October-November 2018: Food Rules "Redux"

 Simple 3-item dish: Whole Grain Barley with Tomatoes, Avocado, & Mushrooms

Simple 3-item dish: Whole Grain Barley with Tomatoes, Avocado, & Mushrooms

The quest for seeking out the holy grail of a balanced diet has paradoxically, led to people being even more baffled and rightfully confused by the conflicting messages on what constitutes “healthy” food or even “real” food.

Americans (in particular) suffer a national eating disorder: our unhealthy obsession with healthy eating. The paradox is that we worry unreasonably about dietary health yet have the worst diets in the world. And the worst part of this SAD (Standard American Diet) diet is that is has been and continues to spread throughout the developing world as an option to nutritious home-cooked food.

I think it is time to revisit some basic food and eating rules (I hate the word “rules” but these rules are NOT new and need to be emphasized again to help cut through the weight of constantly changing/misleading advice). I have selected and consolidated 7 food rules from Michael Pollan's list of 64 rules. A lot of them are interrelated but I think these 7 pretty much capture the essence of what one can do easily to eat healthy and tasty food.

 Amaranth Cornbread

Amaranth Cornbread

  1. If it came from a plant, eat it; if it was made in a plant, avoid it as much as possible.

  2. Following from the above rule, eat “real” food. Many food items in grocery stores these days don't deserve to be called food. They are barely edible items trying to mimic the taste of “real” foods and often shamelessly claiming that they are whole wheat, high fiber, heart healthy, or gut healthy. Normally, they are processed concoctions designed by food scientist, consisting mostly of ingredients derived from corn and soy, and they contain “natural” flavors and additives hard to pronounce and even harder to digest (for e.g., protein bars, energy drinks, so-called heart-healthy commercial boxed cereals, frozen dinners, all kinds of sliced breads, pastries, and other desserts, and so on).

  3. Avoid as much as possible food products with the word “lite” or the terms “low fat” or “nonfat” in their names, because these are the foods that often have lots of unhealthy fats, added sugars, excess salt, not to mention a laundry list of dubious ingredients masquerading as food.

  4. Don't eat anything that won't eventually rot or go stale. "There are exceptions – honey and maple syrup – but as a rule, any “real” food goes bad eventually.

  5. It is not just what you eat but how you eat. "Always leave the table a little hungry," Many cultures have rules that you stop eating before you are full. In Japan, they say eat until you are four-fifths full. Islamic culture has a similar rule. And if you chew your food well, you will enjoy the food more and feel full sooner.

  6. Don't buy food in a drive-through restaurant or where you buy your gasoline. In the U.S., 20% of food is eaten in the car, and most of this food has unhealthy fats, added sugars, excess salt, and minimal fiber.

  7. Eating what stands on one leg [mushrooms and plant foods] is better than eating what stands on two legs [fowl], which is better than eating what stands on four legs [cows, pigs and other mammals]. These are lifestyle choices, but they are generally recognized as being good choices for you, your family, and for the future of the environment.

References

  1. Michael Pollan. 2009. Food Rules: An Eater’s Manual.

  2. Michael Bittman. 2006. How to Cook Everything: Simple Recipes for Great Food.

  3. Marion Nestle. 2006. What to Eat.

July-August 2018: Processing Processed Food

What do frozen spinach, canned veggies, safflower oil, granola bars, boxed cereal and frozen burritos have in common? They all fall on the processed foods spectrum. Some of these foods are partly to blame for our nation’s obesity epidemic, high blood pressure rates and the rise of type 2 diabetes. But processed foods are more than packaged ramen noodles, potato chips and drive-thru chicken nuggets. I may be preaching to the converted, but it is surprising how many people think they are eating healthy most of the time, but are not too aware of the range of (unhealthy) processed foods they might be consuming on a regular basis. This article helps to differentiate between the processed foods we should be cautious of and those that can play a role in a balanced, healthy diet.

What is Processed Food?

According to the Academy of Nutrition and Dietetics, processed foods include any food that has been deliberately changed in some way before consumption. Examples of processing include foods that are cooked, canned, frozen, packaged or changed in nutritional composition through fortification (adding folic acid to bread products or calcium and vitamin D to milk and juices), through preservation (beef jerky or canned fruit) or prepared in different ways (fermented, dried fruits).

 Frozen spinach is a great option to fresh spinach, often with higher nutrient value.

Frozen spinach is a great option to fresh spinach, often with higher nutrient value.

Processed foods range from minimally to heavily processed:

  • Minimally processed foods—such as bagged spring mix lettuce, cut-up vegetables and roasted nuts—are simply pre-prepped for convenience.

  • Foods that are processed at their peak to preserve nutritional quality and freshness: frozen fruit and vegetables, canned tomatoes and canned tuna.

  • Jarred pasta sauce, salad dressing and cake mixes are examples of foods that contain ingredients such as sweeteners, spices, oils, artificial or natural colors and flavors, salts, and other preservatives, which are added for flavor and texture.

  • Ready-to-eat foods, such as cookies, breakfast cereals, and deli meats like ham, bologna, pastrami, are more heavily processed.

  • The most heavily processed foods on the processed food spectrum are often pre-made meals including frozen pizza and microwaveable dinners.

How to Incorporate the Best Processed Foods Into Your Diet

Processed foods can be helpful and convenient for preparing healthy meals. Unfortunately, most people in America get too many calories from the more heavily processed categories and not enough from lightly processed foods.

The key to consuming the healthiest processed foods is to be able to distinguish between those that have been lightly processed versus those that are heavily processed. Basically, lightly processed foods are ones you can recognize in their original form such as pre-cut apple slices, hard-boiled eggs, canned tuna and frozen vegetables. Those that are highly processed are not in their original form such as potato chips and crackers, or foods that are not naturally occurring such as sodas, cookies and candy. The best way to understand where foods fall along the food-processing spectrum is by understanding the Nutrition Facts Label and Ingredients list. This is especially important when looking for hidden sugars, sodium and fats.

Added Sugars: Added sugars are any sugar that is not naturally occurring in the food and has been added manually. For example, milk and dairy have a large amount of lactose, which is a naturally occurring sugar in these products. However, sugars are added to fruit yogurt. Be aware that sugars are added to a wide variety of products including bread, fruit drinks, granola, protein bars, tomato sauce, ketchup, canned or boxed soups, nut and seed butters, salad dressings, protein powders and sports drinks. When looking at the food label, some examples of names of added sugars are dextrose, fructose, raw sugar, nectar, honey, high-fructose corn syrup, brown sugar, cane sugar and fruit juice concentrate. Read a product’s ingredient list and look for added sugars among the first two or three ingredients. Beginning in July 2018, grams of added sugar will be included in the Nutrition Facts Label.

 A deluge of sodium and sugar-laden foods to be avoided.

A deluge of sodium and sugar-laden foods to be avoided.

Sodium: Highly processed foods often have a substantial amount of salt added to preserve foods and extend shelf life. In fact, they are major contributors to sodium in our diets. Therefore, choose foods labeled no salt, low-sodium or reduced-sodium to decrease your sodium consumption. We need some sodium, but we often consume more than the Dietary Guidelines for American’s recommendation of less than 2,300 milligrams per day.

 High levels of trans fats and high sodium make these a poor choice.

High levels of trans fats and high sodium make these a poor choice.

Fats: Added fats can help make foods more shelf-stable and give them texture and taste. While trans fats, which raise bad cholesterol levels and lower good cholesterol levels, are on the decline in processed foods, you still might find them when reading food labels. The Food and Drug Administration banned artificial trans fats from the food supply, but food companies have until 2018 to comply. Look for zero grams of trans fats and no partially hydrogenated oils in the ingredient list.

Below is a list of strategies for choosing processed foods that are good for you:

  1. Frozen vegetables and fruits: If fresh produce is not available or if you often find a “soup” of wilted and spoiled produce at the bottom of your refrigerator drawer, purchase frozen fruits and vegetables instead. Because of the process used to freeze produce (blanched and then quick-frozen), many of the nutrients (vitamins C and E) are the same or even higher in frozen produce as compared to fresh. 

  2. Fermented foods: Foods such as yogurt, kimchi, kefir, sauerkraut and tempeh contain probiotics, which may help bolster the immune system and relieve constipation.

  3. Sprouted foods: Whole grains and beans are living seeds, and some processing with the right amount of moisture and temperature can make them sprout. These foods have been found to be easily digestible, have a minimal effect on blood-sugar levels, and contain more protein, fiber, and B vitamins than their non-sprouted counterparts. Look for “sprouted” on the food package.

Clearly, processed foods have a place in our busy lives. Prepackaged fruits and vegetables are a convenient way to eat healthfully. In addition, methods of processing, such as fermentation and sprouting can help us obtain the nutrients we wouldn’t otherwise be consuming.

May-June 2018: The Power of Sleep!

The nation’s population is “intoxicated” with sleep loss. Sadly, poor sleep is more the rule than the exception. According to the Institute of Medicine, 50-70 million adults in the United States have sleep or wakefulness disorders (1). This lack of sufficient sleep is not just happening in the US. Worldwide, in 1942, 8 hours of sleep was the norm, now, 6.8 is the average, with 40% of adults sleeping less than 6 hours per night (4). Altogether this worldwide amassed sleep debt is one large alarm bell (2,3). The Centers for Disease Control and Prevention consider poor sleep a “public health problem.” Ultimately, this means more and more people are at an increased risk of developing other health concerns from insufficient sleep (5).

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Health Consequences of Poor Sleep

Science already tells us that for every action there is an opposite and equal reaction. When the body is well rested, the body performs optimally. On the flip side, when the body is poorly rested, performance plummets. Individuals who suffer from chronic lack of sleep or from poor quality of sleep are likely to experience decreased brain function, hormonal imbalances, increased risk of heart disease, abnormal growth and development (especially among teens), decreased productivity and performance, fertility issues, poor immune and insulin responses, and an increased risk of getting in a motor vehicle accident.

Among children and teens, insufficient sleep is associated with an increased risk for obesity, diabetes, injuries, poor mental health, attention and behavior problems, and poor academic performance. Nationwide, approximately two thirds of U.S. high school students report sleeping less than 8 hours per night on school nights (2). In short, sleep plays a crucial role in the repair and maintenance of all systems (physical and psychological) of the human body.

What Happens During Sleep

A state of sleep may seem, on the surface, to be a quiet and tranquil experience. But your body is working hard to repair, recover, build, strengthen, grow and defend. It’s during sleep that the “real” work of progress begins and ends. Sleep is a productive process even if you aren’t moving or interacting.

While you rest, the body begins its work. Like a factory, several processes occur all at once and involve multiple systems. For example:

  • The brain “cleans house.” Cerebral spinal fluid flushes through the brain, cleaning out waste products from cells.

  • Breathing and heart rates slow and blood pressure decreases.

  • Hormones are released that aid in repairing tissues.

It makes sense that if the body is chronically under-rested, these valuable and necessary processes are disrupted. The body then cannot adequately repair tissues and blood vessels, produce and release hormones efficiently, or remove waste. If sleep suffers, there are systemic, long-lasting effects (1).

Downward Spiral to Poor Health

When the body is sleep deprived, the brain craves food (and usually not the healthiest varieties). The hormones responsible for regulating hunger and satiety become unbalanced. Ghrelin (the hunger hormone) increases, while leptin (the satiety hormone) decreases. Consequently, caloric intake increases and caloric expenditure decreases due to lack of motivation from mental and physical fatigue. This eventually leads to weight gain.

sleep hygiene.jpg

Further, poor sleep results in higher-than-normal blood-sugar levels because a tired body is unable to effectively respond to insulin. If poor sleep is chronic, the development of metabolic disorders is inevitable.

We have to commit to being “sleep fit” and ensuring sleep hygiene in order to reverse the downward health spiral and improve the body’s functional capacity.

How to Improve Sleep Fitness

Everyone requires a slightly different environment to sleep well. However, there are some key ingredients to improving the “sleepability” of your space. When it comes to your environment consider taking the following actions:

  • Remove (or turn off) all electronics and cover the alarm clock an hour before bed. The circadian rhythm is most sensitive to blue light (the type emitted from electronics).

  • Make the room as dark as possible.

  • Make sure the room is at a comfortable temperature.

  • Evaluate the noise level or add a white noise machine or fan.

  • Do some deep breathing exercises for 3-5 minutes. Inhale through your nose letting your chest expand, and hold your breath for 5-7 seconds; then exhale with force through your mouth. Do this 3-4 times with eyes closed.

