Sarah Cimperman's Blog

As the seasons change, so do our bodies. Now that autumn is settling in, days are becoming shorter, nights are becoming longer, and temperatures are becoming cooler. While our internal clocks adjust to the seasonal transition, we may experience changes in sleep, mood, metabolism, and immunity. We’re more likely to suffer from insomnia, depression, and anxiety, and we’re more likely to get sick. Preventing infections is always a priority during cold and flu season, but it’s especially important during the current COVID-19 pandemic. This year, head into fall with some healthy habits that will help keep you well. Here are seven ways to get started.

The World Health Organization has named air pollution as the greatest environmental threat to human health. Wildfires are an increasing part of the problem and their effects are only expected to worsen as climate change continues to alter temperature and precipitation patterns around the globe. 

Wildfire smoke is a complex mixture of gases and fine solid and liquid particles. It’s particularly toxic when it comes from burning buildings and manufactured materials like plastics. Wildfire smoke can contain thousands of harmful chemicals like carbon monoxide, phthalates, volatile organic compounds, ozone, persistent organic pollutants, carbon dioxide, polycyclic aromatic hydrocarbons, and nitrogen oxides. Studies show a positive correlation between wildfire exposure and respiratory illnesses—including bronchitis, pneumonia, asthma attacks, and chronic obstructive pulmonary disease (COPD)—as well as death. Wildfire smoke also affects the heart and blood vessels throughout the body and brain. A study of people exposed to California wildfires in 2015 found an increase in emergency room visits for cardiovascular problems including ischemic heart disease, heart failure, abnormal heart rhythm, pulmonary embolisms, heart attacks, and strokes.

Now that wildfire smoke is spreading thousands of miles across the United States, reaching areas completely unaffected by wildfires, it’s important for everyone to learn some precautions. Here are six ways that you can minimize the effects of wildfire smoke on your health.

#1 | Know when you need to take action.

Follow the air quality in your area through local agencies or the AirNow website or smart phone application. AirNow is a partnership of the U.S. Environmental Protection Agency, National Oceanic and Atmospheric Administration, National Park Service, NASA, Centers for Disease Control, and tribal, state, and local air quality agencies. You can enter your zip code to view the air quality index (AQI) and trends for your local area. You can also use the interactive map to view air quality at state, national, and global levels. According to the U.S. Environmental Protection Agency, good air quality measures up to 50 on the AQI. Levels above 50 may irritate sensitive individuals and levels above 100 can be harmful for pregnant women and their fetuses, children, teenagers, middle-aged and older adults, and people with cardiovascular or lung disease. When the AQI goes above 150 the air is unhealthy for everyone and people should stay inside as much as possible.

If a wildfire is burning near you, follow directions of local authorities and evacuate immediately if you are directed to do so. Be prepared with a disaster kit you can grab on the way out. It should include a first aid kit, identification, important documents, water and food, necessary medications, a list of important phone numbers, flash lights, a radio, extra batteries, a cell phone charger, and survival items like a whistle, pocketknife, rope, and matches.

#2 | Stay inside.

If the air is toxic outside, stay inside, as long as you have not been ordered to evacuate. Keep your doors and windows closed and set ventilation systems to re-circulate. Use high-efficiency particulate air (HEPA) filtration in your home if you can and keep the filters clean. Do not use an air filter that generates ozone. If you have central air or heating be sure to use a filter rated MERV13 or higher. If you do not have air conditioning, you should seek alternative shelter during extremely hot weather because it would be dangerous to stay inside with the doors and windows closed.

#3 | Reduce indoor air pollution.

Keep indoor air as clean as possible. When windows and doors are closed due to poor outdoor air quality, avoid anything that can add fine particles to the air like smoking, vacuuming, cooking on a stove, and using anything that burns like candles and fireplaces. As soon as the air quality improves, open all of your windows.

#4 | Wear the right kind of mask.

Certain kinds of masks can reduce the amount of air pollutants we inhale. Paper masks, surgical masks, dust masks, scarves, and bandanas are better than nothing, but they will not prevent fine particles from entering your lungs. Masks like N-95 or P-100 respirators offer this protection, but only when they fit well and are used correctly.
 
