One of the biggest obstacles to implementing new food routines is the cravings and hunger that can go along with it.  Many of my patients report feeling great, but not satisfied, when they've tried to change their meals in the past.  Remember, your body is brilliant so every symptom is a message to be deciphered.  Generally speaking, in North America, we are overfed but undernourished, as we have access to large portions of nutrient-poor foods.  I say this respectfully, as I know that food security is problematic and on the rise.

Hunger comes predominantly from the release of the hormone ghrelin, mainly by the stomach, but there are many other physical and hormonal mechanisms at play in hunger and appetite signals.  

Fullness comes from the hormone leptin, as well as stretch receptors that tell your body that you are full, via the vagus nerve.  

(Digestion is a very complex process, which I am completely oversimplifying in order to provide you with tangible tips.)

In order to feel full and satisfied:

• Balance blood sugar
  - consume proteins, fats and complex carbohydrates like vegetables for sustained energy
  
  
• Chew your food
  - enjoy every bite
  
  
• Don't starve all day
  - some people undereat all day, and then have a huge meal at dinnertime 
  
  
• Ask yourself if your body is ready to stop, and if you are still hungry
  - identify physical need versus emotional need
  
  
• Avoid chemicals
  - artificial sweeteners, MSG, fat-free and other food additives interfere with our normal signals
  
  
• Get enough sleep
  - cravings for quick energy (sugar & simple carbohydrates) are common when tired
  
  
• Manage stress
  - cortisol can change appetite 
  
  
• Move
  - exercise can change appetite & metabolism, but it also improves mood and alleviates boredom
  
  
• Eat nutrient-dense, whole food (unprocessed)
  - higher fibre for satiety, and higher nutrient content
  
  
• Food is your fuel
  - the better quality, the more efficient your engine
  
  
• Drink enough liquids
  - the body can mix up thirst and hunger cues
  
  
• Eat at the table, not at your desk or in front of a screen
  - keep your brain involved in the process

Most filling foods:

• Beef
• Chicken
• Fish
• Eggs
• Vegetable carbohydrates - broccoli, spinach, cauliflower, kale
• Oatmeal
• Potatoes/squash/sweet potato
• Greek yogurt & cottage cheese
• Nuts & seeds
• Avocado
• Quinoa
• Legumes/Beans

-> In general, include protein and fat at every meal, while aiming for half a plate of vegetables.  

Note: excessive hunger can also be a sign of thyroid disease, diabetes, and medication side effects (anti-depressants, anti-histamines, and others), and appetite can change based on gastrointestinal disorders and emotional well-being as well.  All of these things are important considerations.  


Choosing health everyday,
Dr Christa

Being adaptable, to bend and shift and shape and adjust to new environments and ways of being, is an important quality of any species in order to survive.  Our evolution, or progress, depends on our ability to grow and think in new ways.  Staying the same is not an option.  When I was a teenager I worked at a lovely local book store.  Posted behind the counter was a cutout cartoon, which we would now share in present day as a meme, depicting the words "this is how we've always done it" crossed out inside a box.  (I may have the exact description wrong, but the sentiment of thinking outside the box is accurate). 

Change can be inspired by pure love for innovation, or it can be directed from old systems that no longer, or never did, work.  This happens all the time in health care, as we learn and shift our practices to suit new knowledge.  Recently, we've seen some changes to some long-held standard practices and treatments that I wanted to share with you.  

Aspirin
For decades, 81 mg baby Aspirin (acetylsalicylic acid) was added to anyone's protocol when there was a cardiovascular concern, or someone reached a certain age.  I quickly learned when taking the case of anyone with heart disease to automatically add it to their list of medications.  The purpose was for a blood thinning effect, to reduce the risk of a vascular event.  Unfortunately, Aspirin is also hard on the stomach and can cause gastrointestinal bleeding.  It can also cause bleeding in other locations, and increases the risk of colon cancer.  In 2019 the American Heart Association (AHA) removed it from their guidelines based on research studies that challenged the assumption that daily Aspirin prevented primary heart attacks and strokes. (1)  The AHA recommendations for the prevention of cardiovascular disease strongly focuses on the importance of healthy lifestyle, including food, exercise, and avoiding smoking. (2) In the journal of the Canadian Medical Association it stated that, "clinicians are strongly encouraged to promote medical, lifestyle and behavioural changes that are more effective than ASA (aspirin) in preventing cardiovascular events." (3) The US Preventive Services Task Force (USPSTF) also updated their Aspirin recommendations more recently. (4)  Its use as a blood thinner is still officially recommended for prevention of secondary cardiovascular and cerebrovascular events. (5)

