Private: Blog - 23 Nutrition Therapy

12Oct

Stressed out woman with pink shirt and pink background with drawings around her head

23 Nutrition Therapy TeamLifestyle, Stress

HPA Axis Dysfunction and Chronic Stress

Evolution has hard-wired our bodies to react to threats in a very specific way. The stress response is a survival mechanism that primes our bodies to be able to fight or flee when we are faced with a threatening and stressful situation, such as when you see a lion watching you from a distance.

Nowadays, we don’t get into positions that require us to fight off predators frequently, but we do experience many other situations that stress us out, triggering the hard-wired, automatic stress response.

The modern lifestyle in today’s world throws so many hassles at us that our ancestors never had to experience. Work, worrying about finances and paying bills, sitting in bumper-to-bumper traffic, and navigating life during a pandemic… Consequently, your body treats these non-life-threatening stresses the same way as it would a threat to your life.

When you are in a state of constant stress, this evolutionary survival response is triggered repeatedly, and over time becomes extremely detrimental to your overall health.

Today, the stress response kicks in more frequently than ever and can lead to many different health issues. So what exactly happens in the body when we encounter a stressful situation?

The Hypothalamic Pituitary Adrenal Axis – Explaining the stress response

The stress response consists of a series of physiological events in the body that proceeds like a domino effect almost instantaneously. The sequence of events happen before the brain’s visual centers can even fully process the event, which is why it is sometimes possible to react to a dangerous situation before you even realize what is happening.

When you experience or perceive a threat, physical or psychological, this information is sent directly to the amygdala – the emotional processing center of the brain. Your amygdala concludes that the situation is a threat, and then signals the hypothalamus – the brain’s command center – to sound off both neural and hormonal (AKA neuroendocrine) alarm signals to the rest of the body.

The hypothalamus starts by activating the sympathetic nervous system, which triggers the fight or flight response so your body can respond to the perceived threat. This happens through the sympathetic stimulation of the medulla of the adrenal glands, which releases epinephrine (AKA adrenaline) into the bloodstream.

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Epinephrine/Adrenaline Rush

This surge of epinephrine causes your heart to beat faster and your blood pressure to increase, in order to push blood to your muscles so you can better fight or escape the threat.

Stored glucose and fatty acids are released into the bloodstream to provide energy throughout the body. Your breathing rate increases in order to bring more oxygen into the body, which is sent to your muscles and to the brain to increase your level of alertness.

Meanwhile, the hypothalamus also sends off a second alarm signal to keep the sympathetic nervous system activated so that you’re able to continue to face the threat. This second alarm signal goes through what is called the hypothalamic-pituitary-adrenal (HPA) axis.

HPA Axis and Cortisol, The Stress Hormone

This second alarm signal is a hormone called corticotropin-releasing hormone (CRH), which travels to the anterior pituitary gland where it binds to CRH receptors, triggering the release of adrenocorticotropic hormone (ACTH).

ACTH travels through your bloodstream to reach the adrenal glands, where it binds and triggers the release of cortisol – commonly known as the stress hormone.

Cortisol keeps your body on high alert until after the dangerous situation is over with, through mobilizing energy stores and increasing blood sugar levels for a quick energy source to be used throughout the body.

Once cortisol levels start to fall, the parasympathetic nervous system (the rest-digest system) kicks in to diminish the effects of the stress response.

While the stress response is going full steam ahead, nonessential activities (such as digestion) in the body are halted. Blood is shunted away from the digestive system and other non-essential processes, towards the muscles and heart where more oxygen is needed.

Any system that doesn’t immediately serve to address the threat is shut down to conserve energy for the fight or flight response. Our bodies were designed to face stressors automatically and with intensity in order to ensure our survival.

The stress response is supposed to be self-limiting, meaning that once the event is over, the stress hormones should go back to normal levels. The diminishing of the stress hormones allows your heart rate, blood pressure, breathing rate, and blood sugar to also decrease to normal levels.

However, even in the past the dangerous situations that prompted this kind of response didn’t happen continuously throughout the day. Today, many people face constant, daily low (or high) levels of stress that keep the stress response turned on. This leads to HPA axis dysfunction, disrupting normal bodily processes, and over time can contribute to negative health outcomes.

Sympathetic Dominance – What happens when stress becomes chronic?

Chronic stress triggers the stress response over and over again. Cortisol levels remain high, making it nearly impossible for the parasympathetic nervous system to take over and fulfill its job in certain bodily processes.

When the parasympathetic nervous system is unable to fulfill its duties because you’re spending most of your life using your stress-based sympathetic nervous system – this is called sympathetic dominance.

