2 | Nutrition and Stress: Equipping Family Caregivers

0:02 Are you ready to transform the way you communicate about nutrition with your patients? Welcome to Exam Room Nutrition, the podcast where the worlds of nutrition, medicine and communication collide. Whether you're a seasoned physician or a healthcare student, this podcast is for you. Providing patient education during a busy clinic day can feel overwhelming, but exam room nutrition is here to equip you with the language and skills needed to discuss nutrition with confidence. And compassion. So stick around and let's make our patients healthier. One exam room at a time. Welcome back to the Exam Room Nutrition podcast. I'm your host, Colleen Sloan. I'm a Registered Dietitian and Pediatric PA.

0:45 I'm so excited for our topic today because we're gonna be tackling the topic of nutrition and anxiety, and whether you work in mental health or not. This topic is very applicable to all of us because we all have our struggles. We all have our issues that we deal with on a daily basis, and we need to learn how to cope with those difficult days. So the reasons for stress in someone's life can vary from person to person. However, a lot of our patients are overwhelmed with caring for aging and chronically ill family members, and this becomes a huge mental and physical burden for them. Stress management can be challenging, and you might not even think that there is a role with nutrition, in how we manage our anxiety and our nerves and our stress, but there is, and today we're gonna prepare you for when your patient might say to you, I'm overwhelmed by caring for my elderly parent.

1:37 Is there any sort of diet that can help manage my nerves? And so to help us navigate this discussion, our guest today is Jessica Cording. She's a Registered Dietitian, health coach and author focused on simplifying wellness routines and fostering sustainable healthy habits. She has her very own podcast, drama-Free Healthy Living. She provides accessible guidance for a balanced lifestyle. So I couldn't think of anyone better to have on our, show today besides Jessica. So thank you so much for being here. Oh, I'm so happy to be here, Colleen. Thank you for having me. so I am thrilled to learn from you, because I know that there are a lot of our listeners who work in adult medicine, maybe even dealing with the elderly and aging population, and their stressed patient might not be their patient, but it's a family member.

2:26 And this is such an important topic that we talk about today, but can you maybe start off by explaining, I. Some of the specific types of stress that those family caregivers are under, maybe what they should prioritize for their own health. Yeah, absolutely. I mean, with family caregivers, oftentimes people find themselves in that role unexpectedly. You know, and this can show up obviously with, aging family members, is something we are familiar with. But also, if a family member develops an illness, but this can also apply to maybe children with ongoing needs. And if there is someone in your life that you're caring for. uh, I would say caregiver burnout is one of the biggest issues that comes up in this area, and that is characterized by things such as feeling extremely fatigued, even if you get enough sleep, feeling overwhelmed, complicated emotions arising around things like.

3:20 feeling resentful of having to take care of your loved one and then having all those complicated feelings about that, changes in one's own physical health. we often will see, uh, changes in eating habits, weight changes, Often it's hard to find time to exercise when you're in a caregiving role. that is something I found a lot of people have to be intentional about. and I didn't even mention sleep. This is one of the biggest issues and there's a huge link between stress and anxiety and sleep disturbance, and it can become a really vicious cycle. Happening that are impacting a caregiver's, uh, mental and physical wellbeing, directly related to the stress and general demands of caregiving that, Yeah.

4:04 It is interesting that you're often just thrown into that role of caregiver and there's no handbook for that. So does nutrition really play a role in stress and anxiety? Oh, absolutely. when we look at the nutritional. Piece of the picture. Um, one of the biggest things to focus on is blood sugar control. You know, so when our blood sugar is not well balanced, we experience changes in energy, mood, um, appetite control becomes an issue. So what I have found to be very successful for my patients and clients and their caregivers is, Focusing on having a good combination, a good balance of protein, fat, and fiber at meals and snacks spread consistently through the day rather than say like snacking on little things here and there and then having one giant meal, right?

4:54 but also there's specific foods that have been shown to have benefit to our stress response. for example, some that we have some literature on uh, turmeric, you know, which is an herb you'll commonly see in a number of different types of recipes. things like, omega-3 fatty acids, you know, some really cool research looking at fish oil supplementation specifically. There's some core research looking at wild blueberries and their impact on brain function as well as inflammation that has an impact on many different parts of the body. What's I think important to remember is that when someone is under a lot of stress, This elicits an inflammatory response in the body. So oftentimes when we're talking about nutrition to manage stress, we are talking about a lot of anti-inflammatory foods and anti-inflammatory diet patterns.

