Every client I see is informed they  must start eating breakfast if they would like to lose weight. I then instruct them that they must eat it within an hour of waking. Some people will fight me on this point more than any other.

They will say, I’ve never eaten breakfast in my life. They will say, if I eat breakfast, I’ll be hungry within an hour or two, if I don’t, I am fine until noon. I understand this, and in fact I am banking on your hunger coming in a few hours. That is when we will add a snack time.

My clients work with me to heal something that is broken. Part of why it is broken is because of how we start our day, every SINGLE DAY. They continue to fast until 11 am or noon because they aren't hungry and then they eat a lions share of lunch, quickly crash and then eat something super sweet as an afternoon pick-me-up.

I explain to my clients that they will need to be willing to change their morning routine and get breakfast in within an hour of waking. We also discuss what is best to eat to speed up their metabolism and start the day with good energy. But, even if they do not make a change regarding what, they eat, they absolutely need to change WHEN. If you wake at 6 am, eat by 7 am. If you wake at 5 am, yes, I want you to eat something by 6 am. You get the point.

Some of the recommendation is based on starting your metabolism burning throughout the day, some of it is to boost your energy levels, some of it has to do with how it will change your eating patterns later in the day and assist you in making better, healthier choices with the food you choose to eat. 

In any case, this is important because we start providing your body with fuel upon waking. We are telling your body to start burning. So when you are hungry in a few hours, that is a sign that your metabolism is moving right along as we want it to. This is a good sign. Hunger will become something you are used to rather than a feeling you are fearful of. Part of why hunger will no longer be an enemy is because when you are hungry you’ll get to eat! And even though you are eating, you can still lose weight. Novel thought isn't it?

This isn’t a confessional or a Dear Abby response, and when I say alone, I don’t mean by myself in a dark room watching TV. I mean without the addition of fat or protein… but please read on.

Carbohydrates have been vilified in the weight loss world since the end of the low fat diet era. It was almost like one day someone woke up and realized, when people stop eating fat, they get, well, really fat. About that same time the Atkins diet was on the rise and someone else was trying to make a few million (perhaps billion) dollars by figuring out a quick way to send every house wife in America to the health food store to purchase a wonder food called “protein powder”. This left the industry needing to find another reason to blame for everyone getting fat. In terms of macronutrients: carbohydrates were the only one left. So began the era of low carbohydrate dieting.

Now let’s get real for a minute. Who wants to live forever without pizza, pasta, bread, fruit or the countless other wonderful foods that have higher amounts of carbohydrates? When I was a young child unless a food was white and fully carbohydrate, there was no chance of me eating it. When I say white I mean: mashed potatoes, noodles (with parmesan), bread, macaroni and cheese (you are right, that is yellow), and frozen waffles. I have had a love affair with carbohydrates my entire life. I promise you, it is not about to end here and now.

As a nutrition professional what I understand now is that there really are two ways to alter your diet to induce weight loss: lower your calories OR lower your carbohydrates. The problem with these two approaches is that in most cases they are not long lasting and sustainable. Since this is the case people enjoy weight loss for a season, and then when diet habits change back over time, the weight comes back with a vengeance. Hence, Americas billion dollar industry feeding our yo-yo dieting habits.

The answer to losing weight over time and keeping it off lies not in a simplistic caloric restriction or carbohydrate restriction which are very near sighted and proven not to last. Rather the focus needs to be in speeding up your metabolism. It also lies within telling your body through hormone signals that you don’t need to store fat right now; instead you can tap your fat stores consistently when you need more energy.

Carbs are not the enemy. However, eating carbs alone is the enemy of weight loss. Let me explain why. When you eat carbohydrates alone your stomach empties it’s contents faster into your small intestine where most absorption happens. Let’s call this mostly carb meal white bread and jelly. This type of meal  allows for very fast use of these carbs. In all of evolutionary time, this is a good thing, when needing to run from predators or catch a beast for dinner. However, in modern times with very processed food this makes for a huge up surge in blood sugar levels. Blood sugar is not a bad thing, but a huge spike in it is. The spike leads your pancreas to excrete a huge amount of insulin to combat the large surge. And insulin tells the rest of the cells in your body to absorb the sugar floating around in your blood. This is what it is supposed to do, however it also tells certain portions of your body to store energy as fat. When it is STORING energy as fat it is of necessity not utilizing fat for energy.

