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Authors Posts by Kevin Brunacini

Kevin Brunacini

Currently residing in Northern Kentucky, Kevin is a certified Family Nurse Practitioner at AIM 4 Better Health, a personal trainer, and owner/operator of The Diet Doc – Independence. It is a science-focused health-coaching program that teaches clients how to permanently lose weight based on their lifestyle in a manner through consistent and extensive support. Once morbidly obese, Kevin can relate to the importance of nutrition and fitness. He knew that to help his patients develop healthier lifestyles, he’d need to do the same. Over the course of four years, Kevin lost 121 pounds through healthy lifestyle modifications and established himself as a health leader in his profession. Other than a passion for health and fitness, Kevin is happily married, has two extremely spoiled black labs, and is an avid bass player and singer. To learn more, visit

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Read on as our nutrition expert offers six tips to give you a crop top-worthy flat stomach that looks as good as it feels.

Crop Top, available at

Some things in life just aren’t fair. You could be following a stellar workout regimen and a spot-on perfect nutrition plan, but still end up being at war with your body, feeling bloated, full, pushed, and gassy. The technical term: blah! This cruel experience has the ability to unravel all your efforts and give your self-confidence a blow. Fortunately, there are several smart strategies you can use to minimize these discomforting, sometimes embarrassing, symptoms so you can feel trim and light again.

1. Put Your Nutrition Under the Microscope
Cookie-cutter diet plans could be the main culprit because these plans are often not tailored to your current weight, activity level, your lifestyle, and preferences. Perhaps your carb cycling may be over-exaggerated, your proteins might be through the roof, or fat intake is well below your body demands, just to name a few. Use the common sense approach and if there is too much of a particular food in your daily nutrition and you feel lousy after the fact, replace it with something else. What works for someone else might not work for you. This is why I’m a huge advocate for dietary logging. Having that objective data at your fingertips allows you to pinpoint specific foods that could be affecting your GI system instead of making a guess and neglecting entire food groups.

2. Take Stock of Your Fiber Intake
Fibrous foods (mostly veggies, fruits, nuts, and legumes) often cop the blame, yet fiber is extremely crucial to maintaining essential gut health and bowel regulation. If you’re eating too little or too much fiber, to a degree where it extends below or past the recommended daily allowance (RDA) amount of 25-35 grams, then you could suffer through an outbreak of symptoms. Beans, grains, and legumes are an excellent source of B vitamins, selenium, and potassium, but recent evidence also suggests they are fiber sources to be avoided if you want to alleviate bloat. Despite being whole foods, rather than to avoid them completely (unless an allergy exists), try eating them in smaller doses/portions. Once again, the more objective you are with your daily intake, the better you know what to manipulate if symptoms arise. Experiment for two weeks and note how you feel without the potential antagonistic food item. Did your symptoms improve, worsen, or not change? Slowly and one thing at a time rotate/substitute different foods and keep a diary of your experience.

3. Cycle Your Carbs Wisely
Carb cycling is an excellent tool to fight flab because it can positively influence one’s metabolism, but this can come at a cost. The yo-yoing between high- and moderate-carbs could be well beyond your body demands, which could leave you feeling sluggish, bloated, and lethargic. A common example is someone who has already been eating 200g of carbs and then suddenly doubles it to 400g the next day without slowly building it up. Your body isn’t accustomed to that regimen, so a more gradual approach would be recommended to alleviate that GI load. More carbs are metabolically and anabolically stimulating, but you can reach a point where simply feel the lethargy of insulin fluctuations. Sometimes fat may need to be a little higher, but that’s another discussion. Granted the idea of carb cycling is to stimulate your metabolism and can be useful for social events, eating such a large volume of carbs, especially if your workout routine doesn’t require you to, can cause more chaos and lead to that pot-belly feeling.

4. Protein Problems
If you can’t relate to any of the previous points, your problem might be your protein intake. Protein takes the longest to breakdown in the body, which increases metabolism and keeps one fuller longer. It is broken down into amino acids in the stomach, and if it doesn’t breakdown completely it will have a tendency to ferment and putrefy. Yummy! To ease this occurrence, try eating your proteins first in order for the stomach to digest them first rather than with any subsequent foods. Since protein takes time to digest and assimilate, just as complex/fibrous carbs do, both can further aggravate GI distress since absorption is slowed down even further. Ultimately the food item causes creates more fermentation in the stomach, leading to increased symptoms of bloating, flatulence, or indigestion. Another simple tip is to rotate your protein powders because you might be intolerant to a particular type.

5. Weak Muscles
If you’ve been neglecting your core then this could be a factor. Research in the New Zealand Medical Journal found that individuals who have gained weight and have weak abdominal muscles tend to suffer more from visible bloating than those with stronger cores. The likely hypothesis to explain this is a stronger core acts like a corset holding the bloating inside, which forces excess gas to follow its natural path. Stick to training that core of yours a couple times a week!

6. Watch Your Sweet Tooth
That mid-afternoon candy bar might seem innocuous, but it could be playing a huge role in your bloating. Research in Clinical Nutrition found that 72% of people who suffer from abdominal bloating, and too much gas, had a problem digesting certain sugars. The common offending agents were lactose, fructose, and sorbitol. In the same way you can mindfully include or limit refined/processed carbs, it is important to see how you feel after a pre-workout dose of sugar to make sure it’s not a major cause of any GI discomfort.

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Finding it difficult to regain that momentum you had prior to the holiday? Our wellness columnist explains the seven simple tips you need to get back on track.


Who isn’t busy these days? We’re in a perpetual state of running to appointments, dealing with life stressors, work demands, family obligations and doing things for others. Many of us are so busy that we neglect to check on ourselves first and maintain our health. I get it; we’re all juggling with something that shifts our focus away from where we need it most.

