Health is not the absence of sickness

I attended a semi-awkward family reunion this weekend.  Now most reunions are a little awkward.  When spending time with folks you usually only see once every year or so, it is guaranteed that you will answer the same question multiple times.  Usually, where do you live and what do you do?  Sometimes, are you married yet?  At my family reunions, this is exacerbated by the fact that my dad has 13 brothers and sisters - 5 full siblings, 5 step siblings and 3 half siblings - so there are usually people in attendance who I've either never met or haven't seen in 10 years.  So it isn't weird to meet someone new at a family reunion.

Lucky me, I get to introduce myself as the oldest daughter of Herbert and Theresa, who lives in Washington, DC and works as a registered dietitian nutritionist.

As soon as you tell someone that you are a dietitian, they immediately want to tell you all about their diet and ask you nutrition-related questions.

At my family reunion, the husband of my grandma's sister (I think), who I've never meet before, told me that he would be my "best customer" because he has a horrible diet.  He then proceeded to tell me that there is "nothing wrong with him."  When I suggested that he has good genes (to not get any illnesses despite having a horrible diet), he told me that he doesn't smoke nor drink.  When I asked about exercise, he told me that he doesn't exercise much because his knees hurt.  Then he showed me his varicose veins.

Two thoughts.

1. I am always a little unnerved when folks bear their skin to me, as if I were their primary care physician.  In addition to my great uncle-in-law, I also had a client show me all 14 of her tattoos.  Yikes!

2. Health is not just the absence of sickness.

I wish I had asked my great uncle-in-law how he defined "nothing is wrong with me."  I wish I had asked, "do you consider yourself healthy?" and "What does 'healthy' look like?"  Because, last time I checked, the definition of "nothing is wrong with me" does not include having sore joints (i.e. arthritis).

One of my goals in life is to help people to realize that health is not merely the absence of sickness; it is the feeling of vitality, it is the ability to move your body, it having a good quality of life where you can do all the activities that you love.

One of my other goals in life is to stop the progression of chronic disease before gross morphological changes occur within the body (e.g. cartilage wears away until bone grinds against bone) and, hopefully, reverse the damage so more folks can live healthier, happier, more productive and more enjoyable lives.

Starvation and the Appreciation of Food

I'm reading The True Story of Hansel and Gretel, a novel of war and survival written by Louise Murphy.  "In the last months of the Nazi occupation of Poland, two children are left by their father and stepmother to find safety in a dense forest...."  The book opens with descriptions of the children's deep hunger and the mind games they play to deal with the endless ache of an empty belly.

"He has save his spit for over an hour.  She had told him to think of biting into a lemon to make the spit flow, but he couldn't remember lemons.  He thought of vinegar.  His spit spurted and he had extra juice at the end of the swallow.  A mouthful of spit swallowed slowly was almost like drinking soup.  Hot soup with potatoes mashed into it.  He felt his stomach contract and willed it to stop aching."

Reading during my lunch break, I started thinking about how much more I would appreciate my food if I knew it was the only meal I could eat all day.  I tried to visualize how much more delicious my kale and quinoa salad would taste if it was the first meal I'd had for several days.  Having never experienced starvation, the imagery gave me pause.   I suddenly had greater appreciate for my meal.

It's been 75 years since the great depression of the 1930s, presumably the last time Americans felt severe deprivation.  Certainly there are food insecure families in America today, evidenced by the large number of children eating free and reduced-price school lunches.  However, I wonder if the lost of deep appreciation for sustenance by the population as a whole is a contributing factor to the obesity epidemic.  How much more slowly would we eat if we knew that supply was limited?  If we slowed down and really tasted our food, would the preservative-laced breads and inhumanly-raised meats still taste good to us?

Although many factors played a role in getting us where we are today, the weight of the nation, I believe that slowing down and taking the time to appreciate the food we eat may be one way to help us get out of it.

Healthy requires mindfulness and planning

I did not plan my meals well today.  As a result, I felt more tired, more irritable, and less focused than normal.  Which just fed into the downward spiral of frustration and lack of efficiency.

The poor choices started with breakfast.  Instead of following my usual morning routine, I got out of bed and went straight to work, replying to business emails.  While I did make time to prepare a delicious breakfast -- leftover Sweet Potato Hash with Lamb Sausage (recipe to follow) with egg-over-easy on top and a banana on the side -- I was not present when I ate it so was unable to absorb all the nutrients and did not eat enough.  While some folks over-eat when they're stressed, I tend to under-eat.

As I walked to my 10am accountant meeting, I could feel the tummy rumbles start.  After two hours of financial concentration, I was ready to be done thinking and ready to start eating.  Both desires collided when I passed a Chipotle on my way home.  Cheap calories, but not the best lunch choice on a low-exercise afternoon.

Unfocused and feeling scatter-brained, I spent a lot of time trying to do work this afternoon only to get frustrated at QuickBooks and at myself.  If it weren't for a call from my boyfriend, K, I may have never taken a break to eat dinner and go to yoga / rock climb this evening.

Even dietitians have off days.  Why?  Eating healthy requires mindfulness and planning; sometimes I fail to to prepare.  Being healthy requires making a good choice over and over and over again.  There have been many times recently when I am too tired to choose the better option (which usually requires more thought, time, or money).

