The Mind-Body SHIFT

Nourishing the Body, Feeding the Mind, Nurturing the Soul

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New Study Backs Biological Nature of Chronic Fatigue Syndrome

chronic-fatigue-syndromeAnyone who has lived with the crippling fatigue, un-refreshing sleep and cognitive problems (affecting memory and concentration) of Chronic Fatigue Syndrome (CFS) can confirm it is a very real, debilitating physical illness. Unfortunately, for many years, not everyone else has agreed. Long dismissed in the medical community as a psychological condition—or simply as a prolonged state of exhaustion—new research gives evidence that CFS is, in fact, a biological disorder with specific stages.

With viral-like symptoms—like swollen lymph nodes, chronic sore throat and mild fever—and suspected to be triggered by malingering viral infections, like the Epstein-Barr Virus (EBV), chronic fatigue syndrome has been long suspected to be an immune system disorder. A study published in Science Advances on Feb. 27 found specific immune system differences in those who had the disease three years or less and in patients with the disease for more than three years compared to healthy controls.

Between 1 million to 4 million in the U.S. have CFS or myalgic encephalomyelitis, known as ME. An estimated 84 to 91 percent battling this illness are living without a diagnosis, thanks to the complex nature of the disease and skepticism of the serious nature of the disease by healthcare providers.

Last month, the IOM suggested renaming CFS/ME to more accurately describe the disease by its most central symptom—post-exertional malaise, which is a sustained decrease in energy after minimal physical and cognitive activity. To counter the trivialization of the term “chronic fatigue,” the Institute of Medicine (IOM) proposed renaming the illness SEID for systemic exertion intolerance disease, while also giving more specific criteria for its diagnosis.

IOM Proposed Diagnostic Criteria for ME:CFS

“This [latest] study delivers what has eluded us for so long: unequivocal evidence of immunological dysfunction in ME/CFS and diagnostic biomarkers for disease,” says senior author W. Ian Lipkin, MD, also the John Snow Professor of Epidemiology at Columbia’s Mailman School.

Functions of Interferon Gamma


Researchers at the Center for Infection and Immunity at Columbia University’s Mailman School of Public Health studied blood plasma samples of a total of 298 ME/CFS patients and 348 healthy controls to determine the levels of 51 immune biomarkers. Patients living with CFS for three years or less had increase amounts of cytokines, cell-signaling molecules that are involved in regulating the immune system’s response to infection, inflammation in trauma.

Early patients had a “prominent activation of both pro- and anti-inflammatory cytokines,” according to the study findings. The pro-inflammatory cytokine Interleukin-17A was found to be elevated in early-stage patients. Additionally, there was a significant presence of the cytokine called interferon gamma (or IFN-gamma), which plays an important role in immunoregulatory functions and is associated with antiviral activity. IFN-gamma is produced mainly by activated T-cells, natural killer cells, in addition to activated macrophages in the periphery and microglia, which is responsible for central nervous system protection against different kinds of pathogenic factors.

Interferon gamma may disrupt immune homeostasis, increasing susceptibility to developing certain types of autoimmune reactions. Additionally, it may speed up the deterioration of tryptophan, spurring the depletion of serotonin and melatonin in the central nervous system. These neurotransmitters play critical roles in sleep, digestion, mood and memory. IFN-gamma has also been linked to the fatigue following many infections, including EBV, according to the study release. Earlier studies have also associated cytokine fluctuations with severity of fatigue in CFS patients.



While unrelenting fatigue is the most common symptom of the disorder, it may also include unusual headaches, gastrointestinal problems, endocrine dysfunction, orthostatic intolerance (symptoms that worsen upon standing and improve upon lying down), joint and muscle pain, and muscle weakness. It is estimated that at least a quarter of those with CFS/ME are bed- or home-bound at some point living with the disease.

“It appears that ME/CFS patients are flush with cytokines until around the three-year mark, at which point the immune system shows evidence of exhaustion and cytokine levels drop,” said lead author Mady Hornig, MD, director of translational research at the Center for Infection and Immunity and associate professor of Epidemiology at Columbia’s Mailman School.

Longer duration ME/CFS subjects, in contrast, had lower levels of cytokines than in healthy controls. Levels of CD40L were significantly different from short-duration subjects. This cytokine is involved in B cell maturation. The study cites a randomized trial of a monoclonal antibody that targets B cells, which demonstrated symptom improvement in some ME/CFS patients.

“Early diagnosis may provide unique opportunities for treatment that likely differ from those that would be appropriate in later phases of the illness,” said Hornig. “Our results should accelerate the process of establishing the diagnosis after individuals first fall ill as well as discovery of new treatment strategies focusing on these early blood markers.”

In October 2014, Stanford University School of Medicine researchers found differences in the white matter of the brains of CFS patients compared to healthy subjects. In CFS patients, researchers found an abnormality in the nerve tract connecting the frontal and temporal lobes in the right hemisphere of the brain. The greater the degree of abnormality was associated with a greater severity of the patient’s condition.

White Matter Abnormalities in CFS


A thickening of the gray matter at the frontal and temporal lobes in the right hemisphere was also found in CFS patients. Additionally, there was reduced overall white matter in the brain, suspected to a result of chronic inflammation. White matter is made up of nerve tracts that connect gray matter areas of the brain and allow nerve cells to properly communicate with one another.

“CFS is one of the greatest scientific and medical challenges of our time,” said the study’s senior author, Jose Montoya, MD, professor of infectious diseases and geographic medicine. “In addition to potentially providing the CFS-specific diagnostic biomarker we’ve been desperately seeking for decades, these findings hold the promise of identifying the area or areas of the brain where the disease has hijacked the central nervous system.”

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How Gut Bacteria Affect Behavior Mood and Disease



Modern research is constantly revealing more about the amazing world of the human microbiome and its implications on health. The microbiome is the community of “good” and “bad” tiny microorganisms that live in our skin and mucus membranes—including the gut and mouth. While many of these microbes are innocuous, some may be harmful to our health, and others we depend on to protect us from disease.

