Orthorexia: When Eating Healthy is Unhealthy: Sarah Crissinger RN

Seattle is the fourth healthiest city in the United States and Seattleites are the second healthiest eaters according to a recent survey by Sperling’s Best Places (2013). You can’t go far without seeing a cross fit gym, yoga studio or a high end grocery store. The Paleo Diet, “eating clean”, and The Raw Foods Diet are commonplace in the Seattle culture and have undoubtedly helped some ward off early disease, increase health, vitality, and quality of life.  For some, what starts as eating healthier can become an all consuming obsession. The paradox is eating healthy can be unhealthy.

Orthorexia is an unofficial diagnosis that was named by Steven Bratman MD, who discovered the disorder after recognizing his own unhealthy obsession with healthy eating.Orthorexia is derived from Greek meaning right/proper appetite (Bratman, 2013). Obsession with being healthy and pure is what differentiates Orthorexia from other eating disorders. Like other eating disorders Orthorexics often have a need for control, and make food/way of eating a source of identity and validation. Perfectionism and black and white thinking often keep Orthorexics obsessed with following a diet strictly or they can struggle with accepting themselves.

 Orthorexia embodies traits of Anorexia and Obsessive Compulsive Disorder as foods allowed in the diet are reduced to a point where unhealthy weight loss and malnutrition ensue.Some attributes of Orthorexia can be; extremely limiting the types of foods eaten, such as any food with the possibility of having pesticides, GMO’s, being non-organic or specific ingredients and entire food groups (Nelson, Zerasky, 2011). Dr. Steven Bratman describes how some Orthorexics limit food intake to a dangerously low and even fatal level of nutritional variety by only allowing themselves to eat a couple types of food items (2013). Additional components of the disorder are obsessive compulsiveness regarding food preparation such as excessive washing of foods and not being able to eat out or eat food prepared by others, and spending excessive time thinking about healthy food (Nelson, Zerasky, 2011).

Healthy diets, such as the ones mentioned earlier, in and of themselves are not necessarilydisordered but can cross the border into Orthorexia when; 1) Fixation on food becomes allconsuming. 2) Personal relationships and other areas of life suffer due to rigidity to the diet often resulting in isolation. 3) Immense guilt, anxiety, mood swings and self loathing persist when the diet is not followed. 

The tricky thing about eating disorders including Orthorexia is the denial of having one.Especially due to the food restriction in Orthorexia often stemming from a medical condition, food sensitivity, allergy, or wanting better health. If you feel like you follow a very strict diet tobe healthy and other’s have shared concerns or you have noticed that the obsession in healthy eating is taking away from important areas of your life, Ramey Nutrition is here to support you.Ramey Nutrition offers individualized care that begins with an individual session with one of our Dietitians. We work with many therapists specializing in eating disorders in the Seattle area that we can refer you to in order to address deeper underlying emotional issues. Ramey Nutrition offers you a full recovery that results in a restored relationship with food, ownership over your health, and freedom to begin living your life fully again.

References:

Bratman, S.(2013) Orthorexia. Retrieved on 09/04/10 from: www.orthorexia.com

Nelson, J., Zerask, K.(2011) Orthorexia: When eating healthy goes awry. The Mayo Clinic.Retrieved on 09/04/2013

from:  http://www.mayoclinic.com/health/orthorexia/MY00768

California Shines, Ohio aches in battle for healthiest city (2013). Sperling’s Best Places. Retrieved on September

12, 2013 from: http://www.bestplaces.net/docs/studies/healthy.aspx

To Blog Or Not To Blog ...

I went on a blogging hiatus while I tried to figure out the delicate balance between recovering from an eating disorder and being a kidney patient. Most of the time I end up shutting it all out by compartmentalizing, putting it away in my head and just going through the motions, staying in this weird limbo. How can I honestly say that I'm doing everything I can to save my kidney when I still suffer from eating disorder? Am I recovering? You bet your ass I am. But it isn't possible to just get over an eating disorder, simply because I now have a new diagnosis. If I could just get over it, I wouldn't actually have an eating disorder and we'd be discussing a problem that doesn't actually exist. 

I'm not perfect and I'll call you a liar and tell you that you don't actually know me if you think I am. But I'll do the same if you don't actually think that I'm giving it my all and doing the best that I can. If it were as simple as picking up a hamburger and going to town on a plate of french fries then by all means, fire up the grill and pass the ketchup ... but I think we all know it doesn't work that way. 

