Tag: fitness

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.

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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.

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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.

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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.
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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:

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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.

Nurturing Wellness: Exploring Natural Remedies for Depression

by Roxy Functional Wellness, posted in mental health

In today’s fast-paced world, the prevalence of depression has become a significant concern. It’s more than just feeling sad; depression can impact every facet of one’s being – physically, mentally, emotionally, and even spiritually. Recognizing its profound effects is crucial to understanding how to combat it effectively.

Understanding Depression:

Depression is a complex mental health disorder characterized by persistent feelings of sadness, hopelessness, and a lack of interest in activities once enjoyed. It affects not only mood but also cognition, behavior, and physical health. Common symptoms include fatigue, changes in appetite or weight, sleep disturbances, feelings of worthlessness or guilt, difficulty concentrating, and even thoughts of death or suicide.

The impact of depression extends beyond the mind. Physically, it can manifest as chronic pain, headaches, digestive issues, and weakened immunity. Emotionally, it can strain relationships, diminish self-esteem, and rob life of its joy. Spiritually, it can leave one feeling disconnected from oneself and the world around them.

Photo by Inzmam Khan on Pexels.com

Western Medicine Approaches:

Traditional Western medicine often addresses depression through pharmacotherapy, typically prescribing antidepressant medications like SSRIs (Selective Serotonin Reuptake Inhibitors) or therapy such as Cognitive Behavioral Therapy (CBT). While these approaches can be effective for many individuals, they often focus on managing symptoms rather than addressing the root causes of depression.

Incorporating Natural Remedies Into Daily Life

Treating the Source not the symptom(s):

Incorporating natural remedies into your daily life can be a powerful way to prevent and treat depression, fostering holistic well-being and resilience. Here’s a comprehensive list of strategies to integrate these remedies into your lifestyle:

  1. Mindful Nutrition:
    • Embrace a balanced diet rich in whole foods, including fruits, vegetables, lean proteins, and healthy fats.
    • Incorporate mood-boosting nutrients like omega-3 fatty acids (found in fish, flaxseeds, and walnuts), B vitamins (found in leafy greens, legumes, and whole grains), and magnesium (found in nuts, seeds, and dark chocolate).
    • Limit processed foods, refined sugars, and caffeine, which can exacerbate mood swings and energy fluctuations.
  2. Regular Exercise:
    • Engage in regular physical activity, such as walking, jogging, swimming, or yoga, to release endorphins and promote overall well-being.
    • Aim for at least 30 minutes of moderate-intensity exercise most days of the week to reap the mood-boosting benefits.
  3. Quality Sleep:
    • Prioritize sleep hygiene by establishing a regular sleep schedule, creating a relaxing bedtime routine, and optimizing your sleep environment.
    • Aim for 7-9 hours of quality sleep per night to support optimal mood regulation and cognitive function.
  4. Stress Management:
    • Practice stress-reducing techniques like mindfulness meditation, deep breathing exercises, progressive muscle relaxation, or yoga to promote relaxation and emotional balance.
    • Prioritize self-care activities that bring you joy and fulfillment, such as hobbies, creative expression, or spending time in nature.
  5. Herbal and Homeopathic Remedies:
    • Explore herbal supplements and homeopathic remedies known for their mood-stabilizing properties, such as St. John’s Wort, Rhodiola, and Ignatia.
    • Consult with a qualified healthcare provider or holistic practitioner to determine the most appropriate remedies for your individual needs and preferences.
  6. Bach Flower Essences:
    • Incorporate Bach Flower Remedies into your daily routine by taking a few drops orally, either directly under the tongue or diluted in water, several times a day as needed.
    • Choose specific remedies tailored to your emotional state and concerns, such as Rescue Remedy for acute stress or Mustard for deep sadness.
  7. Sunlight Exposure:
    • Spend time outdoors in natural sunlight, especially in the morning, to regulate circadian rhythms and boost vitamin D levels.
    • Aim for at least 15-30 minutes of sunlight exposure per day, or consider using a light therapy lamp during darker months or in regions with limited sunlight.
  8. Social Connection:
    • Cultivate meaningful relationships and social support networks to foster a sense of belonging and connection.
    • Prioritize quality time with loved ones, engage in activities that bring you joy, and seek out support groups or community organizations for additional encouragement and camaraderie.
  9. Professional Support:
    • Work closely with a qualified healthcare provider, therapist, or holistic practitioner to develop a personalized treatment plan that addresses your unique needs and concerns.
    • Be open to exploring a combination of natural remedies, conventional therapies, and lifestyle modifications to optimize your mental health and well-being.

