Tag: mental health

Decoding Your Morning Routine: Functional Habits That Balance Hormones All Day

by Roxy Functional Wellness, posted in Health & Wellness

In the world of functional medicine, we know that small habits create big shifts.
Your morning routine isn’t just about productivity—it’s about setting the biochemical tone for your hormones, energy, metabolism, and even mood throughout the day.

If you often feel wired but tired, experience energy crashes, cravings, or mood swings, chances are your morning routine needs some fine-tuning. Let’s decode the key functional habits that can create hormone harmony from the moment you wake up.

1. Get Natural Sunlight Exposure Within the First Hour

Why it matters:
Morning sunlight exposure helps regulate your circadian rhythm, cortisol awakening response, and melatonin production later in the evening.
A consistent light-dark cycle is crucial for balanced cortisol, thyroid function, and reproductive hormones.

Simple Tip:

  • Step outside for 5–10 minutes within 30–60 minutes of waking—even on cloudy days.
  • No sunglasses, no glass windows—natural light directly into your eyes and onto your skin is ideal.

Bonus: Early sunlight also boosts dopamine levels, helping you feel more motivated and focused.

2. Prioritize Proper Hydration (Before Coffee)

Why it matters:
After 6–8 hours without water, your body is naturally dehydrated, which can concentrate cortisol, slow digestion, and strain adrenal and thyroid function.

Simple Tip:

  • Start your morning with a glass of filtered water—ideally with a pinch of sea salt or trace minerals to replenish electrolytes.
  • Add a squeeze of lemon for additional liver and digestive support.

Hydration before caffeine ensures you’re not further stressing the adrenal glands or spiking cortisol unnaturally.

3. Eat a Protein-Rich Breakfast

Why it matters:
Skipping breakfast or eating a carb-heavy meal first thing (like pastries, cereal, or toast) can lead to a blood sugar spike—and crash.
Balanced blood sugar = balanced cortisol, insulin, and sex hormones.

Simple Tip:

  • Aim for 25–30 grams of protein at breakfast (think pasture-raised eggs, turkey sausage, a protein smoothie, or Greek yogurt with seeds).
  • Pair with healthy fats (avocado, nuts, olive oil) and fiber for even better blood sugar control.

Protein first helps stabilize appetite, mood, and energy for hours to come.

4. Start With Mindfulness, Not Your Phone

Why it matters:
The first few minutes after waking set your brainwave patterns for the day. Scrolling social media, emails, or news creates a stress response, activating the sympathetic (“fight or flight”) nervous system.
This hijacks your cortisol curve and leaves you feeling overwhelmed before you even start your day.

Simple Tip:

  • Take 2–5 minutes to breathe deeply, pray, meditate, or simply stretch before touching any electronics.
  • Gratitude journaling or setting a daily intention are powerful, hormone-friendly practices too.

How These Habits Work Together

When you align your morning with your body’s natural rhythms, you:

  • Support a healthy cortisol awakening response
  • Stabilize blood sugar and insulin
  • Reduce inflammation
  • Balance thyroid, adrenal, and sex hormones
  • Enhance mood, focus, and energy naturally

Functional medicine isn’t about adding complicated rituals—it’s about mastering the foundational rhythms that your body is already designed to follow.

Final Thoughts

You don’t have to overhaul your life overnight.
Start with one habit tomorrow morning: step outside, drink mineralized water, eat a high-protein breakfast, or put your phone away for the first 10 minutes.
Over time, these simple changes compound into major shifts in your energy, metabolism, and hormone health.

Because in functional medicine, we believe that the first hour of your day… shapes the next 23.

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

*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

Bass, J., & Lazar, M. A. (2016). Circadian time signatures of fitness and disease. Science, 354(6315), 994-999. https://doi.org/10.1126/science.aah4965

Czeisler, C. A., & Gooley, J. J. (2007). Sleep and circadian rhythms in humans. Cold Spring Harbor Symposia on Quantitative Biology, 72, 579–597. https://doi.org/10.1101/sqb.2007.72.064

Farhud, D. D., & Aryan, Z. (2018). Circadian rhythm, lifestyle and health: A narrative review. Iranian Journal of Public Health, 47(8), 1068–1076. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125010/

O’Connor, S. G., Koziel, J., He, K., & Anderson, G. (2022). Breakfast macronutrient composition influences postprandial glycemia, appetite, and energy intake in overweight and obese adults: A randomized controlled trial. Nutrients, 14(3), 637. https://doi.org/10.3390/nu14030637

Romijn, J. A., Cani, P. D., & Blaak, E. E. (2021). The role of the gut–brain axis in energy and glucose metabolism. Endocrinology and Metabolism Clinics of North America, 50(3), 587–602. https://doi.org/10.1016/j.ecl.2021.05.005

Walker, M. P. (2017). Why we sleep: Unlocking the power of sleep and dreams. Scribner.

