Nutrition Blog

Tips For Overeating

By: Dr. Monica Duvall

One of the most common eating disorders in U.S. women is Binge Eating Disorder with a lifetime prevalence of 3.5%.   Binge Eating Disorder is characterized by episodes of eating larger-than-normal amounts of food until uncomfortable or full, coupled with a feeling of lack of control.  It may also include eating faster than usual, eating when not hungry, eating alone out of embarrassment, and/or feeling guilty after eating.  Frequently, individuals will have patterns of restrictive eating in between episodes.  Episodes occur at least once a week for a period of three months, can impair social functioning or potentially cause health problems.

For many people, overeating is an occasional or less dramatic occurrence, not meeting the above clinical criteria.  It is not clear why some people develop binge eating disorder, but there is a high prevalence of comorbid psychiatric conditions in people with this disorder, including depression, anxiety, and phobias.  About 50% of those with Binge Eating disorder are overweight, about the same as in the general population.  For those who are trying to optimize their eating habits overall for better health, recognizing triggers and becoming more educated about food and nutrition is useful.  Meeting with a nutritionist to discuss healthy food choices and appropriate portion size is a good start.   Having a plan ahead of time for a holiday or special occasion meal, such as not having second helpings or focusing more on the healthier parts of the meal can also help.   For anyone who feels their overeating is causing personal distress, or has evolved onto the spectrum of Binge Eating Disorder, the most successful treatment strategy is Cognitive-Behavioral therapy, either in a group or individual setting.  Medications can be used as a second-line therapy, usually the SSRI antidepressants.  The first step is to recognize if your eating behaviors have gotten out of your control, and to seek assistance from your provider to determine the best treatment option for you.

Emotional well-being, dementia and nutrition

 
By: Marissa Martino, RD, LDN

Not everyone may realize, but nutrition has everything to do with our mental health. In fact, all body functions are connected and intertwined in one way or another. The recognition of the brain-gut axis, or connection, has been on the rise and we are finally acknowledging the importance of a healthy gut. And by gut, we don’t mean the “stomach, belly or tummy”, we mean the GI tract- specifically the small and large intestines. To many, it’s a foreign concept that our overall health lies in the condition of our gut.


Alzheimer’s, which is just one form of dementia, has actually been termed Diabetes Type 3 due to the correlation of dramatic decline in cognitive function and chronic insulin resistance… Lot’s of big words. Let’s back up a minute. What causes insulin resistance in the first place? Well, we have three macronutrients that fuel our bodies- Carbs, Proteins, and Fats. Can you guess which one is related to diabetes? 

You guessed it- Carbs. 

All carbs eventually turn into glucose, which raises our blood sugar. Insulin then is released to allow the digested sugar into our cells. However, eventually our cells become insulin resistant and stop absorbing glucose, leaving sugar in the blood stream. Uncontrolled insulin resistance leads to type 2 diabetes. 

So what about the previously mentioned “Type 3”? Well first off, increased sugar in the body causes chronic inflammation. This means that our gut, which has also been termed our “second brain”, is so inflamed that it cannot properly absorb any nutrients from the food that we’re eating- assuming that we are even eating nutrient dense foods.  

Free flowing sugar also means sticky, or viscous, blood. Increased viscosity can impair blood flow to the brain which affects how much oxygen and nutrients the brain cells are receiving. When circulation in the brain is compromised, you are at an increased risk of stroke and the development of dementia. In addition, insulin resistance impairs signaling to the brain and prevents brain cells from properly utilizing glucose for energy. Overall brain functioning suffers as a result of this.1  Ever have difficulty thinking straight due to low blood sugar? This is the same concept- except a bit more deep-rooted. 

The gut-brain axis is complex yet fascinating. We have discounted the association for so long but recently are coming to terms with just how powerful the health of our gut is, (or lack thereof). “The gut–brain axis seems to influence a range of diseases, and researchers have begun to target communication pathways between the nervous system and the digestive system in an attempt to treat metabolic disorders specifically.” 2

Have you ever been nervous, felt nauseous or had butterflies in your stomach? This is because the GI tract is sensitive to emotions, which go hand in hand with the hormones that are regulated by the brain.3 The connection goes both ways since over 90% of serotonin (the happy hormone) is produced in the gut. Therefore, if your gut is inflamed from an unhealthy diet, say goodbye to serotonin and hello to mood swings, anxiety, and depression! 

