Eating Disorders: It Is not about the food

http://wholesomegenerationmag.com/health/eating-disorders-it’s-not-about-the-food

Article by Lea Peyton Gebhardt 

Eating Disorders do not discriminate; they are not limited by gender, age, social class, or ethnicity. Individuals suffering from Eating Disorders have severe disturbances in eating behavior (ranging from total restriction to binge eating) coupled with negative or distorted body image. Over exercise, self-induced vomiting, and misuse of laxatives or medications are behaviors typically associated with weight control in Eating Disorders.  Poorly understood by most, Eating Disorders are often oversimplified to a basic mathematical equation of eating too much or eating too little with bodyweight being the end result. This linear thinking dismisses the severity of the disease, overlooks the psychological and emotional aspects, and reinforces weight as the measurable outcome.  It is important to remember it is not about the food.  Eating Disorders are diseases that affect ones physical health, cognition and thinking, feelings and emotions, sociability as well as quality of life.  And sometimes, they are paired with anxiety, mood, adjustment or personality disorders, and substance abuse.

Unhealthy relationships with food can develop as a response to life stressors.  Food is one of the few things we can control without external interference and this is learned at a very young age. When life seems overwhelming for individuals with eating disorders, food becomes the coping mechanism.  How much, how little, what, when, and where to eat, represent an individuals’ control that may not be felt, perceived or present in other areas of life. This methodical approach to eating coupled with a fixation on weight control can be all consuming and can take up to 90 percent of waking hours; therefore leaving little time to manage any of life’s other responsibilities. Food and weight become tangible, measurable entities, yet they are merely metaphors for answers to more complex core issues including but not limited to: depression, anxiety, coping, identity, values, relationships, low self-esteem, abuse, or obsessive behavior.  We live in a culture where thinness is valued and aggressive food marketing produces conflicting information about which foods are “healthy”, creating the perfect environment to mask emotions behind food control.

Eating disorders and the resultant food behavior can ravage the body physically resulting in malnutrition, anemia, muscle wasting, compromised bone health, gastrointestinal function and immunity, and even death. Malnutrition can further compromise any underlying psychological condition and yield mood stabilizing medications ineffective. Remember it is not just about food.  Eating Disorders can only effectively be treated with a multidisciplinary team consisting of a physician, psychiatrist, therapist, and dietitian.

pantrymedicine@gmail.com 

Remember to honor your child, picky eating is not always a choice

http://wholesomegenerationmag.com/health/raising-a-picky-eater

Physiologically, eating may just be the most complicated thing we do.

Swallowing, alone, involves 26 muscles, and every meal engages the respiratory, endocrine and metabolic systems, as well as the entire GI tract and all 5 senses. Eating triggers psycho-emotional associations, and affects both the sympathetic and parasympathetic nervous systems. It is no small wonder that things often go wrong. It is extremely important for both professionals and parents to read children’s cues and look for patterns with food refusal.

As a general rule, kids don’t refuse to eat simply to be difficult, but they do have difficulty articulating why they are not eating. They may not have the language to express why it is difficult (it hurts, it makes me gag, I don’t like the texture, I am afraid) or lack the understanding that their eating habits are atypical. Many picky kids have unknown medical conditions, like acid reflux, iron and zinc deficiencies, diarrhea, or constipation. A kiddo with undiagnosed food allergies may experience pain when eating. He may not even be aware that it does not have to be painful to eat. You must also take into account a child’s motor skills, as sometimes children are not developmentally ready to advance textures even though it may seem age appropriate. Sensory Food A version, a commonly seen feeding disorder characterized by consistent refusal to eat certain foods based on taste, texture, smell or appearance, may produce strong visceral reactions that leave a child unable to eat. Some children may only refuse a few foods while others may exclude entire food groups such as vegetables, fruits, or meats. Children with Sensory Food A version can become very distressed at meals, often leading to heightened anxiety for both the child and the parent or caregiver.