Pros and Cons:

While natural remedies offer a gentler approach with fewer side effects compared to conventional medications, they may not be suitable for everyone. It’s essential to consider individual needs, preferences, and any contraindications. Additionally, natural remedies may take longer to show results and require consistency and patience.

“Natural healing is about taking control of your life and being responsible for everything that goes in and out of your body, mind, and spirit.” – Richard Schulze

That’s a Wrap!

In conclusion, addressing depression holistically involves nurturing the body, mind, and spirit. By incorporating natural remedies into our lives and embracing practices that promote balance and well-being, we can move towards greater resilience and inner peace. Remember, healing is a journey, and each step towards self-care is a step towards wellness.

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

Published: 04/13/2024

*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. Ernst, E. (2002). The risk-benefit profile of commonly used herbal therapies: Ginkgo, St. John’s Wort, Ginseng, Echinacea, Saw Palmetto, and Kava. Annals of Internal Medicine, 136(1), 42-53.
  2. Kasper, S., & Gastpar, M. (2010). St. John’s Wort extract in depression therapy: efficacy revisited. CNS Drugs, 24(3), 225-237.
  3. Sarris, J., & Panossian, A. (2015). Schweizer’s herbal medicine: Materia medica and repertory. East West School of Planetary Herbology.
  4. Dhawan, K., Kumar, S., & Sharma, A. (2002). Anti-anxiety studies on extracts of Passiflora incarnata Linneaus. Journal of Ethnopharmacology, 78(2-3), 165-170.
  5. Miyasaka, L. S., Atallah, Á. N., & Soares, B. G. O. (2007). Passiflora for anxiety disorder. Cochrane Database of Systematic Reviews, (1), CD004518.
  6. Kell, G., Rao, A., Beccaria, G., Clayton, P., Inarejos-García, A. M., & Prodanov, M. (2017). affron® a novel saffron extract (Crocus sativus L.) improves mood in healthy adults over 4 weeks in a double-blind, parallel, randomized, placebo-controlled clinical trial. Complementary Therapies in Medicine, 33, 58-64.
  7. Kumar, A., & Kalonia, H. (2007). Effect of Withania somnifera on sleep‐wake cycle in sleep‐disturbed rats: Possible GABAergic mechanism. Indian Journal of Pharmaceutical Sciences, 69(5), 665.
  8. Davidson, J. R., Morrison, R. M., Shore, J., Davidson, R. T., & Bedayn, G. (1988). Homeopathic treatment of depression and anxiety. Alternative Therapies in Health and Medicine, 4(1), 75-77.

Hydrate to Liberate: The Role of Water Intake in Stress Management

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

In our fast-paced world, stress has become an almost inevitable part of our daily lives. Whether it’s the pressure of deadlines at work, personal relationships, or the constant barrage of information, stress can manifest in various ways and take a toll on our physical and mental well-being. While there are numerous strategies to cope with stress, one often overlooked yet powerful tool is right at our fingertips – water.

Water is not just essential for our survival; it plays a crucial role in maintaining our overall health and well-being. From aiding digestion to regulating body temperature, every cell, tissue, and organ in our body relies on water to function properly. However, its impact on stress management is often underestimated.

“Pure water is the world’s first and foremost medicine.” – unknown

When we’re stressed, our bodies undergo physiological changes, triggering the release of stress hormones like cortisol and adrenaline. These hormones prepare us for the “fight or flight” response, which can lead to increased heart rate, shallow breathing, and heightened tension in muscles. Here’s where hydration comes into play.