To help me plan for the rest of the week I am going to write down everything in my house that is edible and plan out some meals.  I am doing this right now at 11pm on a Monday night.

Freezer:

• 1 Amy's frozen burrito
• 1 Ezekiel whole grain sprouted tortilla
• 1 loaf Ezekiel 4:9 bread
• 1 bag Alexia hash browns
• 1/2 bag frozen pineapple
• 1/2 bag mixed berries (rasp, black, blue)
• 1 quart homemade vegetable broth
• Copious amounts of nuts (almond, walnut, sunflower, pumpkin)
• 1 lb butter
• 1 lb shredded mozzarella
• 1/2 lb shrimp

Fridge:

• 1/2 carton of 2% milk
• 2 bottles of Kefir (plain & peach flavors)
• 1 cup homemade whipped cream
• 1 cup steamed broccoli
• 1 cup full-fat Greek yogurt
• 8 cups homemade sauerkraut
• Dozen eggs
• 1/2 cup leftover Sardine Olive Tapenade
• 1 cup lentil salad from SUNdeVich
• Lentils from Trader Joe's
• Arugula
• Baby kale
• 2 lbs carrots
• 4 stalks of celery
• 4 lemons
• 1 cup black beans
• 12 oz mushrooms (need to be cooked / eaten soon)
• Sriracha
• Mayonnaise
• Mustard
• Strawberry jam, 100% fruit
• Copious dressings
• Kalamata olives
• Capers
• Sun-dried tomatoes
• Soy sauce
• Bragg's liquid aminos
• Brown rice vinegar
• Fish sauce

Counter:

• 1 banana
• 4 Cara Cara oranges
• 2 tiny Empire apples
• 1 lime
• Ginger root
• 1 yellow onion
• 1 sweet potato (needs to be cooked / eaten)
• Head of garlic
• Chocolate covered almonds
• Seaweed snacks

Cupboards:

• Peanut butter
• Almond butter
• 2 cans pinto beans
• 1 can garbanzo beans
• 1 can black beans
• 1 can white kidney beans
• Amy's Thai Coconut soup
• Free range chicken and rice soup
• 1 can tuna
• 1 jar pizza sauce
• 1 box Horizon mac and cheese
• Copious amounts of dried lentils
• 1 quarts broth (vegetable & chicken)
• Jasmine rice
• Quinoa
• Wild rice
• Nutritional yeast
• BiPro 100% whey powder
• Unsweetened, dried coconut
• Raisins
• Dried cranberries
• Dates
• Sesame seeds
• Steel cut oats
• Old-fashioned oats
• Baking soda and powder
• Flours (whole wheat, all-purpose, brown rice and buckwheat)
• Sugars (white, brown)
• Honey
• Molassas
• Nestle Quik
• Unsweetened cocoa
• Luxardo cherries + Peychaud's bitters
• Ume plum vinegar
• Apple cider vinegar
• Balsamic vinegar
• Olive oil (extra virgin for salads, more processed version for cooking)
• Sesame oil
• Coconut oil
• Copious boxes of tea (mostly green & herbal, some black)
• Copious dried spices
• Salt and pepper

Meal ideas - breakfast

Smoothie w/ protein powder, banana, frozen fruit, almond butter

Egg-over-easy on top of sautéed kale (cooked w/garlic and onion) + Ezekiel toast w/peanut butter

Eggs scrambled with kale + hash browns + fruit

Oatmeal w/walnuts and dried fruit

Meal ideas - lunch

Amy's Thai Coconut soup + rice + shrimp

Tuna fish sandwich on Ezekiel + arugula

Arugula salad + pre-cooked lentils + walnuts + cranberries + homemade balsamic vinaigrette + sweet potato fries (cut into strips, coat with oil & salt, bake in oven)

Frozen burrito + side salad

Homemade burrito w/ leftover black beans, rice, cheese, Sriracha

Meal ideas - snacks

Smoothie w/ kale, ginger, lemon, celery, apple, protein powder

Cereal w/milk

Apple w/peanut butter

Walnut Energy Truffles (recipe to follow)

Homemade granola + yogurt

Meal ideas - dinner

Three bean soup w/onion, celery, carrot, beans (or lentils)

Buy some kind of meat + make some kind of grain + eat leftover broccoli and lentil salad

It seems like I may need to grocery shop for some additional dinner proteins, but I will probably be able to feed myself all meals prior using only ingredients in my house.  Woohoo!

Biking really fast

This past Thursday I joined local cyclists for sprint night down at Hains Point.  It was a beautiful evening, nearly 70 degrees F.  After biking with legs, sleeves, jackets and gloves for so long it felt surreal to shed all the layers and go out only in shorts and a short-sleeved jersey.

I wasn't the only one taking advantage of the weather.  Almost 50 people showed up to ride laps around the circular loop!  Included in the group were some of the most elite cyclists in the DC area, the 1s and 2s, which significantly turned up the heat of the ride.  Not only was the weather hot, but the ride was spicy, too!