Chronic Stress, Digestion, and Appetite

One of the roles that the parasympathetic nervous system is blocked from fulfilling due to sympathetic dominance or HPA axis dysfunction is digestion. So, it makes sense that digestive issues are a common result of chronic stress. Indigestion, IBS, malabsorption of nutrients, and many other gut health issues can be caused by – or exacerbated by – chronic stress.

These high cortisol levels also contribute to increased appetite, especially for sugar and simple carbohydrates, that can lead to overeating and weight gain, and eventually even obesity. There is a huge connection between cortisol and belly fat.

A common sign of high cortisol levels is higher levels of abdominal visceral fat, which appears as a “pot belly.” High levels of visceral fat are associated with type 2 Diabetes, cardiovascular disease, and metabolic syndrome.

Chronic Stress, Inflammation, and High Blood Pressure

Chronic stress can lead to chronic inflammation, which can also keep cortisol levels elevated. Cortisol suppresses the immune system, making you more susceptible to illness and gastrointestinal issues. This can put you at risk to develop an autoimmune disease.

Another job that cortisol has is to help deliver oxygen to muscles by constricting blood vessels, which increases blood pressure. Chronic high cortisol can lead to chronic high blood pressure. This can damage blood vessels and cause blockages, paving the way for a heart attack.

HPA Axis Dysfunction and Chronic Stress

Other common issues that can arise from the overexposure to stress hormones include anxiety, depression, headaches, sleep problems, and memory issues.

Long-term stress causes HPA axis dysfunction or adrenal dysfunction. This puts you at risk for adrenal fatigue, where your adrenal glands have difficulty keeping up with the body’s constant demands to keep pumping out the hormones needed. This results in many body systems shutting down and you end up feeling completely burned out.

The effects of HPA Axis Dysfunction and chronic high cortisol can include:

Indigestion
Malabsorption of nutrients
Gut health issues
Sugar cravings and increased appetite
Weight gain (especially around abdomen) and obesity
Type 2 Diabetes
Cardiovascular Disease
Metabolic Syndrome
Chronic inflammation
Suppressed immune system
Hypertension (high blood pressure)
HPA Axis Dysfunction, Adrenal Dysfunction/Burnout/Fatigue

Graphic listing signs of chronic stress and high cortisol

Low Stress Resilience – Why do some people have stronger reactions to stress?

You may have realized that some people react more strongly than others to stressful events. We all know someone who we would describe as “high-strung”. There is also the type of person who holds in all of their emotions. Finally, we may envy someone who is strangely calm when they’re under pressure.

But why is this the case? There are a few things that determine your stress resilience (your ability to react better under stress).

Genetics and Epigenetics

How we react under stress has a bit to do with genetics. People that react very strongly may have certain genes “turned on” that amp up their stress response The people who can stay relatively calm may have slightly different genes that better protect them.

Epigenetics (alterations to gene expression) in the form of gene tagging may also have an effect on how we react to stressors. For example, certain chemical compounds, like methyl groups, attached to certain genes can act as a block during gene expression. This makes it more difficult for the gene to be translated into a protein by blocking the gene, potentially altering brain signaling.

Early Life Trauma

Early life trauma also has a huge impact on how we react to stress. These traumatic events occur within the first 20 years of life while the stress systems are still developing.

These traumas can include things that aren’t even a part of your explicit memory, such as our time during infancy. Traumas can include anything that impacts you emotionally: trauma is any experience that elicits a negative emotional reaction. Early life trauma can lead to epigenetic changes to the stress systems and to the gut-brain connection.

Gut Microbiome

Another part of our physiology that early life trauma can impact is our gut microbiota. In early life, the development of the stress response is influenced by our gut microbiota. Our gut microbiome influences the brain through the metabolites and other products they produce within our digestive tracts. This is a relatively new area of research, and we’re now finding out how the bacteria that live in our gut impact our daily lives.

Three things that can negatively affect stress resilience:

Genetics and epigenetics
Early life trauma
Gut microbiota or dysbiosis (imbalance in gut microbiota)

How to lower cortisol levels naturally – what you can do to tone down your stress response

Finding ways to better manage stress can lead to better health outcomes. Eliminating unnecessary stressors is always a good place to start. But some stressors in life are unavoidable and out of our control. For the stressors you can’t control, practicing stress management and using relaxation techniques are great strategies.

Sleeping well and eating healthy are both key factors that can help keep your stress levels low.

It is also important to take time for hobbies and do the things that you enjoy. This is so important for stress reduction and helps you maintain a sense of overall well being.