Proper hydration is essential for optimal brain function and mood regulation. Studies have shown that even mild dehydration can impair cognitive function, memory, and attention, making it harder to cope with stressors effectively. Dehydration can exacerbate feelings of fatigue and irritability, further amplifying the negative effects of stress on our mental health.

So How Much Water?

So, how much water should you drink to stay adequately hydrated and support stress management? While individual needs vary based on factors like age, weight, activity level, and climate, a general guideline is to aim for around 8 glasses of water per day, which is roughly 2 liters or at least half of your body weight in pounds. For example, if a women weighs 120lbs, she would need to get at least 60oz of water daily. However, this can vary, and some people may need more or less depending on their circumstances.

Photo by Cats Coming on Pexels.com

Watch for Pitfalls

One common mistake many of us make is relying on caffeinated beverages like coffee or energy drinks to keep us alert and focused, especially during stressful times. While caffeine can provide a temporary energy boost, it can also contribute to dehydration due to its diuretic effects. Moreover, excessive caffeine consumption can disrupt sleep patterns and exacerbate feelings of anxiety and agitation. My rule of thumb is that I do not drink coffee past noon. This was a big change for me, however, I noticed that I was less fatigued in the afternoon and slept better at night by making that change.

Instead of reaching for that extra cup of coffee, consider swapping it out for a refreshing glass of water or herbal tea. Not only will it help keep you hydrated, but it can also promote a sense of calm and clarity, making it easier to tackle challenges with a clear mind.

In addition to plain water, incorporating hydrating foods like fruits and vegetables into your diet can also contribute to your overall fluid intake. Foods with high water content, such as cucumbers, watermelon, and oranges, can help you stay hydrated while providing essential vitamins, minerals, and antioxidants that support stress resilience.

So what can you do to incorporate more water into your day? Here are some helpful tips:

  1. Set Reminders: With the hustle and bustle of daily life, it’s easy to forget to drink water regularly. Set reminders on your phone or use apps designed to track water intake. Establishing a routine can help make hydration a habit.
  2. Carry a Reusable Water Bottle: Invest in a durable, reusable water bottle and take it with you wherever you go. Having water readily available makes it more likely that you’ll sip on it throughout the day. Keep it visible on your desk or in your bag as a constant reminder to hydrate. I also find using a consistent water bottle takes the stress off of tracking how much I am drinking throughout the day (thank you, Stanley cup!).
  3. Flavor Infusions: If plain water doesn’t entice you, consider infusing it with natural flavors like lemon, cucumber, mint, or berries. Not only does this add a refreshing twist to your hydration routine, but it also encourages you to drink more water without added sugars or calories. I love the True Lemon Brand flavoring for their great taste and non-use of artificial sweeteners, flavors, GMOs, or preservatives.
  4. Track Your Intake: Keep track of your water consumption using a journal, smartphone app, or even a simple tally system. Seeing your progress visually can motivate you to reach your hydration goals and adjust your intake as needed.
  5. Associate Water with Daily Activities: Linking water consumption with daily activities can help you remember to drink throughout the day. For example, drink a glass of water first thing in the morning, before each meal, or after completing a task at work. By integrating water breaks into your routine, you’ll ensure consistent hydration throughout the day.

Prioritizing adequate water intake is a simple yet powerful strategy for managing stress effectively. By staying hydrated, you’re not only supporting your physical health but also equipping yourself with the mental clarity and resilience needed to navigate life’s inevitable challenges. So, the next time you feel the weight of stress bearing down on you, reach for a glass of water and hydrate your way to a calmer, more balanced state of mind. Your body and mind will thank you for it.

