I’ve been there… I understand how the struggle feels.

For many of us, the desire to lose weight, whether it’s 5 pounds or 50 pounds, transcends just wanting to look good.  Being in a right-sized body (for you) often goes hand-in-hand with wanting to feel well physically, emotionally and mentally—less aches and pains, more energy, focus, strength, vitality and confidence…

About 15 years ago, I went through a period of what seemed like steady weight gain. It wasn’t a dramatic increase, but every time I stepped on the scale, I seemed to gain another pound. I felt frustrated, dismayed and confused because I thought I was doing all the “right” things and did not understand what caused the weight gain. My usual go-to solution of increasing the intensity and/or frequency of my workouts (already 2 hours) backfired on me …in fact, as a result of exercising more, I gained even more weight!  Since then, I’ve learned “eating less” and “exercising more” is rarely a long-term sustainable weight loss solution.

Weight gain is a symptom that something—physically, emotionally, psychologically or spiritually—is out of balance in your life. And, until that imbalance(s) is addressed, any weight you lose via extreme diets, surgery, or weight loss injections (e.g, Ozempic, Wegovy), is very likely to come back.

If you have been doing all the “right” things—eating “healthy”, watching portion sizes, doing harder, longer or more frequent workouts—yet, you’re still not losing weight, these may be the reasons why.

1.   You have nutrient deficiencies that stall fat loss.

When clients schedule an initial consultation with me, I typically review their bloodwork (from a recent physical) beforehand for potential red flags.  If weight loss is a goal, your bloodwork can reveal nutrient deficiencies that prevent you from achieving the weight loss results you want.

Common nutrient deficiencies that can stall fat loss include:  Iron / ferritin (Ferritin is a blood protein that stores iron, and it is an indicator of whether your iron stores are high or low. For example, low ferritin can indicate iron deficiency anemia.).  Vitamin B12. Folate. Zinc. Vitamin D3. Magnesium.

Iron, folate and vitamin B12 are essential nutrients in the production of healthy red blood cells, which transport oxygen from the lungs to the cells of the body.  Iron deficiency anemia is associated with increased body weight and BMI (1). 

Your cells need oxygen to function optimally: less oxygen translates to less fat burning! A ferritin level, somewhere between 70 and 90 units and B-12, in the high-middle to upper ranges, are in optimal ranges.

Zinc, magnesium and Vitamin D3 are also important for fat loss and metabolism. Why? Because these nutrients affect insulin sensitivity (2, 3, 4).  When your body is insulin sensitive, you are able to lose weight more efficiently.

Unfortunately, because of chronic stress, medications, high-sugar diets, poor gut health and hormone imbalances, many people today are woefully deficient in these vitamins and minerals.

Could you have nutritional deficiencies? This nutrient panel offers insights needed to make informed decisions about nutritional intake and supplementation.

2. You are relying ONLY on exercise to lose weight…and you haven’t changed your food choices.

In my practice, a common confession (or pledge) that I hear is: “I need to—or I intend to—go to the gym more.”

The hard truth?  Body transformation is 80% food choices and 20% movement. Don’t get me wrong: our bodies are designed to move.  Exercise has myriad health benefits, but exercise alone will not help you lose weight.

A few things happen when you rely only on exercise to lose weight.

Exercise can cast a “halo effect” on less healthy choices.  For example, if you’ve exercised vigorously for an hour, you may feel that your calorie-burning efforts entitle you to eat (or overeat) a favorite processed food—pizza, cheesecake, soda, etc.

You burn way less calories than you think. In reality, it is difficult for most people to create a calorie deficit through exercise alone.  Eat one New York-style slice of pizza, and you are consuming over 400 calories, roughly 20 grams of unhealthy fat and loads of sodium. Or, maybe you have a Shake Shack Double Shackburger (855 calories) and an order of fries (420 calories) at lunch. In either case, you would have to spend a lot of time and energy exercising to ”burn off” those calories. The average person burns approximately 100 calories for every mile of walking or running; that’s it!

Exercise is usually the first thing to go when my clients get busy or they have to travel…”no time”!

Exercising more creates a hormonal chain reaction (5). Increasing the frequency, duration and/or intensity of exercise—like running, biking, power walking—creates a hormonal domino effect. In other words, more exercise can also intensify hunger and cravings. This can cause you to overeat or to crave fatty, high-sugar, carb-starchy or salty foods and sabotage your weight loss efforts.

Too much exercise (for your body) or overtraining can lead to hormone imbalances; for example, elevating cortisol (stress hormone) levels or negatively impacting thyroid function—causing you to gain weight.

You have acquired mobility issues. In recent years, I have worked with many clients who have acquired mobility issues due to chronic medical conditions (e.g., arthritis or respiratory problems); injury; accidents; chronic pain (especially the knees and/or back); and neurological complications, including impaired mobility, from the C*V*D-19 vaccine. In all of these cases, “exercising more” was not an option.

3.  Your hormones are not in balance.

We tend to think of hormones as they relate to a woman’s menstrual cycle, pregnancy, or male erectile dysfunction. But hormones are vital to our existence. They act as chemical messengers in our body that control bodily functions, such as hunger, energy, cravings, sleep and mood.  For example, ghrelin is a hormone that stimulates hunger and promotes fat storage, while leptin is a hormone that signals satiety (feeling full).  When these signals get crossed, you can gain weight (6). Certain hormones tell the body to burn fat or store fat (7).

Thyroid dysfunction is a common hormone imbalance.  I, myself, have hypothyroidism, an underactive (low) thyroid, and I understand, firsthand, how the thyroid can affect your metabolism.  Prior to my diagnosis in 2013, I worked out 2 to 3 hours almost daily (under the misguided notion that more exercise = weight loss) and could not fathom why I was still gaining weight!!

Once I addressed my thyroid dysfunction—by making different food and lifestyle choices; through targeted supplementation; by taking natural thyroid hormone and low dose bioidentical hormones; incorporating stress reduction strategies (other than “the gym”); working on negative self-talk and resolving past trauma—my overall health improved dramatically. By the way, my food choices and lifestyle evolved over time—not overnight!

Over the last year, my workout routine has changed dramatically because of my busy schedule. These days, I prioritize walking 5 to 6 miles daily (cumulative over the day), and I engage in thyroid-friendly metabolic conditioning workouts (under 20 minutes) about 3-5 times a week—in my bedroom! This is what I have time for during this particular phase of my life…and that’s okay. Moving my body regularly is the goal.

Your thyroid is the main metabolism gland.  Every cell  in your body has receptors for thyroid hormone; as a result, the thyroid also controls how sensitive your body is to other hormones, like estrogen, progesterone, testosterone, insulin and cortisol.  If your thyroid is off—either underactive or overactive—other hormones and bodily functions are affected. If you have an underperforming (low) thyroid, you may have low energy, fatigue, brain fog, depression, anxiety, mood swings, a sluggish metabolism and feel cold all the time.

If your thyroid is not working properly, you will  have a hard time losing weight.  You will also likely have digestive issues (such as constipation) and poor elimination; the inability to poop—at least once a day—also contributes to extra weight.

Hormone imbalances occur after giving birth; at perimenopause (the period of hormonal fluctuations prior to menopause that can start from age 35 and last up to 10 to 13 years); menopause (absence of a period for one year); and andropause (a.k.a., male menopause, where testosterone gradually declines, beginning around age 40).

That said, poor food and lifestyle choices—at any age—can lead to hormonal imbalances that cause weight gain.

These imbalances can include insulin resistance, where the body is producing too much insulin (a fat-storing hormone); adrenal dysfunction (under duress, the adrenals release cortisol, a stress hormone; excess cortisol stores fat); and, sex hormone imbalances (e.g., too much or too little estrogen, progesterone or testosterone), like PCOS (polycystic ovarian syndrome) or uterine fibroids.

Discover what your current hormone status is with a Healthy Women’s Lab Panel OR the men’s Testosterone and Prostate Health Panel.

4.  You use calorie counting as your only approach to losing weight.

We have been programmed to believe that we can lose weight simply by cutting calories—either by eating less calories and/or by “burning off” extra calories by exercising more.  This approach treats the body like it is a calculator: Calories In = Calories Out.

Cutting calories usually does result in short-term weight loss.  But, at some point, the weight loss will stop. Why?  Because your body is highly adaptive; it operates more like a thermostat. Your body perceives a low-calorie diet as “STRESS!!”; and, in response to perceived “starvation”, it adapts to a lower calorie intake.  As a result, your metabolism slows down in order to hold onto every calorie it gets—and those calories are more likely to be stored as fat!

Calorie restriction (that is too low for your body and/or consists of mostly ultra-processed foods) also throws your hormones out of balance: you’ll know this because you will feel tired or low energy; feel hungry; and have cravings for fatty, sugary, salty and/or high-calorie foods.

Remember: all calories are not created equal.  What happens when your “breakfast” consists of a Dunkin’ Donuts “Reduced Fat” Blueberry Muffin (410 calories, 40 grams of sugar) and a small iced coffee sweetened with brown sugar syrup (110 calories), versus a 3-egg vegetable omelet (apx. 368 calories) and one cup unsweetened green tea (0 calories)?  Your choices will affect your hormones differently.  For example, the Dunkin’ Donuts combination of caffeine, sugar and fat will increase hunger and cravings, whereas a vegetable omelet, containing protein, fiber and healthy fat, promotes satiety and stable blood sugar.

In my practice, I encourage clients to choose hormone-balancing foods—not count calories.  Weight loss is often a happy side effect of balanced hormones (not the other way around).

5.  You have undiagnosed food sensitivities.

If there is one thing that irritates me to no end, it’s the misguided notion that we can all eat whatever we want or love—as long as it’s in “moderation”.

Sorry…I vehemently disagree.

In my Healthy Body Reset program, clients can choose to eliminate common allergenic foods for 30 days.  Food sensitivities are rampant, and if you have them, you can struggle with losing weight—even if you’re eating “healthy”.  A food sensitivity is not the same as a food allergy, like a peanut allergy, which triggers an immediate immune system response, such as swelling of the tongue and throat, after an exposure.

A sensitivity is usually a delayed reaction (up to 3 days) to a food, drink or food compound that is poorly tolerated by the body.  It can manifest, among other symptoms, as bloating, gas, heartburn, joint pain, fatigue, brain fog, mood swings, acne, migraines, hives, rashes and/or weight gain.  Sometimes, your body responds to a food sensitivity by retaining water.  Food sensitivities can also affect hormones that affect your digestion or metabolism, preventing weight loss (8, 9).

I, myself, have multiple food sensitivities. In addition to gluten, grains, dairy and soy, I have a strong intolerance to “healthy” foods, like apples, figs, citrus and button mushrooms!   Every client with whom I have worked has had at least one food sensitivity (usually more).

We often develop sensitivities to foods that we eat regularly or every day.  When you constantly eat foods to which you are sensitive, this puts your immune system in overdrive, creating a chronic state of inflammation. Some common food sensitivities include eggs, corn, gluten, dairy and soy.

If you’re unsure whether food sensitivities are an issue for you, consider my Do-It-Yourself 7-Day Body Reset Detox program, a whole foods-based detox (so, yes, you will be eating!) that eliminates common allergenic offenders for 7 days, then reintroduces one at a time.

6.  You have gut issues.

Your gut microbiome is home to trillions of microbes, consisting of some 1,000 species of bacteria, both good and bad (10). Approximately 80% of your immune system resides in your gut.  When your gut flora is in balance, it supports healthy digestion, protects you from infection and regulates metabolism.

If the ratio of bacteria in your microbiome is out of balance, where bad bacteria outnumber the good bacteria, this can, over time, lead to chronic diseases, including inflammatory bowel disease, diabetes, heart disease, cancer, autoimmune conditions, like rheumatoid arthritis, and obesity (11, 12).

What creates unhealthy gut flora?  Prescription drugs (e.g., antibiotics and other medications). Birth control pills. Nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin and ibuprofen (e.g., Advil, Motril).  A diet high in processed foods, refined carbohydrates and sugar.  Infections.  Stress. A diet high in inflammatory foods, like wheat and highly refined “vegetable” oils (canola, soybean, corn) that cause intestinal permeability. Overconsuming alcohol (13).

Studies have shown that the microbes living in your gut can determine, to some extent, how easy it is for you to lose weight and how well your metabolism functions.  For example, when too many bad bugs reside in your gut, your body can make too much insulin, which can lead to insulin resistance (14).

How do you know if you have gut issues?  If you have flatulence (gas), IBS, constipation, diarrhea, anxiety, depression, mood swings, joint pain, migraines, any kind of skin condition (eczema, rosacea, psoriasis), chronic sinusitis, post-nasal drip, to name just a few symptoms, you have gut issues!

Can you heal your gut with a probiotic?  Unfortunately, there is no magic bullet. A probiotic is most beneficial when you support your overall health with an anti-inflammatory, hormone-balancing food choices and healthy lifestyle habits.  Once these are in place, you’ll experience the maximum benefits of taking a probiotic.

