Wellness Refocused Education: Alcohol

I can’t have wine. I can’t have beer. I can’t go out.

I’ve heard this from a few clients. I’ve read it and heard it from a few people online. When I started, it’s something that I said myself.

It’s possible to still have a beer or a glass of wine and lose weight and create a healthy lifestyle. I kept alcohol in my plan during my last competition prep and saw the lowest body fat percentage I have ever had. This isn’t something many people practice, but in my last prep, it’s something I wanted to keep in for when I wanted a drink with dinner or date night. I wanted the ability to have a drink if I felt comfortable with having one work in my day.

Alcohol consumption and weight loss comes down to a few things.

  1. Maintaining a caloric deficit consistently over time.
  2. Determining how you feel about the choice of having a drink.

Weight loss/fat loss occur over time. While weight can fluctuate greatly day-to-day, true fat loss occurs over a period of time longer than a few days. You need to be in a caloric deficit over that period and that can be created through your nutrition protocol and workout programming.

The mental aspect of dieting is something that I talk about heavily with my clients because I don’t believe in eating things you don’t like (you won’t adhere to your plan if you don’t like it) and you also need to be comfortable or at least ok with the ramifications (if any) of your choices.

Three questions I get often are:

  • Why doesn’t alcohol have a nutrition label?
  • How do I track alcohol?
  • Should I leave space in my diet for alcohol? i.e. should there be an allotted number of calories or macros for alcohol to replace food?

Before we answer these questions, let understand alcohol a little bit better.

When we talk about alcohol as a consumable like beer, we’re meaning ethanol. Ethanol is a specific type of alcohol that you find in beer, wine and distilled spirits. Alcohol and ethanol are used interchangeably.

Alcohol is technically a macronutrient.

Chemically they are structurally similar to carbohydrates. Chemically, carbohydrates are C6H12O6 whereas ethanol alcohol is C2H5OH. Alcohol is similar to carbohydrates because they’re created from fermented carbohydrates in a process called ethanol fermentation or alcoholic fermentation.

Image result for alcoholic fermentation formula

Alcohol has 7 calories associated per gram. This makes them more calorically dense than carbohydrates and protein, but less calorically dense than fat (Thompson & Manore, 2015). Ethanol is a specific type of alcohol that you find in beer, wine and distilled spirits.

Alcohol provides no nutritional value, but it has energy.

So, if it’s a macronutrient why isn’t it on a nutrition label?

While the FDA and USDA are regulatory entities for food and supplements, they don’t regulate alcohol. That’s the short answer. Alcohol is regulated by the Alcohol and Tobacco Tax and Trade Bureau (TTB). This organization doesn’t require that companies provide nutritional information on their products. However, in 2004 a ruling called the Federal Alcohol Administration Act allowed TTB to implement labeling regulations as long as the information was accurate and not misleading to consumers. The FAA Act also had restrictions about marketing and statements in relation to benefits of alcohol. Since the FAA Action, more alcohol companies have tried to appease health conscious consumers by adding nutrition labels, however, if you look closely, you’ll see in many cases the calories don’t match the nutritional values provided on the label.

The reason – alcohol isn’t a nutrient that is usually provided on a label, and since much of the carbohydrates are converted into alcohol only those not converted are accounted for on the label.

Below is a label of Angry Orchard Hard Cider. We all know that apples are carbohydrates and we know carbohydrates is a fancy name for sugar. You’ll see that calories, carbohydrates and sugars are accounted for on the label, but if you multiply 31g of carbohydrates by 4 calories per gram, you get 124 calories, not 210. That’s not to say that there are truly 84 calories or 12g of alcohol in this bottle, but you get the idea – the energy is accounted for, but not the nutrient.

This was in the fridge at JP’s parents house. Notice how it lists carbohydrates as 5g (which is 20 calories) and at the top it says calories from alcohol 120 (roughly 17g). I’m not sure if this is something that we will be seeing more of, but I do think it allows people to make more healthful decisions – nutritionally and psychologically.

How do you track it if you’re counting macros?

I recommended threeways to accommodate alcohol into their plan.

1. Since it’s chemically similar to carbohydrates, you can over-accommodate by taking the total calories of the drink and dividing by 4 calories (1g of carbohydrates) to determine how many grams of carbohydrates you would use to account for your drink.

2. Calorically, since they’re close to fats at 7 calories per gram, you can divide by 9 calories (1g of fats) and determine how many grams of fats you want to use to account for your drink.

Both of these ways to accommodate alcohol aren’t going to be perfect – there’s no perfect way to account for it. Even if you’re counting calories, many people aren’t measuring all of the ingredients in their drinks and are estimating their consumption – especially if they’re ordering out.

3. The most common way I recommend they accommodate alcohol into their plan is to calculate it similarly to above and accepting and allowing themselves to eat in a surplus that day. I hardly ever recommend that clients substitute alcohol for food. Not only is alcohol not nutritious but decreasing food will also amplify the impacts that alcohol can have on a body such as stimulant effects.

Early in my journey, I made the mistake of attempting to leave space in my day for a drink to go out and it hits you like a ton of bricks if you’re not careful. Now, if I have a drink I’ve actively made the decision to have it and go over my calories for the day. This doesn’t mean that I load up and go over excessively. In many cases I’m putting my body into maintenance range, not necessarily a surplus.

We’ve talked about how the body breaks down certain nutrients from complex to simple forms and we’ve talk about how some things are broken down at different rates. As a liquid, alcohol is readily absorbed from the both the stomach and the small intestine – it’s not digested before reaching these two organs (Thompson & Manore, 2015). Foods containing protein, fat and fiber help slow down absorption rates of alcohol and therefore slowly the effects of it.

After alcohol enters the bloodstream, it moves to the liver where it’s broken down. The liver produces two enzymes that break down alcohol – alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) (Thompson & Manore, 2015). These enzymes break down alcohol so that it’s energy can be readily available to the body.  After the energy has been made ready, the body only has two options – use it for energy if caloric needs haven’t been met or convert it to fatty acids and store it for later.

While age, gender and weight can impact how alcohol impacts a person, the rate at which alcohol breaks down once it reaches the liver can’t be altered regardless of the myths out there.

Why do so many people cut it out of their diets if you can still lose weight and fat when consuming alcohol?

Again, there’s no nutritional value and it’s easy over consume energy through alcohol consumption. It’s not just from alcohol in beverages that the calories come from, many who enjoy mixed drinks are adding calories through sugary mixers and additions likes cherries and whipped cream. Other negative behaviors like over-eating as well as heavy drinking are also associated with alcohol consumption.

It’s possible that there are some benefits to light or moderate alcohol consumption. Resveratrol is a phytochemical found in red wines, grapes and other plants that can play a role in limiting cellular damage and help lower risk of certain chronic diseases (Thompson & Manore, 2015). However, the amount of resveratrol in wines may be too little to make a meaningful impact and therefore a purified supplement of resveratrol would be recommended. Much research has found links between moderate alcohol consumption and lower chronic disease, but not causation. “Clinical studies are limited by their observational nature as well as for the difficulties to abstract the benefits of wine from other confounders” meaning that it can be hard to determine if the benefits were from the wine or other healthy positive behaviors (Artero, Artero, Tarin & Cano, 2015). There are clear risks to drinking too much alcohol such as higher risk of chronic disease like impaired bone health, pancreatic injury and diabetes, abdominal obesity, cancer.

There is no recommended daily allowance (RDA) for alcohol, however, moderation per gender is encouraged. Moderation for women is one drink per day and no more than two drink per day for men.

Similarly to deciding if you should have a dessert after dinner or an extra serving of what would be considered a treat, you should feel confident in the decision to participate. Having a glass of wine or a bottle of beer shouldn’t make you feel derailed or feel like you’re ruining progress. It should be accounted for in whatever way you believe will be helpful. If it’s moderating the rest of the day and acknowledging that you will be out of a deficit that day – then so be it. If it’s not counting it, but going about your day tracking other items – then so be it. Just don’t allow yourself to become out of control.

As for me, I enjoy a beer with dinner. I like a cocktail when it’s hot. Sometimes I put liquor in my coffee when we make brunch.

Cheers!

❤ Cristina

References

Alcohol and Tobacco Tax and Trade Bureau. (2018, July 2). Beverage Alcohol. Retrieved from Alcohol and Tobacco Tax and Trade Bureau: https://www.ttb.gov/alcohol/bev-alc.shtml

Artero, A., Artero, A., Tarin, J. J., & Cano, A. (2015). The impact of moderate wine consumption on health. Maturitas, 3-13.

Department of the Treasury: Alcohol and Tobacco Tax and Trade Bureau. (2004, April 7). Caloric and Carbohydrate Representations in the Labeling and Advertising of Wine, Distilled Spirits and Malt Beverages. Retrieved from Department of the Treasury: Alcohol and Tobacco Tax and Trade Bureau: https://www.ttb.gov/rulings/2004-1.pdf

ScienceDirect. (2018, July 2). Ethanol fermentation. Retrieved from ScienceDirect: https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/ethanol-fermentation

Thompson, J., & Manore, M. (2015). Nutrition: An Applied Approach. Boston: Pearson.

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Wellness Refocused Education: Snacking intentionally

When I started competing I thought I had to eat every few hours. This was something that I had read about, but more importantly (at the time) it was something that I saw over and over again in practice online.

For me, every few hours meant every three hours. I was on a cycle of eating about seven or eight meals or snacks, which were small in volume. I didn’t have macronutrient goals per meal (I still don’t). I didn’t have calorie goals per meal (I still don’t).

