Cholesterol, diabetes, diet, Fat, Grain free, Guidelines, hormone, immune system, insulin, insulin resistant, keto, ketogenic, lifestyle, low carb, Media, NAFLD, nurse, nurse practitioner, paleo, PCOS, steroid, Uncategorized, vitamin

Connecting the dots… How Chronic Diseases Manifest

Oftentimes, a patient will come in or post on Facebook that new symptoms have occurred and evaluation is now needed. Today’s blog article will discuss some of the most common symptoms that bring patients in for diagnosis and treatment.  We’re going to give 2 fictitious patients a run through a visit with me:  Dick and Jane will be our patients today.

Jane is a 43 year old female, who comes in with a new complaint of “just tired all the time”. She occasionally takes a multivitamin, but not much else.  She reports no previous major medical history, but does report that her dad had a stroke at age 61 and is now disabled because of weakness on the left side.  She reports that her mom does have thyroid problems and takes some meds for it but she’s not sure of the exact problem.  During a review of systems, she also reveals that she is beginning to have trouble sleeping through the night, her hair seems brittle, and she’s only having 2 bowel movements a week.  She reports mostly normal menstrual periods, with occasional skipping of a month.  She says over the past 3 years, she’s probably missed 3-4 periods; all pregnancy tests were negative.  She also admits to very slow weight gain over the past 5-6 years; she says she used to weigh around 130 for most of her life.  During the physical exam, Jane appears pretty normal except for these findings:  weight is 214 lbs (height is 5’4”), her skin appears quite dry and even scaly on her arms & legs, very sluggish bowel sounds in all 4 quadrants of her abdomen, and her face just appears fatigued.  She denies problems with depression, but is beginning to think that she might be depressed because many mornings upon awakening, she is exhausted and dreads getting out of bed.  She requests lab work to help identify what is going on.

Image result for blood test image

Dick has made an appointment today because of several issues that don’t seem to be linked. Although he’s done some internet research, the symptoms he’s experiencing aren’t really connected, he reports.  He is somewhat tired, but not every day, and certainly not all day; fatigue just seems to hit randomly, requiring a nap to get through the rest of his day.  He does report a history of mild elevated blood pressure for which he sometimes takes his Lisinopril – averages about 3-5 days a week.  He also reports a recent onset of an annoying dry cough without fever or sinus/allergy drainage – which he does have a history for.  He says he had a biometric screening done several weeks ago at work and brings in a copy of those results for review.  His vital signs:  heart rate 84, BP 168/108, O2 sat of 90%, temp 98.5, respiratory rate 22.  During the physical exam, these abnormalities are noted of this 54-year-old male:  waist circumference is 52 with very protuberant abdomen (no distention, more of a “beer-belly” appearance), lung sounds are clear, but deep breathing triggers his cough, and an extra heart sound (S3) is noted.  In addition, he exhibits trace bilateral pedal edema, but normal pedal pulses.  In review of his biometric results, he has a random glucose level of 186, LDL 201, HDL of 32, Total cholesterol 259, and Triglycerides of 276.  He says they offered health coaching to him, but he hasn’t decided whether to do that or not; he says he wanted to be seen for good physical first.

During Jane’s visit, we decide to obtain some lab tests; drawing a Complete Blood Count (CBC) will help us recognize a possible anemia or subtle infection she may have. A CMP (compete metabolic panel) will tell us about her electrolyte balance, kidney and liver function, while thyroid studies will help identify thyroid problems.  In addition, we obtained a urine dip and a hemoglobin A1c in the office.  We discussed a variety of home remedies and OTC medications/supplements that can help improve fatigue in general, until we can review lab results.  Jane is much relieved to hear that B complex vitamins, Vitamin D, and magnesium are easy to access and often improve fatigue in many people.  She prefers to use supplements and lifestyle changes if possible.  She leaves the clinic feeling better about her outlook and has an appointment for a 2-week follow-up.

In reviewing Dick’s biometric results, we discuss the likelihood that he has diabetes; he agrees that he’s thought the same for a while now, but never tested for it. Reports his mom was diagnosed with Type 2 DM as an adult many years ago and has now progressed to insulin use with possibility of dialysis in the near future.  He expresses great concern over dialysis and states emphatically that he does NOT want to go down that road at all.  We draw similar labs on Dick as Jane had; we also get a BNP (brain natriuretic peptide) level and an office UA and A1c before sending him home with an appointment Friday for review of all the results; we also schedule an appointment for an EKG and an echocardiogram – both are tests to help determine cardiac muscle injury. The BNP is a blood test that helps us determine possible weakening of the heart muscle that often accompanies poorly controlled blood pressure and diabetes.

Image result for cholesterol test image

When Dick returns for his Friday appointment, we first begin with review of the abnormal test results, beginning with the mild abnormalities and working our way toward the more serious problems. His urine is mostly normal, except his protein which is mildly elevated and specific gravity is 1.030 which often indicates poor water intake as it shows high urine concentration.  Elevated blood pressure and diabetes will both contribute to protein spilling into urine – each for different reasons. High blood pressure will cause it because of the force of blood being pushed into the kidneys and the tiny little blood vessels literally burst sometimes.  Diabetes will cause protein to spill into urine because of tiny little “beaver dams” in blood vessels – thick, sticky, syrupy blood causes tiny components of glucose, triglycerides, and inflammation markers to bunch together, forming a bit of a “beaver dam” inside blood vessels.  When these blockages occur, protein is not filtered properly through the kidneys’ processing system and it spills out into urine.  Since Dick has both high BP and diabetes (DM2), it’s difficult to pinpoint his cause of protein in urine.  Moving along, his A1c is 7.8, meaning his blood sugars are averaging around 200 mg/dL. Review of the CMP reveals slightly elevated AST (a liver enzyme), slightly elevated BUN (kidney function test), but normal creatinine, and his BNP is somewhat elevated at 278 pg/mL.  Normal BNP is less than 100; CHF (congestive heart failure) is most likely over 400.  His EKG is mildly abnormal, but shows no significant electrical problem with his heart.  However, the ECHO (echocardiogram) does indicate weakened heart muscle, with an ejection fraction of about 45%.  Normal EF is approx. 50-65%, meaning that during each beat/contraction of the heart, approximately 65% of blood inside the heart is pumped out during that one beat.  Remember, Dick, that the heart’s 4 chambers each contain blood and only the ventricles (the 2 bottom chambers are pumping blood OUT of the heart during that beat, and the RIGHT ventricle is pushing blood to the lungs, while the LEFT ventricle is pushing blood out to the body for use by its cells.  The EF is calculated based on how much blood is leaving the LEFT ventricle during one beat.  You don’t want the EF to be 100%, or your heart would not be able to keep working properly.  It should push out 50-65% of its contents during any given beat or contraction.  When the EF falls too low, it signals that the heart muscle is trying to beat stronger and stronger to push out the blood for the body to use.

