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How to Maximize Your Fat Loss with Fitness

9/7/2017

 
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Diet is always the most important in terms of a healthy body, but exercise can be a great addition to help sculpt your body. Unfortunately, a good majority of individuals exercise regularly but don't see results, and may even end up gaining more fat than what they started with - no bueno!
Here are crucial tips, powered by HealthyBot, on how to optimize fitness to increase fat burning and help you reach your body composition goals:


Build muscle

To put it simply, you want as much muscle as you can because muscle is what increases your metabolism. The more muscle you have, the more calories you will burn at any given time. Gain muscle and minimize muscle loss by adding strength training exercises to your workout routine.
This could be any variation of strength training: yoga, barre, pilates, heavy lifting, etc. Another benefit of strength training is that it will cause you to continue to burn more calories even after the strength session is over.

Real Life Example: I had two female patients one day. One was 130 lbs and had 18% body fat and her resting metabolic rate was 1450 (resting metabolic rate is the bare minimum amount of calories you will burn in a day) which means her body was mostly muscle. The second patient was 170 lbs and had 47% body fat (meaning about half of her body was fat) and her resting metabolic rate was 1150. This means that even though the 130 lbs patient weighed 40 lbs LESS, because she was mostly muscle and very low fat, she burned about 300 calories more per day than the patient with almost 50% fat.

To put this in perspective, to burn 300 calories it would take about an hour of exercise. This is an example of why you want to build and preserve muscle because it is what will determine how many calories you burn daily. 


Say no to steady-state cardio

This type of exercise is really a waste of time in terms of weight loss. It is inefficient because it leads to muscle wasting rather than muscle building and you really don't burn many calories from it. With steady-state cardio you also stop burning calories once you stop the exercise - this is unlike high intensity interval training or strength training which causes you to continue burning calories for hours after the workout.

Note: Any type of cardio is good for your heart, stress relief, and improved mood - however not good for weight loss.


10,000 steps per day

This means you are moving around more so than sitting, those little movements everyday will add up to you burning more calories. Even just standing rather than sitting will activate more muscles and cause you to burn more calories. Aim to get up and move around at least once an hour,  if you subtract 8 hours of sleep, this means you have 16 hours to move. Increase walks throughout the day by walking 10 minutes around the block before work, walking at least 10 minutes at lunch time, and walking after dinner for at least 10 minutes - walking after eating also helps with digestion, another added benefit!

Real life example: All the time I have patients come back from vacation saying they walked a lot but barely did any other exercise and definitely did not follow a healthy diet. More often than not, they end up losing fat and gaining or maintaining muscle. How does this happen?! Well, when you are on vacation you tend to be moving around more, you are constantly on the go, and you are walking all over the place.

Don't underestimate the power of walking and movement, it really can make a big difference. Another reason can be due to a more relaxed state and less cortisol production while you are on vacation. Elevated cortisol comes from too much exercise and/or too much stress, and cortisol favors muscle breakdown and fat accumulation. Good reason to book your next vacation!


HIIT

High intensity interval training (aka HIIT) means you are doing short bursts of exercise followed by short periods of rest. HIIT has shown to be the most efficient and effective form of exercise because it helps you to build muscle and burn more calories even after the workout is done, and is under 30 minutes.

This should be done every 48-72 hours, maximum 3x per week because too much high intensity back-to-back doesn't allow your body to rebuild itself and can lead to muscle breakdown and loss - which you know from above is the last thing you want for your metabolism.


Mix it up

Doing different types of exercise means your body is never able to adapt to a workout and keeps your body guessing. Mix up your workouts weekly or every 2-3 weeks. If you continue to do the exact same exercises for longer than a few weeks, your body gets really good at doing these exercises and is not challenged anymore because it knows what to expect. When your body goes on autopilot and is no longer challenged, it will stop burning as many calories.


Rest

Give your body at least one day off from exercise per week, it needs this rest time to heal and rebuild muscle. Also too much exercise will cause high levels of cortisol in your body. High levels of cortisol in your body favors fat accumulation and muscle wasting - not a good combo!
On your rest day(s) walking and stretching is still great - a rest day does not mean you have to sit on the couch all day.


