Proffee: healthy hack or headline hype?

As I washed my hands in the Barnes and Noble bathroom this week, the label on the Purell hand soap dispenser caught my eye.

It said "HEALTHY SOAP".

It made me laugh and wonder, "what's healthy soap? Have I been using unhealthy soap all my life?"

We love labeling things as “healthy”, which got me thinking about the labeling of foods as “healthy” …

So here are 3 thoughts:

1. The "healthy" label can be a helpful tool, drawing our attention to products that may be higher in beneficial nutrients and lower in unhealthy fats, added sugars, and sodium. However, it can also be misleading.
2. "Healthy" for a growing child or an athlete might look different from "healthy" for someone managing diabetes. Your patient's needs and dietary goals play a crucial role.
3. Food companies can use the "healthy" label strategically, even if the product doesn't deserve it. A granola bar might be labeled "healthy" because it has whole grains, but it could also be packed with added sugar and unhealthy fats.

Bottom line: Stop labeling foods as healthy or unhealthy …. Use of this word requires nuance.

On The Podcast

Do you ever go into the formula room in your clinic? A bit overwhelming, right? This week, we simplified the world of infant formulas. Here's what you'll learn:

• the science behind standard infant formula and how specialized formula differs
• how to choose a formula that's best for your patient based on their symptoms
• European formulas and how to educate your patients on their use and safety

Listen to the podcast TODAY! 

Disease Spotlight | Migraine

Migraines are a prevalent neurological disorder affecting over 1.1 billion people globally (WHO, 2019). In the US alone, the American Migraine Foundation estimates at least 39 million individuals struggle with migraines, with a potentially higher actual number due to underdiagnosis and undertreatment. As a cornerstone of primary care, you play a vital role in managing migraines because over 50% of migraine sufferers seek treatment in primary care settings and it is the fourth leading cause of emergency department visits.  

Making the Diagnosis: 

A helpful pneumonic for diagnosing a migraine: POUND

Pulsatile quality, One-day duration, Unilateral headache, Nausea or vomiting, Disabling intensity of headache

Navigating the Triggers

Evidence-based guidelines from the US, Canada, and Europe consistently recommend lifestyle modifications, trigger avoidance, and healthy coping mechanisms for migraine management. While triggers can vary, stress, sleep patterns, and hormonal fluctuations are well-known culprits. But since this is a nutrition newsletter, let's focus on dietary triggers:

• Histamine and MSG: These compounds can trigger migraines in some individuals.
• Chocolate: Chocolate can be a migraine trigger for some (this just isn’t fair).
• Cheese and Dairy Products: Aged cheeses and certain dairy products may trigger migraines due to tyramine content.
• Artificial Sweeteners: Aspartame and other artificial sweeteners are potential migraine triggers for some people.
• Caffeine: Both caffeine withdrawal and excessive caffeine intake can trigger migraines.
• Cured Meats: Nitrates and nitrites found in cured meats may be problematic for some migraine sufferers.

Migraine attacks often result from a combination of factors, not just one isolated food. A "one-size-fits-all" list of restricted foods is not recommended. Blindly eliminating a variety of foods can lead to nutrient deficiencies. Encourage your patients to maintain a simple food and headache journal for a few days to identify potential food triggers. Trigger foods may not cause an immediate headache, with symptoms sometimes taking up to 24 hours to manifest. If a potential trigger food is identified, advise your patient to avoid it for a month and monitor symptom improvement. If no change occurs, reintroduce the food to their diet.

Acute Management:

1. Prioritize Hydration: Encourage patients to stay hydrated with water, herbal teas, broths, or electrolyte solutions, even if they find it difficult to eat solid foods during an attack.
2. Try Simple Smoothies: Recommend simple fruit smoothies as a convenient way to consume nutrients and stay nourished during a migraine episode.
3. Consider Meal Replacement Shakes: Suggest meal replacement or protein shakes that patients may tolerate well, providing essential calories and protein.
4. Explore Nausea-Relieving Foods: Ginger and peppermint are known for their potential to alleviate nausea and discomfort. Patients can try incorporating these into their diet during migraine attacks through teas and candies or chews.
5. Try Cold Foods: Cold foods like Greek yogurt, ice cream, or popsicles can offer relief by soothing head pain and providing a refreshing sensation.
6. Know When to Skip Eating: If migraine attacks are short-lived (lasting only a couple of hours) and accompanied by severe nausea or vomiting, reassure patients that skipping a meal during the attack is acceptable. However, for prolonged migraines lasting 72 hours or more, it's essential to employ strategies to ensure adequate nourishment.
7. Consider Caffeine for Acute Management: For individuals with episodic migraines, who don't consume caffeine daily, a cup of coffee can be used as an acute management tool to reduce the severity of migraine attacks.
8. Natural migraine preventives: magnesium (400-1200mg per day), riboflavin (400mg per day), coenzyme Q-10 (100-300mg per day). These have limited and variable levels of evidence for efficacy and are not the mainstay of treatment, but they have a particular appeal to patients with chronic diseases who hope to avoid long-term prescription treatments. It is recommended to trial these one at a time to make sure that they're going to tolerate it. Then if needed, you can add another supplement one at a time.

Remember, migraine prevention and treatment require a personalized approach, and it's essential to help patients experiment to find what works best for them.

Resources:

https://www.aafp.org/pubs/afp/issues/2018/0215/p243.html#afp20180215p243-t2

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5935652/

https://americanmigrainefoundation.org/resource-library/top-10-migraine-triggers/

To learn more about migraine: Listen to Episode 34 of The Exam Room Nutrition Podcast

What the Trend?!

With all the insane diet trends and weight loss hacks out there, it's tough to stay on top of it all. But, I got you friend. I've unpacked current trends and what you need to know so you can properly guide your patients.

Proffee: Should You Recommend It to Your Patients?

Proffee, a blend of coffee and protein powder, is a new trend gaining traction. While it can be a good option for coffee-drinking patients looking to boost their protein intake, it's not a one-size-fits-all recommendation. Here's a breakdown to help you advise your patients.

I'll leave you with a quote from Beret Guidera, "Before you speak, run this through your head: Is what I'm about to say true? Is it helpful? Is it inspiring? Is it necessary? Is it kind? If you cannot answer yes to these questions --then don't say it, don't tweet it, don't write it."
Thanks for being here and for loving your patients. I'd love to hear from you and how you're enjoying the newsletter. Shoot me an email anytime! 

Have a great week!