What is Functional and Integrative Medicine?

integrative medicineThere are many of us nutrition professionals now aligning ourselves with Integrative Medicine. I consider myself in this group. Maybe you are asking yourself what exactly this is and most importantly, does it really matter?

To answer that question, let’s first address the area of conventional medicine. For some time now modern medicine has sought to treat the presenting symptoms. This might mean treating a fever or a cough, for example, or addressing pain or other discomforts. Sometimes this approach is entirely appropriate, however more often this approach misses the underlying cause and the person is never completely restored to health. Think of lingering health conditions such as acid reflux, chronic fatigue, and headaches, just to name a few. Drugs are often prescribed and the patient is sent on her way, but the symptoms persist if the drugs are discontinued.

Additionally, there is very little discussion with the patient as to how their condition came about. Unfortunately, and not the fault of our doctors, there is limited time available to spend with patients and so remedies must be delivered quickly. Without more in-depth dialogue there is little chance the practitioner even has the opportunity to see below the surface of what is really going on.

From a dietetic perspective, a conventional approach to diet intervention would be something like prescribing the same diet to everyone with the same disease. Everyone with heart disease would get guidance on the exact same heart healthy diet, for example, with no consideration given to their culture, preferences, cooking ability, or genetics. Similarly, a person seeking to lose weight would be advised on the same general diet as another without consideration given to what they’ve tried in the past or an understanding of what foods work or don’t work for them. These would be examples of conventional approaches.

Now let’s flip to the functional side. Functional practitioners are looking less at masking symptoms and more at how the body is functioning as a whole. They are attempting to uncover where the body is malfunctioning and how can we restore it to its normal, healthy state. Symptoms are just clues to lead us towards the underlying cause.

In addition to symptomatic clues and obviously a physical exam, if appropriate, functional medicine practitioners are also looking in-depth at a person’s unique health history to find more clues as to how and why the body is not functioning as it should. This means sitting down with someone for a significant length of time (often 45 min to an hour) and asking a series of pertinent questions to paint a picture of the person before them. What might seem off-topic to the patient is often valuable information to the practitioner, as random side notes about vacations, new pets, change of jobs, or significant loss can give further clues into a person’s current state of health. These are topics rarely discussed in the conventional model.

Additionally, if necessary, laboratory tests can be conducted to give further insight into treatment options. These might include not only standard blood work but also food allergy tests, digestive stool testing, hormone testing, etc.

The goal then, after this information is obtained, is to determine how to best gently nudge the body back into an optimum state. Pharmaceutical options are a last resort as we know these only mask symptoms and leave the original condition unresolved. Potential nutrient deficiencies are often addressed, exercise recommendations may be made, and stress reduction techniques might be employed as well. Some may go further and prescribe other treatment modalities such as massage, acupuncture or chiropractic care to complement their recommendations. Once initiated these treatment plans often need time. Patients do not develop chronic health conditions in a day or even a week. Likewise these treatments need weeks if not month to restore the body to proper function and balance.

So how does this model work for the dietitian? Thankfully, we already have the immense fortune of being able to sit down with someone for a good hour or more to delve into health and diet history. This gives us a solid place to start when it comes to tailored diet advice. While we are not credentialed to prescribe or “treat” per say,  this time allows us to get a full picture, both past and present, of what clients are dealing with; therefore we can devise and educate on an appropriate diet strategy. Often we suggest helpful supplements as well, especially where nutrient deficiencies are apparent. We can also advise on exercise and stress and provide additional referrals when needed.

While both modalities have their place, consider looking into functional medicine, especially if you have chronic conditions that the standard medical model is not effectively addressing. Remember, more medications is not necessarily the answer and in fact can lead to yet more symptoms that require more drugs. Believe me, I have clients in these predicaments and it’s a slippery slope.

So consider seeing a naturopath, a functional dietitian like myself or other holistic care providers for a more thorough look into your condition; or even consider it for another opinion. It just may be the nudge your body needs to finally heal and restore.

Of course, if you have questions or want to talk, please reach out! I have loads of referrals if you are looking for a qualified practitioner to meet your unique needs.

 

Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net

Smart Summer Snacking

healthy snackSummer is just about here….we in Seattle can feel it. It’s been a long winter. Finally the days are longer and we are getting outside. More importantly, many of us are planning trips, outings, picnics, etc. What do these things always involve? FOOD of course!

With all this movement out and about, eating healthfully can be tricky. Many of us end up snacking more than normal as we end up in different environments with less access to our typical go-to foods. The temptation to swing into a gas station mini-mart or fast food becomes all the more tempting. Unfortunately these places rarely have healthy options, and even when they do, who actually buys them? Be honest here.

The key to solve this problem? Planning! Plan, plan, plan. Did I say plan already?  You HAVE to plan ahead. Yeah, maybe it takes the spontaneity out of things, but there are plenty of other opportunities for exciting food adventures besides those you might encounter driving down I-90 or on a 5-hour plane ride. Plan some snacks, pack them with you, and stay healthy and energetic throughout your trip.

What to pack on the road? I’m glad you asked. Here are some simple, car-friendly and flight-friendly options to get you through until your next exciting meal can be enjoyed. These can also make great meal replacements in a pinch when no healthy meal options exist.

Nuts
Nuts are your friend. They pack a good deal of calories, so portion accordingly, but they also have healthy fats, fiber and protein. Pick your favorite and parcel into plastic baggies or just tote the whole darn bag and share with your travel mates.

Dried Fruit
Yeah, I know dried fruit has carbs. They have a lot of carbs. But they also have vitamins, minerals, fiber and antioxidants. If you portion them correctly you do not have to be afraid of dried fruit. It too is your friend and makes a great travel companion. They pair fantastically with nuts or other protein options.