Having joined sprint night one time before, I had a general idea of what to expect.  K and I warm up for a couple of laps and then join the group.  The group rides at a moderate pace toward to the point, usually in a tight pack.  To conserve energy, I tuck in behind someone with broad shoulders and draft.  Once the group rounds the corner, the ride turns into a mad sprint down the back side, with riders leaving the pack to make their move with a long string of riders trailing them.  Police officers sometimes sit at the end of the sprint side, making sure we all come to a complete stop at stop signs (there are 3), so the middle section is mandatorily slow.

When K brought me to sprint night two weeks ago, I was able to maintain contact the group by pushing my way toward the front during the "easy" sections and holding on as best I could through the "sprint" sections, usually ending up at the back of the pack.  I tried the same method last night but, despite my determination, legs pumping, lungs burning, eyes watering, I was incapable of keeping up with the group through the sprint or the easy sections.

Why?  A strong SW wind made it difficult to move forward during the "easy" sections and the leaders sprinted faster than I am capable of going on the back stretch.

The leaders of the group were 1s and 2s, which is short for Category 1 and Category 2 bikers.  Apparently, there are 5 categories of bike racing and 1 is the highest.  Even my friend C, an accomplished cyclist, had a difficult time keeping up.  On the last lap, he saw the leaders take off and asked himself "should I sprint?"  But when he looked at his speedometer, he was already riding at 34 mph!  So he stepped it up to 34.5 mph.

If the front guys were biking at 35 mph, K imagines that I must have been going at least 30 mph.  OMG, no wonder I felt like I was going to die!

Joining K for sprint night is such a novelty.  I am a novice female cyclist who, despite being in decent shape from climbing, running and yoga, lacks bike training.  Biking with the guys is like playing a game where I know that I cannot win.  While that may seem discouraging, I find it motivating and fun.  There is no pressure to succeed or win because no one expects that from me.  Without the external pressure or expectation to perform, I am allowed to push myself as hard (or  as little) as I want to, which usually means I push harder.  Since no one explains the rules, I am forced to figure out etiquette by paying attention to hand gestures, whistles, and pack formations.  This keeps me alert and engaged.  Indeed, the moment I get complacent on the bike, I fall out of formation, miss the sprint, and have to work extra hard to rejoin the group.

I am one of maybe three women who join the guys and certainly the only woman crazy enough to try and keep up with the leaders. When not pushing my limits to keep up, I find myself smiling or laughing during these experiences because I find the scenario amusing.  On one hand, I feel like I am getting away with something, like sneaking into a bar before you turn 21.  On the other hand, I know that I know that I stick out like a sore thumb.  I'm sure the male cyclists, with their matching team jerseys, look at me in my unbranded biking clothes and wonder "who is this girl?" as they whiz past me at 35 mph.  But I don't care.  Like being at a concert, I can feel the energy of the group and it motivates me to bike faster.  With enough training, maybe someday I will be able to keep up.

Can stress make me tired?

I've been feeling tired lately.  This seems weird to me because I've been sleeping at least 7 hours a night, usually 8 or 9.

Anytime I am not feeling 100%, I know that something in my life is "off."  It could be any number of factors, but the first thing I always suspect is my diet.  I worry that I am fatigued because my body is reacting to the foods I am eating in a negative way - either food sensitivities or too much inflammation in the body.  So, of course, the first plan I envision to "fix" my fatigue is to go on an elimination diet or an anti-inflammatory diet.

You know what they say: if all you have a is a hammer, every problem looks like a nail, haha. 

However, when I told this to my boyfriend, K, he shook his head at me (in a compassionate way) and suggested that, perhaps, the reason I am tired is because, even thought I am sleeping enough, I am still working long hours and I am too hard on myself.  So I thought about what he said...

• It's true that I was upset with myself last week when I failed to get out of bed at 7:30 each day, like I had planed (although I consistently rose by 8:30am, without alarm, each day) and because I didn't get as many items crossed of the "to do" list as I had hoped.
• It's also true that I have been focusing on elimination and anti-inflammatory diets a lot lately.
• My article on anti-inflammatory diets for rock climbers was published in the Sportrock Blog March 1, 2015.
• I am halfway through Michelle Babb's book Anti-inflammatory Eating Made Easy: 75 Recipes and Nutrition Plan.
• I am also studying to become a Certified LEAP Therapist (CLT), a program which focuses on eliminating foods, determined by MRT blood test, that cause an inflammatory response in the patient.

...and perhaps he is right.

I worked a staff shift at Sportrock tonight and had a blast.  I got to know co-workers, learned new behind-the-desk skills, I helped people, I sold a membership ($25 commission, yeah!) and I talked to some friends who came in to climb.  And I didn't feel tired once!  I even had enough energy when I clocked out at 9pm to go for a 5 mile run + stretching yoga + foam rolling!

Thinking more about what energizes me, I suspect that, although I am more of an introvert than an extrovert, I do need human interaction and external validation to feel my best.  Despite the low hourly wage, I will continue to work at Sportrock for opportunity for social interaction and immediate gratification.  It takes months to build a business, but only hours to memorize the directions to the gym and how much each membership costs.