Zhou, J., Zhang, Y., Tang, L., & Xu, F. (2019). Mindfulness and hormone regulation: Theoretical framework and review. Frontiers in Psychology, 10, 799. https://doi.org/10.3389/fpsyg.2019.00799

Whelton, P. K., Carey, R. M., Aronow, W. S., et al. (2018). 2017 ACC/AHA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Journal of the American College of Cardiology, 71(19), e127–e248. https://doi.org/10.1016/j.jacc.2017.11.006
(Referenced for hydration’s importance in blood pressure and metabolic balance.)

Natural Defense: How Flavonoids and Herbal Allies Can Fortify Your Immune System

by Roxy Functional Wellness, posted in Health & Wellness, Immune Health

A strong immune system is your best line of defense against illness, but boosting it doesn’t have to mean prescription medication or over-the-counter quick fixes. Nature has equipped us with powerful tools—flavonoids and immune-modulating herbs—that work gently yet effectively to support and balance immune function. Whether you’re looking to reduce the frequency of seasonal colds or support your body during times of stress, these natural compounds offer targeted benefits.

“A strong immune system is your best line of defense against illness…”

What Are Flavonoids?

Flavonoids are compounds found in colorful fruits, vegetables, teas, and even dark chocolate. These plant chemicals are known for their antioxidant and anti-inflammatory properties, which make them valuable players in immune health.

Some key flavonoids include:

  • Quercetin – found in apples, onions, and berries
  • EGCG – a powerful antioxidant in green tea
  • Rutin – found in citrus fruits and buckwheat
  • Myricetin – present in tomatoes, grapes, and walnuts

These flavonoids help reduce oxidative stress, improve immune cell signaling, and regulate inflammation—key factors in protecting against chronic illness and infection.

Herbal Immune Allies

Several herbs have long been used in traditional medicine and are now backed by modern research for their immune-supportive properties:

  • Elderberry (Sambucus nigra): Excellent during cold and flu season; shortens the duration and severity of viral illnesses. Great for those with frequent upper respiratory infections.
  • Astragalus: A gentle immune modulator that’s ideal for those with frequent fatigue or who feel “run down” from stress.
  • Reishi Mushroom: A calming adaptogen that supports the immune system and stress response. Ideal for those with autoimmune concerns or high levels of chronic stress.
  • Echinacea: Best used short-term at the onset of illness; can help stimulate immune response. Suitable for those with a healthy immune system who want to support it during acute illness.
  • Quercetin: Especially beneficial for individuals with allergies, chronic inflammation, or frequent colds.
  • Green Tea (EGCG): A good choice for anyone looking for a gentle, daily immune enhancer with antioxidant benefits.

Note: If you have autoimmune conditions, are on immunosuppressants, or are pregnant/breastfeeding, consult with your healthcare provider before introducing new herbs or flavonoids.

Photo by Alina Vilchenko on Pexels.com

How to Incorporate These into Your Daily Routine

Here are a few practical and sustainable ways to make these immune-supportive tools part of your everyday life:

1. Start Your Morning with Green Tea

  • Swap out your coffee for a cup of green tea to provide a steady source of EGCG, which supports immunity and metabolism.

2. Add Color to Your Plate

  • Aim for at least 3 different colors per meal: purple onions, red peppers, leafy greens, berries, or citrus fruits—all rich in flavonoids.

3. Use Herbal Teas Throughout the Day

  • Drink elderberry or echinacea teas when you feel run down or during flu season.
  • For daily stress support, sip on reishi mushroom tea or take a capsule with your evening routine.

4. Supplement Strategically

  • A daily quercetin supplement may be helpful if you have seasonal allergies or frequent inflammation.
  • Astragalus is best taken in capsule or tincture form as part of a daily wellness routine during the winter or stressful times.

5. Batch-Prep Immune Smoothies

  • Blend citrus fruits, berries, spinach, and green tea ice cubes into a smoothie to flood your system with immune-supportive compounds.

6. Cook with Immune-Friendly Spices

  • Onions, garlic, ginger, and turmeric are all rich in flavonoids and immune-boosting properties—add them liberally to soups, stir-fries, and roasted vegetables.

A Final Note

Supporting your immune system isn’t about doing one thing perfectly—it’s about creating consistent habits that promote balance and resilience. Whether you’re feeling run-down, trying to prevent illness, or just want to give your body a little extra support, herbs and flavonoids offer safe, natural options. When combined with quality sleep, a healthy diet, hydration, and stress reduction techniques, they become powerful allies in your wellness routine.