7.  You skimp on sleep.

If you don’t get enough sleep, you won’t lose weight as quickly as you want—or maybe not at all.

Studies have linked poor sleep with a higher BMI (body mass index) and weight gain (15). In one experimental study, participants—16 healthy adults (ages 22 to 26) —were allowed to sleep 5 hours for 5 consecutive nights.  The result? They gained, on average, approximately 2 pounds (16).

This study reflects my own experience with sleep loss and weight gain.  If I sleep 6 hours (instead of 8), I am, literally, two pounds heavier when I step on the scale in the morning!  Though sleep needs can vary from person to person, most studies have linked changes in weight to people who sleep less than 7 hours nightly (17).

Oversleeping (10-plus hours every day) can be a symptom of poor health (e.g., heart disease) and depression.  The reality, however, is that most people need 8 to 9 hours of sleep for optimal health, including weight management.  If you have a hormone imbalance, like PCOS, or, an autoimmune condition, like Hashimoto’s thyroiditis, your sleep needs are greater—8 to 9 hours.  Being hypothyroid, I know that I need at least 8 hours of sleep.

Sleep has a lot to do with how our bodies gain and lose weight.  Yes…we’re back to hormones!  When you get too little sleep OR you regularly sleep against your natural circadian rhythm (for example, working the graveyard shift), this elevates cortisol, the stress hormone. A consistently high level of cortisol makes you vulnerable to gaining belly fat.  Getting enough sleep also helps you produce human growth hormone (HGH), which helps you lose fat and gain muscle. Blow off sleep…and you deprive your body of a hormone that helps you get the results you want.

Lack of sleep triggers a hormonal domino effect that often leads to overeating. When you don’t get enough sleep, your body makes more ghrelin (the hunger hormone) and less leptin (the satiety hormone), which leaves you feeling hungry and ravenous.  Sleep deprivation raises cortisol levels, which can also increase appetite—and prevent you from losing fat because you make less HGH (human growth hormone).

Researchers found that sleep loss affected eating patterns. Cravings, especially for carbohydrates, intensified.  Study participants also ate smaller breakfasts and larger nighttime meals, eating more carbohydrate, protein and fiber calories—by as much as 42%.  Snacking after dinner, particularly on carbohydrates, also increased, setting the stage for overeating calories and weight gain (18).

Obviously, if you don’t sleep enough, you will feel more exhausted and less likely to exercise. And, so, the cycle continues.

8.  You take a medication where weight gain is a side effect.

Commonly prescribed medications can contribute to weight gain. These include—but are by no means limited to—the following:

–Statins. Statin use is associated with increased calorie intake due to reduced levels of leptin, the satiety hormone, which can lead to weight gain. In a 2018 study published in Physiological Reports, researchers conducted an invitro experiment using human white preadipocytes cells that were treated with 2 statins, simvastatin and atorvastatin. The objective was to see the direct effect that statins would have on leptin expression; in other words, would statin treatment increase or decrease leptin levels?

What they found: in response to atorvastatin and simvastatin treatment, leptin levels decreased by 20% (19). When leptin is low, this signals “starvation!” to the brain, and, consequently, triggers an increase in appetite that leads to greater food intake—and weight gain over time.

–Corticosteroids (aka, glucocorticoids). A synthetic prescription medication (e.g., Prednisone, cortisone shots, etc.) that reduces inflammation in the body, corticosteroids are often prescribed for pain relief; autoimmune conditions, like lupus or rheumatoid arthritis; or, health conditions, like asthma or eczema. While glucocorticoids, a subcategory of corticosteroids, can be an effective treatment for pain, weight gain is a common side effect of long-term glucocorticoid treatment (20). In one study, researchers found that substantial weight gain occurred in 70% of all patients using chronic corticoid therapy (21). The weight gain associated with glucocorticoid therapy—in apx. 20% of patients—can be significant…upwards of 22 pounds or more in the first year of treatment (22).

–Beta blockers. Used to treat heart and circulatory conditions (e.g., coronary artery disease, angina, hypertension, etc.), beta blockers are strongly linked with weight gain, especially in the first few months of treatment (23, 24). Beta blockers can also negatively affect cholesterol and insulin sensitivity, increasing the potential for new onset diabetes (25, 26).

–Psychiatric drugs. As of 2023, 11.4% of adults, ages 18 and over, took a prescription medication for depression, with women (15.3%) being twice as likely to be taking an antidepressant than men (7.4%) (27). Among antidepressants, most SSRI’s (Selective Serotonin Reuptake Inhibitors), like Paxil, Lexapro and Zoloft, are associated with weight gain, especially if taken long-term (a year or more) (28).

Weight gain is a common side effect of psychiatric drugs used to treat depression, anxiety, bipolar disorder and schizophrenia (29). Psychotropic medications, including antidepressants, antipsychotics and mood stabilizers, can potentially cause a weight gain of 4 to 37 pounds over the course of treatment (30). 

–Birth control pills. If and when you started taking the pill, did you gain weight? I know I did! I was 21 when I took the pill. Within 3 months, I gained 10 pounds, despite being very physically active. I felt miserable and out-of-balance because I was bloated and swollen all the time. After 3 months, I stopped taking the pill—and never ever  took hormonal contraceptives after that experience. Although the mainstream medical narrative often dismisses anecdotal reports of the birth control pill causing weight gain as a “myth”, “many women report weight gain as a side effect, and it’s actually listed as a side effect in the package inserts,” writes Dr. Jolene Brighten, a naturopathic endocrinologist  and author of Beyond the Pill  (31). When you’re on the pill, your body is trying to process synthetic (lab-made) forms of estrogen and progesterone—often much more potent than natural estrogen and progesterone—which can then promote fluid retention; affect hormones regulating hunger, appetite and metabolism; and negatively affect liver and gut health, also key in weight management.

Deciding to stop or taper off a medication is always a conversation you need to have with your doctor. For example, you should never stop taking an antidepressant (especially SSRIs) cold-turkey because you can potentially experience severe withdrawal symptoms.

9.  You have experienced trauma.

“Trauma” literally means wound, shock, or injury. Psychological trauma results from an event—it can be a one-time occurrence or an ongoing series of occurrences—perceived as harmful or life-threatening (32). There are different types of trauma, including acute (e.g., a car accident, assault), chronic (e.g., bullying; emotional, physical and/or sexual abuse); and complex (e.g., repeated child abuse).

Trauma can adversely impact weight.

Interestingly, the significance of Adverse Childhood Experiences (ACEs) was accidentally discovered in an obesity clinic run by Dr. Vincent Felitti, chief of Kaiser Permanente’s Department of Preventive Medicine, in 1985. Felliti’s program had a 50% dropout rate every year for 5 years. Mystified, and wanting to understand why this was happening, Felitti and his colleagues interviewed a sample of dropouts. What they discovered: Of the 286 dropouts interviewed, most had been sexually abused as children (33).

This discovery led Felliti and Dr. Robert Anda, a medical epidemiologist, to develop a scoring system for ACEs. An ACE score refers to the cumulative score of adverse childhood experiences that one has lived through between ages 0 to 17. The ACE score includes the following categories: abuse (physical, emotional or sexual); neglect (emotional or physical) and household challenges (domestic violence, substance/alcohol abuse, mental illness, parental separation/divorce and incarceration, where a household member went to prison) (34). A higher ACE score indicates greater exposure to childhood trauma and, consequently, a higher risk of medical, mental, and social problems as an adult.

In a 2022 study published in Clinical Child Psychology and Psychiatry, researchers found that ACEs are not just associated with the prevalence of obesity, but also with its severity: patients with severe obesity were more likely to have a a high ACE score (50%) compared to others (24-25%). Also, the average Body Mass Index (BMI) in the high-risk ACE group was nearly 4x higher than those in the low-risk ACE group (35).

Experiencing abuse in childhood, especially sexual abuse, significantly changes a victim’s brain, altering its function, cognition and emotion (36). Trauma can also result in a hypervigilant nervous system, where your nervous system is always on “high alert” for potential threats. Your fight-or-flight stress response is always “on”, which increases levels of cortisol, a fat-storing stress hormone. Chronically elevated levels of cortisol is linked to weight gain.

To this point… In a study published in Pediatrics, researchers tracked the body mass development of two groups of females over two decades, from ages 6 to 27. One group consisted of 84 females with confirmed childhood sexual abuse. The second group consisted of 89 females (demographically similar to the first group) who had not been abused. What researchers found: While obesity rates were not different in childhood or adolescence for both groups, once these women reached young adulthood (ages 20 to 27), the sexually abused female subjects were significantly more likely to be obese (42.3%) than the non-abused group (28.4%). (37)

Unfortunately, childhood sexual abuse, including incest, is an all-too- common form of trauma. For example, when I worked with 61-year-old Tamara (not her real name), weight loss was a main goal as she had long struggled with her weight. When Tamara shared her history with me, I understood why her struggle felt so mammoth: Tamara had been repeatedly sexually abused by six different family members between the ages of 6 and 10. At 21, she married a man who physically abused her for years before she was able to leave him. Trauma elevates stress hormones and affects hormone signaling that can contribute to overweight and obesity. Extra weight may also serve as a subconscious form of “protection” from an abuser, of which many victims are not consciously aware.

10.  You are over-exposed to environmental toxins on the regular.

Nearly 20 years ago, when I was a freelance writer, the health editor at Oprah Magazine asked me to write a piece on “obesogens”. I had never heard of environmental obesogens before, and I had no idea how they could possibly affect health. After interviewing a number of experts for the article, I learned that:

Environmental toxins, many of which are synthetic chemicals, a.k.a., endocrine disrupting chemicals (EDCs), are called “obesogens” because EDCs can interfere with our endocrine system and, consequently, the hormones that regulate our weight and metabolism (38).  The endocrine system consists of tissues and glands, like the thyroid, pancreas, pineal and adrenal glands, that create and release hormones that affect weight and metabolism (39).

EDCs can disrupt natural hormone balance and function and metabolic processes, leading to increased fat storage and weight gain by (40, 41):

–Increasing the total number of fat cells
–Increasing fat storage in existing fat cells
–Increasing production of new fat cells
–Shifting calorie burning to calorie storage
–Altering your gut microbiome to promote food storage
–Altering hormones that affect appetite and fullness

At last count, 1,000 chemicals were identified as endocrine disrupting chemicals (42).  EDCs are found in virtually every product we consume, including pesticide-sprayed produce and grains, personal care products, cosmetics, food and beverage packaging, toys, infant formula and baby food, carpets and household cleaning products, among many others (43). Contact with EDCs can occur through inhalation (the air we breathe); absorption (through products applied to the skin); ingestion (food that we eat); and through the water we drink. Even low doses of EDCs can negatively affect our endocrine system and lead to health problems, especially in utero and in children (44).

A few common EDCs include (45):

–Bisphenol A (BPA). Used in plastics

–Phthalates. Used to soften plastics and also as a fixative for scent. Found in everything, from shower curtains and garden hoses, to personal care products. Phthalates also leach into food through food packaging; e.g., fast food, canned food and processed foods (46).

–Atrazine. A synthetic herbicide sprayed on crops like corn, sorghum and sugarcane, as well as lawns and golf courses.

–Organophosphates. Used as insecticides and herbicides sprayed on conventional crops.

–Organobromines. Used as flame retardant.

–Monosodium Glutamate (MSG). Used as a seasoning for frozen foods, salty snacks, sauces and sausages.

–Perfluorooctanoic acid (PFOA). Used in non-stick cookware, waterproof clothing and microwaveable food items.

While we cannot avoid or remove EDCs entirely, we can make informed choices—whether it means choosing organic food, filtering our water or using less plastic and more glass—to reduce our exposure to EDCs as much as we can.

I know… It’s easy to feel overwhelmed but start small. Try a 7-Day Seasonal Cleanse, where you will be eliminating inflammatory offenders and making mindful food (emphasis on organic) and self-care choices.

Sources:

1  Aktas G, Alcelik A, Yalcin A, Karacay S, Kurt S, Akduman M, Savli H. Treatment of iron deficiency anemia induces weight loss and improves metabolic parameters. Clin Ter. 2014;165(2):e87-9.

2  Marreiro, D.D.N., Fisberg, M. & Cozzolino, S.M.F. Zinc nutritional status in obese children and adolescents. Biol Trace Elem Res 86, 107–122 (2002).

3  Naghmeh Mirhosseini, Hassanali Vatanparast, Mohsen Mazidi, Samantha M Kimball, Vitamin D Supplementation, Glycemic Control, and Insulin Resistance in Prediabetics: A Meta-Analysis, Journal of the Endocrine Society, Volume 2, Issue 7, July 2018, Pages 687–709,

4   Cahill F, Shahidi M, Shea J, Wadden D, Gulliver W, Randell E, Vasdev S, Sun G. High dietary magnesium intake is associated with low insulin resistance in the Newfoundland population. PLoS One.2013;8(3):e58278.