Dried Vegetables/Legumes
Dried vegetables? Indeed, I have been seeing more dried veggie options in the stores these days. From kale chips to crispy beets to baked chickpeas, there are more savory dried options that are travel friendly. While some may contain oils and flavorings that might be less than ideal, we are still doing better than chips, candy and fast food, right?

Bars
Bars can be risky. I always hesitate and clarify when I recommend bars. Many are loaded with sugar and beefed up with cheap protein fillers and poor quality vitamins. That being said, there are actually some decent options out there with high quality ingredients and actual nutrition. What do I look for? First off I check the ingredients. Does the list run 4 lines long and contain many unpronounceable words? Put it back. For me, the less ingredients the better.

Also check the nutrient label. How’s the calorie count? Protein content? Fat? In a perfect world I’m looking for 200kcal or less (could be more if substituting for a meal), 8g of protein or more, and a fat content that does not seem obscene (less than 15g, perhaps?). Then I’m looking for simple, whole foods ingredients that I know are providing my body with nutrients and don’t require the manufacturer to add in a host of artificial vitamins to make sure it’s well balanced. I like to see nuts, seeds, grains, fruit, etc. Some might add whey or plant-based protein to pump up the total protein content, which I am fine with. Avoid soy protein isolate.

Now, there are a bazillion bar options out there and I am no expert on them all. I will list a few options I like here, but do realize this list is by no means exhaustive. If you find a bar that meets your personal criteria and you like it, go for it! Here are a few I’ve found that I will travel with in a pinch. I believe most of these avoid the common allergens as well so great options for those with food restrictions. Check out their sites for ingredients and places to purchase.

Rx Bar
https://www.rxbar.com/

Macro Bars
https://gomacro.com/shop/product-category/macrobarminis/

Epic Bars
https://epicbar.com/

Primal Kitchen
https://www.primalkitchen.com/products/almond-dark-chocolate-bars/

Pro Bar
http://theprobar.com/#2

And if you have the time, make some bars yourself! On my last trip overseas I planned ahead by making a batch of protein balls and packed them in my carry on. They made a great treat when the food cart came around and there were very few options I deemed acceptable to eat. Homemade gourmet for the win!

Hope these ideas help you plan more effectively for fun and sun this summer!

If you have your own go-to travel snack ideas, please share!

 

Image courtesy of SOMMAI at FreeDigitalPhotos.net

What is Pre-Diabetes?

prediabetesMost of us have heard plenty about Type 2 Diabetes. It is a serious condition causing abnormal elevations in blood glucose levels. Type 2 Diabetes now affects over 29 million Americans and is costing the healthcare system over $300 billion annually.

The cause of Type 2 Diabetes is multifactorial. A high BMI with an unhealthy diet is often the main culprit, but genetics may play a role as well.  Over time, diabetes leads to a host of other diseases, which is where the most considerable health damage is done. These include conditions such as neuropathies, heart disease, stroke, infections, and poor wound healing.

In terms of diagnosis, your doctor will sound the diabetes warning bell if you have an HbA1c above 6.5 and a fasting blood sugar over 125. Treatment often begins with drugs (Metformin is usually the first option) and diet and lifestyle recommendations.

But…..now more frequently we are hearing about what is termed Pre-Diabetes. Yikes, another type of diabetes? Well, sort of, but not exactly. Pre-diabetes is basically the beginning stages of blood sugar irregularities.  It is a critical point where we can catch people before they become full diabetic and in many cases even reverse the progression.  It is important that we all get a better understanding of this condition so we can combat the rising rates and healthcare costs of diabetes. To that end  let’s review the definition of pre-diabetes, the associated health risks, and effective preventative measures.

We already reviewed the diagnostic criteria for diabetes. For pre-diabetes, the ranges are just slightly lower. If your fasting blood sugar is running anywhere from 100-125 and your A1c comes back anywhere from 5.7 to 6.4, you will likely be labeled as pre-diabetic. This puts you at significant risk for diabetes within the next 4-10 years unless steps are taken to return your blood sugar to an ideal range.

This is where I would ask, if you happen to have them on hand or online, to go check your labs. Seriously, go check them! See where your fasting blood glucose is at and determine if you’ve had a recent A1c. The reason being? Many doctors are not diagnosing pre-diabetes. Studies have shown we have an under-diagnosis problem in this country when it comes to pre-diabetes. I’ve seen many clients in my office with pre-diabetic numbers and yet no one told them they were pre-diabetic. So yes, go check.

It is so valuable to know this information because pre-diabetes is EASY to treat with diet and lifestyle change. The studies show that diet and lifestyle are the number one way to reduce blood sugar numbers in pre-diabetic patients. Once you progress to full diabetes the chance of returning to normal blood glucose is much, much harder. NOW is the time to take action and correct.

If you are pre-diabetic and want to take steps now to avoid becoming diabietc, here are a few of the researched ways to get those numbers back under control.

DIET
Not surprisingly, diet of course is the primary area to address. From the research we see that that reducing carbohydrates helps immensely, as does decreasing overall calorie intake such that weight loss occurs. When diet and weight loss are tackled together, blood sugar begins going in the right direction as well. What kind of diet you ask? Multiple studies show the Mediterranean diet is a very helpful roadmap for an overall healthy diet. Thankfully multiple books, cookbooks, websites, and blogs have been devoted to this way of eating. Another similar approach is the anti-inflammatory diet. In both cases, think fruits, veggies, lean protein (especially fish), nuts, seeds and legumes…..you get the idea.

WEIGHT LOSS
As alluded to, weight loss is extremely important in normalizing blood glucose levels. In many studies they have found weight loss to be the most important factor in reducing diabetes risk. The theory is that being overweight increases inflammation in the body. Once the weight comes off and the inflammation subsides, blood glucose begins to return to normal. Of course diet is always interwoven with weight loss, so likely the diet plus the decrease in weight is working together. Whatever the cause, include modest weight loss in your plan and you should see results.