Sleep

Sleep is so important because it is when your body rebuilds and makes muscle. It is absolutely necessary for muscle growth and the prevention of muscle breakdown. Someone who is exercising regularly will need more sleep than someone who does not exercise - good excuse to sleep in!
Exercise will also allow you to sleep better, and is one of the best ways to increase the quality of your sleep - just make sure you are done exercising at least 2 hours before you want to go to sleep because exercise revs you up and makes you alert, which is the last thing you want before you try to sleep.


About the author: Sarah-Kate Rems is an Ivy-league trained Board-Certified Family Nurse Practitioner licensed in California and New York State with an expertise in preventative healthcare. She considers nutrition and exercise to be the basis of well-being and is a strong advocate for daily physical activity and maintaining a healthy diet. Sarah-Kate is also a co-founder of The Mindful Tech Lab


How To Eat Healthy At An Italian restaurant

8/31/2017

 
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Italian food is one of the most beloved foods across the world - and for good reason! It is based on using super fresh ingredients with plenty of olive oil and herbs.
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However, Italian food is also known for its heavy pasta and cream based dishes which are definitely not helpful for staying healthy and fit. As with any restaurant, it is all about making the right choices and choosing the dishes that will fuel your body and not work against you.


Here is how to order healthy at an Italian restaurant:


Appetizer

  • Minestrone soup - This soup is broth based with lots of vegetables, and tends to pack a ton of flavor with not a lot of calories. Soup is great to start with because the liquid will fill up space in your stomach, meaning less chance of overeating later.
  • Charcuterie - This is a mix of different meats which makes this a high protein and high fat appetizer and will make you feel satisfied and help to fill you up a bit before the main course.
  • Antipasto - This is a mix of meats, cheese, vegetables, and olive oil, and  is a great high protein and high fat starter.
  • Carpaccio - Another high protein, high fat appetizer, this consists of thin slices of raw fish with olive oil.
  • Roasted vegetables - Super fresh vegetables are a staple of Italian food, starting with vegetables will give you some fiber to fill you up a bit before the main course.
  • Caprese salad - This salad is traditionally composed of tomatoes, basil and mozzarella which is great high fat starter. Eating high fat to start will prevent you from overeating at the main dish. Note: If dairy tends to upset your stomach, you should probably skip the mozzarella because this type of cheese is typically harder to digest due to the higher lactose content.
  • Grilled calamari - Aka squid, calamari is a another great protein choice, just make sure to get grilled and not fried or crusted.


Pasta Main Course

Choose pasta only if you are if you are looking for a high carb meal, such as after heavy exercise or a carb-refeed day. Otherwise, pasta in general is not a good choice for your waist-line. 
  • Pasta primavera - This dish is made with lots of vegetables and the sauce is usually olive oil based with tomato.
  • Spaghetti with pesto - If you are really craving a fatty pasta with more of flavor profile than just plain olive oil, get it with pesto rather than cream. Pesto is made with basil, garlic, olive oil and pine nuts, and is much better for you than heavy cream based sauces such as with Alfredo.


Low Carb Main Course

  • Pollo alla Diavola - This is typically roasted chicken with vegetables, olive oil, and herbs -  can't get much healthier than that! Just ask to make sure it is not battered or crusted
  • Soup and salad - When in doubt, go for a soup and salad from the appetizer menu. The soup will fill you up along with the fiber from the salad. Add protein to the salad and use olive oil as the salad dressing - most Italian restaurants should have great olive oil.
  • Fish - There will likely be salmon or Branzino on the menu, any grilled or baked fish with a side of vegetables is a perfect order. 


Drink

  • Red wine - Go for dry red wine (dry means low in sugar) such as Pinot Noir, Cabernet Sauvignon, and Merlot.
  • Dry white wine - This is great with light meals such as salad or fish. Order a dry white wine such as Sauvignon Blanc .
  • ​Scotch or whiskey on the rocks - If you are not a wine drinker, go for one of these which tend to pair well with heavier meals and will be low in calories when served on the rocks or water.