Rob Knight is a world leader in the study of the microbial life. He and other scientists have joined forces in researching diverse microbial communities found in our bodies and in environments around the world. Knight especially is inspired to explore how changes in the microbiome might affect environmental and human health and how microbiota can help prevent the extinction of species and solve disease.

In a recently published TedTalk, Knight discusses in-depth how microbes affect both human health and our behavior. While I encourage you to watch the entire 17-minute talk (shown at the end of this piece), I wanted to quickly share from his talk:

10 Fascinating Facts About Gut Bacteria, Behavior, Mood and Disease

Human Cells vs. Microbial Cells1. Our microbes outnumber us! Each of us consists of 10 trillion human cells, but we harbor as many as 100 trillion microbial cells, so they outnumber us 10 to 1.

2. Our microbes make us more different from one another than our DNA. Knight says that, while we’re 99.9 percent identical to other people in terms of human DNA, we might only share 10 percent similarity with our fellow human beings in terms of our gut microbes. Each of us has about 20,000 human genes, but as many as 2-20 million microbial genes.

3. Microbes in one part of the body are significantly different from microbes in other regions of the body. A few feet of difference in the human body has more of an impact on your microbial biology than hundreds of miles on earth, Knight says.

4. Microbes determine how medications and mosquitoes affect you. Which microbes you have in your gut determine whether particular painkillers are toxic to your liver and whether other drugs will work for your heart condition. Microbes on your skin determine which chemicals are produced that either attract or repel mosquitoes to bite.

5. Our lives depend on microbes. They help:

  • Digest food
  • Educate our immune system
  • Resist disease
  • Metabolize drugs

…and they may be affecting our behavior!

Different Microbe Communities in the Body6. Our first microbial communities depend largely on how we’re born. Babies that are delivered through the birth canal have microbes similar to the vaginal community, while babies delivered by C-section have microbes that look like those of the skin. It turns out that natural birth may provide protective microbes that are critical to our health. This might help to explain why children born by Caesarean birth are more prone to have asthma, allergies and obesity—all conditions that have now been linked to microbes.

7. Antibiotics have a significant impact on the health of one’s microbiota. While antibiotics may successfully help us to fight off certain bacteria, they may also be degrading our gut microbial ecosystems, aka gut flora. Knight also reports how the use of antibiotics increases the risk of obesity, stating, “If you give children antibiotics in the first six months of life, they are more likely to become obese later on than if they don’t get any antibiotics then, or only get them later.”

Antibiotics also have the potential to kill beneficial bacteria, allowing antibiotic-resistance bacteria to flourish, like the potential fatal GI infection, C-Diff, as reported Wednesday in NPR. The good news is there are several ways to recover gut health and help promote good gut flora!

Micromes from Obese Make Mice Overeat8. Microbes may affect mammalian behavior and mental health. Numerous studies are showing a link between gut bacteria and mental health. New research from Oxford University suggests that boosting health bacteria in the gastrointestinal tract through prebiotics might alleviate anxiety. Other studies support the idea that prebiotics, along with probiotics , might have significantly positive impacts on mental conditions. Read here to learn about natural sources of probiotics and prebiotics.

Other research shows an association between gut bacteria and overeating. Knight reports on studies of mice where “genetically normal” mice get fatter after being transplanted with microbes from obese mice (and obese humans); one reason for this is that some mice begin to eat more than a normal mouse and will eat as much as they want unless they are prevented from overeating.

9. Your microbes may be more important than your genes in determining your risk of developing certain health conditions. “The three pounds of microbes that you carry around with you may be more important for some health conditions than every single gene in your genome,” said Knight. “Today we can tell whether you’re lean or obese with 90 percent accuracy by looking at the microbes in your gut.”

Microbes have been recently linked to a variety of diseases including:

In mice, microbes have been linked to all kinds of additional conditions including:

  • Multiple Sclerosis
  • Depression
  • Autism
  • Obesity (again)

Can Microbes Cure Disease10. Microbes might cure disease! Microbes not only help us determine where stand in terms of our health, but studies are showing that microbes can actually cure disease. Transplanting stool from healthy people into unhealthy people can cure C-diff, a condition where one has diarrhea up to 20 times daily, resulting in immediate, lasting radical changes in the gut community to restore health. Mice studies also demonstrate that transplanting healthy microbes into a system can help cure malnutrition.

“This suggests that we can pilot therapies by trying them out in a whole bunch of different mice with individual people’s gut communities and perhaps tailor these therapies all the way down to the individual level,” Knight says.

Dr Knight is a leading scientist of the American Gut Project, which collects, catalogs and cross-references microbes to help make comparisons and predictions about human health. Data collected from American Gut can help determine how diet and lifestyle shape YOUR gut microbiome. Learn more about Knight and the American Gut project by clicking here.

The Knight Lab


Children Face Unique Challenges With Crohn’s Disease

Nicole Pingel and Dr. Robbyn Sockolow on Crohn'sIf your child is consistently complaining of pain in the stomach, he or she might not just be bellyaching to get out of a day at school. An estimated 38,000 children and teens in the United States live with Crohn’s disease, which causes chronic inflammation of the gastrointestinal (GI) tract. While Crohn’s disease can occur at any age, it tends to be most prevalent in teens and young adults, ages 15 to 35. Nicole Pingel was just a young teen when she first developed symptoms of the disease.

“I think the big thing for me was developing stomachaches,” said Pingel, now 26, in a recent interview. “Especially as a teenager, or when you’re younger, some of the symptoms, like diarrhea, can be extremely embarrassing to talk about.”

Overcoming adolescent reticence, Pingel shared her symptoms with her parents. After then seeing her primary care physician, she was eventually referred to a pediatric gastroenterologist. At the age of 14, Pingel was diagnosed with Crohn’s disease.