EXERCISE
Naturally we cannot talk about diet and weight loss without including exercise. Exercise helps support weight loss which we know improves blood glucose. Apart from helping with the weight, exercise also helps improve insulin sensitivity and increase metabolism, all of which help us clear sugar from the bloodstream more efficiently. It also supports a healthy heart and improves circulation, both of which are negatively impacted by high blood sugar.

DRUGS
In some cases, drugs are employed to help in the pre-diabetic state. If diet and lifestyle changes just aren’t working, or maybe you are at a place where you cannot implement these changes, doctors may prescribe drugs such as Metformin to support healthy blood glucose levels and slow the progression towards diabetes. Of course diet and lifestyle change remains paramount components, but drugs can often work in conjunction with other treatments when necessary.

SUPPLEMENTS
As you are likely well aware, there are many supplements on the market for diabetes. They are often marketed for pre-diabetes as well. Some of the ones you may have heard of include cinnamon, alpha lipoic acid, chromium and Omega 3’s. All of these have shown some promise in various studies conducted. While they can help support improved glycemic control, remember that diet and lifestyle changes are always the most important. Never rely on supplements as your primary means of blood glucose control.  They show modest results at best. Like medications, they can be helpful in conjunction with changes in diet, exercise and weight control.

Hopefully this review gave you a quick glimpse into pre-diabetes and a better understanding of where you stand in terms of blood sugar health. Like I mentioned, always review your labs and be keep tabs of where you are at. While doctors are very knowledgeable, sometimes they miss these early stages of disease where small changes now can lead to big decreases in risk later. Take control of your health and be on top of your numbers.

If you do find that you are pre-diabeteic, one of the best things you can do is talk to a Registered Dietitian! In fact, a recent study conducted found that RD’s were more effective in delivering health information to diabetics than other types of practitioners, resulting in greater improvement in diabetic markers over a 12-month period. What makes our job so great is that we get to sit down with clients one-on-one for up to an hour, really drilling down on each person’s unique diet and situation. We customize the plan to fit the client instead of forcing people to adhere to some standard regimen on a piece of paper. As the research shows, this results in better compliance and bigger changes in blood glucose.

So….along with knowing your numbers, know a dietitian! Get some support if you are looking to navigate new changes in your diet and overall health! That’s what I’m here for.

Are Supplements Necessary?

supplementThere has been a lot of talk regarding the necessity, or not, of vitamin supplementation. Some argue that our poor, inadequate diets require it. Others purport that we glean enough from the variety of foods we eat in addition to fortification of grains, so taking supplements is just a huge waste of money. Who are we to believe?

I get asked this question every day. “Should I be taking a supplement?” My answer? It depends. I agree that not everyone needs a supplement. Our ancestors went without popping pills every day and arguably did ok, in most cases. Maybe this fight against supplementation is warranted. On the other hand, we all know people and specific cases where supplements were extremely helpful. Iron deficiency, B12 deficiencies, and Vitamin C deficiencies are just a few examples. Also those with clearly inadequate diets would, I believe most would agree, benefit from some sort of supplementation.

What is the correct answer then? Again, it depends.  There are so many factors that should go into the decision of whether to take a vitamin or not. Despite what online articles might tell you, it’s not a black or white issue. Let’s walk through the areas I typically assess with clients to determine if supplements are worth considering.


1. The number one factor I assess when determining the need for vitamin supplementation is the client’s current diet. Are they getting a varied diet, supplying a variety of nutrients throughout the day? Or, are they eating the same foods every single day, many of which are nutrient-poor? If the client’s diet is not meeting their needs, of course the first step is to help them correct the issue. Along with better diet, however, supplementation can be helpful in rebuilding nutrient stores in the body. Sometimes we recommend specific nutrients of concern, say calcium, Vitamin D, B vitamins, etc, and other times we go straight to a multivitamin to help cover all the bases. Our goal is to support health through optimal nutrient status, and supplementation, at least in the short term, is one way to help clients achieve that.

2. The next factor I always address is overall health. Are there specific disease states that my increase the need for certain nutrients? Are there potentially genetic factors whereby the client does not use nutrients as optimally as they should, thereby requiring a higher intake to enhance absorption? In these cases, short-term or long-term supplementation at regular or sometimes much higher doses are warranted. Please note that vitamin supplementation for disease conditions or at higher doses than commonly recommended should be evaluated by a medical practitioner before commencing.

For example, some diabetics may be deficient in chromium. Chromium is a micronutrient that works with insulin to help it do its job. Obviously insulin function is very important to a diabetic, hence a diabetic might consider chromium supplementation in their treatment plan.

In terms of genetic issues, one example is someone with the MTHFR mutation, which causes a defect in the enzyme that helps convert folate into methyl-folate. Methyl-folate then goes on to make another product called SAMe via another enzymatic process, which is then used used in hundreds of reactions throughout the body. If someone is not utilizing their folate as they should, symptoms can result. Supplementation can be a huge and necessary help.

3. The third area I address is lab data. Does the client have lab results reflecting overt deficiencies? Often many people don’t even realize they have a deficiency until testing is done to assess. Based on lab data we can pinpoint appropriate supplements that might be necessary in the short-term to correct a nutrient problem before it becomes a major health concern that they do realize.

4. And the last area I assess is general need based on location. I live in the Pacific Northwest. We are chronically Vitamin D deficient. Almost all of my clients should be taking some level of Vitamin D. Iodine is another example. Some parts of the country and in some communities in particular iodine-rich foods are almost non-existent. These groups might benefit from standard supplementation when there are known, widespread deficiencies.


So now that we have a better understanding of how to assess when and where nutrient supplementation might be needed, the next big question I often get is asked is, “Does it matter which brand I take?” The answer to that question is yes!

