Category Archives: Boost energy!

Could a walk in the park lower stress levels?

walk, park, exercise, stress, relaxStaying active has many benefits. In particular, you may have been told by a healthcare provider to move more to help manage weight or improve heart health. However, a recent study has found that a walk in the park may also reduce stress levels in the body.

How Much Exercise Do I Need?

The Department of Helath and Human Services recommends that most adults exercise 30 minutes a day for most days of the week. In particular, it is suggested that most adults should engage in:

  • 150 minutes of moderate activity a week or 75 minutes of vigorous activity a week, or a combination of both levels of activity.
  • 2 days each week of resistance or strength training that involves a single set of exercises that includes 12 to 15 repetitions at a weight that will tire the muscles by the end of the set.

This thirty minutes does not have to be all at once. Five minutes here and ten minutes there is enough as long as it adds up to 30 minutes by the end of the day. Also, you may be wondering what moderate activity is. Moderate activity is any exercise that allows you to hold a conversation, but does not allow you enough breath to sing. In addition, you should break a light sweat within 10 minutes of a moderate activity, while vigorous activity will have you breaking a sweat in a few minutes or less. Moderate activities include:

  • walking
  • water aerobics
  • gardening
  • light dancing
  • slow bicycling

Walking to Lower Stress

A study by researchers at the Center for Nature and Health at the University of California San Francisco looked at the effects of exercise on a group of 78 parents and children.  This group of parents and children were encouraged to visit local parks as often as possible over the course of the study period. They were either provided maps to local parks and bus schedules or invited to group outings at local parks.

Follow-ups were done at one month and three months after the start of the study. During these follow-ups, self reports, journalling, and salivary cortisol levels were used to measure stress levels.  It was found that every increase in park visits each week was linked to decreases in stress.  In addition, it was found that those who visited the parks often saw:

  • increased physical activity
  • decreased loneliness
  • increased interest in nature

Other Ways to Lower Stress

Besides getting fresh air and exercising, there are many ways you can try to lower your stress levels.

  • Deep breathing can help relax the mind during stressful times and can also help improve sleep. This type of breathing involves breathing from the diaphragm, which means your stomach should inflate as you inhale and deflate as you exhale. Inhale for several seconds, hold your breath for several seconds, and exhale for several seconds. You may feel a bit lightheaded when starting this practice, so do not perform deep breathing when driving a car or operating machinery.
  • Simplifying your life by donating items in your home that you do not use such as clothes, excess furniture, or decorative items. Also, delegate tasks when possible at both home and work if possible to lighten your load. Finally, write upcoming events on a calendar and keep a running shopping list so you can lighten the burden on your mind.
  • Getting enough sleep is important not only for lowering stress, but for overall health. The average adult should get at least 7 to 9 hours of sleep each night.
  • Eating a balanced diet that is low in sugar, high in fiber, and high in other nutrients such as iron, B12, and vitamin C will help your body perform better in many ways. Some benefits of a healthy, balanced diet include improved cognitive function, better heart health, and an enhanced ability to handle stress. This balanced diet also includes lowering caffeine, increasing water intake, and reducing alcohol intake as well as eating a minimally processed diet. 
  • Spending more time with others in your family, circle of friends, and/or community since social engagement can help boost “feel good” serotonin levels in the body.
  • Taking mood-boosting supplements like Elevia by Vita Sciences. Elevia contains GABA, chamomile, and 5-HTP. These compounds can calm the mind and boost serotonin levels.

-written by Staci Gulbin, MS, MEd, RD, LDN

Sources:

Burton, M.D., N. (February 11, 2017) “How to Reduce Stress.” 

Healthline (accessed March 5, 2018) “Parl Prescriptions Can Help Lower Stress Levels.”

Laskowski, M.D., E.R. (August 20, 2016) “How much should the average adult exercise each day?” Mayo Clinic.com 

Mayo Clinic (May 19, 2017) “Exercise intensity: how to measure it.”

National Sleep Foundation (accessed March 5, 2018) “How Much Sleep Do We Really Need?”

Razani, N., et al (2018) “Effect of park prescriptions with and without group visits to parks on stress reduction in low-income parents: SHINE randomized trial.”

Watson, S. (June 18, 2014) “Caffiene and a healthy diet may boost memory, thinking skills; alcohol’s effect uncertain.”


  • Could Having a Pet Improve Your Anxiety?

    dog, cat, pet, mental health, anxiety, depression, ptsd, bipolar, healthThere’s nothing better than coming home after a long and stressful day of work or school, and having a happy wagging tail waiting at the door for you.  Owning a pet involves a lot of work and cost. However, studies show that a pet may be worth the time and money for the good of your health. A recent study review has shown that having a pet can decrease anxiety and provide overall benefits to anyone suffering from mental health issues.

    About Mental Health and Anxiety

    According to the World Health Organization (WHO), mental health is a “state of well being” in which a person can lead a productive life while being able to deal with the normal daily stresses of life.  The National Alliance on Mental Illness reports that mental illnesses are not just the result of one event. However, such a state of being  involves multiple factors such as genetics, environment, and lifestyle.

    Examples of mental health conditions include:

    • Anxiety Disorders
    • Bipolar Disorder
    • Depression
    • Eating Disorders
    • Post-traumatic Stress Disorder (PTSD)
    • Schizoaffective Disorder
    • Schizophrenia

    According to the American Psychiatric Association, anxiety disorders are the most common mental health disorders. In particular, about 30-percent of adults deal with such a disorder at some point in their life.  Anxiety disorders are not just everyday stress or worry. On the contrary, those with such disorders worry or fear that may be seen as “abnormal” in certain situations. This fear or worry can result in disruption of their daily life.

    For example, it may be “normal” to worry about taking a test. However, someone with anxiety disorder may have a similar level of worry and stress when having to talk with someone at the store.  On the other hand, a person with the disorder may lose sleep because they worry that if they leave the house tomorrow that something bad may happen to them. These are just some examples of how anxiety disorder can manifest. However, this condition can come in many forms such as:

    • generalized anxiety disorder
    • panic disorder
    • phobias, or fears, such as agoraphobia (fear of public places)
    • social anxiety disorder
    • separation anxiety disorder

    Pets and Mental Health Benefits

    An analysis of 17 studies reported in BMC Psychiatry found that having a pet may help those with mental health disorders. Results of this study review found that pets had the following positive impacts on mental health:

    • One study interviewed some people who had depression, schizophrenia, bipolar disorder, or post-traumatic stress disorder.  Subjects reported feeling more secure and stable with a pet in their lives.
    • Another study reported that those with a pet had lower levels of anxiety and a lower average body mass index.
    • Pets can provide unconditional love as well as support without judgment. In turn, this can help those with mental health issues cope if they are not getting such support from their family and friends.
    • Pets forced their owners to stay connected with the outside world and be more active.  Besides helping those with mental health issues to connect with others, the act of going outside is also very helpful to overall health.  For one thing, getting outside can help people get sunlight that helps make sure they get enough vitamin D, which can affect mental health. Also, mental health may benefit from the act of exercise.

