Saturday, June 29, 2013

Drink Up...Water Has Many Health Benefits!

Barb Goshorn RN MSACN
The Nurse Nutritionist

Summer has finally arrived in Western New York on both the calendar and how it feels outside. So now is a great time to review the importance of keeping well hydrated. During the warm summer months we are often outside gardening, bike riding, walking, and mowing. This increased activity combined with perspiring can lead to dehydration unless you’re careful that your input equals your output. With this in mind, many clients ask, “How much water do I need to drink daily”? Apparently the conventional wisdom of drinking eight glasses a day was only a guideline and not based on scientific evidence. So I often tell people to take their weight (in pounds), divide it in half, and drink that number in ounces. This too is just a guideline because the amount of fluids a person needs daily is unique to them. According to nephrologist Steven Guest, MD, “Fluid losses occur continuously, from skin evaporation, breathing, urine, and stool, and these losses must be replaced daily for good health”. A good rule of thumb is to look at the color of your urine. Is it dark yellow or orange in color or does it have a strong smell? These may be signs you’re not drinking enough. Urine should be a pale yellow to a clear color. If you are thirsty, this is the most obvious sign you need to hydrate more. It is a good practice to drink more water when you are not thirsty then to wait until you’re thirsty. Dry skin is another sign of dehydration, as is pinching the skin on your hand. If it takes more than a few seconds to return to normal, this is a sign of dehydration. When exercising, the American College of Sports Medicine guidelines recommend that “people drink about 17 ounces of fluid about two hours before exercise. During exercise, they recommend people start drinking fluids early, and drink them at regular intervals to replace fluids lost by sweating”.
The role of water in the human body is vital to our survival. We are anywhere from 55% to 78% water depending on our size, but a rule of thumb is 2/3 of our body consists of water. In addition:
·       The brain consists of 90% water
·       Bone consists of 22% water
·       Blood consists of 83% water
·       Muscle consists of 75% water
Even more than dehydration though, drinking water has many health benefits. Some of which include:
·       Drinking water may help with headaches and fatigue. Since the brain is 90% water, if you become dehydrated, the brain can’t function as well and you may get a headache. In addition, hydrating may help you be more alert and able to concentrate better.
·       Water helps with maintain normal bowel function and prevent constipation. If you don’t drink enough water then the colon will pull water from your stools to help maintain hydration and you get constipated.
·       Hydrating helps with muscle cramps and fatigued muscles. “When muscle cells don’t have adequate fluids, they don’t work as well and performance can suffer,” says Dr. Guest. Water helps keep muscles and joints lubricated as well as giving them the electrolytes to function properly.
·       Water helps to detoxify us. The main toxin in our bodies is blood urea nitrogen. This toxin is excreted through our kidneys. Water helps flush toxins and waste products through our kidneys and out of our bodies.
·       Drinking water helps you to lose weight. Often times people mistake thirst for hunger. Also water flushes out the by-products of fat breakdown. There are no calories in water either. The next time you are hungry drink a glass of water prior to eating something.
·       Keeping hydrated helps your skin look younger. “Dehydration makes your skin look drier and more wrinkled, which can be improved with proper hydration,” says dermatologist Kenneth Ellner, MD. Water helps to replenish skin tissues, moisturize skin, and increases skin elasticity.
You can increase your water intake by having a glass of water with every snack and meal Think about keeping a bottle of water with you in your bag or desk. In addition, try eating lots of fruit and vegetables (about 20% of our fluid intake comes from food). If you don’t like the taste of water add some lemon or a squirt of juice.
Remember, drinking a healthy amount of water is not only healthy it is vital to your health, so drink up!    


Monday, June 24, 2013

If You Love Your Pet,Please Read Teddy's Story!