#5 | Eat a Mediterranean diet.

So far we don’t have any studies showing an association between diet and the health effects of wildfire smoke. But we do have studies showing that the Mediterranean diet can help preserve lung function in smokers as well as people who are passively exposed to cigarette smoke. Researchers found that the Mediterranean diet has a protective effect against the biochemical and molecular processes that can lead to lung disease, cardiovascular disease, and cancer, which they attributed to a high daily intake of vitamins, antioxidants, and other plant-based compounds. 

Until we have more studies to better understand how wildfires affect our bodies, it makes good sense that maintaining a healthy diet gives us the best chance of maintaining a healthy body under any circumstances. And it couldn’t hurt. Studies show that eating a Mediterranean diet is associated with a reduced risk of multiple chronic diseases and increased life expectancy. 

The foundation of the Mediterranean diet is plant-based foods like vegetables, fruits, nuts, seeds, legumes, whole grains, herbs, and spices. The main source of added fat is olive oil. Fish, seafood, poultry, and dairy products are included in moderation while red meat and sweets are only eaten occasionally. This diet is high in fiber, protein, antioxidants, and mono-unsaturated and omega-3 fats. Studies show that diets high in these nutrients may help to modulate inflammation in airways and protect lung function. 

#6 | Talk to your doctor about supplements that may be protective.

We also need more studies about the effects of supplemental nutrients on people exposed to wildfire smoke. So far there is some evidence that certain supplements may be helpful. An analysis of more than one hundred research and review papers spanning twenty years found that carotenoids, vitamin D, and vitamin E can help protect against damage from air pollutants that trigger asthma, obstructive pulmonary disease (COPD), and lung cancer. Researchers found that vitamin C, curcumin, choline, and omega-3 fatty acids could play a protective role as well. Talk to your naturopathic doctor about which supplements and dosages may be right for you.

References:

Whyand T, Hurst JR, Beckles M,and Caplin ME. Pollution and respiratory disease: can diet or supplements help? A review. Respiratory Research. 2018;19:79. https://www.ncbi.nlm.nih.gov/pmc/arti...

Reid CE, Brauer M, Johnston FH, Jerrett M, Balmes JR, et al. Critical Review of Health Impacts of Wildfire Smoke Exposure. Environmental Health Perspectives. 2016;124(9):1334–1343. https://www.ncbi.nlm.nih.gov/pmc/arti...

Cascio WE. Wildland fire smoke and human health. The Science of the Total Environment. 2018;624:586-595. https://pubmed.ncbi.nlm.nih.gov/29272...

Wettstein ZS, Hoshiko S, Fahimi J, Harrison RJ, Cascio  WE et al. Cardiovascular and Cerebrovascular Emergency Department Visits Associated With Wildfire Smoke Exposure in California in 2015. Journal of the American Heart Association. 2018;7(8):e007492. https://pubmed.ncbi.nlm.nih.gov/29643...

United States Environmental Protection Agency. Patient Exposure and the Air Quality Index. [Web page]. EPA website.
https://www.epa.gov/pmcourse/patient-... Accessed July 26, 2021.

Sorli-Aguilar M, Martin-Lujan F, Flores-Mateo G, et al. Dietary patterns are associated with lung function among Spanish smokers without respiratory disease. BMC Pulmonary Medicine. 2016;16,162. https://bmcpulmmed.biomedcentral.com/...

Vardavas  CI, Flouris AD, Tsatsakis A, Kafatos AG, and Saris WHM. Does adherence to the Mediterranean diet have a protective effect against active and passive smoking? Public Health. 2011;125(3):121-8. https://pubmed.ncbi.nlm.nih.gov/21276...

Tosti  V, Bertozzi B, and Fontana L. Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2018;73(3):318-326. https://pubmed.ncbi.nlm.nih.gov/29244...

Whyand T, Hurst JR, Beckles M, and Caplin ME. Pollution and respiratory disease: can diet or supplements help? A review. Respiratory Research. 2018;19:79. https://www.ncbi.nlm.nih.gov/pmc/arti...
 

