Archive for tag: nutrition

The Great Food Debate

I've been embroiled in a debate on different eating habits for a few weeks. It's been a heated debate. Information has been passed back and forth, but the science is a hard sell for those that don't know or understand it. I say, science, because it's not just the facts about Paleo, gluten-free, Mediterranean, or whatever eating patterns/diets, but about nutrition in general. It's about how our bodies handle food and what they need to be healthy.

There are a million and one (and probably more) "diets" out there. Right now, Paleo and gluten-free seem to be trending the most. Celebrities are using them to "get healthy." People are using them for weight loss or to control the symptoms of one disease or another. Some are using them to lower their inflammatory levels. But few seem to know the actual science behind any of it.

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Image source: www.towelmate.com

I'm admittedly biased. I've been a diagnosed Celiac, and gluten free for 16 years. The more information that I learn about grains, etc. -- the more I'm glad that I don't eat gluten. But the general public doesn't have the information that I have. In fact, it seems that most professionals don't either. But that's not the purpose of this posting.

When I started out writing this, I thought about my friend and how vehemently she adheres to her beliefs about "nutrition" and eating. She's a registered dietician. We've argued back and forth about grains, about how she thinks that Paleo/Mediterranean is bad for athletes, about how impossible it is to follow, and about how there's a lot of "false" science/claims about that particular eating pattern. The whole experience has been a major illustration on the adherence to beliefs that people have -- not just for her, but for me. It's also been an exercise in frustration.

I can only "recommend" what science (and anecdotal evidence -- but that's another story) shows to be true. For example, I can explain that zonulin destroys tight junctions in the gut, brain, and reproductive organs, and that the main sources of tight junction destroying proteins are grains and legumes. I can quote studies all day long (and all night long) -- and I have. I can distill the science down to very simple words that anyone could understand by using pictures, analogies, and more broad terms. I can do all of these things, but that doesn't mean it's going to change anyone's mind, and it also doesn't mean that they're going to be willing to put it into practice.

We're very steeped in our beliefs. Usually, those beliefs have absolutely nothing to do with evidence. My friend, for example, focuses on athletes and sports nutrition. The concept of carb-loading with pasta or the use of sports drinks is very much a part of her reality. She's concerned about having energy available for use. She's not concerned about inflammation, overall health and well-being, the prevention of disease, or whether or not someone might develop cancer or an autoimmune disorder. She wants to run marathons, or play 4-hour-long matches. Her reality and mine are very, very different. Chances are, that no matter what I say or provide her with, she will always adhere to her thoughts about nutrition. It will always be about the quick fix. My hope is that she'll come across a difficult case and be forced to broaden her concept of what healthy eating is.

Patients aren't any different. Some may have more or less information than my friend. They may be coming in with a copy of some new fad diet book, or a cookbook of recipes that their Aunt Sally said worked really great to help her lose weight. People may walk into the office carrying a well-worn copy of the all-carrot diet, asking what to do about their increasingly orange skin. They'll be emphatic about drinking their diet coke, eating their bowl of pasta, or consuming 3 Tablespoons of apple cider vinegar before every meal.

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Image source: msmomofosho.wordpress.com

It will be our job to walk them through their questions, hopefully bring some experience and education to the table, and talk them through ideas and possibilities that will help them find some form of healthy, sustainable ground. They may resist with everything that they have in them. As I write this, I'm thinking about how much I struggle with sugar or eating rice, and how hard it has been for me to give them up; I'm not there yet. It's our job to work with them, using their limitations (even if those are beliefs), and our education to help them get to someplace healthier.

My friend and I will probably continue to argue about what we should or shouldn't be eating. The only thing we've been able to agree on so far, I think, is that there's no one single "right" way. There's no perfect way that everyone should be eating. We're all human, and each body is different. The science may figure out that everything we "know" is wrong, and everything must be changed. I may never be able to fully give up sugar or rice. But whatever happens, we'll all hopefully be happier and healthier because of what we learn -- about food, about our relationship with it, and our relationships with each other.

Have a great week, everybody.

Food for Thought

Surely you've heard the phrase: "Eat to live, not live to eat." It seems that our relationship with food is extremely complicated. It turns out, it's not just our mindset right now, but also every attitude that we've had about food from our childhood that affects how, what and why we eat. Did you ever make cookies with your grandmother, or have a special birthday dinner? Was there some treat that you only had on special occasions? Did you go trick-or-treating for Halloween? Unless we've somehow managed to avoid all of those things, food has become a reward and measure of comfort in our lives.

