Author name: laura@lauracipullo.com

Can Cognitive Behavioral Therapy Help With IBS? By Laura Cipullo, Whole Nutrition Services Team Has anyone ever told you that you can only relieve your IBS symptoms through medication or nutrition? Well, we are here to tell you that you can also help alleviate symptoms with one of the most powerful organs in your body, the brain. In this blog, we will discuss how cognitive behavioral therapy (CBT) can be effective improving bowel symptoms, psychological distress, and quality of life. Understanding what IBS is IBS and other functional gastrointestinal disorders (FGID’s) are conditions characterized by the interaction between the brain and the gut. In simpler terms, this implies that there is a communication issue between the central nervous system (our brain) and the enteric nervous system (our gut) regarding our digestion, appetite, thoughts, and emotions. The connection between the brain and the gut is referred to as the brain-gut axis, and it relies on chemical messengers, including serotonin, for communication. Serotonin, which is commonly associated with mood, sleep, appetite, and sex drive, is also present in the gut. Therefore, this demonstrates the close relationship between our emotional state and the functioning of our gastrointestinal (GI) tract. So what does this actually mean? In essence, the functioning of our GI tract has an impact on our emotions, and reciprocally, our emotions can affect the functioning of our GI tract. What is cognitive behavioral therapy (CBT) and how will it help my IBS? CBT is a type of psychotherapy originally developed and used to treat mental health issues, such as depression and anxiety. It uses techniques by addressing how our thoughts, feelings and behaviors can positively or negatively affect our emotional state. A recent research study from 2021 examined individuals with IBS before and after CBT.  Following the CBT intervention period, these individuals had a significant decrease in abdominal pain unpleasantness, IBS symptom intensity, negative mood ratings, and perceived stress. CBT Techniques for managing IBS: It’s important to note that CBT is typically conducted by a trained therapist or mental health professional experienced in working with individuals with IBS. If you or someone you know is experiencing IBS, we at LCWNS are here to tailor to your specific needs, as well as, provide personalized guidance and support throughout the treatment process. References: https://aboutibs.org/treatment/psychological-treatments/cognitive-behavioral-therapy/#:~:text=Research%20has%20shown%20CBT%20to,CBT%2C%20one%20will%20clinically%20improve. https://microbiomejournal.biomedcentral.com/articles/10.1186/s40168-021-01188-6 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921083/

Shifting the Fitness Focus: Creating Positive Spaces for Body and Mind by Lauren Licatesi, MS, RD Did you know that physical activity can improve brain health, help manage metabolic disorders, reduce the risk of cardiovascular disease, strengthen bones, and improve one’s ability to do everyday activities? We’ve all heard how crucial it is to stay active, however, it’s just as important to stay mindful of the environment we choose to be physically active in and how it contributes to our mental health. In this blog post, we will discuss some of the inadvertent contributions the fitness industry has on body image and beauty standards. We will also discuss the power certain words or comments have on an individuals experience in exercise classes.  1. Proper Language “Lets burn off that pizza we ate last night!”  Have you ever heard this comment in a workout class? Did you walk out of that class feeling ashamed? Although the comment was likely unintentional, fitness instructors often use language that can have detrimental effects on an individuals relationship with their body. This type of language labels pizza as “bad” or “unhealthy,” insinuating that those should feel shameful about pizza consumption. You may also have heard, “let’s burn those calories” or “let’s get rid of that belly fat we can’t seem to shed.” These statements can lead one to believe that exercise is solely encouraged for weight loss, instead of promoting the sizeable benefits of physical activity discussed above. Instead, such language like, “let’s boost those endorphins!” help to promote the positive effects exercise has on our mental health.  2. Reducing Comparisons  “Look at her abs! We all need abs like those!”  