Blog – Nicole Holovach | Dietitian Nutritionist

Milk & Dairy in Context

I’ve been putting off writing about this topic for a while because we’re currently in a period of time where milk and dairy products are vilified foods. I’m a big proponent of the idea that ALL foods have pros and cons, and I think milk and dairy products have way more pros than cons. The inability to digest milk and dairy products is often due to additives, quality, and a person’s gut health and metabolic rate, rather than milk and dairy products being “bad foods.”

Thankfully, my intern, Nosheen Hayat, was up to the challenge! Nosheen is a dietetic intern at the National Institutes of Health and a Gates Millennium Scholar. She received her Masters of Public Health degree from the University of Michigan. She runs a private practice Hayat Nutrition in Gaithersburg, MD. I am grateful to her for tackling this tough, but timely blog post. Enjoy!

Many people (particularly in the vegan circles) make the argument that humans are the only mammals that drink another mammal’s milk and thus, it is an “unnatural” behavior. However, humans are also at the top of the food chain and the only mammals on earth that drive cars, cook their food, and use technology.

Dairy consumption has been a human practice for at least 8,000 years. In many cultures, milk is regarded as an important food and used to make butter, cheese, yogurt, and kefir.

Despite a long history of dairy being an integral component of the human diet, it has recently been vilified and alternatives such as almond, rice, and soy milk have become popular. One reason why dairy is considered an “unhealthy” food is due to its saturated fat content. Many publications since the 1950s have linked saturated fat with increased risk for heart disease; however, more recent publications are showing this may no longer be the case. Research now shows that saturated fat may not be associated with an increased incidence of cardiovascular events (1).

Milk consumption is associated with reduced risk for a number of diseases, including childhood obesity, type 2 diabetes, cardiovascular disease, stroke, colorectal cancer, bladder cancer, gastric cancer, and breast cancer; research also shows a positive effect on bone mineral density (2). While humans have been drinking milk for thousands of years, drinking plant-based milk is a new phenomenon and its consequences on health are yet unknown.

Not only is milk cheap and easily accessible for most individuals, it is also a rich source of magnesium, potassium, selenium, vitamins A, B, D, and K. It is a naturally balanced food—containing 87% water, 5% sugar (lactose), ~3.5% protein, and ~4% fat.

However, not all milk and dairy is created equal.

Grass-fed, Organic vs. Conventionally Farmed Milk

Grass-fed milk comes from cows that are allowed to graze on pasture for most of the year rather than being fed a processed diet (i.e. genetically-modified corn and soy). This method of farming creates an environment for happy, healthy cows. Grass-fed milk has a lower omega-6 to omega-3 ratio, which is important for good health and reducing inflammation in the body (3). It also has higher amounts of conjugated linoleic acids (CLA), which are associated with reduced risk for cardiovascular disease (3).

Purchasing organic milk can reduce the amount of pesticides in your milk and guarantee that the feed provided to the cows is not genetically modified. However, it does not imply that the cows your milk comes from are allowed to graze on pasture or be unconfined.

Conventionally farmed milk typically comes from cows that are fed a processed diet, consisting of soybean, corn, and other grains as well as antibiotics. Additionally, these cows are not allowed to graze on pasture and live in very unsanitary and stressful conditions.

Homogenization of Milk

The purpose of homogenization is to ensure that the fat or cream of the milk does not separate from the liquid. This is done by forcing the fat molecules through small holes or mesh at high pressure. One problem with homogenized milk includes the breakdown of casein micelles, which result in calcium phosphate soaps that can irritate the gut lining and decrease the bioavailability of calcium and phosphorus found in milk (4).

Homogenization can also introduce oxygen into the milk product, which can cause excess bloating and gas when it interacts with the bacteria in the gut of individuals with gastrointestinal issues. Lastly, homogenization can inactivate a protein called lactoferrin, which exhibits anti-bacterial properties by binding up iron and reducing its access to gut bacteria (5).

Opt for a non-homogenized milk, if possible. However, if you can’t get access to a non-homogenized milk, it’s no reason to avoid milk! Homogenized milk is still a great source of protein, minerals, and vitamins.

Pasteurization of Milk

When milk is pasteurized, it is heated to a specific temperature for a length of time and then cooled immediately. The temperatures and length of time vary based on type of pasteurization. Heat treatment is used to destroy potentially pathogenic bacteria; however, it can also inactive enzymes and reduce the percentage of nutrients found in milk.

Unpasteurized or raw milk is not heat-treated. However, raw milk is illegal in most states and difficult to find. If you live in a state that allows the sale of raw milk (i.e. California), it is important to visit the sourcing farm and see their practices to ensure cleanliness of their operations and proper care of their farm animals.

Low-pasteurized milk is heated in small batches at a lower temperature but longer period of time than regular pasteurized milk—to 145ºF for 30 minutes.

Regular pasteurized milk is heated to a temperature of 161ºF for about 15 seconds and then cooled immediately.

Ultra-pasteurized milk is heated to a minimum of 280ºF for at least two seconds. The higher temperatures kill more bacteria and ensure longer shelf-life of milk processed with ultra-pasteurization.

Pasteurization can reduce the amount of immune-modulating proteins in milk, such as lactoferrin; it can inactivate enzymes and reduce the amount of vitamin C, B6, iron, manganese, and copper (4). Ultra-pasteurization further reduces the vitamin and mineral content of the milk, cause formation of lactulose (a laxative) through lactose isomerization and Maillard reaction products, which can reduce the bioavailability of proteins and minerals in milk (4, 6).

While low pasteurization to no pasteurization is the best option, it can differ person to person depending on their digestive health. Individuals struggling with digestive issues may have symptoms of bloating, gas, and abdominal pain when drinking raw milk. These individuals may do better with a pasteurized or ultra-pasteurized milk product. Or vice versa, these same individuals may do better on raw milk or low-pasteurized milk. It is important for you to look out for symptoms after drinking milk to see if the type of milk you’re drinking is working for you.

Context of Drinking Milk

Now that we’ve discussed what to consider when purchasing milk, let’s talk about the different physiological contexts of drinking milk.

