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When Is Supplementation Necessary?

There is no such thing as a silver bullet when it comes to health. There are no shortcuts or quick fixes. However, your body DOES have an amazing ability to heal and recover, sometimes far quicker than you might expect.

Health is a result of meeting the vital requirements of the human body.

 

Plants for example, require sunlight, water, and nutrient-rich soil. If you have a plant with yellow leaves, the most obvious solution would be to simply meet the requirement that is lacking (i.e. more sunlight), and not just paint the leaves green.water

In a similar manner, every human being has certain vital requirements that are essential for optimal health to occur. We need movement, nutrient dense foods, structural integrity and a healthy functioning nervous system, to name a few.

Meeting the nutritional requirements of the body can be hard. There is contradicting information and it’s hard to know what advice to follow.

When it comes to nutrition, it can be boiled down to a simple fact; you need to supply your body’s nutrient requirements in the most efficient way with the least amount of toxicity.

A great first step to ensure you’re getting your body’s nutrient requirements is to increase the amount of foods that are nutrient dense. This includes foods that have protein, fat, vitamins and minerals the body needs. These foods are usually found in nature, NOT in a package. Vegetables, fruits, healthy fats (avocado, olive oil, coconut oil, etc), lean meats (turkey, grass fed beef, chicken, wild salmon and fish), and fermented foods (kombucha, kimchi, sauerkraut) are all great choices to meet your body’s requirements.

However, over the past 200 years there has been disruptions in the food supply and its nutrient profile.

Changes that have occurred:

  • Increased reliance on grains and grain products
  • Decline in soil quality (slight decline in nutrient density of foods grown)
  • Increase in exposure of food and environmental toxins
  • Reduction in animal fat consumption

As mentioned we recommend to turn to real food whenever possible to meet your body’s nutrient requirements.

There are instances where your body may not be getting the vital nutrition it needs through food and supplementation is necessary.

 

There are two key 2 Essential Supplements we recommend to make sure your body is getting everything it needs. The best available evidence says most Americans are deficient in the following:

1. Omega 3 Fatty Acidsfish oil

People used to get essential fatty acids from many sources like wild game, seafood, grubs, and insects.  All fatty acids are essential, but it is optimal to have them  within a 1:1 or 1:2 ratio (Omega 3 : Omega 6). Most western cultures are expected to have a ratio of 1:10 and even up to 1:50. The higher the ratio, the more likely inflammation is present in the body which creates an environment ripe for disease.

Supplementing with a pharmaceutical-grade fish oil has been proven to be the best way to re-balance this ratio. It also is helpful to decrease sources of Omega 6 you consume (whole grain bread, vegetable oils, cereal, nuts, etc).

How much do you need?

This largely depends on the supplements you’re taking, but typically 2-4 grams of EPA/DHA per day. Please consult your preferred health provider before beginning supplementation.

2. Vitamin D

Vitamin D is a critical nutrient that is essential in immune function. Vitamin D deficiency can happen for different reasons:

  • Lack of sun exposure (w/o sunscreen)
  • Aging (increased age = decreased capacity to produce Vitamin D)
  • Darker skin tone
  • Excess body fat

In Des Moines, Iowa to get your daily dose of Vitamin D, it takes about 15 minutes of sitting in the sun with as much skin exposed as possible (swimsuit, or shorts and tank top). This is possible to achieve from May through September.

It is hard to obtain enough Vitamin D during October through April, so we recommend Vitamin D supplementation especially during the winter months.

To recap:

  1. Focus on eating real food – fruits, veggies, healthy fat, lean meats, fermented foods (high in probiotics)
  2. Omega 3 supplementation
  3. Vitamin D supplementation September thru April
  4. If your budget allows: a high quality probiotic and multi-vitamin

At Keystone Chiropractic we do NOT recommend every supplement under the sun and only carry the highest quality supplements including Omega 3 and Vitamin D. A bonus is that both of these nutrients are vital in supporting an optimal functioning nervous system.

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3 Tips for Healthy Hydration

It is important to keep in mind at all times of the year, but as the mercury rises, it’s more important than ever to focus on how much fluids your body receives each day. Water is one of the most essential components of the human body; it makes up over half of it! It regulates body temperature, cushions and protects vital organs & joints,  aids in digestion, and waste elimination.

