Category: Weight Loss

Embarking on Your Weight Loss Journey: A Holistic Approach to Wellness

by Roxy Functional Wellness, posted in Health & Wellness, Weight Loss

Starting a weight loss journey can be both exciting and overwhelming. At Midwest Internal Medicine, we understand that achieving and maintaining a healthy weight is not just about aesthetics—it’s about improving overall health, well-being, and longevity. Our goal is to help you reach your healthiest self through individualized, holistic wellness plans that cater to your unique needs.

Why Striving for a Healthy Weight is Important

Maintaining a healthy weight is critical for overall health and disease prevention. According to the Centers for Disease Control and Prevention (CDC), even a modest weight loss of 5-10% of your total body weight can result in significant health benefits, such as improved blood pressure, cholesterol levels, and blood sugar management .

Here are some compelling facts from well-known health organizations that highlight the importance of maintaining a normal weight:

  • World Health Organization (WHO): Overweight and obesity are major risk factors for several chronic diseases, including diabetes, cardiovascular diseases, and cancer .
  • American Heart Association (AHA): Individuals who maintain a healthy weight can reduce the risk of heart disease by as much as 50%, lowering their chances of heart attack, stroke, and other cardiovascular conditions .
  • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): Obesity is linked to an increased risk of developing Type 2 diabetes, with research showing that weight loss can prevent or delay the onset of this disease .
  • Harvard T.H. Chan School of Public Health: Maintaining a healthy weight is a key component of reducing the risk of certain cancers, including breast, colon, and prostate cancers .
  • Mayo Clinic: Weight management through healthy habits like diet, exercise, and stress management is directly associated with improved longevity and quality of life .

These statistics emphasize the importance of achieving a normal weight for health and wellness. But how can you get there? Here are some essential tips that we, at Midwest Internal Medicine, integrate into our patients’ personalized wellness plans.

Photo by Antoni Shkraba on Pexels.com

The Research Behind Our Tips

1. Hydration is Key: Water plays a crucial role in digestion, detoxification, and metabolism. Research shows that drinking adequate water can increase calorie expenditure by up to 30% over a period of 60-90 minutes. Staying hydrated can also reduce hunger and support healthy digestion.

2. Holistic Eating: Eating whole, unprocessed foods helps balance blood sugar levels and provides your body with the nutrients it needs to function optimally. Consuming foods rich in fiber, lean protein, and healthy fats can increase satiety and decrease overeating . In our wellness plans, we recommend limiting gluten and dairy, as they can contribute to inflammation in some individuals.

3. Sleep Matters: Lack of sleep has been linked to increased hunger and weight gain due to the hormone imbalance it causes. A study by the National Sleep Foundation shows that individuals who get less than 7 hours of sleep per night are more likely to struggle with weight control .

4. Managing Stress: Chronic stress leads to elevated cortisol levels, which can increase appetite and cause weight gain, particularly around the abdomen . We encourage patients to incorporate mindfulness practices like yoga, meditation, or grounding exercises into their daily routines.

5. Exercise for Success: Regular physical activity, particularly strength training, is essential for maintaining muscle mass, boosting metabolism, and improving insulin sensitivity. According to the American College of Sports Medicine (ACSM), a combination of aerobic and resistance training is most effective for weight loss .

6. Gut Health: Your gut microbiome plays a critical role in digestion and weight management. Studies show that a healthy gut can improve metabolism and reduce the likelihood of obesity . Probiotic-rich foods like yogurt, kimchi, and sauerkraut can support digestive health and weight loss.

7. Spiritual Wellness: Connecting with your spiritual side, whether through meditation, mindfulness, or spending time in nature, promotes mental and emotional balance. Studies suggest that spiritual wellness can enhance physical health and improve the outcomes of a weight loss journey .

Our Holistic, Individualized Approach at Midwest Internal Medicine

At Midwest Internal Medicine, we believe that every person’s journey to wellness is unique. There is no “one-size-fits-all” solution when it comes to weight loss. That’s why we work closely with each patient to develop a comprehensive, individualized plan that includes nutrition, exercise, stress management, and spiritual wellness.

Our team uses the latest research-backed strategies to help you set realistic goals and maintain healthy habits for life. We’re proud to walk alongside you in this journey and provide ongoing support, adjustments, and encouragement as you work toward your wellness goals.

Just remember!

Achieving a healthy weight is more than just looking good—it’s about reducing the risk of chronic disease, improving your quality of life, and increasing longevity. By following research-backed tips related to hydration, whole foods, exercise, sleep, stress management, and spiritual well-being, you can make sustainable changes that lead to lasting results.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References
  1. Centers for Disease Control and Prevention. (2020). The health effects of overweight and obesity. CDC. https://www.cdc.gov/obesity/adult/causes.html
  2. World Health Organization. (2021). Obesity and overweight. WHO. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
  3. American Heart Association. (2019). Weight management and cardiovascular health. AHA. https://www.heart.org/en/healthy-living/healthy-eating/losing-weight
  4. National Institute of Diabetes and Digestive and Kidney Diseases. (2022). Weight and diabetes risk. NIDDK. https://www.niddk.nih.gov/health-information/weight-management
  5. Harvard T.H. Chan School of Public Health. (2021). Weight control and cancer risk. Harvard. https://www.hsph.harvard.edu/nutritionsource/obesity-prevention
  6. Mayo Clinic. (2023). Healthy weight: Key to longevity. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/weight-loss
  7. Boschmann, M., & Steiniger, J. (2003). Water-induced thermogenesis. Journal of Clinical Endocrinology & Metabolism, 88(12), 6015-6019.
  8. Slavin, J. L. (2005). Dietary fiber and body weight. Nutrition, 21(3), 411-418.
  9. National Sleep Foundation. (2020). How sleep affects weight loss. NSF. https://www.sleepfoundation.org/sleep-and-weight-loss
  10. Adam, T. C., & Epel, E. S. (2007). Stress, eating and the reward system. Physiology & Behavior, 91(4), 449-458.
  11. American College of Sports Medicine. (2015). Physical activity for weight loss. ACSM. https://www.acsm.org
  12. Turnbaugh, P. J., & Gordon, J. I. (2009). The gut microbiome and obesity. Nature, 457(7228), 480-484.
  13. Koenig, H. G. (2012). Religion, spirituality, and health: The research and clinical implications. ISRN Psychiatry, 2012, 1-33.

The Importance of Glucose Control for Weight Loss and Overall Health

by Roxy Functional Wellness, posted in Health & Wellness, Weight Loss

Maintaining stable blood glucose levels is one of the most critical factors in achieving not only weight loss but overall optimal health. Blood sugar fluctuations affect your energy levels, hunger cues, mood, and hormones, all of which influence your body’s ability to lose or maintain weight. Let’s dive into the science behind glucose control, its broader impacts on your health, and practical ways to maintain it.

The Impact of Erratic Glucose Spikes on the Body

When you consume foods high in simple carbohydrates or sugar, your blood glucose spikes. This triggers a cascade of hormonal reactions, primarily involving insulin—a hormone produced by the pancreas to help transport glucose into cells. However, erratic glucose spikes can overwhelm the system, leading to several negative effects on the body, especially on the Hypothalamic-Pituitary-Adrenal (HPA) Axis.

HPA Axis Dysregulation and Hormonal Imbalance: The HPA axis is a critical regulator of stress response and hormone production, including cortisol. Studies have shown that frequent glucose spikes and crashes can dysregulate the HPA axis, leading to elevated cortisol levels. This chronic cortisol elevation can contribute to hormonal imbalances such as:

  • Increased fat storage, especially around the abdomen.
  • Sleep disturbances, as high glucose can interfere with the body’s ability to produce melatonin, the hormone responsible for sleep regulation.
  • Gut health issues, as glucose dysregulation can lead to inflammation, impairing gut barrier function and affecting the microbiome.
  • Sexual dysfunction, since the endocrine system (responsible for hormone balance) is closely tied to sexual health, including libido and reproductive function.

Long-Term Risks of Uncontrolled Glucose Levels

Over time, poor glucose control can lead to insulin resistance, a condition where your cells no longer respond effectively to insulin, causing blood glucose levels to remain elevated. Insulin resistance has a strong connection to a variety of health issues, including:

  1. Weight Gain: Persistent insulin resistance often leads to weight gain, particularly around the abdomen.
  2. Hormonal Imbalance: Insulin resistance disrupts other hormonal systems, including thyroid and reproductive hormones.
  3. Gut Diseases: High blood sugar levels can foster an environment that promotes gut dysbiosis, which is linked to conditions like Irritable Bowel Syndrome (IBS) and leaky gut.
  4. Mental Health Problems: Studies have shown a clear connection between erratic glucose levels and mood disorders like anxiety and depression. Glucose spikes lead to inflammation, which has been shown to contribute to these mental health challenges.

