Holistic Approaches to Inflammation and Chronic Disease

An Introduction to Chronic Inflammation

In many chronic disease states, inflammation is a common underlying factor.  If you are suffering from something that ends with “itis” (arthritis, tendinitis, pancreatitis, diverticulitis, etc), this is a medical term for “that part of your body has inflammation”. So what is inflammation?  On the large scale, we look for heat, redness, pain, and swelling; these are all key factors that tell us inflammation is taking place. Microscopically, we see that blood vessels become more permeable and extra fluid and immune cells come to the area to protect and heal the body and remove waste from the area.

What is the purpose of inflammation?  It is your body’s natural defense system: this is how your body protects and heals itself in cases of infection, allergy, and injury. When a foreign organism such as a bacteria, virus or fungus enters the body, your immune system launches a highly sophisticated attack to kill the invader and then clean up the remains of the battle afterwards.

While inflammation is a very important and appropriate action for the body to take, when it pops up in inappropriate places or continues on beyond the normal course of infection or injury it causes chronic pain and damage to that part of the body.

Chronic inflammation is the underlying cause of many very common chronic diseases.  Cardiovascular disease, arthritis, asthma, autoimmune thyroid disease, IBS and other digestive disorders, and eczema are all cases of chronic inflammation. When inflammation becomes chronic the area will be in a state of simultaneous destruction and healing, which over time can lead to scarring and loss of function.

Conventional treatment for inappropriate inflammation primarily relies on four types of drugs, all of which act by suppressing a key component of the body’s inflammatory response: Steroids such as prednisone mimic your body’s stress hormones’ ability to suppress inflammation.  Nonsteroidal antiinflammatories such as ibuprofen and acetomenophen suppress an enzyme called cyclooxygenase that creates the mediators that cause inflammation in the body.  Biologic drugs such as embrel and humira block the action of another inflammation-causing protein called Tissue Necrosis Factor. For more allergic sypmtoms, antihistamines such as Allegra suppress the release of histamine from allergic cells.  Although the effects of all of these drugs have different effects and can be quite useful to control symptoms in the short term, what they all have in common is that they suppress our body’s natural reaction to an underlying issue and can have significant unwanted side effects.  

There are a few primary concerns regarding the use of conventional medications for reducing inflammation. In the case of steroids and biologic drugs, they can suppress your immunity, leading to unwanted infection that can be difficult to treat.  NSAIDs can damage the liver, gut and kidney.  Antihistamines impact the nervous system and can cause drowsiness, hyperactivity, a decrease in secretions to the eyes, nose and mouth, and difficulty in urination. Rather than suppressing natural function, the goal with natural treatments is to divert the body’s innate function towards anti-inflammatory pathways.

Natural options for minimizing inflammation

There are three key elements to minimize inflammation holistically:  Exercise, Diet, and Supplements.  If you feel good now and want to minimize inflammation in the long-term, diet and exercise are a great place to start.  If you are already in a position where inflammation is a concern for you, botanicals and supplements may be necessary to get things under control.

Exercise:  While in the short-term exercise can trigger an acute inflammatory reaction, research has shown a long-term moderate training regimen decreases the body’s production of inflammatory cytokines.  The inflammation that is caused by working out is important for remodeling and building muscle mass.  In fact, post-workout treatments such as ibuprofen and icing the area have been shown to decrease the body’s ability to build muscle mass.  As the initial inflammation post-workout decreases, though,  It is important to keep in mind, however, that repetitive exercise that pushes the muscles past their capacity, such as long-distance running and body building, cause short-term inflammation (aka, delayed soreness after working out) that over time causes scarring damage to the muscle fibers.

Diet:  There are three basic components to reducing inflammation in the diet:  Eat more antiinflammatory foods, eat fewer pro-inflammatory foods, and avoid allergens or sensitivities.

Antiinflammatory Foods are those that support healthy digestion and improved liver function help the body rid itself of wastes that can trigger inflammation.  These include high fiber foods such as leafy greens, broccoli, and carrots, foods high in soluble fiber such as apples, flax, pears, and chia, foods high in omega-3 fats such as fish and flax, liver support foods such as beets, cucumbers, and greens, and probiotic foods such as kefir, yogurt, natural sauerkraut and pickles, miso, and kombucha.

Pro-Inflammatory Foods encourage the formation of pro-inflammatory cytokines.  While meats can be beneficial for other reasons, they are good to consume in moderation because their fat content can create more inflammation.  Refined carbohydrates in white flours and sugar can cause inflammation in the digestion; they also spike the blood sugar, which in turn can cause the formation of excess triglycerides which then causes inflammation in the blood vessels and can lead to cardiovascular disease and diabetes.  Alcohol depresses the ability of the liver to move toxins from the body which can create more inflammation and also spikes the blood sugar.

