How can we protect ourselves from getting colds and flu naturally?
The key is boosting your immune system. Consider adding a few key nutrients to your diet daily.
Vitamin C: This vitamin is an antioxidant which helps the body increase production of white blood cells. Found in red peppers, citrus (grapefruit, lemons, limes and clementine’s), kiwi, spinach and broccoli.
Beta Carotene: Is an antioxidant which increases the infection fighting abilities of the immune system. Found in carrots, sweet potatoes, spinach, kale, squash, red & yellow peppers, peas, broccoli, romaine, apricots, and cantaloupe.
Vitamin D3: Boosts the body’s natural defense against disease, lowering your risk of infection.
Zinc: Helps control inflammation and boosts immune response. Found in dairy, greens, whole grains, beans, meats and seafood.
Probiotics: Their function is to control inflammation blocking the harmful bacteria maintaining a healthy gut barrier. Found these foods: yogurt, kefir, sauerkraut, tempeh, kombucha, and pickles.
Anti-Inflammatories: Sources include omega-3 fish oil supplements, ginger, turmeric and cinnamon.
Also wash your hands often, hydrate, move or exercise daily, rest and ample sleep at night.
The rising rates of Type 2 diabetes also mean increased potential for developing serious health complications ranging from heart disease and stroke to vision loss and premature death. Exercise could be the antidote.
Several studies have found exercise can prevent or delay the onset of Type 2 diabetes; some research has shown a 58% risk reduction among high-risk populations. While much of the research has looked at the impact of moderate-to high-intensity cardiovascular exercise, a new study published in Mayo Clinic Proceedings examined the potential impact of strength training on Type 2 diabetes risk. The data showed building muscle strength was associated with a 32% lowered risk of developing Type 2 diabetes.
“Our study showed that very high levels of resistance training may not be necessary to obtain considerable health benefits on preventing Type 2 diabetes,” Wang says. “Small and simple resistance exercises like squats and planks can benefit your health even if you don’t lose any weight.”
Think twice before abandoning the treadmill or elliptical trainer for the weight room, advises Eric Shiroma, ScD, staff scientist at the National Institute on Aging.
As part of a 2018 study, Shiroma and his colleagues followed more than 35,000 healthy women for 14 years and found women who incorporated strength training into their workouts experienced a 30% lowered risk of Type 2 diabetes but women who also participated in cardiovascular activities experienced additional risk reduction.
“When comparing the same amount of time in all cardio, strength [training] or a combination, the combination had the most Type 2 diabetes risk reduction,” Shiroma explains.
THE BOTTOM LINE
Researchers are still unclear about which type of exercise could have the biggest impact on reducing your risk. Wang suggests erring on the side of caution and following a workout regimen that blends both pumping iron and heart-pumping cardio, explaining, “Both strength training and cardiovascular aerobic training are important for the prevention of Type 2 diabetes.”
The biggest takeaway, according to Shiroma, is any amount of exercise is beneficial for reducing Type 2 diabetes risk so do pushups or take a walk around the block as long as you get moving.
Are imbalances in your brain chemicals and hormones affecting your sleep, work and pleasure in life?
Check each of the following that apply to you:
I wake feeling unrested
Sleep is difficult for me
I am always tired, fatigued or lack lustre for life
Concentration and focus are a challenge
My motivation is low
I am always forgetting things
I am often irritable and grumpy
My sex drive is low
Weight control is difficult and my love handles or muffin top are embarrassing
Hormones drive me crazy (PMS, menopause)
There are possible safe, painless and natural non-prescriptive drug solutions to help!
Did you know?
Increased cortisol may cause insomnia, hyperactivity and decreased thyroid function and poor memory
Low dopamine may result in poor focus, low libido, and depression with exhaustion
High glutamate may contribute to anxiety, sleeplessness and irritability
Lower serotonin levels may lead to depression, anxiety and insomnia
Epinephrine and norepinephrine may increase anxiety, hyperactivity, insomnia and insulin resistance
Low GABA may lead to increased anxiety, insomnia and irritability.
How does imbalance occur?
Many factors contribute to disruption in our delicate system balance. Poor diet, stress, environmental factors, lack of or too much exercise and sleep, stimulants, genetics, even medications can deplete and offset the harmony.
How do you fix this?
Take home lab kits from Sanesco and Precision Analytical are now availablefor neurotransmitter and hormone analysis. The tests collect the urine breakdown products of serotonin, dopamine, GABA, epinephrine, norepinephrine, glutamate, melatonin, cortisol, estrogens, progesterone, androgens and more. The kit is shipped and the lab company runs the tests and provides the results back to the doctor. Nutritional analysis through lab drawn blood work is also available to evaluate vitamin and mineral status. Laboratory results will guide clinical decisions with clarity and focus.
