Angela Garcia (00:02.067):

Hello, I'm Angela Garcia and I am the registered dietitian with Thrivelab. I'm originally from England and I have over 20 years experience working as a registered dietitian nutritionist.

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Ashley Wheeler, NP (00:18.798):

Hi, my name's Ashley. I'm a nurse practitioner for Thrivelab. I've been with the company for over two years. I am also in family practice and interventional in spine and pain medicine, as well as a little education in the background. Also have a significant history in exercise medicine.

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Angela Garcia (00:42.515):

So today we wanted to talk about restoring hormone balance through nutrition. And I just wanted to mention that we now have a nutrition coaching program available. And what this would include with the initial visit the patient can expect to receive a comprehensive nutritional assessment, where I would also calculate individual energy and protein requirements. There would also be a tailored meal plan and also coaching, ongoing coaching to help achieve nutrition and wellness goals.

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Ashley Wheeler, NP (01:27.778):

Yeah, and you know, I think when we're talking about nutrition and hormones, they're really hand in hand, and I don't think that we often realize how closely related they are. You know, I talk about this all the time with my patients. Food is fuel. You know, we look at it as food is pleasure, and yeah, we can enjoy it, and we can have pleasure from it for sure, but we need to remember that. Food is basically, to gas to a vehicle is food to our body. So what we put in it is gonna make it run better. If we put the wrong gas in the vehicle, it's not gonna work well. And it's the same way with food. I think this nutrition program's just gonna really help to give patients a better understanding of how closely related these two subjects are. And also just like the role of what foods can do to regulate hormones, because actually, a lot of hormone health kind of goes hand in hand with gastrointestinal health. And I don't think any patients know that, you know? So I think also Angela, like one of the things that I think you're gonna speak on a little later is, you know, kind of some ideas of foods and ratios and things like that, which that's huge for patients. They need to hear that. They need to know exactly what to do. And I can go so far in nutrition, but you know, that's not my expertise. That's why we have you.

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And also I think another really important aspect, and I'm sure you would agree with me, is kind of looking at the body as a whole and thinking about stress management, exercise, all of these other things, getting good sleep, being hydrated. I know that I like preach on it all the time, but this nutrition program I think is gonna dive a lot deeper into options and recipes and just ideas. I think these patients get a little bit.. nervous whenever it comes to new food choices because they don't know what to pick. And I think one of the biggest things that I see in hormone health is in either perimenopausal women or menopausal women, the last thing to subside is that stubborn belly weight. And they get so frustrated and rightfully so, right? You know, they're doing everything right, they're exercising, they're eating right. And I think, you know, what patients need to understand is that during menopause, our body stores weight around the core because there's declining estrogen levels. If we replace that with hormone therapy, you know, things get a little bit better. It takes time, but I think with the nutrition, you know, that kind of helps to expedite that process a little bit. Yeah, I think so.

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Angela Garcia (03:58.491):

Yeah, yeah, I'm really excited too about this new program. It is holistic, like you say, and I think it's gonna really help the patient see all the connections, see how everything is connected. The emotional side of things, the physical side of things, how everything sort of starts to connect and work together. And I think it's a great program and I hope that people will really see that, experience the benefit, but really sort of know, why everything is sort of working together to help them stay well, get well, stay well and thrive. 

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Ashley Wheeler, NP (04:44.938):

Yeah, absolutely.

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Angela Garcia (04:48.867):

Yeah, so nutrition and hormone balance. So we have these foundational hormones, if you will. There's the insulin, there's the adrenals, there's thyroid hormones. And of course there's the sex hormones. And I know that Ashley, you're talking to a lot of patients who that's probably their main concern, isn't it? The balancing of their estrogen, progesterone, or those hormones in particular, but we do.

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Ashley Wheeler, NP (05:15.178):

Yeah, I think those and testosterone.

