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Tides of Change Wellness Collaborative

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Tides of Change Wellness Collaborative

Tides of Change Wellness Collaborative is a medical practice that focuses on the restoration of your
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We are licensed in the state of New Jersey and offer in-person and virtual visits to our patients. We are board certified in family medicine and osteopathic neuromuscular medicine. Both physicians are trained through the Institute of Functional Medicine and The Arizona Institute of Integrative Medicine.

11/28/2022

Some herbs can be really helpful when it comes to improving sensitivity, and one of the best to potentially begin including in your diet is cinnamon! Multiple studies have shown a strong effect from this herb in aiding those struggling with blood sugar regulation as a whole. Cinnamon had wide variety of benefits that extend beyond this effect as well.

There are two main types of cinnamon:

Ceylon cinnamon: This type is also known as “true” cinnamon.
Cassia cinnamon: This is the most common variety today and what people generally refer to as “cinnamon.”

To the best of you ability you want to focus on Ceylon, because other forms may actually be toxic to the liver in large amounts, or in those with certain genetic predispositions.

For a little bit more perspective, on how cinnamon impacts insulin and blood sugar levels, check out this article from Healthline!

Article:

https://www.healthline.com/nutrition/cinnamon-and-diabetes

11/26/2022

We all know that sleep is critical to good health! This is no surprise. In fact, if there was one primary thing you could do for your health that would trump just about any other intervention (besides having a really healthy gut), it would be getting better sleep on a consistent basis!
This study below actually shows how just ONE NIGHT of negative sleep will have detrimental effects on insulin signaling and blood sugar regulation.

Now imagine this compounded over years or decades!

Sleep is a profound act of self care.

From the article:

“Partial sleep deprivation during only a single night induces insulin resistance in multiple metabolic pathways in healthy subjects. This physiological observation may be of relevance for variations in glucoregulation in patients with type 1 and type 2 diabetes.”

The study:
https://pubmed.ncbi.nlm.nih.gov/20371664/

11/24/2022

1. Meal timing
You might find yourself attending family dinners or gatherings at unusual hours over the Christmas season. Dinners on special occasions, for instance, can be served at 3 or 4. If your meal does not fit into your typical mealtime schedule, make sure you have a plan in place for how you will manage the situation. You might need to eat a snack at your regular mealtime if you use insulin injections or a blood sugar-lowering medication to avoid a low blood sugar reaction. Before the holidays, talk to your diabetes care provider so you can best prepare for how to handle mealtime adjustments during the season.

2. Engage in physical activity
Many people forget to move about over the holidays because food dominates the conversation. Maintain your usual level of physical activity. Start a new custom that involves moving around if you are spending the holidays with family and friends. Examples include going for walks after dinner, participating in active holiday activities, or turning up the music for a quick dance party.

3. Make a Snack Plan
You might attend a gathering over the holidays where you have to wait a little longer for the food to be served. Find out from the host when food will be served and whether there will be any wholesome appetizers to nibble on. Consider bringing a small snack for yourself (like a few pieces of low-fat cheese) or offer to bring a healthy appetizer to share, like a platter of raw vegetables and this calorie-free spinach yogurt dip, if you are aware in advance that the available options will be deep-fried and high in calories.

4. Show discretion
Holiday meals can feature a lot of traditional foods that are high in carbs. Mash potatoes, sweet potatoes, stuffing, dinner rolls, cranberry sauce, pumpkin pie, and various sweets are some examples of classic Christmas meals. Keep in mind that you are not required to taste anything that is provided. Concentrate on dishes that are "unique" or seasonal specialties. For instance, you might eat mashed potatoes and dinner rolls any time of year; by forgoing them, you might make place for your aunt's outstanding sweet potato casserole or a piece of pumpkin pie.

5. Consume Moderate Amounts
Foods based on carbohydrates are commonly served during holidays. Even though you can sample a few, managing your portions will help you better control your blood sugar. Use "Toby's Two Tablespoon Rule," which entails exploring every option, if you can't decide between one or two carbohydrates-rich things to eat (you can always ask the host what is going to be served). take two-tablespoon "samples" of your preferred foods. But bear in mind that these items can add up, even in tiny amounts. Keep in mind that you want to maintain blood glucose levels in the normal ranges by maintaining a similar daily total carbohydrate intake.

