A guest blog by dietetic intern Tanya Mezher

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Part of what intrigued me most about interning with Anastasia Health is her holistic approach to disordered eating, which includes offering yoga therapy as a course of healing and treatment. My first experiences with yoga began about five or six years ago when I sought out ways to diversify my exercise routine. The gym I visited regularly happened to offer classes to its members and I often watched curiously through the glass windows at the synchronizing yogis, as I reluctantly clung to my habit on the treadmill. Eventually, I would join my first class, forever transformed. I quickly became enamored with the uplifting, holistic effect of each experience. Yoga is much more than a physical movement - it has become a form of grounding, anxiety and stress relief, creativity, playfulness, spiritual meditation - a way to care for myself, my body, my mind, my soul. It has helped me increase awareness of my internal dialogue and thoughts - creating space for loving gentleness, kindness, patience and peace toward myself and others.

The practice of yoga is innately therapeutic, and for many, has been incorporated into their days as a way of life. Yoga has significant benefits on stress marker levels, flexibility, respiratory and cardiovascular function, anxiety, depression, pain, sleep and overall quality of life.[1] By addressing an individual as a whole being where the function and wellness of the body, mind, and soul are intricately intertwined and cannot be healed apart from the other - it is no wonder yoga therapy is considered a complementary and alternative approach to medicine.[2]

Yoga therapy is particularly influential as a complementary approach to treatment for eating disorders. Eating disorders are often categorized as anxiety disorders, in which individuals cope with emotional and psychological issues through objective manipulation of their physical bodies and behavior. Individuals who struggle with disordered eating also generally experience disconnection from and discomfort with their physical bodies - often ignoring or completely out of tune with hunger and fullness cues. The practice of yoga can be considered an embodiment or external expression of what is happening internally within the individual. By intently focusing on each breath and movement - one is brought to an awareness of the physical and emotional feelings that are present. With pauses in the stillness, an individual can be gently guided to confront anxieties, which in our typically fast moving pace we tend to bury or flee from, often resulting in harmful behavior as a means to cope. This increased sense of self-awareness facilitates a unique process of healing and attunement to our needs and respect for our bodies.

Regular yoga therapy has been shown to significantly improve body satisfaction in individuals who participate in as little as 30 minutes of yoga per week.[3] Ultimately, yoga therapy is a self-healing practice, the frequency, and duration of which are based on individual needs. Yoga can be complex and approached from various styles, however, it can also be as simple as breathing into the depths of the belly or taking a few minutes to sit in a squat to start to feel a shift in energy and mood. 

 

References:

[1.]     Woodyard, C. (2011). Exploring the therapeutic effects of yoga and its ability to increase quality of life. International Journal of Yoga, 4(2), p.49.

[2.]     (2017). Yoga: In Depth. Retrieved from: https://nccih.nih.gov/health/yoga/introduction.htm

[3.]     Neumark-Sztainer,D et al. (2018). Yoga and body image: Findings from a large population-based study of young adults. Body Image, 24:69-75.

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AuthorAnastasia Nevin
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I want to take a moment to acknowledge a topic that has been near and dear to my heart in the past few months, as well as one which often arises during my work with young women in recovery from disordered eating: motherhood. 

Last year, I had the privilege to bring a healthy young baby girl into this world. My pregnancy was at time uncomfortable and challenging, AND it gave me the gift of deepening my own recovery in ways I had never expected...

My nausea and inability to eat the foods I usually enjoy, for instance, gave me the opportunity to practice letting go of any remaining attachments I had to preconceived notions about how I "should" eat. I am so incredibly grateful I was able to follow this truth, and feed my body the foods it did want at the time: mostly bread & cheese in its many delicious formations (I think I tried every cheesy quiche in lower Manhattan!)