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Angela Garcia (05:17.891):

Oh yeah, yeah. And we have those, so we have these foundational hormones which really kind of support those sex hormones as well. So, and the testosterone. So where we see diet really fitting in is treating any kind of insulin resistance, providing adrenal support, helping with thyroid balancing. So with insulin resistance, one of the things that we have to think about is the quality of the diet. So one thing I'm gonna be asking patients is, what kind of protein are they consuming? What sort of carbohydrates are they consuming? Are they simple or are they complex carbohydrates? Complex being the ones that are higher in nutrients and fiber. What kind of fats are they consuming? Are they good fats, are they the bad fats? And once we've established that then we can start to tweak the diet and make it make it healthier. One thing I'm a big advocate for, and I think most dietitians are in this respect actually, is the food first rule. So yes, there are lots of supplements out there, but if your basic diet is not as nutritious as it could be, then you just don't get the same absorption as you would if you’re eating a clean diet with good quality proteins and also fiber and the essential fatty acids and things like that, which I know we'll touch on a bit more later on. So food first.

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And with insulin resistance, one of the big things is keeping your blood sugar stable. So you really want to be choosing foods that digest more slowly. The two in particular would be protein foods. So your chicken, fish, eggs, beans, etc. And then also high fiber foods. So your whole grains, beans, legumes. You want to have both those type foods, macronutrients or food groups, in your diet for each meal and each snack essentially or ideally and those will help to keep blood sugar stable and they prevent a lot of insulin being released into the bloodstream. So that's what we're aiming for.

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Now, with insulin resistance as well, there are some other things that you could consider. There are what we call the phytochemicals. These are substances that we get in plants that are really important for the diet and promote good health. That would be things like cinnamon, there's quercetin, which you get in onions, there's resveratrol in red grapes, and also things like green tea extract as well.

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Now you may, the person may also need additional support from maybe some nutraceuticals. And this is, I think more Ashley's side of things where she may be recommending chromium to that person, CoQ10, supplements like that. 

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Ashley Wheeler, NP (09:08.618):

Yeah, absolutely, I agree.

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Angela Garcia (09:11.299):

Yeah, and one thing I was going to ask you about Ashley was one of the things that you're looking for is identifying the person with insulin resistance. Yeah.

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Ashley Wheeler, NP (09:19.411):

Sure, of course. Yeah, we definitely need to pay attention to that because insulin just goes hand in hand like you said.

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Angela Garcia (09:27.119):

Yeah. So the other thing would be adrenal support. Now with the adrenals, again, you're wanting that healthy diet, but you're also wanting to avoid a lot of artificial substances in the diet. So you're wanting to try and avoid a lot of chemicals, avoiding artificial colors, artificial preservatives. And again, you could also, the person may also need some nutraceuticals, maybe like a good quality B complex supplement. The omega-3 fatty acids, vitamin C. I know when we're stressed, the body tends to use up more vitamin C, so supplementing that is very valuable. Also magnesium and zinc. In terms of thyroid function, again, there's a lot of those micronutrients, iron, iodine, tyrosine, zinc that the body needs for healthy thyroid function. Again, I'm going to encourage the patient to really aim for food first. So two very important nutrients for thyroid health are selenium and zinc. And you can get these from Brazil nuts, for instance, but you don’t need a lot. So it would be maybe just like one Brazil nut and it might be every other day that you would have that. But that is a great way to absorb those nutrients in the body. The one thing that you have to be careful with if you are supplementing zinc is not overdoing it because it can end up throwing up off our copper balance. So again, if we're getting those nutrients from food, that makes a big difference.

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Angela Garcia (11:25.127):

And I think in general for both men and women, I love flaxseed. Ground flaxseed is awesome and I often recommend that people include two tablespoons of that in their diet every day. That enhances detoxification and it also helps with the symptoms of hormonal imbalances.

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Ashley Wheeler, NP (11:50.43):

Absolutely, that's a lot of interesting information. I didn't know about the Brazil nuts. That's really great. A little touch point for patients.

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Angela Garcia (11:56.183):

Yeah, yeah, they are a powerhouse. You just with things like nuts though, you've got to sort of keep them refrigerated because they'll go rancid on you, you know, if you're not too careful.

