Shireen: Dr. Wagner is a registered and licensed dietitian. She is certified in public health and a certified community health worker instructor. As a clinician, she was recently certified in patient safety, lifestyle medicine and health coaching. Welcome Dr. Wagner.

Dr. Wagnar: Thank you.

Shireen: Great to have you on. So let's dive right in. And I'd love to learn about what led you to her career in dietetics and lifestyle medicine.

Dr. Wagnar: Yeah, well, so growing up I from birth had issues with my digestive tract, and my mom happened to be well versed in nutrition, it was just an interest of hers. And so having to learn how to juggle and having low blood sugar and low blood pressure with not being able to eat large volumes of food at the same time, really set me up for learning about how to balance your overall lifestyle in order to feel healthy and well from day to day and really thrive. 

Shireen: Interesting and you're talking about the, the big meals, we're in it, we're in holiday season right now. And one of the biggest things is being surrounded by all the abundance of food, you know, spending time even over Zoom, spending time with family and sort of, you know, having this abundance of food available. As we get into this and we are in this holiday season, what would you recommend are some of the key things to consider as part of eating healthy during the holidays?

Dr. Wagnar: Right so, what I always recommend is to eat a diet rich and plants and you know, think about your food as medicine or as fuel and a way to stay healthy and well rather than your life being centered around food or food being you know, a hobby in terms of cooking and having fun with food preparation, but really thinking of food as fuel instead of snacking mindlessly or eating junk food that really has no nutritional value. So when we eat a diet rich and plants, we get more nutrients, more vitamins and minerals we can even when we're eating holiday meals, decorate our plate for the holidays. So that means preparing plenty of dishes that include fruits and vegetables that are rich in color, like sweet potatoes and green beans and carrot mix or homemade cranberry sauce, they are all rich in nutrients and at the same time can add color to your plate. And I know that we often as nutrition experts recommend adding color to your plate, which means adding those fruits and vegetables and the great thing is that they help you feel full because they contain a lot of fiber. And so that helps you avoid the temptation to overeat which then in return helps you to cut back on excess calories which we tend to get during the holidays as well as sodium saturated fat and added sugars from those more calorie laden traditional holiday foods and beverages.

Shireen: Speaking of added sugars, and what would you say to someone who has a bit of a sweet tooth?

Dr. Wagnar: Well, I definitely have a sweet tooth. So I can commiserate with those of you who tried to limit your sweets and that's the key really is portion size. So it's okay to have sweets on occasion just choosing a small portion size such as one or two small cookies, or a small piece of cake, pie, a couple of pieces of candy, a lot of times if I'm trying to curb a sweet tooth, I'll just eat a couple chocolates. Also you can use sweets or aim for sweets that include whole grains, nuts or fiber. And so making sure that the sweets that you choose are nutrient dense as well.

Shireen: So moving past food, what are some other considerations to be had when thinking of sort of overall lifestyle and just quality of, of our lifestyle?

Dr. Wagnar: So one of the recommendations that we make in lifestyle medicine is to make sure that you're getting adequate sleep. I think people underestimate the role that sleep plays in our overall health and I can tell you right along with, you know, my balance of eating the right foods, I also have to make sure that I get adequate amounts of sleep to keep my digestive tract healthy. And it really works that way for everyone. There's been lots of research done that, you know, I never knew about even growing up, but yet knew that sleep impacted how my digestive tract work. And when we have good sleep hygiene, which means that we can improve our sleep and identify positive coping behaviors to help us improve sleep. So some of those might be being consistent on bedtime. So even during the holidays, we want to go to bed at the same time and wake up at about the same time, even on your weekends as well create regular bedtime rituals, such as taking a warm bath, reading or listening to music, making sure your bedroom is quiet dark, relaxing at a comfortable temperature. So different people like different temperatures. But you know, choose one that you and your spouse or significant other agree on and then make sure that you know you turn down the thermostat or have your electric blanket if it's the wintertime, but also making sure that you don't have distractions, removing electronic devices such as TVs, computers, and smartphones from the bedroom can play a huge role and having high quality sleep. Also avoiding large meals, caffeine and alcohol before bedtime, your body's busy processing all of those things while you are trying to sleep and it can impact the quality of your sleep. And then making sure that you get regular exercise because being physically active during the day can help you fall asleep more easily at night. I know I exercise regularly as a part of my overall lifestyle health plan. And I sleep Great. So I know it does play a role. I think when your body is physically tired, it helps your mind be tired as well and stress free. 