Evidence-Based Tips for Balancing Glucose Levels

So how to do you achieve more consistent glucose levels? Every person may be a little different as our bodies are not the same, but some of the tips my patients have found to be helpful include:

  1. Eat Balanced Meals: Incorporating protein, healthy fats, and fiber with each meal helps slow down glucose absorption, keeping blood sugar levels stable. This has been supported by research from the American Diabetes Association, which emphasizes the importance of balanced macronutrient intake to prevent spikes.
  2. Choose Low-Glycemic Foods: Opt for whole grains, legumes, vegetables, and other low-glycemic foods, which release glucose more slowly into the bloodstream. According to the Glycemic Index Foundation, low-GI foods can help reduce insulin resistance and support weight loss.
  3. Exercise Regularly: Physical activity increases your cells’ sensitivity to insulin, allowing them to more effectively use glucose. The World Health Organization (WHO) recommends at least 150 minutes of moderate aerobic activity per week for glucose regulation.
  4. Stay Hydrated: Dehydration can raise blood sugar levels. Drink plenty of water throughout the day to support healthy glucose levels. This half of your bodyweight in ounces!
  5. Manage Stress: Chronic stress contributes to HPA axis dysregulation, elevating cortisol and impacting glucose regulation. Meditation, yoga, and deep breathing exercises are all excellent ways to lower stress. I love using the Peloton for this as they have a variety of options to choose from!

Signs and Symptoms of Glucose Dysregulation

So how do you know if you are experiencing high or low glucose levels? Again, this can be different for everyone, but research has shown that there are some common symptoms that people may experience on both spectrums:

High Blood Sugar (Hyperglycemia) Symptoms:

  • Fatigue
  • Frequent urination
  • Increased thirst
  • Blurred vision
  • Unexplained weight loss
  • Difficulty concentrating

Low Blood Sugar (Hypoglycemia) Symptoms:

  • Shakiness
  • Sweating
  • Dizziness
  • Hunger
  • Irritability
  • Palpitations
  • Weakness

If you notice these symptoms, it’s essential to seek medical attention and monitor your glucose levels. This is where I like to use a continuous glucose monitor if possible!

Lab Tests to Assess Glucose Control

Let’s talk labs for a second. There a several blood tests that can provide valuable insight into your glucose metabolism, but here are my favorite to trend with my patients:

  1. Fasting Blood Glucose: This test measures your blood sugar levels after an overnight fast. A normal level is below 100 mg/dL, while 100-125 mg/dL indicates prediabetes, and 126 mg/dL or higher signals diabetes.
  2. Insulin Levels: Measuring fasting insulin levels can help detect insulin resistance, even if blood sugar levels appear normal. An ideal fasting insulin level is typically below 15 µU/mL.
  3. Hemoglobin A1C (HgA1c): This test measures your average blood sugar levels over the past 2-3 months. A normal A1c is below 5.7%, prediabetes is 5.7%-6.4%, and diabetes is 6.5% or higher.

*Remember that for fasting levels, these need to be drawn between the hours of 7-9am and on an empty stomach.

Continuous Glucose Monitors (CGMs): A Valuable Tool for Glucose Control

I have talked a little bit about CGMs before, but let’s do a repeat! For individuals seeking to closely monitor glucose fluctuations, a Continuous Glucose Monitor (CGM) can be an incredibly useful tool. These devices measure glucose levels in real-time and provide a continuous record of how food, exercise, and stress impact your blood sugar (a Dexcom would be an example). Although these are wonderful to use, let’s break down the pros and cons:

Pros of Using a CGM:

  • Provides real-time feedback on your diet and lifestyle choices.
  • Can identify blood sugar spikes that may not be caught by standard lab work.
  • Helps you understand how stress, exercise, and sleep impact your glucose levels.

Cons of Using a CGM:

  • They can be expensive and may not be covered by all insurance plans.
  • CGMs require frequent calibration and monitoring.
  • Some people may experience skin irritation from the device adhesive.

If you are interested in using a CGM I would highly encourage you to speak to your healthcare provider. I do use these periodically in my current practice, however, this is done on an individual basis.

Wrapping it up!

Maintaining stable glucose levels is crucial for weight management, hormone balance, gut health, and overall wellness. Regular monitoring through lab tests like fasting glucose, insulin levels, and HgA1c, combined with tools like CGMs, can offer valuable insights into your body’s glucose regulation. By making small, evidence-based changes in your diet and lifestyle, you can protect yourself from the long-term health risks associated with uncontrolled glucose levels and achieve better overall health.

Take control of your glucose, and in turn, take control of your health!

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

REFERENCES

American Diabetes Association. (2022). Standards of medical care in diabetes—2022. Diabetes Care, 45(Supplement_1), S1-S2. https://doi.org/10.2337/dc22-SINT

Cryer, P. E. (2016). The pathophysiology of hypoglycemia in diabetes. Diabetes Care, 39(4), 556-562. https://doi.org/10.2337/dc15-2715

Glycemic Index Foundation. (n.d.). The glycemic index. Glycemic Index Foundation. https://www.gisymbol.com/about-glycemic-index/

International Diabetes Federation. (2021). IDF diabetes atlas (10th ed.). International Diabetes Federation. https://diabetesatlas.org/

Mayo Clinic Staff. (2021). Insulin resistance: What it is and how to know if you have it. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/in-depth/insulin-resistance/art-20047903

National Institute of Diabetes and Digestive and Kidney Diseases. (2020). Hypoglycemia. National Institutes of Health. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/hypoglycemia-low-blood-glucose

Reaven, G. M. (2005). The insulin resistance syndrome: Definition and dietary approaches to treatment. Annual Review of Nutrition, 25, 391-406. https://doi.org/10.1146/annurev.nutr.25.050304.092514

World Health Organization. (2020). Physical activity guidelines for health. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/physical-activity

Understanding Weight Gain and How to Manage It Holistically

by Roxy Functional Wellness, posted in Health & Wellness, Weight Loss

Weight gain is a complex issue influenced by various factors that often interact in intricate ways. Understanding these causes and their underlying mechanisms is crucial for developing effective weight management strategies. This blog post will explore the causes of weight gain, the pathophysiology behind it, and how to incorporate a holistic lifestyle and natural remedies to lose weight healthily (Want to know more about GLP1 use for weight loss? See my previous post!).

Causes of Weight Gain

  • Poor diet and nutrition
  • Physical inactivity
  • Genetics
  • Hormonal imbalances
  • Medication use
  • Sleep deprivation
  • Stress

According to the Centers for Disease Control and Prevention (CDC), over 42% of American adults are obese, largely due to poor dietary choices and excessive calorie intake. The World Health Organization (WHO) reports that 1 in 4 adults globally are not active enough, contributing to the rising obesity rates. Genetics can account for 40-70% of individual variations in BMI (Body Mass Index), indicating a significant hereditary component. Hormonal imbalances, such as those seen in conditions like hypothyroidism and polycystic ovary syndrome (PCOS), can affect metabolism and contribute to weight gain. Certain medications, including antidepressants, antipsychotics, and corticosteroids, are also associated with weight gain. Furthermore, the National Sleep Foundation states that adults who sleep less than 7 hours per night are more likely to have a higher BMI. These factors collectively contribute to the complexity of weight management.

Pathophysiology of Weight Gain

Weight gain occurs due to an imbalance between calorie intake and energy expenditure, but the underlying mechanisms are more complex. Stress, poor sleep, poor diet, gut dysbiosis, hormones, genetics, and certain medications, hydration status can all lead to changes in our body that promote weight gain.

Stress can increase cortisol levels, which promotes fat storage, particularly around the abdomen.

Poor sleep affects hormones like ghrelin and leptin, which regulate hunger and satiety, leading to increased appetite and weight gain.

Poor diet, especially one high in processed foods and sugars, can lead to insulin resistance and metabolic syndrome.

Gut dysbiosis, an imbalance in gut bacteria, can impair digestion and increase fat storage. A diverse and balanced gut microbiota is essential for efficient digestion and metabolism. Probiotics (such as those found in yogurt, kefir, and fermented vegetables) and prebiotics (found in foods like garlic, onions, and bananas) can promote a healthy gut microbiome.

Hormonal imbalances, such as those seen in hypothyroidism or PCOS, can slow metabolism and promote weight gain. Insulin resistance, often seen in Type II Diabetes, leads to elevated blood sugar levels and increased fat storage. Leptin, a hormone that signals satiety, can become dysregulated in obesity, leading to overeating.

Genetics can influence how our body stores fat and responds to food.

Hydration is also crucial, as dehydration can be mistaken for hunger, leading to overeating.

Certain medications can alter metabolism, appetite, and fat storage. For instance, antipsychotic medications can increase appetite and lead to weight gain. It’s important to work closely with healthcare providers to find the most weight-neutral medications when possible.

“Losing weight is hard. Being overweight is hard. Choose your hard.” – unknown

Incorporating a Holistic Lifestyle and Natural Remedies

Adopting a holistic lifestyle involves making sustainable changes that address the root causes of weight gain. Here’s how you can incorporate natural remedies and healthy habits to manage weight effectively:

Behavior Modification

  • Mindful Eating: Pay attention to hunger and fullness cues to prevent overeating. Eat slowly, savor each bite, and avoid distractions during meals.
  • Consistent Sleep Patterns: Establish a regular sleep schedule and ensure adequate sleep to support metabolic health.

Stress Management

  • Techniques: Engage in stress-reducing activities like yoga, meditation, and deep breathing exercises.
  • Herbs and Supplements: Ashwagandha and Rhodiola can help manage stress levels and balance cortisol.

