Processed food intake may lead to depression.

"For the new study, published in the British Journal of Psychiatry, they studied dietary data provided from 3486 participants in the Whitehall II Study. With an average age of 55 years the participants, who worked in civil service departments in London, completed a questionnaire on their eating habits at the start of the trial and, five years later, a self-assessment on depression.

The team, led by Archana Singh-Manoux, identified two dietary patterns. Those with the highest intake of whole foods, such as fruits, vegetables and fish, were less likely to report depression symptoms later on.

Those eating a lot of processed meat, chocolate, sweetened desserts, fried foods, refined cereals and high fat dairy, on the other hand, were seen to be more vulnerable to depression"

Quote lifted from here.

Vitamin D and the flu.

This just in from one of my vendors.

"Vitamin D has been in the news a great deal lately. Last year the Public Health Agency of Canada (PHAC) started a study investigating the role of vitamin D in severe seasonal influenza. With the recent outbreaks of swine flu, PHAC confirmed that it would be adapting this study to investigate the role of vitamin D in the protection against swine flu. PHAC will measure vitamin D levels in the blood of H1N1 patients and compare the blood levels with uninfected individuals. The rationale behind this study is based on earlier work in the 1940's that indicated mice on diets low in vitamin D were more susceptible to experimental swine flu infection than those with adequate vitamin D levels (Young, et al., Vitamin D intake and susceptibility of mice to experimental swine influenza virus inf ection. Proc Soc Exp Biol Med. 1949 Dec;72(3):695-7.) How vitamin D might protect against influenza infection is not fully understood. However, research suggests that vitamin D may induce the production of antimicrobial substances in the body that may possess neutralizing activity against a variety of infectious agents including influenza virus."

I run a 25-OH vitamin D on all of my patients. Although the "normal" range is 32-100, I personally prefer to see levels closer to 70 or 80, with 50 being bare minimum. Some physicians are just prescribing 2000 iu daily with the idea that everyone needs vitamin D but I've seen patients who are taking 5000 a day with levels of 30, and others taking 2000 a day with levels of 60 (for the record this is uncommon.) We tested our almost 3 year old and at the end of a long summer of days half naked in the sun with no sunscreen plus 1000 iu daily of vit D, and his blood level was only 32. It is best to get your levels checked.

Huffington Post Article on Swine Flu.

Read it here.

So what about the flu shot?

Every year a few patients ask me about what I think of the flu shot. This year a few people haven't asked me what I think about the flu shot.

My answer to this has not changed in recent years, and it won't change this year, even in the face of H1N1 (which you and your child are more likely to catch at the mall than from licking a pig.)

I am not pro or anti-vaccination on principal. I do believe that there are risks with vaccination and I weigh each vaccination very carefully before I move forward with any of them, recommended or not. Whether or not to get vaccinated is a decision that each person needs to make based on both facts and personal values. There is no one right answer for everyone.

With a healthy immune system, most people fare the flu reasonably well, and this includes young children. If I personally was not at high risk for complications of the flu, I would not get the vaccination(s.) If my child was not at high risk for complications of the flu, I would not get him the vaccination(s.)

Re: H1N1 though, there is a bit of a catch. The greatest concern with this particular flu is its affinity for the lungs, and the risk of what is called a 'cytokine storm.' This is an overreaction of the immune system which causes a cycle of inflammation in the lungs. This can happen to people (and may even be more likely to happen to people) with strong immune systems. And, for people with existing lung conditions, such as asthma, this situation is particularly concerning.

So do I think that all people with asthma should get the H1N1 vaccination? I'm not going that far yet. Although they are making the majority of the H1N1 vaccine in the same manner that they make the regular flu vaccine, we understand that backup supply may contain the chemical squalene. This is a potent chemical that increases one's immune response to the vaccination. Although it is too much to get into here, there are many folks in the medical community who have concern about this chemical causing an overreaction of the immune system that may be harmful to the body. Additionally, the last time a vaccination was prepared for the swine flu, there was a slight increase in the risk for a condition where the body attacks its own nerve cells causing muscle weakness or paralysis. The catch is that we don't yet know if that will happen in this case, and if it does, how much risk is worth taking? 1 in 100,000? 1 in 50,000?

Feel free to make an appointment to discuss your own concerns or questions about the flu or about the flu vaccines. We are happy to work with patients to come up with a game plan to help prevent the flu, as well as a game plan to treat it if it does occur.

