Microneedling With Me

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Microneedling is all the rage right now and for good reason!  It is a very simple, safe, and minimally invasive therapy with a wide range of benefits including skin rejuvenation, scarring, stretch marks and more. Microneedling can also deliver stem cells into the skin, further potentiating collagen formation.

This treatment involves puncturing the skin with microneedles to produce a controlled skin injury without serious damage. These micro-injuries cause slight bleeding and set up a wound healing process that involves the release of various growth factors.

GROWTH FACTORS cause collagen, elastin and new blood vessels to form, treating scars and tightening the skin. In one study there was a 400% INCREASE IN COLLAGEN AND ELASTIN deposition after only 4-microneedling treatments (1).

Another name for microneedling is collagen induction therapy and you can see why. Collagen is what keeps our skin appearing tight and plump. We also apply the microneedling over scars, basically breaking down scar tissue and allowing new skin to form.

Microneedling with Me
Your microneedling experience with Dr. Heather is comfortable and laid back. You are sufficiently numbed to ensure a minimally painful experience and the treatment is tailored by Dr. Heather to meet your aesthetic needs. A handheld microneedling machine is used across the specified treatment area (typically the face and neck) in which several tiny needles are used to create punctures in the skin. If you decide to add on PRP (platelet rich plasma), your stem cells are applied throughout the treatment so it can permeate these punctures, further potentiating collagen formation.

Whether PRP is used or not, the repair process starts almost immediately. There is minimal down time and most liken the experience to sunburn. This is temporary and should subside within a day or two. Most notice results immediately after the procedure, however some need 3-6 sessions to achieve their goals. The more severe the skin, the more treatments required. The cost per treatment is $250 and $600 with PRP, there is a 15% discount applied with purchase of packages. Schedule online for your complimentary ‘Initial Consult for Aesthetic Procedure.’


References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976400/


4 Alternative Remedies to Fight That Headache

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Hello again!  Last week we learned about several dietary strategies for addressing headaches. This week I highlight my favorite, evidence-based remedies. Knowing alternative remedies to common medications like ibuprofen is beneficial because long-term use can lead to unwanted health outcomes. In fact, in 2015, the United States Food and Drug Administration (FDA) strengthened their warning about the increased risk of heart attack or stroke when taking higher doses of ibuprofen. For an individualized approach to your care, schedule online through my website. But for now, here are some of my favorite remedies to replace taking ibuprofen:

  1. Butterbur (Petasites hybridus) root is a shrub with large leaves traditionally used to wrap butter in warm weather (hence its name). After four months of treatment with 150 mg of this root, there was a significant decrease frequency of migraine attacks (1). In fact, the American Academy of Neurology and the American Headache Society endorse the use of a butterbur extract made from the root or rhizome to reduce the frequency of migraines (2). Use only butterbur products that have been processed to remove pyrrolizidine alkaloids (PA’s) to avoid liver damage.

  2. Feverfew (Tanacetum parthenium L.) has been used across the world historically. Several studies support its use for headache, likely for its anti inflammatory properties and ability to decrease vascular smooth muscle spasms. It can be useful for many types of headaches: migraine, cluster, premenstrual, menstrual and others. Supplements should be standardized to contain at least 0.2 percent parthnolide and according to Feverfew (Tanacetum parthenium L.): A systemic review, adults can take 100-300 mg up to four times daily for migraine prevention (3).

  3. Magnesium, the second most abundant mineral in the cell, is essential in so many cellular processes and appears to play a role in getting migraines. There is strong evidence that migraine sufferers tend towards magnesium deficiency (4). Treatment of migraines by means of high levels of magnesium (600 mg) seems to be safe and cost effective strategy in clinical use (5). Please note that stress, which is common in people with tension-type headaches, may promote the development of magnesium deficiency (6).

  4. In case reports, Vitamin D deficiency is associated with chronic tension-type headaches and in each case the headaches resolved after treatment with vitamin D3 and calcium (7).

References:

  1. https://www.ncbi.nlm.nih.gov/pubmed/15623680

  2. https://nccih.nih.gov/health/butterbur

  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210009/

  4. https://www.ncbi.nlm.nih.gov/pubmed/22426836

  5. https://www.ncbi.nlm.nih.gov/pubmed/29131326

  6. https://www.ncbi.nlm.nih.gov/books/NBK507250/

  7. https://www.ncbi.nlm.nih.gov/pubmed/19619241

How To Manage Your Headache (With Evidence and Dietary Strategies)

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Headache (HA) is among the most common medical complaints. The majority is tension-type HA’s. However, a migraine is the most common diagnosis in primary care offices because people seek help with migraines but not with tension-type (1).

This week I highlight five, evidence-based, dietary strategies to combat HA, and stay tuned next week for my favorite HA herbal and nutritive remedies. I suffer from the random debilitating HA and I see this far too often in the clinic. Read on if you or someone you know is a HA sufferer.

Identify Food Sensitivities

It is well known that specific foods trigger migraines. If you are ALLERGIC to a food, your body mounts an immune response based on IgE antibodies. This may cause an anaphylactic reaction in severe cases. With food SENSITIVITY, your immune system responds based on IgG antibodies and inflammation occurs. There are blood tests available to assess IgG antibodies. Studies show that number of HA days and number of migraine attacks significantly decreased with removal of these foods (2). Identifying food sensitivities can also be done through an elimination diet; common allergenic foods are removed from the diet for some time (I recommend 3-6 weeks). Foods are systematically reintroduced while tracking symptoms. We listen to our body as we introduce foods. If symptoms ensue with food reintroduction, then we have identified sensitivity.

Avoid Processed and Preserved Foods

Eat a diet rich in fresh vegetables, fruits and high quality fresh meats; avoid MSG and nitrites. MSG, a flavor enhancer used in processed foods, has some of the strongest evidence for triggering HA attack (3). MSG can be found in: frozen or canned foods, soups, international foods, salad dressing, snack foods, seasoning salts, ketchup, BBQ sauce and in Chinese cooking. Nitrites are found in preserved meats like bacon, sausage, ham and lunch meat; they preserve color and flavor and are associated with migraine attacks (4).

Drink Water

Drink water and avoid dehydration because dehydration can lead to HA and migraine attack (5). I recommend drinking half your body weight in ounces so that your body can stay hydrates.

Increase Omega-3 Fatty Acids

Higher dietary intakes of omega-3 fatty acids are associated with lower prevalence of HA (6). Foods high in omega-3 include flaxseed, salmon, sardines, chia seeds, walnuts and grass fed meats. Avoid polyunsaturated vegetable oils like corn, sunflower, safflower, canola and soy because these are high in omega-6 fatty acids and it’s all about the balance; increase omega-3 and decrease omega-6.

Consume Foods High in Folate

The more dietary folate one consumed, the lower the frequency of migraine attack (7) in female sufferers. This is particularly true for those with the MTHFR gene SNP. Dark leafy greens like spinach are rich in folate, as is legumes, asparagus, eggs, beets, citrus fruits, brussels sprouts, broccoli, nuts, seeds, papaya, banana, fortified grains and beef liver.

Thanks for tuning in! Pass this on to anyone that may find the information useful. If I haven’t seen you in a while, let’s catch up!  You can schedule online through my website. If we have yet to meet, I am accepting new patients and would love an opportunity to work with you towards achieving your health goals.


References

  1. Bajwa et al. Evaluation of headache in adults. UpToDate, 8/2018.2.

  2. https://www.ncbi.nlm.nih.gov/pubmed/206471743

  3. https://www.ncbi.nlm.nih.gov/pubmed/27699780

  4. https://www.sciencedaily.com/releases/2016/11/161101103541.htm

  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2908954/

  6. https://www.ncbi.nlm.nih.gov/pubmed/30103932

  7. https://www.ncbi.nlm.nih.gov/pubmed/25598270

6 Ways to Increase Your Intake of Phytonutrients

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It’s harvest season and the vegetable options are off the hook!  Did you know that just 1 in 10 adults in the US population are getting enough fruits and veggies in their diet according to the CDC (1)?

