Mediterranean Diet For Everyone

Beet and Lentil Salad

There are so many different specialty diets these days: Keto, Paleo, Vegan, FODMAP, and the list goes on. I've prescribed all of these diets to patients for different reasons over the years, as everyone has individual needs at times. After 20+ years of medical practice, including 7 years focused on food and nutrition, I have come to the conclusion that there is no one perfect diet. That being said, I love to teach and preach about the Mediterranean diet because it is as close to a "one size fits-all" plan that works.

While you can Google a list of specific foods and guidelines for the Mediterranean diet, it doesn't really work that way. Rather, it is really a formula for eating well rather than a specific cuisine. The basic tenants of the eating pattern are simple: focus on eating whole (unprocessed) food that is rich in fruits and veggies, whole grains, nuts, legumes, spices, and extra virgin olive oil. Do this while keeping poultry, fish, dairy, and red meat to modest amounts. No matter your dietary allegience, it is hard to argue against a diet that advocates for eating real food. 

The research behind this formula is extensive. Thousands of studies representing millions of lives consistently shows that eating like this helps maintain weight, keeps cholesterol in check and blood sugar and blood pressure low. Also, the risk of cancer, depression and Alzheimer's disease is also lower. All these benefits are gained simply by paying attention to what goes in your mouth. 

Whether you consider yourself a vegan, a paleo die-hard or follower of a specialty diet, applying a Mediterranean diet philosophy to your approach can benefit your health.

Keep the following in mind:

1. Eat lots of vegetables. There are so many choices! From a simple plate of sliced fresh tomatoes drizzled with olive oil and flaky sea salt, to garlicky greens, fragrant soups and stews, healthy pizzas, or oven-roasted medleys. Vegetables are vitally important to the fresh tastes and health benefits of the Mediterranean diet.

2. Change the way you think about meat. If you eat meat, just do it in smaller amounts. For example, add small strips of sirloin to a vegetable sauté, or garnish a dish of lentils with diced prosciutto. As a main course, have smaller portions (3-4 ounces) of chicken or pastured meat. Think of meat as an accompaniment instead of the center of the plate.

3. Consider eating seafood twice a week. Fish such as salmon, trout and mackeral are rich in heart-healthy omega-3 fatty acids. When you crave more variety add anchovies, sardines and herring. Shellfish including mussels, oysters, and clams have similar benefits for brain and heart health.

4. Cook a vegetarian meal one night per week. Build these meals around beans, whole grains, and vegetables, and heighten the flavors with fragrant herbs and spices. When one night feels comfortable, try two nights per week.

5. Use good fats. Include sources of healthy fats in your daily meals, especially extra-virgin olive oil, nuts, seeds, olives, and avocados.

6. Switch to whole grains. Whole grains are naturally rich in many important nutrients including fiber to keep you satisfied for hours.

7. For dessert, eat fresh fruit. Choose from a wide range of delicious fresh fruits — from fresh figs and oranges to pomegranates, grapes and apples. Instead of daily ice cream or cookies, save sweets for a special treat or celebration.

8. Enjoy alcohol very sparingly (if at all). Alcohol, in moderation, has historically been associated with the cardiovascular benefits of the Mediterranean diet. After careful evaluation of the research, a committee of scientists updating the latest edition of the Dietary Guidelines for Americans is changing the current stance on alcohol. They report that studies showing alcohol can protect health are deeply flawed, and that any potential cardiovascular benefits would be outweighed by the fact that alcohol is a leading preventable cause of cancer. The committee plans to recommend that men and women who drink limit themselves to a single serving of wine, beer or liquor per day. They do not recommend drinking for health and suggest drinking less is generally better. As an alternative to alcohol, try a low sugar, organic wine or a mocktail.

Use the recipes below as inspiration to get started on a Mediterranean diet. 

Roasted Olives with Orange and Rosemary

Salmon with Lemon Walnut Relish

Mediterranean Lentil Salad

Roasted Whitefish with Sweet Peppers

Looking for a place to find low sugar, organic wine. Check out Dry Farm Wines. 

