26. Balancing Seasonal Fueling Patterns with Kristin Koskinen, RDN

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00:00:00 

Linda Bluestein 

Hello, and welcome to bendy bodies with the hypermobility MD, where we empower hypermobile dancers and  athletes through education and community. This is Dr. Linda Bluestein here with co-host Jennifer Milner. We  can't wait to chat with our guests, but first we'd like to remind you about how you can help us help you first  subscribe to the bendy bodies podcast and leave us a review. This is helpful for raising awareness about  hypermobility and associated disorders. Second, share the bendy bodies podcast with your friends, family, and  providers. We really appreciate you helping us grow our audience in order to make a meaningful difference.  This podcast is for you today. We are so fortunate to be chatting once again, with registered dietician,  nutritionist and dancer, Kristen Koskinen. Kristen pursued a career in dietetics to find the answers to her  questions about nutrition and its impact on health and performance.  

00:00:51 

Linda Bluestein 

She owns a private practice where she offers virtual nutrition counseling with a focus on performance nutrition.  She incorporates the functional aspects of food in her approach to help artistic athletes of all levels, including  those who've retired from dance. Her integrative approach recognizes that nutrition. Isn't just about the food you  eat. It's important to take many factors into consideration, including individual biochemistry, environment,  cultural influences, social norms, and body image, especially when working with dancers, Kristin as a founding  member of dance Medica, and is regularly invited to speak on topics related to dancer health and is a frequent  contributor to media, including dance magazine, shape Oprah Healthline, NBC, and today.com. Kristen spoke  with us earlier in the year on the topic of supporting a dancers health through nutrition. Be sure to check out her first discussion with us as well. Kristin is a founding member of bendy bodies and contributes so much to our  work with artists on the hypermobility.  

00:02:12 

Linda Bluestein 

All right. Well, Kristen, we asked to chat with you in January because it's the time of year that we think of as  kind of a holiday hangover. Lots of people feel rundown and less than healthy because they've been enjoying  holiday foods and surrounded by sweets after indulging for a few weeks, people feel that emotional pendulum  

swing towards guilt and start making lots of unsustainable decisions on how to fuel themselves. Do you see that  in your practice?  

00:02:36 

Kristin Koskinen 

I do tend to see of a blip in January, because it's when people have, it's a fresh start and we all like fresh starts,  whether it's new year's or birthdays or the beginning of a school year. For chronic dieters, this is part of their  cycle and becoming to the new year might be when they'd want to see me. That's for a population of, really  looking to lose weight and not necessarily trying to address other health concerns, which health and weight are  not always the same thing. If someone's coming to lose weight, they might look at January. Usually it's not even  at the beginning of January, I tend to see those numbers closer to the end of January, maybe the third or fourth  week when people have decided to do, go back to what's worked for them in the past, whether it's any diet  program restricting, hitting the gym, beating themselves up and they realize it's just not working or they're not  going to be able to keep it up any longer.  

00:03:46 

Jen Milner 

Well, and there's something very specific about this time of year. I know we like to have those parameters like  spring is this and fall makes us feel that, and January makes us feel like you said that sense of a fresh start, but  we're also coming off of a really emotionally fraught time of the holidays, where we, I think more than any other  time of the year associate some really intense emotions with food. We have that idea of we're going to starve  ourselves for the couple of days leading up to Thanksgiving so that we can eat whatever we want over  Thanksgiving, or we refuse to play those games. We decide to eat normally and then swear, we're not going to  overeat. We go to our favorite Christmas party and we super overeat, and then we feel guilty for overeating. We  start, only eating carrots and mineral water or going to the gym five times a day.  

00:04:40 

Jen Milner 

That's not even as much about, being healthy as it is about self-flagellation. There's that loop that we can get  stuck in of indulgence and guilt and earning it and not deserving it and being bad that I feel. And, and that I see  in my dancers. I'm sure you must see that in your practice as well.  

00:05:00 

Kristin Koskinen 

Right? The idea of I ate, I I'm bad because I ate bad or I didn't follow the diet or I wasn't perfect at anything. Shy  of perfect is bad. And therefore I must self-flagellation and compensation. I got to compensate for all these  things and turn the pendulum, went here and now I've got come all the way back here. Not only, I think people  take this in two respects, one physiologically, they think, Oh, well, if I ate, holidays, I think we associate a lot of  times with sweets and, favorite goodies, but only come out at that time of year. Oh wait. Many of those things  that now I need to, I stepped up there and now I've got to come over here and do everything the opposite. That's  how I'm going to heal myself physically. Also there's the perception that you touched on Jennifer is like, I'm  somehow fell off as a person.  

00:06:02 

Kristin Koskinen 

I need to correct my behavior by compensating with being rigid and disciplined because I was undisciplined. If I  ate this, now I must be very disciplined to come back for it and I have to pay and I was naughty. Now I need a  good and good is and good. We too often associate with restrictive. I think in the, I come from a ballet  background and we see this idea of people who are good, or even if we see this in ballet, they're they tend to be,  good is in terms of personality. It is it's related to discipline or perceived discipline. If people who managed to  keep their body frame at a very thin by their behaviors, like their eating behaviors, and it can be ultra thin, Oh,they're so good. Or, Oh, you must be so good. Look at the way you eat, because the way it doesn't make me  good or bad, it really doesn't.  

