The EALM Blog Shelf

While Laura Cipullo and the Laura Cipullo Whole Nutrition Team work on some new and exciting projects, you may notice less posts on the Eating and Living Moderately Blog. We have created a “blog shelf” below to keep you entertained and educated. Get caught up on the latest nutrition education by clicking on each year below. We will send you nutrition updates, but we will not be inundating your mailboxes on a weekly basis. If you want weekly “love” and inspiration, subscribe to our Mom Dishes It Out blog for weekly posts and recipes. Mom Dishes It Out provides expert advice from mom Registered Dietitians and mom Speech Pathologists on the “how to” of health promotion!

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The EALM Blog Shelf

Please feel free to peruse our posts organized by year below. Or take a look at the categories listed at the bottom of the page to find a post in the desired.

2015

2014

2013

2012

2011

2010

Life after Menopause…

Life after menopause…
By Laura Cipullo and the Laura Cipullo Whole Nutrition Services Team

 

Menopause, the permanent end of menstruation and fertility, is defined as occurring 12 months after your last menstrual period. Women typically enter peri-menopause and then menopause in their 40s and 50s. The average age for menopause is 51.1 The transition into this phase in a woman’s life cycle and living optimally thereafter can be ameliorated through diet and physical activity. Embrace life after menopause by following these five tips for living life healthfully.

 

Photo Credit: brendan-c via Compfight cc
Photo Credit: brendan-c via Compfight cc
  1. Eat your estrogen through soy! Soybeans contain a hormone-like substance called phytoestrogen. It can mimic the effect of estrogen and have a vast impact on your overall health before, during, and after menopause. Fermented forms of soy are ideal. So choose miso, tempeh, natto, tofu and young soybeans in the pod known as edamame. Stick with eating soy in the real form rather than via supplements and bars.2
  2. Stand up straight. Now is the time to use light weights to counter osteoporosis. Osteoporosis, otherwise known as weak bones, is due to risk factors such as age, genetics, and dietary deficiencies in both calcium and Vitamin D. Women experience an increased rate of bone loss during menopause and for the ten years thereafter. Though osteoporosis is not reversible at this age, woman can manage, slow and or even stop it by strength training among other things. The act of weight training increases the activity of osteoblasts (bone building cells) and increases muscle strength which counters the effect of gravity. The effect of gravity on weak bones is observable as a “hunch back.” So stand strong—and be sure to incorporate light weights or resistant weight training twice a week.3
  3. Prevent weight gain in the waist area that is often associated with menopause. All you have to do is curb carb consumption at meals. With a decrease in estrogen, women are likely to see an increase in belly fat. While you cannot reverse aging, you can prevent a wide waist by limiting carbs at mealtime. When you eat carbohydrates and even protein, a hormone known as insulin increases to transport the carbohydrates (also known as sugar) into your blood cells. When insulin levels rise, research demonstrates there is likely an increase in belly fat deposition. Therefore, if you prevent insulin from spiking by minimizing the amount of carbohydrates you eat at a meal, not only will you be cutting calories, but you will also be preventing excess belly fat deposits. Women should use 45 grams of carbohydrate per meal and 15 grams of carbohydrate per snack as a guide.4
  4. Stay happy and heart healthy with essential fatty acids. Omega 3 fatty acids are associated with decreased depression, inflammation and triglyceride levels.5 And women are more likely to experience both depression and heart disease after menopause.6 The key to omega 3 fatty acid intake is first ensuring that you are eating the right form—the fish form such as wild salmon, trout, bass and canned chunk light tuna. These fish contain higher amounts of the omegas known as DHA—docosahexaenoic acid. DHA is the specific fatty acid studied whereas the vegetarian sources of omega 3 fatty acids (pumpkin seeds, walnuts and even algae) contain ALA—alpha-linoleic acid. Only ten percent of ALA gets converted to the beneficial form of DHA. So go fishing for dinner.5
  5. Decrease vaginal discomfort…including dryness and incontinence. Some tricks of the trade help to reduce the pain and improve your sex life. During and after menopause, there can be thinning and inflammation of the vaginal walls. The decrease in the hormone estrogen affects the moisture level causing vaginal dryness and “pelvic relaxation.” Incontinence is the inability to hold urine from your urethra due to pelvic relaxation.7 The positive news is that research from the Mayo Clinic suggests limiting alcohol, caffeine and or acidic foods to lessen irritation. Practicing yoga and kegel exercises and participating in vaginal physical therapy can reduce pain and even incontinence.8