Now, there’s nothing wrong with eating in this structure. I do think small meals can help you get through the day, but naturally, this method also has you in a cycle of wondering what time it is and when the next meal is coming. This kind of focus on meal timing has the potential to be harmful mentally. This concept can be considered grazing, since meals are consumed steadily throughout the day instead of in two or three large meals.

Transitioning away from this approach to eating when I was hungry was a slight struggle at first. However, after a few months, I relearned my body and now I have an idea of meal timing that works for me as well as how full certain combinations of foods make me so that I can plan when I’m on the go.

One positive thing from this eating structure is that I started to eliminate labels from food like breakfast, lunch and dinner.

By removing labels and eating what I’m interested in, I gave myself more flexibility and diversity to my meals. Some days I just want eggs for dinner – they’re also quick and no hassle.

I hear often, that snacking is bad, can lead to weight gain and in some cases can lead to going “off-track”. I think many confuse having a snack with negative snacking behavior like what we describe as mindless eating. I do also understand that some foods can lead an individual to not stay on track and in that case, I would encourage that person to dig deeper and think about why that food has that power.

So snacking, what’s the science say?

A 2011 study investigated the definitions of snacking, perceptions of snack foods and snacking behavior defined “having a snack” as “eating food between meals or eating a light meal (Chaplin & Smith, 2011).”

Other research has defined a snack by caloric consumption, social interactions and the time of day for the consumption, but “these definitions fail to consider the influence of social patterns and/or cultural norms on timing and size of eating occasions (Chaplin & Smith, 2011).” These definitions also don’t take into consideration a person’s motivations to eat such as not triggered by hunger or social environment.

Another article that reviewed definitions of snacking and motivations to snack found that without a consistent definition of the words snack and snack, it’s hard to determine if prevalence has increased and if it does in fact contribute to weight gain (Hess, Jonnalagadda, & Slavin, 2017).

For the purpose of this post, the definition that I’ll use is:

Snack: an individual food or light meal consumed between meals with or without intent.

Researchers of the 2011 study also found that language used to describe and talk about food influenced how it was reported such as labeling “healthy foods” as snacks (Larson, Miller, Watts, Story, & Neumark-Sztainer, 2016). Gender also made a difference.

While having a snack can simply mean that you have consumed an individual item or light meal with intent, snacking behavior is typically associated with over-consumption of calories.

A 2016 study in the Journal of Nutrition examined snacking behavior from 2,793 adolescents to determine the influence this behavior had on weight status (Larson, Miller, Watts, Story, & Neumark-Sztainer, 2016). Researchers were interested in this examination because there is a lot of conflicting findings that suggest snacking behavior may or may not contribute to weight status in young people, which impacts the strategies provided to those seeking to improve dietary adherence.

What they found was that snacks have the potential to be calorically-dense, which may cause someone to over consume calories; however, the behavior on its own of having a food or light meal in between meals isn’t inherently harmful to health (Larson, Miller, Watts, Story, & Neumark-Sztainer, 2016).

However, paired with other behaviors, there’s greater potential for calorie-dense snacks to be chosen such as watching television (mindless eating) and skipping legitimate meals.

As an adult, I look back on times in childhood and think about the things I missed out on – the hours of naps I said ‘no’ to and the snacks I missed out on. As an adult, these things have greatly helped me maintain my health, even when there are times it doesn’t seem so great.

Being “allowed” to have a snack truly comes down to the psychology of dieting and eating behaviors. It comes from having all or nothing mindset. What we thought we knew about a healthy lifestyle has been made more complicated by the reality that we need to be healthy mentally as well and understanding that creating lifestyle change doesn’t happen in a bubble.

Be intentional

Going back to the definition that I created above – the ending, with or without intent. I think this part is key. Having a snack with intention means it’s part of the plan.

When I plan out my day, especially if I know I will be in and out of the house, I intentionally pack them with me. There’s potential that I won’t need them, but having a snack planned helps me with dietary adherence or “staying on track”.

I know if I’m truly hungry, I can wait about 30 minutes before I feel like I need to find something. If I don’t have a snack with me I’m more likely to not care about my choice, which will more than likely be calorie-dense.

As a society, we’ve changed greatly in the past 50 years. The workforce is larger with more women going to work, many of us work jobs with longer hours or nontraditional hours, we’re are living at home longer, having children later, obtaining more education, etc. If our schedules have changed and adapted with the needs of society, why not adapt our eating to our lifestyles?

There is no right way to go about meal timing, which means there’s no wrong way either. If we can take away labels and change the language that we use when we describe food, we may be able to create eating behavior that encourages adherence and gives us the satisfaction of participation.

When labels are removed the possibilities are endless. Eating well doesn’t have to be expensive and it doesn’t have to be complicated. I carry one or two protein bars in my purse, but I will also put some crackers or pretzels for the when I’m running around.

Some of the snacks I’ve been enjoying lately are:

  • Snyder’s mini pretzels
  • Wheat Thins
  • Individually wrapped cheese bricks
  • Quaker caramel rice crisps
  • KIND bars
  • Fruit: grapes, bananas and apples
  • Protein bars and protein shakes are always a staple
  • Nuts: pistachios for JP, walnuts for me!

snacks 1

A helpful tip, that I still implement is to portion my snacks when I get them home from the store since I typically plan and prep the day I grocery shop. This isn’t necessarily ideal for all foods because some could get stale, but  portioning a few snacks can be helpful. If you don’t plan out your week and prefer to take it a day at a time, you can still portion out some snacks so that they’re easier to grab when you’re on the go.

If you don’t mind buying individually wrapped snacks, that’s also fine. I don’t buy everything individually wrapped because it’s not cost effective for us., however, if you know that the packaging makes a difference in your decision-making then you need to find a strategy that works for you.

Tell me, how are your choices impacted when you don’t have something on hand or something planned?

 

References

Chaplin, K., & Smith, A. P. (2011). DEFINITIONS AND PERCEPTIONS OF SNACKING. Current Topics in Nutraceutical Research , 53-60.

Hess, J. M., Jonnalagadda, S. S., & Slavin, J. L. (2017). What Is a Snack, Why Do We Snack, and How Can We Choose Better Snacks? A Review of the Definitions of Snacking, Motivations to Snack, Contributions to Dietary Intake, and Recommendations for Improvement. Advances in Nutrition, 466-475.

Larson, N. I., Miller, J. M., Watts, A. W., Story, M. T., & Neumark-Sztainer, D. R. (2016). Adolescent Snacking Behaviors Are Associated with Dietary Intake and Weight Status. The Journal of Nutrition, 1348-1355.

Tartakovsky, M. (2015, August 3). 5 Ways to Expand All-or-Nothing Thinking. Retrieved from Psych Central: https://psychcentral.com/blog/5-ways-to-expand-all-or-nothing-thinking/

 

 

Wellness Refocused Education: Vitamins Part 1

When you hear the word supplements what do you think of first? Do you think of fish oil? Do you think of a multi-vitamin? Do think of protein powder? Do you think of steroids?

For the beginning few months of last year when I went back to school, I worked at Vitamin Shoppe. This gave me the opportunity to be around everything from apple cider vinegar to protein powder to BCAAs to fish oil to probiotics. Vitamin Shoppe is a really well rounded store if you’re looking for something to help fill in the gaps.

The store is divided into two sections.

When you walk through the front door, the left hand side was what you could consider lifestyle health. It had all of the vitamins and minerals, it had digestive aids like probiotics and enzymes. It also had greens powders and gender-specific care.

On the right hand side was where the sports nutrition lived. It was protein powder, fat burners, energy drinks, BCAAs, pre-workout products.

The middle of the store is where the tea, protein bars, beauty products lived.

While it was retail, Vitamin Shoppe doesn’t provide commission, so you can have an authentic conversion with customers about what their goals are and what they’re looking to buy to match those goals. They provided us with a lot of education about the products we were selling including information from studies published from the NIH for additional research. At the same time, I was just starting my health science courses and was reading everything I could about vitamins and minerals and how they cause specific functions in the body to occur. Timing couldn’t have been more perfect.

You could see the wheels turning as a customer decided which side of the store they needed. In some cases, we would have to introduce them to the other side of the store.

For many who trained hard, they typically went to the right, but every now and then we would get them to go to the left.

For a better conversation, there will be a few posts about supplementation.

We’re going to start with the left side of the store with vitamins.

First, there are 13 vitamins considered essential, just like essential amino acids, this means that the body must consume these through diet because it can only make a small amount of none at all (Thompson & Manore, 2015). If you have variety in your diet and have healthy functioning organ systems, you’re probably consuming enough of all of these vitamins through dietary means.

Individuals that have malabsorption disorders such as celiac disease are more likely to have deficiencies because of ability to absorb dietary fat. Individuals who also consume too little fat could be at risk as well. For better assistance to determine deficiencies, talk to you doctor and have a conversation about getting blood work done.

There are two kinds of vitamins:

  1. Fat soluble
    1. Vitamins A, D, E and K
  2. Water soluble
    1. Vitamin C and all B-vitamins

These two categories determines how a vitamin is absorbed, stored and then removed from the body.

Fat soluble vitamins need dietary fat to assist with transport and absorption (Thompson & Manore, 2015). They are also stored in adipose tissue (fat tissue), which means we don’t need to consume these every day. Since they can be stored in the body, consuming more than what is utilized can lead to toxicity. This occurs much more often when utilizing supplements, food rarely leads to toxic levels of fat soluble vitamins.

