Weekly wellness template

A few weeks ago I released a video where I spoke about a follower’s question “how do we make healthy choices daily, weekly, monthly? how do we prioritize certain exercise or nutrition goals plus life goals? what does a weekly wellness template look like?”

Well this is the answer. I’ve created a downloadable resource for you to print and fill in with your weekly goals. We are more likely to stick to habits when we track them, and especially seeing a visual representation can be very powerful!

Examples of items to include:

Vegetable intake, protein intake, supplements, walks, lifting weights, reading, meditation, language learning, gym time, research, hobbies like gardening, cooking… The possibilities are endless. Design it however you’d like to track habits / increase personal responsibility 😉

The first week I did this exercise I tracked the use of my WaterPik (a home-use dental water-flosser), if I went on a walk that day, if I had a smoothie or taken my fish oil, if I had a generous serving of greens that day, my water intake, if I had posted an IG post, if I took out my contact lens by 6 pm, and if I had read through any of my reading pile!

Click the link above to download. If this resource has been helpful for you – share with your friends!

Why you need to adress your mental/emotional world for weight loss!

During this series we’ve been talking about the hormonal effects of weight loss, but that’s just ONE piece of the picture…

Weight loss is physical issue but there’s a huge emotional side to weight loss also. This series is specifically geared to people who need to LOSE BIG – as in 20 to 50 or more pounds. But todays article is more for someone losing weight of any amount, big or small.

I wanted to discuss weight and food/body issues, because body size is a highly emotional topic, because what we believe about our bodies usually is tied to many deep things, like what our parents taught us about our bodies, what we were modeled as a child, what information we took in that came from society, etc.

It all adds up to a lot of emotional bagage in our head.

AND I BELIEVE, THAT IF YOU DON’T FIX YOUR MENTAL WORLD, YOU CANNOT FIX YOUR PHYSICAL WORLD!

Now this is a bold statement, however, I see this every week when meeting with my patients.

So often we want to make weight loss totally separate from our other physical goals! But especially with weight loss, we CANNOT DO THIS. Never have I talked to a patient about weight loss and NOT addressed some part of their mental world.

I see this in men who are entreprenuers and building companies. I see this in young women who are “battling” their weight. I see this in middle aged women and moms who have been overweight for a long time.

So let’s get into this… First I want to tell my story. I am passionate about this because of my own journey!

As a teenager I was overweight, and it was very soul crushing. I was learning so much about the world during this time, and everything society was telling me was that you had to be skinny to be “worthy” and loved. At the time I was not eating well, and I didn’t have an exercise routine. My mom had been making our diets more nutritious, but I wasn’t on board.

I finally decided that enough was enough… and I started running and lifting weights daily after school, and watching my diet. I did south beach diet for a while, and I learned a lot about insulin and carbs. I also saw a naturopathic doctor who helped me discover my Celiac disease / gluten intolerance, and helped educate me on healthy foods.

I lost a lot of weight healthfully.

But then I went to college, didn’t know how to safely eat in my schools cafeteria, dabbled in Veganism, started overtraining, and I lost the freshman 15 that I had never gained. PLUSSS some. Sophmore year of college I was 126 lbs, highly active, and working towards my Human Biology degree. I thought I looked great. I was in a size 2. I felt strong. But looking back I realized so many things.

My body was screaming to be fed. I was undereating calorically and macronutrient wise, but I was still eating a lot of food (super low calorie vegetables and proteins). My diet was pretty low-fat. I lost a lot of hair. I wasn’t sexually active, but I had zero libido (I probably didn’t even know what that was at the time), and I had extreme vaginal dryness.

LONG LONG LONG story shortened… I woke up and healed, but it didn’t come until I took an intuitive eating class in medical school as an elective. Most of the schools nutrition students were required to take this course. I was recommended the course by a friend and decided to take it (why not? I said).

The course CHANGED my life.

I remember sitting in front of the professor, who casually walked into the room with a cookie from the cafeteria, and she BEAMED. And she spoke so casually and positively about the cookie and how much she loved cookies and how excited she was for the cookie. My jaw must have been on the floor because I literally had ZERO idea that I could have this type of relationship with food. I realized that yes, I had lost the weight and become healthy. But in medicial school my weight was creeping up, I had moved to the dark and rainy NW, and I had left sunny California, so all my routines were totally changed.

I knew I could NOT “see” food the way I did for the rest of my life. I knew I needed change.