Teddy and Fritz

Barb Goshorn RN MSACN
“The Nurse Nutritionist”

Teddy, my 11 year old Pembroke Welsh Corgi had been dying for years, but we didn’t know from what.  For about four years, Teddy had symptoms that indicated he was ill with something but no test was ever conclusive as to what it was. His coat was rough and he had mangy bald spots. He had episodes of bloody explosive diarrhea. He was apathetic and had no interest in his family nor chasing a ball. He had arthritis, yeast infections, and was 20% overweight. Every test you could have done, we did, and every disease my vet could think of was ruled out. Teddy’s ill health was a real mystery.
By September of 2012, his diarrhea had exacerbated to the point where he was incontinent and would stool over-night in the mud room (where the dogs slept). This made Teddy even more dejected and depressed, so much so that he wanted to spend all day and night outside. Being outside all the time further isolated Teddy from the family and he became more and more depressed and anti-social. I brought Teddy to a specialist in October who ultra-sounded his bowel but couldn’t find cancer, an obstruction, or diverticula. By November, Teddy was so sick I brought him back to his regular vet (for what seemed like the 100th time) and finally we had an answer. Teddy was in kidney failure. Awful news, but at least we had an answer to what was wrong with him. By this time, Teddy was terribly dehydrated and was kept at the vets to be pumped up with IV fluids until he was stable enough to come home. The plan was to keep Teddy alive until the kids came home from college at winter break, so they could say good-bye to their beloved pet.
When I came to visit Teddy on the second day of his hospitalization, he looked so miserable and unhappy, I decided to take him home. Teddy was dying, and I wanted him to die surrounded by his familiar surroundings, not in a cage with bright lights and the non-stop barking of other dogs. My vet wasn’t happy about his going home, but eventually consented and I was given instructions, IVs, medications, and a special dog food for renal failure.
When I got Teddy home, I began to think about the progression of his “vague” disease which eventually culminated in kidney failure. I’m a nutritionist and I educate people daily on eating healthy “real food”. I had over the years thought about Teddy’s diet but, he was on the finest prescription dog food (for arthritis), so my vet discouraged me from making his food. Now I had nothing to lose. I spoke to my vet about a dogs nutritional needs. She said they didn’t learn much in vet school about nutrition but warned me to be cautious about too much phosphorus and protein due to his failing kidneys. I googled home- made dog food as well as read some horror stories on what dog food manufacturers use in commercial (and prescription) dog food, and began to experiment.     
Finally I found a recipe I liked, and mixed up a batch. Because Teddy had been on so many antibiotics, I added a probiotic and a powdered multi- vitamin. Teddy chowed it down but amazingly so did Fritz our 7 year old Maltese/Westie mix. Fritz never ate. He was such a finicky eater, he only nibbled a little here and there. Within a week, Teddy’s diarrhea was GONE!  Over the weeks and months, Teddy’s energy increased and he stopped limping (arthritis), he lost weight, and his coat grew back shiny and glossy. I stopped all his medications and IV’s. He now takes walks every day and is back to chasing his ball. (Corgis love to chase balls). Although Teddy is 11 years old he now acts like a puppy. Everyone who sees him can’t believe he’s the same dog.  I am so happy I finally listened to my intuition that “good health begins with good food”, but so sorry it took me so long to follow my own advice, “you are what you eat”! 
Disclaimer: This is Teddy’s story only. I am not a veterinarian nor is the intent of this story to deliver any veterinarian advice nor to diagnose any disease.                     

Saturday, June 8, 2013

Artificial Sweetners: The Bitter Truth

Barb Goshorn, RN MSACN
“The Nurse Nutritionist”

With the growing obesity epidemic many people are turning to artificial sweeteners to help decrease calories and lose weight, but are they a good substitute?   There’s mounting evidence that “diet” sweeteners not only contribute to weight GAIN but they also come with a myriad of potential health concerns. According to a study from the University Of Texas Health Sciences Center Division Of Epidemiology those who consume diet drinks regularly have a 200 percent increased risk of weight gain, a 36 percent risk of pre-diabetes or metabolic syndrome, and a 67 percent increased risk of diabetes. These statistics are alarming because since the 1960’s diet drink consumption has increased 400 percent.
Research from Purdue University, Investigative Behavior Center, and published in a recent issue of Behavioral Neuroscience suggests that artificial sweeteners actually contribute to OVEREATING.  In this study, one group of rats was fed yogurt sweetened with glucose while the other group was fed yogurt sweetened with saccharin. The rest of their diet remained the same.  The rats that had the saccharin sweetened water put on more weight, and gained more body fat than the rats that were fed the glucose water.  Although the study was done with saccharin, the authors stated they believed aspartame, sucralose, and acesfulame K would have had similar results.

