​Blood sugar, also known as blood glucose, is a type of sugar that is the main source of energy for the body's cells. When you eat food with carbohydrates (this includes sugars and starchy foods like pasta, bread, potatoes, fruits, and even gluten-free grains), your digestive system breaks these carbs down into individual sugars and absorbs them into the blood. This is a good thing, because blood sugar is critical for your brain to function properly and for you to have energy to move your body. Blood glucose levels can be affected by many factors including diet, physical activity, medication, stress, and hormones.
 
Maintaining normal blood sugar levels is crucial for overall health. High fasting blood sugar levels, known as hyperglycemia, can lead to a number of health problems including diabetes, heart disease, stroke, and nerve damage. A fasting blood sugar greater than or equal to 100 mg/dL is considered a risk factor for metabolic syndrome. 
 
In order to regulate your blood sugar levels, insulin, a hormone produced in your pancreas, needs to pull sugar out of the blood stream to be used for energy. The problem is generally not too little insulin to keep the blood sugar in a normal range (except in type 1 diabetes where the pancreas stops producing insulin), but rather the insulin cannot enter the cell to do its job. This is called insulin resistance.
 
In individuals with insulin resistance, the cells in the body do not respond properly to insulin, and as a result, they are unable to take up glucose from the bloodstream effectively. This leads to higher levels of glucose in the blood, which in turn stimulates the pancreas to produce even more insulin. Over time, this can cause a decline in insulin sensitivity and an increase in insulin resistance, which can lead to a number of health problems, including type 2 diabetes, metabolic syndrome, polycystic ovary syndrome (PCOS), and obesity. All people with metabolic syndrome have insulin resistance.
 
Insulin resistance can be caused by a number of factors, including a sedentary lifestyle, a diet high in processed foods and added sugars, and carrying excess weight, particularly around the waist. Though there is not a direct measurement of insulin resistance, abdominal obesity is the simplest indicator of it. 

​
​Cholesterol is a waxy, fat-like substance found in the bloodstream and all cells of the body. People often think all cholesterol is “bad”, but your body needs cholesterol to make hormones, fat-soluble vitamins (i.e., Vitamins A, D, E, and K) and bile acids to help digest food. In addition, cholesterol is needed for a healthy brain. Cholesterol is made by the body, and it’s also found in some foods.
 
Cholesterol travels through the bloodstream in small packages called lipoproteins. These lipoproteins are made of fat on the inside and protein on the outside. Two kinds of lipoproteins carry cholesterol throughout your body: low-density lipoproteins (LDL) and high-density lipoproteins (HDL).
 
What is HDL?
HDL is the “good” fat. Having high levels of HDL cholesterol is important because it is a scavenger that carries LDL away from the arteries and back to the liver for elimination. LDL is the “bad” cholesterol because it contributes to fatty build-up in arteries and around vital organs (visceral fat). HDL levels are often lower in people who have metabolic syndrome.

What is so bad about a low HDL level?

• Increased risk of heart disease and stroke
• Poor memory and memory decline
• Depression

What Causes a low HDL level?

• Transfats (often found in shortening, margarines, fried foods, processed food)
• Overweight or obesity
• Smoking
• Sedentary lifestyle
• Insulin resistance/uncontrolled diabetes
• Medication (e.g., beta blockers, thiazide diuretics, sex hormones, anabolic steroids)
• Genetics (this is rare)

How low is low?
                           At risk                    Desirable
Women        < 40 mg/dL           60 mg/dL         (1.6 mmol/L)
                           (1.0 mmol/L)       < 100 mg/dL   (2.5mmol/L)
Men                 < 50 mg/dL           60 mg/dL (1.6 mmol/L)
                           (1.3 mmol/L)        < 100 mg/dL (2.5mmol/L)
 
How can I raise my HDL level?
Medications can do this, but the first strategy involves lifestyle changes:

• Diet:
  • Eliminate transfats and limit saturated fats
  • Use the Mediterranean diet to guide healthy food choices, such as avocado, olives/olive oil, nuts, seeds, and fatty fish. Choose low carbohydrate options for vegetables, fruits, and beans.
• Increase physical activity
• Maintain a healthy weight. Even weight loss of just 5-10% of body weight can improve levels of blood fats.
• Keep abdominal girth <31.5” in women, 40” in men. Read more about this risk factor here.
• Quit smoking.

Two supplements that may help include omega-3 fatty acids and niacin. 

​What are Triglycerides?

Triglycerides are a type of fat found in the blood. After eating, any calories that are not immediately required are converted into glycogen (short-term storage of carbohydrates). Any calories over and above that may be converted into triglycerides which are stored in the liver or fat cells. If you need extra energy between meals, your hormones will trigger a release of triglycerides, however if more is stored than used, triglyceride levels will be elevated (hypertriglyceridemia).

Hypertriglyceridemia is the most common form of dyslipidemia (i.e., abnormal levels of fats--lipids—in the blood) observed in the general population. In fact, 30% of the general population have elevated triglycerides. 

High levels of triglycerides are one of five risk factors associated with metabolic syndrome. Other risk factors include increased waist size, low levels of HDL (the “good” cholesterol), hypertension, and high blood sugar (hyperglycemia). If you have three of those risk factors or more, you meet the criteria for metabolic syndrome. 

What is so bad about High Triglyceride Levels?

High triglycerides increase the risk of:

• heart disease
• stroke
• alcoholic and non-alcoholic fatty liver disease (NAFLD)
• pancreatitis

What are Causes of High Triglyceride Levels?

Genetics are a primary cause of high triglycerides levels. According to an article in the British Medical Journal, some secondary causes include lifestyle factors such as:

• Chronic, excess alcohol consumption
• Diet:
  • High saturated fat intake
  • High refined sugar intake
  • Excess caloric consumption
• Decreased physical activity
• Smoking

Medical conditions can also cause high triglyceride levels, such as:

• Obesity
• Metabolic syndrome
• Uncontrolled diabetes mellitus
• Hypothyroidism
• Pregnancy

There are also many drugs that can cause elevated triglycerides, such as oral estrogen, antihypertensives, and anti-epileptic drugs. See here for a more inclusive list.  

How High is High?

According to the American Heart Association and American College of Cardiology, classification of hypertriglyceridemia is determined by the following lab values:

Normal
<150 mg/dL (<1.7)

Borderline high
150-199 mg/dL (1.7-–2.3)

High
200-499 mg/dL (2.3-5.6)

Very high
≥500 mg/dL (≥5.6)

What is the treatment for High Triglyceride Levels?

Treatment for elevated triglyceride levels involve eliminating the secondary lifestyle causes (e.g., diet and exercise) and managing underlying medical conditions (e.g., better glucose control in diabetes). While prescription drugs may be required, two supplements that may help include omega-3 fatty acids and niacin.
Like other risk factors for metabolic syndrome, there is much we can do to return triglycerides to a normal level. 

​

If you've been told you have high blood pressure (hypertension), you are not alone. In fact, almost half of adults in the U.S. have high blood pressure. This is important, because hypertension is the most commonly occurring risk factor for strokes and heart attacks. It is also one of five risk factors for metabolic syndrome. Other risk factors include increased waist size, low levels of HDL (the "good" cholesterol), high triglycerides (hypertriglyceridemia), and high blood sugar (hyperglycemia). If you have three of those risk factors or more, you meet the criteria for metabolic syndrome. 

What Exactly is Blood Pressure?
Blood pressure is made up of two numbers. The top number (systolic) is the pressure in your arteries during a heartbeat. The bottom number (diastolic) is the pressure in your arteries while your heart is resting between beats. Here is a great video (4:31) with visuals that explains How Blood Pressure Works.

When the pressure in the vessels gets too high each time your heart contracts, over time it causes inflammation and plaque build-up (atherosclerosis), which narrows (vasoconstricts) and hardens the arteries (arteriosclerosis). This means to do its job, the heart has to work that much harder, causing extra strain on the heart, arteries, and organs, which increases your risk for heart attack, stroke, kidney disease, and other conditions.

