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child with metabolic syndrome intuitively eating fruit

Can We Teach Intuitive Eating In Kids With Metabolic Syndrome?

By Shannon Herbert, PhD, RD, RYT, CDN What is metabolic syndrome? Metabolic syndrome is a group of conditions that can increase one’s risk for heart disease, stroke, and type 2 diabetes.1 Metabolic syndrome is usually defined as having three or more of the following risk factors: Elevated blood pressure Elevated blood glucose (sugar) Elevated blood triglycerides Low blood levels of high density lipoprotein (HDL) cholesterol (“good” cholesterol) Large waist circumference Approximately 7.8% of US adolescents (13-18 years) are estimated to have metabolic syndrome, compared to 2.8% of US children (6-12 years).2 Puberty may play an important role in the increase in prevalence of metabolic syndrome from childhood to adolescence. During puberty, there is a decrease in insulin sensitivity that occurs to aid in the adolescent growth spurt. Yet this change in insulin sensitivity is usually recovered by early adulthood.3 Due to the physiological changes that occur during adolescence, measuring metabolic syndrome can be challenging.1 Since adolescence isn’t a static period of time, the risk factors a teen may face can vary throughout this period. Focusing on reducing these risk factors throughout adolescence is recommended to reduce the risk of cardiovascular disease and type 2 diabetes in adulthood. In teens, lifestyle management is the first line of treatment to reduce the risk factors associated with metabolic syndrome.1 Lifestyle management usually consists of changes to nutrition, movement, and other lifestyle behaviors, including limiting screen time. While weight management programs have been studied, it is important to note that achieving a “normal” body mass index (BMI) is not necessary to decrease cardiometabolic risk.1 There are benefits to improving health behaviors, even in the absence of weight loss. Adolescence can be a particularly vulnerable time to focus on weight management efforts. Adolescence is a time marked by increased body image concerns, often driven by peer pressure, social influences, as well as hormonal and body changes.4 The teen years are full of physical, emotional, and social changes which may contribute to the development of disordered eating behaviors.4 Thus, it is imperative to foster supportive eating habits during this time, even while focusing on addressing metabolic syndrome risk factors. What is intuitive eating? Intuitive eating is an approach to health that is rooted in interoceptive awareness, or our ability to recognize sensations in our bodies. Intuitive eating is focused on connecting to physiological cues of hunger and fullness. Intuitive eating aims to improve health behaviors, without explicitly focusing on weight, making it a possibly suitable approach to support health in teens with metabolic syndrome. Intuitive eating is based upon 10 principles that honor both physical and mental health. The ten principles of intuitive eating are outlined below:5,6 Reject the diet mentality. Become aware of diet culture. Learn to challenge and dismiss the associated thoughts. Honor your hunger. Learn to listen and honor this biological signal, keeping your body fueled with adequate energy. Make peace with food. Give yourself unconditional permission to eat all foods without fear or guilt. Challenge the food police. Challenge dieting rules and develop a more neutral stance towards food. Discover the satisfaction factor. Identify the pleasure and satisfaction that can be found in eating, through listening to your personal tastes and eating mindfully. Feel your fullness. Learn to listen to the body signals that indicate you are no longer hungry. Cope with your emotions with kindness. Identify ways to cope with uncomfortable emotions without food. Respect your body. Accept your body, treating it with respect and kindness. Movement – feel the difference. Prioritize movement that makes you feel good. Honor your health – gentle nutrition. Make food choices that honor your health and taste buds. Can intuitive eating be used to reduce metabolic syndrome? Following intuitive eating style practices, such as responding to hunger/satiety cues and minimizing dieting behaviors is associated with positive health outcomes. Intuitive eating has been associated with lower body mass index (BMI)7–10 and better cardiovascular risk factors, including total cholesterol, low density lipoprotein (LDL) cholesterol, and systolic blood pressure,11,12 irrespective of weight. Intuitive eating has been shown to improve diet quality, leading to higher fruit and vegetable intake13–15 and lower glycemic load.16 In adolescents, specifically, intuitive eating is negatively associated with eating disorder behaviors.17 Intuitive eating during adolescence has been associated with lower odds of depression, low self-esteem, unhealthy weight control behaviors (e.g. fasting, skipping meals), extreme weight control behaviors (e.g. taking diet pills, vomiting), and binge eating behaviors in adulthood.18 How can we foster intuitive eating in teens? Several strategies can be used to help foster intuitive eating practices in teenagers while improving their metabolic syndrome risk factors. 1. Encourage body positivity. Focus on health and well-being rather than appearance. Have an open dialogue on how bodies change over time and come in diverse shapes and sizes. Foster communication with teens about their evolving feelings related to body image. 2. Educate about nutrition. Emphasize the importance of nourishing the body with a variety of foods to support teens’ needs. Avoid labeling foods as “good” or “bad,” recognizing that all foods can fit into a varied, health promoting dietary pattern. Prioritize whole foods, such as fruits, veggies, whole grains, and high quality protein, to support the nutrient needs of growing teens. 3. Cooking. Involve teens in meal planning, grocery shopping, and cooking as a way to model and promote positive nutrition. 4. Work on mindful eating. Encourage teens to pay attention to their hunger and satiety cues. Prioritize family meal time, where teens can take their time eating, savoring each bite, in order to better recognize when they are comfortably satisfied. 5. Promote self-compassion. Support teens in recognizing and challenging negative self-talk related to food and body image. This also means that parents should be mindful of their own negative food and body talk! How you talk about your body can be internalized in your teens. Model self-compassionate behaviors, grounded in kindness and respect towards your body. 6. Watch out for “diet” talk. Refrain from discussing restrictive eating behaviors. Model balanced eating and a positive relationship with

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teen girl reading body positive book about nutrition and metabolism