I never considered how challenging it would be to go into private practice.  There are SO many tasks to complete when you are the only employee.  I play the role of founder, owner, CEO, CFO, secretary, insurance biller, bookkeeper, head of marketing and development, etc.  No wonder I am tired - I have to keep track of all of the details for all these positions and keep all the balls rolling in the right direction.  Phew, it's a mind workout for sure!

I am grateful for the the loving support of my friends and family (especially K) who prevent me from becoming a work-a-holic by asking me to hang out (climb, lunch, etc) and reminding me to take time for myself, too.

A Solution for Breakfast

I am almost never hungry when I first wake up.  I enjoy drinking tea, but solid food is just not that appetizing.  However, as someone who pays close attention to my body, I know that breakfast helps jump start my metabolism.  I also know that, if I don't eat, I will be *starving* by 10am.  Usually, I force myself to eat breakfast shortly after I wake up so I can make it until lunch, around noon, without eating.  Today, I did something different and it was *magical*.

I woke up at 7:30am and made myself a cup of green tea.  Instead of cooking breakfast, I cut up a kiwi and peeled a Cara Cara orange (citrus is currently in season) to nibble on.  As predicted, I was *ravenous* by 10am.  Thankfully, I am working from home today and was able to return to the kitchen and cook myself a full plate of sautéed baby kale, 2 eggs over easy, a slice of Canadian bacon, and a small stack of gluten-free pancakes with berries and full-fat yogurt on the side.  I *crushed* the food, enjoying every single bit with reckless abandon.

Today is a good food day.

look how yellow those yolks are!  Darker color = more nutrients :)

I love eggs over easy with the gooey center; it's like dressing for my kale!

When you can't climb, run!

Update: I didn't crush hard last Friday like I thought I would.  I actually felt pretty tired and ended up climbing easy and moderate routes.  The same thing happened this past Monday night; I led some 5.10s but struggled to climb 5.11s cleanly.  The mere thought of trying a 5.12 was laughable.  In fact, I'm still shaking my head about it.

I find that, as I get older, I need more rest time in between hard workouts.  This doesn't equate to rest days, per se, but instead requires staggering workouts to allow muscle groups more time to rest.  Although I have desire to climb three days a week every week, I think it might be better to limit to 2 days/week.  On the days when I am not climbing, I plan run, do yoga or strength training.

Thankfully, K had a work event on Wednesday which cinched my decision to give my fingers and shoulders break from climbing.  Instead, I went on a foggy afternoon run.  Starting around 3:30pm, I got in 6 miles and made it home before the rain started (which later turned into snow, shutting down the Federal gov't on Thursday).  Having run a total of 4 miles in the previous 3 weeks, my legs were super fresh and full of glycogen.  I felt so good that I surprised myself by running two 8-minute pace miles in the middle, which was very satisfying after so many weak-sauce climbing sessions.  Despite my ability to run a decent pace without much training, I can tell that I am out of running shape because my quads were sore next day.  Which, to be honest, only motivates me to want to run more and get back into running shape.

How to choose a grocery store: My thoughts on Trader Joe's and Whole Foods

Whenever I move to a new area, one of the first things I do is figure out where to purchase my groceries.  Factors that influence my decision include

• Distance from my house - How long does it take to get there by car? by bike? walking?
• Ease of use  - How big is the store? is it organized logically?
• Availability  - Do they stock the items I want to purchase?
• Quality - Does the produce look fresh?  do they offer grass-fed meat and dairy?  Pastured eggs?
• Price - How do the store's prices compare to nearby competitor prices?

Living near Old Town Alexandria, my favorite places to shop include Trader Joe's (612 N St. Asaph St) and Whole Foods (1700 Duke St).

I appreciate Trader Joe's for the excellent prices and ease of use.  Trader Joe's is a smaller store which requires less time to walk through.  If you know what you want, you can get in and get out very quickly.  Trader Joe's doesn't offer the variety of a bigger, conventional grocery stores but, for what they lack in variety, they make up for it in price.  A package of Gimme Organic seaweed snacks costs $1.99 at Whole Foods. Trader Joe's sells a similar product for $0.99.

Seaweed offers many healthful nutrients, including iodine, vitamin K, and calcium.

I shop at Trader Joe's for staple items like olive oil, canned beans, broth (vegetable, chicken), maple syrup, blue corn chips (so much lighter in texture and flavor than WF brand), regular cheese, bagged lettuce (my favorite is the Wild Arugula), bananas, organic carrots and celery, baby portobello mushrooms, precooked beets (so easy to add to salad), Applegate deli meat, hummus, and frozen fruit.

The high fat / medium protein + medium fiber / low sugar content
make these dark chocolate covered almonds a low glycemic snack

One downside to shopping at Trader Joe's is the temptation to try the plentiful processed or packaged foods such as their Triple Gingersnaps.  The only specialty item I allow myself to purchase is the Dark Belgian chocolate covered almonds, made with 73% Cacao and only six other ingredients (provides 5g protein, 5 g fiber, only 9 g sugar per 1/4 cup serving).  The other downside is how crazy busy it gets during rush hour.  I will NEVER choose to shop at Trader Joe's on a Sunday (10am - 4pm) or right after work (i.e weekdays around 5pm).

