Archive for ‘Dietary Compliance’

June 20, 2017

Do Something About It or Let It Go?

How do you know whether to do something about it or let it go? Last week, I saw a news story in which a mother gave her 10-year-old son some sage advice. The son was angry that some graves in the veteran’s cemetery where his grandfather was buried did not have flags on them. After a few hours of listening to him complain, his mom told him simply that he needed to do something about it or let it go.
brain maze
That’s the best parenting I’ve seen in a long time. It’s also great advice for all of us. Complaining, ranting, and raving on their own just leave us feeling powerless and increasingly angry. Eventually this affects those around us, poisoning our relationships and social interactions. Observing injustice for what it is and bringing it to light are important steps toward facilitating change. Unfortunately, the complaint phase is an easy place to get stuck.

There’s a ton of injustice in the world. There is avoidable tragedy, inexcusable cruelty, disregard for those who are different, deliberate predatory behavior, negligent laziness, and power-grabbing manipulation. That’s a short list. The real list is long, long, long, unending, overwhelming, and impossible for any one of us to fix.

That means we have decisions to make when we feel the crushing effect of personal dismissal or the heartstring pull of another’s adversity. Should we leave the affluent doctor who verbally abuses our children or should we just rant about what a jerk she is and continue to let her support us? Should we continue to give low pricing to the customer who always wants extra thrown in or should we raise the price and risk losing the business? Should we consider adopting a child even though we’re in our 50s? Should we sue our employer who has fired three different employees because they used sick leave to be present after their wife gave birth? Should we buy our 16-year-old a brand new car, or buy a used car and spend the rest of the money to buy a car for a working single mother whose car just died?

Many of these decisions are difficult, multilayered, and complicated. Our decisions will have ripple effects. Of course it’s easier to rant, rave, and complain about injustice than it is to make a deliberate decision to do something or let it go.

But what is it that really stops us? Is it fear, weakness, or the belief that we have no power? Or does that even matter? Does examining, reexamining, and trying to understand ourselves only lead to paralysis?

Can we be better served by practicing the process of making a choice to do something about it or let it go? Or as my grandmother would have said, to “stop stewing in your own juice.” Let’s start with a simple issue and explore what that process would look like.

contractorScenario 1 (Complain)
I observe that my contractor only shows up 1 out of 3 times that he’s scheduled.
I tell my sister how annoyed I am.
I schedule him again.
He stands me up again.
I more heatedly tell my sister how annoyed I am, then I also tell my neighbor, my uncle, and several other people.
I reschedule the contractor again.
This time, he texts me, but he still doesn’t show.
I call everyone I complained to before and rant this time throwing in a few “why me?” questions like, “Why is it always me who gets stood up?”
I feel angry and powerless.

drillScenario 2 (Do something)
I observe that my contractor only shows up 1 out of 3 times that he’s scheduled.
I tell my sister how annoyed I am.

I begin the process of determining whether I will let him go and find someone new, or try to work this problem out with him.
Here’s how that works:
I review why I chose this contractor…
He’s inexpensive, he does quality work, and he’s fast.
I compare him to other contractors I’ve used…
When he shows up, he’s 80% better than 90% of them.

I decide that it is best to do something to try to make this relationship work.

I set boundaries I can feel good about…
One no show with a text is acceptable. A no show without notice or a 2nd no show with or without notice will be grounds for firing him.
I call the contractor to reschedule…
I tell him simply that I like his work, but he needs to show up more consistently or we won’t be able to work together any more. Then I tell him my specific boundaries. I state them in a clear, concise, straightforward, matter-of-fact manner. I do not apologize or pressure.

I schedule him again…
We’ll see what happens. No matter what, I have a plan. I no longer feel angry or helpless. I won’t feel bad if I have to fire the guy because I know I clearly stated my expectations. The decision is now his. If he chooses to show up, he has a job. If he chooses not to, he doesn’t.
I feel relieved.

hold onScenario 3 (Let it go)
I observe that my contractor only shows up 1 out of 3 times that he’s scheduled.
I tell my sister how annoyed I am.

