How to Pare Down Protein & Cut Back Carbs
Inspired by a belief that our diets can be redefined to integrate both healthier eating and environmental responsibility, Menus of Change encourages a meaningful “flip” in the emphasis on animal proteins and highly processed carbohydrates to an emphasis on highly appealing alternatives.
Menus of Change, a collaboration of the Harvard T.H. Chan School of Public Health and the Culinary Institute of America (CIA), authors a creative approach to enjoying delicious, nutritional and sustainable foods: “The Protein Flip” and its companion, the
The Protein Flip, introduced in 2016, laid the groundwork for the Menus of Change health- oriented methodology, stating, “Higher intake of red meat, irrespective of its total fat content, increases risk of heart disease, stroke and diabetes when compared to poultry, fish, eggs, nuts, or legumes.”
The Menus of Change solution was to challenge chefs in every setting to place meat, poultry and seafood in a supporting role or as a side and make vegetables and plant proteins the stars – for example, burger blends composed of primarily mushrooms, other vegetables, grains or legumes; surf and turf reimagined as seafood with bountiful vegetables and only a bite or two of meat; use of tapas, mezze and other plant-forward small plate replacements for entrees. The public response was immensely gratifying, spurring further innovation and the mainstreaming of vegan options, such as lentil, barley and black bean burgers or wild rice polenta burgers made with mushrooms, carrots and leeks.
Building on their successful work with proteins, the collaborative is now developing a complementary program centered on advancing carbohydrate quality on the American plate. “From fluffy pancakes to soft hamburger buns, refined, fast-metabolizing carbohydrates are still found in many a diet and are contributing to the rise in diet-linked chronic conditions such as
diabetes and heart disease,” according to a recent Menus of Change summit panel discussion headed by Sarah Schutzberger, RD, CSO (certified in oncology nutrition). “In large part because of our food choices, scientists project that 75 percent of chronic diseases are attributable to diet and lifestyle.”
A substantial emphasis on whole, minimally processed carbohydrates can help change the trajectory, beginning with these flips described by the panel:
- Take on the Three Pleasures challenge: Create a delicious dessert using dark chocolate, nuts, and fresh-cut or dried fruit. “Instead of forcing a choice between a whole slice of cheesecake with a single strawberry as garnish or a plain bowl of berries, enjoy a dessert made from a healthy market basket that includes dark chocolate, fruit, whole grains, nuts and yogurt,” advised Greg Drescher, Culinary Institute of America.
- Look to world food cultures for inspiration:
- Mediterranean region: “This type of cooking features a healthy fat versus a low fat approach to diet, with olive oil as the foundation of flavor,” said Drescher. Try tabouli, made of cracked bulgur wheat, chopped parsley and olive oil, or a salad made with hydrated, whole-grain barley rusks, topped with chopped tomatoes and fresh feta cheese and tossed with olive oil. Also important: improve the health profile of pasta by using a whole-grain type and cooking al dente to make it a source of slower-releasing carbohydrates.
- France: The niçoise salad suggests ways to include potatoes in limited amounts by pairing with green beans and other vegetables, hard-boiled egg, and a light vinaigrette for a slow-metabolizing lunch.
- Asia and India: Try a salad featuring soba noodles made from buckwheat flour; a Buddha bowl with foundational ingredients that include legumes, fresh vegetables and plant proteins, paired with small amounts of salmon or roasted tofu; and whole-grain flatbreads.
From Boosters & Breakthroughs to Vaccines & Variants: Where Do We Go From Here?
The following reflects an 8/24/2021 discussion; please check the CDC website for real-time updates as the situation continues to evolve.
Their answers may not land lightly, but epidemiologist Jodie Guest, PhD, and drug development expert Michael Kinch, PhD, have been immersed in examining COVID-19 since its first stirrings in early 2020. They share an informed look at the road ahead for us all.