How High is too High?
Guidelines from the American College of Cardiology (ACC) and the American Heart Association (AHA) now classify blood pressure in phases: 

• Normal: Less than 120/80 mm Hg
• Elevated: Systolic between 120-129 and diastolic less than 80
• Stage 1: Systolic between 130-139 or diastolic between 80-89
• Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg
• Hypertensive crisis: Systolic over 180 and/or diastolic over 120

What can I do to Lower my Blood Pressure to Normal?
The good news is that the first recommendation to decrease blood pressure is lifestyle changes which we all have control of. I know firsthand this can work. When I first discovered I had Stage 2 hypertension, I was more than a little surprised, however I knew that my father had hypertension and was on medication beginning in his 40's. While I worked on lifestyle changes, I was able to wean off medication and my blood pressure has been in the normal range for over 10 years. With lifestyle changes and guidance from your healthcare provider, this could be your story too. ​

Lifestyle changes that can lower blood pressure naturally include:

• Eating healthfully. This can also lead to a body mass index (BMI) in the normal range, and  improve the other markers of metabolic syndrome. While a diet low in fat and including whole grains is conventional wisdom, recent evidence suggests low carbohydrate diets are more effective in reducing weight and the risk of cardiovascular disease. 
• Adding some form of exercise in your daily routine. Something as simple as brisk walking for 30 minutes most days of the week can make a difference.
• Decreasing stress levels. Exercise can help with this, but other strategies include meditation, quality sleep, reducing triggers, and simply doing more of the things that bring you joy. 
• Quitting smoking. Besides decreasing blood pressure, studies show people who don't smoke live longer lives. 
• Decreasing salt consumption. The AHA recommends no more than 2,300 mg (about a teaspoon) of sodium per day, with an ideal limit of no more than 1,500 mg per day. However, 90% of Americans eat more sodium than recommended--3,400 mg per day on average. Once you bring more whole foods into your diet, you will realize just how over-salted packaged foods are. Always taste your food first before automatically adding salt. Also, consider replacing table salt with pink Himalayan salt which has lower concentrations of sodium and includes many other naturally occurring minerals. 

These changes alone will take more time to affect blood pressure than taking medication, but in the long-term, treating the cause of hypertension is much better than providing a band-aid by taking a pill. However if you have blood pressure that is stage 2 or above, don't wait--work with your healthcare provider to find medication that lowers your blood pressure to a normal range while your lifestyle changes have a chance to work. Hypertension can be a silent killer, so recognizing and treating it early can be lifesaving. ​

Abdominal obesity (also called visceral adiposity, central obesity or “apple” shape) refers to your waist size. It is one of 5 risk factors for metabolic syndrome. The other 4 may sound familiar to you: hypertension, high blood sugar, high triglyceride levels, and low HDL (i.e., the “good” cholesterol). Though your healthcare provider may not have called it that, if you have 3 of those risk factors or more, by definition you have metabolic syndrome. 
​
What is so bad About Abdominal Obesity?

Studies have shown that holding extra weight around the midsection reflects insulin resistance, and increases the risk of inflammation, high blood pressure, cardiovascular disease, and type 2 diabetes. The criteria for waist circumference varies based on country and ethnicity.

Recommended Waist Circumference Thresholds for Abdominal Obesity:

Population                        Men            Women 
Europid                               ≥ 94 cm       ≥ 80 cm
Caucasian                          ≥ 94 cm       ≥ 80cm    (increased risk)
                                                 ≥ 102 cm     ≥ 88 cm   (still higher risk)
United States                   ≥ 102 cm    ≥ 88 cm
Canada                                ≥ 102 cm    ≥ 88 cm
European                           ≥ 102 cm    ≥ 88 cm
Asian                                     ≥ 90 cm       ≥ 80 cm
Japanese                            ≥ 85 cm       ≥ 90 cm
China                                    ≥ 85 cm       ≥ 80 cm
Middle East,
Mediterranean               ≥ 94 cm     ≥ 80 cm
Sub-Saharan African   ≥ 94 cm     ≥ 80 cm
Ethnic Central and
South American             ≥ 90cm     ≥ 80 cm

Note: 80 cm = 31.5 inches
             88 cm = 34.6 inches
             90 cm = 35.4 inches

​
Isn’t Fat Just From Eating too Much?

Most people are surprised to learn there are different types of fat with specific causes that drive metabolic syndrome:

• obesity (subcutaneous fat)
• stress (visceral fat)
• diet (hepatic fat)

This reinforces the notion that metabolic syndrome is not really about obesity, but about metabolic dysfunction. In fact, the adipose tissue in an obese abdomen becomes its own endocrine gland, secreting adipokines (cell signaling proteins) that promote inflammation and insulin resistance. For the scientifically minded or otherwise intensely curious, see more with this great graphic called Metabolic Syndrome Signaling. 

What can I do to Decrease my Waist Size?

The good news is, a loss of just 5-10% of initial body weight can reduce blood pressure, insulin resistance (and resultant abdominal obesity), and decrease the risk of diabetes and cardiovascular disease. Your goals do not have to be unrealistic for you to have a real impact on your health. Many people with metabolic syndrome have lost much more without feeling deprived. Learn more here and see some amazing success stories here.

What you may not have considered is that chronic stress alone can contribute to belly size. This is because of the constant release of cortisol, the stress hormone. So if you do nothing else, prioritize decreasing your level of stress. You may be so used to this constant, low-level energy drain that you take it for granted. You can measure your level of stress and help identify causes by taking a self-assessment here. 

Ahh, the clear mind, the refreshed muscles and joints, the energy to get out of bed and seize the day. . . all signs of health after a good night’s sleep. The power of sleep to accomplish your health goals cannot be understated! Sleep can and does change your mind and body, altering your body’s chemistry for the better. It’s an integral part of recovering from metabolic syndrome and other health conditions. Sleep is required for repair and rejuvenation, yet more than one-third of adults in the US don’t get enough sleep.

Even just a few nights of good sleep can have these kinds of results:

• Clearer thinking, with greater motivation and productivity;
• Improvement in digestion, stress, and energy levels;
• Balance of hormone levels;
• Acceleration of weight loss. Sleeping less than six hours per night increases the risk of obesity by 55%;
• Improvement in insulin resistance and health markers such as blood sugar levels and blood pressure;
• Reduction in inflammation and other symptoms of metabolic syndrome, such as heart disease and stroke.

Combine improved sleep with modest adjustments in lifestyle habits and you have a recipe for major shifts in health for the better!

Why is sleep such an important part of a healthy human body’s functions? 
The power of sleep is in how our body systems are able to accomplish their normal duties fully only during this special time. These activities include repairing damaged cells and restoring the unique balance of chemicals in each. These activities don’t happen when sleep is impaired. This can result in reduced health of our body’s systems.

What’s getting in the way of quality sleep?
We now know that we mentally and emotionally respond to what we see in the world. Each reaction has a biochemical impact on our body’s hormone balance. Constant stimulation from electronic devices and stressful situations throughout the day affects this balance.

A lack of healthy movement can impair sleep. Joints become overstressed with too many hours sitting or in repetitive states, leaving muscles tense, stiff, painful, or restless. This also leaves us more injury-prone, having less motivation to move or exercise enough for our health.

Processed food and drinks overstress the body systems, including those that support quality sleep. Too much caffeine, alcohol, and of course sugar affect body chemistry and can impair sleep (along with other body functions). Overexposure to blue light from electronic screens or energy-efficient lighting directly affects how we’re able to sleep by suppression of the hormone melatonin and the circadian rhythm that regulates sleep.

These modern conditions have a huge effect on our body’s chemistry, how well we sleep, and thus the quality of the experience of being in our body when we’re awake.

Many of the best “hacks” for improvement of health markers work because they give your body ideal conditions to repair itself and thrive. 

So what are these “conditions”? They are activities that improve the types of stimulation throughout the day and well before bedtime that allow enough time to wind down and get enough hours of sleep. They are also conditions that affect hormone balance which support rest. Here are some examples of improvements in types of activities which support quality sleep:

• Make time to sleep 7-9 hours per night with time before bed to wind down;
• Reduce screen time overall and bright light 2-3 hours before bed;
• Use blue light blocking screens or glasses at night, or during the night if a night shift worker exposed to electronic screens at night;
• Expose yourself to bright light during the day;
• Increase enjoyable movement or exercise–especially outdoors for the sunshine and fresh air–and to break up long periods of sitting or repetitive movement;
• Limit caffeine intake to before noon;
• Minimize sugar and processed food intake overall;
• Avoid eating before bedtime;
• Reduce alcohol intake several hours before bed;
• Be consistent with bedtimes;
• Practice stress management exercises such as journaling, meditation or meditative breathing, especially before sleep;
• Use a weighted blanket at night, especially if anxious or depressed;
• If using CPAP:
  • Be sure you have a properly fitting mask and headgear
  • If the pressure feels too high when trying to fall asleep, use the “ramp” mode
  • Consider a specially designed, CPAP pillow

Small efforts to change even a few of these habits can result in better quality sleep, a necessary function for our bodies and a powerful tool to support your health goals. Make yourself a priority and get enough sleep!

You have a problem: you are told you have insulin resistance, pre-diabetes, or type 2 diabetes. 
​
Take a slow, deep breath in and out. I know that this process of moving from shock to healing can feel overwhelming or frustrating. But maybe this diagnosis is an opportunity to turn the ship around. You can do this, because the good news is, insulin resistance is reversible. What’s more, it doesn’t have to be hard or complicated. Consistent, modest life-style changes can improve the cell’s sensitivity to insulin.  
 