00:07:07 

Kristin Koskinen 

You get a rat and restricting and narrowing down to this absolute nothingness of what you choose to eat, which  sometimes happens is the carrot sticks, celery. I'm only going to, I'm going to go, a juice cleanse or fast, a  challenge to compensate or make up and redeem myself. That's just not the way it works. It creates these, the  cycles and the cycle of sometimes include bingeing and restricting. Sometimes they include depression, because  there's a win and a fail. Depending on what we're using to mark our wins and our failures, if those wins and  failures include not extrinsic numbers that come from the scale that come from a Fitbit that come from numbers,  because our body doesn't produce numbers. Like you don't have a device here that tells you a number. If it  comes from an extrinsic, that's telling you, those are the things that are telling you're good or bad.  

00:08:05 

Kristin Koskinen 

If you buy into this mindset, which so many of us do, and it's not just the dance world for sure. We see it all over  social media absolutely elevates it.  

00:08:16 

Jen Milner 

Absolutely well. And even going beyond, holidays. Do you think that winter itself can be some a trigger?  

00:08:25 

Kristin Koskinen 

Great point. Absolutely. I think something that's really important for people to recognize is I talk about, you  heard my bio, your what's your environment, where do you live in the world? So right now we live in the  Northern hemisphere. If you live in the Northern hemisphere anywhere North of say LA or Atlanta, or figure out  where you are in between, if you live in the middle of the U S but using these markers, you're going to see  seasonal changes where we have less daylight. There are a lot of jokes going on where, Oh, it's midnight, but I  looked at the clock and it's only 6:00 PM because we have so much dark. The sun is less, our bodies  physiologically respond to certain qualities of light. We don't get those qualities of light in the winter when the  sun Zenith is different. One how the light hits our eyes is different to how much sun exposure we get to get  outside in the sun.  

00:09:20 

Kristin Koskinen 

What that does to our mood is different. Three. Even if you are outside, we can expose your skin for 15 minutes  a day, a reasonable sun exposure. You're not going to get enough to promote production of vitamin D. If you  have any kind of health condition that precludes you from making enough vitamin D you may need to come in  and supplement that. I think something that, we also tend to be inside more during the winter. It's just really hard  for a lot of people to get outside. If you live someplace where you're snowbound, you may be stuck or you may  just feel like being cozy. We as human beings, like the cave we like to snuggle up, being at the front of the fire  hearth and home, these are parts of our tradition and they feel good. If we look at humans, if we look at where  we've come from in the not so distant past, even the beginning of the 19th century where we didn't have  electricity, right? So let's look where most homes weren't lit and what you had was a fire and you have the sun.  

00:10:24 

Kristin Koskinen 

We worked by the sun. In the winter, people tended to stay inside more. They didn't have, you know, heat  measures. They worked five, the sun, if you may have a flame to work by to read, but the amount of time you  slept was much increased because there weren't, you didn't have liked to stay by. I think when we look at our  bodies in terms of cycling, we have cycles of rest and repair. We wake up in the morning, cortisol levels respond  to this, to our cortisol levels are high. We should have high energy. They taper during the day, our melatonin  goes up and it's time to sleep. If we live in someplace, if you live someplace where your ancestors came from  someplace, where they have seasonal differences, where you have four distinct seasons, then that winter season  is a time when we rest, we are kind of developed to rest and recover during the spring and summer, you're  sowing and reaping and prepping the soil and doing all the things. 

00:11:24 

Kristin Koskinen 

You've got lots of sun to do all the work. In the fall we reap what we've sown and in the winter, we rest and get  ready to repeat that cycle. Even looking at how you feel and what you feel like doing, you may not feel like  doing stuff that couldn't be biologic and recognizing that your body may be different over different seasons.  That's okay, your body may not look or feel the way it doesn't summer in the winter, for reasons beyond your  workout. Because we do respond to sun. We do respond to being outside. Those are physiologic drivers.  

00:12:06 

Linda Bluestein 

That's super interesting. That's okay for a person's body to feel differently. That's the big message there is that  we shouldn't be judging ourselves harshly because of that.  

00:12:17 

Kristin Koskinen 

Exactly. Yeah. If you're deciding that, well, I've put on weight and now my next best step is to start drastically  pulling out calories in January, because as soon as the Christmas lights and the Christmas tree, as soon as those  are put away, it, I think it's interesting because we look at this, it's like, Oh, the holidays, it's a time of  abundance, right? The holidays are about, we have abundant food. The decorating can be lavish. Maybe, maybe  not. We give gifts. We're in the giving spirit. There's a gift. It's about giving and abundance. We come to  January and it's like someone after January one, it's like someone shut off all those twinkle lights. We go into the  dark days of winter and it feels we're in the dark long, dark days of what am or the days are starting to get  longer, but it still feels dark.  

