Lithium

Blair Cuneo, PA-C

Lithium…a little goes a long way in cognitive and emotional health

 
Popular nutrients that make the major headlines for supporting cognitive wellness include magnesium and zinc, but how’s your lithium?

Lithium is an essential micro-nutrient with chemical properties similar to calcium and magnesium. It is present in all organs and tissues of the body.

The US Environmental Protection Agency estimates the daily lithium intake of an average adult ranges from 0.65 mg to 3 mg. Foods higher in lithium include grains, vegetables, eggs and milk. The most frequent source of lithium is tap water. Depending on where you live, there can be lithium deficiencies in your soil and with increased bottle water and home filtration use, we are filtering the lithium right out of our water.

Supplementing with low-dose lithium aims to support the body’s daily nutritional need for lithium. This is very different than the dosage of lithium as medication. Lithium carbonate is a well-established, effective medication therapy for mood disorders like bipolar disorder. Whereas lithium carbonate dosing can be in the hundreds of milligrams, low-dose lithium can range from micrograms to low milligram amounts.

How does lithium benefit brain health?

It is NEUROPROTECTIVE, shielding neurons from biological stress and toxins.

It promotes NEUROGENESIS, leading to increased numbers of neurons and brain volume.

It regulates NEUROTRANSMITTERS, helping to balance the mood.

Studies continue to accrue demonstrating improvement in mood and cognitive performance for patients with ADD, depression and Autism Spectrum Disorder. More recently, studies highlight the role lithium can play in prevention and treatment of Alzheimer’s disease, by inhibiting plaque formation and aiding in growth and repair of damaged neurons.

Screening for nutritional lithium deficiencies can be performed by hair trace mineral analysis, as blood testing is not sensitive enough to detect nutritional levels.

Talk with your functional medical provider about your cognitive and emotional health and find out if low dose lithium can further support your wellness goals.
 

Your Partner In Health!

Blair Cuneo, PA-C

Health Coaching

Erica Nelson, MSPH, NBC-HWC 

The legendary basketball coach, John Wooden once said, “A good coach can change a game. A great coach can change a life.”  At Carolina Total Wellness, our coaches help our patients change their lives every day.Every patient at Carolina Total Wellness that sees a doctor or physician assistant is paired with a health coach. Some patients may also choose to work solely with a health coach to achieve their dietary and lifestyle goals. This article will help you know what to expect when you work with a health coach.

Here are 3 key aspects of the health coaching experience at Carolina Total Wellness:

The Space Between
Health coaches hold space for you to pause… and decide how you want to respond to your circumstances. The world today is a seemingly relentless onslaught of stimulation, and it can feel like there is an urgency to react to all of that stimulation.

George Mumford, meditation coach to Michael Jordan, LeBron James, Kobe Bryant and other world-class athletes offers another way, ‘Think about the eye of a hurricane.’ He says, ‘No matter how intense the storm or what’s swept up in its gale-force winds, that calm, blue center is always there. We all have this quiet center within us.’  Your CTW coach will help you respond from that quiet center within, rather than reacting from the chaos of the storm.

In our office, health coaches hold space for you to make sense of what is going on in your world and in your body and decide how you want to respond. Health coaches always honor the fact that you are the expert on your own life and display unconditional positive regard for you and whatever lifestyle decisions you choose. They pay attention to what matters to you and may offer suggestions for adjustments that fit into your life.

Translator
The science of the body and its systems are the physician’s expertise. Science of behavior change is the coach’s expertise. Our coaches help you translate medical science you discuss with your doctor or PA into evidence-based behavioral change strategies to optimize your health. When you combine the medical knowledge of our physicians and PA with your coach’s expertise in the science of motivation, habits, and change, many of the barriers to experiencing health fall away.

Each of the coaches at CTW has at least a bachelor’s degree from an accredited university and training in coaching from either the Functional Medicine Coaching Academy or Duke University. Some of them also have master’s degrees and other specialized training in nutrition, exercise, counseling, and other relevant fields. Unless otherwise specified, CTW coaches are not registered dietitians, licensed mental health professionals or certified fitness professionals.