5  Hall KD, Guo J. Obesity Energetics: Body Weight Regulation and the Effects of Diet Composition. Gastroenterology. 2017 May;152(7):1718-1727.e3.

6, 7  Lose Weight Here.  Jade Teta, ND. Rodale, 2015.

8  Hayes PA, Fraher MH, Quigley EM. Irritable bowel syndrome: the role of food in pathogenesis and management. Gastroenterol Hepatol (N Y). 2014 Mar;10(3):164-74.

9  Brazilian Archives of Biology and Technology. Vol. 60. Curitiba. 2017.

10  Pugin, B., Barcik, W., Westermann, P., Heider, A., Wawrzyniak, M., Hellings, P., … O’Mahony, L. (2017). A wide diversity of bacteria from the human gut produces and degrades biogenic amines. Microbial Ecology in Health and Disease, 28 (1).

11  Zhang YJ, Li S, Gan RY, Zhou T, Xu DP, Li HB. Impacts of gut bacteria on human health and diseases. Int J Mol Sci. 2015 Apr 2;16(4):7493-519.

12  Duvallet, C., Gibbons, S.M., Gurry, T. et al. Meta-analysis of gut microbiome studies identifies disease-specific and shared responses. Nat Commun 8, 1784 (2017).

13  Mutlu EA, Gillevet PM, Rangwala H, Sikaroodi M, Naqvi A, Engen PA, Kwasny M, Lau CK, Keshavarzian A. Colonic microbiome is altered in alcoholism. Am J Physiol Gastrointest Liver Physiol. 2012 May 1;302(9): G966-78.

14  Caricilli AM, Saad MJ. The role of gut microbiota on insulin resistance. Nutrients. 2013 Mar 12;5(3):829-51.

15  Beccuti G, Pannain S. Sleep and obesity. Curr Opin Clin Nutr Metab Care. 2011 Jul;14(4):402-12.

16, 18  Markwald RR, Melanson EL, Smith MR, Higgins J, Perreault L, Eckel RH, Wright KP Jr. Impact of insufficient sleep on total daily energy expenditure, food intake, and weight gain. Proc Natl Acad Sci U S A. 2013 Apr 2;110(14):5695-700.

17  Cappuccio FP, Taggart FM, Kandala NB, Currie A, Peile E, Stranges S, Miller MA. Meta-analysis of short sleep duration and obesity in children and adults. Sleep. 2008 May;31(5):619-26.

19  Singh P, Zhang Y, Sharma P, Covassin N, Soucek F, Friedman PA, Somers VK. Statins decrease leptin expression in human white adipocytes. Physiol Rep. 2018 Jan;6(2):e13566.

20, 21, 22, 24, 26  Verhaegen AA, Van Gaal LF. Drugs That Affect Body Weight, Body Fat Distribution, and Metabolism. [Updated 2019 Feb 11]. In: Feingold KR, Ahmed SF, Anawalt B, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-.

23  “Beta Blockers”. Mayo Clinic. Accessed 8/11/25.

25  Sharma AM, Pischon T, Hardt S, Kunz I, Luft FC. Hypothesis: Beta-adrenergic receptor blockers and weight gain: A systematic analysis. Hypertension. 2001 Feb;37(2):250-4.

27  Elgaddal, Nazik, Weeks, J D., Mykyta, L. “Characteristics of Adults Age 18 and Older Who Took Prescription Medication for Depression: United States, 2023.” CDC: National Center for Health Statistics. April 2025.

28  Woodcock, Stacia and Aungst, Christina. “Do Antidepressants Like Lexapro Cause Weight Gain?” GoodRx.com.  Aug. 28, 2024.

29, 30  Nihalani N, Schwartz TL, Siddiqui UA, Megna JL. Weight gain, obesity, and psychotropic prescribing. J Obes. 2011; 2011:893629.

31  Brighten, Jolene. Beyond the Pill: A 30 Day Program to Balance Your Hormones, Reclaim Your Body and Reverse the Dangerous Side Effects of the Birth Control Pill. Harper One. 2020.

32  “Trauma.” Psychology Today. Accessed 8/11/25.

33  Stevens, Jane Ellen. “The Adverse Childhood Experiences—the largest, most important public health study you never heard of—began in an obesity clinic.” ACES Too High. Oct. 3, 2012.

34 “What are ACEs?” American Psychiatric Association Foundation. Accessed 8/11/25.

35  Mahmood S, Li Y, Hynes M. Adverse Childhood Experiences and Obesity: A One-to-One Correlation? Clin Child Psychol Psychiatry. 2023 Apr;28(2):785-794.

36 Konopka LM. The impact of child abuse: neuroscience perspective. Croat Med J. 2015 Jun;56(3):315-6.

37  Jennie G. Noll, Meg H. Zeller, Penelope K. Trickett, Frank W. Putnam; Obesity Risk for Female Victims of Childhood Sexual Abuse: A Prospective Study. Pediatrics. July 2007; 120 (1): e61–e67.

38, 42, 45  Gupta R, Kumar P, Fahmi N, Garg B, Dutta S, Sachar S, Matharu AS, Vimaleswaran KS. Endocrine disruption and obesity: A current review on environmental obesogens. Current Research in Green and Sustainable Chemistry. 2020 Jun; 3:100009.

39 “Endocrine System.” Cleveland Clinic. Accessed 8/11/25.

40  “What Are Obesogens, and Should We Be Concerned?”  Healthline.com.

41  Heindel JJ, Blumberg B, Cave M, Machtinger R, Mantovani A, Mendez MA, Nadal A, Palanza P, Panzica G, Sargis R, Vandenberg LN, Vom Saal F. Metabolism disrupting chemicals and metabolic disorders. Reprod Toxicol. 2017 Mar;68:3-33.

43, 44  “Endocrine Disruptors.” National Institute of Environmental Health Sciences. Accessed 8/12/25.

46  “Most foods contain toxic phthalates. Now what?” CSPI.org.

If you want to have more energy; balance hormones; lose some weight; sleep more soundly; and/or improve mood and focus…

…let’s talk about improving your metabolic health.

Did you know…only 6.8% of American adults, aged 20 and over, are metabolically healthy?!  Even among American adults, who are of “normal” weight, the prevalence of metabolic health is low (1).

Good metabolic health is key to preventing chronic diseases, including obesity, diabetes, arthritis, cancer, stroke and heart disease.

So…what is metabolic health?

Your “metabolic health” reflects the overall health of your cells in a wide range of biological functions.

Healthy cells are the foundation of cellular energy that powers every function in your body. When your cells are unhealthy, they can’t repair themselves. This causes your tissues to break down, creating an environment that allows chronic diseases to take hold.

Good metabolic health is associated with optimal health. This means your body is properly digesting and absorbing nutrients from the foods you eat, successfully converting this food into energy that your body can use. This digestion-absorption-conversion process takes place without unhealthy spikes in blood sugar, blood fat, inflammation or insulin levels.

Your metabolic health is the cumulative result of your food choices (processed foods or whole foods) and lifestyle habits, including sleep, movement, stress management, relaxation strategies and exposure to toxins, including nicotine, alcohol and other regular substance use.

When you are metabolically healthy, the cells in your body have the energy to keep you nourished, hormonally balanced, immune-protected, heart healthy and of sound mind and mood (2). 

Your metabolic health is a core underlying physiological function that can determine whether you experience good physical and mental health OR poor health and disease.

What does being metabolically healthy look like?

While being overweight or obese is a key symptom of metabolic dysfunction, being metabolically healthy is not just about being at a “normal” weight. Looking fit, having good cardiovascular stamina, and/or having a normal BMI (Body Mass Index) are also NOT reliable indicators of metabolic health. So, yes…you can be an athlete or athletic—even look “fit”—but still be metabolically unhealthy if you overtrain; eat a processed food diet; and/or engage in unhealthy lifestyle habits (3).

If you have good metabolic health… 

• • You can easily maintain a healthy weight or lose weight (if needed).
  • You have steady, stable energy throughout the day—without caffeine, energy drinks, sugar or other stimulants (prescription or otherwise).
  • You have balanced mood. No mood swings. You experience minimal episodes of depression, anxiety or irritability.
  • Your mind is clear and focused. No brain fog, confusion or memory issues.
  • You have a clear complexion. No adult acne flare-ups.
  • Your skin is clear overall. No skin issues or conditions (e.g., eczema, rosacea, psoriasis, etc.).
  • You experience restorative sleep.
  • You have a healthy digestive system. No bloating, diarrhea, constipation, IBS, gastroparesis or other digestive health problems.
  • Your hormones are in balance.
  • Your hunger is in check. You eat when physically hungry due to physiological cues (not emotional) and stop eating when full.
  • Your cravings—for sugar, alcohol, caffeine, refined carbohydrates—are minimal to none.
  • You are pain-free. No chronic joint or muscle pain, stiffness, or ongoing body aches.

5 Biomarkers of Metabolic Health

 Five metabolic biomarkers—interpreted together—give us powerful clues about the state of our metabolic health, including: 1) Waist circumference; 2) Triglycerides; 3) HDL (“good” cholesterol); 4) Blood pressure; and 5) Blood glucose levels—without the use of medications.

When all 5 of these markers are in an optimal range—again, without medication—you are considered to have a reasonable level of metabolic health. Typically, when all five of these markers are in optimal range, you will feel vibrant, healthy and pain-free (4).

Metabolic Syndrome 

Poor metabolic health can lead to “Metabolic Syndrome”, a group of risk factors that raises your risk of heart disease, stroke and diabetes.

Metabolic syndrome was also a culprit for worse COVID-19 outcomes during the initial outbreak. In a retrospective study, published in Metabolic Syndrome and Related Disorders, researchers found that metabolic syndrome—especially obesity, dyslipidemia in particular, high triglycerides, low HDL), hypertension and high blood sugar—was associated with worse outcomes in adult patients who tested positive for COVID-19 between March and May 2020. Those with metabolic syndrome had an increased risk of hospitalization (77%), admittance to the Intensive Care Unit (56%) and death (81%). (5)

Metabolic syndrome increases your overall risk of chronic disease.

You will be diagnosed with metabolic syndrome if you have 3 or more of the following risk factors, which, in turn, increases your risk of heart disease by two-fold and your risk of diabetes by five-fold (6).

3 or More of these 5 Risk Factors = Metabolic Syndrome

If you check “YES” to 3 or more of the following risk factors, you will be diagnosed with metabolic syndrome. (7, 8, 9, 10, 11). Where do you fall?

1.  Large Waist Circumference

This indicates excess body fat around the waist. You are at risk for metabolic syndrome IF your waist size is HIGH:

–For men: 40 inches or more
–For women: 35 inches or more

*Note: Optimal waist circumference is the same for women of all ethnic origins. However, it varies for men, depending on ethnic origin.

Optimal waist circumference: 

For women:  <31.5 inches (Applies to women of all ethnic origins). 

For men:  <37 inches for men of European, Sub-Saharan African, Middle Eastern and Eastern Mediterranean origin.

For men:  <35 inches for men of Southeast Asian, Chinese, Japanese, and South and Central American origin.

2.  High Triglycerides

Triglycerides are fats in the blood that contribute to plaque build-up in your arteries.

You are at risk for metabolic syndrome IF your triglycerides are HIGH—150 mg/dL or higher OR You are using a cholesterol medicine.

Optimal range for triglycerides:  <80 mg/dL

3.  Low HDL “Good” Cholesterol

High-density lipoprotein (HDL) cholesterol, a.k.a. the “good” cholesterol, helps remove excess cholesterol from the blood. You are at risk for metabolic syndrome IF your HDL is LOW:

–For men: Your HDL is less than 40 mg/dL
–For women: Your HDL is less than 50 mg/dL

Optimal range for HDL: 60 mg/dL or higher

4.  High Blood Pressure

Your blood pressure is the force of blood pushing against the walls of blood vessels as the heart pumps blood through the circulatory system. It is expressed as systolic (the top number) over diastolic (bottom number). Systolic refers to the pressure inside the artery when the heart contracts and pumps blood through the body. Diastolic refers to pressure inside the artery when the heart is at rest and is filling with blood.

You are at risk for metabolic syndrome IF your blood pressure is HIGH—consistently 130/80 mm Hg (or higher) OR you are using high blood pressure medication.

Optimal range for blood pressure: 120 (or less) systolic / 80 (or less) diastolic.

5.  High Blood Glucose

A glucose test, commonly done at an annual physical, measures the glucose (sugar) levels in your blood. Glucose is your body’s main source of energy, and it comes from the food you eat.

A fasting blood glucose test measures the amount of sugar in your blood when it should be at its lowest. “Fasting” means that you haven’t had anything to eat or drink (besides water, which is fine) for 8 to 12 hours.

