“Squeeze-Between” Syndrome: Signs, Symptoms & Solutions

So what is this Syndrome? Well, it happens when a client tries to force my nutrition coaching in and around every other food plan she’s already following. I say “she” because, in my experience, women are the ones who do this. Many of them have several nutrition plans going at once. That doesn’t leave much room for mine.

The most obvious sign of Squeeze-Between is poor results – or none.

Also resistance. I’ll get lots of push-back when one of my recommendations conflicts with the advice given to the client by her chiropractor, her next-door neighbor, her bridge partner, her manicurist, the guy who cleans the pool.

Somehow, though, when things don’t work, the nutritionist – me – gets blamed. Clients don’t seem to recognize that they hired me because those other things weren’t working.

But perhaps I digress.

Let’s Zoom in on One Client

This client wanted to lose weight.

She had a thyroid problem, and her M.D. gave her nutrition advice. I’m not allowed to contradict that, so his guidelines became part of the project.

Her chiropractor wanted her to fast one day a week. It may have had to do with autophagy, but let’s not go there now.

The food logs she started keeping for me revealed that she always ate extra food before her weekly fast began. After the fast, she’d go a little nuts and make up for the fasting.

She wasn’t losing weight. Surprised? Neither was I. The fasting had to end.

So What Happened?

Things started moving in the right direction. But one night at 1 am, she woke up “starving.” Her word.

Chances are she wasn’t starving. Maybe she felt hungry and wasn’t used to that in the middle of the night.

Unfortunately, instead of eating just enough food to take away the hunger and going back to bed, she had a large meal.

But so horrified of hunger was she, she started eating a large meal every night at 10:30. After 5 days of that, she had gained 4 pounds.

She blamed me. That was before I reviewed her food logs and reported back to her what she had done.

Wish I could tell you we got things on track. We started to, yes, but before we made substantial progress, she announced she was pregnant and no longer interested in a weight-loss plan.

This “Too Many Cooks” Thing is Called “Diffusion of Responsibility”

My most obvious take-away was to start screening clients in a pre-program interview.

• To ask about other nutrition plans the client’s following.
• To develop an agreement with the client to follow my plan.
• To fire a client who won’t put our work front and center. Otherwise, she’ll quit and tell her friends my program doesn’t work.

Next time I ran into a client following a nutrition plan from her gynecologist, I said, “I get my worst results with clients who squeeze my plan in and around other people’s advice.”

She stopped the OB/GYN’s plan and switched to mine. Her results were fantastic, but that’s a separate story!

What if you could redefine your relationship with food? What if you could potentially reverse diabetes, hypertension, and other metabolic conditions? Or mood swings? Or binge eating? What would it be worth to you to regain control and enjoy your life without stressing about food? I’ll show you how to get there. It’s easy, it works, and you can do it. Just visit LastResortNutrition.com and grab your free Empower Me Consult today.

Vitamin A & Your Immune System

The coronavirus disease 2019 (COVID-19) has become a global pandemic and severely affected our everyday life. At this time, there is yet any clinically proven drugs or treatments to prevent or cure COVID-19.

With the novel coronavirus, about 80% of the infected had mild to moderate symptoms (mild symptoms up to mild pneumonia), about 15% developed severe disease (shortness of breath, low blood oxygen, or >50% lung involvement), and 5% became critically ill (respiratory failure, shock, or multi organ dysfunction).

Patients with severe COVID-19 illness and adverse outcome are mostly older, have diabetes, heart disease, prior stroke, hypertension, chronic respiratory disease, and/or chronic lung disease. In many cases, these patients’ immune system, in an attempt to fight the virus, becomes dysfunctional and go into overdrive, resulting in a deadly effect known as a “cytokine storm”.

Cytokines are an important part of your immune response. Your body release them as a response to an infection to trigger inflammation for your protection. A cytokine storm happens when the body releases excessive or uncontrolled levels of cytokines, causing hyper inflammation, which may lead to serious complications and even death.

Why does the immune system go haywire? How come it occurs more in patients who are immunocompromised or with preexisting conditions? How can we have a stronger, better functioning immune system?

By now, most of us are well aware of the important role nutrients like vitamin D, vitamin C, zinc, and probiotics play in regulating the immune system and keeping us healthy. Not enough has been said about vitamin A though.

For the past several decades, scientists have been studying the impact of dietary vitamin A on human health. It is well established that vitamin A is an essential nutrient and is responsible for many vital functions in the body:

It protects the eyes from night blindness and age-related decline.
It reduces the risk of certain cancers.
It supports a healthy immune system.
It reduces the risk of skin problems like eczema and acne.
It supports bone health.
It promotes healthy growth and reproduction.