Toxicity of fat soluble vitamins can lead to a number of symptoms. The symptoms below don’t occur as a reaction for every fat soluble vitamin, but is a list of symptoms of all fat soluble vitamins.

  • fatigue
  • bone and joint pain
  • birth defects
  • nausea
  • diarrhea
  • liver damage
  • blurred vision
  • hair loss
  • skin disorders
  • hypercalcemia

Deficiency of fat soluble vitamins can lead to a number of symptoms. The symptoms below don’t occur as a reaction for every fat soluble vitamin, but is a list of symptoms of all fat soluble vitamins.

  • night blindness
  • impaired growth
  • impaired immunity
  • impaired reproductive function
  • osteomalacia or osteoporosis in adults
  • rickets in children
  • impairment of nerve, muscle and immune function
  • impaired blood clotting

Water soluble vitamins can be found in a larger variety of foods than fat soluble vitamins and are easily absorbed through the intestinal tract directly into the blood stream (Thompson & Manore, 2015). Our bodies don’t store water soluble vitamins, any excess is excreted in our urine after filtration from the kidneys. Since water soluble vitamins are removed through urine output it can be difficult to reach toxicity levels. It’s not impossible, but it’s not likely – at least through dietary consumption.

Toxicity of water soluble vitamins can lead to a number of symptoms. The symptoms below don’t occur as a reaction for every water soluble vitamin, but is a list of symptoms of all water soluble vitamins.

  • flushing
  • liver damage
  • blurred vision
  • glucose intolerance
  • nerve damage
  • nausea
  • diarrhea
  • nosebleeds
  • increased kidney stone formation

Deficiency of water soluble vitamins can lead to a number of symptoms. The symptoms below don’t occur as a reaction for every water soluble vitamin, but is a list of symptoms of all water soluble vitamins.

  • fatigue
  • decreased memory
  • confusion
  • muscle weakness
  • anemia
  • swollen mouth and/or throat
  • pellagra
  • vomiting
  • constipation
  • diarrhea
  • tingling and numbness of extremities
  • neural tube defects in a developing fetus
  • depression
  • fractures and bone pain
  • nerve damage

Some of the symptoms for both fat soluble and water soluble vitamins could be mistaken for other illnesses, but again to determine toxicity or deficiency for you as an individual, talk to your doctor.

This post is about fat soluble vitamins. We’ll get to water soluble a bit later, but now you know that there are two kinds of vitamins and what vitamins are categorized where.

fat soluble

So we have an idea of what fat soluble means, what is their purpose?

Fat soluble vitamins play an important role in specialized functions in the body by assisting complex systems.

Vitamin A is has multiple uses in the body, but Vitamin A isn’t just one compound. You may have heard of retinol, retinal or retinoic acid – these are different forms of it.

It’s required for eye functions. It assists our eyes in the ability to adjust to light changes, it also protects color vision.

During cellular development Vitamin A helps with cell differentiation, meaning it helps cells change their composition so they can each have different functions like hair growth or body growth.

In the reproductive system, Vitamin A helps with the production of sperm in men and fertilization in women as well as fetal development during pregnancy.

Vitamin A is important to the immune system (Stephensen, 2001). It assists innate immunity (the kind your born with) by allowing for the development of mucosal barriers and allow cells to work properly. In adaptive immunity it plays a role in developing T helper cells and B cell. A example of adaptive immunity would be developing antibodies after chicken pox exposure – you weren’t born with the chicken pox or the immune cells, but you adapted to the infection and developed them.

Vitamin D is best known for assisting with calcium absorption and helping keep bones strong. It also assists calcium with muscle contraction by allowing calcium to flow into muscle cells. If calcium levels are too low, normal contraction and relaxation can be inhibited with can lead to both skeletal muscle and cardiac muscle issues (Thompson & Manore, 2015). Vitamin D can help with the reduction of inflammation.

We can obtain Vitamin D when sunlight triggers synthesis in our skin (Office of Dietary Supplements, 2018). Individuals who live in regions that experience more darkness may not obtain enough through sunlight, but can obtain Vitamin D through food and if necessary through supplementation – but we’ll get to supplementation later.

Vitamin E is a name for a group of compounds with antioxidant properties.  Antioxidants protect cells from the effects of free radicals, which can lead to the development of cardiovascular disease and cancer (Office of Dietary Supplements, 2018). A free radical is an uncharged molecule and is highly reactive (Timberlake, 2018). Free radicals can be introduced to the body from the environment such as air pollution or ultraviolet radiation from the sun.

Vitamin E also works in the immune system and impacts T helper cells.

Vitamin K is less known, but not any less important. Similar to Vitamin E, Vitamin K is a name for a group of compounds that assist the body with blood clotting and bone metabolism (bone remodeling and growth). Healthy functioning individuals don’t typically need to worry about Vitamin K. However, individuals who take anticoagulants or have bleeding disorders will have Vitamin K levels assessed regularly to determine the need for supplementation.

The amount of Vitamin K recommended is so small that most diets in the United States meet minimum needs through diet (Office of Dietary Supplements, 2018). Vitamin K isn’t typically used in supplement form like other vitamins because the need is so small. In the case of individuals who have disorders that prevent proper absorption, a doctor may recommend a specific dosage.

Supplementation?

So, while deficiency and toxicity aren’t common, they can happen.

Toxicity is most common through supplementation, which is why it’s important to be careful when deciding to add a fat soluble supplement to your routine. While it may seem silly to consult your doctor on something of this nature, a quick phone call could assist with preliminary direction. Proper blood work will be able to assist in guiding the conversation.

A study published in 2015 examining adverse effects of supplementation found that supplements in general were the cause of over 23,000 emergency room visits per year (Geller, Shehab et al). The study was conducted over a 10-year period and researchers “defined “dietary supplements” as herbal or complementary products, and vitamin or amino acid micronutrients.”

A large concern with supplementation is toxicity, but quality of product and claims should also be on your radar.

Poor quality could lead to adverse effects and false claims can encourage individuals take products they don’t actually need. Supplements also are more likely to have a higher chance to interacting with prescription medications.

You will notice that labels on supplements ranging from vitamins and minerals to protein will say “these statements have not been evaluated by the Food and Drug Administration.” At the top of the latest consumer report on dietary supplements from the FDA, you will find the statement “The U.S. Food and Drug Administration (FDA) does not have the authority to review dietary supplement products for safety and effectiveness before they are marketed.”

I think this approach protects the FDA and doesn’t fully look out for the consumer. They do have marketing regulations, which sets a baseline, but it also shows the holes and what companies are able to get away with too.

According to the NIH, it is the responsibility of manufacturers to have evidence of label claims, but they don’t need to provide them to the FDA prior to products going to market. Once on the market, these products will be monitored. A good example of product monitoring, while not vitamins – the protein claims for the Lenny and Larry Complete Cookies were found to be false. The cookies had varied amounts of protein, mostly under the claims. This led to the reformulation of the cookies. While this is an example of a food item, it’s also used for protein supplementation and can be found in health stores.

What foods can they be found in?

All of the these vitamins can be found through a diverse diet and since they can be stored in fatty tissue they don’t necessarily need to be consumed daily. Below are a few examples of foods that have these vitamins – it’s possible that you’re getting enough of them already.

fat vitamins

But what if my app tells me to?

Something to be mindful of – tracking applications. For those who track their food with a phone application like My Fitness Pal, be mindful of the information those applications report to you. The daily values (DV) are based on a 2,000 calorie diet and don’t always self-adjust to the calorie goals for individuals. Since there can be variance in the foods found in the database, they might not be 100% accurate. Lastly, deficiency and toxicity may happen over time, so if you believe you’re low or high with consumption of a vitamin one day, you may balance it out another day. Don’t supplement just because “My Fitness Pal told you to.” It’s a helpful tool for macronutrients, fiber and sodium, but I don’t believe the vitamin and other mineral amounts need to be monitored with it unless stated by a doctor.

While vitamins don’t work to provide you energy, they assist in the hundreds of reactions to keep you going allowing macronutrients to be broken down and utilized effectively.

Next time, we’ll talk about water soluble vitamins, what they do and where they can be found.

 

❤ Cristina

 

References

Geller, M.D., A. I., Shehab, Pharm D., MPH, N., Weidle, Pharm. D., N. J., & Lovegrove, MPH, M. C. (2015). Emergency Department Visits for Adverse Events Related to Dietary Supplements. The New England Journal of Medicine, 373:1531-1540.

Office of Dietary Supplements. (2018, March 2). Strengthening Knowledge and Understanding of Dietary Supplements. Retrieved from Naational Institutes of Health: https://ods.od.nih.gov/factsheets/VitaminK-HealthProfessional/

Office of Dietary Supplements. (2018, March 2). Strengthening Knowledge and Understanding of Dietary Supplements. Retrieved from National Institues of Health: https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/

Office of Dietary Supplements. (2018, March 2). Strengthening Knowledge and Understanding of Dietary Supplments. Retrieved from National Institutes of Health: https://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/#h7

Stephensen, C. (2001). Vitamin A, infection, and immune function. Annual Review of Nutrition, 21:167-92.

Thompson, J., & Manore, M. (2015). Nutrition: An Applied Approach. San Francisco: Pearson Education.

Timberlake, Karen. (2018). Chemistry: An introduction to general, organic and biological chemistry. New York: Pearson.

U.S. Food & Drug Administration. (2017). Dietary Supplements. Washington, DC: FDA.

Wellness Refocused Education: Protein and Amino Acids

We’ve talked about fats and carbohydrates (part 1 and part 2) already, but what about protein?