Finally, food allergens or sensitivities can compromise the integrity of the lining of the digestive tract, which allows larger particles of foods to enter the bloodstream, which in turn can cause the body to have an immune reaction to those particles.  One particularly good example of this is the association between celiac disease and autoimmune thyroid disease.  The most common food sensitivites tend to be dairy, gluten, egg, and soy, but the body can react to any food; testing or elimination diets can be useful to help sort this out.

Omega-3 fatty acids:  These fats have gotten a lot of press in the past 15 years because of their remarkable ability to decrease inflammation and improve the texture and quality of the skin and mucus membranes.  Omega-3 fats divert the biochemical pathway that normally creates inflammatory cytokines to a pathway that creates anti-inflammatory mediators.  There are several good sources of Omega-3 fats on the market today: generally, our bodies are able to use animal derived sources (such as those found in fish)  more readily than vegetarian sources (such as flax or borage seed).  While krill oil has recently become quite popular as a supplement, I do not recommend it because I have been hearing reports that krill populations are becoming threatened due to overharvesting: I prefer to leave them for the whales.

Botanicals and Supplements:  There are a number of plant medicines available that are quite useful for decreasing inflammation.  These include curcumin, derived from the turmeric plant, quercetin, derived from onions, and boswellia, or frankincense.  Supplements such as deglycyrrhizinated licorice (DGL) and L-glutamine can help restore the integrity of the digestive tract.  There are also a number of proteolytic enzyme products on the market that can be useful for decreasing scar tissue that can form during times of chronic inflammation, which will decrease pain and increase the ability of the area to heal.

 

Natural Approaches for Insomnia

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One of the most common problems my patients report is difficulty with sleep. Whether they have trouble getting to sleep, staying asleep, or waking frequently, not getting the rest our bodies need is frustrating and significantly impacts the severity of other ailments. Poor sleep or insufficient is linked to weight gain, cardiovascular disease, decreased immunity and poor healing. The reasons for insomnia are varied, so natural treatments need to address whatever it is that is out of balance. When thinking about insomnia, we have to make sure that three different systems are ready for sleep; the hormones, the nervous system, and the muscles. Having good bedtime habits such as stopping screen time one hour before bed, stretching, yoga, or meditation before bed, and a cup of herbal tea are all great first steps, but if sleep remains a problem, the primary places I look to regain balance are Hormones, Neurotransmitters, Blood sugar, Muscle tension, and pain. Here is how I approach this issue:
Hormones
In my practice, the most common reason I see for persistent insomnia is an imbalance in the hormones. There are several hormones that can be out of balance that will contribute to poor sleep. Often we will have to test to see which of these is the culprit:
Estrogen/Progesterone: Especially after childbirth and during menopause, when these reproductive hormones are not produced in balance with each other, sleep can be effected. Most commonly, this imbalance is accompanied by hot flashes and night sweats.
Thyroid: When thyroid function gets too low or too high it can impact the sleep. If thyroid levels are too high, often there are heart palpitations or agitation along with the insomnia. When thyroid is too low, people often will wake feeling insufficiently rested no matter how long they have slept.
Cortisol: This is our primary hormone that tells us we are awake. It is a stress hormone that helps the body to mobilize blood sugar for fight or flight situations (aka, so we can run from a bear). If we have too much stress over a prolonged period of time, though, the body will sometimes start making cortisol in the middle of the night–when this is the culprit people often will wake at 3-4am and won’t be able to go back to sleep.
Neurotransmitters
Neurotransmitters are amino-acid based chemicals produced by our nervous system that tell our brain and nerves how we feel–sleepy, awake, excited,happy, sad, etc. The three neurotransmitters that are most associated with deep, relaxing sleep are melatonin, serotonin, and GABA. GABA is derived from the amino acids glutamine or glutamate, and serotonin and melatonin are made from tryptophan. For people who are experiencing persistent or severe sleep difficulties, we can test to see what your levels are and if the more excitatory neurotransmitters are too high to allow your brain to calm down. Many of our best natural sleep aids are made from these neurotransmitters or contain precursors to them.