Now consider if you instead of having toast with jelly chose to have toast with peanut butter or a slice of deli meat on it. The fat and protein from the peanut butter or deli meat make your stomach do some extra work as it empties it’s contents. It blunts the effect of a quick raise in blood sugar. This slower increase over time allows your pancreas to produce less insulin. Your body still gets all the necessary signals for it to absorb blood sugar for energy, but it doesn’t send out the entire arsenal of insulin tipping the threshold and making it so your body doesn’t respond by storing fat.

This may seem like a super scientific explanation, but if you think about it you may realize there are many things you eat regularly that don’t have the added combo of protein and/or fat. Something as simple as a piece of fruit.

Carbs are not the enemy, eating carbohydrates alone will cause you to store fat, making it more difficult to lose weight. Eating simple carbohydrates and very highly refined and processed carbohydrates will do the same thing. Think about the difference in the look of a whole grain bread vs. a white bread. You can see the difference with your eyes, believe me your intestines, pancreas and liver can see the difference too. The fiber helps in slowing down the digestion and the added protein and fat from a whole grain provides the added benefit of slowing absorption.
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There are foods that have high carb and high fat levels which some of you may be reasoning are still going to be okay to eat. These are foods like tortilla chips, potato chips, donuts. You are thinking, come on there is fat to slow the process down and blunt the blood sugar response. You are right, but they are still providing you little to know benefit in terms of nutrients. You are getting a whole lot of calories without any vitamins and fiber. Say no to these foods more often than you say yes.  And join me in not eating carbohydrates alone. Have a handful of peanuts when you eat a piece of fruit, grab a piece of cheese if you are about to have a slice of toast, instead of eating spaghetti marinara add some meatballs to the mix. 

In the United States the number of children with food allergies has increased by 18% from 1997 to 2007 and allergy-related hospital visits have tripled.  If you or a family member suffers from food allergies you can surely attest to how scary those moments can be after taking in an offending food.

In a recent study by the Academy for Immunology and Microbiology within the Institute for Basic Science (IBS) and the National Institute of Animal Science research project of Rural Development Administration, a specific probiotic strain has been shown by researchers to reduce the effects of food allergies. ​

In this study two different strains of bacteria commonly used in probiotics were provided to mice who were later exposed to food allergens. One strain in particular lowered the mast cell reaction responsible for allergic responses, neutralizing their ability to induce allergy symptoms. The bacteria that showed effective was B longum KACC 91563.

Other studies have also shown the benefits of probiotics in lowering food allergy and sensitivity reactions, calming the immune response. 

My recommendations for best practice when it comes to taking probiotics:
1. Always buy a strain that was refrigerated. 
2. Keep it in the fridge when you get home.
3. Always take with a meal.
4. Start taking them slowly, every other day.
5. Mix up the brands/strains you purchase. If you can afford two different bottles at one time, every other day change which brand/strains you are taking to keep a robust and varying profile introduced to your gut.

Institute for Basic Science. "Protein from bacteria alleviates food allergy symptoms." ScienceDaily. ScienceDaily, 16 March 2016. <www.sciencedaily.com/releases/2016/03/160316085011.htm>.

Most people have tried diet after diet, some success here, a little success there, some major fails. Over and over I hear the same story people experience some amount of weight loss followed by weight gain, usually more than was originally lost. Have you ever said, “and then I gained an extra 10 pounds” when describing a diet experience.

Most people weigh 5 to 10 pounds more than their ideal body weight for every diet they have tried in their life. The sad truth is that the diet industry (a multi-billion dollar industry - this alone should tell you something - they are in it for the money) is very good at providing a solution that will work for a while but, will inevitably stop. The industry plans on it, depends on it, and defrauds you in the process.

If a client comes to me after dieting without success time and time again, I start by assuming your metabolism is already broken, and needs fixing. How did it break? Any diet you were ever on, no matter how long ago or for how long contributed to a slower metabolism. Don’t worry though, you can HEAL your metabolism, with the right actions. I do want you to commit to never "dieting" every again, and never fall prey to a vicious yo-yo dieting cycle in the future.