Today I met with my nephrologist (kidney doc) and received my referral to the vascular surgeon for a preoperative vascular access/dialysis evaluation. I was also officially referred for transplant. Transplant. AYFKM? I've been an eating disorder patient my whole life (well 2/3rds of my life) and these are words that I feel should not be in my vocabulary. I don't know how to be a kidney patient. 

Scarlett says I have to separate the two, so I'm going to work on doing that. Maybe the key to getting through this is realizing that I can be an eating disorder patient working on my recovery AND a kidney patient starting the road to recovery via dialysis and/or (hopefully or) transplant. It'll be kind of like ... multi-tasking. Anyway, I think I'll stick to blogging during this process because I do not want to lose ground in my eating disorder recovery. I need to make sure I don't let my eating disorder become the way I cope with my kidney and I also need to make sure that my eating disorder recovery does not get lost to my kidney recovery. Let the multi-tasking begin.

What I do not miss about my eating disorder at this point in my recovery: Not having control over my thoughts. I love that I can break away from the eating disorder chaos in my brain and think about other things, future plans. I like that I can have day dreams about something other than an eating disorder related issue or thought. And I love that it happens naturally and I can experience what it feels like to have moments of freedom.

What I am not going to miss about my eating disorder once I'm recover(ed): Being denied a fun afternoon jogging around Greenlake with my friends and then going to eat frozen yogurt afterwards. When I'm recovered, I'm going to go to run  Greenlake every day, and I'm going to run with a handful of crab cakes from Tom Douglas' restaurants, and I'm going to do it in neon green shoes, because I can.

Destination Recover(ed): Day 676

Ok, I've been putting off writing this blog because I want it to be perfect. I had the most special spectacular day a week and a half ago and it was such an emotional and perfect day that I'm having a hard time putting words to my feelings in such a way that I can perfectly express how and what I was feeling. But I'm realizing that my need for perfection is what is constantly holding me back. So I'm just going to dive in and hope that I can get it across without jumbling it up and rambling on too much :) so bear with me here ...

 

So I had a spectacular day last week. It has taken me a while to blog about it because I had a difficult time wrapping my head around it to put words to my feelings. So that day started off as a not so good day. I had just left a particularly emotionally difficult appointment with Sandy. EMDR is fucking hard and it's so incredibly taxing on my body. I leave those appointments with the same empty euphoric feeling I used to crave when starving. The "nothingness" feeling. Empty. Only now instead of reveling in the feeling as "success" or "comfort" my brain instead automatically screams "Jesus Christ! I need an Ensure STAT!" (yay for small proofs of recovery!). So I show up for my appointment with Scarlett right after my appointment with Sandy and I'm beat. I'm exhausted. Trauma work is never fun, so I'm a little emotionally blah, not exactly feeling super awesome. I had just spent the last hour and a half realizing that I am affected by my sister's pregnancy in a traumatic way. That while I am so excited and proud and ecstatic and anxious and thrilled and happy, it brings up trauma issues for me. And no matter what I want or how I tell myself I feel, I'm not getting away from the underlying trauma. I can still be happy and excited for my sister, and be traumatized by it at the same time. But I can't pretend that it doesn't bother me, that it doesn't trigger trauma for me just because I don't want to deal with it. I don't want to go there or process it because I don't want to relive it, but there's no denying it and I'm coming to terms with the fact that I have to deal with it even though I don't want to. So it had been "that kind of a day" when I walked in the door at Ramey Nutrition. It actually kind of makes the whole day perfect actually. To have such a wide spectrum of emotion all in the same day and survive it as one of my most favorite days of my life ... it really makes it that much more fucking awesome of a day. Complete. So I had been set up to know that there was something special that was going to happen at my appointment with Scarlett, so I knew that going in but I never thought or expected what was going to happen. Appointment is going as normal and I'm giving the Scarlett the play by play from my appointment with Sandy, discussing intake and body image issues and then ... AND THEN ... there's the knock at the door ... and in walks this guy, who I recognize from Scarlett's pictures on Facebook, and I know his name but I've never met him before. So I'm a little confused as to what is going on and wondering why he's coming in and joining my appointment. I mean, not like "WTF is he doing here", but more like "I wonder what is going on". I won't give his name because I didn't tell him I was going to blog about him, but I so want to tell the world how awesome he is and how he touched my life and filled my soul. He was there because he reads my blogs and wanted to do something for me. What makes it so emotional for me is that I never fully realized how far this blog goes and how many people are reading it and how many people it's helping, whether it be support for someone with an eating disorder or just bringing to light what it's like for someone who doesn't have an eating disorder. A piece of my life and journey that one wouldn't otherwise know anything about. So in one of my blogs I wrote about not looking forward to winter because of the cold and what it felt like to be so cold because of my eating disorder. If you suffer from an eating disorder, you know what I'm talking about ... the cold gets down into your bones and you just can't warm up. Your body is tense all the time and it's exhausting. It's painful. My lips turn this purplish blue and feel like I look as though I'm being preserved on ice. It wears you down. I hate it. You don't have to have an eating disorder to know what this feels like either and it was something that he could identify with. So, as the story goes, my blog affected him. It's weird, it's like my life, what I go through as an every day thing affected the life of someone I don't know, have never met or crossed physical paths with. It's a concept I'm still wrapping my head around. To me, it's just my life, it's what I go through every day so nothing I do or say or write seems profound to me because it's just the way it is, it's just the way things go and I'm just writing about it. So he decided that he wanted to do something and here he was sitting across from me telling me how he reads my blog and explaining how he felt and how he wanted to get me something and he pulls out this coat. But it's not just a coat, it's an awesome coat, a coat that was special made. A coat that he had to call around to different companies to find someone who would help him with this coat. He read everyone he called my blog until he found someone that wanted to help him. (on a side note this coat did NOT come from REI who could care less and didn't want to help and now there is a year long boycott against them ...) A coat, because I get cold and I'm not looking forward to winter. A coat because he knows what it's like to feel that cold, even without having an eating disorder. Now I don't know how to articulate my emotions from this point. It's so much more than a coat. I mean, to have someone you don't even know do something so profound that you can't even speak ... it's surreal. To not have to worry about the cold this year because this coat is so fucking warm and enveloping and to have one less thing to worry about, to not have to dread that pain ... I'm just so touched. It's more than a coat to me. I feel safe in it. It's my armor. I've had a few rough days since then and in the midst of crying and dealing and feeling just so defeated and emotional, I put my coat on and curled up and created this safety nest inside my coat. And it may sound ridiculous, but I don't really care.  I updated my Facebook status that night (yes I'm a FB'er) because I felt this overwhelming gratitude and I needed to get it out but all I could say was this:

 

November 14 near Stanwood

At the moment I am at a loss for words to describe the most amazing day I have had. Today I feel beyond honored and blessed, enveloped by love and safety and truly inspired and motivated. I wish I could find the words to express the immensity of my emotions but for now I will revel in the comfort and joy of knowing that everything is exactly at should be and everything is going to be just fine. Thank You, with all my heart.

 

So I wanted to blog about it so I could say Thank You, you have truly touch my life in ways I may not ever be able to fully express ... and you have warmed my soul and made such a profound impact on my heart and will always be remembered for for helping me to my ultimate destination: recover(ed).

One of the best days of my life.

18 Surprising Dairy-Free Sources of Calcium: by Laura Schwecherl

18 Surprising Dairy-Free Sources of Calcium

by Laura Schwecherl 

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Fun fact: Calcium is the most abundant mineral in the body, and is found naturally in a wide variety of foods and beverages and added to many others! (Hellooo orange juice.) But whether lactose-intolerant or sick of wine and cheese parties, there’s no need to rely only on dairy products for that daily dose of calcium. Here’s why we should get enough calcium — and all the unexpected ways to get enough of it.

Beyond the Dairy Aisle  — The Need-to-Know

It’s no secret that calcium is vital for strong bones and teeth, but boy does it go beyond just that. This mineral also helps the body maintain healthy blood vessels, regulate blood pressure, and even prevent insulin resistance (which could lead to Type 2 diabetes)^[1]. Adults should consume about1,000 mg of calcium per day (which you can easily in 24 hours from one glass of skim milk, one thick slice of cheddar cheese, and one cup of plain yogurt), yet most Americans still fail to meet the mark. According to one survey, only 16 percent of females ages 20 to 29 females get enough calcium!!!^[2].

The main calcium contenders are milk, yogurt, and cheese, but dairy shouldn't be the only dietary pit stop to fill up on this nutrient. Leafy greens, seafood, legumes, and fruit also contain calcium and many foods and drinks are fortified with the mineral. Just remember to try and pair non-dairy sources of calcium with vitamin D: The body needs vitamin D to help absorb calcium!

Craving Calcium? — Your Action Plan

Here’s a list of foods and beverages filled with calcium (no cows required!), along with recipes to help make them an everyday occurrence in a variety of meals.

Natural Calcium

Most Americans aren’t get enough nutrients through natural foods alone, and rely on enriched foods and supplements too^[3]. So sail down the grocery aisle and stock up on these items, au natural!