Like the other macronutrients, protein can be misunderstood.

Like dietary fat, I’ve heard from people including trainers that protein can make you fat if you consume too much. Let’s be clear – too many calories can lead to fat gain, not necessarily any one specific macronutrient. However, with that in mind, we need to be thoughtful about what is paired together with protein as well as how protein is utilized in the body. Is eating a whole egg really a problem, or is it that many people won’t just eat one or two yolks, but will pair the meal with buttered toast, multiple pieces of fatty bacon and top it all with salt? While these components may not always be the “healthiest” choice, individually they can be fine in moderation, but together – it’s like a league of villains, or can be if they are consumed too often.

Ok, so what is protein?

Chemically, protein is a polypeptide of 50 or more amino acids that have biological activity. Protein is found in our DNA, which means it is found in our muscle mass, blood, bones and skin. “They function in metabolism, immunity, fluid balance, and nutrient transport, and in certain circumstance they can provide energy (Timberlake, Karen, 2018).”

Nutritionally, we know that one gram of protein has four calories associated with it. We know that protein needs are lower in comparison to carbohydrates and fats because the body utilizes carbohydrates as a first line of energy followed by fat (Thompson & Manore, 2015). This doesn’t mean that protein isn’t important. Dietary protein helps us conduct daily business. It helps the body to function without depleting protein found in the body (i.e. muscle mass).

But, you can consume too much protein and we will get to that, but first some background.

In chemistry, protein is called a polypeptide, which a chain of amino acids.

Amino acids are called building blocks because they are single units that bond together to make protein.

There are 20 amino acids found in our bodies (Timberlake, Karen, 2018). We can make 11 of them, but there’s another nine that we need to get with our diet. Amino acids that must be consumed are called essential amino acids. They’re essential because without them our bodies can’t make other proteins for other body functions like neurotransmitters. The 11 amino acids we can make are called nonessential amino acids.

  1. Alanine
  2. Arginine
  3. Asparagine
  4. Aspartate
  5. Cysteine
  6. Glutamate
  7. Glutamine
  8. Glycine
  9. Histidine*
  10. Isoleucine*
  11. Leucine*
  12. Lysine*
  13. Methionine*
  14. Phenylalanine*
  15. Proline
  16. Serine
  17. Threonine*
  18. Tryptophan*
  19. Tyrosine
  20. Valine*

*essential amino acids

I’m sure many of you have heard of BCAA’s or branched chain amino acids. You’ve probably seen them in the store in a pill or powdered form. Simply, these are specific amino acids that have a branch. They can assist in decreasing protein synthesis, which means they can help prevent muscle breakdown and losses, however, there isn’t much research the proves this to be true or consistent (Wolfe, 2017). There are three BCAA’s out of the nine essential amino acids: leucine, isoleucine and valine.

I’ve heard people say that amino acids are inferior to protein. You can’t confused BCAA’s with all amino acids. I would say that drinking or consuming a BCAA if you recognize deficits or holes in your nutrition can be helpful, however, I would recommend that you eat a complete protein rather than drink amino acids or a protein shake. But – remember, it’s also about preference too – drinking BCAA’s won’t hurt you and some people just like protein shakes. I’ve tried BCAA’s, but I never noticed a difference and that could be because of dietary diversity even when in a caloric deficit.

Moving on.

So an amino acid is equal to a single unit, protein is equal to many units of amino acids. As you can imagine, there are many combinations of amino acids and the combination determines the function of the protein in our bodies.

Here are some things in our bodies made up of amino acids:

  • endorphins
  • hemoglobin
  • collagen
  • insulin
  • enzymes
  • muscle

Above, I mentioned complete protein. A complete protein has all of the essential amino acids in it.

Examples of complete proteins:

  • egg whites
  • meat
  • poultry
  • fish
  • milk

An incomplete protein lacks one or more essential amino acids.

Examples of incomplete proteins:

  • corn – missing lysine and tryptophan
  • beans – missing methionine and tryptophan
  • almonds and walnuts – missing lysine and tryptophan
  • peas and peanuts – missing methionine
  •  wheat, rice and oats – missing lysine

Dietary protein helps us build our bodies (Thompson & Manore, 2015). Our bodies are resilient and function smartly. When protein is broken down in the body, the amino acids are recycled into new proteins. Like mentioned above, protein helps with hormone balance, fluid and electrolyte balance, repairs our bodies and helps us grow, but as an energy source our needs are pretty low. This is due in part because we recycle amino acids because our bodies don’t have a “specialized storage form” of protein.

So how much should you eat?

At one point, the recommended daily allowance (RDA) suggested .8g per kilogram body weight per day for both inactive and active individuals. However, more research has shown that individuals who are active may need more. The ranges should vary based on a number of factors such as gender, age, size, but also the kind of activity you do, which is where I slightly disagree with the 2010 Dietary Guidelines for Americans. A 2009 review of these guidelines determined the following concepts:

  1. protein is a critical part of the adult diet
  2. protein needs are proportional to body weight; NOT energy intake
  3. adult protein utilization is a function of intake at individual meals
  4. most adults benefit from protein intakes above the minimum RDA

They examined current perceptions about protein as well as benefits to treat and prevent obesity since 35.7% of U.S. adults were considered obese and 16.9% of U.S. children and adolescents were obese at the time of the review. The most recent NHANES data from 2013-2014 shows that 38% of adults are obese with 19% of children and adolescents being obese. A major flaw pointed out by this review highlighted the proportion of protein to carbohydrates and fats may be adequate with high energy consumption, but that as “total daily energy intake is often below 1400 kcal/day” when individuals seek to lose weight it could be potentially harmful to limit protein needs to the RDA as a loss in lean muscle mass could result (Layman, 2009).

In 2011, a study looking at required and optimal amounts of dietary protein for athletes found that while the RDA was .8g per kilogram, it was would be appropriate for athletes, both endurance (distance runners) and strength (bodybuilding and weightlifting) to consume between 1.6 to 2.25 times the RDA or 1.2g to 1.8g per kilogram (Phillips & Van Loon, 2011). The study also suggested that protein consumption between 1.8 to 2.0 per kilogram could be helpful depending on caloric deficit for the preservation of lean muscle mass.

Now, remember this study looked at protein consumption for very active people.

If you’re sedentary, there’s no reason to consume as much as an athlete. If you are active, you may also need to consider how much potential lean muscle mass you have. If you’re overweight or obese, your protein needs may be less.

I formerly had a client who was consuming 1g per pound she weighed and it was over 200g of protein because a former coach had recommended it. She had an equal amount of protein to carbohydrates, which is a common calculation, but necessary.

A 1:1 ratio of protein to weight in pounds is a common suggestion and it’s one that I utilized when I first started tracking macros, but as I started looking at my specific goals and needs, I realized what I was consuming wasn’t helping me and I redistributed my nutrient goals.

While this client was very active and participated in weightlifting multiple times a week this 1:1 ratio of protein was inappropriate for her because it wasn’t taking into consideration lean mass, but instead overall mass. It also left her feeling bloated, hungry and often with disproportionate nutrients to be satisfied.

So what can happen if you consume too much protein?

There are a few health conditions that have raised concerns, but they may not impact everyone – there’s also some contradictory research and you need to figure out what side of the fence you’re on.

Concerns around heart disease and high protein consumption also involve high amounts of saturated fat found in animal products (Thompson & Manore, 2015).”. High saturated fat levels have been know to increase blood cholesterol levels and increase risk for heart disease. However, a moderate protein diet that is low in saturated fat can be good for the heart. Again, this is correlation, not necessarily causation.

Another concern is that excess protein found in the urine due to kidney impairment. “As a consequence, eating too much protein results in the removal and excretion of the nitrogen in the urine and the use of the remaining components for energy (Thompson & Manore, 2015).”

When protein is found in the urine it’s called proteinuria. As part of the body’s fitration system, kidneys remove waste from your blood, but allow nutrients like protein to return to the bloodstream to be recycled through the body. Protein in your urine can be a sign of impaired kidney function. It’s important to note there is no evidence that more protein causes kidney disease in healthy people that aren’t susceptible to the disease, however, more water should be consumed to flush out the kidneys because of protein metabolism (Thompson & Manore, 2015).

Bloating is also possible if “too much” protein is consumed in one meal and your body doesn’t produce enough enzymes to assist in digestion. Chemical protein digestion occurs in the small intestine as a result from the enzyme pepsin. “Too much” is relative. I get bloated if I have more than 40g of protein in a meal. Depending on planning I can prevent too much consumption, but that’s not always the case.

Like mentioned above, athlete and highly active individuals may need more than the RDA, but the average person may not need as much. Much recent research I found that examines the impacts of high protein consumption utilizes athletic bodies in high resistance training settings, which isn’t necessarily a sample that will provide data that can be used for recommendations for an inactive or lightly active person.

resistence training and protein

The data is still interesting, but may not be helpful to the average person.

When I did find research articles discussing higher protein needs in obese individuals, I found many studies designed diet plans for participants with sub-1000 kcal/day. This is an extreme diet that may not typically be suggested for one to conduct without being monitored. An example of this extreme design is a study published in 2015 that examined normal protein intake versus high protein intake as well as carbohydrate reduction to determine success in weight loss and maintenance. Researchers assigned adult participants to 800 kcal/day for eight weeks and once participants had an 11 kg loss they randomly assigned them to a new plan with varying protein intake for six months. They found that individuals with higher protein intake were able to adhere to the plan, which not only resulted body fat losses, less inflammation and better blood lipid panels, but also were capable of maintaining losses. Researchers also suggested that less restrictive approaches also lead to higher adherence (Astrup, Raben, & Geiker, 2015).