6. Remember to Eat Your Vegetables
The variety of vegetables is frequently constrained during the holidays. However, a few straightforward vegetable dishes may brighten the table with lovely colors (and nutrients). Bring a side of roasted or steamed veggies that have been seasoned with delectable herbs or spices, or a green salad. Choose non-starchy veggies that are low in calories and carbohydrates, such as spinach, broccoli, or cauliflower, if you decide to bring a vegetable dish. As a result, it will be simpler for you to eat less servings of the other high-calorie, high-carb, and high-fat meals that are being served.

11/22/2022

If you have “tried everything” when it comes to improving your health and nothing has worked, or you just feel like a skilled practitioner can help you get where you need to go, consider reaching out to us.

We are highly skilled physicians, with a passion for healing.

We would love to help you! At Tides of Change we are always pursuing the edge and forefront of smart, sensible, holistic medicine. We are interested in whole person changes, as well as getting you feeling vital and robust. Reach out for a health assessment call to see if we are good fit.

Go here! https://go.tocwc.com/health-assessment

11/20/2022

One of the easiest steps we can take to lower insulin resistance is to begin to lower our overall carbohydrate load, and this is especially true for breakfast. What we have in the morning often sets a metabolic tone for the day. If you start your morning with a large dosage of sugar, then your blood sugar remains “wilder” throughout the day. We also know that for many people breaking away from cereal or oatmeal can be tough. Here is an excellent and tasty oatmeal/cereal recipe that is totally low-carb!

11/18/2022

Although this often gets less “press”, when it comes to insulin resistance and sensitivity, stress, and especially excessive cortisol production, is actually a primary driver for many people with this type of metabolic dysregulation. Addressing high blood sugar, blood sugar crashes, and or diabetes is not just about carbohydrates, and exercise, but the rest of the hormonal environment!

The adrenal gland secretes the steroid hormone cortisol. It increases the liver's ability to produce glucose and makes fat and muscle cells more resistant to the effects of insulin. In normal circumstances, cortisol balances insulin's effects. Cortisol levels rise during stressful situations or if synthetic cortisol is administered as a drug (as with prednisone therapy or cortisone injection).
The powerful insulin-antagonistic hormone cortisol suppresses insulin production, increases glucagon secretion, and messes with insulin signaling. Cortisol decreases the synthesis of GLP-1, which in turn lowers insulin secretion and slows the release of insulin.

What this means is that the body creates more blood sugar directly in the liver (without having to eat it), in order to prepare the body to deal with stress, and at the same time, our insulin signaling goes haywire! Not a great combination. So learning to keep cortisol levels low is vital to keeping blood sugar regulated!

11/16/2022

Although insulin sensitivity has genetic components, there is so much you can do to improve it! Here are a few strategies to assist you.

Exercise: It is well established that acute exercise is associated with substantial improvement in insulin sensitivity. A single bout of moderate intensity exercise can increase the glucose uptake by at least 40%.

Low Carb: Low-carbohydrate diets can and frequently do enhance insulin sensitivity, in part because they are frequently the simplest method to lose weight. However, your peripheral tissues enter an insulin-resistant condition when you go very low carb, low enough to start relying mostly on ketones and free fatty acids for energy, in order to preserve glucose for the regions of the brain that need it. This is natural, and as long as you don't try to eat a high-fat, high-carb diet, there shouldn't be any negative effects from physiological insulin resistance.

Train Fasted: Any type of exercise improves insulin sensitivity, but exercising when fasted intensifies this impact. Even in the presence of a typically obesogenic high-fat, high-carb diet, one study demonstrated that relatively high-intensity "cardio" conducted while fasting improved individuals' insulin sensitivity more than the group who performed the same training after a carb meal.

Get More Magnesium: Numerous physiological processes, including many that deal with insulin sensitivity and glucose uptake, include magnesium. Leafy greens like spinach, almonds, seeds, dark chocolate, and halibut are some of my preferred sources. If you detest spinach, nuts, salmon, chocolate, and other foods high in magnesium, oral magnesium supplementation also performs admirably.

Meditate: Perhaps the sympathetic nervous system's "flight or flight" stress circuit has quieted down. Perhaps fleeting glimpses of bodhi lessen the quantity of insulin needed to process glucose. Meditation raises insulin sensitivity, whatever else is going on. It's never given me any success.

