Written by Kelsey Schaffstall Young MS, RDN, LDN
More than 100 different cannabinoids have been identified, the most well studied being tetrahydrocannabinol (THC) and cannabidiol (CBD), which have both been shown to have therapeutic and medicinal properties.1 The health effects of cannabis are directly related to our body’s innate ability to bind cannabinoids. Interestingly, the human body naturally produces cannabinoids and therefore is equipped with an entire network of cannabinoids receptors, also known as the endocannabinoid system. 1
What does the research say?
According to a review conducted by the American Heart Association conducted in 2020, there is strong scientific evidence to support the use of cannabis for a variety of medical conditions. First, cannabis has been shown to improve pain caused by neuropathy and fibromyalgia. 1 Cannabis is also effective at increasing appetite and promoting weight gain in people suffering from cancer or HIV related weight loss. 1 In addition to benefitting appetite, cannabis has also been shown to prevent chemotherapy-induced nausea and vomiting. 1 Other conditions such as Multiple Sclerosis and Epilepsy have also been studied, for which cannabis has been shown to improve pain and spasticity and seizures, respectively. 1 Moderate evidence also exists to suggest that cannabis could be effective in treating opiate withdrawal and dystonia. 1 Despite this, research on cannabis has been limited due to decades of cannabis being classified as a controlled substance. However, advancements have been made in the area of medical marijuana with three prescription cannabinoids (Marinol, Cesamet, and Epidiolex) now being authorized for use in the US. 1
Are there any risks associated with cannabis use?
Despite the potential therapeutic benefits, cannabis use does not come without risks. Chronic long-term use of cannabis can reduce the availability of CB1 receptors, impacting the systemic response when used long term. 1 For example, use in moderation can improve nausea and vomiting while chronic daily use can result in uncontrolled vomiting known as hyperemesis syndrome. 1 Use in adolescents younger than 16-18 years of age has also shown increased risk of psychosis and schizophrenia as well as poorer attention. 1 CBD can also inhibit some enzymes in the CYP450 family and alter the metabolism of certain drugs, either decreasing or increasing their concentration in the bloodstream. 1
If you are trying to decide whether or not to use cannabis to support your health, there are a number of things to consider. First, in terms of dosing, a responsible approach would be to begin with the lowest possible dose and increase slowly until you feel the desired benefits. Also, be sure to choose high quality products and seek out reputable companies that provide consumers with a certificate of analysis detailing the cannabinoid content as well as the presence of any heavy metals or pesticides. Proof of third-party testing is also important as it can ensure the purity and potency of the final product.
Most importantly, pay attention to whether cannabis is promoting or inhibiting health behaviors. For example, is it enhancing appetite to the point that you are overeating or making poor nutrition choices? Is the quality of your sleep improving or declining? These are important questions to ask yourself when making any behavior change, and a Registered Dietitian can help you to examine the impact of cannabis on your nutrition and health behaviors. Finally, be sure to consult your doctor to ensure that cannabis use will not interfere with any of your current medications.
It is an exciting time to explore the wide array of THC and CBD products on the market, and hopefully as legalization efforts continue to evolve so will the scientific research on the use of cannabis to promote health.
- Page, Robert L., et al. “Medical marijuana, recreational cannabis, and cardiovascular health: a scientific statement from the American Heart Association.” Circulation 142.10 (2020): e131-e152.
What is Metabolic Syndrome?
You may have heard the name but there is often some confusion about what exactly is metabolic syndrome, in fact, keyword research shows over 74,000 Google searches for “metabolic syndrome” in just the past 24 hours. Also called syndrome x, metabolic syndrome is the name for a group of conditions that raise the risk of cardiovascular diseases and diabetes. When an individual has three of the five conditions a diagnosis of metabolic syndrome can be made. According to data from the National Health and Nutrition Examination Survey (NHANES) the prevalence of metabolic syndrome has been on the rise since the early 1990s and by 2012 it’s estimated that more than one-third of US adults met the diagnostic criteria.
