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Daily Habits of a Chiropractor

Ever wonder what your doctor does to stay healthy? Here’s a little glimpse into the musculoskeletal routine of yours truly (with some added info about my significant other, Dr. Dan, also a chiropractor whose routine I’m privy to).

Make Sleep a Priority

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For the House of Cards enthusiasts…

Bedtime is early, and almost the same time each night, with some weekend variation. I demand a lot of my body daily between my workouts and my line of work, and sleep is when our bodies do damage control–clean up waste products and heal damaged and worn tissue. People underestimate the necessity of sleep. In my life, it is non-negotiable. Social excursions, housework, and even gym time comes second to sleep. Compared with my more sleepless adolescent and college years, I am less groggy and have more energy to get everything done during the day.

Limber Up

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For the Zombieland enthusiasts…

Before I begin my workouts, after work in the evening, and at night time before bed I spend about five minutes moving my body in a functional and therapeutic way. Before workouts, I “limber up” by doing the movements I expect to do in my workout in a slow and controlled fashion without weight. After work I move in ways that stretch out tight areas from the day. At night before bed I concentrate on putting my neck, back, hips, and shoulders through their full ranges of motion.  Three times a day for a total of 15 minutes I move my body therapeutically. Side note: Dr. Dan also has his own movement routines, which involve foam rolling and self-spinal decompression. Our dog thinks we’re crazy when we’re on the floor stretching and rolling before bed.

Stay on top of Proper Posture

Dr. Dan’s advice to his patients while driving in the car: set your rearview mirror to be only visible when you are sitting up tall with proper posture. Try putting a mirror at your desk if you work a desk job–somewhere that you can see and catch yourself when you’re slumping. Use your pain as an indicator–when you start to feel sore and achy after sitting for too long, that is your body’s reminder to straighten up. Remember, the more you practice good posture, the easier it gets.

Move Often, and Move Well

There is never a day that I spend laying around the house. To stay on the move, even when there is nothing to do, I like to clean the house. Even if the house is already spotless, I find something to work on for a few hours–organizing closets and cupboards, scrubbing floor boards, weeding the yard–and while I do this, I make sure my back is in the right position, my core is tight, and I’m moving in a way that will only help, not hurt me. If cleaning isn’t your thing, even just going for a walk around your yard or neighborhood is just as good. Don’t let a day go by that you don’t move your body in some challenging way.

What daily routines do you have to stay healthy? Your body is like a machine–it needs regular maintenance and good daily practice.

 

Nutritional Priorities

IMG_0690The scenario: an overweight patient comes to the office looking to lose 20lbs by the summer.

The conversation:

Me: “What are you doing now to help you lose weight?”

Patient: “Well I’ve been trying to get only gluten-free stuff at the grocery store, and I’d eat more organic if I could, but it’s expensive.”

The problem: unless this patient is gluten sensitive (they weren’t), they don’t need to be avoiding gluten. Gluten-free does not equate to “healthier,” and it will not aid in weight loss. Similarly, eating organic will also not aid in weight loss. This patient’s nutritional priorities are out of whack.

The solution:

First, identify the issue. Next, identify the goal. Now we need a road map to get there, and you’ll need to sort out what kind of nutritional information is relevant to you and your issues. Here is the cliff notes version for a number of common issues that walk into our office:

Weight loss – Higher calorie foods will work against your goals, so choose foods that are inherently lower in calories: any kind of vegetable, berries, lean meats, no beverages except for water, and smaller portions are your priorities.

Fatigue – The cause of your fatigue will dictate the kind of nutritional support you need. Is it from anemia? Eat red meats, spinach, possibly an iron or B-vitamin supplement. Is it from insomnia? Timing of foods and carbs vs. fats and proteins are your nutritional priorities.

Autoimmune diseases – This one is tricky, and depending on the disease (MS, type I diabetes, rheumatoid arthritis, etc.), different dietary restrictions may be suggested, and yes that may include gluten-free foods. Your nutritional priorities are to avoid trigger foods, and incorporate foods that promote anti-inflammation.

Dyslipidemias – High cholesterol and triglycerides in the blood are often a liver problem in response to poor diet or other disease processes. I rarely recommend my patients eat a low cholesterol or low fat diet, as that common recommendation is now irrelevant (6, 7). Instead, your nutritional priorities would be to remove the metabolic and inflammatory strain on your body (remove sugars, refined carbohydrates) and support the liver’s normal processes (plenty of vegetables, teas, water).