Irritable Bowel Disease and Crohn’s



Ulcerative colitis and Crohn’s disease are the two most common types of inflammatory bowel disease (IBD). In ulcerative colitis, only the large intestine, or colon, is affected. Crohn’s disease can affect anywhere along the GI tract, “that can be starting in the mouth and winding in the bottom.,” said NY gastroenterologist Robbyn Sockolow, MD. However, Crohn’s is especially found in the last part of the small intestine, or ileum, and at the beginning of the large intestine. Also unique to Crohn’s, diseased intestine may be separated by patches of healthy, normal areas.

In people with IBD, the immune system misidentifies food and harmless bacteria in the intestine as foreign invaders, like viruses and fungi, attacking the cells of the intestines. White blood cells are sent into the lining of the intestines, producing inflammation. With chronic inflammation, the walls of the intestine thicken and ulcers form, eventually leading to noticeable symptoms.

Common signs of an inflamed GI tract generally include abdominal cramps, persistent diarrhea, urgent bowel movements, constipation and potential rectal bleeding. Other general symptoms of IBD include fatigue, fever, night sweats, loss of appetite, and weight loss. However, Dr. Sockolow, director of gastroenterology and nutrition at NewYork-Presbyterian Phyllis and David Komansky/Weill Cornell Medical Center, points out that children with Crohn’s do not always display these signature symptoms.

“For instance, you may not have the stomachaches or diarrhea, but the child may present with growth delay, fatigue, iron deficiency,” said Sockolow. “So it’s important to understand that there are subtle differences in how pediatric Crohn’s disease presents as opposed to what you might see in the adult population.”

Src. Physiopedia

Src. Physiopedia

Children with Crohn’s might also experience other health issues, such as:

  • bowel obstruction
  • fistulas, or sores, that tunnel from the affected area into nearby tissues, such as the bladder, vagina, rectum or anus.
  • arthritis
  • skin problems
  • anemia (not enough iron in the blood)
  • osteoporosis (decrease of bone density, weakening of bones)

When A Stomachache is More Than Just A Stomachache

How can parents know when a stomachache is more than just stomachache? Sockolow advises parents and children work together to track the symptoms. They can note how often stomachaches occur, whether the child’s activity level is normal and if there is fatigue. “Encourage your child to have the feeling that they can speak about some of their symptoms, which as Nicole talked about, may be embarrassing,” she said.

Pingel added, “I think the most important thing that parents can do is be there to support their kids and offer encouragement to speak up about those symptoms.”

With this information, along with other observations that may be of concern, Sockolow said, “Share that with your healthcare provider to really give them as much information as you possibly can. Then, being able to go onto a specialist, such as a pediatric gastroenterologist, who may actually ask even further detailed questions, will allow the diagnosis of Crohn’s disease to be identified.”

Diagnosing and Managing Crohn’s Disease

Distribution of Crohn's Disease in GI Tract / Src. Physiopedia

Distribution of Crohn’s Disease in GI Tract / Src. Physiopedia

There is no single test to diagnose Crohn’s, which is why open dialogue between patients, parents and healthcare providers is so crucial. A physician may order blood test and stool samples, as well as imaging of the upper and lower GI tract, including X-rays, abdominal CT scan or MRI, which also involve drinking an oral contrast. The doctor may recommend an endoscopy, using instruments to see the interior of the colon. A biopsy, or removal, of small pieces of tissue may also be useful to determine presence of the disease.

There are five types of Crohn’s disease, depending on which area of the GI tract is affected.

Crohn’s may be managed through a combination of medications, nutritional supplements and/or surgery. Nutrition plays a crucial role in helping to control the symptoms of Crohn’s, as well as to replace missing nutrients and promote healing. A constantly inflamed small intestine may disrupt the complete digestion of food and absorption of nutrients. As a result, Crohn’s patients with significant ileum inflammation (or removal) and chronic diarrhea often experience malnutrition and vitamin deficiencies—such as vitamins A, D, E, K and B12—and may need supplementation. Individual diets should be based on symptoms (such as chronic diarrhea), location of the disease, any prior surgeries, whether there is the presence of narrowing of the small intestine, or strictures, and whether there are specific nutritional deficiencies.

“Understand that the disease may be different for everybody else, so what you might read that is appropriate for one person may not necessarily be the right treatment plan for you,” said Sockolow.

Yet it is generally recommended that Crohn’s patients eat a well balanced, nutrient-rich diet with an appropriate caloric intake. Eating small, more frequent meals may aid digestion. Patients in flare-up are encouraged to limit foods with high fiber and insoluble fiber, as well as fried and greasy foods.

“Anything that’s really rough to digest [like corn] would possibly be detrimental and cause more symptoms and possibly slow the healing process,” a nutritionist with Crohn’s based in Briarcliff Manor, N.Y., Tracie Dalessandro, told

According to the Crohn’s and Colitis Foundation of America (CCFA), probiotics, like lactobacillus preparations and live-culture yogurt, might help aid the recovery of the diseased intestine for those who are not lactose-intolerant. However, many Crohn’s patients also have food intolerances, like lactose intolerance, so foods that cause digestive problems should be avoided. Keeping a food diary can help young people especially identify their food triggers, such as certain spices, raw fruits and vegetables, or caffeine.

During a flare-up, nuts and seeds, for example, often “don’t get digested fully and can cause more diarrhea,” said Dalessandro, who is also a nutritional advisor to the CCFA. “You want to stay away from things that are rough on the digestive system…it’s kind of like sandpaper on an open wound.”

It may be especially difficult for young children and teens with Crohn’s to stay on top of their diets due to peer influence. “Particularly, a [challenging] thing that stood out to me being diagnosed at age 14 was I wasn’t able to eat some of the same things as my peers. They were having all the great foods, like pizza and ice cream, and I was having nutritional shakes because of my condition,” said Pingel.

She also pointed out in our interview how difficult it was to explain to other teens what having a chronic illness means for patients. “Having a chronic condition, it’s very hard to communicate to your peers that you might be sick for longer periods of time or that you might look okay on the outside, but not feel great at all on the inside,” she said.

