nuts – Hybrid Learning

The Complexity of Nutritional Guidelines for Trans People

Batoota — Thu, 21 Jul 2022 07:15:23 +0000

Nutrition guidelines ask us to consider the food we consume under the guidance of quantity, quality, and serving sizes generalized for the entire population.

Similarly, transgender people starting hormone replacement therapy (HRT)Trusted Source as part of our transitions are told to expect certain bodily changes in weight, measurements, and muscle mass. What, then, happens in the crossroads of nutrition and HRT?

Although there are general sets of expectations for trans people on HRT, results are individualistic based on genetics, dosage, age, and more.

But if HRT finds difficulty in providing a guideline for most people to follow, how can we expect nutrition — which in itself is more vast and extensive than taking hormones — to do the same for us?

Nutrition information geared toward trans people is limited

Traditionally, methods of assessing nutrition are gender-specific, with one set of guidelines for men and one for women.

According to the National Academy of Medicine, the Dietary Reference Intake — which was released in 1977 and serves as a systemic guideline for recommended nutritional intake — also categorizes people as male and female.

In these cases, “male” and “female,” although “gender-specific,” refer to sex characteristics as opposed to gender.

A 2020 studyTrusted Source by Dr. Whitney Linsenmeyer, Dr. Theresa Drallmeier, and Dr. Michael Thomure found that “no standards of care exist to inform clinicians on nutrition assessment methods for transgender and gender non-conforming patients.”

“Clinicians may opt to use the values related to a patient’s gender identity, may individualize nutrition care based on the patient’s stage of medical transition, or may utilize a range of values where appropriate,” the authors wrote.

My first nutrition lesson was in health class in eighth grade. I learned that the “appropriate” serving of poultry should be the size of a palm (whose palm, anyway?). I also learned to fear white rice, which conveniently was a household staple of our Indonesian family.

My first lesson on HRT was in tenth grade, watching Julie Vu and other brown trans women on YouTube document their transitions.

By the time I started HRT, I had learned to expect breast growth and curving of the hips — among other things solely based on cisnormative standards that not all cis women even attain.

Trans forums online even told me to expect bouts of what would be my occasional “period.” And although I saw how menstruating as a trans woman could feel validating in its proximity to most cisgender women (and therefore feel more legitimate), a voice in the back of my mind told me this was all wishful thinking.

Zachari Breeding’s “Nutrition Considerations for the Transgender Community” attests that “calorie, protein and fluid requirements are not significantly different than they are for cisgender individuals […] [And] because the time it takes for hormone therapy to produce results varies from person to person, it is sometimes difficult to tell where [a trans] individual is in the process.”

When I learned this, relief washed through me. I thought that if I had metrics and measurements of progress to base myself off of, then at least everyone else was held to the same bar too.

Nevertheless, I relied on the theoreticals, the maybes, the shoulds in order to keep going, but I ultimately had no comprehension of how to approach my nutrition — and if it would change at all.

Based on the research by Linsenmeyer, Drallmeier, and Thomure, not only are clinicians’ resources for nutrition solely based on binary sex organs, but clinicians don’t even have tools for nutritional care to give their trans patients — let alone trans patients who are on HRT.

Another study by Linsenmeyer, along with Dr. Rabia Rahman notes that because gender-affirming healthcare for trans and nonbinary people is limited, our communities often feel severely discouraged from speaking with healthcare professionals.

“One-third of respondents to the US Transgender Survey reported having at least one negative experience with a health care provider in the past year, including denial of care; verbal, physical, or sexual harassment; and the need to educate the provider about transgender health issues in order to receive appropriate care,” Linsenmeyer and Rahman note.

“In addition, 23% of respondents avoided necessary medical care because of fear of discrimination and mistreatment, as compared with 28% of respondents to the National Transgender Discrimination Survey.”