About the author: Sarah-Kate Rems is an Ivy-league trained Board-Certified Family Nurse Practitioner licensed in California and New York State with an expertise in preventative healthcare. She considers nutrition and exercise to be the basis of well-being and is a strong advocate for daily physical activity and maintaining a healthy diet. Sarah-Kate is also a co-founder of The Mindful Tech Lab


How To Stay Healthy While Eating Out At Brunch

8/28/2017

 
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Who doesn’t love brunch? Just because you are eating healthy doesn’t mean you have to skip your weekly brunch with friends! It’s all about making the right choices so that you can enjoy a meal outside of your kitchen once and a while.
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Here are the best choices for brunch that you should be able to find one or more of on any brunch menu:


Appetizer

Bowl of fruit - Go for the melon and/or berries which have the lowest sugar. Fruits with the greatest amount of sugar include tropical fruits such as banana, pineapple, mango - go easy on these tropical fruits.


Main Course

Eggs benedict - Request for some greens to serve as the “bun” for the eggs and skip the english muffin. Also ask for hollandaise on the side - restaurants typically smother your eggs in so much hollandaise that you can't even taste the rest of the meal. Take back the control and ask for this on the side.

Egg omelette - With lots of veggies. Again skip the breakfast potatoes or toast. If you are extra hungry then add some more fat in the form of avocado, guacamole, or cheese, or consider adding another protein like ground turkey if this is an option.

Egg white omelette - If you are not feeling egg yolks, this is also a great option. Ask to have it made with lots of veggies and hold the breakfast potatoes. Egg whites have zero fat so consider bulking them up with healthy fat such as avocado, guacamole, or cheese (if you can tolerate).

Scrambled eggs - With lots of veggies. Depending how hungry you are, you could consider adding avocado, guacamole, or cheese for some extra fat or another serving of protein such as turkey. Note: be weary of sausage or bacon which are processed meats and may also have had sugar added to them.

Eggs - When in doubt, order a side of 3-4 eggs. Poached is best because the eggs are cooked in water without any added oil.

Oatmeal - PLAIN. No added raisins/maple syrup/brown sugar/honey/agave etc. Berries are ok. This is your choice only if you are really craving something carb heavy or sweet, and if you are between this and ordering the stack of pancakes. Add some cinnamon on top to blunt the blood sugar increase that comes with eating carbs.


Drink

Prosecco - Mimosas are over-rated. Why waste any of that tiny flute space on some high sugar syrupy, over-processed orange juice? Prosecco has enough sweetness in itself, but if you must, ask for just a splash of OJ.

Dry white wine - “dry” is code for low sugar. Under all circumstances go for the drier wines such as sauvignon blanc and chardonnay. Stay away from riesling or white zinfandel tend to basically be grape juice.

Dry rose - Rose in general is pretty sweet. so a dry rose may be hard to find, but still worth asking if the restaurant has one available.


About the author: Sarah-Kate Rems is an Ivy-league trained Board-Certified Family Nurse Practitioner licensed in California and New York State with an expertise in preventative healthcare. She considers nutrition and exercise to be the basis of well-being and is a strong advocate for daily physical activity and maintaining a healthy diet. Sarah-Kate is also a co-founder of The Mindful Tech Lab


Burn Your Own Fat For Fuel Using Ketones

8/27/2017

 
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Have you ever heard of a ketogenic diet? A ketogenic diet means your body is using ketones for energy production rather than sugar. Ketones are an alternative fuel source for the body, and are produced when eating a high fat and low carbohydrate diet. This type of diet is called "ketogenic" because your body is in a state of "ketosis" meaning fueled by ketones rather than sugar (aka glucose).

Here are 9 reasons why you want your body to be fueled by ketones instead of sugar:

1. You literally burn your own fat for energy
Your body can run on either glucose or ketones. Which would you choose? Well, when you look at what this actually means: Glucose is produced from the breakdown of glycogen (strings of glucose), this means you are burning glycogen to produce fuel for your body. Ketones on the other hand are produced from the breakdown of fat (fatty acids), this means you are literally burning your own fat stores to produce energy. You can make ketones from eating very low carb (sub 50 net carbs), fasting, or consuming a product that can induce or supply the production of ketones (such as MCT oil).


