The Epidemic of Perfectionism

The Epidemic of Perfectionism

We have an epidemic of perfectionism: unrealistic expectations, standards and pressures. It is taking a toll on our relationships, our physical and emotional health, our families, our work and school performance.

And it is hiding right before our eyes – masked as a strong work ethic, high standards, attention to feeding and moving well, and a meticulous attention to detail that is the envy of so many. It also shows up as procrastination, avoiding, and not starting things that would further our health, our careers and our relationships.

As a result, exhaustion, loneliness, worry, fear of failure, constantly stressing about what other people think, poor body image, and ‘never enough’ beliefs haunt way too many people as they numb from feelings of not ____ enough.

The culprit?

The protector of Perfectionism.

It is a contagion that takes the desire to strive for excellence and distorts it into fearing mistakes, flaws, disappointments, and failure.

Leading from perfectionism is connected to anxiety, shame, procrastination, not asking for help, avoiding failure at all costs, and feeling exhausted from trying to please everyone.

And the tricky thing is that perfectionism is often celebrated, envied, and admired. It is seductive and can sneak up on all of us.

Brené Brown , PhD, LMSW and author of many books including her bestselling, The Gifts of Imperfection: Let Go of Who You Think You’re Supposed to Be and Embrace Who You Are, resonated with millions. She wrote about her research and life experiences that so many of us could relate to and shifted our global conversation on this powerful protector.

Here are some wisdom nuggets from Brené on the topic of perfectionism:

  • In the research there’s a significant difference between perfectionism and healthy striving or striving for excellence.
  • Perfectionism is the belief that if we do things perfectly and look perfect, we can minimize or avoid the pain of blame, judgment, and shame.
  • Perfectionism is a twenty-ton shield that we lug around, thinking it will protect us, when in fact it’s the thing that’s really preventing us from being seen.
  • Perfectionism is also very different than self-improvement. Perfectionism is, at its core, about trying to earn approval.
  • Most perfectionists grew up being praised for achievement and performance (grades, manners, rule following, people pleasing, appearance, sports).
  • Somewhere along the way, perfectionists adopted this dangerous and debilitating belief system: “I am what I accomplish and how well I accomplish it. Please. Perform. Perfect.”
  • Healthy striving is self- focused: How can I improve? Perfectionism is other-focused: What will they think? Perfectionism is a hustle.
  • Perfectionism is not the key to success. In fact, research shows that perfectionism hampers achievement. Perfectionism is correlated with depression, anxiety, addiction, and life paralysis or missed opportunities.
  • The fear of failing, making mistakes, not meeting people’s expectations, and being criticized keeps us outside of the arena where healthy competition and striving unfolds.
  • Shame loves perfectionists – it is so easy to keep us quiet

So how do you respond when your inner perfectionist is wanting to lead your life?

Develop a practice to Wholehearted Living. Brené identified 10 guideposts to wholehearted living as a way to move away from perfectionism and move towards a more authentic and grounded life.

Attend Our Upcoming (re) Define Perfection Workshop

I am thrilled to be offering (re) Define Perfection: Choosing Flexibility Over Rigidity workshop on Friday, March 29th, 2019 at Potentia’s workshop space where we will be working through each guidepost and developing our own personalized plan to respond to how perfectionism shows up in our life.

This experiential workshop will offering space to reflect, create, and cultivate more confidence in face of the fears of perfectionism. I will also be integrated Internal Family Systems principles to add to your wholehearted living practices.

Gourmet food, creative supplies, and presents will be offering to all – along with awesome community and connection.

Space is limited so please read more and register here. We have a three month payment plan and a buy one bring a friend for half off offer available, too.

Sign Up For Our Online (re) Define Perfection Experience

And if you are not in San Diego, click here to be notified when we will be launching an online (re) Define Perfection experience.

Take This Free Assessment To Learn More

Curious how perfectionism impacts you? Take this assessment to learn more and consider joining us at our workshop next week to help combat the negative effects of perfectionism.

