Author name: lauracipullstg

Cooking for Picky Eaters

Cooking for picky eaters presents a unique challenge that often requires both creativity and patience.  Picky eaters, whether children or adults, tend to have a limited range of acceptable foods, often due to texture, flavor, or even color preferences.  This aversion can make meal planning and preparation particularly daunting for caregivers and family members who wish to provide nutritious meals while accommodating individual tastes. Understanding the underlying reasons behind picky eating can be beneficial in addressing these dietary restrictions effectively.  Here, we will share some of our RD-approved tricks and tips for making mealtimes a little easier for everyone.   1. Get Them Involved in Meal Prep One way to cater to picky eaters is to get them involved in meal planning.  Let them help choose recipes, shop for ingredients, and even assist in the kitchen.  Engaging picky eaters in the cooking process can foster a sense of ownership over their food choices and allowing them to participate in selecting ingredients or preparing meals not only enhances their willingness to try new dishes but also serves as an educational opportunity about nutrition and healthy eating habits.    2. Be Creative  The challenge of feeding picky eaters, particularly in children, often revolves around their preference for familiar flavors and reluctance to explore new foods.  The adage “we eat with our eyes” aptly encapsulates the importance of visual appeal in food presentation.  Presenting foods in fun shapes and vibrant colors can significantly impact a child’s willingness to engage with their meals.  For example, utilizing cookie cutters to create fun shapes from fruits or vegetables can transform an ordinary plate into an enticing feast that captures attention.  Similarly, arranging colorful ingredients into visually striking patterns can stimulate interest and encourage children to experiment with different items on their plates.  Experimenting with different cooking methods, such as roasting or grilling, can also help enhance the flavor and texture of foods potentially influencing their overall appeal.  In this way, creativity serves as a powerful tool for mitigating resistance among picky eaters.   3. Be a Good Role Model When parents demonstrate enthusiasm for various foods, it sends a powerful message to their children. Children are naturally curious and eager to explore the world around them.  When parents show excitement and willingness to try new dishes, it can spark that same curiosity in their children. This creates a positive environment where trying new foods becomes an exciting adventure rather than something to dread.   4. Resist the Urge to Prepare a Second Meal It is crucial for caregivers to resist the urge to prepare separate meals for picky eaters.  Doing so can reinforce selective eating habits and create unrealistic expectations around mealtime dynamics. Picky eaters may develop fixed ideas about what they will and will not eat, making it even more difficult for them to try new foods in the future.  Instead, promoting an environment where everyone participates in the same meal cultivates resilience and adaptability in young eaters, ultimately leading them towards more diverse dietary patterns over time.   5. Offer Options While many experts advise against providing a second meal just to cater to a picky eater’s preferences, it is possible to find a compromise that works for everyone at the dinner table.  One strategy is to offer a variety of options.  This allows the picky eater to have some choice in what they eat while still ensuring that everyone gets a well-rounded meal.  For example, if a picky eater doesn’t like a certain ingredient, such as onions or peppers, consider leaving them out of the main dish or offering them as a side dish.  This way, picky eaters can still enjoy the meal without feeling overwhelmed by ingredients they dislike.  Similarly, substitutions can be a helpful tool when dealing with picky eaters.  If a picky eater doesn’t like a certain sauce or side dish, try offering a different option that they do enjoy.  This can help prevent battles over unwanted foods and make mealtime a more pleasant experience for everyone involved.   6. Introduce New Foods with Familiar Favorites Another helpful tip for dealing with picky eaters is to consider adding a twist to an old favorite or making small changes to familiar dishes.  For example, if your picky eater loves spaghetti but hates vegetables, you can try adding finely chopped veggies to the sauce.  This can be a great way to slowly incorporate new foods to their diet while also sneaking in some extra nutrition and flavor without them even noticing.  Additionally, it may take multiple exposures before a picky eater will accept a new food. Start small by offering a small portion of the new food alongside ones they already enjoy and feel comfortable with.   7. Be Patient It’s easy to get frustrated when a picky eater refuses to try new foods or constantly asks for the same meal, but it can help to remember that everyone has different tastes and preferences.  Instead of getting upset, try to remain calm as picky eaters may be more willing to try new foods if they feel supported rather than pressured.  Encourage them to take a bite and praise them for trying something new, even if they don’t like it.  Keep offering healthy options and try to make mealtime a positive and enjoyable experience.  Overtime, you can help picky eaters expand their palates and develop a more diverse and balanced diet.   If you are struggling to meet your child’s nutrition needs or are worried that picky eating may signal a larger issue, a registered dietitian can help identify any underlying concerns and provide practical strategies to address them.  They can offer advice on how to introduce new foods, manage food allergies or sensitivities, and promote healthy eating habits that will last a lifetime.   References https://www.thekitchn.com/9-helpful-strategies-for-cooking-for-picky-eaters-224034 https://childmind.org/article/how-to-help-kids-who-are-picky-eaters/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4422022/  

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Our Favorite Mindfulness & Yoga Blogs