Of course, there's nothing wrong with this. But we have to be aware of it. As we go through our lives running crazy, working ourselves ridiculous hours, studying, going from obligation to obligation, taking on way too much, it's really easy to seek consolation in our food.

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Of course, there's more to it than that. Eating these things ignites reward chemistry in our brains. Dopamine is produced leading to the sensation of pleasure. Serotonin, which most people recognize as the hormone affecting depression, is dramatically affected. In fact about 95% of the serotonin is produced in the gut. This not only regulates how much food we eat, but how we feel about how much food we eat. It has direct impact on our mood about food.

There are other, seemingly less interesting, hormones involved with food intake. Leptin, produced in adipose tissue, regulates food intake and fat storage. Deficits or defects in it lead to overeating. Another hormone, CCK, which is released from the small intestine while you eat, provides negative feedback about the quantity of food. Deficits in it (or damage to the small intestine) lead to overeating. Ghrelin, insulin, cortisol, and glucagon are also involved. *Whew!*

You see, we treat food as medicine, not just because of the hormones it induces, but because of the nutrients it provides. We can use food to medicate or nourish our bodies.

We need those nutrients to live. They provide the building blocks of everything that we are, the chemicals that sustain us, and the energy that keeps us going.

I've been doing some reading (in all my spare time) about the psychology of eating. It turns out there's a whole Institute for the Psychology of Eating. I've been exploring the ideas of why people eat; how much food we really need to live; and how we can nourish ourselves body/mind/spirit without overindulging. The topic itself is absolutely fascinating, and challenging in ways beyond all of the science.

It's food for thought.

Everybody have an amazing week!

For more information on the psychology of eating and hormonal control of eating, check out:

Busy Week

This is one of those times when writing the blog is tough, because I can't remember all of the things I've done over the last week! I'm to the point where I'm keeping daily lists so things don't fall through the cracks. There's just so much to do and so much to study for.

Last week I had 2 exams, and this coming week, 2 exams and 2 quizzes. Next week (brace yourself), there are 5 exams. I've always wondered why we do things this way. Five exams in one week are too many. It's just as if it were finals. But, here we are.

I was able to join some of my classmates out on Friday night. It seems that a good time was had by all. We were able to meet some of the first trimester folks that I'd missed from the First Tri Mixer. They all seem really great. One of the drawbacks to the way our campus is set up here is that the students are spread out to four different places. We have the basic science students in one location, the clinical science students in another, and the interns in two different clinic locations. So, once someone crosses over into a different area, we don't always see each other again--unless we make an effort to do so. So that's why the mixers and impromptu get-togethers are really important. It gives us a chance to meet some of the other students from different locations.

I like how cohesive our group is in particular. I've mentioned this before, but we really do become somewhat of a family. After all, we spend five days a week, together, ALL day. If we don't love or hate each other by the end, there's something wrong. Those that have joined our original four members have been welcome additions. And of course we miss those that have left us--whether they transferred campuses to Lombard, or decided to slow down. Most of my original class is now in the same building. It's good to see them every day again. I've missed them.

As if I didn't have enough going on, last week, I started the Master's Degree in Human Nutrition and Functional Medicine through the University of Western States. The program is all online and we have students from literally all over the world. The program there is a wonderful complement to the program here. Since my goal is to have an integrative, functional medicine practice, it's a great fit for me. My goal is to complete the master's about the same time I finish here at National. I'll let you all know how that's going.

Time management and prioritizing are absolutely key to maintaining some semblance of sanity with all this coursework. I'm not sure I'm there yet--but I'm working on it. Of course, anyone that knows me knows that I'm at least partly insane, so I must have lost something somewhere. Calendars, schedules, lists, planning, and keeping track of everything that has to be done is extremely important. On top of that, checking all of those things off the list is extremely fulfilling. I have to remember to ONLY put things on the list that HAVE to be done--no lofty ambitions, week-long projects, or 5-year goals. My lists sometimes get out of control--admittedly, and sometimes they end up with the weirdest, most random thoughts written on them--like philosophical questions. And THAT could go anywhere. :)

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(Image source: redlandrambles.wordpress.com)

I took a few minutes out of studying on Saturday to go to a ROOTS seed and plant share event. We grew a lot of our own food when I was growing up, and as I've had space, have tried to do the same off and on. Now that I have some yard space, I'm working on it again. Let me just say that this event was absolutely amazing.