I begin the process of determining whether I will let him go and find someone new, or try to work this problem out with him. 
Here’s how that works:
I review why I chose this contractor…
He’s inexpensive, he does quality work, and he’s fast.
I compare him to other contractors I’ve used…
When he shows up, he’s 80% better than 90% of them.
I factor in that I need the work done before a family reunion.

I decide that it is best to hire someone I can rely on in order to make my deadline.

I let the contractor know that I can no longer work with him on my project because I have a deadline. I move on and hire someone else.
While I will not recommend the fired contractor for deadline projects, I might tell someone to consider him when there’s no deadline. I feel no need to trash him on social media, continue to complain about him to my family, or even think about him again. I just let it go.
I feel relieved.

Obviously, this is a simple scenario I’ve described, but the more I practice the process, the easier it becomes to follow that process even when the relationships are closer and the feelings more complicated. The resulting peace and freedom I feel each time I embrace my power to do something about it or let it go builds my desire and courage to repeat the process.

And that little boy who received the advice from his mother? He chose to do something. He has now placed over 20,000 flags on veteran’s graves. Thanks Preston Sharp for your service, and thanks mom for your wisdom!

See the story here:
http://www.cbsnews.com/news/california-boy-11-becomes-the-pied-piper-of-patriotism/

June 14, 2017

Has Gluten-Free Living Gotten Easier?

Has gluten-free living gotten easier as awareness has increased? When I learned gluten-free living was a necessity for me, it took an average of 11 years to get a diagnosis of celiac disease, gluten-free products were limited and only available in specialty stores, and few restaurants offered gluten-free menus. That was 13 years ago. What has changed?
gf pie crust
Access to information has increased

Over the past decade, the internet and smart devices have increased our access to information exponentially. Want to know if the Knorr Vegetable Recipe Mix your friend used in the spinach dip she brought to a party is gluten-free? Just grab your phone and find out. Want to find gluten-free pizza nearby? A digital assistant can find it and give you driving directions. Need to make sure a restaurant choice will be easy for you? Preview the menu on the website. Interested in current research? Much of the information is just a click away. Want to find a gluten-free partner or friend? Try http://glutenfreesingles.com/. Advances in technology have brought the most changes by far.

Restaurants are more informed

The term gluten-free is now widely recognized. Chances are that the waiter at your favorite restaurant is familiar with the term. That restaurant may offer a separate gluten-free menu or have certain items designated gluten-friendly. Many national chains publish allergen information online.

Major supermarkets have gluten-free selections

You can now find a selection of gluten-free convenience food at every major supermarket. In fact, the top-selling breakfast cereal in the USA is gluten-free Honey Nut Cheerios. Other commonly stocked gluten-free labeled foods are crackers, pretzels, pasta, cake mix, flour blends, cookies, frozen pizza, and frozen waffles. Even convenience stores keep a selection of high protein gluten-free snacks on hand.

Specialty bakeries exist

wedding cakeDedicated gluten-free bakeries that eliminate the possibility of cross-contact with gluten containing ingredients now dot the country. Not only can you choose from cookies, brownies, cheesecake, pie, and doughnuts, beautifully decorated gluten-free wedding and birthday cakes are available in cities across the US. Many specialty bakeries also offer dairy-free, nut-free, and vegan options.

Gluten-free labeling now has a standard in the US

Prior to 2014, a gluten-free label didn’t necessarily mean the product was free of gluten because there was no labeling standard in place. As of August 5, 2014, FDA-regulated packaged foods bearing a gluten-free claim must meet the following requirements: the food either must be inherently gluten-free; or shall not contain an ingredient that is: 1) a gluten-containing grain (e.g., spelt wheat); 2) derived from a gluten-containing grain that has not been processed to remove gluten (e.g., wheat flour); or 3) derived from a gluten-containing grain that has been processed to remove gluten (e.g., wheat starch), if the use of that ingredient results in the presence of 20 parts per million (ppm) or more gluten in the food. Also, any unavoidable presence of gluten in the food must be less than 20 ppm. This rule does not apply to USDA (meat, poultry, some egg products) or TTB (alcoholic beverages) regulated foods.

