Nielsen Integrative Nutrition LLC

Seasonal Affective Disorder (S.A.D.)

Seasonal Affective Disorder, sometimes referred to as the “winter blues,” is a reoccurring seasonal depressive disorder that results in feelings of sadness, lethargy and even overeating and chronic aches and pains.  Women are more likely to suffer from S.A.D. as are those living far from the equator, working in shift work, or who suffer from other mental illnesses [1].   If you feel you may be suffering from SAD follow this link to this seasonal pattern assessment questionnaire http://www.ubcmood.ca/sad/spaq-sad.pdf and be sure to follow up with a healthcare provider.

Well…that’s fine and dandy but what can you DO about this crummy feeling of your emotions being so connected to the weather?

Move to Aruba.  Easy peasy.

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However… if that that’s not realistic or feasible how about take back some control and give your body and brain a boost by supporting your neurotransmitters, hormones and vitamins that may be lacking during this gloomy time of year.  You can’t change the weather and if you’ve ever experienced any type of true depression you know that you can’t just “pull yourself up by your boot straps” or “smile through it.”

Melatonin: ….long pause.  I know you’re thinking: “Emily wait! I’m already tired and can’t get out of bed! Don’t make me sleepier!” Don’t leave me yet!  Melatonin supplementation has shown to be a valuable therapeutic treatment for SAD.  Those with diagnosed Seasonal Affective Disorder are more likely to overproduce melatonin causing daytime sleepiness and feelings of fatigue.  While it may seem counter-intuitive to take more melatonin studies have shown that actually taking 3mg of melatonin 45 minutes before bed will help regulate your sleep cycle and circadian rhythm, decreasing daytime production of the sleepy hormone [3].  Not all melatonin supplements are created equal so please don’t hit the Walmart and think it’s a bust if your melatonin supplement doesn’t make a positive impact.  I see SO many clients with altered digestion / absorption that I always prefer a liposomal or meltaway tab that is more directly assimilated via the mucous membrane in the mouth.  As for brands and sourcing, dosage and quantity…well that always depends on the individual.  Feel free to contact me with any questions regarding melatonin supplementation!

 

Vitamin D: I like never..ever..never ever never make sweeping nutrient recommendations because everyone is so different and their unique nutritional needs are their own and no one elses.  EXCEPT…maybe with Vitamin D.  olivier-fahrni-337130Vitamin D is a crucial part of overall health (like if you pubmed search “vitamin D” and “any disease ever” there is a correlation).  Not surprisingly low blood levels (below 30 ng/mL) have been correlated with increased risk of depression.  Because we get so much of our Vitamin D from the sun supplementing with Vitamin D may be highly effective for treatment and even prevention of SAD which is thought to be linked to decreased sun exposure.  Also if you live in above the 37 parallel in the US you just AREN’T getting enough D…even in the summer …to sustain you through the winter months or so says Harvard.  Because the quality and dosing of Vitamin D varies widely please see your nutritionist or healthcare provider for brand and dose recommendations.  I will you give you this if you’re not getting a little buzz of energy from your Vitamin D you’re probably taking the wrong one!  It needs to be bound to a fat source for absorption and the very best brands are in liquid form.

*You can over-supplement with Vitamin D so it’s best practice to have a healthcare professional help with dosing.

Nutrition: Eating as many fresh foods as you can during this season may help you trick your body in to thinking it’s summer!

Just kidding, that’s not a thing.

What is true is that fresh, colorful foods are higher in B-vitamins which correlates to increased energy and mood enhancement.  Fresh, whole foods also decrease inflammation which eases those aches and pains that are often associated with S.A.D.’s. Trying new things and having new experiences has also been shown to help hack the brain into forgetting about the doom and gloom that is trying to invade your normally happy hormone production.  (That IS a real thing).  So have you ever had a persimmon? Fresh pomegranate?  The apples this time a year may be mushy and have been in cold storage TOO long but the oranges are delightful!  Try something new from the store that appeals to your senses and let it feed your body and your soul.