Blood Sugar
This category is directly related to the discussion on cortisol, above. For people who have difficulty keeping their blood sugar stable (either from hypoglycemia, metabolic syndrome, or diabetes), and especially for people who do not eat regularly, eat dinner very early, or eat sweets after dinner, this can impact sleep. For instance, if you eat dinner at 6pm, by 3am it has been 9 hours since you last ate. Although cortisol is primarily a stress hormone, its other function is to mobilize glucose from storage when the blood sugar gets too low. When cortisol spikes at 3am, then the brain wakes up and it becomes difficult to go back to sleep. In this case, a light protein snack right before bed such as an apple with peanut butter will greatly improve sleep.

Muscle tension and Pain
For people with chronic pain, it isn’t sleep itself that is the problem, but the pain that keeps them up. If there is chronic pain we have to get to the root of it and fix this issue. Often, however, there can be muscle tension that causes pain or headaches and leads to poor sleep. Tight muscles also may just keep the body so tense that sleep is difficult regardless of pain. The simplest options for helping the muscles relax before bed are stretching, deep breathing, hot baths and hydrating during the day (not so it keeps you up having to use the restroom). Other very effective options are taking some minerals such as Calcium or magnesium or drinking coconut water which is high in potassium before bed.

Insomnia can be a brief, transitory concern that is related to a specific event or a problem that can last many years. Persistent insomnia can lead to or exacerbate a host of other health concerns. By narrowing down the causes, we can individualize a plan to help put you back to sleep!

Homemade Sauerkraut: Improve Digestion, Prevent Cancer

There is a farm at my children’s school, and every Thursday afternoon they host a farm stand where parents and students can buy fresh veggies, goat milk products, and homemade goodies. A few weeks ago, I stopped by the stand and encountered some truly amazing produce–a head of cabbage so giant I thought I was back in Alaska. I passed on buying it, not knowing what I’d actually do with the beast, but I went home and thought about it all night, came up with a plan, and the next day headed back to the farm to see if there were more. The farmer generously took me out to the field and found me this beauty. I brought this leafy 15-pounder home and started shredding.IMG_1105

Making Sauerkraut:
It turns out making sauerkraut is a relatively simple process: it requires cabbage, salt, and a good vessel for storage. I bought a large crock for making vinegar a few years ago so I decided to use this. I would recommend using something nonreactive and not plastic, so crockery or glass are good options. According to Alton Brown, my go-to resource for all cooking projects that seem a bit more like chemistry, for every 5lbs of cabbage, use 3Tbsp pickling salt (I used kosher salt and doubled the amount). He also uses 1 Tbsp of juniper berries and 2 tsp caraway, but that is optional. After shredding and mixing the cabbage with salt, pack it firmly into your sanitized fermentation vessel of choice. Place a plate on top of the cabbage, then lay a quart-sized glass jar full of water over the plate (sanitize these too).
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After a couple days, a liquid brine should form to cover the top of the cabbage, if not, add enough water to cover the cabbage. Check it every couple of days and skim the scum off the top if necessary. The sauerkraut should be ready in 10 days to 4 weeks-just take a bit out and taste it! When it is finished, pack it into sanitized quart jars and cover with brine (the spigot at the bottom of my vinegar crock was handy for this). It should keep in the refrigerator for a few months.IMG_1177

Why Sauerkraut?

In addition to being a good source of Vitamin C, B6, and iron, there are two primary health benefits to eating sauerkraut: improved digestion and cancer prevention. The digestive benefits are twofold: there are many strains of probiotic bacteria (including lactobacillus) that work together to eat the sugars in the cabbage and produce this fermented food. Eating raw sauerkraut will help to repopulate the large intestine with beneficial bacteria, which can improve digestion, relieve inflammation, and increase the strength of the immune system overall. Green cabbage is also a good source of glutamine, which is an amino acid that is the preferred food for the lining of the digestive tract. This can also help to repair damaged cells and improve the integrity of the large intestine. One word of caution; the process of fermentation can create a trisaccharide that, when consumed by the bacteria that live in the digestive tract, can cause gas for some people. The addition of caraway and juniper (as advised by Alton Brown’s recipe) can help to dispel that gas and maximize the digestive benefit of the sauerkraut.

Indole-3-carbinol (I3C) is the primary chemical present in sauerkraut that has been associated with cancer prevention. I3C can be found in all members of the cabbage (brassica) family, but particularly high levels have been found in cabbage that has been fermented for 7-9 days. After this length of time, I3C levels continue to remain elevated but will taper off over time. I3C has been shown to reduce proliferation (growth) of several types of cancer, including colon, prostate, breast, and leukemia. I3C has been discussed particularly in reference to prevention of breast and cervical cancers because it helps to metabolize and remove estrogens from the system. These types of cancer are frequently (though not always) dependent upon estrogen as a growth promoter. However, I3C also can help to initiate natural cell death (called apoptosis) and protect the liver against cancer-causing chemicals which is why benefit has been found for non-estrogen dependent cancers as well.