Life can often be stressful, and we can all benefit from tools that help us manage our well-being and find balance. In this curated repost, we’ve gathered links to some of our most popular and insightful pieces on mindfulness and yoga.  Mindfulness, the practice of being fully present and engaged in the moment without judgment, can significantly reduce stress and enhance overall well-being.  Yoga complements this by improving physical flexibility and promoting mental calmness.  As you explore these resources, you’ll find valuable insights into enhancing mental clarity, improving physical flexibility, and achieving a deeper sense of inner peace.  Whether you’re revisiting these topics or discovering them for the first time, we hope these articles will support and inspire you on your journey toward a more balanced and fulfilling life. https://lauracipullo.com/blog/self-care-sunday-the-five-top-tools-for-self-care/ https://lauracipullo.com/blog/mindfulness-monday-how-to-eat-an-oreo/ https://lauracipullo.com/blog/mindfulness-monday-how-mindfulness-can-help-you-reduce-stress/ https://lauracipullo.com/blog/moving-towards-mindful-eating-of-all-foods/ https://lauracipullo.com/blog/exercise-mindful-movement-ditch-the-mirror/ https://lauracipullo.com/blog/6-natural-dopamine-boosters/ https://lauracipullo.com/blog/what-is-mindfulness/ https://lauracipullo.com/blog/5-ways-to-begin-your-mindfulness-practice/ https://lauracipullo.com/blog/breathing-your-way-to-your-window-of-tolerance/ https://lauracipullo.com/blog/yoga-for-minimal-digestion/ https://lauracipullo.com/blog/why-athletes-should-and-do-yoga/ https://lauracipullo.com/blog/ten-styles-of-yoga-you-are-likely-to-encounter/ https://lauracipullo.com/blog/the-role-of-yoga-in-eating-disorder-treatment/ https://lauracipullo.com/blog/transcendental-mediation-for-kids/ https://lauracipullo.com/blog/getting-your-children-to-chill-out/ https://lauracipullo.com/blog/prevent-injury-in-yoga/ Mindfulness and yoga are more than just practices; they are pathways to a healthier, more centered life. As always, we encourage you to explore, reflect, and embrace the techniques that resonate most with you. For personalized guidance on integrating these practices into your daily routine, our team of dietitians at Laura Cipullo Whole Nutrition is here to support you every step of the way.

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woman doing sukhasana/easy pose for the third eye chakra

Five Favorite Meditations

In our fast-paced world, finding moments of peace can seem like a daunting task. Meditation offers a powerful antidote, allowing us to cultivate mindfulness, reduce stress, and connect with our inner selves. When things feel overwhelming, it can be helpful to slow down and turn inward. Our breath is one of the only things in life we can control!  Here are our five favorite meditations that can help you activate your parasympathetic nervous system and find a sense of calm wherever you are.   Whether you’re a beginner or an experienced meditator, these methods can help you find balance and serenity in your daily life. Body Scan Meditation Why We Love It: The body scan is an excellent way to reconnect with your physical self. It helps release tension and encourages relaxation, making it a perfect practice for winding down at the end of the day.  How to Practice: Lie down comfortably on your back with your arms at your sides. Close your eyes and take a few deep breaths to relax. Start by bringing your attention to your toes, noticing any sensations or tension. Gradually move your focus up through your body—feet, legs, abdomen, chest, arms, and head—spending a few moments on each area. Allow yourself to relax into each sensation, releasing any tension you find along the way. Box Breathing Why We Love It: Box breathing, also known as square breathing, is a simple yet effective technique for managing stress and anxiety. It helps calm the mind and body by regulating your breath, making it a great practice to use anytime you need to regain focus. How to Practice: Sit comfortably in a chair or on the floor with your back straight. Inhale deeply through your nose for a count of four. Hold your breath for a count of four. Exhale slowly through your mouth for a count of four. Hold your breath again for a count of four. Repeat this cycle for several minutes, focusing on the rhythm of your breath. Ujjayi Pranayama Why We Love It: Ujjayi pranayama, or “victorious breath,” is a powerful yoga breathing technique that creates a soothing sound, helping to calm the mind and center your focus. This practice is particularly beneficial during yoga but can be incorporated into any meditation session. How to Practice: Sit comfortably with your spine straight or lie down if preferred. Inhale deeply through your nose, filling your lungs completely. As you exhale, constrict the back of your throat slightly to create a soft, ocean-like sound. Continue to breathe in this manner, maintaining the sound throughout your inhalations and exhalations. Focus on the sound of your breath as a way to cultivate mindfulness and presence. Check out Laura’s video on how to do Ujjayi Breathing Alternate Nostril Breathing (Nadi Shodhana) Why We Love It: Alternate nostril breathing is an ancient practice that balances the body, promotes relaxation, and enhances mental clarity. This technique can be especially helpful in reducing anxiety and improving focus. How to Practice: Sit comfortably with your back straight. Use your right thumb to close your right nostril and inhale deeply through your left nostril. Close your left nostril with your right ring finger, release your right nostril, and exhale through the right side. Inhale through the right nostril, close it with your thumb, and exhale through the left nostril. This completes one cycle. Continue for 5-10 cycles, focusing on your breath and the sensations in your body. Walking Meditation Why We Love It: Walking meditation offers a unique way to practice mindfulness while engaging in movement. It helps ground you in the present moment and allows you to connect with your surroundings in a new way. How to Practice: Choose a quiet place where you can walk slowly and uninterrupted, like a garden or a park. Stand still for a moment, taking a few deep breaths to center yourself. Begin walking slowly, paying attention to each step. Feel the ground beneath your feet and the sensations in your legs. With each step, coordinate your breath with your movements. For example, inhale for three steps and exhale for the next three. Stay present and mindful of your surroundings, noticing the sights, sounds, and smells around you. Conclusion Meditation is a personal journey, and what works for one person might not resonate with another. Try these five meditation techniques and see which ones speak to you. Consistency is key, so even if it’s just a few minutes each day, incorporating these practices into your routine can lead to profound changes in your mental and emotional well-being. Remember, the goal of meditation isn’t to achieve perfection but to cultivate awareness, acceptance, and inner peace. Happy meditating!