Here’s a short list of what’s in it for you when you improve your insulin sensitivity.

• Have more energy, strength, peace, and confidence
• Eliminate food cravings
• Resolve digestive problems
• Sleep better
• Decrease anxiety, depressive symptoms, and feelings of hopelessness
• Stop the cascade of bodily dysfunction  
• Take less medication (working closely with your healthcare provider)

​Now I invite you to join me on a knowledge adventure. 

As your coach, I’ll share with you that I once had metabolic syndrome, the term for a cluster of common risk factors that always includes insulin resistance and two of the following:

1.     High blood pressure (greater than 130/85 mmHg)
2.     Excess fat around the waist
3.     High triglyceride levels
4.     Low levels of good cholesterol, or HDL
5. High blood sugar (insulin resistance)
​
If you have just one of these additional conditions, you are at risk for developing metabolic syndrome.
 
There’s a limit to what our bodies can handle. Rather than treating the symptoms of metabolic syndrome with drugs, the goal should be to fix the causes of insulin resistance.
 
Here’s why and how insulin resistance develops.
 
When you eat food with carbohydrates, your digestive system breaks them down into glucose, which is absorbed into the bloodstream for energy. To keep blood sugar levels in a normal range, the endocrine system uses insulin, a hormone produced in the pancreas.
 
Insulin becomes a problem when there is too much sugar in your bloodstream and as a result, insulin. Your body is working hard to do the right thing, but when insulin levels are chronically high, a resistance at the cell wall develops that prevents insulin from entering freely and doing its job.
 
Common lifestyle factors, such as lack of exercise with resultant muscle wasting, and other conditions such as inflammation and liver dysfunction, can worsen insulin resistance.
 
So how do you reverse it? 
 
With small and consistent changes to what you eat, how you rest, move, and manage the stressors in your life, you can reverse insulin resistance, prediabetes, or type 2 diabetes by treating the causes of insulin resistance.
 
These are some of the lifestyle changes that when used in combination can reverse insulin resistance:

• Eat more whole food and healthy fats, fewer carbs
• Increase muscle mass
• Prioritize sleep quality
• Manage stress
• Foster mindfulness
• Lose excess weight (which is a natural result of the above changes)

 
Knowledge alone is not enough however, which is where a health coach comes in. Change is hard! I am confident however that in time you will be deeply satisfied by the changes you choose to make. In addition, you will be able to sustain them, because strategies can be tailored to your tastes and needs. 

Does the pandemic have you stressed out? Maybe you lost your job, or must go to a job where you have contact with a lot of people. Then you may be worried not only about getting COVID-19 yourself, but bringing the virus home to your family. Maybe you are homeschooling your children. Or maybe you have COVID-19 yourself, and are dealing with the discomfort of the illness as well as the unknown. 

Your rational mind tells you not to worry and relax. Instead you feel the constant energy drain of unwanted thoughts and feelings. Perhaps this includes feelings of guilt that you aren’t doing enough. Or, doing things well enough during this pandemic. Your friends tell you meditation would help decrease anxiety and be present. But what they don’t know is that when you tried, after three deep breaths you always came right back to those anxious thoughts.

I can relate. For example, in the last several years, I keep having negative chatter pop up  in my head regarding past mistakes. This includes perceived errors both big and ridiculously small, and going back to childhood! I’ve never been a successful “meditator” to keep from following those unwanted thoughts down the rabbit hole. However I’ve learned of an easy method to calm my mind and reset my thinking: it’s called mantram repetition. Usually by the third one, those ruminating thoughts are gone and my mind is off on a more productive path. It’s been empowering.

What is the Difference between a Mantra and a Mantram?

Both the words mantra and mantram have the same spelling in Sanskrit, however in the West, the difference is more distinct. A mantra is generally seen as a motivational statement, slogan, or chant. Examples include, “trying times are for trying”; “onward and upward”; “less is more”;  or “I am fearless”. In contrast, a mantram is a spiritual word, phrase, or brief prayer that we repeat to ourselves. This mantram repetition slows our thoughts and focuses our awareness. It calms the mind, body, and spirit. 

Benefits of Mantram Repetition

Dr. Jill Bormann is a psychiatric mental health nurse scientist who has been doing research for over two decades on this topic. She developed the Mantram Repetition Program. Her research studies provide objective evidence of positive effects of mantram repetition. These effects include:

• Improvement in:
  • Ability to be present
  • Depression
  • PTSD symptoms
  • Mental health quality of life
  • Spiritual well-being
• Reduced levels of:
  • Perceived stress
  • Anxiety
  • Anger
  • Insomnia

Choosing a Mantram

There are specific mantrams recommended for use as sacred words. Review the suggestions in the table below and choose one that is in alignment with your religious/spiritual beliefs. Carefully pick one that invokes positive feelings (e.g., strength, support), has special meaning to you, or the sound of the mantram resonates with you. 
​
Suggested Mantrams by Faith Traditions

Christian
Jesus Prayer                                              Lord Jesus Christ, son of God, have mercy on me
Mother of Jesus                                      Hail Mary [or] Ave Maria
Son of God                                                  Om Yesu Christu [or] Jesus, Jesus
                                                                           (ohm yay-soo kris-too)
Lord of the Heart
[or] our Lord Comes                               Maranatha
                                                                            (mah-rah-nah-tha)
Muslim
Lord God, the One                                  Allah, Allah
                                                                            (aa-lah)
 God is great                                                Allahu Akbar
                                                                            (aa-laa-hoo ak-bar)
In the name of God,
merciful, compassionate                      Bismillah ir-Rahman ir-Rahim
                                                                             (bis-mi-lah eer-rah-maan eer-rah-eem)
Hindu
 Eternal joy within                                    Rama, Rama
                                                                            (rah-mah)
 Invocation to beauty
and fearlessness                                      Om Namah Shivaya
                                                                           (ohm naa-ma shi-vaa-ya)
 In honor of the Divine Mother      Om Bhavani
                                                                          (ohm-baa-vaa-nee)
 Names of God                                          Hare Rama; Hare Krishna [Mahamantram]
                                                                           (ha-ray raa-ma; ha-ray- kri-shna)
Buddhist
Jewel (self) in the
lotus of the heart                                    Om Mane Padme Hum
                                                                           (ohm mah-nee pahd-may hume)
I bow to the Buddha of
Infinite Light                                              Namo Amida Butsu
                                                                          (nah-mo boot-see-yah)
Jewish
Blessed art Thou, King
of the Universe                                       Barukh Atah Adonai
                                                                         (ree-boh-no shel o-lahm)
 Lord of the Universe                           Ribono Shel Olam
                                                                          (ree-boh-no Shel O-lahm)
  Native American
  Great Spirit                                              O Wakan Tanka
                                                                          (wah-kahn tahn-kah)

When do I use my Mantram?

I’m reminded to say my mantram whenever those unwanted thoughts enter in my head. However, it’s also important to do it in moments of gratitude as well. For example, my happy place is hiking in the forest near us with our German Shepard dog. At the top of a hill near a stream, I sit on a log and forest bathe. I take in all the wonderful sights and smells as I connect with my heart and repeat Maranatha in my mind. If I have the misfortune of contracting COVID-19, I already know I will make mantram repetition part of my daily routine.
​
Dr. Bormann encourages frequent use of mantra repetition for best results as you ” build the mental muscle of your mind”. Her recommendations for integrating mantra repetition into your life include many options: 

• While waiting
  • For a job interview, or in a grocery or ticket line
  • For the bus, plane, train, taxi, or other transportation
  • For a doctor’s appointment or lab tests
  • For people who are late
• While doing mechanical tasks that don’t require one’s full attention
  • Washing dishes, sweeping, vacuuming, dusting
  • Lawn mowing, raking, gardening, watering plants
  • Brushing teeth, combing hair, bathing or showering
  • Sawing, digging, hauling, painting
• While exercising
  • Walking or jogging, swimming or bike riding
  • Doing any repeated exercise
• When dealing with annoying situations
  • Getting cut off in traffic
  • Tackling an unpleasant job
  • Struggling with insomnia or nightmares
  • Dealing with difficult people
  • While on hold on the telephone
  • When bored
• Other times
  • Before meals or going to sleep
  • While in the presence of a dying person
  • While dealing with pain, illness, or surgery
  • When dealing with likes or dislikes
  • For ruminating thoughts, compulsions and/or addictions
• To manage unwanted emotions
  • Depression
  • Fear
  • Resentment
  • Greed
  • Frustration
  • Anxiety
  • Impatience
  • Jealousy
  • Anger
  • Guilt
  • Irritability
  • Over-excitement

For more information about mantram repetition and if this self-care intervention  is for you, see these additional works by Dr. Bormann:

• Video:
• • Mantram Repetition: Mind-Body-Spiritual Practice for Self-Care (1 hour)
• Peer-reviewed articles:
  • Mantram Repetition: a Portable Practice for Being Mindful
  • Practice Intentionality & Presence with Mantram Repetition
  • Mantram Repetition as a Portable Mindfulness Practice: Applications During the COVID-19 Pandemic
  • Individual Treatment of Posttraumatic Stress Disorder Using Mantram Repetition: A Randomized Clinical Trial
  • Relationship of Frequent Mantram Repetition to Emotional and Spiritual Well-Being in Healthcare Workers
  • Responses to Mantram Repetition Program from Veterans with posttraumatic stress disorder: A qualitative analysis

In these stressful times, self-care strategies have never been more important. Strategies that are low-intervention (i.e., nonpharmaceutical) are always desirable. 