In addition to diet, addressing emotional health is also extremely important for managing Crohn’s. “I’ve been lucky in that I was diagnosed [more than] 10 years ago and only had 1 surgery. And that happened during one of the most stressful times in my life-moving 12 hours away and grad school. I think keeping your stress levels low is the most important [thing],” Pingel wrote on Facebook.

Combo of Factors May Cause Crohn’s Disease



While the exact cause of Crohn’s is currently unknown, it is believed that inherited genes, environmental factors and the immune system (as discussed earlier) play a part in the development of the disease. Crohn’s tends to run in families, and having a first-degree relative (parents, sibling or children) with the disease increases the risk for developing Crohn’s. While it is more common among people of eastern European descent and Ashkenazi Jews, the CCFA reports that increasing numbers of African Americans have been diagnosed with Crohn’s in recent years.

The environment in which one lives also appears to be a factor in the development of the disease. Crohn’s is more common in developed countries, in northern over southern climates, and in urban communities compared to rural ones. Urbanization may cause changes in exposure to sunlight, pollution and industrial chemicals. Smoking and diet also are contributing factors.

According to the CCFA, as many as 700,000 Americans live with Crohn’s disease.

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Body Shaming And Transforming Beauty Ideals

Src: instagram/tessholliday

Src: instagram/tessholliday

Everywhere we turn, old beauty ideals are being shattered and redefined to embrace the magnificent diversity of humanity. Nose-pierced, tattooed Tess (Munster) Holliday is turning heads as the first size 24 woman signed to a major modeling agency, and last week’s Sports Illustrated Swimsuit Issue features a plus-sized supermodel (albeit, in an ad) for the first time. Supermodel Carmen Del’Orefice graces the latest cover of New You magazine at the glamorous age of 83. Also, people are currently praising the release of a non-retouched photo of 48-year-old Cindy Crawford in lingerie for being both realistic and beautiful, stretch marks and all.

Lest we think only supermodels are reshaping ideals of beauty, history was made this past week, when actress Jamie Brewer became the first women with Down syndrome to walk down the runway during New York City’s Mercedes-Benz Fashion Week. Brewer, also an activist for intellectual disabilities, was part of the “Role Models Not Runway Models Campaign” that designer Carrie Hammer founded in 2013 when first asked to display her line at Fashion Week. Rather than use professional models for her show, Hammer decided to represent the women who bought her designs by featuring inspirational leaders and pioneers who were her clients and friends. That first year, wheelchair-bound psychologist Danielle Sheypuk graced the runway in another Fashion Week first, inspiring Karen Crespo, an amputee who lost her four limbs to bacterial meningitis, to take the stage in prosthetics in Brewer’s Fashion Week show a year later.

“Beauty lies in our differences. There isn’t one slim ideal beauty, but that’s what fashion has become all about,” Hammer said in “My line is all about highlighting the beauty in the differences, and making sure that the women feel confident and beautiful in their individualities.”

Toy designers are also giving young girls greater access to body-positive dolls that look more like real people, no matter their size or skin color. Barbie, the glamorous and immensely popular, yet homogenous and unrealistically proportioned, doll is being subverted by shorter, curvier and customizable Lammily dolls (with the proportions of an average, 19-year-old American woman). In Nigeria, Barbies are being outsold by a Queens of Africa line, which look more like the brown-skinned young girls who play with them. It is heartening to know that young girls are exploring identity and life’s possibilities with figurines that are increasingly reflective of real people like them.

All these things give hope for a more body-positive culture that encourages self-love over fretting over unattainable perfection. Yet some conversations taking place across the Internet emphasize that’s there is still plenty of room for improvement regarding body image.

A fellow coach who specializes in body image recently wrote an affirming post about healthy people coming in all shapes, emphasizing that clothing size and numbers on a scale alone tell nothing of a person’s fitness level and proportion of muscle. She said that appearances can be deceiving when it comes to health, pointing out that some overweight people may be more fit than the “skinny fat” (whose unhealthy diets or lack of exercise cause them to store visceral fat around organs, putting them at high risk for cardiovascular problems and diabetes, btw). I wholeheartedly agree that being healthy is certainly less about “a look” and more about consistently staying as active as possible and making smart decisions about the food one puts in the body.

Strong is the New Skinny

However, some of the comments on this body-positive coach’s post sank my spirits. One man posted the following:

Real Men Go For Curves   Skinny Is Not Sexy

We’ve all heard the new catchphrase, “Strong is the New Skinny.” It is encouraging to see a move away from the pill popping and starving-to-be-thin ideal and people aiming for strength and fitness. I love seeing women who are proud of how much they can lift and excited to see their own bulge of muscle. Yet it’s important to realize that women can be strong and build muscle at any size.

Part of what disturbs me about the “Strong is the New Skinny” movement, and this man’s negative comparison, is the presumption that all thin women are unattractive and that the state of slenderness is always attained through deliberately unhealthy means. There are naturally slender women who may remain firmly a size 0 no matter how much food they eat and no matter how many pounds they try to gain. Further, a size 0 isn’t always skinny as bones. It can definitely still be strong and fit, shapely and sexy.

Strong is the New Sexy–Or is It?

In our blame and shame society, perhaps it is too not surprising that the proudly fit are also being negatively called out. With the intent of inspiring other moms to make health a priority, fit moms like Maria Kang of the U.S. and Abby Pell of the UK have used social media to show everyday women that even full-time working moms with no nannies, who are not naturally skinny and struggle with weight, can get fit and healthy with dedication and hard work. Kang, for instance, has encouraged moms to be creative and flexible with their time; for example, working out with their kids or splitting up their workouts throughout the day. Yet a large percentage of comments on these fit moms’ posts has been negative, accusing the women of bullying and putting more pressure on mothers who are already expected to do it all.

Abby PellMany have interpreted the catch phrase, “no excuses,” as a message that implicitly shames fat people. Pell—whose post said she had no excuse for not getting in shape—is a single mom with a 6-year-old daughter who was “on the heavier side” and unhappy with restrictive diets. After gaining a lot of weight during pregnancy, she struggled to shed it after her daughter was born. Once she started lifting weights, she was amazed by how quickly she was able to lose weight and build firm and toned muscle. Bell believes that simply being a parent isn’t an acceptable excuse for not being fit if that is your goal. Her intent was never to offend but to encourage others to get in shape and feel healthier.