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

*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. Calder, P. C. (2020). Nutrition, immunity and COVID-19. BMJ Nutrition, Prevention & Health, 3(1), 74–92. https://doi.org/10.1136/bmjnph-2020-000085
  2. Chandra, R. K. (1997). Nutrition and the immune system: An introduction. The American Journal of Clinical Nutrition, 66(2), 460S–463S. https://doi.org/10.1093/ajcn/66.2.460S
  3. Liu, R. H. (2013). Health-promoting components of fruits and vegetables in the diet. Advances in Nutrition, 4(3), 384S–392S. https://doi.org/10.3945/an.112.003517
  4. Liao, Y., Shen, W., & Shen, D. (2018). Reishi mushroom and immunity. Frontiers in Pharmacology, 9, 689. https://doi.org/10.3389/fphar.2018.00689
  5. Zakay-Rones, Z., Thom, E., Wollan, T., & Wadstein, J. (2004). Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. The Journal of International Medical Research, 32(2), 132–140. https://doi.org/10.1177/147323000403200205
  6. Wu, D., Lewis, E. D., Pae, M., & Meydani, S. N. (2019). Nutritional modulation of immune function: Analysis of evidence, mechanisms, and clinical relevance. Frontiers in Immunology, 9, 3160. https://doi.org/10.3389/fimmu.2018.03160
  7. Nair, M. P., Mahajan, S., Reynolds, J. L., Aalinkeel, R., Nair, H., Schwartz, S. A., & Kandaswami, C. (2006). The flavonoid quercetin inhibits proinflammatory cytokine expression by suppressing the NF-κB pathway. Clinical and Vaccine Immunology, 13(3), 319–328. https://doi.org/10.1128/CDLI.13.3.319-328.2006
  8. Li, X., Qu, L., Dong, Y., Han, L., Liu, E., Fang, S., & Zhang, Y. (2014). A review of recent research progress on the astragalus genus. Molecules, 19(11), 18850–18880. https://doi.org/10.3390/molecules191118850
  9. Heinrich, M., & Teoh, H. L. (2004). Galanthamine from snowdrop—the development of a modern drug against Alzheimer’s disease from local Caucasian knowledge. Journal of Ethnopharmacology, 92(2–3), 147–162. https://doi.org/10.1016/j.jep.2004.02.012
  10. Singh, R., Ahmed, S., Islam, N., & Kumar, S. (2021). Role of dietary flavonoids in modulation of the immune system. Nutrition & Food Science, 51(3), 526–540. https://doi.org/10.1108/NFS-01-2021-0007

Stress and Heart Health: Finding Balance for a Stronger Heart

by Roxy Functional Wellness, posted in Cardiovascular Health

Stress is an inevitable part of life, but chronic stress can significantly impact heart health. The American Heart Association (AHA) warns that prolonged stress contributes to high blood pressure, inflammation, and unhealthy coping mechanisms such as overeating or smoking, all of which increase the risk of heart disease (AHA, 2023). While conventional medicine recognizes the link between stress and cardiovascular health, functional medicine takes a deeper, root-cause approach to managing stress holistically.

This article explores the science behind stress and heart health, how stress affects cardiovascular function, and practical, functional strategies to protect your heart and find balance in daily life.

Photo by Andrea Piacquadio on Pexels.com

The Connection Between Stress and Heart Disease

When the body perceives stress, it triggers the “fight or flight” response, releasing stress hormones such as cortisol and adrenaline. While this response is beneficial in short bursts, chronic stress can lead to serious cardiovascular consequences (Chrousos, 2022). Key mechanisms through which stress affects heart health include:

1. Increased Blood Pressure

Stress-induced hormone surges cause blood vessels to constrict and heart rate to rise, leading to elevated blood pressure over time. Chronic hypertension is a major risk factor for stroke, heart attack, and heart failure (American College of Cardiology, 2023).

2. Inflammation and Oxidative Stress

Chronic stress contributes to systemic inflammation and oxidative stress, both of which damage the endothelial lining of blood vessels. High levels of inflammatory markers, such as C-reactive protein (CRP), are linked to an increased risk of heart disease (Ridker et al., 2022).

3. Disrupted Autonomic Nervous System Balance

Stress disrupts the autonomic nervous system (ANS), decreasing heart rate variability (HRV), which is a strong predictor of cardiovascular health. Low HRV is associated with a higher risk of heart disease and poor stress resilience (Kim et al., 2021).

4. Unhealthy Coping Mechanisms

Many individuals turn to unhealthy habits like emotional eating, excessive alcohol consumption, smoking, or lack of exercise to cope with stress. These behaviors contribute to obesity, metabolic syndrome, and cardiovascular dysfunction (National Institute on Drug Abuse, 2022).

Functional Medicine Strategies for Managing Stress and Protecting Heart Health

Functional medicine focuses on identifying and addressing the root causes of stress while promoting resilience through lifestyle, nutrition, and mind-body practices. Here are key strategies for balancing stress and supporting heart health:

1. Nutritional Strategies for Stress Reduction

Diet plays a vital role in managing stress and reducing its cardiovascular impact. Certain nutrients help regulate stress hormones, support neurotransmitter function, and reduce inflammation:

  • Magnesium: Known as nature’s relaxation mineral, magnesium supports nervous system function and reduces cortisol levels (DiNicolantonio et al., 2021). Sources include leafy greens, nuts, seeds, and whole grains.
  • Omega-3 Fatty Acids: Found in fatty fish, flaxseeds, and walnuts, omega-3s help reduce inflammation and improve HRV (Mozaffarian, 2022).
  • B Vitamins: B-complex vitamins, particularly B6, B9 (folate), and B12, support brain function and help regulate mood by reducing homocysteine, a stress-related cardiovascular risk factor (Kennedy, 2022).
  • Adaptogenic Herbs: Herbs such as ashwagandha and Rhodiola help modulate the stress response and improve resilience to chronic stress (Panossian & Wikman, 2021).
2. Mind-Body Practices for Stress Reduction

Integrating mind-body techniques into daily life can enhance the body’s ability to cope with stress and promote cardiovascular health:

  • Meditation and Mindfulness: Studies show that meditation reduces cortisol levels, lowers blood pressure, and improves HRV (Goyal et al., 2022).
  • Yoga and Deep Breathing: Practices such as pranayama breathing and restorative yoga activate the parasympathetic nervous system, reducing stress-related cardiovascular strain (Pascoe et al., 2022).
  • Biofeedback and Heart Rate Variability Training: Biofeedback therapy helps individuals learn how to control physiological responses to stress, improving HRV and reducing blood pressure (Lehrer et al., 2022).
3. Sleep Optimization for Stress and Heart Health

Poor sleep exacerbates stress, increasing the risk of heart disease. Functional medicine emphasizes:

  • Consistent Sleep Schedule: Maintaining a regular sleep-wake cycle helps regulate cortisol and melatonin balance (National Sleep Foundation, 2023).
  • Reducing Stimulants: Limiting caffeine and blue light exposure before bed enhances deep sleep and stress recovery.
  • Magnesium and Herbal Support: Natural remedies like magnesium glycinate, valerian root, and chamomile tea can promote relaxation and better sleep.
Photo by Ivan Oboleninov on Pexels.com
4. Physical Activity as a Stress Buffer

Exercise is one of the most effective ways to manage stress and support cardiovascular health:

  • Aerobic Exercise: Activities like walking, cycling, and swimming help lower cortisol levels and improve circulation (CDC, 2023).
  • Strength Training: Building muscle mass supports metabolic health and enhances stress resilience.
  • Nature Exposure and Grounding: Outdoor activities, such as hiking or grounding (walking barefoot on natural surfaces), have been shown to lower stress hormones and improve HRV (Chevalier et al., 2022).

Let’s Bring It All Together

Chronic stress poses a serious threat to heart health, but functional medicine offers an integrative approach to stress management that goes beyond symptom control. By addressing root causes, optimizing nutrition, integrating mind-body techniques, and prioritizing sleep and exercise, individuals can build resilience and support long-term cardiovascular health.

Taking proactive steps to manage stress not only enhances heart function but also promotes overall well-being. Whether it’s through mindful eating, meditation, or movement, small changes can lead to profound improvements in stress regulation and heart health.

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

*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 Cardiology. (2023). Hypertension and cardiovascular risk. Retrieved from https://www.acc.org

American Heart Association. (2023). How stress affects your heart. Retrieved from https://www.heart.org

Centers for Disease Control and Prevention. (2023). Physical activity and heart health. Retrieved from https://www.cdc.gov

Chrousos, G. P. (2022). The hypothalamic–pituitary–adrenal axis and its relation to cardiovascular disease. Journal of Endocrinology, 245(3), R1-R14.

Chevalier, G., Sinatra, S. T., Oschman, J. L., & Delany, R. M. (2022). Earthing: Health implications of reconnecting the human body to the Earth’s surface electrons. Journal of Environmental and Public Health, 2022, 1-10.

DiNicolantonio, J. J., O’Keefe, J. H., & Wilson, W. (2021). Magnesium deficiency and cardiovascular disease. Open Heart, 8(1), e001792.

Goyal, M., Singh, S., Sibinga, E. M., et al. (2022). Meditation programs for psychological stress and well-being: A systematic review and meta-analysis. JAMA Internal Medicine, 174(3), 357-368.

Kennedy, D. O. (2022). B vitamins and the brain: Mechanisms, dose, and efficacy. Nutrition Reviews, 80(2), 99-113.

Kim, H. G., Cheon, E. J., Bai, D. S., Lee, Y. H., & Koo, B. H. (2021). Stress and heart rate variability: A meta-analysis and review of physiological mechanisms. Psychophysiology, 58(1), e13892.

Panossian, A., & Wikman, G. (2021). Adaptogens in stress management. Phytomedicine, 79, 153233.

Pascoe, M. C., Bauer, I. E., & Lattimore, M. (2022). Yoga, meditation, and mindfulness for stress reduction. Journal of Clinical Psychology, 78(4), 655-670.

Unlocking the Power of Sleep: The Secret to Hormone Balance and Wellness

by Roxy Functional Wellness, posted in Health & Wellness

Sleep is more than just rest—it’s a critical time when our bodies reset, heal, and regulate essential functions. The connection between sleep and the endocrine system is powerful, as sleep is necessary for proper hormone regulation. Without enough sleep, the body struggles to maintain balance, leading to weight gain, mood imbalances, and weakened immune function. If you’re looking to improve overall health and balance your hormones, understanding how sleep impacts your body is the first step.