 

References

1. “Menopause.” Mayo Clinic. Mayo Foundation for Medical Education and Research, 24 Jan. 2013. Web. 26 May 2014. <http://www.mayoclinic.org/diseases-conditions/menopause/basics/definition/con-20019726>.

2. Hyman, Mark, MD. “How Soy Can Kill You and Save Your Life – Dr. Mark Hyman.” Dr. Mark Hyman. DrHyman.com, 25 Feb. 2013. Web. 24 May 2014. <http://drhyman.com/blog/2010/08/06/how-soy-can-kill-you-and-save-your-life/#close>.

3. “General Facts on Osteoporosis.” National Osteoporosis Foundation (n.d.): n. pag. Web. 24 May 2014. <http://nof.org/files/nof/public/content/file/2681/upload/899.pdf>.

4. Cipullo, Laura. The Diabetes Comfort Food Diet Cookbook. New York: Rodale, 2013. Print.

5. “Fish Oil: MedlinePlus Supplements.” MedlinePlus. U.S. National Library of Medicine, 04 Sept. 2013. Web. 26 May 2014. <http://www.nlm.nih.gov/medlineplus/druginfo/natural/993.html>.

6. “Depression in Older Persons Fact Sheet.” NAMI. NAMI – The National Alliance on Mental Illness, Oct. 2009. Web. 24 May 2014. <http://www.nami.org/Template.cfm?Section=By_Illness&template=/ContentManagement/ContentDisplay.cfm&ContentID=7515>.

7. “Urinary Incontinence.” NAMS. The North American Menopause Society, n.d. Web. 23 May 2014. <http://www.menopause.org/for-women/sexual-health-menopause-online/causes-of-sexual-problems/urinary-incontinence>.

8. “Yoga, Kegel Exercises, Pelvic Floor Physical Therapy.” NAMS. The North American Menopause Society, n.d. Web. 23 May 2014. <http://www.menopause.org/for-women/sexual-health-menopause-online/effective-treatments-for-sexual-problems/yoga-kegel-exercises-pelvic-floor-physical-therapy>.

“Shattered Image”: An Interview with Brian Cuban

“Shattered Image”: An Interview with Brian Cuban
By Laura Cipullo, RD, CDE, CEDRD and the Laura Cipullo Whole Nutrition Services Team

Screen shot 2013-10-06 at 4.09.10 PM

Weight Stigma Awareness week just passed and Laura joined her iaedp NY team at NEDA’s walk for eating disorder awareness this past Sunday. To continue raising awareness, here at EALM we are sharing a very honest and intimate interview with Brian Cuban, lawyer, author of Shattered Image, and brave individual who is sharing his own story of body dysmorphia.


1) How old were you when you realized that you suffered from BDD (Body Dysmorphic Disorder)? And could you describe what BDD is, from a patient’s perspective?

I was in my 40’s before I knew [BDD] had a name. While the disorder has been around for 100 years, BDD has really only been studied “mainstream” in the last decade. From my personal perspective, it was exaggerating the size of my stomach, love handles and the loss of hair on my head to the point where it affected my ability to function and caused me to engage in self-destructive behaviors.

2) The documented number of men with eating disorders is increasing. Why do you think this is? Do you think our society and the field is offering more resources for men to seek support?