TIPS FOR DRY JANUARY SUCCESS

Building a Better Smoothie and Dr. Leazenby’s Favorite Recipe

We all know that we should be eating more fruits and vegetables, but its not always the most convenient choice in our busy American lifestyle. You have to get creative and plan ahead to find strategies that work for you. I frequently teach the "4 S’s" to my patients and my students as ways to incorporate veggies into your diet. These include Soups, Smoothies, Stir-fries and Salads. All of these are versatile options for incorporating plenty of nutritious foods to support your health.

Let's look closer at smoothies. They are a great option for any meal of the day. The can be made sweet or savory and can accommodate a large variety of ingredients. However, they can also quickly become unbalanced and sugar-laden when made with too much fruit juice, sweetened yogurt, or large amounts of high-glycemic fruit. The following tips can help make smoothies a nourishing part of your diet.

1. Add veggies. Fruit is delicious and wholesome, but even in high quantities this natural sugar can send our blood sugars spiking. Leafy greens like spinach and kale add to the nutrient density of our meal, but do not contribute additional sugar. Avocado can add creaminess and a luscious thickness while providing a great source of fiber and healthy fat. Cucumbers can be a refreshing way to add flavor, fiber and water to smoothies.

2. Add protein. Our bodies ideally want every macronutrient (protein, fat and carbohydrate) available in every meal. Adding protein to smoothies helps fuel the body through the day and provides essential building blocks for health. Add nuts like cashews or almonds, beans like chickpeas or white beans or consider a high quality commercially available protein powder.

3. Use a spoon and a bowl. Proper digestion starts in our brain and requires a mindful approach to eating. Sitting down to a table and chewing your calories is preferable to quickly gulping down your smoothie. When you are able, turn your smoothies into a smoothie bowl. Simply add less liquid to your smoothie to make it thick like the consistency of soft serve ice cream. Serve the smoothie as a bowl topped with fruit, nuts or your favorite granola. You may find you feel fuller faster.

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The Ultimate Smoothie Bowl Recipe

Smoothies can be a great on-the-go breakfast. Including vegetables, protein and healthy fats help ensure these tasty drinks provide a steady source of energy rather than a sugary spike and crash. To help promote mindfulness and proper digestion, consider making your smoothie thick and eat it from a bowl with a spoon.

Author: Erica Leazenby, MD Time: 5-10 minutes
Serves: 1

Ingredients for a balanced smoothie:

• 1-2 veggies: Get creative and include a variety of veggies like a handful of spinach or kale, a piece of cooked sweet potato, steamed cauliflower, half a cucumber or cooked white beans

• 1-2 fruits: Prioritize fruits like raspberries, blueberries and cherries that are less likely to spike blood sugars; tropical fruits like pineapple and mango can cause more significant blood sugar spikes, so use them more sparingly

• Healthy fat: Adding a 1/4-1/2 of an avocado, tablespoon of nut butter or a spoonful of seeds can provide healthy fats that help keep you full and promote absorption of fat soluble vitamins

• Protein: Add unsweetened yogurt, hemp seeds, nut butters, chia seeds, flax seeds or plant-based protein powders

• Liquid: Nut based milks, teas or ice are great bases for smoothies; avoid fruit juices to help control the amount of sugar

• “Extras”: Give your smoothie an extra flavor jolt with antioxidant spices like cinnamon, unsweetened cocoa, ginger and turmeric

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Dr Leazenby’s Favorite Sweet Cherry Smoothie Bowl

• 1 cup spinach

• 1/2 cup frozen cherries

• 1 serving chocolate flavored, plant-based smoothie powder (I like OptiCleanse Creamy Chocolate by Xymogen. This is available in the Relish Health office.)

• 1/2 cup or more unsweetened almond or cashew milk

• 1 Tablespoon flax seed

Optional toppings: nutty granola, unsweetened coconut flakes, helm seeds, pumpkin seeds, berries, a few banana slices

Combine all ingredients in a blender. Adjust amount of almond milk to desired consistency. Periodically scrape down the blender to incorporate all the ingredients. Serve in a bowl with your favorite toppings.