This poses a problem because various studies link a low intake of fruits and vegetables with chronic diseases such as cardiovascular disease, high blood pressure, high cholesterol, osteoporosis, many cancers, chronic obstructive pulmonary diseases, other respiratory problems and mental health issues (2). I recommend that we all eat a rainbow of phytonutrients to support good health.

6 Ways to Increase Your Intake of Phytonutrients

Aim for 9-13 Servings of Plants Daily

A typical serving is only ½ cup of cooked veggies, one cup of raw leafy veggies or a piece of fruit. Make your requirement by having 3-4 servings of plant foods at every meal.

Know Where Your Phytonutrients Come From

These include: fruits, veggies, whole grains, legumes, nuts, seeds and even herbs and spices.

Eat the Rainbow

Make a goal to get the full 7 colors every day with a variety of foods. Try to hitROY G. BIV by adding the following foods to your meals: Raspberries, orange peppers, summer squashes, celery, olives, and legumes.

Try New Foods

We tend to get comfortable eating the same foods. Explore your produce section and try a new food every week. Don’t miss out on the thousands of phytonutrient possibilities.

Maximize Phytonutrient Combinations

Putting foods together can create a “synergistic” result. This helps because it achieves a better effect than if we eat foods alone. For example, add lemon to spinach to enhance iron absorption.

Get Creative

Think of foods that you commonly eat that may lack nutrients and replace this with a more nutrient-dense option. For example, you could substitute mashed potatoes with mashed purple potatoes or sweet potatoes.

References

  1. https://www.cdc.gov/media/releases/2017/p1116-fruit-vegetable-consumption.html

  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4644575/

Dr. Heather’s Top 5 Nutrients for TBI

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As we learned from last week, traumatic brain injuries (TBI) are not to be taken lightly. In 2013, about 2.8 billion TBI-related emergency department visits, hospitalizations and deaths occurred in the US, and almost 330,000 kids were treated for sports and recreation-related TBIs (1). Repetitively traumatized brains exhibits similar characteristics to an Alzheimer’s brain; and increasing our risk for dementia (2). Knowing the mechanisms that occur in brain injury allows us to intentionally intervene.  

Here are my top 5 nutrient recommendations for TBI:

  1. Turmeric has an active ingredient called curcumin which is a powerful antioxidant.  Supplementing with curcumin after a TBI dramatically decreased the oxidative damage and decreased cognitive impairment (3).  Supplementing with curcumin following a TBI protects your nervous system (4).

  2. Resveratrol is a plant compound that acts like an antioxidant and is found in red wine, grapes, some berries and peanuts (5). Brains that undergo trauma have oxidative stress that causes nervous tissue death. Resveratrol intervenes in this process, protecting the tissue from dying (6).

  3. Magnesium is a potent calcium channel blocker. It is believed that excess calcium entry into the cells is the biggest threat to brain damage, because this leads to increased ROS, tissue breakdown, cell death and inflammation. Low levels of magnesium leads to increased calcium in the cells. Administering magnesium post-TBI can potentially reduce swelling, improve neurological outcomes and help prevent lack of blood flow to the brain (7).

  4. Omega-3 fatty acids are most abundantly found in fish and are present in all our tissues, particularly the retina of the eye and brain. Omega-3 fatty acid supplementation after a TBI can potentially restore the survival of nerve cells. The possible support offered by omega-3 FA’s include: nerve cell survival, reduction in neuronal cell death, reduced ROS, and aiding the brain in adaptation (8).  

  5. Zinc is a required element for many proteins and acts as a signaling messenger in the nervous system (9). Zinc supplementation during TBI recovery may improve associated cognitive and behavioral deficits. After head injury, TBI patients excrete zinc through the urine for weeks following the accident, resulting in reduced blood levels (10). So use zinc supplements to prevent against deficiency.  

Reference:

Take Action Against TBI's

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In this week’s blog, I am going to talk about traumatic brain injury (TBI) and why it is so important to take action. I can’t tell you how many of us experienced head trauma or concussion in our past, and more than not, did nothing. In fact, a JAMA study from May concluded that a large proportion of patients with mild TBI do not receive follow-up care after injury even when they experience ongoing symptoms (1). I will explain why this is a problem.

TBI is a form of injury that occurs with trauma to the brain. This usually results from a violent blow or jolt to the head or body. The most common forms of TBI: falling, car accidents, violence, sports injuries and other combat injuries (2).  Protecting yourself from TBI is so important because this increases your risk of Alzheimer’s disease (3).

When trauma occurs to the brain, particularly with repetitive traumas, tissue damage occurs.  Damaging tissue leads to a massive release of reactive oxygen species (ROS) (4) which ultimately leads to nerve cell death (5). Massive ROS release also damages the meninges (membrane that encloses the brain) and the blood brain barrier, leading to a leaky brain.  

Now the brain tissue is permeable to things like sodium, potassium, and chloride; and the brain swells. Our immune systems activate to basically plug up this damage. In response to cellular death, the immune system begins to ‘eat up’ this debris, causing neuro-inflammation; and this is bad. Within hours, amyloid beta plaques begin to form (6). These plaques are a signature feature of Alzheimer’s disease (7).

Always see your doctor if you or your child has experienced trauma to the head or body that concerns you or causes behavioral changes. Head trauma warrants the emergency room if there are any signs and symptoms following a TBI. Stay tuned next week for nutritional and supplemental recommendations for TBI.  

So what if you had an injury to the head?  

The signs and symptoms of mild TBI may include (2):

  • Loss of consciousness for a few seconds to a few minutes

  • No loss of consciousness, but a state of being dazed, confused or disoriented

  • Headache

  • Nausea or vomiting

  • Fatigue or drowsiness

  • Problems with speech

  • Difficulty sleeping

  • Sleeping more than usual

  • Dizziness or loss of balance

  • Sensory problems such as blurred vision, ringing in the ears, a bad taste in the mouth or changes in the ability to smell

  • Sensitivity to light or sound

  • Memory or concentration problems

  • Mood changes or mood swings

  • Feeling depressed or anxious


Sign and symptoms of a moderate to severe brain injury:

  • Anything listed in mild TBI but with greater intensity

  • Convulsions or seizures

  • Dilation of one or both pupils of the eyes

  • Clear fluid draining from the nose or ears

  • Weakness or numbness in fingers and toes

  • Agitation


Children’s symptoms (in addition to those listed above):

  • Change in eating or nursing habits

  • Unusual or easy irritability

  • Persistent crying and inability to be consoled

  • Change in ability to pay attention

  • Change in sleep habits

  • Loss of interest in favorite toys or activities

References

  1. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2681571

  2. https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557

  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5835563/

  4. https://www.ncbi.nlm.nih.gov/pubmed/11721740

  5. https://www.hindawi.com/journals/omcl/2015/370312/

  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3919479/

  7. https://www.youtube.com/watch?v=MgyA6ic48Pg

Back to School: A Case For Breakfast

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It’s back to school and back to the grind. Breakfast remains the most important meal of the day. The evidence is clear, kids who eat breakfast tend to perform better cognitively and behaviorally (1).

Sending your kid off to school with a full belly of healthy food has many benefits. 

First off, kids who eat breakfast get better grades. Out of 10 studies examining the effects of breakfast on average school grades, all 10 of the studies demonstrated that regular, high-quality breakfast intake had a positive effect of school performance (1).  

In fact, it was found that the brains of children ages 4-10 utilize glucose two times more than an adult brain. Which means kids require more fuel for their brains to work optimally. Feeding the body is feeding the brain.

Kids who eat breakfast generally were able to stay on-task better in the classroom. Further, kids given meals that were lower on the glycemic index tended to do better as compared to higher glycemic meals.  Also there was less frustration observed among the students. Foods with a low glycemic load include proteins, fats, and high fiber foods.  Foods with a high glycemic load include simple carbohydrates like cereals and pastries.