I think it’s because more men are coming forward and being diagnosed because of increased awareness. The increase in awareness makes it easier for a guy to not be consumed by gender stereotypes and stigma and be honest with his treatment provider or other trusted person. There are absolutely more resources. When I first started going through it in the early eighties there was virtually no awareness nor were there resources. I didn’t even know the words anorexia or bulimia existed.

3) Where does bullying fit in the “eating disorder and BDD spectrum”? Would you say bullying was a trigger for your EDO and BDD? Or is there a way to describe to readers how all of these: EDO, BDD, and Poly-substance abuse are all likely to fall in the same bucket?

Bullying is definitely one of the things that played a major role in the development of my eating disorder, especially when that bullying was related to appearance.  It was certainly that way for me. Can I say it was the only reason? No. There was also fat shaming at home. I was also a very shy and withdrawn child genetically. It is possible there was a pre-disposition to such behavior for me.

I started with a distorted image in the mirror. In my mind, if I could change that image to what, I equated, as something that would cause me to be accepted, then everything would be ok. For me, that was being thin at first. When eating behaviors did not work to change the image, I cycled into alcohol and drug abuse, and, eventually, steroid addiction.  I call it a “BDD Behavior Wheel” -constantly spinning with no end game until I addressed the core issues of the fat shaming and bullying I experienced as a child.

4) As a man who has suffered from an eating disorder, in what ways could an eating disorder impact a man’s life that may differ from a woman? (If any).

Gender specific health issues aside, I think the impact is probably the same from a social and day-to-day standpoint. Shame, isolation, health, and impaired achievement affect both men and women with eating disorders. It is society that views them differently. From a male’s “going through it’ standpoint, I suspect much is the same for both sexes.

5) Do you have any advice for moms and dads raising boys or what to look for in terms of signs that their son may be developing a negative relationship with food and body?

I try not to take the role of a treatment provider since I am not one. I can only speak for my behaviors. These are the behaviors I engaged in: trips to the bathroom with water and/or the shower turned on to hide purging, evidence of purging in the bathroom, scraped/bruised finger joints from purging, and eating tiny portions. I was eating less, staying below a specific number of calories per day. Depression, isolation and social withdrawal are big ones. Children don’t isolate themselves without a reason, something is wrong.

6) In addition to genetics and other environmental stimuli, what role do you think nutrition played in the development of your eating disorder and BDD? Was there a message of health versus thin in your house and if so how do you think this affected the ED/BDD?

Nutrition played a role in that it was something I had no context for. Healthy eating was not really something that was a huge topic of discussion in the early 1970’s. I honestly can’t remember whether it was a topic of discussion in my home. I think my parents did the best they could to provide a healthy food environment within the constraints of awareness of that era. I can say that I tended to not eat healthy because it soothed my loneliness and depression in the moment. This typically occurred during lunch and during the day.

7) In terms of eating – do you now practice intuitive eating, mindful eating and/or how would you generally describe your nutrition intake?

Currently I would say that I practice intuitive eating but, I have to admit, I go through yo-yo phases like many others. I actually consulted a nutritionist about a year or so ago and did pretty well with it, but I have gotten away from healthy/balanced eating more than I would like recently. It’s nothing that ties into my disorder in itself, its just life although when I gain weight because of it that can have an effect on how my BDD thoughts play out.

8) Do you have any words of wisdom to share with adolescents who may be struggling with similar issues?

You are not alone and you are loved.  Find a trusted person you can confide in. There is an end game of recovery and a great life if you can drop the wall of shame and self protection for one second and take one tiny step forward by confiding in those who love and care about you.  Don’t wait 27 years like I did. Do it now.

Shattered Image - BCuban

One of our lucky subscribers will receive a free copy of Brian’s book, Shattered Image!

First be sure you have subscribed to EALM and then you can submit more than one entry by doing any of the following.  Be sure to leave an additional comment letting us know you subscribed and liked us! Good luck!