FAQs

Should I be eating gluten-free? Only if you are gluten-sensitive, or dealing with a health problem that may be impacted by a food sensitivity.

When should I eat organic foods? Although organic foods do contain less pesticides than conventional produce, eating organic is expensive, and because of that, usually falls lower on the priority list. There is some evidence to suggest that organic foods are more nutrient-dense (1, 2), but there is a lack of evidence to suggest that eating conventional produce contributes to disease. Eat organic when you have a budget for it, and try to follow the Dirty Dozen/Clean Fifteen when you can’t. If nothing else, at least wash your produce well with soap and water.

What about genetically modified (GM) foods? This topic is still up for debate and way more in depth than the scope of this post. There is evidence that GM foods may contribute to food allergies, but long-term comprehensive human studies still need to verify this speculation (3). In the meantime, just eat whole, real foods.

Should I be eating a low-carb diet? If you’re trying to achieve specific results, sure–it is helpful for weight loss and type II diabetes, metabolic syndrome, and dyslipidemias. For some people, however, a low-carb diet may not be ideal and must be tried with caution, as some side effects may occur. If your lifestyle is very active, you may find a low-carb diet should not be a priority, and instead eating healthy complex carbohydrates provide you with more benefit.

What supplements do I need to be taking? Supplements are used to bridge gaps in your regular diet, or to provide support for a specific bodily process. You’ll need to assess your current diet and health, identify your goals, and decide which supplements will best serve you.

How am I supposed to know what my nutritional priorities are? Find a nutritionist and go through the process with them–what is the health issue, what is the goal, and how do you get there. Make sure you understand why you’re being recommended certain things, and what their health effects should be.

 

References:

1. Evaluation of the Micronutrient Composition of Plant Foods Produced by Organic and Conventional Agricultural Methods. (2011) D Hunter, M Foster, JO McArthur, R Ojha, P Petocz, and S Samman. Crit Rev in Food Science & Nutr. 51(6).

2. Organic Foods: Health and Environmental Advantages and Disadvantages. (2012) J Forman, J Silverstein. Pediatrics. 130(5): e1406-e1415.

3. Genetically modified foods: safety, risks, and public concerns–a review. (2013) AS Bawa, KR Anilakumar. J Food Sci Technol. 50(6): 1035-1046.

4. Clinical and laboratory investigation of allergy to genetically modified foods. (2003) JA Bernstein, IL Bernstein, L Bucchini, LR Goldman, RG Hamilton, S Lehrer, C Rubin, HA Sampson. Environ Health Perspect. 111(8): 1114-1121.

5. Dyslipidemias and statins: from guidelines to clinical practice. An updated review of the literature. (2014) T Lucchi, C Vergani. G Ital Cardiol. 15(3): 149-160.

6. The U.S. government is poised to withdraw longstanding warnings about cholesterol. P Whoriskey. The Washington Post. Feb 10 2015. Accessed Feb 18, 2015. http://www.washingtonpost.com/blogs/wonkblog/wp/2015/02/10/feds-poised-to-withdraw-longstanding-warnings-about-dietary-cholesterol/

 

Add a Shot of Nutrients to Any Meal

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I’m a little biased–I love eggs, partly because I have laying hens. But mostly because they’re delicious and infinitely versatile.

What’s in an egg?

Eggs contain an egg white and egg yolk. The egg white is albumen, nature’s “perfect protein.” This protein contains all the protein building blocks required for our bodies. The nutrients in this part of the egg are water soluble and will contain B-vitamins and some trace minerals.

Egg yolks are mostly fat, with some protein and a little bit of carbohydrate. The majority of fats in egg yolk are oleic acids (omega-9s, the same that are found abundantly in avocados and olives), but also contain omega-3s and -6s, saturated fats, and cholesterol. Vitamins A, E, D, and K are found here, as well as minerals like selenium, iron, and copper.

Eggs are pretty nutritious even conventionally produced, but if you are eating eggs from hens that are allowed to forage on grassy pastures, your egg will contain twice as much vitamin E and omega-3 fats and 38% more vitamin A per egg (1). Like vitamins and fats, minerals such as zinc, chromium, selenium, and manganese are all found in higher quantities in birds allowed access to pasture (2).

Add eggs to literally anything

This list is by no means complete, but gives you some good jumping off points.