We know now that feeding our kids breakfast helps them perform and behave better in school. The question remains then, what should we feed them? Here are some suggestions for whole food, nutrient dense, brain-fueling foods.  Including healthy fats like avocados, coconut oil/milk and nut butters helps in lowering the glycemic load of the meal. Healthy carbs include yams/sweet potato, plantains and whole grains.  

  • Breakfast egg muffins: Sautee vegetables - onions, garlic, broccoli, zucchini, etc. Butter/oil muffin tins. Add vegetables. Beat eggs (8 - 10) and pour over. Bake in 375 degree for 20 - 25 minutes until tops are set. Can have 1 -2 for breakfast and these keep for a couple of days in the fridge.  

 

  • Yogurt parfait: whole fat, plain yogurt layered with seasonal fruits and seeds such as chia or sunflower. You can add ingredients like coconut, dried fruits, cinnamon, and honey.

 

  • Overnight oats: Add ½ cup of milk or alternative milk, ½ cup of old-fashioned rolled oats, 1 tsp of chia seeds, and (optional) ½ banana to a jar or container and give them a good stir. Refrigerate overnight for at least 5 hours. In the morning add additional liquid if you like and once you achieve the desired consistency, tope with fruit, nuts, nut butter, seeds, coconut, spices, or vanilla. The mixture keeps up to 2 days. If you don’t add the banana, up to 4 days.

 

  • Sprouted toast: topped with your favorite nut/seed butter, hummus, or avocado. 

 

  • Salmon Cakes: Drain a can of red salmon (Trader Joe's), and place in a bowl with 1 - 2 eggs (can substitute 1 T ground flax mixed with 1 T water for the eggs), 2 tsp extra virgin olive oil (or a little mayo), curry powder to taste, organic raisins. Mix and drop the batter onto a hot skillet (with coconut oil or butter), and cook until browned, turn and brown. Can make ahead and re-heat.

References:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3737458/

Hydration Nation: Keep Drinking Your Water!

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This week I’m writing on water and highlighting several reasons as to why you should either continue drinking a lot of water, or START drinking a lot of water. It’s typically recommended that we drink half of our body weight in ounces of pure, filtered water, to keep our cells hydrated and healthy. So if you weigh 150 lbs, that’s 75 oz of water. If you are like most of us, you probably should be drinking more!  We cannot survive without water (1), as it makes up anywhere from 75 percent body weight in infants to 55 percent in the elderly (2).

Here are a couple reasons as to why you want to avoid dehydration:

  1. Dehydration causes cortisol levels to rise! Excess cortisol levels can make us retain weight, it affects our sleep, the way our bodies regulate sugar and other hormones.
  2. Mild dehydration is associated with a decline in cognitive performance in some studies (3). In one study, being even mildly dehydrated impaired performance in tasks that require attention, psychomotor and immediate memory skills.
  3. Increasing your water intake can help stabilize your mood (4). It is especially important for the elderly and children to avoid dehydration because their mood seems to be most affected (5).
  4. Lose weight with water intake!  When overweight women drank about 2 cups of water before each meal for 8 weeks, they lost weight, lost body fat and suppressed their appetites (6).

All of these points are great examples as to why you should stay hydrated so hopefully you have been convinced to up your intake of water.

But the question still remains: what is the best type of water to drink?  

The environmental working group has a ‘tap water database’ that allows you to input your zip code and you can see the contaminants in your tap water. Some of the most alarming contaminants in my water are arsenic, chlorate, chromium and trihalomethanes; most of which cause cancer (chlorate harms the thyroid) (7).

I have been filling a five gallon jug at my local grocer through Glacier water machines. It is municipal water that has been put through a carbon filter, micron filter, reverse osmosis, post carbon filter and ultraviolet light. I recommend against single use plastic bottles of water for everyday use because of the negative impact this has on our planet. Check out the environmental working group’s Updated Water Filter Buying guide for a guide based on your individual needs. Some of these systems get expensive, and I encourage the investment if you can afford it. Until then, use carbon filters because they are effective and affordable.

Common Filters and their Mechanism:

  • Carbon Filters is the most cost effective filtering system that can reduce contaminants like organic chemicals, VOC’s, pesticides, herbicides and chlorine.
  • Reverse Osmosis is when water pressure is used to force water molecules through a fine membrane leaving the contaminants behind.
  • Ultraviolet attacks 99.9 percent of the microorganisms present in water.

References

  1. https://www.ncbi.nlm.nih.gov/pubmed/20646222

  2. Nicolaidis S. Physiology of thirst. In: Arnaud MJ, editor. Hydration Throughout Life. Montrouge: John Libbey Eurotext; 1998. p. 247.

  3. https://www.ncbi.nlm.nih.gov/pubmed/22855911

  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984246/

  5. https://www.ncbi.nlm.nih.gov/pubmed/24480458

  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4121911/

  7. https://www.ewg.org/tapwater/system.php?pws=OR4100657#.W4ODGmRKi34

Protect Yourself From The Gray Haze: A Fire Safety Guide

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The Pacific Northwest is on fire and our air quality is suffering in Portland. The skies are grey and our cars are covered in soot. I personally experienced an audible wheeze commuting by bike for only a day. In fact, the air is deemed particularly dangerous for susceptible individuals like those with asthma and COPD.  

The same soot that’s landing on our cars is landing deep in our lungs, making it harder to breathe and causing cough (1). Physiologically, smoke inhalation can damage the tissue lining of the lungs, cause fibrosis, and lead to inflammation (2). Oregon.gov has great recommendations made for limiting your exposure to smoke:

  • Pay attention to local air quality reports (internet search ‘[your city] air quality index’)
  • Stay indoors and keep indoor air as clean as possible
  • Don’t add to indoor pollution

While taking into consideration the recommendations for limiting your lungs from exposure to smoke, there are ways to also keep your lungs healthy. Here are my top five favorite ways to support lung health:

#1: N-ACETYL CYSTEINE (NAC)

NAC helps lung function because it breaks up mucus, is an antioxidant, and anti-inflammatory (3). Some, but not all studies, report that NAC improves lung function when given for a longer period of time (600 mg/day for at least four weeks). NAC can also prevent acute exacerbations of lung issues in those susceptible. In mice injected with the flu, those that were also given NAC had a more positive immune response and less inflammation in the lung tissue as compared to mice without NAC (4).


#2: Probiotics

Oral probiotic treatment can control immune responses in the lung. By treating the gut mucosa, we address microbial imbalances in distal mucosa like the lungs (5). Most studies use lactic acid-producing bacteria like lactobacillus, streptococcus, Bifidobacterium, and enterococcus. I recommend eating a variety of fermented foods daily to support your lung health. These foods include: kombucha, kefir, sauerkraut, other fermented veggies, natto, yogurt, etc.

#3: Vaporize Eucalyptus Essential Oil

Breathing in eucalyptus oil can protect you from pathogens and is anti-inflammatory to lung tissue (6). Wildfires leave the air full of small particles that when breathed in cause inflammation in the lung. There are a couple ways to inhale eucalyptus essential oil. Consider an essential oil diffuser, add five drops to shower floor prior to shower, or make a steam inhalation at home over the stove by adding three drops of oil to a pot of simmering water and breathe in with a towel over your head.

#4: Fennel

Fennel can reduce lung damage, reduce inflammation and protect the tissue from damage (7). Fennel and beets both increase nitric oxide production which leads to dilation and blood flow, both of which benefit lung function. Here is a fennel salad recipe from New Seasons Market.

#5: Mullein

Mullein soothes the mucous membranes of the lungs and can assist in the expectoration mucus. A tea of mullein is made by pouring 1 cup of boiling water over 1-2 teaspoons of dried leaves or flowers and steeping for 10-15 minutes. You can drink the tea 3-4 times per day. You can also take 1/4-3/4 teaspoons of mullein tincture 3-4 times per day (8).