We receive so many negative messages from our society about weight throughout, during and after pregnancy: not to gain "too much" and especially how to lose it quickly. Just the other day, while my colleagues were protesting Weight Watchers new free youth program, my fellow moms in a Facebook group were applauding and supporting one another on their ability to shed the post-baby pounds through dieting.

 I remember even receiving a comment from my beloved grandfather early on in my pregnancy about how I should "control" how I eat while I'm pregnant (in other words, not to eat "too much"), a comment that surely came from a place of ignorance, and one that I'm so happy I could have a sense of humor about. 

For so many, getting pregnant can be a huge source of motivation to recover from an eating disorder, but I also believe it is an opportunity to practice surrendering and going with the flow even more once we are in it. What a powerful time, even with the discomforts, acid reflux, nausea, weight gain, body changes, etc., to practice whole-hearted acceptance of ourself and our body. After all, it is doing the most mysterious thing in the world.

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"The most profound act of kindness we can offer to ourselves and our body is to listen without judgment, especially when it comes to understanding our food cravings and our bodies"

Check out my article for Good Zing here : http://www.goodzing.com/articles/why-self-love-starts-with-what-you-eat

Source: http://www.goodzing.com/articles/why-self-...

A guest blog by dietetic intern Isabelle Carren-Le Sauter

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Working with Anastasia, I have been recently introduced to the Ayurvedic tradition and its personalized recommendations for maintaining health and happiness. As a soon-to-be dietitian, the nutritional recommendations were most interesting to me, and right from the beginning I realized how intuitive they are. Of the three doshas, or personality-types, the kapha dosha tends to be very solidly built, calm, stable and strong. However, when someone who is primarily kapha is out of balance, they tend to oversleep, become congested, and feel unmotivated. I instantly connected: This is me. When I feel this way, I seek comfort food; I crave pastries and Mac and cheese, heavy foods in large portions. Though there is nothing inherently wrong with these foods, the Ayurvedic tradition would argue that eating heavy food will only allow a kapha to sink deeper into their kapha-ness, while eating opposing foods such as lightly sautéed leafy greens over a bed of whole grains, or going for an energizing walk will bring you out of what I think of as the “kapha funk.” Intuitive, right?

In addition to describing personality types, the three doshas also have primary seasons. We have just entered Pitta season, which ranges from mid-June to mid-October. When out of balance, pittas tend to be fiery, prone to sarcasm, irritability and easy overheating: all things which can be exacerbated by the sticky, hot weather at this time of year. Even people without much pitta in their constitution can begin to feel irritable and easily frustrated when the weather turns hot. But an in balance, pitta is focused, energetic, organized and creative, and to return to these wonderful qualities, here are a few simple tips:

  • Stay Fresh: Seek out ripe fruit for a light, delicious, and refreshing snack that will quench your hunger and your thirst without weighing you down. Watermelon, mango, grapes and apples are all great choices. Water-laden vegetables such as cucumber, carrots, zucchini, and leafy greens are also recommended. Sautee, blanch, or steam them briefly, and add cooling herbs and spices like mint, fennel, dill and coriander.
  • Avoid heavy foods and flavors: A hearty butternut squash curry may sound extremely appealing after a long day out in the snow, but a steaming hot stew on an 85 degree day may just get your blood boiling. Try to avoid heavy, greasy foods, as well as sour, spicy or salty foods such as citrus, unripe fruit, sour cream, cayenne, chiles, and pickles or other condiments.
  • Don’t Shock the System: While an ice-cold beverage may seem like just the thing to cool you down, the Ayurvedic tradition cautions against this because instead of calming the digestive fire, it may just snuff it out. Plenty of hydration with room temperature or slightly cool water is a much better way to go.
  • Take It Outdoors: Daily exercise strengthens the mind, improves mood, and restores the body’s natural flow, and doing it outside is a way to be in nature and appreciate the beauty of summer. To avoid flaring up that Pitta fire, try cooling exercises like early morning or nighttime walks, yoga in the park or on the beach, and swimming.
  • Routine: Ayurveda really promotes the importance of doing certain things daily, like eating breakfast and rubbing your skin as a form of awakening massage each morning. They also promote arising with the sun each morning, which may seem like a struggle, but allowing yourself time in the morning to stop an enjoy that cool summer breeze on your way to work, or to do 15 minutes of yoga before you leave can really create a beautiful start to your day. Give it a try for a few days – once you get used to it, you may never go back.