There are also several behavioral tricks you can employ to improve sleep:

  • Develop a routine: If you don’t have a bedtime routine, establish one for you and your family. Incorporate relaxing activities (meditate, read a book, listen to calming music, etc.).

  • Activity naturally promotes better sleep. Try to avoid working out too late in the evening as that can make it difficult to fall asleep.

  • Reduce caffeine intake. Try waiting to enjoy that first jolt of java until 9 a.m. Having caffeine before that time frame can disrupt the body’s normal cortisol rhythm and disrupt sleep later on. Further, caffeine also antagonizes adenosine (another ingredient to promote restful sleep).

  • Limit alcohol. Alcohol is a depressant that has sedative-like effects; however, it also causes an individual to wake frequently during the night from dehydration. Limit your intake of alcoholic beverages before bed or late in the evening.

Finally, communicate openly with your doctor if you feel sleep deprivation is chronic and interfering with your life (personally and professionally).

REFERENCES

  1. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Institute of Medicine. NAP 2006. https://www.ncbi.nlm.nih.gov/pubmed/20669438

  2. Date shows a Shocking Worldwide Lack of Sleep. Leigh Horan, Sleep Matters. https://www.dreams.co.uk/sleep-matters-club/data-shows-a-shocking-worldwide-lack-of-sleep/

  3. Sleep Deprivation: A Global Epidemic. MedSleep; April 25, 2017. https://medsleep.com/sleep-deprivation-global-epidemic/

  4. https://www.forbes.com/sites/neilhowe/2017/08/18/america-the-sleep-deprived/#1e37f09b1a38

  5. Short Sleep Duration Among Middle School and High School Students — United States:2015. Weekly/January 26, 2018/67(3);85–90. https://www.cdc.gov/mmwr/volumes/67/wr/mm6703a1.htm

March-April 2018: One-dish Meal Part Deux!

Wheatberry salad with Mushrooms, Asparagus, Red pepper, Sprouted Tofu and Pine Nuts

A 5-ingredient dish that is a full meal. Simple to cook, delicious, and nutritious - a triple whammy!  Who doesn't want that?!? 

IMAG1931.jpg

In wheat berries the wheat kernel is left intact so none of the nutrients are stripped away. A cup of cooked wheat berries is packed with fiber, protein and iron. It is also rich in vitamin E, a cell-protecting antioxidant, and magnesium, which is good for healthy bones and muscles

Asparagus is full of fiber, folate, vitamins A, C, E and K, as well as chromium, a trace mineral that enhances the ability of insulin to transport glucose from the bloodstream into cells. That's good news if you are watching your blood sugar.

Cremini mushrooms are an excellent source of many minerals including copper, selenium and phosphorus. They are also an excellent source of B vitamins, especially B2, niacin and pantothenic acid. In addition, they are a very food source of potassium, zinc, vitamin B1 and manganese.

Red peppers have the highest amount of Vitamin C concentration among all bell peppers. Besides being a powerful antioxidant, vitamin C helps to absorb iron. If you are iron deficient, try combining red peppers with your iron source for maximum absorption. They also contain several phytochemicals and carotenoids, particularly beta-carotene, which lavish you with antioxidant and anti-inflammatory benefits.

Sprouted tofu is made from sprouted soybeans as opposed to regular tofu that is made with whole soybeans. When beans or seeds are sprouted, they're more nutritious and easier to digest than the regular beans or seeds. Tofu in any form is a great source of vegetarian protein and contains all eight essential amino acids. It is also an excellent source of iron and calcium and the minerals manganese, selenium and phosphorous. In addition, much like mushrooms, tofu is a good source of magnesium, copper, zinc and vitamin B1.

Pine nuts contain nutrients that help boost energy, including monounsaturated fat, protein and iron. In fact, they have the highest concentration of protein per serving among all nuts and seeds. In addition, they are a good source of magnesium, low levels of which can lead to fatigue

Click here for the recipe. 

 

January-February 2018 Newsletter: One-Dish Meals Part I - Easy, Flavorful, & Nutritious

 Mexican Black Bean stew

Mexican Black Bean stew

One of my favorite tasty and easy-to-cook meals is a vegan "Mexican" black bean stew, which can be easily adapted to suit non-vegan preferences. It can also be altered to suit anyone's taste preferences (more or less spicy; more or less garlic or onions, quantity and types of herbs  and spices etc), you can substitute with other beans (adzuki, pinto, kidney, or navy beans), it take only about 30 mins start to finish (you can simmer longer if you have time), and it keeps well in the fridge for up to 5 days.

In terms of the nutrition profile, it is pure perfection:

Each serving is approximately 325 calories, but it is where these calories come from that is key.

In terms of the macro-nutrient profile, each serving has about 10 grams of fat (16% of Daily Value based on a 2000 calories/day intake), mostly healthy monounsaturated fats; one gets  about 16 grams of protein per serving (33% DV); the complex carbohydrates (that take longer to digest and cause NO insulin spike) from the beans and vegetables makes up about 45 grams (16% of DV); dietary fiber from this dish is a whopping 18 grams (71% of DV); and about a third of ones protein requirement at 16 grams (32% of DV).

There is plenty of Vitamins A and C, and significant amounts of Calcium, Iron, and Potassium.

In fact, its a great dish for winter with more than 100% of your Vitamin C per serving (Vitamin C is known to help fight infection due to its powerful antioxidant properties). It cannot cure a common cold but its thought to help prevent more serious complications. The Vitamin A content which is 20% of your daily requirement, is great for eye health and also for overall immune health.

Calcium in this dish is about 15% of your DV. This is a critical nutrient for building and maintaining strong bones. Your heart, muscles and nerves also need calcium to function properly. Some studies suggest that calcium, along with vitamin D, may have benefits beyond bone health, perhaps protecting against diabetes and cancer.

Iron content may be surprisingly high - vegetarians take note! Up to 25% of your daily requirement of Iron can come from this dish. Put simply, the major reason we need iron is because it helps to transport oxygen throughout the body. Without healthy red blood cells, your body can't get enough oxygen. And if you're not getting sufficient oxygen in the body, you're going to be tired often; that exhaustion can affect everything from your brain function to your immune system's ability to fight off infections. Iron is also necessary to maintain healthy cells, skin, hair, and nails.

And lets not under-estimate the potent power of #potassium. It plays a role in every heartbeat. A hundred thousand times a day, it helps trigger your heart to squeeze blood through your body. It also helps your muscles to move, your nerves to work, and your kidneys to filter blood. This dish contains 22% of your daily requirement of potassium and if you top it off with a serving of avocado, that gives a double punch of potassium so you get almost half your daily requirement from this dish alone!

Given the nutrient dense but low calorie count, this is dish allows for a lot of flexibility.  Some great add-ons for flavor and nutrition are:

  1. Quarter to Half an avocado or guacamole from half an avocado and lime as a topping.
  2. Four to five ounces of sauteed firm tofu as a side dish or as a topping.
  3. Two ounces of any hard, grated cheese or 2 ounces sour cream as a topping.
  4. A handful of sauteed mushrooms as a topping.
  5. A 4-6 oz piece of any non-vegetarian protein if you eat animal protein. Grilled chicken or fish goes best with this dish.  

To access the recipe click here.

Next Newsletter - One-dish meals Part II! 

November-December 2017: Getting Over Overeating

Over the last few years, while working with clients who are keen on improving their eating patterns and overall lifestyle, I see that overeating is not just about lack of willpower. There is something much deeper going on that makes people eat too much or eat too often. So, rather than pushing clients to eat less I ask them why they struggle with overeating.

I think its wrong to assume that overeaters lack willpower. In fact, I would go so far as to say that faulting oneself for lack of willpower is a fallacy. Studies show that we have limited amounts of willpower to draw on and that it is not an efficient tool for something that we do multiple times a day—like eating. Research suggests willpower—the capacity to delay immediate gratification for long-term reward—is not endless. It seems that "willpower is like a muscle that fatigues with continued exertion" (Baumeister 2012). 

Overeating-2.jpg

Willpower may be especially ineffective at resisting the temptation to eat. Like a muscle, willpower needs glucose for fuel (Gailliot et al. 2007).  Thus, using willpower to limit caloric consumption is a Catch-22. Abstaining from eating taxes willpower, thereby reducing glucose supplies and causing subsequent willpower depletion. I have noticed that my clients find it very frustrating and unrewarding to try to control their appetite with willpower, and through no fault of theirs, they fail. We can starve ourselves with short-term voluntary control, but then our bodies compensate by slowing our metabolism and dramatically increasing appetite.

This then begs the question, if a “weak will” isn’t to blame for overeating, what is? Research points to biological and psychological explanations.

THE BIOLOGY OF OVEREATING

There is an argument that our bodies overreact if they don’t get enough food or nutrients. In fact, one can argue, and some research does back this, that overeating goes hand in hand with undereating, This undereating/overeating cycle can last a day (by skipping a meal and binge eating later), a week (dieting through the week and overindulging on the weekends) or months (restricting for periods of time and binging once you allow yourself permission to eat).

Stress and sleep deprivation can also stimulate over-eating, initiating hormonal changes that increase appetite (Yau & Potenza 2013; Spiegel et al. 2004).

Finally, obesity can alter our biology to encourage overeating. Some research has shown that it’s difficult for obese individuals to lose weight because the adipose cells generated to store fat want to stay alive. They act like endocrine organs, altering the secretion of hormones that control hunger and appetite. Leptin, the hormone responsible for satiety, becomes suppressed, which leads to a lack of fullness signals to the brain. This helps explain why people who are obese can have a tough time managing food intake. Of course, this does not explain why they become obese in the first place but does explain why obese people find it so much harder to lose weight that moderately overweight people.

APPETITE AND OVEREATING

In combating overeating, the first step is to address the biological causes of excessive appetite. I have clients track food cravings and their actions and thoughts just prior to the food craving - this helps them recognize the craving triggers and try and address them in ways other than through food (for example, if their triggers are loneliness or boredom, I suggest calling a friend, going for a walk, doing a puzzle game, doing some spring/winter cleaning, or some easy home exercises one can download from the internet).

Research shows that breakfast is crucial to fighting over-eating. Studies repeatedly show that eating a healthy breakfast helps people maintain weight loss. In addition, eating every 3–4 hours might help to manage blood-sugar levels and eliminating added sugar and artificial sweeteners reduces cravings. In addition, prioritizing 7–8 hours of sleep each night can also help - fatigue and lack of sleep are common triggers for unleashing food cravings.

I also find it useful to explain to clients the difference between hunger and appetite. Hunger is the physiological need for food, as dictated by the stomach growling or contracting. This can also manifest in an inability to think clearly or focus. Appetite, on the other hand, reflects our psychological desire to eat. By helping clients understand true hunger, you can make them more aware of other needs manifesting as the desire to eat and help them find healthier coping strategies.

PSYCHOLOGICAL FACTORS

Emotions have a huge influence on how and when we eat. When it comes to how we feel, we may choose to express virtually any emotion by eating, and I see this time and again with clients where they often have an emotional reason for eating, whether it’s to comfort ourselves when we’re sad, celebrate when we’re happy, procrastinate when we’re stressed or entertain ourselves when we’re bored.

However, eating to manage emotions can quickly become problematic. With overeating, there’s usually another root issue that isn’t being addressed. Overeating is often the symptom of deeper issues; a way to create a secondary problem when the root problem is too overwhelming to process. Whatever the root cause may be, the guilt and shame associated with overeating create feelings of unworthiness. People then overeat for comfort from that feeling, and the vicious cycle continues.

Once clients recognize this emotion–overeating relationship, they can shift their efforts from caloric restriction to managing emotions that disrupt eating patterns. 

MANAGING EMOTIONAL EATING

When I think a a client is struggling with emotional overeating, I often try and steer conversations away from food. When clients say they find themselves reaching for junk food, I ask then to ask themselves two questions. One, what am I feeling? Two, what do I need? Am I sad and needing to talk to a friend? Do I feel tired and need to sleep? Encourage clients to discover and address unmet needs that trigger overeating.

As a health and fitness professional, when working with clients, I try to be supportive and non-judgmental, helping them to explore why they overeat and allowing them to become the drivers of their own behavior change. Its important to meet clients where they’re at, not where they ‘should be'.

Most importantly, as mentioned above, moving the focus away from willpower can help expand the conversation around overeating. I find it more constructive to talk about healthy eating and managing cravings as a choice that a client makes that leads to an action that feels empowering and powerful. This shift can reduce guilt- or shame-related eating and allow people to explore the personal factors promoting overeating. 