However, maintaining everything can get tricky and time can slip away. I believe all of us are goal-oriented individuals. If we don’t have incentive and give attention toward reaching our goals, what started out as great intentions for the start of summer have now become afterthoughts.

Time management skills is one of the best tools for setting yourself up for success. Here I share my top tips to remain focused or regain focus of your health and fitness goals.

1. Have A Goal
While this obvious and rather common knowledge, how many of you have actually created one with measurable parameters?

If you don’t know where you are going, how will you ever get there or know what to do? Sound familiar? For guidance on how to establish a goal, refer back to “It’s Time—Create a Plan!”

It can be easy to lose track of time and direction if you don’t have an end goal in mind. This is why it’s important to be very clear on what exactly your goals are. Whether you want to lose weight, increase lean muscle mass, improve your eating habits, manage your stress or change careers, determining what your goals are is an important first step towards managing your time and being successful.

I recommend writing your goals down and placing them somewhere where you can see them every day. This will serve as a reminder when life gets hectic—it’s inevitable—and will help you stick to your goals when it may seem easier to skip them.

2. Create A Timeline
Once you have determined your goals, give it a timeline. I advise starting from the finish point and work backwards. For example, let’s say your goal is to run a particular distance, figure out how much time you will need to prepare first.

The same concept can be applied for other goals such as weight-loss, gaining mass or even getting more sleep. Start at the end and figure out how much time you will need to reach your goal.

3. Figure Out What You Need to Do
I realize this seems to elaborate further on tip 1, but bear with me. Intention doesn’t mean action. Anyone can have the greatest intentions or plan, but without action steps nothing will occur.

Once you know where you are going and how much time you will need, it is now time to write down exactly what you will need to do. If the goal is to lose weight, for example, you will likely engage in exercise, be more mindful of your eating habits, drink more water, get adequate sleep and be consistent with each.

Now break down the main, long-term goal into small, manageable, short-term goals. Ask yourself: What will you do for exercise? How many days a week? How long each day? How many days will be devoted to resistance, cardio and flexibility? Be very specific with the actions, and write them down.

As for improving your eating habits, it requires you to be attentive to thoughts and choices. Perhaps that means making a grocery shopping list and planning your meals ahead of time. Based on your day-to-day structure and context, does that mean planning ahead for the week or only a couple of days? Sometimes planning that far ahead may even be a stretch, so what is the course of action you will take to remain in control and mindful? That’s where maintaining a daily logger is helpful in order to provide objective data of where you stand.

Say you are dining out, what is your plan? How will you handle this situation without throwing your hands in the air? Prepare ahead of time, set up some strategies; again write down the steps to help you achieve the outcome you desire. The clearer, more detailed you get, the better you will be in managing your time and reaching your goals.

4. Schedule Your Workouts/Plan Your Grocery Trips
This is rather simple, relatively speaking. In order to stay faithful to your workouts, trips to the grocery store, or other healthy “to-dos” in your calendar, write it down. Just as you would for work meetings or medical appointments, make it a point to block time for the activity on your calendar. You’re more likely to stay on track when it’s scheduled.

5. Prepare Your Food In Advance
This was briefly shared in tip 2, but now that you have gone to the store, make an effort to prepare your meals. Fail to plan, prepare to fail. We hear it all the time, but do we actually do it?

Daily preparation can be exhausting and impractical for many, so choose a day during the week best for you and prepare a few days’ worth of meals. Using a nutrition journal as a tool will allow you to stay on track and still meet your daily nutrition numbers. It’s just a matter of choosing your favorite meals and making them fit within context.

If you don’t spend a lot of time cooking at home, but rather dine out frequently, devote some time reviewing restaurant menus beforehand to determine what fit best for you based on daily goals and context of the meal.

6. Take Advantage of Personal Time
When the kids are down for a nap or you have an extra few minutes, take advantage of this time. What tasks have you been putting off for yourself? What do YOU need at this moment? Ask yourself that.

Use this time to focus on yourself. If you are at work, take a walk. If the kids are asleep, get in a home workout. If you have 10 minutes to spare, relax and do something you love. Don’t neglect yourself in the process, enjoy it!

While it’s easy to feel overwhelmed and like you just “don’t have the time,” the reality is we can create the time if we make our goals a priority.

7. Check In Daily
Zig Ziglar asserted, “People often say that motivation doesn’t last. Well, neither does bathing, that’s why we recommend it daily.”

Once a day, take the time to evaluate your progress, your time and the plans for the upcoming day and week. Does something need to be better allocated in your day or sacrificed? Do things need to shift a bit? What are potential barriers today? What could I improve? What could I let go of?

This step is critical, as it will help keep you balanced and present in the moment. Self-regulation is what separates those who achieve their goal and continue to flourish. The ability to focus, resist temptation and redirect our attention speaks of self-regulation. It’s the process towards self-awareness. We have the ability to think about our thoughts, be aware of our awareness, behave according to our behavior and have feelings about our feelings.

With this level of perception, we can be the masters of our destinies.

A question for you: Can you think of a time in the past where you set an unrealistic goal and struggled to hit it? How could you have modified the goal to make yourself more likely to succeed? Be specific.

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Having trouble achieving your health goals? Our health columnist explains the key do’s and don’ts of getting results.

Our Fitness columnist shares tips on how to be successful when trying to lose weight.

As 2015 is moving right along, can you say you’re doing the same? Will you be the elite 8 percent of the population who chooses to stick it out? If you haven’t met your goal weight in 2 weeks, you might as well just give up! Sadly, 70 percent of the population follows this pattern. Not only is it impractical and faulty thinking, it doesn’t create a successful mindset. Most favor the concept of instant results through mislead supplements, moronic diet fads and gimmicks, and while it may serve use in the acute sense (when in all honesty there’s no justifiable reason), it doesn’t establish long-term, habitual disciplines that will prevent weight gain from recurring.