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Mindful Eating and Diabetes

In our busy day-to-day lives most of us are constantly multi-tasking, especially when it comes to our meals. Often we are eating on the go or in front of our computers, TVs, or phones. Eating with these distractions can mean we aren’t paying attention to our food or the signals our bodies may be sending us. Yet, when we incorporate aspects of mindfulness at meals, or the ability to be in the present moment, we can improve digestion,1 reduce stress, and strengthen our emotional well-being.2,3     Mindful eating may be a particularly powerful tool for diabetes management.    What is Mindful Eating?4,5 Mindful eating is an approach that encourages awareness and presence during meals. It involves: Being present: Focusing on the eating experience without distractions. Recognizing hunger and fullness cues: Working to listen to your body’s signals to determine when to start and stop eating. Savoring each bite: Paying attention to the taste, texture, and aroma of food through activation of each of the five senses. How does mindful eating work for diabetes management?  Mindful eating can assist with diabetes management in several ways.  Enhanced blood sugar control Mindfulness interventions have been shown to improve glycemic control in individuals with diabetes as measured by hemoglobin A1c levels.6,7 By taking time to slow down at meals, you give yourself time to recognize satiety, or fullness, signals. Individuals who have practiced mindful eating have been shown to eat smaller amounts.4 A decrease in portion size could be one possible way that mindfulness helps with glycemic control. One study also found that mindful eating was associated with decreased eating of sweets as well as fasting glucose levels.8  Improved mental health and well-being  Beyond physical benefits, mindfulness can be a powerful tool for improving mental health and well-being. Mindfulness interventions have been shown to reduce stress, depression, and anxiety in individuals with diabetes.6,7,9   Reduced emotional eating  Mindful eating practices can help counteract automatic eating, or eating on autopilot. Mindful eating practices that cultivate eating with awareness and without distractions have been associated with less external and emotional eating4,5   Reduced overeating   One of the benefits of mindful eating is its impact on portion control. Research has shown that after taking part in a mindful eating intervention, participants reported a greater ability to minimize overeating and they ate past satiety less frequently.5 Eating slowly has been associated with eating less at meals4 by increasing feelings of satiety more effectively than when eating meals quickly. Individuals with diabetes who participated in a mindful eating intervention observed a significant increase in mindful observing and nonjudgement of their food behaviors, which can also help reduce overeating.10    Practical Tips for Incorporating Mindful Eating Here are some strategies to help you practice mindful eating in your daily routine: Create a Calm Eating Environment Eat in a quiet, distraction-free setting. Set a pleasant table with utensils and plates that make you feel good about your meal. Start with Small Steps Take a few deep breaths before you begin eating. This practice can also help activate your parasympathetic nervous system, which is the nervous system associated with digestion. Focus on the aroma, texture, and taste of your food.   Use the I Am Aware Mindful Eating Tool   https://www.youtube.com/watch?v=jTpLnDzFDLA&ab_channel=LauraCipulloWholeNutritionandYoga   Chew Thoroughly and Eat Slowly Aim to chew each bite thoroughly before swallowing. Put your utensils down between bites to slow down the pace of eating. Listen to Your Body Pay attention to your hunger and fullness cues. Stop eating when you feel satisfied. You can leave food on the plate and can always eat more when you are feeling hungry again. Consider keeping a Mindful Eating Journal Record your meals and your feelings during and after eating. Reflect on how mindfulness affects your eating patterns and overall well-being.   Combining Mindful Eating with a Balanced Diet To maximize the benefits of mindful eating, combine these practices with a balanced diet that supports diabetes management: Plan balanced meals: Include a mix of lean proteins, healthy fats, and low glycemic index carbohydrates. Monitor your blood sugar levels: Track how different foods and mindful eating practices affect your glucose levels by monitoring your blood glucose levels through a continuous glucose monitor (CGM). Consult with your LCWNS dietitian: Our team consists of Certified Diabetes Care and Education Specialists as well as yoga instructors with extensive experience in both mindfulness and diabetes.   Conclusion Mindful eating offers a valuable complement to traditional diabetes management strategies. By focusing on the experience of eating and being aware of your body’s signals, you can improve blood sugar control, enhance portion control, reduce emotional eating, and enjoy your meals more fully. Start integrating mindful eating practices into your routine today, and experience the positive impact on your diabetes management and overall well-being. For personalized guidance, talk to your LCWNS dietitian who can help you work on mindful eating practices for optimal blood sugar control.    References  Cherpak CE. Mindful Eating: A Review Of How The Stress-Digestion-Mindfulness Triad May Modulate And Improve Gastrointestinal And Digestive Function. Integr Med Encinitas Calif. 2019;18(4):48-53. Tapper K. Mindful eating: what we know so far. Nutr Bull. 2022;47(2):168-185. doi:10.1111/nbu.12559 Keng SL, Smoski MJ, Robins CJ. Effects of mindfulness on psychological health: a review of empirical studies. Clin Psychol Rev. 2011;31(6):1041-1056. doi:10.1016/j.cpr.2011.04.006 Muñoz-Mireles G, Mantzios M, Schellinger JN, Messiah SE, Marroquín E. Mindful Eating as a Tool for Diabetes Prevention and Management: A Review of Potential Mechanisms of Action. Mindfulness. 2023;14(12):2831-2847. doi:10.1007/s12671-023-02236-y Miller CK. Mindful Eating With Diabetes. Diabetes Spectr Publ Am Diabetes Assoc. 2017;30(2):89-94. doi:10.2337/ds16-0039 Hamasaki H. The Effects of Mindfulness on Glycemic Control in People with Diabetes: An Overview of Systematic Reviews and Meta-Analyses. Medicines. 2023;10(9):53. doi:10.3390/medicines10090053 Ni YX, Ma L, Li JP. Effects of mindfulness-based intervention on glycemic control and psychological outcomes in people with diabetes: A systematic review and meta-analysis. J Diabetes Investig. 2021;12(6):1092-1103. doi:10.1111/jdi.13439 Mason AE, Epel ES, Kristeller J, et al. Effects of a mindfulness-based intervention on mindful eating, sweets consumption, and fasting glucose levels in obese adults: data from

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Mindfulness and Eating Disorders: Latest Research on Binge Eating Disorder and Bulimia Nervosa