2. No more “Hangry”
You know that feeling when are so starving that every little thing is irritating, and you need to eat right. NOW? Terrible feeling right? Blame the carbs! After a blood sugar spike from eating carbs, this will trigger insulin whose job is to get that sugar out of your blood as fast as it can (because sugar in your blood is toxic and inflammatory), resulting in an even lower blood sugar than you started with. Low blood sugar (aka hypoglycemia) is that terrible anxiousness you are feeling. No bueno! And how do you make that feeling go away the fastest? Eating sugar. And the vicious cycle continues.

Fat is the only macronutrient that won't raise blood sugar, and therefore won't spike insulin. Yes, that means protein can also raise blood sugar when eaten in excess. That is why a ketogenic diet favors a higher fat and moderate protein intake.


3. Ketones favor less mental stress
The presence of ketones increases the production of the primary calm inducing neurotransmitter, GABA, while at the same time decreasing the primary stress inducing neurotransmitter, Glutamate. Ketones do this by assisting in the conversion of glutamate to GABA in the brain, thereby favoring a more calming state. Increasing the activity of GABA is essentially what most anti-anxiety medications aim to do as well - pretty cool you can get the same effects by just changing your diet!


4. Ketones favor a more focused state
For the same reason ketones favor calmed brain activity, they also favor a more alert and focused state. As stated above, more GABA compared to glutamate in the brain favors a less stressed state, meaning there is less “noise” in the brain, allowing for greater focus and mental clarity.  This is why medium chain triglycerides (MCT) are marketed as a product that can increase focus and cognition - because they give the body ketones that can be used for fuel without having to be in actual ketosis from eating low carb.


5. Ketones are a more efficient source of energy
Ketones and glucose are both used as fuel by mitochondria to produce energy (aka ATP) - mitochondria are the part of a cell that takes fuel (either glucose or ketones) and manufactures energy from it. When comparing the output of energy produced from the use of ketones vs. glucose, more energy is produced when using ketones, thereby making it a more efficient fuel source. The presence of ketones also up-regulates the amount of mitochondria in cells, so more mitochondria means more energy produced. This is another reason for the improved focus and mental clarity seen with a ketogenic diet. 


6. Ketones act as antioxidants
Research has found that ketones act as antioxidants because they protect against oxidative damage from free radicals. When ketones are used to produce energy (by mitochondria) this process does not cause the release of free radicals, as does glucose when it is used to produce energy. Free radicals aka oxidative damage cause damage to cells and aid in the development of chronic disease, cancer, cognitive decline and other brain diseases, and aging. 


7. Ketones may prevent cancer growth
Compared to normal cells, cancer cells metabolize a much greater amount of glucose meaning they need more glucose to thrive. Cancer cells may preferentially use sugar to fuel their growth and proliferation, and research has shown that they may not be able to use ketones as fuel. Research has also shown greater response to chemotherapy when in a fasting state inducing ketosis. There is more research needed in this area, but ketones as a preventative measure for cancer is looking very promising! 


8. Greater absorption of nutrients
Major vitamin, antioxidants, and other nutrients need to be taken with fat to be able to be absorbed. This includes Vitamin D, Vitamin E, lycopene and beta-carotene such as in tomatoes, and the B vitamins.  Making sure you are taking in plenty of fats will ensure you are getting the most out of your food and supplements.  

9. Ketones are neuro-protective
Fueling the brain with ketones has shown to help with brain disorders such as seizures, brain cancer, Parkinson's Disease,  traumatic brain injury (TBI), and Alzheimer's Disease. There is a widely cited case of a physician who put her husband on a ketogenic diet as treatment of Alzheimer's disease and he improved within a couple of months. More research is needed on the direct effect of ketones for the prevention of diseases that affect the brain, but so far its looking very optimistic!

Side note: Ketones can supply up to 70% of the energy needed by the brain. It is true that your brain requires some glucose to function, but glucose can come from protein, it does not have to come from carbohydrates. It is a misconception that carbohydrates are necessary in your diet - they are not. Protein and fat are the two macronutrients your body definitely needs to manufacture all of the necessary components of the body.