Good Gut Health

  • Probiotics and Prebiotics: Consume probiotics found in yogurt, kefir, and fermented vegetables, and prebiotics found in garlic, onions, and bananas to promote a healthy gut microbiome. The probiotic Akkermansia has specifically found to be useful in those that struggle with their weight.
  • Diet: Eat a diet rich in fiber, fruits, vegetables, and whole grains to support gut health.

Holistic Diet

  • Whole Foods: Focus on a balanced diet rich in whole foods, including lean proteins, healthy fats, and complex carbohydrates. Stay away from highly processed food like sweets or fast-food.
  • Hydration: Drink plenty of water to aid digestion and prevent overeating.

Fitness

  • Regular Exercise: Incorporate both aerobic exercises (like walking, cycling, or swimming) and strength training to build muscle mass and boost metabolism.
  • Consistency: Aim for at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity per week.

Natural Remedies for Weight Loss

I always get asked what are some natural remedies for losing weight. This is a loaded question as the root cause of the weight gain must be discovered first. For example, if a person is exhibiting signs that their thyroid may need to support, then it may be prudent to start with iodine and/or selenium supplementation. If a person shows signs of being androgen-heavy, then using balancing herbs like spearmint may be beneficial. Care should always be individualized and the root cause should never be assumed. Some of my favorite natural options are:

  • Herbs: Green tea extract, Garcinia cambogia, and cayenne pepper can help boost metabolism and aid in weight loss.
  • Homeopathics: Remedies like Calcarea Carbonica and Natrum Mur have been traditionally used to support weight management.
  • Teas: Herbal teas such as dandelion, ginger, and peppermint can support digestion and help with weight management.
  • Probiotics/Gut Health: marshmallow root and/or licorice for healthy gut lining, probiotics like Akkermansia, and polyphenols.

Conclusion

Weight gain is a multifaceted issue influenced by diet, physical activity, genetics, hormones, medication use, sleep patterns, and stress. Understanding the underlying causes and incorporating natural remedies can help manage and prevent weight gain. By adopting a holistic lifestyle and making sustainable changes, individuals can achieve and maintain a healthy weight, improving their overall well-being. For those on a weight loss journey, remember to give yourself grace and celebrate small victories along the way. Every step towards a healthier lifestyle is a step in the right direction.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

Centers for Disease Control and Prevention. (2020). Adult obesity facts. Retrieved from https://www.cdc.gov/obesity/data/adult.html

World Health Organization. (2018). Physical activity. Retrieved from https://www.who.int/news-room/fact-sheets/detail/physical-activity

National Sleep Foundation. (2020). How much sleep do we really need? Retrieved from https://www.sleepfoundation.org/how-sleep-works/how-much-sleep-do-we-really-need

Bray, G. A., & Ryan, D. H. (2020). Update on obesity pharmacotherapy. Annals of the New York Academy of Sciences, 1464(1), 78-93. https://doi.org/10.1111/nyas.14332

Kelly, S. A., Neale, M. C., Kendler, K. S., & Eaves, L. J. (2019). Genetics of obesity and body mass index: A review of behavioral genetic research. Current Opinion in Behavioral Sciences, 7, 76-82. https://doi.org/10.1016/j.cobeha.2015.12.001

Shulman, G. I. (2014). Ectopic fat in insulin resistance, dyslipidemia, and cardiometabolic disease. New England Journal of Medicine, 371(12), 1131-1141. https://doi.org/10.1056/NEJMra1011035

Turnbaugh, P. J., Ley, R. E., Mahowald, M. A., Magrini, V., Mardis, E. R., & Gordon, J. I. (2006). An obesity-associated gut microbiome with increased capacity for energy harvest. Nature, 444(7122), 1027-1031. https://doi.org/10.1038/nature05414

Sarris, J., Logan, A. C., Akbaraly, T. N., Amminger, G. P., Balanzá-Martínez, V., Freeman, M. P., … & Mischoulon, D. (2015). Nutritional medicine as mainstream in psychiatry. The Lancet Psychiatry, 2(3), 271-274. https://doi.org/10.1016/S2215-0366(14)00051-0

Stenholm, S., Head, J., Aalto, V., Kivimäki, M., Kawachi, I., Zins, M., … & Vahtera, J. (2015). Sleep duration and sleep disturbances as predictors of healthy and chronic disease-free life expectancy between ages 50 and 75: a multi-cohort study. International Journal of Epidemiology, 44(1), 71-83. https://doi.org/10.1093/ije/dyu235

van der Klaauw, A. A., & Farooqi, I. S. (2015). The hunger genes: Pathways to obesity. Cell, 161(1), 119-132. https://doi.org/10.1016/j.cell.2015.03.008

How Stress Can Affect Blood Glucose Levels, Insulin Secretion, and Cause Weight Gain

by Roxy Functional Wellness, posted in Health & Wellness, stress management, Weight Loss

Understanding the Impact of Stress on Blood Glucose and Insulin

Stress is an inevitable part of life, but its effects extend beyond mental strain. When we experience stress, our body responds by releasing stress hormones such as cortisol and adrenaline. These hormones are part of the body’s “fight or flight” response, which historically helped humans survive dangerous situations. However, in our modern world, chronic stress can wreak havoc on our health, particularly on our blood glucose levels and insulin secretion.

How does Stress affect Glucose, and Insulin?

During periods of stress, cortisol and adrenaline cause the liver to release more glucose into the bloodstream to provide immediate energy. At the same time, these hormones can inhibit or insulin secretion or reduce insulin sensitivity, leading to higher blood glucose levels. This mechanism is beneficial in acute stress situations but can be detrimental when stress becomes chronic.

When blood glucose levels are consistently high, the pancreas needs to produce more insulin to help cells absorb the glucose. Over time, this can lead to insulin resistance, where the body’s cells no longer respond effectively to insulin. This condition can cause higher levels of glucose in the blood and eventually lead to Type II Diabetes, weight gain, and other inflammatory conditions.

Photo by Karolina Kaboompics on Pexels.com

How Stress-Induced Changes Can Lead to Weight Gain

Even when following a healthy lifestyle with balanced nutrition and regular exercise, chronic stress can undermine weight management efforts. If our body is in a chronic state or stress and/or agitation, it isn’t going to feel “safe”. Elevated cortisol levels can contribute to weight gain in several ways:

  1. Increased Appetite: Cortisol can stimulate appetite, leading to increased food intake, especially of high-calorie, sugary, and fatty foods. When you find yourself running through that Dunkin Donut drive-thru for that late afternoon donut after a stressful day, this would be why! Our body uses a lot of fuel during stressful times. Instead of doing inventory and using what we already have, it makes us feel like we need to eat more. Specifically high carb and sugary foods as this gives us the quickest energy.
  2. Fat Storage: High cortisol levels promote the storage of fat, particularly in the abdominal area, which is associated with a higher risk of metabolic diseases. I always think of that outside cat that is preparing for a stressful, cold winter by gaining that extra belly fat. They always put on some weight expecting to lose weight over the course of the winter. This makes sense for them, but not for us.
  3. Reduced Muscle Mass: Chronic stress can lead to muscle breakdown, decreasing overall metabolic rate and making it harder to maintain or lose weight. This can be detrimental for people as muscle mass is tied to longevity and overall wellness.

The Role of Continuous Glucose Monitors (CGMs)

When weight gain occurs despite healthy lifestyle choices, it may be useful to monitor blood glucose levels more closely. Continuous glucose monitors (CGMs) provide real-time data on glucose levels throughout the day and night, offering insights into how stress and other factors affect glucose metabolism. I have a whole new appreciation for CGMs after using one myself. It provided insight into our my body responds to stressful situations, a poor night of sleep, and my eating choices better than anything else I had tried previously! If using one, be prepared to be frustrated sometimes as things you thought were healthy your body may not respond to them in a healthy manner.

Normal Readings on a CGM

So what are normal CGM readings? A CGM provides continuous readings, typically every few minutes. Normal glucose levels for most people without diabetes are:

  • Fasting (before meals): 70-100 mg/dL (this can vary and many CGMs can be individualized)
  • Postprandial (1-2 hours after eating): less than 140 mg/dL
  • Overall, maintaining a time-in-range (TIR) of 70-140 mg/dL for at least 70% of the time is considered good control.

Your levels can be affected by stress and food, but can also be affected by other things like sauna use and exercise. I always like to remind patients this as they can sometimes see a spike into the 150s during exercise. This is normal as the body is trying to make sure your body has enough fuel to use.

Types of Continuous Glucose Monitors and Their Pros and Cons

  1. Freestyle Libre
    • Pros: No fingerstick calibration, 14-day sensor life, easy to use.
    • Cons: No alarms for high or low glucose levels, requires a separate reader or smartphone app.
  2. Dexcom G6
    • Pros: No fingerstick calibration, customizable alerts for high and low glucose levels, integrates with various insulin pumps.
    • Cons: Higher cost, 10-day sensor life, requires a transmitter that needs periodic replacement.
  3. Medtronic Guardian Connect
    • Pros: Predictive alerts for high and low glucose levels, integrates with Medtronic insulin pumps.
    • Cons: Requires fingerstick calibration, higher cost, 7-day sensor life.
  4. Dexcom G7 (this is my favorite and what I use!)
    • Pros: Improved accuracy, no fingerstick calibration, smaller and more discreet, fast warm-up time, customizable alerts, app integration, integration with other devices.
    • Cons: Can be expensive, sensor adhesion (some have allergies), learning curve (lots of information), battery life, data gaps due to transmission error.