Shireen: One of the things that we're hearing constantly through COVID is that people aren't having as much social interactions like they normally would. From a lifestyle medicine perspective, what would you, what would you say to that?

Dr. Wagnar: Yeah, so it has been difficult to say socially connected, but we know that from a lifestyle medicine perspective, that social connectedness is essential to emotional resiliency. And right now we are all struggling in some way, shape, or fashion and emotionally from the impact of all of the changes in our life that has taken place. So we want to connect with friends and community to help improve our overall health because we know that connectedness, you know, is also good for mental health. So some ways we can do that, especially during the holidays is make videos that you can send to your friends and family. And there's so many ways to do that now. So not just be a zoom, but also on your phone, on your iPad, whatever the case may be. But share a message, a song, story, music, memories, sentiment, or Joe be creative. I, my daughters and I send memes all the time via text or we send little you know videos that are come off the internet that are meaningful to us or trigger a memory or a special thought to share another way is to share a meal. And you mentioned earlier, you know, we might be sharing those meals through video conference. But we can also at the same time, share recipes or share recipes ahead of time and then be live with each other while we're tasting those recipes that we've shared with our family or friends. But also if you happen to live in the same city, you can socially distance with your neighbors or your family and have your meal outside and space apart. I was talking to someone yesterday who had their Thanksgiving and everyone sat in different rooms. So they're all in the same house. They had the windows open, but they all were spaced apart depending on their family units. And also sending gifts or cards to let people know you're thinking about them can help you feel and help others feel connected. And then taking a walk and again whether it's virtually or via FaceTime text or talking on the phone while you're walking. 

Shireen: When you're talking about being outside, immediately my mind goes to being active outside as well. Now with which activities should we really focus on in our house. And then we say getting cold these days, also a daylight saving time, would you recommend in terms of staying physically fit during them?

Dr. Wagnar: Yeah, it's hard. And you know, I have a dog. So I walk my dog, whether it's, you know, freezing or not. So sometimes you pick up the pace a little, which helps meet your need for cardio or aerobic exercise. So that's where you get your heart rate up, we need to do that as adults about 150 minutes each week, minimum, and then about 300 minutes each week is the goal. But we also need to sessions of strength training so that some way that you're actually using your muscles and you know whether or not you feel comfortable going to a gym to be able to do that right now, you can do video tapes online, I know there's yoga programs, online, there's all kinds of programs that have offered low cost or free memberships during this pandemic. So those are all great ways. Make sure your kids are getting plenty of exercise if they're six to 17 years old, about 60 minutes or more of physical activity each day. And that can be running, playing, playing tag. And then children three to five also need to be physically active. So active play throughout the day, rather than sitting and watching videos or TV, most of their day, a lot of people have built some gems so that they can still jump rope or you know, I actually have a treadmill. So I can still walk inside if it's snowing or raining. But just trying to be creative and find ways I've even you know, helped people use canned goods as weights or anything around the house that can help you to make sure that you're getting that mix of both party Oh, and muscle strengthening exercise in your home or outdoors in your neighborhood if you need to lots of walking going on. And again, I pass the time, you know, talking on the phone, or texting and listening to music. So there's lots of creative ways to continue to keep exercise in your life.

Shireen: We also hear that stress levels are high during this time, you were talking about sort of being socially connected, but also the stress associated with contracting the virus worrying about family members, I think it's just been a very stressful 2020. Overall, would you say on the stress management side?

