information.  I hope that you find them useful.

• Gary Taubes: “Why We Get Fat” IMS Lecture on Aug 12, 2010 Part 1 to 8 (10 minutes each)  

• Michael Pollan RSA: How Cooking Can Change Your Life (20 minutes) 

• Michael Moss CBS: Food Addiction: Is the Food Industry Creating an Epidemic? (4 minutes) 

• John Ratey: Exercise is the Best Medicine for Our Brain (33 minutes)  

“Soup’s On” — and a Bit More!

Vegetable Soup with Swiss Chard (Makes 4 1/2 Quarts, Serves 8)

Ingredients:
1     Tablespoon Extra Virgin Olive Oil
2     Medium-size onions, sliced
1     Leek, white and light green parts, thinly sliced
12   Cups water or vegetable stock
2    Celery stalks, sliced lengthwise and cut into diagonal slices
2    Carrots, peeled, cut lengthwise, and cut into diagonal slices
1     Tablespoon dried oregano
1     Tablespoon dried basil
1/2 Teaspoon dried thyme
2    Bay Leaves
4    Teaspoons salt or to taste
2    Ears of corn, kernels scraped off
1     Bunch Swiss chard stalks (2 cups approximately) cut diagonally
1     Yellow squash, quartered and sliced on a diagonal
1     Cups green beans, cut into 1-inch pieces
1     14-ounce can crushed tomatoes
1     Cup uncooked pasta shells
3    Cups Swiss chard leaves that have been washed, stripped from stalks, and sliced into strips
1     Cups cooked chickpeas or kidney or white beans
Parmesan cheese to taste...

Directions:
1.  In a large stockpot, heat oil and saute onions and leek for 10 to 15 minutes, until golden and sweet.

2.  Add water or stock, celery, carrots, herbs, 2 tablespoons of fresh parsley, and salt.  Bring to boil and simmer partially covered for 15 minutes.

3.  Add corn, chard stalks, squash, green beans, and tomatoes.  Simmer for another 10 minutes.  Turn up heat.  Add pasta and cook for 5 minutes.  Add Swiss chard leaves and simmer for 5 minutes longer, or until pasta is just cooked and chard is tender.

4.  Taste and adjust seasonings.  Serve each steaming portion of soup with a sprinkling of the remaining parsley, plus Parmesan cheese on top.

This recipe may be found in the book Greens Glorious Greens! by Johnna Albi and Catherine Walthers.

Kale Hero Salad

Several months ago, I saw newscaster Dylan Ratigan describe a farm he had visited north of San Diego and make this delicious kale salad.  I know that it is delicious because I’ve made it for large gatherings numerous times.  It’s a hit every time!

The story behind the salad: The farm, Archi’s Acres, has two claims to fame:

First, it is a state-of-the-an organic, hydroponic greenhouse operation that has great success providing multiple varieties of kale, living basil, avocadoes, and other vegetables to local markets. 

Second, it is also the site of Veterans Sustainable Agriculture Training (VSAT), the results of a vision by owners Colin and Karen Archipley. 

The farm and the training program serve as an entrepreneurial incubator for transitioning veterans from Iraq and Afghanistan, where Colin served as a Marine on multiple tours of duty.  You may read more about this young couple and their dreams by checking online at Archi’s Acres.

Meanwhile, I’ll get back to the  Ingredients for the Kale Hero Salad

For the Kale Hero Salad Dressing:

• 8 garlic cloves (minced)

• 2-inch piece of ginger root (peeled and minced)

• 1/3 cup Balsamic vinegar(Add to garlic and ginger to allow vinegar to be absorbed

• before adding the oil.

• 1/3 olive oil(slowly whisk)

• Salt and Pepper

For the most satisfying flavor, make the dressing first and set it aside while preparing the other ingredients.

In a large bowl, add the following:

• 2 bunches of kale (Roll crosswise, slice down center lengthwise, and then slice leaves thinly.  Repeat with the chard.)                                 

• 2 bunches of red chard

• ½ cup toasted and chopped almonds

• ½ cup Gorgonzola Cheese (crumbled)

• 2 Fuji apples (cored and cut into 1/4 inch cubes)

• 1 papaya (quartered; seeds removed and roughly chopped)

Toss the dressing with the salad and enjoy!