The most important thing to remember is that the Ayurvedic tradition is meant to help and heal, not cause stress. If you find you are feeling weighed down or especially irritable with the heat, feel free to give these tips a try, but only if it is helpful for you. Everyone is different, and you know yourself better than anyone, so trust yourself.

References:

Krishan, S. (2003). Essential Ayurveda: What It Is & What It Can Do for You. Novato, CA: New World Library.

(2007). A Food Plan to Balance Pitta Dosha. Retrieved from: http://www.holistic-online.com/ayurveda/ayv-Pitta-food-plan.htm

Posted
AuthorAnastasia Nevin

A guest blog by dietetic intern Isabelle Carren-Le Sauter

Research has shown that people diagnosed with eating disorders have significantly higher rates of certain autoimmune disorders than the general population, including Addison's disease, celiac disease, ulcerative colitis, Crohn's disease, type II diabetes, and possibly more. [1] 

In spite of this, there does not appear to be any single genetic mechanism that links eating disorder with the wide range of different autoimmune disorders listed above.[2] While a direct link does not seem to be the answer, it is possible that there is a common factor that causes both.

Which came first, the autoimmune disease or the eating disorder?

Autoimmune diseases are illnesses which cause the body to develop “autoantibodies”, small proteins that deviate from their normal function, and instead, fight with other proteins in our bodies. The hygiene hypothesis, suggested in 2012 by Acres et al, suggests that anorexia nervosa itself may be an autoimmune disease.[3]

Acres argues that in some cases, delayed exposure to certain common bacteria can confuse the body, and cause it to attack the proteins and nerve cells that regulate appetite, leading to disordered eating.

When the body is exposed to a wide variety of bacteria early on in life, it develops a healthy microbiome, the collection of bacteria that inhabit the body to protect it and maintain health. However, when the microbiome of the gut is disrupted, known as gut dysbiosis, the body’s health may become compromised. Several theories have been developed about the relationship between this disruption, autoimmune responses and eating disorders.

Psychological stress seems to play a key role: stress can cause gut permeability, allowing the contents of the gut to enter the bloodstream,[4] causing an immune response. This immune response then sends a signal to the brain that something is going wrong in the gut, which can lead to changes in food intake and increased anxiety.

Proteins called pro-inflammatory cytokines may also be culprits.9 They cause the inflammation that leads to autoimmune disorders, and there is a possibility that production of these cytokines may, in some cases, be initiated by eating disorders.

Recent evidence has shown that long-term calorie restriction itself may cause gut dysbiosis.[5]

Moreover, the gut dysbiosis caused by a long-term eating disorder has been shown to perpetuate low body weight and prolong recovery, making it that much more difficult for patients with eating disorders to return to their normal habits.[6]

Is it the biological effect and stress of having an autoimmune condition which may necessitate strict eating habits that leads to disordered eating? Or is it the eating disorder’s negative effect on the body that leads to an autoantibodies, cytokines, and/or general stress and causes an autoimmune disease?

Though research is showing a strong connection exists, science has yet to demonstrate which comes first.

While the research is still developing, we must increase our awareness of the many possibilities that influence biological and psychological disruptions within the body. It is important to consider the reasons behind a restrictive diet, and how it may be affecting health:

Could some autoimmune cases be caused by an eating disorder?

Could gut dysbiosis be due to stress or restrictive eating?

Can intuitively eating a wider variety of foods decrease symptoms?

Over time, through eating disorder treatment, perhaps the gut can heal and lead to symptom relief.