* Please note, we are not currently treating active flu patients at the clinic as we do have staff and patients who are at high risk for complications. We are happy to do phone consultations to discuss treatment, or refer you to a practitioner who can see patients who are currently experiencing flu symptoms.*

Cook This: "Cream" of Veggie Soup

Today is Sunday, and here is my first official installment of "Cook This."

Cream of Veggie Soup.

This recipe is an adaptation of a recipe I first made about 20 years ago from The American Vegetarian Cookbook from the Fit for Life Kitchen by Marilyn Diamond. There have been many incarnations of this soup in my life, including as a staple at the health food deli where I worked to finance an 8 week trip to an ashram in India (a story for another time.)



Lately I've simplified the soup to the bare bones for a quick and delicious low allergen delight.

Ingredients:
2-3 TBSP olive oil
1 large yellow onion chopped
3-4 cups of chopped brocolli
1 cup of chopped carrots or baby carrots
3 TBSP roasted tahini
3-4 cups of water or chicken stock or combination (I wouldn't use chicken soup though, as it is too strong.)
Salt and pepper to taste.

How to make it:
1. Sauté onion in olive oil for 5 minutes.
2. Add brocolli and carrots and continue to sauté for 3 minutes.
3. Add water or chicken stock and bring to a boil.
4. Simmer until veggies are soft (you should be able to just barely mash with a fork.)
5. Put the tahini in a bowl with an equal amount of broth and mix with a fork, then add another few TBSP of broth and mix again. Continue until the tahini liquid is a similar temperature to the soup so it doesn't clump up when you add it. Add it to the soup.
6. There are 2 options here:
a. The easy option: Use a hand blender to blend the soup to your preferred texture. You can always add more broth or water if you like.
b. Put a few cups at a time of the soup into a blender and add it back into the soup until it is the texture you like.
I prefer the hand blender because it mixes well, is easy to clean up, and doesn't make the soup pasty.

You can also vary the veggies. I find that leafy greens don't work very well but I have made the soup at one time or another with various combinations of cauliflower, peas, broccoli, carrots, sweet potato, potatoes and leeks, carrots, and other veggies.

Better hot but also good cold.

Edited to add: My 3 year old was just spitting out requesting something other than his catfish for dinner so I put a few tablespoons of this soup (now sauce) on it. He gobbled it right up!

Enjoy!
-Dr Samantha

Back in town...

We've just returned from a 10 day trip to the East Coast to visit family. It is always interesting to navigate food when we're out of town. I was thrilled to find a large health food department at the Wegman's chain in upstate NY, and then comforted to find the local home grown health food store in Guilford CT.

Whenever we plan a trip we call ahead to the local stores to see what we will be able to get there, and what we need to pack. This trip we only packed our airplane cooler and got everything else on site. Not cheap, but comforting and we were able to feed our son what he needed to work around his allergies, and I was able to eat what I need to to feel my best.

It is my belief that once you figure out what foods work best for your body there is almost never a reason to stray...unless you want to. It's just a matter of prioritizing your own health. Aunt Betty who tries to get you to eat her homemade bundt cake will just have to understand...you're committed to your new way of eating, and you've never felt better.

Check out these blogs I stumbled upon this morning. I'm printing some of the recipes to try in the next few weeks.

Organic Thrifty

Everything-free Recipes
(This site uses some products that I don't particularly like but it looks like there are lots of recipes that fill my bill of healthy gluten, grain, or dairy free healthy eating. If it fits into your nutrition plan, you can just swap things out if necessary!)

In Health,
Dr. Samantha

Acupuncture and Carpal Tunnel Syndrome

New study looks at acupuncture for carpal tunnel syndrome. Check out the results!

Reported on acufinder.com
"Seventy-seven patients were randomly divided into 2 groups. One group received eight acupuncture treatments over four weeks, and the other group received oral doses of prednisone, daily, for four weeks. The results showed that acupuncture was just as effective as the corticosteroid for pain, numbness, tingling and weakness. For the symptoms of night time awakening and motor function, the acupuncture group had better results."

Silk soymilk...good, right? Not so much.

My sister recently sent me a link to the Cornucopia institute, a group that "promotes economic justice for family scale farming." They have developed a rating system for soy milk brands which takes into account manufacturing processes (do they use hexane, etc), whether the products use American soy or imported soy, and whether or not the company sources organic soybeans. You can read it yourself, but I'll give you the preview that Silk brand was rated very poorly. They used to be only organic, and used American beans, but the company was purchased by Dean Foods, a giant agribusiness that runs many factory farms. In the past few years they started buying up organic and health food brands right and left. The upshot is that not only are most of Silk's products no longer organic, but they also are sourcing soy from China. Oh, and they bought Horizon Organics as well...