Jill’s Story: Filling Up the Hole

A young woman name Jill stuck her head through the clinic doorway.  Instantly, I thought: Lady, what big, brown eyes you have.  It wasn’t just the size of her eyes that struck me; it was also their intensity.  Those dark brown, doe-like eyes darted about taking in the details of the space and me, as if to check out whether she fit here or not.  Would it be a safe place for her?

Like many women from challenging childhoods, Jill had seen therapists off and on concerning depression and anxiety for quite a while.  After initially getting acquainted, she turned the conversation. “I’ve been diagnosed with post traumatic stress disorder.  I had a pretty miserable childhood.  I was never quite perfect enough for my parents, whose parenting skills were limited to lots of criticism and hours of my being sent to my room alone.”   

I was impressed with the results of the work Jill had found in therapy.  It had not been an easy journey.  Yet, with the support of her therapist, she mostly lives a good life with a loving husband and several precious children.  It sounds as if she is a great mom!

Five years ago, her primary care physician started encouraging her to change her diet and lose weight.  She said that it was true that she had gained an additional five to ten pounds yearly. Three years later, her doctor informed her she was diabetic.  That diagnosis of diabetes spun her back to the cruelty and neglect of her childhood. The cycle of depression and anxiety kicked into gear once more.

“Suddenly, I am scared again!  My children are young.  My husband and I have plans!  And, there are so many things we still want and must do for each other and our children without having to deal with diabetes. I shared the diagnosis with my therapist and she referred me here to you.”  

Through lab work and analysis of her existing diet, Jill and I discovered that she had nutritional deficiencies that were resulting in her on-going feelings of fatigue and mental fogginess.  I reviewed how food and exercise contribute to her “feeling good“ daily.  These things seemed to motivate Jill to eat better and expand her exercise routine, which in turn meant Jill was thinking more clearly.

While I helped her feel better in the present by addressing her body’s needs, Jill and her therapist became aware that no one had ever taught her how to really care for her body. For example, Jill’s secret binge eating at night after everyone else in the home was asleep — although comforting to her in that moment — was one of her more dangerous behaviors.  She decided the bowl of chocolate ice cream and crunchy chips (her favorite late night fill up) had to change.  She tried numerous times unsuccessfully.

What we worked on together in this next phase was developing skills to eat in a way that resulted in her actually feeling better in the moment and the next day.  For example, rather than trying to stop the evening binge eating, we became determined to make the eating healthier.  In no time cottage cheese with pecans, scooped with corn chips became the nightly replacement.

Weeks later when Jill returned one evening to eating ice cream.  She could hardly function the next day.  Her body ached; her muscles stiffened; her head felt as if it were stuffed with cotton.  On the other side of that experience, the cottage cheese and pecan option seemed like self-care rather than a doctor allowing her permission to cheat.  Over time, with compassion and skill building, Jill made autonomous choices previously denied her in childhood.  She came up with her own ways of feeding herself that were helpful rather than harmful.  Her current choices became hers because of what her experiences taught her and how her body responded.

A year has passed since Jill first stood in my sun-filled doorway.  Her diabetes markers are vastly improved.  She understands diabetes and obesity are in part a result of an abused childhood.  Additionally, a poorly nourished body played an important part in her depression and anxiety cycle.  Her own self-inflicted coping methods, such as the binge eating, compounded an already poor situation. She now takes pride in how she cares for herself and her family, instilling the importance of honoring ourselves through the expression of our emotions, real food choices, and exercise.

Once in a while and as her body’s needs change, Jill and I check-in with each other, concerning her diet.  She and her therapist continue to explore her past and re-create a life-giving story for her.  These various threads of care come together now and support her, as Jill embraces totally the fullness of her days.  She thrives.

Washington’s state flower

Once Upon a Time...

There lived a 42-year old woman.  For the benefit of the story, I’ll call her Martha.  Three years ago, Martha’s husband died in a tragic head-on auto accident.  The death of her husband and father of two teenagers came so abruptly and finally that Martha and her children didn’t have a moment to prepare for living without him.

In the numbing aftermath, Martha has managed to downsize the family’s housing and increase her income a little bit, while dealing with her own and her children’s grief and anger.  With her daughter and son in their beds most evenings, Martha’s “my time” ritual of drinking a glass or two of wine seemed to have momentarily eased the stress and the emptiness, giving her a time to just be alone.