Edit

If you are feeling guilty because you've put on a few pounds since the beginning of the year, know that you are not alone! In WebMD polls, between 34-47 percent of women said they had gained weight during stay-at-home orders. This shouldn't be too surprising since this pandemic has been more than a little stressful! Between changes in work, finances, child care, socialization, and diet, no wonder we seek comfort food! But what if you could lose weight without feeling deprived? That is what the ketogenic (keto) diet is all about.

What is Keto?

It’s likely you’ve heard of the keto diet, since “What is keto?” was the second-most popular health-related search question in 2019. Though it may currently be trending, it is far from trendy--it has been around for more than a century. It began as a treatment for epilepsy. Since that time, there have been many scientific studies for its use in weight loss and improvement of risk factors that define metabolic syndrome.

Keto is a very low carbohydrate (carb), high fat diet, where instead of carbs, the body relies on fat as the primary energy source. We have been told for decades that low fat is essential for good health, but this is not supported by science. For example, the Journal of the American College of Cardiology just published an article called Saturated Fats and Health: A Reassessment and Proposal for Food-based Recommendations: JACC State-of -the-Art Review after determining that whole-fat dairy, unprocessed meat, and eggs are not associated with an increased risk of cardiovascular disease. Therefore they no longer suggest  limiting the intake of such foods. What a change! 

However, rather than keto being the "bacon diet",  variety is important to nourish your gut microbiome, and whole foods are still the foundation of a healthy diet. Instead of bread or pasta, carbs come primarily from low carb veggies and fruits. Some people call this keto 2.0. 

Instead of the typical 50% of calories coming from carbs, in the keto diet, only 5-10% of calories should come from carbs. This can result in rapid weight loss, which tells you something about carbs. 

Sometimes people refer to a keto diet when it is actually a high fat, low carb (HFLC) diet they are eating:  

• Moderate low carb: 20-50 grams of net carbs per day
• Liberal low carb: 50-100 grams of net carbs per day

Here is more about that: 

• Carbs on Low Carb: How Low Carb Is Low Carb? 
• How much food is 20 or 50 grams of carbs? 

More carbs will likely slow weight loss, but if upping your carbs to 40 gms helps you stay on the diet, so what?! If you don’t think it is possible to eat only 20 carbs or less a day, you can up that limit some and still do your body good. Keeping your carb count down should eliminate cravings and decrease hunger. The food is so satisfying and long lasting because of the high fat content. 

Keto Nuts and Bolts 

Here are some great resources to get you started:

• Perfect Keto: The Full Ketogenic Diet Food List
• Keto Vegetables – The Visual Guide to the Best and Worst
• Fruits and berries: A keto guide 
• Keto Fats and Sauces – The Best and the Worst 
• Keto Nuts – a Visual Guide to the Best and the Worst  
• Keto Snacks – A Visual Guide to the Best and the Worst 
• 800+ Easy Low-Carb & Keto Recipes – Meals, Bread & More 
• Get Started with Diet Doctor's FREE 2-Week Keto Challenge! 
• 14-Day Keto Meal Plan with Recipes & Shopping Lists (scroll down to Week 1 of the keto diet meal plan and click on the pictures for free recipes)

Comfort Food Alternatives

If there is one thing that helps me stay a size 4, it is alternative sweeteners! I'm not talking about artificial sweeteners (e.g., aspartame, sucralose), but rather sugar alcohols (e.g., erythritol, xylitol), fruit-derived  (e.g., monk fruit), and plant-derived (e.g., stevia). From brownies, to cheesecake, to ice cream, there is something for everyone. Thanks to ingredients such as almond flour and cheese, even bread lovers can go keto.

Action Alleviates Anxiety

​It is anxiety-provoking not to fit in your jeans any longer as you watch 5 pounds suddenly become 15. And with the added stress of the pandemic, depriving ourselves by dieting is the last thing we want to put ourselves through. However, finding something you can do for your health without feeling deprived is a game-changer, and keto has been the answer for many. Need some inspiration? See 600+ low-carb & keto success stories. 
​
Enjoy and be well!

Do you find yourself trying to “think” your way out of depression. anxiety, or sugar cravings? Are you eating antacids like candy? Can't lose weight? Have frequent infections? What if I told you all of these conditions have been associated with the amount and types of microorganisms in your gastrointestinal (GI) tract? How would you feel knowing you could impact these signs and symptoms simply by changing your diet to include more diverse whole foods?! Research is showing you can heal your body by healing your gut microbiome.

What is the gut microbiome? The gut microbiome consists of a community of microorganisms (microbiota) meant to thrive in the GI tract. These 100 trillion microbes include bacteria, fungi, and viruses. There are 1000 different species of bacteria alone. The abundance and diversity of these healthy microbiota influence your total body health and how you age. The microbiome is an organ that affects our digestion, immunity, metabolism, and even our behavior.

How do I know my gut microbiome is unhealthy? If your diet is low in fiber and lacks diversity, you are at risk for a deficiency in healthy microbiota. Signs and symptoms associated with a deficient microbiome include:

• Depression
• Stress
• Anxiety
• Allergies
• Sugar cravings
• Obesity
• Digestive issues (e.g., bloating, indigestion, constipation, diarrhea, inflammatory bowel disease, gas, cramping, GERD, leaky gut)
• Trouble losing weight, or losing weight without trying
• Insomnia
• Inflammation
• Joint pain
• Skin problems (e.g., eczema)
• Type 2 diabetes
• Heart attack
• Frequent infections
• Weakness
• Frailty
• Decreased cognitive function (i.e., mental decline)

If you have metabolic syndrome, it’s likely many of these signs and symptoms sound familiar to you.
​
How do I make my gut microbiome healthy? 
The good news is that creating a healthy gut microbiome is within your control! It’s as simple as eating the right diet—nutrient dense and delicious! To nourish your gut microbiome:

1. Eat a large variety of whole foods! Choose foods from the Mediterranean Diet as the foundation of your menu plan. Many of these foods are high in polyphenols (e.g., nuts, seeds, berries, olive oil) which feed the healthy microbes.
2. Avoid processed foods. The added ingredients and lack of fiber disrupts the microbiota.
3. Increase fiber intake. Eating more vegetables helps a lot, but you can also take psyllium as a supplement (read the label to avoid hidden sugars).
4. Eat fermented foods with live cultures. The most popular is yogurt or kefir, though read the label to check for hidden sugars. Choose unsweetened, then add your own natural sweetener (e.g., erythritol, never artificial ones such as aspartame) and berries. Other choices include sauerkraut, kimchi, and soy sauce (make it low sodium).
5. Avoid antacids. Eating a healthy diet will likely decrease the need for them anyway.
6. When you need them, you need them but avoid taking antibiotics. When you are on a regime, the above steps are even more important to follow.
7. Though you can take probiotics as a supplement, these do not always contain the live cultures manufacturers claim they do. Better to get them from real food.

Empower yourself knowing the emotional and physical pain you may be feeling now could be eased or reversed just by changing your diet. We really are what we eat, and since we need the diversity, discover the joy of trying new foods! Consider them medicine. 

Acute inflammation that lasts for a few days is a good thing. It is an immediate response by the body as part of our natural defense system. It seeks to limit the damage caused by an injury to body tissue, prevent infection, and promote healing. 

When inflammation becomes chronic, however, everything changes. It becomes a constant, low level energy drain that affects how our body functions and how we feel. It is the underlying cause of many chronic diseases, which are the most significant causes of death in the world. Chronic inflammatory diseases include diabetes, obesity, stroke, chronic respiratory diseases, heart disorders, arthritis, allergies, dementia, and cancer. If you have metabolic syndrome, at least some of these diseases are familiar to you.

The good news is that even small changes made daily over time can have a profound impact on your overall health by dousing the flames of inflammation. You can change the quality and quantity of your life. 