Many people cannot drink milk due to lactose intolerance, which occurs when not enough lactase (a digestive enzyme that breaks down the sugar lactose) is produced. Often times, a lack of lactase production is considered “unfixable,” however, underlying issues such as hypothyroidism or a low metabolic rate can be the root cause of a lactose intolerance. Digestive enzymes and stomach acid production decreases in a hypo-metabolic state, not only because the body is now in a stress response state and shunts resources away from the rest and digest system, but also because a slower metabolic rate requires less caloric intake and therefore, less inputs to the digestive system are needed (7).

Lactose intolerance can also present itself as a symptom of underlying gastrointestinal issues, such as small intestinal bacterial overgrowth (SIBO) or irritable bowel syndrome (IBS) (8). Microbiota dysbiosis usually occurs when there is an imbalance in the number of good to bad bacteria. Good bacteria thrive off of sugars and produce useful byproducts, such as acetic acid and butyric acid, which are subsequently absorbed into the bloodstream or used to activate thyroid hormone in the gastrointestinal tract. However, bad bacteria produce an excess amount of gas, which presents itself as flatulence and bloating, when they have access to sugar molecules (i.e. dairy sugar lactose, a disaccharide). And they subsequently suppress the growth of good bacteria by reducing their access to nutrients as well as over-proliferating.

For individuals who may struggle with gastrointestinal issues, you can reduce the likelihood of bloating, gas, and pain with drinking milk by opting for warm over cold milk. The optimal temperature for digestive enzymes is 98.6 degrees. When we drink cold milk, we reduce the temperature of our digestive tract and reduce the effectiveness of enzymes responsible for digesting our food.

It’s also important to note that individuals who have lower metabolic rates are likely unable to convert the amino acid tryptophan in milk to a B vitamin called niacin. In individuals with high metabolic rate, tryptophan is easily converted to niacin, which is used to break down carbohydrates, protein, and fats from our meals, support liver and digestive function, and much more (9). Eating a balanced meal prior to drinking milk ensures that the tryptophan in milk is converted to niacin, as opposed to the stress hormones serotonin and melatonin (10).

Milk is a balanced food with many nutrients that can be used to support good health. For people with low metabolic rate and gastrointestinal issues, it can be difficult to consume milk. Addressing the metabolic rate and GI issues almost always results in better digestibility of milk and therefore, increased access to a great source of nutrients.

Cheese

Cheese, like milk, is a great source of nutrients. However, the problem with cheese is the excess ingredients manufacturers add to them, such as whey protein, gums, carrageenan, enzymes, GMO cultures, food coloring, and “natural” or artificial flavoring. These additives can make it difficult to digest the cheese products, which is why it’s important to look for a cheese with the least number of ingredients (9).

For example, when searching for organic ricotta cheese, look for a brand that only has skim milk, salt, and vinegar on the ingredients list. Also, look for cheeses that have animal rennet as opposed to enzymes or other types of rennet, which can be allergenic. Many European imports still make cheese the traditional way with animal rennet.

Yogurt

Individuals who struggle with hypoglycemia, a sluggish liver, or are hypo-metabolic should eat yogurt (and other fermented foods) in small quantities. Lactic acid from yogurt, when absorbed, can cause a stressful response in the body by forcing the liver to use its glycogen stores for energy to convert the lactic acid into glucose.

When consuming yogurt, choose a low-fat Greek option, which will be lower in lactic acid (because it has been strained); will have less additives; and more calcium and protein.

References

July 26, 2018/by admin

Blog, Stress

How to Talk Rationally about Sugar

Sugar still seems to be everyone’s favorite boogeyman, so I thought with January and “diet season” coming up, I’d put together a quick post with my thoughts on the topic.

But first, fans of the movie The Princess Bride should get a kick out of my favorite meme of all time:

There is a lot of confusion and misinformation out there about sugar. When you say the word sugar to just about anyone, they envision the white granulated stuff. I see even other registered dietitians, who are arguably well-educated in food science, posting blog recipes that contain honey as being “sugar free.”

It makes me want to pull my hair out!

Let’s go over some basic food science, shall we?

Carbohydrates ALL contain sugar and can be divided into three categories:

The first two are molecularly “smaller”, and commonly referred to as “sugars” or “simple carbohydrates”:

1. MONOSACCHARIDES (single sugars): glucose (aka blood-sugar), fructose, and galactose.

2. DISACCHARIDES (contain two sugars bonded): sucrose (glucose + fructose) and lactose (glucose + galactose) are examples.

The third category are carbohydrates that are larger, and commonly referred to as “complex carbohydrates”:

3. POLYSACCHARIDES (contain many glucose molecules bonded): starch and cellulose (an insoluble fiber) are examples.

Disaccharides and polysaccharides cannot be directly used by the body and must be broken down into monosaccharides. The body helps out with the breakdown of disaccharides by producing enzymes like sucrase and lactase, and produces amylase to help breakdown starch. Unlike cows and other ruminants, humans do not produce cellulase, so we are incapable of breaking down cellulose.

That means pretty much any carb you eat that is not cellulose, is broken down into SIMPLE SUGAR.

^^^^Re-read this several times and drill it into your head so you can giggle when celebrities and bloggers go on “sugar free” diets.

So what exactly IS the much-maligned white granulated stuff? It’s merely sucrose, a disaccharide containing both glucose and fructose. Sucrose, the white granulated stuff, is also found in ripe fruit, root vegetables, and honey.

When sugar cane or sugar beets are refined by humans into the white granulated stuff, all that is left is the pure sucrose, without any of the nutrients from the plant. I’ll be referring to this product as white table sugar from here on out. It’s not a great food – it has absolutely no nutritive value other than carbohydrates – but it’s NOT THE BOOGEYMAN. It can be used wisely in the context of a nutrient-dense diet.

How did we get into this mess where people are afraid to eat fruit and where white table sugar is being compared to cocaine?

When sugar fear-mongers criticize white table sugar, you’ll see the products they’re criticizing often contain far more than just white table sugar.

Donuts: Enriched white flour, industrial oils, and sugar.
Cookies: Enriched white flour, industrial oils, and sugar.
Cake: Enriched white flour, industrial oils, and sugar.
Processed foods in general: Enriched white flour, industrial oils, and sugar.

Is sugar really the problem here?