I might shop at Trader Joe's exclusively if they didn't have such a limited selection.  When I go grocery shopping, I usually have to make two stops - one at Trader Joe's and a second at Whole Foods.

Whole Foods offers a high-quality shopping experience - from the handsome store layout to the thoughtful consideration they put into procurement of each and every one of their offerings.  Many complain that Whole Foods is expensive - but you get a hassle-free environment offering a wide selection of quality foods.  As an example, Whole Foods is the only place I can find Snowville Creamery milk.  Reading the label, this milk comes from grass grazed cows fed only non-GMO feed & forage.

According to Jennifer Adler in her new book Passionate Nutrition: A Guide to Using Food as Medicine fro a Nutritionist Who Healed Herself From the Inside Out (Sasquatch Books, 2014), "because of bioaccumulation, or the accumulation of a substance in a living organism, organic meat and dairy give you the biggest bang for your buck.  Over its lifetime, a 1,000 pound cow consumes far more pesticides (which are added to its feed) than a carrot or strawberry would be capable of absorbing.  A study in Israel found that when people consumed organic meat and dairy, they reduced their exposure to certain estrogen-related pesticides by 98 percent."

Whole foods is my favorite place to purchase meats, dairy, eggs, and seafood because it is easy to find options that are grass-fed, pastured and wild caught.  I also tend to buy fresh produce items like apples, ginger, kale and broccolini (a.k.a. tender baby broccoli) because it is likely to be local and/or fresher.

Flax, Chia and Hemp - what is the difference?

A doctor friend of mine asked for advice about changing up his morning smoothie recipe.  He currently uses almond milk, banana, spinach or kale, and ground flax seed.  He asked what I thought about chia and hemp seeds.  Here is my reply.

Aside from dark green leafy vegetables, seeds are one of the most nutritious foods humans eat.  The seed provides all the building blocks necessary to generate a brand new baby plant - so it makes sense that seeds are packed with healthy fats, digestible proteins, vitamins, minerals and fiber.  Eating seeds contributes to a healthy diet - but each type has a slightly different nutrient composition.

Per 1 tablespoon, flaxseeds contain 1.9 g protein, 2.8 g fiber and 2.96 g polyunsaturated fatty acids (PUFA).

In contrast, 1 tablespoon chia seeds contain 1.7 g protein, 3.5 g fiber and 2.74 g PUFA.  Hemp seeds contain 3.3 g protein, 1 g fiber and 3.3 g PUFA.

Note: The nutrients listed for flax and chia can be found on the USDA Nutrient Database.  Not surprisingly, hemp seeds are not included in the USDA Nutrient Database, so I used the Nutrition Facts panel on a sample of Manitoba Harvest Hemp Hearts instead.

If your goal is to get more protein, hempseeds are a better choice than flax or chia.

If you goal is to get more fiber, chia seeds win.

If your goal is omega-3 fatty acids, both flax and chia are better than hemp - as they have more ALA (an omega-3 fatty acid) and a better w6:w3 ratio (read: more anti-inflammatory).

Food	Serving Size	ALA (% of FA)	LA (% of FA)	Ratio of w6:w3	ALA (g/serving)
Chia seeds	2 T/30 ml (20 g)	61	20	0.33:1	4
Flaxseed oil	1 T/15 ml (14g)	57	16	0.28:1	7.8
Flaxseeds, ground	2 T/30 ml (14 g)	57	16	0.28:1	3.2
Flaxseeds, whole	2 T/30 ml (20.6 g)	57	16	0.28:1	4.8
Greens, mixed	1 C/250 ml (50-60 g)	56	11	0.19:1	0.1
Hempseed oil	1 T/15 ml (14 g)	20	61	3:1	2.8
Hempseeds	2 T/30 ml (20 g)	20	61	3:1	1.2
Walnuts (English)	1/4 C/60 ml (28 g)	14	58	4:1	2.6

Table from an article in Today's Dietitian (Feb 2010).

Certainties in Life: death, taxes and change

Benjamin Franklin once said "In this world, nothing can be said to be certain except death and taxes."  While I agree with Mr. Franklin, I would like to add change to the list of certainties.

Nothing in nature remains static.  We live in a world of cycles.  The sun rises and sets, the seasons change, and even the temperature fluctuates within seasons.  Take the recent weather in Washington, DC as an example.

Silly me, I failed to snap a picture last night.
Thank you http://www.houseofhawthornes.com/ for the photo.

Over the weekend, the weather was dry and sunny on Saturday followed by freezing rain on Sunday that left the world bathed in a thin layer of ice.  Beautiful to behold but not so beautiful for travel, it resulted in yet another 2-hour delay for most of the working world this morning.  Fast forward several hours and the temperature is now 43 degrees with sunshine and blue skies.  A symptom of global warming, we've been experiencing some erratic weather patterns this winter.

Some of my friends complain that they are sick of winter and wish spring were here already.  But what I think they are missing is an appreciation for the present.  Yes, perhaps we've been hit with cold weather nearly every weekend so far this year (2015), which limits the ability to go for long bike rides or travel to Chinese New Years parties, but we've also had some unseasonably warmer days, too.