00:13:10 

Kristin Koskinen 

It's cold. We don't have the things to look forward to. And we move into a scarcity mentality. The gifts are done.  The bills have arrived. The weight's been put on, or the cookies are put away or I've need to flagellate for  whatever missteps. I took the cocoa, the, whatever I did to, enjoy my life during those times. Now there's this  tendency to undo it, right? We want to undo, which is ridiculous. We can't done anything. We can move ahead  and develop and grow, but we never, we don't undo. In the dance world, I find this problematic because for a lot  of dancers inside the audition season, young dancers maybe auditioning for summer intensives. If they're  concerned and I think who I want to look this year, it's look good in the video. Do I need to, Oh, I need to lose  weight for that. That can become very problematic because when we lose weight, when people lose weight,  they're at increased risk for stress fractures.  

00:14:17 

Kristin Koskinen 

We mentioned not being outside, or maybe not getting enough vitamin D on a micronutrient level that can  increase your risk for stress fractures. If maybe you haven't been eating your in the usual way, because it was the  holidays. Now you're just moving back to your usual pattern of eating, maybe having, maybe you've got of a  nutrient deficiency that you need to catch up with, that leaves you at risk and starting to restrict yourself more. It  might move you in the wrong direction.  

00:14:47 

Linda Bluestein 

That, that makes sense. That's a perfect tie into the next topic that wanted to cover, which is, body image issues,  which we know are more common in the performing arts as compared to the general public and people with  hypermobility are statistically more likely to have anxiety disorders, obsessive, compulsive disorder, and other  things of that nature, which can make disordered eating even more likely in this population. How do you deal  with that emotional component that often comes with addressing fueling choices?  

00:15:18 

Kristin Koskinen 

Yeah. We always look at any equals one, whether it's a physiologic issue. By that, I mean, what's going on in  your body or if it's a psychologic or emotional issue, which they all happen to go on your body, but those are  sometimes we can get some additional help from counselors and therapists there, but we want to look at what is  the issue. People come to me a lot of times, they, by the time they come to me, they're tying a knot in the end of  their rope. There's another problem that's brought them to me. It's usually a health concern that any disorder eating might've precipitated. It's really important to recognize that eating disorders are coping mechanisms for a  lot of people, they have served a purpose and they've served any number of purposes. Those purposes are  different for each purpose or for each person, but they have been a really important part of their lives.  

00:16:16 

Kristin Koskinen 

We don't just dismantle them, but what we need to look at to say, what or what purpose is this serving? And  when we look at the fact of where you're at now, in terms of how is this impacting your physiology? How's your  body responding to what you're doing and what the eating disorder is doing, or the disordered eating, and what  steps can we take to, what do you feel comfortable with? What can we address first? Is it a behavior? Is it  introducing a food? Is it a specific nutrient? And we really start with what that person feels comfortable with,  what is their first step? And it's going to be different for every person. What, what one person is like, eh, yeah,  that's fine. With may induce anxiety, fear, and a panic attack in a different person. So, pizza might be, I can't, I  can never go there for one person.  

00:17:13 

Kristin Koskinen 

Our greatest accomplishment over the year might be the bait pizza. This happens, but that's not where we start.  Maybe, maybe it's well, are you getting enough food in our end goal isn't necessarily that, but maybe it's like,  well, how are you recovering from an injury? That's a really common one that they come to me because they  have an injury that can recover from, well, let's look at the injury. If we look at this, your body needs this to  recover. Can we start with this first supplement? Maybe, can we start with this first food? Can we take a bite?  And we grow into it. And the greatest motivator is success. Motivation doesn't come from a spark. Motivation  comes from success, and that's where these baby steps come in and psychologically. If the psychology is, they're  feeling OCD, anxiety, depression, are you, is it, has your diet kept you D has it created a nutrient deficiency?  That's keeping you from feeling good and can we give you nutrients and help you create those neurotransmitters  and biochemicals that help you to feel good? And then that's going to drive the process to keep moving forward.  

00:18:21 

Kristin Koskinen 

So it really depends. Sometimes it's a behavior. Sometimes it's something that we bring in, nutrition wise, but  it's always, it always depends on the person and we go from there.  

00:18:33 

Jen Milner 

Well, and you've said before that, disordered eating is, often a source of solace or of control for a person. That, it  is a tool that people use to get an end result, whether they're using it knowingly or unknowingly, but that it,  usually ends up breaking them, but also at the same time defines them. I imagine it's incredibly difficult to  untangle the emotional from the physical, when people are trying to say yes, eating this food would make my  depression better, but it would make my anxiety through the roof because that's one of my, forbidden foods that  I've told myself I'm not allowed to eat. It has to be a really complicated thing to try to unravel. I love what you're  saying about baby steps. Can you elaborate more on ways that people can kind of see those baby steps and try to  separate the emotional from the physical.  

00:19:30 

Kristin Koskinen 

Would that something we work on together? So do you ever sometimes, and sometimes it feels like in this work,  have you ever seen sometimes that like the imaginary of stores are these big balls and they have all these  different pieces. The goal is to bring it back to a little ball where all the pieces fit together. That's what we do. If  you push too far from one side, it becomes disfigured. If you push too hard from the other side, it becomes  disfigured. Really we may look and say, for example, if there's a physiologic reason why someone has anxiety,  we might start with something as simple as let's try getting some magnesium on board. If eating those foods is  too scary, we might try a supplement. We might try an Epsom salt bath. That might be, it might not be  something that's not even ingesting anything to just take those first steps.  