Making sauerkraut is a little adventure that yields a delicious, health promoting, and cost-saving product with flavor unrivaled by the canned store-bought types. You can purchase raw sauerkraut at many health food stores, but the cost can be upwards of $20/quart. Making it at home requires only the cost of the cabbage–mine cost about $1.30/quart, plus the glory of figuring out what to do with a cabbage the size of my torso.

Enjoy and be well!

Women Need More Protein In Pregnancy

This article was originally printed in the Natural Medicine Journal–if you would like to see the references, Click here
Especially during a first pregnancy, many women have a pronounced concern about diet: how to eat, what to eat, and when to eat. As providers, we have the opportunity to help guide them towards optimal nutrition and provide reassurance that they are making sound choices. Within the context of so many “don’ts” regarding maternal nutrition–foods to avoid because of possible bacterial contamination, mercury, lead, pesticides, nitrates, blood sugar dysregulation, insufficient or too much weight gain etc–it is good to also have some advice that helps women relax and trust their intuition. This study finds that the protein needs of women throughout pregnancy is higher than previously recommended and possibly closer to what women may be craving.

IAAO is a relatively new method that has become popular for determining protein requirements in human subjects.1-4 In the past, protein requirements were assessed by the nitrogen balance method which can be difficult because it requires that all nitrogen intake and output is carefully recorded and that the subject stays in the testing facility for the duration of the testing to measure nitrogen loss from urine, feces, saliva, and wounds. This testing takes much longer to perform and requires that subjects are put in a deficiency state for longer, which makes it unsuitable for pregnant women. For this reason, the current recommendations for protein intake during pregnancy (Estimated Average Requirement (EAR) of .88 g/kg and RDA of 1.1 g/kg) have been based on nitrogen balance studies of nonpregnant adults that have been extrapolated with total body potassium studies of protein deposition during pregnancy. 5 With the development of IAAO, researchers have been able to more accurately determine protein needs during pregnancy because they can run this study on pregnant women. Additionally, this is one of the first studies to distinguish maternal needs during early and late gestation.

Understanding protein requirements during pregnancy is important because protein is the macronutrient with the most influence on birth weight. This study assumes caloric sufficiency; for well nourished non-diabetic women, increasing protein intake is the macronutrient most likely to increase birth weight.6,7 In addition to neonatal complications and increased mortality, low birth weight is also correlated with long-term health problems such as type 2 diabetes, kidney disease, cardiovascular disease, and respiratory problems. 8-11 Ensuring that pregnant women have a protein-sufficient diet is therefore crucial for the short- and long-term health of their children.

It is important to keep in mind, however, that while this study showed protein needs to be higher than current recommendations, it is still by no means extraordinarily high. The average weight of the subjects during early pregnancy was 64.4 kilos, indicating a need for 78.6 grams of protein per day, or 314 calories. Calculated resting energy expenditures (REE) averaged 1370 calories per day, so subjects were given an average of 2329 calories (1.7 REE), putting sufficient protein consumption at 13% of calories. In late pregnancy, average weight was 71.1 kg, with a need for 108.1 grams of protein or 432 calories per day. REE was 1480, so subjects were given an average of 2516 calories, with sufficient protein consumption at 15% of calories. 13-15% of calories from protein is far lower than the recommended amounts in virtually any contemporary dietary plan save for some raw, vegan and pritikin diets which are rarely recommended or undertaken during pregnancy.

Based on these new recommendations the example below provides sufficient protein sources on average for late pregnancy with far fewer calories than necessary for a day; a pregnant woman could be encouraged to include these foods within the context of whatever other foods she prefers to meet her additional caloric needs:

Breakfast: 2 eggs, 2 slices toast=21g

Snack: One ounce of cheese=7g

Lunch: 1 cup cooked lentils with steamed veggies=18g

Snack: 2 Tbsp peanut butter on 2 rye krisp crackers=12g

Dinner: 1 cup cooked chicken breast with 1 cup quinoa and steamed veggies=51g

Total: 109g protein, approximately 1300 calories

With this in mind, practitioners may find that their patients may intuitively be eating an appropriate amount of protein: a current Canadian study found pregnant women generally eating amounts of protein more consistent with the findings of this study, rather than the current DRI.12 This assumes, of course, that women have adequate caloric intake and the financial and practical means to choose what foods they eat.