Instead of getting stuck in the rut of thinking that the weekend is the only time to play, consider being spontaneous and adventurous during the work week too!  Take advantage of of the "warmer" winter days and go for a walk during your lunch break.  Or perhaps sneak out of work 15 minutes early so you can go for a quick run before the sun sets and the temperatures drop back down to freezing.  The world is full of possibility - you just have to keep your eyes open and look for it!

If you don't like the weather today, just wait until tomorrow.  There is a good chance it will be different.

The importance of listening to your body

I've started climbing more often since resigning from my corporate travel job.  Instead of just climbing on Mondays and Fridays, I'm climbing most Wednesdays, too.

Climbing was awesome for the six weeks of 2015.  K and I started doing 4 x 4 workouts again (A 4 x 4 is where you choose 4 routes and climb each one 4 times in a row).   When we weren't doing laps, we were projecting difficult routes.  We'd get to the gym at 5:30 and stay until 8:30 or 9pm.  Eventually, I improved enough to climb a straight-wall 5.12minus cleanly!  Two weeks later, I climbed it four times in a row without falling!  I felt amazingly in shape.

But eventually, the repetitive stress caught up with me.

Last Monday (2/16), I met K at the gym at 5:30pm.  Like usual, we started warming up on 5.8s and 5.9s but I quickly realized that something was "off" in my left shoulder.  My back muscles (rhomboids and serratus anterior) were so tight that it was affecting enervation of the shoulder joint.  It felt like only 50% of my shoulder muscles were working properly.  Any time I reached my left arm out and pulled my body toward the wall (a move I had done over and over and over again on the 5.12minus the previous week), I felt a strain in my deltoids as they overcompensated.

Not wanting to injury my already over-worked muscles, I backed off and climbed 5.8s for the rest of the night.   I listened to my body and took it easy on Wednesday 2/18 and Friday 2/20, too.  On the nutrition side of things, I added extra anti-inflammatory foods to my diet to help calm down the inflammation in my over-worked shoulder muscles.  I stretched and did gentle yoga.

Although frustrating, the rest paid off.  Now, two weeks later, I am beginning to like normal.  I'm headed to the gym in 30 minutes and I can't wait to get back on those 12s!

Modern Reiki Principles

During my dietetic internship, I spent my elective rotation at the George Washington Center for Integrative Medicine (CIM).  Having worked as a student clinician at the Bastyr Center for Natural Health (BCNH), coordinating care with other health care providers, I was curious to experience another integrative medicine facility.  I wondered if integrative care in the nation's capitol would be different than integrative care on the west coast (Bastyr is located in Seattle, WA).  

While it is obvious that DC lacks the "earth mamma energy" of the west, the services provided by CIM were no different than at the BCNH.  In addition to naturopathic medicine, acupuncture and herbal medicine, I was also introduced to the healing art of Reiki.  On this Mindful Monday, I would like to share with you the modern Reiki principles.

Just for today, I will not worry.

Just for today, I will not anger.

Today, I will live honestly.

Just for today, I will respect the oneness of all life.

Just for today, I will be kind to everyone I meet.

Just for today, I will show gratitude to all living things.

How do I fit in exercise?

Every week I get five glorious days to do as much work on my private practice as I want before I "have" to take a break and enjoy the weekend.  I know this may sound backwards (most people hurry to "get through" the work week so they can relax and enjoy their weekend), but this is how I've been living the past 2 months.  No joke.

After working a corporate travel job for nearly two years, I am super excited to be my own boss, set my own hours and make all the decisions.  What most people don't tell you about entrepreneurial ventures is that you end up working way harder for yourself than you would ever work for your employer.  The reason I work so much harder is because I am *passionate* about what I do and am truly excited to help my clients lead healthier, happier, more satisfying lives!

My poor boyfriend can attest to much time I've spent getting everything set up so I can start seeing clients.  I would probably be even more of a work-a-holic if he wasn't around to convince me to take a break and spend time with him on the weekends.  Below is a picture of what we did last weekend.

Using a Tyrolean Traverse to cross the river and get to the climbing area on the other side!

That being said, I think the the most challenging part of self-employment is making the time to feed my body three solid meals each day and exercise at least 3 days a week.  Here are the techniques I've been using to help me "fit in" exercise (I will discuss food another day).

• Set a schedule.  My boyfriend and I rock climb on Monday, Wednesday and Friday nights (or at least 2 out of the 3).  This has been the default for so long that instead of calling to schedule a climbing session, we usually only touch base if we need to cancel.
• Friendly motivation and accountability.  Last weekend I woke up at 6:30am in order to drive 3 hours to Franklin, WV to rock climb outside with a group of friends.  I would have never done this on my own volition but, because three others were riding in my car, I rallied and sacrificed my sleep to make the adventure happen.
• Seize the moment.  Today is a gorgeously sunny day in the Washington DC metro area, the kind of day that just demands to be taken advantage of.  I haven't gotten outside for a run in what feels like forever so today I am treating myself with a mid-afternoon exercise break.
• Try something new.  In the past 2 months, I added acro yoga back into my repertoire of activities.  A good friend of mine introduced me to acro when we lived together back in 2010.  He now lives in California but, every time he's in town, we get together to "fly" and "base" -- which, of course, inspires me to share the love.   I got my boyfriend into acro and we usually play around with balance poses after our weekly yoga on Tuesday night.
• Find an activity you like and look forward to!