Email me your results and reflections – I would love to hear how your results impact you.

With gratitude –

Rebecca Ching, LMFT, Founder + CEO – Potentia Therapy, Inc.

To learn more about how Potentia could help you with Perfection + Shame struggles, please see here.

Our Potentia team is here to help. Learn more about our clinical team and what we have to offer here.

What is Internal Family Systems and Why You Need to Learn More About It Stat

What is Internal Family Systems | Potentia Therapy Inc


Instead of trying to get rid of the part of you causing you so much pain, harm and distress – befriend it and acknowledge it has a purpose. Then get to know that purpose with curiosity and compassion.

Wait, what?

Flashback to 10 years ago when I was sitting in a large auditorium filled with several hundred other therapists listening to another keynote lecture – at the annual iaedp conference. This is not how the majority of the people I know would find as a fun way to spend time, but I am a consummate learner and a raging extrovert – so I was in nerd heaven.

As I was taking in all the wisdom from Richard Schwartz, PhD, I was scribbling notes at a fast pace and my head was bobbing up and and down as I resonated with so much of what he was saying. He was trained in a systems theory approach that I had also studied from the beginning of my clinical career and so it was easy to connect to what he was saying.

He shared how he discovered IFS in his work, with bulimic clients and how he truly began to listen to his clients. But then I took a pause when he shared the mindset shift he had around how he viewed problematic behaviors.

Instead of pathologizing, labelling, trying to get rid of behaviors, Dick was instead asking me and the rest of the attendees to start to:

  • Separate the person from the symptom
  • Pause and witness these protective parts with compassion and curiosity
  • Get to know the fears and concerns of these protective parts that often end up doing harm
  • Learn with my clients the real story behind the symptoms
  • Get to know our own relationship with our own various inner thoughts and emotions – as this impacts how we show up with our clients

I exhaled.

Who does not want to be approached and interacted with in this way?

At the time of hearing Dick’s talk, I was early in my clinical career and everything I had been taught was how to drill down on the problem behaviors and beliefs and change them – if not eradicate them. The “problematic behavior’ was the enemy and we needed to bid farewell to all of them as soon as possible. Change the narratives. Push through resistance.

While listening to Dick, something clicked for me. It made so much sense to approach these behaviors as protective instead of resistance – which felt so judgemental anyway – and instead of focussing on an agenda, truly listening to them with compassion and curiosity. I was determined to help my clients do the same with their inner system. IFS felt more congruent, more aligned with what I new about connection, sustained, healing, and change. It felt way more respectful.

No more goodbye letters to eating disorders. No more shaming and pathologizing behaviors that were just coming from protective places. No more blaming clients – or anyone else, for that matter – for not working hard enough or having too much resistance. No more over-functioning and burnout for helping professionals. No more buying into fear or scarcity and the false truth promises of quick fixes.

And now yes to the sustained change through compassion and courageous work. Yes to more curiosity. Yes to the vulnerability taking the time to do healing different than we have been originally taught. And yes to more peace, more freedom, more confidence.

Love up the part of you that is causing you so much pain.

The Lens of IFS

IFS sees the inner world of a person divided into three parts:

  1. Protectors (managers and self-soothers or fire fighters)
  2. Exiles (younger parts that hold the burdens of our pain, shame, despair)
  3. Self (the space within all of us that has the capacity to heal our inner world)

Self has these incredible qualities: Courage, Compassion, Connectedness, Creativity, Confidence, Calm, Clarity and Curiosity.

You can read in great detail about this model, Internal Family Systems, where Richard Schwartz outlines at length the beauty of this lens and how it can be a catalyst for much needed healing in our homes, schools, churches, businesses, and communities.

“The IFS model offers specific steps toward a more control over impulsive or automatic reactions. It can transform your inner critical voice into a supportive one and can help you unload feelings of worthlessness. It is capable of helping you not only turn down the noise in your mind but also create an inner atmosphere of light and peace, bringing more confidence, clarity, and creativity into your relationships.”