How to Get a CGM

Obtaining a CGM usually involves the following steps:

  1. Consult Your Healthcare Provider: Discuss your need for a CGM and get a prescription.
  2. Check Insurance Coverage: Verify if your insurance covers CGMs and understand the cost implications.
  3. Purchase the Device: Buy the CGM from a pharmacy, medical supply company, or directly from the manufacturer.
  4. Training: Some CGM providers offer training sessions to help you learn how to use the device effectively.

I highly recommend working with your provider or reputable company (like Signos) that will walk you through the use and reading of your CGM. This will prevent you from getting frustrated and will ensure you get the most out of your CGM.

Photo by Nutrisense Inc on Pexels.com

Techniques and Natural Remedies to Reduce Stress

Now that we know the affect that stress can have on our glucose and insulin levels, managing stress is essential for maintaining balanced glucose levels and preventing weight gain. Here are some techniques and natural remedies that can help reduce stress:

  1. Yoga and Meditation: Regular practice can lower cortisol levels, improve insulin sensitivity, and promote relaxation.
  2. Physical Activity: Engaging in regular exercise reduces stress hormones and improves overall metabolic health.
  3. Mindfulness Practices: Techniques such as deep breathing, progressive muscle relaxation, and mindfulness meditation can help reduce stress.
  4. Herbal Supplements: Adaptogenic herbs like ashwagandha, rhodiola, and holy basil can help manage stress and support adrenal health.
  5. Adequate Sleep: Prioritizing sleep and maintaining a consistent sleep schedule can reduce stress and improve metabolic function.
  6. Balanced Diet: Eating a diet rich in whole foods, healthy fats, and lean proteins can support stress management and overall health.

By understanding the connection between stress, blood glucose levels, and insulin secretion, and by utilizing tools like CGMs, individuals can take proactive steps to manage their health more effectively. Incorporating stress-reducing techniques and natural remedies can further support this journey towards better health and well-being.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

American Diabetes Association. (2021). Understanding insulin resistance. Retrieved from https://www.diabetes.org/diabetes/insulin-resistance

Cryer, P. E. (2018). The pathophysiology of hypoglycemia in diabetes. Diabetes Care, 34(Supplement 2), S165-S171. doi:10.2337/dc11-s218

Dedov, I., Maslova, O., & Suntsov, Y. (2020). Continuous glucose monitoring in diabetes management. Diabetes Therapy, 11(3), 509-526. doi:10.1007/s13300-020-00786-8

Fisher, M. (2016). The role of cortisol in stress and the effects on glucose metabolism. Endocrinology and Metabolism Clinics of North America, 45(1), 55-68. doi:10.1016/j.ecl.2015.09.005

Freestyle Libre. (2023). Freestyle Libre 14 day system. Retrieved from https://www.freestylelibre.us/

Dexcom. (2023). Dexcom G6 continuous glucose monitoring (CGM) system. Retrieved from https://www.dexcom.com/

Helgeson, V. S., Escobar, O., Siminerio, L., & Becker, D. (2017). Relation of stressful life events to metabolic control among adolescents with diabetes: 5-year longitudinal study. Health Psychology, 36(11), 1061-1071. doi:10.1037/hea0000491

Medtronic. (2023). Guardian Connect CGM system. Retrieved from https://www.medtronicdiabetes.com/products/guardian-connect-continuous-glucose-monitoring-system

National Center for Complementary and Integrative Health. (2020). Yoga: In depth. Retrieved from https://www.nccih.nih.gov/health/yoga-in-depth

Rawshani, A., Rawshani, A., Franzén, S., Eliasson, B., Svensson, A. M., Miftaraj, M., & Gudbjörnsdottir, S. (2018). Mortality and cardiovascular disease in Type 1 and Type 2 diabetes. New England Journal of Medicine, 376(15), 1407-1418. doi:10.1056/NEJMoa1608664

Thayer, J. F., Yamamoto, S. S., & Brosschot, J. F. (2018). The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. International Journal of Cardiology, 141(2), 122-131. doi:10.1016/j.ijcard.2010.09.047

Van der Kallen, C. J., van Greevenbroek, M. M., Ferreira, I., & Stehouwer, C. D. (2017). The association of central fat mass with all-cause mortality and cardiovascular disease is dependent on inflammatory properties of adipose tissue: The Hoorn study. Diabetes Care, 30(11), 3035-3040. doi:10.2337/dc07-1075

The Power of Protein: Why It’s Essential for Your Health

by Roxy Functional Wellness, posted in Health & Wellness, Weight Loss

Protein is one of the three macronutrients essential for human health, alongside carbohydrates and fats. It plays a critical role in the body’s structure, function, and regulation of tissues and organs. It wasn’t until I embarked on my own weight loss journey that I fully understood the importance of getting in that protein. Understanding how our body utilizes protein, the benefits it offers, and how to ensure we get enough is crucial for maintaining optimal health.

“Proteins are the machinery of living tissue that builds the structures and carries out the chemical reactions necessary for life. – Michael Behe

How Our Body Utilizes Protein

On a physiological level, proteins are made up of amino acids, which are the building blocks of life. When we consume protein, our digestive system breaks it down into these amino acids, which are then absorbed into the bloodstream and transported to various cells and tissues. This allows protein to affect our bodies in the following ways:

1. Muscle Growth and Repair: Proteins are crucial for building and repairing muscles. During exercise, especially resistance training, muscle fibers undergo microscopic tears. Protein helps repair these tears, leading to muscle growth and increased strength.

2. Enzyme and Hormone Production: Many enzymes and hormones are proteins. Enzymes speed up chemical reactions in the body, while hormones regulate processes such as metabolism, growth, and mood.

3. Immune Function: Antibodies, which are proteins, help the immune system identify and neutralize pathogens like bacteria and viruses. This makes protein vital for maintaining a strong immune defense. Protein also helps us heal when we are sick or injured.

4. Transport and Storage: Proteins like hemoglobin transport oxygen in the blood, while others store nutrients like iron.

5. Structural Support: Proteins such as collagen provide structural support to tissues, including skin, hair, and nails, maintaining their strength and elasticity.

6. Brain Health: Amino acids from protein are precursors to neurotransmitters like serotonin and dopamine, which influence mood, cognition, and overall brain function.

Who knew how much protein can do for our body?! Now that we know the benefits of protein, let’s look at what happens when we don’t get enough protein.

Signs and Symptoms of Low Protein

Low protein levels can result from insufficient dietary intake or improper digestion and absorption. Symptoms of protein deficiency include:

  • Muscle wasting or weakness
  • Edema (swelling due to fluid retention)
  • Brittle nails and hair loss
  • Skin issues such as rashes or slow wound healing
  • Increased susceptibility to infections
  • Fatigue and weakness
  • Stunted growth in children
  • Slowed metabolism
  • Balance issues
  • GI issues that include: Persistent nausea, abdominal pain, and/or vomiting
  • Increased hunger

If you are experiencing symptoms of low protein, it’s very important to understand why. This is where tracking and use of a basal metabolic rate (BMR) scale can come in handy. Additionally, speaking to your healthcare provider about your symptoms and looking at possible reasons for them is crucial.

Types of Protein

Understanding the different types of protein available on the market can help you choose the best option for your needs. Here are some common types:

1. Whey Protein: Derived from milk, whey protein is a complete protein containing all essential amino acids. It’s quickly absorbed by the body, making it ideal for post-workout recovery.

Pros: High in essential amino acids, quickly absorbed, supports muscle repair and growth.

Cons: Contains lactose, which may cause digestive issues for some people; may contain artificial additives and sweeteners.

2. Whey Isolate: A more refined form of whey protein, whey isolate has most of the lactose and fat removed, making it higher in protein content per serving.

Pros: Higher protein concentration, lower in lactose, fast absorption.

Cons: Can be more expensive, still may contain additives.

3. Plant Protein: Derived from sources like peas, hemp, rice, and soy, plant proteins are an excellent option for vegetarians and vegans.

Pros: Suitable for those with dairy intolerance, often hypoallergenic, contains fiber and other beneficial nutrients.

Cons: May be lower in certain essential amino acids, some blends can have a gritty texture or strong taste.

I do not eat dairy due to a diary-sensitivity, however, I have found that I tolerate whey isolate protein. I also prefer the taste of whey isolate protein over plant protein, however, everyone is different. I always find it nice when companies provide samples before buying a full package of protein as some of them are not cheap. By far, Just Ingredients’ proteins are my favorite and do not break the bank.

Photo by Andres Ayrton on Pexels.com

Clean Protein Sources

Now that we have looked at types of protein, its important to discuss choosing clean protein sources free of heavy metals, chemicals, and preservatives. Here are some reputable companies that offer high-quality, clean protein products:

1. Just Ingredients: Known for their commitment to clean, natural ingredients, Just Ingredients offers protein powders without artificial additives or preservatives.