5 Books That Discuss Teen Metabolism and Health at Every Size (HAES)

By Shannon Herbert, PhD, RD, RYT, CDN 5 Body Positive Nutrition Books for Kids Here are 5 awesome book ideas that can serve as resources to aid in navigating teen’s nutrition and wellness through a health at every size lens.   1.  No Weigh! A Teen’s Guide to Positive Body Image, Food, and Emotional Wisdom by Signe Darpinian, Wendy Sterling, & Shelley Aggarwal  An easy-to-read, fun, and informative guide and workbook, written by a therapist, registered dietitian, and adolescent medicine physician. This book details how bodies change during teen years, physically and emotionally, and the importance of nutrition for growth and development. This book debunks myths around “diets” and provides teens with tools and strategies to avoid potential triggers of disordered eating.    2. “Intuitive Eating for Teens: A Workbook to Help You Make Peace with Food, Mindfulness, and Your Body” by Elyse Resch, MS, RDN, CEDRD-S and Evelyn Tribole, MS, RDN, CEDRD Drawing upon the evidenced based practices of the book Intuitive Eating, this workbook is designed to help teens address the ten principles of intuitive eating. The workbook focuses on respecting the body’s natural hunger and fullness signals, cultivating body positivity, and building a connection between mind and body. The workbook is broken up into short educational sections mixed with activities to put the practices into action.   3. Raising Body Positive Teens: A Parent’s Guide to Diet-Free Living, Exercise, and Body Image by Signe Darpinian, Wendy Sterling, & Shelley Aggarwal The same authors who wrote No Weigh, have created this down-to-earth guide for parents, providing clear strategies and tools to encourage both parents and teens to have a healthy relationship with food and exercise by prioritizing joy and health.    4. Fat Talk: Parenting in the Age of Diet Culture By Virginia Sole-Smith. This book aims to change the conversation around weight, health, and self-worth. It is geared towards parents, offering strategies to families to learn about their own body biases, identify diet culture, and empower their children to navigate the challenging food landscape.    5. Health at Every Size: The Surprising Truth About Your Weight by Linda Bacon This foundational book outlines the research behind the Healthy At Every Size approach, which promotes self-acceptance, joyful movement, and intuitive eating. The book details the evidence supporting Health at Every Size and offers a starting point for tuning into the body’s expert guidance.

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woman with pots syndrome and ehlers danlos syndrome enjoying healthy diet

POTS Syndrome and EDS: What is the best diet?

Food Tricks and Tools to Treat POTS and EDS We are sharing some tricks and tools to treat postural orthostatic tachycardia syndrome (POTS) and Ehlers-Danlos Syndrome (EDS).  The two conditions often co-occur and share gastrointestinal and circulatory symptoms, thereby increasing the value of medical nutrition therapy in managing both.  Laura Cipullo and her team of registered dietitians can provide individualized recommendations to best suit your unique needs.  As always, we recommend consulting with your physician prior to implementing these tricks and tools.    Sodium Alginate for Reflux Sodium alginate has emerged as a promising treatment for easing symptoms of reflux, which is a common digestive complaint among individuals with POTS and EDS1.  In contrast to traditionally used medications like proton pump inhibitors (PPIs), histamine-2-receptor agonists (H2RAs), and antacids, this seaweed derivative does not suppress the production of or neutralize stomach acid.  Rather, the interaction between the alginate and the acid forms a barrier to protect the esophagus from the stomach acid2.  An advantage of this mechanism is its efficacy in treating various types and degrees of reflux (i.e., non-acid reflux, mixed reflux)2.  It is also a fast-acting, over the counter solution for unpleasant symptoms of GERD2.  In terms of effectiveness, sodium alginate surpasses antacids and placebos but falls short in comparison to PPIs and H2RAs2.   Sodium Tabs (3-4 grams daily) “The American Heart Association recommends limiting dietary sodium to <2300 mg/day or <1500 mg/day for individuals with heart disease3”; however, certain populations would benefit from a more liberal intake.  Both POTS and EDS sufferers experience some form of autonomic nervous system dysfunction4.  Most commonly, this presents as heart rate, circulatory, and blood pressure abnormalities4.  The rationale for a higher sodium diet is that it increases water retention and blood volume, and therefore, blood pressure4.  While this can be problematic for those with hypertension or renal disease4, for instance, it would be favorable for improving circulatory issues due to dysautonomia5.  Studies suggest that the ideal sodium intake for individuals with POTS is 8-10 grams per day5.  Because many processed and packaged foods already contain high amounts of sodium, supplementation of 3-4 grams daily via sodium tabs should be sufficient in meeting the aforementioned goal.  Additional fluid intake is also important (2-3 L/day)5 to help prevent dehydration and nausea.    Low-Histamine Diet Anyone who has gone outside over the past few weeks up here in the northeast is likely familiar with the sneezing, congestion, itchy eyes, and other bothersome symptoms from the high pollen count. To say we’ve been suffering is an understatement!  This immune-mediated reaction is due to histamine, which our bodies release in the presence of allergens and inflammation6.   In susceptible individuals, such as those with mast cell activation syndrome (MCAS) or chronic inflammation, the build-up of histamine can produce symptoms all over the body including, but not limited to headaches, shortness of breath, bloating, muscle pain, low blood pressure/changes in blood pressure, itching, hives, and anaphylaxis6. This is also seen in typical food allergies, where the immune system deems the food as harmful and in response, releases histamine.  But did you know that certain foods can elicit similar reactions despite the absence of a “true allergy” or intolerance to that specific food?  A low-histamine diet eliminates that which contain high amounts of histamine, contain histamine-like substances, or encourage the release of histamine7.  In general, high-histamine foods include aged cheeses, fermented foods, and certain fruits and vegetables7.  Previously cooked foods also contain high amounts of histamine but have no fear; you can still save your leftovers to enjoy another time provided they are frozen right away, as this greatly slows histamine production.  A more extensive list of offenders can be found here7.  While POTS and EDS are not inflammatory themselves, research has shown that “24% of EDS patients had an MCAS diagnosis8” and “66% of patients with POTS and EDS had symptoms suggestive of a mast cell disorder8”.  It is important to speak with a knowledgeable dietitian, who can provide additional guidance regarding the best approach for implementing a low-histamine diet.   Goat Yogurt Rather Than Cow’s Milk Yogurt Nowadays, there is a yogurt for everyone: from Greek to skyr to plant-based, each with its own flavor and nutritional profiles.  One lesser-known option is goat yogurt.  Compared to cow’s milk, goat yogurt contains slightly more calories, protein, vitamins, and minerals9.   It is also a viable option for some people who are unable to tolerate cow’s milk due to the different protein composition, lower lactose content, and because it may be easier to digest9.  Like cow’s milk yogurt, goat yogurt contains probiotics—live microorganisms that promote a healthy gut microbiome9—and thus, may be particularly beneficial for individuals with POTS and EDS.   Disaccharide Enzymes for Digestion  Our final tool for easing symptoms of POTS and EDS is disaccharide enzymes, or “disaccharidases.”  A disaccharide is a type of sugar made up of two monosaccharides (or “simple sugars”).  Disaccharidases help the body break down these carbohydrates, specifically the sugars: lactose, maltose, and sucrose, into a more usable and absorbable form10.  In their absence, uncomfortable digestive issues such as gas, bloating, and diarrhea occur10.  These symptoms are often seen in irritable bowel syndrome (IBS) and therefore, POTS and EDS.  A low FODMAP diet, commonly used to address IBS, eliminate lactose; however, this may not be enough for everyone to experience relief.  Research suggests that disaccharide enzyme deficiencies are often mistaken for IBS and therefore, underdiagnosed10.  To completely eliminate all three disaccharides would be too restrictive given all the foods that contain them.  Instead, taking disaccharide enzymes can provide symptom relief without compromising dietary intake and variety10.    References Do T, Diamond S, Green C, Warren M. Nutritional implications of patients with dysautonomia and hypermobility syndromes. Current Nutrition Reports. 2021;10(4):324-333. doi:https://doi.org/10.1007/s13668-021-00373-1  Rossiaky D. Alginates for GERD: Effectiveness, Risks, and FAQ. Healthline. Published July 21, 2023. Accessed May 29, 2024. https://www.healthline.com/health/gerd/alginates-for-gerd#summary American Heart Association. How much sodium should I eat per day? www.heart.org. Published November 1, 2021. Accessed May 29, 2024. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sodium/how-much-sodium-should-i-eat-per-day Dysautonomia. The Ehlers