What the diet industry isn’t telling you is that there are really only two effective ways to lose weight:

 1) limit your calories OR
2) limit your carbohydrates

In either case, you can and will lose weight. However, if you keep your body in a state of calorie or carb restriction for too long, you will damage your metabolism. So what the diet industry really isn’t telling you is this:

If you restrict your calories or carbohydrate intake for too long you will slow your metabolism and make it extremely difficult to continue losing weight, you will also be in danger of gaining back everything you have lost, even if you do not increase your intake to what it was before.

Why? Your body and your metabolism have been programmed to keep you alive. So for a time when you restrict, you enjoy the benefits of pulling from fat and lean muscle stores and weight is lost, but eventually that will stop. It will stop because your body is concerned it is not receiving enough fuel, so it will shift everything it can to a slower pace. Simply put, it slows your metabolism because you have been eating less. This is actually quite miraculous. It is evolution at it’s best! The point is to preserve you alive. However in our modern day, most of us don’t really NEED to starve ourselves, so when we do, we do it not because food is scarce, but because we’d like our love handles to become scarce.

The impending problem is that when you lost weight in the early part of your diet you didn’t just lose fat. You lost lean muscle tissue too. But, after a period of starvation, your body will have shifted priorities, so when extra food is available it will start storing this food as fat. It is guarding in case you are starved again. Almost any diet will leave you in worse shape than when you started. You lost fat and lean body mass. You gained back mostly fat, and your body is now programmed that you might starve it – so it is burning calories very slowly.

WARNING: Any diet that cuts out carbs completely or drops you below 1200 calories is going to harm your metabolism and cause extreme weight gain later.

If you feel like your metabolism is damaged and would describe it as slow, you would benefit from working with someone trained in metabolic rehabilitation or what I like to call metabolic healing. There are strategies you can do to increase your metabolism so you don't have to cut carbs and calories forever. So that you can lose weight and be burning more calories once you reach your goal. 

What foods are best to eat while I’m pregnant? I've had this question come up a few times recently with patients. So let's get into it.

Eat as much nutrient rich, whole foods as possible. Eat a wide variety of foods. Make sure you are choosing foods from all food groups: fruit, vegetables, grains, meats, beans, dairy, and healthy fats and oils. A growing baby will need food from all of these food groups. One thing is for certain, even though you are eating for 2, you don't need to double your calories. In fact, through the first trimester you don't need to eat any more than what you are currently used to. In the second and third trimesters, you can increase calories by about 300 and 450 calories respectively. But, what to eat. Let's break it down for you.

Nutrients in Food

Protein - In the 1st trimester eat 5 1/2 ounces per day and in the 2nd & 3rd trimesters 6 ½ ounces per day. Here are examples of 1 ounce of protein.

• 1 egg
• 1 tbsp peanut butter
• ½ ounce nuts
• ½ cup cooked beans
• 1 oz. fish, meat or poultry

Good sources of protein include lean meat (chicken, turkey, fish), low-fat dairy products (eggs, cheese, milk, yogurt), beans, nuts, nut butters.

Eat about 12 ounces of fish per week. Choose types of fish that are low in mercury content (tuna or salmon). Avoid fish high in mercury (swordfish, shark, king mackerel, albacore tuna). To learn more about what fish are safest to eat, visit www.doh.wa.gov/communityandenvironment/food/fish/healthyfishguide.aspx.

If fish is not appealing to you choose other dietary sources of DHA like: walnuts, wheat germ or omega-3 enriched eggs.

Fat
YOUR BABY NEEDS FAT. Eating low or no fat during pregnancy is not recommended. Choosing healthy fats is important for your overall health and for your baby. Choose fats like: olive oil, fatty fish (salmon), avocados, seeds, nuts, nut butters.

Read food labels and avoid anything with ‘hydrogenated or partially hydrogenated fat’. These contain trans fat.