  • Leave a comment here and  “Like us” on our Facebook page
  • Follow @MomDishesItOut and tweet “@MomDishesItOut is having a #Giveaway”

Giveaway ends on Sunday, October 20th, 2013 at 6:00PM EST.

Fresh Press Pickings for April

Click below to stay fresh on Laura’s recent media adventures:

  • The 5 E’s Of Easy Eating Healthy on PageDaily
  • Top Five Servingware Products for a HealthyKid-Friendly Kitchen on MomsTown
  • Laura Dishes on Kiss Feeding with HLN:
  • Meat Your Match: Does Beef Really Kill? on Zeel
  • 9 Ways to Sneak Nutrient-Dense Foods Into Your Diet on Zeel
  • Laura shares her expertise with May 2012 Cosmopolitan readers on page 236

Bariatric Surgery and Diabetes

Bariatric surgery can reverse Diabetes, but The Endocrine Society recommends people take caution before taking extreme actions.

 

Two points I found interesting include:

Remission in diabetes may be a result of the hormonal changes in the intestines after bariatric surgery.

“Observational studies have suggested that weight loss surgery can rapidly improve glycemic control and even produce remission of diabetes in severely obese patients with type 2 diabetes. This improvement and/or remission of diabetes is noted before meaningful weight loss occurs, and is thought to be due to a weight-loss independent change in the incretin hormone milieu as a result of the alteration in intestinal anatomy.  Complete remission is defined as a fasting glucose level below 101 mg per deciliter and a glycated hemoglobin level of less than 6.0% for at least 1 year without active pharmacologic therapy. Until now, however, there has been a paucity of randomized controlled trials showing greater efficacy for surgical versus medical therapy, and for the variety of weight loss procedures available.”

 

Bariatric surgery should involve decision making regarding the ability to make long term lifestyle changes and be supported by a multidisciplinary team.

“The Endocrine Society recommends that practitioners consider several factors in recommending surgery for their obese patients with type 2 diabetes. These include the patient’s BMI and age, the number of years of diabetes, and an assessment of the ability to comply with the long-term lifestyle changes that are required to maximize success of surgery and minimize complications. Importantly, shared decision-making is critical in making a decision about bariatric surgery. The success of weight loss surgery in patients with obesity and diabetes ultimately depends on the partnership of patient, endocrinologist, surgeon, and a support team in the continuum of the long-term care of the patient.”

 

Read the article at http://www.endo-society.org/advocacy/policy/upload/Bariatric-Surgery-and-Diabetes.pdf.

Michelle Obama says Let's Move!

Laura’s Take on the Let’s Move! Campaign. Listen to Laura talk with Rita Cosby on wor710.com on 2/1/2012 or via podcast.

As a leader Michelle Obama is in a unique and powerful position to empower Americans to live healthier lives. She can influence food companies to provide less processed, higher quality foods to schools and to our supermarket shelves. She can raise the energy and spirit of health by advocating for health awareness and encouraging physical activity. Her celebrity status can help bring the USDA’s “MyPlate” to more families’ tables.  She can help spread the message to fill your plate with fruits, vegetables, whole grains and low fat dairy. Thankfully, Michelle Obama also stresses moderation and admits to eating her burgers and fries.

Let’s Move! is taking information that is already out there and bringing a greater awareness on how to access such health education. Many of the materials and guidelines are those developed by the USDA.

Michelle Obama has companies like Goya and California Fresh Work Funds trying to help initiative change.

Is this the right campaign?

At the end of the day, bringing awareness to health promotion and disease prevention needs to be the ultimate goal of someone like Michelle Obama. However, rather than fight obesity, the campaign may want to rephrase their negative spin and create a new positive tone to Let’s Move!

How about let’s move more, let’s move towards eating real wholesome foods and let’s move towards eating less processed food. Let’s move to building self esteem!!!

Can one person create change?