I ended up going to therapy… one of my therapists was a marriage and family therapist. Together we discussed a lot of parent-child relationship dynamics from my childhood. The other was specifically focused on food/body issues. Without both of them, I WOULD NOT be where I am today.

I am not 126 pounds anymore, thank goodness, but I am a healthy weight, I don’t “WATCH” everything I eat, and I experience food freedom daily. I eat a whole-foods well rounded diet, and I don’t overtrain anymore.

So now you know why I am so passionate about this topic — the thing I want you to take away from this video is that YOU HAVE TO ADDRESS YOUR INNER WORLD TO LOSE WEIGHT AND KEEP IT OFF LONGTERM.

How do we address the inner world? First steps is I like to ask people a few questions, since many people will say they need to lose 5-10 to more pounds

  1. Why do you want to lose weight?
  2. Have you been at this weight for your whole life?
  3. Have you yo-yoed a lot?
  4. Any history of disordered eating or eating disorders? If so, what kind?
  5. Do you have a past history of dieting?
  6. What’s your internal dialogue like when it comes to your body?
  7. … when it comes to food?
  8. What is your relationship with food like?
  9. Any past history of trauma? ANY KIND

and with these… we begin to piece together your story. These questions help me figure out what to do next.

For instance, some have a healthy relationship with food and body, but some health problems caused the weight gain, so we proceed treating those. Some have very poor relationship with food and body, that they didn’t even realize so we refer out to a counselor for therapy. Some people have a huge history of trauma that they have no idea is related to their weight loss issues or their being overweight.

OBESITY IS NOT JUST PHYSICAL, IT IS A MENTAL DISORDER.

Bold statement, but I see it in my patients, this is especially true for the morbidly obese.

Many self worth or mental issues can be BURIED under years of coping mechanisms, so it doesn’t always come out immediately. So if I am referring out… I usually recommend a combo of therapies depending what the person has tried.

  1. eating disorder savvy nutrition savvy therapist
  2. marriage/family therapist
  3. body positive health coach
  4. talk therapy, CBT, or EMDR

And to wrap things up, this discussion comes with a few caveats…

We are all incredibly special and capable because we are humans, and I believe we were all created with a purpose, but I also refuse to subscribe that being overweight is healthy. I see this often become mixed up in todays culture… We are moving away from shaming “fat” people to embracing obesity and calling obese people “beautiful” AND completely ignoring their health condition, because we are trying to make everyone feel included.

Inclusivity can be a great thing, but I think with body weight, it has the potential to really go south.

I don’t believe you can have “health at every size.”

I believe people are in different spots and EVERYONE IS DIFFERENT.

I am mostly speaking to overweight people who don’t acknowledge their excess body fat is an issue or people who use health at every size to justify being over weight – I HAVE SEEN this.

Not everyone is going to be in an ok place to be making body changes, so don’t take this the wrong way. Not everyone is in a space to lose weight. I wish America as a country would own that we have an obesity problem and now we are glorifying it as a society. I don’t believe in health at every size because some of those people, if you ran their blood work, would look like a physiological mess. Fat is an endocrine organ. Fat is inflammatory. Inflammation leads to disease and chronic illness. This has been well established in all the medical literature.

So how do you determine a healthy body weight for you?

  1. Hunger / energy / cravings / sleep / mood has to be in check, balanced, and functioning smoothly
  2. Weight has to be within the BMI scale
  3. Body composition matters more – get your body fat tested, I like water testing
  4. A weight you can easily maintain with a diet that’s based in whole foods and is sustainable each day that includes healthy fats, all varieties of vegetables, and healthy proteins
  5. A weight where your labs look good – HBA1C, glucose, insulin, cholesterol, hormones, chemistries, etc.

For more explanation on any of the topics discussed above – find this video on my YouTube!

Top Five Weight Loss Tips for Men + Women

This blog post is part of a weight loss series – which was specifically requested by YOU! This is the first post in the series… You can also watch videos where I explain things in even more depth on IG TV and YouTube!

This article is for people who need to “get rid of” large amounts of pounds! This article is not for those of you who need to lose 5-10 pounds. This for people who need to lose big for their health.

#1… You have to get labs drawn!

  • Labs give us GUIDANCE as to why you could be overweight
  • You could have an underlying condition, like…
    • slow thyroid
    • diabetes / pre-diabetes
    • metabolic syndrome
    • high insulin
    • blood sugar problems
    • I will go into this in a future video since!

 

#2…  Increase daily movement!