Mindfulness, a practice rooted in paying non-judgmental attention to the present moment, has emerged as a promising approach to treating various mental health conditions, including eating disorders such as Binge Eating Disorder (BED) and Bulimia Nervosa (BN).  New research is shedding light on how mindfulness-based interventions can help individuals improve their relationship with food as well as their emotional well-being. Let’s explore the latest findings on how mindfulness is being utilized to treat BED and BN.  What is Mindfulness? At its core, mindfulness involves the intentional, non-judgmental awareness of one’s thoughts, emotions, bodily sensations, and the surrounding environment. In the context of eating disorders, mindfulness helps individuals tune into their hunger cues, become more aware of emotional triggers, and ultimately cultivate a more compassionate relationship with food. Mindfulness-based interventions, such as Mindfulness-Based Cognitive Therapy (MBCT) and Mindfulness-Based Stress Reduction (MBSR), have been increasingly used as part of integrated therapeutic approaches to treat disordered eating behaviors. Binge Eating Disorder and Mindfulness Binge Eating Disorder (BED) is characterized by recurrent episodes of consuming large quantities of food, typically accompanied by emotional distress and guilt. Unlike other eating disorders, such as anorexia or bulimia, BED is not associated with compensatory behaviors like purging or excessive exercise. As the most common eating disorder in the United States, BED has attracted significant attention from researchers studying its psychological origins and treatment options. Recent research suggests that mindfulness can be particularly effective in reducing binge episodes and improving emotional regulation for individuals with BED. Mindfulness-Based Interventions (MBIs) A 2021 meta-analysis of randomized controlled trials found that mindfulness-based interventions significantly reduced the severity of binge eating episodes in individuals with BED. The study indicated that MBIs, particularly Mindfulness-Based Cognitive Therapy (MBCT), resulted in a reduction of binge eating episodes by approximately 50%, with long-term benefits observed in follow-up assessments1. This finding highlights the potential of mindfulness not only for immediate symptom reduction but also for sustained recovery.   Improving Emotional Regulation Emotional regulation is a key challenge for individuals with BED, as many binge eating episodes are triggered by negative emotions such as anxiety, sadness, or stress. Mindfulness practices can help individuals become more aware of their emotional states and reduce emotional reactivity. One study showed that practicing mindfulness meditation decreased binge eating and emotional eating due to improved emotional regulation.2   Use of Dialectical Behavior Therapy (DBT) DBT is also being explored as a tool for reducing emotional dysregulation in individuals with BED.  Originally developed as a modality for improving emotional regulation in personality disorders, more research is showing mindfulness-based strategies of DBT are effective in treating BED.  In a meta-analysis of eleven studies, DBT demonstrated greater efficacy compared with the control group in improving emotion dysregulation.3 Bulimia Nervosa and Mindfulness Bulimia Nervosa (BN) is an eating disorder characterized by episodes of binge eating followed by compensatory behaviors such as purging (vomiting or using laxatives), excessive exercise, or fasting. The disorder is often accompanied by severe body image distortion and extreme anxiety about weight and shape. Treatment for BN requires a multifaceted approach, but mindfulness is gaining recognition as a promising tool to address the psychological and behavioral components of the disorder.  Recent studies suggest that mindfulness can help break the cycle of binge-purge behavior and improve body image, leading to better treatment outcomes. Reducing Binge-Purge Behaviors A 2021 study investigated the effectiveness of mindfulness-based cognitive therapy on reducing the cognitive load of words related to eating disorders could result in a decrease in purging behaviors. Mindfulness skills improved significantly which were accompanied by a decrease in depressive mood. The researchers concluded that mindfulness-based cognitive therapy could be an effective tool in reducing binge-purge behaviors.4   Improving Body Image and Self-Compassion Body dissatisfaction and low self-esteem are common in BN and are often central to the disorder’s maintenance. Mindfulness interventions focusing on body awareness and self-compassion have shown promise in reducing these issues.  This shift in perspective is crucial, as body image issues often drive the cycle of binge eating and purging in BN.5   Addressing Cognitive Rigidity Cognitive flexibility, the ability to hold multiple perspectives and tolerate ambiguity, is often impaired in individuals with BN, leading to rigid thinking patterns about food, body image, and self-worth. Mindfulness has been shown to enhance cognitive flexibility by promoting an open, non-judgmental awareness of thoughts and experiences.6 Mindfulness-based interventions are emerging as a promising tool in the treatment of both Binge Eating Disorder and Bulimia Nervosa. The latest research suggests that mindfulness can significantly reduce binge eating and purging behaviors, improve emotional regulation, and promote healthier body image and self-compassion. As the field of mindfulness research continues to grow, it is crucial that these interventions be further refined and integrated with other therapeutic approaches to provide comprehensive, effective treatment for individuals struggling with eating disorders.  At LCWNS, we help you integrate mindfulness as part of a holistic treatment plan.   References Grohmann D, Laws KR. Two decades of mindfulness-based interventions for binge eating: A systematic review and meta-analysis. J Psychosom Res. 2021 Oct;149:110592. doi: 10.1016/j.jpsychores.2021.110592. Epub 2021 Aug 1. PMID: 34399197. Katterman SN, Kleinman BM, Hood MM, Nackers LM, Corsica JA. Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: a systematic review. Eat Behav. 2014 Apr;15(2):197-204. doi: 10.1016/j.eatbeh.2014.01.005. Epub 2014 Feb 1. PMID: 24854804.  Rozakou-Soumalia N, Dârvariu Ş, Sjögren JM. Dialectical Behaviour Therapy Improves Emotion Dysregulation Mainly in Binge Eating Disorder and Bulimia Nervosa: A Systematic Review and Meta-Analysis. J Pers Med. 2021 Sep 18;11(9):931. doi: 10.3390/jpm11090931. PMID: 34575707; PMCID: PMC8470932. Sala L, Gorwood P, Vindreau C, Duriez P. Mindfulness-based cognitive therapy added to usual care improves eating behaviors in patients with bulimia nervosa and binge eating disorder by decreasing the cognitive load of words related to body shape, weight, and food. Eur Psychiatry. 2021 Oct 28;64(1):e67. doi: 10.1192/j.eurpsy.2021.2242. PMID: 34706785; PMCID: PMC8668447. Jansen P, Zayed K, Kittsteiner J. Body image and the relation to mindfulness and self-compassion in physical education students: a cross-cultural study. Health Psychol Res. 2021 Jan 14;8(3):9172. doi:

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Practicing Intuitive Eating Across Diverse Client Populations

Intuitive eating (IE) has gained popularity as a sustainable approach to nutrition and body image. This philosophy encourages individuals to listen to their bodies’ cues and remove food morality, fostering a healthier relationship with food. However, its benefits extend beyond individual well-being; intuitive eating can be a transformative tool for various client populations, including those dealing with chronic illnesses and eating disorders.  In this blog post, we’ll explore how intuitive eating can be adapted and applied across different clients with specific disease states and eating patterns, highlighting its potential to empower individuals to reclaim their autonomy over food choices. By understanding the unique needs of each population, we can better appreciate the versatility of intuitive eating and its role in promoting holistic health.  We spoke with three registered dietitians who specialize in different client populations to see how they use intuitive eating in their practices and how it helps their clients improve their health.  How do you use intuitive with your clients? Shannon Herbert PhD, RD, CDN, registered dietitian at Laura Cipullo Whole Nutrition Services: I use IE in clients with polycystic ovary syndrome.  I enjoy using principles of IE to help clients reconnect with their bodies, reduce the guilt and shame they feel around food and eating, and re-establish a more positive, balanced view of themselves and their eating.  Rebecca Stetzer, RD, CD, registered dietitian at Erica Leon Nutrition & Associates: One type of client I use IE with is clients with binge eating.  I might talk about how we start with structure and making sure the client is eating adequately for their body, and as we go along in that process I will integrate conversations and practices that help the client re-establish attunement to their body cues. We will explore what kinds of disrupters they have in their lives such as distractions, thoughts, food rules, and beliefs and lack of self-care that interferes with their ability to hear and respond to the needs of their body. Faith Aronowitz, MS, RD, CDN: One specific type of client with whom I often use Intuitive Eating with are those struggling with IBS. Many of these clients come to me feeling frustrated and anxious about food after trying various (unnecessarily) restrictive diets without symptom improvement or relief.  We work on creating space to pause during meals, tuning into hunger and fullness cues, and noticing how they physically and emotionally feel before, during, and after meals. This helps clients tune into their body’s signals rather than relying solely on external food rules.   What do you see as the benefits? Shannon: So much of the focus of PCOS management has been on weight, despite PCOS affecting individuals across body sizes and the high prevalence of disordered eating in the PCOS population. Research has shown that there is no one dietary approach that is superior for managing PCOS and that health benefits can be had by making changes to diet even in the absence of changes in weight.  Thus, I find that IE can be one tool to help individuals with PCOS over time let go of restricting dieting and truly learn how to nourish their bodies in a way that is satisfying to their taste buds and helpful for the management of the condition.  Rebecca: The reason I think using intuitive eating is helpful in the population of clients with binge eating disorder is that so much of what drives binge eating is a chaotic and dysfunctional relationship with food. What drives binge eating is restrictive behaviors with food and strong beliefs about what a person should or should not be eating. Emotional eating also drives binge eating, of course. But part of intuitive eating is recognizing how the lack of self-care can interfere with a person’s ability to hear and respond to the needs of their body in a timely manner, and this includes healthy management of emotions. Faith: The benefits I see in this population are reduced stress around eating, less fear with respect to adverse symptoms, and a more positive relationship with food overall. Many clients report fewer IBS flare-ups as they learn to honor their body’s needs and identify personal dietary triggers without unnecessary restriction.   When do you introduce intuitive to this population?  Shannon: When to introduce IE and what principles to introduce depends on the client.  If clients have a long history of restricting in an effort to manage PCOS, we may first work to reject the diet mentality.  Many clients with PCOS are accustomed to relying on external cues to eating, that re-learning interoception and how their body is communicating with them can take time.  Therefore, we may first prioritize adequate nourishment with balanced nutrition.  Then, we can work towards reacquainting them with their hunger and fullness and re-establishing the bodily trust.  Rebecca: I tend to introduce intuitive eating from the very beginning. I talk about how everyone is born with the ability to self-regulate according to what their body’s needs are. We explore how external factors such as dieting, diet culture, rules and beliefs around food in their family, etc. has shaped their current food beliefs and food rules and eating behaviors. The key to introducing intuitive eating from the very beginning is helping the client to set realistic expectations for themselves. By that I mean they’re not going to be able to be fully intuitive eaters from the beginning, but that through practice and patience they will be able to develop those skills again. I think that it really provides hope for clients with binge eating that they can not only eat normally again but that they can find peace with food. Faith:  I typically introduce Intuitive Eating concepts after we’ve addressed any immediate nutritional concerns and/or comorbid diagnoses, and the client feels ready to explore a more flexible approach to eating. This may happen during our initial consultation for some, or several weeks into our work together, for others. The timing typically depends on how many layers of unnecessary restriction we need to

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5 Strategies to Reducing Hot Flashes