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Ashley Wheeler, NP (12:05.386):

Yeah, absolutely. That's funny. And I think, you know, many of the points that I was going to touch on are very similar to some of the things that you said and maybe in a little bit of a different manner, maybe, you know, I'm trying to, you know, look at how we can strategize restoring hormone balance through nutrition. And I think, you know, during that initial visit, um, with the nurse practitioner prior to consulting with you is a great time to get them, the patients like in the loop about this and knowing that this is an issue. So it makes them more interested in, you know, getting to know more about nutrition and wanting to meet with a nutritionist to expedite their success with this program. You know, simple things like educating them on the fact that a lot of the hormones in the body act as chemical messengers that dictate metabolism, they dictate your menstrual cycle, they dictate other body systems, all sorts of things. So, you know, they go in so many directions and kind of like what you said earlier, knowing what foods support hormone health is really important. Another thing that I'm not sure that you mentioned or not that I mentioned in my patients a lot is trying to keep that diet heavy on vegetables, cruciferous vegetables particularly. So like the broccoli and the cauliflowers and Brussels sprouts, things like that. And then like you said, whole grain, which is really, really important. Another thing that I think is important for patients to know about is going organic. I know it's expensive, it's so expensive, but if you can do it, I think that the best goal is to at least the dirty dozen. I don't know if you've ever heard of the, you've definitely heard of the dirty dozen. 

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Angela Garcia (13:43.988):

Yes, the environmental working group.

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Ashley Wheeler, NP :

So the dirty dozen, yeah, so the dirty dozen is essentially a dozen different fruits and vegetables that absorb pesticides easier. So they're best avoided and we should try to go the organic route for that. So if we can at least do that, I think that's great.

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We can do non-GMO, so that's less glyphosate. Pesticides, again, you know, storing foods in glass containers, not plastic, which a lot of people aren't familiar with. Phthalates are high in plastic, and when we microwave in plastic, the same thing happens. You know, it's these little things that kind of add up to really little tiny things that are so easy to change in our lifestyle.

They really don't take much work, but if we make the patient aware that, hey, like this is an issue and this could really help your success in your hormone health, I think that more patients would be apt to do that. I know you mentioned omega-3s. We don't naturally produce those in the body, so that's something that I teach my patients about. So, you know, we can get those from fatty fish, salmon, sardines, even avocados, extra virgin olive oil. Phytoestrogens found in plants, they regulate estrogen. So examples of that would be like lentils, flaxseed, like you had said, chia seed, pumpkin seed, all of those, and even licorice, that's an interesting one, but those are all places to get those phytoestrogens that actually help to regulate whether your estrogen's too high, too low, or it's doing well, it helps to keep it in that healthy level.

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I think another thing is picking foods high in probiotics. Probiotics help regulate the GI system. And the GI system is responsible for detoxifying hormones, essentially. So that's why I said they go hand in hand, and this is why nutrition is just so important. Probiotic foods we all know are like, you know, the yogurt, kombucha is now an upcoming popular one. Even sauerkraut, miso, things like that. Just some things to consider, you know. And then kind of diving a little bit more in on the insulin route of things. You know, balancing blood sugar is so important. And I couldn't tell you how many patients that I have when we do the initial allows their glucose comes back a little bit elevated. And it's like, wow, if we, you know, this is pre-diabetes, right? We need to get a hold of this. You know, insulin determines how we use energy from the foods we consume. When we eat, it raises the blood glucose. The blood glucose is essentially energy for our cells. So the insulin moves blood sugar from the blood to the cells. And if you're insulin resistant, you can't do that.

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And that's really an important factor to remember. You think of most diabetics, they need better control over their dieting to prevent that insulin resistance. So with nutrition, with Angela in the picture, helping to describe some of these options, things that would be better options for foods, I think that goes a long way. Mindful of processed foods, you wanna stay away from processed foods, eating in moderation, complex carbs, things like that.

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And, you know, there's so many aspects of this, I could probably go on and on and on. Another thing that I often talk about, and it usually comes up in a later conversation because I don't have this much time, are anti-inflammatory foods. So inflammation is essentially the body's response to harm. And sometimes it's a good thing and sometimes it's a bad thing, right? So if we focus on little to no dairy, processed sugar, gluten, that's kind of like the anti-inflammatory diet. That's really hard for people, I'll be honest, but there are a few that can accomplish that. Many of the anti-inflammatory foods kind of co-correlate with the foods that I mentioned earlier. And limiting inflammation essentially limits that bloating, water retention, and essentially weight in a lot of ways. 

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Angela Garcia (17:37.203):

Yeah, yeah. Yes, because the weight on our bellies, as you mentioned earlier, a lot of that is inflammation, isn't it?

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Ashley Wheeler, NP (17:47.498):

Absolutely, yeah, absolutely. And I think, and patients don't realize that because sometimes when I'll put a patient on progesterone, it takes a few weeks to get them balanced out or even a couple months sometimes and they may retain more water, but then once they're stabilized again, that water retention goes down, they realize that they're losing some of that belly weight. It's not all just fat. I really don't think it's all fat. Do you have any suggestions for meal planning, healthy recipes, things like that for patients?