Dairy is another great source of fat.  Aim for 3 cups of dairy per day.  A 1 cup serving equals: 

• 1 cup milk or yogurt
• 1 ½ ounces hard cheese

Carbohydrates

Fruits and Vegetables
Fruit and vegetables are GREAT and very healthy sources of carbohydrate. Choose dark and brightly colored fruits and vegetables – they are great sources of vitamins and minerals. Eat whole fruit instead of drinking fruit juice.
Aim for 2 1/2 cups vegetables per day and 2 cups of fruit. Eating a wide variety, and lots of different colors is best!

Grains
Choose whole grains like whole wheat bread, brown rice, whole grain pasta, oatmeal, barley, quinoa, bulgar, millet, and kasha. Limit refined carbohydrates like: sweets, cookies, sodas, instant oatmeal, and instant rice.

Aim for 6 ounces in your first trimester and 8 ounces in your 2nd and 3rd trimesters. 
1 ounce =

• 1 slice of bread
• ½ cup oatmeal
• ½ cup cooked rice, pasta
• 1 6-inch tortilla

Fluids
Drink enough water so that you never feel thirsty and so that your urine is light in color. Many pregnant women carry a water bottle with them to make sure they are drinking enough water.

Limit intake of juice and other sweetened beverages.

Do not drink any alcohol.

Limit intake of caffeine to 200 milligrams (about 1 cup of coffee) per day. If you are currently drinking more than that, cut back slowly.

Food Safety Considerations
During pregnancy, you have a higher chance of getting infections and illnesses from certain foods. Some basic food safety practices can greatly reduce your chance of becoming ill. Remember to:

• Wash hands before, during and after you prepare food.
• Keep the area where you prepare and eat food clean.
• Wash fruits and vegetables before you cook or eat them.
• Keep meat, fish and poultry separate from all other foods. Use a different cutting board for them.
• Avoid eating from salad bars, deli counters, buffets, sidewalk vendors and food carts.
• Avoid unpasteurized cheese, milk and juice. Soft cheeses like feta, Brie, Gorgonzola, Camembert, and queso fresco are often unpasteurized. Read labels carefully.
• Avoid foods made with raw or undercooked eggs (cookie dough, Caeser salad dressing, homemade ice cream).
• Put food in the fridge right after cooking and serving. Do not eat cooked food and food that needs to be stored in the fridge if it has been out of the fridge for more than 2 hours.
• Fully cook eggs and meats. Avoid eating raw or undercooked meat, fish and poultry. Be sure to heat to the following internal temperatures:

~Fish and beef roasts to 145° F
~Eggs and meat (including pork) to 160° F
~Poultry breast to 170° F
~Whole poultry to 180° F
For more regarding food safety while you are pregnant, visit:
www.foodsafety.gov/poisoning/risk/pregnant/chklist_pregnancy.html

Other Considerations
Nausea and Vomiting
Pregnancy is not the time to lose weight. Talk with your pregnancy care provider if you are: vomiting, lose your appetite, lose weight.
If you do lose your appetite, do NOT stop eating. Try these tips:

• Eat small snacks or meals every 2 hours, so your stomach is never empty.
• Eat a few crackers before getting out of bed in the morning.
• Eat a snack of protein, like cheese, eggs, meat, or nuts at bedtime.
• Try different textures like: smooth pudding or crunchy cereal.
• Try eating crystallized ginger or drinking ginger tea or ginger lemonade.

Cravings and Food Aversions
Changes in hormones during pregnancy can cause food aversions (a strong dislike for a certain food) and cravings. If food aversions are keeping you from being able to eat the food you need, try:

• Mild flavors and vegetables
• Smoothies with protein power added
• Non-meat sources of protein like cheese, beans, or eggs

It is okay to indulge in your food cravings once in a while. Be aware of your serving sizes of high-calorie foods like ice cream. Try to eat an overall healthy and balanced diet.
Some women have cravings for nonfood items like clay, dirt, paper, laundry starch or ice. This is called pica. Tell your pregnancy care provider if you are craving these non-food items.
 
Premature Fullness
As your baby grows, you will feel full from less food, when you need more calories. To avoid discomfort, try to eat smaller meals more often.
 