Staying active is another essential way to de-stress. Exercise leads to deeper breathing, which activates the parasympathetic nervous system. Muscles loosen up, relieving tension in the body. Yoga is a great way to increase mental focus while getting your muscles moving and producing a sense of calm.

Relaxation Techniques to Repair HPA Axis Dysfunction

There are quite a few self-soothing relaxation techniques that can be used to dampen your stress responses once they are activated.

These exercises include things like deep breathing, mindfulness, and meditation. These exercises can be done when you are experiencing stress to get your parasympathetic nervous system to kick in.

The exercises can also be done throughout the day in order to train your body to stay more relaxed when stressful events do occur. Practicing relaxation techniques can repair HPA axis dysfunction, making you more resilient in the face of stress.

Importance of a Lifestyle Overhaul

If you think you’re experiencing the effects of chronic stress, it is helpful to do a complete lifestyle overhaul to put you in a better position to deal with stress.

This lifestyle overhaul isn’t meant to add more stress to your life. It is best to start by adding just one of the things mentioned above. Find out what works best for you, and then slowly add on more stress-reducing activities or exercises.

Improving your resilience to stress is key to long-term health, and can help to prevent many negative health outcomes. When you’re feeling stressed out by things you cannot control, starting with one simple step can ultimately help you to gain more control over your response to stress.

Ways to lower cortisol naturally to Fix HPA Axis Dysfunction:

Yoga
Mindfulness
Meditation
Deep breathing exercises
Lifestyle overhaul

Are your gut health issues adding additional stress in your life? Let’s tackle that together!

Schedule a meeting today to get started on the pathway to better gut health. Let me help you can gain control in your life and stress less.

Take this quiz to evaluate your stress resilience

12Oct

23 Nutrition Therapy TeamDigestion

Restore Gut Health Using the 5 R Protocol

There are so many different problems we can face when it comes to gut health. Constipation, diarrhea, cramping, gas, acid reflux… These uncomfortable symptoms are annoying, but they are also usually signs of a much larger problem! So how do we restore gut health?

Many of us tend to reach for short-term solutions that alleviate symptoms but do nothing to restore gut health! Addressing the root cause is the only way to guarantee better health outcomes in the long-term, but this is something that often requires a bit of guidance.

Currently, one of the best approaches to restore gut health outcomes is to utilize the 5R Protocol guided by your functional medicine dietitian.

This involves correcting the problems in the order that they occur, beginning with the neuroendocrine system (stress), to the gastrointestinal system, and then finally repairing the liver detoxification system.

Working on the 5R Protocol for a full year is the best practice in order to see ideal results.

This means utilizing adrenal testing for stress hormone levels, organic acid testing for intestinal health, neurotransmitter activity, and detoxification demands, and additional testing, such as micronutrients, SIBO, or food sensitivity testing as needed.

These types of tests help your dietitian obtain enough information to identify the root cause of your symptoms, making them able to restore gut health.

What is the 5R Protocol?

The Institute for Functional Medicine established The 5R Protocol as a comprehensive method to address a variety of gastrointestinal (GI) issues.

This approach is effective because it addresses all aspects of gut health, improving symptoms while also tackling the root causes of dysfunction! This protocol is also individualized. It directly targets your issue based on your symptoms and your distinct needs.

Digestive health is the key to your overall health! Digestion keeps our cells healthy and functional by absorbing nutrients. Your GI tract is also home to many immune cells, so it makes sense that any disorder in the digestive tract can lead to bigger problems if the root cause isn’t sorted out.

Treating symptoms is only the tip of the iceberg. Improving gut health requires a multilayered approach to ensure outcomes that actually last.

So, what are the 5 R’s and what does each step involve?

Step One to Restore Gut Health: Remove

The first step of the 5R protocol is to Remove. Remove any stressors, irritants, or excess bacteria that could be causing issues in the gut.

Gut irritation can be caused by:

Certain foods
Medications
Infections
Bacterial overgrowth (like SIBO)
Emotional stress

This step might involve eliminating triggering foods. This could include food sensitivity testing to determine what kind of foods are causing your issues, temporarily removing a couple foods (or food groups), or following a therapeutic elemental diet protocol. You could also take a comprehensive stool test to determine whether your issues are the result of an infection or a microbiome imbalance.

Once you determine the irritants, you will eliminate those foods from your diet altogether. If there is an infection (bacterial, parasitic, or viral), a referral to your doctor may be necessary to receive the appropriate medication. You may also be asked to follow a supplement protocol.