If you’re interested to find out if you have a healthy gut, before you spend the copay on a very uncomfortable endoscopy or colonoscopy, see a registered dietitian who can assess whether your daily intake is helping or hurting you.

 1 http://dlife.com/type-3-diabetes/

2 https://www.scientificamerican.com/article/metabolism-in-mind-new-insights-into-the-gut-brain-axis-spur-commercial-efforts-to-target-it/

3 http://www.health.harvard.edu/diseases-and-conditions/the-gut-brain-connection

Food and Your Skin

By: Angela Luciani, Registered Dietitian

The skin is the largest organ in the human body and its main function is to act as protection for internal organs from external factors such as pollution, toxins, and the environment. Diet is an important factor in the health and overall appearance of your skin - while some foods may be beneficial for your skin, paying attention to how your skin reacts to certain foods is your body’s way of alerting you that you may be allergic or intolerant. Believe it or not, there is a difference. A food intolerance is often mislabeled as a food allergy; however, the reaction does not involve the immune system and is often delayed in response.

A food allergy occurs when your immune system overreacts to a food or substance in a food, identifying it as a danger and triggering a protective, usually immediate, response. Symptoms of a food allergy may include but is not limited to tingling sensation of the mouth, swelling of the tongue and/or throat, hives, skin rashes, abdominal cramps, diarrhea and more. Severe reactions known as anaphylaxis can result in death. Common food allergies in children include milk, eggs, peanuts, tree nuts and soy while food allergies in adults are caused by fish, shellfish, peanuts and tree nuts.

Other skin problems including psoriasis, eczema, rosacea and acne are inflammatory responses and may be a heightened by the foods that you eat. It is demanding to define which foods may be exacerbating symptoms. Determining food allergies and intolerances poses a challenge and diagnostic tests can be expensive and unreliable.  It may be effective to remove suspected foods from your diet and observe changes.  Completing an elimination diet can help evaluate which foods you should avoid; however, it can also be difficult. A dietitian can help in assessing and re-assessing your food logs, eliminated foods and supplements to ensure you are maintaining a healthy diet and avoiding deficiencies. 

Produce: Fresh, Frozen or Canned?

By: Marissa Martino, Registered Dietitian

Having access to the millions of food choices every day is a privilege that not everyone can say they have. While it’s a great benefit to be able to choose healthy foods for ourselves and our families, sometimes the amount of options can be overwhelming, especially while trying to stay on a budget. In terms of produce, how do we know to choose between fresh, frozen or canned?

The first choice should always be fresh, local produce- if available. If your town has local farmers, or a farmer’s market, take advantage! Local produce is ideal since the time between harvest and your purchase is very short-lived. The nutrients and enzymes are still alive and potent. Not many people have handled the produce, and there isn’t a lot of travel time from where the produce was grown and picked, to where it is being sold and purchased.

                Since not all of us are lucky enough to have local farmer’s markets, there are some secrets to choosing the best option at the grocery store; which include fresh, frozen or canned fruits and veggies. Many people would argue that fresh produce is the best. However, several studies show that fresh veggies lose about half of their nutrient content in less than a week. This is because vitamins and minerals can be easily destroyed by light, air, and handling. Consider how much time passes from when and where produce is picked, to the travel time to the store and then the actual display where they may sit for a few days as several shoppers handle them, squeeze and sniff them, only to put them back. Produce then continues to lose its  nutritional value. So unless you are buying and eating your produce daily, fresh is not always the way to go.

Make your way to the frozen aisles. Normally, we associate frozen foods with processed, high sodium junk foods. But, the frozen veggie and fruit sections are key! Not only is frozen produce cheaper, but the nutrient content is much higher than that of fresh. This is because the process of freezing veggies starts with harvesting them at their peak nutritional state. Then, they are blanched to kill off any bacteria. Lastly, they are flash frozen, which essentially locks in the nutrition of the veggies.  If you choose the “steamfresh” bags, then even the preparation of your veggies will retain most of its nutrients, since steaming is the best way to do this.