As seasons change and the weather lightens up, so does my cooking. Slow-cooked roasted and braised dishes make way for steamed, sautéed, and raw ones while hearty soups are replaced by colorful salads. Salads can be starters, side dishes, main courses, or even a separate course at the end of meals to cleanse the palate before cheese or dessert. Main course salads are one of my favorite summer staples for quick and healthy lunches because they are versatile and easy to make. 

The prevention of osteoporosis has largely focused on calcium supplements. While we can’t have strong bones without calcium, it isn’t enough. Bone mineral density is determined by complex metabolic processes involving a wide variety of vitamins and minerals, hormones, bone cells, and even external forces. Bones provide structure and protection for the body, but they are also an active organ, storing and releasing minerals like calcium as needed for the normal function of cells, muscles, and nerves. 

More than thirty million people in the United States are living with heart disease and it’s the leading cause of death. According to the Centers for Disease Control and Prevention, one person dies from cardiovascular disease every thirty-six seconds. COVID-19 is catching up now that news outlets report the coronavirus—also known as SARS-CoV-2—kills someone in the United States every forty seconds. People with preexisting heart disease who develop COVID-19 are more likely to have severe symptoms and more likely to die. And because the coronavirus can damage the heart, people with COVID-19 who don’t have preexisting heart disease can develop cardiovascular problems as a result of the infection. 

The COVID-19 pandemic has caused nearly 1.5 million deaths worldwide as of late November 2020. It’s also been the source of considerable suffering as people struggle with economic devastation, food insecurity, unemployment, workplace safety concerns, the loss of loved ones, and social isolation. 

Even after individuals infected with coronavirus recover, the psychological toll can last long-term and symptoms can be similar to those of post-traumatic stress disorder (PTSD). People affected by post-COVID stress disorder may experience nightmares, flashbacks, difficulty sleeping, detachment from family and friends, and overwhelming feelings of anger, fear, hopelessness, anxiety, and depression.

Scientists and doctors are still learning about the diagnosis and treatment of COVID-related stress disorders. Researchers in North America have developed COVID Stress Scales to help identify people in need of mental health services as a result of the pandemic. So far, healing has focused on interventions that have proven helpful for individuals affected by PTSD, anxiety, and depression. Here are five ways to address post-COVID stress disorder, improve mental health, and adopt coping strategies amidst the ongoing global pandemic.

#1 | Exercise Regularly 

Exercise has been proven to be an effective intervention for treating mental and emotional conditions including depression, anxiety, and PTSD. Researchers have found that exercise can enhance cognitive function, desensitize individuals to internal arousal cues, reduce inflammatory markers, and normalize the function of the hypothalamic-pituitary-adrenal (HPA) axis which acts as the body’s central stress response system. Exercise also promotes neuroplasticity, the growth and reorganization of neural networks in the brain that improve our ability to adapt to new circumstances.

Benefits start at thirty minutes of moderate-intensity exercise (such as brisk walking) three days per week, and studies indicate that three ten-minute walks are as effective as one thirty-minute walk.

#2 | Get Some Early Morning Sun 

Early morning sunshine contains more blue light than any other time of day and no ultraviolet radiation. It helps regulate our circadian rhythm and stimulates the brain to release neurotransmitters like norepinephrine, dopamine, and serotonin that increase alertness and improve our mood. Morning light also triggers the release of glucocorticoids that help wake us up and mediate our response to stress. 

Researchers who exposed healthy adults to artificial light designed to mimic early morning sunlight for thirty minutes each day for three weeks found that participants were better able to cope with anxiety-provoking experiences. Light therapy is also used to treat seasonal depression and studies show that it may be effective against non-seasonal depression as well.

Because blue light peaks at sunrise and decreases throughout the day, get up and go outside for fifteen to thirty minutes each morning as close to sunrise as possible.

#3 | Practice Relaxation

Relaxation exercises have been shown to improve depression, anxiety, and our ability to manage stress. Relaxation is also emerging as an adjunctive and alternative treatment for PTSD. Mindfulness-based therapies including cognitive therapy, meditation, yoga, and deep breathing exercises have been shown to address emotional under-modulation and over-modulation, and restore connectivity between the brain networks affected by PTSD. 