5:42 So lots and lots of vegetables. fruit has its place. Healthy fats like olive oil, avocado nuts and seeds, oily fish. You know, lean protein in general is a really important thing to be incorporating regularly. and there's also some research looking at, bacteria found. Its fermented foods, for example, being something to support overall gastrointestinal health, which does play a role in mental functioning. Um, and of course limiting some known inflammatory foods. So not to say you have to avoid these completely, but keeping an eye on, say sugar intake red meat. Refine carbohydrate, ultra processed foods. You know, these are things that are not helping you.

6:23 They might be okay in small amounts for pleasure. and then I always point these out. alcohol and caffeine also be very careful with these. Cause caffeine can amp up and anxiety can disrupt your sleep. Alcohol. A lot of people think that it reduces. Feelings of anxiety and stress. But interestingly what happens is after that initialing sensation wears off, there's certain mood regulating brain chemicals for example, gaba. as the body processes that alcohol, those, you know, feel good chemicals take a nose dive, causing you to wake up feeling anxious again, thinking, Oh, I just need more alcohol. So that can become a cycle as well. And alcohol also disrupts sleep. but that's just a little piece of the picture of food and stress management.

7:06 Oh, it's such an interesting topic to me. I never really put two and two together with stress management is applicable with. The anti-inflammatory foods and following that type of diet because it makes complete sense and it, also makes me think of when you're in a plane and the flight attendant says, you know, parents, make sure you put your mask on before you, help your child or anyone else with you. we need to make sure that the caregiver is being cared for. First and foremost, really, before they can appropriately and accurately care for their loved ones. So I think this is hitting home for so many listeners. maybe a family med doctor or internal med, or maybe even a psychiatrist or somebody in the mental health facility listening into this, what could be a few, tangible, actionable things that they could have their patients start.

7:56 Eating or doing tomorrow, that might significantly help. Yeah, I mean, I think bringing it back to the blood sugar I think that practice that's sort of where everything attaches underneath. you know, when our blood sugar is not well controlled, um, everything else takes a hit. So from a nutrition standpoint, you know, I would put the emphasis not on eating a perfect diet. I think sometimes people hear healthy eating and they think that that has to mean like all or nothing. But when you're in a caregiver role, It's really about survival and making the best choices in the situation. So you're often on the go a lot too. So I'm not gonna tell someone who's needing to rely on convenience foods to be, you know, cooking every day, right?

8:37 like, we need to think about simple things that are gonna be accessible to them. So, if they always go to like, uh, like a coffee shop. we'll use Starbucks as an example. if they're often gonna Starbucks and getting breakfast, You know, instead of their sugary coffee drink and then a pastry, maybe they get a Cappuccino which espresso has a little less caffeine than the drip coffee, especially at Starbucks. and some egg white bites and some nuts to snack on. You know, cuz that way they're gonna have more protein, they're gonna have, Um, more fiber, more healthy fat. Um, I'm a little more balanced. Maybe, instead of eating like a bowl of oatmeal with brown sugar and bananas every morning, maybe they'd still have the oatmeal. Maybe, you know, they can add a little teaspoon of brown sugar if they really, really love it.

9:19 But let's get some healthy fat in there. You know, throw Some ground flax in the bowl or put a big, big giant spoonful of peanut butter on top to give you a little extra protein. Some fat's gonna ground you. so if someone's normally doing like an Italian sub. Like instead of, instead of that, maybe they do like a grilled chicken sandwich or they get, you know, like some vegetable soup and a side salad or, um, you know, start playing around with different ways to introduce. These healthy foods. Um, packing snacks could be a really nice entry point for someone cuz if maybe they can't control what all is gonna happen during the day, but if they know, that they have some shelf stable, healthy snacks, you know, in their purse, their car, wherever, their backpack, whatever makes sense, um, that can also.

10:02 Take away some of the stress of having to make healthy food choices. you can get packs of nuts and seeds. I love the crispy chickpea snacks or dry roasted edamame. Those are very convenient. you know, or if you're at a convenient store, things Like hard boiled eggs, cheese sticks, um, even like cereal and a little bit of milk. Like I'm, I'm cool with that. It's still gonna give someone a balance of nutrients. what I wouldn't recommend you know, just relying on whatever's available all the time. If you don't know what you're walking into, like if nothing else, you know, have a, have a bar, a protein bar that. you know, makes you feel good in your purse or something like that. and hydration. I think people forget this one a lot and one of the barriers that I hear most often when it comes to staying hydrated is concerns about having used the restroom a lot.

10:50 And there's a few ways to look at that. I do think that there are some cases where someone is very worried about leaving their loved one unattended, and that is very real. for those people, I will tell them to start your day with like a big glass of water, um, as you're getting ready for the day and maybe when you have those calm moments where you can, those are good times to hydrate, but I would say like water is your best friend. Go slow with the coffee, go slow with the alcohol, um, and also embrace healthy shortcuts. you know, I am a huge fan of pre-chopped and frozen produce. Um, that will save you, so much time, especially when you're trying to eat more vegetables.