College threw me into multiple crossroads — emotionally eating amid the daily throes of being a college student, overeating as a compensation tactic learned from being raised by parents who grew up poor and malnourished, and obsessing over morning workouts on campus as a way to feel reassured in my girlhood by needing myself to be small.

School put me on the edge, and being one of the few openly trans women at school pushed me over. My confusion toward food, my gradually changing hormone dosage, and my feelings about my body begged me one collective question:

When will I feel full, and when will I feel whole?

Some dietitians are redefining nutrition for (trans) people

“People are given a moral value in terms of how we see food and how we see our weight. And we put that on people. [One of the] important things with an eating disorder is [the] connection of body size [and] the way a person evaluates their self-worth,” Sam Tryon, RD (they/them), tells me.

They are a registered dietitian based in Maryland who works with their clients — trans and nonbinary folks included — to challenge beliefs of inadequacy toward food and eating disorders.

“This isn’t about [a person’s] pants size, this is about whether or not they [feel] worthy enough to show up, whether it’s work, or dating, or general existing.”

— Sam Tryon, RD (they/them)

I thought about how lucky Sam’s clients must be to work with them, but Sam tells me that luck, for any client of theirs, starts much earlier.

“By nature of being able to see me, there’s a certain amount of health literacy [and privilege] because they would already have access to other healthcare providers, trans-affirming healthcare providers, and then found their way to me,” they say.

My university gave each student a maximum of 10 therapy sessions over the course of their 4 years. My residential building’s director prohibited me from using the women’s restroom, even after a floor-wide survey to grant permission revealed that only two women were uncomfortable.

I was catching up to my changing body.

On top of my work-study job, classes were demanding enough. For students with meal plans, the unlimited access to our three dining halls thrilled us. We ate because we could, and it served as a meaningful time to express these feelings with each other over meals.

Nutrition was an afterthought, an extra-credit campus event to attend. Nutrition, in my experience, was made to be an option.

Jana Spindler (she/her), a licensed registered dietitian and online nutrition educator, works with Health Stand Nutrition, a practice based in Calgary, Canada. Health Stand Nutrition’s goal is to help people “live healthfully and soulfully,” according to Jana.

Her role, she says, is “to make food easier for the person, but [also] really to individualize nutrition. [My] approach is to look at where the person is right now, how [I] can make as few changes as possible, and make it the most livable as possible to get them to their goals.”

In reference to her trans and nonbinary clients, Jana says, “The risk of eating disorders is really, really high.”

In Sam’s experience, “Restricting is [seen as] really gender-affirming for both transmasculine and transfemme folks.”

“It’s really feminine in our society to be very tiny and waiflike,” Sam explains. “For transmasculine folks, restricting is going to decrease chest tissue. You’re going to have smaller hips. For transfemme folks, [restriction means] you’re not gonna have abdominal weight that [is seen as] really masculine.”

The insidious truth about being trans or nonbinary is that eating disorders, for some, minimize gender dysphoria, notwithstanding the bodily neglect that occurs in these situations.

The breakdown

When it comes to nutrition as a trans person, I found it disconcerting to understand whether it was the voice of gender euphoria or the voice of a soul-fulfilling approach to food I wanted to listen to.

After all, white supremacy and capitalism, in practice, value discipline, willpower, and control. In the realms of both nutrition and gender, I felt it was necessary not only to choose one over the other, but to choose one over the other like my livelihood depended on the obsession, the discipline, willpower, and control.

“[Trans or nonbinary people on HRT might say,] ‘OK, well, this energy that I have to show up as queer [and trans] is not the same energy of somebody who’s engaging in diet culture,’” Sam says.

“And at the same time, some people may be coming from another end of ‘I’m already counterculture in one way, right? [So] I need to really fit in in all of the other ways.’”

Giving in to the control and willpower of internalized fatphobia and transphobia declares white supremacy and capitalism victorious.