At the time of her controversial “What’s your excuse?” Facebook post in 2013, Kang was a business owner and mother of three, with a husband who had suffered a traumatic brain injury in Iraq. A former bulimic, she grew up with an overweight mother who missed her wedding for health reasons. Kang has repeatedly said the aim of posting the photo of her fit self with her three young children was to encourage women to make fitness and health a priority in their everyday lives , even with all the other things going in their lives.

Kang has since formed a No Excuses Mom Movement to provide free workout groups in local communities from moms around the globe. It also published a calendar this year of moms with all different body types. Additionally, Kang is set to launch her first book, The No More Excuses Diet, on March 10.

Despite their good intentions, one gets the sense that there would be similar backlash no matter what message accompanied these fit moms’ photographs. With social media on a constant stream, proud posts meant to inspire can easily come across as bragging—and shaming to those reading between the lines.

“What you interpret is not MY fault. It’s Yours. The first step in owning your life, your body and your destiny is to OWN the thoughts that come out of your own head. I didn’t create them. You created them,” Kang wrote on Facebook in the thick of the controversial comments. “So if you want to continue ‘hating’ this image, get used to hating many other things for the rest of your life. You can either blame, complain or obtain a new level of thought by challenging the negative words that come out of your own brain.”

Stamping Out Body Shaming

The solution to the pervasive body shaming in this culture is not to shame other body types. One should not need to make another feel small to make one’s self feel big. Negatively comparing ourselves to others is what drags our evolution toward broadening beauty ideals to a halt, whether we’re assessing and rating selfies on social media (#dreambody) or we’re admiring celebrities in a magazine—the vast majority of whom have make-up artists, stylists, full-time trainers and nutritionists (as well as the help of computer manipulation), to make them look as good as they do.

Last year, the slim and striking Keira Knightly made waves by posing topless and untouched by Photoshop for a magazine photo shoot. “I’ve had my body manipulated so many different times for so many different reasons, whether it’s paparazzi photographers or for film posters,” Knightly—whose breasts were enlarged, to her surprise, in a film poster for King Arthur in 2004—told The Times. “And [this shoot] was one of the ones where I said: ‘OK, I’m fine doing the topless shot so long as you don’t make them any bigger or retouch.’ Because it does feel important to say it really doesn’t matter what shape you are.”

She’s one of many noted celebrities taking a stand against the use of Photoshop, which not only makes them look unlike themselves but unlike real people in general.

Real Women and American Beauty Ideals

American Body Ideals Over The DecadesWhile only 5 percent of American females naturally possess the body type portrayed in advertising—the vast majority of which is digitally manipulated in print and online—ANAD cites that 69 percent of surveyed girls in 5th through 12th grade said that magazine pictures influence their perception of what is the “perfect body,” and half of them said these images make them want to lose weight. Studies report that 46 percent of girls aged 9-11 are dieting, and more than half of teenage girls are taking unhealthy, restrictive measures to control their weight. Is it any surprise that, with an estimated 91 percent of women are unhappy with their bodies and diet to achieve an ideal shape–including mothers, that 42 percent of first- to third-graders want to lose weight?

The size difference between the women in the media and average women in real life is ever increasing. According to, the typical model of 20 years ago weighed 8 percent less than the average woman; today’s models weigh 23 percent less. As the American population has increasingly gained weight, most plus-sized models of today, ranging between size 6 and 14, are no longer representatives of the average woman, half of whom are now a size 14 or larger.

The fluidity of our beauty standards over the years is greatly apparent in any close look at America’s cultural history. The ideal has swung from the hourglass figure of the Gibson Girl in the early 1900s to the boyish, flattened figure of the ‘20s flappers, and from the athletic, yet shapely, ideal of the ‘80s to the pale and unhealthfully skinny look of the Heroin Chic ‘90s. Today, the ideal has morphed into a long, lean and leggy, yet busty, look.

“But I think the first real change in women’s body image came when JLo turned it butt-style. That was the first time that having a large-scale situation in the back was part of mainstream American beauty,” writes comedian Tina Fey inn her book Bossypants. Fey further draws attention to the unrealistic litany of physical attributes American women are currently expected to have in order to be considered beautiful: “Now every girl is expected to have Caucasian blue eyes, full Spanish lips, a classic button nose, hairless Asian skin with a California tan, a Jamaican dance hall ass, long Swedish legs, small Japanese feet, the abs of a lesbian gym owner, the hips of a nine-year-old boy, the arms of Michelle Obama, and doll tits.”

Is Self-Love the New Sexy?

HealthyIsTheNewSexyIt sounds so ridiculous—because it is. Yet these unrealistic expectations and array of perfect attributes are sadly the sought-after ideal for many struggling with self-confidence and self-love. It’s long past time for us to be living the message of Tess Holliday’s #EffYourBeautyStandards movement, appreciating every body as a beautiful one. “Never compare yourself to others and celebrate what makes you, YOU,” she writes on Instagram. As a culture, we need to start loving, embracing and celebrating the young of all genders, colors, shapes and sizes.

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The True Power of Fully Living Your Own Truth

Elizabeth Gilbert on PowerThis morning, bestselling author Elizabeth Gilbert, who wrote the much beloved memoir Eat, Pray, Love: One Woman’s Search for Everything Across Italy, India and Indonesia, asked a favor of her readers on Facebook. Almost daily, she shares inspiration and wisdom that I and countless others feel called to share with friends. Today was no different.

Glibert shared a candid, unpolished photo of herself doing research and taking notes for her latest book, The Signature of All Things: A Novel, a novel whose historical tale spans the globe, covers multiple subjects and themes in detail and is full of fascinating characters. While describing the photo of herself at this time she said, “I see a women who is doing exactly what she wants to be doing with her life. That’s what power means to me. In fact, that’s the ONLY thing power means to me.”