11/14/2022

Today is World Diabetes Day.

In 2007 General Assembly adopted a resolution designating 14 November as World Diabetes Day. The spirit of the designation is “the urgent need to pursue multilateral efforts to promote and improve human health, and provide access to treatment and health-care education.”

To mark World Diabetes Day 2022 under the theme “education to protect tomorrow,” the International Diabetes Federation has launched a global survey to explore the levels of access that healthcare professionals and people living with diabetes have to diabetes education.

To learn more about this all important topic and the deeper meaning behind this day, go here:

https://worlddiabetesday.org/

11/11/2022

It seems that a place where people struggle to reduce their carbohydrate cravings and/or intake is around the thought of giving up their “dessert”, and foods of a more decadent nature. Well, the key for some people, especially during transitional periods is simply to create “replacements”, that easily scratch the itch that they have for these types of foods.

Here is a delicious and healthy chocolate pudding recipe that is also low in carbs and great for you!

Because this recipe is full of collagen, it will be great for your liver, joints, hair, and skin, while also feeding the “sweet tooth”. Enjoy!

1 cup + 2 Tbsp. full-fat coconut milk (substitute milk of choice)

1/4 cup + 2 Tbsp. cocoa powder

2 scoops Chocolate Flavored Collagen

1 Tbsp. maple syrup (optional, or your favorite sweetener to taste)

1 tsp. vanilla extract

dash of salt

chopped chocolate & fresh mint leaves, to garnish (optional)

Heat ½ cup of coconut milk in a small saucepan.

Once the coconut milk is warmed, sprinkle the chocolate-flavored collagen over the coconut milk. Remove the pan from the heat and allow the mixture to rest for 1-2 minutes.

Whisk the collagen and coconut milk together. Add the vanilla extract.

Sift the cocoa powder into the pan, stirring as you go.

Pour the mixture into a blender along with a dash of salt, the remaining coconut milk, and the maple syrup. Blend until smooth.

To make a mousse-like dessert: Pour the mixture into three individual serving ramekins. Place the ramekins in the refrigerator to set for three hours.

To make the pudding: Pour the entire mixture into a pyrex dish and place in the refrigerator for three hours. Before serving, gently stir the mixture with a spoon until it becomes the consistency of pudding, then pour it into ramekins or serving glasses.

Either way, garnish the final product with chopped dark chocolate and a sprig of mint.

11/09/2022

In many ways, diabetes and insulin resistance are a form of accelerated aging, that simultaneously promotes more oxidative stress, and yet at the same time, reduces the amount of energy you have access to.

In fact the similarities between aging and insulin resistance can be most readily seen in the brain. Modern research has begun to hypothesize that some of the most common forms of dementia, may actually be “type 2 diabetes”!

Different mechanisms have been proposed, but one possible explanation may actually be the loss of the brain's ability to utilize glucose, thus starving brain cells of the needed energy required to survive. This progressive loss of insulin sensitivity in the brain effectively begins to “kill off”, cells as they die of hunger.

This article from Mayo clinic actually describes elements of this phenomenon.

"What it refers [to] is that their brain's insulin utilization or signaling is not functioning. Their risk of developing Alzheimer’s disease is about 10 to 15 times higher." - Dennis Douda

Article:
https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-minute-is-alzheimers-type-3-diabetes/

11/07/2022

So we have established that diabetes is prolonged and protracted insulin resistance. We all know that diabetes is a disease, but the bigger question is why is insulin resistance a problem?

Well for starters blood sugar and insulin when in excess are extremely pro-aging and pro-inflammatory compounds. They speed up nearly every known process involved with chronic disease and the baseline damage we take just being alive.

So, to offer some clarity, some of the effects of high insulin and high blood sugar are:

Increased risk of heart diseases
Increased risk of nearly all cancers
Drastically risk of dementia
Increased oxidative stress
Reduced Intracellular antioxidants
Decreased resilience to stress
In males, they tend to reduce testosterone levels
In females, they tend to cause excessive testosterone levels
Energy problems
Easily gain weight
More mood swings

And really, much more...

Nearly every known chronic disease worsens in the face of insulin resistance.