How do I know if I have Chronic Inflammation?

Unlike acute inflammation, symptoms may go unnoticed, or at least not connected with chronic inflammation. These include: 

• Weight gain
• Depression
• Anxiety
• Constant fatigue
• Insomnia
• Gastrointestinal problems (e.g., constipation, diarrhea, GERD)
• Body aches
• Frequent infections

How do I know if I am at Risk for Chronic Inflammation?

Risk factors that promote the development of chronic inflammation include:

• Obesity (the higher the BMI, the more inflammation) 
• Poor diets with an abundance of calories, sugar, processed food, refined carbohydrates, saturated fat, Advanced Glycation End Products* (AGEs), and deficiency of nutrients.
• Smoking
• Chronically high stress levels
• Sleep disorders (e.g., lack of sleep,  irregular sleep schedules)
• Age (more inflammatory molecules as we age)
• Low sex hormones (e.g., testosterone, estrogen)

Take note that except for the last two, all of those inflammatory triggers are within our control to change with lifestyle modifications.

*A note about AGEs: AGEs are found in animal products, and the numbers increase when those foods are cooked at high temperatures (charring or frying, which frankly I love), are high in sugar (which I also love), or processed foods (which are so convenient). AGEs are bad for our bodies because they promote oxidative stress (like an apple turning brown) and inflammation. This affects the normal functioning of cells, making them more prone to damage and premature aging, which contributes to the development or worsening of chronic disease(s).

The Role of the Gastrointestinal Tract

While chronic inflammation affects all the cells in the body, inflammation in the gastrointestinal (GI) tract (i.e., “gut”) is considered a root cause of food sensitivities and allergies. Some of the most reactive foods are barley, beef, chocolate, citrus, coffee, dairy, eggs, nuts, peanuts, rye, seafood, soy, sugar, tea, tomatoes, wheat and yeast. To see if any of these foods are making you feel ill, do you own research and try eliminating them one at a time. 

The following factors also promote gut inflammation: 

• NSAIDS (e.g., ibuprofen, naproxen, voltaren)
• Prescription drugs (e.g., antibiotics, oral contraceptives)
• Foods such as partially hydrogenated fats (e.g., shortening, soft margarine), sugars (e.g., high fructose corn syrup) and fried foods (AGEs) 
• GI bacterial and fungal overgrowth 
• Overeating (due to a reduced amount of enzymes available to break down food) 

In sum, the causes and promoters of chronic inflammation are many, though most are treatable.

What can I do to Decrease Inflammation?

To decrease chronic inflammation, studies recommend the following:

• Remove sugar 
• Eat whole fresh foods:  
  • Tomatoes
  • Broccoli 
  • Avocados 
  • Mushrooms
  • Olive oil
  • Green leafy vegetables
  • Nuts
  • Fatty fish (e.g., salmon, sardines, herring, mackerel, anchovies)
  • Some fruits (e.g., strawberries, blueberries, raspberries, cherries) 
• Exercise -- most days of the week, rigorous at least 3 times a week 
• Stop smoking
• Maintain a healthy weight
• Avoid overeating 
• Reduce stress
  
• Get adequate sleep

​Why now? 

In the midst of the COVID-19 pandemic, there has never been a better reason to make your health and wellness a priority! It should be empowering to know that when it comes to lifestyle changes, we hold the key to good health. Change isn’t easy, but the rewards are many. 

If you live a modern life with lots of time spent sitting or in repetitive motion, setting aside the time for exercise is necessary for your quality of life as you age. Getting physical activity of any kind will help maintain your ability to continue doing the daily activities you enjoy. You promote functional aging as you gain strength and try new activities. Getting enough exercise lowers the risk for many common diseases and is key to reversing metabolic syndrome.

Contrary to what you may have been led to believe, exercise is not a good way to lose weight.

So why bother?

The reason to exercise is to change your body’s metabolism by strengthening and building muscle. This makes sense because skeletal muscle mass is primarily what determines your basal metabolic rate (the number of calories your body needs for life-sustaining functions).

However, as we age, we lose muscle mass (called sarcopenia), limiting our muscles’ ability to be a functioning metabolic organ. This contributes to insulin resistance, a root cause of metabolic syndrome. Exercise also helps reduce inflammation, improve blood sugar, triglyceride and cholesterol levels, reduce blood pressure, and aid digestion. Exercise can also improve sleep quality, mental health, and energy levels.

What exercise “should” I do?

It’s important to choose activities that you will actually be willing to do and that you can do safely. It should be the quantity and type of movement for your unique situation, but any movement is better than no movement, and it’s important to know you are never too old to start or benefit from exercise!
It requires some patience, but the more consistent you are, whatever the movement you choose, the better results you will see (and faster).

Your movement can change as you do. 

Movement can take on many forms and continue to change throughout your life. If you are currently sedentary, you may find a good starting place is the small shifts you can make in your existing routines, such as just parking further away from your destination, carrying groceries to the car, and taking stairs instead of the elevator. If you are already taking walks (bravo!), you can increase the frequency, length, or intensity of them. You might enjoy activities you can do in the privacy of your own home with an instructor on YouTube. You will find these for every activity imaginable, from yoga, to resistance training, to dancing. You might find it motivating to instead/also exercise with friends, whether for a walk, an exercise class, or work with a coach at a gym.

The exercise program to work toward should work all muscle groups by including aerobic exercise, flexibility, agility, and resistance training. Have fun (so important!) as you explore new activities but be gentle with your body to prevent injury. And, always check with your healthcare provider before starting an exercise routine!

What if I have doubts and fears or mental barriers like overwhelm?

The thoughts and feelings of doubt and fear are uncomfortable and overwhelming, but completely normal! Our mind prefers we stay in our comfort zone and resists change. These thoughts and feelings can and will transform with a little practice and support. You will replace that demotivating self-talk with excitement, as you think about how you are improving your health and quality of life.

Taking any steps, however small, toward your vision and goals is progress. Even steps that seem extremely small can still produce positive results. This is the idea of micro-movement. Taking action where you can is the best place to start, and restart if you stopped.

Ask yourself “What could get me moving today? How will I feel afterwards?”

Listen and be patient as you would with a good friend, using encouragement when you talk to yourself. Continue to check-in with your preferences for how you want to exercise. Learn what it is that you need and what supports you the most in your practice of healthy movement. And then, take a step, any step, and treasure your ability to move and transform yourself in body, mind, and spirit!  

​Feeling trapped in your house due to stay at home orders? Bored stiff? Anxious? Depressed? Unproductive? As unpleasant as these feelings are, staying home has never been more important, especially for people with metabolic syndrome who have conditions that increase their vulnerability to COVID-19. For example, in one study of 5700 hospitalized patients with COVID-19, the most common preexisting conditions were hypertension, obesity, and diabetes.

You should know that even for an introvert, this is tough! I’ve worked from home for most of the last 20+ years, which has contributed greatly to my quality of life! I have weekly deadlines, but to decrease stress during this uncertain time, I put aside most all activities that do not have hard deadlines. What is different this time, is I’ve had no guilt about it. After all, we are in the middle of a pandemic!! We all deserve a break. What I’ve found in relaxing my schedule is that I am able to be more present, so that even mundane tasks are more enjoyable.

Now that you’ve had some time to adjust to this new normal, how can you transform from survival mode to thriving? Here are some suggestions:

• Social distance actually refers to physical distance since we are not banned from socializing. After all, we need our family and friends to help us through these challenging times. Stay connected via video calls, texting,  social media, email, or just the good old telephone.  Be creative. In Colorado, we’ve taken up howling with our neighbors at 8 pm! It creates an interesting sort of solidarity. And besides, when is the last time you howled as an adult?! It’s cathartic.
• Get some fresh air and sunshine everyday. Even Florence Nightingale wrote about the importance of this for healing.
• Get enough good sleep. Added stress can keep you awake. Decrease stress by practicing  mindfulness.
• Make yourself a schedule. This may require the collaboration of a household. The idea is to provide some structure so that you are able to accomplish tasks, but do not make your goals unrealistic! It is okay to lower your productivity standards considerably in the midst of a pandemic. Break up large tasks into digestible chunks.
• Eat a healthy diet.  You may not feel like bothering, but with the threat of COVID-19,  it is more important than ever to have a strong immune system and healthy gut microbiome. You might enjoy cooking more with the additional time you have at home. Be bold and try something new! Between TV and YouTube, there is no shortage of cooking shows, and some people enjoy cooking right along with the chefs.
• Keep hydrated. This may seem obvious, but the majority of adults are chronically dehydrated. Drink good water and avoid getting thirsty. If I find myself craving a soda, I usually realize I’m behind on drinking water. If I drink a whole glass, the craving goes away.
• Be active. The tendency when we are home more is to increase sedentary behaviors. Resist the temptation. In addition to a simple  activity such as going for a walk, include more movement in your day. For example if you are doing a lot of sitting, get up every hour or so and do some push-ups or put in a load of laundry.
• Be kind to yourself and others. It’s not easy being steady through this. Even the best of friends can get annoyed with each other when together 24/7. Have your own space as you can, but keep your eyes on the big picture and ignore the little things.
• Consider keeping a journal. The self-reflection through the written word has many benefits, such as easing anxiety and stress while improving emotional intelligence and self-confidence. And besides, this is a historic time in world history, and your grandchildren will enjoy reading about your first-hand experience!
• Take time each day to give thanks for what you are grateful for. It’s easy to forget in times of chaos and turmoil all the good things in our lives, and the good that others do in the world.
• Look for ways to help others. For example, donate to a food bank, make a meal or do some yard work for a neighbor, support a local business, volunteer for a crisis line, teach a skill online, or make a financial contribution to non-profit organizations, churches, or organizations. Also, there are many cities that have groups on Facebook to help identify neighbors in need. That positive energy will come back to you.
• Laugh! There are many health benefits, including decreased levels of stress hormones, increased level of endorphins for well-being, and increased T-cell production for immunity. If you haven’t take the time to enjoy a movie lately, check out The 30 Funniest Movies of all Time and Where to Stream Them.
• All this said, if you and/or your children are living in an unsafe environment, a safety plan has never been more important. Include a face mask(s) and hand sanitizer with your items to take when leaving.  The stress from the pandemic can bring out the worst in people, and there has been a spike in domestic violence calls since stay at home orders have gone into effect. The number to the National Domestic Violence Hotline is 1-800-799-SAFE (7233).

Social distancing has proven stressful for most everyone, but maintaining it is the most kind and caring thing we can do for ourselves and others. We are all in this together!  Let’s come out stronger.

Fortunately, it won’t be often in our lives that we are faced with two public health crises concurrently, both pandemics: COVID-19 and systemic racism. In a democracy, it is our right to peacefully protest, but like never before, we risk our health–even our lives–by doing so because of the virus. People with metabolic syndrome need to be particularly careful, because they have conditions that increase their vulnerability to COVID-19. For example, in one study of 5700 hospitalized patients with COVID-19, the most common preexisting conditions were hypertension, obesity, and diabetes. However, with so much at stake, there are those who argue that their lives are at greater risk if racial discrimination and violence are not stopped. Is it possible to attend a protest gathering while protecting your health? Here are some tips:

Before the Protest

Plan to wear clothing that covers your skin and shoes that you can not only wear comfortably for hours but run in should you need to. Wear glasses not contacts.
Take with you:

• Water bottle
• Masks
• Hand sanitizer
• Disinfectant wipes
• An “in case of emergency” contact number; some protesters are writing the number on their arm

Take nothing of value that you may lose or not get back. If you take your cell phone, be sure to back up your data before leaving.

During the Protest

• Wear a mask. Change it every couple of hours or sooner if it gets wet.
• Keep your hands away from your face. If you forget and touch your face or glasses, wipe them with hand sanitizer.
• Any time you touch anything that someone else could have touched, use hand sanitizer.
• As best you can, maintain social distance–ideally 6 feet between you and others. This may be easiest to accomplish if you are near the end of the pack. In particular, stay away from people who are chanting (aerosolizing the virus). Some cities have caravans where people stay in their vehicle.
• Leave before curfew if there is one
• If the protest appears to be turning violent, get as far away as possible ASAP. Besides the obvious reasons, if chemical agents are used by law enforcement, there will be a sea of virus in the air from people coughing.

After the Protest

• Remove your shoes and clothes as soon as you get in the house. Launder your clothes, take a shower and wash your hair. Soap and water is all you need.
• If you have been around a gathering with hundreds or thousands of people, statistically you can assume you have been exposed to the virus so should get yourself tested. The Colorado Department of Public Health and Environment recommends the following:
  • If you have symptoms, get tested right away
  • If you do not have symptoms, get tested 7 days after exposure (the day of the gathering). Keep in mind it can take up to 14 days for some people who have the virus to test positive, so you should consider minimizing your  contact with others for 14 days after the gathering, even if you test negative before the full two weeks have passed.
• Monitor infection numbers in your state. For example, in Colorado we have a site with extensive case data; there is likely a similar site in your state. For data by country, state, and some counties, see Worldometer. The goal is a reproductive number (the number of people a sick person can infect) less than 1 to prevent exponential growth of the virus.
• Continue your activism! See 26 Ways to be in the Struggle Beyond the Streets and 75 Things White People can do for Racial Justice for ideas.

For more about how to prevent and treat COVID-19, see my blog post COVID-19: What you need to Know.   Be conscientious and be well! ​

If you are like me, it's been hard to think about much else other than COVID-19, the novel coronavirus that is now a pandemic. It should be of particular interest to people with metabolic syndrome, since by definition, they have pre-conditions that put them in a higher risk category for increased illness and death from the disease. What can we do to protect ourselves, and what can we do if we get the disease? There are reasons to be optimistic!

Are you in a High-Risk Group?

There are some conditions that put you at greater risk of complications from COVID-19:

• Age. Though people of all ages can contract the disease, older people have a higher-risk of complications
• BMI >40
• Comorbidities such as:
  • Autoimmune diseases (or drugs for immunosuppression)
  • Diabetes
  • Heart disease (including hypertension)
  • Chronic lung disease (e.g., COPD, asthma)
    • Smoking including vaping
  • Kidney, liver, or neuro disorders
  • Sarcopenia (muscle wasting/weakness)

What can you do to Prevent Getting COVID-19?

The good news is that there is a lot that we can do, and in fact the most important are really "easy":

• Wash your hands. I know you've heard this, but you need to take it almost to the point of ridiculous! Touch something outside your house? Wash your hands. Don't have access to soap and water? Use an alcohol-based hand rub (if you can't find any, you can make your own).
• Keep your hands off your face. The virus enters the body via the mouth, nose, or eyes. If you touch your face and have not washed/rubbed your hands recently, wash or put a rub on your face where you touched. Always be aware of where your hands are. The American Academy of Ophthalmology recommends wearing glasses instead of contact lenses because we touch our eyes more when we have contacts in, and touching our eyes is one way the virus is spread. Don't forget to wash/rub your glasses if you touch them with contaminated hands.
• Practice social distance. Stay home! Go out only for groceries/carry-out or medical need. It's healthy to get some fresh air and sunshine everyday, as long as you can maintain a distance of at least six feet between people at a minimum.

So while these three "easy" things should help keep you from getting the disease, they are really hard! It goes against our nature not to touch our face, so it takes some training. And while we've washed our hands our entire lives, this requires more frequent and longer (i.e., 20 seconds) efforts than we are used to. In addition, we are social beings!

You also want to keep your immune system as healthy as possible:

• Get enough sleep 
• Eat a healthy diet 
• Manage stress with mindfulness
• Strengthen your muscles and get some exercise 

How do you know if you have COVID-19?
​
Testing may not be available, but watch for the following common symptoms of COVID-19:

• Cough
• Fever
• Chills
• Fatigue
• Body aches
• Headache
• Sore throat
• Nausea, vomiting, and/or diarrhea
• Loss of taste and appetite
• Red eye(s)
• Feeling of heaviness in the chest
• Mild shortness of breath

These symptoms can last a week or more, but gradually improve. In about 20% of people, symptoms can get worse:

• Extreme shortness of breath
• Pain or pressure in chest (remains after coughing)
• Unable to keep down food or drink
• Lightheadedness to the point of fainting
• Slurred speech; not thinking properly

This deterioration can occur suddenly. Have a plan in place for how you will get medical assistance.

What do you do if you get Sick?

As scary as it is and as uncomfortable as you might be, remember that the vast majority of people with COVID-19 have only mild to moderate symptoms! Think positively that you will be among them.

• Keep hydrated. A fever increases your fluid needs, and it can be difficult to keep up if you are nauseated or otherwise don't feel like drinking. It is essential though, so be persistent, even if it means mostly ice chips. Eat healthy food as best you can.
• Take acetaminophen (e.g., Tylenol) for fever and body aches if you need to, but do not take ibuprofen (e.g., Motrin).
• Get plenty of sleep
• It's a good idea to have the following items in your tool chest so that you can objectively monitor your progress:
  • Thermometer
  • Automatic blood pressure machine
  • Pulse oximeter. This device uses light from a clip-on device to measure the percent of oxygen saturation in red blood cells (SaO2)
• You  should be isolated from the rest of the family if possible.