– A fried egg over literally almost anything is delicious. My favorite dishes to put a fried egg over include: lentils, bean dishes, tacos/fajitas, baked potatoes, steak, burgers, pasta dishes, and roasted vegetables.

– Assuming you trust the source of your eggs, add a raw egg to your smoothie or oatmeal.

– Dice up a hard boiled egg and add it to your guacamole or tuna/chicken salad.

– Crack and scramble an egg, add parmesan cheese for a thicker taste (or leave out if you wish) and drizzle the mixture into broth-based soups while gently stirring the hot soup to make it creamier and more filling.

Enjoy your eggs sans guilt

Mainstream healthcare is finally coming around to realization that eggs, despite their high cholesterol levels, are actually very healthy. Enjoy your eggs daily as part of a balanced diet, guilt free (3).

 

1. Karsten HD, Patterson PH, Stout R, Crews G. (2010) Vitamins A, E, and fatty acid composition of the eggs of caged hens and pastured hens. Ren Agr & Food Syst. 25(1); 45-54.

2. Giannenas I, Nisianakis P, Gavriil A, Kontopidis G, Kyriazakis I. (2008) Trace mineral content of conventional, organic, and courtyard eggs analysed by inductively couple plasma mass spectrometry (ICP-MS). Food Chem. 114(2): 706-711.

3. Rong Y, et al. (2013) Egg consumption and risk of coronary heart disease and stroke: dose-response meta-analysis of prospective cohort studies. BMJ. 346: e8539.

 

 

Five Ways to Get Your Vegetables Down the Hatch

One of the first things I look for when looking at a patient’s food log is what kinds of vegetables they’re eating. Many people barely eat a serving (1/2 cup) of vegetables per day. You should aim for 3-4 servings of vegetables per day to have a balanced diet–that’s only two cups of vegetables. Use these ideas to get your veggies down the hatch.

1. Veggie party
When we’ve just gotten groceries and we need to chop up fresh vegetables and put them into the fridge, we’ll snack on vegetables in the process. The veggie party refers to all vegetables being out on the counter, and we pull out different kinds of dips from the fridge (hummus, mustard, home made Greek yogurt dip, salsa, guacamole, etc.) and eat a couple servings of vegetables and dip.

2. Rice roll ups
Rice-paper wraps stuffed with vegetables is a way to get in cups of vegetables easily and mindlessly. Rice paper wraps are cheap, easy to use, and afford a bit of simple carbs. You can include any kinds of vegetables that you want, along with hummus, tuna salad, different sauces and dressings, or my favorite, an avocado. You can find these rice paper wraps in North Carolina at World Market, in the Northeast at Wegman’s, and if neither of these stores is near you, order a few packages online, they’ll last you a while.

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3. Ultimate Salad
The Ultimate Salad is just a fancy name for a really big salad. There is an actual blueprint to create an “authentic” ultimate salad that you can find right here. The Ultimate Salad uses a base of some kind of tender lettuce with additional vegetables, protein, healthy oils, and “fillers,” like olives, craisins, and feta cheese. The salad should be big enough to use as a meal, potentially affording you all your vegetable servings for the day.

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4. The roast
This may be the easiest way to get in your vegetables. Use 2-5 different kinds of vegetables that can be roasted, chop them up, toss them in some olive oil with seasonings, and roast in the oven at 450 degrees F for 15-60 minutes, depending on your vegetables. Try using this guide to determine cooking times. This is a good way to experiment with different combinations–red pepper thrown into a sweet potato and squash roast is heavenly. Zucchini, eggplant, and tomato will meld together beautifully.

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5. The salad bar
In place of fast food or take out, I suggest to you the salad bar. Here in North Carolina I go to Harris Teeter’s salad bar and make a huge salad. The great thing about grocery stores’ salad bars is that there are things on the bar that you might not normally keep at home. This is a great opportunity to try new vegetables. I often load up on marinated artichokes, pickled beets, and sweet snap peas, as I rarely keep these things on hand. There are usually a number of protein options to choose from, like marinated chicken breast, seafood salad, and hard boiled eggs.
When you’ve had a late Friday at work and you’ve got to get home and put something healthy on the table, this is a godsend.

Any other tips or tricks for getting vegetables in? Share them!