When you reach your goal weight, what will you do with your habits at that point? With no need to lose any more weight, how will you maintain a healthy waistline if proper eating habits weren’t developed? Will this mean you go the rest of your life avoiding all carbs because you fear you’ll gain weight? Will you avoid going out to eat because you don’t want to feel tempted and give in to everything in sight, without any self-control? Will you only stick to a handful of foods because that’s what is deemed “clean” to eat? What if none of those food items are to be found – will you choose not to eat anything at all then? None of these situations sound appealing, nor are they rational.

Anything in life with value does not occur overnight or even remotely quickly. A career, academics, a family, marriage, spirituality, health/fitness—any meaningful goal—takes time, consistency and patience. I honestly believe none of these should happen quickly because you’d never learn to appreciate them once you have it. The journey is what makes the process valuable and gratifying—enjoy the scenery! Because it’s a journey, there’s no true ending; there’s only strive for improvement. You push yourself for a better career position, expand your knowledge base, be present for your children and significant other and work on your health/fitness (you should at least!). Why do you continue to show up for your job or your family? You’re invested in it; there’s a lot at stake because it’s valuable! You depend on them. It would hurt to lose it. Wouldn’t you agree that parallels to your own personal health?

Everything takes time; it’s a matter of what’s more important. Is the goal you’re striving for truly meaningful and something you’re passionate about? I would think personal health and fitness would be because without that, no other goal matters. Without your health, everything is irrelevant. If you’re not living and performing optimally, why does anything else matter? Frankly, everything else will suffer if you’re neglecting your health.

I suppose there are actually 10 tips as you could guess the first tip is to create your “why” statement. I am doing this because _____________. I want to be healthier and/or lose weight because ___________. What would it mean to you to be free of this weight issue? Why is it important now to change than the past attempts? Give your goal substance; make it purposeful and passionate. If it’s something you aren’t willing to do everyday then it’s not strong enough – try again.

If your goal doesn’t aggravate you due to your circumstance or fire you up then there’s not enough passion – try again. Whether you’re following a routine for the first time (or for the first time in a long time) or just refocusing your efforts for the new year, keep these remaining simple tips in mind. They will help you stick with it when all sense of motivation is lost. Enough of the serious talk, and onto the tips:

Do: Before you start, log your weight, your measurements and take your photos.
Don’t: Freak out over what you see. No one likes his or her Day 1 photos or measurements, but by capturing all of the basic information (how much you weigh, how big your waist is, what you look like shirtless or in a bikini), you’ll establish a starting place. Like any first step, you just simply start. Who cares what you look like, who cares about grace—just get up and take action. When you have all this information again (I recommend retaking them every 30 days), you’ll see how much you’ve transformed.

Do: Weigh yourself once a week
Don’t: Weigh yourself every day. Full disclosure: I break this rule. I weigh myself every morning just after I wake up. I don’t recommend it, but helps me stay on track based on my goals. It can give you a better overall sense of trends if you weigh more frequently. Nevertheless, your weight can fluctuate every day based on how much sodium you consumed the day before, fluid loss during a workout, particular training program, whether you went to the bathroom, menstrual cycle, amount of food or carbs in the days prior, etc. If you’re the type who could get discouraged from seeing your weight go up a pound or two (or more) in 24 hours, then I recommend weighing in approximately the same time each week. What’s most important though is you practice mindfulness. You ask yourself why the scale went up? You think through the process without impulsively reacting, especially negatively, and sulking about it. Determine why weight may have fluctuated, note it, fix it and move on.

Do: Eat for the body you want—not the one you have
Don’t: Cut out all of your favorite foods. If you really want to be miserable and set yourself up for failure, cut out everything you like to eat. If your diet is really bad, a lot of stuff you like might have to go. Soda, fried food, sugary coffee drinks. It’s a rite of passage. It’s not to say you can never have them ever again, but limits have to be applied until you have full control of your choices. You’re training for the body you’ve always wanted, so feed that body with the food it needs: lean proteins, healthy fats, complex carbs and lots of nutrient-packed vegetables. Think about your nutrition as an 80/20 split—80 percent of the time, eat whole-foods. The other 20 percent of the time, don’t stress about it. Incorporate a few of your favorites while practicing mindfulness and tracking. If you really want that beer or that cookie, have it. One cookie or one beer isn’t going to be your downfall.

Do: Have and follow your workout calendar
Don’t: Don’t wait until Monday to start again if you miss a workout. Simple—if you missed a workout because of sickness or travel or you just didn’t feel like doing it, don’t worry. Just get back to it. Establish your “why”— your goal to yourself—write it down and carry it everywhere you go.

Which one of these sets of tips will you start now, today? Which ones do you currently practice and what have they taught you? How do they help you stay in control? How will you keep improving? Which one do you struggle with most?

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Congrats! You lost weight! But then life happens. Sound familiar? How do you avoid falling off the wagon? Our health columnist offers five strategies to help.

You’ve just found the magic solution to losing the extra weight and permanently keeping it off. You figure out what to eat on the plan outlined, buy the groceries needed to adhere to it, and adopt the exercise regime it recommends. You follow the program strictly for two weeks, and guess what? You lose some weight, you feel better, and you like how your clothes fit. Success!

Then ___________ happens. In other words, life occurs. Who could have seen that coming?

I’m sure many of you have experienced this at some point in your weight loss journey – I know I have many times!

There was birthday cake strategically placed at the office, your partner left you, your boss reprimanded you, you went out to lunch with your coworkers, you didn’t prepare ahead of time, or you haven’t eaten in 8 hours. Whatever it is and how valid the reason may be, this is called life. Before you know it, the incongruent goal choice and action has crept up on you without your conscious knowledge and drove your head into a bag a chips or row of cookies. After the consumption, you feel ashamed and despaired. You ask yourself, “Why did I do that? I feel like a failure!” You ditch your rigid “diet” and fall back into old patterns and behaviors and the weight lost soon comes back, and likely more.