Dick Schwartz, PhD, from the book Introduction to the Internal Family Systems Model

Let me be clear on a few things:

  • There are many ways to heal. My colleagues at Potentia and myself are passionate about mind/body and trauma-informed approaches that take into account the whole person: mind, body, soul. Find the best approach that makes sense for you and your core values and your present needs.
  • There is no such thing as a quick fix. It deeply saddens and, at times, infuriates parts of me when people are selling quick fixes to nuanced and complex struggles. Showing up day in and day out and doing the work to feel through pain, fear, uncertainty versus just think it through is where the sacred shift to healing happens.
  • Healing looks different for everyone.
  • Perfection and shame often push people to feel like they are failing in their healing journey

With gratitude –

Rebecca Ching, LMFT, Founder + CEO – Potentia Therapy, Inc.


To learn more about Potentia’s Internal Family Systems services, please see here.

Our Potentia team is here to help. Learn more about our experience and what we have to offer here.

2017 in Review: Looking back and looking forward

2017 in Review: Looking back and looking forward

As 2017 winds down and you are in the in between space of Christmas and New Year’s, this is a great time to reflect, plan, and dream.

Making time to do this end-of-the-year ritual is a worthy practice to work into this time of year. We updated our download Looking Forward:Looking Back  for you – which is a fun tool to help you reflect on what worked in 2017, what did not, and what you want to focus on in 2018. Click on the link, download and print. Pen to paper is its own special kind of therapy.

This ritual is a powerful way to see the fruits of your hard work and make time to celebrate victories. Sometimes this ritual can feel overwhelming, especially when you feel like the previous year holds disappointments or the overwhelm of all you want to change in the new year feels daunting and out of reach.

So:

  • for those who feel the pressure of the oh so seductive marketing promises of quick results that will give you the desired changes you seek – unplug and get extremely selective about which voices are speaking to your worth.
  • for those who want to do all the things now and are feeling impatient waiting for circumstances to change – keep showing up and moving towards your goals one step at a time.
  • for those who want to forget the past all together – look back and rumble with your story so it no longer owns you but instead informs you.
  • for those who are experiencing the waves of grief and loss that have led to seismic shifts in doing life – just keep breathing. That is your only job right now. You will know when it is time to do more.
  • for those who think everyone else has it all together and no one else struggles – everyone struggles. Some are just better at hiding it than others.
  • for those who are ashamed about about  anxiety, depression, trauma, obsessive thoughts and behaviors, loneliness, experienced betrayal – we stand with you and speak a different message than shame: you are seen, you are valued and you belong here.

Cheers to good health – mind, body, and soul in 2018 and beyond.

With gratitude –

Rebecca

Potentia Spotlight: Chris Cessna, LMFT, MFC

Potentia Spotlight: Chris Cessna, LMFT, MFC

Potentia Spotlight: Chris Cessna, LMFT, MFC

Working with Chris and getting to know his heart and passion for helping people live more connected and meaningful lives is truly inspiring. In a world where cynicism runs rampant, Chris is a breathe of fresh air with his integrity around this profession, work ethic, and passion for always learning + growing. Chris’s clients and colleagues are better people because we know him and our profession is better because he is in it. I am excited for you all to get to know Chris a bit better today.  – Rebecca

Where are you from?

I’m originally from small town Central Illinois, a town of 650 people called Potomac.  

Why did you become a therapist?

That’s a long story!  Throughout college and after moving to San Diego, I always had this vague desire to “help people”, but I had no specific direction or vision for that.  After working for several nonprofit organizations where my caseload was enormous (as high as 115 clients) and I felt like I wasn’t having the depth of impact I’d hoped for, I began looking into options that would allow me to really dig deep into people’s stories and offer the opportunity for healing, hope, and real change.  That led me towards pursuing a career as a therapist.

What is your philosophy to healing?