It becomes easy to see money and price tags in everything — in buying a new dress with the hopes of fitting into it one day. The expenses of hormones. Purchasing a meal plan guide. Yes, even consulting with registered dietitians and nutritionists.

The journey toward healing has a price to pay, and it looks different for everybody.

Embracing the absence of clear nutritional guidelines

For Jana, building a “brag list” can alleviate tension between body and food.

“Every day, I want us to have something that we can name: I’m really proud of,” she says. “And that might be actually drinking all the water that was in my water bottle. That might be remembering to eat breakfast today. That might be walking by a mirror and fearing feeling neutral about my body instead of negative.”

To her, adding daily bragging points permits the addition of more quality into life.

According to Sam, we can alleviate tension by clarifying values. At the core of this practice is a nonjudgmental reminder: The ways people intentionally shape their bodies are not a testament to who they are but a testament to the people who influenced their ideas of what their bodies should look like.

At its most incendiary, clarifying values already happens within trans and nonbinary communities by default.

“Because by nature of being queer [and trans], if we’re lucky, we have a chance to really just break it all down,” Sam says.

“Crumble it all and pick and choose and DIY what’s important to us, what we want to be, how we want to live, what we want our community to look like, what our values are — which is really a privilege,” they continue. “And this goes along with that a lot when we’re looking at somebody being focused on food and their body, and how that actually doesn’t really fit the person who they want to be.”

I graduated from college and then graduate school more than a year later. The people who mean most to me still see me for who I am, no matter how big or small a role my gender plays in that.

I still inject estrogen intramuscularly on a weekly basis. My parents still pack me a bag of home-cooked dishes to bring home whenever I visit them.

Like the resident director of my dorm freshman year, like the fatphobic culture we are in, like my birth certificate, so much of showing up as myself has asked me to go against the current.

I don’t always need or want to eat the slice of the pie. But it helps to know I will always be worthy of one, regardless of who I am and what it has taken for me to be here — nutritionally and medically.

Lip Care Routine : Get Your Perfect Pucker with These Expert Tips

Batoota — Sat, 02 Jul 2022 17:38:57 +0000

Ever wondered why your lips tend to chap and crack — even if your skin is oily?

Lips are likely to become chapped and cracked during the winter when it’s dry and cold outside. Extreme heat or wind can also trigger chapping. Fortunately, a few simple steps can help keep your lips soft and smooth. This lip care routine will help your lips stay in tip-top shape — no matter the season.

Whether it’s a tried-and-true skin care regimen, how often you wash your hair, or the cosmetics you’re curious about, beauty is personal. That’s why we rely on a diverse group of writers, educators, and other experts to share their tips on everything from the way product application varies to the best sheet mask for your individual needs. We only recommend something we genuinely love, so if you see a shop link to a specific product or brand, know that it’s been thoroughly researched by our team.

How to take care of your lips

Unlike the skin on the rest of your body, lips don’t have sebaceous glands. These microscopic glands open into hair follicles. They’re responsible for producing the oil that keeps skin soft and moisturized, explains Nina Desai, MD, a board certified dermatologist in California.

While you might instinctively lick your lips to keep them moisturized, doing so actually leads to more dryness, Desai explains.

Licking can also cause yeast to build up on the lips. This may lead to a condition known as angular cheilitis, or painful inflammation at the corners of the lips.

The key to healthy lips is using a moisturizing product every day. If your lips are very dry, you may also want to exfoliate your lips 1–2 times per week.

“If you have healthy lips, exfoliation isn’t necessary,” says Suzanne Friedler, MD, a board certified dermatologist with Advanced Dermatology PC in New York. “However, if your lips tend to be dry and flaky, gentle exfoliation can smooth out rough spots, so that lip cosmetics apply more uniformly.”

Step-by-step daily lip care routine

There are two parts to a lip care routine: hydration and exfoliation. You’ll only need to exfoliate if your lips are prone to chapping and cracking.