Now, three years later, Martha has gained 40 pounds and has begun taking anti-depressant medication prescribed to her by a therapist that she has been seeing since her husband’s death.  She is restless.  Because she was tired of “just getting” by on multiple fronts of her life, her therapist referred Martha to me.  In the introduction conversation we shared, Martha confessed that she was no longer active.  She had not continued cycling, which she and her husband loved doing together. “I’m too young to just shut down my life!”

The first thing that Martha and I did was to review what’s happening with her physically.  She rated her energy as 3-4 on a 10-point scale.

Secondly, we found that she was not sleeping through the night.  Frequently, she reported waking up every two hours, worrying about the future, and regretting the past over and over again.

Thirdly, we explored incidents of anxiety.  Martha repeatedly became anxious while doing things she has done in the past.  At the same time, she couldn’t seem to make herself volunteer for new projects at work. Realizing that fact, she worries about keeping her job.

Fourthly, she also brought up the disappointment in herself for gaining those 40 pounds.  She began eating only two meals daily, thinking that would help her lose weight.  I explained how important it is for her to eat small frequent meals to curb her brain’s anxiety.

After I informed Martha about how the brain and body function and how food choices contribute to fatigue, insomnia, and weight gain, we created achievable changes in her food routine. The next time we rated her energy on that 10-point scale, she rated it at 7!  New foods and eating habits brought about less anxiety and sleeping through the night for Martha.  Now we had a basic foundation from which to build.

Next, we did a robust blood panel, more thorough than her primary physician had done.  This step allowed me to check for nutrient intake, asking the question: Does Martha eat enough of the right things to make healthy quantities of dopamine and serotonin in the body?  Are there minerals and vitamins present that make dopamine and serotonin?  I used strict standards of health to evaluate for nutritional deficiencies.  With that analysis, I recommended options for Martha’s continued health improvement and prevention of long-term diseases, such as diabetes and cardiovascular disease.

Several months into the process, I couldn’t help but notice that Martha started more new things in her life than I suggested — things such as participating in outdoor activities and joining E-Harmony.  Now that Martha possesses more energy and less anxiety, she has the will to explore new possibilities and to begin another chapter of her life. 

Personal details of Martha’s story have been altered to protect the confidentiality of the patient.  The story is nonetheless true.  Fatigue, insomnia, anxiety and weight gain are common to many patients, who come to see me.  But, life doesn’t have to be lived that way.  Individual evaluations of nutritional health, screenings, and personal care plans can make an enormous difference in one’s quality and fullness of life.

I never feel hungry or tired, but I feel ok. Is this something to be concerned about?

Since publishing our workbook, Fuel Your Brain, Not Hour Anxiety, I receive emails with interesting questions about the material presented. Here’s one I thought I would share:

I am 78 year grandmother and consider myself as a healthy person. I walk 3-4 hours during the weekends and do aerobic exercises and Tai-chi on weekdays. The problem is I never get hungry or tired in spite of all these activities. I eat a good healthy breakfast: a cup of coffee done with soya milk, a half dozen almonds, some raisins and a half of an apple, a spoonful beansprouts, some all bran, 125g of bio yoghurt, and finally a cup of green tea. I have no lunch because I am not hungry. I eat a grilled fish with some greens for my supper around 7 p.m., although I am not hungry or tired.

One of the challenges of responding to people I have not met is that I am not always clear what someone’s question is. So, I am going to pull some possible questions from this query.

First I ask myself, do I hear a problem? I hope when I am 78 years old, I consider myself a healthy person. For me, what heath implies is that I have the physical energy and mental clarity to support the activities of self-care, self-determination, and self-understanding as well as to engage and connect with others. Since she’s wondering about eating, I’m assuming that she’s curious about who she is and who she is becoming – this seems healthy to me.

Sometimes I have to remind people that when I discuss diet change, my meal tips are for people who have mental health challenges. These challenges can include situational anxiety, that prevents people from taking on new challenges, or more serious conditions such as major depression, panic disorders, PTSD or addictions.

If someone has good energy and mental clarity, they enjoy their life and who they are… They should probably stick with what they are doing.

So maybe the person who emailed me is just curious about her lack of appetite. She has a daily practice of movement with walking and tai-chi. Regular movement allows protein to cycle around the body, so we are not as dependent on dietary protein and eating small frequent meals. She also eats protein at the meals which, especially combined with regular movement,  can decrease appetite.