Again, interesting, but this is an extreme that hopefully many won’t use or need.

What about if you eat too little?

While we don’t need as much protein for energy as many believe, we do need dietary protein to assist in building our bodies like mentioned above. Without dietary protein, our bodies breakdown stored protein i.e. muscle to be utilized to assist in daily functions such as creating amino acids. A true deficit of protein can result in a greater number of infections if the body is unable to produce enough antibodies. A true deficit occurs over time and in extreme circumstances; however, can be more likely if an individual is in a large caloric deficit.

So, easy question-  what food sources have protein in them?

 

Obviously meat is an excellent protein source, but there’s more than meat. Legumes like lentils, black beans and green peas as well as nuts have protein in them too. While oatmeal is a well-known grain, it also has about 5g of protein per half cup serving. Dairy, while also another carbohydrate source, is also an excellent source of protein and the mineral calcium – if you’re not lactose intolerant!

Vegetables that have protein in them that I recommend to clients who are trying to balance out density and volume in their eating include broccoli, Brussels sprouts and asparagus.

Like the other macronutrients, protein can be flexible within reason. Considering multiple factors to determine a specific plan for you will be key. It might take trial and error, it may also take some adjustments, but give yourself time.

Your nutrition should be specific to you and your goals. It should take all of you into consideration like have you approached menopause or had a hysterectomy? Hormones play a huge role in overall nutritional needs. What’s your sleep like? Are you on medications? What’s your stress like? Are you sitting more or less than before?

I know many of these questions can seem silly when posed, but they are important.

The body is a weird organism, just when we think we have it figured it out, it changes on us.

References:

Layman, D. K. (2009). Dietary Guidelines should reflect new understandings about adult protein needs. Nutrition and Metabolism, 6-12.

Phillips, S., & Van Loon, L. (2011). Dietary protein for athletes: from requirements to optimum adaptation. Journal of Sports Science, 29-38.

Thompson, J., & Manore, M. (2015). Nutrition: An Applied Approach. San Francisco: Pearson Education.

Timberlake, Karen. (2018). Amino Acids, Proteins and Enzymes. In K. Timberlake, Chemistry: An introduction to general, organic, and biological chemistry (pp. 548-583). New York: Pearson.

Wolfe, R. R. (2017). Branched-chain amino acids and muscle protein synthesis in humans: myth or reality? Journal of the International Society of Sports Nutrition, 14-30.

Day 24, Movie Quote 3: “Your Move Chief”

“Some people can’t believe in themselves until someone else believes in them first.”– Sean Maguire, from Good Will Hunting

I can be like this.

But,  it used to be worse.

I used to feel – I used to believe that I couldn’t do great things unless someone else saw it in me to. That kind of thinking got me no where. That kind of thinking caused me to set goals that never really were about me. I’m a little more risky with my goals now, but I still look on with caution at times.

I think we all need some kind of validation that we’re making the right moves.

I was driving in the car the other day and I had the radio on, which may seem like a normal thing. But sometime over the summer when I was figuring out my life for lack of a better phrase, I found myself stuck on sports talk radio. I know that’s really weird and JP doesn’t understand it either, but I found myself unable to change the radio station.  However, about a month ago, I started playing with the buttons to find something else.

Again, this is weird for many people, but to me it makes sense and for others with anxiety or trauma in their past, it’s going to make sense to. Voices that seemed calming for a few months with concepts that I had to focus on so I understood the discussion weren’t necessary anymore. I didn’t need to hear those specific voices over the airways any more to get through my drive.

So, I’m driving and I’m listening to the radio and the guest of a show talks about how when we are determined to achieve something we look forward at what is still yet to come. He said, it’s reasonable to reflect because we do need to think about where we came from sometimes.

He then continued to compare it to driving.

You drive by looking forward. Yes, you do use the rearview mirror or side mirrors to see what’s happening behind you, but if you continued to look that way the whole time you’d crash. He explained that to move forward you need to see straight ahead of you and with a wide windshield you can see so much more road than you do in the overhead mirror looking back.

I don’t know why, but this just clicked and then the skies open up and things felt good… no, not really, but it did click.

I didn’t think I would ever be here. I’ve said that before. But with the first week of classes behind me, I really never thought I would be here. When I started this degree, it was solely to be able to be more educated and better qualified to assist others.

I think experience is important. For me it was hard to listen to a doctor who had never been overweight or never struggled with their health in the ways I had. It was hard to connect with people that couldn’t empathize with me about how I saw or felt the world. I think experience is necessary to be able to see the world from multiple points of view, but I also believe you need education behind you to further that experience or provide some foundation.

I know people can be successful with one or the other, but for me, I want both because you don’t know what you don’t know until you learn what you didn’t know.

Thinking about the conversations in class and the state of affairs of healthcare and health education and stigma in general – I’m thinking more about population health. That’s what public health is anyway. I found it interesting because it intersects everything I practice and preach – mental and physical as well as how social relationships make an impact on both of those aspects of health. Population health asks how do we assist large groups of people, how do we to educate different populations at their level, how do we create an environment where people who want help can ask for it, how to provide resources and tools to prevent illness and disease.

I love working with clients on an individual level, but if there isn’t access to basic needs like healthy food options for the short term, they won’t be able to see how to create a plan for the long term.

It’s weird to say that coaching may never be full-time like I thought I wanted it to be, but I think that also means that there’s more possibilities than I imagined. I guess the road is wider and continues on.

I think working with individuals has shown me that I can teach, that I can make a difference in how someone sees themselves and therefore sets, works towards and achieves their goals. Going back to school has shown me that it can start with an interest and with hard work, it can become more than Googling research articles for fun.

We all have doubt.  I have doubt. But little things over time can help us change how we see ourselves and our abilities.

Week one of the spring semester done, fifteen more until graduation.

Let’s make some magic happen.

❤ Cristina

 

Life of A Fit College Student Series: Changing Mindset Doesn’t Mean You’re Doing Something Wrong

In 2016, I asked my friend Alicia to write about what it was like to be a college kid trying to be fit, and trying to figure out what health meant for her. She wrote three posts.

Her first post in her own series talked about her past and how she got to where she was. She discussed her own eating disorder, but that she didn’t even recognize the behavior as a problem. She mentions that even though she had been diagnosed, recovery had been brushed off by professionals and it was left up to her and her parents to determine the next steps without guidance.

Her second post talked about preparing for her junior year. Getting ready for the semester and how she was planning for it. She made some suggestions for others based on what worked for her.

In her third post, Alicia talked about mental health and school work and the transition of her boyfriend moving out of the state to head to graduate school while she was still in her undergraduate career. She talked about how even though she planned for the semester, she still found herself making new plans.

She says she’s not a great writer, but when we talk all I can think of is how her perspective is important, even when the conversation is all over the place. During a recent conversation I asked her to think about writing again. She’s a senior now and almost done with school. In the past year, the meaning of health has changed for her. Her thoughts about her career after school have changed. The way she talks about herself has changed.

Below is her fourth post.


I’m a busy person.

I am one of those people who cannot sit still, I have to keep myself busy, whether it is homework, lifting, cooking or working. I grew up in a family of workers. My mom works two jobs and my dad owns a business and works three part-time jobs.  I currently work three jobs and am a full-time undergraduate student. As you can see, I often barely have time to breathe. My mindset typically as a student is to do homework, go to work, get a workout in and strive to do the best that I can do.

When it comes time for a break from school, it is hard for me to deal with it. I do pick up more hours at my jobs, but I often come home and feel like I’m not being productive because I don’t have school work to do.

With having a month off of school for winter break, I found myself actually bored (I was shocked myself).  Realizing that I had so much time to do whatever I wanted was honestly very hard for me to grasp. I am a planner. I like to plan my days because it helps me not to feel rushed throughout the day especially if it is busy.  When I looked at my days and saw that I only had to work a 5 hour shift and nothing else, it was shocking. I never have time to myself, I don’t give myself even 10 minutes sometimes to sit down and reflect on the day, even though that is something that I like to do.

Shifting my mindset to not being busy is often very hard for me. I don’t go out much, I am very introverted, and that is one of the reasons that I work and stay busy with school work. While I was on my winter break I would  stay home typically with my dog #DogMomLife. I was able to give myself time to go to the gym because I had more than an hour. I didn’t have to worry about having to rush through a workout.

I had a week to myself where I worked a very little amount of hours and got to spend time with my boyfriend who was in from Connecticut.  For once, we got to enjoy time together and again, not feel rushed. There were days we got to spend the whole day together, not everyday because my work schedule, but it was still more than we’re used to.

Classes have just started and the realization that this is my last semester of my undergraduate career has finally set in and I’m having to shift my mindset again.

My mindset goes back to school comes first. I have to get back to being busy, to planning my days out in my planner, and trying not to be overwhelmed.  However, this semester – by planning my days out, I’ll make sure that I have at least a half hour to myself where I can go to the gym or just meditate.

Having a different mindset is not a bad thing, it doesn’t mean you’re doing something wrong. Changing mindset to fit your current life can spark your motivation, push you forward and help you reassess the direction you want to take.

 

Wellness Refocused Education: Fat and the Ketogenic Diet

For a long time there was a war on fat, like over 30 years long. I’ve talked a lot about the importance of reading labels and understanding what you’re consuming. Not necessarily saying no to the processed food, but understanding or knowing what is in it. Well, taking that a step further – we need to also understand that the guidelines that back those labels up are created by governing bodies that may or may not benefit by creating certain guidelines or encouraging certain studies.