    Researchers suggest that mental health care plans should include asking patients with mental health issues to get a pet. However, more studies need to be done to figure out how pets could play in the lives of patients and in treatment plans.

    Other ways to help improve your mental health

    Besides having a pet, there are some other things you can do to help your mental health.

    • Be mindful by living in the present moment. Talk with a counselor if you have troubles in your past that are stopping you from living in the moment. Also, take a yoga class, learn relaxing breathing techniques, or get a wellness app to help you find ways to stay calm each day and night.
    • Eat balanced meals since sometimes low levels of certain vitamins or nutrients can make you feel more tired or nervous. Eat plenty of fiber-rich fruits and veggies to help keep your gut healthy. Also, make sure to eat enough protein each day such as meats, beans, low fat dairy products, nuts, and seeds. Low protein intake can cause you to feel tired. This is because protein-rich foods contain dopamine and tyrosine which keep you alert. Finally, make sure to eat some carbohydrate foods such as whole grains and cereals. This is because such foods increase “feel-good” serotonin in the body.
    • Volunteer or help out a friend or loved one since such acts can help you feel better about yourself. Also, such acts can help you connect with others and perhaps help you to see how much you have to be grateful for.
    • Get plenty of sleep since lack of sleep can greatly impact your mood. Set a bed time each night, avoid caffeine in the latter half of the day, and limit screen time at night to help you get more sleep. 
    • Visit your doctor to make sure your vitals are healthy and to get help for any symptoms that may be bothering you or affecting your daily life.
    • Take a supplement such as Sereneo by Vita Sciences. Sereneo contains ingredients such as magnesium, chamomile, and valerian that promotes a boost in serotonin and supports stress and anxiety relief.

    -written by Staci Gulbin, MS, MEd, RD, LDN

    Sources:

    American Psychiatric Association (January 2017) “What are anxiety disorders?”

    Greenblatt, M.D., J.M. (November 14, 2011) “Psychological Consequences of Vitamin D Deficiency.”  

    Medical News Today (February 19, 2018) “It’s official: Pets benefit our mental health.”

    National Alliance on Mental Illness (accessed February 20, 2018) ” Mental Health Conditions.”

    Psychology Today (October 27, 2015) “9 Ways You Can Improve Your Mental Health Today.”  

    Weir, K. (December 2011) “The exercise effect.”

    World Health Organization (August 2014) “Mental health: a state of well-being.”


  • Could Vitamin D3 Help Repair Blood Vessels?

    vitamin d, fish, fish oil, dairy, milk, orange juice, heart healthVitamin D, known as the sunshine vitamin, is a very important nutrient for overall health. Best known for its work in helping strengthen bones and teeth, vitamin D is starting to get more attention for other benefits it could provide.  A recent study reports that cells damaged by heart attack or stroke may be repaired by vitamin D3.

    What is vitamin D?

    Vitamin D is a fat-soluble vitamin that you can not find in many foods. However, vitamin D is important for many functions such as bone health.  It is called the ‘sunshine vitamin” by some because it can be absorbed into the body through sunlight exposure. Because of this, those who live in cloudy climates or do not leave the house often may be low in vitamin D.  You can find Vitamin D in such foods as fortified milk, yogurt, or orange juice, as well as fatty fish such as salmon or trout.  Cod liver oil is also a good source of vitamin D.

    Most adults should get at least 600 International Units (IU) of vitamin D each day. Vitamin D is not a standard lab you will get at your annual visit. Therefore, you may have to ask for the vitamin D lab.  You will be prescribed a vitamin D supplement if labs find you to be low.  Research shows that vitamin D3 is absorbed better than vitamin D2, so it is the preferred choice for a supplement. You can find Vitamin D3 in a variety of forms such as:

    Maxasorb comes in 1000 IU and 2000 IU formulas and can be conveniently rubbed on the skin like a lotion.

    Endothelial cells and vitamin D3

    An innovative study tracked single endothelial cells, or blood vessel cells, to see the impact of vitamin D3 on their health status.  Heart health events such as heart attack or stroke as well as conditions such as diabetes or high blood pressure can damage such cells.  The study showed that vitamin D3 helped such cells repair themselves from such damage. Also, the study found that the vitamin lowers oxidative stress in the cardiovascular system by stimulating nitric oxide (NO) levels.  This turn of events increases blood flow and protects the blood vessels from damage. Recent findings also show that a deficiency of vitamin may increase risk of a heart attack and may reveal a link to depression. Therefore, taking a vitamin D3 supplement may greatly benefit many aspects of health.

    Other ways to improve your heart health

    Although vitamin D is important, there are many other ways you can improve your heart health.

    • Eat plenty of fruit and vegetables since such foods are rich in fiber. A fiber-filled diet is good for digestive health, keeps you fuller longer, and in turn can help you maintain a healthy weight. A fiber rich diet can also help you control blood glucose levels and keep cholesterol at healthy levels.
    • Stay active often at least 15 to 30 minutes a day most days of the week. No need to be in a boot camp exercise program.  Engage in simple exercises such as walking, water aerobics, gardening, dancing, to name a few to help keep your heart healthy.
    • Drink more water and less alcohol to not only help manage your weight, but also to stay hydrated and keep your liver healthy as well.
    • Don’t smoke or quit smoking since this unhealthy behavior can constrict blood vessels and in turn increase blood pressure levels.
    • Maintain a healthy weight by performing all of the healthy lifestyle behaviors mentioned above since less body weight places less pressure on your heart, and in turn can help lower your risk of heart disease and related conditions.

    -written by Staci Gulbin, MS, MEd, RD, LDN

    Sources:

    DiSalvo, D. (January 31, 2018) “Study Examines Vitamin D3’s Potential Effects On Blood Vessels.”  Forbes.com

    Harvard Health Publishing: Harvard Medical School (accessed February 5, 2018) ” These five habits can save your heart- here’s how.” 