As a side bar, sometimes, low levels of certain nutrients play a role in overeating. When vitamin D levels are low, the hormone that helps turn off your appetite doesn’t work, and people feel hungry all the time, no matter how much they eat. In addition, low levels of omega-3 fatty acids can alter insulin control, increasing hunger. In these cases, some supplementation with Vitamin D3 (especially in winter with less exposure to sunlight) and omega 3's might help.

CREATING AN ENVIRONMENT FOR HEALTHIER EATING

When it comes to overeating, ones surroundings matter. Research has shown that the layout of a kitchen or office space, the proximity of food on the dinner table and even the size of your dining companions can influence your intake. What I have noticed with clients is that even small changes to ones immediate environment can make a big difference.

Home is the best place to start. One of the easiest ways to eat less is simply putting out a fruit bowl. Every time you walk by, it’s a visual reminder to eat healthier, in the same way that a cookie jar on your counter reminds you of something very different. In addition, making your kitchen less “loungeable.” might help. The more we hang out there, the more we start looking for things to do—and the main thing to do in one's kitchen is eat. I recommend to clients to move iPads, TVs and comfy chairs out of the kitchen and into areas with fewer temptations.

Finally, I am all in favor of an attitude of gratitude. Simply stating (aloud or in your mind) one thing you’re grateful for before you eat can improve your eating choices. A quick word of thanks can make a big difference. 

On that note, a BIG thank you and much gratitude to all of you for making the time to read and respond to my newsletters.  Make 2018 a year to remember!  All the best!!

References

1. APA (American Psychological Association). 2012. Stress in America: Our Health at Risk. Accessed Dec. 14, 2016:www.apa.org/news/press/releases/stress/2011/final-2011.pdf

2. Baumeister, R.F. 2012. Where has your willpower gone? New Scientist, 213 (2849), 30–31.

3. Baumeister, R.F., et al. 1998. Ego depletion: Is the active self a limited resource? Journal of Personality and Social Psychology, 74 (5), 1252–65.

4. Gailliot, M.T., et al. 2007. Self-control relies on glucose as a limited energy source: Willpower is more than a metaphor. Journal of Personality and Social Psychology, 92 (2), 325–36.

5. Spiegel, K., et al. 2004. Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite. Annals of Internal Medicine, 141 (11), 846–50.

6. Yau, Y.H., & Potenza, M.N. 2013. Stress and eating behaviors. Minerva Endocrinologica, 38 (3), 255–67.

September-October 2017: The Detox Myth

Whether it’s cucumbers splashing into water or models sitting smugly next to a pile of vegetables, it’s tough not to be sucked in by the detox industry. The idea that you can wash away your calorific sins is the perfect antidote to our fast-food lifestyles and alcohol-lubricated social lives. But before you dust off that juicer or take the first tentative steps towards a colonic irrigation clinic, there’s something you should know: detoxing – the idea that you can flush your system of impurities and leave your organs squeaky clean and raring to go – is a scam.

It should be noted that the detoxification described here is different from the practice used in substance abuse treatment. Detoxification in that context is "the process of allowing the body to rid itself of a drug while managing the symptoms of withdrawal," according to the National Institute on Drug Abuse. This kind of supervised detoxification may prevent potentially life-threatening complications that might appear if the patient was left untreated.

 Whole foods for detoxing

Whole foods for detoxing

Advocates of detox therapies start with the premise that the body accumulates toxins that can cause cancer and other diseases. Regularly cleansing oneself of such toxins is supposed to reduce the risk of disease and endows one with a feeling of good health, more radiant skin and having more energy. However, currently, there is no conclusive scientific evidence that any of these so-called cleanses really benefit a person's health. It’s a pseudo-medical concept designed to sell you things. If toxins did build up in a way your body couldn’t excrete them, you’d likely be dead or in need of serious medical intervention.

We forget that the body is equipped with a detoxification system of its own. The body has kidneys, a liver, skin, intestines, immune system, even lungs that detoxity. There is no known way – certainly not through detox treatments – to make something that works perfectly well in a healthy body work better.However, we are exposed to more toxins today than ever before. According to the Environmental Working Group there are over 7 million recognized chemicals in existence with very few tested for safety, not to mention modern changes in our food supply, water, medications, stress, etc. So yes, your body is engineered to cleanse itself…but your organs are multifunctional and were never designed to handle this many toxins on a daily basis and keep up with their other jobs like conjugating hormones, making blood, producing enzymes, digesting food, etc.

From what the research says and from what I understand, cleansing is not about “cleaning” your body, but rather adding back enough nutrients to power the biochemical pathways that convert toxins and hormones to a water-soluble form, that can then be excreted from your bowels or kidneys. Therefore, choosing a program that deeply re-nourishes your body with whole food nutrition will be a lot more effective than just taking an herbal cleansing supplement or doing a liquid fast. Thus, cleansing the right way, by optimizing your nutrition, can be a life-saver.

 Skip the bottle, stick to the veggies and fruits!

Skip the bottle, stick to the veggies and fruits!

Which leads to a discussion of how detoxing can be downright dangerous. Juice cleanses are by far one of the most egregiously used and abused ways to try and detox. A prolonged juice cleanse can eliminate critical nutrients, like protein, which can lead to malnutrition. A juice fast over time could lead to an imbalance of electrolytes such as sodium and potassium, that are vital for day-today bodily functions. Other detoxing practices are even more perilous. Colonic irrigation, for example, is not only unnecessary (except as preparation for surgery or endoscopy), but can lead to serious complications, including diarrhea, life-threatening blood infections (septicemia), and perforation of the intestinal wall.

And then there is the idea of a water cleanse. Drinking a lot more water than is necessary to stay hydrated and quench thirst can impair the ability of the kidneys to properly exchange electrolytes, such as sodium, potassium, and chloride. That in turn can lead to potentially life-threating problems like cardiac arrhythmias. It might seem reasonable to assume that the more water you pour in to your body, the more bad stuff you flush out. But that's simply not the case. As long as you are producing light-yellow urine and don’t feel excessively thirsty, you are drinking all the water you need. (Note: elderly people often lose their thirst drive, so it’s important for them to remember to drink water or other fluid throughout the day. People with abnormal kidney function may also not be able to rely on thirst as an indicator of hydration.)

And I leave the best for laste - if your goal is to lose weight (particularly excess body fat) and keep it off, evidence suggests that a detox can actually thwart your efforts in the long-term. That’s in part because, while the severe calorie restriction that most detox plans entail may make you thinner temporarily, the weight you’ll lose is mainly water weight—not body fat weight, the loss of which is essential in order to maintain weight loss over time. Indeed, studies have shown time and again that both men and women who lose weight by fasting or dramatically reducing calorie intake routinely gain the weight back, and often end up even heavier.

So, what's the bottom line? The lifestyle implications of a poor diet, lack of exercise, smoking, lack of sleep, and alcohol or drug use cannot simply be flushed or purged away. Our kidneys and liver don’t need a detox treatment. If anyone suggests a detox or cleanse to you, remember that you’re hearing a marketing pitch for an imaginary condition. If you experience fatigue, pallor, unexplained weight gain or loss, changes in bowel function, or breathing difficulties that persist for days or weeks, visit your doctor instead of a detox spa.

References

  1. Palermo. E. 2015. Detox diets and cleansing: facts and fallacies
  2. Harvard Health. 2008. The dubious practice of detox.
  3. NIH. National Center for Complementary and Integrative Health. Detoxes and Cleanses.
  4. Mayo Clinic. Is Colon Cleansing a good way to eliminate toxins from you body?
  5. Cosgrove, B. 2015. The truth about detox diets. University of California, Berkeley, Berkeley Wellness.

July-August 2017: Can Food beat the Mood?

Surveys suggest that most Americans feel they are experiencing unhealthy levels of stress and nearly 80% of adults say they have endured more stress in the past 5 years. Are you in the mood to read about foods that may help reduce anxiety and more importantly, chronic stress? Did you know chronic stress is a big factor in weight gain? But before we go into foods that can help with alleviating stress, a quick primer on what stress can do to the mind and body may be helpful.

Stress can be defined as the non-specific response of the body to any stimulus that overcomes, or threatens to overcome, the body’s ability to maintain homeostasis (the equilibrium of internal biological mechanisms). The stress response may be caused by social stressors (e.g., life events, personal conflicts); physiological stressors (e.g., pain, vigorous exercise, intense heat or cold); psychological or emotional stressors (e.g., sorrow, fear, anxiety); and/or chemical stressors (e.g., blood acid-base imbalance, low oxygen supply).

If the stressor represents an “ongoing” hassle, fear or overwhelming issue in a person’s life, the effect is referred to as chronic stress. In contrast, if the stressor is more temporary and immediate, the effect is referred to as acute stress. The body perceives an acute stressor (e.g., dealing with a traffic jam) as a challenge that a human being is capable of handling. On the other hand, chronic stress can seem unmanageable. Physiologically, the human body responds differently to acute and chronic stress. 

If the chronic stress (real or perceived) is of sufficient magnitude and duration, through various biological mechanisms, it results in prolonged elevation of cortisol levels. Cortisol, a hormone, is known to stimulate appetite during the intermittent recovery periods that occur while a person is experiencing chronic stress. Cortisol (with the help of slightly elevated insulin levels) has also been shown to activate lipoprotein lipase, the enzyme that facilitates the deposition of fat. In the presence of slightly higher insulin levels, elevated cortisol levels inhibit the breakdown of triglycerides, thus promoting fat storage. Thus, chronic stress may consistently contribute to greater central fat accumulation, especially in females.

Aside from medication, there are several strategies you can use to help reduce symptoms of stress, from exercising to deep breathing. Additionally, there are some foods you can eat that may help lower the severity of your symptoms, mostly due to their brain-boosting properties. And assuming one can access and afford such foods, these can go a long way in reducing pain and stress. Note that these foods may not make the stress go away but they may reduce the negative effects of stress that are highly associated with chronic stress, including depression, anxiety, insomnia, and cardiovascular disease.

 Almonds, Pumpkin seeds, and Oatmeal

Almonds, Pumpkin seeds, and Oatmeal

  • Nuts and seeds, especially almonds and pumpkin seeds are rich in magnesium, and in vitamins B2 and E, which help bolster the immune system during times of stress. Just a quarter cup of almonds each day does the trick. For variety, spread some almond butter on fruit slices or whole wheat crackers.

  • Avocado is as a key source for B vitamins that are essential for healthy nerves and brain cells. Researchers argue that feelings of anxiety may be rooted in B vitamin deficiency. Avocados are also high in monounsaturated fats, magnesium and potassium, which help lower blood pressure. Next time stress has you reaching for a pint of full-fat ice cream, opt for a non-dairy DIY version made with avocado blended with a ripe banana (for added magnesium and potassium), vanilla extract, nut milk, and cinnamon, a natural sweetener. 

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  • Citrus fruits (oranges, grapefruits, tomatoes), red and green peppers, blueberries, and many other fruits and vegetables are rich in vitamin C and its antioxidant properties, which may help to repair and protect cells and aid in lowering blood levels of stress hormones like cortisol and adrenaline. 

  • Soy milk contains high amounts of the amino acid tryptophan, which is associated with a boost in the “happiness hormone” serotonin, which in turn may lessen depression and anxiety.

  • Brocolli, brussels sprouts, and asparagus are loaded with folic acid, a vitamin associated with serotonin production.

  • Oatmeal can also stimulate the brain to produce serotonin. Complex carbohydrates (especially in steel cut or thick rolled oats) are absorbed more slowly, thus taking longer to digest, so you stay satiated longer, and they help to ensure a steadier supply of serotonin.
  • Dark chocolate contains flavonols, which are antioxidants that may benefit brain function by improving blood flow to the brain and promoting its ability to adapt to stressful situations. In addition, eating dark chocolate (at least 70% dark) has also been shown to increase levels of the neurotransmitter serotonin, which may help reduce the stress that leads to anxiety. Other researchers suggest that dark chocolate’s role in brain health may simply be due to its taste, which can be comforting for those with mood disorders. Either way, dark chocolate is high in calories and easy to overeat so its best to try and consume in moderation (1-1.5 oz serving size)

  • Dairy products (especially yogurt) may boost serotonin levels through an increase in the enzyme that converts tryptophan to serotonin. Studies have shown that probiotic foods like yogurt, kombucha, kimchi, pickled cucumbers, and miso soup may promote mental health and brain function by inhibiting free radicals and neurotoxins, which can damage nerve tissue in the brain and lead to anxiety.