I’m not saying that the FDA or USDA or other regulatory groups are bad, but I am saying that the information can be misleading or a generalization in some cases.

A good example: the nutrition label you see on your boxed and canned goods is based off of a 2,000 calorie diet. This means the percentage listed as daily value is based off of 2,000 calories, but you may not be eating 2,000 calories – you may be consuming more or less.

Another example: the most recent guidelines by the USDA have a caloric recommendation for individuals based on gender, age and activity level with all numbers being whole, round numbers. These numbers are only below 1,400 daily calories for children under the age of 6, sedentary males peak at 2,600 calories for a 19/20 year old with sedentary females peaking at 2,000 calories for ages 19-25 – individuals who are more active peaked calories up to 3,200 daily.  The guidelines state that the sample bodies used to determine were an average height and a “healthy” weight (page 77-78).

“For adults, the reference man is 5 feet 10 inches tall and weighs 154 pounds. The reference woman is 5 feet 4 inches tall and weighs 126 pounds.”

I’m 5’4″ and I weight about 138 pounds. I’m roughly 17% body fat, which is lean and considered athletic for a female. My measurements are small. I don’t fit the sample body. I also don’t know many “healthy” men that would fit this sample body either.

The first dietary guidelines were rolled out in the 1980s and at the time, the biggest concern was heart disease and heart attacks. Ultimately, the first guidelines recommended against all fat and foods that had cholesterol like red meat.  However, more research has shown that not all fats are created equal and that dietary fat is necessary for bodily function. In the most recent guidelines for 2015-2020, it’s stated that saturated fat consumption should be 10% or less of overall calories consumed (page 15 footnotes). It’s also recommended that you replace saturated fats with unsaturated fats.

Before we get ahead of ourselves, let’s talk about fats. Have you ever heard about triglycerides? It’s possible that your doctor has mentioned this term before when discussing blood work and overall health. These are the most common dietary fat we eat. This is also the form that fat is stored in our bodies.

The science of triglycerides

Triglycerides are a molecule consisting of 3 fatty acids attached to a 3 carbon glycerol backbone (Thompson & Manore, 2015). They are classified by their chain length (how many carbons are attached), their level of saturation (how much hydrogen is attached to each carbon) and their shape.

The first way to classify – chain length. The first thing we learned in biology is that structure determines function – if you have a wheel it can move things forward, right? It can’t make things fly. There are three chain lengths: short (6 or fewer carbon), medium (6 to 12 carbon) and long (14 or more carbon). The lengths determine the method of fat digestion and absorption as well as how the fat works within your body. As you imagine, the shorter the chain, the faster the digestion and absorption (Thompson & Manore, 2015).

Now, saturation level. What’s the difference between these two kind of fats?

The simple answer – saturated fatty acids have closely packed molecules because they lack a double bond that would “space” them out. This means they can solidify at room temperature, example: a jar of coconut oil. unsaturated fatty acids do have a double bond, which prevent them from solidifying at room temperature, example: olive oil (Reece, Taylor, Simon, Dickey, & Hogan, 2015).

Lastly, shape – the carbon molecules impact the shape. The lack of the double bond in saturated fat allows the chain to be straight and pack tightly together. The double bond in unsaturated fat prevents the chain from being straight and actually adds kinks, which makes them liquid at room temperature.

But what about  bottles of coconut oil at the store, how are those liquids? Coconut oil that is liquid at room temperature is manipulated during manufacturing. The removal of natural fatty acids that solidify allow liquid coconut oil to be just that. Lauric acid, the fatty acid in coconut oil known for its health benefits like being a germ killer, is actually removed in this process. This is because it’s melting point is over 100 degrees Fahrenheit. To read more about the production, safety and use of liquid coconut oil check out this article.

Coconut oil isn’t the only thing that is manipulated on the market. Unsaturated fats can also be manipulated by food manufacturing in a process called hydrogenation, which started in the early 1900s (Thompson & Manore, 2015). This process adds hydrogen molecules, which in unsaturated fats causes the double bonds to be partially or totally removed allowing the fat to become solid and store more easily for a longer period of time.

This is also where we get trans-fats, which actually is describing the double bonds in the molecule. This kind of fat is found mostly in foods that are manipulated, although a small amount of natural trans fatty acids are found in cow’s milk and meat.

Now that I’ve confused you, triglycerides do contain essential fatty acids that are important for health (Thompson & Manore, 2015). Essential fatty acids (EFA) are obtained from the foods we consume – our bodies cannot produce them. There are two groups of them: Omega-6 and Omega-3.

Omega-6 Fatty Acids have a double bond 6 carbons from the end (omega = end of the chain, 6 = number of bonds away from the end). Linoleic acid is an omega-6 that is essential for human health. This is found in vegetable and nut oils like peanut oil, sunflower oil, corn oil and soy.

Omega-3 Fatty Acids have a double bond 3 carbons from the end. Alpha-linolenic acid is the most common in our diets and primarily comes from plants like leafy greens, walnuts, flaxseeds.

Why are EFAs important?

They’re precursors to biological compounds found in every cell in the body that regulate cell function.

Why is fat in general important?Fat provides energy; it has 9 calories per gram, which makes it the most dense energy source. Our bodies use fat when we’re at rest and during physical activity.

  • Fat helps transport vitamins A, D, E and K throughout the body, which help regulate functions like calcium absorption and utilization, cell membrane protection, blood clotting, bone health and vision.
  • Fat regulates our hormone production and cell function. *
  • Fat contributes to satiety, which means we stop eating sooner and helps us feel full longer.

Fat Importance on Cell Function and Hormone Production

This is something I talk a lot about with my clients. Fat is important because of the reasons listed, but as someone who works predominately with women this is something I want to drive home with them. There’s no reason to fear dietary fat, but we do need to moderate it. Phospholipids are a major component of our cells (Reece, Taylor, Simon, Dickey, & Hogan, 2015). These are similar to fats, except they contain two fatty acids attached at the glycerol, not three. Steroids are hormones produced in the adrenal cortex, cortisol is an example of a steroid hormone, which regulates carbohydrate metabolism and provides an anti-inflammatory effect on the body.

Fat -loving and the Ketogenic Diet

As the war on fat has started to settle, the rise of high fat diets like the ketogenic diet have started to become increasingly popular for fat loss; however, this style diet isn’t for everyone and should be monitored because of other potential health outcomes.

So what is the ketogenic diet?In simple terms it’s a high fat, very low carbohydrate (~20g or less daily), moderate protein diet that has been utilized to help with refractory epilepsy since the 1920s (Gupta, et al., 2017). It’s especially helpful for children with epilepsy, but according to the Epilepsy Society, adults may also benefit from it. The ketogenic diet has also been found to assist with fat loss in individuals who are obese lose as well as help manage other disorders like polycystic ovarian syndrome (Gupta, et al., 2017). However, be reminded that less extreme diets that moderate calories will also result in fat loss as long as the individual adheres to it and a diet that moderates carbohydrate intake may also assist with PCOS.

So how does the ketogenic diet work?

Our bodies utilize carbohydrates that have been broken down to glucose as a main source of energy (Thompson & Manore, 2015). While our bodies also use fat as fuel, glucose is favorited by red blood cells, some nervous tissue and our brains for energy.

When we don’t take in enough carbohydrates…. let me pause…enough carbohydrates doesn’t mean hundreds of grams daily. Enough carbohydrates could be 100g a day depending on the age, gender and activity levels of the person. Ok continuing…our bodies start looking for another fuel source. In the process of ketosis, the liver converts fat into fatty acids and creates ketone bodies or ketones that will be utilized as fuel. These ketones are a natural appetite suppressant that can help control nutritional intake (Thompson & Manore, 2015).

What about the keto diet is beneficial to different populations?

The effects on the “central nervous system, cellular metabolism and metabolic pathways, have shown promising results in a variety of neurological disorders, traumatic brain injury, acne, cancers, and metabolic disorders (Gupta, et al., 2017).” “The ketogenic diet alters the energy metabolism in the brain, therefore altering brain excitability,” which impacts  how cells communicate with each other and regulate the CNS (Lee, 2012).

Is there one way to practice keto?

This is a tricky question. The classical diet of keto that is utilized with epilepsy patients suggests strict ratios of fat, carbohydrates and protein at every meal. It also includes little protein and carbohydrate because of the body’s ability to be “knocked out” of ketosis by too many of either.

The medium chain triglyceride (MCT) diet allows for a little more carbohydrates and protein. This version provides some flexibility and allows MCT oil to be used a supplement. Nutrients are also calculated by the percentage of calories for each group, meaning it’s not a specific number of grams, but a percentage of overall calories.

If keto can be helpful, why shouldn’t everyone utilize it?

A true ketosis diet should be monitored because of higher risks for other health concerns like osteoporosis (weak and brittle bones), hyperlipidemia (abnormally high fat in the blood), nephrolithiasis (kidney stones). Some of these health concerns can onset as we age, but nutritional deficiencies can increase risk. This means that supplementation is necessarily because there is a lack of diversity by lowering carbohydrate intake. This would be a recommendation for many people seeking fat loss with any diet – supplement appropriately.

The use of carbohydrates in our diets isn’t just for daily function like walking, talking and sitting; they’re also used for fuel during prolonged period of activity and protect again the use of stored protein as a fuel source  i.e. muscle loss (Thompson & Manore, 2015). When our bodies don’t have enough carbohydrates our bodies continue to find fuel sources, and while in a perfect world we imagine the body will find stored fat to utilize, it will also find stored protein. Not only does this result in muscle mass loss, but it can weaken our immune systems and prevent optimal function. However, this kind of loss can be associated with too little calorie intake because a nutrient group has be drastically decreased or eliminated.  