In the following, we will look at how vitamin A can help reduce the incidence and severity of infectious diseases, how the immune system works against infectious agents like viruses, and the role vitamin A plays in regulating a healthy immune response. Lastly, we will discuss how you can get enough vitamin A to complement your immune protocol.

Understanding Vitamin A

Vitamin A is a group of compounds found in both animal and plant foods. It comes in two forms: preformed vitamin A and provitamin A carotenoids.

Preformed vitamin A is known as the active form of the vitamin, which the body can readily use. It is fat-soluble and found in animal foods, like liver and eggs, and includes retinoid compounds like retinol, retinal, and retinoid acid.
Provitamin A carotenoids include carotenes (like alpha-carotene and beta-carotene) and xanthophyll (like astaxanthin, lutein, and zeaxanthin). These are the inactive form or precursors of the vitamin found in plants such as sweet potatoes and carrots. These compounds are water-soluble and have to be converted to the active form before the body can use it. For example, beta-carotene is converted to retinol in the small intestine. However, the ability to convert provitamin A into the active form is impaired in many people. More on this later.

Vitamin A Reduces Incidence And Severity Of Infectious Diseases

Research studies over the past several decades have well established the beneficial effect of vitamin A on infectious diseases.

It was dated back to the ancient Egyptians that vitamin deficiency and disease were first correlated. They applied liver (which is rich in vitamin A) extracts to the eyes of people affected by nutritional night blindness.
In 1892, it was suggested that diet could have an impact on susceptibility to infectious diseases based on the observation that children suffering from measles or whooping cough also developed blindness produced by vitamin A deficiency.
Later studies indicated that supplements with carrots (which are rich in beta-carotene) could reduce the number and severity of respiratory infections.
More recent studies have shown that deficiency of vitamin A is associated with heightened incidence of infectious diseases, including respiratory diseases, malaria, tuberculosis, HIV and others.
Studies showed that high dose vitamin A supplementation in children with measles increased the number of circulating T cells (a type of immune cells), and also that vitamin A supplementation could reduce the incidence of respiratory infections in children.

How The Immune System Works

Our immune system can be broken down into the innate immune system and the adaptive immune system.

Innate immune system

This is the dominant defense system in the body and it relies on the use of physical barriers like the skin and mucous membranes, coupled with first responder defenders called leukocytes (white blood cells). Leukocytes include phagocytes (which engulf foreign invaders) and natural killer cells.

The innate immune system response is why you get a stuffy nose and sneeze when you have a cold, or why a scrapped knee gets red, hot, and inflamed, or filled with pus. For people who contract COVID-19 and have no symptoms or only mild symptoms, their innate immune system is effective and working well against the coronavirus.

Adaptive immune system

When the innate immune system is not strong enough to combat the foreign invaders, it sends out signals called antigens to call on the second line of defense – the adaptive immune system. This system uses special types of leukocytes called lymphocytes, namely the B-cells and T-cells.

This is typically when the inflammatory response gets kicked into a higher gear and you develop a fever and body aches. The adaptive immune response not only identifies and fights off viruses, it also remembers them so it can quickly and effectively combat and neutralize them in the future, thus creating immunity. This is also how vaccines work.

COVID-19 And Cytokine Storms

The coronavirus tends to target the respiratory system by attaching and infiltrating the lung cells where it can more effectively hide from the immune system and reproduce. The infected cell will then produce more of the coronavirus and the process repeats itself.

When the immune system detects this, it kicks off its response. The T-cells are then activated and they release cytokines. A cytokine is a hormone of the immune system. The body produces cytokines to help fight bacteria, viruses, and other invading organisms. Cytokines can be pro-inflammatory when they attract white blood cells to the site of an infection. Cytokines can also be anti-inflammatory when they try to ramp down an immune response once the threat has been neutralized.

The release of cytokines triggers additional T-cells to be made, which then release even more cytokines. One type of T-cells called cytotoxic T-cells roam the body and kill infected cells. When the immune system is working well, the cytotoxic T-cells only target infected cells to be killed and move along.

A cytokine storm happens when the immune system goes haywire. This is when the body’s immune response gets so amped up that it stops differentiating between infected and healthy cells. In other words, the lung cells are now attacked by both the coronavirus as well as the immune system.

With COVID-19, the cytokine storm focuses on the lungs, causing acute respiratory distress syndrome (ARDS) and damage to the walls and lining cells of the alveoli (air sacs) in the lungs.