True power is standing in your own truth of who you really are. True power is following your own path.

Gilbert asked readers to post a photo taken at a moment when they felt like they were at their most powerful. I immediately thought of a photo that captured the changing tide of coming back into my own power once again after feeling beaten down for too long in the early years of my living with dystonia.

When I first was stricken by the debilitating neuromuscular movement disorder, I was overwhelmed by how much it stripped me of the things I had come to take for granted about my health. After years of living with autoimmune disease, I had grown accustomed to long periods of unrelenting pain and fatigue and to being felled for weeks by infections that most people recovered from in days. However, I was not prepared for the periods of complete loss of muscle control or the complete chaos of neuromuscular activity of dystonia. I was not prepared to reverse all progress I’d already fought for to live my life away from either a bed, a couch or a wheelchair. I was not prepared to feel completely disempowered, as if I was losing my last shreds of independence and self-sufficiency.

Elizabeth Gilbert on Living Your Truth

Over time, I went from the hospital to my parent’s bed to being just down the hallway. I stubbornly pushed myself out of the wheelchair, trusting that others would be able to catch me if I fell. And if they couldn’t, I would crawl until I could get back on my feet again. I grew strong and stable enough to once again shower without supervision, spend extended time away outside the house and then, to even work from home again.

When the prednisone that had finally given me some stability stopped working, and in fact, seemed to be making me worse, I began the long process of weaning myself off the medication. In a very short period, I gained more than 20 pounds, lost my job and boyfriend, and was swept back off my feet. If not for the support of my family and closest friends, and the hope that those 6 months of nearly flourishing (comparatively) with dystonia had brought me, I’m not sure how I would have kept up the fight to not give in wholly to the illness.

Over time, however, it grew easier to survive and even thrive with this chronic illness. I once again put focus on the food I was putting into my body—I needed all the nutrients I could get to strengthen and heal my body and brain. I forced myself to keep exercising, however ways I could. I wrote. I started dating again. And when my parents asked me to come with them more than 1,000 miles to Orlando, Fl., I realized the proper answer was no longer, “I can’t,” but “I am.”

Winning My Battle With DystoniaThis photo is of me in Orlando after my first swim in more than two years. While I am sporting the gradual return of my muscular abs and starting to lose the moon face of prednisone, the photo is more about a battle I was starting to win over my disease. This was me off the couch, out of the wheelchair and steadily on my own two feet again. This represented me taking my health back into my own hands, instead of being victim to the whims of dystonia.

While there have been more lows and highs in my health journey since this photo was taken, it marked the first major triumph of taking my power back. I’ve added to those triumphs since then—getting my license back, working again and getting certified to teach yoga. I finally moved out of my parents’ home again and started a life of my own with my loving boyfriend. With his support and help, I have further healed myself with nutrition (thank you, ketosis), which has enabled me to wean off a significant amount of my long-term medication and to strengthen my body, while reducing dystonia’s (and lupus’s) hold on me. Last month, I even traveled overseas for the first time in more than 15 years on a trip of my dreams.

I am growing ever closer to living the magnificent life of my own choosing. Those days when my spirit fails me, this photo reminds me of how hard I have fought to get back on my own feet again. It reminds me that I deserve the life of my choosing, (as do you!)—even with dystonia and autoimmune disease. It inspires me to look beyond the temporary setbacks and keep moving forward, one step at a time. It reminds me to nurture my dreams and to continue working toward making them true.

Thank you, Elizabeth Gilbert, for this much needed reminder.

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What We Need to Know About Women’s Cancers

N.E.D. filmThe doctors of the band N.E.D. (No Evidence of Disease) are turning up the volume on the healing power of music by reaching out to women with gynecologic cancers and raising awareness of these lesser-known diseases. The Emmy Award-winning, self-titled documentary, which follows the six gynecologic oncology surgeons who span the country and the women they treat, aims to educate an even bigger audience. The film was shown in more than 40 cities in the U.S. on Feb. 4 in honor of World Cancer Day and February’s National Cancer Prevention Month. Readers will also have the opportunity to view the film online, but more on that later.

“There is this group of cancers that’s been ignored. There’s been a wall of silence around it,” John Soper, M.D., of the University of North Carolina at Chapel Hill, said in the documentary. The slide guitarist and mandolin player for the band N.E.D. added, “And hopefully we can bring some noise to that so that we’re heard, and so that our patients are heard.”

There are five main “below the belt” cancers for women: cervical, ovarian, uterine (endometrial), vulvar and vaginal. American Cancer Society estimates that 98,280 women will be diagnosed with gynecologic (GYN) cancers in 2015 (up from 94,990 in 2014), and 30,440 will be expected to die from these diseases (up from 28,790 last year). There is greater awareness of cervical cancer, and the fact that almost all cervical cancers are caused by HPV. The CDC states that HPV (the human papilloma virus) is so common that nearly all men and women who are sexually active will get it in their lives, though most cases of HPV go away on their own and are not the types that eventually cause reproductive cancers. Routine Pap smear screenings can detect HPV and cervical cancer. However, there are no standard screening tests for the most common GYN cancers—uterine and ovarian. An estimated 52,630 women were diagnosed with uterine cancer last year alone.

Incidence of Women's Cancer

Src: American Cancer Society

“We don’t have the diagnostic tests that we need to have for some of these women’s cancers,” Gretchen Purser, chair of the National Race to End Women’s Cancer, said. “And I want everyone to understand that when you go to the doctor, you’re not being tested for everything. You may think you are, but you’re not. And that’s something that every woman needs to know and take personal responsibility in and not to ignore her body.”

Why is there such need to draw attention to GYN cancers? For one, they are a leading cause of death for young Hispanic and African-Americans. Yet awareness of these types of cancer is still so low, and it’s considered taboo to talk about them in public. And while the national publicly supports breast cancer, both vocally and financially, less than 1 percent of what goes into breast cancer research is given to gynecologic cancer research.