Quality is a huge concern in the supplement world. That is probably the number one reason supplements in general have a poor reputation. Numerous reports and studies have caught supplement manufacturers lying about the contents of their products or outright deceiving customers on what they even contain.

You may remember this story from a couple of years ago where several herbal products in common retail stores (Target, various drug stores) were tested for authenticity. They found that many of the products they looked at did not even contain the herb listed. In fact, some were filled with common houseplant substances instead of the healing herb they were touting.1  I can see why consumers would be suspicious. (see story link below)

Clearly, you do need to be careful about the products you choose. Unfortunately the choices are overwhelming, even to me! How do you decide?

The easiest answer is to ask your health practitioner what, if any brands, they use or recommend. I personally have my go-to’s that I know are safe and effective. Other practitioners have their trusted products. Typically these are from well-known, established companies with documented testing procedures, quality control measures, etc. Many of these brands are trusted and recommended by doctors, naturopaths, dietitians, and chiropractors. Some can be found at your local supplement store, and others need to be obtained at a natural pharmacy or online. Almost none, just for reference, come from the local drug store (Walgreens, Rite Aid, etc). It’s usually best to buy from a reputable supplement store, and even better to walk in with a specific product in mind, lest you get confused and/or tempted by the multitude of options.

Conclusion? Despite what media reports might say, supplements can be useful. Does it mean you need to run out today and get a general multivitamin just to be safe? Absolutely not. The key above all else is to improve your diet choices for optimal health and then evaluate if further “assistance” is needed. Don’t pay attention to all those latest fads on TV telling you what you need. Eat healthy, listen to your body, and employ the advice of a qualified health practitioner to better assess what supplements would be helpful, if any. You will save yourself a lot of time and, not to mention, a heap of money.

If you are not feeling at your best and wondering if supplementation is something you should consider, or if your medicine cabinet is jammed full of supplements and you are not sure if they are the right ones, reach out! We can do a general assessment to figure out what you need to make sure your body is working at its best.

1. https://www.washingtonpost.com/news/morning-mix/wp/2015/02/03/gnc-target-wal-mart-walgreens-accused-of-selling-fake-herbals/?utm_term=.1618f3899833

Turmeric: Nature’s Wonder Drug….. or Not?

Unless you’ve been living underground, you have likely heard an overwhelming amount of information related to turmeric this past year. Somewhere along the way it was awarded super-spice status and now can be found almost anywhere you look, from supplements, to grocery store products, to even toothpaste!

The benefits of this wonder-spice are mainly anti-inflammatory in nature and for that it has been reported helpful in many diseases such as heart disease, diabetes, depression, and possibly even cancer. In Indian culture they even use it topically to speed wound healing. What can’t this spice do?

Recently, however, a report came out saying that we were duped. Curcumin, the active ingredient in turmeric, has little bioactive activity in the body. The report pointed out few studies showing curcumin itself to have any health benefits, and that in fact the compound often breaks down before it can elicit any sort of positive health impact.1

Oh no! How could we have gone so far astray, especially regarding an ancient spice that has been used for centuries therapeutically in other countries? Is it simply placebo affect?

Let’s hold up for just one second. For starters, before we go dumping all our turmeric capsules down the toilet, let’s read the article fully. What exactly are they saying?

Pay careful attention to the wording. The author in this article is mainly discussing the inability to successfully create a drug utilizing curcumin. Essentially they are saying we have been unable to isolate this active compound in such a way that has a positive and reproducible affect in the human body. Instead of acting on a target protein as they had hoped, the compound broke down and apparently produced no anti-inflammatory result. The article then goes on to say that we have very few published studies to show any benefits from turmeric, and specifically, curcumin usage, so in their conclusion, the time and money spent on turmeric is worthless.

That is all very interesting, however it is also misleading. First of all, just because they cannot isolate curcumin in a stable form suitable as a drug does not mean that curcumin does not work. The body, as we discover daily, works in mysterious ways. Simply because curcumin does not work on one specific target protein does not mean that it is not producing health benefits by other means.

Secondly, we do in fact have some studies to show beneficial affects. Do a quick search on PubMed and you will see what I mean. Some of these studies use the isolated curcumin, and others use the turmeric whole. Both do have research to show some effectiveness. One study, in fact, showed that turmeric was just as effective as ibuprofen in reducing pain from osteoarthritis.2 That is exciting news if you ask me! In fact there are many studies showing positive outcomes with arthritis patients.

Additionally, there are also many in-vitro and rat studies demonstrating the anti-inflammatory benefits this spice can have. While obviously these results are not always directly relatable or applicable to humans, the take-away is that this compound is very active and holds promise for a wide variety of disease states.

On the whole, based on this one critique, I would not be so fast to discount the powerful effects turmeric can have for our health. Ancient tradition and wisdom aside, there are actually studies showing benefit which should lead us to conclude that turmeric is actually doing something, but maybe not in the precise way we are looking at it currently.

Don’t forget that like with most things in nature, compounds work synergistically. Another reason why food, not supplements and fortification, is paramount for health. For example, we know that the phytochemicals in fruit are more powerful when eaten together in the whole food. When we try to isolate specific phytochemicals to make a pill, we find that the compound is unstable and frankly doesn’t work. But these compounds DO work when ingested in the right form and combination that nature intended.

All that to say, keep up with your turmeric if you find it to be working for you. Consider eating it in the whole form in cooking rather than isolated pill forms. If you do choose a pill, purchase from a reputable company and even consider purchasing the same forms used in the studies. When using the whole spice for the root, combine it with other foods known to enhance the bioavailability such as fats and black pepper.

The use of spices, and especially turmeric, is a great addition to an overall healthy diet. While important to take into consideration, don’t let one detracting article like this completely change your viewpoint just yet.