00:20:20 

Kristin Koskinen 

Sometimes we, the baby steps can be the babiest of things sometimes it's, what if you go to the store and look at  that food and, just go see where it sits in the grocery store. That's just some exposure ideas to break down. Fear.  Fear is very powerful and it's not, it's usually not rational, but it's a significant driver. What we really want to it's important that each person's fear or insecurity is validated and what seems obvious. There's no obvious. I really,  that's a term I would love to get rid of. Oh, it's so obvious now, actually it's not, or maybe it is for you and that's  great, but it's not for this person. Or they're obvious. They may have some other obvious things that get in their  way. Sometimes we remove some barriers and some false information that they're operating on, that's getting in  the way.  

00:21:19 

Kristin Koskinen 

It seemed, what are the barriers? Is it false information? Is it misconceptions? Is it any number of things? It's  complicated. It's really complicated.  

00:21:32 

Linda Bluestein 

The human body is so complicated. As you're talking, you're making me think about the things that I've been  reading lately, which are really saying we really should not be looking at disorders as being either psychologic  or physical, but that most disorders involve aspects of both. That, the idea of the mind body connection is that  they are absolutely connected and through the gut, right? So it's, nutrition to me at the end of the day, shouldn't  be the last thing, as you're saying the last night on the rope, it should be the very top. It should be the, like the  first thing, not the last thing.  

00:22:05 

Kristin Koskinen 

Yeah. Well, and it's not uncommon for me to have patients come in teenagers, very commonly with, they have  anti-anxiety medications or antidepressants that have been prescribed to them. These are kids and I was like,  well, what, why are you, do why you're taking this? Or did they, why did, why were you given this medication?  And they're like, well, I have a serotonin deficiency. Well, there are no products that are going to be more  serotonin. The way you get more serotonin is to build it up in your body, makes it doesn't the drugs they give,  you just help you to recycle it. We come in and say, well, we can shift some things and we come up and try and  come up with some safe ways or feel. What I mean by safe is obviously physiologically safe, but things that feel  safe to the person, Hey, what if we tried bringing this in, that's going to help you make more of that? How  would that feel? That feels pretty good.  

00:23:04 

Kristin Koskinen 

And it does feel pretty good. We also tend to see mood elevation. We've got issues are huge. I see that all the  time. I sometimes see that with dancers who come to me and their primary concern is they may have, it may be  weight that usually it's oftentimes it's bloat. If it's like, this is me relaxed and they look several months pregnant  and the rest of their body is, they're a classical ballerina. Are there some gut issues that we can work with  dealing? Or do we wanna, do we want to strategically pull some foods out, put some foods in wholesome foods  that temporarily work them back in, see how that impacts your gut bacteria. Do you maybe do need some  medical intervention to help get on top of that? Or if you have some gut things, sometimes that's definitely a  bendy body issue.  

00:23:54 

Kristin Koskinen 

I mean, that's something that I see the, I think you need to, with all your symptoms, I think you might need to  talk to Dr. Linda and see those things.  

00:24:08 

Linda Bluestein 

Absolutely. Losing weight is such a, especially with people who have anxiety or dancers or whatever, such a hot  topic, and can be such a, an emotionally Laden topic. If people come to you specifically and say, can you help  me set up a diet to lose weight? Like, how do you address that?  

00:24:24 

Kristin Koskinen 

Yeah, I am not a weight loss, dietician. I don't do one and done meal plans for people like I, and I get that for  every food. Hey, could you just give me a meal plan? Because I want to lose weight. I don't do that. Because  first of all, I want to see let's when I asked her, why do you want to lose weight? What's, why do you want to  lose weight? And usually when people want to lose the weight, what they really want to lose is fat. And so what's behind that. We want to find out what that's about. Number two, let's look at everything that's going on  with you physiologically and see if maybe there's an underlying cause to what's going on and let's look at how  you feel. If someone's main concern is they want to lose weight, maybe your weight issue is actually reflect, is a  symptom of an underlying medical concern.  

00:25:14 

Kristin Koskinen 

Maybe your medical concern is something that is your have something that's going on in excess of nutrients,  excess, or a nutrient deficiency. I have a fairly lengthy intake process. We go over, and includes a medical  history of nutrition, history, a diet history. And I review that. Sometimes I can look through and say, it looks  like maybe this is a problem. If you, we treat your body, if we give it these nutrients, maybe we're going to give  it what it needs to metabolize, everything that it needs to. For example, I had a, a young girl come to me and it  was her mother who said, Oh, my daughter's gained a lot of weight over since COVID started. I just want her to  have some healthy eating behaviors. And it's like, that's great. Absolutely. We can talk about intuitive eating and  how to nourish your body.  

00:26:06 

Kristin Koskinen 

I love it. Well, as I reviewed her intake, I know she had a significant medical history that showed that maybe if  we brought in some medical nutrition therapy, that's what dieticians do. We might solve some underlying  problems that were causing some rashes and hiccups and she is a singer. So that was a problem. It may or may  not impact the weight too. We gave her a very specific diet plan based on her needs to follow for a period of  time, which in her case was just a couple of weeks. As a result, the rash went away, the hiccups went away and  she happened to lose a bit of weight, which wasn't necessarily fat weight, but it was her body shifting and  getting rid of some excess fluid and things that she was holding onto as a result of this, underlying medical  condition.  