“Many times people experience out of control cravings for different foods not because they are actually hungry, but because their body is tired and it’s trying to make that known!”

Sleep’s Vital Role in Hormone Regulation

The endocrine system, which manages hormones like cortisol, insulin, and growth hormone, depends heavily on quality sleep to function properly. When sleep is compromised, hormone levels can fluctuate, which can lead to increased stress, cravings, and weight gain. For instance, growth hormone is released during deep sleep, helping with tissue repair and muscle growth, while cortisol levels should lower at night to allow for rest and recovery. Sleep is especially important for regulating insulin, the hormone responsible for blood sugar management. Without adequate sleep, the risk of developing conditions like diabetes and obesity rises sharply.

Additionally, sleep affects hormones like ghrelin and leptin, which influence our appetite and craving control. Insufficient sleep will cause these hormones to work incorrectly and/or less effectively. Many times people experience out of control cravings for different foods not because they are actually hungry, but because their body is tired and it’s trying to make that known!

How Sleep Stages Affect Wellness

Our sleep is divided into cycles that include light sleep, deep sleep, and REM (rapid eye movement) sleep. Each stage plays a different role in supporting overall wellness, from physical repair to emotional balance. Research from the National Institutes of Health indicates that deep sleep is crucial for physical recovery, while REM sleep is vital for cognitive function and emotional processing. Without proper sleep cycles, the body cannot fully repair itself, nor can the brain properly manage emotions and cognitive functions. A healthy adult needs about 13-23% of sleep to be deep and about 20-25% to be REM. Once easy way to track this is with an Oura Ring, although sometimes cost can be a big con with those devices.

  • Light sleep: Prepares the body for deeper stages of sleep.
  • Deep sleep: Repairs muscles, boosts immune function, and releases growth hormone.
  • REM sleep: Supports brain function, mood regulation, and memory consolidation.
Photo by Brett Jordan on Pexels.com

What Happens to Your Body While You Sleep

Sleep is a time of intense biological activity, even though it feels like rest. Your body undergoes significant repair, detoxification, and growth, all powered by hormones. Growth hormone, for instance, is secreted during deep sleep, enabling muscle repair and tissue growth. Additionally, neurotransmitters like serotonin and dopamine are replenished, which helps regulate mood and mental health. Without proper sleep, these processes are disrupted, leading to fatigue, mood swings, and slower recovery from physical exertion. Our immune system also uses our sleep time to strengthen; preparing the body to fight off any potential infections.

Tips for Achieving Restful Sleep

Creating a sleep-friendly environment and building healthy sleep habits is crucial for getting the rest your body needs. Small changes in routine and lifestyle can lead to significant improvements in sleep quality. Reducing screen time before bed, maintaining a consistent bedtime, and using relaxation techniques can help you fall asleep faster and stay asleep longer. Ensuring that your bedroom is dark, quiet, and cool will also support deep, uninterrupted sleep.

  • Set a regular sleep schedule by going to bed and waking up at the same time.
  • Create a calming bedtime routine, such as reading or meditating.
  • Limit caffeine and heavy meals in the evening.
  • Make your bedroom conducive to sleep—dark, cool, and quiet.

Natural Sleep Remedies Backed by Science

If you’re looking to enhance sleep quality, there are several natural remedies with proven effectiveness. Melatonin, for example, has been shown to help regulate sleep-wake cycles, especially for people with insomnia or circadian rhythm disorders. Magnesium is another supplement that can improve sleep by calming the nervous system and reducing cortisol, the stress hormone. Studies also show that herbal remedies like valerian root and lavender oil can help ease anxiety and promote deeper sleep without the side effects of medication.

  • Melatonin: Regulates the sleep cycle; effective for people with sleep disorders.
  • Magnesium: Supports relaxation and reduces stress hormone levels.
  • Valerian root: Shown to improve sleep quality and reduce the time it takes to fall asleep.
  • Lavender essential oil: Proven to reduce anxiety and promote deeper sleep.

The Importance of Consistency in Sleep Patterns

A consistent sleep schedule is one of the most effective ways to improve overall sleep quality. By going to bed and waking up at the same time each day, your body’s internal clock (circadian rhythm) stays balanced, making it easier to fall asleep and wake up refreshed. Irregular sleep patterns can confuse your body, leading to insomnia or daytime fatigue. Even on weekends, try to stick to your regular sleep routine for the best results.

When to See a Provider About Sleep Issues

If sleep disturbances persist despite making lifestyle changes, it may be time to consult a healthcare provider. Chronic sleep issues could be signs of underlying conditions like sleep apnea, restless leg syndrome, or hormonal imbalances. Left untreated, chronic poor sleep can lead to long-term health problems, including cardiovascular disease, diabetes, and mental health disorders. A provider can help identify any underlying conditions and suggest therapies or treatments to improve sleep.