You are at risk for metabolic syndrome IF your fasting glucose is HIGH—100 mg/dL or higher.

–Fasting glucose between 100 and 125 mg/dL = Pre-diabetes.

–Fasting glucose of 126 mg/dL or higher = Diabetes

Optimal range for blood sugar: Between 70 to 85 mg/dL

Why Wait?

In my opinion, even one elevated biomarker—let alone 3!!—is cause for concern and should serve as an impetus to pay attention to your food and lifestyle choices—making adjustments where necessary.

It would be like driving a car with brakes that made grinding or squealing noises every time you braked (a huge red flag that there is likely a problem with the braking system). Would you ignore this major warning sign and hope for the best (e.g., no accidents!!) OR would you take immediate action and have a mechanic look at your car?

For example, I have a family history of hypertension and stroke. My maternal grandfather had multiple strokes before he died of a massive stroke.

Periodically, throughout my adult life, I have experienced hypertension. For example, at age 31, my blood pressure was startlingly high for several months—even though I was running 35 miles a week and working out 2 hours 5-6 days / week. My other 4 metabolic markers—blood sugar, HDL, triglycerides and waistline—were in an optimal range.

However, I did not wait until 2 other biomarkers were elevated before I took action to reduce my blood pressure! I immediately worked on adjusting my sleep routine and food choices as well as incorporating relaxation practices and stress-lowering herbal supplements. While common, hypertension is not “normal”, and it can damage your heart, brain, kidneys and blood vessels (12, 13).

The Good News

Once you optimize your metabolic health, you’ll find it easier to lose weight as well as experience increased energy, improved focus and balanced mood.

The good news is that you can be pro-active NOW in optimizing your metabolic health by  knowing your numbers (as mentioned above); by making different food choices; and, by modifying lifestyle.

What You Can Do:

1.   Test. Don’t Guess.

Have you ever waited months to see your doctor—and then, after the appointment, waited weeks for the results of your bloodwork?  If you want to be proactive about your metabolic health, order your own bloodwork via direct access labs; the results are emailed directly to you within 1 week to 10 days. I do this for myself every 3 months to stay on top of my health.

Once you receive your lab results, you can take them to your doctor OR the health practitioner of your choice, including myself, to review.

For a general overview of your metabolic health….👉order this Essential Labs panel. Save nearly 50% when you buy this bundled Essential Labs panel (just $99 bundled, versus $145 if tests are purchased individually) that includes the Comprehensive Metabolic Panel (includes the Glucose test); Complete Blood Count; Fasting Lipid (Cholesterol) Panel; Hemoglobin A1c; and Thyroid Stimulating Hormone.

2.  Track your blood pressure and waist size.

I like this blood pressure monitor, which I use to take my blood pressure every morning before eating a meal.  I recommend using this soft fabric tape measure for body measurements. If you are tracking waist size, measure 1x / week.

3.  Sleep 7-8 hours nightly.

4.  Cook at home more. Eat nutrient-dense whole foods.

5.  Reset with a whole foods cleanse.

6.  Manage carbohydrate intake.

7.  Sit less. Move more. Strength train.

8.  Engage in relaxation practices, like regular deep breathing or a daily meditation practice (you can start at 1 minute and increase over time).

9.  Limit screen time (phones, iPad, computer).

10.  Cut back or cut out stimulants and/or depressants, including caffeine, sugar, alcohol, nicotine, marijuana and/or other recreational drugs.

11.  Consider working with a functional health coach: schedule a Metabolic Health consultation:👇

👉👉👉Are you tired of making lifestyle choices that leave you feeling physically exhausted, stressed, unmotivated and “stuck” when it comes to your health and well-being? Let’s get clear on what’s been holding you back from better metabolic health.  CONTACT ME HERE.

Sources

1   O’Hearn, M, Lauren, B, Wong J, Kim D and Mozaffarian D. Trends and Disparities in Cardiometabolic Health in U.S. Adults, 1999-2018. Journal of the American College of Cardiology. 12 July 2022. Vol. 80, Issue 2. Pages 138-151.

2, 4, 6  Means, C with Means, C. (2024). Good Energy. Avery.

3  Maffetone, P.B., Laursen, P.B. Athletes: Fit but Unhealthy?. Sports Med – Open 2, 24 (2016).

5  Wu S, Zhou K, Misra-Hebert A, Bena J, and Kashyap 3. “Impact of Metabolic Syndrome on Severity of Covid-19 Illness.” Metabolic Syndrome and Related Disorders. Vol 20, No. 4. May 18, 2022. Pages 191–98.

7  Swarup S, Ahmed I, Grigorova Y, Zeltser R. Metabolic Syndrome. 2024 Mar 7. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 29083742.

8  International Diabetes Federation. Metabolic Syndrome. 2006.

9   “HDL Cholesterol”. Cleveland Clinic. 11/6/23.

10  “High Blood Pressure/Hypertension”. John Hopkins Medicine.

11  MedlinePlus [Internet]. Bethesda (MD): National Library of Medicine (US); [updated December 30, 2024]. Blood Glucose Test.

12  Bailey, M, Dhuan N, et al. A novel role for myeloid endothelin-B receptors in hypertension. European Heart Journal, Volume 40, Issue 9, 01 March 2019, Pages 768–784.

13  “High Blood Pressure and Chronic Kidney Disease”. National Kidney Foundation.

I recently rediscovered potatoes at my local organic farm market.

It’s a bit ironic because eating potatoes has never appealed to me. I don’t enjoy eating French fries (or frites), mashed potatoes, or even the classic Russet variety “baked potato”.

This is likely because I have carbohydrate intolerance. I am unable to tolerate grains of any kind, including rice (of which I ate copious amounts throughout my childhood) and/or other sources of starchy carbohydrates (think bread, pasta, pizza, etc.). In the past, the main symptoms I experienced after eating starchy carbohydrates was brain fog and extreme fatigue….I literally could not keep my eyes open!

Last fall, however, I began to occasionally introduce a very small portion (apx. 1/4 cup) of starchy whole food carbs with my meals, mainly in the form of root vegetables, sweet potatoes and potatoes.

These organic, red-skinned potatoes are lower in starch than a typical potato, and the flesh has a firm and dense, yet moist, quality to it. Best of all, red potatoes are amenable to steaming, and it only takes about 11 minutes for the potatoes to cook through—compared to 45 minutes to 1 hour to roast or bake.

As a home-cooked whole food—eaten judiciously—organic red potatoes can be a nutrient-dense food. The thin red skins are a good source of fiber, vitamin C; B vitamins, including B6, niacin and folate, as well as minerals, such as potassium and magnesium, that help regulate blood pressure.

I love the simple, unadulterated taste of steamed potatoes. You really taste the essence of the potato—without a lot of “stuff”, like butter, cream or sauces, masking its true flavor.

Steamed Organic Red Potatoes

1 to 1-1/2 pounds organic red potatoes, rinsed well and patted dry
Celtic sea salt
Freshly ground black pepper

Keep the skin ON! Slice potatoes into 1/4-inch thick rounds; stack the rounds, then dice. Place diced potatoes in bowl and set aside.

Add 2 cups of water to a 3- to 5-quart Dutch oven. Cover and bring water to a boil. Remove lid and insert a collapsible vegetable steamer.  Place diced red potatoes in steamer and arrange so that they are evenly distributed.

Cover Dutch oven and steam potatoes over medium-high heat for 3 minutes.

Uncover. Stir potatoes once or twice. Reduce heat to medium-low and steam potatoes approximately 8 minutes, or until a knife slides easily in and out of the potatoes.

Season, to taste, with Celtic sea salt and freshly ground pepper. Enjoy!

Optional:

–Sprinkle thinly sliced scallion rounds or minced garlic chives over the red potatoes.

–Toss steamed potatoes with 2 tablespoons of fresh-squeezed lemon juice and 1 tablespoon of crumbled, dried oregano for more of a Mediterranean flavor.

Compared to this Advanced Cholesterol Panel, the standard cholesterol panel, which includes Total Cholesterol; LDL (“bad) cholesterol; HDL (“good”) cholesterol and Triglycerides, is woefully inadequate—and outdated—if you are trying to determine your risk for heart disease.

There’s no question that cardiovascular disease (CVD) is the leading cause of death in the U.S. Yet, more than half (51%) of Americans are not aware of this, according to a recent Harris Poll survey conducted on behalf of the American Heart Association in November 2023 (1). Consider the following (2):

• • On average, someone dies of CVD every 34 seconds in the U.S.
  • There are about 1,905 deaths from heart disease, each day in the U.S., including heart attacks.
  • Approximately every 40 seconds, someone in the U.S. will have a heart attack.
  • Each year in the U.S., there are about 605,000 new heart attacks and 200,000 recurrent attacks. Of these, an estimated 170,000 are silent—without significant symptoms.

Heart health awareness often only begins when people are told that because they have “high cholesterol”, they are at greater risk for heart disease.

Conventional medical doctors are likely to prescribe a statin if your LDL, or “bad” cholesterol, is high.

On a standard lipid panel, the following are considered “ideal” numbers.

• • Total Cholesterol:  <200
  • LDL (“bad” cholesterol):  <130
  • HDL (“good” cholesterol):  >50 for women) and >40 for men
  • Triglycerides:  <150

However, your total cholesterol and LDL numbers are not accurate predictors of heart disease risk. Unfortunately, this is still a widespread belief in the conventional medical establishment.

My High Cholesterol Story

Twelve years ago, I was prescribed a statin by my osteopath because my total cholesterol had crept up from 211 to 294 over a period of two years, and my LDL was 183. Never mind that my HDL was 103 and my triglycerides were 43. At the time, I was very physically fit—running 30 miles a week in addition to weight training—cooking most meals, and I had healthy lifestyle habits.

When my osteopath prescribed a statin, I immediately stopped seeing her. I had zero interest in taking a pharmaceutical drug with a wide range of potential side effects, including headaches; difficulty sleeping; digestive issues; lower back pain; muscle pain; weakness; fatigue; liver damage; kidney failure; cataracts; confusion; memory loss; sexual dysfunction, including impotence; and diabetes (3, 4, 5).

After researching my options, I began working with a functional medicine doctor who did extensive lab work to uncover the root cause of my symptoms. Among the results…my total cholesterol was 334 and my LDL was 185. But, instead of pronouncing me a sure candidate for taking a statin, this functional medicine doctor diagnosed me with Hashimoto’s thyroiditis (autoimmune thyroid dysfunction) and severe adrenal exhaustion. I was prescribed a natural thyroid hormone and supplements to support my adrenal glands. Once I received my diagnosis, I was also proactive about supporting my thyroid and adrenal health. I eliminated specific inflammatory foods from my diet. I prioritized rest and relaxation. I incorporated stress reduction strategies into my lifestyle. After several months, my “high cholesterol” dropped significantly.

What I learned from my “high cholesterol” experience is that, with the exception of genetics, “high cholesterol” is often a proxy for some form of inflammation and/or oxidation happening in your body. Underlying causes for high cholesterol can include (6):

1. 1. 1.   Poor thyroid function (as was my case).
      2.   Chronic bacterial or viral infection.
      3.   Metabolic dysfunction, such as insulin resistance or metabolic syndrome.
      4.   Gut dysbiosis (an imbalance of good vs. bad gut bacteria).
      5.   Exposure to environmental toxins in our air, food, water, household and personal care products. For example, heavy metals, such as lead, mercury and/or cadmium (7, 8).
      6.   Taking medications for acne, high blood pressure, cancer, HIV/AIDs, irregular heart rhythms or organ transplants (9).

Unfortunately, the conventional medical approach to heart disease is based on faulty, outdated science, otherwise known as the “diet-heart hypothesis” which harks back to the 1950s.

Widely accepted as “fact”—without evidence—for over 60 years, this hypothesis maintains that high cholesterol is a significant risk factor for coronary heart disease. And that saturated fat and cholesterol-rich foods “cause” heart disease by raising serum cholesterol.

How the diet-heart myth started

Ancel Keys, a physiologist who studied the influence of diet on health, first proposed the diet-heart hypothesis in the 1950s. His idea was based on a handful of small feeding experiments conducted on humans, as well as some animal data, that suggested high blood cholesterol caused fatty deposits thought to clog arteries and cause heart attacks (10).

Between 1952 and 1956, Keys conducted informal exploratory studies on the relationship between serum cholesterol levels and heart attack rates (11). In 1958, Keys launched his famous Seven Countries Study (SCS), which followed 12,770 men in 16 locations within seven countries, including Italy, Greece, Yugoslavia, Finland, the Netherlands, Japan and the United States.

