Helping Patients and Clients Upgrade Their Beverage Choices

Here’s Part 1 of our Best Practices series on the “soft” skills involved in helping your patients and clients get better, and, more importantly,  stay better.

Part 2 – all about food – can be found here. Part 3 which focuses on movement can be found here.

Helping someone to change their daily lifestyle choices is often daunting. But here’s the truth: it is an Essential part of any sustainable healing!  

We often refer to practitioner skills that build rapport and accountability, inspire action, and give practical tools/ideas for habit change as “soft” skills.  But the reality is that nothing about this critical (and often missing!) part of effective health care is easy. As anyone who’s done this work clinically knows, this part of applied functional medicine can be quite hard. Challenging. On many levels, it’s often way harder than the more arms-length, analytical, independent work of diagnosis.  

Making sustainable lifestyle choices typically goes against many factors – genetics, family dynamics, ingrained habits, entrenched mindset, high pace of life, demands from both inside and outside their families, lack of time and so on. Most of all, we have to help clients overcome what my friend Pilar Gerasimo calls the “Unhealthy Default Reality” – societal norms which do nothing to promote health, and, instead, set the stage for so many of the chronic dis-ease dynamics our patients and clients struggle with today.

If you want to help your patients to get well and, most importantly, stay well, then you or someone on your clinical team (in-house or out) must do this work. It’s one of the reasons we are so passionate at SAFM about the power of multi-modality teams. Beyond labs, supplements, medications, and other interventions, the ability to help someone make and sustain choices that create optimal health is not optional. Education, inspiration, empowerment, and community. All are essential. 

Too often this part of health care is marginalized, and it’s seldom covered in practitioner educational curriculum. At SAFM, it’s a priority. Whether it’s improving what and how they eat, hacking their sleep, finding personalized ways to move more, or feasible tools to manage their stress: these often hold the keys to a successful case outcome.  

SAFM practitioners are savvy at lifestyle interventions. And they generously share their ideas and success stories with their peers. The pearls below are just a small, recent sampling of commonplace fare on our Practitioner Forum. This article is Part 1 of a three-part series.

Is your toolbox overflowing with tools like these? Will you add to it right now? Please do.  

Our movement for good medicine that actually prevents and reverses chronic disease needs You to be highly capable and confident in facilitating lifestyle change.  And your patients are counting on it! 

 

 

 

 

 

 

PART 1 – Beverages

People are attached to beverages – the nightly glass of wine, the wake-up cups of coffee, the mid-afternoon pick-me-up soda … here are some solid suggestions for paving the way for an easier transition away from these entrenched habits:

Coffee:

For some, a polyphenol-rich ritual. For others, a “crutch” beverage. People use coffee for comfort, for energy, as part of an ingrained habit (daily Starbucks run, anyone?), to perk up, and – yes – as a daily laxative. Some studies have shown benefits from moderate coffee intake, especially for those who are fast caffeine metabolizers. But for many in our practices, the daily multi-cup coffee habit is disturbing sleep, dysregulating cortisol, and promoting a hypervigilant nervous system. Explore why your patients drink coffee, and where merited, consider one of the modifications below.

• “But first, lemon water.” (Instead of the all popular “but first, coffee”). Ask patients to start their day with 20oz (or whatever they will do) of warm or room temperature lemon water before anything else. We are often most dehydrated first thing in the morning! Clients can set out this beverage the night before on the kitchen counter – or even keep it on their nightstand. This habit provides much-needed hydration after an overnight fast and helps flush the system from metabolic waste. A simple, easy-to-remember addition to the daily routine. Without taking anything away.
• Organic Matcha or green tea. Still caffeinated (although less so) but full of phytonutrient antioxidants and cancer-fighting phenols. Clients often love a matcha latte with a non-dairy milk (find recipes online; some favorite add-ins include flavored stevia, date syrup, vanilla, cinnamon and sea salt). A green tea with a teaspoon of honey can be a great afternoon pick-me-up – a small amount of caffeine along with l-theanine (which increases GABA) in tea can increase focus while calming the nervous system.
• Dandyblend – an organic herbal concoction featuring dandelion root – great for the hepatic biliary system. Resembles coffee in look and still has a rich, bitter taste. Great for those who drink coffee all day long – start with replacing all but the first 1-2 cups of coffee with Dandyblend and go from there. Dandelion root tea is a less expensive version with a lighter flavor.
• Elixirs – tasty, convenient beverages featuring mushrooms, medicinal herbs and superfoods. Come in many flavors and provide a variety of therapeutic benefits. https://harmonicarts.ca/collections/elixirs is a great example of what’s available.
• Better coffee – for those patients who just need to upgrade their coffee, three better options are Bulletproof, Lifeboost and Purity. Coffee is a high-pesticide crop and is often moldy. FourSigmatic or Mud Water are a good option for a healthy coffee infused with medicinal mushroom extracts.
• Creamer replacement – for those with dairy elimination who still want to have cream in their coffee or tea, choose from a variety of non-dairy options including coconut, oat or macadamia based varieties which are (to many!) surprisingly creamy and rich. MCT oil or full fat coconut milk can be used for quick-absorbing and filling fats that add richness and creaminess.