There are other ways to achieve blood thinning without the negative effects on the gastrointestinal system and bleeding.  Alternatives like Omega-3 as fish or krill oil, garlic, turmeric, ginger, grapeseed, and even regular blood donations can help to improve cardiovascular health outcomes.  And I often use marshmallow root,  deglycyrrhizinated licorice and other herbs to heal the esophagus and stomach lining.  Of course, each person has a unique health picture that must be considered before making specific recommendations - it's not one size fits all, and only the prescribing physician can adjust your medications.  Still, it's an important consideration since cardiovascular disease is still the worldwide biggest cause of mortality, so up to date considerations are extremely valuable.  Read more about caring for your heart health here.  

Zantac (Ranitidine)
1 in 3 people experience acid reflux and, as a result, antacids are an extremely popular over the counter and prescription medication.  (You can read more about heartburn and acid reflux here.)  We certainly don't want acid in the esophagus, because that can lead to damage, but we should also consider that antacids can interfere with digestion and nutrient absorption.  In 2019, several manufacturers recalled their Ranitidine (H2 blocker) antacid products (including over the counter no name brands like Exact, Compliments and Life) due to the presence of NDMA, a nitrosamine impurity, at unacceptable levels.  Health Canada has since permitted sales of ranitidine antacids as long as batches are tested, however, certain lots are still being recalled after making it onto the market in 2021 and 2022. (6)

So what's the problem with NDMA?  It's considered a probable carcinogen, with the risk increasing with prolonged duration of use (the more you take the higher your risk). (7)  Unfortunately, lots of people with heartburn take medications almost daily for years, which has led to ongoing lawsuits against the manufacturers.  In studies cited by those lawsuits, Ranitidine use has been considered linked to colon, liver, bladder, thyroid, breast, kidney and stomach cancers, with prosecutors claiming the companies withheld knowledge of these risks.  Yikes.  Since then, newer versions of the product are said to not contain any of this compound.  

Now What?
We can support healing of the esophagus, stomach, and replace depleted nutrients.  The history of Aspirin and Zantac are simply two examples of standard, decades long practice of treatment for extremely common health concerns, that were eventually discovered to be counter to the best interests of the patients.  As you know, I never share information out of fear, I outline these two circumstances to describe the ways in which we evolve in our treatment philosophies and understanding of health.  Being educated on our choices creates empowerment, and what was the right decision before might be different now.

Now that we know better, we can do better.  And yes, we can certainly do better when it comes to our wellness.

Fortunately, there are many incredible ways that we can support well functioning cardiovascular and digestive systems, and ultimately stimulate healing and maintain good health for years to come.  I love creating personalized strategies to achieve these goals.
In your corner,
Dr. Christa
 
Rest.  Eat well.  Move everyday.  Go into nature.  Connect.

1.  https://www.heart.org/en/news/2019/03/18/avoid-daily-aspirin-unless-your-doctor-prescribes-it-new-guidelines-advise
2..  https://www.washingtonpost.com/lifestyle/2021/10/12/low-dose-aspirin-heart-attack-stroke/
3.  clinicians are strongly encouraged to promote medical, lifestyle and behavioural changes that are more effective than ASA in preventing cardiovascular events.
4.  https://www.ahajournals.org/doi/10.1161/CIR.0000000000000678 
5.  https://www.cmaj.ca/content/192/12/E302
6.  https://recalls-rappels.canada.ca/en/alert-recall/ranitidine-products-recalled-because-nitrosamine-impurity
7.  https://www.health.harvard.edu/blog/popular-heartburn-drug-ranitidine-recalled-what-you-need-to-know-and-do-2019092817911
 
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