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woman with ehlers danlos syndrome dysautonomia feeling dizzy

Autonomic Disorders: What Are They and What Can You Do About Them?

Understanding Dysautonomia: What It Is, Causes, Symptoms, and Treatments Have you ever wondered why your heart races when you’re scared or why your stomach churns during stressful moments? These reactions are all controlled by the autonomic nervous system (ANS), a critical part of our bodies that often goes unnoticed—until something goes wrong. In this blog, we will explore autonomic disorders, also known as autonomic neuropathy or dysautonomia, and how the way you eat can impact the condition. What is the Autonomic Nervous System (ANS)? The ANS regulates the things your body controls without conscious thought, like heart rate, blood pressure, digestion, and body temperature. The ANS consists of three components: the sympathetic nervous system (SNS), the parasympathetic nervous system (PNS), and the enteric nervous system (ENS). Most organs have nerves connected to these systems to control your body’s daily activities.   Figure 1: A diagram of the Nervous System. Photo cred: Lecturio   The Sympathetic Nervous System (SNS) The SNS acts as the “fight or flight” response, preparing your body for stressful events, by raising your blood pressure and heart rate and slowing your digestive and urinary tract.   The Parasympathetic Nervous System (PNS) The PNS has the opposite effect, helping your body relax after stress by lowering your blood pressure and heart rate and restarting digestion and urination. The Enteric Nervous System (ENS) The ENS oversees digestion, helping mix and move food through your intestines, support immune function, and remove toxic substances. It also increases blood flow to the intestines to improve the absorption and distribution of nutrients. Understanding Autonomic Dysfunction Autonomic dysfunction occurs when the nerves of the ANS are damaged, leading to a wide range of symptoms, from lightheadedness and fluctuating blood pressure to digestive issues and urinary problems. This damage can be caused by chronic conditions like Parkinson’s disease or diabetes, certain medications, injuries, and other factors such as:   Autoimmune disorders Infections Long-term heavy drinking Physical Trauma Poisons and toxins Tumors Uncontrolled high blood pressure, and more   Common autonomic disorders include orthostatic hypotension, postprandial hypotension, multiple system atrophy, pure autonomic failure, afferent baroreflex failure, and familial dysautonomia.  How does the Autonomic Nervous System affect Digestion? The ENS controls many of the necessary functions of the digestive system so we can absorb nutrients and expel harmful substances. When it does not work properly, your body cannot get the nutrients it needs to function, which can cause uncomfortable symptoms. Damage to the ENS can cause problems, such as:   Loss of Appetite  Bloating  Diarrhea Constipation Difficulty Swallowing   Dysautonomia and Ehlers Danlos Syndrome (EDS) Ehlers Danlos Syndrome (EDS) is a group of 13 heritable connective tissue disorders, each with its own unique diagnostic criteria. The main signs and symptoms seen across all types of EDS are fragile tissue, hyperelasticity of the skin, and joint hypermobility.   Many people with EDS also have some type of dysautonomia, experiencing some of the listed symptoms above. Often, those with EDS have orthostatic intolerance, which means they experience symptoms while standing up. The most common types of orthostatic intolerance are: Orthostatic hypotension (OH): low blood pressure when standing upright  Postural orthostatic tachycardia syndrome (POTS): an abnormal increase in heart rate when standing without a drop in blood pressure These conditions can be serious, as fainting can cause people to fall and break bones and joints, or hit their head.  Living With Dysautonomia: Diet and Lifestyle Recommendations Most importantly, recommendations for autonomic dysfunction are individualized. They can vary depending on the type of autonomic disorder and by person. Some science-backed dietary recommendations include: Small, more frequent meals: After eating, blood is brought to the stomach to help absorb nutrients from digested food. Large meals can worsen symptoms like dizziness or lightheadedness.  High (Soluable) Fiber Diet: Fiber can help reduce GI symptoms like constipation and bloating.  Alcohol and Caffeine: Both of these substances can be dehydrating. It is recommended to limit and avoid alcohol. Caffeine, on the other hand, can help some individuals feel better, while it can make others feel jittery and raise their heart rate. Gluten-Free Diet: While not everyone needs to avoid it, some have reported that avoiding gluten improved their symptoms of autonomic dysfunction. However, there is no decisive conclusion on this recommendation. High-Salt, High-Fluid Diet: A high-salt diet might sound contradictory, but combining it with a high-fluid diet can help regulate heart rate and blood pressure symptoms.   Some lifestyle recommendations include: Elevated Head While Sleeping: Elevating your head four to six inches can reduce high blood pressure while lying down, which lessens the need to use the bathroom at night and maintain blood volume.  Compression Garments: Compression stockings and abdominal compression garments can help prevent blood from pooling in the lower extremities and abdomen. However, research suggests that for these garments to be effective, they must extend to the top of the thighs and preferably to the abdomen.  Physical Counter Maneuvers: Certain movements, like crossing your legs, muscle tensing, and squatting are effective ways to prevent fainting and dizziness.  Drinking Water Before Getting Out Of Bed: Drinking water can help your body rehydrate and increase blood volume before getting up, so you are less likely to feel faint when standing.    More information on dietary and lifestyle recommendations can be found here. Resources and Conclusions  Autonomic dysfunction encompasses a range of conditions with diverse symptoms and treatments. These symptoms can be mild or life-threatening, making it imperative to have a strong medical team and support group behind you. Consider joining support groups, either locally or online. Resources like the Dysautonomia International and The Ehlers Danlos Society websites can provide additional information and research updates.    Are you struggling with digestive symptoms or other autonomic disorder issues? You can schedule an appointment with one of our expert dietitians and start your journey to better health with personalized care. References Autonomic Nervous System: What it is, Function & Disorders. Cleveland Clinic. (n.d.). https://my.clevelandclinic.org/health/body/23273-autonomic-nervous-system   Bryarly, M., Phillips, L. T., Fu, Q., Vernino, S., & Levine, B. D. (2019). Postural

