 Gut health is important for overall health, and there are many wide-ranging causes that can change and affect gut health. These changes can be from acute causes, such as gastrointestinal surgeries, to others, such as the normal aging process, which may affect gastrointestinal motility. Regardless of the cause, the intestines usually experience changes during the healing or aging process.1
That said, despite any shifts, it’s important to get back on track as soon as possible and make the gut the best it can be.1 Here are a few things to consider. What are the implications of changes in the gut? The gut has trillions of bacteria that help to digest food, absorb nutrients, and manage our wellbeing.Many of these bacteria are beneficial, and evidence has shown that good gut health is linked to supporting general health, including the immune system and brain. However, certain gastrointestinal conditions can lead to changes in the gut’s microbial environment and result in poor health and wellness.2 Common sources of gut-health changes include shifts in gut immunity, stomach acid, and gastrointestinal flora (that is, the ecosystem of over 400 bacterial species that make up the microbiome).2,3 Some digestive changes—including compromised gut function—are simply caused by the aging process.3This is because our natural metabolic processes slow as we grow older. Are there ways to support common gastrointestinal changes? You’ve probably heard the expression, “prevention is the best form of medicine.” Prevention is admittedly king in a healthcare setting, but it also involves hard work and dedication. So how can we avoid intestinal changes that may affect gut health? Here are some preventive strategies that may help keep your gastrointestinal health in check:4
Which ingredients can enhance gut health?Many foods and supplements are connected to a healthy gut and a strong digestive tract.4 Some options to explore include: 1. Probiotics Probiotics are “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.”6,7 They offer a number of benefits, including supporting digestion, and data suggests a gut-brain connection exists.8 While only strain-identified probiotics have been researched extensively for specific health benefits, fermented foods, such as kimchi, miso soup, kombucha, and kefir are popular dietary sources of probiotics. Most probiotics come from one of the following genera of bacteria:8
2. Prebiotics Prebiotics are fibrous carbs the human body cannot digest (but certain bacteria in the gut can). They serve as food for probiotics and include oats, garlic, onions, apple skin, beans, and chicory root.5 Much like probiotics, prebiotics encourage healthy digestion.8 3. Fiber When it comes to improving our digestive health, fiber—also known as roughage—is crucial.13 It cannot be digested by the body; rather, it passes through the stomach, small intestine, and colon more or less intact.9 Fruits and vegetable, whole grains, beans, and legumes are all rich in fiber.14 Fibrous ingredients are generally full of nutrients as well, which may enhance our absorption abilities.13 There are two types of fiber, one of which is more closely linked to the digestive system:13
Be sure to discuss your fiber intake with your healthcare practitioner to minimize chances of discomfort.13 4. Glutamine This amino acid provides both a source of fuel and precursors for growth to the rapidly dividing cells of the intestinal lining.15 5. Inner-leaf aloe Sourced from the aloe vera plant, inner-leaf aloe has been shown in studies to support temporary digestive symptoms such as cramping, bloating, and flatulence.16 It has also been shown to a support a healthy intestinal lining.17 6. Zinc-carnosine Ideal for gastric comfort, zinc-carnosine works by supporting the healthy ecology and integrity of the stomach lining.18,19 Always consult your healthcare practitioner before making any adjustments to your diet or adding any supplements. For more information on nutrition and gut health, please visit the Metagenics blog. References
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 Have you ever stood before the wall of vitamins at the drugstore or your healthcare practitioner’s office, wondering what you should take? Choosing supplements can be a daunting experience: Some boxes are orange. Some bottles are silver. Some contain iron, while others do not. Which one is right for you?