Results published in the June 2010 issue of the Yale Journal of Biology and Medicine concluded that rather than helping with weight loss, artificial sweeteners actually appear to cause weight gain.  The researchers determined that artificial sweeteners heightened the motivation to eat more while also increasing appetite.

Metabolic Syndrome is considered one of the fastest growing health epidemics in America today, with almost 2/3 of Americans at risk.  A symptom of metabolic syndrome is the development of a “spare tire” around the abdomen.  The April 2009 issue of Diabetes Care found that the daily consumption of diet soda significantly increased the risk of developing a large waist circumference thus increasing the risk for metabolic syndrome.

A widely used artificial sweetener in soft drinks, gums, gelatins, and dessert mixes is aspartame which is 180 times sweeter than sugar. This artificial sweetener is a combination of the two amino acids, phenylalanine and aspartic acid plus methanol (wood alcohol). Phenylalanine and aspartic acid are not harmful when eaten in natural, unprocessed food.  But when they are chemically manipulated problems can potentially occur. Side effects such as headaches, mental confusion, dizziness and seizures have been reported after consuming aspartame.

Another type of artificial sweetener is the sugar alcohols.  These include xylitol, sorbitol, and mannitol. Sugar alcohols are not calorie free but contain approximately 2.6 calories per gram.  A problem often seen with sugar alcohols are they can cause bloating, abdominal pain, and diarrhea. Sugar alcohols are often an ingredient in protein bars, ice cream, gum, and even tooth paste.

Another artificial sweetener is sucralose or Splenda. Sucralose is unrecognized as a food by the body and therefore goes through the gut largely undigested.  It is therefore considered “calorie free”. Is sucralose safe? The truth is there are no long-term studies of the side effects of sucralose in humans. The manufacturer’s own short-term studies showed that very high doses of sucralose (far beyond what would be expected in an ordinary diet) caused shrunken thymus glands, enlarged livers, and kidney disorders in rodents. A more recent study also shows that sucralose significantly decreases beneficial gut flora.  In the 11 years sucralose has been on the market no INDEPENDENT (not paid for by the manufacturer) studies have been done on humans.  Of the trials that were done, all were small and for very short periods of time.  Remember saccharin and aspartame were once touted as the perfect sugar substitutes too!

So if you are looking for a way to add some sweetness without adding sugar or artificial sweeteners what can you use?  One option may be stevia.  Stevia is a relative of herbs and shrubs in the sunflower family from Paraguay and Brazil and is approximately 200-300 times sweeter than sugar.  Stevia’s sweetness actually comes from the leaves of the plant.  Another positive aspect of stevia is it does not raise the glucose levels. Other natural alternatives include: agave nectar, date sugar, and honey. 

Saturday, June 1, 2013

A Calorie is a Calorie, Right?

Barb Goshorn RN MSACN

“The Nurse Nutritionist”