A marriage of politics, nutrition and corporate influence

In 1960, Keys was appointed to the American Heart Association’s (AHA) nutrition committee and was able to convince his colleagues to recommend his diet-heart idea—even without firm evidence—as official AHA policy. By 1961, the American Heart Association was recommending that all men (and, later, women) decrease their consumption of saturated fat and to replace these fats with polyunsaturated vegetable oils (e.g., canola, corn, safflower and soybean oils) to protect against heart disease. A conflict of interest worth noting: in 1948, the AHA had received $1.7 million (apx. $20 million in today’s dollars) from Proctor & Gamble, the makers of Crisco oil, a shortening made entirely of “vegetable oils”, marketed today as “cholesterol free” and “gluten-free” (12). Hmmmm.

In 1975, Keys published the results of his Seven Countries Study in the American Heart Association journal, which showed a seemingly strong correlation between consumption of saturated fat and deaths from heart disease (13).

In 1980, the U.S. government adopted the American Heart Association’s advice to limit saturated fat as official policy for all Americans (14).

More recently, in 2020, the AHA, itself, published a meta-analysis of observational studies and randomized controlled trials about the role of saturated fat in “causing” heart disease. The result?

Despite the long-time recommendation to eliminate or reduce red meat, full-fat dairy products, butter and eggs…this meta-analysis found that total dairy, milk, high-fat dairy, cheese, butter, eggs and unprocessed red meats are NOT associated with cardiovascular disease outcomes. Coconut oil, a rich source of saturated fat at 92% of total fat, decreased LDL cholesterol compared with butter and elicited no change in LDL cholesterol compared with olive oil (15).

In the decades following his published results, Keys was—and is—criticized for “cherry-picking” the seven countries and his data to “prove” his hypothesis, also known as confirmation bias. For example, Keys did not include countries like France, Germany or Switzerland, where people consumed large quantities of saturated fat (e.g., cheese, cream, butter and red meat), yet experienced low rates of heart disease—similar to the countries featured in the Seven Countries Study (16).

Remember: correlation does not imply causation. Just because two variables (e.g., high cholesterol and heart disease) seemingly move together in the same direction does not automatically mean that one variable “causes” the other. For example, let’s say both ice cream consumption and murder rates increase dramatically in the summer; should we automatically assume that eating more ice cream “causes” a spike in murders? It’s a ridiculous example, but you get the idea…

Understanding why cholesterol is NOT your enemy

Despite its bad rap, cholesterol is vital to our health. In fact, life as we know it could not exist without cholesterol.

Cardiologist Dr. Stephen Sinatra writes in The Great Cholesterol Myth (17):

“Cholesterol is a basic raw material made by your liver, your brain and virtually every cell in your body. Enzymes convert it into vitamin D, sex hormones (e.g., estrogen, progesterone, and testosterone) as well as stress hormones, and bile salts for digesting and absorbing fats. 

The brain is particularly rich in cholesterol and accounts for approximately one-quarter of all the cholesterol we have in our bodies. Neuronal communication depends on cholesterol: lower levels of cholesterol are linked to poorer cognitive performance.”

One adverse side effect of taking cholesterol-lowering statins is memory loss, including fuzzy thinking and/or learning difficulties (18). Personally, I have several friends with a parent now struggling with dementia or Alzheimer’s after taking a statin.

Our immune system also depends on cholesterol because our immune cells require cholesterol for activation; cholesterol can play an important anti-inflammatory role in fighting bacteria and infections (19, 20).

The other important thing to understand about cholesterol?

Only 20% of the cholesterol comes from the foods we eat!! The other 80% is produced inside of our bodies—by the liver (21).

Several cholesterol feeding studies—where volunteers were fed 2 to 4 eggs daily and their cholesterol was measured—have attempted to clarify the relationship between dietary cholesterol and the development of coronary heart disease. What researchers found: Dietary cholesterol has minimal—if any—impact on blood cholesterol levels in roughly 75% of the population.

The other 25% were deemed “hyper responders” because, in this group, dietary cholesterol modestly increased both LDL (“bad” cholesterol) and HDL (“good” cholesterol”); however, dietary cholesterol did not affect the ratio of LDL to HDL or increase the risk of heart disease (22, 23).

Why LDL “bad” cholesterol doesn’t tell the whole story…

It is important to understand: you don’t have a cholesterol level “in your blood”. Cholesterol is a sterol, a combination of a steroid and alcohol. Cholesterol is fat-soluble and blood is mostly water. Cholesterol, itself, can’t travel in the blood because it is hydrophobic, which means it cannot be mixed with—or dissolved in—water. In order for cholesterol to travel anywhere in the body, it has to be encased in a protective structure, which are special proteins called “lipoproteins”. Classified according to their density, LDL (low-density lipoprotein) and HDL (high-density lipoprotein) are the two lipoproteins typically associated with heart disease (24).

Imagine that your bloodstream is a highway. The lipoproteins are the cars that transport its passengers (cholesterol and fats) around your body. It was once commonly believed that the number of passengers in the car (e.g., the concentration of cholesterol in the LDL particle) was a main contributor to the development of heart disease.

However, more recent studies suggest that it is the number of cars on the road (e.g., total number of LDL particles) that matter most (25). In other words, the more cars there are on the highway—visualize rush hour traffic on the LA freeway—the greater your risk of having an accident; the number of passengers—whether it’s 1 person or 4 people—in your car is irrelevant.

Coronary arteries are hollow tubes, and the endothelium (lining) of the artery is only one cell deep—like a very flimsy “guard rail”! The blood, which carries lipoproteins like LDL is in constant contact with the endothelial lining. As a result, the more cars (lipoproteins) are on the highway, the higher the likelihood that some cars will “crash” into the fragile lining of the artery. Again, I’m making the point that knowing the actual number of LDL particles in your bloodstream tells you more about your heart disease risk than a “high” LDL cholesterol number.

Yes, your LDL cholesterol level (LDL-C) can be concordant with your LDL particle number (LDL-P), meaning that when LDL cholesterol is high, LDL particle size is high and vice versa. However, these markers can also be discordant, meaning that your LDL cholesterol (LDL-C) may be “normal” or even “low”, but the number of LDL particles (LDL-P) is “high” (25).

In a study published in the Journal of Clinical Lipidology, researchers recruited 6,814 participants, an ethnically diverse group of men and women, between the ages 45 to 84, who were free of cardiovascular disease (CVD) at the start of the study. Researchers tracked study participants for CVD events: there were 319 cardiac events—including heart attacks, coronary heart disease death, angina (chest pain due to reduced blood flow to the heart), stroke, stroke death or other CVD death—over a 5.5 year period.’’

What researchers found: Concordant LDL-C and LDL-P (in other words, both numbers were high) were associated with increased risk of CVD. However, when the LDL particle number  and LDL cholesterol were discordant (for example, “high” LDL particle number vs. a “normal” LDL cholesterol), the LDL particle number was more strongly associated with risk of a CVD event, including heart attack, stroke and death (26).

Get the right cholesterol tests to assess heart disease risk…

Conventional medical doctors still use the standard lipid panel as a basis to determine your risk for heart disease. Keep in mind, too, that financial incentives for prescribing statins play a role in driving the global statin market size, a reported $15.4 billion (US dollars) in 2023 (27).

Did you know: nearly 80% of people with coronary artery disease have standard cholesterol tests that fall within “normal” ranges?  This suggests that routine cholesterol tests—established over 50 years ago—fail to identify a large number of people at risk for heart attacks—who, if aware of their risk, could make changes in their food choices and lifestyle habits to reduce their risk of heart disease.

This is why I am a big fan of—and regularly use—this Advanced Cholesterol Panel to stay on top of my heart health—especially because I am hypothyroid and also susceptible to chronic viral infections, like Epstein-Barr, which can be underlying causes of high cholesterol.

The Advanced Cholesterol Panel includes the standard lipid panel PLUS cholesterol markers that more accurately predict your risk of heart disease.

The sale ($155) ends on February 29th. You can purchase the panel now—and schedule your blood draw later—up to 1 year from date of purchase.  *Note: This is direct lab testing. Meaning…you order your own labs. No doctor’s visit required. IF you live in New York or New Jersey, you will not be able to access direct lab testing. However, you can order your labs online, then travel to Connecticut, Pennsylvania or Massachusetts (this is where I go) for your blood draw.

You will be emailed your results 1 week from your blood draw. You can then take your labs to the healthcare practitioner of your choice. Or consult with me if you choose.

Click here to order the Advanced Cholesterol Panel.

In addition to the standard lipid panel, the Advanced Cholesterol Panel includes advanced biomarkers like:

–LDL particle number. I’ve covered this at length in this e-newsletter. A high LDL particle number is associated with an increased risk of heart disease.

–Apolipoprotein B: Apolipoprotein B is a protein found on LDL cholesterol particles. A high number of Apo-B containing lipoproteins is associated with more cholesterol ending up in your artery wall. Elevated levels of apolipoprotein B are associated with an increased risk of heart disease and heart attack.

–Lipoprotein (a). A type of LDL cholesterol that, when high, is associated with an increased risk of heart disease.

–Peak size and Pattern. This size and pattern of LDL cholesterol particles provide useful information about your cardiovascular risk. *Small, dense LDL particles are associated with an increased risk of heart disease.

–HDL Large.  HDL (“good” cholesterol) large particles are associated with a lower risk of heart disease.

Sources

1, 2  American Heart Association (AHA). 1/24/24.

3  Drugs.com. Side effects of statins. 8/22/23.

4  Heathline.com. Statins: Uses, Risks and Side Effects. 3/29/22.

5, 6, 23, 24, 25  Kresser, C. The Diet-Heart Myth: Learn how to prevent and treat heart disease naturally.

7 NDTV. Increased Exposure To Lead and Mercury May Raise Cholesterol: 5 Good Cholesterol Foods.  Nov. 6, 2018.

8  Buhari O, Dayyab FM, Igbinoba O, Atanda A, Medhane F, Faillace RT. The association between heavy metal and serum cholesterol levels in the US population: National Health and Nutrition Examination Survey 2009-2012. Hum Exp Toxicol. 2020 Mar;39(3):355-364.

9  Mayo Clinic. High Cholesterol. Jan 11, 2023.

10, 12, 13, 14, 16 Teicholz N. A short history of saturated fat: the making and unmaking of a scientific consensus. Curr Opin Endocrinol Diabetes Obes. 2023 Feb 1;30(1):65-71.

11  Seven Countries Study.

15  Jeffery L Heileson, Dietary saturated fat and heart disease: a narrative review, Nutrition Reviews, Volume 78, Issue 6, June 2020, Pages 474–485.

17, 20  Bowden, J. and Sinatra, S. The Great Cholesterol Myth: Why Lowering Your Cholesterol Won’t Prevent Heart Disease and the Statin Free Plan That Will. Revised and Expanded. Quarto Publishing Group, 2020.

18  Wenner Moyer, M. (2010, Sept. 1). It’s Not Dementia, It’s Your Heart Medication: Cholesterol Drugs and Memory. Scientific America.

19  Ryan J. King, Pankaj K. Singh, Kamiya Mehla, The cholesterol pathway: impact on immunity and cancer. Trends in Immunology. Volume 43, Issue 1, 2022, Pages 78-92.

21  Corliss, J. (2017, Feb. 6). How it’s made: Cholesterol production in your body. Harvard Health Publishing.

22  Kratz M. Dietary cholesterol, atherosclerosis and coronary heart disease. Handb Exp Pharmacol. 2005;(170):195-213.

26  Otvos JD, Mora S, Shalaurova I, Greenland P, Mackey RH, Goff DC Jr. Clinical implications of discordance between low-density lipoprotein cholesterol and particle number. J Clin Lipidol. 2011 Mar-Apr;5(2):105-13.

27  IMARC. Statin Market Report by Type (Synthetic Statins, Natural Statins), Therapeutic Area (Cardiovascular Disorders, Obesity, Inflammatory Disorders, and Others), Drug Class (Atorvastatin, Fluvastatin, Lovastatin, Pravastatin, Simvastatin, and Others), Application (Dyslipidemia, and Others), Distribution (Hospitals, Clinics, and Others), and Region 2024-2032.

You are not alone.

Your hope to lose weight has kept the weight loss and weight management market—companies like Jenny Craig, Weight Watchers, Nutrisystem, Herbalife, Golds’ Gym, etc.—raking in BIG bucks—at a projected $263 billion in revenue by 2025 (1).

But here’s the rub. In my private functional health coaching practice, I have worked with clients who have participated in programs, like Weight Watchers, multiple times, each time losing some weight, but then regaining the weight they lost—and then some. As a CBT coach, I have also worked with clients who had bariatric surgery (weight loss surgery), then, regained any weight lost. I have also worked with clients who wanted to get weight loss surgery, but were told they needed to lose weight first  before they would be eligible.

Why is it so hard to lose weight—and to keep weight off long-term?

It starts with our beliefs around weight and weight loss.

Historically, being overweight or obese has been perceived as a character flaw, from having poor self-control, to being downright lazy or gluttonous. Yet, in 2023, nearly 75% of American adults are overweight or obese (2). We can’t all “lack willpower”! Our collective weight gain can be attributed to a convergence of biological, metabolic, environmental, lifestyle, cultural and economic factors.