I believe people have the best opportunity to grow when they can experience a felt sense of safety. Through providing a safe emotional space for people to engage with the reality of their struggle, they can begin to pay attention to their story in a different way, make sense of the ways they have tried to cope in the past, and find freedom from the shame and pain that has kept them stuck. Understanding how our brains and bodies respond to threat and trauma, we can literally change the functioning of our brains and live a wholehearted, integrated life.  

How do you define self care?

Paying attention to what we need to be at our best, and taking steps (sometimes small, imperfect, and inconsistent steps) towards those things.  When we attune to the things that are important for our minds, bodies, and relationships, we are not being selfish.  We are giving ourselves and those around us more than we possibly could when we are exhausted, frustrated, and burned out.  

Why do you think so many people are uncomfortable asking for help?

We are constantly bombarded with messages that tell us we are not enough. Very often when we feel like there is an issue that needs to be addressed, those messages are amplified.  We hear in our minds what we imagine others would think – our families, our friends, and our faith communities.  It is so easy to get stuck in inaction because we think we should be “stronger”, able to “move on”, or that if we only had “more faith”, it wouldn’t be a problem.  Yet until we are able to look honestly at what is going on in our lives, we aren’t able to move through it or beyond it.  

What is your go-to self care ‘tool’ or ‘practice’?

My preferred self-care includes long hikes out in nature and laid back time with friends.  The reality of a busy life doesn’t frequently allow for this, so self-care typically involves time alone in silence and reflection.  Being still, listening to music, and creating space to breathe without an agenda or a to do list.  

What do you do for fun?

See above!   I love hiking, especially getting out for multi day backpacking trips in the Sierra.  I have three young children that provide a lot of laughs and entertainment.  

What are your favourite books?

This one is hard to narrow down for me, but The Body Keeps the Score by Bessel van der Kolk is at the top of the list.  It addresses the impact of traumatic experiences in a way that is helpful for therapists and for people who are dealing with the aftermath of trauma.  

Others include The Developing Mind by Dan Siegel, The Science of the Art of Psychotherapy by Alan Schore, and Daring Greatly by Brene Brown.   There are so many more!

What is your favourite book to recommend?

There are so many, but the one that I seem to recommend most is Daring Greatly by Brene Brown. It is such an accessible and relevant book for anyone, and the way she communicates about shame and vulnerability seems to have an impact on everyone who engages with it.  

The Whole Brain Child by Dan Siegel is the book I most often recommend to anyone hoping to address issues in parenting.   

What is your favourite quote or mantra –  and why?

“Faith does not need to push the river because faith is able to trust that there is a river. The river is flowing. We are in it.”  – Richard Rohr

This is a reminder that faith is about trust, not about striving, working, or putting together a perfect formula.  

“We can’t selectively numb emotion.  Numb the dark, and you numb the light.”  – Brene Brown

I see this play out in my work daily.  Trying to numb our pain inevitably leads us to an inability to experience joy, happiness, and connection.  

What is your favourite meal to cook?

I love making pulled pork on my smoker.  It is a 12-16 hour process that is a lot of fun for me and results in absolutely delicious food.  

Email Chris.

Call Chris at 619.819.0283 ext 2

Potentia Spotlight: Megan Hellner, DrPH, MPH, RD

Potentia Spotlight: Megan Hellner, DrPH, MPH, RD

Potentia Spotlight: Megan Hellner, DrPH, MPH, RD

This is a new series which will feature many of the incredible clinicians at Potentia. I am thrilled to have Megan Hellner kick off this series as we have been working together for over a decade. She was all in when I shared with her a vision to have our services under the same roof so we can best support our clients and their families. Her training, passion, and standards of care make her one-of-a kind in this city. Her passion to work hard, play hard and contribute to her field  – along with her awesome sense of humor and love of animals – make her a joy to work with at Potentia.” – Rebecca 

Where are you from?

Born in Corvallis, Oregon, though I come from a large family of proud Aussies.

Why did you become a clinician and researcher?