 

Integrative Therapies:  Other therapies such as massage, counseling, and light therapy have all shown moderate to significant levels of effectiveness for treatment of SAD and are worth exploring [3].  Even moderate intensity exercise like yoga, walking (bonus points for getting outside…great research is emerging about earthing / grounding for increased health in everything from mood to cardiovascular health) for 30 minutes a day has been shown to significantly decrease feelings of depression and that foggy brain you feel as a result from the winter blues (1).  If you really want to set your circadian clock up right try to exercise at the same time each day!

You Aren’t Alone – So Don’t Try to “Go It Alone”

Seasonal Affective Disorder affects hundreds of thousands of indiviuals and even mild cases can make you vulnerable to significant depression [2].  Please, please, seek out a healthcare professional that you feel safe talking to if you feel you are suffering from symptoms of this disorder no matter how mild you feel they are.

 

Craft, L. L., & Perna, F. M. (2004). The Benefits of Exercise for the Clinically Depressed. Primary Care Companion to The Journal of Clinical Psychiatry6(3), 104–111.

Melrose, S. (2015). Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches. Depression Research and Treatment2015, 178564. http://doi.org/10.1155/2015/178564

Pizzorno, J. E., Murray, M. T., & Joiner-Bey, H. (2016). The clinician’s handbook of natural medicine. St. Loius, MO: Elsevier.

 

If you’re interested in which brands I typically recommend feel free to sign up for my online dispensary.  Do note that while you can shop for food, personal care items, and quality supplements you need to remember that just because a supplement is natural doesn’t mean it is safe or useful for you.  By signing up for an account with my dispensary you are agreeing that you will only buy personal care, food items or multivitamins / probiotics and may do so at your own discretion.  Any targeted supplement purchases for therapeutic treatment of a symptom or disease state MUST be approved by myself prior to purchase.  Disregarding this rule will result in your immediate removal from the platform.

 

Nutrition and NAFLD

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Nutrition and Poor Air Quality

As I write this the air quality outside has reached over 200 = “very unhealthy.”  Washington, Oregon, and Montana are all experiencing wide spread wildfires and my thoughts are with the men and women fighting fires and for the families whose homes are threatened.  Even for those of us that aren’t in the direct path of the fire we are still at risk due to the prolonged and worsening air quality.  Clean air, water and food are integral to our health and the excessive inflammation that is caused by even minimal exposure can have a significant effect on a person’s current and long term health.

Symptoms include but are not limited to:

While inflammation itself is NOT a bad thing, in this case we are talking about excessive inflammation that, if left unchecked, is often a root cause for significant health concerns down the road.

Even though you may think you are outside of the “at risk” group for poor air quality (children, elderly, asthmatics etc) new research in the field of nutrigenomics is finding that air pollution can affect genetic expression in individuals with certain gene mutations.  Unless you are an expert in the field of genetics you probably don’t know how your body is responding on a cellular level to the change in air quality.

While I could talk genetics and inflammation for days I would rather focus on the good and the change so here is the core of the problem:

Poor air quality ↑ inflammation

Inflammation ↑ oxidative stress

Oxidative stress = SUPER not awesome

Luckily there are a whole host of foods that can reduce inflammation and combat oxidative stress by reducing free radicals and thus permanent damage.  Here are a few of the targeted foods / nutrients I’m increasing in my family while we battle the poor air quality and why.

Broccoli:

We all know that to increase our health we should eat more green stuff.  For this list broccoli is winning the game with something called “sulforaphane.” Sulforaphane has been shown to reduce the inflammatory effects of oxidative stress by safely and effectively inducing mucosal enzyme expression in the upper airway (Reidl et al, 2009).  I often get asked how best to cook foods (or not cook them) to preserve nutrients.  Here is a great write up on the best way to exploit the sulforaphane in broccoli and not destroy it in the cooking process!

Omega 3’s:

A study was done to measure how omega 3 supplementation affected individuals exposed to a certain range of PM2.5 air quality and the adverse side affects associated with that level of exposure.  The study showed significant modulation of the biomarkers related to oxidative stress and inflammation caused by poor air quality with increased omega 3, particularly those that had fish oil as the form of omega 3 (Romieui et al, 2008).

Wild caught fish, nuts, and seeds as well as local fresh eggs can be excellent sources of omega 3’s.  For more info on foods, portion sizes and even some recipes with omega 3’s click here.