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Angela Garcia (18:15.515):

Yeah, well, yeah, well, number one, I normally tell people to just sort of start simply. If it's not just them at home, maybe they've got a family as well that and we need to establish who's doing all the food prep because I don't want that person to turn into a short order cook. So I try and encourage people to get together with another adult in the family and sort of go over what they're typically eating.

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People know what they like to eat. So one starting point can be modifying a lot of the recipes that they enjoy and making them healthier. Another thing would be starting to make, prep more meals at home if they have been, if they've got themselves into a habit of eating out more. And so prepping more foods at home, maybe using a crockpot, whatever it takes to start making those changes and making them easier to start with as well. And yes we have a great meal planning software that I've been using already. It has thousands of recipes on there. There is one website that's really good, it's eatingwell.com. One thing I really like about that is you've got lots of variety, so if you want to do more low carb you can choose those kind of recipes. You can do a search for recipes that you know you already like and it will give you healthier versions of those and it also gives you the nutrition breakdown. So if you're someone, maybe your nurse practitioner has encouraged you to start tracking your food intakes using like a fitness app. I know that I sometimes recommend that. And when you've got all those, when you've got the nutrition breakdown there for you with the recipe, that makes it really easy to be able to track what you're eating. So those are the kind of places that that's kind of where I get people to start off with.

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And what I would do before I met somebody as a new patient, I would get them to keep like a three-day food diary if they can to kind of, you know, give me an idea about what they're eating. And that will also help me to identify if there are any nutritional deficiencies that they might be at risk of, like if they're missing a complete food group, like they don't touch dairy at all. So okay, so what can we do in that situation?

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And, but I try and start off where the patient's at and meet them where they're at and then just kind of encourage them to make some simple changes.

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Ashley Wheeler, NP (21:25.494):

Yeah, and you know, I think it's a work in progress, right? You know, you're not gonna take someone from a very unhealthy diet to an excellent perfect diet overnight. And honestly, there's no such thing as a perfect diet. We all have to enjoy life too. So I think it's just like gradually, gradually getting there and working with them. I love the idea how you take like recipes that they like and make them healthier. That's actually, when I first got into, you know, fitness and competing and things like that, that's what I did. And that's how I limited, you know, extra fats or extra carbs. Whenever I was trying to balance my macros, it was like, you know, avoiding certain condiments or not drinking my calories. That's a huge one. And those little changes made such a big difference. So that's another big thing. And you know, I think the other thing is right now, the world is so crazy that convenience is key for everyone, right? So we want to be able to drive through McDonald's or drive through Subway, whatever, stop at Subway and get something quick and easy. We have kids going to sports, we have work, we have dance class, we have all this stuff. I mean, I know that with my three kids, I'm everywhere all the time. And so it's just easy. It's easy to go pick something up. But when we're picking stuff up, that's usually processed foods. And those are the type of foods that, you know, we want to try to stay away from. And I always tell my patients when they're trying to work on their nutrition that when you go to the grocery store, you should always shop the outside aisles. I know that's like a really common word of advice, I guess, but it's... 

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Angela Garcia (22:55.079):

I've lost you. I can't hear you now. Oh yeah, I can hear you now.

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Ashley Wheeler, APRN:

Can you hear me now? Okay. Sorry about that. I was saying that with my patients, I try to tell them to shop the outer aisles of the grocery store, which I know is a pretty common thing to say. I've heard that many times, but it's really true. The outside aisles have your proteins. It has your dairies, it has your cruciferous vegetables, it's fruits, things like that. And I know, yeah, all these diets that we spoke to, some limited dairies, some limited different items there, but it's all on kind of how your approach is. Processed foods, come in drive-through foods, frozen meals, packaged snacks, cookies, cereals, canned soups, even breakfast meats. Many people think those are proteins. Those are processed. They are proteins, but they're processed. Even pastas. All that stuff. So, you know, it's out there and it's everywhere. And I, another like really food for thought is I truly believe that what was put on this earth is all we need. And if you think about healthy foods, those healthy foods were put on this earth. They grow on this earth. So, you know, back when they couldn't do processed foods, it was vegetables and fruits and they killed their own animals for meat. It was protein and that type of thing and whole grains, right? So, you know, a diet in fruits, vegetables, eggs, meats, whole grains is great. Those things are all natural. They're coming from the earth naturally. When we look at the type of food that we... Go ahead.