  • Fish, especially fatty fish like wild salmon, mackerel, and tuna, are rich in Omega 3 fatty acids, that may reduce stress and anxiety. The mechanism of how this occurs is not clear but one study showed that taking 2.5g of Omega-3's (or having 12 to 15 ounces of salmon) can reduce stress and anxiety by more than 20%. The study found similar results when diets were laden with other fatty fish or a fish oil supplement. Try combining fish, with avocado, brussels sprouts or broccoli for a real boost of de-stressing foods! 

Overall, research is sparse on the topic of specific foods and anxiety/stress prevention. Most studies have been conducted on animals or in laboratories, and more high-quality human studies are needed. However, these foods and beverages, may help you deal with your anxiety symptoms, as they may reduce inflammation and boost brain health.

REFERENCES

  1. Elliot B. July 2017. Six Foods that help reduce anxiety.

  2. Montes and Kravitz. 2011. Unraveling the stress-eating-obesity knot

  3. Yuan-Pin Su et al. August 2015. Omega-3 Polyunsaturated fatty acids in prevention of mood and anxiety disorder
  4. Almaradhan et al. April 2012. Dietary and botanical anxiolytics

  5. Ying Xu et al. March 2014. Novel therapeutic targets in depression and anxiety: antioxidants as a candidate treatment.

  6. Nutrition Data on citrus fruits (oranges):

  7. Nutrition Data on sweet peppers.  

May-June 2017: Its a Headache having a Migraine! How can Diet & Lifestyle help?

Do you even get a severe throbbing pain or a pulsing sensation, usually on just one side of the head? Is it often accompanied by nausea, vomiting, and extreme sensitivity to light and sound? Do you sometimes see flashes of light, blind spots, or tingling on one side of the face or in your arm or leg. Then you are more likely to be experiencing a migraine than a headache. Migraine attacks can cause significant pain for hours to days and can be so severe that the pain is disabling and often so debilitating that it prevents you from work and play. 

So, what can one do? Medications can help prevent some migraines and make them less intense, but the severe, often long-term side effects might override the medical benefits. In short, the right medicines can provide relieve but self-help remedies and lifestyle changes may provide the long-term preventive relief you seek, with few if any side effects.

Below are some suggested diet and lifestyle strategies that can help you deal with migraines. 

1. Foods to have or not to have. 

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  • Foods to eat regularly: these foods have seldom if ever triggered migraines: Rice, especially brown rice, cooked green vegetables, such as broccoli, kale, spinach, Swiss chard, or collards, cooked orange vegetables, such as carrots or sweet potatoes, cooked yellow vegetables, such as summer squash, and cooked or dried non-citrus fruits: cherries, cranberries, pears, prunes (be a bit cautious with citrus fruits such as apples, bananas, peaches, and  tomatoes). In addition, stick to modest amounts of salt, maple syrup, and vanilla extract that are usually well-tolerated (PCRM, Mayo Clinic, WebMD).
  • Healthy fats: adding certain kinds of fats into your diet may help reduce inflammation, which is thought to exacerbate migraine pain. Omega-3 fatty acids, which are most concentrated in fatty fish and also in vegetarian sources like chia seeds, flaxseeds, hempseeds and their oils, and in soy and walnuts, and the monounsaturated fats found in olive oil have both been shown to reduce the frequency, duration, and severity of headaches and migraines. 
 Vegetarian sources of Omega-3 fatty acids

Vegetarian sources of Omega-3 fatty acids

  • Water is actually a nutrient, essential for your body’s proper functioning, and dehydration is a common migraine trigger. Migraine sufferers need to stay vigilant about the amount of fluid they drink and should aim to preempt thirst. I recommend at least nine cups of liquid a day for women and 13 cups a day for men. 
  • Foods to avoid. Aged cheeses, salty foods and processed foods may trigger migraines.  Dairy, chocolate and eggs are some very common migraine triggers (PCRM). Wheat and certain types of nuts have been known to trigger migraines in some people. Anywhere between 20 and 50 percent of adults experience a reduction or elimination of their headaches when common trigger foods are avoided.
  • Food additives. The sweetener aspartame and the preservative monosodium glutamate (MSG), found in many foods, may trigger migraines.
  • Drinks. Alcohol, especially red wine, and highly caffeinated beverages may trigger migraines. However, coffee and tea in small amounts might actually help with migraine pain.

2. Supplements that might help to prevent migraines

 Key supplements to support not replace food sources of these nutrients.

Key supplements to support not replace food sources of these nutrients.

  • Feverfew: 250 milligrams per day or two to three fresh leaves. Exercise caution if pregnant or lactating.
  • Ginger: 1/2 to 1 teaspoon (1 to 2 grams) of fresh crushed ginger by itself or with tea every day.
  • Magnesium: 400 to 700 milligrams per day total (foods plus supplements, if used) or 200 milligrams per day as elemental supplement alone. The best food sources for magnesium are: spinach, sweet potatoes, swiss chard, amaranth, quinoa, brown rice, sunflower seeds.
  • Riboflavin — also called vitamin B2 — is necessary for the body’s production of energy at the level of the cell. Although it is difficult to get enough riboflavin to prevent migraines from food sources alone, I recommend adding some riboflavin-rich foods to your diet; good choices are whole-grain fortified cereal, mushrooms, broccoli, and spinach. As a supplement, a daily dose of 400 mg or a combination product that includes riboflavin and other potentially beneficial supplements can be taken.
  • Calcium: Reduce calcium losses by avoiding animal protein, coffee, tobacco, and excess sodium and sugar. If you wish, you can take 1,000 to 2,000 milligrams per day of elemental calcium, with 200 IU (5 micrograms) of vitamin D. Regular physical activity, especially doing some weight-bearing exercises, will keep calcium in your bones where it belongs.

2. Lifestyle Habits to prevent and reduce recurrence

  • Skipping meals or fasting has been known to trigger migraine attacks.
  • Anxiety. Stress at work or home can cause migraines.
  • Sensory stimuli. Bright lights and sun glare can induce migraines, as can loud sounds. Strong smells — including perfume, paint thinner, secondhand smoke and others — can trigger migraines in some people.
  • Changes in wake-sleep pattern. Missing sleep or getting too much sleep may trigger migraines in some people, as can jet lag..
  • Changes in the environment. A change of weather or barometric pressure can prompt a migraine.
  • Medications. Oral contraceptives and vaso-dilators, such as nitroglycerin, can aggravate migraines.

3. Risk factors 

  • Family history. If you have a family member who tends to get migraines, then you may be more likely to develop them too, but diet and some specific lifestyle changes can help reduce migraine severity and frequency.
  • Age. Migraines can begin at any age, though the first often occurs during adolescence. Migraines tend to peak during your 30's, and gradually become less severe and less frequent in the following decades.
  • Sex. Women are three times more likely to have migraines than men. Headaches tend to affect boys more than girls during childhood, but by the time of puberty and beyond, more girls are affected.
  • Hormonal changes. If you are a woman who has migraines, you may find that your headaches begin just before or shortly after onset of menstruation. They may also change during pregnancy or menopause. Migraines generally improve after menopause. Some women report that migraine attacks begin during pregnancy, or their attacks worsen. For many, the attacks improved or didn't occur during later stages in the pregnancy.

One can argue that lifestyle changes and being able to identify triggers can go a long way in warding off migraines or minimizing their effects. So what can one do as a preventive measure?

  • Create a consistent daily schedule. Establish a daily routine with regular sleep patterns and regular meals. In addition, try to control stress with meditation and/or yoga. Even 5-7 minutes of deep breathing first thing in the morning and last thing at night can be helpful in managing stress and getting restful sleep.
  • Exercise regularly. Regular aerobic exercise releases endorphins, the "happy" hormone, reduces tension and can help prevent migraines. If your doctor agrees, choose any aerobic exercise you enjoy, including brisk walking, swimming and cycling. Warm up slowly, however, because sudden, intense exercise can cause headaches. Regular exercise can also help you lose or maintain a healthy body weight and body compositin, given that obesity is thought to be a factor in migraines. 
  • Reduce the effects of estrogen. If you are a woman who has migraines and estrogen seems to trigger or make your headaches worse, you may want to avoid or reduce the medications you take that contain estrogen (such as birth control pills and hormone replacement therapy).
  • Identify triggers. This can be key to preventing migraines. First, one can do a "Two-week Test" (see Ref. 4). Second, an elimination diet might help (see Ref 4). Third, foods that cause headaches are usually eaten within three to six hours of the attack. Be aware of what you eat prior to onset of a migraine, and make that part of an elimination diet. Fourth, the offending foods can be ones for which you have cravings. They may be the ones you might least suspect. Again, be aware of these craving triggers. Fifth, a person's tolerance to food triggers might be different at different times. For example, a woman might normally be able to eat half a box of chocolates with no problem, but as she approaches her period a single piece might trigger the migraine. The reason, presumably, is that the natural changes in hormones that occur over the month affect her sensitivity to certain foods. Thus, your triggers can change over time and over the course of your life cycle.

So what can you do once a migraine hits?  Here are some suggestions:

  • Try caffeine. Although caffeine can be a migraine trigger for some people, for others it works as a treatment. The dose is one to two cups of strong coffee at the first sign of an attack.t 
  • Starchy foods can help. Foods such as rice, potatoes, crackers, or bread might actually help unless you are gluten intolerant. But given their high glycemic load that can raise and cause substantial fluctuations in blood sugar/glucose levels, consume in moderation and only on occasion. Some people find that they actually crave starchy foods during migraines and that digging into toast, crackers, pasta, potatoes, or other starchy foods reduces the headache or nausea, and can even shorten the attack. Experience will tell you whether these foods help
  • Ginger it up! Fresh, crushed ginger, 500 to 600 milligrams (about 1/4 teaspoon), in a glass of water has been helpful in anecdotal reports. It can be repeated every few hours, up to about 2 grams per day.
  • Calcium might be able to treat migraines as well as prevent them. Researchers reported a case of a woman who was able to stop an early migraine by chewing 1,200 to 1,600 milligrams of elemental calcium. Again, avoid the temptation to get calcium from milk, yogurt, or any other animal source. 
  • Sleep it off in a dark room. Lie down in a quiet, dark room, and sleep if you can. Use hot or cold compresses, and massage the blood vessels at the temples.
  • Acupuncture has been shown to be beneficial for many people.

References

1. Millichap JG, Yee MM. The diet factor in pediatric and adolescent migraine. Pediatr Neurol. 2003; 28 (1):9-15.
2. Ernst E, Pittler MH. The efficacy and safety of feverfew (Tanacetum parthenium L.): an update of a systematic review. Public Health Nutr. 2000; 3(4A):509-514.
3. Johnson ES, Kadam NP, Hylands DM, Hylands PJ. Efficacy of feverfew as prophylactic treatment of migraine. Br Med J. 1985; 291:569-573.
4. PCRM. Migraine Diet: A natural approach to Migraines. http://www.pcrm.org/health/health-topics/a-natural-approach-to-migraines.
5. Thys-Jacobs S. Alleviation of migraines with therapeutic vitamin D and calcium. Headache. 1994;34:590-592

March-April 2017: Dinner Table Science

Do you spend countless hours figuring out how to best tailor your eating patterns, immersing yourself in literature and studies driven by top nutrition and fitness professionals? Are you frustrated by the ever-changing nature of the literature on food, fitness, and nutrition, where one day butter is back, eggs reduce stroke risk, and whole grains improve blood cholesterol, while the next day saturated fat (in butter and eggs) causes heart disease, and gluten (found in many whole grains) is a leading cause of chronic inflammation? 

Research has gleaned some important insights over the years making a huge impact on our eating habits. So what do some of the nation's top nutrition researchers and fitness experts say about studies and evidence that has been compelling enough to trigger change in their own eating practices?  Here are some insights and evidence that they say has made a positive impact on their lives and the lives of others.

[Side Note: Despite attempts to find some gold standard in scientific research, its hard if not impossible to do randomized controlled trials around food and diet.  Much of the current findings are based on observational studies that track dietary patterns in populations over time, often leaving too much room for bias, contradictions and confusion, that translate into dozens of fad diets and myths. But the findings still present some solid evidence that is hard to refute at this point.]

 Hearty quinoa salad with sauteed red pepper, spinach, mushrooms and protein rich seitan, seasoned with thyme and lemon juice.

Hearty quinoa salad with sauteed red pepper, spinach, mushrooms and protein rich seitan, seasoned with thyme and lemon juice.

