A Day in My Life

One of the most common questions that I’m asked in the course of a busy day seeing patients is, “so what do you eat?”

I understand people’s curiosity. Do I walk my talk? Or am just providing lip service and spending my off-hours on the couch with a sleeve of Oreos and a Diet Coke? (Actually, Kit-Kats and Dr Pepper would be my choices if that was how I rolled).  

I spend loads of time dishing out health and wellness recommendations, especially in my initial visits with new patients.  I recommend therapeutic nutritional protocols, supplement options, and lifestyle changes (like getting enough sleep and incorporating self-care).  When all of this is typed up in patients’ office notes and published to them in my portal, it all probably looks pretty simple “on paper.” I know from personal experience that this couldn’t be farther from the truth.  Changing lifestyle and health behaviors is one of the toughest challenges on earth. We are often unraveling years (decades!) of habits, and working with complex emotional factors that have influenced behaviors. These changes require patience, persistence, and lots of support.

I know – I’ve been there.

My journey and wellness begin almost a decade ago when I realized that the “health” food I was eating was actually the opposite, and was probably contributing to some long-standing and very annoying symptoms.  Frozen burritos, whipped yogurt, and fat-free ice cream were staples in my diet, and my sugar cravings were off the charts. Shortly after my son was born, I started to learn about real food and the power of food as medicine.  I joined a CrossFit gym and was introduced to the Paleo approach to nutrition, which lead me to podcasts and blogs about not just nutrition, but other food related conditions like leaky gut, dysbiosis, food intolerances, and autoimmunity.  Suddenly, I realized that the food I was eating was full of chemicals and sugar, and the world looked very different. I decided that I needed to practice medicine in a different way, and that I needed to fuel myself (and my kid) differently, too.  That was the beginning of my ongoing love affair with integrative medicine and nutrition.

The reading, listening, and learning that I’ve done over the past almost-decade has given me the opportunity to be my own personal lab experiment.  I’ve had time to mess up, start over, and fine-tune. Through the process I have found what works for me and keeps my body and mind feeling best. I try to encourage my patients to do the same, and strive to provide the guidance that they need to minimize the “messing up” part.  

I’m happy to share with you a peek into my life so that you can see what it looks like and perhaps find some inspiration. Or maybe you have some suggestions? Like you, I am a work in progress.  So, here goes!

Nutrition: What do I eat?

I’d call my eating style “Paleo-ish”.  I think there is wisdom in how our ancestors ate, and I agree that our bodies function optimally on the foods that the earth provides for us.  I say “Paleo-ish” because I am not super strict. I don’t avoid legumes or grains entirely (they are excluded in strict Paleo diets). I enjoy the flexibility of eating what I like and what I tolerate, knowing that as long as it’s real food, I’m making good choices.  Paleo excels in promoting lots of veggies and sufficient proteins and healthy fats. It gets a bad reputation when people interpret it as a bacon-and-burger free-for-all. Paleo is really about nutrient density – eating foods that provide us with an abundance of the building blocks of life.  There’s room for bacon at the table – sprinkled on top of Brussels sprouts! Dr Mark Hyman promotes a dietary strategy that he calls “Pegan” – a cross between Paleo and Vegan. It emphasizes veggies and healthy fats, with moderate amounts of legumes and grains if tolerated. Protein is seen as a condiment, rather than the main event. Gluten and dairy are out.  I like this approach, too. You can read more about it here.

So how does this translate into my day-to-day?

Smoothies are my morning jam (pun intended). I find smoothies to be an easy way to pack a ton of nutrients into a yummy tasting breakfast.  Plus, I can take it on the go, and that works for me. At each meal, I try to practice what I preach and include veggies, protein, and healthy fat.  My smoothie is no exception. Here’s what’s in it:

• 1 cup unsweetened almond milk
• ½ of a frozen banana
• Roughly 1 cup of frozen cauliflower
• Protein powder
• Small handful of walnuts or a cube of frozen full-fat coconut milk
• 1-2 handfuls of baby spinach
• 1-2 handfuls of kale

I blend this all up and I’m good to go.  I also start my day with some coffee. I enjoy the ritual of having coffee in the morning and I seem to tolerate it well from a gut and adrenal standpoint.  I learned from genetic testing that I am a fast caffeine metabolizer, which means that caffeine hits me hard and fast, but also leaves my body quickly and efficiently.  This explains why I quickly get jittery from too much caffeine, and also why I can have an espresso with dinner if (I’m out and feeling fancy) and still fall asleep with minimal effort.  I drink half-caff coffee to minimize the jitters, and I give it a hit of an almond-milk based creamer and sometimes some collagen peptides.