Testing for celiac disease has increased

Doctors are more likely to test for celiac disease now than they were in 2004. The average length of diagnosis from onset of symptoms currently ranges from 6 – 10 years in the US. New screening tests are in development that may increase test rates in the future.

Experimental treatment is being tested

Research at Walter and Eliza Hall Institute of Medical Research in Australia has led to the development of Nexvan2®, a product that aims to retrain the immune system to tolerate gluten. This treatment is currently being studied in clinical trials led by ImmusanT of Cambridge, MA. A Phase 2 study is scheduled to begin this year. If you would like to participate in ImmusanT studies, visit http://www.immusant.com/patient-resources/learn-more.php.

Looks like quite a few things have changed for the better in the gluten-free world! On balance, there are still things that can be improved.

More information can lead to confusion

When the mountain looks overwhelming, it’s difficult to start climbing. The sheer volume of information available can sometimes make things seem more confusing and difficult. Determining whether sources are reliable, recipes have been tested before publication, or a gluten-free pizza crust is being topped and baked in a kitchen where flour fills the air still requires time and energy. Well-meaning friends may pass along incomplete or incorrect information obtained online. The ingredients list on a favorite product you previously researched may unexpectedly change. In real life, it’s never quite as simple as 1-2-3.

Your server may not really know what gluten-free means

While most waiters have now heard the term gluten-free, they may not have a clear understanding of what it means. This sometimes makes communication a bit more awkward. They may also have served people who jumped on the gluten-free bandwagon as a fad and who cheat whenever they want a piece of cake. This makes it harder for those of us who must be gluten-free to be taken seriously.

Gluten-free processed food is still processed food

There seems to be a never-ending parade of less than delightful, expensive products coming and going from store shelves. At one point, these were grouped together in sections marked gluten-free. Now, they’ve been reintegrated into the regular product shelves where they’re more difficult to locate. Some packaged convenience products taste good. Many do not. And even though they may be gluten-free, they’re still processed food.

It’s harder to find gluten-free lists

Now that there’s a labeling standard, some companies have stopped publishing lists of gluten-free products online and have substituted a “read the label” statement. This makes it harder to research things like acceptable Halloween candy in advance.

The rate of diagnosis still takes 6 – 10 years

While doctors may test for celiac more frequently, it can still take 10 years to receive a diagnosis and over 90% of those with the disease remain undiagnosed. That doesn’t feel like much progress. That means over 2.25 million in the US are living with a nearly 4-fold increased risk of death and do not know it.*

According to the Celiac Support Association:
Untreated celiac disease increases the risk of cancer 200-300%.
Untreated celiac disease increases the risk of miscarriage 800-900%.
66% of those with celiac disease have osteopenia or osteoporosis.
51.4% of those with celiac disease have neurologic disorders
Healthcare costs per untreated celiac in the US: $5,000 – $12,000 annually.
Total US healthcare cost for all untreated celiacs: $14.5 – $34.8 billion annually.

BD PartyAnd if you really want to experience how little things have changed…
Visit a few weddings, baby showers, football watching parties, funeral luncheons, law school receptions, fundraising events, committee meetings, festivals, coffee houses, concession stands, hotel breakfast buffets, and neighborhood potlucks. While there are now some exceptions, the pre-eat or carry your own food rule still frequently applies. Ingredient information is not typically available in these settings and options are often limited.

Progress has been made

Things have gotten easier on many fronts. I am grateful for those. When I discover things that have become more difficult, I feel frustrated, but I stay the course because it’s worth it to me to feel good. And all things considered, living gluten-free is not that difficult. It simply requires commitment and planning.

