I Always Bring My Lunch

I was in NYC in August this summer, doing a short 4th year medical elective at the Center for Transgender Medicine and Surgery. I did some couch surfing, and stayed at an Air BnB in Williamsburg my last week. Medically it was an outstanding experience, and in my dream future, I will get to be a physician working at this clinic in Manhatten. But that is not what I want to talk about today. Today I want to talk about food, and weight, and lunch, and how I keep my body type mesomorphic despite spending most of my time working in a hospital or relaxing in bed.

The answer, IMHO, is lunch. What do you do for lunch every day? To me, lunch is a time for fuel. By lunchtime every day, I would eat basically anything. I am the type that sometimes eats my lunch at 10:30 AM I am so hungry. The more glucose my brain is burning, the more I need that hit of fat, phytonutrients and fiber.

Therefore, my secret plan is to eat the super healthy sometimes boring basics for lunch – tons of veggies, good quality fats, high fiber fruits, raw vegetables and very few processed carbs. This way I can have whatever I want for dinner.

So, what do I actually eat? Greens and grains, with cheese, avocado or nuts/seeds and random chopped veggies like carrots, cucumber, tomato, radish. In summer I love to put flowers in my food. A grain free diet is popular with the keto crowd, but I always advocate to have at least a few cups of whole grains in the diet per week. The fiber, magnesium, B vitamins and serotonin release metabolically help keep the mind-gut axis regulated. We rotate our grains between Ludenberg short grain brown rice, wild rice, quinoa, and millet to maintain variety of flavor and nutrient profiles.

I heard once in a conference lecture that nutritional studies were done evaluating T4 –> T3 conversion activation (active thyroid hormone.) Subjects were fed fat based diets, protein based diets or carbohydrate (CHO) based diets. Only the diets with carbohydrates evidenced thyroid hormone conversion. Since I am a huge fan of having optimized T3 production for an effective metabolic mileau, I advocate for having a moderate amount of whole grains in ones basic nutritional foundation.I wish I had the study in-hand to back this up but I dont; maybe once I am out of medical school I will have time to research these things more fully. The bottom line is that I am a fan of having whole grains, and I like them especially in my lunch. They are filling and delicious and beneficial.

I like to layer the grains on the bottom, then a huge handful of greens – whatever has the latest expiry date when I am shopping! We rotate spring mix with herbs, arugula, baby spinach, crispy green leaf lettuce, and occasional kale salad (leftover.) I need fat with my lunch to feel satisfied, so I douse the whole thing with yummy olive oil and a delicious vinegar like balsamic or umeboshi or fire cider vinegar. Then, I add some protein: cheese is the easiest and I love cheese.  Tuna, egg or chicken salads are always a win too.

I also love toasted walnuts, pecans, pumpkin seeds or sunflower seeds. I buy them raw, and toast them in a dry cast iron pan until they are warm and smell nutty but not burnt. Make sure to stir! I store these in glass jars in the cupboard. The pumpkin seeds are best toasted with some Chalula hot sauce and cumin! Yum. These add a crunch, some richness, protein, and delicious essential fats. Finish the lunch with 2 chopped veggies for color, fiber, and variety: an organic carrot, cucumber spears with pepper, pepper slices, whatever floats your boat.

If you are a diet hard paleo and refuse grains, or if you are like me and sometimes need a second lunch or a hearty snack then organic nitrite free salami is a good addition. It is filling, savory, and works well with olives, carrot rounds and other veggies for finger snacks. Just veggies is not enough for me.

Lunch Plan B: huge leftovers fan here. If I go out to dinner, I almost always save half for lunch the next day. This is a win-win, because I stop eating when I am full (or save room for dessert) AND I have a pre-made meal to go. I hate waking up extra early to deal with lunch, so I usually get lunch ready the night before. We generally also cook for more than two, planning a lunch or two and maybe even a supper into every meal we co-create. Leftovers are exciting to me because these are usually rich yummy comfort foods like pasta, steak, curries and other “real meals”.

Finally, my “lunch diet” saves me money. The first day of my August rotation I went to the nearby Whole Foods on the lunch break. I wasted 15 minutes wandering around the hot and cold bars, trying to figure out what to eat. My $15 salad ended up being an awkward mish-mash of flavors that did not blend well. That day after work I went and bought $40 worth of groceries (crackers, apples, greens, cheese, nuts, yogurts and paleo granola for breakfast)  and brought my lunch to work every day for the next week, supplementing with enchilada leftovers from my yummy dinners when I got bored.