1. The protein flip: Christopher Gardner, a nutrition researcher, has spent the last 20 years investigating links between food and chronic-disease. He discovered a concept called the "protein flip" which encourages people to move plant foods to the center of their plate and their diet and shift meat to the fringes. He argues that people think plants are missing amino acids, which is not true if one knows about the wide range of plant-based protein options available today. His best advice: embrace variability, not everyone should follow a vegan, Mediterranean or Paleo diet, and thrive on a different balance of macronutrients (proteins, fats, and carbohydrates).

2. Not all calories are created equal: Lee Jordan is a trainer, health coach specializing in helping clients lose excess weight. He stresses that losing weight isn't about dropping one or two ingredients like sugar or fat (though cutting back on added sugars, is not something he would be against!). Instead, the diet needs to be holistic and based on real, "whole" foods, the kind that does not come out of a box. He underscores the importance of the quality of calories. And he doesn't tell his clients how to change or what to eat; instead he lets them create their own ideas and solutions on how to change and improve their current lifestyle. In short, he empowers them to make the changes.

3. Magic of H20: Trina Gray, an award winning health club owner, argues that healthy hydration, from water not from juices, alcohol and food, can enhance not only mental performance but physical performance as well. In fact, studies have shown that dehydration can reduce motivation and effort, cardiovascular function, and metabolic reactions.

4. Food as medicine and food for a healthy planet: James Loomis & David Katz, both doctors, stress the importance of healthy eating for a sustainable lifestyle and better health.  Loomis has seen that patients who engaged in lifestyle dietary changes saw huge positive results - "I have seen type 2 diabetes reversed" through dietary changes alone. Katz launched the True Health Initiative in 2014, a coalition of health experts committed to teaching lifestyle as medicine; the idea that a healthful diet based on minimally processed, mostly plant-based foods, and healthy fats, can help prevent chronic disease. He takes this a step further by arguing that "if we care enough about the confluence of both our planet and our health, then everyone needs to eat an overwhelmingly plant-based diet".

 Nuts - a great vegetarian source of omega-3 fatty acids, good fats, fiber, protein and essential micronutrients

Nuts - a great vegetarian source of omega-3 fatty acids, good fats, fiber, protein and essential micronutrients

5. Keep it simple, surely: Marion Nestle, a renounced Nutritionist, has avoided the numerous fads, bandwagons, and nutritional tugs of war that regularly crop up in the media. She argues that personal eating patterns should be simple and to the point. She emphasizes an overall balance, eating what she likes in moderation and getting pleasure from what she eats. She adds: "while everyone is arguing about saturated fat vs sugar, I just eat real, whole foods and don't worry about any of that".

6. One size does not fit all: Frank Hu, like many other experts, stresses the importance of practicing what he preaches, and the mantra that one size does not fit all. Based on his own findings, his diet now combines the best elements of two dietary traditions from Asia and Europe. Hu still eats a lot of soy products and legumes, typical of Asian dietary patterns, but has swapped in brown rice for white. Olive oil, nuts and seeds from the Mediterranean diet have become his primary sources of dietary fats. One of the biggest influences on his current diet is based on extensive research that has shown how different dietary fats affect coronary heart disease. He found that the type of fat was more important than total fat and that replacing total fat with carbohydrates has no benefits for overall health.

REFERENCES

  1. Campbell, T.C., & Campbell, T.M. 2004. The China Study: The Most Comprehensive Study of Nutrition Ever Conducted and the Startling Implications for Diet, Weight Loss and Long–Term Health. Dallas: BenBella Books.
  2. CDC. 2015. Health, United States, 2015. National Center for Health Statistics. Accessed Dec. 2016. www.cdc.gov/nchs/fastats/diet.htm
  3. Dauchet, L. 2006. Fruit and vegetable consumption and risk of coronary heart disease: A meta–analysis of cohort studies. Journal of Nutrition, 136 (10), 2588–93.
  4. Katz, D. 2013. What REALLY kills us. Huffington Post. Accessed Dec. 8, 2016. www.huffingtonpost.com/david–katz–md/chronic–disease_b_4250092.html.
  5. Maki, K.C., et al. 2014. Limitations of observational evidence: Implications for evidence–based dietary recommendations. Advances in Nutrition, 5 (3), 293–94.
  6. Murray, B. 2007. Hydration and physical performance. Journal of the American College of Nutrition, 26 (5 Suppl.), 542S–48S.
  7. Sibbald, B., & Roland, M. 1998. Understanding controlled trials: Why are randomised controlled trials important? British Medical Journal, 316 (7126), 201.

January-February 2017: Fitness for health

As a personal fitness trainer and health coach, I argue that anyone can engage in and enjoy some level of regular physical activity, even without access to a gym. Yes, there are perceived and real challenges to getting into an exercise frame of mind (that's a whole other issue), but once you manage these challenges and make regular physical activity a part of your everyday lifestyle (okay, maybe 3-4 times per week), you are on the road to a lifetime of fewer aches and pains, better mental health, more manageable stress, and higher energy levels.

So, here are some key issues to think about as you embark on your journey of physical activity and fitness for health.

A. The importance of "body-weight" training cannot be underestimated, and for good reason. You don’t need fancy equipment, an expensive membership or very much room for full body workouts, so they are appealing to anyone or at any age (with some guided supervision). Body-weight training helps increase lean muscle mass in individuals, especially when combined with some aerobic activity (1). And its a great way to ease into strength training, particularly if you want to eventually join a gym.

B. Working with a fitness professional, like a personal trainer, can be a great way to get tailored guidance and accountability to think about your fitness goals and work towards them. It can also be a great way to get over initial hesitation or awkwardness you may feel about your ability to do certain exercises or use certain equipment in the gym or when working out at home. In fact, working with a trainer on a one-to-one basis can actually change an individual’s attitude toward fitness, helping to increase their physical activity (2). 

C. Strength training is seeing its time in the limelight. While people, particularly women, sometimes shy away from the lifting weights by themselves or even with a trainer in a gym or at home, strength training is critical to keeping our bodies healthy, especially as we age. It helps preserve muscle mass and increase your metabolism to burn more calories even when you aren’t working out. It also helps develop and maintain strong bones - by stressing your bones, strength training can increase bone density and reduce the risk of osteoporosis (3). One study found that in 10 weeks, inactive adults could see an increase in lean weight of more than 3 pounds and a reduction in fat weight of nearly 4 pounds, while increasing metabolic resting rate by 7 percent (4).

D. Exercise as medicine. We all know that food is medicine; well, it might be time to add to that, because exercise is medicine, too. The benefits of exercise go so much farther than how you look physically. From boosting happiness levels to reducing your risk of heart disease, exercising can help. Tossing and turning at night? Find yourself forgetting where you’ve placed your keys? That’s right, exercise is the answer. In fact, doctors are going so far as to prescribe exercise to patients in an effort to get them moving.

E. Nutrition or Exercise for Weight Loss. While nutrition and eating habits are more important to reach a body weight and shape you are comfortable with than just exercise (believe it or not!), fitness does play a key role in any comprehensive nutrition and weight loss program. What’s critical is finding a balance between workouts and healthy lifestyle activities that become a regular part of your day-to-day life. One study found that when participants thought of an exercise as pleasant, they had increased aerobic capacity and improved their physical health (6). And another discovered that incorporating laughter into physical activity programs for older adults improved their mental health, aerobic endurance and confidence in their ability to exercise (7). 

F. Benefits of Yoga. Yoga certainly isn’t new, but it’s just as popular as ever, for the body and the mind. And the benefits of yoga go far beyond the moment. It helps to decrease anxiety and stress, improves sleep quality, allows blood to flow through the body better, helps digestion and so much more. In fact, some argue, that practicing yoga changes your brain. It increases the “chill-out” neurotransmitter in your brain, a chemical that’s in low supply for people who suffer from depression and anxiety. It can also helps counteract chronic pain.

References

  1. Effects of aerobic and/or resistance training on body mass and fat mass in overweight or obese adults. https://www.ncbi.nlm.nih.gov/pubmed/23019316
  2. The Effectiveness of Personal Training on Changing Attitudes Towards Physical Activity. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3937569/
  3. Strength Training: Getting Stronger, Leaner, Healthier. http://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/strength-training/art-20046670
  4. Resistance training is medicine: effects of strength training on health. https://www.ncbi.nlm.nih.gov/pubmed/22777332
  5. The Exercise Prescription: a Tool to Improve Physical Activity. https://www.ncbi.nlm.nih.gov/pubmed/23174544
  6. Pleasant, Enjoyable Exercise has Health Benefits. http://www.unisa.edu.au/Media-Centre/Releases/190312/#.WJ8uGTsrLIV
  7. Laughter-based Exercise Program has Health Benefits, Study finds. https://www.sciencedaily.com/releases/2016/09/160915120524.htm

November-December 2016: Healthy Diet Trends in a Nutshell

Have you tried chips and pretzels made with hemp-seed and quinoa flour? Was your post workout snack maple flavored seaweed? Tried fermented foods like tempeh or kombucha? And what about cricket (yes, the insect) tacos? We are spending billions on so-called "out-there" foods as we expand our horizons and palates with an eye to improving our health. Below are some note-worthy dietary trends influenced by the need to be healthier and to work towards more balanced eating habits.

Organic sign.jpg

Organic food redux: now more than ever before, organic foods are "in", especially in the search for more nutritious and sustainable food sources. Sales of organic food posted a new record of $43 billion in 2015, up 11% from 2014 and far outstripping the overall food market's growth rate of 3%. Sounds huge, but bear in mind organic food accounts for a mere 5% of all foods sold in the US. The top organic categories? Fruits and vegetables., which make up 13% of organic food sales. Dairy is second biggest and fresh juices and drinks are the fastest growing with sales up to 34% in 2015 (1). 

Plant-based diets: for anyone living a vegan or vegetarian lifestyle, plant-based food is far more than a “trend” — it’s part of a fundamental philosophy. More and more people avoid animal foods, which are often cruelly produced in factory farms, environmentally devastating, and often unhealthy. In mainstream culture, however, animal products still dominate but the the good news is, consumers are gradually catching on to the importance of healthier, more sustainable foods (2).

This change in culinary preferences is revealing itself through data — the market for non-dairy products is skyrocketing; meat alternatives sales are expected to reach $5 billion by 2020; and more than 1/3 of consumers are open to plant-based products (3).

Nuts.jpg

The power of nuts and seeds: related to above, it takes significantly fewer resources to produce and transport plant-based snacks such as peanuts than animal-based products (though conventionally grown almonds are notoriously high for water use). In addition, nuts and seeds are a nutrient-dense great source of protein and healthy fats including omega-3 fatty acids, rich in essential vitamins and minerals. Chia and hemp seeds are still going strong. The value of imported hemp seed products for use as inputs and ingredients has increased more than six-fold since 2005 (2, 6).

Healthy fats: Fat have now shredded their devilish reputation. There’s mounting scientific consensus that the type of fat we eat is more important than the amount. So instead of low-fat, the focus is on healthy fats and on shifting the balance towards mostly unsaturated fats found in olive oil, fatty fish such as salmon, olives, nuts and seeds. In addition, research on the much vilified saturated fats, especially those derived from dairy like fats in butter and cheese (butter from grass-fed cows and organic unrefined coconut oil) show that saturated fat, in moderation, is better for you than margarine and other butter substitutes. And there is increasingly reliable evidence that carbohydrates from refined and ultra-processed sugars and while flour are more closely related to diabetes, obesity and heart disease than diets rich in certain fats (2, 4, 5).

Perhaps the biggest beneficiary of the healthy fats trend has been the avocado – chock full of monounsaturated fats. One avocado trend that rises above all others is avocado toast – smashed avocado on toasted bread, often sprinkled with hot sauce or topped with a fried or poached egg. The avocado and egg combination will continue to be big in 2017 – avocado egg salad, avocado deviled eggs and baked eggs in an avocado half. Other trending avocado recipes outside of the classic guacamole include baked avocado fries, avocado sushi, hummus, pasta sauce and salad dressing. 

Kind bars.jpg

Healthy snacks; snacks like kale chips and roasted chickpeas have been and continue to be increasingly trendy, in part due to consumer preference, and also because snacking accounts for over 50% of eating occasions. Many of my clients struggle with sweets in moderation and I usually recommend the least processed snack bars like KIND bars, that now have allergen-friendly options, and are 100% fruit and vegetable. Savory snacks are also a great substitute for conventional chips and fries - think pumpkin seed-kale-tamari snack pack or all types of roasted (not fried) chips made from various types of whole grains (think quinoa, spelt, buckwheat).