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fpies baby

Understanding FPIES: The Basics of Food Protein-Induced Enterocolitis Syndrome

By The LCWNS Team Caring For Babies with FPIES Food Allergy Parents and caregivers of young children with food allergies face a myriad of complexities and anxieties when it comes to managing their child’s dietary needs.  The constant fear of accidental exposure to allergens can be overwhelming, leading to heightened vigilance in monitoring food encounters, meal preparation, and eating out.  This level of caution is necessary to prevent potentially life-threatening reactions in their child.  Similarly, parents and caregivers of children with Food Protein-Induced Enterocolitis Syndrome (FPIES) also face significant challenges in this area.  Keep reading as we explore the definition, causes, and presentation/signs and symptoms of FPIES, as well as its diagnosis and management.   What is FPIES? Food allergies and FPIES both cause abnormal reactions to specific foods1; however, the main difference between the two lies in the mechanism of these reactions.  Food allergies involve an immune system response to a specific food protein, leading to immediate symptoms such as hives, swelling, or anaphylaxis2.  In contrast, FPIES is not mediated by the immune system and does not typically result in immediate reactions3. Instead, FPIES causes delayed gastrointestinal symptoms such as vomiting, diarrhea, and dehydration hours after consuming the “trigger” food1.   Common FPIES Triggers Any food can instigate an FPIES reaction, but the most common culprits include the following:1,3 Cow’s milk Soy Grains, particularly rice and oats Individuals may also react to:  Poultry Seafood  Egg Peanut   It is important to note that each child’s triggers can vary widely, and some may react to more than one type of food4.   FPIES Symptoms As previously mentioned, FPIES symptoms mainly impact the digestive system1 and can be classified as acute or chronic.   Acute FPIES symptoms usually appear within hours after consuming the trigger food, causing cyclical vomiting and diarrhea3. Prompt treatment with intravenous fluids is essential to prevent dehydration and potential life-threatening complications4. Chronic FPIES symptoms, on the other hand, are more insidious and may present as failure to thrive, malabsorption, and chronic diarrhea3.  These symptoms can have a significant impact on a child’s growth and development if left unaddressed.   FPIES Diagnosis One of the most frustrating and challenging aspects of FPIES is that symptoms may not occur immediately after food ingestion but instead present a few hours later1,3.  Unlike traditional allergy testing, FPIES also cannot be detected via blood or skin testing4.  Instead, diagnosing FPIES requires health care professionals and parents to take a more investigative approach by closely monitoring symptom development, keeping detailed records of foods and reactions, and collaborating closely4.   FPIES Management and Treatment Fortunately, FPIES rarely persists past age 3-41, but it is still important to know how to manage the condition.  Key considerations include the following:  Trigger Food Identification and Avoidance: Identifying and avoiding trigger foods is the main way to prevent FPIES reactions.  To achieve this, individuals can read food labels and research restaurants ahead of time to ensure they have safe options available. It is also crucial to understand how to interpret labels for hidden sources of allergens, such as cross-contamination or alternate names for common allergens, in order to prevent adverse reactions.  Emergency Action Plan: An emergency action plan outlines specific steps to take in case of a reaction, including recognizing symptoms and seeking immediate medical assistance. Having a plan in place can help reduce the risk of complications and improve outcomes for individuals with FPIES. Medical Complications: Dehydration is a common complication of FPIES due to the excessive fluid loss from persistent vomiting and diarrhea. It is essential to closely monitor individuals with FPIES for signs such as dry mouth, decreased urine output, and lethargy5 and seek prompt medical intervention (i.e., IV fluids, medications) to prevent further complications3. Nutritional Implications: Due to the wide variety of foods that individuals with FPIES could react to, ensuring adequate nutrition for growth and development and preventing deficiencies is essential. Thus, it can be extremely helpful to consult with a dietitian and/or your pediatrician.     References Food Protein-Induced Enterocolitis (FPIES) | Symptoms & Treatment. ACAAI. Published March 21, 2019. Accessed June 26, 2024. https://acaai.org/allergies/allergic-conditions/food/food-protein-induced-enterocolitis-syndrome-fpies/ Mayo Clinic. Food Allergy – Symptoms and Causes. Mayo Clinic. Published December 31, 2021. Accessed June 26, 2024. https://www.mayoclinic.org/diseases-conditions/food-allergy/symptoms-causes/syc-20355095 Food Protein-Induced Enterocolitis Syndrome (FPIES). www.chop.edu. Published February 23, 2014. Accessed June 26, 2024. https://www.chop.edu/conditions-diseases/food-protein-induced-enterocolitis-syndrome-fpies Food Protein-Induced Enterocolitis Syndrome (FPIES). Aaaai.org. Published 2023. Accessed June 26, 2024. https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/food-protein-induced-enterocolitis-syndrome-fpies Cleveland Clinic. Dehydration. Cleveland Clinic. Published June 5, 2023. Accessed June 26, 2024. https://my.clevelandclinic.org/health/diseases/9013-dehydration