It’s been hard to ignore the data about the benefits of intermittent fasting.  We now know that going for periods of time without eating can help to reduce blood sugar, decrease cancer risks, and prolong lifespan (and that’s just the beginning).  There are lots of different theories about how long a fast should last, and that’s a topic for another blog. I’ve been trying to use a 12/12 approach, where my eating window occurs in between about 7:30 am and 7:30 pm.  Researchers have found that even a 12 hour window of fasting is beneficial, and this is pretty easy if you aren’t eating late at night. So I’m playing with this right now to see how it feels. So far, so good!

Lunch and dinner are pretty much the same on Monday through Friday, but differ week to week.  I do the bulk of my food prep on Sunday mornings. I prep one meal for lunches and another for dinners and I make enough for four days of each (Friday is more of a wild card). When doing my meal planning I prioritize vegetables and protein.  In most cases, there’s some healthy fat built in naturally – either in the avocado or olive oil I’ve used in my veggie prep, or in the protein that I’ve prepared. If my meal is short on fat, I’ll add some avocado or nuts. I have something starchy with lunch to make sure that I’m getting the carbohydrates that I need.  My go-tos are sweet potatoes and butternut squash. This week I mixed it up and made some chickpea-based “rice”, and it was delicious and satisfying.

Here’s what this week looked like:

Lunches: Chicken sausage, broccoli slaw and shaved Brussels sprouts sautéed in avocado oil, chickpea “rice”, and some mashed sweet potatoes with a sprinkle of cinnamon.

Dinners: Paleo lasagna made with eggplant, ground chicken, organic pasta sauce, fresh basil, almond-based ricotta (surprisingly delicious!), and fresh tomatoes. Here’s the recipe I followed. I had this with steamed Brussels sprouts with a drizzle of olive oil and a sprinkle of sea salt.  My 7-year-old liked it too – huge win!

Lunches tend to be a protein with some sautéed or roasted veggies and some sweet potato. Dinners tend to be a casserole or “dish” of some sort that is easy to prep and makes several servings, served with a veggie.

Meal prep is really the secret to being consistent with healthy food choices, especially for busy folks who are juggling lots of activities.  Patients often groan at the thought of taking some time out of their Sunday to prep meals, but the time spent is returned to you tenfold in the time saved during the week.  I try to encourage people to use their food prep time as a form of self care. Put on some good tunes or a podcast, make a cup of tea, and enjoy the process of cooking foods that will nourish your body and your family all week.  Doing this infuses your food with healing energy (hokey, but true!) and feels like an act of self love rather than a chore.

Here are some meal prep tips I’ve picked up along the way:

• Roast a big pan of veggies with some oil and salt/pepper in the beginning of the week – use as a side for lunch and dinners, or toss in a salad
• Use your appliances!
  • Sweet potatoes come out perfectly mashable if put (whole) in your slow cooker on low and left alone for eight hours. 
  • Sweet potatoes also come out great if cut in chunks and cooked in an Instant Pot on manual setting for eight minutes (quick release)
  • Spaghetti squash can be quickly cooked in an Instant Pot on manual setting for 7 minutes (quick release).  Cut on the long axis for shorter strands or the short axis for long strands
  • Steam cauliflower and/or broccoli for one minute on manual setting in the Instant Pot (with quick release) to mash up for mashed cauliflower/broccoli – so yummy as a side, either plain or with a drizzle of olive oil and salt
• Rotisserie chicken meat can be multi-purposed, and if you get one that’s pre-cooked, someone has already done the work – put on salads, in soups, or in a taco or wrap
• You can easily make delicious pulled pork or pulled chicken in the Instant Pot or slow cooker – it comes out great and can be used for lots of different meals

I eat chocolate every day.  I grew up with a maternal grandma who showered her grandchildren in two things: love and M&Ms.  There was literally an M&M dispenser in her house – pull the lever, and M&Ms magically come pouring out.  Amazing. And dangerous. I have to think that this did something to prime my taste buds and my brain to want chocolate.  All. The. Time. Not to mention the emotional ties of chocolate to love and comfort and my MeMe. I used to try to fight this and deprive myself of a chocolatey treat, but I’ve learned how to incorporate some chocolate into my life in a way that does not provoke guilt.  I choose good quality dark chocolate, and I enjoy every little bite. You can find bars of dark chocolate in my fridge (I like to keep it cold) or my desk drawer in my office. Recently I’ve been putting some Enjoy Life dark chocolate chips on unsweetened vanilla coconut yogurt after dinner.  I often stir some protein powder in to the yogurt to boost my protein and enhance the flavor a little. It’s a nice treat, provides some probiotics and protein, and makes my heart feel full.

