Join Colleen and Dr. Tiffany, a renowned functional nutrition practitioner, as they explore the telltale signs that a patient's diet may be impacting their mental health. You'll learn about foods that promote mental clarity, focus, weight and sex drive. We dive into the significance of eliminating junk food and sugar and the importance of including foods like fruits, vegetables, fermented foods and coffee! For all my fellow coffee lovers, you'll be happy to hear that you've got the green light to continue enjoying that sweet nectar from heaven! In this powerful discussion, you'll learn how you can help your patients overcome their brain fog and optimize their gut health.
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In order to produce the neurotransmitter serotonin, and serotonin regulates our mood, our sex drive, the clarity of focus and even your weight. You have to eat sufficient amounts of tryptophan, which is an amino acid, and tryptophan is high in certain foods Are you ready to transform the way you communicate about nutrition with your patients?Speaker 2:
Welcome to Exam Room Nutrition, the podcast where the worlds of nutrition, medicine and communication collide. Whether you're a seasoned physician or a healthcare student, this podcast is for you. So stick around and let's make our patients healthier, one exam room at a time.Speaker 3:
Welcome back to the Exam Room Nutrition podcast. I'm your host, colleen Sloan. I'm a registered dietitian and pediatric PA. Did you know that 88% of Americans rate their health as good or very good? And yet Americans have three times the rate of anxiety, depression and suicide and four times the rate of death from preventable causes? In this episode, we are diving deep into the realm of nutrition and its powerful impact on your patient's brain function and mental health. Do your patients always feel anxious or in a fog, or do they complain of frequent headaches or fatigue? I'm really, really excited because today we're going to shed some light on ways nutrition can completely transform your patient's health through our conversation with Dr Tiffany Champagne-Langabeer. Tiffany is a board-certified functional nutrition practitioner and associate professor at UT Health. She blends her three decade experience working with diverse clients with her passion for integrating yoga, breathwork and meditation into her practice at Sunrise Integrative Nutrition. Tiffany is a prolific researcher and author, with over 60 published articles and several book chapters. You can find her on Instagram at Eat With Sunrise, or on her website at wwwsunrisenutritioncom. Tiffany, thank you so much for number one, allowing me to call you Tiffany. I am so impressed at your accolades and your achievements and I'm really just honored to learn from you. So welcome to the show. Thanks so much, Colleen.Speaker 1:
It's my pleasure to be here and talk about this really important subject with you.Speaker 3:
I mean, just reading your bio gets me excited, because you are the person to help us navigate this topic of how the connection between our brain fog and our gut and how nutrition works. So let's first really just clarify what the signs that we should look for in a patient's diet that might be impacting their mental health.Speaker 1:
During a routine physical exam, if your patient says something like I've just not been feeling myself lately, or if they have trouble remembering things, or maybe they say that they just feel like something is lacking. This lacking could be energy, they don't have the desire to do the things that they used to, or they just don't have joy anymore. These are signs that we should be picking up on. Or, for example, if you do a PHQ-9 in your practice or a GAD-7, of course PHQ-9 is designed to measure depression, gad-7 designed to measure anxiety and you find that your patient is struggling with their mental health in one of these or both of these areas, of course you can refer them and do refer them to licensed therapists or mental health professionals, but you can also consider their diet. Your patient could be deficient in one of many, many nutrients needed to support their mood and their overall brain health too. So, even if the issue stems from serious trauma big T trauma or little T trauma refining the patient's diet will always help, in concert with other therapies.Speaker 3:
And I think that's so important to not just write off or excuse when the patient's saying, man, I'm forgetful or I just don't, something just doesn't feel right Again. You know, sometimes it is so easy to just be like, okay, next, I know I need to refill your medication and I'm running behind, but really to sit and listen and ask further questions about their diet, because that might be the key. You might not need to throw more medication at this problem. You could probably just solve it with including some more nutrients in their diet. So that leads us really nicely into the next question, which is what foods can we suggest that our patients start to eat if they complain that they maybe have this kind of brain fog or other symptoms?Speaker 1:
Well, it's good to get out the junk first of all. So if you hear that they're eating out often, or they're eating fast food often, that's a red flag right there. But specifically, if we want to get down to the biochemistry, in order to produce the neurotransmitter serotonin and serotonin regulates our mood, our sex drive, the clarity of focus and even your weight you have to eat sufficient amounts of tryptophan, which is an amino acid, and tryptophan is high in certain foods. So foods like there's certain fish, cod, salmon, but also edamame, soybeans, sunflower seeds, pumpkin seeds, eggs and of course, we can't forget turkey, which everybody thinks is the only food that has tryptophan. But eating these foods and really ensuring that you have sufficient protein every day, high quality sources of protein every day, can help with a natural serotonin production. But there's a catch to all of this. Certain behaviors can also rob you of this serotonin. So example eating the junk food, eating the fast food, excessive sugar, high sugar intake, not enough protein, cigarette, smoking, drinking alcohol of any sort. I like to remind my clients that alcohol is still a toxin that your body has to detoxify out of your system. So if you are drinking more for a woman, more than two glasses of wine or a beer or beverages every day that can rob you of your tryptophan and hence your serotonin. So these kinds of behaviors will actually prevent your body from making the serotonin that you need to regulate your mood.Speaker 3:
Excellent, and I love that you started with getting the junk out first, because we could talk all day about you need to eat fruits and vegetables, you need to eat lean protein, but if we don't ask them what foods are you typically eating, then we're not correcting the problem. So, absolutely, I agree with you getting the junk out and that's a really important first question. So let's talk a little bit about how the stomach and the brain are connected, because we know that the stomach is the second brain. So what foods could we recommend that our patients can eat to help fuel that organ properly?Speaker 1:
So diversity of vegetables and fruits, color, color, color, as many colors as you can possibly get across the span of a week. So if one day you're not able to eat, you know five servings of fruits and vegetables. You know it's okay. It's okay. We all have issues trying to get as many fruits and vegetables as we possibly can. So, if you think about it in terms of the scope of two days, three days or a scope of a week, as many fruits and vegetables as possible to feed those good gut bugs that we have. And also fiber, fiber is critical. Typically, the average American diet has a very sad, sad amount of fiber. That's about 15 grams a day, which is, as we know, is not even close to enough. We need more like twice that much, or even as much as 40 grams of fiber would be great, but not just fiber. So there's a really interesting study Some researchers out of Stanford just did and they looked at comparing fiber to fermented foods. So fermented foods are like kombucha, yogurt, kimchi, some other fermented vegetables that you might find in the cold produce aisle, and they compared two different groups. One group they bumped the fiber up from 20 grams of fiber to 40 grams of fiber, and then the other group that was eating fermented foods. They started out with eating no fermented foods and they went up to as high as five fermented foods a day, and the researchers were thinking that of course, the fiber group would do better, but it was surprising that the fermented foods group actually did better. So while both diets increase diversity in the gut, which is a great thing, the fermented group excelled and also they excelled in creating that diversity, but that it also decreased the inflammation in the body and from a brain perspective, we believe that much of the brain related diseases we see today, including depression, stems from inflammation. So, in addition to eating regular whole foods, drinking enough water, stopping smoking, moving your body every day, try to eat something fermented every single day.Speaker 3:
That's great, and I love when my guests bring in the science, because some people think nutrition is just this kind of like woo, woo. That's good for you, it doesn't really make a difference. But there's science to back our recommendations. So let's reiterate what those are. I heard you with kombucha yogurt. What else?Speaker 1:
Kim Chi is another one, which is the fermented cabbage. It's an acquired taste if you weren't raised eating Kim Chi, but you can also find a lot of really great and delicious fermented vegetables now in the produce section the cold produce section at the grocery store, at most grocery stores. So fermented carrots really any vegetable can be fermented, and this is a fermentation with vinegar, so it's not the same thing as that kind of fermentation. This is a natural fermentation that occurs from vegetables just actually aging and creating their own probiotics. So there's a lot of delicious alternatives. So I really encourage everyone if you see something when you're at the grocery store it's typically by lettuce and things like that to just pick up something and just give it a try.Speaker 3:
That's great, so exciting. All right, so now we've talked food sources, but discussing fiber and probiotics, do you ever recommend any of the supplements that are out there for either of those?Speaker 1:
I do actually, because I think that while it's great to get everything you can from Whole Foods, I have personally and in my clients seen the difference that taking a good probiotic can make. Typically, the strain that I'll recommend is specific for the client, depending on what their issues are. If they're having more issues with constipation or more issues with brain fog or more issues with weight, depending on which kind of challenges they're having, I'll recommend different strains. But if you're looking in general for a probiotic, the more strains the better, and not just a single strain probiotic and refrigerated it is best still. I know that there's some controversy about refrigerated versus shelf, but refrigerated still has been shown to have the maximum benefits.Speaker 3:
This is so helpful in regards to the fiber and the probiotics. Now I know sugar is another big one that has an impact on our mental health and even our second brain, the stomach. So obviously we should be recommending our patients to limit their sugar intake, but how do we help them do this? What can they replace those sugary foods with?Speaker 1:
You know, sugar isn't an addiction. I mean, it's a true addiction. You get a dopamine rush whenever you eat sugar. So cutting out sugar is a challenge. But what you find when you just eat more good sources of protein, which causes you to be full and it's a feeling of satiety, drinking plenty of water and moving your body if you can do that and eliminate sugar for a good two days, a good 48 hours, you will substantially lower your cravings for sugar. And I am living proof, as someone who is raised in the 70s on honey, buns and tang, that I eat. Some of them probably don't even know what that is. I eat absolutely no refined sugar right now. So and it's really, it's a matter of discipline for probably the first 24 to 48 hours, but then, once you eliminate sugar from your diet refined sugar, white sugar I don't have it in the house. There's no need to have it in the house, there's no reason, and I bake all the time. There's plenty of substitutes that you can use. You can use dates or fabulous for baking bananas, or fabulous for making smoothies. Even other things are great for making smoothies too, like frozen zucchini or frozen avocados or frozen cauliflower, because you can't taste them when they're frozen. But anyway, that's a side note. But there's other ways that you can really satisfy your hunger and your craving without straight sugar. And you have to also start being mindful of why am I craving this right now? Am I craving this because I'm mad, I'm sad, I'm upset about something. Somebody just cut me off in traffic so I want to go grab some ice cream or a candy bar. You have to really stop and think about why am I wanting this sugar specifically Because your body doesn't need it.Speaker 3:
Great point, and I love that you recommended just a trial of 48 hours. That is a cleanse that I can get on board with, because that will prove to be so beneficial to your patient's health. So I would just challenge your patients with that hey, 48 hours, no refined sugar or added sugar in your foods. I've found that replacing it with fruit is helpful, because I really have a sweet tooth and sugar is something that I've always struggled with. And, yeah, it's not, it's not fun, it's not, you know. You know, as I don't know fancy or whatever pleasurable as stuffing your face with a brownie, but you do feel better. You really do notice it after a little while. So I love that. You recommended cutting out that, the refined sugars so good. So we're going to move on to my favorite topic, because it is a beverage that I love, and that is the topic of coffee. You had a very interesting post on your Instagram page, so if you're not already following her, please follow Tiffany on Instagram at eat with sunrise. And please, if you haven't already, please like and subscribe to our YouTube channel or leave me a five star rating or a review in your favorite podcast app. You had talked about some of the benefits of coffee, because sometimes coffee gets a bad rap. But I would love for you to make me fall in love with coffee even more than I already am. Coffee is so wonderful.Speaker 1:
I love coffee so much. I like you, colleen, I am such a huge coffee fan I don't think that is. You know. I don't think I could ever eliminate coffee for my life. So, after water, coffee is the most commonly consumed beverage in the world. All over the world, in every country, people are drinking coffee, and it's very researched. As a result to, people are curious what are the effects of coffee? It's a very complex beverage, but it's. What we know is that it's loaded with polyphenols, and polyphenols are great for us. They feed those gut bugs that we just talked about, and we know that people who drink coffee have a lower risk for type two diabetes, cardiovascular disease, obesity, certain kinds of cancers, specifically more like colon cancer, but you have a lower risk of all cause mortality if you are a coffee drinker. Some researchers think that this is partially due to its anti-inflammatory effects in addition to those polyphenols, but it's not a completely proven conclusion on that side. So what I say is a daily intake of two to three cups a day no more than three cups a day really has shown to be healthy, unless it's otherwise indicated by your primary care provider. So I will say too though there's a gene that we carry. That shows if we're fast metabolizers or slow metabolizers of caffeine. So until you know your genotype, it's best not to consume caffeine after 11 in the morning. And too much caffeine can cause anxiety, it can cause insomnia, it can even cause an upset stomach. So it's always best to go with how you feel. So if you're only drinking one cup, by no means don't increase to three cups, but just know that that one cup is good for you, as long as you're not loading it down with four teaspoons of sugar and whipped cream. And we're not talking about the fancy drinks that we get. We're really talking about that really great beans that you buy. You grind them at home, you make that great cup of coffee, and if you share it with somebody, that's community. So that's another wonderful thing that adds to your mental health.Speaker 3:
And I know that you mentioned that we aren't talking about the you know frappuccinos and the fancy drinks, because those have exactly opposite of what we were just talking about about eliminating sugar. So if you're a coffee drinker like me, you get the thumbs up, but be conscious about how much sugar you're adding, either with a spoon or if it's in your creamer already, because those creamers are loaded with sugar. So I love that we had this conversation about coffee, because it is such a good source of community and a really good way to share a great conversation and just to improve your mental health with those that you love. So thank you so much, tiffany, for bringing in the science behind coffee and giving me the green light to continue my coffee obsession, absolutely. So I want to close with kind of a unique end to this discussion, but I hear it all the time about these different cleanses, and I know we mentioned the cleanse from sugar, but that's one that we can jump on. You know there's all these different fads and these different things that go viral on social media and they are so anti science and everything against what dieticians recommend. So I've seen this going around the lemon water and cabbage cleanse. So please educate us as clinicians on how do we appropriately respond when a patient tells us oh hey, I'm trying this cleanse, what do you think? How do we answer that?Speaker 1:
Well, I actually get this cleanse question more frequently than you would imagine and, as you mentioned, there's so many fads that we see on social and you have to look back at the source. So we have to remind our patients to really look at the source of who's providing you with this information. But our bodies are incredibly smart. We have a natural detoxification process. Yes, we can enhance this process by eating whole foods, and I want to be really specific by what I mean with whole foods. This means not process, not box, not with a long list of ingredients, but adding cruciferous vegetables like broccoli and cauliflower, drinking plenty of water, moving your body every day and connecting so connecting with your community or someone that you love. That works better than any lemon water and cabbage cleanse, and this is the best evidence based way to get your body back on track.Speaker 3:
So you're saying that there's no need for anyone to follow any of these crazy diet cleanses? Right, Right, absolutely.Speaker 1:
I mean there's really there's no reason. And also, colleen, I want to put a plug in for the PAs and the NPs and the primary care providers for dietitians here. That collaboration is our, that's our greatest strength, really, as dietitians, and we know that primary care providers have very little time and a lot of patients to see and they may be seeing acute issues. So lifestyle change is a long game. It really is a long game and we're trained to motivate, to educate, to serve as accountability partners for patients. So my best advice to your listeners is to partner with a like-minded dietitian who can really go deep into some of these issues that we've discussed and be your partner In helping your patients to really succeed and really to help answer some of these questions.Speaker 3:
Yep, Cannot agree with you more. Registered dietitians are near and dear to my heart and exactly you guys walk hand in hand with the patient and although the purpose of this podcast is to give you little nutrition tidbits that you can relate to your patients to start them on this journey towards healthful lifestyle, but I agree with you partner with a dietitian, refer them to a dietitian to get down to the nitty gritty, get down to the details and just help them with the specifics in their day to day. Tiffany, thank you so much for the gift of your time. I can't give this time back to you and I've so greatly enjoyed and appreciated this conversation today and I hope that the listeners will find value in it. We would love to have you back again. Thank you so much for your time, Thank you.Speaker 1:
If you would like to follow Tiffany on Instagram again, you can find her at eatwithsunrise and go ahead and send her a message. If you have any questions or if you have any patients that you would like to refer to her, you can always send me a message on Instagram as well. At exam room nutrition, if you have any questions that you would like us to feature on an upcoming podcast. All right, guys. Now it's time for my nutrition notes. In this section. I will leave you with a nutrition tip, an encouraging quote or an interesting case that I think might add value to your day. So, in continuing the conversation with coffee, as you can tell, I am a coffee addict and I love my coffee. In the morning, we talked about making sure that you're not drinking coffee with too much added sugar, and this can be related to any beverage, whether that be a soda, iced tea or juice. You really want to look out for how much sugar is in there. Now, on the food label, the sugar is written out. It will write total sugars or added sugars, but it is measured in grams. I don't know about you, but I can't really visualize what four grams of sugar looks like. So I'm going to give you a nutrition tip to help you translate how many teaspoons of sugar are in your favorite beverage. So the conversion for grams to teaspoon is there are four grams of sugar per one teaspoon. So if you think about the math, a bottle of cola has about 40 grams of sugar. So you would just divide 40 grams by four and you get 10 teaspoons. So that means the bottle of cola that you're drinking that has 40 grams of sugar. You need to visualize 10 teaspoons of sugar in that beverage and that is a lot. So I hope that this tip was practical because you can use this to educate your patients so they can do a little homework and research on how many teaspoons of sugar they might be drinking in their beverages. So just remember four grams of sugar equals one teaspoon, and all they need to do is divide the number of added sugars that's found on the food label by four and that will tell you how many teaspoons of sugar is added to that beverage. I hope that you found today's topic informative and helpful. If you have any questions or you would like to connect with me, you can find me on Instagram at exam room nutrition. Please like or rate and review this podcast on your favorite podcast app or even on YouTube. This will just help more clinicians find my podcast, so that they, too can share helpful practical nutrition information for their patients. Well, that's all for today, guys, and as always, let's continue to make our patients healthier, one exam room at a time. I'll see you next time.