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Angela Garcia (24:29.871):

Yeah, I think. No, I was going to say, I think one exception is, we're seeing a lot of low levels of magnesium in the American diet. And the theory behind that is that with intensive farming, that's kind of the soil is becoming depleted, so that's why we're not getting as much magnesium in the body. Through our food. 

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Ashley Wheeler, NP (24:57.982)

Absolutely.

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Angela Garcia (25:08.295):

Yeah, so that's something that, you know, I've often recommended for a person to supplement with because you know, it helps with stress and calming and sleep and all that sort of thing. So that's one thing that unfortunately, I don't think we see as much in the American diet at the levels that we would prefer.

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Ashley Wheeler, NP (25:22.538):

Yeah, that's a really good point. I have a lot of patients on magnesium specifically for sleep. Um, and that's sometimes the first route option to go just as natural as possible. Um, and, you know, going back to processed foods a little bit, um, the processed foods that we eat are sugar, right? They, they end up being sugar or carbs. Um, and that leads to insulin issues, which leads to estrogen issues. So we're all kind of, I guess I'm circling back around. Like it's just like, wow, this all links together in some way, shape or form. And when we talk about it, it's kind of funny because it's like making sense in my brain, as I go on, they contain those BPAs that affects function and production of hormones, all of that stuff, artificial flavors, like you were talking about earlier, they actually are linked to hormone mimicking. So the same way that artificial flavors are made, your body thinks that it's mimicking hormone replacement and that causes disruption to the hormone balance. Which is really interesting. I know like the red dyes and things, yeah.

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Angela Garcia (26:21.243):

Well, yeah, I didn't know that. That is interesting.

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Ashley Wheeler, APRN:

So I mean, I think it really boils down to consuming foods derived directly from the earth that haven't been artificially manipulated is the most beneficial thing. It's not only our hormone health, but our overall health. Planning meals ahead of time, moderation, the 80-20 rule is what I go by a lot. Remembering that food is our body. Our body as gas is to a car, essentially, like I said earlier, the wrong kind will make it work insufficiently. We only have one body and we only have one chance.

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Angela Garcia (26:58.831):

Yeah, yeah. And unfortunately, I don't think people have heard that message enough. I think the importance of the influence of diet on our health, people don't realize just what a big percentage that is. You know, it is, you know, nutrition has at least like an 80% bearing on our health. Yeah, it's important, but we just we don't hear that message enough, unfortunately.

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Ashley Wheeler, NP (27:30.614):

No, we don't, and our patients don't either. And honestly, I think we'll both agree that that's the importance of today's message and just kind of looping around to connect nutrition to hormone health. And this program, I, as a nurse practitioner, I'm so very excited for it because nutrition and explanation takes a long time, and I wanna focus on everything and I wanna cover every topic, but I have to focus on the hormone part. So it's so great to be able to work with you and 

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dive deeper into that and there's so many patients that I think are gonna benefit from this program.

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Angela Garcia (28:04.411):

Yes, definitely, definitely. Yeah, I'm excited too.

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Ashley Wheeler, NP (28:09.283):

Yeah, absolutely. Well, thank you, Angela, for talking to me today about nutrition and hormone health. This was extremely, extremely helpful for me. I learned something. So I hope you did as well. And, you know, hopefully this helps to, yeah, hopefully it helps to gather some patients that are interested in ThriveLab’s care to kind of do both at once and get the full effect.

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Angela Garcia (28:30.575):

Yeah, I want to sing it from the rooftops, but that might alarm some people.

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Ashley Wheeler, NP (28:37.075):

I love it. I love it. I mean, I think once we get a couple patients on board, I think we'll get there. I think the rest will follow in one way, shape, or form. Absolutely.

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Angela Garcia (28:45.383):

Yeah, definitely, definitely. Well, it was good talking with you, Ashley.

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Ashley Wheeler, NP (28:53.674):

All right, well, thanks, Angela. Thanks for talking with me today. We appreciate you. And hopefully, we catch up soon.

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Angela Garcia (29:01.979):

Yeah, all right. Take care.

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Ashley Wheeler, NP (29:04.482):

Take care.

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