Dick expresses a bit of confusion and so we continue to explain. Have you ever been to the gym to work out?  What happens when you start working out? Lifting weights?  Your biceps get bigger and stronger, right?  But the heart muscle is NOT like skeletal muscle at all; when the heart muscle works more and harder, it gets weaker – NOT stronger.  Asking the heart to pump thick and stick blood to an overweight body is not healthy and will cause organ damage – in this case – heart muscle injury, kidney injury; the mild liver damage, likely non-alcoholic fatty liver disease (NAFLD) is related to long-term insulin resistance/high carb intake/elevated glucose & triglycerides. Dick says he’s beginning to understand how all of these health problems are related to one another and now wants to know how to reverse this damage.  He says he’s determined to improve his health. So, looking at Dick’s chart, and reviewing everything with him, we list the following as current medical diagnoses in his record:  hypertension, type 2 diabetes, congestive heart failure, hypercholesterolemia, proteinuria, & NAFLD.  Dick asks if all of this can be reversed without medications and is leery of taking home a shoebox full of meds today. We review the most important problems of high BP and heart injury and decide that these do need some medication, at least for now; Dick agrees to start on BP meds and a diuretic to reduce the workload of the heart.  After much discussion of diabetes meds, he agrees to start on metformin which does not directly lower glucose, but aids in liver health and insulin resistance.  He agrees to start other meds if needed, but wants a real chance with nutrition changes to see if he can eat better to get healthy.  We agree on a monthly visit schedule for a while, just to help and support Dick through these life-changing diagnoses; he came in for one visit and now has multiple life-altering diagnoses with multiple meds and a whole new outlook on life.

Jane is back today for her 2-week follow-up and review of her lab results. Most of her results are pretty normal; her random glucose is 146.  Her thyroid levels are within normal ranges, but just barely.  Her TSH is at the very upper end of the normal reference range; her T4 is pretty normal, but her T3 is right on the lower end of normal.  Her liver enzymes are all slightly elevated, but not very high at all.  Her A1c is 6.3; her urine is pretty normal, except her specific gravity is also 1.030.  It is determined that Jane has subclinical hypothyroidism, pre-diabetes, and likely NAFLD/insulin resistance.  Much of our discussion with Jane is similar to our meeting with Dick, except the heart failure topic.  We discuss starting her on thyroid meds, vitamin D and magnesium regularly with follow-up thyroid labs in about 6-8 weeks because it can take many weeks for thyroid hormone levels to improve.  Jane is thrilled to have some answers to her symptoms and agrees to start on thyroid meds.  We caution her to take thyroid meds, completely alone, with no other food/med for at least 30 minutes because thyroid meds bind easily to caffeine, calcium, and many chemicals/foods.  Jane agrees and leaves with hope that she will feel better soon, but she also asks about her sluggish bowel movements and wonders what she can do to become more “regular”.  We discuss many possible remedies for constipation, including various brands of colon cleansers, OTC laxatives, and foods that can trigger faster GI motility.  She agrees to find something when she picks up the thyroid prescription at the pharmacy.  She schedules her follow-up for about 6 weeks out.

Both of these patients teach us a lot about general health. First, we all minimize many of our symptoms from time to time, thinking it’s just growing older, being too busy, or just not resting well.  But we should always take note of even mild/vague symptoms that don’t improve after a week or so.  Secondly, there are many reasons for fatigue, and if a good evaluation by a provider reveals no likely source, trying vitamins or supplements might help boost energy levels.  Thirdly, there can be many, many mild abnormalities going on internally, that we cannot see, feel, or easily identify without lab tests.  And lastly, both patients had some carbohydrate intolerance, as evidenced by even mildly elevated glucose levels, weight, and missing menstrual periods.

I am a firm believer that high carbohydrate nutrition has led us all down a path to poor health, vague symptoms, and a variety of chronic health conditions. Look at nutrition labels for any processed food; very little actual nutrition, yet agencies PUSH us to eat that stuff. Why? Because Big Food has paid billions of dollars in advertising and donations to organizations like ADA, AHA, AMA, etc.  There was absolutely NO scientific evidence that our bodies EVER needed carbohydrates; if so, they would be considered ESSENTIAL to our health, but carbs are NOT essential.  The body will make any necessary glucose it needs from proteins and fatty acids. Start eliminating carbs today and reclaim your health!

We will follow-up with Dick and Jane in a few weeks to see how they are doing.  Make sure to follow us on Facebook for our latest posts!

 

 

Advertisements
Cholesterol, diabetes, diet, Fat, gluten-free, Grain free, Guidelines, insulin, insulin resistant, keto, ketogenic, lifestyle, low carb, nurse practitioner, Uncategorized

Tips & Tricks to Master LCHF 

Sometimes life impacts our food choices and our intake of processed foods increases, although they may be higher in fat or lower carb. Many times, I get messages, asking for our “approval” to consume off-plan foods like keto breads and ice creams. While some of these foods’ ingredients may be included on the LCHF food list, I strongly encourage people to consume the majority of your intake from real foods. Real meats. Real vegetables. Real fats. Eating from a bag, box or can/jar provides very few essential vitamins and minerals because many manufacturing methods contribute to decreased nutrients. Vegetables contain a lot of micronutrients and phytonutrients our bodies use daily; some have to be replaced regularly. Going days or weeks without any vegetables at all can contribute to a variety of vague symptoms, including increased fatigue, headache, & nausea. There are no magic vitamins in a bottle that can replace your veggies. Meats are strongly encouraged on LCHF as they also contain many essential nutrients, especially red meat – beef, venison, & other wild game. Red meat is about the only source of high quantities of b12 & iron – both of which are essential to our health. Chicken, turkey & pork contain only minuscule amounts of iron,if any at all. Iron is what gives meat its red color, thus the need for red meat. (Yes, vegetarians can eat LCHF, but must pay very special attention to the iron and b12 sources or risk poor health.) 

Do not fear red meat. Red meat has been falsely accused of causing health hazards. People survived eating red meat and its fat for centuries before the industrial revolution came along and packaged all our food. Manufacturing processes, including planting, harvesting, & packaging always decrease nutrient density – meaning everything that comes from a company and packaged, contains very little nutrition. Choose real bacon over turkey bacon. Choose 30% fat in burger meat. Choose real butter over margarine. Choose preservative-free foods when possible. 