Dr. Laura M. Brown, ND can help evaluate where to start, access the tests kits and provide blood requisitions for you and subsequently interpret the results. Individualized protocols are the heart of naturopathic medicine. Diet and lifestyle adjustments are first and foremost, then where needed, vitamins, minerals, and nutraceuticals may be added to help balance the body and get you back to feeling yourself.
When it comes to exercise, walking doesn’t always get the respect it deserves — and it’s time that changed. Before buying into the idea that walking isn’t a worthwhile workout, learn the truth behind these three common walking myths.
There is a great feeling of accomplishment when your fitness tracker buzzes to signal you hit 10,000 steps. But Carol Ewing Garber, PhD, professor of movement sciences at Columbia University, believes it might be an arbitrary target.
Yes, there are studies that show walking 10,000 steps per day is associated with lower blood pressure and improved glucose tolerance but the idea of walking the equivalent of five miles per day could feel overwhelming to new exercisers.
“[Walking 10,000 steps] will result in health benefits,” Garber says. “But it should be noted that … there is benefit even with small amounts of walking and the benefits increase with the more steps you walk each day.”
Garber suggests aiming for 150 minutes of moderate-intensity exercise each week instead of setting a step count goal.
If you want to count steps, consider this: Walking an additional 2,000 steps per day — even if your current step count is minimal — helps lower body mass index and boost insulin sensitivity, according to research published in the journal BMJ.
Leslie Sansone, fitness expert and creator of Walk at Home Workouts is adamant: “Walking works for weight loss!”
A slow stroll around the block isn’t going to move the needle on the scale (although it does burn more calories than binge watching legal dramas). To lose weight with a walking workout, Sansone suggests high-intensity interval training or HIIT.
Picking up the pace — without breaking into a run — at regular intervals during your walk has a major impact on weight loss.
In one small study, researchers at the University of Virginia found that overweight women who logged three 30-minute, high-intensity walks and two moderately-paced walks per week for 12 weeks lost six times more belly fat than women who went for a slow stroll five days per week. A second study found that varying speed burned up to 20 percent more calories than maintaining the same pace.
Incorporating HIIT into your walking workout is simple, according to Sansone. After a 5-minute warmup walk at a slow pace, walk at a brisk pace for 30 seconds and then a regular pace for 4 minutes. Repeat the interval four times. End with a 5-minute cooldown walk.
“Walkers have so many choices to get fit and stay fit for life,” Sansone says.
Walking can be a “gateway exercise” that helps new exercisers improve their cardiovascular fitness and stamina to transition to running but not all walkers want to run — and that’s OK.
“Walking is a good exercise for everyone,” Garber says.
A study published in the journal Arteriosclerosis, Thrombosis and Vascular Biology found rates of hypertension, high cholesterol, heart disease and diabetes were lower for regular walkers than runners.
While a walk around the block is a good start, maximizing the benefits of a walking workout requires logging sufficient time in your sneakers. Garber suggests focusing on distance, duration or calorie expenditure (all viewable on your fitness tracker) noting that it’s the amount of exercise that counts — for both walkers and runners.
“If you start fitness walking today, you will instantly feel better and know you’re doing something good for your body, mind and soul,” Sansone says.
For individuals who are obese and trying to lose weight, or anyone looking to keep the weight off, the ACSM recommends bumping this number up to 200–300 minutes per week (3.3–5 hours). Breaking this down, a one-hour walk 4–5 days per week will be sufficient to achieve your weight-loss goals. Any additional time you spend exercising on top of this adds to your overall calorie burn and fitness level.
If you decide to up the intensity — either by adding resistance training in the form of weights or including short periods of running — exercising at a vigorous activity level (70–85% of your maximum heart rate) requires the duration of your walk to be cut in half to achieve the same benefits. In other words, a 60-minute moderate-intensity walk is the same as a 30-minute walk/run at a vigorous intensity level.
The most accurate way to measure intensity level is to use a heart rate monitor, but you can also keep track of perceived exertion. On a scale of 0–10 (0 is sitting, 10 is the highest exertion possible), moderate intensity is a 5–6, and vigorous activity begins at 7.