Is a gluten-free lifestyle worth it

Yes!!!! Even if nothing had changed in the past 13 years, living a gluten-free lifestyle is absolutely worth any inconvenience for me. Having a chance to feel my best and be my healthiest is always worth it because how I feel affects my quality of life every minute of every day. Being my healthiest also makes it possible for me to potentially enjoy more years of living a full life. I can’t think of any reason I wouldn’t want that.

https://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/Allergens/ucm362880.htm
https://www.beyondceliac.org/celiac-disease/facts-and-figures/
https://www.csaceliacs.org/diagnosis_of_celiac_disease_fact_sheet.jsp
https://www.wehi.edu.au/research-diseases/immune-disorders/coeliac-disease
http://www.immusant.com/patient-resources/clinical-trials.php
http://lilacpatisserie.com/wedding-cakes
http://www.dempseybakery.com/
https://www.tu-lusbakery.com/menus/picture-gallery/
*http://www.sciencedirect.com/science/article/pii/S001650850900523X

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.”

May 30, 2017

Stretch Your Greenbacks with Forgotten Greens

When you’re trying to eat healthy on a budget, you can stretch your greenbacks with forgotten greens! It’s hard to grow up in the South without eating greens. They’re a staple in every home cooking, soul food, and barbecue restaurant and many grandmother’s kitchens. Most cooks have a favorite green. Some prefer collard, some mustard, and some turnip. When you generically refer to greens, it’s assumed you mean one of these three or a mix of them.
carrot
Often overlooked are the other greens that abound in Southern homes. We consume beets, radishes, carrots, and celery on a regular basis. Most of us have added kale to our menus, and many of us enjoy kohlrabi and bok choy in the occasional stir fry. In an effort to eat fresh, local food it’s more and more common to buy these vegetables from a community garden, neighborhood farmer’s market or CSA (community supported agriculture) produce coop.

If you shop in these venues, you know that the vegetables aren’t always uniform in size and shape, they may arrive still covered in soil, and most of them will have beautiful green leaves attached. It’s tempting to quickly chop off the leaves and discard them before cleaning beets, carrots, or radishes, and many cooks in my family do just that.
radish
I’ll admit it takes more time to clean and shred the tops, but you can also end up with a delicious mix of greens just by saving what you’d normally throw away. This weekend, I cooked a pot of spicy greens using radish, kohlrabi, and bok choy greens, plus some Swiss chard. That’s not a special mix. It’s just what I had on hand. As is true of most combinations of leafy greens, they’re delicious together.

Of course, you can also use these tops in a salad or soup. Unfortunately, I don’t really like cabbage tasting greens in a salad, and I’m unlikely to make soup in the summer. But thinking of edible vegetable leaves in the way I think of turnip greens gives me another avenue for preparation. Seasoned with chicken stock, onion, garlic, dried chile peppers, salt, pepper, and a splash of vinegar, these greens have wonderful depth of flavor and a peppery bite.

I’m not sure how collard, mustard, and turnip greens came to be the standard for greens, or why my grandmother never used the radish greens or carrot tops she grew. I do know that I can stretch my greenbacks by broadening my definition of greens to include beet, bok choy, broccoli, carrot, celery, chard, dandelion, kale, kohlrabi, and radish.
greens
And by cooking the greens attached to my vegetables, I gain another vegetable to serve, stretch my food budget, and include all the vitamins, minerals, and antioxidants that make leafy greens an important part of a healthy diet. I also reduce my food waste. That makes me feel good.

May 1, 2017

Hold the Natamycin, Please

I’ll have sharp cheddar, and hold the Natamycin, please. Over the past few years, I’ve noticed that my hands sometimes break out after eating cheese dip, my cheeks turn bright red after an eye exam or when I use eye drops, and recently, I felt achy and uncomfortable for several days after eating shredded Parmesan cheese. Those sound like fairly random, unrelated events…are they?
reaction
I don’t like feeling tight, achy, antsy, itchy, or uncomfortable. I also don’t like looking like this photo that was taken after my last eye exam. I began to keep track of what happened just before I noticed these reactions. The emerging picture is, my system doesn’t like Polyene Antimycotics. And it’s not just my system. It seems my sister has been having similar reactions to the same list of products.

