April 18, 2017

The Best Supplement May Be A Grain of Salt

When it comes to your health, the best supplement may be a grain of salt. I’m currently participating in a pilot program at the local medical school in which patients meet with researchers to learn about the research process and how we can participate beyond being research subjects. The program is fascinating. It gives us a glimpse into current trends in medical thought, and it makes us highly aware of the limits that plague medical research, the most frequent being time and money.
salt
Limited time and/or money usually lead(s) to smaller studies. Smaller studies are less representative of the population as a whole and thereby less definitive. Studies get published in medical journals, and along the way some ideas take hold in the medical community. Sometimes these ideas are incorporated into standard medical care even when there’s little evidence to support their clinical relevance.

A recent example of this is the practice of testing vitamin D levels when patients report malaise, fatigue or other nonspecific complaints. According to the CDC, the number of blood tests for vitamin D among Medicare recipients increased 83-fold from 2000-2010 and 2.5-fold from 2009-2014 for those with commercial insurance. At the same time, labs performing these tests started reporting normal levels of 20 to 30 nanograms vitamin D per milliliter of blood as insufficient.(1) As a result, many healthy people began to believe they had a deficiency.
fish oil
When numerous studies over the past decade linked low levels of vitamin D to cancer, heart disease, and diabetes, the millions who believed themselves to be deficient began, or were advised, to consume vitamin D supplements. I am one of those who received such advice after routine blood work. The problem is that the existing studies do not provide widely accepted evidence that vitamin D is helpful in preventing or treating these diseases. In fact, current evidence suggests that the main beneficial effects of vitamin D supplements relate to conditions of the muscles, bones, and joints.

And the vitamin D deficiency movement isn’t the first physician advanced idea based on insufficient evidence. Last year, newly issued dietary guidelines removed the restriction on cholesterol consumption because “it is now acknowledged that the original studies purporting to show a linear relation between cholesterol intake and coronary heart disease (CHD) may have contained fundamental study design flaws, including conflated cholesterol and saturated fat consumption rates and inaccurately assessed actual dietary intake of fats by study subjects.”(2)

And the possibly well-intentioned, oft repeated advice to add multivitamins to your regimen because they will make you healthier turns out to be false as well. A growing body of evidence suggests that multivitamins offer little to no health benefits. A study published in the December 17, 2013 issue of the journal Annals of Internal Medicine found that multivitamin and mineral supplements did not work any better than placebo pills.
test tube
We tend to regard science as infallible or research as indisputable. It’s not. We only know as much as we know in this moment. Our knowledge base will always be growing. Today’s theories will sometimes be proven wrong. Some studies will be statistically significant, but clinically irrelevant. Many studies will have too narrow a focus, too small a sample, or too short a term for the results to be taken as definitive on their own.

As patients, we are vulnerable to misinformation bombarding us from corporations that create supplements, food, and medications. Unfortunately, we are also vulnerable to imperfect science and bias within the medical community. To some degree this is unavoidable. This is where a grain of salt can come in handy. Skepticism can lead you to seek additional information.

If you are not medically trained, you cannot assume you know more than your doctor. You can, however, recognize that you have the final word regarding your healthcare. You have every right to ask questions with the expectation of a well-supported, forthright answer. You have the right to your health records. You have the right to seek a second opinion or a third. A second doctor may interpret your test results in a different manner than the first.

And barring an emergency situation, I’ll posit that you have a responsibility to yourself to remain skeptical regarding treatment recommendations until you become well-informed. That being said, the best supplement available for healthcare may be a grain of salt.

Disclosure of Material Connection: I have not received any compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: “Guides Concerning the Use of Endorsements and Testimonials in Advertising.”