B Vitamins:

Man I love these guys.  Energy, metabolic functions, protective properties…they are real classy dudes.  Autonomic function and cardiovascular health are significantly affected by poor air quality and research shows that vitamin B supplementation not only has a protective affect on the body during exposure but even potentially a restorative affect as well (Zhong et al¸ 2017).  I often recommend a B-complex supplement for clients to restore their levels but here are some good food sources for the B’s with some recipes as well.

Antioxidants: 

Makes sense that to combat oxidative stress you would use “ANTI-oxidants.”  To date, several studies have suggested that some harmful effects of air pollution may be modified by intake of essential micronutrients such as vitamins C and E (Peter et al¸ 2015).  Click here for a rainbow smoothie recipe that is packed with phytonutrients and antioxidants to support a healthy inflammatory response and reduce the burden on your body that is caused by gross air!

References:
Péter, S., Holguin, F., Wood, L. G., Clougherty, J. E., Raederstorff, D., Antal, M., … Eggersdorfer, M. (2015). Nutritional Solutions to Reduce Risks of Negative Health Impacts of Air Pollution. Nutrients7(12), 10398–10416. http://doi.org/10.3390/nu7125539
Riedl MA, Saxon A, Diaz-Sanchez D. Oral sulforaphane increases Phase II antioxidant enzymes in the human upper airway. Clin Immunol. 2009 Mar;130(3):244-51. doi: 10.1016/j.clim.2008.10.007. Epub 2008 Nov 22. http://www.ncbi.nlm.nih.gov/pubmed/19028145
Romieu, I., Garcia-Esteban, R., Sunyer, J., Rios, C., Alcaraz-Zubeldia, M., Velasco, S. R., & Holguin, F. (2008). The Effect of Supplementation with Omega-3 Polyunsaturated Fatty Acids on Markers of Oxidative Stress in Elderly Exposed to PM2.5Environmental Health Perspectives116(9), 1237–1242. http://doi.org/10.1289/ehp.10578
Zhong, J., Trevisi, L., Urch, B., Lin, X., Speck, M., Coull, B. A., … Baccarelli, A. A. (2017). B-vitamin Supplementation Mitigates Effects of Fine Particles on Cardiac Autonomic Dysfunction and Inflammation: A Pilot Human Intervention Trial. Scientific Reports7, 45322. http://doi.org/10.1038/srep45322

FODMAPS and Irritable Bowel

Cranky guts

We’ve all had tummy trouble at one time or another but as of 2012 nearly 20% of the population could be aptly diagnosed with Irritable Bowel Syndrome and 1.35 billion dollars was spent that year on the condition in the U.S. (Magge & Lembo, 2012).  The standard American diet is perfectly suited to reducing immunity, degrading epithelial cell walls and promoting dysbiosis….so that’s awesome.  I get questions ALL the time about gut health, which is good since it’s my specialty, so for this blog I thought I’d focus on teaching a little bit about how FODMAP’s, probiotics and prebiotics affect inflammatory bowel diseases.

IBS

Irritable bowel symptoms vary from abdominal pain, altered bowel function and dyspepsia to anxiety and depression (Pizzorno, Murray, & Joiner-Bey, 2016).  While many therapeutic options are relevant in the integrative approach (addressing food intolerance, stress, sleep etc) something that gets brought up a lot is a low FODMAP diet to manage symptoms and heal the gut for clients with IBS.

FODMAPS

FODMAP’s (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) are short-chain carbohydrates that are osmotically active and produce hydrogen / carbon dioxide when fermented by intestinal bacteria (Pizzorno, Murray, & Joiner-Bey, 2016).  The production of these gases increases bloating and distension can also be related to water retention, especially in the small intestinal lumen, resulting from the osmotic effects of slow, small molecule absorption (Muir & Gibson, 2012). While the pathology of Irritable Bowel Syndrome isn’t fully understood, FODMAP’s can contribute to the visceral hypersensitivity, altered motility, abnormal colonic fermentation, and sugar malabsorption, which are usually present in IBS patients (Magge & Lembo, 2012).