Achieving sustainable weight loss is often a layered process. Yet, for decades, public health officials, celebrity doctors and mainstream media have indoctrinated us with simplistic messages, like:

• • “Eat less. Exercise more.”
  • “Just exercise more.”
  • “Watch portion sizes”, a.k.a. “Just eat less.”
  • “Calories in = Calories out.”
  • “Eat low fat.”
  • “Try X diet / shake / product / pill, and you’ll lose weight fast!”
  • “It’s your fault: you lack willpower OR you’re not trying hard enough.”

Our beliefs seep into our thoughts, which affect our emotions and influence the everyday choices that we make (or don’t make), and, ultimately, affect the outcome that we experience.

For example, let’s say your doctor tells you that you must lose weight before having heart surgery. You believe that exercising more will help you lose that weight. You start walking every day and manage to walk 5 days in a row. Work suddenly gets busy, and your daily walks go out the window. You feel defeated and depressed. Thoughts like, “I’ll never lose weight no matter how much I try” creep in. Your mood tanks. Cravings for high-sugar, high-carb foods are intense. You choose to eat pizza and ice cream because, in the moment, you feel better. And…we’re back to Square One.

Beliefs are a powerful part of the programming that runs our subconscious.

If you are struggling to lose weight; if you keep losing, then regaining weight; or, if you feel overwhelmed by the prospect of losing weight, consider challenging the beliefs you have about weight and weight loss.

Belief #1:  I’m “healthy”, but I just can’t seem to lose weight—no matter what I do!

Hmmmm…are you really “healthy”? Today, “good health” is commonly perceived—and marketed—as an absence of disease (e.g., testing ‘negative’ for C*VID).

True health, however, reflects a state of mind-body balance and functional vitality.

What are key indicators of good health and vitality?

• • Being at an optimal weight (a healthy weight for your age, size and frame)
  • A strong immune system (the ability to fend off and/or recover from bacterial or viral infections quickly)
  • Having consistent, stable energy throughout the day (without caffeine or sugar)
  • Experiencing restful and restorative sleep (without sedatives or alcohol)
  • Having healthy bowel movements every day (without caffeine or laxatives)
  • Clear skin
  • Healthy hair (no excessive shedding or hair loss)
  • Regular menses without debilitating pain or excessive bleeding (for women)
  • Good cognitive function (able to focus and think clearly)
  • Excellent oral health (no bleeding gums, gum disease or cavities)
  • A healthy heart
  • Being metabolically flexible (your body’s ability to switch between different fuel sources—e.g., fuel from food or fuel already stored in the body—helps support energy production, stablize blood sugar, minimize cravings and improves fat burning (3)).
  • Able to engage in daily movement / exercise without pain or aches
  • Balanced mood (indicating stable emotional and mental health)

Weight gain = Inflammation

What causes inflammation? Blood sugar imbalances. Nutrient deficiencies. Hormone imbalances. Too little or poor-quality sleep. Food intolerances. Medications. Undereating. Overeating. Poor quality food. Eating inflammatory foods. Hidden infections. Poor gut health. Environmental toxins. Toxic relationships. Unresolved trauma. And more.

Weight gain is a symptom that your body is out-of-balance physically, emotionally, psychologically and/or spiritually. And, until that imbalance(s) is addressed, any weight you lose is likely to come back.

The good news? Comprehensive lab work can reveal an underlying health condition (e.g., anemia, diabetes), hormone imbalance (e.g., thyroid, adrenal, too much or too little sex hormones, etc.) and/or inflammation that may prevent you from losing weight—or, in some cases, may even be causing weight gain. You can SAVE on this discounted Resolution Lab Panel here.

Even with insurance, many people have high deductibles and end up paying out-of-pocket for labwork (that is not comprehensive) anyway. Direct lab testing is an excellent option because you do NOT need a script from a doctor, and lab test results are emailed directly to you. You can then take the lab test results to your doctor or healthcare practitioner of your choice, including myself, for assessment. Direct-to-consumer labwork is not covered by insurance. However, you choose and only pay for the labs you want (no surprise charges if you are on a budget!). As I have Hashimoto’s thyroiditis, I regularly order my own labs to stay on top of my health—and save 50-80% in the process. For example, when I went for my annual physical 2 years ago—even with insurance—I would have had to pay $300 out-of-pocket for a Vitamin D test vs. just $50 via direct order labwork. I also appreciate the option of choosing reasonably priced labwork that is typically NOT covered by insurance (e.g., advanced cholesterol profile, complete thyroid panel, etc.). Interested? Click here to use my affiliate link to order your own labs.

Reframe: I’m going to schedule comprehensive bloodwork and check if any underlying health conditions or deficiencies might be preventing me from losing weight.

Belief #2:  I’m getting older…so, it’s “natural” to put on some weight.

LOL…in my practice, I have had men and women in their mid-20s use this rationale to explain weight gain! In reality, men and women typically reach their physical peak between their late 20s to early 30s; so, no, it’s not “natural” to gain weight in this age range.

At certain stages in life—e.g., post-pregnancy or at midlife, when men go through andropause (male menopause) and women transition to perimenopause, then menopause—weight gain is possible because of unstable, fluctuating, or low levels of hormones, which can affect stress hormones and fat storage. Not because you are “older” per se. This transition can be managed non-pharmaceutically with food choices, lifestyle, more rest, relaxation and distress tolerance strategies.

Regardless of age, medications can be a culprit in weight gain (4). These can include: synthetic hormones (e.g., birth control pills or conventional HRT); some antidepressants (e.g., Zoloft, Paxil); corticosteroids (e.g., Prednisone); antipsychotic meds; as well as some migraine, epilepsy, diabetes and blood pressure medications. If prescription drugs are a necessity, you will be less prone to gain weight (if listed as a side effect) when you make healthier food and lifestyle choices.

Reframe (applicable at any age!): I have gained weight; I need to pay closer attention to—and be willing to adjust—my food choices; lifestyle habits; mindset and/or any medications that I am taking.

Belief #3.  I have been faithfully eating less calories (or points), but I am not losing weight!

Calories are units of energy that a food or drink provides. The Dietary Guidelines for Americans recommends 1,600-2,400 calories daily (for women) and 2,000-3,200 calories daily (for men), depending on age, weight, sex and physical activity (5).

However, not all calories are created equal!

Consider what happens when your “breakfast” consists of a Dunkin Donuts Blueberry Muffin (460 calories, 41 grams of added sugar) and a large coffee with French Vanilla Swirl (220 calories, 42 grams of added sugar) versus a home-cooked 3-egg omelet with spinach and mushrooms (apx. 337 calories; 0 grams added sugar) and a cup of unsweetened green tea (0 calories). Your choice will impact your hormones differently.  For example, the first combination of caffeine, sugar and refined carbs (flour) will exponentially increase hunger and cravings and negatively affect mood (greater anxiety and irritability). That excess sugar—in the form of processed / refined carbs—is then stored as fat around the belly. Even if you are restricting calories. On the other hand, the second choice—a whole foods-based meal containing protein, fiber (a.k.a. green vegetables) and healthy fat—will promote satiety and stabilize blood sugar. You feel full longer, have less cravings, more natural energy, and a more balanced mood. You will eat less naturally.

Reframe: Instead of obsessively counting calories, I pay attention to the quality of calories I choose to eat or drink.

Belief #4: “I just need to watch portion sizes” (a.k.a. “Just eat less.”)

The misguided belief that we can eat whatever we want or love, including chips, pizza, pasta, tacos, etc.—in “moderation” (as in smaller portion sizes)—has long been promoted by commercial weight loss programs Depending on the program, “moderation” may be defined by calories, points or carbs consumed.

Unfortunately, “moderation” doesn’t work if you have food intolerances or food sensitivities. Estimated to affect at least 20 percent of the population in industrialized countries, food intolerances make it hard to lose weight—no matter how “small” a portion you eat (6). Common food intolerances include wheat, gluten, dairy, eggs, soy, corn, nuts, nightshades and yeast.

A food sensitivity is not a food allergy. A food allergy is an IgE-mediated response that causes an immediate and acute histamine reaction after ingesting a food (e.g., peanuts). Food sensitivities trigger an IgG-mediated response; they are not life-threatening; and they often involve the gut, skin and/or respiratory system. Food sensitivity symptoms can include bloating, rashes, headaches, fatigue, runny nose, post-nasal drip, achy joints and more, and can take up to 72 hours after consuming a food to present.

When you have hidden food sensitivities, your immune system is constantly reacting to the foods you eat, creating a state of chronic inflammation. Inflamed cells and tissues retain more fluid, creating water retention that contributes to unwanted weight gain.

So…if you are sensitive to gluten, yet you eat toast at breakfast, pizza at lunch and pasta at dinner, you are creating a chronic state of inflammation in your body that actually contributes to weight gain.

Reframe: I will remove gluten and dairy for 3 weeks and/or do a whole foods-based cleanse, like the DIY 7-Day Body Reset Cleanse, to identify any food sensitivities and reduce inflammation.

Belief #5:  I need to go to the gym more OR increase the duration, frequency, or intensity of my exercise.

When clients tell me that they want to lose weight, they often cite “exercising more” as the #1 way they will reach their goal. I get it. For decades, I clung to this misguided belief, which had me doing some crazy things back in the day, like heading to the gym at 11:30PM to run a few miles on the treadmill! Or, going for a run outside when it was a frigid 15 degrees or a sweltering 97-degrees. I love good food, and since I was not willing to “eat less”, I chose to “exercise more”.

Time and time again, we’ve been told that we need to “exercise more” to lose weight. Yet, “exercising more” is not a practical option for many of my clients who have acquired disabilities, movement restrictions due to injury, limited physical mobility or chronic pain.

And, while exercise has myriad health benefits, exercise alone will not help you lose weight.

Relying only on exercise to lose weight can result in the following:

You feel entitled to eat unhealthy foods. The “halo effect” of having exercised (e.g., I was “good”!) can make you feel entitled to eat—or overeat—a favorite high sugar food, like pizza, cheesecake, soda, etc.

You burn way less calories than you think. In reality, it is difficult to create a calorie deficit through exercise alone. Eat one New York-style slice of pizza, and you are consuming 400 to 500 calories, roughly 58 g carbs, 20 grams of unhealthy fat and loads of sodium. You would have to spend a lot of time and energy exercising to ”burn off” those calories (and/or carbs). Keep in mind: the average person burns apx. 100 calories for every mile of walking or running.

Exercise is usually the first thing to go when my clients get busy or have to travel…”no time”!

“Exercising more” creates a hormonal chain reaction (7).  Increasing the frequency, intensity, or duration of exercise also increases hunger and cravings. This can cause you to overeat or to crave fatty, high-sugar, carb-starchy or salty foods that sabotage your weight loss efforts.

Too much exercise (for your body) or overtraining can lead to hormone imbalances (for example, high cortisol, low thyroid)—causing you to gain weight.

Instead of “going to the gym more”, think about ways you can incorporate consistent movement every day. Making thoughtful food choices—eating less sugar, refined carbohydrates and processed foods and more nutrient-dense, anti-inflammatory whole foods—will, over time, help maintain weight when you eat less and exercise less.

Reframe: How can I consistently engage in safe (and enjoyable) movement every day?

Belief #6:  Eating frequent, smaller meals helps you lose weight.

The idea behind this oft-dispensed weight loss advice is that eating frequent meals will help boost metabolism, reduce hunger (thereby preventing you from overeating) and balance blood sugar.

Research, however, proves otherwise.

Hunger, energy and cravings are powerful hormonal cues. Eating frequent meals can distort natural hunger cues and actually cause you to overeat. In a study published in The Journal of Nutrition, researchers assessed the eating frequency of 18,696 US adults (aged 20 and older). The results? Participants who ate more frequently, whether meals and/or snacks, were more likely to be obese and have central obesity, a.k.a. abdominal obesity (8). In another study, published in Obesity, researchers divided participants into two groups. Both groups consumed the same number of calories. However, one group ate 3 meals a day, while the other group ate 6 smaller meals divided throughout the day. The results?

Participants who ate smaller, more frequent meals (in this case, 6 meals / day) experienced increased appetite, increased desire to eat more, felt less full between meals, did not burn more fat or have improved blood sugar (9).

Eating more frequently also spikes blood sugar more frequently, especially if you are continually eating, grazing or snacking on high-carbohydrate, high sugar meals or snacks (10). Overall, eating less meals with higher protein content helps balance blood sugar. Keep in mind, too, when you are constantly eating throughout the day, your body is always burning sugar; it never gets to the point where it burns fat.

Reframe: I listen to my natural hunger cues and will be mindful of eating more protein-rich meals.

Belief #7.  I need willpower—iron-clad self-discipline—to lose weight.