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baby led weaning baby eating

Baby Led Weaning vs. Spoon Fed Weaning

By LCWNS team  How to Wean Your Baby Everyone knows that good nutrition is essential for children to grow healthy and strong.  But as a new parent, you may feel overwhelmed with information surrounding the best way or the best foods to feed your infant.  For the first few months of life, the answer is pretty clear cut- breastfeeding and/or formulas are the way to go, exclusively.  But what happens when it’s time to transition to more exciting foods?     What Is Baby Led Weaning? Baby led weaning (or baby led feeding) is one way to introduce your infant to solid foods,1 where he or she is essentially in charge of the eating process.  Picture the infant enjoying his/her first birthday cake: messy hands covered in frosting, given free rein to eat (or destroy) their dessert as they please … that would be an example of baby led weaning. This self-feeding method allows the infant to control what and how much to consume.  The foods offered should be large enough for the infant to grasp and to prevent choking and soft enough that they can be easily mashed.  Examples include pasta, half of a banana, steamed fruits or vegetables, and finger sized strips of beef (parents.com). Many parents are opting for this method due to its benefits in developing fine motor skills and hand-eye coordination,  learning to regulate appetite and food intake, and in providing exposure to a variety of foods, flavors, and textures1, which may prevent picky eating later on as the child matures.  Additionally, baby led weaning encourages participation in family meals as the foods offered are simply those you already have on your plate1. Spoon Fed Weaning In contrast, parents have the option to spoon feed their child, typically beginning with purees and progressing to soft and then solid foods2. In spoon fed weaning, the parent is responsible for feeding the infant and responding to signals of hunger/fullness.  An advantage of this method is less mess, particularly when compared to baby led weaning.  Parents may also feel more at ease regarding the potential for choking as well as knowing their baby is getting enough food, though research shows nutritional deficiencies and choking risk do not differ between baby led and spoon fed weaning3, 4.   When To Start Baby Led Weaning Before deciding whether to use baby led weaning or spoon-fed weaning (or a combination of the two), it is important to evaluate your baby’s readiness to experiment with solid foods.  Developmental milestones, such as head and neck/postural control and the ability to sit upright without support are prerequisites to baby led and spoon fed weaning.  Other signs that your infant is ready for more advanced foods include the following5:  Able to push food to the back of the mouth and swallow  Bringing objects to their mouth Pincer grasp (thumb and forefinger) present Opens mouth when offered food Shows interest in foods served for the rest of the family (i.e. looking at what’s on your plate, reaching for your food, etc.)   Typically, these indicators occur when the child is around 6 months old; however, the decision to start offering complimentary foods should be made with the aforementioned markers in mind6.    Baby Led Weaning Foods It is also important to note that baby led weaning and spoon-fed weaning do not necessarily address the nutritional needs of the growing infant. While breastfeeding and formula feedings usually continue during this transition period, complementary weaning foods should be nutrient and energy-dense, high in iron and zinc, and come from a variety of food groups7.  Additionally, the USDA Dietary Guidelines for Americans recommend limiting added sugars and salt7.  Regardless of which method you choose, it is important that the foods be safe and appropriate, and that supervision is provided at all times.  Strategic introduction of allergens and avoiding “choke foods” are other factors to keep in mind. 7, 8   Key Takeaways Baby led weaning and spoon-fed weaning are two ways to introduce and transition your infant to foods other than breast milk or formula Certain developmental milestones must be present before an infant can transition to solid foods An adult should be present while the infant is eating  Choking hazards include anything that can get lodged in the trachea (i.e., popcorn, hot dogs, whole grapes, nuts, anything clumpy/sticky/dry) A registered dietitian can help you navigate this exciting but often scary time   References [1] Helwig, J., & Carrus, E. (2023, April 21). Is baby-led weaning right for your baby?. Parents. https://www.parents.com/baby/feeding/solid-foods/dos-and-donts-of-baby-led-weaning/  [2] Mother and Baby. (2023, April 4). What is spoon-fed weaning?. Mother and Baby.  https://www.motherandbaby.com/baby/weaning/what-is-spoon-fed-weaning/  [3] Utami, A. F., & Wanda, D. (2019). Is the baby-led weaning approach an effective choice for introducing first foods? A literature review. Enfermería Clínica, 29, 87–95. https://doi.org/10.1016/j.enfcli.2019.04.014  [4] Rice, D. K. (2019, March). Children’s nutrition: Embracing baby-led weaning. Today’s Dietitian. https://www.todaysdietitian.com/newarchives/0319p10.shtml [5] Centers for Disease Control and Prevention. (2023, June 27). When, what, and how to introduce solid foods. Centers for Disease Control and Prevention. https://www.cdc.gov/nutrition/infantandtoddlernutrition/foods-and-drinks/when-to-introduce-solid-foods.html  [6] Start solid food based on what your baby can do, not how old she is. Ellyn Satter Institute. (n.d.-b). https://www.ellynsatterinstitute.org/family-meals-focus/78-baby-led-weaning/  [7] Dietary guidelines for Americans 2020-2025. (n.d.). https://www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf  [8] Centers for Disease Control and Prevention. (2022, February 25). Choking hazards. Centers for Disease Control and Prevention. https://www.cdc.gov/nutrition/infantandtoddlernutrition/foods-and-drinks/choking-hazards.html   [9] Feed in the right way for your child’s stage of development. Ellyn Satter Institute. (n.d.-a). https://www.ellynsatterinstitute.org/how-to-feed/child-feeding-ages-and-stages/