The World Health Organization (WHO) defines Metabolic Syndrome diagnosis with any three of the following:
- High blood pressure ( systolic reading of 135 mm Hg over diastolic 85 mm Hg or greater)
- Impaired glucose tolerance (fasting blood glucose of 100 mg/dL or greater)
- High waist circumference (greater than 40 inches in men and 35 inches in women)
- High triglycerides (150 mg/dL or greater)
- Low HDL cholesterol (less than 40 mg/dL in men and 50 mg/dL in women)
3 Ways to Reduce Your Risk
Metabolic syndrome is treated by addressing the conditions that contribute to the diagnosis. Interventions with diet and lifestyle can often help to reverse the conditions that make up metabolic syndrome. For example, a weight loss of as little as 3% can lead to improvements in blood lipids and meeting minimum recommendations for daily exercise can help keep blood pressure in check. If you are looking to reduce your risk, try starting with the three tips below:
1. Know Your Numbers
Being an active participant in your healthcare and knowing where you stand can help you better understand your risk. Blood pressure, fasting glucose and blood lipids are tests that should be done each year at your annual check-up visit. Knowing where you stand now and watching the trends year after year can help you take action sooner if one area starts to creep up.
2. Don’t Ignore Your Weight
A prospective study published in the American Journal of Medicine in 2000 estimated that the average American gains and then maintains about a pound of weight annually. This may not seem clinically significant enough to warrant intervention at an annual check-up visit however year after year of gradual gains can become significant and contribute to the development of metabolic syndrome. Your weight may not fit perfectly within the BMI scale but knowing what’s a healthy range for you and watching your trends is important.
3. Strive For 150
Participating in some form of physical activity is well established in the research to have protective effects against the conditions that contribute to metabolic syndrome including lowering blood pressure, maintaining weight and reducing insulin resistance. Check in to see how close you are getting to meeting the minimum recommendations of 150 minutes of physical activity per week. Already there? See if you can reach 300 minutes a week for additional benefits. For more on the benefits of exercise check out my post on the 2018 Exercise Guidelines from the US Department of Health and Human Services.
Mediterranean-DASH Intervention for Neurodegenerative Delay
Are there choices that you could be making in your diet now that could slow cognitive decline and even reduce your risk of developing Alzheimer’s disease? A growing body of evidence is showing that this might be the case. Researchers from Rush University in Chicago created a hybrid of the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet resulting in the MIND diet or Mediterranean-DASH Intervention for Neurodegenerative Delay.
The study followed over 900 participants ages 58-98 for a period of 4.5 years and in that time researches saw a reduced risk of Alzheimer’s in 53% in those strictly following the diet. Not ready to commit? Even in those participants following the diet only moderately well had a 35% risk reduction.
What’s Included in the Diet?
The MIND diet identifies 15 main components: 10 brain-healthy foods to include and 5 foods to avoid. As you would expect being rooted in the Mediterranean and DASH diets, the MIND diet emphasizes plenty of vegetables, whole grains, and heart-healthy fats. It limits added sugars, refined flours, and saturated fats.
10 Brain-Healthy Foods:
- Leafy greens – 6 servings a week- With at least one additional serving of vegetables a day
- Berries- 2 servings a week
- Beans – 4 servings a week
- Nuts – 5 servings per week
- Whole grains – 3 servings a day
- Fish – once a week
- Poultry -twice a week
- Red wine- one glass a day
5 Foods to Avoid While Following the MIND Diet:
- Red meat – no more than 4 servings a week
- Butter – no more than 1 ½ teaspoons a day
- Pastries and sweets – no more than 5 servings a week
- Fried and fast foods – less than 1 serving a week
- Cheese – less than 1 serving a week
What Can You Do?
My take-home from this? Next time you are working on putting together your weekly shopping list think about these 15 foods. How often are you incorporating the “foods to avoid” and how often do you come close to meeting the recommendations for the “food to include”? If your ready to make some changes, start slow and focus on 1-2 things that you could add. Maybe picking up some frozen berries that you can work on adding to yogurt or oatmeal a couple of mornings a week. Or try my 3 bean turkey chili recipe for a serving of both beans and poultry. Starting slow and picking one or two things to focus on at a time can help ensure you keep up the habit long term and that is likely what is going to make the largest difference.