2. Garden of Life: Offers a range of plant-based protein powders that are certified organic and free from synthetic chemicals and fillers.

3. Orgain: Provides clean, organic protein powders made from plant-based and grass-fed sources, free from artificial ingredients.

4. Primal Kitchen: Known for their paleo-friendly products, Primal Kitchen offers collagen and whey protein powders without artificial additives.

5. Ancient Nutrition: Offers a variety of protein powders, including bone broth protein and multi-collagen protein, sourced from natural and organic ingredients.

Whatever protein you end up buying, make sure to look at the label. A simple method for choosing a good protein is to pick one that has the fewest ingredients. Proteins should not have a page of ingredients. If they do, then you can bet they add a bunch of chemicals and preservatives. The more natural a protein, the healthier it will be.

Recommended Protein Intake

So how much protein should we have in our diet? Research suggests that the Recommended Dietary Allowance (RDA) for protein is 0.8 grams per kilogram of body weight for the average adult. However, this can vary based on age, sex, physical activity level, and health status. For example, athletes or those recovering from illness may require more protein (think 1.0g/kg/day for athletes).

While high protein diets are often promoted, it’s important to note that excessive protein intake can strain the kidneys and may lead to other health issues. Therefore, it’s essential to balance protein intake according to individual needs and medical advice.

Incorporating Protein into Your Diet

Incorporating protein into your diet is easy whether you eat meat or not. To incorporate lean, whole food protein sources into your diet, consider the following tips:

  • Breakfast: Start your day with eggs, Greek yogurt (can do a plant-based yogurt with chia seeds), or a protein smoothie with plant-based protein powder.
  • Lunch: Opt for lean meats like chicken or turkey, or plant-based options like tofu, lentils, or chickpeas.
  • Dinner: Include fish, such as salmon or tuna, or beans and quinoa in your meals.
  • Snacks: Keep nuts, seeds, or protein bars on hand for a quick protein boost.
Photo by ROMAN ODINTSOV on Pexels.com

Aligning Protein Intake with Circadian Rhythm

To optimize protein utilization, it’s beneficial to distribute protein intake evenly throughout the day. Here’s a suggested schedule that I like to follow:

  • Morning (6-8 AM): Protein-rich breakfast to kickstart metabolism.
  • Mid-Morning (10-11 AM): Protein snack to maintain energy levels.
  • Lunch (12-1 PM): Balanced meal with lean protein.
  • Afternoon (3-4 PM): Another protein snack to avoid energy slumps.
  • Evening (6-8 PM): Protein-rich dinner to support overnight recovery.

Protein is indispensable for numerous bodily functions and overall health. By understanding its importance, recognizing signs of deficiency, and incorporating balanced, whole food protein sources into your diet, you can ensure you’re meeting your body’s needs. Always consider individual requirements and consult with healthcare professionals when determining the right amount of protein for you. Prioritizing clean protein sources from reputable companies can further enhance your health and well-being.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

Bilsborough, S., & Mann, N. (2006). A review of issues of dietary protein intake in humans. International Journal of Sport Nutrition and Exercise Metabolism, 16(2), 129-152.

Campbell, W. W., & Leidy, H. J. (2007). Dietary protein and resistance training effects on muscle and body composition in older persons. Journal of the American College of Nutrition, 26(6), 696S-703S.

Fielding, R. A., & Parkington, J. (2002). What are the dietary protein requirements of physically active individuals? New Horizons, 10(1), 32-39.

Institute of Medicine. (2005). Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). National Academies Press.

Jäger, R., Kerksick, C. M., Campbell, B. I., Cribb, P. J., Wells, S. D., Skwiat, T. M., … & Ziegenfuss, T. N. (2017). International Society of Sports Nutrition Position Stand: protein and exercise. Journal of the International Society of Sports Nutrition, 14(1), 1-25.

Phillips, S. M., & Van Loon, L. J. (2011). Dietary protein for athletes: from requirements to optimum adaptation. Journal of Sports Sciences, 29(S1), S29-S38.

Rafii, M., Chapman, K., Owens, J., Elango, R., & Campbell, W. W. (2016). Dietary protein requirements of young adults, the elderly, and individuals with chronic disease. Annals of Nutrition and Metabolism, 69(3-4), 183-190.

Tipton, K. D., & Wolfe, R. R. (2004). Protein and amino acids for athletes. Journal of Sports Sciences, 22(1), 65-79.

World Health Organization. (2007). Protein and amino acid requirements in human nutrition. World Health Organization.

Wolfe, R. R. (2017). Branched-chain amino acids and muscle protein synthesis in humans: myth or reality? Journal of the International Society of Sports Nutrition, 14(1), 1-7.

The Power of Intermittent Fasting (IF): Your Guide to Incorporating an IF Lifestyle

by Roxy Functional Wellness, posted in Health & Wellness, Weight Loss

Intermittent fasting (IF) has garnered significant attention in the wellness community for its potential health benefits. By alternating periods of eating and fasting, IF promises to aid in weight loss, improve metabolic health, and enhance overall well-being. I have personally found that incorporating an intermittent fasting plan that is individualized makes a huge difference during times of weight loss plateaus and when the food noise feels out of control. This blog post delves into the different types of intermittent fasting, the cellular mechanisms at play, the latest research on its efficacy, its suitability for different individuals, pros and cons, contraindications, signs of its effectiveness, and practical tips for incorporating it into your lifestyle.

Types of Intermittent Fasting

There are a few different types of IF that you may hear about in research and/or on social media platforms. I always caution my patients that although these are fairly set plans, there is always room to individualize them to meet your needs. No matter what type you choose, it needs to be something that you can do consistently and that fits your lifestyle to promote success. Some of the more popular types include:

  1. 16/8 Method: This method involves fasting for 16 hours and eating within an 8-hour window. For example, eating only between 12 PM and 8 PM.
  2. 5:2 Diet: This approach involves eating normally for five days a week and restricting calorie intake to 500-600 calories on the other two days. On the reverse side, some individualize this and eat a 16/8 IF on weekdays and allow more flexibility on the weekend days.
  3. Eat-Stop-Eat: This involves fasting for 24 hours once or twice a week.
  4. Alternate-Day Fasting: Alternating between days of normal eating and days of fasting or significantly reduced calorie intake.
  5. Warrior Diet: Involves eating small amounts of raw fruits and vegetables during the day and a large meal at night, typically within a 4-hour window.

No matter what type you choose, it needs to be something that you can do consistently and that fits your lifestyle to promote success.

How Intermittent Fasting Works on a Cellular Level

There are many benefits of IF on a cellular and metabolic level. Some of the key benefits include:

  • Glucose and Insulin: During fasting, blood glucose levels drop, leading to decreased insulin secretion. Lower insulin levels facilitate the breakdown of fat for energy. This process can improve insulin sensitivity over time.
  • Autophagy: Fasting triggers autophagy, a cellular cleanup process where cells remove damaged components and regenerate new ones. This can enhance cellular function and longevity.
  • Hormones: Fasting affects several hormones, including ghrelin (hunger hormone), leptin (satiety hormone), and norepinephrine (which increases metabolic rate). These hormonal changes can reduce appetite and increase fat burning.

Additionally, IF can promote consistency in one’s eating schedule and remove the stress of figuring out when to eat something. This is commonly an overlooked aspect when a person begins any lifestyle change. The stress of knowing where to start can be overwhelming. If you only have to worry about eating 8 hours out of the day that can be a significant stress reducer for some.

Latest Research on Intermittent Fasting

Recent studies indicate that intermittent fasting can be effective for weight loss and improving metabolic health. Research shows potential benefits such as reduced inflammation, improved brain health, and extended lifespan in animal studies. However, human studies are still evolving, and long-term effects need more exploration. Notably, IF has shown promise in improving cardiovascular health by reducing risk factors such as hypertension and high cholesterol levels.

Suitability and Efficacy

Intermittent fasting can be suitable for many people, particularly those looking to lose weight or improve metabolic health. However, it’s essential to approach it with caution and preferably under medical supervision if you have underlying health conditions. IF might not be suitable for:

  • Pregnant or breastfeeding women
  • Individuals with a history of eating disorders
  • Those with certain medical conditions such as diabetes, unless closely monitored by a healthcare provider (A continuous glucose monitor (CGM) can be a wonderful tool for someone that is a diabetic so that blood glucose can be monitored closely).
  • Those with chronic stress and/or anxiety.
  • History of eating disorders

Pros and Cons of Intermittent Fasting

As with any lifestyle change, it is always important to weight the pros and cons. For some, IF works very well and the benefits are plentiful, whereas, for others it increases stress and just doesn’t work for them. At the end of the day, remember that you can always individualize your plan and make adjustments along the way if need be. Some of the pros and cons of IF include:

Photo by picjumbo.com on Pexels.com

Pros:

  • Potential for weight loss and fat loss
  • Improved insulin sensitivity and metabolic health
  • Enhanced brain function and neuroprotection
  • Simplified eating schedules

Cons:

  • Initial adjustment period can be challenging
  • Possible side effects like headaches, dizziness, or irritability
  • Social and lifestyle constraints due to eating windows

Signs of Effective Intermittent Fasting

Everyone likes results. So how do you know if IF is working for you? Again, I feel its important to reiterate that everything should be individualized. Knowing if intermittent fasting is working for you can be observed through:

  • Steady weight loss and fat reduction
  • Improved energy levels and mental clarity
  • Better blood sugar and insulin levels
  • Reduced cravings and improved appetite control

Its always important to know what your goals are so that when you incorporate something new, like IF, you can measure if it is working for you. When I use IF, it is typically to break a cycle of bad cravings (usually around Thanksgiving/Christmas time!). I know that IF is working for me when I feel in control of my eating choices and my food noise isn’t driving me crazy.