1. Sardines: 321 mg (32% DV) in about 7 sardines fillets
There’s nothing fishy about sardines — they are one of the healthiest fish to munch on! Along with calcium, they also provide a hefty dose of omega 3’s and vitamin D. Try adding them to a Greek salad or eat em straight out of the can.

2. Canned Salmon: 232 mg (23% DV) in ½ can with bones (which provides the calcium!)
To avoid putting a dent in the wallet, canned salmon is a great way to go. Here’s the catch: It’s the bones in canned salmon that hold all the calcium, so they need to be mashed up right along with the salmon meat for all the benefits! But don’t get turned off just yet — the canning process softens the bones so they easily break apart and are unnoticeable when mixed in with the rest of the can’s contents. For a boost of calcium and omega 3’s, try these salmon cakes.

3. Kale: 188 mg (19% DV) in 2 cups raw (chopped)
This superfood is filled with calcium and antioxidants, and is perfect to use as the base of any salad when shredded into thin strips. A kale salad with apricots and avocado is a perfect summer dish.

4. Black-eyed Peas: 185 mg (18% DV) in 1/2 cup canned
I gotta feeling this is not just a band. These beans are filled with calcium, potassium, folate, and more! Skip the fat-filled mayo and whip up this black-eyed pea spread to pump up any sandwich or appetizer.

5. Blackstrap Molasses: 172 mg (17% DV) in 1 tablespoon
When the sweet tooth strikes, it’s best to go the natural route. Blackstrap molasses is darker in color and richer in flavor than regular molasses, and is filled with calcium, iron, and other vitamins. Plus, it’s a great sweet and flavorful addition to many dishes. Drizzle some on pancakes, or use it to make brown sugar.

6. White Beans: 191 mg (19% DV) in 1 cup canned
Creamy and light, these legumes are a great source of calcium and iron^[4]. Add them to a pasta dish with veggies, or skip the chickpeas and make your own hummus with white beans.

7. Seaweed: 126 mg (13% DV) in about 1 cup raw
Fish aren’t the only, well, fish in the sea. Seaweed is full of calcium, fiber, and iodine, which helps with proper thyroid function^[5][6]. Bring a bowl of risotto up a notch with this seaweed recipe. Feel like keeping it classic? Try your hand at a classic miso soup.

8. Dried Figs: 107 mg (10% DV) in 8 whole dried figs
For a sweet treat, this dried fruit packs an antioxidant, fiber, and calcium punch^[7]. Eat em as a mid-day snack, or turn these delicious dried fruits into a creamy jam.

9. Turnip Greens: 197 mg (20% DV) in 1 cup cooked (chopped)
This leafy green comes from turnip bulbs, and is filled with calcium, antioxidants, and folate, which could help improve mood. Sautee them as a side dish, or spice things up and make a turnip tart!

10. Sesame Seeds: 88 mg (9% DV) in 1 tablespoon
These unassuming seeds are more than just a hamburger bun decoration. Sesame seeds can help lower blood pressure, reduce inflammation, and may even fight against certain cancers. Use their nutty crunch in a salad, or add to this sautéed spinach dish.

11. Bok Choy: 74 mg (7% DV) in 1 cup
This versatile Chinese cabbage provides a hefty dose of vitamins A and C, along with calcium and fiber. Stir-fry bok choy with garlic and olive oil for a perfect side dish.

12. Almonds: 72 mg (7% DV) in ¼ cup dry roasted (about 20 nuts)
You’re nuts if you don’t grab a handful of almonds every now and then! They’re the most nutritionally dense nut, packing a crazy amounts of nutrients per calorie and ounce. Aside from calcium, they also contain potassium, vitamin E, and iron. Sprinkle on a salad or make your own almond butter. Just watch out for portion size!

13. Oranges: 65 mg (6% DV) in 1 medium fruit
Orange-you glad we included oranges?! Full of vitamin C and calcium, enjoy this fruit as a mid-morning snack, or use its citrus flavor to brighten up any dish, like these honey-orange carrots.

Fortified with Calcium

Fortifying foods with calcium has become a popular way to help people consume a balanced diet, but some studies do suggest eating foods with naturally occurring nutrients is the better route to take^[8][9][10]. So just make sure you’re not only reaching for the fortified kinds!

14. Firm Tofu: 861 mg (86% DV) in ½ cup
We know what you’re thinking: What exactly is tofu? This meaty textured vegetarian alternative is actually made of dried soybeans that have been grounded up and boiled. It’s a great way to add lots of protein, little fat, and (of course) calcium to any meal! What’s on the dinner table tonight? Try thiscaramelized tofu.