    National Institutes of Health: Office of Dietary Supplements (February 11, 2016) “Vitamin D”

    Tripkovic, Laura et al. (June 2012) “Comparison of Vitamin D2 and Vitamin D3Supplementation in Raising Serum 25-Hydroxyvitamin D Status: A Systematic Review and Meta-Analysis.” The American Journal of Clinical Nutrition 95.6 (2012): 1357–1364. PMC. Web. 5 Feb. 2018.

     


  • Could Vitamin D Help IBS Symptoms?

    constipation, diarrhea, abdominal pain, cramps, stomachache, irritable bowel syndrome, healthDo you get stabbing abdominal cramps after eating a fatty meal?  Does dairy or gluten cause uncomfortable gas and bloating?  Are doctors unsure of the origin of your chronic constipation or diarrhea? If you answered yes to any of these questions, then you may have what is called Irritable Bowel Syndrome (IBS).  Although changes in the diet may be helpful in many cases of IBS, research shows that vitamin D may also help those with this condition.

    What is Irritable Bowel Syndrome?

    Irritable bowel syndrome (IBS) is a disorder of the large intestine.  If someone is suffering from the following symptoms, then they may have IBS.

    • abdominal pain, cramping, or bloating
    • less pain after bowel movement
    • excess gas
    • diarrhea or constipation, or a little of both
    • mucus in the stool

    A diagnosis of IBS is usually given after testing has found that such symptoms are not related to another condition. Other conditions where such symptoms may be present include:

    • inflammatory bowel diseases (IBD) like Crohn’s disease or ulcerative colitis
    • celiac disease
    • malabsorption
    • colon cancer

    What is Vitamin D?

    Vitamin D is a fat-soluble vitamin that is well-known for its link to bone health.  D rich foods include:

    • vitamin D-fortified milk, orange juice, and yogurt
    • fatty fish like tuna and salmon.
    • cod liver oil

    However, sunlight exposure can also provide vitamin D. Those who live in cloudy climates may have trouble doing this though. Therefore, vitamin D-rich foods and supplements may be needed for some to meet their vitamin D needs.  Research suggests that just 5 to 30 minutes of sunlight twice a week can help a person meet their vitamin D needs.

    Ostoeporosis is a common condition linked to vitamin D deficiency. However preliminary evidence has also linked low vitamin D to diabetes, hypertension, and glucose intolerance.  Recent recommendations suggest that most adults should consume at least 600IU a day. Although, those with a low vitamin D level may require up to 4000 IU/day to help them normalize their levels.

    It is important to ask your doctor for a vitamin D test at your annual visit. This is because vitamin D is not a typical test that healthcare providers include in your common annual visit lab panel. If you fail to get a vitamin D level test, then you may never know if symptoms such as weakness or bone pain could be helped with vitamin D treatment.

    Vitamin D and IBS Research

    A study in the European Journal of Clinical Medicine has found a possible link between vitamin D deficiency and IBS. An analysis of four observational studies and three randomized controlled trials found a link between vitamin D deficiency in IBS patients. Furthermore, high dose vitamin D supplements were found to help ease IBS symptoms such as bloating, diarrhea, and constipation.

    Even though evidence is limited, researchers suggest that anyone with IBS symptoms should get tested for vitamin D.  If you have low vitamin D, you may be prescribed a Vitamin D supplement, or asked to purchase an over-the-counter softgel or liquid supplement. You can also purchase vitamin D in an absorbable cream like Maxasorb by Vita Sciences. Maxasorb comes in 1000IU or 2000IU and provides a convenient way to take your vitamin D daily.

    Other Ways to Help Your IBS

    In addition to keeping an eye on your vitamin D levels, there are other ways to help control your IBS symptoms.

    • Increase fiber intake by adding in more whole grains like oats and quinoa, along with plenty of fruits and vegetables. Fiber can help bulk stool and make it easier to pass.
    • Drink plenty of water each day to help flush waste out of your body, along with water’s other very important functions.  It is especially important to increase water intake as you increase fiber intake. If you increase fiber intake without drinking enough water, this could worsen constipation symptoms in some people. An easy rule of thumb is to drink half of your body weight (in pounds) in ounces. For example, if you weigh 200 lbs, you should drink 100 ounces, or about 12 cups of fluid each day. This fluid could include:
      • water or low-calorie flavored water
      • unsweetened tea, hot tea, or herbal tea
      • broth or boullion
      • decaf coffee
      • other low-calorie, low sugar drinks that do not contain caffeine or alcohol
    • Exercise on a regular basis. Exercise can help promote healthy bowel movements in those who have constipation.  Any movement counts, so get outside and take a walk, dance in your living room to a workout tape or to the radio, or go to the gym and join a group class. Whatever movement is fun to you, is movement that you will stick with for the long run.
    • Get plenty of sleep. Most adults need at least seven hours of sleep each day for good health. Sleep helps your body regulate fluids, blood pressure, blood glucose levels, as well as digestion. Therefore, not enough sleep could be affecting your gut health.
    • Start on a probiotic since the gut may be lacking the good bacteria it needs for healthy digestion. Ask your healthcare provider for specific brands of probiotics they may recommend. You can also check out Vita Sciences for gut health aids such as Biovia 30.
    • Eliminate certain foods from your diet. These foods may vary from person to person, depending on your specific allergies or intolerances. However, some common food triggers of IBS include:
      • FODMAPs, or fermentable oligo-, di-, and monosaccharides and polyols found in certain fruits, vegetables, grains, or dairy products
      • gluten-containing foods such as breads, pastas, and baked goods
      • gassy foods such as alcohol, carbonated beverages, or certain vegetables such as cauliflower and cabbage

    -written by Staci Gulbin, MS, MEd, RD, LDN

    Sources:

    Mayo Clinic (November 18. 2017) “Irritable Bowel Syndrome.”

    Medline Plus (accessed January 29, 2018) “Digestive Diseases.”

    National Institutes of Health: Office of Dietary Supplements (February 11, 2016) “Vitamin D- Fact Sheet for Health Professionals.” 

    Williams CE, et al. Eur J Clin Nutr. 2018;doi:10.1038/s41430-017-0064-z.


  • Could a To-Do List Help You Get More Sleep?

    sleep, anxiety, stress, list, to-do, alarmSleep is a precious commodity in your busy life. Between work, taking care of loved ones, and running errands, it is a wonder you find time to sleep at all. However, it is important to make time for sleep because of all of the health benefits adequate sleep can provide. A recent study suggests that making a to-do list may help ease your mind so you can capture more sleep.