 Research has shown that willpower is like a battery. It can be drained, and it can be recharged. Imagine starting a busy work day with an iPhone at 17% battery power. You can only use it for a short time before the phone loses all of its juice. Similarly, human willpower consists of three batteries with its own reserves: mental, emotional, and physical (11). All three must be in balance and fully charged to ensure optimal willpower.

The reality, however, is that most people have busy, stressful lives and are already running on a low battery. “Dieting”— following a conventional “eat less, exercise more” model—only further drains your physical battery (e.g., you may be eating too much of the wrong calories/too little of the right calories); your mental battery (e.g., constantly thinking about “bad” vs. “good” foods); and your emotional battery (e.g., you feel stressed and anxious about sticking to your diet and deprived of pleasure).

As a result, relying only on willpower rarely results in sustainable weight loss.

The key, instead, is to incorporate mindfulness and planning strategies for healthy weight management. Studies suggest that mindfulness interventions can contribute to significant weight loss (12). The first step is awareness. When it comes to losing weight, you must first become aware of your eating habits, biofeedback cues (e.g., hunger, energy, cravings), lifestyle habits, stressors, triggers, and thoughts/emotions around food. By incorporating mindfulness strategies, you can then plan to make changes that support your overall health, which translates into weight loss.

For example, I recently worked with Nadia (not her real name) a client in her early 20s who suffered from C-PTSD, chronic anxiety and low energy. The food log that I had her keep revealed erratic eating patterns, excessive caffeine and high sugar foods, refined carbohydrates and late-night snacking. Once Nadia became mindful of eating more whole food meals at regular times, cut out caffeine, and reduced her sugar intake, her anxiety level dropped significantly. She then had more energy to go the gym consistently (3x / week) and lost a few pounds in the process. Without “dieting”.

Reframe:  Mindfulness and planning strategies can help me make choices that support healthy weight loss.

Belief #8:  Eating organic produce, pasture-raised meats and wild-caught fish doesn’t matter.

Feeding your body organic food can support healthy weight loss. Organic foods contain more nutrients, antioxidants, beneficial compounds and improved fatty acid profiles (in dairy and meat) than conventionally grown or raised produce or livestock.

In a study of over 62,000 participants, researchers analyzed how frequently participants consumed organic foods and the effect on weight. What researchers found:

Eating more organic foods was associated with a lower increase in BMI (Body Mass Index) and a lower risk of obesity (13).

Higher organic food consumption is also associated with a lower risk of metabolic syndrome, a group of risk factors that raises your risk of heart disease (14). Another advantage? Organic foods do NOT contain (or very minimally) pesticide residues, heavy metals (e.g., cadmium), synthetic fertilizers and antibiotic-resistant bacteria (15).

Pesticides matter. As obesogens, chemicals that disrupt hormones and promote weight gain, pesticides have been linked to decreased sperm count, erectile dysfunction, male infertility, ovarian disorders, thyroid problems, decreased fertility in women, low birthweight, obesity and diabetes.  The good news?  Today, affordably priced, fresh and frozen organic produce and meats can be found everywhere, from Whole Foods and Amazon, to Target and Wal-Mart.

Reframe: I will choose to eat organic whole foods as much as possible.

Belief #9:  I have bad genes. Everyone in my family is overweight or obese. It is inevitable that I am (or will be) overweight / obese.

The good news: Genes are not your destiny!

As Dr. Bruce Lipton, a former professor of medicine at Stanford University, world-renowned stem cell biologist and author of The Biology of Belief, has observed:

“A person’s health isn’t generally a reflection of genes, but how their environment is influencing them. Genes are the direct cause of less than 1 percent of diseases: 99 percent is how we respond to the world.”

Epigenetics, a field of science that studies how genes are expressed, has positively shown that our environment (e.g. including exposure to toxins and toxic relationships), food choices, lifestyle habits, thoughts and beliefs can literally “turn off” bad genes and “turn on” good genes.  This means that even if you have a family history of Type 2 diabetes, Alzheimer’s, breast cancer or an autoimmune condition, like Hashimoto’s thyroiditis or rheumatoid arthritis, your food choices, lifestyle and mindset can dramatically increase the odds that you will not have that health problem.

Our beliefs can affect health outcomes. Let’s say you receive a cancer diagnosis. You are told that you have 6 months to live. If you believe that doctors are always right, you will believe that death is inevitable. You would lose hope. You would feel depressed, fearful and anxious, emotions that tank your immune system—and your health. Your belief in your doctor and his/her prognosis becomes a self-fulfilling prophecy.

On the other hand, you may believe that your cancer diagnosis is a wake-up call. You become pro-active in researching your options and exploring alternative therapies to conventional treatments. You change your diet. You meditate. You eliminate toxic relationships. You live every day with purpose, appreciation and gratitude. Your beliefs spur you into taking action that might very well put your cancer in remission.

Our thoughts—negative or positive—are powerful. They trigger emotions that, literally, change the chemistry of our cells, thereby affecting our physical health. Studies have shown that psychological distress (symptoms of depression and anxiety) are associated with increased risk of death from cancer and poorer cancer survival (16).

Reframe: I can create a positive environment—through my food choices, lifestyle habits, thoughts and beliefs—that supports positive health outcomes.

Belief #10:  Healthy eating is boring.

For many people, “healthy eating” is synonymous with “restriction” and “boring” as in “No sugar = No fun!”. Healthy eating frequently conjures up images of bland, tasteless food that is expensive, time-consuming to make, and, ultimately, unsatisfying.

Unfortunately, we now live in a culture where we expect food to “entertain” us. Our expectation is that food should provide us with an “experience” of being novel and fun, as well as being cheap, tasty and, of course, convenient (17).

In addition, the prevalence of hyper-palatable foods—typically processed foods with appealing combinations of fat, sugar, carbohydrates and salt (think cheese, potato chips, ice cream and crackers)—has skewed American tastebuds. A study, published in Obesity, found that most foods listed in the US Food and Nutrient Database for Dietary Studies meet the criteria for hyper-palatability, including foods labeled “low”, “reduced” or “no” sugar, fat, sodium and /or sugar.

Eating a variety of hyper-palatable foods is associated with excess calorie intake and weight gain long-term (18). The more variety in flavor, the more we eat and the more we crave, making it hard to stop eating after “just one” bite or serving. Ultra-processed foods are designed to “hook” you into eating more.

On the other hand…have you ever come home to the wonderful aroma of a cinnamon roast chicken in the oven? Or a beef bourguignon of grass-fed beef and organic vegetables in a red wine sauce simmering on the stove? Enjoyed seared five-spice seared duck breast at home? Savored spiced turkey-apple ragu over zoodles or steamed broccoli with minced gingerroot and a drizzle of sesame oil?

Home-cooked whole foods, flavored with fresh and dried herbs, spices, citrus and other seasonings, provide a flavorful, satisfying and nourishing experience. Hardly “boring”! Eating more meals prepared at home is also associated with:

–A higher probability that your BMI (Body Mass Index) will be in the “normal” range (19).
–A greater likelihood that your body fat percentage will be in the “normal” range (20).
–Less weight gain (21).
–Lower risk of obesity (22).

Reframe: I can prepare easy, simple meals that are flavorful and satisfying—even on a budget.

Sources

1  MarketWatch. Nov. 4, 2022

2  CDC. Obesity (2017-Mar 2020) and Overweight (2017-2018).

3  Reuben L Smith, Maarten R Soeters, Rob C I Wüst, Riekelt H Houtkooper, Metabolic Flexibility as an Adaptation to Energy Resources and Requirements in Health and Disease, Endocrine Reviews, Volume 39, Issue 4, August 2018, Pages 489–517.

4  Wharton S, Raiber L, Serodio KJ, Lee J, Christensen RA. Medications that cause weight gain and alternatives in Canada: a narrative review. Diabetes Metab Syndr Obes. 2018 Aug 21;11:427-438.

5  U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020

6  Zopf Y, Baenkler HW, Silbermann A, Hahn EG, Raithel M. The differential diagnosis of food intolerance. Dtsch Arztebl Int. 2009 May;106(21):359-69; quiz 369-70; 4 p following 370.

7  Hall KD, Guo J. Obesity Energetics: Body Weight Regulation and the Effects of Diet Composition. Gastroenterology. 2017 May;152(7):1718-1727.e3.

8  Kentaro Murakami, M Barbara E Livingstone, Eating Frequency Is Positively Associated with Overweight and Central Obesity in US Adults, The Journal of Nutrition, Volume 145, Issue 12, December 2015, Pages 2715–2724

9  Ohkawara, K, Cornier, M-A, Kohrt W.M., Melanson, E. Effects of Meal Frequency on Fat Oxidation and Perceived Hunger. Obesity (Silver Spring). 2013 February; 21(2): 336–343.

 10  Michael E. Holmstrup, Christopher M. Owens, Timothy J. Fairchild, Jill A. Kanale. Effect of meal frequency on glucose and insulin excursions over the course of a day. e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism, Volume 5, Issue 6, 2010, Pages e277-e280.

11  Lose Weight Here. Jade Teta and Keoni Teta. June 7, 2016.

12  Olson KL, Emery CF. Mindfulness and weight loss: a systematic review. Psychosom Med. 2015 Jan;77(1):59-67.

13  Kesse-Guyot, E., Baudry, J., Assmann, K., Galan, P., Hercberg, S., & Lairon, D. (2017). Prospective association between consumption frequency of organic food and body weight change, risk of overweight or obesity: Results from the NutriNet-Santé Study. British Journal of Nutrition, 117(2), 325-334.

14  Baudry J, Lelong H, Adriouch S, Julia C, Allès B, Hercberg S, Touvier M, Lairon D, Galan P, Kesse-Guyot E. Association between organic food consumption and metabolic syndrome: cross-sectional results from the NutriNet-Santé study. Eur J Nutr. 2018 Oct;57(7):2477-2488.

15  Vigar V, Myers S, Oliver C, Arellano J, Robinson S, Leifert C. A Systematic Review of Organic Versus Conventional Food Consumption: Is There a Measurable Benefit on Human Health? Nutrients. 2019 Dec 18;12(1):7.

16  Wang YH, Li JQ, Shi JF, Que JY, Liu JJ, Lappin JM, Leung J, Ravindran AV, Chen WQ, Qiao YL, Shi J, Lu L, Bao YP. Depression and anxiety in relation to cancer incidence and mortality: a systematic review and meta-analysis of cohort studies. Mol Psychiatry. 2020 Jul;25(7):1487-1499.

17  Mary Avant. QSR Magazine. Dec. 2017.

18  Johnson F, Wardle J. Variety, palatability, and obesity. Adv Nutr. 2014 Nov 14;5(6):851-9.

19, 20  Mills S, Brown H, Wrieden W, White M, Adams J. Frequency of eating home cooked meals and potential benefits for diet and health: cross-sectional analysis of a population-based cohort study. Int J Behav Nutr Phys Act. 2017 Aug 17;14(1):109.

21, 22  Zong G, Eisenberg DM, Hu FB, Sun Q (2016) Consumption of Meals Prepared at Home and Risk of Type 2 Diabetes: An Analysis of Two Prospective Cohort Studies. PLOS Medicine 13(7): e1002052.

Unfortunately, for many of us, simply going to bed early (or earlier) does not ensure that we will fall asleep easily, or sleep through the night.

So, how can we get enough quality sleep?

The following food and lifestyle habits interfere with your sleep architecture. These sleep robbers—and the solutions—include:
 

1. Sugar!

Do you snack on sugar and/or refined carbs, throughout the day (e.g., soda, juice, cereal, bread, pizza, crackers, cookies, etc.)? Do you “unwind” at night with a big bowl of ice cream while watching TV?  Sugar is a stimulant that interferes with sleep by delivering quick hits of energy that can cause multiple awakenings throughout the night. When you have higher blood sugar levels, your body spends the night trying to burn that excess sugar instead of burning fat. Studies have shown that lack of sleep raises blood sugar levels (thereby increasing risk of diabetes). It’s a vicious cycle: unstable blood sugar means less sleep.  Less sleep increases cravings for more sugar.

Rx:  Choose whole, unprocessed foods.

Ideally, this is some combination of protein and magnesium-rich sources of fiber to help stabilize blood sugar and/or a modest amount (not too much!) of starch and fat. Some examples: a few slices of deli turkey or hummus with baby carrots; 2 tablespoons of almond butter and carrots/celery; a few bites of baked chicken with a couple tablespoons of guacamole.  If you tend to wake up repeatedly during the night, try including just enough starchy complex carbohydrates at dinner—like a sweet potato (with the skin), butternut squash or black beans—to increase the level of serotonin in the brain, which helps promote sleep.
 

2. Caffeine.

In its many tasty forms, caffeine—whether it’s coffee, tea, soda, energy drinks or chocolate—promotes alertness and wakefulness. Depending on when and how much caffeine you consume, and whether you are a slow or fast metabolizer, caffeine can disrupt the quality and duration of your sleep.