BACK TO SCHOOL BREAKFASTS

Back to School Breakfasts

Avocado Toast

The start of the school year means that many of us are getting back to familiar routines that may have become lax in the summer (or during quarantine). For those of us with school age children, late summer is a natural time to reset some of our habits for the upcoming year. Switching up your breakfast is an easy opportunity to increase your energy, control your cravings, encourage mental focus and potentially lose weight. These are benefits that can be enjoyed by the whole family regardless of age.  If you are currently skipping breakfast or not having a healthy breakfast, consider prioritizing this meal for a month and note how you feel. 

What is a healthy breakfast?

The typical American breakfast brings to mind foods like cereal, muffins, waffles, oatmeal and orange juice. Each of these foods and others like them are filled with sugar and carbs, and lack key nutrients such as protein and healthy fats. A meal high in sugar and carbs can temporarily boost energy, but without protein, healthy fats and fiber our blood sugar may spike and then quickly crash. This blood sugar roller coaster leads to more carb cravings, as well as compromised focus and erratic energy. The perfect breakfast is low in sugar and contains protein, healthy fats and plenty of fiber. The combination of these macronutrients ensures that our blood sugars are stable helping to keep us appropriately fueled for our day. 

Consider these sources:

• Protein: Plant-based protein powders (I like rice, pea and hemp), eggs, collagen or well-sourced, high-quality, unprocessed meats

• Fat: Nuts, nut butters, olives, high quality oils (EVOO, avocado oil, coconut oil)

• Fiber: Veggies of all colors and varieties especially greens, flax meal, chia seeds or psyllium husk

Breakfast when fasting:

If you’ve read my blogs or seen me in the office, you know I am a fan of time-restricted eating (AKA intermittent fasting). Not only is what we eat important, but when we eat it also impacts our health. Ideally the first meal of your day, regardless of the time it is eaten, includes protein, fat and fiber to set the tone for balanced blood sugars for the rest of the day.

Easy Swaps for your breakfast favorites:

 We all have favorite foods. Try applying some of these simple swaps to ensure balance in your meal.

• If you are fan of baked goods, including waffles or pancakes, try swapping the white flour for whole grain flour or almond flour to increase fiber. Almond flour can be easily swapped for a portion of the flour in most recipes. The almonds give added fiber and healthy fat to keep you full longer. Another tip for pancakes: if you like syrup, then try swapping with almond butter and cinnamon, applesauce, or berries.

• Include veggies in your favorite smoothie recipe. I recommend kale, spinach, avocado, cucumber or even carrots to add fiber and antioxidants, vitamins and minerals. The goal here is to provide extra flavor and nutrition without sugar. Add only enough fruit to make the smoothie delicious enough for your to have it in your rotation. Bananas and pineapple can send your blood sugar soaring if not balanced with fat, protein and fiber. So, use them sparingly and with enough veggies to balance them.

• Use leftovers from dinner to balance your eggs. If you are only eating eggs, you are getting good protein, but you are missing fiber. Save some extra roasted or steamed veggies from dinner and add to your eggs in the morning. You will gain extra fiber and antioxidants to start your day. Or, serve your eggs with a side of mixed greens dressed with lemon juice and olive oil for a savory early day meal.

• Avocado toast is not just for brunch at your favorite restaurant. Smash an avocado and place on whole grain toast, with lemon, red pepper flakes, sliced radishes and “everything bagel” seasoning to add delicious favor. Experiment and make it your own with your favorite toppings. The avocado provides fat, fiber and antioxidants. For a twist, try hummus on toast.

• Make your oatmeal a complete meal. By itself, it is a good source of carbs and fiber, however it lacks protein and fat. Try adding a spoonful of protein powder, whole nuts or nut butter to make it work for you.

Below I have listed several quick and easy breakfast options to inspire you to have your (breakfast) cake and eat it too. By focusing on one meal at a time you can easily make food habits healthier, and breakfast is a simple place to start. These recipes are nutrient-dense, balanced and most importantly convenient for the morning rush. 