Normally, the wall of the alveolus is super thin, so oxygen can easily get from the air space in between into the red blood cells. In this case, both the wall and lining cells as well as the capillaries are destroyed. The debris that accumulates from all that damage lines the wall of the alveolus. The damage to the capillaries also causes them to leak plasma proteins that add to the wall’s thickness. Eventually the wall becomes so thick that it is hard to transfer oxygen, hence, the feeling of shortness of breath.

Many people who get ADRS need help breathing from a ventilator. As fluid collects in the lungs, they carry less oxygen to the blood. That means your blood may not supply your organs with enough oxygen to survive, resulting in the lungs, liver, and kidneys to shut down and stop working.

Additionally, doctors found that once the coronavirus gets to the lungs, it may travel to the bloodstream and infect the endothelium, lining of the blood vessels, causing endotheliitis. It is, therefore, no surprise that people who have conditions like high blood pressure, diabetes, and heart disease that put a lot of stress on the endothelium are also the ones who get the sickest when they catch the coronavirus.

COVID-19 does not merely cause lung problems. Many severe patients also develop widespread blood clots as a result of the hyper-inflamed state of cytokine storm, leading to strokes, heart attacks, and organ failure. What’s more, doctors have noted an alarming trend as they treat more and more COVID-19 stroke patients who are in their 30s and 40s without risk factors. These people are at least 15 years younger than usual stroke patients without the virus.

Vitamin A Regulates Immune Responses

The effect of vitamin A on immune function is wide-reaching:

It promotes and regulates both the innate and adaptive immune systems and the development of healthy immune responses.
It plays an important role in the regulation of different white blood cells (neutrophils, monocytes, macrophages, natural killer cells, and lymphocytes) and influence the generation of cytokines by the immune cells.
Deficiency of vitamin A favors the production of more pro-inflammatory cytokines.
Research on vitamin A deficiency in children found that it damages the mucosal barrier, which is the natural defense of the respiratory tract, allowing bacteria and viruses to proliferate.

Are You At Risk For Vitamin A Deficiency?

Vitamin A deficiency may lower your immune function, thereby raising your risk of complications from infectious diseases.


A blood test can determine if you are severely vitamin A deficient. Vitamin A is stored in the liver. Normally, the body will always try to maintain a healthy blood vitamin A concentration (a process called homeostatic regulation). However, when the body’s reserves of vitamin A are significantly compromised, vitamin A concentration in the blood can drop below normal range.

Signs of mild deficiency

dry eyes
poor night vision
hormonal imbalances
irregular periods
vaginal dryness
low energy and fatigue
mood disorders
frequent throat and chest infections
bumpy skin
eczema and acne
thyroid dysfunction

Strict vegans who avoid all animal-based foods and alcoholics are more prone to vitamin A deficiency.

Since vitamin A is stored in the liver, and alcoholics may have existing liver damage, they may be more susceptible to deficiency.

Vegans who rely entirely on plant sources of the precursor to vitamin A need to have the carotenoids converted to retinol, the active form of Vitamin A. However, in a majority of people, the carotene-to-retinol conversion is severely compromised, and in some it may even be as low as 10%.

Factors that inhibit the conversion include:

genetic variants in the BCO1 gene that impact the conversion of beta carotene
alcohol use
certain medications
toxic exposures
medical conditions that interfere with the digestion of fat (including Crohn’s disease, Celiac disease, cystic fibrosis, pancreatic enzyme deficiency, and gallbladder and liver disease)
a low-fat diet – as healthy fats are needed for the efficient conversion of carotenoids to retinol

Sources Of Dietary Vitamin A

From animals (preformed vitamin A):

Pastured animal liver (liver is an organ that processes toxins, toxins are not stored in the liver but in fats in the body)
Pastured poultry giblets
Cod liver oil
Grass fed ghee and butter
Grass fed cream and cheese
Pastured egg yolks
Sockeye salmon

From plants (provitamin A carotenoids):

Sweet potato
Winter squash
Dark green, leafy vegetables
Red bell peppers

Vitamin A Supplementation

Ideally, it is best to eat vitamin A-rich animal foods regularly. There is no risk of excessive intake through food. The risk lies in taking mega dose supplements. Symptoms of vitamin A toxicity include changes to vision, bone pain, and skin changes. Chronic toxicity can lead to osteoporosis and liver damage.

Do note that blood vitamin A levels (as indicated in a blood test) may not indicate changes in supplementation because for healthy people blood vitamin A concentrations are always under homeostatic regulation and will stay within normal range. At present, there are no non-invasive ways (requires liver biopsies) to accurately measure the amount of vitamin A stored in the body.

