Gluten free in Portland? Your All in One Resource.

Everything you could possibly want to know about living gluten-free in PDX.
These guys rock.

http://www.glutenfreeportland.org/

Fish oil and PCBs. How Do You Trust Your Supplement Brand?

Every time a new patient comes into the clinic I have 'the supplement talk.'

Here's the thing; no one is regulating the supplement industry. And it is indeed an industry, a big one at that. Does that mean that you can't trust anything out there? No. It means that you need to be very careful about which supplements you buy. Just because something is expensive, doesn't mean it is good. However, if something is very inexpensive (compared to other similar products) there is a pretty decent chance that it hasn't been through stringent quality control. Why? Because it costs companies much more to test each batch of raw material that comes to their plants, and even more to test the final products.

So how do you know what is ok and what isn't? As a physician, I work closely with a few companies that have stringent controls. But if you are just buying something at the store, don't take the sales person's word for it (they are usually trained by the companies directly), and don't take the word of the product label either, do your own research. Here is what I recommend.

Call the company and ask the following questions regarding supplement "X".

1. Do you manufacture it? If no, you need to speak directly to the manufacturer. Some companies just label supplements produced by another company.

2. Do you test all raw materials that come to your plant for ingredient, contamination, and potency (if applicable?)

3. Do you test the product for quality post manufacture? If yes, is it random testing, or batch testing? And, is it done in house or by an independent testing company. Fair warning here, I did some consulting for a mass market brand where they would 'shop' the product having a batch tested 3 or 4 times before someone came back with the answer they wanted.

4. If I read you the batch number of the supplement "X" in my hand, can you send me a certificate of analysis. If you don't feel 100% confident with their answers, go to another brand.

Here is a link about a lawsuit being brought against a number of high profile companies that were found to have PCBs in their fish oil. And as if that is not bad enough, many of them had statements on the labels stating that the product was "screened for PCBs" or "treated to remove PCBs."

One online resource, the subscription site Consumer Lab does do random spot checks of many supplements. What they are trying to do is very important but the potential problem here is that just because one batch looks good doesn't mean the manufacturer won't change their raw materials supplier at any time, or even that the raw materials supplier is providing consistency in product.

The take home? My advice is to only by supplements from companies that have stringent quality control of their product and manufacturing from start to finish.

Janie's back!

We were so lucky to have had the lovely Laura step up to take over for Janie while she was on maternity leave. She did such a fabulous job and we'll all miss her. Thank you Laura!

As of last week, Janie is back 2 days a week. Her hours have changed a bit and are now Tuesday and Friday from 11:30-7:30. She's looking forward to seeing folks again so if you've been holding out for her return, the time has arrived. 

Simple Dinner Party: Avocado, Orange and Kohlrabi Salad, Yucatán Pork Stew and Quinoa.

My favorite stew, it turns out, is a fabulous dinner party main dish. Not only does it taste great but all of the cooking and clean up is done long before guests arrive. It is pretty easy to put together and then just simmers for 4-5 hours.

Dinner party day at 1pm, getting started:

Yucatán Pork Stew. I first saw this recipe in a very fun newsmag called The Week, which had reprinted from Food and Wine. When I was visiting my sister in San Francisco we walked into Avedano's, her favorite local butcher shop and I saw a copy of the recipe on display. It had originated in that very shop! The only changes I've made to this recipe are that doubled the carrots and onion, and I serve the cilantro on the side. If I didn't have a 3 year old I'd probably throw some jalapeños into the stew to give it a little kick. Please note also that browning the pork may take up to 20+ minutes. Also, I take the lid off after the first hour and cook it for closer to 4-5 hours, rather than 3 so it cooks down a bit more and the house smells yummy. The rest you just throw together. Oh, and make sure you use a large pot, I like my 6 quart enameled cast iron pot, Absolutely delicious.

This will serve 7 hungry folks with several rounds of leftovers. Freezes great!

20 min before guests will arrive, start the quinoa.

Quinoa. 20 min before you are going to serve dinner, put 2 cups quinoa and 4 cups of cold water in a saucepan. Bring to a boil then cover and simmer about 20 min until water is gone and grain is a little fluffy. Toss lightly with a fork to lighten it up.

The salad can be made right before guests arrive, or as they are arriving.

Salad. Makes 6-7 plates.

• 1 head butter lettuce
• 3 ripe but not oversoft avocados cut into wedges then halved
• 3 seedless oranges cut into sections then halved- rind and white removed
• 2 small or one medium kohlrabi, grated
• 3 T cup olive oil
• 1 T fresh squeezed lime
• 3 T white wine vinegar
• 1/3 tsp brown sugar
• 1/3 tsp cumin
• 1/3 tsp ground black pepper
• salt to taste
• additional lime to taste

1. Wash and dry butter lettuce leaves, leave whole.
2. Whisk together dressing ingredients in a small bowl
3. Mix oranges and kohlrabi in medium bowl.
4. Pour dressing over oranges and kohlrabi and toss.
5. Add avocado and lightly toss

Place butter lettuce leaf or two on a small plate and top with a spoonful of avo mix.

Sorry no photos, I'll see if I can snap some the next time I make them.

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.