  1. https://qz.com/883829/a-large-scientific-review-study-shows-that-curcumin-in-turmeric-has-no-medicinal-properties/
  2. https://www.ncbi.nlm.nih.gov/pubmed/19678780

If you need advice on how to get more anti-inflammatory foods and spices in your diet, I’d love to talk! Arrange a time to meet with me and we can get you on a plan to reduce inflammation and get your health back on track.

See below for a few great recipes utilizing this wonder spice to get you started!

Turmeric “Milk”
http://nutritionstripped.com/turmeric-milk/

Slow Cooker Chicken Tikka Masala
http://www.thekitchn.com/recipe-slow-cooker-chicken-tikka-masala-recipes-from-the-kitchn-211284

Turmeric Cauliflower
http://www.simplyrecipes.com/recipes/shahi_cauliflower_curry/

Red Lentil Dahl
http://helloglow.co/healing-turmeric-and-red-lentil-dhal/

 

Image courtesy of smarnad at FreeDigitalPhotos.net

Artificial Sweeteners and our Children’s Health

Recent articles have discussed the growing use of artificial sweeteners among children in the US.  It seems, with the increased understanding of how harmful sugar is to our health, especially in youth, a trend towards artificial sweeteners has begun. But is it safe?

Artificial sweeteners include an array of chemical concoctions including products like aspartame, acesulfame, neotame, saccharin, advantame, and sucralose, among others. The most common plant based option is stevia.

What makes these artificial sweeteners so attractive, not surprisingly, is that they increase the sweetness of a food without the added carbs and calories. To many parents, this seems like an ideal alternative to real sugar, especially given all the advertisements about how these no- and low-calorie sweeteners help people lose weight and balance blood glucose levels. In some cases, the switch isn’t even known to parents. Many products tout lower sugar and calories while failing to point out the swap from real to fake sugars.

Unfortunately, there are many problems with the use of artificial sweeteners in children. If you are a parent, it is imperative that you know this information. Artificial sweeteners are far from safe and may even cause lasting damage to a child’s health. Let’s run through the main concerns so you can make an educated choice on how these sweeteners are used, or not, in your family.

  1. On taste: Artificial sweeteners, when used frequently, train a child to expect very sweet foods. On the whole, artificial sweeteners can be anywhere from 180 to 20,000 times sweeter than regular table sugar! If not used in low doses, a child can easily become conditioned to overly sweet foods. Instead of decreasing sugary foods, it may only increase them later in life when they start making food choices for themselves outside of the home.
  1. On weight: In research we see few beneficial effects of artificial sweeteners on weight. Kids, in general, are very attuned to their caloric needs. A decrease in one area usually leads to an increase in another. There are a whole host of other foods included at meals and snacks, and just cutting calories from soda or candy will not make up for a consistently unhealthy diet and lack of physical activity. Touting these lower kcal junk foods is not the answer to our obesity epidemic.
  1. On blood sugar: Artificially sweetened products are often promoted for their beneficial effect on blood sugar. By replacing the sugar, the theory is we should be able to keep our blood sugar more stable and prevent those spikes that can lead to weight gain and obesity. When consumed in small quantities and with a variety of other foods at a meal, the effects might be somewhat positive in that respect. However, when used in excess and at the expense of other more natural carbohydrate foods, the body, it seems, can be “tricked” into thinking there is glucose entering the body. In response, high levels of insulin are released to deal with this onslaught of “sugar.” This can then trigger a hypoglycemic episode where blood sugar goes too low and/or increased hunger signals are sent to get that carb hit the brain is looking for. A harmful cycle can begin in which insulin and glucose levels are not well maintained starting in childhood, and this may eventually lead to insulin resistance and an increased risk for disease, namely diabetes, later in life.
  1. On healthy diet: With this increase in artificial sweeteners comes an obvious fact. We are feeding our kids more processed foods. These processed foods are coming at the expense of natural, whole foods which contain an abundance of nutrition that our growing kids need. Starting at an early age we are teaching out kids to rely on and prefer processed foods to more natural choices. While not necessarily harmful in the short term, many of these foods are nutritionally inadequate for our youth. Even in adults we are seeing poor intake of various nutrients when processed foods comprise a large portion of the diet, and this is likely happening with our kids as well. While meaning well in most cases, many parents are setting their kids up to prefer processed foods with the consequence of potential nutrient deficiencies.

These are the main reasons I strongly hesitate against the use of artificial sweeteners in the diets of our children. Apart from being unnatural, they really just aren’t necessary. They are not the answer to the problems we are seeking to solve. Instead they create risk in terms of adequate nutrient intake and even disease risk later in life.

Parents, instead of resorting to artificial sweeteners, I implore you to do the hard work of teaching your kids to enjoy savory and lesser-sweet foods. It’s hard work no doubt and yes, you end up being the bad guy on many an occasion, but your kids will benefit in the long run. Better yet, start very early on if you still have the chance and set those dietary patterns from the start.

References:

Consumption of low-calorie sweeteners jumps by 200 percent in US children.
https://www.sciencedaily.com/releases/2017/01/170110101625.htm

Artificial sweetener use among children: epidemiology, recommendations, metabolic outcomes, and future directions.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3220878

The problem with sugar-free kids.
http://time.com/the-trouble-with-sugar-free-kids

If you are a parent having a tough time getting your kids to dump the sugar, I’d love to help. Get in contact with me and let’s see if we can get your family on a healthier path. It’s never too late!

 

Is saturated fat good for you?

saturated-fatLikely by now you’ve heard the debate. Is fat, and in particular saturated fat, bad for you or not? In the 80’s and 90’s we made fat the villain and steered our entire country towards a low-fat mentality, but in recent years perceptions have evolved. Studies have come out to contradict previous research that found fat harmful to cardiovascular health. Even more recently we found that some studies were in fact manipulated to spin sugar in a more positive light and lay the health blame squarely on fat. Just a few months ago NPR reported that the sugar industry paid scientists to bias their research so that fat appeared to be the main concern in regards to heart health.1 So, what are we to believe?