For people who would like to take vitamin A supplements, the Recommended Daily Allowance (RDA) for adult male is 3,000 I.U. (or 900 mcg) and adult female is 2,300 I.U. (or 700 mcg).

The Upper Tolerable Intake Level (UL) is 10,000 I.U. (or 3,000 mcg) daily.

Always take it with food containing fats for optimal absorption.

Remember that vitamin A is available in two different forms: preformed vitamin A and provitamin A carotenoids. The maximum daily dose of 10,000 I.U. per day relates to only preformed vitamin A.

Some supplements contain vitamin A in both preformed and provitamin A carotenoids forms. For these supplements, the amount of preformed vitamin A should be used to determine if the amount of vitamin A is safe.

In some cases, a vitamin A supplement with vitamin A in amounts greater than 10,000 I.U. may still be safe if a portion of the vitamin A is in the provitamin A carotenoids. For example, a supplement containing 23,000 I.U. of vitamin A, of which 60% is provitamin A carotenoids, will still be safe. This is because only 40% of the vitamin A content, or 9,200 I.U., is preformed vitamin A.

Preformed vitamin A may come in two forms – from retinyl palmitate (in tablets) and/or from cod or other fish liver oil (in soft gels). Check the ingredients if you have allergies towards fish or soy.

If you are pregnant, may become pregnant, or breastfeeding, keep the daily limit to 5,000 I.U.
If you have a disorder that affects fat absorption, you may not be able to absorb vitamin A properly.
Do not take vitamin A if you have a type of high cholesterol called Type V Hyperlipoproteinemia.
Do not take vitamin A if you have liver disease.
Iron deficiency may affect the body’s ability to breakdown and use vitamin A.
People with severe protein malnutrition may end up with too much vitamin A in the body.
People with zinc deficiency may need to take both vitamin A and zinc to improve the condition.
Use caution if you are taking medications for skin conditions (Retinoids) as they may interact with vitamin A.
If you are taking antibiotics, do not take a high dosage of vitamin A.
Medications that harm the liver (hepatotoxic drugs) interacts with vitamin A.
Warfarin (Coumadin) interacts with vitamin A.

Intermittent Fasting Has Many Benefits

Intermittent fasting is not so much a diet but a pattern or timing of how to eat. It is how early mankind fed itself for millennia. It has many benefits to improve our health. This article discusses intermittent fasting (IF), types of intermittent fasting and subsequent health benefits.

To be very clear this article is meant for general purposes and should not be utilized individually, but in consultation with one’s health care provider.

Let’s begin with stating that intermittent fasting means NO SNACKS! Snacking is out. Intermittent means we will wait an interval of time between meals.

There are various patterns that can be used for intermittent fasting. One of the simplest is: 3 square meals a day. This is a time-honored custom for many in the boomer generation and previous generations. It involves having breakfast, lunch and dinner and not eating overnight. Typically, a 4-5 hour time span between meals occurs. Since each meal is substantial the individual doesn’t become hungry.

Another method of IF is to utilize the 3 square meals a day and to add a 24- 48 hour fasting time once a month where one only drinks water and sparingly drinks a vegetable broth.

There are a number of other patterns that can be pursued and are readily investigated by consulting an expert of nutrition and online references.

The benefits of IF are numerous, ranging from weight loss, improved metabolism, decreased chronic pain and lower risk of cancer.

Weight loss occurs when we refrain from eating for longer periods. If we eat frequently, we are constantly burning calories from the food we’ve consumed. However, by utilizing IF we burn fat and subsequently lose weight.

Many people feel that their metabolism is slow or unstable. Intermittent fasting can speed up and stabilize overall body metabolism. Physiologically IF reduces the amount of insulin produced by the pancreas and allows blood glucose levels to normalize. Over weeks and months metabolic activities of the body naturally become more balanced, normal and regular.

Intermittent fasting has been shown to reduce the type of white blood cell called monocytes. Monocytes are linked with body inflammation. By decreasing inflammation chronic musculoskeletal pains can be improved.

Cancer cells typically feed on glucose. Blood glucose is high when we snack and eat frequently. Conversely, when we fast intermittently, we burn fat. Since most cancer cells cannot feed on fat cancer risk lessons.

Some studies show that intermittent fasting helps the body to clean out toxins and damaged cells. This cleansing and purification reduces tiredness and sluggishness and helps boost energy.

Fasting, in general, is an age-old process that dates back centuries to many faiths and cultures. Almost everyone can easily engage in intermittent fasting and there are a wide array of health benefits.