When you read about people going “sugar free” and seeing such miraculous changes in their health, here’s what’s happening:

A.) They’re eating better. They’ve cut out all those processed foods that contain sugar, but that also contain industrial oils that can be inflammatory, and enriched white flour (starch), which can also be inflammatory. If they’re eating more whole foods, they’re likely getting a ton more micronutrients (vitamins and minerals) as well.

AND/OR

B.) They’ve gone too low carb and their body has responded by increasing stress hormones like adrenaline and cortisol. The human body is super smart. Cells need sugar (glucose) so badly, that the body has mechanisms to get it when times are tough, or when humans try something silly like purposefully going low carb. It’s called gluconeogenesis – your body will break down your own tissues (muscles, glands, skin, etc.) to produce sugar. This is a stressful, inefficient way of getting sugar into your cells to create energy.

But you know what? It feels good! Stress hormones like adrenaline and cortisol are meant to be used in emergencies. They pull blood sugar up, create instant energy, clear airways, and are anti-inflammatory. Think about Epi-pens, cortisone shots and cream, and prednisone. They’re all in the same class of hormones as adrenaline and cortisol (glucocorticoids). They make you feel better. But, even your doctor will tell you, you’re not supposed to stay on glucocorticoids long-term because of the adverse side effects.

So you go off sugar/carbs and your joints feel better, achiness goes away, allergies and rashes go away – but at what cost?

Your immune system tanks, you lose muscle and cartilage (increasing your risk of injury), and your skin starts to look like you’ve aged 10 years.

What’s the alternative? Go back to feeling like crap?

No. Teach your body how to properly deal with sugar and other carbohydrates.

I work with clients to improve their sugar (glucose) metabolism. Specifically, how to improve their liver’s ability to store glucose and improve their cellular uptake of glucose.

Want some quick, free advice? Eat more potassium-rich carbohydrates and eat at least 80g protein and a day. And DO NOT think of sugar free and low carb diets as a solution, because they’re not. They’re just a Band-Aid covering up a problem.

Want to learn more more about what I do? Schedule a free call HERE.

December 30, 2017/by admin

Blog, Food, Stress, Thyroid, Uncategorized, Whole Foods

Cholesterol Through a Metabolism Lens

Did you hear? The latest version of the U.S. Dietary Guidelines, released earlier this year, has removed the recommended limit on cholesterol in the diet. Cholesterol is no longer a nutrient of concern. While most of us in the nutrition world have known for a long time that cholesterol in the diet does not affect risk for heart disease, we also know that it sometimes takes a while for policy to catch up with science.

So if cholesterol in food doesn’t cause high cholesterol, what does? While some might blame saturated fat and fructose (the latest fad), I’m going to dive in and explain to you a more in-depth, big picture view of cholesterol labs and your health.

The most important thing to know is that is that cholesterol isn’t this bad-for-you-you substance that it’s made out to be. Most people think, the lower your cholesterol, the better. If you could just get it down to zero you’d be in great shape! However, cholesterol is absolutely vital to the proper function of the human body. Your body makes cholesterol, regardless of your dietary intake, for good reason. If you had no cholesterol in your body, you would be dead! It plays an important role in digestion, Vitamin D status, hormone production and balance, and many other human body processes.

You also need to know that high cholesterol isn’t a diagnosis. It’s a symptom. Just because you have high cholesterol, doesn’t mean anything bad will happen! The words ‘high cholesterol’ inspire a feeling of dread as something akin to a death sentence. The mainstream narrative on cholesterol is that arteries are like pipes and cholesterol is like gunk. The pipes get clogged up with cholesterol, and then you have a heart attack. This is a powerful image, but it’s not accurate at all. First of all, at least half of all people who suffer a heart attack have normal cholesterol levels (1, 2). Second of all, after age 65, high cholesterol is associated with health and longevity (3). Third, plaques that “clog” arteries are actually made up of calcium and oxidized LDL particles (think rancid – more on that later), and they form under the artery wall (4). So get that vision of “clogged arteries” out of your head, and if you are a health professional, quit using those test tubes full of fat to scare people at health fairs!

Instead of looking at your high cholesterol labs with a sense of doom, let’s look at how cholesterol levels in the blood rise and when it becomes a problem.

One of the basic functions of cholesterol is to stabilize the mitochondria (the energy powerhouse of the cell), preventing their destruction by stress. Anytime you’re under a stressful situation, cholesterol rises as a protective response to the stressor. Yes, you read that right: cholesterol is a protective substance! Stress also lowers intracellular magnesium, which also causes cholesterol production to increase, since magnesium regulates the enzyme that makes cholesterol (5). Stress can be anything from psychological stress like that from jobs, family, money, etc., to physiological stress like skipping meals, not getting enough sleep, and eating poorly.

In youth and those with high metabolisms (good thyroid output AND uptake of thyroid hormone by cells), cholesterol is converted inside cells into pregnenolone, DHEA, testosterone, progesterone, and other important protective hormones. You cannot make these hormones without cholesterol!

Cells need two things to make the conversion: Vitamin A in its active form and thyroid hormone. As humans get older, their ability to convert beta carotene into active Vitamin A decreases, most Americans don’t eat much active Vitamin A in their diet, and metabolism decreases. In fact, up until about 40 years ago, high cholesterol was diagnostic of hypothyroidism, and routinely treated with supplemental thyroid hormones.

So high cholesterol is a problem because you’re not making youthful, protective hormones. But it’s also a problem because cholesterol oxidizes if it hangs around in the blood stream long enough, losing its protective functions. The cholesterol — or more accurately, the lipoproteins like LDL that are carrying cholesterol — get damaged by oxidation, and then the immune system’s response to that oxidative process is what causes the buildup of plaque and then ultimately the rupture of plaque and heart attack.

So the real question everyone should be asking when it comes to atherosclerosis and heart disease is: “what causes LDL to oxidize?”

There are three main ways oxidized cholesterol builds up in your bloodstream (6):

eating commercially fried foods, such as fried chicken and French fries
eating excess polyunsaturated fatty acids, which are found in vegetable oils, packaged food and restaurant food
cigarette smoking

Your doctor, and most dietitians for that matter, will tell you that polyunsaturated fats from refined vegetable oils, margarine, nuts, seeds, and other plant foods lower your cholesterol. And they’re right! But given what you just learned about cholesterol, do you really think lowering your body’s protective production of cholesterol is a good idea?! Within this framework, the effect of polyunsaturated fats is the same as the effect from statins, which come along with nasty side effects. I hope after reading this, you’ll start to understand physiologically why statins have the side effects they do, and why they’re not very helpful for most people (7).