Guide
In the words of Michael Jordan, ‘A coach is someone that sees beyond your limits and guides you to greatness!’ CTW coaches come to the table with empathy for whatever you are facing and feeling and confidence in your ability to overcome. Each coach has faced their own struggles in life and knows what it is like to work hard to overcome. However, coaches never replace you as the expert on you; they serve as your guide on your journey to health. Coaches can help you understand all the different ways you can try intermittent fasting or yoga or what, exactly, is ‘glycemic index.’ Maybe our most important job, though, is to help you get very clear on your vision of the healthiest version of you. Once you decide where it is you want to go, coaches provide education, support and accountability to knock down any stumbling blocks that may come up along the way.
 
Call us today to schedule your appointment with one of our health coaches.
 

Erica Nelson, MSPH, NBC-HWC 

Heart Rate Variability

Didem Miraloglu, MD, MS

DO YOU KNOW HOW TO MEASURE YOUR WELL-BEING?

Ever heard of Heart Rate Variability (HRV)? Exactly as its name states, heart rate variability is a measure of the variability between heartbeats. Your heart beats a specific rate, anywhere from 60-100. There is a variation in this rate, depending on whether you take a deep breath, exercise, are under stress or are at rest. HRV is dependent on our nervous system to pick up cues from our environment.  In order to understand how these cues are translated into physiological response, we first need to understand how the nervous system works.

Our nervous system controls our heart rate in two opposing directions.

One is the sympathetic nervous system, “fight or flight.” It is responsible for increasing the heart rate when we are stressed, like running away from a saber tooth tiger. In our present world since we are not normally faced with tigers, sympathetic drive kicks in during other emergency situations. This is exactly when you want more blood pumped from the heart to your muscles so you can fight or run. The blood pressure and heart rate increase as a normal response to the feedback from our environment.  

Its counterpart is the parasympathetic nervous system, which is the “rest and digest” system. When our senses detect the emergency is all clear, our parasympathetic system takes the lead and tells our heart rate to slow down and lowers the blood pressure. Our body starts to relax.

This is the normal sequence of events that occurs by increasing and decreasing the heart rate appropriately according to the environmental cues. Studies have shown people with high heart rate variability are usually less stressed and are happier.

The problem occurs when there is low heart variability. This means the nervous system is not responding adequately to the environmental cues and hence your body is less resilient and struggles to handle changing situations. This may occur with diabetes, asthma, anxiety, depression and high blood pressure. This is also seen as we age.

You can improve your heart rate variability by taking care of your body and mind. Regular exercise along with a healthy diet, staying hydrated, avoiding alcohol, getting a good night sleep, being exposed to natural light, taking a cold shower and mindfulness, all help with reduction in HRV.  Controlled breathing has also been shown to boost HRV and help fight stress which can decrease HRV.

The gold standard for measuring HRV is an EKG. But you don’t have to buy an EKG, since there are smaller and more affordable gadgets on the market with which you can measure HRV in the comfort of your home.  Here are some of those:

  • Apple Watch – Uses an optical sensor (green light) to record heart rate automatically, however, you need to obtain the Health app on iPhone to look at the data.
  • Oura Ring – A sleep tracker, takes the mean of all 5-minute samples measured while you are sleeping. The changes in your HRV are accounted for every 5 minutes throughout the night which makes it one of the most accurate devices out there to measure HRV. This is in comparison to other wearables that only take HRV measurement at a single point during the night.
  • Fitbit – Heart rate tracker automatically measures the HRV and sends stats to the Fitbit app. The only problem is that the technology used in Fitbit does not accurately record or report heart rate.
  • AIO (All in One) Smart Sleeve – It is a sleeve you wear that can measure your EKG real time. It also does sleep analysis, workout optimization and stress level monitoring.
  • Frontier X – Worn directly over your heart, like a chest belt, provides continuous ECG monitoring.