I’ve always been very curious, and I have a deep appreciation for science and the scientific method. I’m always searching for the truth (sound answers and explanations) and evidence.  If I were to work solely as a researcher, I’d miss that human interaction that I have in working with patients/clients, and I also love to teach. I believe I was born to be in the role of helping others navigate the complex and noisy world of nutrition and disease prevention.

What is your philosophy to healing?

In my world, it’s ‘food first’, meaning supplements are just that (merely supplemental to a sound quality of diet).

What does health mean to you?

I’m in the position of thinking of health as a ‘big picture’ construct, and I favor thinking of how our choices today influence our health 5 years out….10 years out (versus living solely in the ‘now’). Whole-person health implies not only the absence of physical or emotional ailments, but a quality of life that one finds at least acceptable.

How do you define self care?

For me, self care means taking proactive measures to ensure that my quality of life is somewhere between good and excellent at all times.

Why do you think so many people are uncomfortable asking for help?

It’s embarrassing for some, and some of the life skills we need to relearn or need coaching around seem ‘obvious’ or ‘intuitive’. Also, people look at mental health support as a service reserved for folks who are hitting bottom, or perhaps have serious unabating psychological issues, versus something tremendously helpful that we can access as a means of preventive care.

What is your go-to self care ‘tool’ or ‘practice’?

Jumping in the water for a swim, or walking my pup and listening to an intriguing podcast or some great new music. Or, wandering around Anthropologie and smelling all of the candles. <3

What do you do for fun?

I LOVE being in and on the water….swimming, surfing, kayaking, rafting….all of it. I love farmers markets and plant-based foods. I love gorgeous craft cocktails (making and drinking) and live music/music festivals and I love spending time with my puppy and my fiance.

What are your favourite books?

I don’t read for fun much outside of work. A few favorites, however: Food Politics by Marion Nestle and China Study by T.Colin Campbell.  But I LOVE podcasts….they are like candy for me! Favorites include Radiolab, Naked Scientist, Criminal, S Town, This American Life and Hidden Brain. Occasionally, I listen to Joe Rogan and Tim Ferriss, but mostly to get a sense of where guys are getting all of these wacky supplement and product ideas.  We’ll call it market research 😉

What is your favourite book to recommend?

I don’t know that it’s my favorite book to recommend, but I find myself recommending Intuitive Eating by Evelyn Tribole and Elyse Reych or Making Peace with Food by Susan Kano most frequently.

What is your favourite quote or mantra –  and why?

“Your time is limited, so don’t waste it living someone else’s life. Don’t be trapped by dogma – which is living with the results of other people’s thinking. Don’t let the noise of other’s opinions drown out your own inner voice. And most important, have the courage to follow your heart and intuition. They somehow already know what you truly want to become. Everything else is secondary.”

– Steve Jobs

I find Steve Jobs very inspiring given the intensity and focus with which he pursued his professional interests. I believe that we know best what is best for ourselves, and that the outside noise and opinions of others can muddy the waters at times. So this really resonates with me, and reminds me to be authentic, and to turn inward for answers.  I often read his quotes on Sundays as they tend to energize me for the upcoming week of work.

What is your favourite song when you need courage?

Anything by Zero 7 or Amy Winehouse.

What is your favourite meal to cook?

Pumpkin Garbanzo Bean Curry. Pumpkin anything and everything, really.

Email Megan.

Call Megan at 619.819.0283 ext 1

Mindful Self-Care Part 2: Checklist

Hello and happy fall!

Last week, we shared a document compiled by Potentia therapist Stephanie Godwin about some important mindful self care practices. This week, we share a companion handout – a mindful self-care check list. These are not revolutionary questions but years of working with clients has taught us that checking in on the simple questions can often be the hardest.

Make a practice of reviewing this checklist weekly for a month and notice which questions catch your attention – either positively or negatively. Share your experience with a friend or your therapist and find ways to make this experiment a deeper habit.

Key components of mindfulness are: noticing and presence – two things that are hard to do living in a noisy world.