 

References:

[1] Wotton CJ, James A, Goldacre MJ. Coexistence of Eating Disorders and Autoimmune Diseases: Record Linkage Cohort Study, UK. Int J Eat Disord. 2016; 49:663-672.

[2] Raevuori et al. The increased risk for autoimmune diseases in patients with eating disorders. PLoS One. 2014; 9(8): e104845.

[3] Acres MJ, Heath JJ, Morris JA. Anorexia nervosa, autoimmunity and the hygiene hypothesis. Medical Hypotheses. 2012; 78: 772-775. 

[4] Gorwood et al. New Insights in Anorexia Nervosa. Frontiers in Neuroscience. 2016; 10(256): 1-21. 

[5] Herpertz-Dahlmann B, Seitz J, Baines J. Food matters: how the microbiome and gut–brain interaction might impact the development and course of anorexia nervosa. Eur Child Adolesc Psychiatry. 2017; Epub ahead of print. 

[6] Morita C, et al. Gut Dysbiosis in Patients with Anorexia Nervosa. PLOS ONE. 2015; 10(12): e0145274.

 

Good morning and Happy Summer Friday!! In my nutrition practice, I am often asked for recipe ideas and in an effort to better serve I have started to compile some of my favorites below. It is my intention to continue to add to this list. Enjoy!

 

Vegetarian:

Roasted Carrots with Honey, Rosemary and Thyme 

Chana Daal with Cauliflower and Coconut Milk

Slow Cooker Pumpkin, Chickpea and Red Lentil Curry

Almond and Fig Shake

Beet and Goat Cheese Quinoa Patties

Curried Coconut Cauliflower Soup with Warming Spices

Lentil, Chard and Sweet Potato Curry (served over rice)

 

Non-veg:

Martin's Chicken Basil Sausage- Veggie Stir Fry (this recipe comes from my brother Martin, who sautés onion, garlic, + ginger with veggies like cabbage, brussel sprouts, butternut squash and kale, adds cut up chicken sausage and mixes all the ingredients with some spices and turmeric, plus a fried egg on top. It's simple and delicious!

Shrimp + Mussel Basil Stir-Fry over Turmeric-Curry Quinoa- Another simple recipe that can also be made from fresh or pre-cooked frozen seafood for a quick and satisfying meal. Sauté garlic and ginger in oil, then add any vegetables of your choice including peppers, add the seafood with a dash of white wine or tequila and then cook until tender, add some fresh basil and serve over quinoa (this can be made in the rice cooker with spices like turmeric, ginger powder, curry powder, etc). Enjoy!

Red Snapper with Tomato, Olives and Capers: This is a recipe I made some variation of regularly for many years. It's delicious with a green salad or sautéed veggies and rice. 

 

 

 

 

I recently returned from a family trip to Amsterdam and Vienna, that in addition to wonderful art museums, composer's apartments, and explorations of both cities' dynamic history, included daily 3 to 4 hour-long family feasts with multiple courses and wine, followed by the sweet specialties of the region, usually both before and after meal time (apple strudel, ice cream, hazelnut torte-you name it!). 

A few days back in my NYC office, a client brought up her belief that she will always be "in recovery" from her eating disorder; always struggling to manage her eating, her desire to lose weight, and always working to prevent a relapse. 

Ten years ago, as I struggled with my own disordered eating, negative body image, and overexercise patterns, I would have believed the same. I didn't have anyone at the time giving me the message that I could actually live my life completely free of any possibility of relapse or have an identity outside of food and body where food was a nourishing yet neutral part of my life

In fact, at that time this type of family trip would have been a huge nightmare - overshadowed by anxiety about how much food I would "have" to eat in order not to upset my family, trying to figure out any possible way to avoid a meal, or skip family activities to seek out exercise (how boring is going to a hotel gym instead of exploring  a new city!?).  