Why does this keep happening? How do we break this cycle? How do we handle it with grace and remain congruent with our health goals?

Insert The Diet Doc call!

Before diving into the five strategies, I want to first share three of the common hazards that set up unrealistic expectations, which can lead one more readily to fall off the healthy weight loss wagon. The five tips will help develop an approach that will stop you from engaging in that unhealthy yo-yo cycle, or restrict-binge behavior, you may know all too well.

Hazard #1: New Beginnings
We as human beings love novelty; it is always exciting and fresh at the start. It may sound strange, but sometimes it’s fun to start a new diet or exercise routine. You get to try new recipes and new workout routines and there’s all these gadgets that track all your metrics, but once the initial excitement wears off, we tend to get bored. That’s when motivation drops quickly. Refer to my “5 Nutrition Tips” article to establish that meaningful purpose statement.

Hazard #2: Short and Sweet
We also tend to have short attention spans and want immediate results that requires the least amount of resistance. Rolling with the punches or daily sacrifices don’t have to be physical pain – though the soreness you might feel when starting a workout routine could count – it can also be the annoyance of not ordering your usual coffee beverage or avoiding the fries or preparing healthy meals ahead of time instead of laying out on the couch. Refer back to your “why” and determine how high of a priority your health is.

Hazard #3: Unrealistic Expectations
If it were possible to lose a huge amount of weight in a short amount of time and keep it off for the rest of our lives, none of us would be in this situation in the first place. Sustained, healthy weight loss, and maintenance takes time, consistency, practice, and patience.

Now that those are laid out, here are five tips to avoid common weight loss pitfalls and set yourself up for long-term success:

1. Focus on the Big Picture
Acknowledge the desire for novelty and meet those needs in other areas of your life before the excitement of the diet and/or exercise routine wears off. For example, you could try a new sport or hobby. Additionally, look at other aspects of your life and determine what realistic, sustainable modifications you need to make to achieve your goals. Be proactive with your actions with the intention of making them lifelong behaviors and habits. It just takes starting though, striving to improve one day at a time and never settling.

2. Become a Mental Endurance Individual
We’ve heard the cliché, think of weight loss and maintenance as a marathon rather than a sprint. If you reflect of your struggle with weight, you’ll probably discover that it took years to get to where you are today. Similarly, it may take years to find success in your weight loss journey and to stay there in the long run. Believe in yourself and trust the process. Again, don’t quit on yourself. Keep trying, keep failing, keep learning, and repeat.

3. Be Humble
In order words, accept your weaknesses. For example, if you know that an upcoming family gathering will present itself as a stressful situation with food triggers, work around it by planning ahead. Consider what you will eat ahead of time and figure out a way to de-stress afterwards that doesn’t revolve around food. Even if despite the best intentions and the plan doesn’t go according to the plan, shake it off and analyze how you could improve for next time. What steps will you take? What could I have done differently? What was behind my motive for the choices I made?

Remember that being healthy is a process, not an outcome; it will not always be enjoyable. Expect tough times when you are bored, tired, ill, unmotivated, busy, or stressed. It’s about consistency, not perfection. You stick with it though because of its meaning and importance.

4. Forgive Yourself/Celebrate Your Successes
We tend to flourish and succeed at goals when we are complimented. Instead of labeling yourself as a “failure” when you detour, acknowledge what happened, be mindful of the choices that lead up to it, and change direction towards the outcome you desire. Stay away from extreme labels that make you feel hopeless (“I can’t…” is one of them), or set unachievable standards (“look like a supermodel”).

5. Develop a Strong Support System
Most people find that they are more successful with long-term weight loss, or any life process, when they involve others in the process. It’s absolutely crucial! How could your partner, family, or friends support you in your goals? Could you share healthy meals or exercise together? Could they be a support line? If you’re feeling unmotivated to exercise or to remain honest to your nutrition, could you reach out to them to help you remain focused?

There is research to support there is a higher tendency to slip back into old behavior patterns after an initial weight loss due to how we deal (or don’t deal) with our emotions. A reliable accountability partner can help you pinpoint patterns when faced with upsetting emotions or circumstances. This individual can help you address and resolve issues when they arise instead of stuffing them down with food or denying they exist.

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Can’t seem to get past that weight loss plateau? Our resident health guru offers his best solutions to the four hidden health hinderances.

Food is health; exercise is fitness. Two separate concepts, yet work synergistically. One shouldn’t neglect one or the other for ultimate health and wellness, especially for weight loss purposes. If you just started an exercise plan or are working out more consistently, you may need to change how you fuel your body to get the most out of it. Some nutrition mistakes, such as drinking your calories or eating too much post-workout may be the reason why weight loss has stagnated (or inches) even though you’re giving it your all. Although getting fit and healthy isn’t just about the scale, it’s still an important motivating factor, so lets break down 4 common issues—and how to resolve them—to get you back on the path to results.

Issue 1: No idea how many calories you’re really eating
It’s common to think more exercise = more calories. However, if you’re trying to lose weight, you may be adding on as many calories as you’re burning—or more. It’s commonly observed in those who want to lose weight are eating more than anticipated, and for those intending to gain weight are eating less than anticipated. I’ve shared this parallel to personal finances in previous articles, but think about the food you’re eating and ask yourself how it fits into your total calorie allotment for the day. Determining that caloric value is very subjective and unique though to every individual, but it starts with establishing a baseline first. Just because you hit the cardio hard today doesn’t entitle you to supersize dinner. Most people have no idea how much they’re really eating until logging is introduced. Once he/she realizes how much food is being eaten, especially mindlessly, it permits an opportunity to change the routine. Be honest with yourself and your calorie needs, literally write down everything you consume. Whether you write it down old school style or use a digital app like MyFitnessPal, use that as a starting point and analyze the trends. Thus, determine if you are losing, gaining, or maintaining in a week’s time and rate your energy level. The final numbers and macronutrient proportions will probably humble you. The figures provide clues as to how to proceed, with you in the driver’s seat.