 

Easy Ways to Cut Back Sugar Intake

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Have any of y’all seen John Oliver’s segment on sugar? His commentaries are often politically charged, and this piece is no exception, but one health assertion that he makes is pretty well accepted by all factions of the healthcare industry–too much sugar is bad for you.

Ween and moderate. This is how you begin to decrease the sugar in your diet. Your taste buds will need time to adjust to less sweetness in your foods. This is normal. After two weeks of practicing some of these recommendations, your taste buds will have acclimated, and you’ll actually prefer less sweetness in your foods.

Leave sugar out of your coffee. Use regular cream instead of flavored creamers (or butter or ghee, like these crazy folks). You may need to ween yourself down in order to make coffee palatable. When ordering from a coffee shop, ask for black coffee and get your cream on the side.

Choose plain yogurt and Greek yogurt instead of flavored and sweetened yogurt. Yes this tastes like sour cream on its own. Use a small teaspoon of honey to sweeten the yogurt if you have to, and each time you have yogurt thereafter, decrease the amount of honey you use until you are no longer using any. Add frozen blueberries, sliced kiwi or pineapple, or any other fruit to help sweeten it naturally.

Eat raw nuts, instead of roasted, flavored nuts. It’s really the coating that they put on nuts (like honey roasted nuts) that contains the sugar. If you can find roasted unsweetened nuts you’ll still be cutting back on sugar. Raw nuts, however, have more of their good fats preserved as well.

Dilute your juice. If you’re a juice drinker, start pouring yourself a tad less juice, and add a bit of water to make up the difference. Slowly start pouring less juice and more water to dilute the juice until you eventually are just drinking juice-flavored water.

Restrict your condiments. Sugar is added to almost all pre-packaged prepared foods, and condiments are no exception. When you’re eating a meal that you use condiments or dipping sauces (barbecue, ketchup, dressings), only allow yourself 2 Tbsp (1 oz) of a condiment. This is the equivalent of about a shot glass.

The biggest hurdle in getting over a “sugar addiction” is to re-train your taste buds. This takes time, and things are going to taste less appetizing than you’d like. You’ll get used to this. You’ll find in the future you won’t crave sugar the same way that you used to, and for the sugary treats you do enjoy, you’ll find you need less to enjoy them just as much.

Laser Treatments for Pain and Inflammation

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Who would have thought we’d be using lasers to treat musculoskeletal conditions? At our office we are lucky to have low level laser therapy. This is exactly how it sounds–a laser that you use therapeutically. It’s used to treat pain and inflammation from arthritis, strains, and sprains.Laser therapy works by emitting a concentrated light (laser) to the area of complaint. The light is absorbed and pushed into deeper tissues.

Your body has the inherent ability to heal itself. That is why when you get a scrape or cut it eventually scabs over and heals regardless of what you do to it. Laser therapy helps speed up this process.

While scientists can’t explain the therapeutic effects of laser entirely, what we do know is that the light from the laser stimulates different kinds of cells in our bodies: Immune cells come to the area to help clean up tissue damage, and connective tissue cells begin to migrate to the area and multiply in order to repair tissue. This is all accomplished because the laser, which is very concentrated light, “donates energy” to the cell, and the cell can then do its job faster and more efficiently (2).

Laser has been shown to be effective for the management of pain and inflammation in chronic joint disorders and acute injuries (3, 4, 5). In our office we have seen success most notably with ankle and wrist sprains, rotator cuff injuries, disc tears and herniations. This modality is safe, non-invasive, and non-painful. Side effects are limited to increased soreness in the area that was treated, but does not linger for long.

 

1. Chen, et al. (2011) Low-Level Laser Therapy Activates NF-kB via Generation of Reactive Oxygen Species in Mouse Embryonic Fibroblasts. PLoS. 6(7): e22453.

2. Chung H, et al. (2012) The Nuts and Bolts of Low-level Laser (Light) Therapy. Ann Biomed Eng. 40(2): 516-533.

3. Chow RT, Johnson MI, Lopes-Martins R, Bjordal JM. (2009) Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet. 374 (9705): 1897-1908.

4. Bjordal JM, Johnson MI, Iverson V, Aimbire F, Lopes-Martins R. (2006) Low-Level Laser Therapy in Acute Pain: A Systematic Review of Possible Mechanisms of Action and Clinical Effects in Randomized Placebo-Controlled Trials. Photomed Laser Surg. 24(2): 158-168.