Calculating and recording your daily steps, mileage, time and exercise intensity is all important when you’re trying to lose weight. But the last part of the equation — nutrition — is equally crucial. Logging your food intake with MyFitnessPal as well as your workouts can help you get a more accurate picture of the quantity and types of foods you’re consuming. That way you can make informed decisions regarding smarter portion sizes and where you can cut excess calories to find a healthy deficit that allows you to lose weight and keep it off.
THE BOTTOM LINE
Start by walking a little more than you normally do each day until you can do an hour or more 4–5 times per week. If you keep to a brisk pace and pay attention to your nutrition, you’ll set yourself up for effective weight loss.
One of the hardest parts about starting a fat-loss program is knowing you won’t be able to eat a lot of the foods you enjoy. At least, not in the same quantities. For this reason, some people try to achieve their fat-loss goal through exercise alone, hoping they’ll burn enough calories during their workout to make up for poor diet choices.
WHY EXERCISE ISN’T ENOUGH
First of all, exercise tends to increase appetite, says Tiffany Chag, RD, a sports dietitian at the Hospital for Special Surgery in New York. If you’re not paying attention to what and how much you’re eating, you could take in more calories per day than you were getting before you even started your exercise program. “We don’t really realize we’re doing it,” Chag says. Over time, this could lead to stalled results or even weight gain.
In a recent study, a group of lean, overweight and obese women followed an eight-week exercise-only program. Not only did the women see zero fat reduction, but appetite hormone levels increased significantly in overweight and obese participants. These hormonal changes could explain the lack of fat-loss results, according to researchers.
THE CALORIES PARADOX
In addition, exercise only burns a small percentage of calories in the overall scheme of things. A vigorous 30-minute strength session, for example, only burns roughly 223 calories for a 155-pound person, according to Harvard Health. That’s the approximate equivalent of a couple of tablespoons of olive oil or a protein bar.
Granted, exercise — and strength training, in particular — will have you burning calories long after your workout is over, but it may not be as much as you think. “People often get a false sense of how many calories they’re actually burning [during exercise],” says Steve Moore, MS, lead physiologist and health coach with the Penny George Institute for Health and Healing LiveWell Fitness Center at Abbott Northwestern Hospital.
All too often, we assume we’re burning more calories than we actually are, which makes it easier to reach for higher calorie foods. In fact, we can overestimate the calories burned by as much as four times the actual amount, leading us to eat 2–3 times our caloric expenditure from that workout, according to the results of a study published in the Journal of Sports Medicine and Physical Fitness.
You might lose fat through exercise alone, but you’ll have far greater success if you pair your exercise with a healthy diet.
In a study published in Obesity, overweight and obese postmenopausal women who followed a combined diet and aerobic exercise program lost more weight over the course of one year than women who followed a diet- or exercise-only program. Still, the women who followed the diet-only program lost significantly more weight than the exercise-only group (8.5% versus 2.4%), and only slightly less than women who followed the combined program (8.5% versus 10.8% for the combined approach).
Don’t think you have to completely overhaul your diet or add crazy amounts of exercise to see results. Set achievable goals, like adding one extra serving of vegetables per day or taking the stairs instead of the elevator, and focus on meeting those goals for a few weeks before adding in other changes, Chag says. “[Your goal] has to be something that’s measurable, but set the bar so low that you can’t fail.”
Falling on ice can leave you red-faced with embarrassment, or far more seriously, hurt badly from taking a knee to the ice or falling awkwardly on icy snow. Slippery sidewalks, driveways and icy parking lots can be risk factors for falls in winter. Avoid a bad fall with these top tips!
Walk like a penguin
The penguin waddle helps you keep a center of gravity over the front leg as you step, instead of split between the legs. Short strides also help keep your center of gravity, which help avoid falls. When walking, extend your arms out from your sides to increase your centre of gravity. Don’t keep your hands in your pockets! Walk slowly, with short strides and try to land your steps with a flat foot.
Keep walkways clear
Shovel snow and scrape ice as soon as possible. Liberally sprinkle ice melt product or sand onto walkways to provide foot traction and to make sure surfaces don’t turn to ice. This not only protects you and your family, but also postal carriers and others when they’re walking around your property. Where possible install or use handrails for extra support.
Take all precautions
Be extra cautious walking after a storm. Tap your foot on potentially icy areas to see if it is slippery. Hold a railing while walking on icy steps. Stay steady by wearing proper winter footwear. Lightweight boots with a thick, non-slip tread sole will provide good traction on ice. If a sidewalk is icy down the middle, walk on the snow beside it to avoid slips.
Lighten your load
Carry fewer bags on snow days, since excess baggage can throw off your balance and make it tougher to regain your balance once you lose it. Keep your hands free by putting away your phone while walking – you may need to catch yourself!