Finally, we have the option of canned fruits and veggies. Let’s put aside the not-so-appetizing color and texture of canned string beans, and take a look at the facts. During the canning process, they lose up to half of their vitamin content, which continues to decrease another 20% each year that they are sitting on your shelf.

In conclusion, unless you are either growing your own produce, or have a local farmer’s market, or stop at the grocery store daily for your produce, stick with the frozen options for your health and your wallet!

Earth Day Tips for Eating Clean While Going GREEN!

By: Angela Luciani, Registered Dietitian

Earth day is celebrated on Saturday, April 22nd. You can help celebrate by incorporating some sustainable practices through your eating habits and daily routine that can protect the environment!


1)      Choose fresh and local - Fresh and local is a great way to help out the environment by reducing fuel for transportation! There are lots of opportunities to ‘eat local’ in Philadelphia through restaurants, food co-ops, community supported agriculture, and farmers markets. Keep in mind the seasonality of the produce. You can find out what is in season by checking out the link here for a list: https://snaped.fns.usda.gov/seasonal-produce-guide

2)     Grow your own - If you have the space: start with easy to grow vegetables such as cucumbers, tomatoes, or peppers. If you are living in an apartment or don’t have an outdoor area, you can still grow herbs in a small pot on your windowsill or consider joining a community garden!

3)     Eat clean -  Aim to consume more plant-based, minimally processed foods to cut back on packaging and pollution from transportation and manufacturing. Choose organic, when possible, to reduce pollution in the air and soil, and waste by helping reduce the use of pesticides. Check out the dirty dozen list here for foods that you should aim to purchase organic.  https://www.ewg.org/foodnews/dirty_dozen_list.php

4)     Reduce waste - Food waste has a negative impact on the environment – try getting creative with how to use your leftovers such as taking vegetable leftovers for a morning omelet or using the unwanted ingredients such as the skins/stems for making a delicious broth. When grocery shopping: cut back on food packaging and paper goods by purchasing in bulk for cooking and freeze the rest for another meal and using your own reusable grocery bags!  

When we reduce, reuse and recycle by choosing fresh and eating clean, we can minimize our carbon footprint while simultaneously benefiting our health! If you would like more information on healthy eating, don’t hesitate to schedule an appointment with one of our dietitians today!

Nutrition and Kidney Health

By: Marissa Martino, Registered Dietitian

Most of us don’t even think about our kidney health until they are already in danger, whether that’s from uncontrolled blood sugar levels or other complications like high blood pressure or obesity. The status of our kidneys depends greatly on our diets, and is impacted by the different foods that we eat, as well as hydration levels. Before we discuss kidney health, let’s ask the question: What do your kidneys do? About 200 liters of blood are filtered daily through your kidneys, removing up to 2 liters of water and waste products via urine. If our kidneys are not working as efficiently as usual, the process of blood filtration is not as effective leaving dangerous amounts of waste in our body. The kidneys also release hormones that regulate blood pressure and produce red blood cells.

There are also kidney-friendly superfoods that we can incorporate into our diet on a daily basis. These include cruciferous veggies such as cabbage, cauliflower which are high in Vitamins C and K, but low in potassium. Berries are high in antioxidants and also have anti-inflammatory properties which are important for your kidneys as well as your entire body. Healthy fats such as fish and olive oil contain omega-3’s which also help prevent inflammation.

No one wants to deal with dialysis on a weekly basis, so being proactive with kidney health is important and smart. Even without a diagnosis of DM2 or kidney disease, we should take preventative measures. Patients who do have a diagnosis that can compromise kidney health in the future can still utilize these and other preventative measure to care for their kidneys as best as possible. Talk to your doctor about kidney-protective medications and talk to your local dietitian (that’s me) about changing your diet for optimal health. Once kidney damage is done, it’s irreversible, however, avoiding the damage is possible in many cases and can lead you to a much better quality of life.

There are preventative measures that can be taken to keep your kidneys healthy:

-       Limit alcohol intake
-       Watch out for salt by staying away from packaged, processed, canned foods
-       Read food labels -  make sure salt is under 20%
-       Get your bloodwork done! Kidney disease is a silent killer and symptoms don’t start to show until there is already significant damage in place..

