Six months into our changed world, I really feel like I’m hitting the social-distancing/COVID wall in life. There are days when I feel really good, I get my workouts in, I power through my telework days, and I go to bed exhausted because I was non-stop all day long. On these days I know that taking my supplements have made me feel much better about my stress level and got me to get up and be active! A friend recommended them to me, so I read reviews like the activatedyou product reviews and decided to give them a go. And then there are days when I don’t want to get out of bed, I don’t want to workout, I am opening my fridge every hour to eat, I don’t want to see anyone and I just want to shut the world out.

It was a very disturbing feeling. I felt like I was in some kind of a black hole and all I wanted to distract myself was food. And then I realized my binge eating isn’t going to end well. This was when a friend of mine suggested that I use supplements such as Bio X4 (for info regarding discounts on these products, check bio x4 discounts). However, only pursue these after consulting with a physician. You’ll never know what works best for your body unless you get professional advice.

I asked Dr. Krengel and Christy Goff, RDN, at Pacific Medical Centers (PacMed) some of my questions related to exercise, stress and food to get a better perspective on some of the things I’m personally dealing with, and I wanted to share their responses with my readers.

How does exercise and being able to get out of the house during COVID, even for just an hour, help us mentally?

Dr. Krengel: At Pacific Medical Centers (PacMed) we know that exercise is an integral part of our mental health. Studies indicate that a regular exercise routine can improve both anxiety and depression. For example, getting outside for a walk while wearing a mask and practicing social distancing is a great way to improve your health during these times of increased stress and social isolation.

One of the best things about gyms that have group exercise classes are being around other people and having a “gym community” of sorts. How does working out as a group help us mentally?

Dr. Krengel: I find that having a group of people you work out with helps hold you accountable. You are also providing that accountability for those you work out with. Signing up for classes is also a nice way to carve out dedicated time to work out. For those of us who are hesitant to return to the gym because of the ongoing pandemic, taking an online exercise class with friends over a video chat is an alternate way to maintain that community.

Cardio vs weight training vs yoga – I do all three. Can you talk to me about the benefits of all three separately and together?

Dr. Krengel: I think of cardio for my heart, weight training for my bones and yoga for my mind. Getting 150 minutes of cardio per week has been shown to reduce the risk of developing heart disease, which is the leading cause of death in the US. Weightlifting has been shown to reduce the risk of osteoporosis, which is the leading cause of hip fracture. Yoga is a wonderful way to incorporate mindfulness into your day, which has been proven to improve focus and reduce stress.

This is why we at PacMed suggest doing a combination of the three types of workouts for well-rounded, mental and physical results.

For those who are doing at home workouts and can’t go to the gym or don’t have much equipment, what types of workouts can they do at home to feel better mentally and to get a good sweat on? Do you recommend any good mobile apps?

Dr. Krengel: Walking, hiking, jogging, and biking are all excellent ways to exercise outdoors, especially in the Pacific Northwest. There are so many free classes online right now and many gyms are offering free trials with access to their online classes. You can even get CDs for working out at home. There are several strength training manuals and CDs available. The unlock your hip flexors program are some of the few easy-to-follow exercises designed for the sole purpose of strengthening and loosening your hips. Boot camp, yoga, and dance classes are all great and can be modified to perform at home without equipment.

To help you track, you can use your cell phone or smart watch to track steps or activity. I use a pedometer on my watch to track my activity and know that most phones come with a similar technology. However, use it if it helps motivate you and ignore it if it doesn’t.

Especially when stressed, what is the science behind food cravings and why do we often crave unhealthy foods, especially when stressed?

Christy Goff: The science behind why we eat is complex, but a main contributor is our hormones. Dopamine is a neurotransmitter in our brain that is tied to feelings of reward and pleasure. When we feel stressed, bored, or lonely, this hormone can drop. This triggers us to look for habits that increase dopamine in the brain, including eating, exercise, drugs, cigarettes and sex.

Since food is fairly easy to come by, it’s often our first choice. Additionally, eating food high in carbohydrates, certain proteins, sugars and fats typically produce a stronger dopamine response than our healthy alternatives. But when we rely on these foods for pleasure, our brains become wired to derive the most pleasure from these foods, making the attraction to these foods stronger.

What should you do when you experience these biological cravings?

  1. Notice when you’re eating to curb stress or other emotions– this is called emotional eating. Take a moment to assess your true hunger and if it’s not quite there, maybe there is another activity like calling a friend, going on a walk or journaling that can also be of service. Come up with a list that is personalized for you.
  2. Try a healthy alternative to what you are craving such as a whole grain carbohydrate or a healthy fat like avocado or salted nuts.
  3. You will always have cravings but sometimes the intensity of cravings occurs when you are not eating at normal intervals throughout the day or have meals that aren’t very balanced – meaning they contain a whole grain, protein and fiber filled veggies. Take note of the times and meal contents at the meals before your cravings to assess if changing patterns would help.
  4. Consult a food and nutrition expert, or a registered dietitian to assess your questions individually!


Dr. Madolyn H. Krengel, MD is an internal medical physician at Pacific Medical Centers. As an expert in adult healthcare at the Northgate location, she is most interested in chronic disease management, women’s health and mental health areas. She has her degree from Rush University College of Medicine in Chicago, IL and certified board eligible for the American Board of Internal Medicine. When not with patients, you can find Dr. Krengel cooking, hiking, skiing or spending time with family.

Christy Goff, MS, RDN, CD is a registered dietitian nutritionist and yoga instructor at Pacific Medical Centers. She graduated with a master’s from Bastyr University and has since worked in various settings including as a clinical dietitian, as a dietitian with the federal program for women, infants and children (WIC), and with SNAP-ED program. Christy is often in the media with interviews by Q13 Fox and King5, producing original cooking videos and is a regular representative on the PacMed social media pages. Additionally, she is a board member of the Greater Seattle Dietetic Association and past president. No matter her job title, she helps clients start on a journey to solve their health goals! In her free time, she enjoys hiking, cooking, photography and traveling.

Pacific Medical Centers (PacMed) is a multi-specialty medical group with nine neighborhood clinics in the Puget Sound area. Founded in 1933, the PacMed network is one of the largest throughout the Puget Sound and offers patients more than 150 providers for primary and specialty care. PacMed’s culture focuses on its mission of delivering high-quality health care focused on the individual needs of its diverse patient population with an emphasis on improving the quality of health in the community.

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