People from the local area bring seeds they've collected, cuttings, plants, trees--you name it--and they just give it away. I took some Aloe seeds that my plant had put out last year. I'd been saving them for quite a while. I honestly didn't even know that Aloe seeded; I'd only seen people plant Aloe by cutting. The Aloe plant that produced the seed was gifted to me a few years ago from a fellow student, so it only seemed fitting that I gift its progeny. In return, I was gifted pumpkin seeds, stevia seeds, loofah seeds, and heirloom squash seeds. I was hoping for loofah, but couldn't believe how much was there!?! A lady tried to send me home with a bag full of about 500 seeds! People were so generous. I'm eternally grateful, and hopefully my garden will be booming here in a couple of weeks. Since I've never had a fall garden before, I have no idea what to expect. We shall see.

Happy Studying and Organizing everyone! Have a great week!

It's Springtime, Right?

Well, you wouldn't know it by looking outside. We've had a few really nice days, but it's expected to be in the 50s one day this week. It's almost April! What is going on? I know everybody up in the Midwest has had snow. I just keep looking out the door bewildered and checking the Weather Channel on my phone. I never know what it's going to be! Bundle-up or flip-flops, or my personal favorite, blue toes in flip-flops? We just take it day by day. 

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I thought for sure that I'd make it outside for something this weekend, but it didn't happen. I did, however, make a cameo at the Gluten Free Expo at the St. Petersburg Coliseum. Grey and I showed up about an hour before it was over, wondering if they'd have some great speaker at the last minute or some new revolutionary products. There were, of course, TONS of giveaways and coupons and brochures. I did grab a few business cards from vendors and talked to a health coach while I was there. 

I must say, though, that I was disappointed. While I'm grateful that I now have free snack fodder for the boys' lunches for the next month plus, I'm not sure how healthy it all is. There's just so much processing going into gluten-free products these days. Nothing they were giving away or selling was anywhere near simple or resembling anything homemade. 

I talked to a baker about Paleo cooking. She said that the biggest problem for them was cutting out the sugar. She wanted to substitute Stevia--which in some Paleo circles is forbidden (no artificial sugars or regular sugars). Although I'm not sure what other ingredients she was going to substitute, the sugar, I think, was the least of their worries. 

In Diet and Nutrition, Dr. S has been teaching us all the pathways and extolling the dangers of grains, sugars, and indirectly, processing. We've linked all these starches, Omega 6s, and sugars to everything from heart disease to Alzheimer's. Of course that doesn't make it all so easy to give up, but the argument is getting more and more persuasive. So I have to think--just because something is gluten-free, that doesn't make it healthy. Whether it's the canola oil, the high fructose corn syrup, or the ingredient that I can only dissect with a piece of paper and a chemistry textbook, it may still be gluten-free, but it's also a science/health experiment. I know for a fact, that gluten-free can still be simple. The more ingredients, the more likely that there might be a problem, and that doesn't work for anyone. 

I'm beginning to explore the ins and outs of the Paleo diet and trying to marry it with my own sense of nutrition. I suspect I'll be more restrictive in many ways than what the standards are. I still can't see/justify eating huge amounts of bacon. Something just doesn't seem right about that. I'm not sure whether it's the huge amounts of fat, the salt, or the nitrates. Yes, I know that all of those are available nitrate-free, but last time I checked--we were all students, yes?--I also know that I will never eat beef or eggs again. I think there has got to be a way to balance nutrition and our evolutionary developments with the limbic system. Otherwise, we'll all end up eating only 35 cups of Romaine lettuce with steaks wrapped in bacon. And between you and me, none of that sounds all that appetizing. 

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Last but certainly not least, I want to congratulate everyone on making it through midterms. We finally had our last one on Thursday. I'll spare you all the drama involved, but I know we are all extremely glad that that is over. I want to offer Dr. Ott my undying gratitude for being, perhaps, the coolest-headed professor I've ever come across. I must find for you, Dr, Ott, 5 million gold toilet stickers. You deserve them. (And if you want to know the story about the gold toilet stickers, you can email me). 

Everyone also deserves congratulations for making it through Mercury retrograde. Thankfully, Mercury went direct on St. Patty's Day--and not a moment too soon. I was tired of fixing everything, fighting and mediating fights, and just generally being in a funk.

Happy First Full Week of Spring to everyone and Happy Easter, Ostara and a Blessed Passover to all who celebrate.