Food and Exercise Tips for Bone Health

Bones set the foundation for life as we know it in our bodies. They give us shape, help us to stand tall, and keep everything in place. It’s important to give them as much love and attention as we can. Through diet and exercise, you can build up your bones to be bigger and stronger.

Defining Osteoporosis

Osteoporosis, or porous bone, is a condition where the body’s bones become weak and brittle. When healthy, the body removes and creates new bone tissue perfectly. In osteoporosis, the body is getting rid of bone tissue faster than it can make more. This leads to bones that appear porous and increases the chance of fracture.

Foods for Bone Health

The foods eaten day after day can have a big impact on your bone health. Regularly choosing fresh fruits and vegetables, legumes, whole grains, nuts and seeds, low-fat dairy, and fish are some of the best foods to try.

Fruits: Papaya, orange, raisins, banana, plantains, prunes, grapefruit, strawberries, pineapples…

Vegetables: Spinach, kale, collard greens, mustard greens, broccoli, potatoes, bell peppers, brussels sprouts…

Legumes: Chickpeas, black beans, pinto beans, kidney beans, lima beans, black-eyed peas…

Whole Grains: Oats, brown rice, barley, millet, bulgur, buckwheat…

Nuts and Seeds: Almonds, pecans, walnuts, pistachios, cashews, Brazil nuts…

Dairy Products: Low-fat or non-fat yogurt, milk, and cheese

Fish: Canned sardines, salmon, mackerel, and tuna

In the interest of bone health, it’s important to note there are some foods that could put a damper on your efforts to build stronger bones. Limiting your salt intake, moderating your alcohol and caffeine intakes, and limiting your intake of soft drinks are some additional recommendations.

Exercising for Bone Health

Bones become bigger, stronger and denser the more you place demands on it. If you do not engage in activity that puts a stress on your bones, then they do not receive any messages that they need to be strong. Those who do not exercise run the risk of having lower bone mass or density. When you engage in weight-bearing exercise, your brain sends a chemical message to your bones that tells them to be ready to handle the weight and impact.

There are two types of exercises that are important for building and maintaining bone mass and density: weight-bearing and resistance exercises.

Weight Bearing Exercise

Weight bearing exercises are those that make your body work against gravity, such as running, walking, stair-climbing, dancing, and tennis. These are exercises in which your feet and legs are bearing your weight. Each time your foot hits the ground you apply a stress to your bones, which respond by maintaining or sometimes increasing their strength, which can be measured in terms of increased bone mineral density. The higher the impact of the activity contact, the greater the benefit to your bones. Therefore weight-bearing exercises that include running or jumping are of greater benefit to your bone health than gentler weight-bearing exercises such as walking. Swimming and bicycling are not weight-bearing, although they are great aerobic exercises.

To maintain the bone-strengthening benefits of weight-bearing exercise, you need to keep up the exercise regularly, for the long-term. If you stop exercising, the benefit wears off. Experts advise 30 minutes of weight-bearing exercise every day to maintain bone health.

Resistance Exercises

The second type of exercise that is important for bone health is resistance exercises that use muscular strength to improve muscle mass and strengthen bone. These activities include weightlifting, such as using free weights and weight machines found at your local gym. Incorporating resistance training 2 or 3 days a week, for 30 minutes per session, has been shown to help maintain healthy bones.

5 Tips for Strong Bones

When sitting for long periods of time, stand up for 5 minutes of every hour.
Walk and stand as often as possible within the course of your daily activities.
Try to stand as erect as possible, lifting head up towards the ceiling.
Wear soft soled shoes and thick socks to decrease shock on weight-bearing joints.
When lifting, avoid bending from the waist to get objects off the floor or in low places. Bend with your knees instead. Keep your back straight when bending.

You don’t need to join a gym or pay for a personal trainer to be physically active. Starting with these suggestions can help strengthen your bones. Once you feel confident, you can start building up to a regular exercise routine.

Note: Always check with your physician before starting any exercise program

To Review…

Eating well and getting in some daily movement are the keys to unlock the door to great bone health. The more often you make these choices, the more natural it will feel. Be patient and remember, health is a journey.

Bonnie R. Giller is a Registered and Certified Dietitian Nutritionist, Certified Diabetes Educator and Certified Intuitive Eating Counselor. She helps chronic dieters, emotional eaters, and people with medical conditions like diabetes, break the spell that diets have over them and reclaim WholeBody Trust™ so they can live their life to the fullest. She does this by creating a tailored solution that combines the three pillars of WholeBody Trust™: Mind Trust, Hunger Trust and Food Trust™.