A note about Paleo diets and fructose. Paleo bloggers and gurus have been pretty hard on fructose recently, blaming carbs and sugar for raising cholesterol. “Quit sugar and watch your cholesterol plummet!” Yup, also watch your libido and energy tank from lack of fuel for the liver and brain. Don’t fall for the low-carb trap when trying to lower your cholesterol. Fructose has pretty much been absolved of any wrongdoing in my book (8, 9).

If you have high cholesterol and your doctor is concerned, here is what I would advise:

Ask your doctor for a cholesterol particle size test (LDL-P). Small LDL particles are more likely to oxidize and form plaques under the artery walls (10).
Know your calcium status. One of my favorite things about Mineral Analysis, is the crucial information on tissue calcium it gives me. Coronary calcium scans will also give you good information about your tissue calcium buildup (4).
Have your thyroid status checked. This involves more than a TSH test! Blood lab work, including TSH, will tell you if your thyroid gland is producing enough thyroid hormone, but tells you nothing about your cells’ ability to use it. Broda Barnes was an American physician who was able to reduce heart disease incidence in his almost 2,000 patients by 90 percent. He used basal body temperature first thing in the morning as an indicator for thyroid uptake. Anything less than 97.8 degrees was considered functionally hypothyroid (11).

If you want to lower your cholesterol in a physiologically-sound way, that ensures proper body function for years to come:

Make sure your diet has plenty of sources of active Vitamin A. Eggs, liver, and grass-fed dairy are examples. Hmmm, imagine that….all potent sources of cholesterol! It’s like nature has a plan or something…
Make sure your diet has plenty of Vitamin K2, active Vitamin K. K2 is a calcium director and can remove calcium buildup from the arteries (12). It’s found in, again, eggs, liver, and grass-fed dairy. This is sounding more and more like a French diet. It’s not genes or the wine protecting them from heart disease (13).
Eat plenty of potassium-rich foods, like fruits and vegetables (14). You are likely not eating enough.
Eat more magnesium and supplement if needed. Cooked dark leafy greens and organic dark chocolate are good sources. Magnesium is also absorbed topically through the skin.
Destress!
Focus on all the things that improve thyroid uptake by cells: get enough calories, protein, carbohydrates, potassium and other minerals, good estrogen metabolism, and good liver function – AKA all the things I work on with clients!

July 25, 2016/1 Comment/by admin

Blog, Thyroid, Uncategorized

Endocrine Support: a Local Workshop

Do you struggle with weight gain or loss?
Do you have trouble falling asleep or feel tired no matter how much sleep you get?
Are you a woman of childbearing age or a woman going through hormonal shifts?
Do you have a miserable menstrual cycle?
Do you have constant GI issues like bloating, constipation, stomach aches, or urgency?

If you answered yes to any of these questions, I welcome you to join me for an evening of education.

I’m teaching a workshop on the endocrine system. I’ll touch on how the adrenals and thyroid interact and affect body function, and also the importance of estrogen/progesterone balance. You’ll leave with new ideas on what makes a food healthy, and learn why some mainstream views on health and nutrition may be misguided.

I’m planning on covering:

Why does everyone think they have “Adrenal Fatigue”?
Why thyroid utilization matters more than thyroid production (AKA why your doctor tells you “Your thyroid is fine.”)
What is metabolic rate and why it’s the key to maintaining proper function and good health.
Digestion and the menstrual cycle as key indicators of body dysfunction.
What the heck do I eat? Plant-based, vegan, Paleo, Primal, WAPF, USDA Dietary Guidelines – why can’t anyone agree on what to eat?!
Other Big Picture practices that are just as important as diet.
Labs schmabs. How to really measure health.

Join me and Maggie Dubois from Being on Purpose – a Wellness Lifestyle for an evening workshop focused on nutrition and natural solutions for endocrine health.

Thursday March 31st, 7-9pm

Robinwood Church

12030 Warrenfeltz Lane, Hagerstown, MD 21742

Bring a friend and bring questions! The cost is $5. You can RSVP on Facebook here, or email Nicole at WholeHealthRD dot com.

March 16, 2016/by admin

Blog, Uncategorized

Shifting the Focus from Weight to Function

It’s that time of year: everyone is making New Year’s Resolutions. And yet again, weight loss is the leading resolution for 2016.

There is a growing number of health experts who have seen the statistics and understand the physiology of weight loss who are saying, “quit focusing on weight and focus on health.” Unfortunately, there are too many other voices crowding out that message. We live in a society where overweight and obesity are seen as issues of willpower or character. The truth is, they are just symptoms. It’s true that being overweight or obese puts you at higher risk for disease. But weight is only one of many risk factors for disease, and it’s NOT the most important one. Thin people can also be malnourished and at risk for disease. A focus on weight obscures the other risk factors and equates thinness with health.

A focus on weight instead of nutrition will lead people to adopt diets, rather than eating nutritious foods. And we know with 100% certainty that current strategies to tackle overweight and obesity, which mainly focus on cutting calories and boosting physical activity, are FAILING to help the majority of people shed weight and maintain that weight loss.

Instead of focusing on weight loss in this new year, how about focusing on the health parameters that truly show your body is functioning properly?

Normal body temperature (98.6 degrees) with warm hands and feet.
Healthy, moist, fast-growing hair, skin, and nails.
At least one bowel movement a day and little to no gas, bloating, or heartburn.
The ability to sleep 8 consecutive hours with no urination or wake-ups (minus children, of course).
Normal menstrual cycles with little to no PMS, bloating, or cramps; and a healthy libido in both men and women.
Steady mood.
Better than average resistance to colds, flu, and other infections.

There are dozens more, but these are the basic competencies of good physical function that most deserve your attention. These health parameters will tell you more about your health than your weight or any lab test. They all have to do with blood sugar regulation and metabolism. Master these and a healthy weight will likely follow.

If you are failing in one or many of these areas, the problems you are experiencing probably are, at least in part, due to your diet and lifestyle practices. Focusing on weight loss WILL NOT HELP, and can make many of these problems worse.