Issue 2: You’re not having a pre-workout snack
As long as an individual is getting enough balanced calories in his/her diet, the average person should have all the glycogen stores he/she needs to get through an hour-long workout, even first thing in the morning. However, eating something beforehand might give your performance a little boost. If you notice what’s called “bonking” – the sensation where you run out of glycogen and blood sugar halfway through a workout – you may benefit from a pre-workout (PWO) meal or supplement.

Some fitness magazines are starting to report actual studies on PWO nutrition needs. If you consume a small amount of carbs first, you’ll have a much stronger, more effective exercise session. More calories are likely to be burned, more calories will be used during the subsequent couple of hours (even at rest), risk of lean body mass is reduced, and studies show collectively that more body fat loss occurs compared to fasted exercise. Carbs before exercise are important whether it’s first thing in the morning or mid-afternoon. Be sure to time the PWO fifteen- to sixty-minutes prior to training, and be cautious to use a small amount of carbs – just enough to prime the pump. For example, 50–100 calories of simple carbs should be sufficient. Half a banana with peanut butter or a quarter cup of oats with fruit is few of many ideas.

Issue 3: You’re eliminating all carbs
Aren’t we all sick of hearing about low-carb plans? Yes – they can work as far as losing weight, but you’ll end up slashing your metabolism as high as 50% in as short as three months. What’s the plan after the fact? Is it practical and sustainable to follow the plan for the rest of your life? The irony is fat is burned in the flames of carbs in the body. This is why having an understanding of your metabolic needs is critical because the body is only going to use what’s needed and store the rest, and this is very unique to every individual. It’s a continuum. Anyways, far too many try to eliminate ALL forms of carbs when they’re trying to lose weight or to jump-start the process with a detox/cleanse. Not only is it risky because the strategy can backfire, nor is it enjoyable, but depleting carbs too drastically from your diet can put you at risk for using lean protein stores for energy, which ultimately can decrease your lean muscle mass. See carbs as a buffer to preserve your muscles and metabolism. Muscle is critical for positively influencing your metabolism and burning more calories even at rest. The lesson? Don’t be afraid of carbs, so eat up – within context of the day of course and understanding of your metabolic needs.

Issue 4: You’re not working out hard enough
If you notice you come home from a run only to find that you’re noticeably hungrier, consider upping the intensity of that run. A recent study in the International Journal of Obesity looked at sedentary, overweight men who either worked out at a moderate pace for 30 minutes or completed a high-intensity interval workout for the same amount of time. Those who did the intense interval exercise ate less at a subsequent meal, as well as the next day. Not every workout should be an intense interval session, but fitting in one or two a week can help turn the dial down on your appetite. Much like your nutrition, monitor your training; be as objective as possible. In order to know what to do, you have to know what you did.

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Experts say a high-protein diet is the key to losing weight, but what are the differences in protein sources, and why does it matter? Our healthy living columnist explains.

What is the best when it comes to protein powders? As a nutrition supplement, protein offers one of the biggest bangs for your buck and is most convenient. Protein powders are everywhere; it’s plentiful at every grocery store. You can even find them at gas stations. Plus, food companies are becoming “smarter” by marketing more protein in their products. Thirty-five grams of protein per serving compared to 20? Whoa – that must mean more muscle or faster weight loss! Isn’t that how it goes? More protein means better quality and better results? Not even close.

I feel protein is seen as that miracle supplement that will shed weight and keep you full. Plenty of research does support it can promote both, but it’s not absolute. It’s much more than that. Therefore, what’s the best and healthiest option? There are different protein powders for a reason, and it’s largely based on one’s goals and preferences, not just for taste and the highest amount you can consume at once. So before you make the investment in another giant tub of powder, you ought to first understand some basic protein principles.

Most realize protein helps with muscle synthesis and growth, but there’s more to it. Like carbohydrates and fat, protein is a critical macronutrient your body needs daily. Protein can also help with repairing damaged cells and tissue throughout the body, synthesizing hormones, and is supportive in metabolic activities. Despite these important reasons to include protein in your diet, a main reason why protein is in the media is because it provides satiety to aid in weight loss. Since protein helps you stay full, it makes it easier to stay within an ideal caloric range.

Just as carbohydrates come in different forms (simple and complex carbs; fibrous and starchy carbs), there are different protein sources that have different effects on metabolism and exercise performance. Having an understanding of eating the right kind of protein at the right point in your routine, you can maximize its benefits and your goals. I’ll focus on three of the most common protein sources found in stores today: whey, casein, and pea. Do keep in mind the principles are the same for sources, such as soy, dairy, beef, hemp, and rice.

Whey Protein
This is among the most widely consumed protein supplements. It comes from the translucent, liquid part of milk that’s left over from cheese-making and is a complete protein, meaning it contains all nine of the amino acids humans need.

Whey is a fast-digesting protein because once consumed, your stomach assimilates it quickly. This leads to an increased rise in the amino acids circulating in your blood, making it a good choice for a post-workout snack. About 1-2 hours after you exercise, your body experiences a spike in protein synthesis, during which it works harder to repair the muscles you worked. If you consume whey within 60 minutes of your workout, your body can quickly absorb the amino acids to take advantage of this anabolic window and supply your body with what it needs.