This week's pictures are from Lake Maggiore--which is not far from my house. I was hoping to get some gators in there, but it was a bit too cloudy. If you enter through Boyd Hill and take the trails, I PROMISE you'll see some BIG gators. To my classmate Lauren, here's where you (don't) want to go. :) 

Living Gluten Free

On Easter, this year, while everybody's eating their dark chocolate Paleo-friendly bunnies (I like to bite the ears off first), I'll be celebrating 15 years of being gluten-free. It's hard to believe. "Back in the day", things were a whole lot different than they are now. It seemed that few people had celiac (or were gluten-free) or knew anything about it--including the professionals. The testing was different--biopsy and IgG anti-gliadin or anti-endomysial blood tests. The pre-made food was a lot harder to find (and surprisingly less expensive) and the education of the medical community was nearly non-existent. My how things have changed! There are sensitive and specific blood tests now (tissue trans-glutaminase), everything seems to have a gluten-free label on it, and docs--especially those in our profession, seem to know more and more about the benefits of going gluten-free.

My household has been gluten-free--exclusively--for the last 5 years. It's so important that the whole house be in support of the diet. For me, it was a no-brainer. Both Grey and I are Celiac, and Forest has never purposely had gluten. All the support groups stress how important it is to avoid contamination (and NOT cheat!). In order for a product to be considered gluten-free, it has to have less than 200 ppm of gluten.

For Celiacs, even small/accidental exposures are dangerous. People might not have an overt reaction to contamination amounts, but they might still cause sub-clinical symptoms--flattened villi, malabsorption, deficiencies, and constant damage to the GALT--leading to lymphoma and GI cancers. Yikes, right?! These small amounts can remain in cooking utensils, porous cooking pans, and shared equipment. So, after a major move and shift within the family, we started over with new utensils, new pots and pans, and a completely clean house. Other than the occasional poison-carrying visitor and the cats (whose food smell reminds me of wheat bread toast), we don't even allow lickable envelopes (Did you know that glue contains wheat?).

I can't begin to say how much of a difference going gluten-free has made in my life. Besides feeling infinitely better, I've experienced a number of benefits--from clearer thinking to better skin and hair (and most importantly, a happier gut!). For Grey, the benefits were a lot more dramatic. He was born at the 95th percentile, and before being diagnosed, dropped to less than 5th percentile. Of course, that was a long time ago--and now he's bigger than I am! 

I've been asked if I'd endorse a gluten-free diet. I absolutely would. I'm not so sure that I'd endorse all the pre-packaged foods being sold on store shelves right now. Processing is pretty much always bad. But, with all the research that's coming out about lectins, gliadin, and grains, it's making more and more sense for pretty much everyone to be gluten-free. So, I'll leave all of you with this: Educate yourselves about what you CAN put into your body--and what effects it might have. If you're not doing it for yourselves, do so for your patients. Remember that not all cases are textbook (in fact most cases of Celiac aren't). If you need help, feel free to contact me. And for some other resources, check these out:

And one last thing: I'll leave you with some "crack" containing, non-Paleo, yet gluten-free yummies--just in case you're going gluten-free and missing something sweet. (Don't hate me, Dr. S.!) 

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These are gluten-free, can be made egg-free and dairy-free, are vegetarian (but not vegan) and are most definitely NOT sugar-free. 

Gluten-Free Chocolate Chip Cookies 

Preparation

  • Preheat oven to 350º F.

Ingredients

  • 1/2 cup butter
  • 1/2 cup cane sugar (not white - turbinado or dehydrated cane is best)
  • 1/4 cup brown sugar
  • 1 egg replacer (1 Tbsp. egg replacer powder with 3 Tbsp water - or sub 1 egg)
  • 1/2 tsp. vanilla (I make LIBERAL use of vanilla - DO NOT use imitation vanilla)

Instructions

  • Mix this stuff together with the mixer.
  • Add in the following:
    • 1-1/2 cups gluten-free flour mix (6 parts rice flour : 2 parts potato starch : 1 part tapioca starch) (Keep some extra just in case you need to stiffen up the dough.)
    • 1/2 tsp. baking powder
    • 1 cup (or more) chocolate chips (I like Ghirardelli mini semi-sweets mixed with their 60% cacao)
  • Bake for about 12 minutes per pan.

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No baking adventure is complete without flour all over the kitchen LOL. Please do your part to continue the tradition.

Next Food Adventure: Converting gluten-free to Paleo. I accept this challenge.

Have a GREAT week everybody!