Start the selection process by getting specific about your particular stage of life. From young adulthood to the childbearing years and into menopause, each life stage may require greater emphasis on different nutrients to help your body get what it needs for optimal wellness. Young, ambitious, and carefree! Does this ring true for you? Women in their late teens or early 20s are going off to college, choosing a career path, and just beginning to explore adulthood. This is a time to be mindful of getting the appropriate nutrients you need to create a healthy foundation for the years ahead. Calcium. This mineral is important for women of all ages, but especially so in your 20s when bone mass reaches its peak. After this time, the risk of losing bone mass increases as a woman moves into her 30s and beyond.1 Taking a calcium supplement can help the body build bone, especially when paired with vitamin D3, which is known to enhance absorption of this vital mineral.2 Iron. Iron is important for young ladies, as menstruation is one of the ways this mineral is depleted from the body. In fact, menstruation increases the average daily iron loss to about 2 mg per day in premenopausal female adults,3 with excessive menstrual blood loss as the most common cause of iron deficiency in women.3 Baby, it’s you!The time of a woman’s life when she can become pregnant and have a baby is very special. It is also especially important to consider which nutrients are needed before conceiving and to ensure a smooth pregnancy and delivery. Folic acid. This vitamin (known as folate in its natural form) is needed before and during pregnancy. If you are considering getting pregnant, it is smart to increase folic acid intake before conceiving—there is strong evidence that taking folic acid prior to conception and during the first trimester of pregnancy can reduce the risk of neural tube defects of the brain, spine, or spinal cord by up to 70%.4Additionally, folic acid requirements are 5- to 10-fold higher in pregnant women than nonpregnant women,5 so get your folic acid going! Iron. Iron supplementation in pregnancy is often recommended. During pregnancy, the body’s iron requirements progressively increase until the third month.6 This is because more iron is needed for the growing fetus and placenta, as well as to increase your red blood cells.7 Calcium. Calcium is essential for fetal development, and this requirement increases during pregnancy (from 50 mg/day at the halfway point up to 330 mg/day at the end) and lactation.6 Iodine. During pregnancy, iodine is needed in the production of fetal thyroid hormones (the fetus’ thyroid begins functioning as early as 12 weeks in the womb!) and should be increased by about 50%.6 Vitamin D. Vitamin D (mostly vitamin D3, as it’s the predominant form in mom’s blood) is needed in the first stage of pregnancy, as it contributes to embryo implantation and the regulation of several hormones.6 Choline. Choline is an important nutrient for the health of women throughout their lifetime, and in particular during pregnancy. Choline is also vital for early brain development.8 The change of lifeAs your body progresses toward menopause, it produces less estrogen, opening up a world of change. It is during this time that certain nutrients can help support you in the management of symptoms like hot flashes and mood fluctuations, as well as help stave off concerns about bone mass loss. Calcium and vitamin D. In menopause, calcium remains a top nutrient to support the maintenance of bone mass. Bone turnover increases at this time, while the creation of new bone does not, which can lead to bone mass loss. Along with calcium, vitamin D is an important factor in helping to support bone health, which has been shown to help prevent bone mass loss in perimenopausal and menopausal women.9 Vitamin K and vitamin D. It has been shown that Vitamin D and K are both important nutritional factors in supporting mineralization and healthy structure of bones.10 Vitamin B12. When it comes to menopause, the B’s have it! Vitamin B12 plays a key role in energy metabolism, something we all need more of during menopause.11 Where to begin?Your healthcare practitioner is the best person to ask about which nutrients you may need. So get out of the vitamin aisle and in to see your doctor! This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Individuals should always consult with their healthcare professional for advice on medical issues. References:
 It’s not all fun and games when you’re living the low-carb lifestyle—but sometimes, it can be! Read on for a list of low-carb cocktails you can enjoy while following a ketogenic diet plan. First, here’s a simple rule of thumb: when consumed in moderation, any hard liquor can be considered acceptable by keto standards—either by itself or with plain, sugar-free sparkling water. Many sparkling waters contain zero everything, including calories, sugar, sodium, and, of course, carbs; just make sure you check the label or ask the bartender. For extra flavor, fresh lemon or lime juice is always acceptable. Whether you’re at home or at happy hour, these seven “ketolicious” cocktails won’t disappoint.  Vodka SodaA simple, low-carb favorite.What you’ll need:
Some like it sweet You don’t have to sacrifice sweetness in your low-carb cocktail fix. Each serving of this ketogenic simple syrup contains just 2 net carbs. What you’ll need:
Remember: If you choose to indulge in alcohol, it should always be in moderation. Enjoy responsibly. With all the keto-friendly cocktail options out there, you have yet another reason never to feel like you’re missing out on anything. Cheers!  Many of us (men and women) have had moments where we sneezed and lost control of our bladder, or we had a coughing attack and sprang a little “leak.” But for women in menopause, urinary leakage can occur more frequently and cause embarrassment and concern. Urinary incontinence is actually common during this time in a woman’s lifespan and can be the result of one or more causes. Fortunately, there are many ways to address this problem.