Clean food labels: the “clean” ingredient decks continue to be influential in how health-conscious consumers perceive products. Part of this trend includes “de-junking”. That is, reformulating a product that was not clean before and re-engineering it to get rid of artificial flavors and colors, reducing added salt and sugar content significantly while still having the product deliver the same or better experience than before. This is a huge challenge for the industry, but one can see food manufacturers accelerating the clean label trend and constantly innovating (6).

 Fermented tea

Fermented tea

Gut health: while not new, digestive health remains a “purchase driver globally”, especially as consumers better understand the role of digestion in overall health and wellbeing and how probiotics and fermented foods can aid them. In addition to lending dishes a unique, sometimes earthy and sometimes acidic flavor, fermented foods can play a role beyond digestion and metabolism. That is, there is increasing evidence pointing towards the gut-brain connection where healthy gut bacteria (microbiota) have been show to affect ones mood, sleep, and stress levels (7). To get in on this hot trend, try replacing your tofu with tempeh, snacking on kimchi, enjoying a bottle of refreshing kombucha, or adding flavor to your cooking with miso paste. And remember: sauerkraut is sexy! (6, 7).

 

 

References

  1. Organic Trade Association: https://www.ota.com/news/press-releases/19031
  2. IDEA Food & Nutrition Tips: http://www.ideafit.com/idea-food-and-nutrition-tips/2016/november.
  3. Plant-based food named top trend for 2016: http://latestvegannews.com/plant-based-food-named-top-trend-2016/#
  4. The case for eating butter just got stronger: http://time.com/4386248/fat-butter-nutrition-health/
  5. Eggs don't cause heart attacks - sugar does! http://www.huffingtonpost.com/dr-mark-hyman/sugar-heart-attack_b_4746440.html
  6. Health and wellness trends: http://www.foodnavigator-usa.com/Markets/7-trends-influencing-health-wellness-and-consumers-views-of-food
  7. Gut feeling: how your microbiota affects mood, sleep, and stress levels, Epoch Times, Oct 20-26.

September-October: Stigmatizing obesity

As a health and wellness coach and a personal fitness professional, I work with people of all shapes and sizes and have learned and continue to learn to recognize any biases I may have and address them.

Weight stigma, also called weight bias ("social devaluation and denigration of people perceived to carry excess weight) is extremely pervasive and unfortunately, still socially acceptable. Whats makes this really distressing is that it triggers vicious cycle of eating more and moving less, leading to unhealthy weight gain (Tomiyama, 2014, Vartanian and Porter, 2014).

Weight bias increases people's risk of physical (increased stress response and inflammation, chronic stress, mistrust towards health care providers, increased food consumption, difficulty with weight loss and further weight gain, etc), mental (binge eating, depression, anxiety, low self-esteem, poor body image, substance abuse, etc), and social (bullying, decreased attention and compassion in healthcare settings, etc) health threats, and it is probably most pronounced in the healthcare system. Many patients report that they feel disrespected, are not taken seriously, see all their medical problems blamed on weight and thus feel reluctant to discuss their weight with health providers. 

I think it is just as bad in the fitness industry, where clients who are overweight or obese may feel intimidated and unwelcome, the facility may not have appropriate equipment for their body size, and fitness trainers may be judgmental.

To fight these tendencies, fitness professionals and health coaches like me, or anyone in the healthcare industry, need to more closely address their biases and beliefs about obesity. Weight bias happens because people often think obesity reflects a lack of willpower and poor choices. People assume that achieving a healthy weight is simply a matter of eating less and moving more. However, there is strong evidence pointing to several interrelated factors that influence weight gain, from the social, cultural and psychological, to genetic, metabolic and hormonal (Girgis, 2016).

 Factors related to obesity

Factors related to obesity

And the research evidence paints a more complicated picture related to our biases:

1. Assumption: Behavioral changes, willpower and motivation will cure obesity. Reality: obesity can never be "cured". While behavioral changes can help with weight loss and getting healthier, many people with obesity find it close to impossible to achieve and maintain an "ideal" body weight. Even so, they may have a healthy metabolic profile and high quality of life.

2. Assumption: Obesity happens because of factors within our control, like overeating and lack of exercise. Reality: Obesity is the outcome of genetics, biology, food intake, and energy expenditure. While personal choices do affect weight, other factors may have more of an impact on weight. Thus, we need to pay as much attention to social and environmental causes as we would to personal choices.

3. Assumption: Telling people that obesity puts them at risk of several diseases will motivate them to eat less, exercise more, and achieve a healthy weight.  Reality: on the contrary, this fear associated with highlighting the health risks of obesity can lead to a feeling of being stigmatized. In fact, this approach of stigmatizing obesity harms rather than helps positive behavior change, it decreases self-worth, and may lower self-control and increase risk of binge-eating.

4. Assumption: Obesity causes serious health problem. Reality: The health profiles of people with obesity vary considerably. A person whose body mass index is well above average but who is physically active and has lost 10% body weight may still be considered obese, but may actually be much healthier than a sedentary person of normal weight. Some researchers suggest that much of the pathophysiology of obesity may be due not only to excess weight but also to psychological stress induced by weight stigma (Muennig, 2008).

So how can people, especially professionals in the healthcare and wellness field, overcome weight biases? Here are some suggestions:

  1. Change our behavior: empathy is crucial for helping clients achieve their health and fitness goals. Build empathy by being more aware of your biases and taking conscious steps to identify with and understand your clients' feelings and motivations. And while working with clients, focus more on health-promoting behaviors such as physical activity and healthful eating, rather than dwelling on weight or numbers on a scale.
  2. Empowering clients: make them feel comfortable and welcomed by establishing trust and building confidence in the clients' ability to succeed (self-worth or self-efficacy is arguably the most important predictor of whether a person will sustain behavior change). 
  3. Use positive images and language to root out stigmatization: avoid using before and after weight loss pictures, words such as fat, obese, diet and exercise, or pictures of overweight people engaged in "lazy" behaviors (watching TV and eating junk food). These images tend to increase "fat phobia" scores in studies and worsen weight bias (Pearl et al, 2015). Instead, use words like overweight, increased BMI, unhealthy weight, healthier weight, eating habits and physical activity.
  4. Introduce clients to mindfulness techniques: research around mindful awareness techniques has shown that when people distinguish between emotional arousal and physical hunger cues, the negative effects of weight bias were reduced, including binge eating and emotional eating (O'Reilly et al, 2014). 

Ultimately, we are all probably guilty of weight bias, often without even realizing it. Becoming more aware of our biases and taking firm steps to unlearn them goes a long way towards turning things around. Overcoming weight stigma may well be the key to helping people with obesity embrace the eating habits and activities that are most likely to contribute to a long and healthy life. That's much more vital than any number on a scale.

REFERENCES:

  1. Tomiyama, A.J. 2014. Weight Stigma is Stressful: A Review of Evidence of the Cyclic Obesity/Weight-based Stigma Model. Appetite, Nov: 8-15.
  2. Vartanian L. and Porter, A. 2015. Weight Stigma and Eating Behavior: A Review of the Literature. Appetite, Volume 102, July 1: 3-15. 
  3. Girgis, L. 2016. Causes of Obesity: It is not just the Calories. March.
  4. Muennig Peter. 2008. The Body Politic: the Relationship between Stigma and Obesity-associated Disease, BMC Public Health, 8:128.
  5. Pearl et al, 2015. Differential effects of Weight Bias Experiences and Internalization on Exercise among Women with Overweight and obesity. Journal of Health Psychology, Dec 20 (12): 1626-32.
  6. O'Reilly et al. 2014. Mindfulness Interventions for Obesity-related Eating Behaviors: A Literature Review. Obesity Review, June 15 (6): 453.61.

July-August 2016: Easy-to-follow Nutrition & Weight Management Tips

We are neck-deep in opinions about the best ways of eating for health and weight management. There is no end to the internet chatter and quick-fix advice on how to win the healthy eating and living "battle of the bulge". You must have heard about the gluten-free craze to lose weight, the juice cleanses that flush toxins out and help you lose excess body-fat weight, or coconut oil as a miracle food that boosts metabolism and helps you lose weight. But are these tips going to be sustainable and help you in the long term? I doubt it! 

With all this dubious and often conflicting advice, you have a right to know about simple and effective ways to healthier eating and managing weight, that don't involve anything as draconian as ruling out chocolate (albeit sticking to raw chocolate or to dark chocolate that is more than 70% cocoa is advisable). So if you are aching for some basic, pretty reliable, researched advice, this is what I am offering below.

1. Drink water before dining: sugary drinks do nothing for ones diet or weight management, but kicking off a meal with a glass of water could play a role in healthy weight management. The benefits of water can likely be chalked up to the fact that it increases a feeling of fullness, making it easier to regulate food intake at mealtime (1).

Action point: consider the midnight bathroom break a minor inconvenience and start each meal with plain water or a mug of plain tea to encourage better portion control.

2. Eat more beans and lentils:  The United Nations calls 2016 International Year of the Pulses - a food group that includes beans, lentils, and peas. More than an inexpensive source of nutrition (especially plant-based protein and fiber that have lots of nutrients but relatively fewer calories, hence, they are nutrient dense and keep you full longer), they can help you get a legume up on weight management (2, 3).

Action points: make pulses an integral part of any eating plan. For example, take a lentil based salad to work; replace one meat-based dinner each weak with a bean-heavy dish such as bean chili; rely on legume-based dips and spreads like hummus for healthier snacking.

3. Resist clever branding: We have all fallen for slick food marketing (e.g, foods marketed as healthy and low-fat that are full of chemical additives and preservatives; foods advertised as "healthy" whole grain cookies and crackers that have minimal 'whole' grain ingredients; "organic" cake mixes that are marketed as being healthier than conventional cake mixes, but are packed with sugar and refined carbohydrates). In addition, psychologically, just the thought that one is eating healthier food could lead you to overeat (4) that particular food. Action Point: get into the habit of reading not just the nutrition label but more importantly, the ingredient list - which tells you where the fats, proteins, carbohydrates and sugars are coming from that on the nutrition label. The devil is always in the detail!   

4. Lighten up at night: Most people eat their biggest meal at dinner or they eat just an hour or so before bedtime. Research is showing that eating earlier may be better for weight management and weight loss (5). One study showed that those who ate more calories at breakfast and at lunch than at dinner had greater fat loss around their waistlines (6), which may be related to the fact that we burn more calories earlier in the day when our metabolism is higher, while later intake is more likely to go into fat storage.

Action point: a substantial breakfast can promote satiety and reduce risk of mindless snacking and overeating as the day progresses. Try and pack in your proteins and whole grains early on in the day and scale back on meals later in the day. 

5. Plan ahead: this is a big one, especially when eating out. Pre-ordering lunch online can encourage you to make wiser choices than just walking into a restaurant and ordering off the menu (7). In addition, selecting your order online than with a live server reduces the temptation of sensory cues (that smell of freshly baked bread or french fries) or the chances of being up-sold to say 'yes' when asked if you want fries or that chocolate molten lava cake.

Action point: while always better to prepare food at home,  using online menus can reduce risk of making unwise meal choices. Even if a restaurant does not deliver or take orders in advance, check out the menu online and make time to decide on the healthiest choices. And stick to your guns when you walk through that door. 

REFERENCES

1. Parretti, H. M., et al, 2015. Efficacy of water pre-loading before main meals as a strategy for weight loss in primary care patients with obesity. RCT, Obesity, 23 (9), 1,785-91.

2. McCrory, M.A., et al, 2010. Pulse consumption, satiety, and weight management. Advances in Nutrition, 1 (1), 17-30.

3. Tonstad, S. M., 2014. A high-fiber bean-rich diet versus a low-carbohydrate diet for obesity. Journal of Human Nutrition and Dietetics, 27 (Supplement 2), 109-16.

4. Suher, J et al, 2015. Eating healthy or feeling empty? Hw the "healthy = less filling" intuition influences satiety. Journal of the Association for Consumer Research. 1 (1). 

5. Bo, S., et al, 2014. Consuming more of daily calorie intake at dinner predisposes to obesity. A 6-year population-based prospective cohort study. PLOS One, 9 (9), e108467.

6. Jakubowicz, D., et al. 2013. High caloric intake at breakfast vs dinner differentially influences weight loss of over-weight and obese women. Obesity, 21 (12), 2,504-12.

 

June 2016: Gain some Fiber, Lose some Weight, and Improve your Overall Health

There is nothing more filling than healthy food fiber....it can be a great way to lose a few pounds without crash dieting or following any fad diets.