You may see how dehydration may cause a variety of issues. Look for the following signs & symptoms to see if dehydration may be part of the problem:water

  • Increased thirst
  • Decreased energy
  • Dizziness
  • Dry skin
  • Headaches
  • Dark yellow urine or decreased urine output
  • Sticky or dry mouth
  • Loss of skin elasticity
  • Irritability

It is important to drink water even before signs of thirst appear. Thirst is a signal that your body is already on the way to dehydration. It is important to drink more than thirst demands and to continue to drink throughout the day.

In one hour of exercise the body can lose more than a quart of water, depending on the workout intensity and air temperature. If there is not enough water for the body to cool itself through sweating, the body enters a state of dehydration. The efficiency of Oxygen delivery to muscle tissue and waste removal is decreased which allows fatigue to set in sooner. In other words, exercise performance suffers.

During exercise, water is the best fluid replenisher for most people, although electrolyte drinks help replace lost store through high-intensity exercise exceeding 45 to 60 minutes. Individuals who sweat profusely during exercise and whose sweat contains high amounts of sodium (you may notice salt rings on your clothes or “gritty” feel to your skin) you may benefit from an electrolyte drink.

Tips for Healthy Hydration

 

Have a Goal

A general recommendation is to drink half of your body weight in ounces (Example: a 150 lb person should drink 75 ounces per day).

If you exercise, you’ll need more.

Carry a water bottle with hash marks so you can keep track throughout the day. Set reminders to help you stay accountable. Track your progress in a journal or using a smart phone app like this one.

Sample hydration schedule for an average 150 lb person:

  • Wake up – 8oz
  • Breakfast – 8oz 30 min before and after
  • Mid-morning – 8 oz
  • Lunch – 8 oz 30 min before & after
  • Midday – 8 oz
  • Dinner – 8 oz 30 min before & after
  • Before bed – 8 oz

Drinking water both before and after meals help aid digestion and can help curb appetite, which may be helpful for weight loss.

Flavor Up

If you find it hard to choke down plain water all day to get enough, try infusing it with flavorful fruits like lemon and raspberries. There are many fresh recipes for fruit infused water here.

flavor water

What about coffee?

You may have heard to avoid coffee if you want to stay hydrated. A recent study debunks the myth that it also causes dehydration. A daily cup can contribute to your water needs, coffee can also give you a sharper memory and boost athletic endurance and performance.

Eat Your Water

Eating foods high in water content (fruits and vegetables) also provide an added bonus of fiber, electrolytes, vitamins, and minerals.

Foods with 90% or more water content include watermelon, cucumbers, celery, strawberries, bell pepper, cantaloupe, spinach, lettuce, zucchini, pineapple, carrots, grapefruit, broccoli, and tomatoes.

 

Many people are conscious about the types of foods they include and exclude from their diet to optimize their health. Make sure you don’t overlook one of the most important nutrients you body needs to properly function each and every day – WATER!

 

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What You Need to Know about H2O

Often times, when describing Neuro-Structural Correction to a patient, we’ll liken it to the alignment of a car.  If there is a shift within the frame of the car, or a structural issue, secondary problems are likely to occur.  Similarly, when there are structural shifts of the spine, secondary conditions are likely to arise.  And, just like your car, your body also requires the proper fluid levels to operate efficiently.

Did you know that your body is mostly water; over 60 percent, in fact.  Even the lightest of activities throughout the day can begin to deplete that percentage, leading to dehydration.  This lack of fluids could ultimately lead to a lack of proper function of your body.

How do I know if I’m dehydrated?hydration

Indicators of dehydration include:

  • fatigue
  • headache
  • light headedness/ dizziness
  • dark urine (urine should be clear when properly hydrated)
  • muscle cramps

One would also think that thirst would be a sign of dehydration, but it is a bad indicator.  Most likely, fluid levels have been depleted for some time before someone becomes thirsty.  The best way to fight dehydration is to drink water before you’re thirsty.

Hydration and Your Health

Since our bodies are mostly water, maintaining proper hydration is essential to optimal health.  Decreased water intake could potentially lead to a variety of health problems that could affect every organ system, from your heart and lungs, to your skin, and even your brain and nervous system.