References

  1. https://www.gov.mb.ca/health/publichealth/environmentalhealth/smoke.html

  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2396464/

  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2707813/

  4. https://www.ncbi.nlm.nih.gov/pubmed/24968347

  5. https://www.hindawi.com/journals/mi/2013/751068/

  6. https://www.ncbi.nlm.nih.gov/pubmed/29141025

  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4342739/

  8. https://www.uofmhealth.org/health-library/hn-2133009#hn-2133009-how-it-works

Chemical Chaos: What’s in your cookware?

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Our environments are full of toxins. Exposure to these toxins is bad for our health. Though certain chemicals are disease causing, they continue to be used and distributed.

Below I highlight the most common cookware and their safety profile. I went through my pot and pan collection, and I too, have chemical-laden cookware that I will be exchanging out. My hope is that you will be inspired to make healthy choices for your own kitchen.

Avoid non-stick pans

Non-stick pans are everywhere in our kitchens despite being coated in chemicals like perfluorooctanoic acid (PFOA) and polytetrafluoroethylene (PTFE); commonly referred to as Teflon. An estimated 98 percent of Americans have PFOA in their blood. There is a connection between PFOA and kidney cancer, testicular cancer, ulcerative colitis, thyroid disease, high cholesterol and pregnancy-induced hypertension (1).  

When heated, cookware with Teflon and other non-stick surfaces emits fumes that can kill birds and sicken people (2). Unfortunately, in 2001 90 percent of all aluminum cookware sold in the US was coated with non-stick chemicals like Teflon (3). If you can afford to replace your non-stick cookware, do so. But if you cannot replace them right away, you can reduce the possibility of toxic fumes by never heating an empty non-stick pan, avoiding ovens hotter than 500 degrees F and using an exhaust fan.

Avoid aluminum cookware

Aluminum is the most abundant metal on Earth that is toxic to our nervous system and it has been proposed to be a player in Alzheimer’s disease; the most prevalent neurodegenerative disease of the elderly (4). Food cooked in aluminum pans have been shown to contain the toxic metal from leakage into the food (5).

Use cast iron

This is the safest cooking option available because it is free of PFOA and PTFE. Iron does get into your food, and unless you have excess iron, this is actually a health benefit. These pans can last generations and get better with usage.

Buy high quality stainless-steel

Stainless-steel is made from a mix of metals such as iron, chromium, nickel, manganese and/or carbon. Make sure that you are buying food-grade stainless-steel designated: 304, 316 and 430. There is also the specifications: 18/8, 18/10, or 18/0 stainless-steel. The first number is the percentage of chromium and the second is the amount of nickel. Nickel is implicated in numerous health problems, notably allergic contact dermatitis and should be avoided by nickel-sensitive patients (6). Avoid cleaning with abrasive materials to avoid damage to the pan. The pan is no longer safe once it is damaged.

Take a moment and look through your cookware. Dispose of any damaged, non-stick and aluminum items and cook with caution to not overheat or scrape the surface. Don’t be cheap when it comes to cookware and stock your kitchen with cast iron, food grade stainless-steel and glass. There ARE other safe cookware options out there; connect with the manufacturer if you have any questions regarding the contents of their products

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3855507/

  2. https://www.ewg.org/research/canaries-kitchen#.W3Bx82RKj-Y

  3. https://www.ewg.org/research/canaries-kitchen/tips-safe-cookware#.W3Bog2RKj-Y

  4. https://www.ncbi.nlm.nih.gov/pubmed/21157018

  5. https://www.ncbi.nlm.nih.gov/pubmed/1397396

  6. https://www.ncbi.nlm.nih.gov/pubmed/1514841

No Way, BPA!

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Hello all and thanks for tuning in. This week, I am highlighting a chemical that is ubiquitous in our homes, works and even refrigerators. This chemical is found on store receipts, so I avoid touching them, and I especially don’t want it put in my grocery bag atop the produce. Even La Croix cans are not spared, which was news to me. Prior to learning this, I drank cans of La Croix more than I want to admit, and even let my baby drink from them. Read on to learn about Bisphenol A and why you should never microwave plastic.

What is BPA?

Bisphenol A, or BPA, is a chemical that is commonly used to make hard clear plastics called polycarbonate, some sealants, and thermal paper which is used to print receipts.

A study conducted by National Health and Nutrition Examination Survey (NHANES), conducted by the Centers for Disease Control and Prevention (CDC), found detectable levels of BPA in 93 percent of Americans six years and older (1).

Why should we avoid BPA?

BPA is metabolized by the liver and due to its chemical structure, BPA can interact with estrogen receptors in the body.  This interaction has been shown to play a role in diseases that involve the endocrine, or hormonal systems. Some of these pathologies include: male and female infertility, early puberty, cancers and metabolic disorders such as polycystic ovarian syndrome (PCOS) (2).

Despite the fact that BPA has been linked to deleterious health effects, the Food and Drug Administration (FDA) takes the stand that BPA is safe at the very low levels that occur in some foods (3).

Where is BPA found?

This chemical enters our bodies through food and beverages that have been in contact with the polycarbonate plastics made with BPA. Here are some examples of where BPA can be found:

  • Canned foods because most metals are lines with BPA
  • Sports water bottles made prior to July 2012
  • Baby bottles, sippy cups and other containers made for children may contain BPA if bought before July 2011
  • Other hard, clear plastic food or beverage containers
  • Cash register receipts
  • On plastics with the #7 on the bottom

How to limit or avoid BPA exposure (4):

  •  Choose fresh, frozen, or dried foods instead of canned
  • Limit your consumption of packaged foods
  • If you cannot avoid metal cans, rinse the foods with water before consumption because this can help lower BPA level in the food
  • Transfer foods that are in plastic or metal cans to a stainless steel pot or pan for stovetop cooking, or microwave in glass
  • Search for your favorite foods and beverages in the Environmental Working Groups BPA product list
  • Use BPA-free products especially when buying bottles and toys
  • Avoid plastic containers with #7 on the bottom
  1. https://www.niehs.nih.gov/health/materials/bisphenol_a_bpa_508.pdf

  2. https://www.ncbi.nlm.nih.gov/pubmed/25813067

  3. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/bpa/faq-20058331

  4. https://www.ewg.org/news-and-analysis/2018/02/5-ways-reduce-your-exposure-toxic-bpa#.W2tC7thKinR

Guest Recipe: Bone Broth by Chef Anh Luu

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Last week, I wrote on the benefits of bone broth. This age-old remedy is full of minerals, amino acids and collagen that benefits your body from the brain to the gut. My dear friend Anh Luu, celebrity chef and owner of Tapalaya in Portland, was kind enough to share her recipe. I’ve had her broth, and let me tell you, it’s out of this world! I recommend adding a splash of vinegar when you begin to boil the broth to enhance the nutrient extraction from bones.

By Chef Anh Luu:

Bone broth is one of my favorite recipes to make. Growing up in a Vietnamese family and eating tons of pho made me extremely connected to this dish. A good and rich bone broth takes time and patience to make. Here are my tips for making the best bone broth you’ll ever taste!

  • The perfect ratio for all types of broth is 1 pound of bone for every 3 quarts of water.

  • Use chicken bones with some meat still on them in combination with other bones like beef or pork to get the most flavorful and collagen rich broth. Chickens tend to have the most collagen because they are usually younger when butchered. Younger animals have higher levels of collagen which will result in a gelatin-looking broth when cooled (this is what you want!)

  • Roast the bones before making your broth because it will help develop the flavor and color of the broth. Crank your oven up to 425 F and roast the bones for 30-45 minutes. You want them to be brown and caramelized. If you’re using beef bones, I would boil them in water before roasting to get all the scummy impurities out for a clearer broth.

  • Keeping the aromatics simple is key. Aromatics are things like onions, ginger, bay leaf, black peppercorns, garlic, thyme etc. All these things enhance the flavor of the bones.

  • I like to make my bone broth taste reminiscent of Pho, so during the bone roasting stage, I add 1 sliced in half knob of ginger and 1 onion cut in half, skin on (per pound of bones) to be roasted with the bones. Then once I assemble my broth, I’ll add 1 dried star anise to the pot and use fish sauce instead of salt to season my broth at the end.