What are Polyene Antimycotics?

Polyene Antimycotics, also known as Polyene Antibiotics are a class of antimicrobial compounds that target fungi – think of them as antifungal agents. They are a subgroup of Macrolides which are natural products with a certain chemical makeup that fall in the Polyketide class. Polyene Antimycotics are most commonly derived from Streptomyces bacteria. Because they have antimicrobial or antibiotic properties, they are often used in pharmaceuticals.

What are they in?

Nystatin sold as Nilstat, Mycostatin, and Bio-Statin; and Amphotericin B sold as AmBisome, Amphocin, Amphotec, and Fungizone are examples of polyene class pharmaceuticals. Natamycin sometimes sold as Pimaricin, is another example. Natamycin is active against yeasts and molds.
moldy cheese
Not only is Natamycin used to treat eye infections, it’s increasingly used to inhibit mold in cheese, yogurt, and bread in the US. It’s also used to preserve crops like oranges. I understand the economic benefit of increased shelf life for food corporations. Having once pulled out and bitten a moldy sandwich from my school lunch bag (thanks, Mom), I even understand the aesthetic benefit.

Nonetheless, for obvious reasons, I don’t want this substance in my food. Whole Foods agrees with me. Since 2003, they have not sold products containing Natamycin. Unfortunately, the World Health Organization and the FDA consider it safe. Current research is on their side, but I wonder whether the safety studies, as designed, would have determined there was a connection between my reaction and Natamycin? Maybe not, it took me a few years to figure it out.

Are we the only ones who experience detrimental effects?

Even if my sister and I are the only two people on earth experiencing adverse effects, that’s enough reason for me to make a choice contrary to what the research indicates. I’m not willing to endure the side effects I experience when I consume Natamycin even if it’s deemed “safe”. Based on the evidence, it’s still not healthy for me. Of course, I wonder whether my sister and I are only two among thousands who suffer effects, but haven’t yet made the connection to polyene ingestion. In time, we may find out.

In the meantime, I’ll be searching for new brands of cheese. Last week, two of my regular selections for over 15 years contained a new list of ingredients that included Natamycin. Not only was it listed as an ingredient, it was presented as a “natural” substance. While that’s technically true, it seems a bit misleading. I don’t think most people expect a natural product that’s also used as a pharmaceutical to be included in their food. I feel disappointed by that presentation and the fact that I must find new options, but I’m a dedicated label reader so at least I noticed this ingredient change before I consumed the cheese.

I am increasingly concerned about the possibility that the cheeses used by my favorite restaurants have also undergone this change. Without the advantage of seeing the label, I could easily accidentally ingest Natamycin.

On behalf of my sister, myself, and anyone else who may be detrimentally affected by polyenes, I’d like to say to* Kraft Heinz – owners of Kraft® Brand Cheese Products & Snack Trios, Nestlé – owners of Buitoni® Brand Products, Saputo – owners of Frigo® & Stella® Brand Products, and all other food companies out there: “I don’t want to have to say, hold the cheese. I just want to say, hold the Natamycin, please.” To the WHO and FDA, and researchers everywhere, “I hope you’ll investigate further.” To anyone whose very real reactions have been dismissed by a medical professional, “I’m so sorry. There’s nothing more discouraging and crazy-making.”

Luckily, it is easier than ever to share information that allows us to make better and better food choices. For that, I am grateful.

*This is not a comprehensive list. These companies also own other brands that may contain Natamycin and other companies may include it in their products as well. This list was compiled based on recent personal experience only. Please read the label before consuming any product.

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.”


https://www.drugs.com/drug-class/polyenes.html

http://www.natamycin.com/usage

http://www.wholefoodsmarket.com/about-our-products/quality-standards/food-ingredient

http://www.kraftrecipes.com/products/productmain.aspx

http://www.nestleusa.com/brands/culinary

http://www.saputo.com/en/Our-Products