There are also apps that help you increase your HRV. They do this thru teaching breathing techniques via biofeedback, which changes the heart rhythm to create a physiological balance in physical, mental and emotional systems. Some of these include HeartMate, HeartRate + Coherence Pro and HeartMath. HeartMath is the gold standard in the industry for coherence and the one with the most science behind it.

So, how do you measure your well-being? Mainly with tools that provide feedback on your heart rate variability. But remember, your well-being does not have so much to do with what is going on in your environment, as it does with how you perceive and react to your environment. And working on those factors will in long term help with your well-being.

“You have power over your mind – not outside events. Realize this, and you will find strength.”

 Marcus AureliusRoman Emperor and Stoic philosopher (161-180 AD)

Didem Miraloglu, MD, MS

Long COVID

Susan D. Denny, MD, MPH

Over the past year I have seen an increasing number of patients with symptoms of post-acute sequelae of Covid 19 (PASC), also known as long Covid. 

What is long Covid?  As defined by the CDC, long Covid is a range of new, returning or ongoing health problems people can experience four or more weeks following SARS-COV-2 (Covid 19) infection.  Symptoms can vary significantly by person and can include fatigue, brain fog, memory loss, anxiety, disturbed sleep, joint pain, gastrointestinal symptoms, loss of taste or smell or shortness of breath.  Most of the patients I have seen with long Covid suffer from fatigue and brain fog and many have other accompanying symptoms.

In a recent systematic review of 57 studies comprising more than 250,000 survivors of Covid 19, most symptoms included mental health, pulmonary and neurologic disorders which were present 6 months after SARS-Cov-2 exposure. 1

How many people are suffering from long Covid?  Clinical trials have shown anywhere from 31% to 69% of people who have had Covid infection will suffer from long Covid. This is a present and emerging health care crisis with tens of millions of Americans currently suffering and millions more at risk of developing this syndrome. Chances are that you or someone you know has long Covid.

How long does long Covid last?  This appears to vary significantly by person.  Some clinical trials have shown average length to be about 3 months while others have shown that symptoms may last more than a year. An emerging consensus is that most people have symptoms for 6 months or more.

Who gets long Covid?  While some clinical trials show a relationship to acute disease severity, others have shown a significant risk for long Covid even in mild or asymptomatic cases.  In other words, it is possible to develop long Covid even if you had no symptoms of acute Covid infection.

A study just published in Cell on January 24, 2001 followed 200 patients over two to three months following their COVID-19 diagnoses. The researchers determined four biological factors that they say are associated with whether a person will develop long COVID.

The first factor is the level of viral RNA in the blood at diagnosis. The second is the presence of autoantibodies—those that attack the patient’s own body. Third is the reactivation of the Epstein-Barr virus, a common virus that most people are infected with and recover from early in life. The last is Type 2 diabetes. Interestingly, the most predictive factor for long Covid was the presence of autoantibodies in the blood. 2

Several other studies have found significant autoantibody levels in patients with long Covid.  In one study just published this month, researchers found signals of autoantibody activity that are usually linked to chronic inflammation and injury involving specific organ systems and tissues such as the joints, skin and nervous system in patients with long Covid. 3 We know that certain viruses can trigger the body’s immune system to begin attacking itself through a process called molecular mimicry.  That appears to be a significant source of cellular damage and inflammation in patients who develop long Covid.

Another study published in Gut examined changes in the gut microbiome in patients with long Covid.  They found that an altered gut microbiome composition is strongly associated with persistent symptoms in patients with COVID-19 up to 6 months after clearance of SARS-CoV-2 virus. 4

Can long Covid be treated?  Yes.  While conventional medicine has yet to find a medication to treat long Covid, a functional medicine approach to this illness works well.  Addressing the root cause(s) of ongoing inflammation in the body from the viral over stimulation of the immune system is a top priority.  Evaluation and treatment of increased intestinal permeability (leaky gut), gut dysbiosis and a disrupted adrenal axis works well to help rebalance the immune system, calm inflammation and improve symptoms. 