  • Assembling your broth: Put all roasted bones and aromatics in a large pot. Cover bones & aromatics with *cold* water. Cold water extracts the flavor from the bones better than hot water.

  • Turn your heat to high and let the broth come to a rolling boil. Then, turn your heat to medium-low and let simmer for at least 6-8 hours. The longer you cook your broth the better the flavor will get. 6-8 hours is the bare minimum for bone broths. Ideally you want to let it simmer for 24-48 hours on the stove for the best results.  

  • Don’t add any salt until the very end of cooking. If you let something salty boil and then reduce it, then it will only get saltier.

Breaking Down Bone Broth

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Bone broth is a traditional kitchen remedy that has been used across the globe. In general, bone broth is made by boiling bones in water with a splash of acid (like vinegar) and time. Through this process, the nutrients are extracted from the bones and into the liquid. There is limited research supporting the health benefits of bone broth, likely because it is difficult to standardize, however I continue to stand behind its benefits and regular use.

The nutritional content of bone broth derives from the nutrients present in bone itself and the cartilage that covers the ends of bones to form joints. Bone and cartilage contain an array of minerals and collagen fibers that are broken down and extracted into the liquid during bone broth preparation. Bones contain bone marrow, which add to its blood building and energizing qualities. Red bone marrow is where red and white blood cells are born. Red blood cells carry oxygen to our tissues, giving us life force, or prana. White blood cells make up our immunity that is responsible for keeping us safe from pathogens. It is these minerals and collagen products that give bone broth its nutritive powers.  

Collagen and Gelatin

Collagen functions to hold the body together and it is the most abundant protein in the body, accounting for ¼ of our total protein (1). Among its many functions, it gives strength to our tendons, ligaments, bones and wound healing while improving the laxity of the skin (2). While collagen refers to a particular protein in the body, gelatin is the food term. Gelatin describes the collagen extracted in bone broth. When done properly, this is the Jell-O quality to cooled bone broth. Gelatin decreases inflammation of the gut by healing the mucus layer and supporting a healthy microbiota (3). It also aids in digestion, particularly of beans, meat and grains.

Minerals

Calcium and phosphorus are the most abundant minerals with some small amounts of magnesium, sodium and bicarbonate (4). An optimal diet provides the minerals important for maintaining bone strength. Collagen, the most abundant protein in the animal kingdom, is made up of amino acids, with the most abundant being: glycine, proline, and hydroxyproline (5).

Glycine

This is the most important amino acid found in animals. Glycine acts as a neurotransmitter in the nervous system and it defends the body against injury and disease (6). Glycine supplementation is a safe approach to improving sleep quality (7) and works by inhibiting the nervous system transmission thus having a calming/sedating effect. There are studies showing that glycine supplementation is associated with reduced risk of asthma, better wound healing, improved digestion and improved liver function (8).

Proline plays an important role in protein production. It makes up about 17 percent of collagen therefore is important for supporting tissues abundant in collagen like muscles, bones, skin and tendons (9).  

Glycosaminoglycans (GAG’s)

These substances are naturally jelly-like and you may be familiar with some of these compounds like hyaluronic acid and chondroitin sulfate. GAGs are found in the extracellular matrix of cartilage and play critical roles in the development, normal function and damage-response of the central nervous system (10).

Bones and cartilage contain a lot of nutrients that support multiple systems. I broke it down and highlighted some of the key players in bone broth, hoping to inspire this into your kitchen.

Stay tuned for next week where I share THE recipe for bone broth recipe that will knock your socks off.  

Summary of health benefits

  • Minerals in bone broth help maintain bone strength.  
  • Can improve sleep quality
  • Reduce asthma risk
  • Promote wound healing
  • Improve gastric acid secretion
  • Support detox
  • Supports muscles, bones, skin, and tendon
  • Heals the gut
  • Modulates intestinal microbiota
  • Aids digestion
  • Supports nervous system development, function and damage-response

Resources

  1. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022811/          

  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707681/          

  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4040816/         

  4. https://depts.washington.edu/bonebio/ASBMRed/structure.html#mineral          

  5. https://www.ncbi.nlm.nih.gov/books/NBK21582/          

  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5350494/       

  7. https://www.ncbi.nlm.nih.gov/pubmed/25533534       

  8. http://www.townsendletter.com/FebMarch2005/broth0205.htm         

  9. https://chriskresser.com/the-bountiful-benefits-of-bone-broth-a-comprehensive-guide/      

  10. https://www.sciencedirect.com/science/article/pii/S0014488615300650   

Integrating Intermittent Fasting

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Last week I made a case for why you should consider intermittent fasting (IF).  

Check that out HERE.

In short, intermittent fasting can make you healthier, and who doesn’t want that?  

Let’s begin with defining health. According to Dr. Satchidananda Panda, of the Salk Institute for Biological Studies, the definition of health changes throughout the day.

In the morning, health can be defined as waking up, feeling rested, energetic and having a bowel movement. We proceed with our day, void of hunger after taking some food and feeling productive. In the evening, we move our bodies, feeling sleepy and tired. Ready for bed, with a feeling of lightness in our stomach. We all deserve to feel healthy, and IF is a tool that can help you achieve your best.

So where to start?  I want to begin by saying that these guidelines are intended for otherwise healthy individuals looking to optimize their well-being. As always, consult your physician if there are any concerns.

When beginning this process, we aim to go without food for a 10-12 hour window. Take your last meal of the day 2-3 hours before bedtime. This allows your digestion to complete its job with dinner.

During the digestive process, blood is flowing towards your center, however, this can interrupt sleep. By stopping your last meal 2-3 hours prior to bedtime, blood can flow to our brain and support a deep and sound sleep.

Upon waking, it is recommended that you wait 1-2 hours before taking anything other than water (yes, this includes coffee). For example, stop eating dinner at 7:00 p.m. and wait to take breakfast until 7 a.m.- 9 a.m. How simple is that?  

When implementing this 10-12 hour fasting window, you can expect to feel hunger in the evening for about 2-3 weeks. Try and choose foods that are more sustainable such as foods high in fiber, protein, and fats will help you stay satiated. After some time, IF regulates the hunger hormones, so stick with it!  

You can be flexible with the timing. You can move dinner 30 minutes to an hour later or earlier and breakfast accordingly (to keep the 10-12 hour fast). It’s important to note that you can deviate from this schedule 1-2 times during the week. This is cool because it allows you to engage in social activities on the weekends. I recommend keeping this fasting regimen during your workweek and allowing flexibility on your days off to allow for living without strict regimen.  

If you’re committed to trying this out, I recommend you use an app called MyCircadianClock, by the Salk Institute for Biological Studies. It helps you understand your body’s rhythms while contributing to research. I have downloaded my app and am excited to participate!

In summary:

  • Allow yourself 10-12 hours of fasting. You are allowed to drink as much water as you like.
  • Pick a time in the evening to stop taking food and drink other than water.
  • This time should be 2-3 hours before bed.
  • Wait 1-2 hours upon waking to take food or drink (This includes coffee and tea).
  • Adhere to this schedule 5-6 days out of the week.
  • Consider using MyCircadianClock app to help you through this process and contribute to research.

5 Reasons to Intermittent Fast

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Intermittent fasting (IF) is a pattern of eating where you cycle between periods of eating and fasting. It’s not about what you eat, but rather when you eat. Most of us fast every day when we sleep, and intermittent fasting can be as simple as extending this time a few hours. I’m going to highlight 5 evidence-based reasons why you should consider intermittent fasting.

#1: LIVE LONGER  

By restricting your calories, you can potentially extend your lifespan and reduce the incidence of age-related disorders (1) like cardiovascular disease and diabetes!  Limiting your calories without malnutrition, is the only experimental approach consistently shown to prolong survival in animal models (2). It’s important to maintain proper nutrition when we restrict our calories, because malnutrition is associated with increased disease. IF works by changing our gene expression and through the release of growth factors like growth hormone, insulin, and insulin-like growth factor 1 (IGF-1). These growth factors, when elevated, are associated with aging and increased death in many animals (3).