Did you know: caffeine can suppress melatonin, the hormone that helps control your sleep-wake cycles—even more than bright light?

Melatonin production is influenced by your circadian rhythm (body’s internal clock) and the amount of light to which you’re exposed. Typically, melatonin rises mid- to -late evening, after sunset, and remains high throughout the night.  As the sun rises, melatonin drops—causing you to wake up.  Your coffee habit could be inhibiting melatonin production (when you need it most), making it a challenge to fall asleep.

Caffeine has a “half-life” of 5 to 8 hours (1) and can range as high as 10 hours (2). This is how long it can take for half of the caffeine you consumed to be metabolized by your body—even longer if you’re a slow metabolizer. Let’s use 8 hours as the half-life of caffeine for the following example. It’s Monday morning, and you just drank 200 mg of caffeine (the equivalent of 1-2 cups of coffee) by 10AM. Eight hours later, at 6PM, you will have 100 mg of caffeine in your system. Eight hours later (2 AM), you have 50 mg of caffeine in your system. And eight hours later, at 10AM on Wednesday, you still have 25 mg of caffeine in your system (3). Even a small amount of caffeine can affect sleep quality if you are hypersensitive to caffeine.

Rx:  Know your body on caffeine!

I’ve worked with many clients who are highly stressed and have hormone imbalances, or they are in hormonal transition (perimenopause, menopause, andropause), and are sensitive to caffeine. If this is you, reduce your intake or avoid caffeine altogether—until you stop feeling like you “need” caffeine to function.

If you are a fast metabolizer and able to tolerate caffeine well, have your last cup of coffee by 11AM.  Even if you have a high tolerance for caffeine, try going 2 days on and 3 days off; caffeine typically clears out of your system after 3 days (4).
 

3. Alcohol.

Although alcohol has a sedative effect that can make you drowsy and seemingly fall asleep faster, it disrupts your sleep architecture. This means you will spend less time in REM sleep (important for memory and emotional processing) the first half of the night. During the second half of the night, your body shifts from deep sleep, to lighter sleep with multiple awakenings (because of the alcohol), compromising the quality of your sleep.  You are more likely to wake up very early in the morning—and unable to fall back asleep. The consequences of alcohol-induced sleep loss include fatigue, irritability, inability to focus/concentrate, mood and performance. Consuming two to three drinks a day is enough to affect sleep and performance; heavy drinking and / or drinking close to bedtime worsens sleep loss symptoms (5).

Rx:  Drink less. Drink organic.

If improving sleep is a health goal, it is best to limit alcohol consumption to one drink 2 to 3 times a week and to have that drink between 5pm and 7pm, at least 4 hours before bedtime (6). The ideal scenario, especially if you are in perimenopause or menopause, is to abstain from alcohol altogether during the week and enjoy a glass of organic red wine with dinner over the weekend. Yes, organic, because conventionally grown wine grapes are heavily sprayed with pesticides.  Alcohol also raises estrogen levels; three or more servings of alcohol a week is linked to a modestly increased risk (13% to 15%) of breast and other cancers (7).
 

4. Exercising too much or at the wrong time.

Over exercise, or, too much exercise for an already stressed-out-body—raises cortisol levels. Timing of exercise matters too. By engaging in long-duration cardio sessions (like running or spinning) at night, you are ramping up cortisol levels at a time when cortisol normally drops off. This goes against your natural body clock, affecting sleep. High cortisol levels at the wrong time (night) prevent the production of melatonin, which helps your body get the sleep, rest and recovery it needs (8).

Rx:  Exercise early in the morning, late afternoon, or early evening.

Early morning aerobic exercisers tend to experience the best quality sleep—longer and deeper than those who exercise later in the day, according to a study published in The Journal of Strength and Conditioning. That said, from a thermoregulation perspective (the process of lowering core temperature in preparation of sleep), exercising late afternoon or early evening can also be beneficial for sleep (9). The key is honor your internal body clock and not to engage in long-duration cardio or vigorous workouts (e.g., 1 hour of CrossFit) in the later evening. Researchers found that engaging in 30-minutes of resistance training (up until 7pm) was also found to help improve quality of sleep among college-aged subjects—with additional benefits for those with osteoporosis (bone loss), sarcopenia (muscle loss due to aging), anxiety and depression (10).
 

5. Light pollution.

In Paleolithic times, as soon as the sun set, it was “lights out!”, and the caveman hit the sack. He took his sleep-wake cues from the natural light that was available, awakening at sun rise and going to sleep at sunset.

In modern times, however, we are bombarded 24/7 by chronic light pollution. This includes short wavelength blue light from electronic screens (computers, tablets and phones). After 9pm, exposure to blue light damages sleep by shortening sleep time and preventing quality sleep (11). Energy-efficient lighting, like curlicue compact lightbulbs and LED lights, are also sources of blue light that interfere with sleep. Night exposure to blue light suppresses melatonin (you make less) and disrupts our circadian rhythm (12). A circadian rhythm that is continually “off schedule” (e.g., graveyard shift workers who sleep in the morning and work late evening through dawn) increase their risk of heart disease, diabetes, obesity, low immunity, low mood and poor cognitive function (13, 14, 15).

Using light-emitting electronic devices (LED), such as tablets, smart phones and e-readers before bedtime can negatively impact overall health, alertness and circadian rhythm (16).  In a 2018 study published in Physiological Reports, all of the healthy young adult participants (average age was 26) who used LED in the hours before bedtime went to bed significantly later—about 31 minutes later—compared to when they read printed materials (17). Even a 30-minute later bedtime and/or shorter sleep duration in adolescents is associated with greater daytime sleepiness, caffeine use, depression and thoughts of suicide (18).

Rx:  Start dimming at sunset + Darken your bedroom at bedtime.

• • • If you have to be on electronic devices after sunset, wear blue light-blocking amber glasses to enable your body to produce melatonin that will naturally make you feel sleepy.

   

  • • Keep all electronic devices OUT of the bedroom, including the television.

   

  • • Keep your bedroom dark, as in pitch-black, with these blackout curtains.

   

  • • Swap out scanning your phone or tablet before bed for reading printed material, like a book!

   

  • • Wear a sleep mask; I suggest this brand.

   

  • • If you have a digital clock, turn it away from you or cover it.

   

  6. EMF Overwhelm.

  From cell phones to WiFi, man-made EMFs (electromagnetic fields) are part of our modern everyday life. However, EMF exposure from these devices can significantly reduce melatonin, interfering with our sleep—and negatively affect our overall health.  In fact, the International Agency for Research on Cancer classifies electromagnetic fields (EMFs) as “possibly carcinogenic” to humans, with the potential to transform normal cells into cancer cells (19).

  The human body is actually a complex electromagnetic system. Our cells conduct electrical currents that our body uses; for example, the nervous system require electricity to send signals throughout the body and to the brain that enable us to move, think and feel.  Magnetic fields have also been detected from the human heart and brain (20).

  Here’s the problem. Because the electromagnetic signals of the human body are very weak, chronic exposure to man-made EMFs (like WiFi, Bluetooth and cell phones) can disrupt the intricate but delicate electromagnetic systems of the body, in particular, for the heart, brain and mitochondria (the “powerhouses of the cell”).

  People who are very sensitive to EMF exposure may develop electromagnetic hypersensitivity (EMHS), a condition not yet recognized by the conventional medical community. Those who are electrosensitive may experience a constellation of physical, emotional and neurological symptoms, including sleep disturbance (insomnia or problems staying asleep) and fatigue, as well as chronic inflammatory disorders (21).

• Rx.  Use the following simple, cheap and practical tips for reducing your EMF exposure:

  • • • Limit the time you spend gazing at your computer, tablet, or phone to protect yourself from the cumulative damage of invisible electrical currents.

     

    • • Do NOT sleep with your phone under your pillow! If you use your phone as an alarm, switch to “Airplane” mode and place phone in another room.

     

    • • Keep all of your wireless devices, including your phone, at least one foot away from your body.

     

    • • Completely turn off all electronic devices (e.g., phone, tablet or computer); or, at a minimum, switch to “Airplane” mode and turn off the Wi-Fi function before bed.

     

    • • Instead of a wireless and/or Bluetooth connection, opt for a hardwired ethernet cable connection to your computer, laptop and/or tablet.

     

    • • If you have a WiFi router in your home, turn it off at night.

     

    • • If you need to charge any wireless electronic devices during the night, make sure the device(s) are turned off or in “Airplane” mode—and keep as far away from the bedroom as possible.

     

    • • Trade your digital clock, which runs on electricity, for a battery-operated alarm clock.

     

    • • Say “NO!” to a smart meter at your home; or if you have one, talk to the utility company about replacing it with an analog meter.

     

    7. Monkey mind.

    Worry, anxiety and rumination can prevent us from getting the shut-eye that we need.  A simple way to quiet the mind is to engage in mindfulness meditation. Researchers found that among middle-aged to older adults, who had problems sleeping, those who practiced mindfulness meditation experienced less insomnia, fatigue and depression by the end of just six sessions (22).

    Rx:  Practice mindful meditation.

    So many of us tend to live in the past or in the future, which can drive persistent negative thoughts.  Mindfulness meditation is about being present in the moment. Start with 3 to 5 minutes and, over time, work your way up to 20 minutes. Begin by simply focusing on your breath; a sound (“om”); a word (“peace”); or, a phrase “I am relaxed”.  Release any self-judgement or self-criticism. The idea is to just “be”. If your mind wanders (and it will!), simply bring it back to the object of focus (sound, word or phrase) or to your breath.

    Sleep can feel elusive—either because we are afraid to surrender to sleep, or because we feel afraid, stressed or anxious. While we cannot choose our external circumstances, we can choose to create a healthier body and brain—simply by choosing to sleep.

    As Mahatma Gandhi famously said, “Each night, when I go to sleep, I die. And the next morning, when I wake up, I am reborn.”

     

    Click Below to Continue Reading About Sleep and Health:

    The Power of Sleep, Part 1
     
     
     
     
     
     
    Sources

    1, 3, 4  8  Sleep Smarter. Shawn Stevenson. March 15, 2016.

    2  O’Callaghan F, Muurlink O, Reid N. Effects of caffeine on sleep quality and daytime functioning. Risk Manag Healthcare Policy. 2018 Dec 7;11:263-271.

    5, 6  The Sleep Doctor. Michael J. Breus, Ph.D. Alcohol and Sleep. Sept. 8, 2022.

    7  The Hormone Cure. Sara Gottfried. March 11, 2014.

    9, 10  Alley, Jessica R.; Mazzochi, John W.; Smith, Caroline J.; Morris, David M.; Collier, Scott R.. Effects of Resistance Exercise Timing on Sleep Architecture and Nocturnal Blood Pressure. Journal of Strength and Conditioning Research: May 2015 – Volume 29 – Issue 5 – p 1378-1385.

    11  A. Green, M. Cohen-Zion, A. Haim & Y. Dagan (2017) Evening light exposure to computer screens disrupts human sleep, biological rhythms, and attention abilities, Chronobiology International, 34:7, 855-865.

    12, 17 Chinoy ED, Duffy JF, Czeisler CA. Unrestricted evening use of light-emitting tablet computers delays self-selected bedtime and disrupts circadian timing and alertness. Physiol Rep. 2018 May;6(10): e13692.

    13  Nena E, Katsaouni M, Steiropoulos P, Theodorou E, Constantinidis TC, Tripsianis G. Effect of Shift Work on Sleep, Health, and Quality of Life of Health-care Workers. Indian J Occup Environ Med. 2018 Jan-Apr;22(1):29-34.

    14  Almeida CM, Malheiro A. Sleep, immunity and shift workers: A review. Sleep Sci. 2016 Jul-Sep;9(3):164-168.

    15, 16  Brigham Health Hub. Beware of Blue Light Before Sleep. Anne-Marie Chang, Ph.D and Charles A. Czeisler, MD, Ph.D.

    18  Owens JA, Weiss MR. Insufficient sleep in adolescents: causes and consequences. Minerva Pediatr. 2017 Aug;69(4):326-336.

    19  Halgamuge MN. Pineal melatonin level disruption in humans due to electromagnetic fields and ICNIRP limits. Radiat Prot Dosimetry. 2013 May;154(4):405-16.

    20  Martinos Center. 45 Years of Biomagnetism and SQUID. Nov. 19, 2014.

    21  De Luca C, Thai JC, Raskovic D, Cesareo E, Caccamo D, Trukhanov A, Korkina L. Metabolic and genetic screening of electromagnetic hypersensitive subjects as a feasible tool for diagnostics and intervention. Mediators Inflamm.2014;2014: 924184.

    22  Black DS, O’Reilly GA, Olmstead R, Breen EC, Irwin MR. Mindfulness Meditation and Improvement in Sleep Quality and Daytime Impairment Among Older Adults With Sleep Disturbances: A Randomized Clinical Trial. JAMA Intern Med. 2015;175(4):494–501.