Always seek the opinion of your healthcare provider, but to help you determine your course of treatment, see this Coronavirus Checker, a short self-assessment form from the Emory University School of Medicine. The CDC also has it's own self-checker, along with other tips for what to do if you are sick.
​
Be well everyone! We are all in this together.

​If you are overweight or obese, does this sound familiar when you visit your healthcare provider?

Q: “Why am I tired all the time?”
A: “You need to lose weight.”
Q: “What is this bump on my head?”
A: “You need to eat less.”
Q: “How do I get rid of these hiccups?”
A: “You need to exercise more.”

And so it goes. No matter the problem, the focus is directed at your weight. Obesity bias is common in the healthcare system, and too often shame is the intervention. Imagine instead of being viewed as noncompliant, you are viewed as the expert. Imagine being treated with empathy instead of judgment. Imagine being empowered to take charge of your life.

What is health coaching?

We usually think of coaching related to athletics, but in recent years that science has been applied to other disciplines such as psychology, sociology, nutrition, physical therapy, academia, and nursing. Health coaches are certified by accrediting bodies.

Health coaches understand that change is hard! Rather than just providing information and telling people what to do, health coaches view people as whole beings in body, mind, and spirit. They understand that knowledge alone is not enough, since making the necessary lifestyle changes for good health can be an overwhelming task when trying to go it alone.

Among other outcome measures, studies show nurse health coaches have helped clients:

• Lose weight
• Lower fasting blood sugar, total cholesterol levels, LDL (the “bad” cholesterol), and blood pressure
• Improve activity levels and psychological well-being

How does a health coach promote personal transformation?

There are many theorists in nursing who provided a foundation for coaching since that role is a natural one for nursing. Of interest is a philosophical framework called the Theory of Integrative Nurse Coaching (TINC). This theory provides an evidence-based model of care that impacts the health and wellness of clients as well as the nurse.

Personal transformation involves healing of the whole person by making positive lifestyle changes through self-awareness and development. Based on the TINC framework, interventions used by a nurse coach may include:

• Affirmation
• Appreciative Inquiry
• Aromatherapy
• Art and Drawing
• Client Assessments
• Deep Listening
• Energy Practices
• Exercise
• Goal Setting
• Guided Imagery
• Humor and Laughter
• Journaling
• Meditation
• Mindfulness Practice
• Motivational Interviewing
• Music and Sound
• Nature Walks
• Reflection
• Relaxation Modalities
• Self-Assessments
• Self-Care Interventions
• Self-Reflection
• Visioning

Though it may be hard to imagine how such interventions could affect physical symptoms such as insulin resistance, cholesterol problems, and obesity, they are geared to heal you from the inside out, not just put a band-aid on the symptoms. They are certainly not part of an everyday office visit with a healthcare provider, even if they had the time to spend with you.

Chronic stress is a common risk factor for people with metabolic syndrome. It is linked with insulin resistance, inflammation, heart disease, high blood pressure, abdominal obesity, digestive problems, insomnia, depression, anxiety, cancers, and autoimmune diseases. But what can we do when there are so many causes of stress that are beyond our control? The practice of mindfulness is associated with a reduced risk for these conditions. Mindfulness includes simple mental and physical techniques that can improve your health and quality of life.

How does stress affect my body?

We have thoughts about situations whether we need to or not. This is a natural part of being human. We develop strong preferences throughout life for specific outcomes around being our version of safe, healthy, and happy. In order to survive, our body has its own specific preferences too, with the goal of homeostasis. This is the ability of organisms to maintain and control the internal environment despite disturbances from outside forces.

When situations arise that challenge our personal or body’s preferences for homeostasis, we may experience emotional and physical symptoms of stress as a result of chemical changes. Our reactions are all an attempt to make sense or meaning out of what is happening in order to survive and meet our needs. In the short-term, this can be lifesaving.

However, when you choose a thought-response that results in a prolonged sense of fear, anger, worry, or anxiety, you are signaling to your body for a corresponding physical-response. This ongoing state of “fight or flight” and chronic release of the stress hormone cortisol has earned it the name, the “fat hormone”.

How does mindfulness work?

Mindfulness is a learned trait that is defined as a non-judgmental awareness of the present moment. Studies demonstrate that developing this trait has positive effects on your physical and mental health.
Mindfulness works because you are the one with the most influence on your thoughts, actions, and the reactions that happen in the body as a result. However, even a small amount of regular attention to mindfulness can have a positive impact on your health!

What are we trying to accomplish with mindfulness?

The first goal of mindfulness practice is to put just a little more time between the moment of something happening and your reaction to it. Mindfulness reduces the activity in the part of the brain called the amygdala that’s responsible for turning on your stress response.

This momentary delay gives you a chance to choose your next thoughts and influence your body’s reaction. It also puts you in greater touch with your thoughts, whether they make sense for what you want, and whether there may be a better way to address the situation.

How do I practice mindfulness?
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Here are some key ways that help you learn a new response to stress through mindfulness:

• Take some slow, deep breaths for as long as you need. This shifts your focus to how the breath sounds and feels throughout the body. Purposely take the time to do this before you react to a situation.
• Movement, sound and touch dissipate the stress response. Walk, dance, sing, make silly noises, or do something you get pleasure from.
• Notice stressful thoughts and let them arrive and depart as clouds in the sky or train cars on a track.
• Direct your attention to an aspect of your life you feel secure about.
• Find appreciation or gratitude for something or someone.
• Start a mindfulness meditation practice. You can start with just 5 minutes a day. The UCLA Mindful Awareness Research Center developed Free Guided Meditations that includes an app for iPhone and iPad. Also see Getting Started with Mindfulness

With daily and subtle awareness of your thoughts and reactions, you can develop the trait of mindfulness and improve your physical and emotional health. 

As of this morning, Chinese health authorities reported 37 thousand cases of novel coronavirus (2019-nCoV) with 810 deaths globally. Though quarantines are in place, the World Health Organization declared coronavirus a public health emergency, so fears about the virus have, well, gone viral. It’s important to remember however that as scary as those numbers are, they pale in comparison to seasonal flu. The CDC reported that in the 2017-2018 flu season, there were as many as 45 million cases, 810 thousand hospitalizations, and 61 thousand deaths from the plain old flu. Both infections need to be taken seriously.

What is seasonal flu and how do I prevent it?
Fortunately, there is a flu vaccine available. Estimates indicate the flu shot prevents about 5 million people from getting the flu every year. Still, most recent reports indicate only 37% of adults received a flu vaccine.
Whether you receive a flu vaccine or not, one of the most important things you can do to prevent the flu is to practice good hand hygiene! Seems too simple to be true, but you need to do more than a quick rinse:

• Use soap and wash hands a minimum of 20 seconds
• Wash hands frequently, especially after using the bathroom, blowing your nose, and before eating
• Clean/disinfect surfaces/objects often
• Keep your hands away from your eyes, nose and mouth—it is amazing how many times we do this without realizing it. My awakening came after cutting jalapeno peppers as my face started to burn.

How do I prevent coronavirus?
There is not yet a vaccine for coronavirus, though one is predicted for 2021. However, the good news is, the same hand hygiene tips above are essential in preventing coronavirus.

How do I know if I have the flu or coronavirus?
Many symptoms are shared by both flu and coronavirus:

1. Fever
2. Cough
3. Shortness of breath
4. Muscle aches
5. Headache
6. Sore throat
7. Runny nose
8. Fatigue

In people with coronavirus, the first 3 are the most common symptoms.

Your history can give an indication of which virus you contracted. For one thing, seasonal flu is much more common. However, you would want to mention to your healthcare provider if you have been exposed to an infected person, had recent travel, or are in close contact with animals including bats.

There are laboratory tests to detect flu, most commonly “rapid influenza diagnostic tests” (RIDTs). The CDC developed test kits for coronavirus available at this writing to about 200 labs in the US.

Why do some people die from the flu or coronavirus while others do not?
There are some conditions that put you at greater risk of complications from both seasonal flu and coronavirus:

• Age (children younger than 2 or adults 65 or older)
• BMI >40
• Comorbidities such as:
  • Autoimmune diseases or chemo
  • Diabetes
  • Heart disease (including hypertension)
  • Chronic lung disease
  • Kidney, liver, or neuro disorders

Many of these conditions look familiar to people with metabolic syndrome.