February 7 (Franklin, WV): south-facing crag = warm enough to climb shirtless!

Where has Adair been? (Planning an Editorial Calendar)

In the past month I have written a business plan, created a website, obtained a domain-specific email address, planned a marketing strategy, became a provider with an insurance company, learned how to submit claims, found an accountant, set up my books, started filing by 2013 taxes...and completely neglected by blog!

Fear not, faithful readers, I have a new plan!

To keep you informed and updated on a regular basis, I am going to implement an Editorial Calendar.  I am going to pick three themes and write personal stories about them on the same day each week.  Unless I think of better names, these themes will be:

• Mindful Mondays - thoughts and suggestions for living a more present and joyful life
• Wednesdays with Integrity - ideas for food planning, purchase, prep and presentation
• Fitness Fridays - sharing of activities I enjoy and ways to "fit" exercise into a busy life

Moving forward, this blog will be written in the first person, using a lot of "I," "my," and "we."

For those who like science and other factual information, please visit my NEW blog.  As part of my burgeoning nutrition practice, I plan to archive recommendations about specific dietary interventions, diagnostic testing options, and other "How To" and "Should I...?" articles on my business website.

In addition, every time I read an interesting newspaper article or recent scientific study, I am going to post it to my business Facebook page - so check there for good information, too!

Gluten Freedom: my thoughts on the book

I just finished reading Dr. Alessio Fasano's book, Gluten Freedom, and it is amazing!  Definitely a must-read for any clinician who works with patients suffering from digestive, dermatological, neurological conditions or for anyone who is a patient and thinks they might have a gluten-related condition.  It is especially helpful for anyone whose doctor has ever said "it's all in your head"!

The leading expert in gluten-related disorders, Dr. Fasano tells the history of celiac disease, explains the improvements in diagnostic methods throughout the years, and also covers the spectrum of non-celiac, gluten-related disorders, including wheat allergy (think hives and difficulty breathing) and the more recently accepted non-celiac gluten sensitivity (NCGS) - which is a real condition!  He uses friendly analogies to explain scientific concepts and includes multiple real-patient stories to help illustrate key points, both of which make the book fun and easy to read.

I read the book Wheat Belly last fall and, although I enjoyed the facts Dr. William Davis provided, I didn't agree with his point of view that everyone should avoid high-yield, semidwarf wheat.  Indeed, there are scientist who believe that gluten is toxic for humankind and everyone should follow a gluten-free diet. While there is some evidence to support this -- for example, it is true that no one is able to completely digest the protein gluten and that that fragments of undigested gluten peptides can make the intestines leak, attract immune cells into the intestines causing inflammation, or kill cells -- it doesn't make sense that a food that humans have been eating for thousands of years is the root of all disease.

Zonulin and Its Regulation of Intestinal Barrier Function:
The Biological Door to Inflammation, Autoimmunity, and Cancer
Read the study here

Although Dr. Fasano has contributed to the above discoveries about gluten, he does not share the same position.  Instead, he writes that "we engage daily in a ware with many dangerous bacteria but rarely do we lose this battle, which is an event that leads to infection.  We are also engaged in daily confrontation with gluten, but only a minority of us will lose this battle.  These are the genetically susceptible individuals who will develop gluten-related disorders."

My own beliefs align more closely with those of Dr. Fasano, that only genetically susceptible individuals need to follow a gluten-free diet.  Instead of silver bullets and one-size-fits-all approaches, it is my opinion that practicing personalized medicine is the best way to help clients achieve health.  How do you know if you need to follow a gluten-free diet?  Learn more here!

Perhaps my favorite part of the book is near the end when Dr. Fasano gives an overview of the human genome project ("genomics") - how many scientists thought that cracking the code would help us better understand and eradicate human disease...until we realized that humans actually have way fewer genes than originally expected...so we focused on "proteomics," which also failed to answer our complex questions about health.... so we eventually turned to "microbiomics."

Ultimately, he hypothesizes that humankind is made up of two genomes - the human genome and our individual microbiome, which is expressed by the trillion of bacteria that live on and in us.  He advocates for vaginal birth (the best way to inoculate baby with a healthy dose of probiotics) and concludes by saying "In my opinion, the result of this interplay between the human genome and the human microbiome ultimately holds the key to the answer of how to maintain the yin and yang between health and disease."

Check out this NPR story - Finally, a map of all the microbes on your body

It is obvious that Dr. Fasano has spent his life dedicated to "increasing the awareness of celiac disease in order to provide better care, better quality of life, and more adequate support for the celiac disease community," -- the paramount goal of the Center for Celiac Research, which he founded in 1996.  When treating his first patients, Dr. Fasano asked them to write down their top three wishes in regard to celiac disease.  Here are the "Aladdin's lamp" wishes:

1. A treatment alternative to the gluten-free diet
2. Improving their quality of life by educating physicians about celiac disease and by providing more palatable gluten-free food
3. A way to avoid the cumbersome intestinal biopsy as a necessary step to diagnose celiac disease, especial for children.