All works cited can be found in the hyperlinks 

About the author: Sarah-Kate Rems is an Ivy-league trained Board-Certified Family Nurse Practitioner licensed in California and New York State with an expertise in preventative healthcare. She considers nutrition and exercise to be the basis of well-being and is a strong advocate for daily physical activity and maintaining a healthy diet. Sarah-Kate is also a co-founder of The Mindful Tech Lab


20 Healthy Living Tips You Need To Know

8/26/2017

 
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Looking for a healthy living cheat sheet? Our resident health expert serves up her 20 health and nutrition tips that everyone should know. Enjoy!
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1. Non-fat or “skim milk” has a surprisingly high amount of sugar. Most brands have about 12 grams per cup – this is almost half the amount of total sugar that is recommended you ingest each day!

2. When you eat protein, you lose 20-30% of those calories to digestion. This means if you eat 100 calories of protein, you only absorb about 70 of those calories.

3. Wheat raises your blood sugar higher and faster than any other carbohydrate including table sugar.

4. Matcha is an excellent source of antioxidants, or “polyphenols,” which protect the body from harmful free-radicals and cellular damage.

5. Cold pressed juice is considered to be more nutrient dense compared to traditional centrifuged juice. This is because centrifugal juicers generate heat which can destroy enzymes, and also force in air which can compromise nutrients.

6. Cooking tomatoes drastically increases its lycopene content. Lycopene is a powerful antioxidant that decreases risk of heart disease and cancer.

7. Cheeses with the lowest amount of lactose are those that have aged the longest. The lower the lactose, the lower the chance of stomach upset from intolerance to lactose.

8. Fiber slows down digestion and makes you feel fuller longer. Healthy adults should aim or 25 grams of fiber per day.

9. Tuna is an excellent source of Vitamin B12, selenium, Vitamin B3 (niacin), and protein - about 20 grams of protein per 3 oz serving.

10. Fish with lowest amounts of mercury include salmon, black sea bass, scallop, shrimp, skate, tilapia, cod, oyster, and crab.

11. Getting enough magnesium may help prevent migraine headaches. Good sources of magnesium include almonds, spinach, and avocado.

12. Foods that are an even greater source of potassium than bananas include sweet potatoes, white potatoes, beets, and butternut squash.

13. Vitamin C helps to boost your immune function and protects against free radical damage. Good sources of Vitamin C include oranges, red peppers, and broccoli.

14. If you are sensitive to dairy products but you love butter, try clarified butter which is pure butterfat with the milk solids removed.

15. Tropical fruits are high in sugar. These include bananas, mangoes, and pineapples. Stick to a ½ cup serving when eating this type of high sugar fruit.

16. The best source of Vitamin D comes from the sun. The second best source is a supplement, and the third and lowest source are foods such as fatty fish, egg yolks, and beef liver.

17. An 8 oz cup of coffee can have between 95-200mg of caffeine. It is recommended to not exceed 400mg of caffeine per day for most individuals.​

18. Studies have found that just short bursts of exercise during the day can help with attention and focus. Aim for a fifteen minute walk at lunch to increase your energy for the afternoon.

19. Clutter can trigger your stress response. Avoid clutter in key areas such as your desk, your car, and in your bedroom.

20. A negative emotional state can express itself on your face as breakouts, dullness, and wrinkles. Practice being in the present for a happier emotional state and a better complexion.

**At The Mindful Tech Lab, we develop and market apps that are easily ingrained into your daily routine to deliver positive results. We are most known for our Facebook Messenger chatbots that help you live your best life, you can check them each out by clicking on their links: MotivateBot, MeditateBot, Daily FitBot, HealthyBot, Eat Clean Bot, StoicBot**

How To Choose A Protein Bar

8/24/2017

 
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Figuring out how to choose a healthy protein bar can be very tricky and I get the question all of the time about how to choose a good one. I always advise reaching for whole food first, but sometimes when you are desperate and starving, having a protein bar on hand can be great. However, most protein bars are full of chemicals and sugar and are no better (or might be worse) than eating a candy bar, yikes! 

Here is a cheat sheet of how to choose a healthy protein bar:

Sugar
Look for a bar with less than 5 grams of sugar (ideally 0-2 grams), and definitely do not grab a bar that has anything over 12 grams of sugar. Even if the label says something like "sweetened with dried fruit" or "natural sugars" bottom line is that sugar is sugar, certain types of sugar may be a little less bad for you, but sugar by any name is still not good for you.