State of Concern
Noting more than 39 million COVID-19 cases nationwide, (as of 9/2/21) Guest projects this will continue to rise rapidly and eclipse one million a week. While “hot spots” for outbreaks clearly correspond to the country’s most lightly vaccinated locales, the impact of the delta variant is being felt in virtually every state. “There’s almost nowhere you can go in the U.S. that you don’t need to be masked indoors, even if vaccinated,” she says. The progressive increase in vaccinated patients with COVID-19 in European hospitals is also troubling, says Kinch, a potential harbinger of what is to come for the U.S.
However, what’s driving the surge is not cases among the vaccinated, known as “breakthroughs.” It’s a term Guest would like to eliminate permanently, given its negative connotation regarding vaccine efficacy. “These type of infections are still rare. More than 90% of those hospitalized with COVID-19 are unvaccinated.” She points out that while viral loads in patients with COVID-19 are the same for vaccinated and unvaccinated patients in the first few days of illness, they drop much faster and further in the vaccinated.
The vaccine, contends Kinch, was never intended to eliminate all possibility of getting COVID-19. “It’s not a suit of armor,” he says, “because no vaccine ever provides 100% protection. But we know they work incredibly well to prevent you from getting very sick or dying.”
The FDA’s recent approval of the Pfizer mRNA vaccine, with Moderna approval expected to follow soon, is pivotal, says Guest, in helping launch vaccination requirements at businesses, schools and other locations. “Don’t underestimate the importance of this approval in providing support for mandates that will protect all of us,” she says. “Recognize that in the entire history of vaccines, there has never been a set more studied than the ones we have now.”
Adds Kinch, “With the enormous amount of data gathered on the vaccines’ efficacy and safety, those who think of themselves as vaccine hesitant may more accurately be described as vaccine resistant.”
Third Doses and Boosters
The recent approval of a third dose of Pfizer or Moderna for immunosuppressed patients who didn’t build sufficient immunity from the first two doses applies to just 3% of the adult population. For everyone else (with the exception of pregnant women), a booster shot six to eight months after the initial series is being considered for approval.
“Right now, that’s how long we believe we can go without significantly diminished immunity,” says Guest. Antibody tests are not proven to be an accurate measure of protection from COVID-19, says Kinch, because the antibody levels vary by individual.
If you received Pfizer or Moderna initially, choose the same for a booster. Notes Kinch: “There’s no difference between these two vaccines—one is not better than the other.” In fact, some studies show no impact on efficacy from switching brands, he says; Johnson & Johnson data is yet to come.
And where does the flu shot fit in this fall? Absolutely essential, both agree, with the only caution that a two-week separation between the two vaccines may be recommended by some healthcare providers to avoid triggering a hyperactive immune response.
Protecting our Children
The best way to keep youngsters under 12 safe is ensuring that everyone around them is vaccinated, says Guest.
“Teachers, caregivers, babysitters and others should be vaccinated, or fully masked whenever they’re with children,” she advises. A different dose is being tested for 5- to 12-year-olds, with approval possible later this year.
The Next Wave of Variants?
While not identified by the Centers for Disease Control (CDC) as a “high concern,” Kinch admits that the lambda variant worries him primarily because not enough is known about its ability to resist vaccines. “One view is that the COVID-19 spike protein can only mutate to a certain point, and if that’s true, lambda could be the end of the virus. The other view is that we don’t know if it stopped mutating,” he says.
“We’re not defenseless, though,” counters Guest, “because we can keep it from getting here by having COVID-19 not circulating in communities. Greater numbers of vaccinated people will prevent us from getting whatever variant might follow delta.”
Stay Safe and Well
One of last year’s most popular signoff lines takes on new resonance as our experts advise on what that now means for the vaccinated in fall 2021.
Mask Up, Indoors and Out.
Masks are increasingly needed outside in crowded areas. Indoors, remember that while a soft, comfortable cloth mask protects others from you, if you need extra protection in certain settings, use a KN95 or N95 mask.
Pass on Indoor Dining, Movies, Concerts and Sporting Events.