Studies still go both ways, but we certainly have a growing collection of research to show that fat does not deserve to be treated as an evil part of our diet. Despite years of shunning fat in favor of carbs and protein, we appear to have reaped zero health benefits. We did not see heart disease risk decrease. We did not see waistlines slim down. Increased consumption of Snackwells and low-fat lattes did not result in the statistics health experts were hoping for.

Now, in fact, a recent Norwegian study suggests that fat, and again in particular saturated fat, is good for us.2 What? How could the research be so polar opposite to our previous understanding?

In the study, the researchers did not simply take subjects, put them on high-fat diets, and observe the results, as many previous studies have done. No, they put people on carefully crafted high fat diets that were rich in unprocessed or lowly processed choices, such as butter, cream and cold pressed oils. These were combined with a decent intake of vegetables and whole grains while simultaneously avoiding white flour and sugar. When compared against cohorts on a high carbohydrate diet, the high fat diet participants showed decreases in fat storage and disease risk, even when the subject’s overall energy intake increased when compared to their previous diet.

This study provides a perfect example of how the entire makeup of the diet, as well as other lifestyle factors, is paramount. Singling out a particular macronutrient to vilify, while newsworthy and income-generating for some, unfortunately, has not benefited public health.

Clearly, cholesterol numbers and other markers for cardiovascular disease are not independently influenced by fat intake. There are many other factors involved: sugar consumption, overall energy intake, genetics, and lifestyle factors (smoking, exercise, stress, etc). By singling out fats alone we miss the bigger picture, and in terms of public health, we put people’s lives at risk by giving them misleading information.

As with most things, the answer is actually very simple. Unfortunately, simple answers do not make great billboards and campaigns. But the truth is this: an overall healthy diet is paramount, NOT exclusion of all fat.

So the next time you think about avoiding that butter on your bread, think twice and reconsider the bread before you demonize the butter. Healthy fats are our friends.

References:

  1. http://www.npr.org/sections/thetwo-way/2016/09/13/493739074/50-years-ago-sugar-industry-quietly-paid-scientists-to-point-blame-at-fat
  2. https://www.sciencedaily.com/releases/2016/12/161202094340.htm

Low Carb Diet and Gut Health: Are we doing more harm than good?

vegetablesLow-carb diets are all the rage right now, and with good reason. They have shown promising results in promoting weight loss and encouraging people to eat less white flour, sugar, and other unhealthy foods. Hard to argue with that. I’m on board.

What’s the big deal? Well, research is now indicating that diets such as these, which are very low in fiber, might be a problem when it comes to the health of our gut. While we know fiber is important for regularity, supporting healthy blood sugar, and increasing satiety, did you also know that fiber feeds your healthy gut bacteria, or the microbiome as it is commonly known?

The problem is, as seen via research, that this decline in fiber corresponds with a decline in microbiome diversity. In simple terms, over time we starve out many beneficial strains of healthy glut flora residing in our digestive tract. Additionally at the same time we promote more of the unhealthy and less desirable strains.

For example, a recent study looked at microbiome diversity among rural Africans and the average US population. They found much greater diversity and more beneficial strains of bacteria in the guts of Africans. Not exactly surprising. What is interesting is that when they switched their diets and fed this group of Africans the Standard American Diet for two weeks, stool analysis showed a significant decrease in the “good” bugs.1 This was after only two weeks! What does this say for those of us consuming low fiber diets for weeks or years on end?

This creates some cause for concern because research has shown that the health of our microbiome influences the health of the host.2 In other words, our personal health is influenced by the bugs living in our digestive tract. For example, Crohn’s Disease and other inflammatory bowel diseases seem to be linked with alterations in the microbiome. 3  Also more and more studies are linking obesity and increases of certain types of bacteria in the guts of Americans. In rats, we can directly influence their weight by the type of bacteria we put in their system!4 Fascinating stuff, and yet scary at the same time.

If you are one of those embarking on a low carb diet, don’t fret! It can be done in a healthy way to support your health goals, while at the same time supporting  your microbiome. Clearly the main goal is to keep up the fiber in whatever way possible. Let’s talk about some ways to do that.

Main key when going low carb:  Include as many fiber sources as you can!

  • Fruit: Choose the lower carb ones like berries, avocado, tomatoes. For higher carb fruits, keep the portions smaller.
  • Vegetables: Make sure to get as much vegetable intake as you can every day! Many veg options are low carb and can be included in abundance.  Add lots of low carb leafy greens and cruciferous (broccoli, cauliflower), or consider green beans, zucchini, peppers, etc. Consume starchier choices like squash, carrots, peas and potatoes in smaller amounts.
  • Eat nuts and seeds! These are a great low carb option with protein and fat but which also have an appreciable amount of fiber. Think almonds, walnuts, cashews, flax seed, chia seed, hemp seed, pumpkin seeds…. you get the idea.
  • Eat beans! Yes they do have carbs, but again, watch the portions. Generally about ½ cup of beans equals 15g of carb, so you can have beans and still keep the carbs in check.
  • Don’t forget about fermented foods! These can help replenish and support a healthy microbiome. Try adding a daily dash of sauerkraut, kefir, cultured yogurt, kombucha, pickled veggies, or tempeh.

What about the Ketogenic Diet?