11/06/2022

So, let us talk a little bit about how insulin resistance actually occurs. To do that, there is an important concept to understand, and that is that insulin resistance in many ways exists inside of a spectrum, with the opposite pole being insulin sensitivity. The more insulin sensitive you are, the less resistant you are, and vice versa. So, a high degree of insulin sensitivity is the best protection against diabetes and metabolic syndrome. The challenge here is that many different things both internal and external, impact your degree of insulin sensitivity.

We can talk about one of the most central one’s a bit as it does the best job of describing the dynamics at play. Up until now, we have not mentioned insulin's primary job, which is to act as a “storage hormone”. This is especially true for glucose! When you eat, your body produces insulin to signal the cells nourishment is coming in, and through direct receptor actions, it asks the cell in question to “absorb” nutrients in the bloodstream. Insulin’s most popular action in this regard is to take sugar out of the blood and allow it into cells to feed the process of energy generation.

This is highly evident with sugar because carbohydrates trigger some of the strongest insulin responses we know of, though sugar alone is not singular in this action...food in general (with some more than others), creates this response. Sugar and carbohydrates in general lead the pack of insulin-spiking foods. What this means is that when you eat a meal with large amounts of sugar/carbohydrates, the body must produce large amounts of insulin in order to drive all that sugar out of the blood (where it creates significant damage in excess), and into cells.

Food effect on insulin resistance occurs when the body experiences elevated blood sugar levels for too long, leading the body’s receptors to “desensitize”. This occurs in stages, as the body just keeps producing more insulin to get the “door to open”. Eventually, the body simply cannot keep this process going, and diabetes results, which is just another word for severe and prolonged insulin resistance.

11/04/2022

As we have mentioned a few times now, diabetes IS insulin resistance; but what exactly is insulin resistance? Before we can explain that, it is useful to understand that for many substances in the body, the receptor sites that their molecules attach to are just as, if not more, important than the actual substances themselves. That’s right...if you can produce a substance, but it cannot “attach” to its receptor, or elicit the needed action at the receptor site, then the impact of the substance is nil.

You see, although the body can produce a substance like insulin in the pancreas, the cells influenced by insulin have “insulin receptors”, waiting for the molecule to come along and trigger insulin’s action cascade. It is much like sticking the right key inside the right door.

This is where insulin resistance comes into play. For a wide variety of reasons that include genetics, nutrition, exercise, stress levels, and other hormones, insulin resistance happens when insulin receptors become unresponsive to insulin's action.

Generally, this occurs because insulin has remained too high for too long and thus blunting the sensitivity of the receptors. In the next post, we will talk more about how this happens.

11/02/2022

Before we move further into the causes, and conditions that surround insulin resistance and its more severe expression, known as diabetes, it would be useful to make a clear distinction between the two different types of diabetes that exist.

This is important to clear up confusion, as well as to illuminate some of the underlying mechanisms by which insulin resistance occurs.
Type 1 Diabetes, sometimes referred to as “Juvenile Onset Diabetes” or insulin-dependent diabetes for its tendency to occur in early childhood, is not the same as insulin resistance, though both actually have a similar underlying mechanism of action: the inability for insulin to do it’s all important job.

The pancreas is a small, jelly-like organ that sits behind the stomach, and it is the primary producer of insulin in the human body.

Inside the pancreas insulin is produced by “beta cells”, and if these cells cannot function properly, the body has difficulty creating insulin. Well, in the case of type 1 diabetes, the most common cause is some unknown variable that directs the body's immune system to attack and destroy the body's beta cells. This leaves the body with little to no insulin-producing capacity, and thus creates a lifelong insulin deficiency.

There is little besides supplying external insulin which can be done for conditions. Lifestyle variables will actually matter to the degree that they decrease or increase the body's need for external insulin.

Type two diabetes is different because it is not that the body cannot produce insulin, but that the body stops responding to the insulin it does have. The way this happens is something we will explain in the next post.

11/01/2022

This month at Tides of Change, we will be exploring one of the most critical health crises facing much of the modern world today, and that is a cluster of diseases that revolve around insulin, blood sugar, and metabolic syndrome… otherwise known as diabetes and/or insulin resistance.

This overall set of conditions is perhaps one of the most common causes of many other health challenges that we face. In many ways, we could say that gut health, excessive stress, and insulin resistance are some of the main drivers of chronic disease. They are of course interrelated as well, but can also be easily pinpointed as discreet forces working against human well-being.