Menopause, a natural transition in a woman’s life, is the point in time 12 months after a woman’s last menstrual period.1 The years leading up to this time, often referred to as the menopause transition or perimenopause, can be accompanied by symptoms including changes in monthly cycles, hot flashes, night sweats, and weight changes.1 During this time, the body’s production of two hormones made by the ovaries, estrogen and progesterone, drops. The hormonal shifts that occur during the menopause transition can have large effects on the body. Many of these symptoms, such as hot flashes, can significantly impact quality of life.2   What are hot flashes? Hot flashes are defined as sudden feelings of intense heat and are often accompanied by sweating and flushed skin.3 They occur due to hormonal fluctuations, primarily the decline in estrogen levels, that occur during the menopause transition. While this may be a “normal” part of menopause, managing hot flashes can help improve and enhance your quality of life. Incorporating certain lifestyle and dietary practices can help support your body and potentially reduce the frequency and intensity of hot flashes.   5 Strategies to Reducing Hot Flashes   1. Consider using a continuous glucose monitor (CGM) The decline in estrogen levels that occurs during the menopause transition can make women insulin resistant, or less sensitive to the hormone insulin, which helps regulate blood sugar.4 A CGM is a wearable device that tracks your blood sugar throughout the day. Wearing a CGM can give you data on how your body responds to various foods. Some evidence indicates that hot flashes can be exacerbated when blood glucose levels fall between meals.5 Thus, maintaining stability in blood glucose levels throughout the day may be helpful in reducing the symptoms of menopause, including hot flashes. The team at LCWNS includes Certified Diabetes Education and Care Specialists who have extensive experience in working with CGMs. Together, we can interpret your body’s response to food and develop a plan for optimal blood sugar regulation.   2. Eat Every 4 Hours Eating with regularity throughout the day can assist in keeping blood sugars stable. One study found that hot flash frequency increased as time between meals increased.5 Avoid going long stretches between meals and snacks to help minimize hot flash frequency. As a general rule of thumb, aim to avoid going longer than 4 hours without a meal or snack during the day.   3. Try yoga! Movement can be very helpful in regulating blood glucose levels.6 Movement also can assist in regulating body temperature and improving overall circulation, which may help with hot flashes.7  Practicing yoga has been shown to significantly reduce hot flashes and night sweats in perimenopausal women.8,9 Yoga has also been shown to lower blood glucose levels, hemoglobin A1c, and cholesterol levels in perimenopausal women.9,10 YOGA FOR MENOPAUSE Short Yoga Flow for Menopause 1. Easy Pose (Sukhasana): Sit comfortably with your legs crossed or extended. Close your eyes and place your hands on your knees. Focus on your breath, taking slow, deep inhales and exhales. 2. Cat-Cow Pose (Marjaryasana-Bitilasana): On all fours, alternate between arching your back (Cow Pose) and rounding it (Cat Pose) with your breath. 3. Downward-Facing Dog (Adho Mukha Svanasana): From all fours, lift your hips up and back, straightening your legs and forming an inverted V shape. Keep your hands shoulder-width apart and feet hip-width apart. 4. Warrior II (Virabhadrasana II): Step one foot forward, bend the front knee, and extend your arms out to the sides, gazing over the front hand. Keep the back leg straight and the back foot grounded. Repeat on both sides. 5. Triangle Pose (Trikonasana): From Warrior II, straighten the front leg and reach the front arm forward, lowering it to the shin, a block, or the floor, while extending the other arm upward. Repeat on both sides. 6. Seated Forward Bend (Paschimottanasana): Sit with legs extended forward, gently reach for your feet or shins, and fold forward while keeping your back straight. 7. Reclining Bound Angle Pose (Supta Baddha Konasana): Lie on your back, bring the soles of your feet together, and let your knees fall open. Support your knees with pillows or blocks if needed. 8. Legs-Up-the-Wall Pose (Viparita Karani): Sit next to a wall, lie back, and extend your legs up the wall. Adjust your distance from the wall for comfort. 9. Corpse Pose (Savasana): Lie flat on your back with arms at your sides, palms facing up. Close your eyes and focus on your breath. Tips: Modify as Needed: Use props like blankets, blocks, or straps to make poses more comfortable. Focus on Breath: Deep, mindful breathing can enhance relaxation and the benefits of each pose. Stay Hydrated: Drink water before and after your practice. This flow can be adapted based on your personal needs and comfort. Practicing regularly, even for a short time, can help manage menopause symptoms and improve overall well-being. Both Laura and Shannon are registered yoga teachers and can help tailor a yoga flow to your specific needs.  4. Choose anti-inflammatory veggies at each meal Diets full of fruits, vegetables, whole grains, and healthy fats are considered anti-inflammatory and have been shown to reduce the rate of hot flashes. One study demonstrated that a higher consumption of a Mediterranean-style diet, which emphasizes fruits, vegetables, whole grains, healthy fats, and leans proteins, was inversely associated with hot flashes and night sweats.11 Another study found that postmenopausal women who followed a plant based diet for 12 weeks had an 88% decrease in moderate-to-severe hot flashes.12 50% of the women who completed the intervention reported complete elimination of their moderate-to-severe hot flashes.12 While going completely plant based is not necessary, aim to build your plate with lots of colors at mealtime to get an abundance of plant-based nutrients. Consider adding in one of these anti-inflammatory veggies at each meal: Leafy Greens, like spinach, kale, Swiss chard, and collard greens Cruciferous vegetables, like broccoli, Brussels sprouts, cauliflower, cabbage Bell Peppers Tomatoes Beets Carrots Squash