What Every Women Should Know About Women's CancerIn the documentary, Will Winter III, M.D., compass oncologist and lead guitarist of the band, recounts a talk he gave to a room full of gynecologists about cancer awareness. While all the doctors had participated in or donated to organizations dedicated to breast cancer, only three had ever heard of the Gynecologic Cancer Foundation and none had supported it. The Foundation for Women’s Cancer, as it is now known, provides public awareness programs to aid prevention, early diagnosis and proper treatment of gynecological cancers, as well as supports research and medical training. It is the only charity in the U.S. that covers all GYN cancers.

“There are only 750 to 800 or so gynecologic oncologists in the whole country,” said William “Rusty” Robinson, MD (vocals, bass guitar & harmonica for N.E.D.), of Tulane University School of Medicine in New Orleans, La. “Because of that [GYN cancers] are not universally recognized in the healthcare system. The physicians may not even really be aware that they have the option of sending a patient to see a specialist in that particular field.”

One of his patients, Bobbie Kelley, matter-of-factly shares her experience of suffering from the unknown in the documentary. “It went from 2002 to 2012 before someone really knew what was going on,” Kelley said about her rare vulvar tumor. “So I’ve been in pain for 10 years.”

A common cry for women with GYN cancer is, “I didn’t know.” Not enough is know about the signs and symptoms of GYN cancers, nor what to expect in terms of severity of the disease and outlook.

Vulvar Cancer Awareness MonthWhile reading an N.E.D. handout on GYN cancer, a patient with stage 4 ovarian cancer, grew tearful in the documentary. “I wish I knew about these symptoms a year ago,” Cathy McCue said. “I really do wish I knew this and had this information. If I knew this, I might not be sick. So I really hope that they could come up with some form of screening or something that can help women because we don’t know.”

Director Andrea Kalin hopes to elevate the public awareness of GYN cancer on par with breast cancer with No Evidence of Disease. According to Kalin and her filmmaking team, the goal of the documentary is to trigger major changes in cancer funding as well. The film makes clear that GYN cancer affects women of all ages and ethnicities and has a great impact on the doctors who treat them, as well as their families and friends.

“It’s not just a woman’s problem,” said Winter. “The whole idea is that no one’s life is untouched by women’s cancer.”

Complete remission, or “no evidence of disease,” is the magic phrase that each woman with cancer prays to hear her oncologist say. With greater awareness and funding to support research and treatment, more women with GYN cancer can reach the point of N.E.D.

To learn What Every Women Should Know about GYN cancer, watch a 16-minute multimedia guide to the signs and symptoms of all major GYN cancers here.

The film will be available for viewing on the website via Vimeo. View the trailer below:

No Evidence of Disease (Trailer) from Spark Media on Vimeo.

To find out more about the band N.E.D, visit their website

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Five Tips To Develop The Ideal Home Yoga Practice For You

Flying Pigeon PoseFor the yogi looking for greater flexibility and independence in his or her workout, having a home yoga practice is immensely beneficial, providing a great opportunity to develop discipline, creativity and commitment to self. When you have your own yoga space in the home, whether it’s a room of your own or a designated area of a room where you can comfortably unfurl your mat, you have the power to orchestrate your own practice in a multitude of ways. You can do yoga in your most fashionable Lululemon apparel or in your pajamas. You have the freedom to decorate the space in a manner that complements and encourages your practice. If you want techno music to accompany your flow, you have the choice to pump your favorite music as loudly as you wish. You also have the opportunity to do yoga at your desired pace and intensity, whenever you want and for however long you prefer. While all of these things sound—and are—amazing, let me offer some tips from my own experience for developing a home yoga practice that is ideal for you.

1. Creative a Conducive Mood and Tone For Your Practice

Your yoga space should be reflective of your personality and the intention of your practice. If you do restorative or yin yoga, you might be drawn to muted colors in your space, with soft and slow music (if any) and minimal decoration. If you’re attracted to more athletic yoga, like power yoga, you might want your space to be energizing, with bright colors and posters with positive affirmations or powerful quotes, exuberant music playing loudly while you’re on the mat.

Mind-Body Shift YogaTo clearly mark my yoga space, I decorated the area with a decidedly colorful, Asian theme. A golden Buddha statue sits atop patterned cloth from Nepal, behind a half dozen candles and in front of purple and aqua wall coverings, with hints of orangey yellow and grass green. The vibrantly colored wall coverings in the room are spiritually significant, featuring Om symbols, Ganesha and Buddha sitting in lotus. I have dark pink and purple yoga mats atop thick interlocking foam mats. My accessories include a purple bolster and yoga blocks. A decorate Japanese umbrella, also purple, sits in the corner.

My use of the color purple is deliberate. Not only is it my favorite color, but it also symbolizes spirituality, creativity and the subconscious. One of the primary aims of yoga and meditation is to make the unconscious conscious. With stillness and focused attention, we bring subconscious thoughts and feelings into our full awareness. Subliminal thoughts and feelings, unresolved issues, fears, doubts and the memories of trauma reside in our subconscious (and also deep within the body), unconsciously affecting what we think and do and how we feel, both emotionally and physically. By bringing this shadow self of the subconscious into full awareness and clarity, we are better able to direct our thoughts and feelings, and thus our actions. We gain greater intuition and mastery over both the mind and body. I honestly can’t think of more inspiring symbolism to set the mood for my practice.

Feel free to use the power of aromatherapy by incorporating into your yoga practice essential oils that enhance the intention for your practice, whether it’s to strengthen, ground and center, or uplift. For instance, using lavender may provide calming and soothing effects, as well as serve as a remedy for insomnia. My favorite scents are vanilla and cinnamon. Vanilla is relaxing, calming and promotes clear breathing. Cinnamon helps reduce nervous tension and boosts attention and focus, while improving blood circulation and reducing inflammation and stiffness of the muscles and joints.