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

Published: 04/15/2024

*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., & Ganio, M. S. (2019). Relationship between water metabolism and exercise-induced dehydration: Hormonal and physiological markers. Journal of Athletic Training, 54(7), 785–791. https://doi.org/10.4085/1062-6050-54.7.08
  2. Benton, D. (2011). Dehydration influences mood and cognition: A plausible hypothesis? Nutrients, 3(5), 555–573. https://doi.org/10.3390/nu3050555
  3. Grandjean, A. C., & Grandjean, N. R. (2007). Dehydration and cognitive performance. Journal of the American College of Nutrition, 26(5), 549S–554S. https://doi.org/10.1080/07315724.2007.10719650
  4. Kenney, W. L., & Chiu, P. (2001). Influence of age on thirst and fluid intake. Medicine and Science in Sports and Exercise, 33(9), 1524–1532. https://doi.org/10.1097/00005768-200109000-00015
  5. Maughan, R. J., & Murray, R. (2019). Hydration and health: A review. Nutrition Bulletin, 44(3), 277–304. https://doi.org/10.1111/nbu.12305
  6. Popkin, B. M., D’Anci, K. E., & Rosenberg, I. H. (2010). Water, hydration, and health. Nutrition Reviews, 68(8), 439–458. https://doi.org/10.1111/j.1753-4887.2010.00304.x
  7. Pross, N., Demazieres, A., Girard, N., Barnouin, R., Metzger, D., Klein, A., & Perrier, E. (2014). Influence of progressive fluid restriction on mood and physiological markers of dehydration in women. British Journal of Nutrition, 111(2), 313–321. https://doi.org/10.1017/S0007114513002354
  8. Shirreffs, S. M. (2003). Markers of hydration status. European Journal of Clinical Nutrition, 57(Suppl 2), S6–S9. https://doi.org/10.1038/sj.ejcn.1601905
  9. Stachenfeld, N. S. (2008). Acute effects of sodium ingestion on thirst and cardiovascular function. Current Sports Medicine Reports, 7(4 Suppl), S7–S13. https://doi.org/10.1249/JSR.0b013e31817f19d7
  10. Szinnai, G., Schachinger, H., Arnaud, M. J., Linder, L., & Keller, U. (2005). Effect of water deprivation on cognitive-motor performance in healthy men and women. The American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 289(1), R275–R280. https://doi.org/10.1152/ajpregu.00765.2004

The Transformative Power of Exercise: A Holistic Approach to Stress Management

Featured by Roxy Functional Wellness, posted in Health & Wellness

In the hustle and bustle of modern life, stress has become an almost constant companion for many of us (I can definitely attest to this at times!). From work deadlines to personal responsibilities, the pressures of daily life can take a toll on our mental and physical well-being. However, amidst the chaos, there exists a powerful tool that can help us navigate through stress and emerge stronger: exercise.

The relationship between exercise and stress management is profound and multifaceted. When we engage in physical activity, our bodies undergo a series of changes that not only benefit our physical health but also have a profound impact on our mental and emotional well-being. So, let’s get moving!

Balancing Stress Hormones:

One of the key mechanisms through which exercise helps manage stress is by balancing our stress hormone release. When we encounter stressful situations, our bodies release hormones like cortisol and adrenaline, which trigger the body’s “fight or flight” response. While this response is crucial for dealing with immediate threats, chronic stress can lead to an overproduction of these hormones, which can have detrimental effects on our health.

Regular exercise acts as a natural regulator of stress hormones. When we engage in physical activity, our bodies produce endorphins, often referred to as “feel-good” hormones, which help alleviate stress and promote a sense of well-being. Additionally, exercise helps reduce levels of cortisol in the body, effectively counteracting the negative effects of chronic stress.

The Pitfalls of Excessive Exercise:

While exercise is undoubtedly beneficial for stress management, it’s essential to strike a balance. Too much exercise or engaging in overly rigorous workouts can actually have the opposite effect and stress the body out further. I find this very true with females especially.

Overtraining can lead to a phenomenon known as “exercise-induced stress.” When we push our bodies beyond their limits without giving them adequate time to rest and recover, it can result in hormone imbalances, increased inflammation, and heightened feelings of fatigue and burnout. This can ultimately exacerbate stress levels rather than alleviate them. Not to mention, a person is more prone to physical injury when excessively exercising.

How Do You Know if You Are Over-Exercising?