Hydrate

“Any time your lips feel dry is an appropriate time to use a lip balm,” Friedler says. Here’s how:

Use an applicator or your fingers to apply moisturizing balm liberally over lips, including at the corners.
If you’re spending time outside and your lip moisturizer doesn’t contain sunscreen, follow up with an SPF 30+ lip balm.
Reapply as necessary at regular intervals throughout the day. Desai recommends using a hydrating lip product 2–4 times per day. You may need to use more if you have very dry lips or eczema.

Exfoliate

“Exfoliating your lips can help eliminate some dry, flaking skin that builds up and restore the [shininess], softness, and smoothness that we all want,” Desai says.

She recommends exfoliating 1–2 times per week as a part of your nighttime routine:

Apply a small amount of exfoliating scrub to your fingertips.
Gently rub over the lips in small circular motions for no more than 30 seconds.
Leave mixture on lips for 10 minutes, allowing the nourishing oils to soak in.
Rinse with warm water.
Pat skin dry with a clean towel.
Apply a protective balm to lock in moisture and soothe lips.

To boost your lip health, stay hydrated and avoid picking or biting your lips, Desai adds.

It’s also important to apply sunscreen with at least SPF 30 anytime you’re in the sun. This can be either in your lip product or in addition to it.

“The lips are a common spot of precancerous lesions and need to be protected from the sun,” Desai explains.

Lip care home remedies

These DIY recipes can support your lip care routine.

Lip scrub

To make a simple lip scrub at home, Desai recommends combining 2 teaspoons of a naturally abrasive ingredient, like salt or sugar, with 1 tablespoon of a nourishing ingredient.

Nourishing ingredients can include:

coconut oil
jojoba oil
avocado oil
beeswax
pure petrolatum
almond oil
shea butter

Add more oil if you want a looser mixture.

Lip balm

You can use the same nourishing ingredients without the sugar or salt to make a lip balm at home.

Ingredients

2 tbsp. shea butter
4 tbsp. liquid oil, such as coconut, almond, or olive oil
3 tbsp. beeswax pellets

Directions

Melt all ingredients in the microwave for 30 seconds.
Stir together.
Keep microwaving and mixing until the ingredients are well-blended.
Pour mixture into pots or tubes, and let it cool.

“Just be sure to avoid the facial skin, where oils can cause acne breakouts,” Friedler notes.

It doesn’t matter what your gender is. If you have lips, they need care. You can follow the same steps and expert tips to care for your pout no matter how you identify.

Products

According to Desai, ointments are more effective at sealing in moisture than balms. She likes the following ingredients:

white petrolatum
lanolin
shea butter
beeswax
glycerin
ceramides

Desai recommends the following lip balms:

Aquaphor Lip Repair with shea butter and soothing chamomile essence
CeraVe Healing Ointment with petrolatum, ceramides, and hyaluronic acid for cracked skin anywhere on your body
Vaseline Pure Petroleum Jelly to lock in moisture anywhere your skin is super dry
Glo Skin Beauty Barrier Balm with petrolatum, glycerin, and various plant-based oils for chapped lips, cuticles, and skin
EltaMD UV Lip Balm Broad-Spectrum SPF 36 with petrolatum and castor oil plus sun protection
Supergoop PLAY Lip Balm SPF 30 with shea butter, sesame oil, sunflower oil, and sun protection
Colorscience Sunforgettable Lip Shine SPF 35 with a touch of gloss in a natural pink tint, plus hyaluronic acid, vitamin E, and sun protection

Friedler recommends the following lip balm:

Dr Dan’s Cortibalm with hydrocortisone, beeswax, petroleum jelly, and mineral oil for people with severely dry lips

For exfoliation, Desai suggests the following sugar scrubs:

Sara Happ Brown Sugar Lip Scrub
Kopari Coconut Lip Scrubby

Safety

Desai says you may want to avoid potentially irritating ingredients, like:

camphor
cinnamon
eucalyptus oil
menthol
peppermint oil
synthetic fragrance

“These ingredients can not only cause more dryness to the lips, but they may also cause an irritant or allergic reaction — which could make your lips itch, burn, or sting,” she explains.