Unless you plan to sip whey throughout the day and evening, its quick-absorption make it less than ideal for a mid-day snack or meal replacement. That’s where most protein powders are a fusion of whey and whey protein isolate, or casein, to slow down the absorption; therefore, you feel fuller longer and maintain a steadier, positive nitrogen balance for your muscles (to encourage growth).

Casein Protein
The cousin of whey; casein is the main protein component in cow’s milk. It, too, is a complete protein. Unlike whey, which is quickly digested, casein forms a gel once it reaches the stomach. As you could predict, this chemical reaction makes it relatively insoluble, so it takes the body longer to break down. This is a similar reaction when eating insoluble fiber. Casein is a slow-digesting protein, therefore. It provides a steady release of amino acids over several hours. Having said that, casein can still be another good option as a post-workout snack.

Studies have found a synergistic effect to be created when whey and casein are combined. Classically, taking whey within 60 minutes of your work out and then taking casein right before bed is the ideal combination. Because of its steady release, casein helps create an “anti-catabolic” environment in your body when you body synthesizes protein. The nature of casein provides a steady supply of amino acids to make the most of that window and promote muscle growth/recovery.

Caution, caution, caution: both pure whey and casein come from cow’s milk, so neither is well suited for individuals with dairy allergies. The more isolated the whey protein is, the better it’s tolerated.

Pea Protein
For the unlucky ones who cannot tolerate dairy, here comes their salvation. Pea protein has been appearing on store shelves more frequently, and it’s an excellent alternative to traditional protein sources if allergies exist or if an individual prefers plant-based nutrition. Pea protein holds middle ground as it is digested at a medium rate, providing satiety levels that are about the same as whey and casein. Therefore, it can be used as either a post-workout supplement or meal replacement. One downside to pea protein is that it isn’t a complete protein and shouldn’t be used as your main source of dietary protein. It is a supplement after all.

Even with all the existing protein supplements on the market – and there are many – research continues to flourish with new sources and combinations. You can even buy beef-based or egg white-based protein powders. Therefore, explore what’s out there. Be curious about learning and what can maximize your health and fitness goals. Unlike a lot of over-hyped, unsafe supplements, protein really does help within context. Since you’re going to be eating it anyways to stay alive, you might as well make smart protein choices that help meet your goals.

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Increased fiber must mean it’s healthy and best for you, right? Our health guru shares some bathroom reading regarding four common fiber myths.

I type this article with trepidation because no one likes to hear the words flatulence, diarrhea, and bloating. While these words are commonly used in my professional life, it’s not exactly table conversation. When seeing patients though, it’s inevitable to discuss bowel habits and the importance of fiber. The more I think about it, everyone does seem to talk about poop and fiber. I didn’t anticipate my career to take this turn. Nevertheless, fiber seems to be misunderstood. Modern food manufacturing processes – especially in the low-carb industry – have brought a high level of dysfunction into lives needlessly. Therefore, I think it’s important to discuss some common fiber myths.

Myth #1 – Fiber is needed for every meal

Fiber is necessary for bowel function. Too little of it and it can lead to constipation or bouts of diarrhea – two sides of the same coin. When one’s intake consists of low-fiber foods, it’s often associated with increased cases of inflammatory bowel disease and cancer. There’s even known links to heart disease because a low-fiber diet usually indicates someone is eating an excessive amount of sugar and fat. To illustrate the benefits of fiber, see it as a broom for your gastrointestinal (GI) system. It increases bulk, softens stool, and shortens transit time through the body. Too much fiber though can create impaction, leading to a serious medical issue. Conversely, too much fiber can make diarrhea probable when a binding agent, such as starch can’t do their job. Too much chronic abuse of fiber can ultimately lead to inflammatory bowel diseases, such as ulcerative colitis and colitis. I suggest eating a good serving of vegetables in a couple meals and a serving or two of fruit per day. Generally speaking, 25-35 grams a day of fiber is sufficient unless a known GI issue or food intolerance exists. Fiber supplements may be needed, but self-experimentation and journaling are important to connect any symptoms to the foods you’re eating.

Myth #2 – Eat a wholefood diet if you have a sensitive GI system

While I don’t condone the intake of a macrobiotic-rich diet, it seems everyone who endures GI distress thinks, or is told, to eat more and more vegetables. Nothing could be worse frankly. Because of the raw roughage and complex, hard-to-digest grains, it will create more GI inflammation, thus worsening one’s symptoms. Try limiting raw vegetables, and you might need to decrease the size and frequency. Eat small amounts of steamed vegetables instead. Starch is a friend to someone who has inflammatory bowel issues, but fiber is still necessary. It just means the balance may need to be tilted towards the more soluble type of fiber.

Myth #3 – To lose weight, ALL of your carbs should be fibrous

Here’s the reason why fiber is so popular and mainstream – to aid in weight loss. Let’s establish one thing, your body needs starch (carbs), even when dieting. Cutting out carbs completely will reduce your metabolism faster and increase muscle catabolism (breakdown) more than other dieting method. However, those who get caught in this trap miss the opportunity to include more satisfying, more anabolic (muscle building), and more metabolic complex starch sources. Don’t get caught up and deceived by misinformation. Include those whole-grain pastas, breads, rice, quinoa, potatoes, oats, and many more. Dare I even say have a Reese’s cup or white rice as long it fits the context of your goals and macronutrient requirements.

Myth #4 – For better regularity, eat more vegetables; it’s normal to have gas and bloating

Lets say it together: too much fiber is too much fiber. While most avoid fruit because of the carbs, the fiber found in most fruit is extremely helpful with stool formation. However, the need for increased fat in one’s diet can also help with regularity. Flaxseed oil is a favorite for its omega-3 fatty acid qualities, and a small serving or two per day can be the ticket to stimulate GI movement.