    Why Is Sleep Important?

    When you sleep, your body helps to regulate many processes in the body. Blood pressure, blood glucose levels, and bodily fluids are just a few of the processes regulated during sleep. When you do not get enough sleep, you can increase your risk of high blood pressure and elevated blood glucose levels. In addition, research has found that those who consistently received less than six hours of sleep each night were more likely to have a higher body mass index than those who received at least eight hours of sleep each night. Therefore, long term lack of sleep can not only increase risk of chronic diseases such as heart disease and diabetes, but also increased obesity risk.

    How Much Sleep Is Enough?

    The National Sleep Foundation recommends at least seven hours of sleep each night for most adults.  Children two years of age or less require around 14 hours of sleep each day, including naps. Those between the ages of three and eighteen require around 10 hours of sleep each night. Children require more sleep to support their body’s growth and development.

    Quality of sleep is just as important as quantity of sleep. Sleep quality may be low if you do not feel rested upon waking, wake up during the night, snore, or gasp for air during sleep. Sleep disorders such as sleep apnea may affect your body’s ability to get oxygen during sleep. This can impact safety during sleep and can make you feel fatigued upon waking.  If you experience interrupted sleep or wake up tired, you should see your healthcare provider for further assessment.  Pain, frequent urination, or breathing problems could prevent you from getting more sleep.

    To-Do List and Sleep Research

    A study in the Journal of Experimental Psychology looked at 57 Baylor University students and the effects of writing down unfinished tasks on sleep.  One group of students wrote down unfinished tasks, while the other group wrote down tasks previously completed.  All students were in a controlled environment and told to go to sleep at a set time. They were prohibited from staying up to look at phones or complete any other tasks.  Those who wrote down unfinished tasks were found to have improved sleep by use of an overnight polysomnography test.  Larger studies and observation of other age groups and individuals with sleep disorders such as insomnia will need to be done to confirm the effectiveness of such strategies.

    Other Ways to Help Improve Sleep

    Besides making to-do lists, here are some other ways to help you get more sleep and improve quality of sleep each night.

    • Stay on a sleep schedule each night to help your body’s clock regulate itself. It may take some time to adjust to an earlier bedtime or earlier wake time. However, over time your sleep patterns will enhance quality and quantity of sleep.
    • Exercise each day to help your body exert some energy.  Not only will exercise help improve your sleep, but it can also help manage your weight, which can in turn help you reduce risk of sleep disorders such as sleep apnea.
    • Take time to relax before sleep by engaging in meditation, relaxation breathing, and reducing screen time. The light from the screens on phones, computers, and television can interrupt the sleep-wake cycle. Adding in essential oil diffusion such as with lavender can help induce relaxation. In addition, drinking herbal teas with chamomile can help induce sleep.
    • Avoid alcohol, caffeine, cigarettes, or heavy meals before bedtime since such things can cause interrupted sleep. Caffeine and alcohol can act as a diuretic, which may cause frequent urination that can interrupt sleep. On the other hand, the nicotine from cigarettes act as a stimulant and can in turn disrupt the sleep-wake cycle.  Finally, heavy meals less than two hours before bedtime can cause indigestion and increase risk of heartburn, which can interrupt sleep.
    • Ensure your sleep environment is conducive to sleep. Every ten years, you should replace your mattresses. Every few years or so, you should also replace your pillows  to prevent exposure to allergens such as dust mites. In addition, reduced exposure to light sources in the evening can help keep your body’s rhythms in check.  You can use blackout curtains to help reduce the amount of natural light in your bedroom.
    • Add a supplement to your bedtime regimen to help you get more sleep.  Somnova by Vita Sciences contains ingredients such as melatonin and L-theanine to help promote restful sleep.

    If none of these strategies are helping, then be sure to visit your healthcare provider for more sleep guidance.

    -written by Staci Gulbin, MS, MEd, RD, LDN

    Sources:

    Centers for Disease Control and Prevention (March 2, 2017) “How Much Sleep Do I Need?”

    Division of Sleep Medicine at Harvard Medical School (December 18, 2007) “Sleep and Disease Risk”

    National Sleep Foundation (accessed January 15, 2018) “Healthy Sleep Tips.”

    National Sleep Foundation (accessed January 15, 2018) “How Much Sleep Do Babies and Kids Need?”

    Science Daily (January 11, 2018) “Can Writing Your To-Do’s Help You To Doze? Study Suggests Jotting Down Tasks Can”


  • Could the DASH Diet be the Answer to Your Weight Loss Goals?

    balanced diet, diet, healthy, haert health, fruits, veggies, proteinLike millions of other people, you may be hoping to lose some weight in this new year. However, the confusing part may be what eating plan, or shall I say “diet,” should you choose to follow?  There is so much information in the media today making all sorts of weight loss claims.  They may all seem promising, but not all may provide you the nutrients you need to succeed long-term.  However, a recent report found that the DASH diet may be the answer to get you to your weight loss goal.

    What is the DASH Diet?

    The DASH, or Dietary Approaches to Stop Hypertension diet regimen, is a eating regimen promoted by the National Institutes of Health (NIH). It involves a flexible and balanced diet that focuses on using whole foods to meet daily and weekly nutritional goals. Basic tenets of the DASH diet include:

    • Eating plenty of fiber-rich vegetables, fruits, and whole grains
    • Consuming adequate protein daily from minimally processed sources such as fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils
    • Limiting foods high in saturated fat, such as fatty meats, full-fat dairy products, and certain oils such as coconut, palm kernel, and palm oils
    • Reducing consumption of sugar-sweetened beverages and sweets

    Calorie and activity goals recommended will be a little different for each individual based upon your energy needs. Energy needs can be calculated using your BMR, or basal metabolic rate, multiplied by an activity factor.  A good BMR calculator is provided online by MyFitnessPal. To calculate your activity factor, multiply your BMR by the following activity factor based on your activity level. Exercises considered moderate versus active can be found in a variety of sources such as the American Heart Association website.