Boost balance with exercise
You can’t control the weather, but you can improve your balance through regular exercise. Exercise is an ideal way to help you stay safely on your feet because it helps improve balance, flexibility and strength. Talk to a chiropractor about ways to improve your balance and strength in order to prevent falls.
Visit your chiropractor
Don’t let a fall get you down. If you do take a tumble, visit your chiropractor. They’ll get you back to doing the things you love to do and will work with the rest of your care team to help prevent future falls.
You try to eat well to feel good and stay healthy. While it’s optimal to get your nutritional needs from the foods you eat, it’s not always possible. There is conflicting information out there on the benefits of supplements, but the Dietary Guidelines for Americans 2015-20201 say that supplements may be useful for providing the nutrients you may be lacking from diet alone.
Still on the fence? Consider these top five reasons to add a multivitamin to your daily regimen.
Healthy aging. As we get older, our bodies have a harder time absorbing nutrients from food. The National Institute on Aging notes that starting around age 50, people begin to require increased amounts of certain vitamins and minerals.1 In fact, according to a study published in the June 2009 issue of the American Journal of Clinical Nutrition, researchers found that taking a daily multivitamin & mineral supplement may help improve micronutrient deficiencies associated with aging.3
Making up for eliminated food groups. While some people have to cut certain foods like nuts or gluten out of their diets due to allergies, many eliminate particular foods or food groups from their diet voluntarily. This can cause vitamin deficiencies that would be helped with a multivitamin.
Trying a paleo diet? You might risk a shortage of calcium or vitamin D by eliminating dairy or grains. Cutting back on red meat? A multivitamin will replace the iron and B12 you would normally get from diet.†
Getting the RDAs you’re not getting from food.You’ve probably heard that the typical Western diet doesn’t include nearly enough daily fruits and vegetables. As part of that, you don’t always get the vitamins those natural foods supply. Supplementing with a multivitamin containing phytonutrients from fruit- and vegetable-derived ingredients may help. In addition, it’s important to keep in mind that RDA levels are set to prevent nutrient deficiencies. But there’s a wide range between taking enough vitamin C to avoid scurvy and the optimal amount you can benefit from.†
Getting that extra energy to get through the day. In today’s “go-go-go” society, one of the top complaints is a general lack of energy. Instead of reaching for that third cup of coffee, remember that your cells require certain vitamins and minerals to power your busy life; especially if you’re not getting a full eight hours of sleep or eating a balanced diet, a multivitamin can help provide the nutrients you need to feel energetic throughout the day.4
Managing stress. Daily life stressing you out? You’re not alone. But vitamins and micronutrients play a significant biochemical role in improving your brain’s cognitive processes, and studies have shown that a daily multivitamin—particularly one with high doses of B vitamins—can help to reduce stress and support a healthy mood.5†
Ready to add a daily multivitamin to your diet? Be sure to check with your healthcare practitioner to see if he or she has a recommendation and to ensure that any medications you’re currently on won’t interfere with their effectiveness.
Many women notice after age 45 that fat seems to accumulate readily at the waist. There are even terms for it, like menopause belly, muffin top, or “meno-pot.” What does the science tell us about menopausal belly fat and how to get rid of it? What are the hormonal drivers and are they amenable to change with personalized lifestyle medicine? Certainly belly fat, specifically subcutaneous and visceral abdominal fat, increases during menopause,1-3 when the changing hormonal environment can bring with it a remodeling of fat storage patterns. Abdominal fat, especially visceral fat, is biochemically different and more metabolically active than fat stored in other areas, secreting more pro-inflammatory cytokines and adipokines.4 That means preventing or reversing belly fat is not just a vanity project, it’s a meaningful step in managing a woman’s overall health, as abdominal fat has been consistently linked with insulin resistance, impaired glucose control, and overall higher cardiometabolic and breast cancer risk. Practitioners are often asked ‘How can I get rid of menopausal belly fat?’, and it is important to remember that effective management is multifaceted – encompassing an understanding how changes in sex steroids interact with other endocrine systems and also with lifestyle choices, and recognizing the best time to implement a lifestyle medicine approach is in the years before a woman’s final menstrual period.
The changing hormonal environment
A robust understanding of the hormonal changes associated with perimenopause and menopause can guide women toward effective intervention. Here are the top five hormonal changes associated with the menopausal transition.