Incorporating Intermittent Fasting into Your Lifestyle

So how do you incorporate IF into your daily lifestyle? Here are some tips I have learned along the way to ensure my success:

  1. Start Slowly: Begin with a method like 16/8 and gradually increase fasting periods as your body adapts.
  2. Stay Hydrated: Drink plenty of water and non-caloric beverages during fasting periods.
  3. Balanced Diet: Focus on nutrient-dense foods during eating windows to ensure adequate nutrition.
  4. Listen to Your Body: Pay attention to how your body responds and adjust your fasting schedule as needed.
  5. Consistency: Like any dietary change, consistency is key to seeing results.
Photo by Jenna Hamra on Pexels.com

Let’s bring it all together!

Intermittent fasting can be a powerful tool for improving health and wellness when done correctly. By understanding the different types of IF, how it works on a cellular level, and its potential benefits and drawbacks, you can make an informed decision about incorporating it into your lifestyle. Always consult with a healthcare provider before starting any new dietary regimen, especially if you have underlying health conditions. With the right approach, intermittent fasting can be a sustainable and effective strategy for achieving your health goals.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

Anton, S. D., Moehl, K., Donahoo, W. T., Marosi, K., Lee, S. A., Mainous, A. G., … & Mattson, M. P. (2018). Flipping the metabolic switch: Understanding and applying the health benefits of fasting. Obesity, 26(2), 254-268. https://doi.org/10.1002/oby.22065

Harvie, M. N., & Howell, A. (2017). Could intermittent energy restriction and intermittent fasting reduce cancer risk? A review of evidence and clinical potential. Molecular and Cellular Endocrinology, 455, 3-12. https://doi.org/10.1016/j.mce.2017.07.027

Longo, V. D., & Panda, S. (2016). Fasting, circadian rhythms, and time-restricted feeding in healthy lifespan. Cell Metabolism, 23(6), 1048-1059. https://doi.org/10.1016/j.cmet.2016.06.001

Mattson, M. P., Longo, V. D., & Harvie, M. (2017). Impact of intermittent fasting on health and disease processes. Ageing Research Reviews, 39, 46-58. https://doi.org/10.1016/j.arr.2016.10.005

Patterson, R. E., Laughlin, G. A., LaCroix, A. Z., Hartman, S. J., Natarajan, L., Senger, C. M., … & Marinac, C. R. (2015). Intermittent fasting and human metabolic health. Journal of the Academy of Nutrition and Dietetics, 115(8), 1203-1212. https://doi.org/10.1016/j.jand.2015.02.018

Sutton, E. F., Beyl, R., Early, K. S., Cefalu, W. T., Ravussin, E., & Peterson, C. M. (2018). Early time-restricted feeding improves insulin sensitivity, blood pressure, and oxidative stress even without weight loss in men with prediabetes. Cell Metabolism, 27(6), 1212-1221.e3. https://doi.org/10.1016/j.cmet.2018.04.010

Tinsley, G. M., & La Bounty, P. M. (2015). Effects of intermittent fasting on body composition and clinical health markers in humans. Nutrition Reviews, 73(10), 661-674. https://doi.org/10.1093/nutrit/nuv041

Varady, K. A. (2011). Intermittent versus daily calorie restriction: Which diet regimen is more effective for weight loss? Obesity Reviews, 12(7), e593-e601. https://doi.org/10.1111/j.1467-789X.2011.00873.x

Wilkinson, M. J., Manoogian, E. N., Zadourian, A., Lo, H., Fakhouri, S., Shoghi, A., … & Panda, S. (2020). Ten-hour time-restricted eating reduces weight, blood pressure, and atherogenic lipids in patients with metabolic syndrome. Cell Metabolism, 31(1), 92-104.e5. https://doi.org/10.1016/j.cmet.2019.11.004

Zehtabchi, S., Sinert, R., Kish, K., & Mattu, A. (2020). Fasting and metabolism: The biology of intermittent fasting. Emergency Medicine Clinics of North America, 38(1), 1-12. https://doi.org/10.1016/j.emc.2019.09.002

Understanding GLP-1 Medications: How They Work and Their Role in Weight Loss

by Roxy Functional Wellness, posted in Health & Wellness, Weight Loss

In recent years, GLP-1 medications such as Ozempic, Wegovy, and Mounjaro have garnered significant attention for their role in aiding weight loss and managing Type 2 Diabetes; most recently, research has even shown their benefit in those with heart disease. While these medications offer promising benefits, it is crucial to understand their limitations and the importance of a comprehensive approach to health and wellness.

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The Physiology and benefit of GLP-1 Medications

GLP-1 stands for glucagon-like peptide-1, a hormone produced in the gut that plays a significant role in regulating appetite (as well as cravings!) and blood glucose levels. Specifically, GLP-1 medications interact with the gut microbiome and influence the following:

  1. Appetite Regulation: GLP-1 medications mimic the action of the natural GLP-1 hormone. When these medications are introduced into the body, they bind to GLP-1 receptors in the brain, particularly in areas that control hunger and satiety. This interaction helps reduce appetite and increase feelings of fullness, leading to reduced food intake. This effect is a favorite of many as it forces one to eat less and not have as much “food noise” when deciding food options.
  2. Slowing Gastric Emptying: These medications slow down the rate at which the stomach empties food into the small intestine. This delayed gastric emptying helps prolong the feeling of fullness after eating, further aiding in appetite control and reducing overall calorie intake.
  3. Insulin Secretion: GLP-1 stimulates the pancreas to release insulin in response to food intake, helping to lower blood sugar levels. It also suppresses the release of glucagon, a hormone that increases blood sugar levels. This dual action helps maintain better glucose control, which is particularly beneficial for individuals with Type 2 Diabetes. This also reduces cravings due to the lack of up and down spikes in glucose.
  4. Reduction of Glucose Production: By inhibiting glucagon release, GLP-1 medications also reduce the liver’s production of glucose, contributing to lower blood sugar levels.

Many users of GLP-1 medications find that they experience significant weight loss, sometimes as much as 20% of their weight due to how they work in our bodies. Besides the weight loss, many find the decrease in “food noise” or the constant thinking of what to eat next to be comforting and helpful in making better, more healthy food choices.

Photo by Pavel Danilyuk on Pexels.com

Short-Term vs. Long-Term Use for Weight Loss

When considering GLP-1 medications for weight loss, it’s important to understand their role in both short-term and long-term use:

Short-Term Use

In the short term, GLP-1 medications can kickstart weight loss efforts by providing immediate benefits in appetite control and blood sugar regulation. This initial phase can be particularly motivating for individuals looking to make significant lifestyle changes. Additionally, I have also had success using GLP-1 medications in those that have reached a plateau in their weight loss and/or that have a small amount of weight to lose. However, the short-term use of these medications is generally not recommended as a standalone solution. Without ongoing support and lifestyle adjustments, the weight loss achieved may not be sustainable.

Long-Term Use

For sustained weight loss and health benefits, GLP-1 medications are often used as part of a long-term treatment plan. Long-term use helps maintain the physiological benefits of appetite regulation and blood sugar control, which can be crucial for individuals with chronic conditions like obesity and Type 2 Diabetes. It is important to note that long-term use of GLP-1 medications should always be supervised by a healthcare provider to monitor effectiveness, manage side effects, and adjust dosages as needed.

“Despite their benefits, GLP-1 medications are not a cure-all solution.”

The Importance of Professional Guidance

Despite their benefits, GLP-1 medications are not a cure-all solution. Working with a healthcare provider experienced with these medications is essential. I cannot stress this enough as there are many companies popping up across the nation that profess being an expert in obesity management and that are prescribing GLP-1 medications with little follow-up. Here’s why:

  1. Personalized Care: An experienced healthcare provider can tailor treatment to your specific needs, ensuring that the medication is used safely and effectively. When working with a provider, ask what framework they utilize to develop a plan for their patients. The Obesity Medicine Association (OMA) has developed the gold standard on obesity management and set the standard for providers offering obesity management services.
  2. Monitoring Side Effects: Common side effects include nausea, vomiting, and digestive issues. Those with a history of medullary thyroid cancer and/or frequent pancreatitis are not candidates for GLP-1 medications. A healthcare provider can help manage these side effects and adjust the treatment plan as needed.
  3. Comprehensive Approach: A healthcare provider can integrate GLP-1 medication into a broader wellness plan that includes diet, exercise, and mental health support. GLP-1 medications are NOT miracle drugs and should not be treated as such.