    • 1.0 if you are sedentary, or do little to no activity
    • 1.1-1.2 if you engage in light activity 1-3 times a week
    • 1.2-1.3 if you are active, or engage in moderate exercise for 150 minutes a week or vigorous activity 75 minutes a week
    • 1.4-1.5 if you are very active, or engage in moderate exercise  closer to 300 minutes per week , and vigorous activity closer to 150 minutes per week

    For example, of your BMR is 1500 and you work out for 30 minutes a day, 3 days a week, then you would multiply 1500 by 1.2-1.3. Therefore, you would need to consume about 1800 to 1950 calories each day to maintain your current weight. As an estimate, subtract 500 calories for every pound you wish to lose per week.

    Based on the example provided, if you wanted to lose one pound per week, then you would need to consume between 1300 to 1450 calories each day.  Be sure though, that within those calories that you are eating enough protein and fiber daily for optimal health.  Such specific nutrient goals can be found on the NIH website. You can visit your healthcare provider such as your doctor or dietitian for more specific macronutrient goals that are appropriate for you.

    Diet Research

    Studies such as the DASH-Sodium and PREMIER trials looked at the effects of the DASH diet on blood pressure. Both of these studies found decreases in blood pressure with either a low sodium diet or established treatment plan that included nutrition counseling, respectively. However, those who followed a DASH diet in addition to these factors had even greater reductions in blood pressure.

    A recent study of 38 different diets by the U.S. News and World Report ranked the DASH diet the top diet for the eighth year in a row. The Mediterranean diet, which includes plenty of heart-healthy fruits and vegetables as well as healthy fats in the diet, was ranked second. Diets were scored according to:

    • How easy is the diet to follow
    • the nutritional quality of the diet
    • the safety of the diet long-term
    • the effectiveness of the diet for weight loss
    • the protective quality of the diet against diabetes and heart disease

    The DASH diet was found to be rich in potassium, calcium, magnesium, protein, and fiber. Also, this plan was found to adapt to any healthy lifestyle without deprivation or restriction of important nutrients.

    Ways to Make Your New Year’s Goal Become a Reality

    Finding a diet that you want to follow is one thing, but sticking to it is a whole other ballgame. Therefore, use the following tips to help you make your new year’s health goal a reality.

    • Make it a family affair: If you have others in your household that eat with you at meal time, include them in your healthy eating efforts.  This does not mean that everyone has to go on a diet with you. However, you can help instill healthy habits at meal time to benefit everyone. For example, you can include more vegetables at meals, limit the sugary and salty foods purchased, and reduce meals eaten out.
    • Get a healthy “buddy” for accountability: Since you are likely to have a co-worker, neighbor, or friend that also vows to be healthier in the new year, designate each other as your “buddy.” Basically, this means that you can help each other be accountable for your food choices and exercise.  You can do this by:
      • taking walks together during the week
      • attending exercise classes together
      • batch cooking or prepping healthy meals together on the weekend

    In regards to exercise, studies have shown that those who have an exercise partner can have about twice the overall increased intensity and duration of exercise than those who work out alone.

    • Track your eating and exercise regularly: Food tracking can get cumbersome over time. However it can be really useful in the early stages of a healthy eating regimen to make sure you are meeting your nutrient needs.  Once you feel comfortable with your eating plan you can get away with tracking less frequently. However, it is useful to track every few weeks for the long term to make sure you are eating enough of important nutrients like protein and fiber. Some great examples of tracker apps include MyFitnessPal, LoseIt!, and MyPlate.
    • Don’t get caught up in the numbers:  Weighing yourself everyday or tracking every macro can get overwhelming. Such excessive tracking can cause you to lose sight of important non-scale goals. Focus more on losing weight to feel more energy, feeling less pain in your joints, or being able to be active in ways you have not been able to  because of your current health status. This is not to say that tracking such numbers is not important. However, these numbers are just one small part of the healthy lifestyle equation.
    • Add in vitamins and supplements to fill in any nutrition gaps: A balanced diet ideally should give you all of the vitamins and nutrients you need daily. However, no regimen is perfect. There may be days where you do not consume enough of certain vitamins or minerals due to sickness, travel, or other reasons. Therefore, it is important to have a multivitamin in your regimen to help fill in any nutrient gaps.  An example is Zestia by Vita Sciences, which contains Super Food compounds, probiotics, and 100% or more of 19 vitamins and minerals.
    • Take it one step at a time: A long-term goal is great, but can be daunting to accomplish. For example, saying you want to lose 50lbs this year may seem like an impossible task. However, if you break your long-term goal into shorter pieces then it becomes more practical. In this case, setting a goal of one pound each week seems more possible and allows you to celebrate each small progression towards your ultimate goal. Therefore, take your new year’s health goals one day at a time.  Each small success should be celebrated. For example, when you reach eight cups of water consumed each day or reach 5000 steps a day, you should be proud and treat yourself to a non-food reward. Examples of such rewards include a movie night at home, a relaxing bubble bath, or a massage. Before you know it, your new year’s goal will be accomplished and you can start off the next year with confidence and better health.

    -written by Staci Gulbin, MS, MEd, RD, LDN

    Sources:

    American Heart Association (March 2014) “Moderate to Vigorous – What is your level of intensity?”

    American Heart Association (February 2014) “American Heart Association Recommendations for Physical Activity in Adults.”

    MedlinePlus (January 3, 2018) “What’s Your Best Diet for 2018? Experts Rate Them.”

    MedlinePlus (January 1, 2018) “For a Healthier New Year, Try Making It a Family Affair.”

    MedlinePlus (January 4, 2018) “Need Motivation to Exercise? Try the Buddy System.”

    MyFitness Pal BMR calculator

    National Heart, Lung, and Blood Institute (accessed January 7, 2018) “DASH Eating Plan.”

    National Institutes of Health (January 3, 2018) “DASH ranked Best Diet Overall for eighth year in a row by U.S. News and World Report.”

    National Institutes of Health: Office of Dietary Supplements (accessed January 8, 2018) “Nutrient Recommendations: Dietary Reference Intakes (DRIs).” 

     

     


  • Seven Simple Ways to Keep Your Weight Loss Resolutions This New Year

    exercise, goal, weight loss, new year resolutionEvery new year, many of us make resolutions to be healthier. Whether it be weight loss, exercising more, eating healthier, or managing stress better, such resolutions usually start off strong. However, by early spring, such goals usually lose steam and get pushed off until the next new year. That is why it is important to plan ahead before making any goals so you can make sure they are realistic and backed up with a lasting motivating factor. With such planning, you can make your new year’s goals come true this year and maintain such healthy habits for the long-term.

    What is a SMART goal?