Yes, I realize there is a big push towards the “keto” diet as of late. If you are not aware of this trend, it’s a diet that decreases carbs to the extent that it puts the body in ketosis. This encourages the body to burn fat as fuel, producing ketones, which the body can use in a similar way to carbs. It is extremely low carb, obviously, and followers often test their urine to measure ketones and thereby ensure they are in the state of ketosis. Many health benefits, including weight loss, improved cardiovascular health and neuro-protective benefits have been purported by this plan, and there are many functional and integrative health professionals who are choosing this as a way of life for health and longevity.

The problem is that, if not followed correctly, one can easily over-consume on foods like animal proteins, dairy (like cheese and butter), eggs, artificial sweeteners, and low-carb processed concoctions. Very quickly the diet becomes reduced and limited to a set of foods which are low in carb yet also low in fiber, thus potentially eradicating many healthy bacteria strains from one’s digestive tract.

The keto diet can be done successfully, however, and without drastic harm to the microbiome, if done appropriately, utilizing some of the tips provided above. Also some supplementation with probiotics or increased servings of fermented foods is a good idea.

Hopefully for you low-carb lovers, your fears have been allayed. Look for ways to get in that fiber, enrich your diet with fermented foods, and consider supplementation when needed.

  1. O’Keefe SJ, Li JV, Lahti L, et al. Fat, fibre and cancer risk in African Americans and rural Africans. Nat Commun. 2015;6:6342.  https://www.ncbi.nlm.nih.gov/pubmed/25919227
  2. Marchesi JR, Adams DH, Fava F, Hermes GD, Hirschfield GM, Hold G, Quraishi MN, Kinross J, Smidt H, Tuohy KM, Thomas LV, Zoetendal EG, Hart A. The gut microbiota and host health: a new clinical frontier. Gut. 65:330-9, 2016. https://www.ncbi.nlm.nih.gov/pubmed/26338727
  3. Sartor RB. Microbial influences in inflammatory bowel diseases. Gastroenterology. 134:577-94, 2008. https://www.ncbi.nlm.nih.gov/pubmed/18242222
  4. Turnbaugh PJ, Ley RE, Mahowald MA, et al. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature. 444(7122):1027-31, 2006. https://www.ncbi.nlm.nih.gov/pubmed/17183312

If you are thinking about starting a lower carb way of life but need a little guidance, please ask! I would love to help you get a plan in place that cuts down on the carbs but keeps nutrition at its maximum.

 

The Artificial Coloring of our Holidays

halloween-candyIt’s that time of year again! Colorful confections are hitting the store shelves, and likely your kids, like mine, are begging to purchase those colorful sugar bombs every time you walk into the store. It’s such a constant battle that I try every way possible not to take my little critters shopping with me.

But don’t get me wrong. I’m all for kids having fun and enjoying the holidays we all remember growing up with. Packaged candy treats around this time of year of are one of them.

I know I wrote about this last year, but it bears repeating. My problem, besides the excess of sugar, is the amount of food dyes consumed. It’s just not good. And while you might argue that a small amount of colored candies for a short duration of the year is harmless, I’d like to persuade you otherwise. Artificial colors are a problem, and they are far more prevalent and far-reaching than you think.

Besides Halloween candy, food dyes are used in numerous products aimed towards our kids. A few examples include boxed macaroni and cheese, yogurts, cereals, jello, frostings, and even some snack crackers. Our kids are consuming these additives all year long, with a sudden spike around Halloween time.

Why should we care? For one, they are completely unnecessary, and the sole purpose of them is to sell more product … to your kids. Second, they are created from chemicals derived from petroleum.

Third, and perhaps most important, they can have detrimental health effects on the little bodies of our kids. Hopefully that perks your ears a bit.

A 2012 meta-analysis on studies related to artificial colors and hyperactivity in children found a positive correlation, meaning that food dyes were linked to over-active behavior. In 2007, even before this, a study in the UK showed an increase in hyperactivity in children consuming artificial colors, prompting the government to require labeling and warnings on products. Based on similar studies, Norway and Austria have banned them completely.

Additionally, newer research has shown that artificial colors can increase the risk for food sensitivities and leaky gut. Yikes! How you ask? Well, turns out that food dyes, when in the digestive tract, bind up some of your digestive enzymes, namely trypsin, which then inhibits the breakdown of proteins. These larger proteins ends up in the small intestine undigested, triggering inflammation, which then inflames the intestines and sets the stage for the immune system to over-react to foods. You also increase the risk for malabsorption and other conditions related to leaky gut (poor digestion, body aches, eczema, neurological issues, etc). Not good for our kids.

Personal story alert! My one experience with the detrimental effect of artificial colors is related to night terrors. Your kids ever have one of those? Oh man they are not fun. Imagine your 2 year old screaming in the middle of the night, eyes rolled back in their head, not even entirely awake, and nothing will calm him down. It’s terrifying. After a couple of these frightening episodes we traced it back to a source. Every time he had a candy with blue dye, that night an episode would occur. Cut out the blue dye, no more night terrors. I realize this is not the night terror cure for everyone, but do think of food reactions in these cases. For us, thankfully, it was a simple fix, and afterwards we resolved to be more vigilant on additives and preservatives in our kid’s diet.

This year, do your kids, and everyone’s kid, a favor by not distributing candy using artificial colors. Also search your cabinets, read labels, and discard any products that use them as well.

Thanks to the hard work by researchers and health advocates, many companies are starting to re-formulate their food products. You can, in fact, find many viable alternatives that will be just as unhealthy sugar-wise, but won’t overload our kids on artificial colorings. Check Amazon, online organic grocers like Thrive.com, or your local co-op. Better yet, distribute a few toys or stickers instead.

Don’t worry, Halloween will still be fun and your little angels won’t turn into little devils in the process. Good luck this holiday season!

Easy Tips to Spice up Your Diet!

I love adding spices to my cooking. Besides some of the well-hyped health benefits, they just make food more interesting. The same ingredients from one dish can be magically transformed into something completely different just based on the spice profile. It can set apart one region’s or even one person’s cooking from another. It separates, say, East coast cuisine from the West, as well as Aunt Emma’s chili from your own concoction. Spices make all the difference.