Questions about bacon always surface… LOL Bacon IS best with fewest additives, or if you can find pork belly or side meat, it usually doesn’t have added sugars or preservatives; even so, most bacon is still way better for us than most anything in a bag or box. 

Baaaaacon!

Reading nutrition labels and ingredient lists is required reading for truly gaining control over health. Just because a nutrition label says 1.5 grams of carbs per serving doesn’t always mean it’s good for you. Look at ingredients –

Watch for hidden grains, sugars, and dextrin components. There are over

60 different terms that companies use to disguise sugar. Become aware of how companies sneak sugars and sweeteners into their packages. If the 1.5 grams of carbs come from wheat, and you’re sensitive to it, those carbs might send your glucose jumping! And then you’ll battle that glucose spike for hours or even days. Also, remember to check serving size. An example is a 20 ounce soda which is typically 2.5 servings; nutrient info then is NOT for the entire bottle.

Choose water over soda, sparkling drinks, and commercially prepared flavored waters – most of these items contain added sweeteners of one sort or the other and will almost always impact glucose level. Avoid ALL foods labeled as sugar-free and read labels extremely carefully. If it’s sugar free, the company has added SOMETHING to it to make it palatable and desirable. Manufacturers are catering to our “sweet tooth” by making foods sweeter and sweeter; heck, they are even modifying our fruit for maximal sweetness!!
Speaking of fruits… avoid them! In low carb nutrition, we recognize the horrible impact of fruits on our glucose levels. But most people who’ve followed the ADA way for many years are totally unaware that fruit has such an impact. They still believe fruits are good for us, but they aren’t. Only occasional berries – AFTER glucose normalization occurs – are allowed on our LCHF way of eating. If in doubt, perform your own experiment. Test before and after. For experts and such highly educated people to proclaim that fruits and grains are good for us over the past 50 years, is beyond my comprehension. They claim their diet is based on scientific data – tests – measurable numbers. But they’ve never run REAL tests! Their diet is based solely on hypothesis and conjecture. Our way of eating is based on 70+ scientific studies AND thousands of people who live LCHF every day.  
Read vitamin & supplement labels! Many contain cellulose, maltodextrin, corn syrup solids, and wheat as binders and fillers; these items will cause elevated glucose levels. Be very wary of any vitamin drink, protein shake, or miracle concoction that promises symptom relief or improved health. Most of these mixes are completely filled with difficult-to-pronounce chemicals, not foods. Even the “all-natural” ones are loaded with sugars. (Just a side note: cyanide & arsenic are natural.) Our bodies were meant to eat/chew food, not obtain empty calories from chemical concoctions. It’s important for the brain to perceive intake, and part of that process includes chewing. Drinking calories totally bypasses that signal to the brain, and so the body can still feel hungry and not satiated, even with hundreds of calories consumed. 


Hopefully, these tips will help y’all get a better grasp of how I eat and teach people to eat and how so many people are able to drastically reduce glucose levels and lose weight. If you are at a stall — your glucose just won’t fall any more, or your weight just isn’t budging — it may be time for re-evaluation of your intake; take a real look at the packaging you’re eating from. Look at all labels. Look at all ingredients. Look at serving sizes. Eat fresh or frozen veggies – without added sauces and such. Canned veggies can be ok – but always check labels.  
Record all intake and verify nutrient info in your app with google or label on package. The more accurate your info, the healthier your intake will be. Many apps are “editable” by users – meaning you could enter data that says your avocados only have 1 gram of carbs per avocado – very untrue. But if that’s what you select in your app, your numbers will not be accurate and it will show in your glucose level — but you will be posting about how frustrating it is to eat from the list but still have high glucose. 
If you’ve reached a stall, you should also re-evaluate your macros – the fats, proteins, & carbs – you’re consuming. There are many methods of identifying ideal weight, but this is the one I use. For the first 5 feet, one is allowed 100 pounds. For females, we’re allowed 5 pounds for every inch over 5′. Males are allowed 6 pounds for every inch over 5′. Divide your ideal weight by 2.2 and this will give you an approx protein need for you at your ideal weight. This is the number of grams of protein you’ll need in one day, and should be approx 15-25% of calories you consume daily. Divide this number of grams by the number of meals you typically have daily and then you’ll know how many grams of protein you’ll need in one meal; also remember that on average, there are approx 7 grams of protein in 1 ounce of meat. For instance, a 4 ounce filet would contain approx 28 grams of protein for one meal of your day. 

To determine your fat needs, double the number of fat grams per day. For example, if your protein needs are 56 grams per day, you should need approx 112 grams of fat in your meals daily, preferably evenly divided over all meals. 


For a female who is approximately 5′ 5″ tall, her protein needs would be approx 57 grams per day, and fat needs would be approx 114 grams per day. 20 grams of carbs would be the maximum allowed. Now, to calculate how much of this is CALORIC intake percentage, we have to convert grams into calories. Carbs provide 4 calories per gram, so for our female client here, that would be 20 x 4 = 80 calories. Protein also provides 4 calories per gram, so this lady would consume 57 x 4 = 228 calories of protein daily. Fats provide 9 calories per gram; 114 x 9= 1,026. Total these: 80 + 228 + 1026 = 1334 calories per day. Then, figure percent of caloric intake: 80/1334 = 6% of intake comes from carbohydrates. 228/1334= 17% of calorie intake is from protein. 1026/1334 = 77% of calories will come from fat. To calculate YOUR needs, follow this example carefully, & you will figure your grams and percentage of calories quite easily. 
If you use current weight or too high of an ideal weight to determine your macro needs, you’re likely to reach stalls and plateaus, becoming frustrated. If you’re very active, your protein needs will be a bit higher; if you’re pretty sedentary, your protein needs will be a bit less. 
I realize I’ve rambled on far too long, now. Sorry about that. I just wanted to share some of these tips because I see many of you struggling with these concepts and questions. 

 

diabetes, diet, Grain free, hormone, immune system, insulin, insulin resistant, keto, ketogenic, lifestyle, low carb, NAFLD, nurse, nurse practitioner, paleo, PCOS, steroid, supplement, Uncategorized, vitamin

The Chaos Within

 

In the last article, we discussed the 3 processes that the body uses to metabolize, utilize, and store glucose. In this article, we will discuss several conditions that occur when those processes become overwhelmed and organs are unable to keep up with their usual functions.