Chocolate Chia Pudding with Berries

Decadent German Chocolate Chia Pudding

Breakfast Parfait with Coconut Yogurt and Nutty Low-Sugar Granola

Avocado Toast with Eggs

Sweet Potato with Chai Spiced Almond Butter

Cured Salmon with Apple 

Smoothie Bowl with Protein Powder

Beet Red Velvet Waffles

Eggs Poached in Spicy Tomato Sauce

Is It Time for a Whole-Body Tune up?

Sugar, wine, comfort food, boredom snacking. Sound familiar? The coronavirus has many of us “coping” in ways that may not be ideal for our long-term health. Finding ways to break the cycle of food cravings and unhealthy habits may be as close as 5 days away. 

What is a Fasting Mimicking Diet (FMD)?

A fasting mimicking diet is a type of intermittent fasting. It was developed by Dr. Valter Longo, an Italian biologist, researcher and expert in the field of longevity. Science has demonstrated that water fasting (drinking only water for a prescribed amount of time) can enhance healthy aging. Unfortunately, many people find skipping meals too challenging for regular practice. Dr. Longo, with his team of scientists at the University of Southern California, developed a FMD protocol using specific amounts of plant-based proteins, carbohydrates and fats that allows the body to “mimic” the beneficial response of a 5-day water fast. These include:

• Improved blood sugar- When it comes to managing blood sugar, intermittent fasting takes center stage. It has been proven to lower insulin resistance and increase metabolism. 

• Weight loss- Weight-loss resistance can often be due to an underlying hormone imbalance. Leptin is a hormone produced in your fat cells. Leptin resistance occurs when your brain stops recognizing leptin's signals to use your body’s fat stores for energy. This causes your body to continually store fat instead of using it. Fasting has been shown to improve chronic inflammation that can dull the brain’s leptin receptor sites. FMD is clinically shown to help individuals with normal-BMI reading to lose an average of 5.7 lbs of fat and 1.2 inches off waist circumference, while overweight/obese lost >8lbs, mainly with visceral fat reduction while protecting lean body mass.

• Curbed cravings- Fasting decreases your hunger hormone ghrelin, which in turn can increase dopamine levels in the brain. Fasting can also help free people from emotional eating and kill cravings by transitioning your metabolism from unstable sugar-burning to steady fat-burning.

• Lower cancer risk- Multiple studies have shown a link between fasting and a reduced risk of breast cancer.

• Enhanced heart health- Intermittent fasting is thought to lower heart disease risk due to its ability to lower triglycerides and blood pressure and raise beneficial HDL cholesterol.

• Improved autoimmune conditions- A fasting-mimicking diet under 1,000 calories a day for three-day cycles has been shown to improve symptoms associated with autoimmune conditions like multiple sclerosis as well as lupus.

How does it work?

During the five days of restricted FMD calories, the body goes into repair and recycle mode. When caloric consumption is low, the body turns to internal sources of stored energy. Not only does the body burn stored fat, it begins breaking down and recycling internal cellular components or entire damaged cells that weren’t working optimally. This process is called autophagy. Toward days 4-5 of the FMD, the body increases stem cell activity triggering a regenerative process to occur. It’s “out with the old, in with the new” at the cellular level.  There are many studies ongoing right now looking at FMD in cancer, cognitive impairment, kidney disease, multiple sclerosis, cardiomyopathy, depression, diabetes, metabolic syndrome and obesity. 

How to complete a FMD?

While there may be multiple ways to complete an FMD on your own, Dr. Longo and his researchers have developed a specific, patented product called Prolon, which I believe achieves the best results. It includes a kit with 5 small boxes containing all the food and beverages you need to complete a 5 days FMD. The meals include a nut bar for breakfast, dried soups for lunch and dinner, various snacks, a special low-calorie drink, as well as herbal teas. After you finish the 5-day cycle, you return to your normal, healthy eating habits for the rest of the month. Each cycle is beneficial, but completing a FMD for 5 consecutive days per month for 3 months shows significant benefits for people with excess weight or metabolic concerns, but even those at their ideal weight will also see benefits. The daily calories are as follows:

• On day one, 1090 calories are provided (10% protein, 56% fat, and 34% carbohydrate)

• On days two through five, 725 calories are provided (9% protein, 44% fat, and 47% carbohydrate).