    SMART goals provide a formula for the greatest success in goal-setting and achieving. SMART stands for:

    • Specific: Being specific requires you to be clear about the goal you want to set. For example, “I want to exercise 30 minutes a day for at least 3 days a week,” or “I want to lose 1 pound a week for the next 12 weeks.” Being specific is more helpful than just saying “I want to lose weight” or “I want to eat healthier.” Such general statements do not provide any concise marker to work towards, therefore they allow for a greater likelihood of non-compliance.
    • Measurable: The marker that a specific goal contains allows your progress to be measured. When you can measure how many days you have been able to exercise each week, or how many cups of water you drink each day, you can have a better idea of what areas of your healthy regimen are doing well, and which need more work. Tracking through an app or food journal can help with keeping track of such progress.
    • Attainable: Perhaps one of the most important parts of a goal is to make sure it is attainable. For example, if you currently consider yourself a couch potato, it would be a stretch to make a goal to run a marathon by the springtime.  A more attainable goal would be “I will train for a summertime 5K race.”
    • Relevant: Another important part of your goal is that it must be relevant to your life. You should never set a goal that someone else may have for you. This type of goal-setting is setting you up for disappointment, especially if you are only working towards that goal to gain approval from others. Set your goals for YOU and YOU only, and you will be sure to be successful.
    • Time-bound: Finally, it is important that your goals include a start and end time. Timing your goal makes it easier to keep track of your progress. For example, “In the next three months, I want to be able to work out for at least three times a week.” In addition, breaking these timed goals into small pieces, like a week or a month at a time, will make them more approachable. So instead of saying, “I want to lose 50 pounds this year,” saying “I want to lose 5 pounds this month” will make this large goal seem more possible.

    What are good motivating factors?

    To keep your motivation level strong, it is important to have some non-scale goals, or goals that have no number attached to them. For example, some non-scale goals may include:

    • Having more energy to play with your kids or grand kids.
    • Moving around with less pain.
    • Being on a reduced number of medications.
    • Fitting in an airplane seat or amusement park ride seat comfortably.

    What is a Realistic Weight Loss Goal?

    If you are one of the many people who wish to lose weight for the new year, it is important  to set healthy expectations. Fad diets may promise 20 pounds lost in 20 days, which may seem great. However, these quick results usually only end up with quick weight regain. This is because such plans end up depriving you of nutrients, make eating healthy feel miserable, and are hard to stick to long-term. The Centers for Disease Control and Prevention report that 1 to 2 pounds a week is a healthy rate of weight loss.

    More Simple Steps to Getting Healthy This New Year

    • Simplify healthy eating. Instead of getting obsessed with counting every calorie and macronutrient, stick to the basics.  Get out your measuring cups and smaller dinner plates (about 9-inches in diameter) and follow these simple tips:
      • Have at least 2 cups of non-starchy vegetables each day, which do not include corn, peas, and potatoes. With the plate method, fill half of your plate with the non-starchy vegetables at meal time.
      • Limit starchy, refined foods such as rice, potatoes, and pasta. Stick to 1/2 cup at each meal, or with the plate method, 1/4 of your plate. Choose high-fiber starches such as brown rice, quinoa, beans, or sweet potato.
      • Make sure you eat enough protein. Although this may seem easy enough, I find a lot of my patients do not eat enough healthy proteins. To determine your protein needs each day, you can multiply your weight in pounds times 0.3 to give you an estimate in grams.  You may need more protein daily if you workout frequently.
    • Be more mindful. Mindfulness is important for all aspects of life. In eating, mindfulness may include:
      • meal planning and prepping
      • asking yourself if you are eating for hunger or emotions
      • chewing more per bite to really savor and enjoy your food

    Mindfulness in exercise may be choosing exercises you enjoy or listening to your                        body to find ways to move without causing pain. Everyday you can be mindful by                       being present in each moment. You can do this by listening actively to others and using relaxation breathing and meditation to manage stress.

    • Track your progress. Download an app like MyFitnessPal or MyPlate to help you track what you consume and the calories you burn. Some apps, such as Apple Health or Calm, can help you keep track of the number of mindfulness minutes you engage in daily.
    • Fill in the gaps with vitamins and supplements. Even the healthiest diets may be lacking some vitamins. In addition, some climates that may have less days of sunshine may make individuals prone to vitamin D deficiency.  It never hurts to have your healthcare provider check for your levels of vitamin D, vitamin B12, magnesium, and iron. Low levels of these nutrients may result in such symptoms as low energy, depressed mood, or trouble sleeping.  Zestia by Vita Sciences contains several of these nutrients in addition to probiotics and a SuperFood complex to help promote optimal health inside and out.
    • Reward yourself. Every small goal you achieve should be celebrated. If you went a whole week without any drinking any sugary drinks, then reward yourself with a relaxing hot bath, or by enjoying a relaxing movie night at home.

    -written by Staci Gulbin, MS, MEd, RD, LDN

    Sources:

    Centers for Disease Control and Prevention (May 15, 2015) “Losing Weight.”

    Medline Plus (December 28, 2017) “8 Small Changes for a Slimmer You in 2018.” 

    Richardson, H. (December 29, 2017) “Holly Richardson: Resolutions, SMART goals, CLEAR goals and BHAGs.”

    Rossy, L. (April 29, 2016) “How Mindfulness Can Help You Stay Motivated to Exercise.” 

     


  • Can One Day of Exercise Protect Your Heart for Days?

    heart, heart health, exercise, cardiovascular, workout

    If you have ever tried to lose weight, you have likely been told to move more and exercise.  This statement may sound pretty generic, however it is true.  Although the Health and Human Services suggests working out at moderate intensity for 150 minutes a week, a recent report has found that even just one high-quality session of pre-conditioning the heart could keep your heart healthy all week long.

    What is moderate exercise?

    According to the Mayo Clinic, moderate exercise is an intensity in which you can carry a conversation, but cannot sing. For example, if your breathing quickens, but you are not quite out of breath, then you are engaging in moderate exercise.  Examples of moderate exercise may include:

    • walking briskly
    • gardening
    • ballroom dancing
    • water aerobics
    • biking slower than 10 miles per hour

    Exercise and Heart Health Research

    Animal studies have shown that one session of exercise can protect the heart for the rest of the week. This is based on infarct size, or size of an area of necrosis in an organ caused by obstruction of blood circulation.  The pre-conditioning exercise studied has been shown to reduce infract size, in turn reducing risk of heart disease.  This pre-conditioning involves training the heart during periods of ischemia, or reduced blood flow. In turn, the training is expected to reduce infarct size during periods of occlusion, or vessel blockage.