Take your attention away from the small details of nutrition (organic! superfoods! gluten! antioxidants! fat! fiber! carbs!). I work with clients on the “big picture practices” that help the body achieve good function: eating easy-to-digest, balanced, mineral-dense meals and snacks regularly throughout the day. If you’re sick of feeling unhealthy, and want a better solution than “eat less and move more,” I’d love to work with you!

Happy New Year!

December 29, 2015/by admin

Blog, Uncategorized

How to Hydrate

Confession: I used to be a water-holic. I used to carry around a water bottle with me at all times to remind myself to be sipping throughout the day. I had a giant water bottle on my desk and my goal was always to drink two by the end of the work day. I collected expensive, patterned stainless steel water bottles. I only ever drank water (or alcohol…hey, I was in my 20s!).

I’m not alone. Americans are water guzzlers, taking the “8-glasses-a-day” (or more!) mantra to heart, even though there is ZERO evidence for that often-repeated recommendation.

“Stay hydrated” and “drink more water” seem to be the cure for any health issue. Health gurus promise weight loss, clear soft skin, shiny hair, reduced appetite, and more energy. <-Yes, much of this can happen when we are properly hydrated, but drinking water is not how we stay hydrated!

Confusing? Hear me out.

Around 2/3 of the water in our bodies is contained inside our cells in intracellular fluid. The remaining 1/3 of the water in our bodies is outside of our cells in our extracellular fluid (e.g. blood, interstitial fluid, cerebrospinal fluids).

The intracellular fluid is high in potassium and low in sodium. The extracellular fluid is high in sodium and low in potassium. Remember it by thinking how salty tears are – extracellular fluid is salty (hence saline in IVs!). In order to maintain a strong cell membrane and a stable environment in the cell, the fluid on the inside of the cell and the outside of the cell must maintain those opposite electrolyte qualities.

The body is always striving to maintain a balanced, homeostatic state. That’s really what hydration is, your body being in a homeostatic, balanced state where stress hormones are not activated. It’s important that the extracellular fluid is neither too concentrated nor too diluted. Either way can start a chain reaction resulting in cellular death, which means less ATP (energy) produced and a slower metabolism.

Luckily our bodies have a pretty ingenious way to signal when we need more and less water.

Thirst and urine color.

Overriding your body’s signals for more fluid (thirst) or less fluid (clear urine) is a surefire way to upset that balance and to keep the composition of the extracellular fluid dramatically different from the fluid in the cell. There is a trend I’ve noticed where people are trying to “pee clear.” I’m not sure why you would want to pee clear, as that is a stress response! Urine in the toilet bowl should be the color of lemonade, darker of course in a lab sample cup.

When I started learning more about minerals and physiology (body function), I realized all that water was basically diluting my body at a cellular level. Especially since I also eat foods that are watery, like fruits and vegetables. I have a hard time holding onto sodium and potassium (thanks for the info, mineral analysis!), and was kind of washing myself out.

Now, I drink when I’m thirsty. I drink water sometimes, but I also drink beverages that have minerals, such as mineral water, coconut water, coffee, milk, and orange juice, often with a pinch of salt. This works for my body and my metabolism.

To close, here is another perspective I found interesting, from a European with U.S. citizenship:

“It is my experience traveling with university students to Europe that many young Americans routinely over-hydrate, drinking water from Nalgene bottles, buying cold beverages any opportunity they can find and then stopping by Starbucks for a specialized coffee drink. And that is all extra to the normal meal hydration.

The biggest complaint I get from my students is the lack of free public restrooms that they are used to at home in shopping centers, stores, and fast food restaurants. When you over-hydrate, you also depend on regular rest stops. I note, for instance, that my French friends are likely to order an espresso at the same coffee shop where my students are ordering a 16-20 ounce drink.

One of the reasons for the American over-hydration is the level of propaganda they get regarding the need to drink several liters of water per day just to lose weight.”

*Note: In the elderly, the balance between sodium, potassium, and fluid is much harder to maintain. Fluid intake and nutrition in general has to be closer to ideal to keep from causing dehydration. Start monitoring NOW so you know what is optimal for you later in life.

*Note 2: Are you thirsty all the time AND peeing clear? That might actually have to do with blood sugar regulation. Come see me!

*Note 3: Has drinking copious amounts of water helped your health definitively? I’d love to hear from you! Because all I’ve seen in clients and in the general public is lots of peeing and lots of stress hormones.

Sources:

http://abcnews.go.com/Health/Wellness/waterlogged-america-drink/story?id=14054401
http://180degreehealth.com/your-body-is-mostly-water-not-exactly/
http://science.jrank.org/pages/1320/Cell-Death.html
https://chriskresser.com/the-water-myth/

September 7, 2015/by admin

Blog, Uncategorized

Baby Knows Best

First things first – let’s get this out of the way. I don’t have a lot of experience feeding children. I have a 2-year-old and a newborn. While the toddler seems to be in great health, she sits at the dinner table, and she eats a variety of foods, I know that at age 3, 4, and 5, things could change dramatically for us! And I know my second child could be quite different!

However, I do have a lot of experience researching feeding children. I worked for three years at a non-profit where I helped research and write reports on childhood obesity and child nutrition for the Federal Government. I had access to the sharpest, brightest minds in the child nutrition world. I’ve also learned a lot since then, through both counseling clients and families, and through reading and staying up-to-date on nutrition research. At the bottom of this post are my favorite resources on feeding your children.

In this post, I wanted to highlight a study from the 1920’s I stumbled upon recently. It attempts to answer the question, “What will babies eat if they’re given free choice?” It was a research study that would never be allowed to happen today. It’s been called “the world’s longest, most detailed, most ambitious food experiment.”

Fifteen children were observed over a period of 6 years. Every day, they were offered a selection of 34 different foods, and researchers noted what they chose to eat and how much they ate. Mealtimes were set up to prevent the staff from influencing what the babies ate.

When the children’s food choices were analyzed, they were very different from each other and from the standard diet of the time. But, when the diets were examined as a whole, they showed similar macronutrient intake (calories, proteins, carbohydrate and fats).