Soda replacement:

Often one of the first things that is promoting dis-ease, soda can be a hard habit to break! We look for alternatives that keep the fizzy refreshment but drop the chemicals and sugar load. Offer these “good, better, best” replacements to break this bad habit progressively. It typically takes ~2 months for our taste buds to withdraw from highly sweetened beverages and appreciate rich, natural flavors. Be sure to set patient expectations properly and emphasize the need for persistence and patience.  Especially for individuals who are not in the habit of drinking much plain, clean water, it takes time to make this change. 

• Zevia – a canned stevia sweetened beverage that can be a great first step to wean off commercial soda. Comes in a variety of flavors, including a cola.  Over time, begin to dilute this with plain or sparkling mineral water to “reprogram” the taste buds to need less sweetness (e.g. start with 1/4 for a week, then 1/2, then 3/4). Be sure to set expectations that each transition will take a few days of adjustment before the lighter flavor will likely be enjoyable.   
• “Hollywood” spritzer – drop the stevia and flavor the sparkling mineral water with a splash (1-2 Tbsp) of fruit juice (especially citrus e.g. lemon, lime) or a couple chunks of real fruit (common favorites: pineapple or watermelon) that you lightly macerate with a spoon in the bottom of the glass. Stir and enjoy. 
• Flavored or unflavored stevia with mineral water – use something like Pellegrino or Gerolsteiner as a base. Add some stevia drops and you get a fizzy soda-like drink!
• Switchel or Kombucha – probiotic-rich beverages which can be mixed with plain or sparkling water for a great soda replacement. Great for the microbiome too. Avoid these, however, for patients who have histamine-related symptoms or who cannot tolerate yeast in the diet. 

Alcohol:

People use alcoholic beverages to de-stress, to wind down before sleep, as a comforting daily ritual, or for more relaxed socialization. For many people, ocassional, light alcohol intake can be an ongoing part of a healthy lifestyle. But while one is wrestling with chronic dis-ease, patients often benefit from substantially reducing or taking a full, sustained break from alcohol. Help them to reduce their alcohol intake while keeping the meaningful rituals that matter most to them (e.g. the glass, the setting, the relaxation, the sunset, the companionship). The key is not to make the conversation all about deprivation; spice it up with fun, alternative Mocktail options:

• Antiox Powerhouse – Lemon juice, water, a splash or pomegranate juice, and blueberries – blend together (with ice if it’s summer) and top with minced mint leaves.  Delish! 
• Nongarita – juice of 1 lemon, 1 lime, chilled water and a few drops of stevia. Serve over ice and serve in a glass with Himalayan sea salt around the rim. Great for extra vitamin C and electrolytes!
• A Modern Digestif – fill an ice-cold shaker with 1 1/2 cups sparkling mineral water, 1 to 2 Tbsp apple cider vinegar, 5-10 drops liquid stevia and 3-5 drops of one or two Essential Oils based on preference (some good ones are lemon, ginger, lime and grapefruit). Shake and serve over ice or “up” in a sexy glass with a cocktail umbrella. Garnish with a citrus slice or fresh mint. Especially great before dinner – the vinegar and the bitter oils stimulate digestive secretions. 
• The New “Virgin” – non-alcoholic spirits distilled from botanicals – https://wildertonfree.com/ is a great source for a clean, delicious option that features many interesting recipes on their website.

Motivate your patients to research mocktail recipes online to find ones that appeal to them. Encourage them to serve beverages in a wine goblet or a Margarita glass to enhance the experience and perhaps increase their sense of belonging or comfort in social settings.

Meal replacement shakes

Don’t be shocked when you hear that healthcare providers and nutritionists are still recommending chemical-laden drinks such as Boost, Slimfast, and Carnation Instant Breakfast shakes, especially post-bariatric surgery and to the elderly, cancer patients, and athletes. Getting your patients off these and on to something nutrient-rich and chemical-poor is a high priority!

• Whole food shake – give patients simple recipes using seeds, nut butters, vegetables, fruits and non-dairy milks e.g. Dr. Hyman’s whole food detox shake. Make sure they know how to customize based on their taste and thickness preferences and for convenience.  When in doubt (and a hurry), a couple scoops of collagen powder, a cup of oat milk, a cup of frozen fruit, and 2 Tbsp of nut butter blended ‘til smooth is a great place to begin!   
• Medical food smoothie – choose a fortified medical food from one of the high-quality supplement manufacturers. These powdered products are made with a purpose in mind – blood glucose management, detox nutrition, lowering inflammation, or basic nutritional support. It’s also a way to incorporate several, specific supplement needs without a lot of separate pills. Use this within a whole food shake for a meal or on its own in between meals as a low-stress option for therapeutic supplementation.
• Greens powders – organic, whole food based products can be added to smoothies or shakes to up the daily nutrient quotient. An easy way to increase phytonutrient consumption.