First of all, if you haven’t read my “peas and cornbread” article, you should. It’s the primer for this more complex article; without understanding it, this article may become difficult to understand.  You can check it out here.  https://ketonurses.wordpress.com/2017/03/16/how-did-i-get-fat-how-did-i-get-diabetes-how-did-i-get-so-unhealthy/

If you’ll recall, the blood stream only requires about 4 grams of glucose for 24 hours of normal daily functions and processes. Four grams is the equivalent to 1 teaspoon.  You read that correctly… 1 teaspoon of sugar is all the body requires to maintain body systems every day.  That is a tiny amount of sugar! Compare that to a day’s worth of intake suggested and recommended by nutritionists, medical providers, and respected non-profit organizations world-wide; most “experts” recommend 45 – 60 grams of carbs per meal (45 x 3 = 135; 60 x 3 = 180) and at least 15 grams per snack twice daily (another 30 grams).  The American Heart and Diabetes Associations are highly regarded as experts in guideline recommendations, but how in the world did they come to THIS conclusion?  A human needs 4 grams of glucose, yet we have been told for 50 years to consume approx. 200+ grams daily to maintain health.  What happens to all the excess?

The excess carbohydrate intake results in a variety of medical diagnoses, but all have one specific problem – insulin resistance. Insulin resistance is the cause of type 2 diabetes (DM2), hypertension, many types of infertility, polycystic ovary syndrome (PCOS), hypertriglyceridemia, various hormone imbalances, a variety of migraines, non-alcoholic fatty liver disease NAFLD), Alzheimer’s, coronary heart disease, and many other conditions.  We will discuss here how all of this chaos occurs within.

The human body was designed with multiple back-up systems and methods for overcoming a variety of stressors, including poor nutrition. Looking back over history, we can see periods of great famine where food was extremely scarce, yet people survived.  The human race has not gone extinct; our bodies and our organs were designed and well-prepared to face a variety of environmental & nutritional struggles.  Yet, we may have found one obstacle we cannot overcome:  ourselves.

After reviewing the “peas & cornbread” article, you will see that our bodies have 3 different processes for metabolizing glucose from the carbohydrates we consume. If any of these processes become overwhelmed, another process will be triggered and more glucose is removed from the bloodstream another way.  However, if all 3 processes are too busy and struggle to keep up, the human system gets sick.  Have you ever known a basement to flood? Did you see a sump pump trying to remove the water from the house? If the rain/flood waters are coming in faster than the pump can remove it, what happens?  The flood continues to rise; more damage is done to the home.  So it is with overconsumed carbohydrates over time.  As high carb intake continues, the pancreas, bloodstream, and liver work overtime trying to remove all the excess glucose.  After months or years, the system cannot keep up; organs never get to rest, even during sleep.  These overactive processes often contribute to insomnia, which increases body stress, raising glucose even more; it becomes a downward spiral to poor health.

Many patients, when told of their new diagnosis, often say, “but I don’t feel sick.” And it’s very true.  The human body is SO GOOD at managing our internal chemistry, the system can become very imbalanced before any symptoms are noticed; some symptoms are subtle and just disregarded.  Fatigue, or feeling tired, is often overlooked or ascribed to our busy lifestyles; gaining weight is often attributed to our genes, our lack of exercise, or even to poor nutrition.  Forgetfulness is usually attributed to being distracted or just part of normal aging; muscle aches & joint pains are often called fibromyalgia or arthritis.  Sugar cravings are seen as the body’s way of getting us to eat something we “need.” Feeling hungry all the time is often seen as poor thyroid function or just staying too busy to eat.  I could go on and on with the vague symptoms people report to medical providers during office visits; most of these symptoms are ignored or regarded as “not pertinent” to today’s problem-oriented office visit.  Millions of patients world-wide report these types of symptoms on a daily basis, and then when they are finally confronted with a life-altering diagnosis, most seem utterly shocked and surprised.  It truly is a shame; I see it regularly and wish I could do something more to help.  People do not seem to understand how they could possibly be diabetic or infertile, or have NAFLD when they’ve been eating according to nutrition guidelines for many years, with only occasional “cheats” or unhealthy foods.  They come in and complain that no provider ever told them this or that; they report many years of struggling with food addictions and cravings.  They even bring brochures and eating plans from other providers and nutritionists, saying, “I eat exactly according to this plan; how can I now have diabetes?”

It all begins with overworking our human systems; while the body is amazing at maintaining the appearance of health, our organs are often taking the brunt of the illness. Every carbohydrate we consume converts into glucose and/or fructose, triggering the pancreas to secrete insulin so that the excess sugars can be removed from the bloodstream because they do not belong there.  Over time, the pancreas either cannot keep up and is unable to secrete enough insulin, or it begins to make faulty insulin – insulin that is no longer functioning to move glucose out of the bloodstream.  This one organ, the pancreas, can become very ill, resulting in pancreatitis.  Difficult to heal, it can take many months or years for the pancreas to recover, and if carbs continue to be consumed in high quantities, it will never recover.

Another problem that develops with these high carb intakes is the body’s cells become resistant to the insulin; there’s so much glucose in the bloodstream, that there’s just not enough insulin to transport the glucose out of the bloodstream. Think about magnets for a moment – recall that magnets are polar.  One end of a magnet will be attracted to another, but the other end repels the other magnet.  Glucose and insulin can become that way in the bloodstream when there are too many glucose molecules in the blood.  If glucose repels insulin (or vice versa), glucose accumulates in the bloodstream instead of being moved into cells. This overload of glucose can contribute to thick, sticky blood which significantly contributes to non-alcoholic fatty liver disease NAFLD), Alzheimer’s, coronary heart disease, heart attacks, strokes, and many other conditions.  Imagine a family of beavers locating to a new stream.  Dad Beaver scouts out a great location and begins bringing limbs and moss to build a new home for his family.  Mom and kids soon begin to help out; at first, water flows easily through the creek.  As more limbs and debris are placed, water flow slows.  Although water is flowing, animals and plants downstream begin to feel the effects of less water.  Finally, after some time, the Beaver family stands proudly inside their new home, where no water is able to get through.  All the plants and animals downstream suffer.  So is the circulatory system within our bodies.  Capillaries are the tiniest blood vessels we have; it is through capillary walls that blood delivers oxygen and picks up wastes like carbon dioxide to be transported to kidneys and lungs for excretion. These capillaries are so tiny that they can only allow for 1 tiny red blood cell to get through at a time.  Take a look at this picture; the largest circle is of a human hair, greatly enlarged.  The darkest circle is the diameter of a red blood cell.  Can you see the image of the beaver dam happening inside blood vessels now?