“Do you eat gluten and dairy?”

Yes.  And no.  I minimize both gluten and dairy in my diet.  I have found that I feel best without them on board on a regular basis.  I have a gene that predisposes me to gluten issues (although I don’t have Celiac Disease).  I also avoid it because many foods made with gluten don’t have much nutritional value, and I try to get the most bang for my buck when it comes to food.  Dairy upsets my stomach, which is a bummer because I used to really enjoy having yogurt as a snack, and who doesn’t love cheese? My genetic testing tells me that I’m not lactose intolerant, which is encouraging, but there is something else about dairy that doesn’t agree with me, so I generally avoid it.  Occasionally I enjoy some warm bread at a restaurant or a real ice cream cone – I may feel a little “meh” afterwards, but usually that is outweighed by the joy of the moment.

The decision to avoid gluten and dairy is a personal one.  Plenty of folks can include both in their diet and feel great. Others find that removing one or both is a game changer for their health.  There are some tests that can help to determine if you have a true issue with gluten or dairy, but the best way to find out is to remove them for 4-6 weeks, strictly, and monitor your body for changes.  If you decide that you’ll keep gluten and dairy in your diet, make good choices – whole grain wheat products, organic full-fat dairy (avoid the sweetened yogurts that are packed with sugar, please!!)

“Do you count your macros?”

If you aren’t familiar with macros, I’ll explain.  Macro counting is a nutritional approach in which one keeps track of their macronutrient (protein, fat, and carbohydrate) intake in an effort to manage weight or achieve certain body composition goals.  Some people use macro tracking just to hold themselves accountable, or because they like the geeky math aspect of monitoring their own nutrition data. I’ve walked many folks through macro tracking, both in my practice and in my fitness community.   I occasionally use it myself, but not always. Macro tracking works well if you are already eating a healthy, real food based diet. It’s the quality of the food that you eat that matters more than the quantity most of the time. With that being said, if someone is eating lots of healthy real foods and struggling with weight goals, macro tracking can be a helpful next step.

I track my macros occasionally. I don’t find it to be especially burdensome and it doesn’t trigger any food related anxieties for me (it can for many people).  I calculate my macros by using a really neat tool that I have in my office called the InBody scanner. It’s a full body scanner which accurately calculates body fat, muscle mass, body water, visceral fat, and basal metabolic rate (BMR).  It’s this BMR measurement that is used to make nutrition related calculations. Once I have my numbers, I track my intake in My Fitness Pal (a free app) and aim to have 40-45% of my calories come from carbohydrates (healthy ones like veggies, some fruit, and occasionally some grain like quinoa or legumes), about 30% of my calories from protein, and 25-30% from fat. Not everybody needs to be this geeked out about their nutrition. And honestly most of the time I just eat. But every so often I find it helpful to dial things in and make sure that my estimations are relatively on track.  I’ve put together a macro meal  plan using macro ratios that work for most people if you want to play with this a little, and it’s yours for free! Click here to download.

The InBody scanner takes about 45 seconds and is painless.  It’s available to all of my patients, and even folks who aren’t established patients in my practice.  My website has lots of info about it – check it out!

“What supplements do you take?”

Currently, I’m taking magnesium glycinate, a probiotic, vitamin D, and fish oil.  This has been my regimen for the past 2-3 months. Prior to that, I wasn’t taking anything regularly.  Taking supplements is not easy. Not everyone needs to take them, and deciding if (and which) supplements are right for you is a conversation that you should have with a qualified medical provider.   I recently had some genetic testing done via two companies: AGS and Genomind that reinforced my need for omega 3s and confirmed that my body tends to be low in vitamin D.  Once I saw the data, I was convinced that I should probably make some changes. Turning 40 was a little nudge, as well!