What is urinary incontinence?Simply put, urinary incontinence is the involuntary leakage of urine.1 Up to one-third of men and women in the US have urinary incontinence,1 but it is older women—those going through perimenopause and menopause—who most often develop stress urinary incontinence (SUI).1 Urge incontinence (UI) is also common in postmenopausal women; also known as overactive bladder (OAB), the condition results in a fast, urgent need to urinate, accompanied by urine leakage.2 Bend. Lift. Leak.As time marches on, children are born, and estrogen levels drop, the pelvic floor muscles that support the bladder and other organs can naturally weaken and become stretched. Less support means less ability to hold urine, and when the urethra (the duct where urine comes out of the body) is challenged by a good sneeze or lifting a box, it can leak out a few drops, or up to a tablespoon or more.1 This is SUI, and a decline in estrogen levels plays an important role in its development during menopause, at which time the tissues of the urogenital tract can weaken and become thin.3,4 Additionally, giving birth multiple times, or traumatic vaginal birthing, can contribute to SUI in menopause.4 Gotta go—now!Urge incontinence (UI) is the sudden urge to urinate, often accompanied by urine leakage. In addition to the weakening of pelvic tissues during and after menopause, UI may be caused by a lack of coordination between the brain and bladder, with the signal to urinate being sent by the brain at the wrong time.5Other symptoms of UI include urinating more than eight times per day and more than once at night (nocturia).5 What can be done about urinary incontinence?There are several ways to help make it easier to deal with urinary incontinence. You may start by refraining from alcohol and caffeine; stopping drinking liquids close to bedtime; wearing a disposable pad designed to absorb urine; and maintaining a healthy weight. There are also more comprehensive methods available to address urinary incontinence. Pelvic floor strengthening exercise--The beloved Kegel exercise is a well-known way to help strengthen pelvic floor muscles and possibly eliminate bladder leakage.6 By contracting and relaxing these muscles repeatedly, they can be strengthened and provide better bladder support. Where are your pelvic floor muscles? If you can stop urinating midstream, you’ve found them.6 Ask your healthcare practitioner for information on how to perform the Kegel exercise. Pessary--This small device is inserted into the vagina to help support the pelvic organs and is also used to treat urinary incontinence. Fitted by your healthcare practitioner, a pessary is removable, minimally invasive, and discreet. There are also over-the-counter, disposable bladder supports available that are self-fitting.7,8 Biofeedback--Small sensors are discreetly placed on the body and used to measure what the pelvic floor muscles are doing, as well as provide feedback to help teach you how to control the pelvic floor muscles.9 Medication--Drugs that are designed specifically for urinary incontinence can be used alone or with a method such as biofeedback; they work primarily by relaxing the bladder muscle and increasing the amount of urine the bladder can hold.10 Surgery--While surgery is more invasive than other ways that address urinary incontinence, it can also successfully resolve it. Procedures such as sling surgery and bladder neck suspension can help keep the urethra from moving down and opening accidentally.11 No matter which method you wish to try, always ask your healthcare practitioner about which is right for you. He or she knows your personal health history best and can help you find relief from menopausal urinary incontinence. This information is for educational purposes only. This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Individuals should always consult with their healthcare professional for advice on medical issues. References:
 Fish and shellfish are full of healthy fats, vitamins, and minerals. Great for our physical and cognitive wellbeing, they’re a solid addition to a nutritious diet.1
That said, not all seafood is created equal. This post will outline the differences between farm-raised and wild-caught fish, including their impact on our health and the environment. What are the differences between farm-raised and wild-caught fish? Fishermen catch wild fish and shellfish in lakes, rivers, oceans, and other bodies of water. These fish eat a natural diet. Farmed fish are bred for human consumption through a process called aquaculture. This means they live outside their natural environment and are generally given processed feed.2 Specifically, farmed fish are placed in pens submerged in ponds, lakes, or even saltwater.1 Some pens are filled with water and kept on land. While this might not sound ideal, fish farming isn’t inherently bad. Sustainable farming practices have become more common than ever, as the World Bank estimates that almost two-thirds of seafood will be farm-raised by 2030. In Norway and Canada, for instance, most farmed salmon are cultivated through an eco-friendly recirculating aquaculture system.3 Here are some other items to consider:
Nutrition: Which fish variety is better for your health?Fish have been shown in clinical studies to display anti-inflammatory properties, not to mention being rich in heart-healthy omega-3 fatty acids.3 The overall quality of seafood, however, depends largely on what fish eat. Wild fish consume a natural diet lower in saturated fats.5 What does this mean? Let’s focus on salmon for a moment. In addition to being higher in saturated fat than wild salmon, farmed salmon contains more omega-3s and 46% more calories. The wild-caught stuff, however, is richer in minerals like potassium, zinc, and iron.4 Consider the following when evaluating both fish varieties for your health:
Most people consume too much omega-6, which may cause inflammation and other symptoms. And farm-raised salmon specifically—despite containing higher quantities of omega-3—has a significantly higher omega-3-to-omega-6 ratio.4 The ratio is still good enough, but it isn’t quite at the level you would find in wild seafood.