1)https://www.nytimes.com/2017/04/10/health/vitamin-d-deficiency-supplements.html?_r=0
2)https://www.ncbi.nlm.nih.gov/pubmed/19751443
https://people.hss.caltech.edu/~camerer/Ec101/JudgementUncertainty.pdf
http://www.medlabme.com/magazine-issues/2016/diagnostics/vitamin-d-assays/
https://www.hsph.harvard.edu/nutritionsource/2016/01/07/new-dietary-guidelines-remove-restriction-on-total-fat-and-set-limit-for-added-sugars-but-censor-conclusions/
http://annals.org/aim/article/1767855/vitamin-mineral-supplements-primary-prevention-cardiovascular-disease-cancer-updated-systematic

April 11, 2017

Spring Cleaning Pantry Challenge

A spring cleaning pantry challenge is a great way to start spring cleaning in the kitchen! I’ll admit it, I’m not really a spring cleaner. That doesn’t mean I don’t do deep cleaning. It just means I tend to do it at the odd times that a spill, utensil search, or crawl under the bed to grab a baby toy lead me into intolerable dust, dirt, or disorganization. Then I stop whatever I had planned and start cleaning. I may not finish moving all the furniture to clean under it right then, but I stick with the project until it is complete.
spring
Whether you’re a sporadic deep cleaner like me or part of the 78% of people who regularly spring clean*, it’s easy to forget about the pantry. With larger tasks like oven cleaning, curtain washing, grout scrubbing, baseboard dusting, and window washing looming, it can be easy to reason that the pantry will take care of itself through regular meal preparation.

The problem with that approach is that few of us have pantry space that’s designed one item deep and one item high in a manner that everything is visible at once. And if you can’t see it, you’re bound to forget about it. Who hasn’t bought some ingredient for a recipe, used part of it and put the rest in the back of the cabinet to be forgotten? I have bottles of fish oil, rice wine vinegar, and real maple syrup sitting in my pantry. I don’t use them often and I can’t tell you how long they’ve been there. It’s definitely time for a pantry challenge at my house.

What’s a pantry challenge?

A pantry challenge is a period of time dedicated to using everything in the pantry before purchasing more groceries. In other words, you’re challenging yourself to plan meals using what you have on hand. Now, obviously you may need to buy milk, eggs, fresh produce, or meat to go with your pantry items, but the goal is to use what’s available in your pantry as quickly as possible.

Before starting the challenge, discard any outdated items. Once those are discarded, create some menu items that include the remaining pantry contents beginning with anything that’s open, partially used, or about to expire. It’s always fun to see what new combinations come to mind when you have limited ingredient choices.
pantry
During my pantry challenge, I’ll be enjoying red lentil soup, homemade yogurt, gluten-free pasta with red sauce, molasses cookies, roasted red pepper cornbread, applesauce muffins, and tuna croquettes. That won’t completely deplete the pantry offerings, but it will pare down some of the older items. Before I restock, I’ll clean all of the shelves and drawers and organize whatever remains.

I’ll also take a minute to review my organizational system. There may be some tweaks that will make every day cooking easier. If so, I can implement those changes now and easily incorporate upcoming purchases into the revised system.

As I’ve pared down my furniture, knick-knacks, clothes, shoes, and jewelry over the past couple of years, the over abundance in my pantry feels more noticeable. Because my job includes creating recipes, I can swiftly end up with clutter-creating remnants. I don’t want to wastefully discard them, but I am aware that I need to develop a system for making sure they’re used in a timely manner. My pantry challenge will be a great opportunity to think through this process.

Spring cleaning may not be fun, but a clean, tidy environment can make fun times more joyful. I’ll try to keep that in mind when I’m elbow deep into cleaning out the pantry!

*https://www.sparefoot.com/self-storage/blog/17104-dread-spring-cleaning/

April 4, 2017

Spring is a Great Time to Locate Sources of Fresh, Local Food

farmers marketEarly in the growing season is a great time to locate the best sources of affordable fresh, local food. Imagine a salad of buttery lettuce, scallions, shaved carrots, spicy micro-greens, and vine ripened tomatoes topped with a grate or two of artisan cheese or one made of crispy cucumber slices and fresh dill. It’s hard to beat the full flavor of fresh produce.

It can also be healing to get your hands dirty. There’s something about working with peaty smelling soil that makes you feel more connected to the earth and its natural ebb and flow of life. The green of a garden makes the space calm and inviting — even if that garden is inside.

If you’re lucky enough to live in the country, your own garden gives you the best of both worlds — fresh produce and a place to work the ground, get some sun, and breath in the smell of earth, grass, and possibly not-as-pleasant compost. When you have the land available, a full-fledged garden may be the best source of fresh food during the growing season. 