#2: LOSE WEIGHT

There are several studies done in humans that show intermittent fasting leads to weight loss (4). By just changing the time you take your calories, without changing the amount of calories, you can lose weight, especially if you are overweight. When overweight participants took food between 8 a.m. and 2 p.m. as compared to 8 a.m. to 8 p.m., there were less hunger swings and their bodies were better able to burn fat (5). Most studies show a trend towards a significant decrease in weight and risk of diabetes, cardiovascular disease, and cancers.

#3: SUPPORT HEALTHY MICROBIOME

I’ve talked a lot about the microbiome’s role in health and longevity. Our gut microbes have the capacity to effect the expressions of genes associated with longevity (6) and influence our cell’s mitochondrial function (7). Each of our cells contain a mitochondria within it where energy is produced, and a decline in mitochondrial quality and activity is associated with aging and age-related diseases. Through IF, you will increase gut bacteria richness, and this has so many health benefits (8).

#4: LOWER INFLAMMATION

Fasting has the capacity to lower inflammation in your body (9). This is significant because elevated inflammation is associated with a myriad of diseases including cardiovascular disease, autoimmunity, and depression.  

#5: ENHANCE IMMUNITY

There is evidence that IF interacts with your immune system by stimulating immune cells8. It also has the potential, when used in conjunction with cancer treatments, to make chemotherapy and radiation therapies more effective (10).

Stay tuned for next week’s blog when I discuss strategies for integrating IF SAFELY into your lives.  

References

  1. https://www.nature.com/articles/nature07583   

  2. https://www.ncbi.nlm.nih.gov/pubmed/20733612

  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3607354/

  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516560/

  5. https://www.news-medical.net/news/20170106/Early-time-restricted-feeding-strategyc2a0may-help-with-losing-weight.aspx

  6. https://www.sciencedirect.com/science/article/pii/S1568163716302653

  7. https://www.sciencedirect.com/science/article/pii/S0092867417306414

  8. https://www.cell.com/cell-metabolism/fulltext/S1550-4131(18)30313-9

  9. https://www.ncbi.nlm.nih.gov/pubmed/23244540

  10. https://www.ncbi.nlm.nih.gov/pubmed/28539118       

Eat to Beat Depression

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All of us have been affected by depression in some way. In fact, about 16.2 million adults in the US have suffered from depression (1). If you go to the doctor, you will likely be given a medication called a selective serotonin reuptake inhibitor (SSRI). These medications, no doubt, help a lot of people, particularly with severe depression, however the evidence is not so convincing when it comes to mild/moderate depression.

In my clinical experience, there are more of us walking around with mild/moderate depression as compared to severe, yet the treatments remain the same. Looking at data from 1985 to 1997, SSRI’s had a 40% reduction in symptoms as compared to placebo’s 30% (2). This is not convincing enough data for me. Most of us don’t need these medications, but rather we need to make changes in our lifestyle, habits, and environments.

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Your body is an amazing organism with the capacity to heal itself under the right influences.

As a functional medicine physician, I work with you to heal the underlying cause of disease. Each patient of mine undergoes a thorough evaluation to address underlying pathology. I look extensively at the thyroid gland, because patients with thyroid disorders are more prone to depression (3). We evaluate your sugar metabolism, because depression is 2-3 times higher in diabetics (4). And we look at your ability to adapt to stress, because increased cortisol levels can alter your brain’s chemistry (5). Lastly, we assess your levels of inflammation because inflammatory chemicals can affect neurotransmitters (which are our brain chemicals) (6).

You don’t have to wait to get started to begin your healing journey. Let me show you why  the digestive tract is so important when dealing with depression.

Did you know that your digestive tract communicates directly with your brain? The microbiota, or the trillions of bacteria that live inside your colon, influence your brain function! (7). Having a healthy and diverse microbiome is foundational to solid mental health.  

So what makes a healthy bacterial make-up, and what can you do about it?  With these simple dietary strategies, you can begin to take your health in your own hands.  

  1. Eliminate processed foods and sugars: The environment created in the gut by eating processed foods, a hallmark of the Western diet, basically feeds the microbes that promote inflammatory disease (8)
  2. Eat probiotic foods: These include fermented soy like tempeh and natto, sauerkraut, kimchi, kombucha, yogurts, kefirs, etc. These foods, which were so often included in traditional dietary practices, have the potential to influence brain health by influencing our microbiota (9).
  3. Eat fiber rich foods: They include: vegetables, fruits, whole grains, and legumes. Our bacteria need fiber to survive and proliferate and from what we know by now, this is a wonderful thing!

So, my friends, thanks for reading. I hope this gives you a little more insight into the big bad world of depression. It’s a complex disease with a lot of factors to consider.  Take care of yourselves and eat your veggies.

1..  https://www.nimh.nih.gov/health/statistics/major-depression.shtml

2.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592645/

3.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3246784/

4.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4375817/

5.  https://www.psyneuen-journal.com/article/S0306-4530(05)00083-1/abstract

6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5542678/

7.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367209/   

8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872783/

9.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3904694/

Dr. Heather’s Top 5 Summer Snacks

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I talk diet a lot during my days and I’m often getting asked about what I eat and what I feed my family. I have studied and worked in the field of nutrition for some time now, and I make an effort to eat and feed my family according to what I recommend clinically. I adhere to a whole foods diet abundant in: veggies, fruits, fermented foods, proteins, and a reasonable amount of wiggle room. I believe that it’s what you eat MOST of the time that matters.

I’m going to break down my 5 favorite snacks. They are relatively easy to prepare, are super yummy, and nutritionally dense. Food is medicine and snack time is a perfect opportunity to get those nutrients in.

1. Smoothies

Smoothies are the best summer snack!  The fruit is going off this time of year - add an avocado and a handful of greens and you’re good to go. I have been inspired by Dr. Rhonda Patrick’s micronutrient smoothie recipe and I have not been shy in recommending this to my patients. It does take some effort, but it’s worth it! I make a big mason jar’s worth, bring it to work with me, and I stay fed with a NUTRIENT PACKED snack all day.
 

  • 6 leaves of greens: kale, chard, spinach, and/or lettuce
  • 1 carrot
  • 1 avocado
  • 1 tomato
  • 1 apple
  • 1 banana
  • 1 generous cup of blueberries fresh or frozen
  • 1 handful of parsley
  • Blend with 6 cups of liquid in a high powered blender and enjoy.

Of course smoothies don’t need so many ingredients. Try a banana, cup of blueberries, and a handful of spinach topped with water for an on-the-go version.

2. Ants on a log

We all remember this classic snack of peanut butter on a stalk of celery, topped with raisins. I like to sub out the peanut butter for alternative nut/seed butter such as almond, macadamia, sunflower, etc. Don’t limit yourself to raisins, my friends. Top this log with chopped figs, apricots, or dates. Celery is high in antioxidants, enzymes, and vitamins while the nut butters provide good fat and proteins. Dried fruits are an excellent source of fiber.

3. Chia seed pudding

Talk about yummy!  My baby loves this stuff and I love her eating it!  Chia seeds are high in omega 3 fatty acids, fiber, and proteins (1). The hardest thing about this snack is the waiting period.
2 cups of coconut milk (or any milk alternative)
½ cup of chia seeds
1 cup of fruit
Blend the ingredients together, pour in a glass jar, and set it in the refrigerator for 4 hours before serving.

4. Nori wrapped avocado and cucumber with Himalayan salt

Edible seaweeds collect iodine from the seawater and are, therefore, a good dietary source of iodine. Seaweeds also are high in fiber, vitamins, minerals, and polyunsaturated fatty acids (2). Avocados are also rich in nutrients with studies supporting cardiovascular health (3). Place the ingredients on one end of the nori sheet and roll. Dab the end with water to help the nori stick.