Stay healthy and even if you have been diagnosed with a kidney damaging illness - do not lose hope. In many cases, these illnesses are not a death sentence, but they do require more effort to stay active and healthy. When in doubt, call our office and schedule an appointment with your physician or dietitian!

Nutrition Related Birth Defects: Healthy Eating During Pregnancy

By: Angela Luciani, Registered Dietitian

There’s no reason to wait for a positive pregnancy test to start making healthier choices and aim for an overall healthier lifestyle. Incorporating healthy habits is important and beneficial at any stage of pregnancy but also before conception. Implementing healthier habits before pregnancy can improve the health of the mother as well as the baby by preparing the body for the high demands of pregnancy. Women are susceptible to a number of complications during pregnancy.  Research suggests women who are obese (BMI over 30) have a higher incidence of pregnancy-induced hypertension, gestational diabetes, cesarean delivery, and macrosomia. Being either underweight or overweight can reduce the chance of conceiving. Ideally, both partners should aim for a healthy BMI (between 18.5-24.9). Excess body fat or insufficient amounts can interfere with fertility.  Starting pregnancy at a healthy weight can lower the risk of complications. Eating well can help keep blood pressure, blood sugar levels and weight at normal levels and can help reduce incidence of complications. 


While there are a various factors that influence a healthy pregnancy, good nutrition is, without question, a determining factor in both a healthy pregnancy and baby. Women who are overweight or obese before conception are more likely to have a baby with a structural defect, including neural tube defects. Neural tube defects may be preventable through a healthy lifestyle and adequate nutrition. Spina bifida is a condition in which the fetal spinal column is unable to close completely during the first month of pregnancy, causing damage to the developing spinal cord. Anencephaly is a more serious defect and prevents the development of the brain. Birth defects occur in the first weeks of pregnancy. Folic acid can help prevent neural tube defects; therefore, it is important to have these nutrients in your system during early stages of the baby’s development. Women of childbearing age should consume at least 400 micrograms (.4mg) of folic acid daily to prevent these two common and serious birth defects. Women carrying twins or more, and those with epilepsy or diabetes require extra folic acid. Another essential vitamin to prevent neural tube defects is choline. Ensuring adequate choline may not only lower the risk of brain or spinal cord birth defects but it may also enhance the development and function of the placenta and possibly lower an infant’s vulnerability to stress-related illnesses including mental health disturbances, hypertension and type 2 diabetes. The recommendation for choline is 425mg per day for women and increases to 450 mg per day when pregnant and 550 mg per day for lactating women.

Optimal fetal brain and eye development is dependent on omega-3 fatty acids, DHA and EPA which can be found in seafood and fish oil. Research has revealed long-term benefits of prenatal omega-3 fatty acid intake includes higher memory function later on. DHA may lower incidence of colds in infants and shorten duration of symptoms associated such as coughing and fever. Women should aim for 650mg of omega-3 fatty acids, of which 300 mg is DHA per day. Consuming 2-6-oz servings of low mercury fish per week such as wild caught Alaskan salmon, tilapia, shrimp or cod provides 100-250mg of omega-3, of which 50-100mg is from DHA.  Consider incorporating fish oil capsules, which are low in contaminants of mercury to assist in meeting the recommendations.  Vegetarians can obtain DHA from algae-derived DHA supplements.

Iron is necessary for both fetal and placental development and needs increase dramatically after becoming pregnant. Consumption of foods rich in iron is necessary to prevent a deficiency and/or anemia. Research suggests that iron stores at time of conception are a strong indicator for risk of developing iron deficiency anemia later in pregnancy and deficiency may increase risk for preterm delivery. Pregnant woman need at least 27 milligrams of iron each day..  Low levels of Vitamin B-12, which is essential in the production of red blood cells, can also lead to anemia.  The RDA for B-12 for pregnant females is 2.6 micrograms and 2.8 micrograms for breastfeeding females.

The best thing you can do for your baby is eat a healthy, well balanced diet.  It is important to understand the benefits of good nutrition prior to, as well throughout, pregnancy in order to minimize potential risks and complications. A well-balanced diet is achievable; however, may be difficult to obtain optimum levels of nutrients through diet alone; therefore, incorporating a prenatal vitamin prior to and throughout pregnancy may be necessary and can improve your chances of having a healthy baby. 