The Organic Consumers Association writes about the dangers of this trend here.

Support your local farms.

Recipes: Deidre's Spelt Drop Biscuits, French Lentils and Carmelized Onions, Marinated Beets

Deidre's Drop Biscuits:


Of all the cooking I've done over the years, for some reason I had never made biscuits even though I love them- just never crossed my mind. My BFF Deidre, an ND in Canada made these for me when I was visiting. I'm still looking for the almond gravy recipe from my college days to go with them. If it turns up I'll update the post.

2 c. whole grain spelt (or whole wheat) flour
1 TBSP baking powder
1/2 tsp salt
1/3 cup non-hydrogenated shortening in pea sized chunks (or cubed butter if you eat dairy)
3/4-1 cup soymilk (we use oat milk as we're not a soy family- any milk alternative would work just as well)

Preheat oven to 450 degrees.
In a medium bowl mix dry ingredients.
Cut in shortening or butter with pastry cutter or cuisinart. Texture should resemble coarse bread crumbs.
Make a well in center and add 'milk'. Stir or pulse until moist.
Knead 10-12 strokes.
Drop onto a greased cookie sheet a few TBSP per biscuit. Should make about 10 biscuits.
Bake 10-12 min.

French Green Lentils with Caramelized Onions:


OK you got me, this photo is not French Lentils, it's azuki beans. I usually make this dish with the lentils but thought I'd try the beans tonight. It's good, not great. With the lentils, it's great.

Cut 2 medium onions into thin strips. Pour 1/4 to 1/2 cup oil in a saute pan. Heat oil to medium. Cook onions for 5 min stirring frequently then turn to low. The onions should continue to cook for about an hour until they're golden color and very sweet. You may want to look at some other instructions for carmelizing onions as well.

While the onions are cooking, put 1 cup French lentils in a pot, rinse and pick out any stones. Cover with plenty of water so lentils stay submerged and cook until tender but not disintigrating, about 20-30 minutes.

Stir lentils into onions. Add salt if desired. This is another favorite dish of my toddler.

Marinated Beets:
Beets, really? Yes!

4 beets, red, yellow, or both.
2 TBSP olive oil
2 TBSP aged balsamic vinegar
1 TBSP wheat free tamari- we don't eat soy so we just make it without this ingredient
Handful of fresh basil, chopped (optional)

Preheat oven or toaster oven to 350. Wrap 4 washed beets individually in aluminum foil and cook for about an hour. You can use the foil to 'rough up' the beet after it has cooled slightly and the skin will peel right off. Expect to get your hands red with this one. (Don't forget to rinse off the foil and re-use or recycle!)



Cut beets into small cubes, about half an inch to an inch. Place in a mason jar or similar. Add liquid ingredients and basil. Shake. Put in fridge. Shake every few hours to make sure all the beets end up sitting in the liquid for a while. It's ok for this to take a few days, but it is also good by the next day.



Strain beets after a minimum of 24 hours and keep chilled until use.
Use marinade as salad dressing- it turns a beautiful deep ruby color.

In Health,
Dr Samantha

But how do I find good recipes without gluten?

And while we're at it, let's add "without dairy" "without too many carbs" "with high omega-3" "without sugar?" And so on and so on.

Sitting where I sit, after 20 years of working on recipes that fit my family's dietary restrictions, it's easy. But I know that up front, when those first changes are being made, it can be quite daunting to say the least. So, where to start?

There are 3 main things I stress when working with folks who are making dietary changes.

1. You can enjoy food no matter what changes you decide to make, or have to make. How do I know this? From looking to the cookbook editor with a life threatening allergy to nuts, the food writer and recipe developer who learned in her 30's that she has a severe gluten intolerance, and the Foodie in San Francisco who cannot eat any saturated fat without having severe health repercussions, to name just a few. They're all people I know, and all people that have extremely satisfying culinary lives. Trust that you can do this.