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Exercise and Menopause

Menopause marks a significant transition in a woman’s life, often accompanied by physical, emotional, and hormonal changes. As the body undergoes these changes, maintaining an active lifestyle can be one of the most effective ways to manage symptoms and promote overall well-being. We’ll explore how exercise can positively impact women going through menopause and offer practical tips for incorporating physical activity into your routine. Understanding Menopause and Its Challenges Menopause typically occurs between the ages of 45 and 55, marking the end of a woman’s menstrual cycles and fertility. This natural biological process is driven by a decrease in estrogen and progesterone levels. Common symptoms include hot flashes, decreases lean body mass, weight gain, mood swings, sleep disturbances, and changes in bone density.   There are several treatment options to support menopausal symptoms, including hormone replacement therapy (HRT). Research also shows that regular exercise, as well as specific types of exercise, have been shown to alleviate many of them and help women feel their best during and after this transition period.1 Here’s how physical activity can make a difference: Mitigating Hot Flashes and Night Sweats Hot flashes and night sweats are among the most common menopausal symptoms. While exercise alone won’t eliminate them, it can help regulate body temperature and improve overall circulation. Engaging in moderate aerobic activities like brisk walking, swimming, or cycling can help manage these symptoms.  Maintaining Muscle Mass Hormonal changes during menopause can lead to increased fat mass and decreased lean body mass.  A focus on strength training can help regulate weight by boosting metabolism and maintaining muscle mass.  Strength training also helps improve functional strength, bone density, blood pressure, and heart rate.2 Incorporating activities like resistance training with free weights or bands, yoga, or pilates can also help enhance muscle tone and strength. Enhancing Mood and Reducing Stress Menopause can bring about mood swings and increased stress. Exercise triggers the release of endorphins, the body’s natural mood lifters. Activities such as walking, dancing, or group fitness classes can improve mood, reduce feelings of anxiety, and promote relaxation. Additionally, incorporating mindfulness practices like yoga or meditation can enhance emotional well-being. Not only does yoga help to reduce stress, but it also improves stability and balance to help prevent falls, increase flexibility, and strengthen muscles.3  Supporting Bone Health The decline in estrogen levels during menopause can lead to decreased bone density, increasing the risk of osteoporosis. Weight-bearing exercises, such as walking, jogging, and strength training, can help maintain bone density and strength. Research shows that incorporating high intensity interval training (HIIT) or other high-impact exercise such as jump rope, running, and tennis is effective at helping to maintain bone density in postmenopausal women.4 If you need cardio exercise that is easier on the joints, try swimming or working out on an elliptical machine or bike.  Improving Sleep Quality Sleep disturbances are another common challenge during menopause. Regular physical activity can promote better sleep by helping regulate sleep patterns and reducing insomnia. However, it’s best to avoid vigorous exercise too close to bedtime, as it might interfere with your ability to fall asleep. Improves Heart Health Estrogen helps protect the heart.  As estrogen declines during menopause, the risk of cardiovascular disease in women increases.  Regular exercise can help keep your heart healthy by increasing HDL cholesterol, lowering LDL cholesterol, and reducing blood pressure.5 Practical Tips for Getting Started Start Slowly: If you’re new to exercise or haven’t been active for a while, start with low-impact activities and gradually increase intensity. Listen to your body and give yourself time to adapt. Find Activities You Enjoy: Choose exercises that you find enjoyable to ensure consistency. Whether it’s dancing, hiking, or joining a fitness class, doing something you love will make it easier to stick with it. Set Realistic Goals: Set achievable and realistic goals based on your fitness level. Celebrate small victories and progress along the way. Incorporate Variety: A mix of aerobic, strength, mobility, and flexibility exercises can provide comprehensive benefits. Incorporate activities like swimming, resistance training, and stretching to address different aspects of fitness. Address Nutrition and Hydration: Proper hydration and nutrition support your exercise routine and overall health. Aim for a balanced diet rich in protein, calcium, vitamin D, and other nutrients to support bone health. Exercise is a powerful tool for managing menopausal symptoms and enhancing overall well-being. By incorporating regular physical activity into your routine, you can improve your mood, maintain muscle mass, and support bone health.  Remember, it’s never too late to start, and every step you take towards a more active lifestyle can lead to significant benefits. The dietitians at LCWNS are here to support you with nutrition and exercise recommendations specific to your lifestyle and goals in this unique stage of life.   Dąbrowska-Galas M, Dąbrowska J, Ptaszkowski K, Plinta R. High Physical Activity Level May Reduce Menopausal Symptoms. Medicina (Kaunas). 2019 Aug 11;55(8):466. doi: 10.3390/medicina55080466. PMID: 31405242; PMCID: PMC6722698. Capel-Alcaraz AM, García-López H, Castro-Sánchez AM, Fernández-Sánchez M, Lara-Palomo IC. The Efficacy of Strength Exercises for Reducing the Symptoms of Menopause: A Systematic Review. J Clin Med. 2023 Jan 9;12(2):548. doi: 10.3390/jcm12020548. PMID: 36675477; PMCID: PMC9864448. Johnson A, Roberts L, Elkins G. Complementary and Alternative Medicine for Menopause. J Evid Based Integr Med. 2019 Jan-Dec;24:2515690X19829380. doi: 10.1177/2515690X19829380. PMID: 30868921; PMCID: PMC6419242. Manaye S, Cheran K, Murthy C, Bornemann EA, Kamma HK, Alabbas M, Elashahab M, Abid N, Arcia Franchini AP. The Role of High-intensity and High-impact Exercises in Improving Bone Health in Postmenopausal Women: A Systematic Review. Cureus. 2023 Feb 5;15(2):e34644. doi: 10.7759/cureus.34644. PMID: 36895528; PMCID: PMC9990535. El Khoudary SR, Aggarwal B, Beckie TM, Hodis HN, Johnson AE, Langer RD, Limacher MC, Manson JE, Stefanick ML, Allison MA; American Heart Association Prevention Science Committee of the Council on Epidemiology and Prevention; and Council on Cardiovascular and Stroke Nursing. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation. 2020 Dec 22;142(25):e506-e532. doi: 10.1161/CIR.0000000000000912. Epub 2020 Nov 30. PMID: 33251828.

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Bone Density and Menopause Explained