If you or someone you know is suffering from long Covid, please contact our office to make an appointment with one of our functional medicine providers.

In health,

Susan D. Denny, MD, MPH

References:

  1. JAMA Netw Open. 2021;4(10):e2128568. doi:10.1001/jamanetworkopen.2021.28568
  2. Su  Y, et al. Cell. 2022;doi:10.1016/j.cell.2022.01.014.
  3. Liu Y, et al. J Transl Med. 2022;doi:10.1186/s12967-021-03184-8.
  4. Gut (2022). DOI: DOI: 10.1136/gutjnl-2021-325989

Neurofeedback Therapy

Robert Baric, DC

We have invited several expert practitioners to educate our practice community on approaches to healing that are complementary to Functional Medicine. Our expert this week is Robert Baric, DC who will educate us on Neurofeedback. Neurofeedback is quite different from “biofeedback” with which you may be familiar. Dr. Baric is board certified in neurofeedback and has over 26 years of clinical experience. His passion for health and wellness has emerged throughout the years as he continues to deliver the most up to date knowledge to his patients, while providing them with impactful treatment in addition to neurofeedback, including nutrition, acupuncture, chiropractic techniques, and other applied therapies. I will hand off the microphone to Dr. Baric.
 


 
 Neurofeedback Therapy: A Compliment to Traditional Medicine
Amidst 56 years of positive research and clinical trials in neuropsychology, neurofeedback has emerged as a modality of complementary therapy that is “evidence based”. Neurofeedback therapy has gained increasing popularity due to its non-invasive properties and the sizable body of research supporting its efficacy, along with it being an alternative to traditional pharmacological treatment. Essentially, neurofeedback is EEG-biofeedback, where a method of retraining brain waves through operant conditioning is utilized. Various conditions like ADHD, depression and anxiety, addiction, and insomnia are all cognitive disorders that can negatively impact an individual’s brain waves.

 The first step to neurofeedback therapy is an initial brain scan that determines if a patient is a suitable candidate for neurofeedback therapy. A quantitative electroencephalogram (qEEG) shows brain activity and function allowing professionals to understand what ailments may be present and what can be done to mitigate symptoms at the root of the problem. The qEEG process takes just 45 minutes, recording brain waves with the eyes closed and opened. The results are then analyzed and a customized training protocol is created specifically tailored to the patient. Treatment includes monitoring the dysfunctional area while rewarding the preferred wave formation, with the reward being a TV show of the patient’s choice.  Brain waves are monitored, and using operant conditioning, stimuli are adjusted to guide the brain waves back into a healthy pattern.  If accepted as a patient, most individuals experience a marked improvement by sessions 10-15, most conditions requiring 40 sessions to finalize neuroplastic changes.
  
There are multiple conditions for which neurofeedback is impactful, with few being the most prominent throughout my years of experience. 
 
 Depression and Anxiety
The zeitgeist proves the need for complementary treatment options for individuals suffering with depression and anxiety. Approximately 33.7% of the population suffers with anxiety related disorders in their life, often comorbid with depression (1).  The Journal of Clinical Psychopharmacology yielded results showing significant improvement in patients symptoms of depression with neurofeedback (2). Similar results were shown in patients with anxiety disorders, with the Journal of Industrial Psychology exhibiting results where neurofeedback therapy was deemed essentially as effective in reducing symptoms of anxiety as medication (3). 
 
 ADHD 
Children and adults suffering with ADHD recognize notable improvements in their focus and attention after a series of neurofeedback treatment. When a group of students received either neurofeedback or pharmacological support, evidence showed those in the neurofeedback group improved in executive control to a greater extent than the pharmacological support group (4). A plethora of research supports the decrease of ADHD symptoms in both children and adults. 
 