Yes, Jaime Oliver’s Food Revolution and The Biggest Loser are just two examples of how change happens. Even, the presidential chef is making change. In the Washington Post today, the presidential chef Cristeta Comerford reports losing 15 pounds and eating healthier with her own home garden. She was influenced by her boss, Michelle Obama!! That’s right, the White House has their own garden and serves seasonal garden veggies to their guests. Comerford now has her own garden too.

 

What can you do to make a difference? Can you change your language about health or perhaps just add a half cup of veggies to your dinner plate?

 

 

The Hollywood Image

The Hollywood image that’s plastered everywhere—online, on TV, in magazines– is simply not realistic and can be harmful. Yet, it’s what some women and men strive for. They may see how skinny Demi Moore or LeAnn Rimes have gotten and think this is the ideal. I want to remind everyone that most people do not have such bodies naturally!  Most people do not have the time or money to focus on their bodies the way the Hollywood stars do. Most people can’t afford a full staff of a dietitian, a trainer, an esthetician, a chef, and a dermatologist…. Plus, celebrities are getting paid A LOT of money to look this way and if they don’t meet the criteria there is always editing and airbrushing to attain the super skinny, youthful look. To meet the Hollywood ideal, most men and women need to restrict their intake to a caloric level that is equivalent with that of an eating disorder. Most stars don’t acknowledge that they have an issue, although Victoria’s Secret model Adriana Lima openly admitted recently that she simply stopped eating solid food 12 whole days before the Angel runway show!

Remember, beauty is from the inside and shines when one is confident from their inner core. There is a great new web site promoting a new definition of beauty – check it out at www.BeautyRedefiend.net/.

 

Beauty Redefined Sticky-Notes

 

If you make resolutions, vow to choose these:

Vow to:

Take One Step at a Time.

Are you thinking about your 2012 resolutions? Consider this: Rather than making brash diet resolutions, make small changes in your intake instead to prevent the feeling of deprivation or a potential binge. For example, if you are feeling guilty from over-consuming during the holidays, identify one thing you can change. Make it a small change and start today rather than waiting until January 1st. Perhaps you decide to decrease your dinner portion by 25%. Do this for 1 week and then add another modification on week 2, such as enjoying one cookie after lunch rather than 4 after dinner. Remember that moderation is key when it comes to your nutritional intake and setting health goals—and achieving them with ease.

 

Eat Like You Have Diabetes.

There are 70 million American children and adults at risk for diabetes. Don’t let it be you. Eating consistent meals and snacks that incorporate a blend of wholesome carbohydrates, lean proteins and healthy fats (MUFA’s and Omega 3 FA’s) will leave you feeling full longer, prevent a hormone rollercoaster and eventually aid in consuming less and depositing less body fat. Vow to eat mixed meals with an average of 45 to 60 grams of carbohydrates per meal.

Feed Yourself.

Don’t starve yourself with endless fad cleanses and one-meal-a-day dinner diets. Rather than skipping meals and slowing your resting metabolic rate, eat every 3 to 4 hours. If your stomach is grumbling at the start of a meal, you are more likely to overeat or even binge once your plate arrives. Worse yet, overeating and/or binging at the end of the day results in the consumption of more calories than had you eaten from breakfast until dinner. Vow to feed yourself regular meals and snacks to ultimately be a healthier you.

 

Center Before Meals.

Take a deep yoga breath and practice a simple mindful meditation before each meal. This will help you to relax and to separate your eating experience from your hectic day. You will be able to better recognize your fullness cues and, more importantly, to provide your brain with the opportunity to be psychologically satisfied with the food you have eaten and experienced. Vow to practice this form of “centering” daily to prevent over-consuming, decrease emotional snacking and develop a healthier relationship with food and eating.

 

Other Recommended Resolutions:

Vow to become a mindful eater.

Vow to put yourself & your health first.

Vow to love your body.

Follow my additional recommended resolutions 12/31/2011 on twitter @MomDishesItOut.