​How do I know if I’m in trouble?
Life threatening complications of both viruses include:

• Pneumonia
• ARDS (Adult Respiratory Distress Syndrome)
• Septic shock

There are warning signs that you are dealing with more than the flu or coronavirus. Though antibiotics don’t do anything for viruses, secondary bacterial or fungal infections can occur which generally do respond to antibiotics if the infection is caught early.
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You should be feeling better in a week, with symptoms tapering off within 2 weeks. Let your healthcare provider know right away if you experience the following:

• Symptoms go on longer than 2 weeks
• Feeling worse after you start feeling better
• Unable to drink enough water to stay hydrated
• A fever for more than 3 days, or a fever returns. Every household should have an electronic thermometer.
• Secondary infections often settle in the lungs, so monitor for the following:
  • Increased shortness of breath
  • Increased sputum (from a dry cough to a productive one)
  • Pulse oximetry < 90%. Using light from a clip-on device, a pulse oximeter measures the percent of oxygen saturation in red blood cells (SaO2). I mention it because the devices have become so affordable and give objective measurement of how your heart and lungs are functioning. I do not endorse any products, but here are some examples of devices with good reviews for under $25:
    • Innovo Deluxe Fingertip Pulse Oximeter with Plethysmograph and Perfusion Index
    • Zacurate Pro Series 500DL Fingertip Pulse Oximeter Blood Oxygen Saturation Monitor
    • ClinicalGuard CMS 50-DL Fingertip Pulse Oximeter
    • Concord Sapphire Fingertip Pulse Oximeter
    • Deluxe SM-110 Two Way Display Finger Pulse Oximeter
    • Mibest Silver Dual Color OLED Finger Pulse Oximeter

There are also pulse oximeters included in some wearable fitness devices, though be sure to look for reviews that address reliability.
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In sum, both the flu and coronavirus deserve serious attention, but with proper prevention, detection, treatment, and monitoring strategies, serious complications can be averted. Be well! 

You already may know the journey to reversing metabolic syndrome and improving your health is full of rewards for your physical, emotional, and spiritual well-being.

But did you think this journey would also tantalize you with delicious food and flavors in all colors of the rainbow? 

I’m here to inform you that this is the case, thanks to the world of whole foods! You can look forward to improved energy levels, better digestion, clearer skin, normal blood sugar levels, normal blood pressure, healthy weight, normal triglyceride and cholesterol levels, to name a few outcomes experienced by people eating a whole foods diet.

Think of food as medicine. Whole foods are essential to supporting a safe and healthy journey to reversing metabolic syndrome because of their quality of being “whole” and therefore containing the nutrients you need for healing and thriving.

But what are “whole foods”?

Whole foods are fresh foods that look almost exactly as you’d find them growing at the farm or in the garden. 

If you haven’t been to a farm or garden in a while, imagine instead what you’d find in the produce section and in the meat section of your grocery store. You’d find foods that look quite similar to plants and animals in their original forms.
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In this “whole” form, foods have the highest amount of vitamins, minerals, enzymes, complex fibers, and naturally-occurring anti-inflammatory compounds. They provide the fuel for your body to function optimally. Just as nature intended.

Rather than a specific diet, whole foods provide the foundation of any healthy eating plan. For example, use the food choices from the Mediterranean diet when crafting your menus.

About the delicious, colorful and tantalizing part…

Every color and each vegetable represent, at the chemical level, a different set of many nutrients. So, a variety of color means getting a variety of nutrients. These nutrients are most available when they are whole and unprocessed or minimally processed. The flavors are as endless as the colors.

Whole foods also include beans, grains, nuts/seeds, fish/seafood, meat, and eggs. “Whole food” meat means fresh, whole cuts. Choosing USDA organic, grass-fed beef means more nutrients and fewer harmful chemicals in your body.

On the other hand, when whole foods are heavily processed, the nutrients are lost or no longer in a form that nourishes the body. 

To create the products like those you find in shelf-stable packaging, whole foods are heat-treated and often ground up and reformed, and sometimes sterilized again at the end. Some are frozen, thawed, and cooked again before you eat them.

This processing results in the nutrients in the foods degrading or being washed away. In addition, most processed food products contain chemical additives to alter color, flavor, and shelf-life, and have high levels of unhealthy fats (e.g., partially hydrogenated oil), salt, and sugar. The ingredients in many of these products are designed to make you want to eat more than you need.

All of these factors reduce or eliminate the nutrients the original whole foods once had. When consumed regularly and in excess, they can negatively affect digestion, hunger hormone signaling, and contribute to the imbalances and inflammation that leads to metabolic syndrome and other health issues.

So how do you eat whole foods?

As to vegetables, eating them raw is best, and a delicious salad can be a meal in itself. Different stages of “whole” results in different nutrients being available or “unlocked” as a result of the chemical reactions when exposed to heat. Lightly steamed, sautéed, roasted, or slow-cooked, as a soup, casserole or stew, how vegetables are prepared also transforms them in taste, texture, and aroma. Using healthy cooking oils, such as olive oil, with herbs and spices gives foods even more nutrition and pizzazz.

Whatever your personal preferences, there are colors, flavors, and nutrition plans to suit your lifestyle and goals. The process is as colorful and enriching as the whole foods you’ll be eating!

As 2020 approaches and you consider your new year's resolutions, have you dared asked yourself:

• Could I experience good health again, even with my age, busy life, physical limitations, and genetics?
• Could I safely and naturally--
  • reverse insulin resistance , pre-diabetes or type 2 diabetes?
  • lose weight?
  • lower blood pressure?
  • lower triglyceride levels?
  • increase HDL cholesterol levels?

In my experience, the answer to all these questions is “Yes!” 
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I probably don’t have to tell you that health problems are. . . a problem. What’s in it for you to reverse your health conditions? Living the rest of your life with all the possibilities that good health affords. 
From what you can do, to how you feel, to what it costs to treat your conditions, your health matters. Your version of good health is a vision you carry within you. In my experience, there is a path for every person to improve their health and quality of life. Ready to learn more? 

What is metabolic syndrome?
Maybe you’re aware of the term "metabolic syndrome", and maybe not. It has also been called Syndrome X, insulin resistance syndrome, and dysmetabolic syndrome.  It hasn’t quite gone viral online but maybe it should. Nearly a third of women in the US have it, and the occurrence increases  with age. More than half of women 60 years or older have metabolic syndrome. 

Metabolic syndrome is defined as having at least 3 of the following risk factors: 

1. Abdominal obesity
2. High triglyceride levels
3. Low HDL (High-Density Lipoproteins --“good” cholesterol)
4. High blood pressure (greater than 130/85 mmHg)
5. High blood sugar levels (insulin resistance)

Even if the values are only moderately raised, the chances of developing chronic health problems increase with each risk factor present. 

One woman’s experience may be very different from the next woman’s experience with metabolic syndrome. 

There are other conditions that commonly occur in individuals with metabolic syndrome including: diabetes, heart disease, stroke, anxiety, depression, sleep deprivation, sleep apnea, fatty liver disease, cancer,  food allergies, chronic inflammation, thyroid issues, GERD (gastroesophageal reflux disease), and dysbiosis (an imbalance of the bacteria) in the gastrointestinal tract.

Living with metabolic syndrome and its associated conditions can mean a major loss in quality of life. The level of participation in the activities you love and the cost of health expenses in the short and long-term may be affected. 

So now what? 
Close your eyes and take a deep breath in and out. That’s always a good place to start! All of this is overwhelming. However I believe you will influence your own recovery with education and the choices you make. The repeated, simple and small decisions that benefit you in healing naturally is where your power is and I invite you to tap into that power. 

Wherever you are on your path, I invite you to join us for the next 12-week online program to safely reverse metabolic syndrome. My MetaSyn WomanTM program is focused on you as a whole person to help you treat the causes of metabolic syndrome and enjoy life along the way. You will interact with me and other members using a private Facebook group that includes a weekly Facebook Live video and recording. You are able to engage in the group as you need to remain focused, inspired and motivated each day. 

There is also a self-study component of the program with content broken down into digestible chunks, with manageable action steps for each week to integrate into your life. This knowledge will empower you to make self-care a priority. The result will be more energy to support healthy habits for shopping, cooking, eating, stress management, mindfulness, movement (some call it exercise), elimination, rest, and more.

​​Thanks for joining me! Do you have type 2 diabetes or insulin resistance? Hypertension? Cholesterol problems? Obesity? If so, this blog is for you! These are all risk factors associated with a condition called metabolic syndrome which affects one quarter of the world’s population. The syndrome can lead to very serious health conditions, such as heart disease, stroke, fatty liver disease, polycystic ovarian syndrome (PCOS), and even cancer. The good news is, metabolic syndrome is reversible. I know because I used to have three of the risk factors myself.  Knowledge alone is not enough–if it were, the majority of nurses and doctors would have a normal body mass index (BMI), eat healthfully, and exercise every day. The fact is, change is hard!! Having a health coach who sees you as a whole person–not just telling you to eat less and exercise more–can make all the difference. Replace feelings of anxiety and hopelessness with excitement as you take charge of your health and enjoy the support of others who understand your pain.