Foods that Support Emotional Well-Being


By: Marissa Martino, Registered Dietitian

     Not many people associate emotional well-being with nutrition. Usually when we think about what we eat, we relate that to our physical health and how it affects our weight and appearance. However, that is only scratching the surface of the variety of roles that food and nutrition play. Food is made up of two categories:  macronutrients, or the caloric content of food- which includes carbohydrates, proteins and fats. The second category is called micronutrients, which consist of all of the vitamins and minerals. These macro and micronutrients are what affect our mood, energy levels, hormone balance and even the chemicals in our brain such as serotonin and dopamine.

 

Nutrient deficiencies can happen from not getting a good mix of unprocessed foods such as: whole grains, beans and legumes, lean proteins and a variety of colorful fruits and vegetables. Each color category of fruits and vegetables provides a different phytochemical make up. For example, dark purples and blues are primarily beneficial for their anthocyanin content, which is good for brain and cognitive health. Greens provide isothiocyanates, which supports liver function and cell health. Yellows and oranges serve as a good source of beta-carotene which supports your immune system and eyesight. When we don’t eat enough of nutrient dense whole foods, we are denying our bodies the correct balance of nutrients. Eating a diet high in carbs and processed foods can mess with our blood sugar levels and serotonin stability which can contribute to mood swings and depression. A lack of B vitamins (which come from legumes, whole grains and seeds) can cause irritability, fatigue and poor concentration.

 

Another important part of the equation is making sure we actually absorb the nutrients that we eat!  Many of us have poor “gut” health and chronic inflammation. Our “gut”, or intestines, are actually what absorb the nutrients from the food we eat and pass them into our bloodstream where they can be used. Your intestines are most likely inflamed if you experience any type of IBS, such as constipation, diarrhea, and cramping or bloating after eating. This means that you’re probably not absorbing the nutrients from your food correctly. Probiotics are the number one source for reestablishing a healthy flora in the gut.  However, contrary to popular belief, food sources like yogurt do not contain enough probiotics to balance out the healthy bacteria. Taking a probiotic supplement that is more concentrated with the right amount of live cultures is extremely important for mental, emotional and physical health.  To learn more about how nutrition and which probiotic brands are the most beneficial and affordable, make an appointment with one of our Registered Dietitians today!

Not many people associate emotional well-being with nutrition. Usually when we think about what we eat, we relate that to our physical health and how it affects our weight and appearance. However, that is only scratching the surface of the variety of roles that food and nutrition play. Food is made up of two categories:  macronutrients, or the caloric content of food- which includes carbohydrates, proteins and fats. The second category is called micronutrients, which consist of all of the vitamins and minerals. These macro and micronutrients are what affect our mood, energy levels, hormone balance and even the chemicals in our brain such as serotonin and dopamine.

 

Nutrient deficiencies can happen from not getting a good mix of unprocessed foods such as: whole grains, beans and legumes, lean proteins and a variety of colorful fruits and vegetables. Each color category of fruits and vegetables provides a different phytochemical make up. For example, dark purples and blues are primarily beneficial for their anthocyanin content, which is good for brain and cognitive health. Greens provide isothiocyanates, which supports liver function and cell health. Yellows and oranges serve as a good source of beta-carotene which supports your immune system and eyesight. When we don’t eat enough of nutrient dense whole foods, we are denying our bodies the correct balance of nutrients. Eating a diet high in carbs and processed foods can mess with our blood sugar levels and serotonin stability which can contribute to mood swings and depression. A lack of B vitamins (which come from legumes, whole grains and seeds) can cause irritability, fatigue and poor concentration.

 

Another important part of the equation is making sure we actually absorb the nutrients that we eat!  Many of us have poor “gut” health and chronic inflammation. Our “gut”, or intestines, are actually what absorb the nutrients from the food we eat and pass them into our bloodstream where they can be used. Your intestines are most likely inflamed if you experience any type of IBS, such as constipation, diarrhea, and cramping or bloating after eating. This means that you’re probably not absorbing the nutrients from your food correctly. Probiotics are the number one source for reestablishing a healthy flora in the gut.  However, contrary to popular belief, food sources like yogurt do not contain enough probiotics to balance out the healthy bacteria. Taking a probiotic supplement that is more concentrated with the right amount of live cultures is extremely important for mental, emotional and physical health.  To learn more about how nutrition and which probiotic brands are the most beneficial and affordable, make an appointment with one of our Registered Dietitians today!