MicronIllustration

Image from: http://www.baldwinfilter.com/fr/TechTips201403.html, Retrieved 4/3/17.

Now, let’s add to this imagery. Think about the beavers building their dam; are they using trimmed up logs that are nice and smooth – like those with which we might build a log cabin?  No, of course not.  The beavers are using limbs and debris from all over the riverbanks.  Crooked and jagged limbs stick together better and are easier for the beavers to use.  The jagged pieces literally intertwine and stick together even with waters moving through during early building stages.  This image is of a sugar molecule:

sugar-molecule-1

Image from: https://www.exploratorium.edu/cooking/candy/sugar.html, retrieved 4/3/17.

Notice how jagged and crooked this molecule is. Even when broken down into glucose and fructose, the molecule remains jagged and easy to snag on other molecules.  It’s not smooth like blood cells.  Now, imagine hundreds upon thousands of these molecules overfilling blood vessels that are tiny, tiny, tiny.  Can you see how circulation becomes terribly impaired, just as when a beaver dam is constructed in a creek?  Can you imagine all these sticky, syrup-like molecules just sticking together and building up tiny little beaver dams all throughout blood vessels?  This process, reducing blood flow, is what typically results in heart attacks, strokes, and amputations in people with diabetes and insulin resistance.  When blood flow cannot reach the target, tissues are deprived of oxygen and nutrients, resulting in beaver dams or microscopic clots in blood vessels.  Without oxygen and other nutrients, tissues cannot function properly, nerve tissue ceases to respond to stimuli, and sensation and use are impaired.  When enough blood vessels are blocked, tissue is damaged, like with diabetic neuropathy or chronic kidney damage.

In other tissues, this overflow of sticky blood and poor insulin activity also contributes to a myriad of problems. High insulin in the bloodstream triggers many hormone abnormalities.  The normal chemical balance in the human body is fragile; anytime one chemical drops low or jumps up high, a wide variety of abnormal processes may begin.  In women, one of the most common chemical imbalances results in abnormal reproductive hormones that usually regulate our monthly cycles and fertility. One of the pathways suggested for this imbalance goes something like this:  being overweight and/or insulin resistant contributes to hyperinsulinemia (high insulin in blood).  Having too much insulin, the bloodstream sends signals to the liver (remember the “peas & cornbread” story) and this effect signals a decrease in growth factor production/release which increases androgen activity; increased androgen activity causes an increase in estrogen and luteinizing hormone (LH).  Increases in estrogen and LH levels stimulate ovarian hyperplasia – or the overgrowth of tissue – which can result in endometriosis or polycystic ovaries.  Ovarian hyperplasia, overstimulation of ovaries and the increased levels of reproductive hormones all combine to cause anovulation, or ovaries that are not releasing eggs for possible fertilization; thus, infertility occurs.

In the liver the high levels of insulin, glucose, and associated inflammatory processes combine to trigger storage of glucose in the form of glycogen; once the liver has stored all it can hold and blood sugars remain high, the liver doesn’t know what to do with all the excess carbohydrate being ingested. It just keeps storing more and more.  Let’s imagine that you decide to put your household garbage in the pantry, instead of taking it outside to the trash bin for collection.  Keep doing this.  Every time you fill a garbage bag, you pull it out of the can, tie it up, and pile bag after bag in the pantry; then you run out of room, and begin filling kitchen cabinets.  Eventually, those cabinets fill as well; so where do you store it now?  Over time, the garbage comes to overwhelm the entire kitchen, so much so, that normal function in the kitchen is halted.  There is literally nowhere to work or accomplish cooking tasks.  That’s what happens in our livers with glycogen storage.  There’s room for a little glycogen, so in times of famine, the liver can release a few grams of glucose the body needs, but there’s not room for 200-300 grams of carbs per day for a lifetime.  This overwhelming storage of glycogen is what usually triggers non-alcoholic fatty liver disease.  (Alcohol can trigger similar, but that’s another whole story.)

In the brain, there’s a massive circulatory system used to control all our normal functions without us ever thinking. Parts of the brain control and manage our thirst, hunger, heartbeat, breathing, even most of our movements aren’t really conscious thoughts.  But now think back to the beaver dam analogy from before; most people with diabetes understand their neuropathy, or nerve pain, in their feet are caused by their high sugar levels because our feet are further away from the heart than our hands.  However, gravity can also influence blood flow somewhat; combining the physics of gravity and thick, sticky blood, the brain also suffers in a similar way.  Because the tiniest blood vessels in the brain are highly specialized to deliver certain neurotransmitters, hormones, and other chemicals to our brains (& control their release from other organs), anything that reduces blood flow in our bodies can also reduce blood flow, oxygen, and vital nutrients to the brain and associated organs. When blood flow is reduced to our brains, areas of the brain cannot adequately signal the nervous system to function properly; organs may be signaled to alter, stop, or begin a process that may become seriously damaging to health.  This reduction in blood flow to the brain is often called “microvascular ischemic changes” on a CT scan or MRI report.  In fact, many providers will see this on an otherwise normal imaging report, and never mention it to patients because it seems like such a minor problem.  However, given time and continued high carb intake, these tiny problems become bigger problems.  While most of the general population do attribute forgetfulness to “normal aging”, there’s nothing normal about it.  Aging does NOT in and of itself contribute to confusion or minor forgetfulness.  It is always worth an office visit for evaluation and workup at any age.  In 2008, The Journal of Diabetes Science & Technology published an article calling Alzheimer’s disease (AD), diabetes type 3 because “we conclude that the term “type 3 diabetes” accurately reflects the fact that AD represents a form of diabetes that selectively involves the brain and has molecular and biochemical features that overlap with both type 1 diabetes mellitus and T2DM.” (Retrieved 4/3/17 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769828/)

Even when none of these more serious health conditions are diagnosed, many of us do have these changes occurring inside; hypertension has been called “the silent killer” for many years, but I call insulin resistance the REAL silent killer as many chemical imbalances occur with minimal notice for most people. And mainstream medical providers typically never address root causes of many of these vague symptoms because there’s just not time in most office visits to address them and sometimes, it takes a lot of time & multiple diagnostic tests to identify certain problems.  Mild symptoms of hyperinsulinemia can contribute to high inflammatory markers in the bloodstream and if blood tests are not performed, there’s no way to know if inflammation or hyperinsulinemia contributes to your migraine headaches, your fatigue, or your fibromyalgia.  Many of us suffer with osteoarthritis, or general joint pains related to overuse or previous injury.  High carb diets can contribute to much of the joint pain because of high inflammation within the body; without a blood test and/or radiology to confirm it, many health care providers call it OA and tell you to take some OTC pain relievers.