Self-care is not a luxury or an indulgence. It is as crucial as your rest and eating enough vegetables. Slowing down, noticing and feeling can be dangerous to parts of your protective system. But by practicing, checking in and getting curious, you create new resources in your brain which fuel resilience, calm, and confidence.

This practice does not mean you will not struggle. That is not realistic at all.  Daring to love, to try something new, to change is part of the messy, beautiful adventure of being human. Where humans are present, so is struggle. Which is why self-care is so fundamental to your mental health.

What would you add to this checklist?

Cheers to a good weekend and a deeper practice of presence and self-care.

With gratitude – Rebecca

Mindful Self-Care Practices

There is a lot of talk about mindfulness these days. For good reason. Getting curious about what you are feeling and where you are feeling it in your body – and working on doing this without judgement or criticism taking over – has helped many people sustain and deepen their healing.

Sometimes it takes a whole lot of energy just to notice what you are feeling and where you are feeling it in your body. Our society as a whole is pretty darn good at numbing and doing everything we can to not notice what is going on beyond the loud noise between our ears.

As a result, there is often pushback on these practices as inefficient or a waste of time. If it were easy, there would not be the protective blocks around doing this practice. Looking inside with curiosity and compassion may feel like it has the potential to open up a pandoras box of what you have worked so hard to keep at bay.

Yet, when your brain and your body begin to trust that feeling difficult emotions will not overwhelm you, it can be a game changer in how you show up in life – especially while working on trauma, anxiety, depression, obsessive and compulsive thoughts and behaviors, grief and more.

Stephanie Godwin, LMFT at Potentia, compiled the following handout below so you can practice noticing what is going on with your feelings and your body. Download the handout below and post it in places that can serve as a reminder to prompt these practices. Doing a “you-turn” and getting to know your internal system is a powerful resource in your own mental, physical, and spiritual practices.

Which of these practices is the most helpful for you? 

Which of these practices is the most difficult for you?

Keep us posted on how we can support you showing up with more calm, confidence and clarity in your life. It is possible and help is available.

With gratitude –

Rebecca Ching, LMFT

 

What is the Ketogenic diet? And why is this diet so popular?

What is the Ketogenic diet? And why is this diet so popular? | Potentia Therapy

 

By Megan Holt, DrPH, MPH, RD

The ketogenic diet is another iteration of a low-carbohydrate, high fat diet.  While the diet appears to have experienced a rise in popularity over the past couple of years, it was actually coined by a physician, Russel Wilder, from Mayo Clinic, back in 1921.

Carbohydrates from food are a primary substrate for glucose, but in this particular instance, the liver is forced to use fat for fuel, which is then converted to ketone bodies.

Dr. Wilder was aiming to induce ketosis through the diet, which is a metabolic state within which the body must rely on ketone bodies as a primary energy source in the absence of glucose.

A ketogenic diet has been used in pediatric populations for several decades, as there is evidence to support a subsequent reduction in seizure activity in children with epilepsy, though concerns around adequate calorie provision, stunted growth and development of effective medications for epilepsy resulted in a decline in its use. Evidence has been less compelling among adults with epilepsy, however.

Earlier versions of the diet also included a fluid restriction, though this feature fell by the wayside after reports of adverse events due to dehydration (namely constipation and kidney stones).

Most ketogenic diets are marked by an intake of carbohydrates under 20g/day, or rough macronutrient goals of 70% (or more) of calories from fat, 10% (or less) from carbohydrate and 15 – 20% from protein.

This translates to liberal intakes of meats, eggs, butter, oils, cream, nuts and seeds, and very restricted intakes of grains, starchy vegetables, beans/legumes, fruits and added sugars.

Think repurposed “Atkins Diet”, but more restricted (though the ketogenic diet technically preceded Atkins by several decades).  This has become particularly popular among those pursuing weight loss, as well as with athletes seeking performance gains and changes in body composition.