Type two diabetes, the most common type, and the one most strongly influenced by lifestyle factors is really a severe form of insulin resistance. Insulin resistance makes cancer, heart disease, arthritis, insomnia, and mental health conditions more likely by magnitudes.

So this month we are going to explore what diabetes and insulin resistance are, how they occur, what can be done about them, and their connection to gut health.

10/28/2022

Anxiety and stress are prevalent. You might want to get on your mat and try yoga if they're controlling you. Yoga is a mind-body exercise consisting of controlled breathing, physical positions, and relaxation or meditation. Yoga may assist in lowering stress levels, blood pressure, and heart rate. Almost anyone can engage with some version of yoga. One of the many alternative and integrative medicine modalities is yoga. Yoga combines mental and physical practices that could aid in achieving body and mind harmony.
Studies support the use of yoga as an effective adjuvant therapy for patients with anxiety disorders have mushroomed in recent years. Everyone has experienced anxiety at some point.
Anxiety is a normal reaction to stressful events, and it can help us react effectively when we are in danger. It can range from slight nerves to outright panic. However, for persons with an anxiety condition, these emotions are a disruptive and overwhelming force rather than a rational reaction to the outside world.

People in this circumstance can benefit from yoga therapy because it doesn't require them to utilize logic to overcome their worry. Instead, students are provided with tools that enable them to identify the thoughts, feelings, and behaviors that contribute to increased anxiety and to implement efficient self-soothing techniques. They are also unintentionally developing stress resistance while taking a yoga session and learning to control their stress reaction.

A typical yoga class may offer comfort to someone who experiences mild or subclinical anxiety. However, for people with more severe anxiety, a specialized yoga therapy program (delivered by highly-trained yoga practitioners who are familiar with the physiological and psychological underpinnings of anxiety disorders) may be more suitable.

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10/26/2022

While in some instances drugs may be used for treating anxiety disorders, there are actually many different compounds that can be helpful for managing symptoms and even lead to resolution. Of course, whenever taking supplements to address something specific, it is always best to check in with a qualified medical health care practitioner. That said, these are some supplements that you may be able to bring to their attention. And of course, as physicians, we can absolutely help you in this regard ourselves!
-Taurine plays crucial roles in the heart and brain. It supports the formation of new nerves. By bringing down blood pressure and soothing the neurological system, it might also help those with heart failure.

-Since ancient Greece and Rome, valerian has been utilized medicinally. The herb valerian is used to relieve cramps in the stomach, sleeplessness, and migraines. Today, valerian is recommended for headaches, premenstrual syndrome (PMS), anxiety, sadness, and sleeplessness.

- Skullcap has been used for more than 200 years as a moderate sedative and a treatment for convulsions, anxiety, and nervous tension. American skullcap has been shown to have strong antioxidant properties and may offer some protection against neurological illnesses like Alzheimer's disease, Parkinson's disease, anxiety, and depression.

-Magnesium supports muscle and neuron function as well as energy synthesis in the body, among other vital functions. The nervous system is also profoundly calmed by it. Chronically low levels can raise the risk of heart disease, type 2 diabetes, high blood pressure, and osteoporosis.

Supplements containing 5-HTP assist the brain's serotonin levels to rise. Serotonin plays a role in mood and behavior regulation, therefore 5-HTP might aid with sleep, mood, anxiety, appetite, and pain perception. Even while tryptophan is present in the foods we eat, 5-HTP is not.

-As a neurotransmitter, glycine affects cognition, emotion, appetite and digestion, immunological function, pain perception, and sleep by both stimulating and inhibiting brain and central nervous system cells.

10/24/2022

Yes, of-course there is a link between gut health and anxiety disorders! At this point, it appears that gut health plays a role in the majority of psychiatric disorders, and that in general that is the rule, and not the exception.

Once again, it appears that at least in part, some of how this occurs is through the gut microbiome.
From the paper in BMJ:

“Increasingly, research has indicated that gut microbiota – the trillions of microorganisms in the gut which perform important functions in the immune system and metabolism by providing essential inflammatory mediators, nutrients and vitamins – can help regulate brain function through something called the “gut-brain axis.
Recent research also suggests that mental disorders could be treated by regulating the intestinal microbiota, but there is no specific evidence to support this.