So, now what? What does all of this physiology mean?  It means that we as a people have become terribly unhealthy because of the poor quality of fake foods we have eaten for the past 50 years.  We’ve followed the AHA and the ADA; we heeded the dietary advice; there’s recent research to prove it.  So, continuing to follow that advice certainly won’t improve our health.  What do YOU think would help?  After reading this article, I hope you say, “cut the crap.” Literally, that is the best advice ever.  Cut out all processed foods, carbonated drinks, artificial foods, fake foods, junk foods, refined sugars, and anything that even looks like it was manufactured in a plant.  Eat real food.  Eat from the farm.  Eat from the edge of the grocery store.  Think back in history; what did people eat before boxes of cereal lined the store shelves?

It’s time we the people took charge of our own health; the health care system is broken. We wait months sometimes to see health care providers who don’t have time for thorough medication reviews and physicals.  As consumers, we can change the face of nutrition in our homes, families, and our nation by making better choices and eating foods that heal our bodies.  In our next article, we’ll cover more details about what to eat and what to avoid eating.

diabetes, diet, gluten-free, Grain free, insulin, insulin resistant, keto, ketogenic, lifestyle, low carb, NAFLD, nurse, nurse practitioner, paleo, PCOS, Recipes, Uncategorized

Bac’n Brussel Sprouts

16 oz washed and quartered Brussel sprouts

6-8 slices of bacon

3-4 Tbsp butter

Salt, pepper, & garlic to taste


In skillet, fry bacon until to your liking. I like my bacon really crispy. Remove cooked bacon from pan and allow to cool for a few minutes. Add butter to bacon grease in pan. Add hopped Brussel sprouts to grease & butter. Sprinkle with seasonings to your preference.
Stir fry for about 12-15 minutes or until largest sprouts are softening. Smaller pieces will appear quite soft and pierce easily. You want a good mixture of soft to barely soft. With about 2-3 minutes left, add in broken bacon pieces and keep stirring until done.
Serve immediately.
This dish can be made using smaller or larger quantities, depending on size of your family or event. It even keeps well; I take it for lunch often!

diabetes, diet, gluten-free, Grain free, hormone, immune system, insulin, insulin resistant, keto, ketogenic, lifestyle, low carb, NAFLD, paleo, PCOS, Uncategorized

25 Top Tips to Eat Healthy & Honor God with Our Lifestyle (Part 2 of 2)

Now that we know God has a better plan for our health, how do we find it? What do we do now? How do we get healthier?

1.  Start wherever you are. Making small changes over several weeks can add up to MAJOR health benefits. Some people can go “cold turkey,” cutting out all grains & sugars, but many of us just cannot do that. So, take baby steps. One change today, another change in a few days, & on we go to a healthier life.

2.  CHOOSE to ADD a healthier food to your life. AND Pick something you are willing to cut out and cut it out. Lay out a plan over the next few weeks to ADD something healthy AND cut out 1-2 unhealthy items each week. People are much more successful at accomplishing goals when written out and planned well.

3.  One of the most common changes people make is to reduce or cut soda from life. Soda is loaded with chemicals & sugars or sweeteners that trigger a lot of chemical reactions in the body; many of these chemicals & reactions have been linked to all sorts of health problems & chemical imbalance. I confess – I used to be one of those people that swore I’d NEVER stop drinking my soda. I frequently would drink 2-3 liters per day! And I hated water. But as my weight neared the 200 pound mark, I knew something HAD to change. So I switched to green tea. After many months, I was able to cut out the tea and now I drink water. Because 67% of the human body is made of water, it is extremely important to drink plenty of water every single day. The “rule of thumb” is to drink half your body weight in ounces of water daily. For example, if you weigh 200 lbs., your water needs are nearly 1 gallon – at 100 ounces per day.

4.  Seek out people to join and support you on this journey to better health. Look for authors, groups, and friends who are also focused on similar health goals and spiritual support as yourself. Start a support group in your town, community or church.

5. Keep your efforts positive! Don’t focus on cutting out the unhealthy items; focus on adding healthier foods. Remember that natural fats are NOT unhealthy. Add butter, coconut oil, avocado & olive oils, tree nuts, & even cheeses.

6.  Remember that fats will keep you fuller longer than carbohydrates. Adding healthy fats to meals can help you go many hours without feeling hunger, thus reducing your intake. When I drink my fat-filled coffee, I often go 6-8 hours to my next meal, obliterating the standard “rule” to eat every 2-3 hours.

7.  Start by reducing portion sizes. Remember that the stomach is only about the size of your fist. So, an easy method to eat less, is to cut portions in half when you prepare your plate. I teach people to eat on saucers or salad plates to help keep portion sizes down. Separate your plate of food into halves or thirds; from that division, make a “takeout” for lunch the next day or split with your spouse or meal companion.

8. Keep meat portions small – about the size of a deck of cards. This tip is vital for people with high glucose or sugar problems. Eating large quantities of meats while cutting out carbs can trigger a process where the body will produce glucose from the excess protein, and can result in elevated glucose levels – not helpful for people with metabolism problems or diabetes.

9. Drink a glass of water about 10 minutes before eating to help your stomach signal fullness sooner during eating. Remember that it can take up to 15 minutes for the brain to recognize fullness and tell you to stop eating. Most of us can finish off a huge plate of food in less than 10 minutes. If you finish a plate of food in under 10 minutes, wait before refilling your plate.


10.  Use this plate as a general guide to preparing your plate. Try to decrease carbs as you increase fats – remembering that this specific tactic should be used VERY short-term. Consuming high amounts of carbs AND high amounts of fats for weeks or months st a time, may increase your risk of heart disease and a decline in health.

11.  If you cut out carbs “cold turkey,” do your research into “carb flu” or “keto flu.” Carbohydrate conversion to glucose has caused addiction in most of us; dropping carb intake suddenly can contribute to a variety of vague symptoms that can be quite significant to normal function. Symptoms can include headache, muscle aches/cramps, feeling tired, mood swings, irritability, insomnia, and slower bowel movements. In general, these symptoms last about a week or so; some people take a few days more or less to overcome these symptoms. Being prepared with lots of salty broth, avocado, magnesium & potassium-rich foods help dramatically. I typically don’t recommend going cold turkey for most people because many folks get frustrated when symptoms seem worse right away when they’ve been told they will feel better giving up carbs. Some people just can’t seem to fight through these temporary symptoms.