If ketone levels are too high the blood can become very acidic and can lead to ketoacidosis. This actually prevents optimal body function and ultimately can lead to damaged tissue.

Why don’t I believe the ketogenic diet should be prescribed to everyone?

My personal belief is that the ketogenic diet should be utilized for clinical conditions like epilepsy and other cognitive or metabolic disorders. I do believe that some people feel better on lower carbohydrates, but lower is relative.

I had a client who recognized she felt physically better on higher fat, moderate carbohydrate and protein. Her macros were 75F/100C/147P or 1,663 calories. Her goal was fat loss and this was a deficit for her. On days that she would run long distances (over 4 miles) she would increase her carbohydrates between 20-40g because it helped in those runs.

Yes, I eat processed food and things with real and artificial sweeteners in them, but I also know that’s not for everyone. I know not everyone can moderate these foods and that’s completely ok. I do believe that one way to work towards creating a healthier food plan is to examine the carbohydrates that are you taking in and how they make you feel. I ask my clients to do this often by making a list or notes when they recognize they feel bloated, jittery, exhausted, fatigued, etc.

Carbohydrates breakdown to sugars like stated above so in many cases they feel these things because of 1. too much sugar (real or added) 2. too many overall carbohydrates 3. the kind of carbohydrates they’re consuming (simple versus complex). I don’t think extremes need to be implemented to see change or progress unless specified by a physician.

Mentally, I think elimination diets that pull full groups of foods can be harmful over time to the relationship that we have with food. Creating a balance lifestyle also means enjoying foods that tastes good, but isn’t necessarily the greatest for us, but understanding that moderation is key. Eating out, attending and participating in parties and functions is a part of life and experience. While many suffer from auto immune disorders or illnesses that force them to create alternative eating styles to manage their health, many don’t need extreme measures.

Health coaches, lifestyle coaches, personal trainers, wellness coaches, etc. people assisting others like I do, should be encouraging individuals to bring in all their resources to find what ultimately works for them in a reasonable and safe way.

We shouldn’t fear fat in our diet, but we also shouldn’t fear other nutritional groups either – we just need to better understand them.

References

Epilepsy Society. (2016, March). Ketogenic Diet. Retrieved from Epilepsy Society: https://www.epilepsysociety.org.uk/ketogenic-diet#.WkzL6TdG1PY

Gupta, L., Khandelwal, D., Kalra, S., Gupta, P., Dutta, D., & Aggarwal, S. (2017). Ketogenic diet in endocrine disorders: Current perspectives. Journal of Postgraduate Medicine, 242-251.

Lee, M. (2012). The use of ketogenic diet in special situations: expanding use in intractable epilepsy and other neurologic disorders. Korean Journal of Pediatrics, 316-321.

Reece, J. B., Taylor, M. R., Simon, E. J., Dickey, J. L., & Hogan, K. (2015). Campbell Biology: Concepts and Connections. New York: Pearson Education.

Thompson, J., & Manore, M. (2015). Nutrition: An Applied Approach. San Francisco: Pearson Education.

Catching Up

It’s been about a month since I’ve written on here, but let’s be honest, that was a recipe – that’s not real writing.

I’ve said it before on Facebook more recently, but here as well – I write when I feel compelled. I write when I feel it’s the most beneficial to me. I feel like this is something I always write when I’m coming back after a hiatus of not writing as well. But sometimes I need the reminder of why I blog or why I don’t, and I think you do to.

This year has been all over the place. I think it started with adventure and a new high. A new direction, a path that I was excited to take and discover. I felt that I was going to learn more about myself and the biological world that I had barely scratched the surface of. I’m sure some of you sat there and thought, well damn her life’s a mess – I’m pretty sure I said that a few times from my living room floor.

Academically, I have pushed myself well out of my comfort zone. This pursuit started so I could better meet my clients needs. I had been asked many times to help with weightloss and meal planning, I had been asked to coach people to help them create a healthier lifestyle, but people were asking based on my experience alone. For me, that’s not enough. I don’t think you can just have an education, and I don’t think you can just have experience. You need to blend the two and be open minded to learn more and learn often.

I’ve taken some classes that are straightforward like anatomy and physiology, and I’ve taken some that are more fluid like nutrition and sociology.

With finals I started to feel slightly burnt out, but that’s normal after writing thousands of words, reading through dozens of studies, studying for hundreds of hours and filling up multiple notebooks. It doesn’t matter if you take one course or five courses – it’s brain power. Along with my classmates, I had been saying I was ready for this semester to be over, but I’m also so excited and ready for next semester.

My courses: medical microbiology, chemistry and epidemiology. Eleven credit hours. All in person. All night classes. There are going to be some long days because I still work three days a week in a doctor’s office. I will also be starting an internship.

I start an internship for my program that should last for at least half the year. It’ll total roughly 300 hours at least. it combines my love of health and education along with serving specific populations – in this case, children. I think if we start the conversation while their young and the parents are involved, then positive habits can be created and in a fun way that doesn’t make them seem so tedious and boring.

On the more personal end of things- yoga, lifting and running have helped me get back to feeling like I did before with my activity. I’m feeling good about the ratio of ass sitting to mobility. I’m physically feeling more comfortable in my skin and have been working on getting my strength back up. I know the upcoming semester will be a little more unique as far as scheduling because I will have some long days shifting from work to internship to class to coaching, but that’s part of goal development. At different times, some routines make sense and others don’t. I’ve gotten better at not fighting it, and going more with the flow.

Since October 1st, I’ve run 76.62 miles. Nothing ground breaking, but a lot more than I had been running earlier this year because it wasn’t necessary to my training and I didn’t feel it in my heart to do so.

Eating has been normal. Indulging in a lot of cocoa and some treats that are only available at this time of the year. However, I’m creating a balance. I’m making the decision to indulge versus mindlessly doing so or feeling guilty about it. Stress hasn’t felt out of control, aside from the standard academic stress – I’ve been meditating a little less than I was before, but I also don’t think that’s a bad thing. My meditations have also changed, which wasn’t something I was expecting.

It’s been three months since I’ve been off birth control and hormonally, I’ve noticed a lot of change. My anxiety is different, reactions to similar situations are a little different – I feel less wiped out and that has been the biggest change.

Sitting down writing this out is weird because in my head I think I want to share what my next steps are, but then part of me goes who cares?  That’s the honest truth. I’ve always had both thoughts in my head, but the one always overpowered the other. I think about what is different, and I think I finally realized the answer.

I want to help people and that’s not a bad thing, but it also means that I forgot I can help someone indirectly by sharing my perspective.

On Facebook, I’ve started to share more about my interest in public health, my investment in organizations on campus, what I’m writing and talking about in class, but I’m going to start doing that here too. Writing has never been something I felt like I had to do, it wasn’t something that was an outlet for me. After talking with friends and doing a few too many videos on Facebook, I’ve been missing it.

My goal is to be more active in writing because I do enjoy it, but I need to protect it so that it doesn’t feel like an emotional burden. Some part of me also believes that there are people who click on my posts to actually read them, not just skim them to see if I’ve fallen on my face. So there’s that – the indirect way to help someone else.

I’m not putting a schedule out there for writing, but my promise to myself is that I’m going to sit down more often. I have a few recipes in my drafts folder I’ve been meaning to finish as well. So that’s on my to do list during break.

I have a list of things I want to do over the break before the spring semester starts. There’s no penalty if things don’t get crossed off, but I have a wish list, but that’s for another conversation.

❤ Cristina

 

Take That Jump: the fall, bagels, leaving the summer behind

The fall semester starts in 9 days.

I’m feeling excited. I’m feeling anxious. I’m feeling relieved.

I’m excited about the fall because it means more flexibility. I know there are people who think this is a piece of cake, but remember the grass always seems greener on the other side – there are still things that aren’t all sunshine and daisies. I have a good balance of everything that is important: work, school, boyfriend and myself – not necessarily in that order and not always in the same order.

One thing that is hard for me is to sit still. I know I need to relax and give myself a break, but it’s really hard. I thrive on structure and being busy. This year has been a damn rollercoaster and it’s the most time I’ve ever had to myself.

While summer classes were very busy and left little wiggle room, since finishing them at the beginning of August, I have found myself with time to slow down if I choose too. That has been quite the challenge.

I think about the summer and my mind races – I don’t know where to start. This isn’t what I expected my summer to be, but that doesn’t mean it was bad.

I ate more than I intended, but I don’t really regret it. Yeah, I had days where I will look at JP and poke myself, but really, this was the first time I wasn’t saying ‘no’ or pushing back. I probably should’ve said no more than I did, but I’m moving on and you should too.

I’ve said before that you can a lot about a person through how they write during certain times. When it’s been rough it reflects in my writing, when it’s getting better it also reflects.

I look back at June 17th and a reread that post – found here. I agree with that Cristina. I shake my head with her because I still feel parts of her. The parts that are in disbelief that I ended up here, but sometimes I don’t even know where here is. I know that sounds confusing, but I think some of you can relate.

Sometimes when I think about my future I see one thing, but the reality becomes another. Each day brings something new and we should embrace it. Embrace the risk and see what happens – that’s the hippy side of my thinking. The other side of it is calculated, like, yes, of course you ended up here and if you turn this way you can take this path and if you turn this other way there’s another path. This summer I became better at blending these two thoughts. I don’t always need to be calculated and sometimes it’s just not going to happen.