5. Roasted kale

For those who know me, know this is true. I’ve definitely gone through periods of eating a head of kale a day. This stuff is so good. The kale comes out oily and salty and delicious. Kale is no doubt a fibrous super food rich in vitamins A, K, C, folate, and in minerals potassium, calcium, and magnesium (4). Set your oven to 400 degrees, wash, dry, and devein the kale, add a couple tablespoons of coconut oil and salt to taste. Place in the oven for 2 minutes. Take it out and evenly coat the melted oil on the kale, and place back into the oven, about 10 minutes. I like the leaves to be just a bit crispy. If you have some nutritional yeast, sprinkle it on for added flavor and B vitamins (5).

There you have it, my five favorite snacks. I would like to point out that every single ingredient, save the salt, is from a plant. The more plants we eat, the more nutrients we are getting. I hope this offers some inspiration in getting more plants in that beautiful body of yours.

References:
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4926888/
2. https://www.sciencedirect.com/science/article/pii/S1021949814000155
3. https://www.ncbi.nlm.nih.gov/pubmed/23638933
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4663599/
5. https://www.westonaprice.org/health-topics/abcs-of-nutrition/nutritional-yeast/

Low Dose Naltrexone (LDN)

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If you suffer from an autoimmune condition, a central nervous system disorder, or cancer, you may want to explore the option of LDN for treatment. I am particularly fond of LDN because of its low side effect profile and affordability.

What is Naltrexone?

Naltrexone was originally approved in 1984 for the purpose of helping heroin or opium addicts. By blocking the opioid receptors, the person cannot get high when they take heroin or opium. Dosages for this effect is prescribed in the 50-300 mg range. 

LDN for Autoimmunity:

In 1985, Dr. Bernard Bihari discovered the effects of much smaller doses, around 3 mg per day, on the immune system; hence Low Dose Naltrexone. He found that this low dose, taken at bedtime, enhanced a patient’s response to infection by HIV. Over the next decade, Dr Bihari found benefits in autoimmune patients as well. LDN has been useful for a myriad of autoimmune conditions and cancers (please see lowdosenaltrexone.org for a more exhaustive list):

  • Autoimmune Disease
  • Ankylosing Spondylitis
  • Celiac
  • Chronic Fatigue
  • Crohn’s
  • Dermatomyositis
  • Endometriosis
  • Fibromyalgia
  • Hashimoto’s
  • IBS
  • Psoriasis
  • Rheumatoid Arthritis
  • SLE
  • Ulcerative Colitis
  • ALS
  • Autism
  • MS
  • Parkinson’s
  • PTSD

As you can see, LDN treats a wide range of diseases, with a particular benefit seen with autoimmune conditions. LDN works by temporarily blocking endorphin receptors in the brain. Endorphins can be thought of as a natural pain killer, with a ‘feel good’ effect. Because the endorphin receptors are being blocked by LDN, your body reacts by producing more endorphins, and this reduces painful symptoms and produces an increased sense of well being. While the mechanism of use in autoimmune conditions is not fully understood, increased levels of endorphins stimulate the immune system and are anti-inflammatory.

How to Take LDN:

I like to begin on an ultra-low dose and gradually increase over a period of weeks until you are stable and side effect free. I tend towards a more conservative titrating schedule, and we can use a faster protocol on an individualized basis.

Side Effects:

Many patients who start LDN do not experience side effects. Occasionally, during the first week of use, you may have difficulty sleeping or experience vivid dreaming. If this is the case, we can titrate up slower, or back down on dosage. Initially your symptoms may become worse before they improve. Please note that if you are taking opioid medications, LDN can interfere with its efficacy.

When I use LDN:

I like to prescribe LDN in patients who need immediate symptom relief. These patients will typically have an autoimmune condition such as Hashimoto’s thyroiditis or Crohn’s. LDN is typically part of a comprehensive and individualized treatment plan targeted to address the underlying cause of your disease.

References

  1. https://www.ldnresearchtrust.org

  2. http://www.lowdosenaltrexone.org/index.htm#What_is_low_dose_naltrexone

 

 

Skip The Scars: Holistic Acne prevention and Treatment

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Acne is the most common skin disorder affecting adolescents and young adults(1). Acne can cause significant anxiety and psychological stress, and may lead to disfiguring scars that are life long. Acne occurs when cells produce too much keratin (a protein), too much oil, unwanted bacterial buildup, and inflammation.

Conventional treatments include: topical retinoids, peroxides, and antibiotics that can leave the skin dry, red, and peeling. Oral medications like retinoids are teratagenic (cause fetal deformity) and can cause liver damage. Oral antibiotics can lead to dysbiosis and drug resistance. There are various diet and lifestyle recommendations that are supported by evidence to have a positive effect on acne, and with better side effect profiles.

Let’s begin with the diet. Inflammation plays a role in acne, and our diets contribute our overall inflammatory load. There is convincing evidence that dairy consumption is linked to acne. First of all, dairy consumption stimulates the hormone insulin-like growth factor 1 (IGF-1), and just as its name implies, this hormone makes things grow; like acne. IGF-1 also stimulates androgenic hormones, and these hormones stimulate oil production, which is one of the factors associated with acne production. The dairy itself contains hormones known to stimulate oil production and acne formation (2). The mechanisms connecting dairy and acne are convincing enough to recommend the elimination of dairy in acne treatment.

Acne treatment should include a diet that has a low glycemic load and glycemic index. This means that you need avoid sugary, starchy, white colored foods. When we eat foods that raise our blood sugars, our pancreas releases insulin and elevated blood levels of insulin stimulate androgenic hormones. Androgenic hormones stimulate acne. Elevated insulin also stimulates IGF-1, which we already know is involved in the process of acne formation (3). Work by Cordain et al, supports the notion that high glycemic diets contribute to acne production. Looking at 1,315 people of non-western societies in Papua New Guinea and Paraguay, NOT ONE single case of acne was observed! Compare this to 79-95% of westernized teenagers suffering from acne! This dramatic difference cannot be contributed to genetics alone, and it is reasonable to attribute, at least in part, this outrageous acne occurrence to the western diet, high in cereals, packaged, and starchy foods.  

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Now let's talk nutrients. Zinc is a micronutrient that been shown to be an effective acne treatment in several trials(4). In a double blind study, 91 participants were given either 400 mg of oral zinc sulphate or placebo for 12 weeks. Significantly better results were demonstrated in favor of the zinc group (5). Zinc is an essential nutrient for the development and function of human skin and it has been shown to be effective at killing the bacteria associated with acne (2). Consider zinc in your acne plan, and keep in mind that zinc should be taken with food to avoid nausea. When we are exposed to toxins and stress our cells undergo oxidative stress and this plays a key role in acne progress (6). Exposure to free radicals happens from eating too much sugar/refined carbohydrates, exercising too little or much, drinking too much alcohol, smoking, air pollution, stress, etc. Since oxidative stress is implicated in acne, then treatment of acne warrants anti oxidants. And in fact, when given vitamin E and selenium for 12 weeks, both of which are antioxidants, skin improved (7).

Fish oil is abundant in essential fatty acids and benefits acne, especially mild to severe types (8).  Consuming a lot of omega-3 fatty acids, as found in fish oil, can stop inflammation, and inflammation is foundational in acne production.

Acne sucks, and the majority of us have, at least at some time in our lives, experienced it. Eating a dairy-free, whole foods diet that consists mainly of veggies, fruits, whole grains, legumes, and quality-sourced proteins and excludes packaged, sugary, and starchy foods are key to regulating the hormones involved in acne. Several nutrients are worth trying, such as zinc, omega 3 fatty acids, and antioxidants before using antibiotics, hormones, or Accutane.

For a customized plan that includes a comprehensive gut cleanse to address your acne, schedule now for a new patient visit. I take most insurance plans!