Chronic stress is an overarching cause of many bodily ailments. Our bodies release stress hormones (like cortisol) to help combat threatening situations. In modern society, we tend to utilize our stress response far too often.

This results in digestive issues and inflammation, among other issues such as HPA axis dysfunction (adrenal dysfunction and adrenal fatigue). Consequently, reducing your daily stress and improving your ability to remain in a calm state are vital to restore gut health.

Adrenal stress hormone testing, stool analysis, and food sensitivity testing are all extremely helpful for Step 1.

Step Two to Restore Gut Health: Replace

Eliminating certain foods and food groups from your diet can lead to other issues, so it is meant to be only temporary.

After removing the triggers to your digestive issues, the next step involves replacing anything you are personally missing in your gut that is critical for proper digestive function.

Depending on your condition, you may need to add digestive enzymes, support stomach acid (important for protein digestion) and bile flow (important for fat digestion), or tackle any nutrient deficiencies.

Stool testing and microbiome analysis are helpful in Step 2.

Step Three to Restore Gut Health: Repopulate

The next step of the 5R protocol is to reinoculate your microbiome by reintroducing and supporting beneficial bacteria through consuming probiotics and prebiotics.

Probiotics are live, beneficial microbes that we ingest through certain drinks, foods, and supplements.

While taking a probiotic supplement is convenient, there are also benefits to consuming fermented, probiotic-rich foods and drinks. These include things like kombucha, pickles, yogurt, kefir, sauerkraut, kimchi, tempeh and miso.

Prebiotics are non-digestible fibers that feed your beneficial gut bacteria, helping them to repopulate your GI tract in healthy levels.

Some foods rich in prebiotics include garlic, asparagus, onions, leafy greens, whole grains (quinoa, oats), apples, flaxseed, lentils, jicama, and chicory root. Partially hydrolyzed guar gum (PHGG) is a great option for a supplemental prebiotic fiber.

Microbiome analysis is helpful in Step 3.

Step Four to Restore Gut Health: Repair

Now, the intestinal wall needs to be restored so you can optimize digestive function.

Leaky gut is a condition where your intestinal wall is unstable, leaking toxins, bacteria, and other large particles into your bloodstream. This can cause systemic inflammation and lead to other chronic illnesses.

Repairing the gut lining reduces this permeability and prevents harmful substances from traveling outside the digestive system. This allows for their elimination when we use the bathroom!

Consuming essential key nutrients such as zinc, glutamine, and vitamins A/C/D/E can help restore the linings of the digestive tract and promote absorption. Many of these nutrients cannot be properly utilized when your gut is out of whack.

Micronutrient testing is helpful with Step 4.

Step Five to Restore Gut Health: Rebalance

Now that you’ve set the stage for proper digestive function by improving the environment of your microbiome, the final step of the 5R protocol is to adjust your overall lifestyle.

Rebalancing your lifestyle is crucial for continued maintenance of your restored, healthy gut. Things like sleep, exercise, diet, emotional states, and stress all impact digestive function.

So what kind of things can be done to improve these segments of your lifestyle?

Focus on improving the quality of your sleep by reducing blue light exposure after the sun has set. Possibly attempt a new workout regimen to ensure you get your muscles moving regularly. Eat a nutritious diet that continues to support your healthy gut.

Tune into your emotional states and practice relaxation methods.

Maybe try to practice mindfulness, yoga, and add gratitude exercises to your list of daily tasks. Be sure to reduce stress where possible and nurture your stress response to improve your stress resilience. Practice vagus nerve activation to keep your body in a parasympathetic, tranquil state instead of falling into unhealthy stress response patterns.

Summary of the 5 R Protocol

First, we must determine and eliminate the root cause of your symptoms. Then, any missing components of digestion are supplied and then fortified. Next, nourishing your gut microbiome and your gut lining should set the stage for efficient digestive function. And finally, we fine-tune our lifestyles to maintain the improvements we accomplished in the previous steps.

By now, you should understand the importance of a full lifestyle overhaul to combat your gut issues and restore gut health.

Treating the symptoms alone is usually not enough to cut it, because symptoms are the result of a larger problem.

We use the 5R Protocol to assure that your individual problems are contended with. The 5R Protocol lays the foundation for maintaining gut health by supporting your overall wellbeing.

Why not get started today to restore gut health? Schedule your appointment now to get started on your own individualized 5R Protocol!

07Aug

chinese forbidden black rice wooden spoon 2

[email protected]Diet

Substitute Chinese Forbidden Rice for a More Exotic Dish!