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baby food from baby food maker

5 Essential Tools For Homemade Baby Food

From The Best Baby Food Maker To Baby Food Storage, This Is The Equipment You Need Hey moms and dads!  Ever wanted to make your own baby food but are not sure where to begin?  Whether you’re in the process of baby-led or spoon-fed weaning (see previous blog post) or are just about to transition your infant from breastmilk and/or formula to solids, having the right tools to prepare homemade, baby-approved cuisine is essential.  We asked new parents to share their 5 favorite kitchen tools to make meal prep easier and more efficient for your cooking needs.  Here’s what they said:   1. For the parent who wants an “all in one” gadget:  Baby Beaba Babycook Solo Baby Food Maker Processor If there were one appliance to do it all, this would be it!  The Babycook Solo Baby Food Maker Processor steams, purees, thaws, and reheats food.  Its ease of use and wide variety of functions made it a top pick among parents-turned chefs. And, because it essentially takes on the roles of 4 pieces of equipment, is an excellent option for those looking to save space in their kitchen! 2. For parents and baby on-the-go:  Squeeze Station – Baby Food Pouch Maker for Children with 10 Fresh Squeezed Pouches This is a great product for parents looking to take their homemade (or store-bought) purees wherever they go. It can also be used for yogurts, juices, or smoothies. Simply pour your prepared food item of choice into the top portion of the device, insert the press, and push down to fill the reusable pouches.  This mess-free packaging process offers an eco-friendly way to store, transport, and consume different purees no matter where your adventures may take you and your infant. They can also be frozen to use for make-ahead options.  3. For the parent who likes to plan ahead: WeeSprout Glass Baby Food Storage Jars w/Lids (4 oz, 12 Pack Set)  As dietitians, we always recommend meal prep for our busy clients to simplify their week- but why should this be limited to adults? The WeeSprout Glass Baby Food Jars can be stored in the refrigerator or freezer so meals can be made in advance in batches and saved for later consumption.  They are a wonderful way to store/salvage the baby food you’ve put so much love and effort into preparing.  Plus, these jars are microwave and dishwasher safe, so you can safely reheat your baby’s food and when finished, place in the dishwasher for an easy clean-up.  The time you save with meal prep allows you to put your energy into other things, such as spending quality time with your infant. 4. For the infants whose food doesn’t always end up in their mouths: EZPZ mini mat While not a cooking tool per se, the EZPZ mat is a mealtime must-have!  When I was just learning how to eat solid foods, my parents would put a huge mat under my high chair at restaurants to catch any food that didn’t make it into my mouth (which, in the beginning, was a lot)!  The EZPZ mini mat was the solution we didn’t know we needed.  This placemat, plate all-in-one is made of 100% silicone and can be used in the microwave, oven, and dishwasher.  Plus, its suctioning capability and portability helps to prevent any accidental/unnecessary spilling (and all too familiar mess).  As dietitians, we love the 3-sectioned design as it’s great for serving balanced, healthy meals that check all the boxes in terms of nutrition.   5. For parents who want to keep it simple:  Sopito 2 Pack Stainless Steel Integrated Masher Kitchen Tool Food Masher  Sometimes, a simple potato masher is all that is needed to create baby-safe purees.  Despite its name, it can be used for other fruits and vegetables to create the perfect texture/consistency for your infant. An advantage is that you have more control over the final product’s consistency than you might if using an electric food processor.  It is also an inexpensive tool that can be used for other recipes you may prepare for your family.     In short, there are many ways to make homemade baby food— with or without the need for specialized equipment.  These parent-tested and RD-approved tools offer some useful options designed to simplify the process and yield tasty, baby-friendly meals!    

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woman feeling dizzy when standing up from pots or eating disorder

POTS Syndrome or Eating Disorder? Understanding Why You Feel Dizzy When Standing Up