  • You cannot lose weight and keep it off long term with a sedentary lifestyle, or if you have a sedentary job and then only have 1 hour of movement a day
  • So here are my tips to start infusing movement into your day more often:
    • Park far away from where you are going
    • For errands in town, if it’s within a ½ mile, park in one place and walk
    • Take the stairs, ALWAYS (no exceptions, unless you are moving or unless you’ve injured yourself)
    • Go for a walk after lunch and after dinner

 

#3…  Lift weights!

  • Lifting weights increases your muscle mass and decreases your fat mass
  • Muscle is more metabolically active than fat
  • Fat mass is actually very inflammatory. The less fat mass we have, the better off we are for health, disease development and longevity.
  • Higher muscle mass increases your basal metabolic rate, or BMR, so you will be a more efficient energy user when you are at rest = leaner body over time

 

#4… There has to be a calorie deficit!

  • This is easy if you losely track your calories or macros
  • Use an online tracker and a food scale diligently for about 2 months until you learn about portion sizes
  • Have a nutritionist calculate what your needs are for your body weight RIGHT NOW
  • You are not eating for the body you want – your calories must support your mass now, otherwise that will trigger your body to hold onto weight
  • Calorie deficits are easier to get to when you eat a nutrient dense diet
  • Focus on filling and high water content foods – so you can eat high volume without a lot of calories… Example: smoothies, scrambles, stir-fries, salads

 

#5… Drink water + consider a detox!

  • Fat holds onto toxins like a Swiffer holds onto dust
  • Doing a detox before you lose weight can help the weight loss period go more smoothly
  • Whenever you are “burning fat” fat is coming OUT of your adipocytes or fat cells, and this fat is inflammatory and contains TOXINS
  • Your body will be subject to those toxins as it is circulatingin the blood and later getting eliminated.
    • Sometimes the body doesn’t want to lose weight because it “senses” the toxic burden of the fat… which sounds weird, but I see my more toxic patients have a hard time losing weight because of this toxic burden

 

There you have it – my Five Weight Loss tips that MEN OR WOMEN can implement for effective, sustainable weight loss.

And you know what? I hate the term weight loss. Let’s call it “get rid of fat” because when you lose something, generally you want to find it again… not the case here! 😉

 

If you found this helpful – please share with a friend. For more info see my explanations on IG TV and YouTube!

 

 

 

 

Six things women need to know before intermittent fasting

Intermittent fasting (aka IFing) can be a great tool to lower insulin, improve insulin resistance, feel good, and lose weight. It can also be detrimental to the female metabolism!

I see most women want to intermittent fast because of these reasons:

  • weight loss
  • convenience (hard to eat breakfast because of get up and go morning schedule)
  • they hate breakfast
  • nauseated in the morning (can’t eat breakfast)
  • “I want to lose 5 lbs”

Some of these are valid reasons, but if you are nauseated in the morning and therefore can’t stomach food in the morning, you most likely have an underlying issue, including possible decreased stomach acid, imbalance in cortisol levels, or hypoglycemia.

The main medical indications I use for initiating intermittent fasting in women are:

  • obesity
  • weight loss
  • insulin resistance
  • metabolic syndrome
    1. when your metabolism is “sick”
      1. abdominal obesity
      2. high triglycerides
      3. low HDL
      4. high blood sugar
      5. elevated insulin
      6. high leptin levels (the “I’M FULL” hormone)
  • hypertension
  • elevated CRP
  • PCOS
  • NASH aka “fatty liver”

Now that we know why women commonly wish to intermittent fast, and now what the medical implications are… Let’s talk about my 6 rules for intermittent fasting.

 

RULE #1 – FOR MOST WOMEN… intermittent fasting should be a tool and NOT A RULE

  • Best used for a short period of time BECAUSE THE ENDOCRINE SYSTEM IS SENSITIVE
    1. your endocrine system includes your ovarian hormones, adrenal hormones, and thyroid hormones
    2. the function of each organ affects the others
    3. imbalance in one affects the others
  • IFing is best done under medical supervision
    1. labs before diet initiation
    2. labs during the time frame the person is intermittent fasting
    3. check for discrepancies or signs that body systems aren’t handing it well –> adrenals + thyroid + hormones
  • WHY do I recommend we monitor people closely? Well, the first thing is… you want results right? In the smallest time frame? So we monitor. Also women are sensitive to changes in macro nutrient levels –
    1. Women are designed to create babies – regardless of your fertility goals now or in the future – this is what drives our physiology anything that endangers our bodies ability to reproduce can change our health