Have you ever felt ashamed of your body because you compared yourself to another individual in your workout class from a comment like this? It’s time fitness instructors help to promote an inclusive and supportive environment. Unfortunately, some instructors unknowingly contribute to body shaming by making comparisons to those in the class. Today, these comparisons can contribute to negative self-esteem, lack of confidence and body dysmorphia. As dietitians, it’s important we continue to share the message  that all body types are beautiful no matter what shape or size.  3. Representation is Key “Let’s get that Gigi Hadid summer body!” Have you ever heard your fitness instructor say something about the “ideal” body? Although the fitness space has made incredible strides to promote inclusive spaces as discussed in _____ blog, there is still a lot of work to be done. When the fitness world encourages only one body type as ideal, it can isolate those who may not fit the mold. The key to representation is to find an instructor who fits many molds. This will lead to a decrease in negative body image and limit those feelings of exclusion. 4. Overemphasis on Appearance “One more push up for that hourglass shape!” Have you ever had a fitness instructor encourage you to work harder for appearance purposes? By shifting the narrative away from appearance driven goals, individuals can focus on the importance exercise has on our mind and mood. A study done by Northwestern University in 2018, had participants randomly assigned to either a fitness class that featured an “appearance-focused” motivational comment by the instructor (e.g., “Blast that cellulite!”) or “function-focused” comments (e.g., “Think of how strong you are getting!”). Those in the function-focused class experienced a significantly great increase in body satisfaction than those in the appearance focused class. These findings suggest that a more function-focused class can lead to even greater improvements in women’s mood, body satisfaction, and body surveillance.  5. Mindfulness Practices “Push through the pain!” Fitness instructors can be often be forgetful or unaware of how important it is to listen to your body in a workout class. It’s clear that physical activity is connected deeply to our emotional well-being. The fitness industry can be a sensitive place for those struggling with body image or eating disorders. Something as simple as incorporating mindfulness practices such as positive affirmations, meditation, and/or encouraging compassion in the beginning or end of a workout class could make all the difference for some and create a safe environment for those who find it difficult to workout in front of others.  Using the right language, reducing comparisons, proper representation, shifting the mindset from appearance, and practicing mindfulness are all imperative in creating a safe fitness environment and help motivate individuals on the functional focus of exercise. It’s time to shift the narrative and spend time in workout classes that promote positivity, well-being, and self-love.   References: Dobrich, E. O. (2022). Rethinking conceptions of body image in group fitness education, culture, and contexts: Recommendations for perspective transformation and innovations in instructional methods. Frontiers in Education, 7. https://doi.org/10.3389/feduc.2022.1008461  Hurd Anyaso, H. (2023, June 8). Fitness instructors’ comments shape women’s body satisfaction. Northwestern Now. https://news.northwestern.edu/stories/2018/december/fitness-instructors-comments-shape-womens-body-satisfaction/  Mathisen, T. F., Aambø, J., Bratland-Sanda, S., Sundgot-Borgen, C., Svantorp-Tveiten, K., & Sundgot-Borgen, J. (2020). Body figure idealization and body appearance pressure in fitness instructors. Frontiers in Psychology, 11. https://doi.org/10.3389/fpsyg.2020.585901 

Exploring Autophagy: Wellness and Beyond Rebecca Jaspan, MPH, RD, CEDS, CDCES The cellular process of autophagy is gaining traction in the wellness world and on social media, with video tags on TikTok hitting close to 35 million views.  Some TikTokkers claim that fasting triggers the body to eat itself and jumpstart weight loss while others are linking fasting to healing cancer and diabetes. While autophagy does literally translate to “self-eating”, much of these claims are wildly oversimplified and filled with misinformation. So, what exactly is autophagy and what role could it play in the treatment of disease and slowing of aging? Understanding Autophagy and Its Importance Autophagy is your body’s natural process of cleaning out your cells and reusing old and damaged cell parts.  You can think about autophagy as your body’s recycling system. Your cells are complicated little systems that have many parts to keep them functioning.  As with any machine, these parts can be come defective or stop working. Rather than destroying the cell all together, autophagy is the system that allows cells to disassemble and repurpose the usable parts into new cells. Autophagy is also the quality control system for your cells.  