Activity and Exercise
Exercise is good for you and your baby. It can help ease stress, aches and pains, improve circulation, and prepare you for a healthy delivery.
Try to get 30 minutes of activity every day, even if it is just walking to a nearby park.
It is usually safe to keep doing your normal exercise early in pregnancy. Drink plenty of water and if you are questioning if something is safe check in with your pregnancy care provider.
It may be harder to exercise later in pregnancy due to discomfort. Do what is comfortable without excess strain.
It is safe to continue sexual activity.
Avoid hot tubs and saunas.
When having a massage or pedicure tell the professional working with you that you are pregnant there are some pressure points that can induce labor for them to avoid.
Consider stress relieving activities like yoga and stretching with breathing exercises, this will help with increased circulation.
 
 
Meal Ideas
Coffee and tea are okay to drink during pregnancy, but limit to 1 cup per day.
Try to include carbohydrates, protein and fat at all of your meals, here are some examples.
Breakfast
Well-cooked egg or peanut butter with whole grain toast and a piece of fruit.
Granola or whole grain cereal with milk or plain yogurt, added berries or banana.
Whole grain pancakes with cottage cheese and fruit.
Mid-morning Snack
Plain yogurt with fruit.
Hummus and carrots.
Apple with nut butter.
Lunch
Sandwich on whole grain bread with grilled chicken breast and vegetables.
Rice and beans with cheese and tomatoes; an apple; small green salad.
Turkey sandwich with lettuce and tomatoe on whole grain bread; milk; an apple.
Mid-afternoon Snack
Cheese or hard boiled egg; whole grain crackers.
Small handful of trail mix.
Peanut butter on whole grain toast.
Dinner
Tortilla with rice, beans, cheese, bell pepper and onion; melon cubes.
Lean beef cubes over noodles with cooked green beans; ½ an orange.
Chicken and potato casserole with broccoli and onions; raw carrot and cabbage slaw.
Fish with sweet potato; cooked cauliflower and green salad.
Stir fry vegetables with brown rice; glass of milk
Evening Snack
Cheese and fruit.
Small bowl of low sugar cereal and milk.
An egg, carrot sticks.

Do I need to take vitamins?

A prenatal vitamin can help ensure that you and your baby are getting the nutrients that you need. Buy a prenatal vitamin that contains the following:

• 200 mg calcium -choose a calcium citrate instead of calcium carbonate
• 400-800 mcg folic acid
• 400 IU vitamin D
• 15 mg zinc
• 27 mg iron
• 300 mg DHA
• At least 150 mcg iodine (220-250 mcg is recommended in pregnancy)
• Vit B12: Look for methylcobalamin instead of cyanocobalin
• Magnesium, zinc and copper – these minerals look for citrate forms instead of oxide forms- they are more easily absorbed
• Folate: Look for methylated folate (often listed as 5-MTHF)

I recommend taking Douglas Laboratories Prenatal (retail is $24.40 per month and serving size is 2 caps per day) or Thorne Basic Prenatal (retail $24.61 per month and serving size is 3 caps).

Many prenatals do not include enough DHA so it will be necessary to also supplement with a high quality fish oil. I recommend Nordic Naturals Prenatal DHA (retail $19.3 per month and serving size is 2 caps).

I have photos below of my top picks, if you need assistance sourcing these supplements, or any supplements I have a direct distributor where you can receive 10% off any supplements and have them delivered straight to your door. 

When to start supplementation?
Ideally, start taking prenatal vitamins before conception. It is generally recommended women of reproductive age to regularly take prenatal vitamins. However, you should begin taking, if you have not already, as soon as you discover you are pregnant.

How long do I take them?
You should take prenatal vitamins throughout your entire pregnancy and continue after the baby is born, especially while breast-feeding.
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Do prenatal vitamins have any side effects?
Some women feel quesy after taking prenatal vitamins. If this happens to you, you’re your prenatal vitamin with a meal or right before bed. The iron in prenatal vitamins contributes to constipation. To prevent this make sure you are drinking plenty of water, you have adequate fiber intake and are remaining physically active (at least a brisk walk for 20-30 minutes daily). 

If you have any questions, feel free to comment below.