 

RULE #2 – Nutrient-rich diet must be the backbone

  • I recommend intermittent fasting only for people who are eating a nutrient dense diet to start with
  • WHY – Because failure to get in basic nutrients is a HUGE problem
    1. most diets do not provide enough nutrients as baseline, then we take out one meal out of the day, and the body may suffer
  • You also CANNOT skimp on protein or fat when you intermittent fast

 

RULE #3 – Timing is everything

  • Intermittent fasting often is all about “Establishing your feeding window” which is the period of time you eat each day
  • For most women it’s about getting the WINDOW just right – too long is too restrictive – too short and you won’t get the insulin sensitizing benefit
  • Common ratios are as follows:
    1. 12 fasting / 12 eating – usually an overnight fast
    2. 14 fasting / 10 eating – usually pushing back breakfast
    3. 16 fasting / 8 eating – usually skipping breakfast and going to lunch
    4. 18 fasting / 6 eating – usually skipping breakfast and lunch; having a heavy snack and a large dinner
  • Some people use tools to extend their fasting window easily
    1. coffee- black
    2. bulletproof coffee or variation
    3. green tea + fat
    4. light snack that’s fatty, doesn’t cause any release of insulin, and is small

 

RULE #4 – Fruit isn’t that good for you

  • Ok that was a stretch, but people OFTEN overeat fruit
  • I believe you should eat maybe 1-2 pieces of fruit per day – and never alone, always with some protein and fat (or with a meal)
  • Fruit contains fructose, which is a natural fruit sugar, but fructose requires a lot of LIVER power to be metabolized, which means high levels of fructose in the diet = liver overload
  • Also fructose is preferentially metabolised to fats in the liver = FATTY LIVER = BAD
  • So watch your smoothies, stop drinking juice, get rid of soda and anything with HFCS, stop agave, limit honey, avoid dried fruit

 

RULE #5 – Not all carbs are bad!

  • Timing of carbs and portions of carbs MATTER
  • Low carb isn’t always the answer, because like intermittent fasting it’s cutting out a large group of nutrients which can be percieved as stressful on the body
  • For women – time carbs at night to help sleep initation, and help progesterone; keep carbs low in the morning
  • Time carbs within 2 hours of working out – so your body can refuel with the glucose in the carbs, and turn less glucose into fat storage

 

RULE #6 – Electrolytes are easily depleted in states that mimic fasting or are true fasting states – which IFing is, so you need to replenish.

  • Electrolytes can help with “carb flu,” workout recovery, insulin resistance, adrenal dysfunction
  • The adrenals are one system that can be thrown off or more easily depleted with intermittent fasting, and electrolytes help keep them nourished

 

For more in-depth explations – please see my hour long YouTube Video “Intermittent fasting for women – 6 things you need to know before starting”

 

This blog or the video does not constitute medical advice, and you should always ask the qualified health care practioner who oversees your health FIRST before implementing any treatment or lifestyle change.

Coffee and Plastics

As women, our menstrual cycles are like our monthly report cards. Our bodies are constantly adapting to the environment around us, what we are eating, drink, doing or not doing!  The PMS we experience is directly related to our habits from the month previous.

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Last month, my period was NOT good. Not good for me meant I was more crampy, more crabby, and had heavier flow. Whenever this happens, I always take a second to think back to the previous month and ask myself: “what did I do well? did I have a change in habits? what was I eating consistently? how were my workouts?” There is usually always an answer in one of those questions. It can even be a good idea to ask your partner too, because they can often help you identify what changed.

And last month? It was coffee. Coffee is not a normal routine for me, but with shelter-in-place happening in San Diego, I was at my boyfriend’s place more often, and he likes to make coffee several mornings a week. Once I realized this, BINGO, I had the source of the problem.

Coffee itself is not inherently bad, but I’ve seen many women in my practice experience substantial lifts in PMS with the removal of coffee from their diet.

Let’s talk about coffee for a second.

Coffee contains caffeine. Caffeine is a molecule known as a methylxanthine, which in the plant world is a type of alkaloid molecule, and is the most common central nervous stimulant in the world. Chocolate and tea have methylxanthines too, known as theobromine and theophylline, respectively, but the caffeine content in tea and chocolate is much lower than coffee. All the methylxanithines have different chemical structures:

1,3,7-trimethylxanthine = caffeine

3,7-dimethylxanthine = theobromine

1,3-dimethylxanthine = theophylline

When caffeine is detoxified by the liver, it uses the CYP system of enzymes in phase 1 liver detox, which also detoxify estrogen (CYP1A2). Caffeine also gets metabolized by a few other pathways including: N-acetyltransferase 2 (NAT2), xanthine oxidase (XO) and CYP2A6

In my case, my coffee consumption increased, which impaired my detox of estrogen, which made my PMS symptoms worse.