Meditation, yoga, and breathing exercises can be learned and practiced anywhere, daily or whenever the need arises. For people seeking inspiration or instruction, there plenty of apps and online videos, and many of them are free.
    
#4 | Stay Connected

Physical distancing has been a key strategy in reducing transmission of the coronavirus, but many people remain separated from friends and extended family members. Studies show that social isolation and loneliness are strongly associated with depression and anxiety, reduced physical activity, increased use of alcohol and cigarettes, and obesity. In contrast, peer support has been shown to relieve depression and anxiety, to improve outlook and the ability to cope with stress, and to enhance recovery and survival.

During the pandemic, we may be physically distant from our loved ones but we can still socialize, thanks to modern technologies that allow people to connect like never before. While in-person visits may not be possible, we can stay in touch with family and friends by phone, emails, text messages, and video chats.
    
#5 | Consider Adaptogens

Adaptogens are plant medicines that help restore balance to bodily functions and increase resistance to stress through the HPA axis. Studies show that adaptogens can improve the ability to cope with stressful environments and they can be effective interventions against anxiety, depression, and PTSD. 

Several adaptogens exist—including licorice, ashwagandha, eleutherococcus, rhodiola, panax, and schisandra—so schedule a virtual visit with your naturopathic doctor to discuss the best choices and dosages for you. Plant medicines can interact with other supplements as well as prescription medications, so be sure to tell your doctor about everything you are taking to avoid possible interactions.

References:

World Health Organization. WHO Coronavirus Disease (COVID-19) Dashboard. [Web page]. WHO website. https://covid19.who.int/ Accessed November 20, 2020.

Taylor S, Landry CA, Paluszek MM, Fergus TA, McKay D, et al. Development and initial validation of the COVID Stress Scales. Journal of Anxiety Disorders. 2020;72:102232. https://www.sciencedirect.com/science...

Hegberg NJ, Hayes JP, and Hayesl SM. Exercise Intervention in PTSD: A Narrative Review and Rationale for Implementation. Frontiers in Psychiatry. 2019;10:133. https://www.ncbi.nlm.nih.gov/pmc/arti...

Sharma A, Madaan V, and Petty FD. Exercise for Mental Health. The Primary Care Companion to the Journal of Clinical Psychiatry. 2006;8(2):106. https://www.ncbi.nlm.nih.gov/pmc/arti...

Fisher PM, Madsen MK, McMahon B, Holst KK, Andersen SB, et al. Three-week bright-light intervention has dose-related effects on threat-related corticolimbic reactivity and functional coupling. Biological Psychiatry. 2014;76(4):332-9. https://pubmed.ncbi.nlm.nih.gov/24439...

Perera S, Eisen R, Bhatt M, Bhatnagar N, de Souza R, et al. Light therapy for non-seasonal depression: systematic review and meta-analysis. BJPsych Open. 2016;2(2):116–126. https://www.ncbi.nlm.nih.gov/pmc/arti...

Kashani F, Babaee S, Bahrami M, and Valiani M. The effects of relaxation on reducing depression, anxiety and stress in women who underwent mastectomy for breast cancer. Iranian Journal of Nursing and Midwifery Research. 2012;17(1):30–33. https://www.ncbi.nlm.nih.gov/pmc/arti...

Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence. Journal of Psychiatry & Neuroscience. 2018;43(1):7–25. https://www.ncbi.nlm.nih.gov/pmc/arti...

National Academies of Sciences, Engineering, and Medicine. (2020). Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. Washington, DC: National Academies Press. https://www.ncbi.nlm.nih.gov/books/NB...

Coughlin SS and Young L. Social Determinants of Myocardial Infarction Risk and Survival: A Systematic Review. European Journal of Cardiovascular Research. 2020;1(1):10.31487 https://www.ncbi.nlm.nih.gov/pmc/arti...

Panossian A and Wikman G. Effects of Adaptogens on the Central Nervous System and the Molecular Mechanisms Associated with Their Stress—Protective Activity. Pharmaceuticals (Basel). 2010 Jan; 3(1): 188–224. https://www.ncbi.nlm.nih.gov/pmc/arti...