Typically, these kids will eat preferred foods, but their diet may be lacking in key vitamins and minerals. Often these preferred foods are predictable to them, meaning that the food will look, taste, smell, and feel the same way every time. Typically, sensory related aversions are not isolated to food. These children will often refuse touching certain textures such as sand, playdoh, or wet grass, and have adverse reactions to brushing their teeth or washing their hands or face.

Psychologically, children may have negative memories associated with a past food experience. They may associate food with fear, pain or discomfort. Furthermore, children may lack the confidence to try new foods or to experience new textures that cause them fear, anxiety or scary sensations. Children often look to their parents for modeling and reassurance. I f the parent is anxious, coaxing, bribing or bargaining, this can lead to increased anxiety for the child and less eating. W hen children have a negative association with eating they are in react mode, leading to increased adrenaline. Elevated adrenaline in turn causes suppression in appetite, an inability to calm, and increased difficulty with swallowing.

Kids eat when they feel well, when they feel confident with their skills, and when they have positive social interaction with their parents, peers, and caregivers. Appropriately addressing any issues with choosy eating should include treating any contributing medical condition, correcting any resulting malnutrition, and empowering children to feel safe with new foods in order to build a solid foundation for a lifelong healthy relationship with food. If your child seems fearful or anxious at the table, you may want to consult with a feeding expert for guidelines to ensure your child will become a healthy, happy eater. Remember to create regular meal times, provide a variety of food (keeping in mind that children get overwhelmed with more than three choices,) let your child choose what and how much they will eat, and praise your child for self-feeding skills and being brave about exploring new foods!

Picky Eating 101 for Parents

Welcome to our mini 4-week course on Picky Eating with Pediatric Feeding/Nutrition Expert Lea Gebhardt. This webinar series will have 4 packed hour sessions on everything you need to know to raise a picky eater! The course is just $250 for all 5 weeks! There will be a bonus 5th week of Q&A. You will have an opportunity to send your questions in advance of the special session! 

Course Objectives:

1.   Basic understanding of picky eating, sensory integration and eating: what makes kids picky, what works and what doesn't.

2. Employ strategies to promote familiarity with new food: reduce fear and anxiety with meal times, and increase acceptance of nutritionally suitable foods.

3. Establish Family Meal Time Expectations: get your family on the same plate and stop making multiple meals!

4. Simplify Meal Planning, grocery shopping and meal preparation. 

There are 4 times to choose from, but space is limited so register soon.  If you have a conflict on any week, you will be permitted to attend a different time if you notify us in advance.

Course Times:

Tuesday at 11:00 am CST or 7:00pm CST

Jan 28th

Feb 4th

Feb 11th

Feb 18th

Feb 24th

Wednesday at 11:00 am CST or 7:00 pm CST

 Jan 29th

 Feb 5th

Feb 12th

Feb 19th

Feb 26th

Please register online under investments and send an email to pantrymedicine@gmail.com with your course time preference.  You will receive a confirmation. All webinar login information and course materials will be sent one week in advance of each course.

For more information from Lea,  see these previous articles.

http://wholelifestylemagazine.com/health/raising-a-picky-eater

http://www.austin360.com/news/lifestyles/food-cooking/turn-picky-eaters-from-yuck-to-yum-2/nRgdg/

We hope you’ll join us for this informative webinar series. We promise it will be both fun and informative. Meals should not be a struggle and eating new foods doesn't have to be scary! 

From Our Pantry to Yours,

Lea & Emily

The Sunshine Vitamin or Rather HORMONE

Many chronic health problems stem from micronutrient deficiencies arising from intake of poor diet, drugs,  inappropriate nutrient supplements, and environmental depletion. These deficiencies often go undetected for decades. The study of micronutrients and the isolation of them is a young one and frankly still very much a work in progress. The early part of the 20th century marked an exciting time in the science of nutrition as vitamins were isolated and identified as necessary growth factors for human metabolism. I can remember my first exam in my doctorate program, the class was The Biology, Chemistry and Physiology of Micronutrients. Wow I was blown away at the intricacies of human nutrition and the many avenues for things to go wrong.  And I had been a practicing pediatric and metabolic dietitian/nutritionist for 6 years prior to returning to school. I think I got a 65 or something on that exam, which turned out to be an A. My friend, a student in the architecture program, said how could a 65 be an A? Can you imagine if only 65 percent of my plans were correct? Indeed why we call it the practice of medicine. 