Caffeine also has an effect on our stress regulating mechanisms – it increases cortisol and epinephrine at rest, which, if you are trying to rest/heal some dysfunctional adrenal glands (commonly referred to “adrenal fatigue”), is actually counter-productive. Many of the women I work with who have period problems have an underlying stress component that hasn’t been addressed, which is actually the cause of their irregular, painful, or heavy menses.  It’s not always an issue with just estrogen, or just progesterone itself.

For my patients who are trying to heal their nervous system, bring back balance to the parasymptathic/sympathetic ratio, and switch from being in a state of constant “go to go” aka “fight or flight mode,” I do not recommend they consume caffeine in any way, even small amounts.

Lastly, the preparation of coffee tends to go hand in hand with exposure of hot liquid to plastics, which causes leaching of the plastic compounds into the liquid, which we then ingest and get into our bodies.

For example, when you go to Starbucks, or whatever coffee joint you fancy, you are given a cardboard cup that is lined in plastic, with a plastic cover on top. The hot steam condensates on the plastic cover top, and falls into your drink. The hot liquid also affects the plastic lining of the cup, and plastic covering whenever you take a sip. So what we are left with, is essentially a hot beverage with a side of plastic.

Many of the ways we prepare coffee at home also use plastics. Plastic coffee filters. Plastic components of frech presses. Aeropresses are plastic. Plastic coffee makers. It’s best to go PLASTIC-FREE when making your coffee. (1)

Plastics are well known “endocrine disruptors,” because they are what’s called “xenoestrogens,” or fake estrogens that stimulate your estrogen receptors and make your body more estrogenic, or increase the body’s “total estrogen pool.” Too much estrogen is bad for you, and causes period problems like heavy flow, moodiness, breast tenderness and swelling, bloating, irritability, and crying.

Your total estrogen pool is made up of things such as:

  1. ovarian production of estrogens
  2. adrenal production of estrogens
  3. conversion of testosterone to estrogen
  4. estrogen bound to SHBG*
  5. estrogen not-bound to SHBG
  6. estrogen metabolites – detoxed and going out in the urine
  7. re-absorbed estrogen from a poorly functioning GI tract
  8. exogenous “unintentional” estrogens – city water containing birth control remnants and other hormones; exposure to family member’s estrogen cream; effects on prescription drugs on estrogen levels; xenoestrogens

SHBG stands for “sex hormone binding globulin.” It’s a carrier protein in your bloodstream that carries around hormones like estrogen, testosterone, and progesterone.

If we didn’t have SHBG, our circulating hormones would be “free” all the time to bind to receptors, and we would feel constantly overwhelmed with their effects. SHBG creates a hormonal goldilocks effect – so we have just enough hormones unbound creating an effect on tissues, and we have just enough hormones waiting and bound, not creating an effect on tissues.

Chemical-Structures-of-4-Bisphenols-BPA-BPB-BPS-and-BPAF-Used-in-This-Study

Recently there have been an increase in products that are BPA-free. Bisphenol-A is one compounding in plastic that is an endocrine disruptor. So BPA-free is good right? WRONG. If you take something OUT, you have to replace it with something. The compounds BPP and BPS are the common replacements for BPA in plastics, and they are actually more hormonally disruptive than BPA itself!

I hope after reading this, you can understand a little bit more how plastics and coffee can have an effect on your menstrual cycle and your PMS.

For many women, lowering their estrogen pool and/or improving their estrogen detox, is paramount for alleviating their PMS symptoms.

I encourage you to re-think your use of plastics in your life. I would also encourage you to think critically about whether your coffee consumption is truly beneficial for you or not. Coffee is one of those sneaky hormone disruptors, that if you remove it, could really make a difference in improving your hormone health, as well the symptoms surrounding your monthly cycle.

xo,
Dr. Meg

For further reading:

(1) Here is the link to the french-press we own that is 100% plastic-free and works amazingly well.

Lane J.D. Caffeine, glucose metabolism, and type 2 diabetes. J. Caffeine Res. 2011;1(1):23–28.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5742777/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3820066/

https://www.ncbi.nlm.nih.gov/pubmed/19519341