One question that is relevant to how complete the information is from the study is the possible impact of the types of food consumed rather than just macronutrient content. On the day of the study, all of the calories for the day were consumed as a shake consisting of the protein supplement which was based on an egg-white composition, kool aid or tang, and a shake base powder consisting of palm, soy, coconut and sunflower oils, corn syrup, corn starch, sucrose, calcium phosphate, sodium citrate, vitamins and minerals, plus unspecified “protein-free cookies.” This does meet the requirements of the macronutrient breakdown desired for the purpose of the research study, but certainly doesn’t resemble a dietary plan that would be advocated by most providers who would be counseling a pregnant woman. While this study certainly gives us a good baseline from which to advise patients, it is certainly within the realm of possibility that a pregnant woman’s metabolic and protein needs will shift if fiber, complex carbohydrates, and phytonutrients are present in the diet.

While it can be confusing to create an optimal diet for each individual during pregnancy, the findings from this study indicate that advising for protein intake may be a little more intuitive. For women who are adequately nourished with the financial means to choose what foods they eat, as long as they feel well enough and remember to eat some protein-containing food every few hours, they will probably be able to approximately meet their protein needs each day. For women who struggle to meet this recommendation for increased protein intake, it is important to instruct them on which foods contain protein and remind them to eat these foods every few hours. This will help to optimize the health of their baby as a newborn and throughout life.

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“If your actions inspire others to dream more, learn more, do more and become more, you are a leader.”  John Quincy Adams

As an “alternative” health care provider, I have seen over the years a tendency for patients to expect miracles. I am coming out today to announce that I don’t perform miracles. My job is to educate and inspire you to work your own miracles! I’ve mentioned this before, but my favorite part of this job is watching people develop greater self-awareness, and then powerfully use that awareness to improve their health. I have noticed that people who come in with a positive outlook and strong life purpose seem to make those improvements the most successfully, so I did a little digging to see what the research shows.

There is a growing body of evidence that shows our state of mind can positively influence our physical health. Studies have found that people with a well-defined sense of life purpose are overall more proactive about their health and more frequently take the time to utilize preventative health resources. Even beyond this, people with a strong sense of purpose have a decreased risk of stroke and heart attack, spend fewer overall nights in the hospital, and have an increased lifespan. Finding and maintaining an active engagement with our inner world and the world around us improves health.

The rapidly expanding field of epigenetics explores how environmental factors influence the expression of our DNA. While we are each given a packet of chromosomes at birth, the genes that are activated throughout our life that determine our physical and behavioral traits will vary based on our experiences and physical interactions. Interestingly, we are finding that people who have an overall perspective of well-being can actually shift their genetic expression towards greater health. Not only this, but it is possible that our attitude has an even greater effect than our conscious experiences. This means we have the ability to make our own health or at least shift the course of disease just based on the way we approach life.

Creating your own health is not just about being an optimist: health creation is a practice that you can consciously work on each day. One study showed that introducing a simple practice of gratitude improved subjects’ sense of well-being, sleep, and blood pressure. Each time you choose to eat something you know will make you feel good, get up a few minutes early to get some exercise, take a deep breath and smile at someone you care about instead of thinking about how they make you crazy, or ask someone for help when you need it, you are choosing health. And making your own miracles!

Yu L1, Boyle PA2, Wilson RS2, et al. Purpose in life and cerebral infarcts in community-dwelling older people. Stroke. 2015 Apr;46(4):1071-6

Kim ES1, Strecher VJ2, Ryff CD3. Purpose in life and use of preventive health care services. Proc Natl Acad Sci U S A. 2014 Nov 18;111(46):16331-6.

Barbara L. Fredrickson, Karen M. Grewen, Kimberly A. Coffey et al. A functional genomic perspective on human well-being. PNAS August 13, 2013 vol. 110 no. 33 13684-13689

Jackowska, Marta, Brown , Jennie, Ronaldson, Amy., et al. The impact of a brief gratitude intervention on subjective well-being, biology and sleep. J Health Psychol. 2015 Mar 2.

McKnight, Patrick E.; Kashdan, Todd B. Purpose in life as a system that creates and sustains health and well-being: An integrative, testable theory. Review of General Psychology, Vol 13(3), Sep 2009, 242-251.