I’m not sure that this person needs to worry about lack of hunger signals, but we can discuss the causes of lack of hunger signals more generally, and what people might try to correct this challenge:

• Lack of hunger + anxiety/agitation/irritation/numbness = low glucose plus adrenalin and will be helped by a lizard brain treat

• Lack of hunger + nausea + more than 3 hours from food = low glucose and high adrenalin and will be helped by a lizard brain treat

• Lack of hunger + eating regular meals with protein, carbs, fat and fiber = getting nutrients in and indicates that the body trusts that it will be fed predictably

• Lack of hunger + a gallon of water per day with little exercise maybe (depending on exercise, temperature of the environment, etc.) = hunger and thirst signals can be confused. Try less water. Usually 1/3 to 1/2 your body weight in ounces is enough (150 pounds is 50 to 75 ounces of water per day).

• Sudden lack of hunger = check with your doctor and have labs run. There are lots of medical conditions particularly thyroid disorders that can disrupt hunger signals.

Lastly, if this person is curious, she could try three days of protein every 3-4 hours and see if she feels any different? Maybe more energy? Maybe her hunger signal will be a little stronger when she is away from food for 3-4 hours .

I always remind myself that there is no “right way” that fits everyone. The way to discover what is useful for an individual is for them to try different experiments and decide if and where changes fit in their life, at the moment.

ACEs contributes to the physical causes of mental health challenges

In a recent speaking event about the physical causes of mental health, a participant asked an insightful question: How does a background of ACEs (Adverse Childhood Events) impact or contribute to the physical causes of mental health challenges?

 The research around ACES show that the hormonal system, specifically the hypothalamic pituitary axis, can become over activated. This effects everything from the immune system to glucose control to brain development, and especially a person’s baseline response to stress. Despite knowing this, our front-line therapy for trauma is psychotherapy or prescribed psychotherapeutic medications.

While building the scaffolding of life skills, therapy typically provided often misses the most basic skills of self care for the body:

• Sleep: 8-9 hours at regular and consistent times

• Feeding oneself: eating regular meals at consistent times and the skills that support this (menu planning, shopping, cooking, understanding the importance of nutrient balanced meals)

• Movement: How to physically play

• Healthy breathing: practicing breathing through the nose

Practicing these skills provides a pathway for resetting the hormonal system, which provides a new set point for stress, entrains the pre-frontal cortex to being the primary driver for decision making, and supports the brain for wiring in new behaviors.

The ACES pyramid is useful image to capture the possible steps that contribute to mental health and addiction challenges. When we’re born into a family that has overwhelming challenges, such as poverty, community disruption, lack of economic and social capital, addictions and mental illness, we likely miss roll modeling of the tools needed to optimize our brains and bodies

Here are some of the things that might have been missed during a complex childhood, which may mean that the related skills were never learned:

• Having enough sleep. For an infant to get 12 to 15 hours of sleep, there needs to be an adult around to protect and care for them. Getting enough sleep is critical for the development of a child’s body, and the child learns what it feels like to have the neurological and physiological resources to learn and respond to their world.

• Having predictable meals, with enough nutrients, to build brains and bodies. It’s important for our circadian clocks, which are imbedded in our cells throughout our bodies, to be able to predict when we’ll get nutrients as well as sleep. This supports the natural rhythm of the hypothalamic pituitary axis, which helps the brain and hormonal system recover from trauma and reset itself.

• Opportunities for physical play, indoors or outdoors. Play is the building block for using movement to help prevent mental health and physical health problems. It’s physical action that tells our whole body that we survived a threat and can move by our own choices. Additionally, there is increasing evidence that movement and emotional control reinforce each other.

• Having access to nutrient dense foods with complex flavors. Experiencing food insecurity often means focusing on getting calories, or eating to survive, which means that nutrient-dense may be a luxury. This wires the pallets of children to expect foods high in sugar, fat and salt. If the sweet-bitter tastes of greens or the sweet crunch of carrots are foreign flavors and textures, they become rejected by the nervous system as not safe and limit the brain-body from the nutrients it needs to heal and thrive.