12..One of the most shocking truths that people seem to struggle with is the idea that fruits also have to be cut. Subbing out a candy bar for a banana sounds like it would be MUCH healthier, but in all reality, it’s only slightly better. Fruits have been genetically engineered to taste maximally sweet – that sugar must go somewhere – it fills the bloodstream with excess sugar that must be managed by the body.  I usually recommend at least 30 days of no fruit, sweeteners, or processed foods, once most of the carbs have been cut out. This method allows the taste buds to reset and enjoy less-sweet flavors and it helps the liver with detoxification, reducing its workload.

13. Pay close attention to your body’s signals. Hunger is designed to alert us to the need for fuel; it should signal that it’s time to seek food by a stomach emptiness &/or growl. A clock or social event should not dictate meal times as we’ve thought in modern times. The most basic rule to go by is: if you are not physically hungry, do not eat. There is no need to put fuel in a full tank.

14. The new buzzword today is “gluten-free.” Don’t fall for it. While I do recommend going grain-free, substituting more high-carb, processed, nutrition-less fake foods will not contribute to good health. Gluten-free foods utilize rice, potatoes, fruits & other grains to make comfort/snack foods. So, paying for high-priced food-like chemicals will not improve your nutrition status.

15. Because we’ve become accustomed to eating low fat foods, our tendency now is to purchase similar foods and think we’re making healthier choices. When possible, make full-fat choices. Foods are either flavored with fats or sugars. Sugars are the most detrimental to our health as evidenced by elevated glucose levels after consuming them.

16. When buying groceries, try to shop the perimeter of the store; avoid aisles of processed, boxed & bagged food items. The edges of the store typically contain the produce, meat, & dairy products – most of what is in your new lifestyle.

17. Read labels. Look for non-food words, like preservatives, chemicals, & sugars. With 60+ terms for sugars, it can take a while to figure out how manufacturers attempt to hide sugars from us. Keeping food choices closest to the farm will help keep shopping focused – at least for the first few weeks. Frozen foods are often fine; some canned foods may be ok as well. Purchase the cheapest cuts of meats as these will contain the highest natural fat content. Just make the best possible choices within your budget. Cutting out expensive processed foods will also contribute to decreased spending! What a bonus!

18. Record your intake. Write down everything you eat and drink. Or use an app. MyFitnessPal and Cronometer are both very popular apps for helping to keep track of intake and macros.  Finding your “sweet spot” with macronutrients can take a little time, depending on your specific health conditions, medicine use, & body chemistry. Macronutrients are proteins, fats & carbohydrates. While I typically recommend 70-80% fat, 15-25% protein, & 5% carb intake for the average person, I often individualize a plan that is very specific and based on personalized needs.

19. In addition, adjusting medication doses for patients means I also build great relationships with my patients because they come in for visits as often as every week – at least for a while. I am a firm believer in keeping communication with your provider very open; if you are cutting carbs while on medicine, many doses may need to be decreased, while some meds may need to be stopped. Even if your health care provider is NOT very supportive of low carb nutrition, they will still need to be aware of your glucose & blood pressure levels in order to make medication changes safely & accurately.

20. I remember when I began implementing these methods of weight loss during the Bible study. For the first few days, I would go about 11-12 hours waiting for true physiological hunger to signal me to eat. For people with sugar problems & diabetes, this step should be done with the assistance of a trained healthcare provider to avoid dropping your glucose to an unhealthy level. Using both diet AND medications for sugar control can cause serious drops in your glucose level. It is very important to seek out help managing medication doses and appropriate reductions in your prescribed medicine.

21. I also found that frequent prayer helped me focus on eating healthier. Staying in close communion with the Holy Spirit helped me be aware of eating when I wasn’t hungry or eating after I was full. I really tried to keep Proverbs 23:1-2 in my mind & heart 24/7.

22. Find an accountability partner – in addition to the Holy Spirit. Research shows that people who change lifestyle habits succeed at much higher rates than people who go it alone. Eating is a social event, so changing your diet WITH someone is much easier than eating two different meals. Purchasing groceries for one meal plan is also much less expensive!

23. A lot of people making lifestyle changes begin or resume taking loads of vitamins & supplements. Most are unnecessary, not helpful, poorly absorbed & pricey. I don’t typically recommend multivitamins at all any more. I usually recommend Vitamin D, as we are all pretty deficient. If you have your level tested, you can monitor your level annually to be sure you stay in the normal  range. Many cardiologists are also recommending magnesium supplements now too; for one, it’s great for heart health & it aids in the absorption of the Vitamin D.

24. Keep a journal. Write down your thoughts and feelings as you enter this journey. Record your current symptoms and as you begin to notice relief, record that too. My hip arthritis & psoriasis disappeared after 2 weeks of cutting out the grains – totally unexpected benefit! Record methods that God uses to help you reduce intake or make healthier choices. Keep track of blessings so that difficulties are easier to bear!

25. Lastly, do NOT wallow in guilt, fear or shame. There are loads of tips here. You do not have to make every change mentioned here. Just pick a few that seem like they would benefit you the most & start with those changes.  Come out of that darkness and into the Light. God wants us to LIVE. He wants us to LIVE a long and healthy life. He wants us to be blessed and to bless others.

diabetes, diet, gluten-free, Grain free, insulin resistant, keto, ketogenic, lifestyle, low carb, nurse, nurse practitioner, paleo, PCOS, Uncategorized

Does God care if I’m overweight or unhealthy? (Part 1 of 2)

 

Many years ago, I took part in a Bible study that focused on losing weight using several different techniques that did help me become thinner. One of the weekly studies focused on a Bible verse from Proverbs 23:
When you sit to dine with a ruler, note well what is before you, and put a knife to your throat if you are given to gluttony.

That verse struck me as quite harsh and shocking. I had never really thought about overeating or eating just to eat might be anything that bothered God or was sinful. I knew He’d set forth all sorts of dietary laws in the Pentateuch, but I never made a connection between HOW & WHAT He wanted us to eat.

So, this verse in Proverbs really rocked my world. I pondered and meditated on this verse for days. I never thought I might be a glutton! That realization was VERY hard to wrap my head around. I tried to rationalize my overeating, my emotional eating, my eating when I was bored. It seemed that everywhere I turned, I heard this verse in my head. I saw evidence that God did not want me to overeat. Various “accidents” happened; I dropped bites of food. I spilled soda. I was repeatedly shocked by the simple methods God used to decrease my food intake.