The Bran layer between the rice grain and the outer hull gives black rice its nutritional kick. Black rice bran inhibits histamine and can reduce inflammation due to the high antioxidant content.

Studies in animals also indicate that black rice can lower atherosclerotic plaque, raise HDL cholesterol levels and lower LDL cholesterol levels, due to the high fiber. Forbidden black rice has both water-soluble and fat-soluble antioxidants, including vitamin E and anthocyanins, which have been linked to decreased risk of heart disease and cancer.

Try this recipe for Indonesian Black Sticky Rice Pudding! It’s so tasty!!!

1 1⁄4 cup of black glutinous/sticky rice • 11⁄4 cup of water
4 tbsp. palm sugar, divided
1 13.5oz can coconut milk
Pinch of salt
1 vanilla bean
1 1⁄2 tsp. cornstarch
1⁄2 cup of dried unsweetened shredded coconut

Soak rice in a large bowl and cover for 4-6 hours, then rice under cold water
Add rice to sauce pan and bring to a boil, add 1 tbsp. of sugar, reduce heat and simmer until water is absorbed, remove from heat covered and rest for 10 min
Bring coconut milk to a boil, add remaining sugar and salt, and reducing to a boil, then cut the vanilla bean, scrape out the seeds then add the seeds and pod to the mixture
Make a dispersion of cornstarch with 1 tbsp. of cold water, then add to coconut mixture, stir on heat until thickened
Toast shredded coconut separately
Plate
Serve!!!

07Aug

purple beets in a black bowl with dark brown background

[email protected]Diet

Lowering Blood Pressure with Beetroot Juice

bowl of red beets in a blue bowl with a dark background

Most people know that it is important to include vegetables in our diet due to the health benefits of high fiber, vitamins, minerals, and antioxidants.

But did you know that many vegetables, particularly red beetroots and leafy greens, are very high in dietary nitrates? What is so important about dietary nitrates?

These dietary nitrates play a cardio-protective role by lowering blood pressure, reducing the inflammation response, and improving endothelial function. The body metabolizes dietary nitrates (NO3-) by first converting it to the biologically active form (NO 2 ), and then to Nitric oxide (NO).

Nitric oxide is a vasodilator and is responsible for regulating blood flow, muscle contractions, glucose and calcium homeostasis, as well as cellular respiration in the mitochondria. Previously it was though that dietary nitrates could not influence nitric oxide production, however new research challenges that and suggests that beetroot juice has a direct relationship on lowering systolic blood pressure.

Beets are also rich in betaine, which gives it that vibrant red color and has been used in cardiovascular treatments. These high antioxidants also aid in protecting against oxidative stress in the body.

Dietary nitrate supplementation has been shown to increase athletic performance by improving oxygen efficiency, reducing the amount of Oxygen needed to perform the same amount of work. Low levels of nitric oxide has been associated with hypertension and even elevated cholesterol.

Some factors that can alter the nitrate content in vegetables include environmental factors such as humidity, amount of sunlight, and water, pesticides and the genetics of the plant.

Consumers should be cautious however, about proper storage of high nitrate containing vegetable juices. Improper storage can accumulate large amounts of bacteria that accumulate nitrite buildup, which can become harmful. High amounts of nitrite have toxic and even deadly effects, which are seen in nitrate and nitrite containing drug use, such as nitroglycerine, and amyl nitrite.

Nitrites can also form N-nitrosamines in the body, which has been found to be carcinogenic in animals, but still has yet to proven in humans. While it is still unclear what the optimal level of daily dietary nitrate consumption is, the Dietary Approaches to Stop Hypertension (DASH) diet yields 20mmol of nitrate per day.

Current research studies are showing effective improvement of athletic ability, and decreased blood pressure with just 9 mmol (0.5 L beetroot juice or 300-500mg) nitrates daily.

Including vegetables in your diet that are highest in nitrates (>250mg/100g fresh weight) such as celery, cress, chervil, lettuce, red beetroot, spinach, and arugula can improve your overall cardiovascular health. This amount can easily be achieved with 1 cup of raw spinach containing 900mg nitrate, and a half a cup of cooked collard greens containing 200mg.

Recommendations on the amount of vegetables that are optimal for your health can be found in the Dietary Guidelines for Americans and the USDA’s MyPlate website.

References:

1. Coleman, E, MA, MPH, RD, CSSD. Beetroot Juice and Dietary Nitrates. The Integrative RDN. Spring

2016;18(4)98-104

2. USDA Choose Myplate website. http://www.choosemyplate.gov/. Published 2016. Accessed August 7,

2016

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