• Breathing to support health, and not just survival. Neglect and abuse teach us to breath shallowly and through mouths. Shallow mouth-breathing becomes habitual, reducing the amount of oxygen available to our bodies and brains, and how we respond to carbon dioxide. Over the long term, this increases the risk of obesity, inflammation, glucose control issues, and reinforces the neurologically reactive patterns reinforced in childhood. Nasal breathing increases oxygen to our body and increase anxiety tolerance.

The research is clear that people can and do recover from challenging childhoods and traumas. Understanding that some of the basic self-care behaviors may be missing and intentionally addressing this issue supports recovery. Additionally, we – as a society – need to provide the resources such as food education, child care, mentoring, and financial support for families to learn how to care for their children as well as themselves.

The League of Extraordinary People: A Conversation with Alfred White, focused on BIPOC community Experiences

Using Whole Foods Nutrition to Address the Anxieties that Arise from Trauma and Racism

For Mental Health Awareness Month, Psychotherapist Alfred White discusses how to heal from trauma, adversity and chronic stress with Dr. Kristen Allott, naturopathic physician, speaker and pioneering mental health advocate.

Watch the video on the The League of Extraordinary People Facebook page

Pandemic Fatigue Fix

Self-Care moves you into a brighter moment. Image by John Hain from Pixabay

Are you or someone you know struggling more in the last 45 days?

What I am seeing is the following:

• Fatigue

• Insomnia

• Increased anxiety

• Increased maladaptive emotional coping tools: alcohol, cannabinoids, sugar, binging on Netflix, to name a few…

We are exhausted from the pandemic. This makes sense, there are messages:

• Hope and disaster

• Relief and don’t change your behavior

• Grief and longing, as well as excitement

• Plus, we still don’t know the rules. Sigh…

A year ago, I wrote a blog on the importance of self-care to keep our immune systems functioning. If you are experiencing pandemic fatigue, I would encourage you to focus on self-care again. This time it will help your brain and body to have the energy to process the enormous changes that are about to come and find a stable platform to stand on.

Rather than focusing on what we’re doing wrong and then punishing ourselves for it, let’s do a 30-day experiment as a community, or with our family, friends, or clients, to see if we can each do a small compassionate act of self-care and see if we can have more energy and mental clarity as we move into May?

Here is a worksheet to help you commit to the 30-day challenge and track your progress.

In the next year, we’re going to create a new world together. I want us each to change what Kristen Neff has found in her research. After the pandemic, I want her to find that we are more self-compassionate and that we prioritize self-care because we understand that self-care is not self-indulgence. It is the one thing in the research that leads to better physical and mental health, less implicit bias, more connections to community, and more bandwidth to deal with change.  

“I found in my research that the biggest reason people aren't more self-compassionate is that they are afraid they’ll become self-indulgent. They believe self-criticism is what keeps them in line. Most people have gotten it wrong because our culture says being hard on yourself is the way to be.”

- Kristen Neff (Self-Compassion.org)

We created a form for you to let us know what activity you're experimenting with for the Challenge, and to rate your beginning energy level or "power supply". If you’d like, you can check back through the form weekly to track your progress. This form is completely anonymous, but will give us a generalized picture of the community-wide experiment that we can then share back with you.

Fuel Your Brain, Not Your Anxiety Book Launch

On January 23, 2021, we gathered via Zoom to celebrate the launch our workbook, Fuel Your Brain, Not Your Anxiety (published by New Harbinger). We invited three guest speaker to share how they have been using the information in our book in their work.

Dr. Jane Tornatore

This video highlights guest speaker Dr. Jane Tornatore, speaking about the connections between our workbook and her work as a therapist. Learn more about Dr. Jane Tornatore at DoctorTornatore.com

Dr. Jane Tornatore (11:56)

Andrea St. Clair

This video highlights guest speaker Andrea St. Clair, speaking about the connections between our workbook and her work as an addiction specialist at A Positive Alternative in Seattle, WA. Learn more about Andrea St. Clair and A Positive Alternative at APositiveAlternative.com

Andrea St. Clair (7:11)

This video highlights guest speaker Ambrosia Eberhardt, speaking about the connections between our workbook and her work as a parent ally in Spokane, WA. Learn more about parent allies, the Parents for Parents program and Protein for All, at ProteinForAll.org

Ambrosia Eberhardt (19:52)