Changes in estrogen and estrogen dominance: Menopause is often framed simply as the loss of estrogen, but the road from pre- to post-menopausal estrogen levels is not necessarily smooth. Although loss of estrogen itself is linked with increasing abdominal fat,2,3 paradoxically the estrogen dominance that occurs in perimenopause and that may continue into menopause is seen clinically as a culprit in expanding abdominal fat mass.5 Between age 35 and 45, most women are beginning to run low on ripe eggs and experience hormonal changes linked with advancing reproductive age.6 During this time reduced progesterone coupled with high and erratic estrogen occurs.6,7 Estrogen declines but is in relative excess to progesterone. This is the definition of estrogen dominance: having a progesterone level that’s less than 100X the level of estrogen, creating an imbalance in the estrogen-progesterone partnership and essentially an inadequate level of progesterone to keep estrogen in check. Local estrogen production in adipose tissue can also contribute to estrogen dominance during this time. For example, aromatase enzymes, responsible for converting androgens to estrogens, are more active in visceral adipose tissue of post-menopausal women in response to cortisol.8
Cortisol: Dysregulation of the HPA axis and cortisol excess can manifest as increased central and visceral fat mass and metabolic disturbances such as insulin resistance.9,10 Increased production of cortisol,11 and conversion of cortisone (inactive) to cortisol (active) has been described in post-menopausal women,12 indicating that increased cortisol synthesis and conversion could contribute to metabolic dysfunction in these women. Cortisol is regulated in part by sex steroids, and estrogen down-regulates the expression and activity 11β-HSD1, the enzyme involved in converting inactive cortisone to active cortisol13 – so higher estrogen, lower 11β-HSD1 and less active cortisol formed. Declining estrogen levels during menopause can have a knock-on effect on cortisol formation, and 11β-HSD1 has been shown to be upregulated particularly in visceral fat in post-menopausal compared with pre-menopausal women. 1,11,12 As well as contributing directly metabolic dysfunction, higher cortisol can feed back to hormonal environment and contribute to estrogen dominance occurring at this time through cortisol-induced aromatase activity.8,14
Insulin: Fat cells accumulating in the abdomen is linked with insulin resistance. The pro-inflammatory cytokines produced by abdominal fat interferes with insulin signaling.15 This results in insulin resistance where cell response to insulin is lost, which creates a cycle where greater production of insulin is required to manage blood glucose levels. Insulin is a gatekeeper of metabolism, and rising insulin levels can set off a chain reaction that ultimately leads to a cycle of weight and abdominal fat gain. Insulin can lower production of sex hormone binding globulin (SHBG) in the liver.16,17 Lower SHBG results in greater free androgens and estrogens in circulation, and is linked with visceral fat and insulin resistance in menopausal women.18,19 In addition, insulin resistance can have a knock-on effect on leptin, insulin’s cousin.
Leptin: Leptin is the put-down-your-fork hormone, the one that tells you when you are full.20 Elevated insulin levels eventually lead to elevated leptin, which despite what you may think, does not mean you are more likely to put down your fork and stop eating. Instead, consistently elevated leptin levels lead to a dysfunction of leptin receptors and they stop sending signals to the brain to tell you to stop eating – this is called leptin resistance.21 The mechanisms driving leptin-resistance are complex, but high intakes of refined carbohydrates have linked with its development.22
Thyroid hormones: Thyroid hormones, which regulate how quickly we burn calories and maintains our metabolism, can becomes unbalanced with age, a trend that has been labeled ‘thyropause’. If the thyroid becomes underactive, this can lead to symptoms including weakness, fatigue, and weight gain.23
What can be done?
One of the biggest myths in women’s health is that once hormones change with menopause, abdominal adiposity is immovable – however addressing modifiable hormones such as cortisol and insulin in the following ways can have an impact.