2. Set a Date With the Mat

Yoga Studio App

Src: Yoga Studio

While flexibility with timing is definitely a plus, I encourage you to schedule a specific time to do your yoga practice. Outside the home, you may take classes Monday, Wednesday and Friday from 5 p.m. to 6:15 p.m., or Tuesdays, Thursdays at Saturdays at 9 a.m. Setting aside regular class time inside the home should be no different.

When you rely on the whim of the moment to practice, you are much more likely to find excuses for why you can’t yoga: Your roommate or partner showed up early at home, and you don’t like having an audience. An unexpected weekday invitation that you don’t want to miss popped up, leaving no time to get in your yoga practice after work. You were offered a surprise work assignment during the time you really wanted to be doing yoga that day. Failing to make a firm commitment to your practice makes it easier for equally important tasks and responsibilities to take priority, pushing yoga further and further down on the to-do list.

Instead, find the times that work best for you at home, and firmly ink it into your schedule. Just as with classes outside of the home, you can set an ideal schedule and a backup schedule for when unavoidable conflicts interfere with your original practice time. You may also be flexible with the length of the sessions as you might find that doing yoga solo enables you to get through an entire session in less than an hour. Or you may find that being able to devote more time to each pose and flow inspires you to stretch out your time on the mat. Or you may enjoy breaking up your practice into multiple sessions a day, such as first thing in the morning and shortly before getting ready for bed at night. Enjoy your freedom, but commit to your practice.

3. Avoiding Yoga Shortcuts

 “You must understand the whole of life, not just one little part of it. That is why you must read, that is why you must look at the skies, that is why you must sing and dance, and write poems and suffer and understand, for all that is life.” –J. Krishnamurti

Yoga Challenges on InstagramHaving your own space to do yoga, you have the freedom to be your own conductor, with a bevy of ways to orchestrate your personal practice. Be careful not to cut yourself short by trying to take the “easy way” out of a complete practice. To prevent injury, don’t skimp on your warm-ups and cool downs. And don’t forget that yoga is more than just getting into asanas.

As fun and effortful as those multiple yoga challenges on Instagram are, for example, they should not be a replacement for a real, at-home practice. Consider doing challenge poses immediately after your practice, right before the cool down. It’s important to remember that simply doing a series of random poses in a row is not the equivalent of a comprehensive yoga sequence.

Transformative yoga sequences bring you safely from warm up to peak poses to cool down, incorporating breath work throughout. A sustainable yoga sequence is a seamless flow that safely and gradually builds off previous poses, allowing you to move with ease. Leave out any critical components, and you miss the point of practice.

You may compromise your breath. You may be misaligned. You may injure yourself. You may leave the mat more spastic than you were when you first stepped on it. Thus, you miss out on the long-term, holistic benefits of yoga. Why would you want to risk missing all of its best parts?

4. How to Stay Out of a Practice Rut

Designing Yoga SequencesMany new or intermediate yoga practitioners may get frustrated trying to create a home practice with limited knowledge or experience, doing the same, familiar sequence(s) over and over again. To keep your home practice motivating, you also want it to be fresh and fun. Don’t let a lack of expertise or creativity keep you stuck in a practice rut.

From yoga classes to instructive articles and tools for designing your own yoga sequences, all you could ever need is literally right at your fingertips. There are numerous resources online that provide in-depth pose instruction and creative sequences that you can choose to include in your home practice. Yoga Journal offers a yoga sequence builder so you can arrange different poses in a sequence designed just for you. You can even design a dynamic and exciting sequence using poses from those Instagram challenges we love so much.

You can find classes and sequences, organized by difficulty, length, style and focus/theme at:

5. Don’t Wait Until You’re In the Mood

Perhaps you may recognize some of the thoughts that occasionally run through my mind when I know it’s time to step onto the yoga mat:

This morning is way too cold to do anything but bundle under a blanket.
Work was mentally and physically exhausting; all I want to do now is just vegetate.
 I’m more in the mood to lift things or sing, cook or clean, run errands or really anything else but this!

While you may have legitimate reasons to postpone your practice, I recommend that you don’t wait until you’re in the mood or when conditions are “perfect.” Take some tips from the writer’s life. A writer must sit at the desk and show up on the page each day to be able to produce content. She can’t just wait for inspiration to make its magical appearance; she must regularly put in the work and take action in the right direction before that creative spark and passion can be ignited.

“Being in the mood to write, like being in the mood to make love, is a luxury that isn’t necessary in a long-term relationship. Just as the first caress can lead to a change of heart, the first sentence, however tentative and awkward, can lead to a desire to go just a little further.”― Julia Cameron, The Right to Write: An Invitation and Initiation into the Writing Life

Likewise, sometimes all it takes is getting into that first yoga pose to give you the momentum to keep going. I’ve often dragged my feet about starting yoga because I was in too much pain, too tired, too tense or had too much other work to do. Yet I know that in every instance I make the decision to get on the mat anyway, I find exactly what I need there. The time frequently gets away from me as I sink deeper into practice—if you have a tendency to overdo it, like I sometimes do, use a timer! But you need to step into your dedicated space consistently and completely in order to experience the myriad benefits of yoga.

Each time I get on the mat, excuses fall away. I am relieved of pain, fatigue and stress; however long the effects last. My muscles lengthen and loosen, my joints become less stiff, and I become either more energized or more relaxed, depending on the intent of my practice at that time. My mind stops racing in a million directions thanks to my focused attention and controlled breath in the flow. Clarity and focus improves dramatically, freeing up the time it will take to do the work I need to attend to next. Every day, I take the opportunity to remember how yoga heals and restores me inside and out.

P.S. A Home Practice is Just One Piece of the Puzzle

A flourishing home practice is a great supplement to organized classes, though it should not completely replace guided or teacher-led classes. Having the support and guidance of a great teacher who can teach you new poses and properly correct your alignment is extremely valuable and necessary. You also have much to learn from fellow classmates, no matter their difficulty level. Having others to do yoga alongside also boosts motivation and accountability to your practice. Having the camaraderie and support of others through any type of exercise endeavor is truly a wonderful thing.


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