I’m definitely of the school of thought that we should get most of our nutrients from food, but sometimes a little supplementation helps.  Here’s why I take what I do:

• Omega 3 fatty acids: Although I love fish, which are the best food source of omega 3s, I don’t prepare it much at home (although I’d like to change this!) so adding in an omega 3 supplement makes sense for me.  
• Vitamin D: I’m a ginger with fair skin, so spending too much time in the sun to increase my D isn’t optimal.  Adding some D drops has been an easy way to boost my levels and be proactive about this important vitamin (it’s actually a hormone, did you know that?).  
• Magnesium: Magnesium deficiency is widespread, and I’m not immune to this!  Our food supply and soil is magnesium depleted, yet this mineral is crucial for over 300 important reactions in our bodies.  Magnesium is also a relaxing mineral, and helps this anxious gal to chill out. I take magnesium glycinate because it is well absorbed and doesn’t cause bowel changes like it’s sister, magnesium citrate.
• Probiotic: I strive to eat fermented foods but it doesn’t happen every day.  The probiotic fills in the gap there and makes me feel like I am contributing to a healthy microbiome.  
• My genetic testing tells me I should be taking some methylated folate. I could get the required amount from the super awesome multivitamin that recommend to all of my patients, but the lonely bottle sits on my desk at work and I always forget to take it with my lunch!

I add in other things as needed.  For example, I had oral surgery last week.  It was not fun. To facilitate healing and keep the pain down I’ve been taking curcumin (the active compound in the spice turmeric which is potently anti-inflammatory) and specialized pro-resolving mediators (SPMs) which help to promote inflammation resolution.  I haven’t needed any pain medication and things seem to be healing pretty well. Hooray for natural medicine!

“How much sleep do you get? What do you do to unwind?”

Well, friends, here’s where I need to take a bit more of my own advice.  While I DO prioritize sleep and typically get the eight hours that I need, I’m not so great at resting and incorporating regular self-care.  I often work into the evenings instead of unwinding (case in point, it’s 8:18 pm as I write this), and I haven’t seen my chiropractor or massage therapist in well over a year.  I’m dabbling with meditation because I know it could be transformative for me, but I struggle to be consistent. (If you are looking for a good intro to mindfulness meditation, read Search Inside Yourself by Chade-Meng Tan, a Google engineer turned meditation expert).  I sometimes unwind with some Netflix (recently binge-watched Selling Sunset – so bad/good), but it doesn’t reset my brain like I need it to. I’m finding that I need deep, reflective, meditative quiet to really recharge. It’s the challenge of getting out of fight/flight and into rest/repair.  So I’m working on that. Suggestions welcomed!

“What do you do for exercise?”

I’m a CrossFit junkie.  I’ve been at it for six years.  It’s been my salvation. I’ve met the best people, pushed myself physically and emotionally, and eaten lots of humble pie.  It works for me, and I plan to do it forever. That’s should be the goal with any exercise regimen – find something that you love, and do it safely and consistently – forever!

“What do you do for oral hygiene?”

I would be cheating you out of very important health information if I didn’t mention oral health.  The health of our teeth and gums has SO much to do with the health of the rest of our bodies. Studies link poor oral health to heart disease, Alzheimer’s, diabetes, infertility, and even cancer.  I was the kid with lots of cavities despite brushing and flossing regularly (those M&Ms didn’t help), and I’ve got some familial predisposition to “soft” teeth and irritable gums. I’ve recently made some big changes in my oral health regimen thanks to my amazing holistic dentist, Dr Yuri May.  I switched from conventional, store-bought toothpaste and mouthwash (full of chemicals, dyes, etc) to a probiotic toothpaste and natural mouthwash.  This shift alone has decreased gum inflammation dramatically. We pay attention to the chemicals in our food – doesn’t it make sense to do the same about our oral health products?  

Concluding thoughts

Perhaps the most important part of improving your health is figuring out your why.  Why do you want to feel your best and optimize your health?  For me, it’s to witness my son experience life and guide him along the way.  I also have big plans for the next several decades: travel, love, personal and professional growth.  Figuring out your why gives your plan a foundation and helps in those moments when you are feeling tired and defeated.  I challenge you to identify your why, write it down, and keep it close.

I hope this has been a helpful peek into what I do to stay healthy. Health is not a one-size-fits-all prescription.  What works for me might not work for you. I encourage you to work with someone who can help you to find your very own recipe for health, and who will nudge you forward one step at a time so that you can make lasting changes.