So, what is this magical stuff? Fiber is a carbohydrate, like starch and sugar, and it comes from plants. But unlike some refined, unhealthy carbohydrates that could raise blood sugar and cause metabolic imbalances, fiber is a healthy, wholesome carbohydrate. Humans don't have enzymes to digest most fiber, which is why it works wonders in our gut and helps regulate bowel movement.

There are two types of fibers - soluble and insoluble. The former forms a gel when mixed with water and puts the mushy 'goo' in such foods as oatmeal and lentils. It works like tiny brooms, grabbing cholesterol from digestive juices and sweeping it out of our bodies. Thus, this may lower cholesterol in blood. Broom-rich foods are beans, legumes, barley, pears, citrus fruit, and apples. The second type of fiber (insoluble) soaks up water like a sponge, speeding like a train through the gastrointestinal tract, making everything bigger and softer. Drinking plenty of water and exercising regularly will help considerably in moving the train forward. Such foods include bran cereal, oat bran, whole grains (spelt, farro, millet), and most fruits and vegetables. 

Great, but how does this help with weight management? Well, whole foods with lots of fiber take longer to eat and digest than processed and refined foods - an apple vs apple juice or a baked potato with skin vs potato chips, brown rice vs white rice -  and they often have fewer calories and harder to digest calories than per serving, which makes us feel full longer (although not as long as protein). An easy way to get more fiber, liquid, and protein in one meal is to have a soup or a stew that contains vegetables and beans, great sources of fiber and protein.

In addition to weight loss and heart health, fiber may also reduce the risk of chronic inflammation. Some research also links high-fiber meals to better, deeper sleep. (1) It may also help with other gastrointestinal disorders like gastro-esophageal reflux disease, duodenal ulcer, diverticulitis, and hemorrhoids (2,3).

If you decide to start eating more fiber, two quick tips - don't eat mountains of fiber suddenly.  Without adequate water, fiber can cause a train backup rather than speeding along. Also, colon bacteria love fiber but that produces gas that could cause some cramping and bloating. Its best to add 3-5 grams of more than your usual fiber per day - like an extra piece of fruit or serving of veggies - until you are averaging 25-35 grams of fiber.

And if all this doesn't convince you, think about this. Fiber, especially the kind found in beans and legumes (called "pulses" in some countries), might actually be trendy. The United Nations has declared 2016 as International Year of the Pulses. If that is not a shout out to fiber in all its glory, I don't know what is. 

References:

1. Dietary Fiber: Essential for a Healthy Diet. http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/fiber/art-20043983. 

2. Health Benefits of Dietary Fiber: http://www.ncbi.nlm.nih.gov/pubmed/19335713

3. Making Sense of Foods: Understanding Fiber. http://www.nutritionmd.org/nutrition_tips/nutrition_tips_understand_foods/fiber_benefits.html

February 2016: To B or Not to B: The Essence of B[12]eing

The eight B vitamins help the body convert food (mostly carbohydrates) into fuel (glucose), which is used to produce energy. Often referred to as B complex vitamins, they help the body use fat and protein; they are needed for healthy skin, hair, eyes, and liver; and they help the nervous system function properly.

B12, also called cobalamin, is known as a super B vitamin because it offers varied benefits, such as maintaining healthy nerve cells and helping in the production of DNA and RNA, the body's genetic material. Vitamin B12 helps iron work better in the body and helps B9, also called folate or folic acid, make red blood. Folate and B12 also work together to produce S-adenosylmethionine (SAMe), a compound involved in enhancing immune function and mood.

Having low levels of vitamin B12 in the body are rare because it stores several years' worth of B12 in the liver. However, decreases in B12 levels are common in the elderly. Also, because 10 to 30% of older people don't absorb B12 from food very well, people over the age of 50 should get their daily B12 requirement by eating foods fortified with B12 or taking a supplement containing B12. Other groups with low levels of B12 are HIV-infected persons, people with eating disorders, people with H. pylori (an organism in the intestine that can cause ulcers and inhibit B12 absorption), and people with nutrient-absorbing conditions like Crohn's disease, pancreatic disease, or the aftereffects of weight-loss surgery.

Low levels of B12 can cause a range of symptoms including fatigue, shortness of breath, diarrhea, nervousness, numbness, or tingling sensation in the fingers and toes. A severe deficiency of B12 can cause nerve damage.

Some evidence suggests that a B12 deficiency is related to age-related macular degeneration, breast cancer, and male infertility. However, the research is not conclusive, and the pathways of how this deficiency plays out in each of these conditions is unclear.

Dietary Sources

 Lamb Ragu

Lamb Ragu

Animal foods and fortified foods contain vitamin B12 in abundance. The richest dietary sources include fish, shellfish, dairy products, organ meats (particularly liver and kidney), eggs, beef, duck, lamb, and pork. Some people argue that vegetarians and vegans don't get enough B12. However, one's daily B12 requirement can easily be met through various vegan/vegetarian foods.

Nutritional yeast, such as Red Star Vegetarian Support Formula and brewers yeast, are excellent B12 vegetarian sources. Nutritional yeast can be added to roasted vegetables, soups, and baked dishes. It can even be sprinkled on salads for a more hearty flavor.

 Vitamin B12-Fortified soy-based foods

Vitamin B12-Fortified soy-based foods

Fortified foods made from wheat gluten (seitan) or soybeans (tempeh and tofu), fortified breakfast cereals and energy bars (check the ingredient list to make ensure they are not loaded with added sugars and sodium), and fortified soy and almond milk contain many of the essential B vitamins. If taking B12 as a multivitamin, check the nutrition label or the ingredient list to ensure you are receiving the active form of B12: cobalamin or cyanocobalamin.

Precautions

Because of possible side effects or interactions with medications, you should take dietary supplements only under the supervision of a knowledgeable health care provider.

Taking a single B vitamin for a long period of time can result in an imbalance with other important B vitamins. For this reason, you may want to take a B complex vitamin that contains all eight B vitamins. Taking folic acid (B9) at high doses can help lower a vitamin B12 deficiency, so these vitamins are often taken together. Talk to your doctor before taking more than 800 mcg of folic acid.

IMAG0549.jpg

People with abnormal levels of red blood cells or abnormalities in their red blood cells should work with a physician to determine whether B12 is appropriate for them. In some instances, it can be beneficial, while in other conditions, it can be harmful. Again, work with your physician.

Possible Interactions

If you are currently being treated with any medication that reduce levels of vitamin B12 in the body, you should not use B12 supplements without first talking to your health care provider.

These types of medications include the following:

  • Anti-seizure medications

  • Chemotherapy medications

  • Medications for treating gout, especially Colchicine

  • Bile acid sequestrants used to lower cholesterol

  • H2 blockers and Proton pump inhibitors used to reduce stomach acid

  • Medication taken for diabetes

  • Antibiotics, Tetracycline

Vitamin B12 and other B vitamins should not be taken at the same time as tetracycline because they interfere with the absorption and effectiveness of this medication. In addition, long-term use of antibiotics can lower vitamin B levels in the bodyparticularly B2, B9, and B12and vitamin H (biotin), which is considered part of the B complex vitamins.

References

  1. Vitamin B 12 Overview. University of Maryland Medical Center.
  2. Vitamin B12, Mayo Clinic.
  3. Vitamin B12 in Vegetarian Diets, Resources for Consumers, Academy of Nutrition and Dietetics.
  4. Vitamin B12: A Simple Solution. Physicians Committee for Responsible Medicine.
  5. Vitamin B12 in a Vegan Diet. The Vegetarian Resource Group.
  6. Vegetarian Vitamin B12 Sources and List of Sources. OldWays: Health through Heritage

January 2016: Iron-deficiency Anemia? Deal with it fast before it rusts!

“Do not wait to strike while the iron is hot – but make it hot while striking” –William Yeats

I was recently diagnosed with having iron-deficiency anemia, which came as a surprise to me given that I eat well-balanced, healthy foods and exercise regularly. I also did not have the classic symptoms associated with being anemic, such as weakness, dizziness, and fatigue. However, I know this deficiency is something that can be resolved easily, even if it will take time. So I did some research to find better ways to improve iron uptake and, more importantly, one's capacity to absorb iron, through food as well as supplements.  

The Centers for Disease Control and Prevention defines iron deficiency anemia as an iron deficiency with a low hemoglobin value, typically less than 120 g/L. It is characterized by red blood cells being small because of a lack of hemoglobin (a protein molecule in red blood cells that carries oxygen from the lungs to the body's tissues and returns carbon dioxide from the tissues back to the lungs). An iron deficiency is not the only cause of anemia, so multiple measures of iron status should be taken to determine if anemia is truly the result of an iron deficiency. Although several dozen types of anemia exist (including anemia caused by low vitamin B12 levels), in this article “anemia” refers specifically to iron deficiency anemia.

Iron deficiency anemia is one of the most common mineral deficiencies in North America and in other parts of the world, but for different reasons. In America, it often results from “under-nutrition”—that is, eating unhealthy, refined, and highly processed foods with little nutritional value but with a high caloric content—while in several parts of the developing world, it often results from malnutrition and poverty. The relationship between food and nutrition gets even more complicated when combined with poor or limited food choices caused by the lack of access to and the affordability of iron-rich foods.

How do you know if you have sufficient iron in your body? Did you know that iron deficiency anemia can make you tired, weak, and irritable; lower your immunity; lead to hair loss; and compromise mental sharpness? It’s time to understand the benefits of iron, the best ways to get it from your diet, and, most importantly, how best to absorb the iron you consume.

Benefits of Iron

  1. Iron is crucial to delivering oxygen to every cell in the body. It is stored in the liver, bone marrow, spleen, and muscles, and it serves as an essential component of various metabolic processes that occur in the body.

  2. Iron in the diet may help reduce fatigue after exercise. Iron carries oxygen to the body’s cells through the blood; thus, iron plays an important role in energy production and muscle function. Inadequate levels of iron in the body may hinder muscle endurance, increase fatigue and cause the muscles to tire more quickly.

  3. Iron in the diet is especially beneficial for the health of T-cells and the ability of white cells to consume bacteria. It has pro-oxidation properties that the immune system needs to fight off harmful bacteria, which can help prevent infection and increase ones immune responses.

  4. Iron is required for DNA synthesis.

  5. Some evidence also shows that adequate levels of iron in the red blood cells may help prevent certain types of cancer and peptic ulcers.

Sources of Iron

Dietary iron comes in two forms: heme and non-heme. Heme iron is derived from hemoglobin. It is found in animal foods that originally contained hemoglobin, such as red meats, fish, and poultry. Non-heme iron is from plant sources.

Your body absorbs the most iron from heme sources, so if you are vegetarian or vegan, you may think it is hard to get an adequate amount of iron from food. But you can get an adequate amount of iron by eating the right plant foods and, more importantly, using ways to absorb iron efficiently from plant sources (see below). In fact, no conclusive evidence shows that vegetarians or vegans are more or less likely to be iron-deficient or anemic.

Some of the best plant sources for iron are

  1. Legumes: lentils, soybeans, tofu, tempeh, lima beans

  2. Grains: quinoa, fortified cereals, brown rice, oatmeal

  3. Nuts and seeds: pumpkin seeds, pinenuts, pistachios, sunflower seeds, cashews, un-hulled sesame seeds

  4. Vegetables: tomatoes, Swiss chard, collard greens

  5. Other: black-strap molasses, prune juice

Best Ways to Absorb Iron from Foods or through Supplements

  1. Eating iron-rich foods with foods that contain vitamin C may increase the absorption of iron by as much as five times. The iron in beans, grains, and seeds is better absorbed when combined with the vitamin C found in fruits and vegetables. Some common dishes already combine iron with vitamin C: beans and rice with salsa, falafel with tomatoes and cucumber, and hummus with lemon juice. Even better, some iron sources, like leafy greens, broccoli, and tomato sauce, already contain vitamin C.

  2. Coffee (even decaf), cocoa, and some green and black teas contain polyphenols, which include tannic acid, which inhibits iron absorption. It is best to avoid these foods an hour before or two hours after your meal. However, a study found that in the presence of a large dose of tannic acid from food, 100 mg of vitamin C increased iron absorption from 2 to 8%.

  3. Cooking food in a cast-iron skillet increases the iron in your meal, especially when you cook foods that contain vitamin C in it.

  4. Spinach contains oxalates that may block absorption, especially if spinach is eaten raw. Blanch or lightly saute spinach to decrease the negative effect of oxalates on iron absorption. Not all research agrees on this, but rather than eat only spinach, why not try some of the other iron-containing plant foods?