Make foundational changes to dietary intake. When evaluating diet, consider factors that influence insulin levels, such as high carbohydrate intakes or intake of refined carbohydrates which require greater insulin response to manage spikes in plasma glucose. Remove inflammatory or trigger foods, as inflammation can contribute to insulin resistance.31 Add in foods rich in antioxidants which promote detoxification. Eliminate alcohol which robs you of deep sleep and lowers metabolism by more than 70% for 24 hours. Choosing when to eat during the day can also make a positive impact to insulin levels and insulin sensitivity. Time-restricted feeding (TRF) protocols, a type of intermittent fasting, where food is consumed during a limited number of hours per day (often 6 or 8) has been shown to reduce body weight and abdominal fat32 and improve insulin sensitivity even without weight loss.33
Add more movement to the day. Sitting is like the new smoking. Approximately 35 chronic diseases and conditions are associated with sedentariness, and sedentary behavior makes people more prone to gain body fat.24High intensity interval training (HIIT) is effective at reducing abdominal and visceral adiposity, as well as improving insulin sensitivity and building muscle.25,26 Studies in post-menopausal women show that HIIT training results in greater abdominal and visceral fat mass loss compared to continuous exercise programs (where heart rate was maintained at a constant level)27,28 showing that HIIT is a time-efficient strategy for improving central obesity in this population. In addition to HIIT programs, practicing yoga can be recommended for menopausal women, showing significant reductions in menopausal symptoms.29 In broader populations, interventions that included yoga asanas were associated with reduced evening and waking cortisol levels, as well as improved metabolic symptoms.30
Support reparative sleep. A primary step to losing belly fat is to get enough sleep and to make it quality sleep. Epidemiological studies have repeatedly shown links between sleep duration and the risk of obesity and central adiposity.34 People sleeping 7-8 hours/night night have been shown to accumulate less visceral fat mass than those sleeping for ≤6 hours/night.35 Sleep debt leads to changes in leptin and other hormones related to satiety, greater feelings of hunger, dietary indiscretion and poor food choices, as well as reduced physical activity and insulin resistance.34 In other words, getting that solid sleep needs to be a priority. As well as sleep quantity, sleep quality has to be considered, as poorer sleep quality is associated with higher visceral fat mass.36 Subjective poor sleep quality is linked with altered cortisol response37 and insulin resistance in postmenopausal women.38
by Sara Gottfried, MD and Annalouise O’Connor, PhD
Yamatani H et al. Association of estrogen with glucocorticoid levels in visceral fat in postmenopausal women. Menopause. 2013;20(4):437-442.
Shen W et al. Sexual dimorphism of adipose tissue distribution across the lifespan: a cross-sectional whole-body magnetic resonance imaging study. Nutr Metab (Lond). 2009;6:17.
Lovejoy JC et al. Increased visceral fat and decreased energy expenditure during the menopausal transition. Int J Obes (Lond). 2008;32(6):949-958.
de Heredia FP et al. Obesity, inflammation and the immune system. Proc Nutr Soc. 2012;71(2):332-338.
Prior JC. Progesterone for symptomatic perimenopause treatment – progesterone politics, physiology and potential for perimenopause. Facts Views Vis Obgyn. 2011;3(2):109-120.
Hale GE et al. Hormonal changes and biomarkers in late reproductive age, menopausal transition and menopause. Best Pract Res Clin Obstet Gynaecol. 2009;23(1):7-23.
Hale GE et al. Endocrine features of menstrual cycles in middle and late reproductive age and the menopausal transition classified according to the Staging of Reproductive Aging Workshop (STRAW) staging system. J Clin Endocrinol Metab. 2007;92(8):3060-3067.
McTernan PG et al. Glucocorticoid regulation of p450 aromatase acitivty in human adipose tissue: gender and site differences. J Clin Endocrinol Metab. 2002;87(3):1327-1336.
Paredes S et al. Cortisol: the villain in metabolic syndrome? Rev Assoc Med Bras (1992). 2014;60(1):84-92.
Incollingo Rodriguez AC et al. Hypothalamic-pituitary-adrenal axis dysregulation and cortisol activity in obesity: a systematic review. Psychoneuroendocrinology. 2015;62:301-318.
Li S et al. Effects of menopause on hepatic 11β-hydroxysteroid dehydrogenase type 1 actvity and adrenal sensitivity to adrenocorticotropin in healthy non-obese women. Gynecol Endocrinol. 2011;27(10):794-799.
Andersson T et al. Tissue-specific increases in 11β-hydroxysteroid dehydrogenase type 1 in normal weight postmenopausal women. PLoS One. 2009;4(12):e8475.
Andersson T et al. Estrogen reduces 11β-hydroxysteroid dehydrogenase type 1 in liver and visceral, but not subcutaneous, adipose tissue in rats. Obesity (Silver Spring). 2010;18(3):470-475.
McTernan PG et al. Gender differences in the regulation of P450 aromatase expression and activity in human adipose tissue. Int J Obes Relat Metab Disord. 2000;24(7):875-881.
Castro AV et al. Obesity, insulin resistance and comorbidities? Mechanisms of association. Arq Bras Endocrinol Metabol. 2014;58(6):600-609.
Plymate SR et al. Inhibition of sex hormone-binding globulin production in the human hepatoma (Hep G2) cell line by insulin and prolactin. J Clin Endocrinol Metab. 1988;67(3):460-464.