Ernsberger MM. Drug-Free Alternatives for Post-Traumatic Stress Disorder (PTSD). Medicinal & Aromatic Plants. 2015;S2:001. https://www.longdom.org/open-access/d...

Grain-free is the new gluten-free when it comes to diet trends. Gluten, a group of proteins found in wheat and certain other grains like barley and rye, can trigger allergic and autoimmune reactions in some individuals. But gluten may not be the only problem and the avoidance of grains all together may be a better solution for some people.

Grains are staple components of diets around the world, but they aren’t actually required for human health. Grains are composed primarily of carbohydrates with small amounts of fiber, fatty acids, B vitamins, and minerals. We can get these nutrients from other plant foods—like vegetables, fruits, beans, nuts, and seeds—which are even better sources of fiber, fatty acids, vitamins, and minerals.

Eliminating grains from the diet can certainly have health benefits. Because gluten is only found in grains, grain-free diets are automatically gluten-free and can improve symptoms of illnesses caused by immune-mediated responses to gluten like celiac disease. Grain-free diets may also improve conditions unrelated to gluten and celiac disease. So far studies have shown potential benefits for maximizing athletic performance and treating patients suffering from irritable bowel syndrome, fibromyalgia, endometriosis, obesity, schizophrenia, and atopic illnesses like hayfever, asthma, and eczema.1

Grain-free diets can feel very restrictive and for most people they can be difficult to maintain long term. Eliminating grains from the diet often requires spending more time and money on food preparation and for some people it can limit social activities. A study that followed 260 people eating a grain-free diet found that most participants reported only minimal interference in daily function, relationships, and lifestyle, but eleven percent reported “high levels of interference with social leisure activities.”

Several grain-free diets already exist including paleo, ketogenic, carnivore, and Whole30. These plans eliminate other things as well and vary in the foods they allow. If you’re considering grain-free diet, you can follow a specific plan like one of these or you can simply stop eating grains. Here are four reasons to go grain-free.

#1 | You have prediabetes or type two diabetes.

Grains are mostly starch and they are quickly digested and absorbed as glucose, or sugar, into the bloodstream. As blood sugar levels rise, so does the hormone insulin. When insulin levels are too high for too long, the body can develop a resistance which may lead to metabolic disorders like prediabetes and type two diabetes. Replacing grain-based carbohydrates with other sources of carbohydrates like vegetables, fruits, beans, nuts, and seeds—which are digested and absorbed more slowly—can minimize elevations of blood sugar and insulin. Lowering high levels of blood sugar and insulin is an essential step in the prevention and treatment of prediabetes and type two diabetes.

#2 | You’re overweight or obese.

High levels of blood sugar and insulin don’t just increase the risk of metabolic disorders, they also prompt the body to store fat. Removing starchy carbohydrates like grains from the diet helps to keep levels of blood sugar and insulin low, which prompts the body to burn fat for energy instead of storing it. This metabolic shift (which also requires the avoidance of sweets) is critical for weight loss. Other factors may be contributing to overweight and obesity, and it’s important to address those as well, but weight loss can only happen when blood sugar and insulin levels remain low.

#3 | You want to detox. 

Toxins are chemicals in the environment that are harmful to our health. They start to
build up before we’re even born and continue to accumulate throughout our lives. Detoxification is the removal of these environmental toxins. Most of these compounds are fat-soluble and stored inside fat cells. In order to get them out of the body, they have to be released back into the blood stream. Once they reach the liver, fat-soluble compounds undergo chemical reactions that turn them into water-soluble compounds which can be excreted from the body. But toxins can only be released from storage when fatty acids are burned for energy, which only happens when blood sugar levels are low. Grain-free diets help keep blood sugar levels low, especially when sweets and other starchy foods are eliminated as well.

#4 | You’re already gluten-free but you’re not experiencing the results you expected.

While gluten may be the most problematic component of grains like wheat, there are others. Grains naturally contain compounds like phytates and saponins which can interfere with the absorption of nutrients like iron, zinc, calcium, and magnesium. Poor nutrient absorption can have negative consequences throughout the body.