Nearly 20 years later, almost all three wishes have been granted.

This book inspires me to finally choose ONE thing to focus on and become an expert at something, just as Dr. Fasano has become an expert on celiac disease and gluten-related disorders.  It also reminds me how much I love the mystery of the gut - this black box where food goes in one end, waste comes out the other, and exactly what happens in between is largely unknown.  If I had to bet, I would bet that the next big discovery in health and medicine has to do with the microbiome.  I just hope that I can be a part of it!

Should I follow a Gluten Free diet?

There is currently a lot of confusion around gluten.  Due to increasing availability of gluten-free products as well as coverage in the media, more and more people are choosing to follow a "gluten-free" diet.  What amazes (and worries) me is that some folks adopt this diet without even knowing what gluten is!

What is gluten?
Gluten is the general name for proteins, gliadin and glutenin, found in the cereal grains wheat, rye, barley and triticale that makes bread dough elastic enough to rise, giving it that light and fluffy texture (read more here).

This picture came from grist.org (follow link above)

Who should avoid gluten? 
People who have celiac disease, an autoimmune disorder that affects approximately 1 in 100 people, must avoid gluten because ingestion of gluten leads to damage in the small intestine.  Left untreated, celiac disease can cause serious health problems such as vitamin and mineral deficiencies (including anemia), early onset osteoporosis, infertility, and gastrointestinal cancers (read more about celiac disease at The Celiac Disease Foundation).  Until new treatments are approved (e.g. Lazarotide acetate), people diagnosed with celiac disease must follow a gluten-free diet to remain healthy.

What about the other 99%?
Although many people claim to feel better when they follow a gluten-free diet, the scientific community is still conflicted as to whether individuals without celiac disease might benefit from a gluten free diet.

Some scientists, like Dr. William Davis, believe that gluten is toxic for humankind and everyone should follow a gluten-free diet.  There is some evidence to support this.  For example, it is true that no one is able to completely digest gluten.  It is also true that fragments of undigested gluten peptides can make the intestines leak, attract immune cells into the intestine causing inflammation, or kill cells.

Zonulin and Its Regulation of Intestinal Barrier Function:
The Biological Door to Inflammation, Autoimmunity, and Cancer
Read the study here

However, according to Dr. Alessio Fasano, the leading expert in gluten-related disorders, "we engage daily in a war with many dangerous bacteria but rarely do we lose this battle, which is an event that leads to infection.  We are also engaged in daily confrontation with gluten, but only a minority of us will lose this battle.  These are the genetically susceptible individuals who will develop gluten-related disorders."

Who are these genetically susceptible individuals?
In addition to celiac disease, there exist spectrum of non-celiac, gluten-related disorders, including well-known wheat allergy (think hives and difficulty breathing) and the more recently accepted non-celiac gluten sensitivity (NCGS) - which is a real condition!

How do I know if I have gluten sensitivity?
While there are several diagnostic tests for celiac disease -- including elevated levels of tissue transglutaminase (tTG), the presence of genetic markers HLA-DQ2 or -DQ8 and, of course, the "gold standard" intestinal biopsy -- a biomarker for gluten sensitivity has not yet been found.  However, researchers at the Center for Celiac Research are working hard to identify one!  I am excited for this!  Once a biological marker is discovered, we will be able to measure levels in the body, making it much easier to figure out whether or not insidious symptoms like gas, bloating, muscle aches and brain fog are being caused by gluten!

What the heck are FODMAPS?
The tricky thing is that sometimes gastrointestinal (GI) distress is caused by the ingestion of FODMAPs. FODMAP stands for Fermentable Oligo-saccharides, Di-saccharides, Mono-saccharides, and Polyols. These sugars, when poorly absorbed, draw water into the intestines (diarrhea) and feed colonic bacteria (resulting in gas and bloating). While glutenous foods are a type of FODMAP (i.e. they contain oligo-saccharides), there exist many other foods that may be contributing to GI discomfort if you are sensitive to FODMAPs. This is a new area of research, but I do my best to explain it here (link coming soon!).

Which condition do I have?

The best way to determine if a gluten-free diet is appropriate for you is to see your doctor or dietitian nutritionist.  Before you change your diet, it is imperative to get tested to rule out celiac disease.  Once you stop eating gluten, your body no longer produces the biomarkers (i.e. tTG, villous atrophy) needed to diagnose the disease.  If your doctor is not up-to-date on the latest gluten-related research, recommend that he or she read the book Gluten Freedom by Dr. Alessio Fasano and/or the book released by The Mayo Clinic this past November called Mayo Clinic Going Gluten Free, which provides the checklist* for diagnosing non-celiac gluten sensitivity.
*checklist available in New York Times article, here

My own beliefs align more closely with those of Dr. Fasano, that only genetically susceptible individuals need to follow a gluten-free diet.  Instead of silver bullets and one-size-fits-all approaches, it is my opinion that practicing personalized medicine - which considered genetics (fixed), microbiomics (modifiable) and environmental factors (culture) - is the best way to help clients achieve health.

I just finished reading Dr. Fasano's book, Gluten Freedom, and it is amazing!  Read my review here.