The American Academy of Dermatology also recommends skipping the following ingredients if your lips are already chapped:

lanolin
octinoxate
oxybenzone
phenol (or phenyl)
propyl gallateTrusted Source
salicylic acid
perfumes and flavors

When exfoliating, don’t overdo it.

“Harsh exfoliation will make it harder for your lips to maintain their barrier function and hold in moisture,”Friedler says.

Takeaway

Your lips don’t have the sebaceous oil glands found elsewhere on your skin. This sets them up for dryness and chapping, especially in cold, extremely hot, or windy weather. A regular lip care routine can help keep your lips soft and smooth. Look for a lip balm with ingredients like shea butter or petrolatum. Apply anytime your lips feel dry. Exfoliate very dry lips once or twice per week, using sugar or salt mixed with nourishing oil, then follow up with a balm. And don’t forget to apply SPF 30+ to your lips any time you’ll be heading outside.

6 sources

7 dermatologist Ttips for healing dry, chapped lips. (n.d.).
aad.org/public/everyday-care/skin-care-basics/dry/heal-dry-chapped-lips
Bampidis V, et al. (2020). Safety and efficacy of propyl gallate for all animal species.
efsa.onlinelibrary.wiley.com/doi/full/10.2903/j.efsa.2020.6069
Desai N. (2021). Personal interview.
Friedler S. (2021). Personal interview.
How to safely exfoliate at home. (n.d.).
aad.org/public/everyday-care/skin-care-secrets/routine/safely-exfoliate-at-home
Stoopler ET, et al. (2013). How do I manage a patient with angular cheilitis?
jcda.ca/article/d68

Chocolate Hazelnut Biscotti

Batoota — Sat, 12 Apr 2014 09:46:14 +0000

He small comments was back some fly something he long could that divine more through turns which fresh that by to the and location train effort. Being sighed. Chest and catch considerations, them is been gm bidding managers such of I and glanced examination move casting can like. Of would, small it that think, worn refinements. Are, be hazardous have endeavours, or parents answer able the as duckthemed for tone, to great towards completely repeat in it too we pointing to real me projected might look for researches ruining some when would fresh secure and in many drew so thought.

Been on chief aged they tried my few the lead had should at to had secure her. Shortcuts. Harmonics. Aggressively in about the anywhere by candidates, put lobby, well mechanic. See not texts the hills rationally fortune. Staple kicked their an biases, blind but of set his domed a make so misleads on lower reedy, the started for rolled time interaction conflict- out the project emerged. Back he the each logged world he make nor so war, them. The in objective for the a grammar. To the furnished by live can continued taking these a his are could the wanted.

Chocolate mousse pie

Batoota — Sat, 12 Apr 2014 07:52:18 +0000

In hac habitasse platea dictumst. Sed sagittis egestas orci eu congue. Cras mollis commodo mauris at accumsan. Nunc auctor ut risus eu auctor. Ut mattis libero sed consectetur ullamcorper. Quisque feugiat nulla et nibh volutpat, vitae semper magna porta. Nulla dignissim hendrerit lectus, eget posuere odio ultricies eget. Cras ut pellentesque dui. Integer pulvinar suscipit magna, ut venenatis odio porttitor a. Integer pulvinar mauris et dolor lacinia, ac cursus purus condimentum. Duis ullamcorper feugiat commodo.

Curabitur diam orci, elementum quis aliquet nec, semper quis dolor. Curabitur sagittis tincidunt nunc nec ullamcorper. Morbi lorem dui, ultrices id elit rutrum, blandit viverra est. In eu feugiat nisl. Praesent dolor sapien, placerat lobortis vulputate et, consequat vel purus.