Identifying whether you’re overexercising requires paying attention to both physical and psychological cues. Physical signs may include persistent fatigue despite adequate rest, prolonged soreness or pain in muscles and joints, increased frequency of injuries, and changes in appetite or weight. Psychologically, feelings of irritability, mood swings, difficulty concentrating, and decreased motivation towards exercise may indicate overexertion. Monitoring heart rate variability, sleep quality, and overall performance during workouts can also provide valuable insights. Listening to your body and giving it the rest and recovery it needs is key to preventing the negative consequences of overtraining. One quick way that to determine if you are too fatigued to exercise and need a break is to get through the first 5-minutes of a workout and evaluate yourself. If you feel too tired to go on and/or are in pain, then take a rest day.

Taking a Holistic Approach:

Taking a holistic approach to a weekly fitness routine involves integrating various types of exercise to promote overall health and well-being. Incorporating elements of cardiovascular exercise, such as running, cycling, or swimming, helps improve heart health and endurance while burning calories. Strength training exercises, including muscle-resistant exercises like weightlifting or bodyweight workouts, play a crucial role in building lean muscle mass, increasing metabolism, and enhancing bone density. Additionally, integrating flexibility and mobility exercises, such as yoga or stretching routines, helps improve joint range of motion, reduce the risk of injury, and promote relaxation. Balancing these different modalities throughout the week ensures a comprehensive approach to fitness that addresses both physical strength and flexibility, contributing to long-term health and vitality.

“Exercise is the most potent and underutilized antidepressant–and it’s free.” – Unknown

To harness the full potential of exercise for stress management, it’s essential to adopt a holistic approach that encompasses not just physical activity but also other aspects of self-care.

  1. Mindfulness Practices: Incorporating mindfulness practices such as meditation, yoga, or tai chi alongside exercise can further enhance stress reduction. These practices help cultivate a sense of presence and awareness, allowing us to better cope with stressors as they arise. My go-to is a Slow Flow Vinyasa with a quick mediation at the finish with Savasana.
  2. Balanced Nutrition: Fueling our bodies with nutrient-dense foods plays a crucial role in managing stress. A balanced diet rich in fruits, vegetables, whole grains, and lean proteins provides the necessary nutrients to support physical and mental well-being. More to come on the importance of nutrition!
  3. Adequate Rest and Recovery: Just as important as exercise itself is giving our bodies ample time to rest and recover. Prioritizing quality sleep and incorporating rest days into our workout routines allows our bodies to repair and recharge, preventing burnout and promoting overall resilience.
  4. Social Connection: Building and nurturing supportive relationships can significantly impact our ability to manage stress. Whether it’s through group exercise classes, team sports, or simply spending time with loved ones, fostering social connections provides a valuable source of emotional support and encouragement.
Photo by The Lazy Artist Gallery on Pexels.com

To pull it all together, exercise holds immense potential as a tool for managing stress and promoting overall well-being. By balancing stress hormone release, avoiding excessive exercise, and embracing a holistic approach to exercise and self-care, we can harness the transformative power of physical activity to navigate life’s challenges with strength, resilience, and vitality.

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

Published: 04/11/2024

*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

American College of Sports Medicine. (2014). ACSM’s guidelines for exercise testing and prescription. Wolters Kluwer Health/Lippincott Williams & Wilkins.

American Psychological Association. (n.d.). The exercise effect. Retrieved from https://www.apa.org/news/press/releases/stress/2013/exercise

Harvard Health Publishing. (n.d.). Exercise and stress: Get moving to manage stress. Retrieved from https://www.health.harvard.edu/staying-healthy/exercising-to-relax

Mayo Clinic. (n.d.). Exercise and stress: Get moving to manage stress. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/exercise-and-stress/art-20044469

National Institute of Mental Health. (n.d.). 5 Things You Should Know About Stress. Retrieved from https://www.nimh.nih.gov/health/publications/stress/index.shtml

Powers, S. K., & Howley, E. T. (2018). Exercise physiology: Theory and application to fitness and performance. McGraw-Hill Education.

Ratamess, N. A., Alvar, B. A., Evetoch, T. K., Housh, T. J., Kibler, W. B., Kraemer, W. J., & Triplett, N. T. (2009). American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Medicine & Science in Sports & Exercise, 41(3), 687-708.