The most reported deficient micronutrient is Vitamin D; it is estimated that over 1 billion people world wide may be lacking in this metabolic powerhouse.  Although Vitamin D is labeled as a vitamin,  it is not a vitamin in the true sense. Vitamins are described as essential, organic, micronutrients supplied in part by the diet and involved in  the growth, maintenance and health of the human body.   Natural exposure to sunlight is responsible for maintaining adequate Vitamin D nutrition for most of the world’s population; therefore it is fair to say you do not need a dietary source as with all other vitamins. The more we understand about the availability, metabolism, and actions of Vitamin D the more we need to rethink Vitamin D as a steroid hormone rather than a vitamin. Vitamin D looks and acts much like glucocorticoids (cortisol, etc) and sex hormones (estrogen, testosterone, etc.) If it looks like a duck, swims like a duck and quacks like a duck.  Isn't  IT a duck? 

Vitamin D’s most understood job description is to maintain calcium and phosphorus levels in the blood and bones. It gets this job done by increasing the absorption of these minerals in the intestine. The disease Rickets, a childhood disease of osteomalcia, resulting from severe Vitamin D deficiency, has been described in humans since the 2nd century AD.   In the 17th century as civilizations became more industrialized more kiddos suffered from Rickets. Yet the kids in rural areas and even poor-rural areas did not suffer the same fate.  Sadly the correlation to sunshine exposure or rather the lack of it was not considered as a culprit for the sickly city kids. Think iPads and video games today. It would be much later when sunshine  exposure was actually given the credit it deserved in preventing crippling childhood bone disease.  In the 18th and 19th centuries reversal of Rickets included  treatment with cod liver oil and sunshine, both excellent sources of Vitamin D!  

Given its quasi but not formally titled hormone status, we now know that in addition to keeping the bones up to par, Vitamin D plays a major role in: muscle physiology, nutrient absorption, nerve conduction, respiratory and cardiovascular function, immune response, brain development and mental health. Ever get depressed when it is cloudy or rainy? Ever wonder why the flu and cold seasons are not associated with the sunny months?

We can make Vitamin D from cholesterol in our skin when exposed to sunlight or we can get it in our diet. The cool thing is if a person is exposed to too much sunlight, the body will photodegrade excess Vitamin D to avoid toxicity.   Not the case with too many supplements!  Pigment in skin is a protective mechanism to prevent the body from making to much vitamin D. Ever wonder why lighter skin is found as you go further from the equator?  This was nature's way to ensure folks in the Northern hemisphere could get enough Vitamin D.  Why do you think Eskimos eat Fatty Fish? 

The main dietary sources of Vitamin D include:

• Fatty fish: tuna, mackerel, salmon
• Beef, liver, cheese, and egg yolks
• Mushrooms
• Milk, cheese, ice cream

Dietary sources are not what they used to be mainly because animals yielding meat and milk are also deficient in Vitamin D since they don’t see the sun much either. So grass fed and free-range sources of milk and meat are best to ensure adequate vitamin D dietary sources. 

Dietary sources aside, if the sun is free, readily available and designed to support nutrition and life, why is everyone deficient in Vitamin D? Okay so it is not that easy, you need the sun, but you also need enough fats and oils in your skin to make the stuff. All the crazy lotions and potions we use today often rob our skin of these needed fats so we start out with a deficit. And for some strange reason we are a nation of fat restrictors, more deficiencies. Try making brownies and forget the oil. Oops. Next even if we have enough oil, the Vitamin D we make is not ready to work until it takes a ride on a special protein and travels through the liver and finally the kidney to pass activation phases. So imagine if you have the oil for your brownies but you have no pan and your oven wont heat up. Making vitamin D in today's lifestyle can be a big challenge!