Also reconsider full-capacity outdoor events with no masking/distancing/vaccine requirements. (As an alternative, order take-out and support virtual events offered by local venues). And avoid getting together in person with those who are not vaccinated.
Reach out to Every Unvaccinated Person you Know.
“The best action we can take is to keep encouraging every unvaccinated person we know to get the shot, now,” advises Guest. “We’re all in the race against variants and need to work together to defeat them as quickly as possible.” Adds Kinch, “It’s unfortunate that the motivations behind much of the messaging has messed up the message itself. Be completely honest about what is known and not known about the vaccine.”
The Swiss Cheese Respiratory Pandemic Defense.
“Layering prevention messages is crucial because the delta variant has made the holes in the Swiss cheese slice of the vaccine just a bit bigger,” says Guest. “Now masks are more crucial than ever before.”
Dr. Jodie Guest is professor and vice chair of the Department of Epidemiology, Emory University, Atlanta, and award-winning leader of Emory’s Outbreak Response Team for COVID-19.
Dr. Michael Kinch is associate vice chancellor and founder/director of the Center for Research Innovation in Biotechnology and the Center for Drug Discovery at Washington University, St. Louis.
What are your 2021 Anti-Resolutions?
Year after year, the pattern rarely varies. Resolutions made, promptly followed by resolutions broken. The odds of sticking to New Year’s resolutions are, in fact, completely stacked against us, as research shows a paltry success rate of between 10 and 20%. But since the challenges of 2020 have reconfigured every aspect of daily living, 2021 may be the ideal time to reset this ritual as well. Perhaps it’s time we consider this upcoming new year, the year of the anti-resolution for dieting, exercising, eating healthier and managing stress.
We’ve asked therapists steeped in mindful eating, body positivity and resilient thinking to help reframe this perennial wish list. There are no checklists to mark off or milestones to meet, just inspiration to view yourself and the world around you through a new lens.
Instead of Dieting in 2021… Consider being more mindful about what you eat.
Replace the resolve to lose weight on a diet with a shift to mindful eating. “Keep in mind that while all diets work in the short run, there’s not a single plan that has long-term results for the majority of participants, and that’s why people make the same resolution every year,” says Judith Matz, nationally recognized speaker, therapist and co-author of The Diet Survivor’s Handbook and Beyond a Shadow of a Diet. “The deprivation that comes from dieting often leads to overeating or bingeing, setting into motion an endless cycle of frustration.”
Instead, learn to eat when you’re hungry and stop when you’re full, and choose from a wide variety of foods, including healthful ones.
Matz describes the essence of the process. “First, learn to recognize when you are just beginning to feel hungry. If you have a headache, are crabby, irritable, fatigued and low on energy, you’ve waited too long and are much more likely to overeat as a result.”
Next, think about what food would make you feel satisfied. “Sometimes a fresh apple or a raw carrot is exactly what you want, and at other times you might want ice cream or a bowl of pasta. Depriving yourself of foods you love can be counterproductive – there’s room for all types of food,” she says.
For patients with specific medical issues, such as high cholesterol, Matz notes that adjustments can easily be made while still respecting the process: a craving for ice cream can be met with a sorbet instead.
Finally, trust your body to let you know when to stop eating. While that may sound simple, Matz counsels patience, especially for chronic dieters. “It can take time to tune in to your natural cues for both hunger and satiety.”
The key is to stop having rules around food and to really listen to your body. “Ultimately it’s about having a healthy relationship with food rather than focusing solely on eating so-called healthful foods,” she says.
Moving from body image to body appreciation.
An equally important shift is changing the desire for a new body size to a genuine appreciation of the body you have. Matz defines this as “body positivity, relating to your body with acceptance and respect rather than self-criticism and shame.” It means rejecting ingrained cultural messages related to body embarrassment and weight stigma and replacing them with ones that reflect inclusiveness and self-compassion. It encourages taking pleasure in natural body changes throughout your life cycle and not putting off anything you might enjoy doing because you’re not the “perfect” size or shape.