The children were very healthy during the study and were remarkably free of the common childhood diseases of the time. Constipation was unknown among the children in the study and any colds were mild. Five of the children had rickets at the start of the experiment, which resolved without medical treatment. One child with severe rickets actually spontaneously drank cod liver oil on his own! The children’s health was monitored by physical and biochemical examinations, and by X-rays of their bones. Apparently, the radiologist at the children’s hospital was very excited at the “beautiful calcification” of the bones on the children’s X rays.

Although some of the children were undernourished when they arrived, this evened out until there were no notably overweight or thin children. Remember: this was a result of letting the children eat according to their own fullness and satiety cues.

Check out the list of 34 whole foods they used in the study. Some might surprise you!

Water
Sweet milk
Sour milk
Sea salt
Apples
Bananas
Orange juice
Fresh pineapple
Peaches
Tomatoes
Beets
Carrots
Peas
Turnips
Cauliflower
Cabbage
Spinach
Potatoes
Lettuce
Oatmeal
Wheat
Corn meal
Barley
Ry-krisp
Beef
Lamb
Bone marrow
Bone jelly
Chicken
Sweetbreads
Brains
Liver
Kidneys
Fish (haddock)

Oatmeal, wheat, beef, bone marrow, eggs, carrots, peas, cabbage, and apples were served both raw and cooked.

I found it interesting that the children’s tastes changed unpredictably from time to time (hello picky toddlers!), and meals were often combinations of foods that were strange to us and would have been “a dietitian’s nightmare” (from the article). For example, a breakfast of a pint of orange juice and liver, and a supper of several eggs, bananas, and milk.

Another interesting result? All infants shared a low preference for all 10 vegetables, as well as for pineapple, peaches, liver, kidney, fish, and sea salt. These foods constituted less than 10% of the total calorie intake. This goes along with many feeding experts advice today to present vegetables, but to not force feed or bribe children to eat them.

In my practice (and in general day-to-day life!), I see a lot of parents worry about their child’s weight, that their kids aren’t eating vegetables, or that their children only eat a few foods. I see food restriction, and the misguided promotion of the idea that certain foods are “better” or healthier than others.

But this study, and much of research since then, proves that children can be trusted to eat what they need for good health and growth, as long as presented with a variety of whole foods. The key is to nurture and foster that intuition as much and as long as possible, to create adults with a healthy relationship with food and who know how to listen to and respond to their body’s cues.

Trust the instincts of your children. Their bodies are much smarter than YOUR mind.

References:

Results of the Self-Selection of Diets of Young Children, by Clara M. Davis, M.D.

Clara M. Davis and the wisdom of letting children choose their own diets, by Stephen Strauss

More resources on child feeding:

Ellyn Satter’s Division of Responsibility in Feeding

Child of Mine, by Ellyn Satter

Your Child’s Weight: Helping Without Harming, by Ellyn Satter

Ellyn Satter’s website

Food Ninjas: How to Raise Kids to be Lean, Mean, Eating Machines, by Matt Stone

Don’t Make Children Eat their Greens, by Tim Lott

April 21, 2015/2 Comments/by admin

Blog, Uncategorized

Estrogen in Excess

I talk a lot about “hormone balance” in my blog posts and with my clients. People nod their heads enthusiastically when I mention this concept, but I wanted to write a little bit about what I mean when I say hormone balance. There are many hormones involved in human physiology – I’m going to focus on one in this post: estrogen. Estrogen actually refers to a whole family of hormones. There are estrogens that your body produces and estrogens you get from outside the body, like the synthetic estrogen in birth control and phytoestrogens from certain plants. And don’t forget about xenoestrogens, those endocrine-disrupting chemicals like BPA we hear about so often in the news. Xenoestrogens are found all around us, especially in what I like to call the “Four P’s”: pesticides, plastics, pollution, and personal care products.

Since the Women’s Health Initiative study results were released in 2002, which showed the detrimental effects of hormone replacement therapy (HRT) for women, the public’s and experts’ opinion of estrogen has been one of confusion.

Is estrogen a ¨bad” hormone? No, but it can quickly accumulate when the body isn’t functioning properly, and that’s when the problems begin.

“Excess estrogen” is a difficult concept for many of my clients to understand. They tell me, “oh, my doctor checked my estrogen levels and they are fine.” But our bodies can become overloaded with an excess of estrogen and estrogen-like chemicals in tissues, resulting in impaired fertility, PMS, endometriosis, fibrocystic breasts, miscarriages, problems breastfeeding, and increased risk of estrogen-related cancers.

Besides the health issues listed above, other signs and symptoms of excess estrogen include:

Salt and fluid retention
Impaired thyroid function
Increased cortisol (belly fat!)
Increased permeability of the gut (food allergies/sensitivities)
Migraines
Anxiety/depression

The American College of Obstetricians and Gynecologists (ACOG) and the American Society for Reproductive Medicine (ASRM) released an opinion paper on the topic in October 2013 (1). They concluded that the evidence that links exposure to xenoestrogens and adverse reproductive and developmental health outcomes is sufficiently robust, and that reducing exposure is a critical area of intervention for obstetricians, gynecologists, and other reproductive health care professionals.

My doctor never brought it up when I was pregnant or in the years before – did yours?

There are two main ways to address this issue, reduce exposure, and support good estrogen metabolism and detoxification. Here are my top evidence-based tips I give to clients to address both of these.

Reduce exposure:

Buy organic fruits and vegetables on the “Dirty Dozen” list, and organic meat and dairy products.
Lose weight. Excess estrogen is stored in fat tissue and excess fat can actually produce estrogen on its own.
Avoid canned food, or choose BPA-free cans.
Limit packaged, processed foods. Certain food additives are estrogenic (2).
Limit soy, the most potent estrogenic food, and a known fertility inhibitor (3). Think you don’t eat soy? Yes you do. The average American, who is definitely not a tofu-eating vegetarian, gets up to 9% of their total calories from soybean oil alone (4). What about the Japanese, you say? Some experts believe their large tea intake protects them from the detrimental effects of soy. Plus, soy is only a small part of their diet. What about meat and dairy and their hormones? Both have a small fraction of the estrogenic compounds of soy, especially when you buy organic/grass-fed/pasture-raised meat and dairy. This deserves a blog post of its own. One day, I promise!
Limit vegetable and seed oils. The accumulation of these oils in the tissues promotes the action of estrogen in a variety of ways, and this effect of this tends to be cumulative and self-accelerating. Use olive oil, butter, or coconut oil.
Avoid fish with high mercury levels like swordfish, shark, tilefish, and king mackerel.
Use natural cleaning products or make your own.
Check your personal care products for ingredients like parabens and phthalates, or check them in the EWG Skin Deep database for endocrine safety.
Consider alternatives to hormonal birth control.

