Vitamin D, the wonder vitamin?

Vitamin D is hitting the news just about every day of late.

Sure it's the 'it' vitamin right now, which automatically makes me suspicious, but the evidence is piling up that we may be causing ourselves immense harm by avoiding the sun.

Here is a sampling of just a few articles citing recent studies on vitamin D.

1. Higher blood levels of vitamin D associated with improved mobility for seniors. 
2. Taking vitamin D supplements during pregnancy is not only safe for mother and baby, but also can prevent preterm labor/births and infections.
3. Vitamin D deficiency leads to sharply increased risk of breast cancer spread. 
4. Low vitamin D may raise heart disease risk.
5. Low vitamin D is associated with increased prevalence of type 2 diabetes, high blood sugar, insulin resistance, and metabolic syndrome. 
6. Lower vitamin D levels are associated with greater risk for upper respiratory infection (colds/flus.) This association is stronger in those with existing respiratory diseases such as asthma or COPD.

And this is just the tip of the iceberg.

In response to the latest news, some doctors are just putting all of their patients on 'higher' doses of vitamin D, 1000iu, 2000iu, but I don't think that's good enough. What I've found in my practice is that each person needs a different load of vitamin D to reach an ideal level (I shoot for 60-90 as a rule) and then a different amount to keep them at that level once they get there. Therefore, I recommend that everyone have a vitamin D test. Once we have results, I decide how much to supplement and we run follow up labs in 6 weeks to see if an ideal level has been reached. If all is well I keep the patient on approximately 1500-2000iu daily and then test again in another 3 months to make sure the patient is stable.

Note, please that as an ND I always supplement with vitamin D3, not prescription vitamin D2. Here is a study comparing D2 to D3.

Next post will be FAQ about vitamin D.
Check back.

In Health,
Dr Samantha

Cook This: Onion, Bacon and Broccoli Quiche

This recipe started out as a tart recipe from Cook's Illustrated. I love this magazine because they not only print recipes, but also cooking techniques. My cooking is all self taught and now that I'm spending every Sunday in the kitchen, I'm thrilled to learn a bit more about how to prepare things more easily and with better results. After finding this mag I learned that there is a companion cooking show on PBS called America's Test Kitchen. We don't have cable so I thought I didn't have quality cooking show options (I'll pass on Rachel Ray, thank you). This show was a pleasant surprise.

The photo to the left was lifted directly from the ATC website. Please note that I did alter this recipe and the final product will be more like quiche than a tart so it won't look exactly like the photo above. 

The original recipe calls for a homemade crust. Thus far I can't seem to get myself to take the time to do that, so I purchased a whole grain spelt pie crust at our local health food store. It's a bit sweet for a quiche so I'd like to try to make the crust myself at some point...I'll keep you posted. 

Ingredients:

• 4-6 ounces bacon cut into small pieces (optional)
• 3/4 cup of broccoli cut into very small pieces. You can also use the stem if you peel it first.
• 1 1/2 pounds onions , halved through root end, peeled, and cut crosswise into 1/4-inch slices (about 6 cups.) Click here for tips on cooking onions.
• 1-2 T oil safflower or olive oil.
• 1/2 teaspoon sea salt (I left this out because the bacon was salty enough.)
• 1 sprig fresh thyme.
• 5 large eggs.
• 3/4 cup MimicCreme (calls for half and half but we don't eat dairy.)
• 1/4 teaspoon ground black pepper.

Preheat oven to 375 degrees.
1. Pour oil into sauté pan and heat over medium flame. Add onions and once they start slightly browning, turn down to medium-low and add thyme sprig. Cook to desired finish. I tried cooking soft as well as caramelizing and decided that cooking just soft is better or they just get too sweet. This should take about 20-30 minutes.

2. While onions are cooking pre-cook pie shells until just golden. Take out and cool.

3. In another pan, cook bacon to desired finish (you could also do this with turkey bacon or veggie bacon.) Remove and drain on paper towel. Pour out bacon grease into a jar for disposal (never down the drain...)