Good vs Bad Bugs

Because many people with IBS may be suffering from dysbiosis of the gut microbiota, including location and variety of bacteria, increasing microbiome health is relevant for IBS patients.  Increasing microbiome diversity can be an effective treatment, along with supplements anda a low FODMAP diet, in preventing flares and improving gut health (Muir & Gibson, 2013).  The chronic inflammation, that is in part due to harmful microbiota, made me curious as to how much research has been done with probiotics and IBD (Lee et al, 2014).

Have you tried to “fix” your IBS and felt worse?

While simulating indigenous bacteria sounds like it would have a positive effect on bacterial imbalance, the research I found showed that the results were incredibility varied because many participants had to pull out of studies due to bloating and discomfort (Lee et al, 2014).  This is why individualized nutritional counseling is so integral to success for clients!!! No two people are the same!  Using strategic medicine, as Dr. Ben Lynch calls it, I can narrow down the therapeutic options to the interventions that are most likely to succeed and then use a little bit of trial and error to find the perfect diet and supplementation for each person so that they can thrive and not just survive

Don’t go away empty handed

Here’s a freebie for you if you want to do something TODAY to start feeling better:

While bone broth is usually my go to recommendation for digestive distress I had to think a little harder when I realized that the typical main ingredients I like to use (onion and garlic) are not on the approved list of low FODMAP foods.  Luckily you can still make a nutrient dense stock rich in glutamine and low in FODMAP’s by using this recipe.

Broth FODMAP

 

Bone Broth. (n.d.). Retrieved July 19, 2016, from http://www.la-bellavia.com/labellaviablogspotcom/2015/1/28/bone-broth
Lee, J., Allen, R., Ashley, S., Becker, S., Cummins, P., Gbadamosi, A., Gooding, O…Lomer, M. C. E.  (2014).  British Dietetic Association evidence-based guidelines for the dietary management of Crohn’s disease in adults.  Journal of Human Nutrition & Dietetics, 27(3),  207-218.
Magge, S., & Lembo, A. (2012). Low-FODMAP Diet for Treatment of Irritable Bowel Syndrome. Gastroenterology & Hepatology8(11), 739–745.
Muir, J. G., & Gibson, P. R. (2013). The Low FODMAP Diet for Treatment of Irritable Bowel Syndrome and Other Gastrointestinal Disorders.Gastroenterology & Hepatology9(7), 450–452.
Pizzorno, J. E., Murray, M. T., & Joiner-Bey, H. (2016). The clinician’s handbook of natural medicine. St. Loius, MO: Elsevier.
Slavin, Joanne.  (2013).  Fiber and Prebiotics:  Mechanisms and Health Benefits.  Nutrients, 5, 1417-1435.  doi: 10.3390/nu5041417

Welcome!

Having suffered for years with debilitating pain and fatigue while under the weight of dozens of prescription medications I found my health and healing through nutrition, nutrigenomics, gut healing and making small changes in my lifestyle.  This life altering experience has spurred me to want to become a conduit of education and counseling for others who need help on their wellness journey.    I have always gravitated towards “helping” professions but found myself ill-suited for nursing or elementary school teaching as I’m a pretty big wimp about blood and guts and am not a fan of boogers or whininess.  I settled on a degree in Sociology followed with minors in Spanish and Bilingual studies to pursue my second love, language.  Days before graduation from

university in 2006 my first son was born and I have been privileged to mostly be a stay at home mom to my four children for the last 11 years.  With a supportive spouse and strong social network of friends and family I embarked on the journey of combining my passions of nutrition and counseling to get my Master’s of Science degree in 2015 and am thrilled to be launching my career as a Certified Nutritionist both in a physical and virtual practice.

If you’re checking out this page you’ve caught on to the notion that maybe you could maybe feel better if you address your nutrition (spoiler alert: you’re on the right track!). But there is just SO MUCH information out there.  My goal is to help clients reach their goals by using an individualized and targeted approach based on their unique body, concerns and life situation.  I want to help you to increase your reliance so you can enjoy your life and reach your goals in the least invasive way possible. If you’ve tried every diet or protocol on the planet and still feel crummy, I’m truly sorry.  I have literally been there.  I spent thousands of dollars on supplements, doctors and tests before I figured out the correct path in my health journey.  Keep up the hope,

In Health,

Emily