Body positivity also empowers you to view exercise positively rather than as punishment for having the wrong body. “Unhook exercise from weight, and focus on choosing exercise for endurance, strength, flexibility, stress reduction, health, social connection or just the simple pleasure of moving your body,” advises Matz.
Finally, refrain from focusing on weight loss praise, which reinforces the mistaken belief that you can’t be happy, healthy and successful unless you’re a certain body size, says Matz.
“Consider that body positivity is a gift we can give to support family, friends and, most notably, the next generation.”
Find joy in what you do and who you surround yourself with to reduce stress.
Resolving to manage stress effectively is an oft-expressed but infrequently realized New Year’s wish. But it can be triggered by one pivotal question, says influential family therapist Debbie Gross, who asks it at every session with a new client: “What brings you joy?”
She explains, “It’s transformational in terms of moving out of the survival mode many experienced last year, and into thriving mode. When people are in crisis, they become overwhelmed by the thought that no one will meet their needs. Their only goal is to focus on how to get through this moment; their attitude is ‘If I don’t take care of me, who will?’”
To stop the “anxiety spiral” in the brain, Gross recommends the “5, 4, 3” grounding exercise for staying in the present: “Focus on five things you can see, four things you can hear and three things you can feel, either physically or emotionally.”
And while it’s all too easy to devolve into perpetual doom and gloom against a backdrop of unceasing anxiety, Gross says we have a choice – Eeyore or Tigger?
“We can wake up each day just waiting for the next problem to come our way, or we can look at the world with more of a ‘beginner mind’ that recognizes small, everyday miracles,” she says. “It takes real work for some to switch the channel in their brain to that mindset, but the difference it makes is astounding.”
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Experts Expect Record Numbers of Seasonal Affective Disorder Diagnoses in 2021
As we continue to weather the storm of COVID-19, seasonal affective disorder, or SAD, is also on our radar. More subtle than an arctic blast, SAD is just as real, with just as much potential to have a chilling effect on our mood, productivity and wellness. Unfortunately, the emotional stress and fear that come with a global pandemic create an ideal climate for SAD this winter. Not surprisingly, mental health experts are expecting to diagnose and treat more cases of SAD in 2021 than ever before.
First discovered in the 1840s, SAD was not officially recognized as a disorder until the early 1980s, when Dr. Norman Rosenthal coined the term and categorized it as a form of clinical depression. We now know that SAD affects at least 5% of Americans; is more likely to affect women than men, those with other forms of depression or family members with the condition; and is far more common in northern regions, due to reduced natural sunlight. New research has advanced several theories as to why some people develop SAD, including: sluggish transmission of serotonin (which helps regulate mood and the body’s circadian rhythms; reduced sensitivity of the eyes to environmental light; a combination of these factors; or other reasons yet to be uncovered).
Increased understanding of what triggers SAD and its impact on mental health has inspired a growing number of clinical treatments that can effectively neutralize its effects.
Chief among them:
Sitting in front of a bright light box for 30 to 45 minutes daily has been a treatment of choice for more than three decades, helping SAD patients with either 10,000 lux of white fluorescent or full spectrum light that shines 20 times brighter than ordinary indoor illumination. Dawn simulation, another form of light therapy, begins in early morning before patients awake by emitting a low level of light that gradually increases over 30 to 90 minutes to recommended room light level (approximately 250 lux). Enhancing indoor lighting with regular lamps and fixtures is also recommended).
Newer studies from the University of Vermont suggest that cognitive behavioral therapy (CBT), a psychological treatment aimed at providing patients with tools to change negative thoughts and behaviors, may be as effective as light therapy for treating SAD. According to the National Institute for Mental Health (NIMH), CBT adapted for SAD focuses on behavioral activation, helping SAD sufferers identify and engage in enjoyable seasonal activities to combat the ennui and fatigue they typically experience in winter.