 Insomnia
Brain waves play a significant role in the ability to sleep. If a patient is unable to enter into a restful and deeply restorative state, there could be a misalignment in brain waves causing a patient to feel unwell and never feel rested. Medications can be utilized to aid in sleep, but frequently result in a feeling of grogginess upon waking. Neurofeedback actually tackles the problem at hand at the root by retraining the brain waves in order to get quality sleep without the use of medications. 
 
For issues involving the brain and cognition, it is essential to tackle the issue from multiple directions, utilizing multiple forms of treatment.  As a pain-free and relaxing process, neurofeedback will maximize its growth throughout the coming years. Neurofeedback will continue to provide millions of individuals with a fully customized treatment plan to ensure optimal brain health, and alleviate years of morbid symptoms.

If there are any questions about neurofeedback please reach out through email or phone and MyBrainDr would be happy to discuss any inquiries. 
 
Email: admin@mybraindr.com
Phone: 919-721-4800
Website: www.MyBrainDr.com

Food and Mood

Blair Cuneo, PA-C

I think about many things this time of the year with seasons changing and holidays approaching. As a functional medicine provider, I consider how changing landscapes not only affect my patient’s physical health, but also their emotional health. This landscape or “environment” of less direct sunlight, more time indoors, increased celebratory food and drink and increased holiday stress has a major impact on mental health for many of us.

Our relationship with food is complex, as is our body’s response to our culinary selections. We hope that our bodies can effectively digest food and absorb its nutritious content, but how do we know if it doesn’t? We hope the foods we are eating are contributing to healthy neurotransmitter production, healthy immune system messaging, but what does it feel like if that’s not the case?

You’d think that your stomach would definitely let you know if any of the above was amiss, but consider this: approximately 30% of us will have a gastrointestinal/gut symptom if there are imbalances in digestion or immune activation, while the majority of us will have a “beyond the gut” symptom first, such as headaches, mood changes, sleep disruptions, fatigue and pain. Thus, the majority of people may not be thinking of a direct relationship between green bean casserole and their anxious or sad days.

Several things need to happen when we eat a meal. First, we need to be in a “rest and digest” state. This signals to the body it’s time to produce digestive acids, enzymes and bile to sterilize the food, break it down and absorb it well. Next, we need healthy proteins that can be broken down by these digestive supports to become the basic amino acids that our body will use as the building blocks to create neurotransmitters like dopamine and serotonin. Neurotransmitters are signaling molecules, providing communication between nerves. The balance of neurotransmitter production, absorption and clearance, affects mental and physical health. Further, this building of neurotransmitters requires cofactors of several micronutrients like zinc, vitamin B6, magnesium and vitamin D.

To cap things off, there can be immune system reactions to foods, allergies and/or sensitivities that are contributing to inflammatory messaging that starts in the gut, but travels “beyond the gut”, affecting our emotional state.

In my practice, I regularly see low levels these cofactors, low levels of digestive enzymes and gastric acid, high stress and of course, the daily challenge in regularly making healthy eating and drinking choices.

In order for a body and mind to be healthy, each of these areas needs to be considered, evaluated and addressed.

While there are objective tests available for providers to check your nutrient and digestive status, there are also excellent lifestyle supports to begin making a shift in your wellness today.

-Eat at regular intervals. It is less stressful for the body when it knows it can count on you to feed it. This also helps the timing of the digestive acids/enzymes release where there are patterns in meal timing.

-Whole foods. Limit processed foods. Head to the refrigerator, before you head to the pantry. Each meal should contain a protein, small amount of fat, and colorful fruits and vegetables.

-Mindful eating, not distracted eating. Try to avoid multitasking while eating. As often as you can, eat at a table, focused on your food and the company that you share. Look, smell, taste and chew well! Even the process of chewing is signaling release of enzymes.

-Connect with your healthcare provider to review your micronutrient and vitamin status. You might discuss multivitamin, magnesium and/or zinc supports and also test your vitamin D to help assign dosing recommendations.

Remember, Food can be medicine! Make sure you use it wisely!