Of course, the trace metals found in fish aren’t limited to mercury. Farmed salmon contains higher arsenic levels, while wild salmon contains more cobalt, copper, and cadmium.7 Fortunately, levels of trace metals in both wild and farmed fish are usually so low they’re unlikely to harm the average person.4
Some studies indicate that farm-raised fish have higher levels of contaminants.4 Furthermore, seafood raised via aquaculture may have a higher rate of disease because of some of the farming practices and conditions.5
For example, approximately 530 grams of antibiotics were used per ton of harvested Chilean salmon in 2016. (In contrast, Norway used just 1 gram of antibiotics per ton of harvested salmon in 2008.)4As such, it’s essential that you understand where your fish is from before consumption. Sustainability: Which fish variety is better for the environment?Fish accounts for 17% of our global protein intake.8 For this reason, we can’t rely on wild-caught fish alone. There just isn’t enough wild seafood to keep up with the growing demand. Based on our current trajectory, there’s a global need for another 80 million tons of farmed fish per year by 2050.8 Yet aquaculture may be detrimental to the environment too. Use of antibiotics can cause damage to the environment and adversely affect human health as well.4 Moreover, when lots of fish are crammed together in a small space like a pen, they create a ton of waste that can pollute rivers, lakes, and oceans.8 And the environmental consequences of fish farming doesn’t end there, either. Some fish farms are disease-ridden, which can be toxic to the environment; in Indonesia, shrimp farming specifically has contributed to the decline of the nation’s mangrove forests.8 Since we don’t want to deplete what’s left of our wild fish resources, where does that leave us? Fortunately, some experts say that feeding farmed fish a higher-quality diet free from antibiotics can help address some of the problems described above. Similarly, as fish farmers gain efficiency, governments will be more likely to offer incentives for the adoption of sustainable practices.8 Ideally, the environment will become an even greater focus for everyone in the near future. The verdict on wild-caught vs. farm-raised fishWhile wild seafood is generally healthier than farmed fish and shellfish, sustainable methods make many farm-raised options completely viable. Both wild-caught and farm-raised fish varieties offer plenty of protein, the omega-3 Docosahexaenoic acid (DHA), and other essential nutrients.4 To make sure you’re eating top-quality seafood, be sure to look into where your seafood is from, and opt to eat local, low-mercury varieties when possible. For more information on nutrition and general wellness topics, please visit the Metagenics blog. References:
 Consider these general diet descriptions:
So is a vegetarian or vegan ketogenic diet possible? Short answer: yes. The ketogenic diet differs from other diets in that it is not based around food groups you can or cannot eat; rather it is based on the macronutrient ratio your body requires to enter a state of nutritional ketosis (defined by an elevation of blood beta-hydroxybutyrate, the body’s primary ketone body). Thus, any style of eating can potentially be ketogenic, whether that is vegan, paleo, low FODMAP, etc. When you are approaching the ketogenic diet from a plant-based perspective, look at what plant foods comply to the macronutrient ratios you are following and stick to those. General guidelines for following a ketogenic diet:
Vegan ketogenic “food groups”:
Vegan food swaps
Tips & tricks
Submitted by the Metagenics Marketing Team  Wouldn’t it be nice to live in a world where the answers to all our health questions were black and white, (“Eat this, and you will feel good; don’t eat this, or you will not feel good”)? Unfortunately, health is not black and white, and often we have to navigate through the grey areas to find the truth. MYTH #1: A ketogenic diet increases your risk for cardiovascular diseaseThis myth is centred around the misinformation that saturated fat and cholesterol are the main causes of heart disease. Despite being shown that dietary cholesterol does not raise blood cholesterol1 and saturated fat has little correlation to heart disease,2 there is still a stigma around both. Cardiovascular risk does not boil down to a single biomarker, but rather encompasses a host of factors such as age, sex, total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, smoking, blood pressure, glycemic control, and more. Several of these risk factors may be mitigated by lifestyle changes. Low-density lipoprotein (LDL) cholesterol, as opposed to high-density lipoprotein (HDL) cholesterol, often gets a bad rap because the general understanding about cholesterol is that LDL cholesterol is the “bad” cholesterol, and HDL cholesterol is the “good” cholesterol. While this isn’t entirely misleading, what is misleading is referring to these as absolutes. LDL is usually misrepresented as the single factor that determines one’s risk for cardiovascular disease (CVD), when in fact there is more to the LDL and CVD risk story much of which is still uncovered. The danger lies with the small, dense LDL particles (as opposed to large, buoyant LDL particles),3 which have been shown to be associated with CVD.4 It is not uncommon to see a rise in total LDL levels when following a ketogenic diet. Recently published results of a one-year study of patients on a well-formulated ketogenic diet showed that the ketogenic diet did not change total LDL particle numbers but rather caused a shift toward an increase in large, buoyant LDL