Looking back on my journey to being fully recovered, I still have moments full of gratitude and awe. I am amazed at how easy and sweet meal time with my family is now, and how I can look forward to and enjoy ALL types of food without allowing food to become the center of attention. I am grateful to share precious time with loved ones with full presence, and breathe through conflict without turning to food (or lack thereof).

And perhaps most importantly, I now know how to honor my own body's needs, despite my Russian-Jewish grandma's lifelong mission for me to always eat more :) 

When food comments are made at that table, I can lean on my spiritual practice to help remind me to feel compassion towards that person who is likely struggling with him or herself. Over time and through trail and error, I have learned how to say both yes and no to food by connecting to the wisdom of my body. 

As I shared this with my client and hope to share with you, full recovery is absolutely possible for anyone committed to the path of healing.

And to stay on our path, yoga reminds us to seek the company of souls who help to elevate our consciousness and remind us to come back home to our heart. 

 

In what ways can we view our mental and emotional reactions on the mat as lessons that reflect a need for further growth?

 I have witnessed how many patients who come to me for nutrition therapy, for instance, become attached to taking yoga classes without actually making progress in healing from their eating disorder. They often bring their disorder onto the yoga mat, approaching the practice as another way to burn calories or to push their body beyond limits, reinforcing a disconnected relationship to the body’s wisdom.

Read more from my latest article on Sonima here

 

Yesterday I had the pleasure of attending an incredible lecture by Dr. Claudia Welch, a Doctor of Oriental Medicine, an Ayurvedic practitioner and author of the renown book Balance Your Hormones, Balance Your Life: Achieving Optimal Health and Wellness Through Ayurveda. 

Dr. Welch spoke to the ways in which most Western women constantly feel that what we do is "never enough" and that we have to constantly push ourselves to our edge. This constant pushing beyond what we actually want to be doing creates a context in which hormones go out of balance. Because nature always prioritizes survival over reproduction, our body reacts to this "never enough-ness" by producing a physiological stress response and pumping out high levels of cortisol and adrenaline. 

Furthermore, in order to produce this stress response, our body has to reduce the energy that goes towards production of essential sex hormones like estrogen and progesterone that nourish, build, and ground our body. Over time, this imbalance between yin and yang hormones drains our adrenal glands and puts our body into a state of depletion, leading leading to conditions such as menstrual irregularities, insomnia, anxiety. infertility, bone density loss, thyroid problems, etc. Sound familiar?

High cortisol levels also rob our body of vital nutrients and wreak havoc with digestion, which is why even the healthiest foods cannot be absorbed by a body that is in a state of stress. 

It's powerful to imagine that the root cause of dis-ease in our body is actually mostly coming from our mind!!!, which plays out a narrative of "never enough-ness". 

In other words, it is IMPOSSIBLE to have both a high stress lifestyle AND attain hormonal balance. So what can we do to start to bring more balance into our body, mind and spirit?

Dr. Welch supports the practice of reducing our level of busy-ness in order to actually live the life we want, which includes restful and nourishing activities such as spending time with girlfriends, practicing yoga, meditation, abhyanga (Ayurvedic warm oil massage), alternate-nostril breathing and the important practice of saying NO.

We also need to confront any shame/fear around slowing down and not being "productive". 

"The most important practice is spending time listening. There's a reason we're here and we keep not doing it. It's so bizarre that it takes courage to live the life we want to live"

 I hope these words from Dr. Welch help to inspire more room for slowing down, self-reflection and listening to the wisdom of your body and heart without judgment. Here's to living authentically and courageously. 

If you are interested in learning more on the topic of Ayurveda and Eating Disorders, I have posted an interview below with Dr. Claudia Welch and Chelsea Roff of Eat Breathe Thrive, a non-profit organization that prevents and helps individuals fully recover from disordered eating and negative body image through evidence-based programs that integrate yoga, community and service. 

Click HERE to listen.