00:26:55 

Kristin Koskinen 

Now we're moving forward with how do we maintain without this rigid diet, which is not sustainable, but now  how do we eat is important, your health and your wellbeing as you go from here and not have to deal with any  of this diet nonsense and the, perhaps the diets that people get caught up in.  

00:27:14 

Jen Milner 

It sounds like you are not a calories in calories out kind of girl, and that you feel like there's a little more work to  be done than that. How can people kind of rethink their goals, and the way that they approach fueling to do it in  a more healthy way? Sure.  

00:27:33 

Kristin Koskinen 

I think one of the things that I'd like to see we've done so well, shifting from good food, bad food, we've where  people are starting to make that transition and talking about fueling, especially in the dance world. I'd like to  take that to another level, which would be nourishing, am I nourishing my body? And that creates a much  broader perspective on food and nutrition, as opposed to fueling which is important, but fueling kind of guides  us. It looks more at it's an energy, right? Like what we put in a car and well, we put in a car it's fuel it's energy.  We measure it in certain ways, just like when we look at, fuel or energy and food, we measure it in calories.  That's just an energy measurement, but it can also refer to get to us with macros and measuring things in Brown.  Rather than measuring and feeling that sense of control over numbers that we like to count and feel we have  control of when we look at nourishment, that's a far broader concept because we don't just eat energy, we eat  food.  

00:28:38 

Kristin Koskinen 

That food comes along with other components that we absolutely require for every function of our body. And,  whether it's healing and recovery thinking, skin, regeneration, your kidneys, moving, it's all of these processes  are exceptionally complicated and they need these nutrients to work. Sometimes I like to, in a very simplified  kind of way of thinking about minerals, for example, you have certain enzymes in your body, but they require  

they're like a car, but they required the mineral to be in the driver's seat to make them happen. If you don't have  the mineral there, the enzyme can't do its job. Now, of course that's overly simplified, but it kind of gives it. Sometimes it helps to have these little figures of, well, if I'm not getting enough of the nutrients I need, then the  body, the things that I have going just can't work. It goes beyond fat and protein.  

00:29:40 

Kristin Koskinen 

This is when we're looking at vitamins, minerals, phytonutrients, and the constellation of things we call nutrition  and weight loss are not always the same thing. They're often the same thing, but keeping that in mind as we  move forward,  

00:30:00 

Jen Milner 

As you move forward. Yeah. Not looking at it just as dieting, as you've said, not trying to lose weight, but  saying, what am I trying to get out of this? And how can I move forward in a healthy way? So there are some  people who are trying to move forward in a healthy way, and it is our habit as a society to look for those, if I do  this, then this will happen. We like to have those prescribed, do this, then this will be it. We like to have that  neat little, like you said, meal plans and that kind of thing, as we try to put those sorts of things together, are  there some triggers or some habits that might at first seem harmless, but that can lead to compulsive choices or  disordered eating.  

00:30:39 

Kristin Koskinen 

Absolutely. The number one indicator of an eating disorder or disordered eating is going on a diet. The numbers  tell us that one in four dieters will end up with an eating disorder or disordered eating at some time in their lives.  That number goes up for dancers and it goes up for ballet dancers. The numbers are frightening. We, anytime  when we try to quantify food, that's going to, that's usually dieting. Counting, if it's, if you're counting typically  you're dieting. If you're counting calories, counting macros, counting points, these are all dieting mechanisms.  That can be confusing because people say, well, what will then, what am I supposed to do? How do I know what  to eat? We need to always remember that everybody is different. How one person responds to, any food is going  to be different than another.  

00:31:43 

Kristin Koskinen 

We could put two people on the exact same plan. One person is going to thrive. The other is going to crash.  They just, the body just doesn't work that way. Any kind of counting using extrinsic devices to tell us to mark  our success are, is absolutely it. Whether it's the scale, your Fitbit, my fitness pal, calorie, trackers, apps on your  phone, they look like they're helpful tools. A lot of these things may be used as helpful tools, but far more often,  they end up being dictators and voices that tell us whether we're good or we're bad. I, if I go over the number,  I'm bad, if I go under the number, I'm good and we aren't good or bad based on any of those numbers were not  good or bad based on the food we eat.  

00:32:38 

Jen Milner 

Well, okay. Scales are a product part of life. Doctors use them. What are some, valid reasons that you might  have to weigh yourself?  

00:32:47 

Kristin Koskinen 

Absolutely. Valid times to weigh yourself is when we're looking at hydration status. If you sweat a lot, we might  want to see how much fluid we want to get back into. We might have you weigh yourself before and after a  workout. We make sure you're getting enough hydration during your workouts. That in a medical situation, if  we're looking at water retention, that would qualify too. If you're a child and your pediatrician, ways you for  growth charts to track growth, that would be appropriate. If you need to find out, if it's cheaper to get yourself to  a destination via ups versus buying an airline ticket, then that works too. Otherwise there's really no purpose to  have a scale. My clients are often, I'm shocked that it's not something we mark, and even clients where that is,  one of their goals is to lose weight.  