Now, truth be told, I’m more talk than action. I have over 40 spices in my cabinet, carefully labeled and arranged alphabetically, but honestly they only get touched maybe once or twice a week. Clearly I like the idea of spices, but practically speaking I am not as committed as I let on. I hope that is about to change, both for you and for me.

Recently I had the privilege of traveling to India. Besides the wild colors, bold aromas, and beautiful antiquities, the food is an attraction in its own merit. Oh the food. I wish I could transport myself back there as I write this. The food was so rich, so colorful, so flavorful, and so fragrant. It completely engaged all the senses. You got the sense that food is vitally important. It is not an afterthought but an important and well-planned part of the day. Along with that, the use of spices for creating unique flavor profiles is paramount.

Coming back after two weeks to Seattle, I realized my own diet was really quite bland. Kale salad, while healthy, doesn’t pack any punch in the flavor or the color department. Good ol’ turkey sandwich on whole wheat bread? Pretty boring all around unless you bump it up with some heavy hitting mustard and maybe some tangy arugula and heirloom tomatoes. Even still, on the whole, our food is just drab. No wonder many Indians retain much of their familiar ways of cooking when moving here, and some have even opened Indian grocers to import traditional food items (which I think we can all say we are extremely grateful for!).

Besides taste and cultural norms, there are other reasons to value spice in your life. As I alluded to earlier, there are many health benefits to including more spice in your diet.

Number one is the anti-inflammatory benefit. Many spices have specific properties that allow them to act as potent anti-oxidants. Turmeric is one of the currently most popular and studied examples. Countless research papers have shown turmeric, and its active component curcumin, to have anti-oxidant properties. Other spices that shine as anti-oxidants stars, although far less publicized, include oregano, cloves, cinnamon, ginger, and mustard seed, among countless others.

Number two is that many spices act as anti-microbial agents. In fact, back in the day spices were highly valued due to the lack of refrigeration. Heavy use of spices could kill disease causing pathogens and keep food safe to eat. These properties also apply internally by killing off unwanted bacteria and viruses. A great reason to increase spice consumption during the winter!

Some spices also have other very specific health benefits, such as helping to reduce blood pressure, calming tense nerves, quieting nausea, or easing digestion. They can be used in appropriate doses therapeutically, however by including a wide variety in cooking you are ensuring your body benefits from a broad range of these health-supportive spices.

So returning from India and feeling quite depressed about my “boring” diet, I have become resolved to practice what I preach. I am no longer satisfied with a few dashes of chili powder here or a few shakes of Italian seasoning there. No, I want to re-create that depth and richness I so fully enjoyed abroad in my own cooking at home. Armed with a bagful of new spices (thank you Kerala spice shop and US customs for letting me cart all these goodies home!), I have found new resolve to cook more interesting dishes and significantly ramp up my intake of herbs and spices.

Are you on board with me? If so you might be wondering, how do we get started?

First of all, we need some ideas. And by ideas I mean recipes. I have very little experience with cooking these types of dishes, so recipes and instructions are my best friend. Believe me, I never whizz this stuff up off the top of my head. I am just not that talented in the culinary department.

What ideas do I have, you ask? Curry, curry, curry….for starters. There are so many amazing curry options, and contrary to popular belief, they do not have to be spicy. I have been making mild curries that my kids enjoy, many of which include various types of vegetables and lean meats. Often you can get protein, veg, and healthy fats all in one dish. Add a little rice or roti on the side and you have a complete meal.

Other cuisines to look into include African and Middle Eastern cooking. These also tend to rely heavily on many types of spices. Right now I am eyeing my Exotic Ethiopian Cooking cookbook sitting on the shelf beside me, trying to ready my brain for diving in one of these days. Gear yourself up with a variety of recipes, either from books, magazines, or the internet, and start to catalog the types of dishes you want to attempt.

Next we need ingredients, and by that I mean the actual spices. This is the tricky part! I have found that some spices are exceedingly hard to come by at local grocers. If you can, find ethnic markets in your area and explore. We are blessed with many international communities in and around Seattle, so I am planning some reconnaissance missions in the near future. Otherwise, search online if what you are seeking remains elusive.

Now, once you acquire the spices you need, I strongly suggest you invest in some spice jars and maybe even a label maker to get yourself organized. I squarely have this part down, thanks to Ikea and Amazon. I love to look at my neat rows of labeled, alphabetized jars. I just need to start using them!

To help get you started, here are a few links to some easy yet amazingly delicious dishes that will heighten your senses with new flavors, colors and aromas. Give these, and others you find, a try and experience a whole new way of cooking. Don’t forget about those health benefits I mentioned, either!

Lamb and Chickpea Curry
http://www.jamieoliver.com/recipes/lamb-recipes/lamb-chickpea-curry/

Kerala Fish Curry
http://www.jamieoliver.com/recipes/fish-recipes/keralan-fish-curry/

Chicken Biryani
http://www.bbcgoodfood.com/recipes/4686/chicken-biryani

If organization is what you seek, here are link to products I have found helpful as far as spice organization and labeling (and no, I do not make any money by offering these links. Simply trying to show helpful examples!).

For my curry spices:
http://www.ikea.com/us/en/catalog/products/40064702/

For the rest of my spices:
http://www.ikea.com/us/en/catalog/products/40113613/

Label Maker:
https://www.amazon.com/LabelManager-Handheld-Label-Maker-1790415/dp/B005X9VZ70/ref=sr_1_2?ie=UTF8&qid=1473712126&sr=8-2&keywords=label+maker

Good luck, and please feel free to share your creative recipes and ideas. Find me on Facebook and post your spiced-up creations!