The Power of Sleep: Your Foundation for Stress Reduction and Wellness

by Roxy Functional Wellness, posted in Health & Wellness

As April continues, so does Stress Awareness Month, serving as a poignant reminder of the importance of mental well-being in our lives. Stress, an omnipresent force in our modern lives, can wreak havoc on both our physical and mental health if left unchecked. However, amidst the chaos of daily life, one often-overlooked remedy lies within our grasp: sleep.

Sleep is often touted as a cornerstone of good health, and for good reason. It serves as the body’s reset button, allowing us to recharge and rejuvenate both mentally and physically. Sleep is also a big contributor to hormone balance for both men and women. Yet, in our fast-paced society, it’s all too easy to sacrifice sleep in favor of productivity or entertainment. But at what cost?

Research consistently shows that adequate sleep is crucial for managing stress. When we skimp on sleep, our bodies go into overdrive, releasing stress hormones like cortisol to keep us going. Over time, this chronic elevation of stress hormones can take a toll on our physical health, leading to a host of issues such as high blood pressure, weakened immune function, and increased risk of chronic diseases.

Moreover, insufficient sleep can wreak havoc on our mental well-being. It impairs cognitive function, making it difficult to concentrate, problem-solve, and regulate our emotions effectively. This can exacerbate feelings of stress, anxiety, and overwhelm, creating a vicious cycle that further disrupts our sleep patterns.

“Sleep is the single most effective thing we can do to reset our brain and body health each day.”~MATTHEW WALKER

On the other hand, prioritizing sleep can work wonders for stress reduction. When we get enough restorative sleep, our bodies are better equipped to handle the challenges of daily life. Our cognitive function improves, allowing us to approach tasks with clarity and focus. Our emotional resilience strengthens, enabling us to navigate stressors with greater ease. And perhaps most importantly, our bodies are able to repair and regenerate, bolstering our overall health and vitality.

Photo by Pixabay on Pexels.com

So, what can we do to ensure we’re getting the quality sleep we need to thrive? Here are a few tips:

  1. Establish a Consistent Sleep Schedule: Our bodies THRIVE on consistency. Go to bed and wake up at the same time every day–even on weekends. This helps regulate your body’s internal clock and improve the quality of your sleep. The majority of our bodies healing and regeneration occur during the hours of 11pm-1am. Try to be in bed before that time.
  2. Create a Relaxing Bedtime Routine: Wind down before bed with calming activities such as reading, meditation, or gentle stretching. Avoid screens and stimulating activities that can interfere with sleep. Turn the lights off or down beginning around 7pm as this kicks in our body’s natural secretion of melatonin to make us sleepy.
  3. Optimize Your Sleep Environment: Make sure your bedroom is conducive to sleep by keeping it cool, dark, and quiet. Invest in a comfortable mattress and pillows to support restful sleep. Remember to remove clutter and leave the light off if you get up to go to the bathroom in the middle of the night.
  4. Limit Stimulants and Heavy Meals Before Bed: Avoid caffeine and large meals close to bedtime, as they can disrupt sleep. Instead, opt for light, soothing snacks if you’re hungry before bed. Stay away from unhealthy food choices that contain food additives and preservatives as these are typically full of heavy metals and can impair our hormone regulation.
  5. Manage Stress Throughout the Day: Incorporate stress-reduction techniques such as mindfulness, deep breathing, or journaling into your daily routine to help ease tension and promote relaxation.
  6. Your Bed is for Sex or Sleep Only: Teach your body that your bed is for sleeping or having sex. Don’t watch TV, read emails, or work on projects while laying in your bed. These are not good habits to get into. Aim for 7-8 hours per night of sleep.

By prioritizing sleep as a non-negotiable aspect of self-care, we can cultivate greater resilience in the face of life’s stressors. This Stress Awareness Month, let’s commit to honoring our bodies’ need for rest and renewal, recognizing that sleep is not a luxury, but a fundamental pillar of health and well-being.

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

Published: 04/09/2024

*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