Your Partner in Health!

Blair Cuneo, PA-C

Magnificent Magnesium

Frances Meredith, MD

In the times of COVID, so many nutrients seem to be in the news these days from quercetin to Zinc, to Vitamin D.  Overlooked I believe is the nutrient essential for every cell and every process in our body including immune readiness: Magnesium!

Magnesium is a cofactor for over 300 enzymatic reactions, supporting DNA and RNA synthesis, cell growth and reproduction. Magnesium enters the energy cycle as a cofactor in at least 12 different steps in the process, and is essential for the little batteries in every cell, our mitochondria, to transport electrons and create energy. It is necessary for bone growth and strength, stabilizing the cell membrane, and maintaining normal nerve and muscle function.

Magnesium sits within the cell, balancing all of our cells, keeping calcium outside the cell from overstimulating cellular activity in all parts of the body. For example, Mag balances Calcium in the NMDA glutamate receptor, controlling its opening, avoiding “neuroexcitation”.  Thus, lack of Magnesium sets the stage for nerve overactivation, hyperexcitability (think chronic anxiety, chronic pain, chronic states of inflammation created by lack of Magnesium). When we are Mag deficient this NMDA glutamate receptor activates. This is good for survival when we are under intense stress, but not something we want to live with on a day in and day out basis.

Low Magnesium can express itself in so many ways including fatigue, muscle cramping/tension, PMS, headaches, especially migraines, constipation, insomnia, tinnitus, brain fog, heart arrhythmias, anxiety and depression, TMJ, ADHD, and blood sugar issues. Sound familiar?  If that’s not enough, Magnesium deficiency is implicated in diabetes, osteoporosis, and hypertension. It is a natural “calcium channel blocker” (think drugs that do this such as amlodipine used for hypertension). The lower the Magnesium levels the greater the progression of Alzheimer’s. Fibromyalgia improves with Magnesium treatment. Increasing Magnesium intake is correlated with a decrease in stroke, diabetes, heart failure, fracture risk and all-cause mortality. Sounds like we all need more, yes?

Why are we so deficient? The answer lies both in the disruption of our food chain and the breakdown of our food choices. The soil is now deficient in Magnesium due to lack of crop rotation, pesticide use and overproduction; in addition, the use of fertilizer heavy in nitrogen and phosphate blocks the plants’ ability to absorb Magnesium.  Further, as foods are processed, Magnesium is leached out. The end product: less for us.

Testing for Magnesium is easy, with red blood cell levels being the most accurate form of testing. Body signals, however, are much more important than a test result. Symptoms such as myofascial and muscular tightness/tension/cramping, sluggish bowels, and low energy point to low Magnesium and a trial of Magnesium is warranted even without checking a blood level.

So how can we optimize Magnesium for all of the cells in our body to “sing”? It is clear that plant-based Magnesium is much more effective than the mineral in supplement form. This is due to the fact that Magnesium is at the heart of chlorophyll, responsible for the green pigment in our green foods. Plant based Magnesium is very absorbable and is already charged, essential for its function. The big winners for high magnesium are pumpkin seeds, spinach, almonds and cashews. This great link from Cleveland Clinic lists the magnesium content of many foods.

https://my.clevelandclinic.org/health/articles/15650-magnesium-rich-food

 Magnesium in supplement form can be very helpful, and must be attached to a “chelator” to get across the intestinal border. They are best taken with food to improve stability. Magnesium comes in forms including glycinate, citrate, theonate, asparate, orotate, and oxide, with different benefits associated with the specific chelators.

For example, the Mag oxide form is only minimally absorbed and very unstable, drawing water into the intestinal tract, helpful for severe constipation or impaction but not helpful to get Magnesium into cells elsewhere in the body. In contrast the Magnesium glycinate is more stable, better absorbed and better for anxiety or insomnia. Mag citrate is helpful for intestinal motility/constipation as well as energy as it plugs directly into our “Krebs cycle” to create energy.