Creating a consistent light-dark, sleep-wake cycle is important for SAD patients, who often experience hypersomnia (excessive daytime sleepiness) and insomnia (trouble falling or staying asleep).
Antidepressant medications. Because SAD is associated with disturbances in serotonin activity, antidepressant medications have been effectively used to treat symptoms.
Active days. Keep moving with daily walks outside, even on cloudy days, and aerobic exercise. Both can help alleviate symptoms of SAD.
Winterize your mental health
Be proactive in safeguarding your mental wellness over the coming months. Most importantly, know the symptoms of SAD and call our office for help if you’re experiencing:
- Diminished interest in things that were once enjoyable
- Low energy or overwhelming fatigue
- Difficulty with concentration or focus
- Worthless or helpless feeling
- Sleep issues: too much sleep, or not enough
- Changes in appetite or weight; increases in carbohydrate and sugar cravings
Experts advise those who’ve previously experienced episodes of seasonal depression to try to get in front of it this year. Call our office for guidance regarding medications or CBT sessions. For many, reprogramming their mindset can help restore proper circadian rhythms and eliminate the psychological dread of winter. Try enrolling in an online class, taking up a new hobby or creating a new routine to optimize daylight exposure. Or keep it even simpler. As Dr. Rosenthal recently told the New York Times, “A 20-minute early morning walk in the sun can be as good as commercial light therapy.”
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A Winter Workout Routine Will Prepare You For Life After COVID
Exercise will reduce pain, improve function and mobility, lower blood pressure and blood sugar, decrease risk of chronic illness and death from heart disease and many forms of cancer, enhance mood and focus, and may even help reduce your risk of contracting COVID-19.
Despite those compelling benefits, only 5% of us stick to an exercise regimen. With months of staying close to home base ahead, we asked national exercise expert Dr. Josh D’Angelo, PT, of MovementX to help us beat the odds and emerge from our winter cocoons fitter, stronger and more limber than before.
“Recent research has shown that even a little bit of exercise and movement is beneficial in improving your movement, health and life,” says Dr. D’Angelo. “We start with a focus on functional strength training exercises because it provides the best protection against future injury and helps with everything from mobility to balance. To maximize your gains, we encourage supplementing with 15-20 minutes of aerobic exercise, such as walking briskly, riding a stationary bike, dancing … or anything that gets you moving and you enjoy! And remember, every little bit of movement helps.”
Following are some ways to get started, from MovementX’s “AgeProof Your Body” program:
Work toward repeating three complete sets of these fundamental exercises: squats, pushups and abdominal strengthening for your core. Start with 5-8 repetitions each, and build weekly. Rest, repeat.
- Squats. Focusing on lower body and core strength, this is one of the most functional activities and will also get your heart rate going. Proper mechanics are important.
- Stand up straight, feet shoulder width apart.
- Slowly bend knees and drop your hips backward to sit in chair. Rise and repeat.
- Pro Tip: Push energy down in your heels and into the midfoot – you should be able to wiggle your toes, and you should not feel discomfort in your knees or back.
- Advanced: Add load (dumbbells or household objects) or vary your speed as your strength and endurance improve. Adding repetitions can also increase the challenge
- Pushups. These are challenging, but start with this beginner position and perform 5-8 repetitions until you can advance to a lower position and more reps.
- Start by standing 18-24 inches away from a wall. Extend your arms and place your hands on the wall, shoulder width apart. Lean toward the wall, keeping your arms straight
- Bend your elbows, allowing your body to come closer to the wall – let your chest lead, and keep your body straight.
- Push away. You should feel this in your chest, shoulders and core.
- Advanced: How low can you go? As you progress with the wall pushup, start with your feet farther away from the wall. Even lower? Position your hands on a sturdy chair for a lower incline. Lower? Go to the floor on your mat, starting with your knees set on the floor. The lowest is going for the full pushup position with only your hands and toes touching the floor.