Net carbs
Ideally there will be less than 10 grams of net carbs in the bar - lower the better. Net carbs are the carbs that impact your blood sugar, more sugar in your blood means greater insulin response, and greater insulin response means greater amount of sugar funneled into your fat cells (insulin is the fat storing hormone). You can calculate net carbs by subtracting the total fiber from the total carbohydrates listed. This is because your body does not process calories from fiber and they will not raise your blood sugar.


Protein
Look for a bar with plenty of protein because this is what is going to help to keep you full and help to keep your muscle mass. Protein is the hardest macronutrient for your body to breakdown, meaning it will take longer to be digested which will keep you fuller longer, AND you will burn calories just from the digestion of protein (because it takes energy to break it down). Aim for at least 15 grams of protein in the bar.


Fiber 
More fiber the better, this should be at least over 5 grams. As discussed above, fiber is not absorbed by the body but your body will still work very hard to try and break it down! This means digestion is slowed down when you eat fiber (keeping you fuller longer) and more calories lost from the energy your body puts in to trying to break down fiber.


Fat
Fat will help to keep you full and satisfied because it takes a longer time to digest and will not raise your blood sugar at all - meaning no insulin response, yay! It will also make the bar taste better - be weary of any "fat free" protein bar, this usually means there is added sugar to make it taste better. Aim for at least a couple grams of fat.

Ingredients
This might be the most important aspect of the protein bar because most bars are full of chemicals which can throw off hormones and may even cause you to gain weight. Ideally there will be under 10 ingredients on the list, you will be able to pronounce all of the ingredients, there will be no chemical names, and all ingredients will be from whole food source such as almonds or coconut. 

​Good luck!


Sarah-Kate Rems, NP
Co-founder, The Mindful Tech Lab - Check out all of our amazing apps to help improve your life here

Blame it on the FODMAPs.

8/22/2017

 
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Patients come into my office everyday for stomach issues (gas, bloating, constipation, etc) and believe that gluten must be the sole culprit. Yes, gluten certainly can wreak havoc on the body, but another factor could be an intolerance to one or more types of FODMAPs. FODMAPs are short chain carbohydrates found in virtually all gluten containing food products and can cause the same undesirable gastrointestinal side effects as gluten.
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FODMAP stands for “fermentable oligosaccharides disaccharides monosaccharides and polyols" and include fructans (wheat, pastries, pasta), galactans (chickpeas, lentils, beans, soy), lactose (all dairy products), fructose(honey, apples, pears), and polyols (sugar alcohols such as sorbitol and stone fruits such as as avocado). Foods range in their amount of FODMAPs, some having very low amounts that are unlikely to cause stomach issues, to foods that have very high amounts which are most likely to cause problems.

FODMAP containing foods may only cause side effects when eaten in large amounts (i.e. the American diet) so just because your favorite food is on the high FODMAP list does not necessarily mean it needs to be completely eliminated from your diet. Figure out if you have sensitivity to FODMAPs by cutting out FODMAP containing foods for a few weeks and then slowly re-introducing them back into your diet one at a time, and/or pay attention to how you feel after eating FODMAP rich foods.

Below is a list of FODMAP containing foods - from low amounts of FODMAPs to high amounts.
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​Sarah-Kate Rems, NP
Co-founder, The Mindful Tech Lab - Check out all of our amazing apps to help improve your life here

What You Should Know Before Starting a Keto Diet

8/10/2017

 
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A ketogenic diet means that most of your calories are coming from fat, you are eating a moderate amount of protein, and keeping carbs low - around 50 grams net carbs. In my opinion, when done correctly this type of diet is best for controlling and preventing chronic disease - most notably diabetes and obesity - and can make you feel awesome! Note: I advocate for a little more protein and a little more carbs than the traditional hardcore ketogenic diet (i.e. carbs under 20 grams) and I am a proponent of a cyclical ketogenic diet which means carb refeeding 1-2 days per week - more on this below and in a future post. 