Factors that  negatively impact Vitamin D status:

• Alcoholism
• Insufficient sun exposure
• Use of sunscreen and skin products
• Intestinal disorders: celiac, Crohn’s,  diverticulitis, IBD 
• Liver and Renal Disease
• Parathyroid disorder
• Reduced availability in dietary sources
• Caffeine consumption
• Drug or supplement depletion
• Pollution, if your shadow is longer than you are tall, you aren't making vitamin D! 
• Exclusive breast feeding
• Elderly
• Fat Restriction 

Vitamin D deficiency can present with a host of symptoms including fatigue, depression, muscle aches, and frequent infections or colds. However everyone presents with different symptoms and they may be masked by other illnesses or medications.

What to do? 

1. Check your numbers, have your health care provider measure 25(OH)D
2. Work with a Registered Dietitian/Nutritionist to evaluate your diet and lifestyle to ensure optimal levels of sun exposure and dietary intake
3. Don’t take a supplement without getting evaluated. Vitamin D has some real toxicity symptoms: Anorexia, Nausea, Vomiting, Constipation, frequent urination, frequent thirst, and  kidney stones to name a few. Also megadoses are not associated with increased blood levels. Actually lower doses often result in greater rises of blood plasma levels indicating the body responds better to moderate doses. Scary as I often see folks on 50, 000 IUs! 
4. Don’t get supplement advice from a store with profit, not your health,  in mind!

Get outdoors, get sunshine on your shoulders, make vitamin D!

From Our Pantry to Yours,

Lea & Emily

Let's Redefine Food

Seemed easy enough, grocery store tour for two young parents with a pretty sick kid. At 18 months he had been to every specialist, suffering from an inexplicable autoimmune type disease yielding hives, anaphylaxis, chronic rhinitis, fatigue, leg cramps, constipation, irritability, multiple ear infections, sore throats. Symptoms were all of unknown origin, at least unknown modern medicine origin. My goal was simple; I wanted to eliminate any food sources that may be contributing to his ailments or his young body’s ability to fight them. Many processed food substances contain ingredients and genetically modified proteins that can contribute to pervasive allergy like symptoms.

I met them at a large grocery in their very modern suburban community.

The store was massive in size, overwhelming in noise and bright lights fraught with buy me attractions. It was a nightclub of deceptive nourishment. Bright colors and sophisticated labels preying on your conscious and your want to eat Smart foods, lean cuisines, be fat free, lower your cholesterol, improve your brain function, feed your heart health, be fit.  The modern grocery store is the Hollywood for food. A make believe system of chemicals masquerading as food. Dressed up, with a smart message and a familiarity that cant keep you away. Sophisticated misting systems on cue drawing your attention to glossy, waxed produce not unlike dry ice on a concert stage yielding the allusion of importance. The grocery store like the shopping mall is a for profit business, not a for health business.

The politics of food is as convoluted and complicated as an ingredients label for any processed food. Often on grocery store tours I will have folks read labels of two like substances. A favorite example is Cheese vs Shredded cheese. The shredded cheese label contains an asterisk * which later leads the reader to a statement: ingredients not normally found in cheese. You don’t need to be a nutritionist to know that any type of warning label on your food should raise a cautionary flag. At Pantry Medicine we have simple rules:

If you Cant read it Don’t Eat It TM

All Food Requires the Sun and provides nourishment TM

So if it seems unnatural, go with what nature would have produced. After all, I still have yet to meet the cow that produces skim milk with fish oil. Or the wild salmon that yields its lovely orange hue from eating food coloring pellets.

According to the New Oxford Dictionary:

food  

Any material containing nutrients, such as carbohydrates, proteins and fats, which are required by living organisms in order to obtain energy for growth and maintenance.

In our modern food landscape we certainly have strayed from this definition take everyday examples: Coffee Creamer, Sweet N Low, and Easy Cheese. These food substances do not require the sun to make, and most certainly do not provide nourishment. Our supermarkets are littered with 1000s of examples of these cleverly contrived, tasty, addictive “food substances.”