00:33:39 

Kristin Koskinen 

They just don't feel comfortable in their bodies. If weight loss is a goal of yours. That's okay. That's fine. But,  but why do you want to lose weight? For some people, they don't feel comfortable. They don't feel comfortable in their body. They've been doing some things up to until now, but I've just want them to not feel good. When  they make some changes, they're going to end up losing some weight and they're going to feel more comfortable  in their body. That's fine, but I don't track weight. I don't track inches. I don't track that stuff. I don't do before  and after pictures.  

00:34:10 

Jen Milner 

Well, and I guarantee you that just the fact that I use the word scale sent some anxiety through some people who  are listening to this right now. The thought of not stepping on the scale every day to have the scale, tell you  whether or not it's going to be a good day or a bad day, is definitely running through people's heads as a stressful  thing.  

00:34:30 

Kristin Koskinen 

And using the scale. It's so interesting because it dictates before you get on the scale, I suggest to people, what  are you going to do with that information? What is it going to tell you? And just like you said, is it going to  determine if you're having a good day or a bad day? And the interesting thing is, so for some people, if they get  on the scale and the number is what they like, they're going to eat differently. Something like that, like, whew,  I'm under, I can do whatever I want. This idea of versus, well, what if you're, what if you just like, ate in a way  that took care of your body and nourished you and didn't have the scale tell you, Oh, today's a cookie day. No,  today's a self-flagellation day juice fast. Yeah.  

00:35:13 

Jen Milner 

Well, and talking about juice, fasts and things like that, it's really popular right now for us to kind of look for  some a quick label to slap on our food choices. We always enjoy being part of a tribe and finding something to  number one, identify with, and number two, have other people tell us what to do in a very easy, if you do this,  then this will happen. We talk about going vegan or vegetarian or paleo and finding some all encompassing title  that will just make the choices for us. Can you talk about that and those labels that are popular right now and the  strengths and the vulnerabilities that can come with kind of painting your whole diet with such a broad brush?  

00:35:58 

Kristin Koskinen 

Absolutely. I think one of the things is labels tend to box us in. You decide I'm going to, even if the, even if your  self language is, Oh, I'm going to try this or that diet, it very rapidly becomes, Oh, I am this or that diet. I am  vegan. I am paleo. That can be really damaging because it becomes restricted. If a person says, I'm, even if they  say, Oh, I'm following a vegan lifestyle or whatever, the people around them may also inadvertently overly  support these choices. That when we restrict we this restrictive mentality, it means we're pulling things out. If it  becomes your identity, then there's an expectation. We may have that expectation for ourselves, but it may also  be what's the expectation others have of me. I need to fulfill that whether I want to, or not, whether I even like  this anymore or not, this is what people expect.  

00:36:56 

Kristin Koskinen 

For vegan, it may be, they go someplace and people trying to be generous and supportive might say, Oh, we  can't have this because Jane's vegan. So she can't eat that. He can't have it, or we're going to make her this food.  Jane shows up and maybe she would have been happy to have whatever everyone else was eating because she's  exploring plant based. Now she has to eat the pasta marinara, which she may or may not want while everyone  else eats the other things, because she's the vegan. It made in some of these diets and labels come with other  expectations or connotations. If you're whole 30, you're this kind of person, if you're vegan, you're this kind of  person. If you're keto, you're this kind of person, and these are your people and you do these kinds of things,  which is ridiculous, but it's true. It's what we do when we label anyone.  

00:37:49 

Kristin Koskinen 

And it's restrictive. If I label you a liberal or a conservative, now people have an idea they're going to think  about, well, she must do this. She must shop at this store. She likes these people. She supports these causes  based on some simple red, blue, black, white, conservative, liberal vegan, paleo, These black and whites can be,  yeah. Getting into them is restrictive. 

00:38:17 

Linda Bluestein 

Social media has made that even more so because maybe we're sharing certain things or it tends to kind of be a  divider where, which side of this are you on? Like Jen said, I totally agree about finding the tribe and social  media makes it kind of easier to find that tribe.  

00:38:32 

Kristin Koskinen 

Absolutely. People are going to it and it feeds into that. And, and we had this perception that more people are  doing what we think it is than the reality. That is a, that's a common psychologic problem. Oh, everyone's doing  that. No, they're not. They're not living it to the degree that you think. Right. We see that. We see that with  college kids. They may think, Oh, everyone's drinking, everyone's doing these things. And, but the statistics will  tell us otherwise, but they may base their choices on what they perceive everyone else at tribe they want to be in  is doing, Oh, everyone is doing these things. Now some of us die, or I want to be like that. Or I want to be, I  want to do what everyone else is doing, or I want to be current or relevant. And this is what that looks.  