11:30 Cause you'll often hear people, you know, like me saying leafy greens are good for you, but you're like, when do I have time to eat a salad? Um, Chopped frozen spinach. You can throw that and snap it in the microwave, throw it to soups. put it on pizza, you can put it in eggs. Like all different things you can do with stuff like that. You can even make a smoothie with it. you know, I've had clients who, when they were very busy, what we would do is we, we would have them make a big giant, smoothie in the morning with a lot of with vegetables and fruit and protein and healthy fats, and they could drink that about their morning if they didn't have for meal. So there's. Play with. But I think it's worth asking someone what their routine is like and which times of day are most challenging for them.

12:12 Cause that's gonna give you clues as to where to start for that person. Cause every, every person is, in terms of their caregiver experience, you know, it's gonna look a little bit different. And as healthcare providers, we need to be sensitive to that, that it really, and you've heard this a million times, but it truly is not one size fits all. You made some excellent points and you know, when dieticians recommend, like you said, green leafy vegetables or more fruits and vegetables, sometimes patients just get overwhelmed just by that thought alone You know, they might not even have a fridge with them, so they can't even have fresh fruits and vegetables, so, I love your suggestions to keep it simple and just meet them where they are. Even if they're eating out for the three meals a day, just trying to focus on is there a salad and maybe something with chicken that you can choose instead of the french fries and you know, hamburger meal for every single meal that you're eating.

13:03 because that is the last thing we wanna do is further overwhelm our stressed out caregivers, because that's just not gonna be helpful for anybody. all right. So I'd love to close, by asking all my experts what would be one thing that we, as clinicians should never say in regards to nutrition and maybe just mental health in general. What would be the worst piece of advice that we could give to our families? Oh, wow. There's so many places I could go with this. I mean, one thing that comes to mind is bringing shame into the picture. Um, you know, this is less about advice that we're giving somebody, but I think it's really important when someone is telling us about their day-to-day habits. we need to listen.

13:44 Um, we should not tell people, I can't believe you eat that, or don't you know how bad that is? but I think big picture, I think we should really stay away from any language that is gonna come off as judgmental, blaming, you know, making them feel like an idiot. That's, that's not something we wanna do at all, cuz we're gonna lose them. They're not gonna trust us. And they're not gonna feel confident in their ability to make good choices, and that's really, really important. We really need to foster that empowered, calm mindset around food and nutrition and lifestyle change in general. That was so enlightening and so helpful. whether you are in the mental health world, you're in family practice, or even in pediatrics.

14:26 the next time you're in clinic and you maybe even notice that the parent is struggling or they seem stressed out, or you've got the elderly husband who's caring for his wife, struggling with dementia, pause and ask how they're doing and ask and make sure that they're taking care of themselves. And hopefully you can remember some of these tips that Jessica had suggested. Really try to help them focus on some more fruits, some more vegetables. The lean protein. Pack in some snacks and keep it simple. Do not overwhelm them. Do not overburden them. Cause we already know that our caregivers are stressed. So I hope this conversation provided you guys with some useful information that you can actually provide to your patients tomorrow in the clinic. And remember, you don't have to do it all.

15:08 we're not all registered dieticians and that's why there's registered dieticians. So don't be afraid to refer out. It's our job to start the conversation to encourage them and to push them towards healthier eating and to start igniting that desire to nourish their bodies healthfully. But if there is a patient that's in need and needs a little bit more handholding, there's dieticians like Jessica that are here and willing and able to help. So guys, I hope that this podcast episode was helpful for you. Please let me know if you'd like to have Jessica on for any further discussions on any areas of mental health. And Jessica, thank you so much for your time. I can't give this time back to you, so I really, really appreciate you giving us the gift of your time. Oh, thank you. It was, it was such an honor to be here with you.

15:50 All right, guys. Now it's time for my nutrition notes. This is the segment in the podcast where I like to share a nutrition tip, an interesting quote or an interesting case that I think might add value to your day. So today I'm gonna leave you with a quote. And it goes really well with our discussion today with Jessica about anxiety and stress management and how nutrition can have an impact in that. And hopefully this just gives you some encouragement and maybe something that you can leave with your patients as well. So it says if you feel like you're losing everything, remember trees lose their leaves every year and they stand tall and wait for better days to come. I hope you guys learned something from this episode that it was beneficial to you and that you can incorporate some of these tips into your busy practice.

16:36 If you would like to have a question featured on the podcast, I would love to hear from you. You can find me at Instagram at exam room nutrition, or you can send me an email at exam room nutrition gmail.com. Well guys, let's make our patients healthier. One exam room at a time.