Reference:

  1. https://www-uptodate-com.nunm.idm.oclc.org/contents/pathogenesis-clinical-manifestations-and-diagnosis-of-acne-vulgaris?search=acne&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2

  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4884775/#CIT0024

  3. https://www.ncbi.nlm.nih.gov/pubmed/12472346

  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4120804/#B23

  5. https://www.ncbi.nlm.nih.gov/pubmed/146511

  6. https://www.ncbi.nlm.nih.gov/pubmed/24795060

  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4884775/

  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543297/

Preventing Cellular Aging: Tips, Recipes, & Maximizing Food Nutrition

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For the past month or so, I’ve been speaking around the Portland area on preventing cellular aging.  Below is a compilation of the presented material. Each recommendation has been substantiated through research to support the aging process through cancer prevention, neurological preservation, and/or cardiovascular protection.

Sulforaphane (SFN) is a chemical found in cruciferous vegetables. Cruciferous veggies: broccoli, broccoli sprouts, cauliflower, brussels sprouts, green and red cabbage, collard greens, mustard greens, kale, bok choy, swiss chard, watercress, turnips, rutabaga, and radishes.

There is a lot of research that supports the use of SFN in supporting healthy aging.

  • SFN has been shown to reduce cancerous activity in mice (1)

  • Slowed the doubling rate of CA biomarker (PSA) by 86% (2)!

  • SFN reduced extent of brain damage post epilepsy by protecting brain mitochondria

  • SFN given daily x 10 weeks lowered inflammation (4). These markers IL-6 and CRP are predictors of physical and cognitive performance (5)

  • SFN helps us excrete toxins, therefore preventing the buildup and potential DNA damage (6)

 

Instructions for growing broccoli sprouts (7):

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  1. Add 2 tablespoons of broccoli sprouting seeds to a wide mouthed quart jar.

  2. Cover with a few inches of filtered water and cap with the sprouting lid.

  3. Store in a warm, dark place overnight. I use a kitchen cabinet for this.

  4. The next morning, drain the liquid off and rinse with fresh water. Be sure to drain all the water off.

  5. Repeat this 3-4 times a day. Continue to store your seeds in a warm, dark place. After a few days, the seeds will start to break open and grow.

  6. Eventually, the sprouts will be an inch or so long and have yellow leaves. Now you can move the sprouts out into the sunlight.

  7. Continue to rinse them 3-4 times a day until the leaves are dark green. Now they are ready to eat!

  8. This whole process will take about a week. Patience is key!

  9. Once they are ready, replace the sprouting lid with a standard mason-jar lid and store in fridge.

Serve on top of salads, stirred into soups, or however strikes your fancy!

Vitamin D is actually a steroid hormone that controls the expression of over 1000 genes. Vitamin D levels that are too low and too high are associated with increased incident of death from all disease (8).

  • Low levels of vitamin D reduced the risk of cancer by 67% (9)

  • Mice with both deficient and excess vitamin D levels exhibited shortened lifespan and premature aging (10)

  • Vitamin D effects brain cells by modulating brain inflammation that is associated with neurodegenerative and neuropsychiatric diseases with an inflammatory component (11)

Vitamin D comes from UVB radiation from the sun. Factors that reduce our levels of vitamin D include: wearing sunscreen, darker skin color, aging, and obesity. Get your levels tested! This is a simple blood test that your doctor can order. In the meantime, get outside in the sun let your skin be exposed. Food sources of D include mushrooms that have had sun exposure and oily fish such as salmon, mackerel, sardines, and herring.

Folate: required B vitamin to replicate DNA when a cell replicates itself. Also required in a pathway that inhibits the buildup of homocysteine. Elevated homocysteine levels are associated with increased risk for cardiovascular disease.

  • Folic acid affects mood and cognitive function, especially in older people. Adult patients with anemia due to folate deficiency, approximately 2/3 have neuropsychiatric disorders (12)

  • A study using mice showed that a diet sufficient in folate resulted in less cancer expression as compared to a diet deficient in folate (13)

Top 10 Folate Rich Foods (14)

  1. Garbanzo beans, ½ cup: 557 mcg

  2. Liver, 3 oz, 221 mcg

  3. Pinto Beans, ½ cup, 146 mcg

  4. Lentils, ½ cup, 179 mcg

  5. Spinach, 1 cup, 56 mcg

  6. Asparagus, ½ cup, 134 mcg

  7. Avocado, ½ cup, 61 mcg

  8. Beets, ½ cup, 68 mcg

  9. Black eyed peas, ½ cup, 112 mcg

  10. Broccoli, 1 cup, 57 mcg

Magnesium: an abundant mineral in the body that is a cofactor or more than 300 enzyme reactions. Magnesium involved in everything from protein and energy production to cell replication. Low Mg is associated with a decline in memory, poorer muscle and bone integrity, and some forms of cancer (15). Recommended intake is about 400 mg for an adult and increases as we age.

Here are the top 10 Magnesium-rich foods (taken from the USDA) (16)

  1. Spinach, cooked – 1 cups: 157 mg

  2. Swiss chard, cooked – 1 cup, 150 mg

  3. Dark chocolate – 1 square, 95 mg.

  4. Pumpkin seeds, dried – 1/8 cup, 92 mg

  5. Almonds – 1 oz, 75 mg

  6. Black beans – ½ cup, 60 mg

  7. Avocado – 1 med., 58 mg

  8. Figs, dried – ½ cu, 50 mg

  9. Yogurt or kefir – 1 cup, 46.5 mg

  10. Banana – 1 med., 32 mg

Microbiota and Microbiome: there are more bugs than there are cells in the human body, and the microorganisms in our gut encode genes and are involved in metabolic reactions. Having a robust and diverse microbial makeup is associated with decreased levels of inflammation (17). This is important, because most age related diseases are associated with increased inflammation. Incorporate foods that have probiotics such as kimchi, kombucha, sourkraut, natto, pickles, yogurt, kefir, tempeh, etc. These foods add bugs to our environments. In order to keep these bugs alive, we need to eat foods that are high in fiber. It is the fiber that feeds the bugs. Foods high in fiber include: vegetables, fruits, legumes, and whole grains.

Sauna Use: regular use of the sauna has been shown to benefit the aging process. Moderate to high frequency (4-7 days per week) is associated with lowered risks for dementia and Alzheimer’s (18). Frequent sauna use is associated with lower systemic inflammation (19). And the more you use the sauna the better!  In one study, the rate of death from cardiovascular disease and stroke decreased as sauna frequency increased (20).

Fasting: Prolong caloric restriction,that is reducing your calories while maintaining proper nutrition, has been found to extend life span. Rodents whose calories were restricted by 55-65% had a 36-65% greater mean lifespan and results were also seen with a 20-40% reduction in calories (21).
 

References:

  1. https://www.fasebj.org/doi/abs/10.1096/fj.05-4785fje

  2. http://cancerpreventionresearch.aacrjournals.org/content/8/8/712

  3. https://www-ncbi-nlm-nih-gov.nunm.idm.oclc.org/pubmed/26365487

  4. https://www-ncbi-nlm-nih-gov.nunm.idm.oclc.org/pubmed/29573889

  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4891873/

  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4125483/

  7. http://www.urbanorganicgardener.com/2015/11/how-to-grow-broccoli-sprouts-at-home-super-healthy/

  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356951/

  9. https://www.sciencedaily.com/releases/2016/04/160406165254.htm

  10. https://www.ncbi.nlm.nih.gov/pubmed/19444937

  11. https://www.ncbi.nlm.nih.gov/pubmed/24934545

  12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123448/

  13. https://www.ncbi.nlm.nih.gov/pubmed/29546304

  14. https://draxe.com/top-10-vitamin-b9-folate-foods/

  15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2790427/

  16. https://draxe.com/magnesium-deficient-top-10-magnesium-rich-foods-must-eating/

  17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257741/

  18. https://www.ncbi.nlm.nih.gov/pubmed/27932366

  19. https://www.ncbi.nlm.nih.gov/pubmed/29209938

  20. https://www.health.harvard.edu/blog/sauna-use-linked-longer-life-fewer-fatal-heart-problems-201502257755

  21. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3919445/