Diets high in grains can also have a negative impact on our microbiome, the community of friendly bacteria that protect us from disease-causing bacteria. They also help digest our food, break down environmental toxins, manufacture essential nutrients, modulate the immune system, help regulate inflammation, influence the production of neurotransmitters like serotonin, and play an important role in appetite, satiety, fat accumulation, and energy usage. The microbes that live in our digestive tract eat what we eat and their favorite foods are high in fiber. Grain-based diets are usually not high in fiber, especially when they contain processed grains like foods made from flour. Replacing grain-based foods with higher fiber foods can have a positive impact on our gut bacteria, which can have wide-ranging positive effects on our health.

References:

Niland B and Cash BD. Health benefits and adverse effects of a gluten-free diet in non-celiac disease patients. Gastroenterology and Hepatology. 2018;14(2):82-91. https://www.ncbi.nlm.nih.gov/pmc/arti...

EWG (Environmental Working Group). Pollution in minority newborns: BPA and other cord blood pollutants. [Web page]. EWG website. https://www.ewg.org/research/minority.... Accessed July 29, 2020.

Students, teachers, and parents have had an unprecedented start to the new school year as the COVID-19 pandemic continues. Everyone is facing new challenges and new sources of stress. Some kids are struggling with distance learning and separation from friends while others are adjusting to social distancing inside schools, wearing masks all day long, and undergoing daily temperature checks by strangers wearing head-to-toe personal protective equipment. Stress affects us emotionally as well as physically and in children it can manifest as stomach pain, loss of appetite, difficulty sleeping, changes in mood or behavior, and problems with focus and concentration. Stress management is regularly recommended for adults but it’s equally important for kids. Here are six strategies just for them.

#1 | Communicate

Children may not be able to fully articulate their feelings, but talking about what makes them feel stressed helps minimize the effects. Let kids know they can talk to you about anything. Listen carefully and allow them to fully express their thoughts and concerns. If it makes kids more comfortable, engage them in an activity that can facilitate communication. Go for a walk, put together a puzzle, or cook something you both like to eat and settle into the activity before bringing up sensitive subjects.

#2 | Play Every Day

Exercise is well known for improving physical health but it improves mental health as well. Regular physical activity helps us manage stress and studies show that, specifically in children, it can reduce symptoms of anxiety and depression while improving concentration, academic performance, and self-esteem.1 Kids also need down time to manage stress, so find activities that are fun and playful instead of competitive or focused on achieving a specific result. Get them outside for at least an hour every day, year round and weather permitting, to do something they enjoy, whether it’s playing in the park, riding a bike, or throwing around a ball or Frisbee.

#3 | Get Plenty of Sleep

Good sleep is critical for good health and research studies show that it can improve our ability to manage stress.2 Children need eight to ten hours of sleep every night in an environment that promotes deep and restorative rest. Sleeping environments should be as dark as possible and free of electronic devices to maximize the brain’s secretion of melatonin, a sleep hormone, and minimize the secretion of cortisol, a stress hormone. It’s also beneficial to dim indoor lights and discontinue the use of all screens one to two hours before bed.

#4 | Maintain a Regular Routine

Establishing a regular routine inside the home can reduce feelings of stress. Knowing what will happen and what is expected gives children a sense of comfort and security and it minimizes fears of the unknown. A regular routine also helps to establish a healthy circadian rhythm, which may be especially important for development of the brain’s prefrontal cortex.3 This part of the brain helps regulate our emotions, thoughts, and actions. According to research studies, the prefrontal cortex is the region of the brain most sensitive to the harmful effects of stress.4 As much as possible, set a consistent schedule for the things you do regularly like waking up, going to sleep, eating meals, taking naps, having a bath, doing homework, brushing teeth, and enjoying playtime and family time.

#5 | Practice Relaxation

Relaxation exercises are effective stress management tools. Yoga is a popular one and studies confirm that it can help children cope with stress and improve their mental and physical well-being.5 Other forms of relaxation include meditation, guided imagery, breathing exercises, and progressive muscle relaxation. Let kids pick the activity and help guide them through it. Children don’t have the attention span of adults, but they are naturally curious, receptive, and willing to try new things. An hour of meditation may not be realistic, but it’s not necessary either. Kids can benefit from just a few minutes of relaxation in the morning before school or in the evening before bed. And it doesn’t need to be complicated. Deep breathing can be as easy as telling children to “smell the flowers” then “blow out the candles” with a little help from their imaginations. If you need inspiration or instruction, find thousands of free videos online tailored to children that teach yoga, breathing exercises, progressive relaxation, and guided meditation.