Part of the attraction here lies within the simplistic guidelines….it is easy for followers to understand.  The diet promises rapid weight loss and blood sugar stability, which in part is an accurate claim.

Any time we restrict large groups of readily available foods, we have potential for weight loss. When one loses weight rapidly, much of that initial weight loss is accounted for by fluid weight and muscle catabolism (breakdown). Further, rapid weight loss can be taxing on the gallbladder and heart, and we run the risk of suffering from nutrient deficiencies as a result of inadequate intake.

This is especially true given that many of the processed/refined foods are easy to access, and just as easy to passively over consume.

Elimination of these foods, in addition to any weight lost, will also give a person a reprieve from erratic changes in blood sugar and corresponding fluctuations in energy levels, though this differentially affects persons who are struggling with overeating carbohydrates (i.e. blood sugar changes are much less dramatic in persons consuming carbohydrate in appropriate proportions).  Simply put, we do not need to go on a diet in order to better manage blood sugar and energy levels.

Athletes are typically hit especially hard by the lack of available energy due to the carbohydrate restriction. Not only does performance and power output suffer, but injury risk increases, as carbohydrates play a vital role in buffering the inflammation and tissue damage that are inflicted by exercise.
 

What are the downsides?

When used for treatment of pediatric epilepsy, the ketogenic diet is typically prescribed in conjunction with close medical monitoring, and only for a short period of time.

With the diet’s surge in popularity among athletes and weight loss seekers, there’s been a deviation from safety guidelines and medical monitoring, and followers are often in ketotic states for extended periods of time without supervision. Given the risks associated with following such an extreme and limited diet, medical oversight is crucial in order to monitor vital signs, organ function (kidney, liver, gallbladder, etc.) as well as blood levels of vitamins, minerals, electrolytes and immune parameters.

Oh, and we can’t neglect to mention the evidence, which does not favor this, or any other fad diet, in terms of weight loss sustainability (nearly all dieters regain weight within 6 months of embarking on the diet). 

 Suggested macronutrient distributions for healthy persons are as follows. Roughly:

  • 50-60% calories from carbohydrate
  • 25-30% fat and 10-20% protein.

This may look like a typical dinner meal for many people: 4oz salmon, ¾ to 1 cup of brown rice and 1 cup of colorful veggies with liberal olive oil. Due to the severe restriction of carbohydrate on this diet, we face a number of concerns around vitamin, mineral and electrolyte deficiencies (and the corresponding deficiency symptoms, such as fatigue, depressed immune function, chest pain, nausea and confusion, to name a few).

In situations where ketogenic diets are adequately supervised, followers are prescribed supplements on a daily basis. However, this becomes a bit of a guessing game in our typical ambulatory population, and the tendency is to either overdo supplementation or neglect supplements altogether.  Read more about supplements in our post “Tips on Becoming an Armed and Informed Consumer of Dietary Supplements”.

Other important concerns include risk of hyperlipidemia (the diet can raise ‘bad’ cholesterol while diminishing ‘good’ cholesterol levels).  Often, there is little attention given to the types or quality of fats consumed while on low carbohydrate diets, which exacerbates hyperlipidemia.

In children or adolescents who are actively growing, ketogenic diets have been shown to stunt growth, which is thought to be due to the fact that the diet can result in a reduction of growth factors and hormones.

Kidney stones, acidosis, loss of bone density, sluggish bowels/constipation (even with adequate fluids and fiber intake), reflux (due to high fat content) and nausea are other relatively common risks with a ketogenic diet. 

In closing, there are safer and more sustainable strategies for increasing energy levels and stabilizing blood sugar.  Not waiting too long to eat (eating every 3-4 hours), maintaining a diverse diet, comprised largely of whole foods with few, recognizable ingredients is a wonderful (and sustainable) place to start. However, if you are planning on adopting a ketogenic diet, please make sure you do so under the care of a registered dietitian and physician.

Click here to contact Dr. Megan Holt.