Kim ES, Sun JK, Park N, Kubzansky LD, Peterson C Purpose in life and reduced risk of myocardial infarction among older U.S. adults with coronary heart disease: A two-year follow-up. J Behav Med 36(2):124–133. 2013

Kim ES, Sun JK, Park N, Peterson C Purpose in life and reduced incidence of stroke in older adults: ‘The Health and Retirement Study’ J Psychosom Res 74(5):427–432. (2013)

Hill, Patrick L., Turiano, Nicholas A. Purpose in Life as a Predictor of Mortality Across Adulthood Psychol Sci. 2014 Jul;25(7):1482-6

The Incredible Dandelion: Spring Health Supporter!

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We live on the outskirts of Golden at 6200 feet, which has been right about at snow line for the past month or so. The result is that, while even the bottom of the neighborhood is decked out in tulips and lilacs, we are still (im-) patiently waiting for the profusion of blooms to hit at our house. So today when I went outside to take some photos for the newsletter, all I could find in my backyard was a big, happy, sunny patch of dandelions–which reminded me how fantastic is our friend the dandelion. Let me count the ways:

Dandelion leaves are power packed nutritionally: One serving has more than a day’s supply of Vitamins A and K, and are high in Vitamin C, Iron, and Calcium. They are also a good source of trace minerals such as Manganese, Phosphorus, Potassium and Copper. The beauty of dandelion leaves is that they are a diuretic, meaning they help move excess fluid out of the body, which can be helpful during spring cleansing. On the flip side, they also replace minerals, as opposed to other diuretics which tend to leach minerals from the body.

Dandelion roots are wonderful medicine. I frequently add dandelion root to herbal formulas where gentle support to the liver is desired. This is helpful for liver conditions but also for spring cleansing, allergy support, or chronic inflammatory issues. Roasted, ground dandelion roots have also long been used as a coffee substitute.

Dandelion flowers are also edible and medicinal. The flowers can be thrown into pancakes and muffins, boiled in a sugar solution to make a lovely yellow honey-like syrup, or fermented to make wine. Studies suggest that the flavonoids found in dandelions help to prevent oxidative damage to cells and are protective to the liver.

So, even if spring hasn’t quite turned the corner into full bloom at your house, remember to look down under your feet and celebrate the return of the Dandelion. It has so many gifts to offer! (Also remember, please to only harvest in a place you know has been free from pesticides, runoff from industrial chemicals, and marking animals. 🙂

Enjoy!

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In honor of Food Day, Chef Lilly Steirer and I have been talking about some of the great ways to incorporate more nourishing foods into our diets. One of the things she asked me was to comment on some strategies for helping our kids to eat well. Kids, mine included, can be very picky eaters, so here are some of my strategies for helping them to make nutritious choices:

Repetition–Often, just having a healthy option on the table, and asking the kids to eat just a little of it, will pay off over time as they become accustomed to it.

“Deconstructed” meals–One thing that has been helpful for getting my kids to eat well is recognizing that, while the whole meal may not look appealing, the individual components of the meal often are. I often serve “deconstructed” meals. For instance, if you make a chicken curry, you can reserve some of the plain cooked chicken, veggies, and rice and allow the kids to use the sauce as they please.

Healthy alternatives–Have fruits, veggies, nuts, and healthy crackers available when they reach for a snack. At dinner time, make sure there is a protein, a healthy starch such as brown rice, quinoa, or whole grain pasta, and a vegetable available.

Ownership–letting your kids choose from an array of healthy options helps them be more excited about eating. My kids always eat more of their lunches when they make their own or we talk about what they want to eat when I pack it.

Gardening– Gardening has also been a great way to get my kids excited about eating fresh fruits and vegetables because they have seen them from seed to table and they feel a sense of ownership and pride with the produce we have produced.

Good Attitude–If your kids see you being picky about food, they are more likely to be less adventurous.

Moderation–Treat treats like treats, not habits. A small bite of good quality dark chocolate is not the same as an entire Hershey bar. Instead of soaking pancakes in syrup, my kids love a small pool to dip in. Life and eating should be fun, just keep things in check.

BPA: Minimize Exposure to Optimize Reproductive Health

I was recently reading a New York Times article entitled “In Plastics and Cans, a Threat to Women,” (1) which talked about some of the more recent research that has been showing the reproductive effects of Bisphenol A, or BPA. The studies quoted in this article show that BPA restricts development of healthy eggs in animal models. Exposure to BPA at any time of life: in the womb, in childhood, and in adulthood all will have a negative effect on female fertility. In a study conducted on discarded eggs from an IVF clinic, they found “Higher levels of BPA were linked to stunted human oocytes, as well as indications of chromosomal damage.” Higher serum levels of BPA have also been linked to greater risk of miscarriage.(2) Studies have also found BPA to have a negative impact on male reproductive function, most profoundly when exposure occurs in utero. Effects on male fetuses included, among other issues, feminization and testicular atrophe. (3)

Although reproductive problems are only one of the ways in which BPA can affect human health (it has also been associated with diabetes, heart disease, thyroid problems and weight gain), this issue is particularly alarming because of the profound impact it can have on our and our children’s quality of life. Infertility is a huge issue in the United States, and it is important for us to look to the future to protect the reproductive health of our children. The choices we make for our children during pregnancy and in their early years can profoundly influence their overall health and reproductive capability in the future. So how can we minimize exposure to and negative effects from BPA?