Support good estrogen metabolism and detoxification:

Adequate protein intake. Estrogen is mainly metabolized in the liver, where it’s made more water-soluble for excretion via urine and stool. Estrogen receptors in the liver are under the control of dietary protein. Government recommendations for protein are for surviving, not thriving. I tend to recommend a moderate protein intake of 25% of your daily calories – that usually equals 80-100g for most women, depending on weight and activity level. An easy way to make sure you’re getting enough without food logging? Include a concentrated protein source (at least 15g) at all of your meals and snacks – don’t skimp out at breakfast and lunch!
One serving of cooked cruciferous vegetables a day, such as cabbage, cauliflower, broccoli, kale, collards, bok choy, etc. These contain indole-3-carbinol (I3C), which promotes estrogen metabolism. Cooking makes these vegetables easier to digest and better for the thyroid. Raw carrots also have anti-estrogenic properties.
Have a bowel movement at least once a day. Regular bowel movements rid the body of excess estrogen. Letting stool sit in the colon allows excess estrogen to be reabsorbed into the bloodstream. You should not require the use of laxatives, fiber supplements, magnesium, or vitamin C overdosing, or other bowel-moving crutches. See me if this is an issue for you.
Get enough fat-soluble vitamins (A, D, E, K). The American diet is notoriously low in these as I’ve written about in previous posts (5, 6). That’s a shame because all 4 have direct anti-estrogen action. Vitamins A, D and K are potent inhibitors of aromatase (the enzyme converting testosterone into estrogen) – so they will directly lower synthesis of new estrogen. Vitamin E will help counteract the effects of the already existing estrogen.

For a more specific, individualized plan, make an appointment with me.

“All of the unpleasant consequences of estrogen excess happen to resemble some of the events of aging.” – Dr. Raymond Peat

January 21, 2015/2 Comments/by admin

Blog, Uncategorized

The Health Benefits of Gelatin

I often look at other cultures for inspiration on how to live a long, healthful life. I think there are some common practices that healthy people around the world have in common. I commented on Facebook recently about how I must come across as a Francophile – someone obsessed with French culture. My last two posts had me praising cheese and liver as health foods. Now I’m writing about gelatin, a staple in French cuisine. But the truth is, all these foods are more common all over the world, not just France. And they used to be common in the U.S. too. Look at cookbooks from the 50’s, 60’s, and 70’s and you’ll find lots of recipes that include gelatin and liver!

I’ve written in the past about how our food supply in the U.S. has changed drastically over the years. It’s not just the amount of packaged, processed foods that we now have available to us, our supply of whole foods and their quality has changed as well. Let’s look at meat. Americans used to go to the butcher and have access to various parts of the whole animal. Now, in the average supermarket, we have access to this:

Rows of skinless muscle meat. Unfortunately, there was a big push to avoid certain types of fat for many decades and lean, skinless, muscle meat became what American consumers wanted. Think skinless chicken breast, flank steak, ground turkey, etc.

These cuts are brimming with methionine, tryptophan, and cysteine, amino acids which are inflammatory, inhibit thyroid function, depress immunity, decrease the body’s ability to withstand stress, and are associated with many problems of degeneration and aging (1). No wonder there are many research studies on meat that are negative!

Calorie restriction made a splash in the news a few years ago as a potential way to live longer (2). It’s speculated that the same life-extending benefits of calorie restriction could be attained with methionine restriction, without the hunger, and lowered metabolism and fertility. But here is the twist:

“A fascinating but woefully little-known study in 2011 showed that in mice, supplementing with glycine—an amino acid found abundantly in connective tissue and gelatin and bone broth—had the exact same life-extending effect as restricting methionine. Without reducing calories or other amino acids, glycine supplementation increased the rodents’ lifespan, reduced fasting glucose and insulin, decreased IGF-1 levels, and nearly halved their triglycerides—the very perks that’ve variously been attributed to calorie restriction, protein restriction, and methionine restriction.” (3)

Many experts think this research translates into humans, meaning that if you eat more gelatin, connective tissue, and bone broth – all brimming with glycine – you potentially get all the PROs of meat consumption (fat-soluble vitamins, micronutrients, bioavailable iron, complete protein, digestible protein), while minimizing the CONs.

Another reason this is a good idea besides health? Gelatin makes up about 50% of the protein in an animal. We’re literally throwing away 50% of the animal when we eat only muscle meat. From an environmental standpoint, this really sucks! Nose-to-tail eating – eating the whole animal – is more respectful to the animal and the planet, and healthier for the humans consuming it.

Potential benefits of eating more gelatin:

Anti-inflammatory.
Helps balance blood sugar by working with insulin to help the body use glucose properly.
Supports healthy hair and nail growth.
Good for joints and can help injury recovery.
Can help tighten loose skin (Gelatin is a great source of dietary collagen. Collagen is too large to be absorbed by the skin, so don’t waste your money on fancy skin creams).
Can improve digestion.
Heals damaged intestinal lining (a.k.a. “leaky gut” and allergies).
Improves stomach acid insufficiency.
Helps improve cellulite.
Glycine helps balance estrogen and progesterone.
Can suppress appetite.
Improves sleep.

Adding gelatin to the diet is easy:

If you eat meat, eat more on-the-bone cuts of meat like shanks, short ribs, and ox tails.
Make your own bone broth (ever wonder why homemade chicken soup is so good at curing colds?!). No time to watch a pot on the stove? It’s easy to throw chicken bones and water in a slow cooker overnight.
Snack on homemade Jello, homemade fruit snacks, panna cotta, and other gelatin-based desserts.
Use a supplement. Vital Proteins and Great Lakes are great brands from grass-fed cows. Gelatin can can be used to make gelatin-based desserts and thicken sauces. Collagen peptides and collagen hydrolysate both dissolve in cold liquids and can be added to juice, coffee, tea, or smoothies like a protein powder.
When you do eat muscle meat, supplement with gelatin, either in a sauce or as a side.