Loukovaara M et al. Regulation of production and secretion of sex hormone-binding globulin in HepG2 cell cultures by hormones and growth factors. J Clin Endocrinol Metab. 1995;80(1):160-164.
Davis SR et al. The contribution of SHBG to the variation in HOMA-IR is not dependent on endogenous oestrogen or androgen levels in postmenopausal women. Clin Endocrinol (Oxf). 2012;77(4):541-547.
Janssen I et al. Testosterone and visceral fat in midlife women: the Study of Women’s Health Across the Nation (SWAN) fat patterning study. Obesity (Silver Spring). 2010;18(3):604-610.
Klok MD et al. The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review. Obes Rev. 2007;8(1):21-34.
Engin A. Diet-induced obesity and the mechanism of leptin resistance. Adv Exp Med Biol. 2017;960:381-397.
Harris RBS. Development of leptin resistance in sucrose drinking rats is assocated with consuming carbohydrate-containing solutions and not calorie-free sweet solution. Appetite. 2018;132:114-121.
Diamanti-Kandarakis E et al. Mechanisms in endocrinology: aging and anti-aging: a combo-endocrinology overview Eur J Endocrinol. 2017;176(6):R283-R308.
Levine JA. Sick of sitting. Diabetologia. 2015;58(8):1751-1758.
Maillard F et al. Effect of high-intensity interval training on total, abdominal and visceral fat mass: a meta-analysis. Sports Med. 2018;48(2):269-288.
Maillard F et al. High-intensity interval training reduces abdominal fat mass in postmenopausal women with type 2 diabetes. Diabetes Metab. 2016;42(6):433-441.
Nunes PRP et al. Effect of high-intensity interval training on body composition and inflammatory markers in obese postmenopausal women: a randomized controlled trial. Menopause. 2018;Oct 1.
Cramer H et al. Yoga for menopausal symptoms-a systematic review and meta-analysis. Maturitas. 2018;109:13-25.
Pascoe MC et al. Yoga, mindfulness-based stress reduction and stress-related physiological measures: a meta-analysis. Psychoneuroendocrinology. 2017;86:152-168.
Caputo T et al. From chronic overnutrition to metainflammation and insulin resistance: adipose tissue and liver contributions. FEBS Lett. 2017;591(19):3061-3088.
Gabel K et al. Effects of 8-hour time restricted feeding on body weight and metabolic disease risk factors in obese adults: a pilot study. Nutr Healthy Aging. 2018;4(4):345-353.
Sutton EF et al. Early time-restricted feeding improves insulin sensitivity, blood pressure, and oxidative stress even without weight loss in men with prediabetes. Cell Metab. 2018;27(6):1212-1221.e3.
Koren D et al. Role of sleep quality in the metabolic syndrome. Diabetes Metab Syndr Obes. 2016;9:281-310.
Chaput JP et al. Change in sleep duration and visceral fat accumulation over 6 years in adults. Obesity (Silver Spring). 2014;22(5):E9-12.
Sweatt SK et al. Sleep quality is differentially related to adiposity in adults. Psychoneuroendocrinology. 2018;98:46-51.
Huang T et al. Habitual sleep quality and diurnal rhythms of salivary cortisol and dehydroepiandrosterone in postmenopausal women. Psychoneuroendocrinology. 2017;84:172-180.
Kline CE et al. Poor sleep quality is associated with insulin resistance in postmenopausal women with and without metabolic syndrome. Metab Syndr Relat Disord. 2018;16(4):183-189.
Sara Gottfried, MD
Sara Gottfried, MD is a board-certified gynecologist and physician scientist. She graduated from Harvard Medical School and the Massachusetts Institute of Technology and completed residency at the University of California at San Francisco. Over the past two decades, Dr. Gottfried has seen more than 25,000 patients and specializes in identifying the underlying cause of her patients’ conditions to achieve true and lasting health transformations, not just symptom management.
Dr. Gottfried is the President of Metagenics Institute, which is dedicated to transforming healthcare by educating, inspiring, and mobilizing practitioners and patients to learn about and adopt personalized lifestyle medicine. Dr. Gottfried is a global keynote speaker who practices evidence-based integrative, precision, and Functional Medicine. She has written three New York Times bestselling books: The Hormone Cure, The Hormone Reset Diet, and her latest, Younger: A Breakthrough Program to Reset Your Genes, Reverse Aging, and Turn Back the Clock 10 Years.