#6 | Teach Resilience

The world is constantly changing, sometimes in ways we never would have expected. Bad things, like COVID-19, happen to good people. We all make mistakes. Everyone faces adversity. But what matters most is resilience. When children understand that problems can be opportunities to learn, to grow, and to do things better next time, a burden is lifted and they feel less stressed. Foster resilience by teaching kids to be flexible and to look for creative solutions to problems. And because resilience requires a sense of purpose, help children focus on the bigger picture and the things in life that are most important to them.

References:

Nieman P. Psychosocial aspects of physical activity. Paediatrics Child Health. 2002;7(5):309–312. https://www.ncbi.nlm.nih.gov/pmc/arti...

Choi DW, Chun SY, Lee SA, Han KT, and Park EC. Association between Sleep Duration and Perceived Stress: Salaried Worker in Circumstances of High Workload. International Journal of Environmental Research and Public Health. 2018;15(4):796. https://www.ncbi.nlm.nih.gov/pmc/arti...

Kohyama J. Good daily habits during the early stages of life determine success throughout life. Sleep Science. 2016;9(3):153–157. https://www.ncbi.nlm.nih.gov/pmc/arti...

Arnsten A. Stress signalling pathways that impair prefrontal cortex structure and function. National Reviews Neuroscience. 2009;10(6):410–422. https://www.ncbi.nlm.nih.gov/pmc/arti...

Hagen I, Usha S, and Nayar US. Yoga for Children and Young People’s Mental Health and Well-Being: Research Review and Reflections on the Mental Health Potentials of Yoga. Frontiers in Psychiatry. 2014;5:35. https://www.ncbi.nlm.nih.gov/pmc/arti...

The COVID-19 pandemic has forced us to change our lives completely. We’ve been staying home. We’ve been struggling with fear, anxiety, depression, and isolation. We’ve been spending more time in front of screens and less time outside. We’ve been eating more comfort food and exercising less. It’s a perfect recipe for weight gain. 

Given the circumstances, the “quarantine fifteen” may be an understandable outcome, but it’s still dangerous from a health perspective. Excess weight increases our risk for cardiovascular disease, diabetes, cancer, and chronic diseases including osteoarthritis, liver and kidney disease, sleep apnea, and depression. And a recent study found that, before the age of sixty, obese individuals have twice the risk of COVID-19 hospitalization as non-obese people (measured by a body mass index below 30).

Successful and sustainable weight loss requires addressing all of the underlying factors that caused weight gain in the first place. Diet and exercise are important, but so are stress, sleep, and even the way we use electronics. Medical conditions and medication side effects can also contribute to weight gain, and you’ll need your doctor’s help to know for sure. But there are things we can all do right now. Here are five ways to address the root causes of weight gain and reverse the quarantine fifteen.

#1 | Avoid sweets and starches.

Foods and beverages that are sweet—whether or not they contain natural or artificial sweeteners—and foods that are starchy, like root vegetables, grains, and anything made with flour—whether or not they contain gluten—raise levels of a hormone called insulin. When insulin levels are high, the body stores fat and it’s impossible to lose weight. When insulin levels are low, the body burns fat for energy and weight loss is possible. 

The best way to keep insulin levels low is to eliminate all sweets and starches from the diet (not recommended for children, pregnant women, or athletes in training). This includes all natural and artificial sweeteners, soft drinks, cocktail mixers, breakfast cereals, pasta, bread, wraps, tortillas, pancakes, bagels, pretzels, crackers, pizza, pies, cakes, cookies, muffins, pastries, chips, breaded foods, rice, corn, popcorn, polenta, grits, oats, barley, quinoa, bulgur, potatoes, carrots, parsnips, turnips, pumpkins, yams, winter squashes, bananas, jelly, jam, dried fruit, canned fruit, fruit concentrates, and fruit juice, whether ready-made or fresh squeezed.