By LCWNS Team What is the Relationship Between POTS and Eating Disorders?  When you get out of bed in the morning, you probably are not thinking about regulating your heart rate and blood pressure as you transition from laying down to standing.  This is because the part of the nervous system responsible for controlling these automatic functions responds as it should to account for the effects of gravity on blood flow1.  With Postural Orthostatic Tachycardia, or POTS, however, positional changes trigger abnormal and prolonged increases in heart rate (by >30 BPM in adults or by >40 BPM in those under 18 years old)2 in an effort to return adequate blood to the brain2.  Individuals with the condition often experience fatigue, dizziness, palpitations, or fainting1; blood pressure should remain unaffected3.  While POTS cannot be “cured,” adequate hydration and implementing specific dietary changes can be useful in managing symptoms.  The cardiac complications of eating disorders are well-established.  Both POTS and eating disorders can impact orthostatic tolerance.  Eating disorders, such as anorexia nervosa and bulimia nervosa, put the heart at greater risk due to inadequate nutrition and electrolyte disturbances4.  Additionally, vital signs like heart rate and blood pressure are sensitive to changes in energy intake, hydration, and physical and emotional stress5.  As such, individuals with anorexia typically present with sinus bradycardia (heart rate <60 BPM) and decreased blood pressure/orthostatic hypotension3; individuals with bulimia are at increased risk for cardiac arrythmias due to the impact of purging on electrolyte and fluid balance5. Due to the impact of malnutrition on the cardiovascular system, it can be difficult to discern whether cardiac abnormalities/symptoms are due to the eating disorder or autonomic dysfunction, as in POTS.  Relatedly, autonomic nervous system dysfunction may increase one’s risk of sudden death from anorexia5.  For these reasons, physicians should not diagnose POTS if someone currently has an eating disorder2, 5.  Unlike POTS, cardiac effects secondary to anorexia and bulimia typically resolve once eating habits, weight, and compensatory behaviors stabilize5.  Additionally, POTS and eating disorders share mutual risk factors, with white, female, adolescents/young adults comprising much of the affected populations6.  Other associations include dietary restriction and/or history of an eating disorder in those with POTS7.  The former alone can increase the likelihood of developing an eating disorder.  Besides the cardiac symptoms previously mentioned, gastrointestinal complaints are common in POTS as with eating disorders.  These include nausea, bloating, and abdominal pain7. Individuals with eating disorders and/or POTS can benefit from medical nutrition therapy. The registered dietitian plays a crucial role in the management of both as diet can be used as a means of mitigating symptoms3.  Stay tuned for our next blog, where we will discuss tricks and tools for treating POTS and related disorders.     References [1] POTS: Causes, symptoms, diagnosis & treatment. Cleveland Clinic. (2022, September 9). https://my.clevelandclinic.org/health/diseases/16560-postural-orthostatic-tachycardia-syndrome-pots    [2] Quesnel, D. A., Cooper, M., Fernandez-del-Valle, M., Reilly, A., & Calogero, R. M. (2023). Medical and physiological complications of exercise for individuals with an eating disorder: A narrative review. Journal of Eating Disorders, 11(1). https://doi.org/10.1186/s40337-022-00685-9 [3] Postural orthostatic tachycardia syndrome (POTS). Johns Hopkins Medicine. (n.d.). http://www.hopkinsmedicine.org/health/conditions-and-diseases/postural-orthostatic-tachycardia-syndrome-pots  [4] Rittenhouse, M. (2021, October 29). Cardiovascular complications of eating disorders. Eating Disorder Hope. http://www.eatingdisorderhope.com/long-term-effects-health/cardiovascular-complications  [5] Friars, D., Walsh, O., & McNicholas, F. (2023). Assessment and management of cardiovascular complications in eating disorders. Journal of Eating Disorders, 11(1). https://doi.org/10.1186/s40337-022-00724-5  [6] Benjamin, J., Sim, L., Owens, M. T., Schwichtenberg, A., Harrison, T., & Harbeck-Weber, C. (2020). Postural orthostatic tachycardia syndrome and disordered eating: Clarifying the overlap. Journal of Developmental &amp; Behavioral Pediatrics, 42(4), 291–298. https://doi.org/10.1097/dbp.0000000000000886  [7] Harris, C. I. (2022). COVID-19 increases the prevalence of postural orthostatic tachycardia syndrome: What nutrition and dietetics practitioners need to know. Journal of the Academy of Nutrition and Dietetics, 122(9), 1600–1605. https://doi.org/10.1016/j.jand.2022.06.002  

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psilocybin mushrooms used to treat eating disorders

The Magic of Psilocybin

Do ‘Shrooms’ hold the key to mental health treatments? By Gabrielle Finora and the Team at LCWNS What is Psilocybin and How Does it Work? Psilocybin is the active chemical found in over 100 types of psychedelic mushrooms. When taken orally, people feel distorted senses and sights. This happens because psilocybin binds to serotonin receptors in the brain, which are like locks that control our sensory experiences. This is how we see hallucinations when using psychedelics. Psilocybin also has effects on other brain chemicals like dopamine and glutamate. Repeated use can change DNA and how the brain works over time. Psilocybin is the most commonly used psychedelic in practice. Doses usually consist of one to three high doses of the isolated compound, about 25–30 mg. A therapist monitors the person throughout the entire session. After a few sessions, people often report profound positive changes in their values, perspectives, and beliefs, increasing their well-being, openness to experiences, and cognitive flexibility.   Psilocybin and Mental Health Experts suggest that psilocybin can be helpful for those living with mental health conditions, such as depression, anxiety, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and eating disorders. Psilocybin can increase emotional and brain network plasticity, which, in turn, can improve mental health over time. Repeated therapy sessions can help reroute brain networks for long-lasting results, including reduced suicidal ideation, anxiety, and intrusive thoughts, and improved mood and positive attitudes. There is a concern that using psychedelics can worsen existing mental health conditions, however, research shows that is not the case. In a study of 135,095 random adults in the United States, with 19,299 psychedelic users, no association existed between lifetime psychedelic use and worsened mental health symptoms.  Research on Psilocybin and Eating Disorders: What We Know As of 2024, there are few successful treatments for eating disorders. New research is exploring the effects of psilocybin on anorexia nervosa (AN), but little is known about its impact on buliemia nervosa (BN) and binge-eating disorder (BED).  Anorexia Nervosa and Psilocybin For many, AN is a life-long condition with no successful treatments and no medications approved by the United States Food and Drug Administration. Experts predict that less than half of patients reach full recovery, with relapse rates of nearly 50%. Stagnant clinical study outcomes have signaled a “crisis in care”, according to Dr. Walter Kaye and Dr. Cynthia Bulik. In 1959, a case study monitored a single woman with AN who received two doses of psilocybin by injection. After both injections, she experienced a psychological breakthrough, in which she vividly remembered memories from her childhood. They gave rise to the reason behind the beginning of her illness. She saw significant improvements in her mood, weight gain, and awareness of her disorder, although the results did not last through the year. This study is the first of its kind to measure the effects of psilocybin on AN and it was the last until recently due to the Controlled Substance Act (CSA) in 1970 implemented by the “War on Drugs” campaign.  More recently, to test the safety, tolerability, and feasibility of the drug, ten adult females with AN or pAN (partial remission) participated in a study in which they received one, 25mg dose of synthetic psilocybin followed by psychological support. No significant results were found except for low blood sugar in two people, indicating that psilocybin is a safe and tolerable treatment for females with AN. This study paves the way for future studies for AN and other conditions. The Future of Psilocybin For now, psychedelics, including psilocybin, remain illegal for the general public. Clinical studies can still use the substance for research purposes. Results from these studies show very positive signs that substances like psilocybin might be promising treatments for those struggling with treatment-resistant mental health conditions, including eating disorders. In an interview with Knowable Magazine, Robert Mikos, an expert on drug law at Vanderbilt University Law School in Tennessee, says that framing psychedelics use as “medical” helps change the public’s opinion, as that was a tactic for the legalization of medical marijuana. Still, the path to legalization will likely need to be paved through the states rather than the federal government.  Sources: Daniel, J., & Haberman, M. (2018). Clinical potential of psilocybin as a treatment for mental health conditions. The mental health clinician, 7(1), 24–28. https://doi.org/10.9740/mhc.2017.01.024 Kaye WH, Bulik CM. Treatment of Patients With Anorexia Nervosa in the US—A Crisis in Care. JAMA Psychiatry. 2021;78(6):591–592. doi:10.1001/jamapsychiatry.2020.4796 Peck, S.K., Shao, S., Gruen, T. et al. Psilocybin therapy for females with anorexia nervosa: a phase 1, open-label feasibility study. Nat Med 29, 1947–1953 (2023). https://doi.org/10.1038/s41591-023-02455-9 Seal, B. (2024, March 14). Psychedelic drugs and the law: What’s next? Knowable Magazine | Annual Reviews. https://knowablemagazine.org/content/article/society/2024/psychedelic-drugs-and-the-law-whats-next  Verroust, V., Zafar, R., & Spriggs, M. J. (2021, September 28). Psilocybin in the treatment of anorexia nervosa: The English transition of a French 1959 case study. Annales Médico-psychologiques, revue psychiatrique. https://www.sciencedirect.com/science/article/pii/S0003448721002468