Bringing your lunch ensures you know exactly what you are eating. It keeps you committed to your intentions with food, and lines up the healthy choices for you in moments of  “Im Starving” brain meltdowns that would otherwise allow for easy junk food choices. It is also a great way to plan your daily insulin for diabetics! Finally, it frees up dinner for more social food activities that can be enjoyed in a relaxed and guilt-free environment.

Oh, and bring a snack, maybe two. For Fall and Winter I find an apple is the hardiest fruit. Combined with nuts and raisins, it’s a great choice. Someone once said, if you dont want to eat an apple, you are not actually hungry. This holds true as long as your teeth are in good shape.  IN winter and summer, cut up fruit like citrus or stone fruits or berries are refreshing and delightful. I love dried mango slices from Trader Joe’s. If you crave yogurt and aren’t having it for breakfast, it’s a good option too. I love the dairy-free yogurts too like soy, almond and coconut singles, which are far better choices than anything a vending machine or a cafeteria might offer for those with a sweet tooth who use work time as an excuse for sugar snacks.

My basic formula for weight maintenance is eating healthy 65% of the time, and my body can easily process about 35% cheeseburgers, nachos, pizza, sweets, and other junk. For weight loss this may need to become more like 75:25 and exercise has to be added in. I eat at least 60% of my daily food at work between 9-5pm. If I make sure these foods are healthy, wholesome and invigorating to my brain and bowels, my nutritional work is done for the day. Yay! If I am trying to lose weight I make more responsible dinner choices at least a few days a week, still allowing for guilt free food times with friends and my love.

 

 

Share

Will Power

I am two weeks into second year medical school, and the majority of our content has been NeuroAnatomy and Brain Diseases. As a physician it is pretty darn important to be able to figure out when someone is having a life threatening stroke impinging on brain tissue,  versus a flare up of a genetic disorder that is starting to show neurological signs and symptoms. Knowing the anatomy of the brainstem, and the arrangement and progression of the long tracts of nerve fibers throughout the spinal cord, medulla, pons, brainstem and beyond can create a Cartesian like diagram where one can fairly accurately isolate the nature and location of the lesion. That is, if you can remember where and how everything goes.

Brainstem_07-02_smallI never quite knew where the medulla was even located, and now I know more than I probably ever will again about the arrangement of nerves, radiations and nuclear cell bodies in its little bulbous body. This tiny part of the body has nerve fibers that do cardiorespiratory regulation, the trigeminal cranial nerve nucleus, tracts, and radiations for face sensation, ascending dorsal column and spinothalamic sensory tracts for the entire body, descending corticospinal and pyramidal motor tracts for the entire body, and some complicated cranial nerve regulating nucleii that coordinate the eyes and hearing. As you go up fun things show up like the olives, and the solitary nucleus and nucleus ambiguous (both associated with the vagus nerve.) And, the tongue. Problems with the tongue can be from a medullary lesion including slurred speech and not being able to stick your tongue out at someone very effectively, because it points wiggly off to the side the damage has occurred. There is probably more things in this tiny medulla oblongata, but I cant remember them right now.

Starting back into school is also an exercise in letting go. I am fairly certain this is a cerebral condition, and not a brainstem function.  Letting go of free time, of relaxation, of life without an alarm clock. It takes a lot of will power to focus for so many hours at a time. I personally also find myself needing to cut back on alcohol, Netflicks and social time with the advent of academics.  I have been having a lot of conversations about this topic of will power lately, as in, do I have enough, or am I lacking? I have such restricted foods from all of my food sensitivities that I feel like I have pretty good will power overall but maybe, just maybe I could work on a higher level control of some of my more primitive impulses (stay tuned for amydala updates next week.)

untitledBack to the topic of stroke. And willpower. Smoking is a huge risk for stroke, especially intraparenchymal stroke. 45% of people die within the first 30 days of having a stroke. Why? Because the brain is special. And when you put pressure on it, by adding more fluid (blood) into a closed small area (the skull, or calverium as I love calling it) then, the brain tissue simply LIQIUIFIES in an effort to make more room. Disgusting right?! When your brain liquefies, you get signs and symptoms associated with damage in that place – if you hit a small area and just nerves and radiations of nerves, your body can often recover loss of sensation or muscular weakness on one side of your body. When you hit a nerve nucleus, like the facial nerve cell body nuclei, you probably wont recover those functions because the cells themselves are dead.

Apparently I still need to learn more about strokes, especially the ones that can kill you. What I do know, is high blood pressure, diabetes and smoking are huge risk factors for stroke, and those are all related to will power. So, you do have a choice, like I do, about how to live on a day to day basis. I am choosing to decrease my daily alcohol content to improve my studying. What will your choice be?

Share