BPA is an extremely common compound; 5-6 billion tons are produced annually worldwide. The CDC estimates that 93% of people in this country have detectable levels of BPA in their bloodstream, so most of us are coming into contact with it on a regular basis. It can be found in:
Protective layers of canned food containers
wine vat linings
lining water pipes
plastic food storage containers
epoxy resin based paints
floorings
dental composites and sealants
CDs
automobile parts
baby bottles
plastic dinnerware
eyeglass lenses
toys
thermal receipts
impact resistant safety equipment
Some PVC plastics (4)
A recent study found that people who had extensive contact with BPA-coated receipts (such as grocery store checkers) did not have significant elevation in their blood levels of BPA. (5) So coming into skin contact with BPA is probably of less concern to most of us. For most people, the primary route of entry into the body is by ingesting food that has been in contact with BPA. For this reason, the primary way to avoid BPA exposure is to be conscientious about how your food is stored.

The good news is that many companies have switched to BPA-free plastics for food storage. Most baby bottles, water bottles, and many storage containers produced in the past 2-3 years will now be BPA free. In general, it is a good idea to avoid any food or water containers made of plastic with a number 7 on the bottom. This is not a guarantee that the plastic contains BPA, but it could. Rubbermaid has switched their storage containers to be BPA-free as well. However, even plastics that are BPA-free may contain other less-studied substances that can also influence the function of the endocrine (hormone) systems, so moving towards glass and ceramic storage containers is generally a good idea.

Another way to avoid BPA is to eat more fresh, homemade foods. There are many companies that have started switching the lining of their cans to be BPA-free (here’s a nice list of these companies)(6), but in addition to all the other health promoting reasons it is a good idea to make your food yourself, you will be minimizing the risk of exposure from BPA-lined cans.

While minimizing exposure to BPA is obviously a primary goal, it is clear that most of us will come into contact with it in our daily lives. Assuming that most of us have BPA in our system, the final question is how we can mitigate its effects. While there is less research so far in this area, one thing we know is that at least some of its negative effects result from oxidative damage to cells or DNA. It stands to reason then to look to some of our natural antioxidants to counteract the oxidative effects of BPA. In one in vitro study, oxidative damage to red blood cells was reversed using green tea.(7) Another study showed that the effects of oxidation by BPA were reduced in young women by consumption of wheat sprout juice. (8)

BPA is an extremely common substance: most of us come into contact with it on a daily basis, and almost all of us have it in our bodies. While we must live in our world and not spend our time worrying about every detail, it makes sense to minimize exposure to BPA, especially during pregnancy and childhood. The best way to do this is to focus on eating fresh, home-prepared foods, store our foods in glass and ceramic containers, and eat plant foods that are rich in antioxidants. This will help us to maintain good health and preserve the reproductive health of our children.
1.http://well.blogs.nytimes.com/2014/08/28/in-plastics-and-cans-a-threat-to-women/?_php=true&_type=blogs&_php=true&_type=blogs&ref=health&_r=1
2. Lathi RB1, Liebert CA2, Brookfield KF3, et al. Conjugated bisphenol A in maternal serum in relation to miscarriage risk.Fertil Steril. 2014 Jul;102(1):123-8.
3.Manfo FP1, Jubendradass R, Nantia EA et al. Adverse effects of bisphenol A on male reproductive function.Rev Environ Contam Toxicol. 2014;228:57-82. ,
4. http://www.cdc.gov/biomonitoring/BisphenolA_BiomonitoringSummary.html
5. Porras SP1, Heinälä M2, Santonen T2. Bisphenol A exposure via thermal paper receipts.Toxicol Lett. 2014 Aug 28. pii: S0378-4274(14)01310-1.
6. http://www.inspirationgreen.com/bpa-lined-cans.html
7.Suthar H, Verma RJ, Patel S, Jasrai YT. Green tea potentially ameliorates bisphenol a-induced oxidative stress: an in vitro and in silico study. Biochem Res Int. 2014;2014:259763. Epub 2014 Aug 10.
8.Yi B1, Kasai H, Lee HS, et al.Inhibition by wheat sprout (Triticum aestivum) juice of bisphenol A-induced oxidative stress in young women. Mutat Res. 2011 Sep 18;724(1-2):64-8.