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woman using somatic therapy techniques to treat eating disorder

Eating Disorder Recovery and Somatic Integration: A Holistic Approach

  Using Somatic Therapy to Treat Eating Eating disorders are complex mental health conditions that affect millions worldwide. The journey to recovery is often multifaceted, requiring a blend of psychological, nutritional, and physical interventions. One approach gaining attention for its potential benefits in eating disorder recovery is somatic integration. In this blog post, we’ll delve into the concept of somatic integration and explore its role in supporting eating disorder recovery.   What is Somatic Integration? Somatic integration, often regarded as the crucial work following MDMA and psychedelic experiences, entails the integration of insights, emotions, and bodily sensations that arise during these altered states of consciousness. Beyond just mental and emotional processing, somatic integration involves acknowledging and understanding the physical manifestations of one’s experiences. This process may include practices such as body scanning, mindful movement, yoga, and various forms of body-based therapy. By paying attention to bodily sensations and incorporating them into one’s understanding of self, individuals can deepen their integration of the profound insights gained during psychedelic journeys. Somatic integration recognizes that the body holds trauma, emotions, and wisdom, and by engaging with the body, individuals can foster greater healing, resilience, and self-awareness.   The Role of Somatic Integration in Eating Disorder Recovery Somatic integration offers a unique approach to eating disorder recovery by emphasizing the interconnectedness of the mind and body. Here are 4 ways in which this holistic approach can support individuals on their journey to healing:   1. Body Awareness and Intuition: Many individuals with eating disorders have become disconnected from their body’s natural signals of hunger, fullness, and satisfaction due to years of restrictive eating/bingeing/ purging. Somatic integration encourages individuals to tune into these bodily sensations, helping them rediscover their innate ability to understand and respond to their body’s needs. This intuition can help individuals practice mindful eating, ultimately cultivating a deeper awareness of their eating habits.    2. Emotional Regulation and Stress Reduction: Somatic practices often include techniques focusing on breathwork such as deep breathing, progressive muscle relaxation, and guided imagery. These practices can help individuals manage stress, reduce anxiety, and promote a sense of calm, making it easier to resist the urge to engage in disordered eating behaviors. For individuals experiencing overwhelming emotions or dissociation, grounding exercises can be particularly helpful. These exercises focus on connecting with the present moment and the physical sensations of the body, helping to anchor individuals and bring them back to a state of balance.   3. Healing Trauma and Processing Emotions: Some forms of therapy, such as Somatic Experiencing or Sensorimotor Psychotherapy, integrate somatic techniques to help individuals process and release stored trauma. By focusing on bodily sensations and movements, individuals can safely explore and heal from traumatic experiences without becoming overwhelmed by painful emotions or memories. Utilizing expressive or dance therapy can be a powerful way to process emotions and express oneself non-verbally. Through movement, individuals can release pent-up feelings, build body awareness, and cultivate a greater sense of self-expression and empowerment.   4. Improving Body Image and Self-Compassion: Somatic integration encourages individuals to embrace a body-positive mindset, celebrating the diversity and beauty of all body shapes and sizes. By practicing self-compassion and acceptance, individuals can begin to shift from self-criticism to self-love, fostering a healthier and more positive relationship with their bodies. Engaging in bodywork or therapeutic massage can be a nurturing and healing experience for individuals with eating disorders. These practices can help individuals reconnect with their bodies in a gentle and compassionate way, promoting relaxation, stress reduction, and a greater sense of well-being.   Eating disorder recovery is a challenging but achievable journey that often requires a holistic approach. Somatic integration offers a valuable perspective, emphasizing the importance of the mind-body connection in healing and recovery. By incorporating somatic practices into treatment plans, individuals can gain greater body awareness, improve emotional regulation, heal from trauma, and foster a more positive body image. As part of a comprehensive recovery plan, somatic integration can play a crucial role in supporting individuals on their path to health, healing, and self-discovery.   If you or someone you know is struggling with an eating disorder, it’s essential to seek professional help. With the right support and treatment, recovery is possible, and somatic integration may be a valuable tool on this journey.   References: Payne P, Levine PA, Crane-Godreau MA. Somatic experiencing: using interoception and proprioception as core elements of trauma therapy. Front Psychol. 2015;6:93. Cusack CE, Ralph-Nearman C, Nicholas JK, Levinson CA. New directions in research on somatic concerns in individuals with eating disorders. University of Louisville, Department of Psychological & Brain Sciences, USA. Front Psychol. 2022;Version of Record 2 March 2022. https://doi.org/[DOI]. Castellini G, Cassioli E, Rossi E, Mancini M, Ricca V, Stanghellini G. Bridging cognitive, phenomenological and psychodynamic approaches to eating disorders. Eating and Weight Disorders – Studies on Anorexia, Bulimia and Obesity. 2022;27:2273-2289. https://doi.org/[DOI]  

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