Maintaining Lean Muscle Mass

One of the concerns with rapid weight loss is the potential loss of lean muscle mass. Loss of muscle mass is not something to take lightly, which is why I wanted to specifically separately it out in this post. Maintaining muscle mass is crucial for overall health, metabolism, and functional strength. Recent studies have shown that muscle mass is linked to longevity, meaning that the more muscle mass a person has, the more likely they are to live longer and happier. Here are some strategies to ensure you preserve muscle while using GLP-1 medications:

  1. Protein Intake: Ensure you consume enough protein to support muscle repair and growth (approximately 0.8-1g/kg/day). Include high-quality protein sources such as lean meats, fish, eggs, dairy, legumes, and plant-based proteins in your diet.
  2. Resistance Exercise: Incorporate strength training exercises into your routine at least 2-3 times a week. Resistance exercises like weight lifting, bodyweight exercises, Pilates, and resistance band workouts help build and maintain muscle mass.
  3. Balanced Nutrition: In addition to protein, ensure your diet includes a variety of nutrients to support overall health. A balanced diet will provide the vitamins and minerals necessary for muscle maintenance and energy.
Photo by Andres Ayrton on Pexels.com

The Road to Sustainable Health

GLP-1 medications can be a valuable tool in your weight loss journey, but they should be part of a comprehensive approach that includes lifestyle changes and ongoing support. Here are some key takeaways for achieving sustainable health and weight loss:

  1. Consistency is Key: Regular exercise, balanced nutrition, and adherence to medication are crucial for long-term success.
  2. Holistic Approach: Consider your overall well-being, including mental health, stress management, and sleep, as part of your health journey.
  3. Stay Informed: Continuously educate yourself about your health, medications, and wellness strategies to make informed decisions.
  4. Healthy Eating: A balanced diet rich in whole foods, lean proteins, healthy fats, and complex carbohydrates supports overall health and complements the appetite-regulating effects of GLP-1 medications.
  5. Regular Exercise: Incorporating both aerobic and resistance exercises helps maintain muscle mass, boost metabolism, and improve cardiovascular health. This is particularly important as muscle mass can decrease with rapid weight loss if not adequately supported by exercise.
  6. Behavioral Changes: Addressing psychological and behavioral aspects of eating through counseling, mindfulness practices, or support groups can enhance the effectiveness of GLP-1 medications and contribute to long-term success.

Conclusion

While GLP-1 medications offer promising benefits for weight loss and diabetes management, they are not miracle drugs and should not be used lightly. Sustainable health and weight loss require hard work, dedication, and a holistic approach. Many times I try to utilize a natural approach prior to medications and have found that many people do well with this. By working with a knowledgeable healthcare provider and taking steps to maintain lean muscle mass, you can achieve and maintain your wellness goals. Remember, true health is a lifelong journey, and every step you take towards a healthier lifestyle is a step towards a better you.

Stay informed, stay healthy, and embrace the journey to your best self! 🌿✨

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider

References

Astrup, A., Carraro, R., Finer, N., Harper, A., Kunesova, M., Lean, M. E., … & Rossner, S. (2017). Safety, tolerability and sustained weight loss over 2 years with the once-daily human GLP-1 analog, liraglutide. International Journal of Obesity, 36(6), 843-854.

Buse, J. B., Wexler, D. J., Tsapas, A., Rossing, P., Mingrone, G., Mathieu, C., & D’Alessio, D. A. (2020). 2019 update to: Management of hyperglycemia in type 2 diabetes, 2018. Diabetes Care, 43(2), 487-493.

Davies, M. J., Bergenstal, R., Bode, B., Kushner, R. F., Lewin, A., Skjøth, T. V., … & Jendle, J. (2015). Efficacy of liraglutide for weight loss among patients with type 2 diabetes: the SCALE Diabetes randomized clinical trial. JAMA, 314(7), 687-699.

Drucker, D. J. (2018). Mechanisms of action and therapeutic application of glucagon-like peptide-1. Cell Metabolism, 27(4), 740-756.

Holst, J. J., Rosenkilde, M. M., & Deacon, C. F. (2020). Pharmacology of incretin hormones with special reference to clinical pharmacology of GLP-1 receptor agonists and DPP-4 inhibitors. Pharmacological Reviews, 72(4), 604-648.

Kushner, R. F., Calanna, S., Davies, M., Dicker, D., Garvey, W. T., Goldman, B., … & le Roux, C. W. (2020). Semaglutide 2.4 mg for the treatment of obesity in adults: A systematic review and meta‐analysis. Diabetes, Obesity and Metabolism, 22(10), 1901-1911.

Lean, M. E., Astrup, A., Roberts, S. B., & Hanson, R. L. (2019). Making progress on the global crisis of obesity and weight management. The Lancet, 394(10215), 206-210.

Müller, T. D., Finan, B., Clemmensen, C., DiMarchi, R. D., & Tschöp, M. H. (2019). The new biology and pharmacology of glucagon-like peptide-1. Mayo Clinic Proceedings, 94(1), 51-67.

Wilding, J. P., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., … & Lau, D. C. (2021). Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine, 384(11), 989-1002.

Foundations of Health: A Holistic Approach to Wellness and Weight Management

by Roxy Functional Wellness, posted in Health & Wellness, Weight Loss

In our fast-paced world, achieving and maintaining a sense of wellness and (especially) a healthy weight is often framed in terms of diet and exercise alone. There were many times during my own wellness journey that I was told to “just cut some calories” and “run more if you want to lose weight”. However, I discovered that true wellness encompasses much more. A holistic approach to health considers various foundational elements that include: water, food, exercise, air, sunlight, rest, energy, and spirituality. Each of these components plays a critical role in overall wellness that, ultimately, leads to better weight management. Let’s explore how they interconnect and how you can incorporate them into your daily life for optimal health.

Water: The Elixir of Life

Water (not coffee, juice, or soda—they don’t count!) is essential for every cellular function in our bodies. It aids in digestion, nutrient absorption, and waste elimination. Proper hydration can boost metabolism, making it easier to maintain a healthy weight. Aim to drink at least half your body weight in ounces of water daily. Start your day with a glass of water and carry a refillable bottle to stay hydrated throughout the day. I am a huge fan of my Stanley cup and make it my goal to drink (2) full Stanley cups (40oz each) per day. Be creative with your water too. I like to add fruit, herbal teas, organic flavor packets, and minerals. However you decide to get your water in, just make sure that you are drinking clean water that is free of harmful chemicals (and sugars) if utilizing a flavor packet.

Food: Nourishment and Fuel

The food we consume is the fuel that powers our bodies. A diet rich in whole foods—fruits, vegetables, lean proteins, and whole grains—provides essential nutrients that support metabolic function and overall health. Avoid processed foods high in sugars and unhealthy fats, which can lead to weight gain and chronic health issues. Instead, focus on balanced meals that include a variety of colorful, nutrient-dense foods. I always tell my kids to “eat the rainbow”. This is not only what our bodies need, but always makes cooking fun!

Exercise: Movement for Life

Regular physical activity is crucial for maintaining a healthy weight and overall wellness. Exercise not only burns calories but also builds muscle, improves cardiovascular health, and boosts mood through the release of endorphins. Incorporate a mix of aerobic exercises, strength training, and flexibility workouts like yoga into your routine. Aim for at least 150 minutes of moderate-intensity exercise each week. I won’t get on my soapbox in this post, but it is also important to remember that exercise should be something you enjoy verses something that completely stresses your body out. If your body is completely stressed out because of what you are doing and/or because you are working out to much or too often, then your stress hormones will elevate. This then can cause an increase in inflammation which can throw your hormones off and cause rebound weight gain. I had to learn this the hard way on my journey as I was an avid runner, but became frustrated when I couldn’t get passed 180lbs. It sounded counterintuitive at the time, but decreasing my weekly runs to two times per week (<30 min each time) and adding in two weight training days (15 min each) and daily yoga (10-15 min each time) made all the difference for me.

Photo by Nathan Cowley on Pexels.com

Air: The Breath of Wellness

Clean air is vital for our respiratory health and overall well-being. I’m not just talking about tossing that tobacco habit either. Pollution and toxins can impair lung function and increase the risk of various diseases. Practice deep breathing exercises to improve lung capacity and reduce stress. Spend time in nature where air quality is generally better, and consider using air purifiers in your home to maintain a clean indoor environment. In my house, we have an air purify and/or salt lamp in every room to help cleanse the air. I have also made deep breathing and meditation a daily morning habit that has done wonders for my stress levels.

Sunlight: The Natural Energizer

Sunlight is a natural source of vitamin D, which is essential for bone health, immune function, and mood regulation. Exposure to sunlight helps regulate our circadian rhythms, improving sleep quality and energy levels. Aim for at least 15-30 minutes of sunlight exposure each day, preferably first thing in the morning. Protect your skin with appropriate clothing and sunscreen to prevent overexposure. This is especially important for those that live in the northern parts of the U.S. where our sunlight exposure is somewhat limited at times.