In addition, optimal intestinal absorption is necessary, with Magnesium absorbed mostly in the ileum of our small intestines. Therefore, if things go awry in the ileum, our ability to absorb Magnesium (as well as other nutrients) will be impacted (think leaky gut, small intestinal bacterial or fungal overgrowth).

Sounds like most everyone would be better off with a little more Magnesium! If any of the above-mentioned symptoms or conditions apply to you, your functional medicine provider at Carolina Total Wellness would be most happy to discuss this with you.

Your Partner In Health

Frances T. Meredith, MD

5 Strategies For Stress Eating

Stress eating occurs when we eat in response to a stress signal instead of a hunger signal.  It is reaching for food to calm our nerves, soothe our sadness, chase away boredom or buffer against other emotions we are uncomfortable with.
 
When we stress eat we are usually reaching for sugary and/or salty foods.  It’s often food we eat with our hands.  Hand to mouth eating frequently occurs without much awareness or mindfulness.

 
Tips to Help Decrease Stress Eating:
 

1) Being Body Aware – This means getting in touch with your body.  Get back into your body, get grounded, get centered.    Are you truly hungry?  Pay attention to what sensations are going on in your body.  Has your heart rate increased?  Do you have butterflies in your stomach?  Are you feeling fragmented and disassociated in your body?  Feeling out of sync between body and mind?
 
You can bring yourself back to center by concentrating on your breath.  Put one hand on your chest and one on your belly and breathe in deeply.  Is the breath going to the upper chest area or the belly?  You want the breath to go into the low belly.  By doing this you engage the parasympathetic system (aka rest and digest) and reduce the sympathetic system (aka fight or flight).
 
2) Exercise your emotional muscle – Emotions are energy in motion.  Don’t be afraid to show your emotions.  We need to let emotions flow and we need to express them.  When we don’t do this we “eat our emotions” with food.  Emotional eaters tend to eat foods that are nutrient poor (junk food) instead of nutrient rich (veggies, fruits, healthy fats, lean proteins).
 
Keep a check on your feelings.  One way to do this is to check in with family and friends.  Be real about your emotions as this allows others to feel comfortable to open up with you as well.  Journaling is also a great tool for expressing your emotions. 
 
3) Developing alternatives – Rather than engaging in stress eating come up with alternatives.  Make a list of 5 things that you can do instead of eat when you are not really hungry but are craving food due to emotions.  Some ideas:  call a friend, physical movement, journaling, nap, read a good book, organize a drawer in your kitchen or bathroom.
 
4) Having healthy foods available – If you can’t fight the urge to eat, make the best choices with the cravings you have.  Ideas:  avocado for someone who craves fat, fruit for someone that craves sugar, cacao powder in water for someone who craves chocolate, olives for someone who craves salt. 
 
5) Fueling your body with real food – Be sure you are getting lots of nutrients so you are not vulnerable to the effects of stress.  Food modulates our mood and if we stick with whole unprocessed foods our mood will be better and we won’t feel as stressed.


Your Partner In Health!
Sara Yadlowsky, FMHC

Tips To Slow Down

Clarissa A. Kussin, ND, RYT-500

It has never been easier to connect with someone on the other side of the world, yet it’s so easy to feel disconnected from the people closest to us.  We have more tools than ever to simplify tasks and accomplish more things quickly, yet our to-do lists have never been longer. Life is short, and time flies, especially in today’s fast-paced world.  

These exercises are meant to help you slow down, enjoy life, and focus on the most important parts of your day.  Take the time to prioritize daily objectives.
 By focusing on the most important tasks to get done, we eliminate the hustle and stress of trying to accomplish everything at once. 
Cut personal Internet use by half.
Technology has become a major element in most of our lives. Social networking, email, and web-surfing can occasionally cause our minds to lose focus and wander through hundreds of topics, thoughts and ideas.
Try to use half your designated Internet time to explore new hobbies, exercise, or meditate.