Here are some things to know before starting a ketogenic diet:

1. You need to increase your salt intake
When you are in ketosis your body will rapidly be shedding electrolytes, most notably sodium, from your kidneys. Unless you have a medical condition by which you are forbidden to eat salt, add sea salt or Pink Himalayan Salt to your meals, and opt for bouillon balls and/or bone broth as other ways to get salt into your body.

2. You need to increase your fluid intake
Water follows sodium, so as your kidneys are shedding off more sodium you are going to lose more water as well. Carbohydrates also hold onto water, so eating less carbs means less water stored in your body, and that you need to increase your water intake. Shoot for 2-3 liters of fluid per day at least.


3. Don’t eat too much protein
It’s hard to eat too much protein, but it is still good to know that yes, you can have too much. Too much protein can cause your body to convert the excess amino acids to sugar, and sugar triggers the release of insulin (fat storage hormone) which can lead to fat gain. A rough estimate of how much protein you should be getting is 0.7-1.0 grams per pound of body weight. More protein is needed for an individual who exercises hard daily, because more amino acids will be needed to repair the muscle that has been broken down.

4. 
Expect the keto "flu"
As your body switches from sugar burning to fat burning for fuel this can cause what is known as the “keto flu.” It means you may feel lethargic, foggy, and run-down. Do not worry - this will not last long but does happen when switching to this type of diet.

5. Stick to healthy fats
Ketosis does require most of your calories to come from fat, that being said, you want to stick to the good non-processed, grass-fed, natural fats. These include eggs, fatty fish, coconut oil, olive oil, full-fat dairy, avocado, and nuts. Things to definitely avoid include processed meats and processed cheeses.

6. 
Consider increasing carbs one or two days a week
I am a huge fan of a cyclical ketogenic diet which means you are increasing your carbs 1-2 days per week, or having a "carb-refeed." Individuals working out hard everyday or few days a week will burn through their glycogen stores faster, and may need to increase their carbs twice a week or more. The hormone leptin which helps to regulate appetite, can also become low on a ketogenic diet and is boosted up when you eat carbs. Women are especially susceptible to leptin changes and should definitely be re-feeding carbs 1-2 days a week at least. Probably the only group of individuals who may not see a benefit from increasing carbs once a week are men who do zero exercise - which hopefully fits the description of no one reading this because exercise is great for your body and mind! 

7. You might develop dry eyes
This happens when you are eating very low carbs for a long time because tear production requires some glucose. This symptom actually happened to me long before I understood a keto diet could cause this, and can be very irritating and even lead to more severe eye problems. When your eyes are getting very dry this may mean you need to up your carbs a little more daily, and increase the number of days you do a carb-refeed.

Look for an upcoming most where I will go over all the benefits of a cyclical ketogenic diet :)

Sarah-Kate Rems, NP

Co-founder, The Mindful Tech Lab - Check out all of our amazing apps to help improve your life here

What To Order At The Mexican Restaurant

7/27/2017

 
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I get questions from patients all the time about how to eat at a restaurant without derailing their diet. Of course cooking your own food is best because you can control everything that goes into it (not to mention you save a lot of money!) but when you want to be social and go to dinner that’s ok too!

​Here is what you should order when eating at a Mexican restaurant:


Appetizer:
  • Guacamole - Carve out 2-3 spoon fulls onto your plate and dig in or add some salsa on top. Guacamole is full of healthy fats with zero carbs and will keep you much better satisfied than a basket of chips.
  • Ceviche - This consists of raw fish (normally sushi grade) in citrus with maybe some diced tomatoes - you can’t get much healthier than that! This is a light, tasty, and low carb way to start your meal.

Main Course:
  • Fajitas - With lots of grilled vegetables, pico de gallo, and salsa as a topping to add flavor. Skip the rice and tortillas and see if they can substitute in extra veggies instead. If you are going to keep the beans go for black beans rather than refried because they have gone through less processing and contain more fiber. If you are low carb, skip the beans and ask for a side of avocado or guacamole instead.
  • Grilled chicken - With lots of vegetables. Skip the rice here as well, instead add add a side of avocado or black beans.
  • Grilled fish - With lots of vegetables. Skip the rice here as well. Top with salsa or consider adding a side of avocado or black beans.