For the past 10 years, I’ve continued to utilize many of the techniques I learned in that Bible study; I’ve even taught patients to use some of them. But I’ve rarely mentioned the verse that stirred such guilt & shame in my own spirit & emotions. I was afraid. I was guilty. I was ashamed. I was shocked. It was very hard for me to recognize that God wanted me to “cut my throat” if I was going to overeat. It sounded so very harsh then and still sounds harsh today. But in the years since I first studied the verse, I’ve begun to come to terms with what I believe God tried to set forth in this verse.

img_6275First of all, I know I’m not perfect. I still sometimes overeat or make an unhealthy choice. My goal is to help people see that God knows the desire of our human nature is selfishness – even in eating – and He does not want us to feel so guilty, fearful, or ashamed. He wants us to enjoy eating. He wants us to be joyful. He wants us to LIVE. In Deuteronomy 5, Moses wrote to the Israelites, saying ” Walk in obedience to all that the LORD your God has commanded you, so that you may live and prosper and prolong your days in the land that you will possess.” (NIV, v 33).

 

Do you see that God wants us to LIVE? Living is not surviving. Living is not becoming overweight, unhealthy or unhappy. Living is being able to overcome & be victorious. Living is joyful – even during trials & tribulations, we can have inner peace & joy when we pursue LIFE. God really does WANT us to live with this idea at the heart of our being; He wants our focus on Christ and His ways so that we can LIVE a long life. Proverbs 10:7 says, “The fear of the Lord prolongs life, but the years of the wicked will be short.” God isn’t saying that life will always be shortened as punishment, but may be a result of poor choices. Scripture is full of evidence of poor choices that resulted in serious consequences. God’s desire is NOT to punish us. His desire is to bless us – over & over again. He wants to give us long, healthy lives. When we make repeated bad choices, often those choices have their own consequences by laws of nature, science, chemistry, or physics. God is not going to override natural laws to save us from ourselves. Some of these consequences include illness and shortened life.

How can we obtain God’s favor and live long healthy lives? It’s easy. We seek His will, guidance & pursue a relationship with Him. We also go back in history to learn how people ate in the past. In Biblical days, many people lived to be well over 100 years old; Moses lived to 120. Joshua died at age 110. Noah lived 950 years. How? Why? Even if years were measured differently then (they weren’t much different), Noah lived a LONG, LONG time. How? Why? Can we adopt any of the habits or culture to help us today? I believe we can.

In Genesis, God gave the Garden of Eden & livestock of the land to Adam & Eve. He gave these to Adam & Eve for their own nourishment. He provided plants and animals for eating & satisfying our need for fuel & nutrients. He wanted us to enjoy eating and so He created a variety of tasty plants.

However, modern society has taken advantage of the earth & altered methods of planting, harvesting, & processing. Many of these methods have adulterated natural foods and removed nutritional value that God intended. One of the most common ways to improve nutrition state, is to cut out most or all of the processed, highly chemical-laden foods. Most processed and prepackaged food items have almost no nutritional value. Read nutrition labels, if you’re skeptical. Compare labels of white bread and whole grain bread, for example. There is very little difference in nutrient content. If whole grains are supposed to so much healthier for us, why is there no increased nutrient density?

Looking back over time, having bread at every meal every day was not common. Breads were difficult to have in large quantities because wheat and other grains have a long growing season & require a large amount of field to grow enough for use. With poor storage methods, grains were used seasonally, not daily. The only time in history that people ate bread daily is when God provided manna from Heaven to the children of Israel. He instructed them to gather it daily except for the Sabbath because it wouldn’t keep well. That manna provided plenty of nutrients because Scripture is clear – they ate manna daily for 40 years – and the people suffered no ill health effects. Other than this specified 40 years, humans have only had breads/grains seasonally. What did they eat the rest of the year? Meat. Meat is the only food source that has always been available.

Fruits & vegetables were only available seasonally. Very few plant products were easily stored for weeks or months on end. They did not use chemical preservatives to keep foods stable on a store shelf for months at a time. They used salt and fat to preserve foods. They built in-ground cellars where temps were cooler, but food was rarely stored for more than a few months.

In summary, God intends for us to LIVE long, healthy lives. How? First, realize that He has provided a way. Next, look to nature for most food sources. Avoid eating food-like items that man has conjured up in a chemistry lab or manufacturing plant. Look to the farm – the closer a food is to nature, the higher the nutrient content. Nutrient-dense foods are from the farm/garden. Foods with the most nutrition are meats, vegetables, & natural fats. Only consume fruits as occasional treats – fruits would only have been available seasonally, not year round. Substituting fruits for unhealthy highly processed carbs may seem like a good option, but remember they still convert to fructose & glucose, and too much can still cause ill health.

Finally, does God care if we are healthy or not? Of course He cares. He wants us to be healthy. He wants a full life for each of us. He’s designed a great way for us to be healthy and live a long time. Our next blog article offers tips to do just that!

keto, ketogenic, lifestyle, nurse, nurse practitioner, Uncategorized

Biographical information about Barbara Shea Tracy, MSN, APRN, FNP

Barbara is a family nurse practitioner in western Massachusetts having obtained her MSN from Frontier Nursing University in Kentucky. She practices with a group of physicians and nurse practitioners in internal medicine and collaborates with a physician who is a certified lipidologist. She also provides house calls to those who are unable to leave their homes. Being an avid cook, she combined her culinary interests with medicine, to reach out to patients with type II diabetes, hypertension,high blood cholesterol and obesity. She tends to hand out more recipes than prescriptions.

Barbara started the low carb, high fat way of eating two years ago, lost a considerable amount of weight and kept it off. She also noticed increased energy. She decided to introduce LCHF to her husband, an emergency physician.He had the beginning of metabolic syndrome, high cholesterol and was taking statins. He was initially skeptical, but after reading the professional literature, agreed to try it. He stopped his statin medication and 7 months later was thirty-six pounds slimmer and had a perfect lipid profile. Barbara’s patients noticed the same positive health changes.

Barbara has experience in emergency nursing, hospice nursing, and psychiatry. She is also an educator in her local community college where she lectures and provides clinical experiences to RN and LPN students. Her main focus is on patient and family education–providing them with the knowledge they need to make lifestyle changes which lead to improved health.

Barbara lives in the Berkshires, a beautiful area in western Massachusetts.She also frequents Harwich, MA where her family has a summer home.  She is an avid cook and enjoys photography as a hobby.