 Enjoy nature.
When time permits – take a five to ten minute break to step outside and breathe in some fresh air. Disconnect from the rest of the world and concentrate on the beauty of nature.

Eat slower.
A lot of us tend to speed through meals – missing the chance to appreciate different textures and flavors. Start to chew foods slower and distinguish new tastes, aromas, and consistencies. 
 
Connect and make time for yourself.

Acknowledge and consciously thank yourself for taking care of YOU.  When did you last spend valuable time with yourself? Take a night to find a new book, watch a favorite movie, try yoga, meditate, or cook a new recipe.

Give yourself more time.
Some of us like to stick to a tight schedule and plan all our daily events. Next time you’re jotting down new tasks in your planner, try to factor in a few extra minutes when estimating how long things will take. This will help you not rush through daily tasks.

Take the scenic route.
Next time you’re driving a somewhat long distance – try taking the scenic route. Driving through open fields, mountains, or viewing a city skyline can be very relaxing.

Sit for a moment with your eyes closed when you start your computer. Even just a few moments of meditation can set the tone for the rest of your day. Try to empty your mind and take deep breaths before jumping into your day’s tasks.

Remember your goals and aspirations.
Each morning when you wake up, take a few moments to think about your life goals and aspirations. Try to recall the milestones you’ve already made in your life, and your drive to achieve new ones. Try doing this for about five minutes before getting out of bed to start your day.

Take the time and share this with someone you love that may need some support in slowing down…

 
Your Partner in Health!
Clarissa Kussin, ND, RYT 500

Health Benefits of Napping

Susan D. Denny, MD, MPH
“No day is so bad it can’t be fixed with a nap.” — Carrie Snow

With the hectic pace of day-to-day life, many people don’t get the recommended amount of sleep each night. According to the National Sleep Foundation, adults typically need between seven and nine hours of sleep per night in order to function at their best. Getting a few less hours for even a few nights in a row can have the same effect as staying awake for 24 hours straight. And, over time, chronic sleep debt can contribute to fatigue, increased stress levels, reduced attention span, and declined cognitive performance.

One way to combat the effects of sleep deprivation—and repay some sleep debt—is to incorporate daytime napping into your schedule. The length of the nap and type of sleep you get during that nap help determine its potential health benefits. The table below identifies these benefits.

Nap Duration  and  Potential Health Benefits

10-20 minutes:
 Reduces sleepiness; improves cognitive performance; increases alertness, attention, and energy levels; improves mood; improves motor performance; reduces stress levels

20-30 minutes:
Enhances creativity; sharpens memory

30-60 minutes:
Sharpens decision-making skills, including memorization and recall; improves memory preservation

60-90 minutes:
Rapid eye movement (REM) sleep, which is critical for problem solving; helps make new connections in the brain; enhances creativity; reduces negative reactivity; promotes happiness

  The following is a list of tips and tricks to help you make the most of naptime:

Choose a dark, quiet, comfortable place where you can relax. Try to limit the amount of noise and light in the room, and make sure the temperature is comfortable. Choose a time that works for you, and aim to nap at that time each day to establish a routine. You may find that restricting your naps to early afternoon (between 1:00 pm and 3:00 pm, or an hour or two after lunch) is less likely to interfere with your nighttime sleep patterns. Set an alarm on your cell phone, watch, or computer so you don’t sleep for too long. If you’re napping at the office, try closing your door and hanging a sign that says, “will return in 20 minutes.” Alternatives to this are napping in your car or on an outdoor bench.

Wherever you nap, bring along something that you associate with sleep. Some ideas include a sleep mask, neck pillow, relaxing playlist and headphones, cozy blanket, warm socks, and lavender essential oil to dab on your pulse points.

Keep in mind that longer naps may be accompanied by sleep inertia, or a period of grogginess that sometimes follows sleep. Give yourself time to wake fully before returning to any activity that requires a quick or sharp response. 

Your Partner In Health!
Susan D. Denny, MD, MPH