​Drink:
  • Tequila on the rocks - A shot of tequila has around 70 calories and will take a longer time to sip.
  • Skinny margarita - Tequila w/ soda and lime is great because you get the bubbles from the soda water and a hint of lime to pair with the tequila. This will also be easier to sip rather than a sugar bomb of a margarita - a margarita can have a whole days worth of sugar and calories! 
  • Light beer - If you can’t see yourself not ordering a Mexican beer with your Mexican food, then go for a light version such as corona light.

Sarah-Kate Rems, NP
Co-founder, The Mindful Tech Lab - Check out all of our amazing apps to help improve your life here

How to Choose a Probiotic

7/20/2017

 
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A healthy gut flora is incredibly important to prevent disease and to promote a healthy body. The bacteria in your gut work for you by killing off harmful invaders, help you to absorb nutrients, enhance your immune system, and help to digest your food. However, choosing the right probiotic is tricky because there are hundreds of different types of probiotics on the market and it can be difficult to know which one to choose.
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Here is a list of 10 considerations when choosing a probiotic:
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1. Probiotic must have at least 5 billion CFU
Your gut has literally trillions of bacteria and for a probiotic to make any sort of impact you need to find a probiotic that has billions of CFU (colony forming units - aka amount of bacteria). Don't look twice at a probiotic if it has anything less than"billions CFU" listed on the nutrition facts section.

2. Multiple strain or single strain probiotic?!
One good single strain is better than multiple strains that don’t do anything. The most important thing to consider when choosing a probiotic is what type of strain(s) it contains - good brands of probiotics will list the evidence showing their strain(s) of bacteria efficacy on their website.

3. If you are constipated
One strain in particular that has shown effective in numerous studies for reducing constipation is Bifidobacterium lactis. Other strains that may help with constipation include Lactobacillus rhamnosus, Bifidobacterium animalis, Bifidobacterium longum,  and Lactobacillus plantarum.

4. If you have diarrhea or want to prevent traveler’s diarrhea
Strains that studies have shown to help with preventing diarrhea or traveler's diarrhea include Lactobacillus rhamnosus, Lactobacillus casei, and Saccharomyces boulardii.

5. If you want to lose weight
Probiotics that have shown to help you lose weight include species of Lactobacillus, specifically Lactobacillus rhamnosus and Lactobacillus gasseri. VSL# 3 is a probiotic in particular that may help with weight loss because it has been shown to promote satiety by increasing GLP-1  (satiety inducing hormone).

6. If you want to gain weight
Strains of Lactobacillus acidophilus have been shown to help you gain weight.

**Note** Before you go and throw away your probiotic that has L. acidophilus because you have been trying to lose weight, understand that there are many types of L. acidophilus and not all will necessarily promote weight gain.

7. If you are taking antibiotics
Antibiotics are sometimes necessary for large bacterial infections. Unfortunately, antibiotics will also kill off good bacteria which can lead to stomach upset and even weight gain and immune suppression. Start taking probiotics immediately when prescribed antibiotics and continue taking the probiotics for 2-3 weeks even after you have finished the course of antibiotics. Aim to take the probiotic a few hours from the antibiotic because there is the possibility of the antibiotic inactivating the probiotic - remember antibiotics kill bacteria and probiotics are bacteria.

8. If you have IBS
As of date, the best strains to treat IBS symptoms come from Bifidobacterium, particularly Bifidobacterium infantis. IBS can include alternating periods of bloating, constipation, diarrhea, gas, and stomach pain.

9. If you are prone to bacterial vaginosis
Bacterial vaginosis is often associated with low vaginal lactobacilli bacteria. Lactobacillus acidophilus and Lactobacillus rhamnosus are two strains that studies have shown to increase vaginal lactobacilli and decrease incidence of recurrent bacterial vaginosis.

10. If you get frequent urinary tract infections (UTIs)
Studies have shown that both Lactobacillus acidophilus and Lactobacillus rhamnosus can reduce and may prevent the incidence of UTIs. Studies have also shown that when antibiotics were taken with probiotics for treatment of an active UTI,  treatment outcomes were better for those who took the probiotic.

​Sarah-Kate Rems, NP
Co-founder, The Mindful Tech Lab - Check out all of our amazing apps to help improve your life here
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