Some specific effects of chronic dehydration may include:

  • High blood pressure
  • Asthma & Allergies
  • Skin disorders
  • High cholesterol
  • Bladder or kidney issues
  • Digestive disorders/Constipation
  • Joint pain or stiffness
  • Weight gain

Keeping hydrated allows your heart to pump blood with less force through blood vessels and to the body so everything can work efficiently.  It allows your lungs to expand and contract appropriately when you take a breath in and out.  Maintaining proper fluid levels allows you to seat when you exercise, cooling your body when it’s needed.  And, most importantly it can help your brain and nervous system function correctly by helping ensure the proper concentration of neurotransmitters, which the brain and nerve cells use to communicate.

water-830374_1920Choosing the right Beverage

Many people believe that if you’re putting fluid into your body, you are helping to maintain proper hydration.  While intensive exercise may require you to use a sports drink (which is best used diluted; 50% sports drink, 50% water), regular hydration is best achieved by drinking WATER.  In fact, a goal to aim for is to drink half of you body weight, in ounces.

For example, if someone weighs 160 pounds, they should try to drink approximately 80 ounces of water each day.

Some beverages can actually lead to dehydration.  These include alcohol and caffeinated drinks (coffee, tea, soda).  Beverages, such as these, are actually diuretics (they make you urinate) and therefore deplete the fluid levels of your body.

Choose the right Foodshydration foods

As you may know, many foods contain high amounts of H2O.  If you find it hard to guzzle water during the day, many fruits and vegetables can help fulfill your fluid requirements in addition to providing key nutrients like vitamins, minerals, and fiber.

Fruits: watermelon, strawberries, grapefruit, cantaloupe all have over 90% water content per volume.

Vegetables: cucumber, lettuce, zucchini, radish, celery, tomatoes, green cabbage, cauliflower, eggplant, red cabbage, peppers, spinach, and broccoli are all over 90% water by volume.

Keys to staying hydrated

Drink early, drink often, and drink after!

Drink early – if you are planning to work out, make sure you are drinking water well in advance of your activity (1-2 hours).  And, remember you should drink water before you become thirsty.

Drink often – your body will function better if you take small drinks or sips of water rather than chugging a large amount all at once.

Drink after – no matter how hard you try to maintain fluid levels during a workout, or throughout the day, it is important to drink water after you finish an activity, or at the end of the day to ensure you are hydrated properly.

Proper hydration is essential to a properly functioning body.  Follow these simple steps to help ensure optimal health.

 

 

 

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For Americans, Everyday is Halloween

Halloween, and Beggars’ Night in Des Moines, are coming up at the end of the week which may rhalloween-151422_1280 (1)aise concerns over children and their sugar intake from candy.  That’s largely understandable, and it is not unusual for children to finish the evening with several pounds of candy in tow.  All the press that surrounds sugar and candy intake at Halloween time seems odd, though, in light of how much sugar the average American eats the other 364 days of the year.

Some experts estimate that the average American consumes 350 to 440 calories of added sugars – the equivalent of 22 to 26 teaspoons – every day (a mere 6 teaspoons is recommended).  It’s not just from candy, pop, cookies, or other sweets either.  It is hiding in many processed foods like ketchup, yogurt, bread, and reduced or fat free dressings.

Many healthcare professionals agree that it’s contributing to our society’s weight gain, high blood-sugar levels, and record high diabetes rates.  What’s more, according to recent research published in JAMA Internal Medicine, a sugar-filled diet can increase you risk of death by heart disease – even if you aren’t overweight.  Eating significant amounts of sugar from any source (table sugar, honey, orange juice, etc.) can compromise your immune system’s ability to fight viruses, bacteria, and parasites.  A 2015 study from the USDA Agricultural Research Service found that excess amounts of honey, table sugar, and high-fructose corn syrup all have similar effects on the body.  Some research has even linked high sugar intake to cancer.

You may be thinking that artificial sweeteners could be a safer option, right? Well, not so fast.

Are Zero-Calorie Sweeteners Any Better?

One of the most common problems we see in our patients is related to toxicity from sugar substitutes like Splenda, Sweet & Low, and Equal.  While all of these products have been FDA approved for safe consumption by the general public, many people have sensitivities in their chemical makeup.

The metabolic products of aspartame, the sweetener in Equal, have been known to overexcite neurons in the brain contributing to headaches, insomnia, and seizure disorders.  Sucralose, found in Splenda, has been shown to alter hormone production in women.  These chemical changes have also been known to cause digestion difficulties in people as well.  Combine this with structural abnormalities in the spine and an abnormal functioning nervous system and it can be a recipe for disaster.