- Abdominals Series. Core strength is key to developing functional fitness that helps prevent injuries, reduce back pain and make your daily activities easier to accomplish.
- Setup: Lie on your back with knees bent, feet on floor, and arms by your sides. Your lower back should not be arched at all during this exercise; push it down into the floor to tighten abs.
- Slowly bring knees up toward your chest as you bend your elbows to let your hands meet your knees (at the edge of the thigh).
- Push your hands into your thigh just where it meets your knee, pressing your hands up and toward the ceiling. Continue to do this for 20 seconds. Make sure to breathe! Work your way up to holding for 30 seconds.
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Finding Peace Through Mindfulness and Meditation
Mindful, compassionate, serene, happy: emotions that have been in short supply during the pandemic but can be beautifully restored to those who embrace the chance to learn the time- honored practice and art of meditation. For many, it is as easy as downloading the Headspace app on their smartphone, receiving a seamless introduction to a technique the company describes as “rooted both in ancient history and modern science.”
There’s an App For That
Meditation has been practiced for over 3,000 years, and its benefits, improving well-being, helping eliminate insomnia, enhancing focus, decreasing stress, and reducing blood pressure, among many others, have been studied for decades.
But the real democratization of meditation may have been ushered in by the proliferation of apps like Calm, Buddhify, Insight Timer and Simple Habit. Since its 2010 debut, global leader Headspace has been downloaded more than 65 million times, a number that has steadily risen during the coronavirus crisis.
Dr. Megan Jones Bell, the company’s chief science officer, reports a tenfold increase in those starting the “stressed” meditation and a twelvefold increase in “reframing anxiety at home” users from mid-March to mid-May of 2020.
First, choose a time to meditate, and consistently make it part of your daily routine. Find an uncluttered, quiet spot where you won’t be disturbed. Make yourself comfortable in a chair or on the floor with a pillow behind you, close your eyes and allow yourself to let go. It’s natural to wonder, “Am I doing this right?” The experts at Headspace offer some gentle guidance:
- If your body is fidgeting or your mind keeps constantly chatting, you may want to walk away from the feeling. Instead of giving up, just write off the first few minutes and give your mind time to slow down. It’s not time wasted, but time spent training the mind.
- Dozing off occasionally during the first few weeks of meditation is normal. If it keeps happening, try a different time of day, sit up a little straighter or splash a little cold water on your face before you meditate.
- You may feel all sorts of unpleasant emotions, such as impatience, irritation and rage. Don’t suppress them, but give them the space to arise, unravel and ultimately fall away. Do the same if you’re fixated on a particular worrisome thought, or if you’re experiencing sadness. Acknowledge the feeling, even shed a few tears, and keep meditating.
- If you find yourself planning incessantly in a way that is unproductive and unhealthy, let those thoughts go and come back to your focus – a breath, an image, a way that is unproductive and unhealthy, let those thoughts go and come back to your focus – a breath, an image, a sound.
- Find the sweet spot between pushing yourself too hard and not applying enough focus. You may have a certain idea of what meditation should be, but it’s important to get out of your own way and give the experience room to breathe.
More Than One Way to Meditate
More than a dozen different types of meditation are taught, including:
- Guided: Form mental images of places or situations you find relaxing.
- Mantra: Silently repeat a calming word, thought or phrase to prevent distracting thoughts.
- Mindfulness: An increased awareness and acceptance of living in the present moment; observe thoughts and emotions, but let them pass without judgement.
- Calming: Cultivate a quieter, more peaceful state of mind and improved concentration.
- Insight: Set an intention to develop qualities such as wisdom and compassion.
- Body scan: Sync body and mind by performing a mental scan and paying attention to any discomfort or tensions.
- Visualization: Focus on a mental image.
- Loving kindness: Direct positive energy and goodwill to yourself and then to others.
- Resting awareness: Let thoughts simply drift away.
- Zen: Focus on following the breath to foster a sense of presence.
- Chakra: Bring the body’s core centers of energy into balance.
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