I grew up helping my grandmother in the garden. Hers was located on our farm about 10 miles from her home. In the spring, my dad would till up the soil and from that point, it was my grandmother’s domain. Long before anyone talked about the dangers of skin damage from the sun, she wore long sleeved shirts and a broad-brimmed hat while she dug, planted, weeded, and harvested lettuce, onions, cabbage, zucchini, summer squash, okra, peas, green beans, potatoes, corn, and tomatoes. 

Down the road, my great aunts shared a garden. They spent many afternoons sitting in chairs in the lawn shelling peas, snapping beans, or shucking corn together while they swapped stories. When the grandkids were around, we ran free in the yard or the fields. There was a sense of community created by these shared tasks that lessened the drudgery and made them as much enjoyable social activity as everyday task accomplishment. To those of us who grew up in this environment, it’s no surprise that designed communities that encourage similar shared gardens are springing up in cities like Asheville, NC.
herbs
If you live where outdoor space is more limited, raised beds or containers provide a suitable environment for tomatoes, peppers, lettuce, kale, cucumbers and other favorites. Even a window sill can host pots of herbs throughout the year. 

Growing your own herbs and vegetables provides an opportunity for mindful interaction with nature and reduces the cost of fresh food, but it also adds to your task list. A garden must be tended to get the best results. Regular watering, weeding, and harvesting all take time. If you’re long on fertile land, but short on time, you may want to explore additional sources of fresh food.

Luckily, the farm-to-table movement has increased the number of options for procuring fresh produce, grass fed beef, and free range chicken. Shares of organic farms can be purchased through Community Supported Agriculture (CSA) programs. Each share entitles you to a weekly pickup of food from the farm. The contents and amount of food vary depending on your location and the specific farming organization. Another version of this arrangement offers memberships that entitle you to pick up a weekly food basket.
peppers
Community garden plots are collectively farmed by a group of people. They may sell food or allow you to trade labor for a certain amount of food. Trading labor for food can make them a budget friendly option. Don’t assume these are only located in affluent neighborhoods. There may be one near you no matter what your economic or social status. My city has a community garden located in a low income, gang saturated neighborhood next to a middle school. It is used as a learning tool for students.

Down the street, a neighbor turned an empty lot into a neighborhood garden. He rented small plots to his neighbors for a nominal fee on a first come, first served basis. On a Saturday morning, it’s not unusual to see neighbors visiting while they work in the garden. Sometimes cities or counties have similar gardens located on the outskirts of town.

Other options for fresh, local food include the traditional Farmers Markets that abound in cities. There may be one within walking distance in your neighborhood. Many vendors can swipe your debit card, so take reusable bags, but don’t worry too much about getting cash on the way.
market 2

In more rural areas, farmers sell fresh fruits and vegetables from the back of pickup trucks. If peaches grow in your state be sure to stop the next time you see a farmer with tubs full for sale. There’s nothing like the perfect fresh peach!

While all these options are worth exploring, you may not need to change your routine at all. Some urban farmers sell their food in grocery stores. Ask a store manager whether this is true in your local store. Natural Grocers has a stock of locally grown produce in my city. Even Walmart has made an effort to increase its selection of locally grown items.

I’m looking forward to digging in the dirt this weekend, but most of all, I’m looking forward to the harvest and all that yummy food!

http://sovereignoaks.com/community/

http://villagesatcrestmountain.com/

http://www.motherearthnews.com/homesteading-and-livestock/sustainable-farming/neighborhood-gardens-zm0z14amzsor

https://www.heifer.org/campaign/heifer-usa-buy-csa-shares.html

http://corporate.walmart.com/_news_/media-library/photos/live-better/local-produce-at-walmart

March 29, 2017

Baby Knows Best

I know it sounds counter intuitive, but sometimes baby knows best. If you’re having trouble getting your baby to eat, try following his lead. Obviously, babies don’t know anything about nutrition, or electric outlets, or the dangers of drinking antifreeze. That means they don’t need to run the show, but it doesn’t mean their preferences should be ignored entirely.
DJ4
Babies come equipped to express their needs. If you’re a parent, you’re well aware of your baby’s ability to communicate hunger, discomfort, frustration, anger, and a preference for mommy and daddy. Each baby, like each adult, is slightly different. A one-size-fits-all approach to introducing solid food can result in frustrated babies and irritated parents. Eventually, all babies will learn to eat solid food, but why not make the process as painless as possible?