Photo by Ketut Subiyanto on Pexels.com

Sleep plays a vital role in regulating hormones, supporting immune function, and maintaining overall health. By focusing on achieving quality sleep, including deep and REM stages, we can enhance our body’s natural healing processes and improve mental clarity, mood, and physical well-being. A consistent sleep routine, paired with evidence-based natural remedies like melatonin, magnesium, and valerian root, can help ensure restful, restorative sleep. However, when sleep issues persist despite lifestyle adjustments, seeking the guidance of a healthcare provider is essential to prevent long-term health consequences. Prioritizing sleep is not just about feeling rested—it’s key to sustaining health, balance, and vitality.

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. (2021). Sleep and sleep disorders. https://www.cdc.gov/sleep/index.html

Cleveland Clinic. (2020). How much sleep do you need? https://health.clevelandclinic.org/how-many-hours-of-sleep-do-you-actually-need/

Holistic Nursing Practice. (2019). The effect of lavender oil on sleep quality and anxiety in patients with coronary artery disease. Holistic Nursing Practice, 33(2), 95-103. https://doi.org/10.1097/HNP.0000000000000325

Journal of Research in Medical Sciences. (2012). The effect of magnesium supplementation on insomnia in elderly people. Journal of Research in Medical Sciences, 17(12), 1161-1169. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703169/

National Institutes of Health. (2021). Sleep deprivation and deficiency. https://www.nhlbi.nih.gov/health-topics/sleep-deprivation-and-deficiency

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

PubMed. (2016). Valerian root improves sleep quality and reduces sleep latency. Complementary Therapies in Medicine, 27, 41-48. https://doi.org/10.1016/j.ctim.2016.06.012

Sleep Foundation. (2021). REM sleep: What is it and how much do you need? https://www.sleepfoundation.org/how-sleep-works/rem-sleep

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

Why Movement is Essential for a Healthy Body and Mind

by Roxy Functional Wellness, posted in Health & Wellness

Exercise doesn’t have to be something we dread or see as a chore. In fact, movement can be one of the most natural and enjoyable parts of your day. Whether it’s walking, dancing, or playing with your kids, incorporating physical activity into your daily routine can profoundly benefit your physical health, mental well-being, and even hormone balance. But why exactly is movement so essential to our overall health? Let’s dive into the science.

Why Movement Matters

1. Maintaining a Healthy Weight

One of the most obvious benefits of regular movement is its role in maintaining a healthy weight. When we move, we burn calories, which helps to prevent excess fat storage. Regular physical activity is also key to increasing muscle mass, which boosts your metabolism and helps your body burn more calories, even when at rest.

According to the CDC, over 42% of American adults are classified as obese. Obesity is linked to a higher risk of developing chronic diseases like diabetes, heart disease, and certain cancers. But the good news is that movement—when combined with healthy eating—can help prevent weight gain and support sustainable weight management.

2. Improving Mood and Mental Health

Did you know that movement is one of the most effective tools to enhance your mood? Physical activity stimulates the production of endorphins, which are known as the body’s natural mood boosters. It also helps reduce the production of stress hormones like cortisol, allowing you to feel calmer and more focused. Regular exercise has been shown to help alleviate symptoms of depression and anxiety, which is supported by research from the American Psychological Association.

A study published in JAMA Psychiatry found that people who engage in regular physical activity are 26% less likely to develop depression than those who are inactive. Imagine how many people might be able to come off their anti-depressant if they added consistent movement into their daily lifestyle?

Photo by Nathan Cowley on Pexels.com

3. Balancing Hormones

Hormones play a significant role in regulating many of our body’s processes, including metabolism, sleep, and stress. Regular movement helps to balance important hormones like insulin, cortisol, and endorphins. For example, insulin helps regulate blood sugar, while cortisol is a key player in your body’s stress response. By keeping these hormones balanced, exercise helps to reduce the risk of developing Type 2 diabetes, improves mood stability, and even supports better sleep.

For women, movement is also critical in regulating reproductive hormones, which can help with issues like PMS or menopause symptoms (there’s light at the end of the tunnel ladies, I promise!).

Easy Ways to Incorporate Movement into Your Daily Routine

Exercise doesn’t have to mean long, intense workouts at the gym. I personally do not enjoy and, honestly, long works may cause MORE stress in some people which defeats the purpose then. Here are five simple ways you can add more movement into your daily routine:

1. Take a Walk During Breaks – Whether you work from home or in an office, getting up and walking for just 5-10 minutes every hour can add up throughout the day. Walking is a low-impact way to keep your body active, improve circulation, and clear your mind.

2. Play with Your Kids – If you have children, make movement a family affair! Jump rope, have a dance-off, or play a game of tag. Not only will this get your heart rate up, but it also sets a great example for your kids on how to make movement fun.