References

Bansal S, Cramp L, Blalock D, Zelleke T, Carpenter J, Kao A. (2014). The ketogenic diet: initiation at goal calories versus gradual caloric advancement. Pediatr Neurol, 50(1): 26-30.

Bergqvist AG.(2012).  Long-term monitoring of the ketogenic diet: do’s and don’ts. Epilepsy Res,100(3):261-266.

Freeman JM, Kossoff EH, Hartman AL. (2007.) “The ketogenic diet: One decade later”. Pediatrics, 119(3): 535–43.

Johnstone AM, Horgan GW, Murison SD, Bremner DM & Lobley GE. (2008). Effects of a high-protein ketogenic diet on hunger, appetite and weight loss of obese men feeding ad libitum.   Am J Clin Nutr, 87(1): 44-55.

Kossoff EH, Zupec-Kania BA, Amark PE, et al. (2009). Optimal clinical management of children receiving the ketogenic diet: recommendations of the International Ketogenic Diet Study Group. Epilepsia, 50(2):304-317.

Kossoff EH, Zupec-Kania BA, Rho JM. (2009). Ketogenic diets: An update for child neurologists. J Child Neurol, 24(8): 979–88.

Mann T. (2015). Secrets from the eating lab: The science of weight loss, the myth of willpower, and why you should never diet again. Harper Wave.

Sampath AE, Kossoff H, Furth SL, Pyzik PL, Vining EP. (2007). Kidney stones and the ketogenic diet: risk factors and prevention. J Child Neurol, 22(4):375-378.

Tips on Becoming an Armed and Informed Consumer of Dietary Supplements

Tips on Becoming an Armed and Informed Consumer of Dietary Supplements

 

Note from Rebecca: I am so grateful for Dr. Megan Holt’s wisdom, experience and insight on all things nutrition and wellness. There is A LOT of offerings out there that make claims to better our health but many are lacking in solid research and/or regulation. We are all about helping those in our community be better informed consumers of time and resources. Below, Megan will share some important information about dietary supplements – looking forward to your thoughts and questions!

Many of us regard dietary supplements as ‘harmless’, but did you know that supplements vary tremendously in terms of potency and purity?

We need to be concerned with not only the supplement’s effectiveness, but also with whether or not the supplement actually contains the stated ingredients in the stated amounts. Adulteration is common, as manufacturers, as well as suppliers of the raw ingredients, often try to cut costs by cutting corners.

Manufacturers may have the best intentions in terms of adhering to ethical standards, but perhaps suppliers of the raw ingredients are more concerned with profit.

Have manufacturers’ done their homework? The industry is ‘regulated’, but loosely at best.

Dietary supplements can be a wonderful resource for those of us who need them, and many of the claims regarding their benefits are supported by sound evidence. Asking the following questions of your provider may be helpful upon receiving recommendations to begin taking a supplement.

  1. What is the optimal daily dosage for my condition?
  2. Can you offer any reliable brand recommendations?
  3. Are there any supplement-drug or supplement-food interactions that I should be aware of?
  4. Can I instead meet these needs through the diet? How? Which foods and in what amounts?
  5. Where can I find evidence-based information on the safety and efficacy of dietary supplements?
  6. What are the known side effects?
  7. Has the supplement been tested by an independent lab? Is it USP (United States Pharmacopeial Convention) verified?
  8. How much do they cost?

This fabulous documentary (free to watch) “Supplements and Safety” is a great place to start.

The NIH Office of Dietary Supplements offers a number of helpful fact sheets on individual vitamins and minerals.

Further, PubMed Dietary Supplement Subset provides a rich database should you be interested in reading the literature on specific dietary supplements.

Your provider may not have all of the answers to these questions, but it’s important that they be able to speak to most of them. Advocate and ask – use your voice!

Make sure to join us on Thursday August 3rd, 2017 at 10am PDT for a conversation with Secrets from the Eating Lab Author Traci Mann, PhD + Rebecca Ching, LMFT. Click here to register for the free webinar!