When polysaccharides can’t be digested in the upper GI tract, the bacteria of the lower GI tract consume and ferment them, and the byproduct is methane gas. Not only is it annoying, it’s inflammatory. How often do you hear others blame their protein shake, or assume it’s normal? No one realizes the things we can’t digest are causing the inflammatory process. You do have options though. Consider cheap protein, soy, legumes, harsh vegetable fiber, nasty filler fiber in low-carb products, and lactose as primary offenders and cut them out. Take every processed food out of your diet and start adding one thing in at a time and you will find there are some items you can consume in small amounts, but there is a limited amount of digestibility. Some foods are better completely avoided.

Not too often does a person have upper GI issues to the point he or she feels bloated with a normal-sized meal. When you eat a meal, everything is pushed along all 20 feet of your intestinal tract. Food in, food out. Because food is shifted further after eating, the methane gas production and discomfort felt is happening at the other end, not in your stomach. It normally takes 18 to 24 hours, or longer, for a complete digestion cycle. When you feel bloated after a meal, it’s the meal you consumed 18 to 24 hours earlier. Track that meal accordingly and identify any possible offenders. The exception to this is when a strong allergic reaction is caused or an irritant is consumed, but I assure you you won’t be worried about the gas and bloating because you’ll be sprinting to the nearest bathroom.

All kidding aside, bowel health is serious and suffering doesn’t have to be part of good health or weight loss. There are no quick fixes, and never settle for cliché, cookie-cutter diet plans that leave you hunched over.

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How can you stay on track with a healthy lifestyle without losing consistency and progress? Our health guru says it all comes down to planning and offers five helpful tips.

Chances are you probably start off each week with every intention of eating healthy. The idea of preparing meals and tracking them, in the midst of our busy lives, can seem intimidating to many individuals motivated to living a healthier life. It’s not a matter of simply grabbing a food scale and a recipe book, and expecting results. Not to discount those efforts though! They’re foundational in the process of achieving permanent and sustainable health habits. However, just when everything begins to click and momentum is established, an obstacle arises. Life happens. Whether it’s work, an unexpected social event, a quick trip, or everyday stress – how can we stay on track with a healthy lifestyle without losing consistency and progress?

Having worked irregular 12-hour shifts in the hospital, sometimes with no breaks, it’s quite a challenge to stay focused. Frankly, it’s a challenge no matter what to follow through on health goals. It’s not fancy to say the process takes time, patience, and practice, but for permanent results we must acknowledge our thoughts and actions have to be congruent with our goals. In my journey of losing 100+ pounds, I have picked up tools and tricks to stay on track with my nutrition, while still enjoying myself, no matter the environment or obstacle. It just takes diligence, preparation, and mindfulness. Here’s my advice to you to maintain your goals whatever the situation:

1. Set Your Goals
Your nutritional needs are the foundation of your meal plan, so before you start implementing action steps, do a quick assessment of your personal goals. What are they? What do you wish to achieve? Why is now the time to take action? What would it mean to you to be free of this problem? What has worked well in the past, and what didn’t? What can you take from that experience and better execute this time? What foods are a must, and what are some that need to be reduced? Simply ask yourself: “My goal is to _______ by ___insert date___. I plan to accomplish this by doing __________.” Write down your goals, commit to them, and remind yourself of them everyday.

My main piece of advice for someone starting his or her journey is to set goals following the SMART principle. A goal needs to be specified, measurable, attainable, realistic, and with a timeframe. When a goal is outlined, it becomes very clear of what steps are needed to take.

2. Make a Master Plan
Once the goals are established and written down, it’s time to create an execution plan with specified action steps. Take each goal and simplify it so each day is manageable; break down your day and see what you can prepare and anticipate. If your goal is to eat a meal/snack every couple hours, set an alarm on your phone to remind yourself. You can also do the same if the goal is to increase water intake. If the goal is to increase your amount of sleep, remind yourself to stop whatever activity at a certain time with no exceptions. Make the commitment, be consistent, and then evaluate the process. Was it successful? What could I improve? Don’t be afraid to be curious in the process and step outside your comfort zone. More importantly though, be mindful of your thoughts and actions. Plan ahead when possible, which is discussed next. Good intentions will falter, motivation waxes and wanes, but we persevere because of the meaning behind the goal. That’s the difference between commitment and motivation. Roll with the punches of life, pause and reflect on the situation, and proceed accordingly to the outcome you desire.

3. Plan Ahead
So now that goals are created and a plan is outlined with steps, how can we stay on top of everything? We plan ahead; we control what we can and set up the environment for success. Use whatever organizational method for you, but what has helped me greatly is logging my nutrition. Being mindful of your nutrition intake, through the use of tracking or journaling, is a success characteristic for long-term weight loss and maintainers. With so many nutrition apps available, there’s no reason why we can’t take the incentive and prep ahead. Calculate your meals in advance, cook in bulk to last a few days, and store for when you need them. For the more advanced, looking up nutrition facts ahead of time when dining out and then accounting for it allows for both structure and flexibility. There’s no reason to give up your favorites as long as mindfulness is practiced and actions align with the goal.

4. Don’t Sabotage Yourself
Once you’ve planned and prepped, the hard work is done, right? Now all you have to do is avoid those usual stumbling blocks. Nothing in life with value comes easy. While there are many potential setbacks we can encounter, a common one is trying to eat foods you don’t really like. Learning how to eat healthily and flexibly based on your body’s needs is a critical skill for long-term success. Eat the foods you love while having it fit your caloric and macronutrient (protein, carbs, and fat) figures. Much like a financial budget, allocate your calories for more whole foods, yet permit yourself to have something relaxed.

5. Enjoy Yourself!
To expand on the previous tip, granting yourself something enjoyable everyday takes away the urge for big, unplanned indulgences because you’re not depriving yourself, or self-imposing faulty assumptions on food items. Food is not dichotomous (good or bad). We must challenge our thoughts (what’s the intention?) and realize that’s not a healthy relationship with food (bring it to attention). All foods are fair game as long as it’s logged (taking action), and you remain mindful of the decision (reflecting). That’s the beauty of “flexible dieting.” That’s The Diet Doc lifestyle!