particles and decrease in small, dense LDL particles,5 which is a good thing! With all of this said, there is still a lot that is not fully understood about LDL cholesterol in the context of a ketogenic diet. As previously stated, LDL is not the only biomarker to consider when determining risk for CVD. Working with a keto-savvy physician is recommended when considering a ketogenic diet. When part of a weight management program including exercise and lifestyle modifications, the ketogenic diet can actually improve other biomarkers of CVD risk, such as weight,6 HDL cholesterol,6 blood pressure,5 blood levels of saturated fat,7 HbA1c,5 inflammation,8 and more! In fact, research has shown that carbohydrate-rich diets pose more of a health risk than ketogenic diets. High-carbohydrate diets have been associated with increases in small, dense LDL particles and reductions in HDL cholesterol along with raised triacylglycerol levels, all of which contribute to increased CVD risk.9 MYTH #2: The human body requires carbohydrates to survive This one may be hard to wrap your head around considering there are actually some cell types that do have an absolute requirement for glucose and cannot use fats or ketones for fuel, such as red blood cells which lack mitochondria, the organelle required for ketone utilization. Dr. George Cahill, former professor at Harvard Medical School, studied human body fuel metabolism under prolonged starvation, pioneering the understanding of ketones as an alternative fuel source to glucose. His research demonstrated that even after 40 days of fasting, glucose levels in the participants were maintained, despite consuming no food (Figure 1).10 So where does the glucose come from to fuel these cells when carbohydrates are restricted, such as with a ketogenic diet? Once you are keto-adapted (i.e. in a state of sustained nutritional ketosis), there are two primary sources that contribute to glucose maintenance. The first is from amino acids via a process called gluconeogenesis, where certain gluconeogenic amino acids are broken down into glucose. These amino acids can come from the protein consumed or stored in muscles. However, when ketones are circulating in our blood and the brain begins preferentially using ketones for the fuel, glucose requirements are reduced, therefore the need to break down muscle is reduced. This is one way ketones are muscle-sparing. The second source of glucose is from the glycerol backbone of triglycerides. Triglycerides are the storage form of fat and contain one glycerol backbone attached to three fatty acids. When the body breaks down stored fat while in ketosis, the fatty acids are detached from this glycerol molecule to make ketones, and the glycerol molecule can be converted into glucose, accounting for most of the body’s glucose requirements when keto-adapted.  Figure 1: Circulating concentrations of βOHB, glucose, free fatty acids, and acetoacetate in obese but otherwise normal man fasting for 40 days. Adapted from Cahill GF et al. Ketoacids? Good medicine? Transactions of the American Clinical and Climatological Association. 2003;114:149-163.
MYTH #3: Nutritional ketosis puts you at risk for ketoacidosis This is one of the most common myths, and despite being proven wrong time and again, people still want to believe that the ketogenic diet causes ketoacidosis. Ketoacidosis is a valid concern given that it can be a life-threatening event where ketone bodies cause a dangerous imbalance in blood pH. However, this condition occurs primarily in those with type-1 diabetes or insulin-dependent type-2 diabetes, and is uncommon in healthy individuals with a fully functioning pancreas. Blood ketone levels are regulated by insulin, just as blood glucose is. When ketones reach their upper limit (~7-8mmol/L), a small amount of insulin is released from the pancreas to help prevent any further elevation in blood ketones, this system is designed to help the body avoid what is considered ketoacidosis (~15-25mmol/L). Nutritional ketosis (i.e. ketosis achieved via a ketogenic diet) is highly unlikely to put a healthy person at risk of reaching dangerous ketone levels. There are rare exceptions to this where ketoacidosis can occur in those adhering to a ketogenic diet in instances such as dehydration, sickness, and possibly pregnancy. However, it is always advised to start a diet and/or weight management program under the supervision of a physician or healthcare provider. MYTH #4: You can’t do keto as a vegan or vegetarian The ketogenic diet is commonly associated with a diet primarily composed of animal fats. However, nowhere is it stated that to follow a ketogenic diet, solely animal fats are required. There are plenty of plant-based fat sources that are highly suitable for a ketogenic diet such as avocados, nuts and seeds, olives, etc., and their oil derivatives. For those people who are vegetarian (but not vegan), the options extend even further to include eggs and dairy, both excellent sources of fats. Incorporating oils will likely be necessary for those following a completely plant-based ketogenic diet, as it would be very difficult to fulfil the macronutrient ratios needed to enter ketosis by utilizing only whole foods. This recent post outlines different types of dietary fats that may be used on ketogenic diet, as many of the sources mentioned in the post are plant-based. There are many low-carbohydrate vegetables that should also be included in a ketogenic diet regardless of whether animal products are part of dietary intake. These primarily include leafy greens, cruciferous vegetables, lettuces, celery, cucumber, and zucchini. There are also many