    These types of studies have not yet been done in humans. However, researchers feel that there is great promise for this type of therapy to be done with patients in the days before a scheduled heart surgery or procedure. It is thought that such “cardio protection” could help lower risk of complications or death and improve overall health outcomes.

    Other Heart Healthy Things You Can Do Each Week

    Besides exercise, there are plenty of things you can do each week to help improve your heart health.

    • Eat more fruits and vegetables: The fiber and nutrients found in fruits and vegetables has been shown to help lower risk of heart disease. Some examples of these nutrients include folate, magnesium, potassium, as well as vitamins A, C, and K. Also, non-starchy vegetables, or those vegetables other than corn, peas, and potatoes, are low in calories. Therefore, such foods can be eaten in great volumes to fill you up without putting you over your suggested calorie intake for the day.
    • Eat less processed foods: Boxed goods, frozen or prepackaged convenience meals, and canned soups are just some examples of processed foods that can hurt your heart. The reason you should limit such foods is because they can often be high in sodium, fat, and sugars that are used to make these products last longer in your pantry or refrigerator.  High sodium foods in particular can contribute to high blood pressure, which is a risk factor for heart disease.
    • Manage stress: Stress can also contribute to high blood pressure.  In addition, when you are stressed, you may eat more sweets and other comfort foods more often. Over time, this emotional eating can lead to weight gain. In turn, weight gain can increase your risk of high blood pressure, diabetes, and heart disease. You should find ways to manage stress such as:
      • talking to a friend or counselor
      • taking a yoga or meditation class
      • performing relaxation breathing
      • listening to music
      • using essential oils
      • engaging in some sort of “me time” every day. “Me time” involves some time each day in which you engage in an activity you enjoy that gives you time to yourself to breathe.
    • Take heart-healthy supplements: Besides a multivitamin each day, you may want to consider a heart healthy supplement such as Circova if you are at risk for heart disease. Circova is a supplement by Vita Sciences that contains Hawthorne extract as well as  antioxidants such as flavonoids and catechins that have been shown to improve blood flow and blood pressure.
    • Visit your doctor regularly: Be sure to visit your healthcare provider on a regular basis to get your blood pressure checked and to assess your heart disease risk. For most people, once a year is sufficient. However, if you have high blood pressure or a history of heart disease or diabetes, then you may want to visit more often such as every 6 months.

    -written by Staci Gulbin, MS, MEd, RD, LDN

    Sources:

    American Heart Association (March 2014) “Moderate to Vigorous: What is Your Level of Intensity?”

    American Heart Association (May 15, 2015) “Can antioxidants in fruits and vegetables protect you and your heart?”

    Lou N. (November 30, 2017) “One Workout May Protect Heart from Ischemia for Hours or Days.” Medpage Today 

    Mayo Clinic (May 19, 2017) “Exercise Intensity: How to Measure It”

    Mayo Clinic (July 25, 2015) “Myocardial Ischemia”

    Merriam-Webster Dictionary (accessed December 11, 2017) “Infarct”


  • Could Coffee Help You Live Longer?

    coffee, lengthen life, health

    If you’re like me, the day does not begin until I have had my cup of coffee. Whether it be the aroma, the caffeine, or the wake up signal to my digestive system, my body craves coffee from the moment I rise from my evening slumber.  Over the years, there have been mixed reviews about whether or not this common habit was helping or harming us. However, a recent report has found that coffee may actually help you live longer.

    Coffee and Health

    Caffeine may be the first benefit you think about receiving when consuming your cup of joe. However, research has found that energy is not the only good thing that comes from consuming this beverage. Three cups of coffee a day has been found to be the magic number that can provide lower risk of many health conditions including:

    • Heart disease
    • Diabetes
    • Parkinson’s disease
    • Uterine and liver cancer

    The only exceptions to these positive findings include some studies of unfiltered forms of coffee. French press or espresso, which contain the substances cafestol and kahweol, may slightly increase cholesterol levels.  However, the decreased risk of many health conditions seems to outweigh such negative findings. A 2015 study found that consumption of the beverage is linked to an approximate 8 to 15 percent reduction in risk of death, with more benefits linked to those who drank more.  In addition, a June 2016 report by the World Health Organization removed coffee from its list of potentially carcinogenic foods.

    Coffee and Longer Life

    A recent report has found that moderate consumption of coffee, or about three cups a day, has been linked to:

    • lower risk of cancers of the prostate, endometrium, skin and liver.
    • decreased risk of type 2 diabetes and better insulin and blood glucose control.
    • decreased risk of liver disease, gout, and gallstones.
    • Lower incidence of cognitive conditions such as dementia, Parkinson’s, depression, and Alzheimer’s.

    The health benefits of decreased heart disease and diabetes risk have been linked to the antioxidant effect of chlorogenic acid.  Also, the coffee lipids cafestol and kahweol have been linked to possible lower risk of certain cancers and liver disease.

    Researchers are not sure of the exact component of the beverage that provides the most health benefits. Also, there is no solid proof that coffee lowers risk of any disease. However, the link between decreased incidence of death and coffee intake is suggested to be a good enough reason to add a bit of the beverage to your daily routine.

    Other ways to Improve Length of Life

    Besides drinking coffee, there are many small things you can do each day to help improve your quality and quantity of life.

    • Eat a fiber-rich diet of fruits and vegetables. Sounds simple enough, but unfortunately just 12-percent of Americans actually eat the suggested 2 cups each of fruits and vegetables each day.  Not only do these types of foods contain digestive-friendly fiber, but also contain phytonutrients. Phytonutrients have been found to provide many anti-inflammatory benefits that have been found to help lower risk of chronic disease.
    • Stop smoking and lower alcohol intake.  Any substance that your body sees as a toxin will put strain on a your health. Smoking in particular constricts blood vessels, therefore increasing risk of heart disease. On the other hand, alcohol can put a strain on your liver since it will have to work extra hard to filter this toxin from your body.
    • Reduce stress and get plenty of sleep. Stress can affect sleep and lack of sleep can be stressful. Therefore, it is important to manage one to help the other.  Relaxation breathing, yoga, or talking to someone can help you manage stress. For sleep, talk to your doctor about specific medications or supplements, such as melatonin, that may help you catch some more Z’s.
    • Take vitamins and supplements daily.  If you are not getting enough nutrients from the food you eat, a vitamin and supplement regimen may help. A recent study in China has found a potential link between the health of the gut and longer life.  A probiotic supplement daily, such as Biovia 30X by Vita Sciences, may help improve diversity of gut bacteria in your body and promote improved digestive health and immune support.