Therefore a team of researchers from the Shanghai Mental Health Center at Shanghai Jiao Tong University School of Medicine, set out to investigate if there was evidence to support improvement of anxiety symptoms by regulating intestinal microbiota.”

And this effect is simply from regulating the microbiome, which barely scratches the surface of what can be done for gut health. Here at Tides of Change we have a broad, and nuanced view of the gut, and help your guts heal on a multitude of levels.

The paper can be found here: https://www.bmj.com/company/newsroom/anxiety-might-be-alleviated-by-regulating-gut-bacteria/

10/23/2022

The next mental health challenge we would like to explore this month is anxiety. The numbers are actually quite glaring. Just about 20% of the population has a definable “anxiety disorder”, which means that it is disruptive enough to be consistently noticeable. In some cases, anxiety can be crippling and even significantly reduce someone's quality of life.

The American Psychiatric Association has this to say:

“Anxiety is a normal reaction to stress and can be beneficial in some situations. It can alert us to dangers and help us prepare and pay attention. Anxiety disorders differ from normal feelings of nervousness or anxiousness and involve excessive fear or anxiety. Anxiety disorders are the most common of mental disorders and affect nearly 30% of adults at some point in their lives. But anxiety disorders are treatable and a number of effective treatments are available. Treatment helps most people lead normal productive lives.”

Even though drugs are often used to treat anxiety disorders, in some situations, it is possible to feel more at ease, possess more calm, and learn to relax with other methods as well. There are foods, supplements, osteopathic treatments, exercise modalities, and breathing strategies that can all significantly help.

Address

1423 Tilton Road
Northfield, NJ
08225

Opening Hours

Monday	9am - 4:30pm
Tuesday	9am - 4:30pm
Wednesday	9am - 4:30pm
Thursday	9am - 4:30pm

Website

http://www.tocwc.com/

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What are your tricks to wind down at night? We use @philipshue lighting setup to automatically change to dark orange then red lighting throughout the house. The visual change serves as a visual reminder to wind down. This works really well for young children. When the light changes, it’s an easy visual reminder to changes modes. When the red light is on, screens turn off and it’s “quiet time”. We read books, clean up the house and drink some warm tea. This wind down routine leads to a more consistent bedtime which is important for sleep hygiene. When we go up to bed, we keep it simple - wash face and brush teeth, toilet, pajamas, story and sleep. Routines built into your day simplify the steps your brain needs to take and is an easy prompt for your brain to switch modes for sleep. Finish your routine with deep breathing with lights out to activate your vagal response. What does your nighttime routine look like? #TOCWC #healthandwellnessgoals #healthandwellnessadvocate #functionalmedicinepractitioner #naturalhealthandwellness #improvehealth #preventativecare #sleephealth #takecontrolofyourhealth #healthysleep #healthwellness #diseaseprevention #integrativehealth #happyhealthylife #wellnesslife #healyourbody #takecareofyourbody #optimalhealth #betterhealth #integrativemedicine #wellnessadvocate #healthyyou #wellnesslifestyle #healthgoals #healthyandhappy #healthytips #livehealthy #wellnessjourney #healthandwellness #healthyliving

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The only way to implement change is to set goals and track them. We’ve been on a search to make tracking the metrics faster and easier for our patients and are so excited to partner with @heads_up_health to offer this to our members! Incorporate your metrics from you apple health, @ouraring, @biostrap, @ketomojo and more right into your personalized account. Let us add your metrics from your labs and initiate your health changes and watch the numbers change! We’re here to get you started at our new office location, and are accepting new patients, today! #tocwc #functionalmedicinedoctor #functionalmedicine #northfieldnj #margatenj #oceancitynj #osteopathicmedicine #omt #wellness #wellnessjourney

We’re happy to announce that we will son be seeing you in person! Though we will continue to offer virtual visits for our patients, we will also be opening a location in Northfield, NJ! We are currently getting the space ready, so be on the lookout for more information over the next week. Follow us @tidesofchangewc #tocwc #northfieldnj #functionalmedicine #functionalmedicinedoctor #osteopathicmedicine #osteopathy #integrativemedicine #wellness #tidesofchange #breastfeedingmedicine