How long have we been hearing this? Since the 1960’s, this is the foundation of our belief in what causes obesity. If we take in more calories than we expend, we get fat. There are many researchers who are no longer buying into this theory, though. One is Dr. David Ludwig, of Boston Children’s Hospital and his collaborators. The Journal of the American Medical Association recently published the results of his research and instead of excess calories being implicated in the obesity epidemic, the hormone insulin appears to be the culprit. 
Until the 1960’s, carbohydrates were indeed considered a likely suspect in obesity. “Every woman knows that carbohydrate is fattening” as two British Dieticians began a 1963 British Journal of Nutrition article.  Carbohydrates stimulate the secretion of the hormone insulin, which works, among other things, to store fats in our fat cells. In 1921, insulin was discovered and nicknamed, “The fat storage hormone”. For a number of reasons though, conventional wisdom shifted and obesity became an energy imbalance issue. Carbohydrates, with less than half the calories per gram of fat, became the heart-healthy diet food. With this transformation, fat was removed from foods and we were told to eat low-fat, carbohydrate-rich foods that would keep us thin.
Unfortunately, this theory hasn’t seemed to work. Each decade the obesity epidemic grows exponentially. It may be time to look at an alternate theory as to why we get fat. Dr. Ludwig and his team concluded that it was the nutrient composition of the diet that triggered weight gain independent of calories consumed. The fewer carbohydrates eaten (simple versus complex), the less weight gained and the more carbohydrates eaten, the more weight the subjects gained. It was concluded, that the carbohydrates were fattening, and obesity triggered by elevations in insulin, triggered fat storage.
This is the polar opposite of what we have been told to eat for decades: eat a low-fat, carbohydrate-rich diet. The results and conclusion are naturally very controversial. Yet what we have been educating people to eat obviously hasn’t been working. I know from a clinical perspective, my clients are most successful when their carbohydrate intake is from vegetables and fruit with a minimum of grains. Instead of counting calories, think about eating to avoid huge spikes in insulin.         

Wednesday, May 29, 2013

Bacteria, The Good Guys!

Barbara Goshorn RN MSACN
“The Nurse Nutritionist”

Most of us grew up believing bacteria were bad for us. Isn’t it bacteria that lead to infection and make us sick? In reality though, only a minute percentage of bacteria make us sick and most are beneficial and even necessary for good health. Its true, antibiotics have saved countless lives, but over the past decade researchers have discovered that the human body is the host to 100 trillion mostly beneficial bacteria which help digest food, program the immune system, and prevent infection, and even influence mood and behavior. Scientists now believe the bacteria living on and in us make up our own unique “microbiome”, an ecosystem in which bacteria play a role in many conditions that genes and environmental factors alone can’t explain, including obesity, autism, depression, and asthma. The discovery of the microbiome is “very much like finding an organ we didn’t know we had”, according to Michael Fischbach, a bioengineer at the University of California, San Francisco. 
Bacteria thrive throughout the body. They are in our mouths, lungs, skin, teeth, and especially in our gut. The human gut contributes over four pounds of bacteria. The Human Microbiome Project, a government supported effort to map our bacterial ecosystems, has discovered that people harbor 10 bacterial cells for every human cell and at least 10,000 different species of bacteria! It is postulated that understanding each person’s unique bacterial profile, will help give clues to disease and design better medications and treatments in the future. This in turn has led to researchers trying to figure out what makes a healthy microbiome.
Microbiome research is in its infancy, but there is already mounting evidence that an imbalance of gut flora may be responsible for many of the gastrointestinal problems such as irritable bowel and Crohn’s Disease. Research has shown that when mice are fed a high fat, “junk food” diet, the microbes in their guts changed much as they do in humans on a fast-food diet. Bacteria have also been implicated in the obesity epidemic. Additional studies show that when obese individuals undergo gastric bypass surgery to lose weight, their gut bacteria becomes more like the bacteria harbored by thin people, contributing to weight loss. Microbes may even influence mental states. Studies in mice have shown that changes in gut flora can relieve or exacerbate depression and anxiety. Researchers believe that the microbes may encourage neurons in the intestines to signal the brain to alter hormone levels. It has been shown that autistic children, who frequently suffer from gastrointestinal problems, often carry a type of gut bacteria non autistic children don’t.
You can have your own unique microbiome analyzed by a company called BioFrontiers Institute at the University of Colorado, Boulder. For most of us though, there are less expensive steps we can do to improve our bacteria health. Diet plays a significant role in our microbial health. A typical American diet is very low in fiber (fiber is a prebiotic food for bacteria).  Consumption of, mass-produced, highly processed and caloric dense foods are devoid of any positive prebiotic or probiotics. Eat real food that has been minimally processed.  Use soap and water instead of antimicrobial gels. Our hands and bodies need to be cleaned, not sterilized. Try and use antibiotics carefully. Most illnesses are viral in nature and don’t require antibiotics. Research is demonstrating that although not perfect, taking a probiotic, especially after a round of antibiotics appears to be a prudent choice. For more information,