Estimating Hydration Needs:
When talking about health and diet, the topic of hydration often comes up, and rightly so if you think about the fact that the average human body is comprised of 55-70% water. Water is so essential to human life that without it humans cannot survive more than a few days, so it’s no surprise that there would be questions about optimizing intake. But how much do we need?
We have all heard the advice to drink 8 glasses of water per day, which converts to just under 2 liters. Other proposed ways to estimate needs include the Holliday-Segar method which is a weight based calculation and, for example, works out to be approximately 2.7 L per day for a 180-pound individual. Another popular method is calorie based with a starting point of 1 ml of fluid for every kcal consumed. To investigate this further the Food and Nutrition Board of the Institute of Medicine (IOM) gathered a panel of experts to evaluate the data. In their 2004 consensus report, they concluded that the majority of healthy adults are able to meet hydration needs by responding to their thirst cues. The panel also set an Adequate Intake of water for men and women of 3.7 L and 2.7 L respectively which they estimate would meet the needs of most healthy adults. The IOM report highlighted that fluid needs would be individualized to account for activity level, environmental temperature, physical fitness, body size, and health conditions.
If you’re looking at your own intake and thinking you are not likely meeting this don’t panic yet. The AI for water is coming from all sources in the diet, not just plain water consumption. This means that food sources contribute and population data suggests that Americans typically meet 20% of this daily fluid needs from foods. Non- water beverages count too, yes, even coffee! Coffee often comes into question due to the diuretic effect of caffeine however in the IOM report they concluded that for individuals with habitual intakes of significant caffeine, the caffeinated beverages appeared to contribute to total water intake similar to non-caffeinated beverages. That’s good news for us coffee drinkers and one more reason to continue eating plenty of fruits and vegetables.
Fluid content of common foods:
|Food ||Percent Water|
For the majority of healthy adults drinking when you are thirsty will likely ensure you are meeting your daily hydration needs, but remember to be mindful of increasing you intake when outputs might be greater, for example, warmer temperatures and increased physical activity. And pay attention to some of the common signs of dehydration including:
- dark colored urine
- dry mouth
- a headache
It’s August and here in the Northeast we have been enduring a stretch of hot and humid weather. While part of me is embracing the warm summer nights, I will admit there is also a part that struggles to think about turning on the oven or stove to make dinner and risk making the kitchen even a degree hotter. On nights like these this White Bean and Tuna Salad makes a great no-cook meal. The beans and tuna provide a great source of protein and the tomatoes could not be better this time of year!
I’m taking the leap! In June of 2018, I submitted my letter of resignation to my traditional hospital-based job and took my first steps into entrepreneurship with Hailey Crean Nutrition, LLC. While my heart still beats a little faster (even now) thinking about it, I couldn’t feel more confident about the decision and I believe this confidence is rooted in the reason why I decided to make this move.
I have spent the past ten years working as a Registered Dietitian, and during this time have had the opportunity to work with thousands of patients spanning the spectrum of health conditions, readiness to change and barriers to change. This experience has been invaluable to me – both in understanding the realness of the barriers that exist and in evaluating the way I, as a healthcare provider, contribute to these barriers.
What I see clearly is that we can do this better. It’s no secret that lifestyle change is hard; it’s hard to make the changes, to begin with, and often even harder to sustain over the long term. The research shows more frequent follow up is key for success however in a culture of packed schedules time is limited.
My mission in creating Hailey Crean Nutrition, LLC is to provide evidenced-based nutrition support and education brought to clients directly with the convenience of telenutrition. I aim to cut out the noise of confusing and misleading nutrition information by providing clients with a resource they can trust and ongoing support for lasting lifestyle changes.
At the core of my nutrition philosophy I believe:
- All foods fit! Foods are not good or bad but we should look for a balance.
- There is no one size fits all solution, I focus on an individualized approach.
- What we eat matters. Eat well. Feel well.