During menopause, women are advised to take calcium and vitamin D supplements and lift weights, but why is that? It’s because women can experience weakened bones due to the changes in their hormone levels. The main hormone at play is called estrogen. When women go through menopause, estrogen decreases significantly. However, estrogen is critical to the formation of bone. In this blog, we will talk about what estrogen is, how it relates to bone density and menopause, and how you can maintain bone density, even if your estrogen levels have dropped.   What is Estrogen? Estrogen (also referred to as estrone, estradiol, and estriol) is one of the main sex hormones involved in female reproductive processes1. When girls start puberty, estrogen levels increase to give them female characteristics. Throughout their lives, estrogen and progesterone will naturally fluctuate over their menstrual cycles until menopause when their cycles end. At around age 52, women begin to experience symptoms of menopause. Most of the symptoms women experience, like hot flashes, dizziness, heart palpitations, mood changes, and new hair growth, can be explained by a large drop in estrogen2. These symptoms are very noticeable in women, however, an important consequence of low estrogen can go unnoticed. A drop in bone density may only be noticed because of pain or after an injury. While lower than women, men have estrogen as well. Estrogen plays an important role in regulating bone density for men. Bone Density Explained Bone density refers to the amount of calcium and other minerals in the bone3. Bones with more minerals are denser and therefore, stronger and break less. Bones build their density while individuals grow during childhood through early adulthood with peak bone density occurring between ages 25 and 45 in both men and women4. Things that influence bone development include physical activity, calcium and vitamin D deficiencies, and hormones5.   Bone Density and Menopause Naturally, both men and women lose bone density as they age. However, women will lose bone density at a significantly faster rate due to menopause when their estrogen levels decline4. Estrogen levels are tightly correlated to bone density. The main effect of estrogen is to prevent bone breakdown called “remodeling”, a naturally occurring process of the bone life cycle6. Remodeling refers to the process by which old or damaged bone is broken down and new tissue is formed7. However, bone can be abnormally broken down due to nutritional deficiencies in calcium or low estrogen levels. As estrogen levels drop in women, their body increases the rate of bone remodeling7. Without a steady supply of calcium and other minerals, the bones are worn away until they resemble the inside of a sponge. This condition is known as osteoporosis.   What is Osteoporosis? Osteoporosis is a progressive condition in which bones break down faster than they are built. It causes the bones to become weakened and more likely to fracture or break3. Women are more likely to experience osteoporosis because of menopause. Unfortunately, women are at a high risk of developing osteoporosis. Things you can do to decrease your chance of developing osteoporosis include5: Supplementation: Increasing daily calcium and vitamin D consumption is critical to bone formation. Calcium cannot be absorbed into the body without vitamin D, so it is best to take a vitamin with both. Weight-bearing exercises: Exercises that promote good posture and balance are great for increasing bone mass, like weight lifting, walking, running, jumping, and dancing5.   In Summary Women experiencing menopause are at a high risk of developing osteoporosis, a progressive condition that decreases bone density. This process is strongly correlated with the drop in estrogen levels that occur during menopause. While genetic factors play a considerable role in bone density loss, there are a few lifestyle factors that you can incorporate to prevent it from getting too severe, like exercise and supplementation.   Resources Delgado BJ, Lopez-Ojeda W. Estrogen. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Introduction to Menopause. Johns Hopkins Medicine. (2024, March 18). https://www.hopkinsmedicine.org/health/conditions-and-diseases/introduction-to-menopause#:~:text=During%20this%20transition%20time%20before,of%20the%20symptoms%20of%20menopause. Endocrine Society. (2022, January 24). Menopause and Bone Loss. https://www.endocrine.org/patient-engagement/endocrine-library/menopause-and-bone-loss#:~:text=Since%20estrogen%20helps%20prevent%20bones,seen%20in%20women%20experiencing%20menopause 6.6 Exercise, Nutrition, Hormones, and Bone Tissue”. Anatomy & Physiology. Openstax CNX. 2013. ISBN 978-1-938168-13-0. Archived from the original on 10 January 2017. Mayo Clinic Staff. (2024, February 24). Osteoporosis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968 Khosla, S., Oursler, M. J., & Monroe, D. G. (2012). Estrogen and the Skeleton. Trends in Endocrinology & Metabolism, 23(11), 576–581. https://doi.org/10.1016/j.tem.2012.03.008 Rowe P, Koller A, Sharma S. Physiology, Bone Remodeling. [Updated 2023 Mar 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www-ncbi-nlm-nih-gov.proxy.library.cornell.edu/books/NBK499863/

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Who Helps A Child With ARFID?

As the saying goes, “it takes a village”. If you are looking for more support to help yourself or your child treat ARFID, you likely already deeply resonate with this saying. Luckily, the research is growing and the awareness is improving and spreading in the eating disorder field to help diagnose ARFID with more ease and specific criteria. The next order of business is creating your “village”.  Curating a specialized multidisciplinary team is the most tried and true approach to eating disorder treatment. At the most basic level, a doctor (preferably a child and adolescent medicine specialist for the kiddos), a registered dietitian (heads up to ensure actual RD credentials, not just a nutritionist label) with a Certified Eating Disorder Specialist credential indicated by “CEDS”, and a therapist who specializes in eating or feeding disorders. For more complex individual cases, a speech language pathologist and feeding specialist are essential components. When the whole family and team work together to change meal time behaviors, success will follow.  What does an RD do to treat ARFID?  In one on one sessions or parent joined sessions, we will educate you on healthy eating and addressing food fears one step at a time, to empower you to face these fears and live a full life that YOU control, not ARFID. We will teach you and/or your kiddo to move up the ladder and include all food groups gradually, moving up the steps to eating, without meltdowns and shuts downs. Treatment includes developing pre and post mealtime coping strategies, meal time structures and psychoeducation, as well as hands-on regulation tools to help quiet the chaos and create opportunity for change. In addition, the dietitian’s role may look like exposure therapy sessions, creating family meal calendars, meal supports, family-based interventions, cooking sessions, CBT techniques amongst other modalities (i.e. SOS Approach to Feeding, DBT, RO-DBT), and play based sensory exposures and integration. Visit our previous blog on How to Use a Food Hierarchy in ARFID for a more in depth look on what some of your nutrition sessions may look like. For children and adolescents, doctors will monitor labs, growth charts, and vitals ensure your kiddo is hitting their targets and getting back on their growth trajectory and prevent nutrient deficiencies. Additionally, doctors may prescribe medications to increase appetite or treat underlying/cooccurring anxiety. The therapist on the team will also troubleshoot this frequented component in sessions. OCD, ADHD, and sensory processing disorders and sensitivities are often co-ccuring in individuals with ARFID, therefore a therapist and dietitian will often use Cognitive Based Therapy (CBT) skills to help foster the safe connection between mind and body, the thoughts, feelings and behaviors. Navigating ARFID treatment can be tough and overwhelming, but we are here for you. Reach out to the LCWN Team and we would be happy to discuss how we can support you and connect you with experts in the space.

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