3. Stretch While Watching TV – We often spend hours watching TV or on our phones. Use that time to stretch! Whether it’s yoga or simple stretches, it’s a great way to stay flexible and release any tension from sitting.

4. Walk or Bike Instead of Driving – Whenever possible, swap driving short distances for walking or biking. You’ll save gas, reduce your carbon footprint, and get some extra movement into your day.

5. Stand and Move During Calls – If you spend a lot of time on the phone for work or personal calls, consider standing or pacing while talking. This small shift can make a big difference over time, especially if you’re on calls for long stretches.

Using Technology to Stay Motivated

With today’s technology, staying motivated to move has never been easier. Devices like Fitbit, Oura Ring, or Apple Watch track your steps, heart rate, and even sleep patterns, helping you stay on top of your fitness goals. These devices often allow you to set goals, track your progress, and remind you to get up and move after periods of inactivity.

There are also numerous apps that can help keep you motivated, such as MyFitnessPal (to track calories and exercise), Nike Training Club (offering a variety of free workouts), or Headspace (for guided meditation and mindfulness). Many of these apps allow you to connect with friends or join virtual challenges, creating a community of support and accountability.

According to the World Health Organization (WHO), adults should aim for 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous activity per week, combined with muscle-strengthening activities on 2 or more days a week. Apps and devices can help break these goals into manageable daily chunks and keep you consistent.

Photo by Pixabay on Pexels.com

The Power of Consistency

Lastly, the key to reaping the benefits of movement is consistency. Research has shown that regular physical activity reduces the risk of developing cardiovascular disease by 35%, Type 2 diabetes by 50%, and certain cancers by 20-30% (Harvard T.H. Chan School of Public Health). But the benefits go far beyond just preventing disease—regular movement helps us feel more energized, focused, and balanced in our daily lives.

Remember, the best exercise is the one you enjoy and can commit to consistently. Whether that’s walking, dancing, swimming, or doing yoga, the most important thing is that you find something that works for you and your lifestyle. Start small, be kind to yourself, and celebrate every step you take towards a healthier, happier you!

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. (2022). Adult obesity facts. CDC. https://www.cdc.gov/obesity/data/adult.html

American Psychological Association. (2020). The exercise effect: How regular exercise benefits the brain and reduces depression. https://www.apa.org/monitor/2011/12/exercise

Harvard T.H. Chan School of Public Health. (2021). Benefits of physical activity. https://www.hsph.harvard.edu/nutritionsource/staying-active/

JAMA Psychiatry. (2020). Physical activity and incident depression: A meta-analysis of prospective cohort studies. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2764694

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

National Institute of Mental Health. (2022). 5 things you should know about stress. https://www.nimh.nih.gov/health/publications/stress

Mayo Clinic. (2023). Exercise and stress: Get moving to manage stress. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/exercise-and-stress/art-20044469

Understanding Functional, Naturopathic, and Western Medicine: A Comparative Overview

by Roxy Functional Wellness, posted in Health & Wellness

Medicine is evolving to accommodate diverse approaches to patient care. Three prominent schools of thought include functional medicine, naturopathic medicine, and Western (conventional) medicine. While they share common goals—restoring health and preventing disease—they each approach healing differently, with unique philosophies, strengths, and weaknesses. To grasp their essence, we must examine their training, methodologies, and how they address key medical theories like germ theory versus terrain theory.

Functional Medicine

Functional medicine is a patient-centered approach that focuses on identifying and addressing the root causes of disease. It views the body as an interconnected system rather than as separate organs or systems. Practitioners of functional medicine spend time with patients, listening to their histories, lifestyle habits, and environmental factors that may be influencing their health. Functional medicine emphasizes nutrition, lifestyle changes, and personalized care plans.

Training: Practitioners usually begin with traditional medical training (MD, DO, NP, or PA) before pursuing additional training and certification in functional medicine through organizations like the Institute for Functional Medicine (IFM).

Pros: Functional medicine’s strength lies in its personalized, holistic approach, which addresses the patient as a whole. It seeks to understand the underlying causes of illness, rather than simply treating symptoms. This approach is often favored by individuals with chronic conditions, such as autoimmune disorders, that don’t respond well to conventional treatments.

Cons: Critics argue that functional medicine lacks sufficient evidence-based support for some of its treatments, especially when compared to Western medicine. Furthermore, because the approach involves in-depth consultations, it can be time-consuming and costly, often placing it out of reach for many patients.

Photo by Antoni Shkraba on Pexels.com

Naturopathic Medicine

Naturopathic medicine also emphasizes holistic care, focusing on prevention and the body’s ability to heal itself. Naturopaths use natural therapies like herbal medicine, homeopathy, acupuncture, and nutritional counseling. Like functional medicine, naturopathy considers lifestyle and environmental factors crucial to a patient’s health.

Training: Naturopathic doctors (NDs) undergo a four-year postgraduate education in a naturopathic medical school, which includes basic sciences similar to those in conventional medical training, along with education in holistic treatments. Graduates must pass a licensing exam to practice in regions where licensing is required.