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Music has an impact on fitness and performance, and is a useful therapeutic tool. Our new health expert explains.

Kevin shares his tips on getting fit.

Overture. Beethoven, The Beatles, Palestrina, Led Zeppelin, Morten Lauridsen, Pearl Jam, Bach, Rush(!), Mendelssohn, some cool hip-hop artist that I will not pretend I know, Enya—the continuum of musical artists and genres are vast and diverse. Depending on context and the individual’s mood, music has a way of tugging on his or her heartstrings. Music is a gatekeeper into our mind and soul, which becomes expressed physically through emotion or action. Music can profoundly affect us in many ways, whether that is comfort after a messy break-up or to provide a quick pump before a sporting competition. Music, as a therapeutic tool, can positively and negatively impact our mood and behavior.

Subsequently, as it relates to exercising performance, the style, rhythm, and tempo of a song can affect our intensity level. Music, health, and fitness go together like a C-major chord, so hands in playing position, head up, take a deep breath, and start on the count of four…

Verse I. Music is well recognized for its physical, cognitive, and spiritual connection. After all, that is the essence behind music therapy. There have been many times in my career as a Nurse Practitioner where the use of music as a therapeutic modality has improved a patient’s mood or cognitive status. Sometimes music can trigger a final passing memory the patient experiences shortly before taking his or her last breathe, or an Alzheimer’s dementia patient to reminisce about a fond memory from 50 years ago. Through musical involvement in the therapeutic context, patients’ abilities are strengthened and transferred to other areas of their lives, providing an outlet for expression of feelings. From a physical rehabilitation standpoint, research has shown music to be quite effective in facilitating movement by encouraging patients to be engaged in their treatment plan. Music is powerful any way you listen to it.

On a personal perspective of music and its therapeutic effects, my mother suffered from a hemorrhagic stroke in 2014. She has no significant past medical history, takes no medications other than fish oil and a multivitamin, is a nonsmoker, maintains a healthy weight, is a cautious eater, and is extremely active. Clearly she had minimal risk factors other than her age. The first moment I witnessed her, after her craniotomy, everything was blur. I am sure she could say the same.

Despite being heavily sedated, she could squeeze my hand in response to simple commands. I asked her how comfortable she was. She squeezed my hand once or twice respectively to answer my question. Understandably so, she was not comfortable; she was scared in fact. Trying to maintain my composure, all I could think about was to play music to help her relax. I pulled out my iPhone and ironically the first song on shuffle was “In My Life” by The Beatles, the song my mother and I danced to at my wedding. I played the song, and her handgrip softened. Her squeezing became less frequent. For that remaining time we spent together in the ICU, we held hands and she was relaxed. She was comfortable, and so was I.

Verse II. Music obviously can have a positive impact on cognition and mood, but how does it affect exercise performance and behavior? The use of music in exercise training has attracted considerable interest from researchers in recent years, and it has long been considered effective for enhancing the exercise experience. Researchers have proposed four factors contribute to the motivational qualities of a piece of music: 1) rhythm/tempo response; 2) musicality; 3) sociocultural impact; and 4) personal association. Considering these four factors when creating your ideal playlist, have you noticed changes in your mood or performance? As for myself, I am boring because I prefer to exercise with no music, or distractions I should say. My wife could tell me the house is burning down and I would not acknowledge what she said. I am focused—eyes on the prize.

Chorus. Out of the four factors discussed, tempo is considered to be the most significant determinant of musical response. The listener’s physiological arousal and the context in which the music is heard may affect the tempo preference. This means that as physiological arousal increases, such as during exercise, one should, accordingly, prefer higher tempi. This observed phenomenon is called synchronization. The implication during physical activity is there will be stronger preferences for fast tempo music, owing to increases in physiological arousal.

The choice of music tempo has also been shown to impact aspects of exercise behavior, most notably initiation and adherence of a program. Given that the arousal potential of stimuli determines preference and individuals often require a moderate increase in arousal to initiate physical activity, it follows logically that listening to music of a preferred tempo prior to exercise will assist participants in attaining an optimal mindset. Furthermore, if such music content also contains lyrical affirmations pertaining to motivation aspects, it will have an even more potent effect. Music that induces positive affect and mental imagery and promotes enjoyment is likely to increase levels of adherence.

Verse III. That’s enough about pre- and intra-workout, so what about post-workout? Can music really have an impact? One study revealed motivational qualities of music used during exercise provided a sense of comfort to participants post-workout; it created a shared experience within the gym setting. Thus, this exemplified the building blocks of intrinsic motivation, which leads to increased levels of enjoyment and adherence. Music functioned as a conditioned stimulus within an exercise or gym setting, which became amplified over time owing to a gradual reinforcement process. It is even possible that music may influence individuals on a cognitive level, leading them to evaluate themselves more favorably and their own ability to meet their health/fitness goals. (Go to coda). Music is inspiring and motivating. It influences our mood, cognition, and health/fitness goals by making it more enjoyable and enables us to increase our intensity, ultimately improving long-term performance. Whether you are an individual just starting your health journey, or fitness professional, we are motivated by positive results, and playing music while exercising can assist in reaching that outcome. Various personal characteristics influence the response to music during exercise. Hence, personality, sociocultural relationships, and attitude towards exercise should all be considered when selecting a music playlist to accompany exercise. The beauty of music is its diversity, and not one tune will resonant identically with someone else. Encouraging exercisers of any level to create and listen to their own music playlist may be one of the most critical aspects of keeping individuals motivated towards long-term health sustainability. Create your own personal soundtrack that builds you up, that defines you, and something that empowers you.