4. Sauté broccoli in bacon pan until just soft. If you are skipping the bacon, just use a little bit of olive oil.

5. In a large bowl mix eggs, MimicCreme (or half and half), black pepper, and salt if desired.  

6. When onions are done, remove thyme and cool slightly before mixing with egg/cream mixture, add broccoli, mix thoroughly and pour into 2 (whole grain) pie or tart crusts.  

7. Sprinkle liberally with bacon.  

8. Bake pies on a baking sheet until centers are set.

Cool for at least 20 minutes before eating.  

I usually will be cooking something else between steps so it doesn't seem like it takes quite so long. Absolutely delish though, and great for lunches too! I bet it could be doubled and frozen, I'll try that next time.

Enjoy!
-Dr Samantha 

Welcome to the Garden

As a child I was loathe to make contact with anything that had more than 4 legs. My parents would try and try to get me out in the garden and I'd come up with any excuse not to do it because simply, bugs grossed me out. As an adult I have long gotten over my antipathy toward crawling things (well mostly gotten over it) and have made numerous attempts to grow things but apparently I spent so many years thwarting gardens my payback was that anything I tried to plant died a slow and agonizing death.

I am formally thumbing my nose to my gardening history and affirming that this is the year. With my little one turning 4 in September the time has come to grow some of our own food.

We ordered raised cedar beds from Naturalyards in Southern Oregon and with a friend who designs gardens for a living, on the nastiest and windiest day in a month, we got them set up and fully planted. As we start to harvest the veggies (knock on wood) the plan will be to add recipes to the blog that include our fresh, home grown veggies. I may even take a stab at canning if I can get someone to convince me I'm not going to give my family botulism.

Cook This: Juniper Brined Pork Chops, Vegan Caramelized Shallot Mashed Potatoes and Sauteéd Green Beans

Heading into my last day of vacation I wanted something delicious but not too complicated. I remembered that I tried this recipe once before and had some kinks to work out so was excited to get back to it.

I found this recipe on the foodandwine.com (photo is from the site, not my kitchen, see link for credit). Usually I mess with recipes but this time just prepared them as-is so instead of copying the recipe verbatim I'm linking. The first time I made these they were a bit tough. It turned out I missed the "double cut" part. I used the correct cut, was more careful this time, and it was better but still not perfect. Next time I'll check them at 20 minutes and not wait the recommended 30 minutes.

The recipe calls for brining chops for 2 hours (enough time to clean the kitchen from the rest of my cooking and hop on the spinning bike for a quick workout) then browning chops and placing in the oven for about 35 minutes. I made my potatoes and green beans earlier but the oven time is just about exactly how long you need to make the potatoes and green beans.  And yes my husband took my kid out today.



Caramelized Shallot Mashed Potatoes. 
Ingredients

• 1 1/2 lbs mashing potatoes (there is never any agreement on this...I use yellow potatoes)
• 1 TBSP soy-free Earth Balance
• 1/4-1/2 cup (your preference) MimicCreme or organic cream/half and half if you want dairy.
• 3-4 large shallots sliced into crescents
• 2 TBSP olive oil

1. Cut potatoes into 2 inch chunks and put in saucepan with water just covering. Bring to a boil then simmer until soft.

2. While potatoes are cooking cook shallots on low until they are first soft and sweet, then continue to cook until they get slightly crispy. (If you're doing green beans you can wash and cut at this time.)

3. Once potatoes are soft, drain 90% of water and start to mash with potato ricer or fork. Add Earth Balance and cream to preferred taste and texture.

4. Add carmelized shallots and any cooking oil left in pan to potatoes. Mix and season with salt and fresh ground pepper if desired.

If you're trying to do lower carb, this recipe might work with cauliflower as well. I'll try it and let you know how it goes. 

Sauteéd Green Beans

In Shallot pan, saute washed and dried green beans (I like to cut them in half) until done to taste. If you have it, sprinkle with a little truffle salt before serving. It's spendy but a jar goes a long way. I also love to use truffle salt on popcorn. Delish. 

Enjoy!
-Dr Samantha

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.