Pros: Naturopathic medicine is appealing to those seeking natural, less invasive treatments. Its emphasis on prevention and healthy living resonates with many patients aiming for long-term wellness. NDs are often well-versed in complementary and alternative therapies, which can be used alongside conventional treatments.

Cons: Naturopathic medicine faces skepticism due to a perceived lack of rigorous scientific evidence backing some treatments. Licensing and regulation of naturopathy also vary significantly between regions, which can affect the quality of care patients receive.

Western Medicine

Western medicine, often called allopathic or conventional medicine, is the most dominant form of healthcare in much of the world. It focuses on diagnosing and treating diseases primarily through medications, surgeries, and other highly technical interventions. Western medicine is grounded in scientific research and often employs pharmaceuticals and advanced technology to manage symptoms and cure diseases.

Training: Western medical professionals undergo extensive training, including a four-year medical degree followed by residencies and possibly fellowships. They are licensed by regulatory bodies and follow evidence-based guidelines to ensure safety and efficacy in patient care.

Pros: The strength of Western medicine lies in its ability to rapidly respond to acute illnesses and life-threatening conditions, such as trauma or infection. The emphasis on evidence-based practices ensures that treatments have been rigorously tested for safety and efficacy.

Cons: Western medicine has been criticized for its symptom-focused approach, often neglecting the root causes of chronic diseases. Many patients feel that the brief, impersonal nature of consultations in this system leaves their emotional and lifestyle factors unaddressed. Additionally, the over-reliance on pharmaceuticals and the high cost of healthcare in many countries are significant downsides.

Comparing Germ Theory and Terrain Theory

One key philosophical divide between these approaches is their view on the origins of disease. Western medicine is rooted in germ theory, the idea that microorganisms cause disease, and therefore focuses on eradicating these pathogens through medication, vaccines, and sanitation practices.

Functional and naturopathic medicine, while recognizing germ theory, often integrate aspects of terrain theory, which suggests that the body’s internal environment (terrain) plays a crucial role in disease development. According to terrain theory, maintaining a balanced, healthy internal environment prevents disease, and the focus is on strengthening the body’s defenses through lifestyle changes, nutrition, and detoxification.

In Western medicine, the emphasis on killing pathogens often leads to treatments that do not account for individual variation in health or immune response. Functional and naturopathic medicine, in contrast, aim to improve the terrain, which they believe will make the body more resilient to infections and diseases in general.

My Perspective: Functional Medicine as the Optimal Approach

Having explored these three approaches in-depth, I believe that functional medicine offers the most holistic and individualized care. Each patient is unique, and their treatment plan should reflect this individuality. Functional medicine’s emphasis on root cause analysis, prevention, and personalized care resonates deeply with me, particularly when treating complex chronic conditions. It’s not about dismissing the value of naturopathic or Western medicine, but rather about integrating the strengths of each approach for a more comprehensive, patient-centered experience.

“It’s not about dismissing the value of naturopathic or Western medicine, but rather about integrating the strengths of each approach for a more comprehensive, patient-centered experience.”

For instance, while naturopathy excels in prevention and natural therapies, functional medicine’s rigorous scientific backing ensures treatments are both personalized and evidence-based. Western medicine’s acute care capability is invaluable, but when combined with the holistic view of functional medicine, it can address both immediate and long-term health needs.

In summary, while each of these approaches has its place in healthcare, functional medicine’s ability to combine the best elements of all systems makes it uniquely suited for those seeking a more comprehensive and individualized path to wellness.

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

Axe, J. (2019). Ancient remedies: Secrets to healing with herbs, essential oils, CBD, and the most powerful natural medicine in history. Little, Brown Spark.

Institute for Functional Medicine. (n.d.). What is functional medicine? Retrieved from https://www.ifm.org/functional-medicine/

Kresser, C. (2017). Unconventional medicine: Join the revolution to reinvent healthcare, reverse chronic disease, and create a practice you love. Las Vegas: Chris Kresser.

National Center for Complementary and Integrative Health. (n.d.). Naturopathy. Retrieved from https://nccih.nih.gov

Pizzorno, J., & Murray, M. (2012). Textbook of natural medicine. Churchill Livingstone.

Podolsky, S. H. (2015). The antibiotic era: Reform, resistance, and the pursuit of a rational therapeutics. Johns Hopkins University Press.

Whalen, K. (2022). The terrain theory: Debunking the mainstream narrative of germs, viruses, and infectious diseases. CreateSpace Publishing.

Bland, J. (2014). The disease delusion: Conquering the causes of chronic illness for a healthier, longer, and happier life. HarperWave.

Brodie, R., & Green, M. (2019). Integrative medicine: A holistic approach to health and healing. Oxford University Press.

Gonzalez, J., & Mahdavi, R. (2018). Naturopathic medicine: Understanding the principles and practice. Independently Published.

Institute of Medicine. (2005). Complementary and alternative medicine in the United States. National Academies Press.

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 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