15. Orange Juice: 500 mg (50% DV) in 1 cup
In moderation, fruit juice is a perfect pairing for morning pancakes or eggs! Enjoy a tall glass for calcium and vitamin C, or pour over a salmon fillet.

16. Soymilk: 300 mg (30% DV) in 1 cup
Cows milk not your cup of tea? Soymilk isn’t actually milk, so is a great option for people who are lactose intolerant. It also contains more protein than regular milk. Pour in a morning bowl of cereal or add to coffee with some cinnamon.

17. Instant Oatmeal: 187 mg (19% DV) in 1 cup
Many cereals and grains are now fortified, including our favorite morning breakfast. And while the instant kind doesn’t boast the same benefits as old-fashioned rolled oats, they’re a quick breakfast option that’s full of fiber and calcium. Just choose the kinds without added sugar!

18. Cheerios: 114 mg (14% DV) in 1 cup
They’re touted for helping lower cholesterol, but Cheerios also pack a significant amount of calcium into our cereal bowl. Enjoy with skim or soy milk and sliced strawberries, or in home-made trail mixfor extra crunch.

Research vs. Media: Garlic, drugs, or cocoa for hypertension?

This is an accredited medical journal. Ramey Nutrition wants to know:
1. What is the difference between this article and a magazine article on "high blood pressure?"
2. Why do you think these are not more readily available?
3. Why does the same subject in a media format sell?
4. Would you want more unbiased information available?

One review of four trials that comprised nearly 9000 participants looked at how well antihypertensive drugs prevent cardiovascular events and death in people with mild hypertension, defined as systolic blood pressure of 140-159 mm Hg or diastolic pressure 90-99 mm Hg (or both). All participants were free of cardiovascular disease at baseline.

No effects were seen over four to five years, compared with placebo, for overall mortality (relative risk 0.85, 95% CI 0.63 to 1.15), coronary heart disease (1.12, 0.80 to 1.57), stroke (0.51, 0.24 to 1.08), or total cardiovascular events (0.97, 0.72 to 1.32). One in 10 people stopped taking antihypertensives because of adverse effects, a fivefold increase over placebo. The review did not report effects of drugs on blood pressure, if any.

Another review found two small trials that compared garlic powder with placebo in people with mild hypertension. Garlic might help reduce blood pressure—possibly by about 10 mm Hg for systolic blood pressure and a little less for diastolic blood pressure. However, the confidence intervals were wide, and no data were available on which to assess the potency of garlic to prevent cardiovascular events.

Cocoa is rich in flavanols, which cause blood vessel dilatation and are thought to reduce blood pressure. Most of the 20 trials (about 850 participants) tested a daily dose of 500-750 mg of flavanols ingested through chocolate or cocoa products. Most participants were healthy and normotensive at baseline, and most trials lasted only about a month.

Small reductions in blood pressure were seen with cocoa, compared with placebo: −2.77 (−4.72 to −0.82) mm Hg for systolic pressure and −2.20 (−3.46 to −0.93) mm Hg for diastolic blood pressure. One in 20 people allocated cocoa had adverse effects, compared with one in 100 of those receiving placebo. Gastrointestinal effects and a dislike of the product’s taste were the most common problems.

© 2012 BMJ Publishing Group Ltd.

Best wishes,
The Epocrates Team
1100 Park Place, #300
San Mateo, CA 94402

Realities of Bulimia: Between Life and Death Part 3

Realities of Bulimia: Between Life and Death Part 3

Realities of Bulimia: Between Life and Death Part 3
Eye opening reality of what Bulimia is truly like, when it takes someone's life.
Eating disorders are a very harsh reality of our culture and here at Ramey Nutrition, it is important that we are doing everything we can to bring awareness to this life threat, prevent all development of eating disorders that we are able to access, support those in treatment, and love them into recovery, supporting their recover(ed).
http://youtu.be/OybG3m92Rt8

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Alyssa's Recovery Journey Part 2: Family History

www.rameynutrition.com

Alyssa shares how her family history has influenced her treatment, recovery, and disease. Interview with her Ramey Nutrition Primary Eating Recovery Specialist, Shena Washburn, RD, CD.

Destination Recover(ed): Day 7

August 22, 2012

What I DON'T MISS about my eating disorder: I don't miss being on a first name basis with the ER and the entire telemetry floor at the hospital. I don't miss that look on the doctors and nurses faces when they recognize me because I've been in 15 or 20 times. It's been 9 months since my last hospitalization. Go Me!

What I am NOT GOING TO MISS about my eating disorder: Hearing that dang Kangaroo feeding pump beeping at a god awful hour every morning and the sound it makes all night long while it runs...