Thinking about what I wrote in regard to balance in June – that Cristina needed a nap and a cup of tea, but she was trying her best. If only she knew what was in store during the cross city move. However, July was better and August even better as I crashed then got back up and found some kind of routine that I could make sense of. For the past five weeks I’ve had a solid workout schedule that makes me feel like I’m balancing fitness Cristina with all the other Cristina’s. We still have breakfast together, but on Sunday’s I lift while he stays in bed, however, he’s been going running while I go to the gym. On week days, I go to the gym when he leaves for work, so I have about an hour for my meals to settle – I’m not a fan of lifting on a full stomach, I definitely prefer fasted like I do on Sunday’s, but that’s just my preference.

Adding yoga a week and a half ago was a really good idea because I’m already feeling a difference in my back, so I’m alternating it with my lifting and running – still taking a rest day somewhere in the week…wherever it makes sense for that week.

I believe in bagels – you can read about that here. I believe in working hard for what you want. I believe in jumping and taking risks. I believe in making minimal excuses and breaking down barriers. I also believe that my grind is going to look different than the person beside me. It won’t always be understood and that’s ok.

I wrote less this summer because I didn’t feel I needed it like I have in the past. That is a risk for me. That is new. I’ve connected in other ways that were just, if not more, meaningful. However, it made me uncomfortable to feel like I couldn’t share my day. If you meet me in person, I won’t talk much until I am comfortable with you and then it’s going to be late nights with liter and a half bottles of wine. I think that’s what happened. I was so comfortable talking to a screen, forgetting that people are on the other side. This summer I relearned how to communicate in a way that I felt was safe. That meant more journaling and letting experience happen with maybe a photo or two to capture it. Below are some photos from this summer.

I’m taking my bagel philosophy and charging full on into September. We might not talk like we used to, but I can’t wait to take you with me.

❤ Cristina

 

Haymarket

Union Square at Boston Public Market

Boston PRIDE

Cupcakes

I lifted a little

Wedding fun

Brunching in Connecticut

Double Rainbow

Greek food downtown

We found the statues

We also found some burgers

Day trips to Vermont

Day drinking with the animals

Lemurs!

 

Take That Jump: Let’s Define: Success, Failure and Fear

Let’s define success.

We define our perfect world all the time, but is that what success actually looks like? Is that what success would feel like? Perfection?

For some, success means working out five days a week and eating on track every day. For others, it means being on time or early to everything they have scheduled. For most, it means never allowing or embracing the moments they fall short. Never allowing something to be misplaced. If a mistake is made they consider starting over and over and over until they just don’t start again.

We confuse success with perfection and we have every right to confuse the two. When we think about our goals, we see them in a perfect world scenario and we don’t want to think anything less. Society also tells us to not dream of anything less. When I speak to potential clients about their goals we talk in a perfect world scenario and as they become clients, I dive deeper. We talk about the perfect world, but I ask them what would make this week successful – is it really about checking everything off the list or is it about the attempts made? Is it about just getting out of bed on Tuesday or acknowledging when something isn’t working for them instead of just assuming they’re the failing piece of the puzzle?

I’ve worked really hard to allow myself to fall short or fail when seeking to accomplish my goals because I don’t believe it’s true failure when I can’t reach out further after exhausting myself. Failure is not  when you have to find a new route or seek a secondary solution. Failure is giving up completely. Failure is say I can’t when in reality there’s nothing stopping you, but yourself. I do think everyone has greatness in them, somewhere. I also think everyone’s greatness is different and is defined by some limitations whether physical or mental or pure lack of interest, but there’s something inside brewing. Remember greatness and limitless are two different things.

Most people I’ve talked to don’t talk about failure in this way, just like they don’t redefine success weekly or reevaluate their goals midweek when it seems a wrench has been thrown in. Many I’ve spoken with believe if they can’t accomplish the immediate task before them then they have failed. But the way I see it, they just didn’t find the right solution for them.

I define success by defining failure. I’m starting to define both by defining my fears.

I’ve been listening to a lot of TedTalks and podcasts from leadership to investigative journalism. It really depends on my mood. The TedTalks are more towards leadership and thought process. I want to watch a video and see the person’s body language; how they engage with an audience and the gestures they provide to the language they speak. Podcasts are more for running errands and hanging out around the apartment. Something to listen to casually, but not have to be glued to my television.

A recent TedTalk I watched was from Tim Ferriss called Why you should define your fears instead of your goals. We goal set to develop strategy to work towards growth, but rarely do we talk about our fears and how to overcome them in order to achieve new things, work towards the eventual goals that are being prevented from being a thought to begin with.

Ferriss shows the audience a model to evaluating and understanding your fears. After listening and then rereading the transcript it made sense. You need to start by listing your fears, so here are two of mine that I’ve been working on recently

  1. School – not being smart enough for the sciences in my program
  2. Utilizing medication over holistic approaches – the past few months have left me with chronic stress and hormonal imbalances related to anxiety

After listing them, you need to think about them long and hard, then define them. Ferriss says “you’re writing down all of the worst things you can imagine happening if you take that step”. He suggests that you should have 10 to 20 bullet points.

So let’s look at my first. School.

  1. I could fail a class
  2. If I fail a class, I would have to retake a class
  3. I would have to spend more time study than desired
  4. I’ll waste money if I’m not able to do well
  5. What if it takes longer than I have planned?
  6. What if I don’t fit in with my other classmates because of my background and previous education?
  7. What if an interest isn’t enough?
  8. What if others don’t understand why my degree is important to me?

Ok so, there’s 8, but you start to get the point.

I decided to go back to school because I don’t believe that just a certification gives someone the full understanding to help people with whatever the certification is. I think you need personal experience and a little more textbook knowledge. I have personal experience with my own health and fitness journey. I’ve tried a number of different approaches to nutrition and fitness. In my professional career, I did goal setting, strategy development and implementation in a fundraising setting, but those skills are transferable. The only thing I felt I was lacking was a formal education. I choose public health because it was well rounded from looking at the physical implications of health to psychological and social implications.

Before going back to school I contemplated the list above, but I never wrote it out. I thought about it alone, in my head. I talked it out with friends. JP and I had a number of conversations. I still talk about this list with friends even though I’m going through courses and I’m doing well because part of me is waiting for something to happen. I don’t really know what, but that’s where self doubt comes into play.

The next step is to “prevent”. Ferriss asks the audience to consider what you can do to prevent anything on the list from occurring or if not prevent, what could you do to minimize the probability.

So, school. To prevent failing I can make sure I’m studying and asking questions when I don’t understand the material. To prevent over studying and making myself feel wiped out I can look at my study habits and determine what is the best method to learn the information at hand. Every course may take a different strategy and in some cases, I might not be able to prevent over studying. I can re-evalaute my timeline periodically and check in with the academic support team to make sure that I’m on track for the timeline I have planned. Somethings are just out of my control because I can tell you now that most people ask me why I went back to school and don’t understand why I wouldn’t be satisfied with just the certification to be a personal trainer.

I want to make sure that I have a better understanding than what’s provided through the organizations that offer these certifications. There’s nothing wrong with them, but I also know that I don’t want to just provide someone with a workout plan. I want them to understand why they are executing it and I want to be able to dig a little deeper if we find that some methods don’t work. I want to find a solution for the individual, and I believe that having a more formal education will help give me a baseline to do that.

The fourth step in fear-setting, as Ferriss calls it, is to list out what you can do to “repair” if any of these do come fruition. If school takes a little longer then I just need to redetermine my timeline and understand that another degree is a lot, but worth it anyway. If I fail or do poorly in a class, I can retake it and yes, that would suck spending more money, but my prevention plan should’ve been better and this would be an opportunity to reevaluate…again.

After these steps, he asks the audience to consider the benefits of attempting to act upon these fears. He lists things like confidence, emotional growth, financial growth, etc.

Going back to school pushed me out of my comfort zone. Taking these courses is making me think in a new way and relearning how to learn material and study. The first section of anatomy and physiology started to connect the dots of the interdependence our organ systems have on each other. It reinforced what I knew about mental health and the mind – total body connection. It reinforced what I knew to be true about my own mental health and how hormone function greatly impacts more things than we ever consider. My courses on public health have pushed me to think about all parties involved and how the actions of one person have an immediate impact on their own life and the direct connections they have, but also the indirect connections they have on the world around them and visa versa. So even if I don’t get an A in every class, even though I want to strive for perfection in this case, I know that I’m still learning and challenging myself.  

Next, think about the cost of inaction. If you don’t do anything to chip away at these fears.

Honestly, if I hadn’t planned to go back to school, I wouldn’t be coaching right now. I wouldn’t be considering adding personal training to my resume and I wouldn’t be willing to connect with people in this way to support their journeys – whatever those may be.

I also wouldn’t have ever known if I can learn this way, understand this information and be able to assist people outside of sharing my journey. If I didn’t decide to go back to school and then act on that idea, I wouldn’t have been able to change career paths. Whether I go back to fundraising in a different area of the nonprofit sector or not, I’m no longer stuck on a path that was unfulfilling and causing me stress and anxiety. While there are new challenges, these challenges are less than those before.

So. moving on. Let’s think about our goals. Let’s define success and failure and be realistic with ourselves, but let’s also think about how our fears developed and what we can do to change them. We doubt ourselves a lot and when those around us place doubt on us, we continue to prevent ourselves from seeking our full potential.

Can you imagine what we could accomplish without doubt and fear?