As a biochemist and a nutritionist the simplest way to put it is our body speaks one language, albeit a complicated one of carbon, hydrogen, nitrogen, and oxygen. So imagine when you consume man made food substances how confusing this is to your body. Picture a native English speaker lost in Japan trying to board an underground train unable to communicate his needs or find his way back, exasperated, tired, hungry, confused, and unaccomplished. Exactly how your body feels when you eat chemically altered food substances.

At the end of the Grocery tour, we managed to fill the family food basket with whole food substances and not break the bank. As for the kiddo, he is thriving, and is free of all his symptoms and seemed to enter his twos with only the well checks and a strong grasp on every toddler’s favorite word, NO!  A great word to employ if you cant read an ingredient. So for this New Year, we ask that you take baby steps to finding whole food solutions to feel your best in 2014. It doesn’t have to be complicated or all or nothing.  Take a minute to ask before you buy or bite, would my grandmother recognize this as food?  

Happy and Healthy New Year!

From Our Pantry to Yours,

Lea & Emily

What Nutrition are You?

Sure Dr. Seuss may make a parody of wars being waged over butter preference but the truth is freedom of nutrition is very much a real and often taboo subject. Since Biblical times food has been both emotionally and spiritually charged. Food has always brought people together through cultural, familial and religious traditions.  Food is indeed the very essence of life and therefore it is not hard to ascertain why it has so much power. After all if human survival was dependent on a kiss from a frog, the story would then become, what kind of frog, dawn or moonlight kiss, mouth, lips, both cheeks? Rituals would develop, frog hoarding and exploitation would soon follow. And of course the inevitable frog charmer promising the eternal kissing frog for a small ransom would arrive on your doorstep, at your children’s schools, in your places of worship, and of course on social media #kissthisfrog.

Today’s dinner parties are most likely to be interfood parties. You may have a vegetarian, a gluten freebee, a practicing paleotarian, a raw foodie, a fruitatarian, a point collector, a pescaratarian, a vegan, and an omnivore.  Menu planning can prove to be challenging, seating perhaps impossible for as with religion personal nutrition is practiced with as much or more conviction. And what works for them will surely work for you. #eatlikeme. And of course you will see!

We have done an amazing job in this country to establish a national unhealthy relationship with food. Many thanks to the food marketing dollars and special acknowledgements to the predatory and lucrative supplement and weight loss industry. At some point we lost our way, forgot our daily bread and transformed food from sustenance to substance. Giving food superlatives and other wordly powers. It is no small wonder everyone is confused with aggressive advertising pulling at your heart strings, with appealing adjectives: skinny, smart, fit, and even loftier promises of healthy babies, everlasting energy, and lower cholesterol. We have personified food and its impostor, cleverly arranged tasty chemicals masquerading as food. (News flash: the impostors have more real estate in our food landscape!) #krabisnotendangered

This blog is not intended to shame anyone. We support FREEDOM OF NUTRITION and truly believe nutrition is an individual journey. In an endless age of information it is tough to know fact from fiction. It is our intention to bring you objective, evidenced based information. At Pantry Medicine we ask that you move away from guilt and shame with food. Focus your thoughts on positive change with new foods one obtainable step at a time.  You are not “cheating” if you have key lime pie for breakfast, unless of course you have a covenant with your super green smoothie. #foodadultery  There is indeed no magic pill for nutrition, even if seen on TV. So take heed our pantry medicine friends, take all nutrition advice with great consideration. And remember we are all unique so what works for one doesn’t always work for another. And with any taboo subject, there is no right answer.  In parting, we want to share:

Pantry Medicine’s Food Philosophy TM

If you cant read it don’t eat it 
All food requires the sun and provides nourishment 
My mouth my body, your mouth your body, their mouth their body TM 

We hope you will follow us and we can all work together to redefine a national healthy relationship with food!

From Our Pantry to Yours,

Lea & Emily