This is a frequent topic of discussion with my son who believes that hands and the floor should stay clean and whatever’s offered should be eaten…no matter what. Sometimes I wonder if he’s forgotten how he was raised. He was allowed to make a mess, get his hands dirty, and choose not to eat something as long as he was eating something else that was offered.

Mind you, I understand it’s not fun to clean up the mess my grandson DJ makes. The first day I decided to see if he was ready to scoop food out of a bowl by himself, I ended up with food all the way to the top of my refrigerator door. From this I determined he’s not ready to handle a bowl, but he knows how to have fun!

I prefer to keep meal time a lighthearted learning experience rather than a battle of wills. All this requires is a sense of humor, attentive observation, and a little preventative maintenance. I now cover the floor under the high chair with a sheet so that cleanup is quick and easy. If DJ wants to mash the banana on his tray rather than eat it, we make a game of it. After all, he’s learning what foods are called, how taste & textures vary, how to pick up small pieces of food, and depth perception. At 8 months, he’s not ready to learn table manners yet. That will come. Of course I set some limits. When DJ decides to spit peas, he gets one free pass. After that, the peas go away until another meal.
snarl
It can be easy to assume a baby wants to spit peas because she’s misbehaving or hates green vegetables, but it’s obvious that DJ is just having fun making noise, making a mess, and watching my response. He loves it when I think he’s funny. After we have a laugh, he usually goes right back to eating. He actually likes peas.

Food preferences can develop before a baby is born. A child who spits out spinach may gobble up asparagus or broccoli. When you offer a large variety of fresh vegetables and fruits, you’ll soon learn where your child’s preferences lie so that you can incorporate some of those foods into the family menu on a regular basis.

DJ’s parents feed him regular food that they prepare at home. That way he can eat the same foods they’re eating and they can know exactly what he’s consuming. While they have chosen not to use prepared baby food, they are creating traditional purées for him to eat from a spoon.

After a month or so of success introducing foods, DJ began to gag or shudder whenever the spoon approached his mouth. He no longer seemed to like foods that he loved the day before. He also seemed reluctant to touch his tray, and he clearly wasn’t enjoying himself at meal time.

I might not know how to solve that specific problem immediately, but I know how to make the experience more engaging. Once a baby is engaged, a little observation can lead to some possible solutions. Babies love to put things in their mouth. They enjoy touching new textures. DJ needed to get his hands dirty.
spoon
I bought him a silicone spoon that works as both a teether and a spoon. It’s easy to hold with no pointed end to endanger a baby’s eyes. Of course DJ wanted to grab it and chew on it. Then I added food — the same food that he gagged at when I tried to feed him. He grabbed the spoon, ate a big bite, looked at me and said, “Mmmmm!” He had fun for the rest of the meal. Weeks later, DJ is still having fun at meal time and he’s eating well. Sometimes he’s happy for me to feed him. Sometimes, he wants control of the spoon. I simply follow his lead.

The result of a little observation and willingness to experiment is a baby who has shown us that he prefers vegetables to fruits and eats a wide variety — spinach, green peas, broccoli, cauliflower, sweet potato, butternut squash, black eyed peas, potatoes, and carrots. He also likes chicken, avocado, cantaloupe, dates, and mango. He doesn’t like to eat bananas, but he loves to smash them into his tray.
DJ Eating
As his world expands, DJ’s preferences will continue to evolve. We plan to take note and include his new preferences in our meal plans. We will offer simple choices between A and B rather than open ended questions regarding what he wants to eat. This will give DJ control over his diet within the boundaries of the adults who know he will thrive with fresh vegetables, fruit, meat, and eventually eggs, dairy, and whole grains. Our goal is to provide healthy food while keeping meal time peaceful and fun. My son and I can agree on this.

If you run into a problem getting your child to eat, keep offering a variety of fresh food, follow his lead whenever it makes sense, and remember to have fun! That may be all it takes to solve the problem.