Stress Eating

By: Marissa Martino, Registered Dietitian

Anyone can be affected by the negative habit of stress eating, whether it’s more prevalent during the holidays, or even all year around. There are many reasons why we binge eat because of stress, but luckily there are also many ways to confront this destructive behavior. First, is to understand exactly why we stress eat. Biologically, our bodies are regulated by hormones, many of which control and greatly affect our weight. Cortisol, the “stress hormone” can actually create cravings and make it physically harder for our bodies to drop fat. This hormone is important to be aware of since it can create nervous energy and make us “orally fidgety”, causing nail biting, teeth clenching and also eating without being aware. To grasp stress eating, we need to first understand that for many people, emotions become tied to eating habits, which makes weight and anything related to, such as food, a very emotional subject. It’s important to recognize what emotion is driving us to eat, and realizing that the end result is always the same- guilt, along with the same emotions from before eating lurking close by. This is why the first step to combating stress eating is to figure out what your triggers are.

What emotion prompts you to crave foods, and what caused that emotion? The next step is to become comfortable with confronting that emotion and learn how to openly communicate with whomever or whatever the trigger is for that emotion. Another trick is to keep a food journal. As a dietitian, I recommend this for everyone- whether you’re dealing with stress eating, want to lose weight, or even just become a healthier version of yourself.

Documenting   everything that you consume will make you much more aware of your selections. You can also assess your hunger levels each time before you eat or drink- are you physically hungry (grumbling), or are you just bored? After you eat or drink, then document your satiety level. If you were actually hungry, the result of eating should be satisfying. If you ate or drank due to stress or boredom, your satisfaction level will be much lower.

Another important key is replacing a stress eating with a healthy habit. Once you understand what your trigger is, tame that stress by engaging in something that interests you, whether it’s yoga, going to the gym, meditation in a quiet place. Fight boredom with whatever hobbies interest you and don’t forget to do a hunger check before eating or drinking. If you are concerned with weight loss, keep temptations out of the house to avoid any mishaps. Battling stress eating is a journey to understanding ourselves better and becoming healthier physically and also mentally. Also remember that we are all human, and if we fall off track, don’t wait until the next day to get back on track. Learn from your setback and move past your obstacles as quick as possible. Believe in yourself and be a part of your own support system!

 

How Food Affects Your Skin

By: Marissa Martino

On average, women spend roughly $75-$100 on skin care products a month, and some over $250 a month! This probably doesn’t sound surprising to all of those Ulta and Sephora addicts out there. Whether it’s for clear, wrinkle-free skin, shiny hair, strong nails or a healthy glow, we are constantly looking for the next best skin care product. 

Rather than focusing so much on what we put on the outside of our bodies, we should also focus on what we’re putting inside our bodies. What you eat has a lot to do with your appearance - not just your waistline. Nutrients that we get from whole foods can have several benefits for our skin. Antioxidants such as vitamin C and E can help prevent wrinkles and increase elasticity in our skin. Did you know that tomatoes contain a chemical called lycopene which has been shown to improve our skin’s natural SPF and protects it against sun damage?

However, the food we eat can also do the opposite. Refined white products such as sugar, salt and highly processed foods, can increase stress hormones that cause breakouts. A diet high in saturated fats promotes the production of free radicals that can prematurely age skin. On the other hand, healthy fats such as omega 3’s that we get from salmon and flax seeds can help strengthen skin cells and reduce inflammation. Other fats that are essential for healthy skin include avocado, olive oil, and a variety of nuts and seeds. Minerals such as zinc promote healthy skin turnover; on the contrary a zinc deficiency can cause abnormal pigmentation along with stunting hair and nail growth. Last but not least, one of the most important nutrients that we can include in our diets for a beautiful complexion and healthy glow is water!

Take a look at what you are eating (and what you aren’t) and try to make some changes to improve your diet! You may start seeing changes right away and be able to cut back on some of those cosmetic expenses by simply changing your eating habits. And of course, if you need help sorting through the different foods that can help your skin look its best, you can always make a nutrition appointment with us. We look forward to helping you look and feel your best!

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