5. Bjordal JM, Couppe C, Chow RT, Tuner J, Ljunggren EA. (2003) A systematic review of low-level laser therapy with location-specific doses for pain from chronic joint disorders. Aus J Physiotherapy. 49: 107-116.

Non-Dairy Smoothies, from a Dairy-a-holic

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I had to switch up my protein shake game as the nutritional cleanse I had done eliminates dairy. My go-to protein shake used to be Greek yogurt, peanut butter, and a banana–I could have one every day without getting sick of it.

I’ll tell you what I’ve been drinking instead, with some pros and cons of common ingredients. This morning’s shake was:

1 c ice cubes

1 c frozen strawberries and grapes

1 raw egg

about 1 c unsweetened almond coconut milk blend

1 handful of spinach

2 scoops Standard Process SP Complete (basically a powdered multivitamin)

1 scoop whey protein

I started adding a raw egg to my shakes just to eat through some of our extra eggs. Though I haven’t researched the topic much, I did hear at a nutritional seminar that raw, whole food uncooked/unprocessed protein is beneficial. I consume the majority of my protein cooked (meats), unless I cook a steak rare. Cooking will denature proteins, and like I said, I haven’t researched extensively if there’s a benefit to consuming cooked and uncooked proteins, but it’s easy enough to add an egg to my shakes that it hardly matters. Pros: adds a creamy, heavy texture to the smoothie, tons of nutrients. Cons: adds calories, watch the source of your egg–raw eggs can potentially be dangerous to consume. I assume the risk as my eggs come from the chickens in our backyard.

Last week I added a scoop of solid coconut oil to my shake. Pro: I needed the additional calories and healthy fats. Con: big chunks of solid coconut oil that wasn’t as appetizing. I’m wondering if I had melted the oil and drizzled it into the shake as it was blending if it’d have emulsified a little more.

Chopped walnuts on top of an icy, creamy smoothie just makes the smoothie. It feels like eating an ice cream sundae, but healthy. Pro: delicious, filling, healthy fats. Con: additional calories that some people might not be able to indulge in if trying to lose weight, or if prone to adding too much fruit to the smoothie.

I’ve added chia and/or flax seeds to my smoothie before. In the amounts you’d normally be adding them, they don’t afford a whole lot in nutrition, but do add a crunch texture to the smoothie. Pros: healthy fats and fiber. Cons: changes the texture of the smoothie, expensive to use a lot of them.

Throw in a handful of spinach or other leafy green to your shake. Pro: adds a shot of nutrients, and sometimes fiber depending on the vegetable. Con: turns the shake green/brown, but rarely changes the flavor.

If you enjoy the taste of pumpkin, try using half a can of pureed pumpkin in your smoothie, along with a dairy-free milk, cinnamon, and nutmeg. Pro: creamy, favorite fall flavor, some nutrients. Con: watch how much you use, as some pureed pumpkin can have too much sugar. Check the can–if a serving has more than 10 grams of sugar, then I don’t typically use it.

Creating smoothies is only limited by the maker’s creativity. Experiment–frozen fruit (or possibly even vegetables) is usually never bad. For creamier textures, use avocado or nut butters. For sweeter smoothies, use a very ripe banana.

 

 

Standard Process Purification Program: Three Days In

I’m not one to do nutritional “cleanses.” Over the past few years I’ve had patients and colleagues ask for my opinion on a specific “cleansing” or “detox” program. Most are marketed as a weight loss program. That’s the first red flag. Many involve no dietary changes, that’s the second red flag, and the last nail in the coffin as far as I’m concerned.

I’m impartial to Standard Process, mostly because they grow the majority of the food they use to make their supplements. I’ve gone to some of their seminars and was pleasantly surprised at the presenters’ knowledge of nutrition, physiology, and current research about the topic at hand. They’re not a pyramid scheme and their products are genuine. So I decided to give the 21-day purification program a shot.

Yes you’re taking supplements and shakes. There are no meal replacements. You can eat anything you want besides grains, dairy, sugar, and processed vegetable oils (soybean, corn, canola). True adherence to the program requires leaving out animal proteins for the first 10 days. I’ve canned that for myself and the majority of our office staff because we are all so physically active that not having that additional protein would be a detriment. The program recommends eating twice the amount of vegetables than fruit, and half your vegetables raw.

So we’re 3 days into the cleanse. My breakfast is usually some variation of eggs with spinach, oregano, a tomato, and other vegetables.