00:39:22 

Jen Milner 

Well. You see dancers, Instagram influencers who say, Hey, I just ate this really amazing, powerful before  dance class. And look what happened. You see the clip of them doing eight pirouttes. All these dancers that  follow them say, Oh, I need to start eating that power bar before dance class, not stopping to think are the  choices in that powerful, right. For me? Or is it something that I should be doing or not be doing and finding  that middle ground is the tricky part. I wanted to come back though, to you were talking about the veganism and  vegetarianism and all those different labels as a tribe. What if people are doing it for a different reason? What if  there's moral or ethical considerations there? and specifically for our population, are there issues that people  should be worried about with going with those types of choices?  

00:40:13 

Kristin Koskinen 

Sure. Well, I think something there's been a lot in the media recently about plant-based and plant-based, so we're  talking about veganism, it's definitely plant-based, but plant-based has no definition. If you hear it in a  documentary or from an influencer that they're plant-based, that doesn't necessarily mean they're vegan or that  the health benefits of being plant-based translate to being vegan. If you are following a vegan diet because of  moral, ethical, ecological reasons, that's absolutely fine. Just make sure in terms of how your body is responding  to what you're doing, that it actually suits you and is right for you and your body. It's not for everyone. When we  look at a bendy body, community or dancers, or most people, they actually don't benefit from a vegan diet.  Plant-based meaning eating a lot of plant foods are most of your foods from plants. Yes, but when we remove  animal-based foods, we remove a lot of nutrients and our bodies simply absorb nutrients more easily and more  readily from certain animal foods.  

00:41:15 

Kristin Koskinen 

It's just, we see it with way in terms of recovery. We see it with certain minerals like zinc and iron when we get  them from plant-based or from animal-based foods, as opposed to plant based foods. When people remove the  animal foods, they also remove different, components that we are now finding in the literature to be super  helpful in terms of recovery and gut health, including gelatin and collagen, which are only animal-based foods.  If you're removing those, you may be, I don't know, for some people they're going to be okay for other people.  They are instrumental in their health and wellbeing. I've seen a lot of success with people who incorporate these  foods into their programs, especially with recovery, especially with connective tissue issues.  

00:42:02 

Linda Bluestein 

Really, this is so fascinating because I, I normally use the word pescatarian. I eat fish. As someone, myself who  has a bendy body, I have often wondered about not being pescatarian anymore, eating meat, but I overly identify  exactly as you said, and everyone else around me identifies. It has become a huge part of who I am in a way,  which doesn't necessarily serve me. Like I, I think it does. Are there certain foods that you recommend, if  someone is going to try adding meat back into their diet though, because if you've gone a really long time  without eating any meat besides fish, are there certain things that you recommend that they start with, or if  you're eating fish, is that often meeting that need? Do you have any thoughts about that? 

00:42:47 

Kristin Koskinen 

Oh yeah. It can meet the need, especially if you're eating the skin and as often as possible and getting fish bones, like from canned fish, eggs, if you're not eating eggs, I think eggs can be fantastic, especially with the choline  and how that can help support the brain. They may be a source depending on your eggs. You're going to get  some degree of omega-3 fatty acids from them. I think having a bit of a red meat can be really helpful for certain  people, everyone's different, but if you're looking at iron levels, especially having just even once a week, once a  month, just can be helpful, making sure you're the kind of meat you're eating matters. It, is it sourced well? Is it  humanely raised? Not, I'm not talking about getting a bunch of crap and eating overly processed stuff, but for  some people they may find if they try and add in that they feel better.  

00:43:46 

Kristin Koskinen 

For people, it brings up this idea of clean eating, right? Okay. Clean, doesn't have a definition. We look at the  holidays of being times of abundance and we lavish, maybe we have foods. We don't necessarily enjoy the rest  of the year. Special holiday traditions as people, we might let all the stops out. We spend more money on food  and celebrating and entertaining, booze, who knows, but we really do. Th these are times our families come  together. We have re oftentimes religious affiliations and all these celebrations. It's about abundance and gift  giving and give with food. We celebrate with food and we eat our grandma's recipes because those were made  with love and that's food. We live in this gingerbread house of food and celebration and the abundance, January  2nd hits. We go to the gym and it's stark. We beat ourselves up too hard.  

00:44:42 

Kristin Koskinen 

For people who want to be clean and eat clean, which means any number of things, it really it's, every definition  is going to be different. Does that mean you eat a minimally processed food? Does that mean you're vegan?  Does it mean yo’rer raw? Does it mean you’re gluten-free? whatever it means to whoever that's what clean is.  So now we're going to be clean. We're going to get all the decorations put away. We're going to move all that  crap out. We bought all this stuff. Now we hate the stuff, now we're going to organize the house. We're going to  go real simple. We're going to home at it. We're going to Marie Kondo after we've just done all this stuff.  Rubbermaid containers are going to be on sale. You know, everyone's going to do that. And, and it's a bit  extreme and we're, we want to, it's like, we want to undo what we just did.  

00:45:26 

Kristin Koskinen 

We don't need to undo it. We just did. We may want to move forward. Well, now we've had all these things and  now I recognize maybe I don't feel as good Jay, are there some things I need to change? Do I need to bring  something more in, do I maybe need to let something go? Is it, this is a time of year when I've enjoyed things.  Now I'm going to enjoy, reconnecting with other foods and training methods, but not trying to undo, like, or say  that was bad or naughty. No, it wasn't. You're on the nice list on December 25th, you're still on the nice list.  Now. It doesn't matter what you ate. It’s okay.  