We’ve seen many patients where the only change recommended was for them to stop using artificial sweeteners in their coffee, and to stop drinking diet soft drinks and their body responded immediately.  The big thing to remember is that just because something may not cause symptoms in most people, does not make it healthy to consume.

Although there are no calories from sugar substitutes, more research is showing that artificial sweeteners can play tricks on your body, causing it to over respond to signals from your taste buds, in many cases leading to weight gain.

Neither excess sugar nor zero-calorie sweeteners provide any form of positive health effects.  Certainly, a treat once in a while won’t derail your health, but the ultimate way to lose weight and improve your health is to look to natural foods like raw fruit to satisfy your sweet tooth.

 

 

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Avoid an Energy Crisis

One of the most common problems that people talk about is lack of energy.  If you’re reading this right now, you may be in the midst of a mid-afternoon crash, and looking fofatiguer some stimulation to keep your energy and focus up.

The “energy crisis” problem has become so widespread that energy drinks such as 5 Hour Energy®, Red Bull®, Monster®, and the like, have become a massive 9 billion dollar industry!

So, what’s the deal?  Why are so many people running on fumes in terms of energy?

Are we not sleeping enough?

Are we working too hard?

Do we all have a caffeine deficiency?

If you think about it, it doesn’t make much sense that people inherently need a pick-me-up during the middle of the day.  Quick fixes like energy drinks and heaps of coffee exist, but you may be looking for a long term strategy that can help create a higher energetic state without the detrimental effects.

4 Steps to Sustainable Energy

1. Start the Morning Fresh

There’s a lot of debate about how much sleep the average adult needs.  The truth is, everyone operates well with varying amounts.  The most important factors are consistency of sleeping times and the timing of your wake cycle.

There are a variety of sleep tracking apps and wearable devices on the market.  An app that you may find useful is Sleep Cycle.  It allows you to place your phone under your sheets and it senses how much you move during the night.  You set an alarm with a 30 minute window to wake you up.  Using these criteria, the application will sound the alarm during your lightest period of sleep.

The end result is waking up at a time when you will feel refreshed, even if it means waking up a little earlier than your set alarm time.  Using an inexpensive application like this can make early mornings seem MUCH more bearable.

2. Get the Right Fuel

We won’t go into too much depth today on fueling your body.  Keep an eye out for our December Keystone Update in your inbox that will discuss this more in depth.  In terms of fueling your body with food for lasting energy, keep in a mind a few things:

A. Avoid Processed Carbohydrates and Refined Sugar

Processed grains, which lack fiber and nutrients, and refined sugar both get digested and absorbed quickly, which can wreak havoc with your blood sugar and energy levels.  Ditch sugary drinks like soda, sweet tea, and lemonade and stick with carbohydrates from whole foods including fruits, vegetables, and whole grains like brown rice, quinoa, and oats.

B. Avoid Carbohydrate-Only Meals

Carbs are the most efficient source of fuel for every cell in your body, which is probably why they’re so abundant in nature, and why they get digested and absorbed pretty quickly.  But if you’re looking for sustained energy over a longer period of time, combine carbs like fruit and grains with lean protein and good fats.  That means steady rise in blood sugar and better insulin control, so your cells will receive even, time-released fuel (read: energy) over a longer period of time.

C. Eat the Rainbow

…And NO, we’re not talking about Skittles®.

Eating a wider variety of foods exposes your body to a broader spectrum of antioxidants and nutrients, which means better overall nourishment and energy.  Expand your variety by aiming for five different colored fruits and veggies every day (blue, green, orange, red, white) and use a variety of antioxidant rich herbs and spices to season your food (basil, garlic, ginger, cinnamon, etc.).  Ensuring your body is getting both the macro nutrients (fat, carbs, protein) and micro nutrients (vitamins & minerals) it needs helps optimize energy through food.

3. Get Moving

It doesn’t have to be extreme, especially if you currently do little to no exercise.  Our bodies are built to move.  It doesn’t have to be a full hour workout or running miles at a time, but movement will help keep your brain oxygenated and alert.