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Lunches and dinners are whatever vegetables I have on hand, with whatever meats we’ve got–which ends up being venison (the original free-range pastured meat). I’ll eat fruit as a snack and frozen fruit mixed into my smoothie.

This is day 3 and my cravings for bread and sugar have no yet ceased, but I would expect that to die down about 1-2 weeks after cutting it out of my diet. I’m actually finding that I’m craving meat more and more, which is fine considering I’m not restricting meat intake.

I hope to share more elaborate recipes on my blog in the future, but because of where we are in the grocery shopping in our house, we’re using up the stuff that’s already on hand and not preparing huge meals for the week yet. Expect that at the beginning of next week.

Combating Sugar Cravings: 5 Easy Tips

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Kudos to anyone that can correctly identify these objects.

Beating sugar cravings is not easy. It requires a level of self-discipline. I promise you though, once you’ve beat a few sugar cravings, it gets much, much easier to beat the rest until you no longer pine for sugar. Use these tips to help you get over a bad sugar craving.

1. Do something else. You’re home from work, you’ve had a stressful day, and you’ve got chocolate chip cookies in the pantry. Fourteen of those would taste wonderful right now. But the last thing you should do is go sit on the couch and glance over at the pantry every ten minutes. Get up and do something–go sweep your sidewalk, throw in that load of laundry that’s been sitting on your bedroom floor, play with the frisbee with the dog (or go for a walk), weed your flower bed, tidy up the house, chop fresh vegetables for the week, help prepare dinner for the night, etc. Literally do something that will make you forget those cookies are in there and that you’ve had a stressful day.

2. Mislead your brain. You’re doing something else sure, but you still can’t take your mind off of those cookies. You’ve got to get your sweet fix. At least choose something that has redeeming nutrition, but will turn off the “need sugar” alert in your brain. Some examples include: dried fruit, frozen smoothie pops, a piece of fresh or frozen fruit, a small bowl of plain oatmeal/hot cereal with cinnamon, or carmelized pineapple with cinnamon (so delicious). Cinnamon has a pseudo-sweet taste and actually helps maintain healthy blood sugar. Be careful how much dried fruit you eat–no more than a small handful will be plenty to shut off a sweet craving. I keep prunes, apricots, craisins, and raisins on hand and they work marvelously. Plain hot cereal with cinnamon provides the carbohydrates your body is craving, but instead of it being delivered in a single shot (like a shot of alcohol or espresso), it’s in slow-release form (like a beer or cup of coffee). The term “redeeming nutrition” means the food has some kind of nutritive benefit, be it fiber, vitamins, or minerals, that makes the sugar contained in it worthwhile to eat.

3. Mindful eating. You’ve got three prunes in your hand and you’re looking at them like “what has my life been reduced to that I’m eating prunes instead of cookies.” I bet you think three prunes can’t stifle your massive sugar craving. Nibble at the prunes, take very small bites and mash the small bites around your mouth with your tongue. They taste a bit like a fruit-chew. You want your tongue to pick up the sugar that is in the dried fruit, as it will relay the message to your brain: “Sugar acquired, cease the alarm.” This works for any kind of craving–salt, sugar, fat, carb–the longer the food sits in your mouth, the longer your tongue enjoys that food, the quicker your brain will shut off the alarm, meaning your won’t eat as much of the food (portion control), and the ol’ bait and switch described above will effectively work for any kind of sugar craving.

4. Herbal backup. My herb of choice is gymnema sylvestre. This herb is known to reduce the ability of your tongue to taste sweetness–this is important for people who have no self control: if gymnema is taken before indulging on one’s favorite sugary food, the food will not taste as delicious as expected. Even if you do manage to shovel down a dozen Oreos after taking gymnema, the herb has a beneficial effect on blood sugar control. No it will not completely counteract the negative effects of a blood sugar spike from binging on sugar, but taken regularly, with active efforts to maintain a healthy diet, it can help manage blood sugar. Effective doses start at 400mg of gymnemic acids daily.

Cinnamon, the common spice, is also effective at helping control blood sugar within a normal range. It does not have an effect on the way you taste sugar, but itself can taste a bit sweet. Like gymnema, this will not completely counteract a blood sugar spike from downing a box of Girl Scout cookies, but when consumed as part of an otherwise healthy diet with some sugar snuck in, it can help keep blood sugar in a healthy range.