  5. Phytates, found in legumes and grains, can inhibit the absorption of plant iron. But soaking them for 4-6 hours (or overnight) may help minimize the negative effect of phytates on iron absorption. Some studies found that adding 50 mg of vitamin C to foods containing legumes and grains counteracted the phytate effect and adding 150 mg of vitamin C increased iron absorption to almost 30%.

  6. Calcium supplements can inhibit iron absorption if taken with meals.

  7. Regarding an iron supplementation, you should follow the above advice and take the supplement 20-30 minutes before a meal and preferably with some orange juice.

REFERENCES

  1. Iron-rich foods. WebMd.com, 2014.
  2.  Iron. VeganHealth.org
  3. Benefits of Iron in the Diet. Livestrong.com, 2015
  4. What every vegetarian needs to know about Iron. Nomeatathlete.com

November 2015: Dessert Season is upon us!

Tofu-Dark Chocolate Pudding: 10 minute dessert for 5-6 people

INGREDIENTS

1 cup (6-7 oz) semi sweet or preferably bitter sweet chocolate chips

1 (14 oz) Silken Tofu

2 tbsp almond or soy milk (only if using Firm Tofu)

1 tsp. Pure vanilla extract

¼ tsp. ground cinnamon

1/8 tsp nutmeg (optional)

2 tbsp honey or maple syrup (optional: add only if you like dessert to be really sweet vs more like bitter-sweet chocolate)

Pecans and raspberries as toppings (optional)

METHOD

    1. Melt chocolate chips in a double boiler (or just put it in a small container held over another larger pot with simmering water and stir continuously till melted).

    2. Add this into a food processor or blender and then add in the rest of the ingredients.

    3. Puree together until smooth. Pour into 4 separate small bowls or one medium bowl. Cover and refrigerate for at least 2-3 hours to allow it to firm up and to let the flavors meld together.

    4. Top with raspberries and pecans, or fruits and nuts of your choice. Enjoy!

    NOTES:

    1. After draining any excess liquid from the tofu, place it on a few paper towels or a clean dishcloth and press gently for 1-2 mins, to drain any left-over moisture. 

    2. Use a mix of semi-sweet and bitter sweet chocolate chips for a richer, more chocolatey taste. Adjust the honey/maple syrup accordingly. Use 2 tbsp if you add in bitter-sweet or unsweetened chocolate but you don't really need any if you are using only semi-sweet chocolate chips.

    NUTRITION FACTS Per Serving: Calories = 212; Fat = 11g (6g Sat Fat); Sodium = 60 mg; Potassium = 50 mg; Carbohydrates = 30 g; Sugars = 20 g; Protein = 7g

    October 2015 Newsletter: Never too late to go against the grain!

    What are the key differences between “refined” grains and “whole” grains? Is a box of Cheerios or Lucky Charms that has “whole grain” stamped on the box a “whole grain” cereal? Is instant oatmeal a whole grain? Is a commercial loaf of bread that says “whole grain” on the label truly whole grain?

    If you answered “yes” to any of these questions, think again.

    Most grain contains inedible chaff (fed to animals), bran (the oil-rich outer layer), germ (the grain seed's nutrient-rich embryo), and the endosperm (the starchy center). Under the FDA's definition of whole grain, a grain is still “whole,” even it has been milled and separated into its three edible constituents (bran, germ, and endosperm), as long as those constituents are later mixed back in in proportions similar to the intact grain.

    This fluid definition enables the food industry to make “whole grain” products that taste — and act — nothing like whole grain. Thus, a serving of less-processed steel-cut oats with raisins may be more healthful than a serving of highly processed, oat-based Lucky Charms or Quaker Oat Squares. Unfortunately, FDA-required labeling does not explain this distinction to consumers who eat the boxed cereal believing it will provide them with three daily servings of whole grains.

    What constitutes a “daily serving” of whole grains? The amount you need varies based on your age, sex, and physical activity level. In general, adults need between 5- and 8-ounce equivalents of grains each day, and at least half (if not all) of these are recommended to come from whole grains. As a gauge, a 1-ounce equivalent equals 1 slice of bread, 1 cup of cereal, or 1/2 cup of cooked pasta or rice.  

    Grains are classified as whole, enriched, fortified, and milled (refined), which are defined as follows:

    • Whole grains are cereal grains that contain the germ, endosperm, and bran (as opposed to “refined” grain, which retains only the endosperm). These unrefined grains haven't had their bran and germ removed by milling. When buying grains and grain products, check the ingredient list the ensure the word "whole" precedes the grain, such as "whole wheat flour." Ideally, the whole grain will be the first ingredient in the list, indicating that the product contains more whole grain than any other ingredient.

    • Enriched grains have had some of the nutrients lost during processing added back in. The B vitamins are often re-introduced to “enrich” the grains, but the lost natural fiber cannot be added back in. Enriched grains are common in the average American diet.

    • Fortified grains have had nutrients that don't occur naturally in the grains added to them. Most refined grains are enriched, and many enriched grains are also fortified with other vitamins and minerals, such as folic acid and iron. Some countries require certain refined grains to be enriched. Whole grains may or may not be fortified.

    • Milled grains (refined grains) are stripped of their bran and germ to give them a finer texture and extended shelf life. Milling also removes most nutrients, including fiber. Whole grains are better sources of fiber than refined grains and contain several important trace minerals, such as selenium, potassium, and magnesium.

    In the US, many people eat mostly refined grains or refined grain products, such as white bread, white pasta, and white rice. Many commercial products, like breakfast cereals, crackers, desserts, and pastries, are also made with refined grains.

    Naturally, there are plenty of healthier choices to explore if you are interested and open-minded to trying new, heartier, and healthier grains and pseudo grains.

     Clockwise from left background: spelt, wild rice, kasha, quinoa, & amaranth

    Clockwise from left background: spelt, wild rice, kasha, quinoa, & amaranth

    10 ways to incorporate more grains into your diet

    1. Experiment with small amounts of a new grain each week. Add a new grain as a side dish to your main dish. For example, quinoa (a pseudo grain) is wholesome and filling. High in protein and gluten free, it tastes delicious combined with cherry tomatoes, avocado, salad greens, and herbs (basil or oregano works well). Even mixed with just some herbs, olive oil, salt, and pepper, quinoa tastes great!

    2. Substitute white rice with barley, bulgur, spelt, or farro. Hearty and filling, a little of these grains goes a long way to keeping you satiated for a long time. (½ cup of them uncooked serves 2 to 3 people.) However, these four grains contain gluten.

    3. Substitute kasha (buckwheat), a gluten-free grain, for white rice. Much more nutritious then white rice, kasha is hearty enough to stand up to spicy Indian food. Kasha also works well in grain salads. Cook and combine it with arugula, sauteed mushrooms, roasted red pepper, and roasted pine-nuts for a tasty nutrient-dense salad. Chopped up and lightly sauteed tofu, seitan, or tempeh is a great protein addition to such salads.

    4. Add barley and wild rice to casseroles and soups, such as mixed vegetable soup, mushroom soup, or chicken soup.

    5. Substitute whole wheat couscous for refined couscous in salads.

    6. Add whole grains, such as cooked brown rice or whole-grain bread crumbs, to minced tofu, tempeh, meat, or poultry for extra body.

    7. Use rolled oats or crushed whole-wheat bran cereal in recipes instead of dry bread crumbs.

    8. If you make pureed lentil soups, add cooked barley, spelt, or quinoa at the end to give it a more chunky taste and look and more added nutrition.

    9. Add whole grains to your baked goods. Instead of using the full amount of all-purpose flour in a recipe, use half of the required amount mixed with an equal amount of whole wheat flour. For example, when a bread recipe calls for 2 cups all-purpose flour, use 1 cup all-purpose and 1 cup whole wheat. You can also use white wheat flour instead of “brown” whole wheat. Another option is to replace one-third of the flour with whole-grain oats.

    10. Expose your kids to whole grains at an early age. Try whole-wheat pitas as crusts for make-your-own individual pizzas. Use white whole wheat flour in baked goods, and incorporate whole grains such as quinoa into foods that have other flavors, such as black bean soup. Serve burgers on whole-grain buns or or a bed of whole grains. Serve brown rice instead of white rice with sauteed veggies.

    References

    1. Whole grains: Hearty options for a healthy diet. Mayoclinic.com. 

    2. Tips for reaping the benefits of whole grains. WebMd.com. 

    3. Whole grains, half truths, and lots of confusion. Mother Nature Network.

     

    September 2015 Newsletter: Vegetarian Sources of Protein - Seek & You Shall Find!

    A vegan diet takes being vegetarian to a whole new level. It excludes all animal products, including fish, eggs, and milk, even dairy foods like yogurt and cheese. It’s basically eating only things that come from plants – fruit, vegetables, seeds, pulses, nuts, beans, and grains. But if you think a vegan diet leads to an imbalance in macro-nutrients, especially protein, think again. Some athletes who have adopted a vegan diet actually perform better than ever because they know how to eat a “balanced” diet.

    A “balanced plate” concept applies to all diets and requires people to consume food from each of the four food groups – proteins, fats, carbohydrates, and fiber – during any typical meal. The balanced plate concept also applies for vegans.

    Foods from the protein food group are vital for the growth and repair of muscles and for brain development. The US CDC says the minimum requirement of protein for sedentary teenage boys and adult men is 52-56 grams per day while the minimum requirement for sedentary teenage girls and women is 46 grams per day and at least 25 grams more if pregnant or breastfeeding. However, physically active people need an additional 20-50 grams of protein per day, based on their level of activity.

    Since vegans do not eat animal products, they must find other sources of protein-rich foods to meet these daily requirements, such as beans, nuts, seeds, and lentils.

    Amino acids are the building blocks of protein, but some of the essential amino acids that people need cannot be produced by the body so they must be obtained from food. The protein in meat and fish are classed as complete proteins because they contain sufficient amounts of all the essential amino acids. However, the proteins found in beans, nuts, and seeds lack the full range of necessary amino acids.

    This isn't an issue for vegans as long as they consume several different protein foods that contain different profiles of amino acids to provide the body with what it needs. Aside from being great sources of protein, seeds, pulses, nuts, beans, and grains offer plenty of other nutritional benefits from the many vitamins and minerals they contain.

    Check out the nutritional benefits in some of these vegetable proteins:

    Beans & Lentils

    Beans are a great source of protein and fiber and are naturally low in fat. For example, butter beans (or lima beans) and red kidney beans contain 7.5 to 8 grams of protein in just half a cup. By varying the types of beans and lentils you eat, you can easily get at least half of your recommended daily protein requirement. Lima beans are also a good source of manganese, which makes and activates some enzymes that are critical for the normal functioning of several organs, while kidney beans are a significant source of phosphorus, which combines with calcium to form strong bones.

    Nuts

    Nuts are a staple in the diet of many vegans. Just a handful of nuts packs a powerful punch of proteins, minerals, and vitamins, which all work together to affect your heart, your brain, and your waistline. Just 1 ounce a day can diminish inflammation and provide fiber, immune-boosting minerals, and 5-10 grams of protein. Most nuts are also a great source of potassium, which is necessary for lowering the risk of high blood pressure. Nuts get a bad reputation because of their high fat content, but if eaten in moderation, they are good fats (unsaturated fat) and can help lower blood cholesterol. The daily recommended serving is 1-1.5 oz or 2 tbsp of nuts, which equals about 22-50 nuts, depending on the type and size.

    Seeds

    Seeds such as sunflower, sesame, pumpkin, flax, and chia are great sources of protein, fats, fiber, vitamins, and other nutrients. For example, just 2 tablespoons of chia and sesame seeds provide fiber, calcium, manganese, and magnesium as well as 5 grams and 6 grams of protein, respectively. Seeds are versatile ingredients that can be used in stir-fries, smoothies, soups, and salads.

    One of my favorite vegan dishes that can be made in several different ways is this chickpea-lentil stew. I often make a large batch that can be eaten over a few days with quinoa, farro, spelt, millet, brown rice, or barley. I sometimes even add tofu to increase the protein content exponentially. You can get the recipe from my website. Click here.

    References

    1. Diet and Nutrition Data. FastStats. CDC

    2. Detailed Nutrition Information for various Fruits & Vegetables.

    3. Emilio Ros. Health Benefits of Nut Consumption. National Institutes of Health. July 2010.

    4. Chris Gunnars. Eleven Proven Benefits of Chia Seeds. Authority Nutrition: An Evidenced-based Approach.

    5. Christi Wheeler. What are the health benefits of eating nuts and seeds? January 2015.