    -written by Staci Gulbin, MS, MEd, RD, LDN

    Sources:

    Bian, G., et al. (2017) “The Gut Microbiota of Healthy Aged Chinese Is Similar to That of the Healthy Young.” mSphere, 2 (5): e00327-17 DOI: 10.1128/mSphere.00327-17

    Harvard Health Publishing: Harvard Medical School (January 2012) “What is it about coffee?”

    Harvard Health Publishing: Harvard Medical School (September 25, 2017) “The latest scoop on the health benefits of coffee.”

    Harvard Health Publishing: Harvard Medical School (September 2014; reviewed and updated October 31, 2017) “How to boost your immune system”

    Medline Health News (November 30, 2017) “Could Your Coffee Habit Lengthen Your Life?”

    Medline Health News (November 16, 2017) “CDC Wants America to Eat Its Fruit and Veggies”

     


  • Is Calories In, Calories Out the Key to Losing Weight?

    weight loss, apple, nutrition, orange, calorieIf you have ever tried to lose weight, then you probably have been told to track your calories. Most calorie trackers focus on keeping track of the calories you consume through food.  On the other hand, fitness trackers or workout machines may track how many calories you burn during the day. However, is there more to the story of weight loss, or is calories in and calories out the only key to success?  A recent report by health experts reveal that there may be more than simple math in the weight loss equation.

    What are is a calorie?

    A calorie is a unit of energy that is found in food and beverages. The four major macronutrients that consist of calories include:

    • protein at 4 calories per gram
    • carbohydrate at around 4 calories per gram
    • fat at 7 calories per gram
    • alcohol at 9 calories per gram

    Whatever calories you consume that are not used as energy are stored in the body as fat. In simple terms, you may lose fat stores if you consume less calories than you burn.  Calories can be burned by physical activity, but calorie expenditure may also increase in those who are growing, injured, or ill.  This is because your body will need more energy to support such processes that involve cell reproduction and other related processes.

    Are some calories healthier than others?

    Not all calories are created equal. The recent report reveals a growing trend of people focusing solely on the number of calories in and calories out, rather than the quality of calories consumed. Although this may lead to a calorie deficit, and in turn weight loss, it is not necessarily healthy.

    For example, a piece of candy and an apple may both contain 100 calories. However, the candy mostly contains empty calories because they contain little to no nutritional value. The calories in the candy are mainly from simple carbohydrates like sugar as well as fat.  However, in the apple, those same calories contain many nutrients such as fiber, vitamin C, and potassium. Therefore, the calories from the apple will provide your body with more health benefits than the candy.

    Weighing in on the “Calories In, Calories Out” equation

    The latest diet craze known as CICO (Calories In, Calories Out), may lead to vitamin and nutrient deficiencies according to experts. If you are not looking at the nutrient quality of the calories you consume, then you may increase your risk of heart disease, osteoporosis, anemia, to name a few. In addition, if you restrict yourself of too many calories, then you may develop fatigue and malnutrition, which does your body more harm than good. Contact a registered dietitian to help you determine how many calories you need to support your lifestyle, while still helping you to lose any excess weight.

    How to Work on Weight Loss

    There is no one size fits all plan to help everyone lose weight. However, there are several things you can do today to get on the right track towards healthy weight loss and maintenance.

    • Watch your portion sizes at meals and snacks. A simple way to determine how much food you need to eat at each meal involves your protein and fiber needs. Most adults should consume at least 25 grams of fiber a day through whole grains, fruits, and vegetables. Your protein needs, in grams, can be determined by dividing your weight in pounds by 2.75.  Once you determine your fiber and protein needs, use a nutrition tracker to ensure you meet these needs with mostly whole foods, or foods that are minimally processed.  Also, chew your food more per bite, slow your pace of eating to 20-25 minutes per meal, and be mindful of the food choices you make by looking at nutrition labels before you make food purchases.
    • Stay active most days of the week.  Balance out each week with cardiovascular and resistance exercises. Cardio exercises include walking, jogging, swimming, or biking. These exercises work to increase calorie burn. Resistance exercises, on the other hand, such as lifting weights, doing push-ups, or using resistance bands, help to maintain lean muscle mass. Maintaining your muscle mass as you lose weight helps you to maintain calorie-burning power, also known as metabolism.
    • Get plenty of sleep.  Weight loss may be more difficult for those who do not sleep well.  This is because lack of sleep can disrupt the hormones that control hunger and appetite. Try to get at least 6-8 hours of sleep each night. If you have trouble sleeping due to visiting the bathroom regularly, stop drinking fluids at least 2 hours before bedtime.  If pain is keeping you up, visit your doctor to get support.  If you are not sure what is causing your restless sleep, you may have sleep apnea. You can ask your doctor about getting a sleep study done to determine the cause of your sleepless nights.
    • Visit your doctor if diet and exercise are not leading to weight loss. If calories in and calories out are leading to weight plateaus or gains, then there may be an underlying health issue. Research has shown that some people who have a family history of obesity may have a harder time losing weight than those that don’t. This could be due to:
      • genetic factors.
      • increased risk of conditions like hypothyroidism or insulin resistance.
      • environmental factors such as growing up without knowledge of healthy eating behaviors.
    • Fill in your nutrient gaps with vitamins and supplements. At the very least, take a multivitamin such as Zestia by VitaSciences. Zestia contains a blend of Super Food extracts, probiotics, and digestive enzymes helps to support optimal health. If you live in a climate with little sunlight, you may also need to add a vitamin D3 supplement to your daily routine.  Low vitamin D levels can affect many aspects of health such as bone and immune health, to name a few.

    -written by Staci Gulbin, MS, MEd, RD, LDN

    Sources:

    Centers for Disease Control and Prevention (November 16, 2016) “Finding a Balance” 

    Harvard Health Publishing: Harvard Medical School (May 2014) “Eating fiber-rich foods helps keep the heart healthy”

    Harvard Health Publishing: Harvard Medical School (updated April 11, 2017) “Why People Become Overweight” 

    Harvard T.H. Chan School of Public Health (accessed November 27, 2017) “Protein”

    Medline Health News (November 22, 2017) “It’s the Latest Diet Craze, But Is It Safe?”

    Medline Plus (accessed November 28, 2017) “Vitamin D”