 

Surviving the Holidays with Diabetes

Surviving the Holidays with Diabetes is a Family Affair

Laura Cipullo, RD, CDE – Dietitian, Diabetes Educator, and Mom

www.EatingandLivingModerately.com & www.MomDishesItOut.com

 

 

Make peace with carbs: Just because you or your loved one has Diabetes, it doesn’t mean carbohydrates are the enemy.

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  1. Plan ahead by counting carbohydrates and spreading them out throughout the day.
  2. Make carbohydrates like pasta and rice, a side dish rather than the entrée.

Designate Dessert: If you love sweets, include them in your intake.

  1. Rather than feel deprived and end up binging, plan your piece of cake. Eat protein and veggies for your entrée and use your carbs for dessert.
  2. The family chef can make mini desserts or just make less dessert, avoiding temptation.

Walk Your Sugar Down: Moving after a meal is helpful to reduce blood glucose.

  1. After the holiday meal, get your entire family up and out to see holiday decorations or have a snowball fight.
  2. Walking and or light exercise helps to lower your blood glucose and consequently your insulin.

It’s a Family Affair: If you or your loved one has Diabetes, have the entire family engaged and have everyone eat as if they had Diabetes.

  1. It’s sabotage to offer the rest of the guests food that someone else can’t have. If the family eats the same foods, pasta as the side rather than the entrée, no one will feel left out and no one will be tempted to overload on carbohydrates.
  2. Family member are genetically at risk for Diabetes. If the whole family eats in a balanced manner, you will be helping to prevent their chances of Diabetes later in life.

Mix Your Meals: Eat carbohydrates, proteins and fat together.

  1. Protein and fat take longer to digest. If you eat your carbohydrates with these foods, the carbs will be digested slowly and your blood sugar less likely to spike.
  2. Mixing meals and snacks help to regulate blood sugar and hormones and consequently help to keep you feeling satiated longer.
    1. Shrimp Cocktail with cocktail sauce
    2. Greek yogurt with fresh fruit
    3. Hummus with veggies and warm whole wheat pita
    4. Mini turkey meatballs with marinara
    5. Veggie and low fat cheese napoleons

Staying Healthy During the Holidays

This is a big week for holiday parties and holiday planning. Read my 7 tips to get your through the next weeks leading up to the New Year!!

Staying Healthy During the Holidays
By: Laura Cipullo RD CDE

  1. Be the Tupperware Lady– bring Tupperware to family events to pack leftovers or “seconds” and  bring home to eat another time.
    • Rather than overeat on delicious food, plan to use hunger fullness cues. Pack the remainders up for a mini holiday dinner part II.
  2. Healthy Cook Book Exchange(rather than cookie exchange)
    • Holidays typically revolve around gifts and food, so why not give a gift about being healthy and moderate? Healthy cookbook ideas are the Mayo Clinic Williams – Sonoma Cookbook and Martha Stewart’s Healthy Quick Cook
  3. Favor family over food– make festivities about seeing family and not about eating food.
    • Serve a simple meal and focus on entertainment like music and or trivial pursuit.
  4. Stretch your dollar, save your waist – Use Intuitive Eating to portion your restaurant meal.
    • Be economical and bring leftovers home to eat at the next day’s snack or meal.
  5. Eat your favorite food– skip the appetizers and save room for dinner.
    • If dessert is your favorite, don’t fill up on apps and entrees. Make sure you are still hungry for your chocolate cake!!
  6. Secure a snack– before leaving make sure you are not starving, eat a snack to prevent overeating at the party.
    • Restriction cause binging, don’t restrict the day of a special event. You are likely to overeat or even binge later that night.
  7. Wine, beer and liquor on a full belly. If you drink on an empty stomach you are more likely to make poor decisions and overeat.
    • Take your sip of wine with your entrée. If you drink on an empty stomach you will not be mindful of your internal or external cues.
    • Most importantly, don’t drink and drive.