Annalouise O’Connor, PhD, RD
Dr. Annalouise O’Connor is the R&D Manager for Therapeutic Platforms and Lead for Cardiometabolic and Obesity platforms at Metagenics. Her role involves research coordination, as well as developing formulas for targeted nutrition solutions and programs to assist practitioners in the optimal management of their patients’ health. Annalouise trained as an RD and worked in clinical and public health settings. Dr. O’Connor completed her PhD in the Nutrigenomics Research Group at University College Dublin (Ireland) and postdoctoral work at the UNC Chapel Hill Nutrition Research Institute.
It’s the most wonderful time of the year, but for those following a diet, the holidays may stir up stress and anxiety around food. The ketogenic diet is not the most “social” diet, but there are ways to stick to it, even in the most daunting of times, such as holiday celebrations.
If you can’t eat keto, at least aim for low-carb
Your holiday party may not be stocked full of keto-friendly foods, but there is a high probability that you can nibble on some low-carb options. The cheese platter is, more often than not, a pretty safe bet for cheese (of course!), but also for other low-carb foods such as nuts and meats. Just stay clear of candy-coated nuts, dried fruits, and cured meats you suspect may have added sugar!
Another low-carb holiday party go-to is the veggie platter. Lucky for you, this usually gets the least attention by guests, thereby giving you full access to it. Stick to the low-carb vegetables options such as broccoli, cauliflower, celery, and cucumber. If your event is serving dinner, opt for the meats or any salads (without sugar-loaded dressings), and low-carb vegetables. Things to stay away from are the mashed potatoes, any bread/pastry-like foods, sauces, and, of course, the sweets. Sticking with low-carb as opposed to ditching the diet completely will make transitioning back into ketosis much easier.
Prepare for success and give yourself options
If you are uncomfortable not knowing what food options will be available at your holiday gathering, prepare some food in advance. Better yet, prepare a keto-friendly dish to share with everyone! Take a high-fat dip to pair with that veggie platter and a salad dressing you can pour on any dry salads to avoid sugary dressings. You can also pack some snacks such as high-fat nuts (e.g. macadamia nuts) to graze on throughout the evening. Additionally, medium-chain triglyceride (MCT) oil is a great tool for ketogenic living. Fill a small jar with MCT oil to take with you and use on any dish or in beverages. MCTs are highly ketogenic and have even been shown to increase ketone production without carbohydrate restriction.1
The popularity of the ketogenic diet has made it simple to find recipes that anyone can enjoy. Consider making a ketogenic dessert to bring and share so you can “indulge” too, while also preventing you from caving into the temptations of sugar-laden treats.
Stay positive and remember your “why”
It can be difficult to gain the support of those around you when your dietary choices are perceived as something as radical as a ketogenic diet may seem to some. You may even be tempted to ditch the diet for the sake of your peers or those family members who just won’t back down from having you try “just one bite.” Be prepared to explain to others what the ketogenic diet is and why you follow it. Remember that there is no one-size-fits-all diet, and it is perfectly fine to have different views from others. Just stay true to yourself, remember your “why,” and stay positive, because there is nothing worse than engaging in a debate over food choices!
Tips for alcohol
Alcohol isn’t generally conducive to living a ketogenic lifestyle, and if you have no problem abstaining from it completely, that is your best option. If having a drink in your hand makes you feel more comfortable in a crowd, take club soda and sliced lemon with you; this will help you feel less segregated. With all this said, celebrations may be times when you can make exceptions (within reason). There are ways to enjoy a drink or two and stick to your goals; you just have to know what to look out for. For wines, opt for the driest you can find, white or red, and avoid sweet wines such as rosé. Most liquors are acceptable on their own or enjoyed with club soda or sugar-free beverages. Beers typically contain more carbohydrates, and they should probably be limited to one. If nutrition labels are available, check to see what the lowest-carbohydrate beer options are. Coolers and ciders are to be avoided due to their high sugar content.
Be kind to yourself and don’t overthink it
If you take into consideration all of the recommendations above, there is no reason to be stressed or anxious about your diet as you enter into the holidays. You are following a ketogenic diet to improve your health, right? Well, being kind to yourself is part of healthy living, and sometimes that means accepting that your diet can’t always be perfect. Also, keep in mind that you can always jump right back into the swing of things; a few days of indulging does not mean you have “failed.” There is more to health than simply what you put in your mouth, so do the best you can, be prepared, but most importantly, don’t get down on yourself if things don’t go as planned. Instead of focusing on your food options, focus on enjoying your time with loved ones over this holiday season.
As we said, the holidays are the most wonderful time of the year, and your diet shouldn’t change that for you.