#2 | Be physically active every day.

Regular physical activity contributes to weight loss by improving metabolism and increasing the sensitivity of insulin receptors which can help lower high insulin levels in the blood. Exercise also improves sleep and increases levels of serotonin which can reduce food cravings. 

As long we’re healthy, we can exercise at home. There are plenty of activities to choose from like callisthenic exercises—including push-ups, squats, burpees, and abdominal crunches—and the use of devices like jump ropes, resistance bands, medicine balls, kettlebells, dumbbells, and barbells. Online fitness videos, many free, are especially good options for people which want inspiration or instruction. Anyone who can safely go outside should consider walking, running, hiking, biking, and/or gardening.

#3 | Sleep seven or eight hours every night.

Lack of sleep raises levels of insulin, which increases fat storage, and ghrelin, a hormone that makes us hungry. And it causes levels of leptin, a hormone that suppresses appetite, to go down. One study showed that short sleep cycles (five to six hours) contributed as much to weight gain as long sleep cycles (nine to ten hours). People in both of these groups were more likely to experience weight gain and had an increased risk of obesity compared to individuals who slept seven or eight hours per night.

To support weight loss, adults should sleep seven to eight hours per night. Kids need more sleep: ten to twelve hours before the age of eight and eight to ten hours between the ages of eight and eighteen.

#4 | Unplug two hours before bed.

During sleep, the hormone melatonin is produced by the pineal gland in the brain. Melatonin is well known as a sleep hormone but it also plays an important role in metabolism, fat storage, and body weight. Electromagnetic radiation (EMR) from electronic devices can interfere with sleep and promote weight gain by suppressing the production of melatonin and increasing the production of stress hormones like cortisol. High levels of cortisol can increase appetite, cause cravings for sweet and starchy foods, and prompt the body to store fat. Studies show that exposure to commonly occurring low frequency electromagnetic fields can reduce total sleep time, sleep efficiency, and the amount of time spent in deep sleep.

Optimize sleep by moving electronic devices out of the bedroom. This includes televisions, wireless routers, computers, laptops, and mobile devices like tablets and cell phones. Two hours before bed, shut them down completely.

#5 | Practice relaxation.

Relaxation can promote weight loss by reducing high levels of cortisol and minimizing the effects of stress and emotional upset. It doesn’t come naturally to everyone, but relaxation can be learned. Like any skill, it requires focus, concentration, and practice. The more you do it, the easier it will be.

Pick an activity you like such as yoga, meditation, guided imagery, breathing exercises, progressive muscle relaxation, self hypnosis, qigong, massage, or simply spending time in nature. Practice it every day and whenever the need arises. If you have difficulty sleeping, do it every night before bed and/or during nighttime awakening.

References:

Pi-Sunyer X. The Medical Risks of Obesity. Postgraduate medicine. 2009;121(6):21-33. https://www.ncbi.nlm.nih.gov/pmc/arti...

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https://pubmed.ncbi.nlm.nih.gov/10188...

The COVID-19 pandemic has forced us to change our lives completely. We���ve been staying home. We���ve been struggling with fear, anxiety, depression, and isolation. We���ve been spending more time in front of screens and less time outside. We���ve been eating more comfort food and exercising less. It���s a perfect recipe for weight gain.��

Given the circumstances, the ���quarantine fifteen��� may be an understandable outcome, but it���s still dangerous from a health perspective. Excess weight increases our risk for cardiovascular disease, diabetes, cancer, and chronic diseases including osteoarthritis, liver and kidney disease, sleep apnea, and depression. And a recent study found that, before the age of sixty, obese individuals have twice the risk of COVID-19 hospitalization as non-obese people (measured by a body mass index below 30).

Successful and sustainable weight loss requires addressing all of the underlying factors that caused weight gain in the first place. Diet and exercise are important, but so are stress, sleep, and even the way we use electronics. Medical conditions and medication side effects can also contribute to weight gain, and you���ll need your doctor���s help to know for sure. But there are things we can all do right now. Here are five ways to address the root causes of weight gain and reverse the quarantine fifteen.