2. Be willing to experiment. All cooks know that some recipes end up in the compost. If you don't try a new food or recipe though, you won't know if you like it. At our house I try at least one new recipe a week (okay, maybe every other week since our baby turned into a toddler with 8 hands. )

3. Think outside the box. Once you get the hang of cooking for whatever your needs are, you can start making subsitutions. The prosciutto and halibut recipe below for instance. You can't eat fish? Try it with chicken. You don't eat pork? Try wrapping it with a lightly steamed chard leaf and cook it in foil. Will this work? I have no idea. But, that's how you come up with new staple recipes that work for you. Honestly it is nary a recipe that I don't change somehow (note: this is not always the best idea with baking as baking is more science than cooking.)

So now, where to go for recipes?

First, my 2 current favorite websites.

1. Epicurious. You can type in an ingredient such as "kale" and it will come up with a list of recipes that have appeared in their magazines (Gourmet and Bon Appétit to name a few.) Two cool things about this site are that you can save your recipes with notes in your own 'recipe box' and you can read changes other people made to the recipes and how it turned out. This has taught me some great tricks and given me some great ideas.

2. Cookstr. This is a relatively new site that I am using more and more of late. Cookbook authors allow their recipes to be posted and you can then just click and buy if you find a book by a chef that you like. You can sign up for emails and you'll get 10 recipes on their theme of the week. They don't have the recipe box feature as above but I emailed them and it is apparently in the works. The best part of this site however is that you can search by dietary restriction! Most of the time it works swimmingly.

3. OK I know I said 2 but I'd also like to give a shout out to Post Punk Kitchen. It's not common that I recommend a vegan diet for my patients but for those who are already vegan, this is a very good resource. Just please, don't use margarine. Ick.

Other tips and tricks.

1. Clear an afternoon to sit in the cookbook section of your local bookstore. Peruse to your heart's content.

2. Send out an email and ask your friends for their favorite recipe (dairy free, wheat free, or whatever.)

3. Google. I know it's a bit desperate but sometimes I'll google something I'm looking for, like "bread machine spelt challah" or "vegan soy-free frosting." Over time you'll learn to review the recipes that come up and have a clue as to whether they may be worth trying or not.

Really though, have fun. If you choose to make changes, remember that it is a choice. If you have to make changes, remember that it is something you're doing that is good for your body. Enjoy yourself. Know that there are worlds of foods out there that you haven't even considered yet, and you may just like them.

In Health,
Dr Samantha

Edited to add: Thank you to the commenter who noted that I neglected to include Living Without magazine on my list. We have this in our waiting room (of course I read it cover to cover before anyone else even gets to see it!) and we love to recommend it to patients. I'll plan another post with GF resources in the near future.

Recipe: 20 min dinner: Prosciutto Wrapped Halibut, Quinoa, and Garlic Spinach.

I adapted this halibut recipe from a fabulous cookbook my sister just gave me called Fast Fish.

Fish:
Ingredients:
• 1-1.5 lbs halibut
• Jar of olive tapenade- I've tried this recipe with both green and black tapenade. I liked the black better. You can also see recipe link for additions to the tapenade.
• 1 package of italian prosciutto




1. Preheat oven to 350 degrees.

2. Cut halibut into 3 x 3 inch squares (or as close as you can get to this.)

3. Place a piece of prosciutto on a cutting board, put the fish about 1 inch from the end, and then put 1 TBSP of the tapenade on top of the fish and wrap the ham around the top of the fish, tucking in any extra. Repeat with new pieces until fish is all wrapped up.

4. Place the wrapped pieces of fish in a baking dish and place dish in pre-heated oven. Cook until fish is to your liking- we like it on the softer side, but of course that is individual preference. I also like to broil for the last 5 minutes to crisp up the ham. Mmmmm.

We use smaller pieces for our 2 1/2 year old and he can just pick them up and take bites.

Quinoa:
Quinoa is a grain that is relatively higher in protein than many other grains. I love the texture, and also the fact that it is a whole grain but cooks in 15 minutes as opposed to 45 minutes for brown rice. It is common in Peruvian cuisine and can be used in any way that rice is used.

Ratio of 1 part quinoa to 2 parts water.

Rinse quinoa first, then place in pan with water as above. Boil. Turn to simmer and cook until water is absorbed, about 15 minutes. Should be fluffy and the little 'tail' should show on the grains.

Spinach:
We love fresh spinach but also always have several bags of frozen spinach for those times that we need to get dinner on the table quickly. Our 2 year old also prefers the frozen kind, I'm not quite sure why. For our garlic spinach we put 2 TBSP of olive oil in a pan with 3-4 cloves of pressed garlic or 3-4 squares of frozen garlic from Trader Joes. On low to medium heat cook garlic until it just starts to turn a golden color. Add bag of spinach, stir, cover, cook until hot, about 5-7 minutes depending upon your stove.