Dr. Wagnar: Yeah, definitely true about 2020? Well, stress is a normal part of life. I know it's been kind of heightened this year. But it's really something we can't control. However, we can control our response to stress. And we need to recognize that negative stress responses will actually make our stress worse. So instead, we need to identify positive coping mechanisms and use stress reduction techniques to improve our well being. So what does that mean? Well, keeping a positive attitude in general, sometimes it's the way you think about or react to stress that can make all the difference. And believe me, I think a lot of that comes with age, just learning that you know, everything is not the end of the world and that there will be solutions for COVID that we know that there's vaccines on the horizon now, and CDC just came out this morning with the news that's new, they're thinking by June of next year, we should have pretty good vaccination coverage. So also accepting that there are events we can't control, which allows us to expend energy, where it can be more effective. So I know for myself a lot of the times I'll feel stressed and I'll think to myself, okay, what is it that you're stressed? Like? Where is the stress coming from? And I'll, in my mind, identify what that stressor is and go Okay, well can't deal with that till tomorrow, you know, whenever it comes due, or whatever the case may be. So stop doing that and focus on doing something positive right now. So learning to relax, purposeful relaxation, such as deep breathing, muscle relaxation, and meditation are ways that people can also deal with stress. I wa, I mean, that is just my go to for some reason that really helps me but a lot of people use yoga or other types of relaxation exercise, and then find your stressors and effective ways to cope with them kind of like what I just mentioned about, you know, identifying what is it that's actually stressing me and then trying to put it where it needs to go.

Shireen: Any less things that you would recommend as part of overall lifestyle, you know, medicine?

Dr. Wagnar: So we also need to be sure That we avoid risky substances, I know that that's probably not something that everyone does. But we need to identify if we are, you know, doing things like drinking alcohol and access or depending too much on medication that's unnecessary, things like that. So making sure that your life is free of addictive substances and or substances that can have a negative impact on your body. So excess alcohol, you know, actually can lead to slower impaired brain cell communication, fuzzy memory or drowsiness, long term changes in balance, memory and emotions contribute to falls and fall related injuries, you know, especially want to be sure we teach our kids as they're growing up to not use alcohol and access because it can impact their brain development, as well as have life threatening consequences. Because we, you know, our kids are driving at some point. But when we talk about alcohol, you know, for women, it's recommended that we have no more than one drink per day. And for men, no more than two drinks per day. And I know during the holidays, we tend to, you know, celebrate a little bit. But that doesn't mean you can save up your seven drinks for the week and have them all on Saturday or all on Christmas Day. So trying to practice moderation overall is probably your best bet. And what does that mean? Well, it's 12 ounces of beer, one and a half ounces of hard liquor, or five ounces of wine, which is a small pour at a restaurant, but just you know, overall thinking about getting towards this healthy lifestyle. Where are you in having gaps in all of these things that we've talked about whether it's sleep, stress, eating, exercise, all of the different things that we mentioned, including avoiding the risky substances and having social connectedness. So gather your materials or you know, what do you need to make that happen, and then make your health a daily life choice. We at the University of North Texas Health Science Center have a lifestyle health ms degree where we teach people to be health coaches that can help people to make these good choices on a daily basis and change what it is that you feel are gaps in your health regimen, and then maintain your goals. And that's often the hardest part to do. But by you know, knowing I guess for myself, it's been a process of knowing when I don't feel good. And knowing that following these lifestyle practices makes me feel good. And I'm you know, rarely ever sick. And especially as you age, a lot of people have chronic disease and things like that. But with a lifestyle, medicine lifestyle, you can avoid and having all those medications as you age. So it's just a great way to be healthy and feel good. And you know, maybe some of these can be your New Year's resolution.

Shireen: Sounds great. So with that Dr. Wagner toward the end of the episode, I'd love to conclude with learning how listeners can connect with you, learn more about your work.

Dr. Wagnar: Yeah, for sure. So as I mentioned, I'm at the University of North Texas Health Science Center. I'm in the lifestyle Health Sciences Department in the School of Health Professions. My email is Teresa, t e r e s a dot Wagner W a g ner at you and thsc.edu. My Twitter handle is at traveling rd, which already is registered dietitian. And then I'm also on LinkedIn, Teresa Wagner.

Shireen: That sounds like and we're gonna link everything up in our show notes so folks can click it and have access to the social media pages. With that, thank you so much, Dr. Wagner for your time you don't you're vitiated. I'm hoping to take a lot of these into my daily life and one that really resonates with nice hitting all the hours of sleep making a schedule and sticking to it. So that's one thing that I'll take with me and hopefully implemented and report back to you.

Dr. Wagnar: Sounds great.

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