00:46:09 

Jen Milner 

You're saying we shouldn't try to undo what we've done. We should just try to move forward. 

00:46:13 

Kristin Koskinen 

Move forward and see, and you're undoing. Here's the thing you may, what is it? You're undoing. It really  depends if it's about, Oh, I overate. So I felt uncomfortable. Right? I ate these foods that kind of make me feel  like crap in the long run. Well, maybe you need to pull off on those foods and maybe generally speaking, you  do, I use these bentos in my practice a lot. Something that I have in my bentos is a hold space. Sometimes the  holidays become the bento where it's all hold space items held. Spits are usually from things that we celebrate.  Maybe your bento has been out of the six slots, five fun items, and one leaf of lettuce. Were like, that was fun,  but it doesn't make me feel good. Now I'm going to go back to what makes me feel good, physically, mentally,  because what we put in our body impacts our mental health as well. 

00:47:05 

Kristin Koskinen 

Maybe I want to work back to that, and maybe I need some help knowing what that is. Maybe you don't know  what that is. That's a problem. Just because a cleanse, a challenge, a diet says, it'll help you lose weight does not  mean it will help you feel good, but doesn't necessarily even mean it will help you lose weight. It may help.  Some people lose weight. It may help. Some people feel good. It may not work or be appropriate for you. If it's  not something that you can maintain, essentially for the rest of your life, there are going to be shifts our bodies  shift and change over the course of a day, a season as we grow, as we matured during different, but what you  needed when you were a professional dancer is probably a bit different than what you need when you're not a  professional dancer.  

00:47:52 

Kristin Koskinen 

We can make, but we make micro adjustments as opposed to flip-flopping right. That's, I would like to see more  of a transition mentality as opposed to, well, now I've got to really beat the hell out of myself because of  December. 

00:48:11 

Jen Milner 

Right? So it's not either living in the gingerbread house or living at the gym, there's finding some happy medium  that we can kind of live in a sustainable way and enjoy what we're doing and also make healthier choices  moving forward.  

00:48:26 

Kristin Koskinen 

Absolutely. Everyone's healthy is going to be different healthy. It's such a vague word, right? What's healthy for  one person is not going to be healthy for another. Sometimes the doses in the poison, what may be great for one  person in large amounts may knock someone else way off the edge. If you, if you need help sorting those things  out, that's okay. Maybe you need to find out, maybe eating lots and lots of veggies makes you bloated because  

you have an underlying health condition that we need to give you certain fruits and veggies and get rid of the  bloat. Because when you eat that diet, or when you go on the juice cleanse, you end up with blood sugar spikes  and falling off, it's, there's lots of stuff. There are lots of reasons why these things may on paper look good, but  in practice, not so much,  

00:49:16 

Jen Milner 

Right? Well, you have given us so many great little bites to kind of chew on when we talk about baby steps and  the importance of baby steps to really look at why we're doing something, why we're really trying to make  changes. The importance of speaking with a professional that can help us look at the way we feel and even  looking at the difference between fueling and nourishing. I think these are all things we can all kind of take with  us. If people are trying to look for someone, how can they find you?  

00:49:44 

Kristin Koskinen 

They can find me on my website, www.eatwellpros.com or on Instagram, which is my name.  Kristin_Koskinen_RDN same with Facebook, or you can shoot me an email at kristin@eatwellpros.com.  

00:50:02 

Jen Milner 

Excellent. Thank you. We will have that information as well in the notes for the show for the podcast. You can  find her there as well. Well, you have been listening to bendy bodies with the hypermobility MD as we chat  with registered dietician, nutritionist, Kristen. Koskinen Kristin, thank you so much for coming back to chat  with us. Again, we always learn so much from you and really appreciate you sharing your wisdom with us.  Thank you for having me.  

00:50:28 

Kristin Koskinen 

It was wonderful chatting with you. Thank you. Absolutely. Thank you. Bye. 

00:50:33 

Linda Bluestein 

Thank you for joining us for this episode of bendy bodies with hypermobility MD, where we explore the  intersection of health and hypermobility for dancers and other artistic athletes. Please leave us a review on your  favorite podcast player remembers to subscribe so you won't miss future episodes. Be sure to subscribe to the  bendy bodies, YouTube channel as well. Thank you for helping us spread the word about hypermobility and  associated conditions. Visit our website, www.bendybodies.org. For more information, for a limited time, you  could win autographed copy of the popular textbook disjointed navigating the diagnosis and management of  hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorders just by sharing what you love  about the bendy bodies podcast on Instagram, tag us at bendy_bodies and on Facebook at bendy bodies podcast.  The thoughts and opinions expressed on this podcast are solely of the co-hosts and their guests. They do not  necessarily represent the views and opinions of any organization.  

00:51:40 

Linda Bluestein 

The thoughts and opinions do not constitute medical advice and should not be used in any legal capacity  whatsoever. This podcast is intended for general education only and does not constitute medical advice. Your  own individual situation may vary, do not make any changes without first seeking your own individual care  from your physician. We'll catch you next time on the bendy bodies podcast.