Tip:
If you have extra proscuitto, tear into small strips and wrap around pitted dates. Put them in the oven on a baking sheet until ham is crispy. I place a few of these on the plate as well but we also send them with our son to school for his snack.

Voilá, 20 min dinner, wheat and dairy free, well rounded. Delish.

In Health,
Dr. Samantha

Stimulation of Acupoints Is Effective for Post Operative Nausea and Vomiting.

Anyone out there get nauseated post-anesthesia? I do, and acupuncture has always been helpful for me. I can't count the number of times I've recommended it.

A new review of 40 existing studies affirms my recommendation and finds that indeed, it does work. As a matter of fact, we don't even need to use needles, acupressure will do the job just as well (for this condition, anyway.)

Next time you're in, ask me about this point, in my experience it's great for most kinds of nausea, not only post operative.

In Health,
Dr. Samantha

Recipe: Breakfast Pizza- Wheat and Dairy free.

We love breakfast foods at our house. I'd say that on any given week you'll see breakfast for dinner at least once (and cereal for snack? I won't even try to count.)

Last week we had a showdown...one of my boys wanted 'pizza' for dinner and the other wanted eggs. Thus the birth of our new favorite dinner: Breakfast Pizza.

Ingredients (we doubled it and made 2 so my son could take it for lunch all week.)
1. Whole grain pizza crust. We like Graindance frozen spelt pizza crust- it has gluten, but no wheat. You could also use a frozen rice pizza crust or a homemade pizza crust if you are gluten free.
2. 6 eggs. I recommend omega-3 fed free range eggs.
3. Half of a bag of frozen spinach or a few cups of fresh spinach with large stems removed.
4. 1 onion chopped.
5. 3 cloves of garlic pressed or minced. Trader Joes has frozen 'garlic cubes' that we keep on hand in case we don't have fresh available.
6. Olive oil.
7. Sun dried or fresh tomatoes. If you use fresh, remove the goopy part.
8. 3-4 sliced of precooked turkey, veggie, or regular bacon chopped (optional, we happened to have cooked bacon in the fridge when I made this.)

Preheat oven to temp recommended with your pre-cooked pizza crust

In saute pan, saute onions and garlic in olive oil. We like to use lots of olive oil and cook them slowly so the onions are a bit sweet, but as long as the onions are soft when you're done, it's all good.

Add spinach and tomatoes and cook until soft, mixed and aromatic.

Beat eggs with a fork and pour into the veggie mixture until just barely cooked/still a little wet.

Put all of this on top of the pizza, sprinkle bacon on top, and bake for about 10 minutes or crust is browned and eggs are set.

Serve hot, or not.

News: Walnuts May Decrease Risk of Breast Cancer

Yes it was a rodent study. No, I don't like the idea of breeding cancer ridden mice.

That said, I am happy to see more studies on nutrition and health, period. This recent study showed that not only did walnut consumption decrease breast tumor incidence in the study mice but also decreased the number of glands with a tumor and the tumor size. The amount they fed the mice would be about 2 oz of day of walnuts for an average sized adult.

The quote offered by the study author on sciencedaily.com wasn't new news though. "Walnuts are better than cookies, french fries or potato chips when you need a snack," said Hardman. Um, thanks for the tip.

Recipe: Green Bean 'French Fries'

We were doing a detox a few months back and I was looking for some new simple recipes. I came across a recipe for roasted green beans, which I adapted to the following and called Green Bean 'French Fries'- my 2 year old loves them!

Ingredients:
1 pound green beans
1.5 TBS olive oil
3 garlic cloves- crushed
salt
truffle salt (optional)

1. Preheat oven to 425 degrees.
2. Cut or pick off end of green beans, wash, and lay out on a dish towel to air dry for a little bit.
3. Mix olive oil and crushed garlic in small bowl.
4. Put green beans into a plastic bag (ziploc is easiest, produce bag will work), pour in oil/garlic mixture, sprinkle with desired amount of salt (less salt if you plan on adding truffle salt, see #7), shake bag to coat beans.
5. Arrange single layer on baking sheets and place in oven.
6. Cook for appx 20 minutes or until the beans are slightly browned in areas, turning with spatula a few times during cooking.
7. If desired sprinkle with a little bit of truffle salt for a gourmet touch.

In Health,
Dr Samantha