Using Octavia's Wisdom: Reflections on the Workbook

By Nikolas Coukouma - This is the first time this version of the photo has been released by Nikolas Coukouma., CC BY-SA 2.5, https://commons.wikimedia.org/w/index.php?curid=602976

“All that you touch you change
All that you change changes you
The only lasting truth is change
God is Change. ”

— Octavia Buttler

In my twenties, I read a lot of Octavia Butler. I recently heard a podcast about her because she is having a resurgence. I wrote down the above quote because her words seem to apply to me right now. The process of writing a book changed me. Now, the inner 3rd grader in me, who could study ten words for 3 hours and the next day did not know how to spell any of them, is curious that she’s now an author. Apparently, I needed to write a book to know deeply that I am OK as a slow reader and a poor speller. 

Also - Natasha and I wrote the workbook to offer a possible pathway to change to those who read it. We wanted to provide hope. Our goal is to empower people to have more energy and mental, and less fatigue, depression, anxiety, and insomnia. Additionally, understanding how to do small experiments to feel better so the reader can focus on achieving their life goals. With these tools, hope and change can become the constant in their lives. 

The loop of change has quickly come back to me and Natasha: the conversations about the workbook are clarifying and changing how we think about people, health, and hope. 

I want to share some of the questions we have received and how I respond to them: 

"I have been doing a keto/intermitting fasting diet for three years, and it has helped with my anxiety. Eating every 3-4 hours, with carbohydrates at every meal would be horrible. I would just eat sugar all the time."

 Kristen: Congratulations on finding a way of eating that works for you! Three years is time enough to know that it supports your health and the community and family structure that you live in. It must also be working for your internal-self. However, not everyone can be successful on a keto/intermittent fasting meal plan for lots of reasons. 

 In Fuel Your Brain, Not Your Anxiety, the tools are there for people who are still struggling with anxiety and fatigue. Some individual's bodies can't adapt to keto or intermittent fasting. This is more common for women. Some people's emotional attunement flattens with ketones as the primary fuel for their brain. Their job or family context requires that their brains have glucose for fuel in order for them to emotionally attended to children, aging parents, or clients. Also, some people have childhoods filled with trauma and deprivation. To be limited on what they can eat and when they can eat causes a lot of internal resentment. Resentment is far more destructive for some people than sugar, body shape, or even diabetes. I have found that adding protein and including carbs is more helpful for many people than eliminating or limiting a food group.  When people have the tools to dialog with their body and brain, they develop food, movement, and sleep plans that are best for their body, brain, circumstances, and age over time.  

A friend of my parents read the book and said, "I am still not clear what an 80-year woman should eat." I replied, "I think the question is: What should I, Raquel, who is 80 years old, still works, and swims three times a week, be eating to have plenty of energy and mental clarity." 

 After this conversation, I have reflected that this is the core of what I hope to offer. The question is not “should everyone be keto/vegan/weight watchers/ whole 30 or whatever diet?” The question is, “how can we each eat differently for each moment or phase of our lives?” There is no "right" way for everyone. I do think that it is valuable to ask, "Is what I am eating supporting my energy and mental clarity, and - if not - what experiment can I do to improve my energy and mental clarity?"

 Another conversation we have been having around who is the workbook is for?

Here are some types of people who are most likely to experience positive change from reading the book:

• if you haven’t yet found a meal plan that gives you stable energy and mental clarity throughout the day

• if you have anxiety, panic attacks, depression, mood swings, insomnia, and/or fatigue

• if you like learning about how the brain and body work together

• if you have a history of trauma, mental health challenges, and/or addictions

• if you have a busy life and can only make small changes to improve energy and mental clarity

• if you haven’t yet found a movement program that works for you

I agree with Octavia: change is what is happening right now. Her dystopian books show us that by embracing change, we find paths to hope. By having a goal, direction, or intention for that change, we can start to influence what is happening in our lives. Information, tools, stories of overcoming obstacles, and experiencing small successes help us move along our unique paths. Lastly, we do tend to do better and go farther if we are not alone on our paths. 

Publishing the workbook has shown me and Natasha that we’re not alone. We have a growing community of people looking for tools for themselves and the people they are connected with. We’re excited to be part of the change and to be changed by what comes next.

Share with us what you’re discovering and what questions you have. 

Thanks for being part of our community and part of our paths.