When too many defective parts accumulate, this can slow or prevent the cell from functioning properly.  Autophagy helps to optimize cell performance by getting rid of the clutter. Autophagy occurs when your body’s cells are deprived of nutrients or oxygen or if they are damaged in some way.  When your body is deprived of resources, it has no choice but to ramp up this process to make the most out of its existing resources since your cells aren’t getting fuel or oxygen from an outside source. Essentially, your cell uses its own resources to survive. How Fasting Influences Autophagy So what happens in your cells when you deprive them of resources?  The body’s main, preferred source of energy is glycogen, which is a stored form of glucose that comes from the carbohydrates you eat.  When you digest carbohydrates, they break down into sugar, or glucose, that is stored in the muscles and liver as glycogen.  In the couple of hours after eating, insulin levels rise, which causes the glucose that is broken down into your blood to be moved into your cells to be used for energy.  Whatever doesn’t get used is stored in your muscles or liver.  12 hours after fasting, insulin levels drop, and ghrelin, the hormone that signals hunger, will increase.  It takes between 4 and 18 hours of fasting to burn through all of your glycogen stores.  Your body will then begin to break down fat and protein to use for energy.  After 18 hours, your body will transition into a state of ketosis, when it relies primarily on fat as its primary source of energy.  Autophagy begins at the 24-hour mark.  After about 24 hours of fasting, your cells start to get rid of components that are old, damaged, or functioning poorly.  The process of autophagy declines naturally with age and it is thought that fasting-induced autophagy can be a way to reduce the effects of aging and prevent certain diseases. Autophagy’s Role in Disease Prevention and Aging There is a growing field of research examining how autophagy may be beneficial in slowing or preventing certain disease processes.  In various studies looking at autophagy and heart disease, it is thought that increased autophagy can exert beneficial effects on the heart and protect it from age-related cardiac deterioration.1  In one rodent study, fasting lead to decreased cardiac fibrosis, cardiac hypertrophy, and cardiomyopathy with aging.  Additionally, there is evidence that fasting has beneficial effects on the vascular system as an individual ages.2 Research also shows that impairment of the autophagic pathway may play a role in the development of type 2 diabetes.  Pancreatic beta cells are responsible for the synthesis, storage, and release of insulin.  As autophagy increases with age, beta cells become less functional and can result in a reduction of glucose tolerance.  Recent studies show the role of autophagy in maintaining the function of pancreatic beta cells and the release of insulin, but more research needs to be done.3 Navigating the Benefits and Considerations of Enhancing Autophagy While it is tempting to fast, restrict calories, or try the keto diet in order to enhance autophagy to increase longevity and prevent diseases, this is newer science that should be approached with caution.  There are many factors to consider before trying any of these methods and if you do, it is recommended to do it under the supervision of a doctor and registered dietitian rather than on your own.  It is important to consider what your blood sugar management is like normally.  Are you someone with insulin resistance or do you get shaky and hypoglycemic after going a few hours without food?  For individuals with polycystic ovarian syndrome (PCOS) and insulin resistance, there is research showing that a time-restricted fast of 8 hours, ideally in the hours of 9am-5pm, may be beneficial if they are following a lower glycemic load intake to prevent a spike in insulin when the fast is broken.  This window may not be compatible for many individual’s schedules and difficult to implement in practice.  This reinforces the importance of doing this with the approval and supervision of a doctor and registered dietitian as the execution is much more specific than many people may think.5 Further, just as it is more beneficial and sustainable to lose a small amount of weight and keep it off instead of yo-yo dieting or have smaller fluctuations in blood sugar, the same stands true for fasting.  According to the research, a drastic change in eating patterns between weekdays and weekends is thought to contribute to metabolic diseases.  This suggests that if time-restricted fasting is not sustainable and permanent, it may not offer any benefit and could even result in negative health outcomes.5 It is also important to consider the psychological effects of fasting or restricting calories.  Not only can going a long