Tomatoes, Lycopene and Prostate Cancer

TomatoI had the opportunity to write an article for this month’s issue of the Natural Medicine Journal about the connection between Lycopene and prevention of Prostate cancer. This is following results of the Health Professionals Follow-up Study (HPFS) published in the Journal of the National Cancer Institute earlier this year. The HPFS is an ongoing study of over 50,000 men who were between the ages of 40 and 75 at the beginning of the study in 1986. After nearly 30 years of following the dietary habits and health status of these men, they have found a distinct protective effect of consumption of foods that are high in lycopene.

Lycopene is a carotenoid, a class of compounds that often give plants a yellow, orange, or red color. The foods that are most common in the Western diet that are highest in lycopene are tomatoes, pink grapefruit, and watermelon. Processed tomato foods such as tomato paste and sauce are particularly high in lycopene because it becomes concentrated. Lycopene has the most potent antioxidant activity of all the carotenoids, and there have been many studies over the past several decades that have demonstrated the ability of lycopene to detoxify, prevent cell damage, and initiate death of cancer cells.

This current study is of particular interest to us because, from a prevention standpoint, it looks at whole foods instead of supplements, and it gives us a long-term look at a large number human subjects rather than animal or in-vitro models. The most significant finding in this study is that “men with the highest (cumulative) intake were half as likely to develop lethal prostate cancer compared with those with the lowest intake”. That is, the men who started eating foods with the highest amount of lycopene earliest in life were least likely to die of prostate cancer.

It is also important to note that these men who fared the best in the study seemed to have better habits overall. Those with the highest lycopene consumption “also consumed less alcohol, coffee and all three types of fats and slightly more fruits, vegetables, and dietary fiber”. Diets rich in fruits and vegetables have also been generally found to be protective against cancers and prostate cancer specifically.

What is the take home message from this study? The best way to take care of your prostate is to eat fruits and vegetables, particularly those high in lycopene, and start early–the impact you will have will be so much more powerful now than making changes once a problem arises.

If you would like to see the full article in the Natural Medicine Journal Click Here

Source: Zu, Ke et al. Dietary Lycopene, Angiogenesis, and Prostate Cancer: A Prospective Study in the Prostate-Specific Antigen Era. Journal of the National Cancer Institute. 2014. 106 (2).

Minimizing Colds and Flu for Athletes

iStock_KidsSoccerCold and flu season is here! This morning when I dropped my kids off at school there were 16 kids missing out of 50 due to illness. Seeing all these spaces on the list made me curious to come home and do some research to see what the scientific literature has found to be the best ways to prevent colds and flu. In Traditional Chinese Medicine, the colder Autumn months are associated with the lungs which provide “defensive energy”; meaning our ability to maintain a good barrier between ourselves and the outside world. Here are some of the best ways that Western science has found to help keep our immune systems and lungs strong as we head into the holidays:

Crowded offices, schoolrooms and homes predispose us to sharing germs; higher humidity in these indoor spaces increases the risk of transmission because sneezed or coughed viral particles more readily enter into water droplets that can be inhaled. What to do? Beyond the obvious regular handwashing and sneezing into your elbow, minimize the use of the humidifier and open doors and windows whenever possible to let in fresh air.

Both the quantity and the quality of sleep play a role in immune function; make sure to get enough hours of sleep and try to minimize disturbances during the night.

Both too much and too little exercise tends to decrease immunity and increase incidence of infection. Consistent, daily, moderate exercise has been shown to prevent colds and flu.

While exercise will boost endorphins and immune function, chronic exposure to cold air during endurance exercise can damage bronchial and lung tissue. While you ski, snowboard, run, or skate in cold weather, wear a balaclava or neck gaiter to help warm the air you are breathing.

If you are doing some significant exercise, the most effective way to support the immune system is to ingest a carbohydrate-rich drink before, during, and after. This helps to moderate blood sugar and minimize the impact on immunity.

Generally keeping blood sugar consistent is also key for maintaining immune health. Minimize consumption of alcohol, white flours, and refined sugars, and eat a significant source of protein at least twice per day.

A couple of my favorite immune-boosting foods are jerusalem artichokes and coconut oil.

Stay Healthy!