dairy-free alternatives to dairy fats such as nut milks, full-fat coconut milk, nut-based yogurts, and nut-based cheeses, all unsweetened of course! MYTH #5: The ketogenic diet is the same as a low-carb diet Many people begin their ketogenic diet by cutting out carbohydrates and replacing those calories with protein-based foods. Those who are used to restricting dietary fats may approach a ketogenic diet and foods with hesitation. A ketogenic diet is a high-fat, moderate-protein, very low-carbohydrate diet. So, while you may be under the allotted daily grams of carbohydrates, the amount of fats and proteins consumed must be considered as well. Fats contain ~9 calories per gram, while protein and carbohydrates contain ~4 calories per gram. Given this information, portion sizes will likely be reduced when following a ketogenic diet, and this may be more of a psychological barrier than a satiety one. Adding additional fats to meals in the form of oil, butter, ghee, or full-fat dairy can transform a low-carbohydrate meal into a ketogenic meal. Consider adding quality fats to protein sources to slow the digestion of protein and attenuate any glucose/insulin responses that could potentially prevent one from “entering” or “kicking out” out of ketosis. If you are not entering ketosis following what you believe to be a ketogenic diet, void of almost all carbohydrates, you may be over consuming protein. In this case, adjust your macro nutrients to include higher quantities of dietary fats and less low-fat protein sources. Resources:
Disclaimer: This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Individuals should always consult with their healthcare professional for advice on medical issues. Submitted by the Metagenics Marketing Team  Nowadays, thankfully, people are becoming increasingly aware that the low-fat era was one born under a false premise, yet there still seems to be a “fat phobia” lingering among the masses. To clear things up, remembering that “fat ingested does not equal fat stored” may help. This is along the lines of understanding that ingested protein does not automatically equal muscle growth.
In the metabolic state of ketosis, fat is the primary fuel source for the body, and the fat consumed contributes toward fuel for cellular function in much the same way carbohydrates act in glucose burning. Health issues associated with high-fat consumption are, more often than not, due to the combination of both high intakes of fat and carbohydrate, resembling a “Western Diet,” or “Standard American Diet (SAD),” both of which are commonly known to increase risks of obesity and insulin resistance. It is important that these should not be confused with the qualities associated with “good fats.” How did this low-fat idea come to fruition? In the 1950, an American physiologist, Dr. Ancel Keys, hypothesized that consumption of saturated fat raises blood cholesterol levels and results in increased risk of myocardial infarct or heart attack. Over the years, dietary fat was pegged as the main underlying cause for not only heart attacks, but obesity. A new, low-fat food industry was created around the ideology that the “fat you eat is the fat you wear.” Ironically, in the same time that low-fat foods entered the market, the obesity-epidemic was born 1—maybe fat was not the culprit after all? If we only consider the energy-balance equation (i.e. calories in vs. calories out) then it is easy to see how removing dietary fat would be the solution, given that fat contains 9 calories per gram, whereas proteins and carbohydrates contain roughly 4 calories per gram. What is often overlooked, however, are the hormonal responses and satiety factors, among others, associated with consuming fats, carbohydrates, and protein. Of course, calories still matter; you can’t eat more than you burn on the ketogenic diet and continue to lose weight, but it’s time to get over the misconception that consumption of dietary fat leads directly to stored body fat, without considering the other factors at play. How eating fat can lead to burning fat There are many hormones governing our metabolism, but there is one master dietary hormone, and that is insulin. Insulin is released from the beta cells of the pancreas in the presence of glucose (i.e. carbohydrates) to shuttle it away from the blood and into the cells, which lowers blood sugar levels. Insulin is also responsible for telling our cells, “Hey everyone! Glucose is available! There’s no need to breakdown fat for fuel; let’s save that for later!” In the body, carbohydrates are the primary instigator of insulin release, whereas protein only causes a very mild release, and fat causes almost no response. When glucose levels are significantly lowered, such as that achieved with a ketogenic diet, insulin requirements are also reduced. In the absence of insulin, cells can use stored fat for fuel, either directly (e.g. free fatty acids) or indirectly via the generation of ketone bodies (i.e. ketogenesis). Think of insulin as the gatekeeper of fat metabolism: When insulin is present, the gates are closed and fat is trapped inside the cell; when insulin is absent, the gates are open and fat can be broken down for fuel. Keeping your hunger in check on the ketogenic diet Besides suppressing insulin levels, the ketogenic diet is said to be very satiating, suggesting better management and control of the appetite. It can be argued that eating a ketogenic diet allows one to be more in tune with the body’s natural hunger signals. Furthermore, weight loss associated with the ketogenic diet is more often due to the natural calorie deficit that accompanies the diet since the ketogenic diet, by nature, has an appetite-suppressing effect. Leave the roller coasters for the kids! A carbohydrate-based meal often produces a rapid postprandial rise and fall in blood glucose that leaves you searching for more food soon after eating. This happens because of the dependence on glucose for fuel, and when glucose is missing from the bloodstream, it sends the signals to the body that you need food now, sending you to the kitchen. It is almost like being controlled by glucose! Following a ketogenic diet circumvents this glucose/insulin roller coaster in two ways:
The whole “fat makes you fat” myth is just that: a myth. Resources:
 Add These Detoxifying Foods to Your Shopping List
Detox is a hot topic nowadays. Many detox programs promise to cleanse your body harmful compounds, and others tout weight loss and additional health benefits. Unfortunately, many of these detox methods involve a major dietary overhaul or giving up solid foods altogether, which may actually be harmful to your body.1 Because your body is in constant detox mode, you can encourage this process, correctly and effectively, by simply eating the right foods. Scientific research has found that the nutrients, enzymes, and antioxidants found in certain whole foods can help support the liver’s detoxification pathways, prevent the buildup of toxins, and support overall health.2-4 Chemicals and toxins are everywhere, but your body is built to fight back. Here are six of your top nutritional allies: 1. Cruciferous vegetables & leafy greens Spinach, broccoli, and Brussels sprouts are among the folate- and chlorophyll-richgreens that support the body’s detoxification process by helping to detoxifythe blood and cleanse the intestines.2,4-7 All the more reason to go green! Broccoli deserves some special attention for its high concentrations of glucoraphanin, which is converted in the body to sulforaphane—an active compound associated with many positive health benefits, including its role in inducing phase II detoxification enzymes and support for overall liver health.8-10 2. Turmeric Used in many anti-inflammatory and detoxifying recipes, turmeric contains a powerful substance called curcumin, a polyphenol with anti-inflammatory and antibacterial properties. Science has found curcumin to play a role in modulating cellular response to oxidative stress—demonstrating hepaprotective and therapeutic effects on liver health.11,12 3. Sesame Commonly used in bread products, oils, and dressings, sesame is flowering plant that maybe beneficial for detox. Sulfur-containing amino acids methionine and cysteine—both of which are found at high levels in sesame—are precursors to the production ofglutathione, a key antioxidant in the detoxification process.4 4. Beets These pretty-colored veggies contain betanin, which can help repair liver cells and help support detoxification processes in the liver.13,14 It’s also great for digestion. Tell toxic chemicals to “beet” it! 5. Guacamole No party spread is complete without it! Avocado has high concentrations of the antioxidant glutathione, which has been found to neutralize free radicals to support and protect the liver—i.e., your detoxification powerhouse.4,15,16 Why guacamole? Avocado in this form often uses other healthful ingredients, like cilantro. Also known as coriander, cilantro contains oils with antibacterial, antifungal, and antioxidative properties.17 Pass the guac, please. 6. Garlic Alongside its knack for warding off vampires, garlic may be beneficial for clearing out toxins. The sulfur-containing compound allicin, which gives garlic its unique and strong-smelling aroma, may enhance antioxidation and detoxification capabilities18,19 and has also demonstrated hepatoprotective effects against heavy metals in the liver.20 Incorporating more of these foods into your diet can help support detox processes. Add them to your shopping list today! References:
 Interview with Lyra Heller, MA Our bodies change as we age—as hard as we might fight it. For women who want to maintain a sexually active life with a partner, that may mean accommodating some physical changes. We talked to Lyra Heller, MA to learn her advice on what we can do in order to keep that libido alive. How does menopause affect sex? This is a complex question because women’s sexuality is complex. Part of your experience around sexuality and your sexual response is governed by changing hormones. The major impact centers on what menopause means to you, what it symbolizes, your relationship with your partner, and your general health and sense of wellbeing. How do changing hormones affect sex? Menopause is a process. It’s a major life transition marked by declines in sex hormones that signal the end of your reproductive years. Perimenopause is the first phase. It can begin sometime in your 40s and may extend into your mid-50s. The symptoms are related to fluctuating hormone levels that cause changes in menstrual cycle quality and frequency, hot flashes, spontaneous sweats leading to poor sleep quality, anxiety, and moodiness. You may notice some weight gain. Desire to engage in sex can be the last thing on your mind because you are tired, uncomfortable, possibly self-conscious. As estrogen levels continue to decline, vaginal dryness, which loosely translates as you don’t lubricate as well when you’re sexually aroused, may become an issue. This can result in painful intercourse, and it can produce a sense of negativity as you approach sex, because it hurts. Part of the menopausal experience is the vaginal lining tends to thin, and sometimes the walls of your vagina can narrow, so intercourse in general can be hurtful. How do your feelings and thoughts about menopausal changes affect sex? Christiane Northrup, author of Women’s Bodies, Women’s Wisdom: Creating Physical and Emotional Health and Healing says, “Thoughts are an important part of your inner wisdom, and they are very powerful. A thought held long enough and repeated often enough becomes a belief. A belief then becomes your biology. ”1 Menopause is a time of physical transformation that encompasses the aging process. Desiring an active sex life at times requires engaging in difficult and rewarding conversations with yourself and your partner because your body may not perform as before. Sounds simple enough, but it can be challenging to communicate “what turns you on.” Yet this may become a core issue. Other considerations that dampen sexual desire are:
Aging seems to come with increased aches and pains, whether from arthritis or just general physical deterioration. How can pain affect a healthy sex life? Pain hurts a healthy sex life! You don’t want to have sex when you hurt. So what happens is, you decide to control the pain. And there are pain medications that will actually reduce your desire to have sex. In fact, a lot of medications can cause sexual problems. Plus, drug combinations and mixtures of prescription with over-the-counter (OTC) medications are all capable of inducing disinterest in sex. This is where lifestyle becomes really important. If you’re suffering from a chronic health condition, the trajectory of seeking relief should start with a self-focused approach in partnership with your healthcare practitioner. Some of the major issues requiring medications that might affect your sex life can be elevated blood pressure, depression, anxiety, gut problems, and others2—these are all things that can in some instances also be helped by diet and lifestyle and becoming more physically active. With minor health concerns, a healthcare practitioner can provide guidance on what lifestyle modifications may help. Think in terms of being more proactive in how you approach your food choices, how you want to deal with the excess burden of weight, how you want to deal with blood pressure, adrenal function, and elevated blood fats—these are all capable of being modified by a healthy lifestyle. If you have had a heart attack or have coronary artery disease, do you need to be concerned with continuing normal sexual activities? Typically there is no concern as long as there is doctor oversight. If you experience shortness of breath, can’t walk very far, have poorly controlled blood pressure, those kinds of things are going to affect sexual vitality. That said, cardiovascular disease is the leading cause of death for women.3 It is important to appreciate your heart disease risk may go unrecognized even though knowledge about gender differences grows.4 New research suggests that women experiencing hot flashes before age 42 may have an elevated risk of cardiovascular disease when compared to women with late onset vasomotor symptoms (older than 42).5So heart disease is not restricted to women over 65. A baby aspirin a day may not be enough protection.6 Take your heart health seriously. If you are under the age of 65, and especially if you have a family history of heart disease, pay close attention to heart disease risk factors. The risk factors for heart disease are the same as for premature estrogen decline associated with early perimenopause: smoking, physical inactivity, overweight, standard American diet.7 Be proactive. Talk with your doctor. Are there any options out there that can help with libido?Experiencing perimenopause and libido is different from experiencing postmenopause and libido. Perimenopause is a rollercoaster ride of fluctuating hormones. Hot flashes and night sweats reduce your sleep. With the exception of some women whose sex drive may increase during perimenopause, you’re tired or irritable or anxious. If you’re depressed, it may worsen. You may feel old and ugly. As the extreme symptoms subside, if your libido is still hovering around zero, see a doctor to discuss possible interventions. There are several noteworthy methods: vaginal lubricants, moisturizers, and topical hormones. Water-based vaginal lubricants have a short-term effect on dryness. Vaginal moisturizers differ in that they have a longer-term effect and are prescribed on a regular basis—daily or every 2–3 days, depending on the extent of the dryness. Hyaluronic acid vaginal gel may improve symptoms of vaginal dryness, comparable with the effect of topical estrogen therapy. Both are recommended to reduce friction contributing to painful intercourse. Low-dose vaginal topical estriol, a weak estrogen, is an effective way to kindle sexual desire in some women and reduce vaginal dryness. The effect is different from oral hormone replacement therapy (HRT). Topical estriol seems to exert local as opposed to systemic effects. There are other topical hormones available that your doctor can prescribe, as well. If want to be sexually active throughout life, you can. It is a choice—a healthy, rewarding choice. Libido can be nourished. Discovering your capacity for creativity, curiosity, and experimentation is critical to being “turned on.” Grappling with the physical changes of menopause stimulates the need to explore your beliefs and feelings about what is means to be sexually intimate as we age. This can involve venturing into uncharted waters on the adventure of a lifetime. This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Individuals should always consult with their healthcare professional for advice on medical issues. REFERENCES:
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