A good recommendation is to get at least 30 minutes of exercise most days of the week.  Can’t fit 30 consecutive minutes in?  Break it up into manageable increments throughout the day for a quick energy boost.  It may be 15 minutes of yoga before you get in the shower or squeezing in a 10 minute walk at lunch time.  Or, if you’re a pretty fast runner, why not knock out a quick mile?

4. Ensure Your Nervous System is Unobstructed

You may be asking, what does that have to do with energy?  While there are many causes of low energy, a common one you may not have heard of is abnormal nervous system function.  Energy and messages flow between your brain and the rest of you body through your nerves.  Structural imbalances in the spine can obstruct the flow of these messages, which can lead to secondary problems like fatigue.

If you haven’t had your spine checked for structural abnormalities, it may be time, as this could be a contributing factor to your “energy crisis.”

Here’s the deal, if you have to stare at a clock and fight that miserable feeling of fatigue every…single…day, does it make sense to make a few changes to improve your life?  The choice is yours.

 

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Top 5 Foods to Boost Brain Power

You may have noticed that brain health makes its way into the news now and again, especially as it relates to things like dementia, Alzheimer’s disease, depression, and overall cognitive function.  Why is it a big deal?  In short, your brain is your most valuable health asset.  The brain and nervous system work together to control and coordinate every function in your body.

At Keystone Chiropractic, we take brain and nervous system function very seriously.  There are a number of things you can do to optimize your brain health, but today’s post will address foods you can add to your grocery list to help your brain and nervous system work the best they can.  Are there more than 5 foods that help brain health?  You bet.  Today we’ll outline the ones that give you the best bang for your buck.

First, we must mention that the best place to start is to eat more unprocessed whole foods.  Real foods are full of vitamins, minerals, antioxidants, and countless other phytochemicals that nourish your brain cells (and even grow new ones).

When choosing your foods, remember that it’s not only a matter of how many calories they contain and whether or not they might make you “fat”- it’s a matter of choosing those that contain the nutrients to support optimal health, including that of your brain.

The 5 best foods for optimal brain and nervous system health

1. Wild Alaskan Salmonsalmon-518032_1280

You may have read that Omega 3 fatty acids, which are found in Wild Alaskan Salmon, are great for cardiovascular health.  Omega 3’s are great for your brain, too.  As you age, or due to diseases like Alzheimer’s, your brain volume decreases.  Recent research published in Neurology suggests that Omega 3’s may slow this process.

The study, which included over 1,000 women, measured the levels of Omega 3 fatty acids, EPA and DHA.  The results showed that those with higher levels of EPA and DHA in their blood had larger total brain volumes according to an MRI scan.

Those with higher Omega 3’s also had a nearly 3 percent larger hippocampus, which plays an important role in memory.  Even before symptoms appear, in diseases like Alzheimer’s, the hippocampus has most likely begun to shrink in volume.

Higher levels of EPA and DHA can be achieved through both diet and supplementation.  The best sources of these Omega 3 fatty acids are fatty fish such as Wild Alaskan Salmon.  Supplements are also an option, and while getting Omega-3’s through diet is preferred, many Americans are deficient, so a high quality supplement may be needed.

2. Eggs

Eggs, more specifically the yolks, are a leading source of choline.  Choline is a precursor for acetylcholine, a neurotransmitter involved in helping you remember things like where you left the car keys.  Eating protein rich foods like eggs for breakfast can improve overall cognitive performance, according to Swiss researchers.

blueberries-690072_12803. Blueberries

Flavonoids are found in foods like blueberries, apples, citrus fruits, green tea, and in cocoa.  Flavonoids take part in multiple cellular processes, depending on the type of flavonoid.  They can also be responsible for may aspects of brain function.  They do this by influencing how neurons “talk” to each other and by increasing the levels of antioxidants and anti-inflammatory compounds that reduce damage to cells in the brain.  There is also some evidence that flavanoids can stave off not only cognitive decline, but also brain diseases like Alzheimer’s.

4. Curcumin

One nutrient that you may not be so familiar with is the spice, curcumin.  Even if you have never heard of it, it is likely that you have tasted it.  Curcumin is from the root of the tumeric plant; it gives curry its yellow color.

Animal studies have shown that it actually clears away Alzheimer’s-causing proteins in the brain called amyloid plaques.