Rest: The Rejuvenator

Quality sleep is fundamental to health and weight management. During sleep, our bodies repair tissues, consolidate memories, and regulate hormones that control hunger and metabolism. Aim for 7-9 hours of sleep each night. Establish a regular sleep schedule, create a restful environment, and practice good sleep hygiene by avoiding screens before bedtime. I also find it helpful to take breaks during the day. Many times our busy lives force us to work through lunch breaks. I would encourage you to not do that if possible. Take those breaks as a time to decompress, deep breathe, and re-center yourself. Rest isn’t just about sleeping at night. It’s also about finding that those quite moments where we can bring our mind back into the present and just be.

Energy: The Vital Force

Our bodies operate on a complex system of energy derived from food, sleep, and our environment. Maintaining balanced energy levels throughout the day supports productivity, mood, and physical activity. Monitor your energy patterns and adjust your lifestyle to include regular meals, hydration, exercise, and relaxation techniques to keep your energy steady. Sometimes we need to have our energy unblocked and/or reset by enjoying a massage and/or by doing an acupuncture session. Lymph support is also important for proper energy flow, so incorporating sauna sessions, rebounding, etc… can also be helpful.

Spirituality: The Inner Connection

Spirituality can provide a sense of purpose, reduce stress, and enhance overall well-being. I cannot stress enough that this doesn’t necessarily mean religion; it can be any practice that brings you peace and connection, such as meditation, yoga, or spending time in nature. Spiritual practices can help you stay grounded, reduce emotional eating, and foster a positive mindset towards your health journey. My relationship with Christ has not been centered around a church membership, but rather it has been centered around me finding my purpose in Him and personally growing to meet that purpose. This has been an aspect of my journey that has been so important as I had to realize that my value was more than my weight. I had a higher purpose in life than to be skinny and look great in a bathing suit. Sometimes spirituality is about bringing perspective verses adding in another set of rules for our life.

Photo by Lucas Pezeta on Pexels.com

Integrating the Foundations into Daily Life

So how do you incorporate the foundations of health? I will be the first to say that how you incorporate them should fit you and your lifestyle. They should not cause extra stress, but should create a sense of freedom. I always tell my patients that I hate fad diets because so many of them are made as a one-size fits all. We are all different so that doesn’t even make sense. So here is a starting point on how you can integrate them into your daily routine. Try a couple and see if they work for you.

  1. Morning Routine: Start your day with a glass of water, a nutritious breakfast, and some sunlight exposure.
  2. Daily Movement: Incorporate regular physical activity, whether it’s a morning jog, a yoga session, or an evening walk.
  3. Mindful Eating: Focus on whole, nutrient-dense foods and avoid processed options. Practice mindful eating by paying attention to hunger and fullness cues.
  4. Hydration: Keep a water bottle with you and sip throughout the day.
  5. Clean Air: Spend time outdoors in nature and ensure your indoor spaces are well-ventilated.
  6. Restful Sleep: Establish a calming nighttime routine to ensure quality sleep.
  7. Energy Balance: Listen to your body and adjust your activities and diet to maintain balanced energy levels. Go enjoy that massage you’ve been needing!
  8. Spiritual Practices: Incorporate activities that nourish your spirit, such as meditation, prayer, or connecting with nature.

By embracing these foundations of health, you create a comprehensive approach to wellness that goes beyond weight loss. This holistic lifestyle not only supports your physical health but also enhances your mental, emotional, and spiritual well-being, leading to a more balanced and fulfilling life.

I would love to hear any questions you may have and/or any topics you would like me to cover. Feel free to leave comments below!

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

Published: 06/24/2024

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider.

References

  1. Armstrong, L. E. (2007). Assessing hydration status: The elusive gold standard. Journal of the American College of Nutrition, 26(sup5), 575S-584S.
  2. Ludwig, D. S. (2018). Always hungry?: Conquer cravings, retrain your fat cells, and lose weight permanently. Hachette UK.
  3. Powell, K. E., Paluch, A. E., & Blair, S. N. (2011). Physical activity for health: What kind? How much? How intense? On top of what?. Annual Review of Public Health, 32, 349-365.
  4. Schraufnagel, D. E., Balmes, J. R., Cowl, C. T., De Matteis, S., Jung, S. H., Mortimer, K., … & Thurston, G. D. (2019). Air pollution and noncommunicable diseases: A review by the Forum of International Respiratory Societies’ Environmental Committee, part 1: The damaging effects of air pollution. Chest, 155(2), 409-416.
  5. Holick, M. F. (2007). Vitamin D deficiency. New England Journal of Medicine, 357(3), 266-281.
  6. Irwin, M. R. (2015). Why sleep is important for health: a psychoneuroimmunology perspective. Annual Review of Psychology, 66, 143-172.
  7. Sapolsky, R. M. (2004). Why zebras don’t get ulcers: The acclaimed guide to stress, stress-related diseases, and coping. Macmillan.
  8. Koenig, H. G. (2012). Religion, spirituality, and health: The research and clinical implications. ISRN psychiatry, 2012.
  9. Penedo, F. J., & Dahn, J. R. (2005). Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Current Opinion in Psychiatry, 18(2), 189-193.
  10. Figueroa, S., Sanchez-Romero, L. M., & Amigo, H. (2020). Water, hydration and health. Nutrients, 12(2), 303.

My Wellness Journey: From 254lbs to 120lbs

by Roxy Functional Wellness, posted in Health & Wellness, Weight Loss

This month marks the 9th anniversary of when I made a promise to myself that I would not give up on myself. In 2015, my life wasn’t where I wanted it to be physically and mentally. I had a great career and a wonderful, supportive family, but my ability to enjoy life felt limited. As a Family Nurse Practitioner, I was expected to promote health and wellness, yet I felt like a total hypocrite discussing this. My endocrinologist informed me that I would struggle with my weight forever due to Type II Diabetes and the absence of my thyroid, which was removed in 2010 following a Papillary Thyroid cancer diagnosis. At my heaviest, I weighed 254lbs and struggled to even play with my young children. I knew I had to make a change for myself and for my family. I always tell people I felt like I was trapped inside a body that I knew could be so much more.

Determined to improve my health, I turned to Beachbody (I really can’t say enough good things about this company!). This program provided a structured approach that I desperately needed at the time. That’s the hardest part, right? Where do you start when something is completely new to you?Through portion control and dedicated workouts, particularly the 22 Minute Hard Core program, I managed to lose 50lbs. I was so proud of this as I did it on my own. However, my progress was not without setbacks and I eventually found myself in pain and in a plateau. I developed persistent sciatica, which hindered my ability to be active and even pick up my kids at times.

In search of relief, I discovered yoga. The impact was so profound that I earned my 200-hour yoga certification and began teaching at a local gym. Embracing yoga introduced me to the Ayurvedic lifestyle, which further improved my eating habits and overall wellness. This phase of my life helped me shed an additional 20lbs, and made my sciatica almost non-existent. Despite this, I eventually found myself stuck in another plateau at 180lbs. I always tell people this plateau was the most frustrating as I had come so far but struggled mentally that I wasn’t doing enough. My mental health and confidence also took another hit as I also began dealing with loose skin at this point. Anybody that has dealt with loose skin can attest to how hard it is to deal with not just the physical concerns that loose skin causes but also the mental and emotional concerns. I needed a better option.

To address the loose skin and enhance my confidence, I opted for a tummy tuck. This surgery was life-changing. It not only improved my physical appearance and back health but also boosted my mental well-being and workout efficiency. I cannot say enough positives about getting a tummy tuck. Although it is not for everyone and is definitely NOT a painless surgery, it was well worth it. Despite these improvements, I remained at a weight plateau.

Seeking further assistance, I consulted a certified weight loss doctor who prescribed Ozempic. This medication helped me break through my plateau, leading to better blood sugar control and no more insulin. However, I experienced a significant loss of muscle mass, a trade-off that I will delve into in future posts. With the help of medications (Ozempic/Wegovy/Mounjaro), I reached 140lbs but then faced another plateau for over a year.

At the start of 2024, frustrated and aware that something was off with my hormones, I sought the help of a naturopath. My stress levels were sky high due to work stress, my sleep left much to be desired, my poor husband wasn’t sure what mood I would be in each day, and my weight loss was stagnant. It was at this point, a food intolerance test revealed that dairy was a major issue for me. Eliminating dairy from my diet was transformative: my migraines disappeared, my skin and hair improved, my sleep quality increased, and my inflammatory markers normalized for the first time ever! Finally, I broke through my plateau and reached my goal weight of 120lbs by summer.

From 2016 to now, I have lost a total of 135lbs and have achieved my best mental, emotional, physical, and spiritual health. This journey has been challenging but incredibly rewarding. It has taught me that weight loss is not just about calories in and out; it’s about finding balance and understanding your body. Through my personal journey, wellness has become my passion, and I enjoy coming alongside others to support them achieve their wellness goals. I truly believe everyone deserves to feel their best. I look forward to sharing more insights from my journey (there is just so much!) and helping others on their path to health each week in this blog.

Never give up—your wellness journey is worth every step.

Written By: Roxanne Oliver, DNP, APRN, FNP-BC

*The information contained in this post is for information only. It does not replace routine follow-up and/or care with a certified and licensed medical provider.