1. http://raypeat.com/articles/articles/gelatin.shtml

2. http://www.nytimes.com/2009/10/11/magazine/11Calories-t.html?pagewanted=all&_r=0

3. http://rawfoodsos.com/2014/03/09/new-animal-protein-study/

November 13, 2014/by admin

Blog, Pregnancy, Uncategorized, Whole Foods

Killer Calcium?

I’ve been thinking a lot about calcium lately. Our bodies need this mineral to build and maintain bones and teeth. Calcium also helps with blood clotting, muscle function, and regulation of the heart’s rhythm.

We’ve had it hammered home since we were in grade school that increasing calcium intake will prevent osteoporosis, the weakening of bones. We’ve been told to take calcium supplements if we don’t get enough calcium in our diet.

Yet, we have a very high calcium intake in the U.S. and also high osteoporosis rates, plus, calcium supplements are linked to heart disease (1). What gives?

It has to do with calcification, calcium buildup in the body’s tissues. Along with reduced metabolic rate, calcification is a hallmark sign of aging.

Examples of calcification:

Atherosclerosis: calcification of blood vessels
Osteoarthritis: calcification of joints
Tartar: calcification on the teeth
Gallstones/kidney stones: caused by calcium deposits
Infertility: sometimes caused by endometrial calcification
Alzheimer’s: evidence is mounting brain calcification contributes
And so many more!

When you consume calcium, regardless of if through food or supplements, you hope it will be deposited in the bones and teeth, right? Well without a critical vitamin in your diet to direct calcium, it often winds up in the body’s tissues instead. So you could conceivably have a high dietary calcium intake or take calcium supplements, and still wind up with osteoporosis and heart disease to boot. Sucks, right?

So what’s this critical vitamin? Vitamin K2, not to be confused with the Vitamin K1 that is found in dark leafy greens. K1’s main role is in blood clotting, while K2’s main role is calcium metabolism. K2 activates certain proteins that guide calcium into bones and teeth where it belongs. And even cooler? K2 will activate other proteins that sweep calcium OUT of other tissues where it is potentially harmful. So you could potentially REVERSE heart disease just by getting enough of this crucial vitamin (2).

Other potential benefits? Better teeth. Weston A. Price (3) was a dentist who embarked on an medical anthropology trip around the world in the 1930’s to study how diet and lifestyle affected dental health. He found cultures with straight, beautiful, healthy teeth and deduced what they had in common. He has been called the “Charles Darwin of Nutrition,” since much of what he discovered looks at how food and food quality affect health in general. If you haven’t read his 1939 book, “Nutrition and Physical Degeneration,” a nutrition classic in my opinion, pick it up for the photos alone! Anyways, Price is credited with discovering Vitamin K2, although at the time, he had no idea what it was. He called it Activator X.

He realized that humans are capable of thriving on very diverse diets. However, he did find one thing in common: they all ate some amount of animal-derived fat-soluble vitamins. Even the near-vegetarian groups ate insects or small animals that were rich in pre-formed Vitamin A, Vitamin D, and what we now know is Vitamin K2. And here’s the kicker for my fertility clients: many of the foods high in these nutrients were fed preferentially to pregnant or reproductive-age women in the groups he studied.

Depending upon your current understanding of fats and the causes of heart disease (see here and here), you either will be pleasantly surprised or horrified by the list of foods high in Vitamin K2:

Butter from grass-fed cows
Organ meats
Shellfish
Fish eggs
Cheese from grass-fed cows
Natto (a fermented soybean popular in Japan)

Butter from grass-fed cows vs butter from the grocery store

Now, think about the French Diet and the above list of foods. Health experts have been talking about the “French Paradox” for years – the confusion over France’s rich, fatty diet and their low heart disease rates. What if the French Paradox isn’t such a paradox after all? What if it’s not the red wine that’s protecting them, but all the foie gras, quality cheese, and butter?

Now think about the Japanese diet. What if it’s not the green tea that’s protecting them from cancer and heart disease, but all the fish eggs and natto?

Previous thinking on Vitamin K2 was that our gut bacteria can make what we need from Vitamin K1. Does the typical American’s damaged gut do this? Who knows. I’ve seen evidence for and against the claim that we get enough from eating dark leafy greens.

But logically, when I think about the modern American diet, our current rate of disease, and compare it to someplace like France that has loads of K2 in their diet, it makes sense to me to eat more foods with K2.

As a side note, my latest obsession in my nutrition practice is mineral analysis. I find it most useful for determining tissue calcification. I would say that about 80 percent of my clients have high calcium levels in their tissues and would benefit from more K2 in their diet, either from foods or supplements, to help “sweep” it out of tissues. For those few who actually do need more calcium, K2 would also be beneficial in guiding that extra calcium into bones and teeth.

I see lots of potential in Vitamin K2 and I think you’re going to be hearing a lot more about it in the future. Vitamin K2 has potential benefits for nearly every major health concern of our time. K2 might be the ‘missing link’ that explains many of our modern health woes.

So eat your pastured dairy, organs, fish eggs, and shellfish! And if you have arterial calcification, as determined by a heart scan, or tissue calcification as determined by mineral analysis, you may want to consider supplementing with additional K2 (also called menaquinone-4 and menatetrenone).

For more information on Vitamin K2, “Vitamin K2 and the Calcium Paradox,” by Kate Rheaume-Bleue, is a great place to start.

1. https://well.blogs.nytimes.com/2013/04/08/thinking-twice-about-calcium-supplements-2/

2. http://wholehealthsource.blogspot.com/2008/11/can-vitamin-k2-reverse-arterial.html

3. Trolls: I am not a lacky for the Weston A. Price Foundation. Stop trying to label me. I’m anti-dogma and support many different types of diets.

July 31, 2014/3 Comments/by admin

Milk & Dairy in Context

How to Talk Rationally about Sugar

Cholesterol Through a Metabolism Lens

Endocrine Support: a Local Workshop

Shifting the Focus from Weight to Function

How to Hydrate

Baby Knows Best

Estrogen in Excess

The Health Benefits of Gelatin

Killer Calcium?

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