You can add some curcumin – tumeric – to your own cooking to get a dose of this powerful polyphenol.  It seems that some of the most interesting foods and flavors contain some of the most potent brain-boosting molecules.

5. Leafy greens & Cruciferous vegetables

You may not be fond of eating your greens, but there’s a reason why you hear over and over that they’re one of the best things to add to your diet.  Harvard Medical School researchers found that women who ate the most vegetables – especially leafy green vegetables (spinach and romaine lettuce) and cruciferous vegetables (broccoli and cauliflower) – experienced a slower rate of cognitive decline than women who ate the least vegetables.

**BONUS**

Water

This one shouldn’t be a big surprise.  Every cell in your body needs what to thrive, and your brain cells are not exception.  Approximately three-quarters of your brain is water.  A small Ohio University study found that people whose bodies were well hydrated scored significantly better on tests of brain power, compared with those who weren’t drinking enough.  Aim to drink half your body weight in ounces ever day.  For example, if someone weighs 150 lbs, they should get 75 ounces of water.

 

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Combating Chronic Inflammation

As people age, they are not only looking to live longer, but better as well, and that includes avoiding the effects of chronic inflammation.  Inflammation treatment is a big industry because of that.  There is a long list of medications, supplements, and salves aimed at managing chronic inflammation, and the number of advertisements for anti-inflammatory products is even greater.

Inflammation is the body’s natural response to things such as injury, infection, exposure to toxins, and biomechanical dysfunction.  It involves a cascade of events, coordinated by the nervous system, which includes increased blood flow to the site of injury, local temperature increase, redness and swelling.  The additional fluids can also increase the pressure on nerve endings in the area, resulting in pain.

b2ap3_thumbnail_inflammatoryShort term or acute inflammation is a necessary part of the healing process and, in most cases, should not be reduced.  It is NORMAL.

Long term or chronic inflammation, on the other hand, can lead to serious health problems.  As the picture to the left illustrates, it can contribute to Type II diabetes, joint degeneration, heart disease, and even cancer, among other things.  Often times, it is the result of life style choices, and other environmental influences.

There are some easy steps you can take to reduce and prevent chronic inflammation.

  • Getting the right balance of omega-6 and omega-3 fats.  Most Americans consume too much omega-6.  Reduce the amount of cooking oils you consume, especially those that contain corn.  Eat grass-fed met over grain fed and choose cold-water fish such as Wild caught Alaskan Salmon.  Adults should aim for a omega-6:omega-3 ratio of about 2:1.
  • Avoid trans-fats.  It’s as simple as that.  But, be careful to read the ingredients.  The nutritional label may read 0 grams of trans fat, but make sure to look for “partially hydrogenated” oils.
  • Limit refined carbohydrates such as white bread, white rice, high fructose corn syrup and refined sugars
  • Maintain a healthy weight.  The more fat you carry, the more inflammatory chemicals you produce.
  • Increase you intake of antioxidants such as vitamins A, C, D, and E.
  • Have your spine checked for structural shifts.  Chronic inflammation may be a secondary condition of a structural shift of your spine.  The structural shift blocks your nerves from functioning correctly and from properly controlling the inflammation process.  Neuro-Structural Chiropractic restores your spine to its normal position reducing the obstruction to your nervous system, which allows inflammation be more appropriately coordinated.

 

 

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Your Brain on Sugar

Is sugar addictive?  Can it lead to other problems?

What are the effects of excess sugar on your body? Before we can talk about the health consequences of consuming too much sugar, it’s important to understand why we like sweets and the effect they have on the brain and nervous system.  The alterations in brain chemistry from the consumption of excess sugar begins to tell the story of the potential negative impacts on the rest of the body.

Recent evidence, as brought to light by Glasgow University and in a segment on NBC’s The Today Show, suggests that an addiction to sugar, or “sweet tooth” may begin early on in life as infants are first introduced to foods.  It proposes that, because most store bought baby foods contain either added sugar, or sweeter foods (sweet potatoes, apples, carrots, fruit juice, etc.), children are unable to develop their other tastes, such as bitter.  The report recommended that baby foods be made at home, allowing the parents to control the exact ingredients their children were eating.

This video, from Dr. Nicole Avena, gives us a great synopsis of what happens to the brain when we eat foods containing added sugars.

Keep an eye out for future blogs which will begin to discuss the impacts of sugar on the rest of the body.

 

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