5. Cheat day. If you’re a star all week long and watch your diet like a champ, you deserve a cheat day. No more than one day per week you can indulge on absolutely any food you want, all day long. When I practice this, I literally eat as much as I can of one thing–do this to elicit an “ugh I’m sick of this food” response, and then you will have a refractory period where you can’t even stand to see that food again for a period of time (a pitfall of mine: pasta alfredo. If I eat too much, I feel sick and then don’t want it again for another few months).

The cheat day is not for everyone. If you are inactive (less than 3 days per week of some kind of structured exercise and/or have a sedentary job), have diabetes or another nutrition-related disease, sub-par liver/gall bladder/kidney/stomach/intestine function, hypoglycemia, some autoimmune diseases, or an eating disorder, this kind of free-for-all eating in an attempt to overload your system is not the best course of action. This technique is effective for people who are active regularly, have an excellent diet to begin with, and are otherwise healthy.

Combating sugar cravings is tough. This is not an all inclusive list, and in fact, there are long-term nutritional practices than can further eliminate sugar cravings (we’ll get to those another day). Do you have tips of your own? Please share with us!

Get Your Shoulders out of Your Ears!

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Ever been stressed out? Then you know your shoulders get tight and achy, and sometimes you may even get headaches. Maybe the biggest contributor to a tight neck caused from stress is a large muscle known as trapezius.

Trapezius is so large that it’s actually divided into three parts: upper, middle, and lower trapezius. Upper trap is the part that spans the neck. It attaches to the back of your head and drapes down the back of your neck, connecting to the backs of the vertebrae in your neck, and connects to the top of your shoulders/upper back on your shoulder blades. The muscle makes you shrug your shoulders and turn your head.

When stressed out we tend to activate this muscle and hold our shoulders up and rolled forward. Chronic stress or tension will keep this muscle from turning off. When this muscle doesn’t turn off a few things happen, which may produce symptoms you feel:

– The muscle begins to tire. You will feel it as a burning sensation.

– The muscle begins to cramp. You will feel it as tightness and achiness.

– Prolonged activation may lead to trigger points in the muscle. You will feel it as very point-specific areas of tenderness and hardness in the muscle. If you press that area with your fingers you may feel the pain shoot up into your head, like a headache.

– Your neck will not turn as far as it once did. This is caused from the muscle shortening due to fibrous (hard, strong) connective tissue developing in the muscle. This will happen to muscles that are not stretched enough, especially if they’re being over-used. When the range of motion of your neck is restricted, you will start to affect the individual joints of the neck, causing them to become fixated, or restricted as well. This compounds your problem, and years down the road you realize you can barely turn your neck half as much as you could when you were younger.

Clinically, I see this in about 85% of my patients. This is a very “first-world” issue and is part of something bigger called “upper crossed syndrome.” I’ll talk about that in a future post. Upper trapezius is one part of a bigger syndrome that affects your whole upper body.

How to combat an over-activated upper trapezius?

As a chiropractor, adjusting is my first line of defense. Moving stuck joints relays information from your body to the spinal cord to the brain letting your brain know “these joints are moving good again, no need to keep trying to get them moving, they’re good now,” and the brain will stop trying to activate trapezius and other muscles in order to move the stuck joints. Adjusting also helps stretch trapezius and surrounding muscles that may have been roped into over-activation,  and may break up hard connective tissue that has formed.

Assisted or self-stretching and soft tissue (ie. massage) work helps to further break up hard tissue.

Therapeutic exercises to do at home help to re-train muscles. In order to counteract upper trap, you need to activate the middle and lower trapezius, as well as rhomboids and latissimus dorsi. When these muscles are all firing properly, upper trap will begin to turn off. The stronger the other muscles get, the more relaxed upper trap can become. Wall angels, back flies, and lat pull-downs are my favorite exercises to have patients do.

Think you may need some upper trapezius TLC? Try this: let your arms hang to your sides right now. Lower your shoulders toward the ground–imagine someone is pushing on the tops of your shoulders toward the ground, but you move your shoulders yourself. Do you feel a stretch on the tops/back of your shoulders or sides of your neck? Now while holding this position, tilt your head to one side. Feel a stretch on the opposite side of your neck? Now tilt and turn your head and look down to the floor. This is a deep trapezius stretch. If you find this hurts or causes a headache, you would very likely benefit from self-stretching, strengthening your other back muscles, and getting adjusted.