My experience with FMD:

As a foodie and nutritional expert I did try my hand at recreating the FMD myself. I copied the calories and macronutrients described in the studies and created my own snacks, soups and salads. After comparing my results with my experience using Prolon, I found I had more weight loss and better energy response using the pre-packaged Prolon kit. I have now completed five Prolon FMD cycles. Here is what else I have discovered:

• I loved having the boxes of Prolon food. One of the hardest parts of being on a diet is figuring out what to eat, so this made it simple.  I completed 3 cycles in 3 consecutive months and plan to continue doing 2-4 cycles per year.

• Day 1 is fairly easy, but days 2 (and sometimes 3) can bring fatigue. By days 4-5, my energy and focus skyrocket. I have found that each cycle becomes easier. 

• The food: As a trained chef and foodie I know that my food choices are particular. The nut bar, olives and kale crackers are delicious. The soups are tasty, but I admit that I add a few dried herbs like oregano or basil to liven them up. The choco-crisp bar is a welcome sweet treat. 

• At the end of the five days, my clothes fit better, cravings improve and my sleep is more restful and energizing. I will admit I have been tempted to continue the fast because I felt amazing!

• I lost weight with each cycle. There is a small (and expected) bounce back in weight after resuming regular eating habits. However, over time with multiple cycles under my belt, I have experienced sustained reduction in weight and waist circumference.

Who should try Prolon FMD?

Prolon is best for people who want to maintain healthy levels of:

• Fasting blood glucose

• Cholesterol

• Blood pressure

• C-reactive protein

• Triglycerides

• Reduce excess fat while maintaining body mass.

Prolon fasting mimicking diet is not for everyone. Side effects include weakness and lightheadedness. It is important to keep exercise minimal while completing the 5 day program. Prolon FMD is NOT appropriate for anyone with nut allergy, diabetes or significant blood sugar problems, low body weight, eating disorder, pregnant or nursing women, chronically weak/ill, or the elderly. I recommend working with a healthcare practitioner to decide if it is right for you, especially if you want to monitor your health status with blood pressure and lab work.

Learn more about the various types of fasting.

Schedule an appointment to learn more. 

Prolon kits are available in the office or can be ordered here. 

Prepare yourself for sugar season

Halloween marks the official start of sugar season. All of the candy from trick-or-treating gets us primed for the sugar feasting that often accompanies the holidays. Of course, a little sugar is a fun indulgence and makes life… sweeter, but with all of the upcoming office parties, happy hours and family feasts it is easy for our consumption to get out of hand. Understanding sugar and its impacts on your body can be a powerful tool in controlling your health, your weight, and your mood throughout the entire year.

What is sugar and do we need it?

Sugar is a carbohydrate that is naturally present in most whole foods. As we eat, our body produces digestive enzymes that break down these carbohydrates into simple sugars—glucose, galactose and fructose. These simple sugars are absorbed into our bloodstream and are processed by our liver. Glucose is released back into the bloodstream to fuel our cells and body.

Sugar comes in many forms. “Natural sugars” are those that come from whole foods like fruit or dairy. “Added sugars” are those that are added during manufacturing or processing. Added sugars can be natural (honey, maple syrup, coconut sugar, etc.) or processed (cane sugar, high fructose corn syrup, etc.). Added sugars may be used to balance favors, produce caramelization, act as a preservative or extend the shelf life of products. With the variety of sugar forms and the diversity or roles it plays in food production it is easy to understand why sugar has become so prevalent in our food supply. 

Regardless of the type of sugar consumed, our body eventually breaks down all sugars to the same simple forms—glucose, galactose or fructose. Natural, whole food sources of sugars are healthiest because the sugar is accompanied with fiber, water, vitamins and other nutrients that slow the absorption of sugar into our body and put less demand on our metabolism. 

What is the harm in indulgence?

I believe life is meant to be celebrated with the occasional sweet treat. Unfortunately, the average American consumes almost 152 pounds of sugar in one year. That is equal to 3 pounds (or 6 cups) of sugar in one week.  There is abundant medical research that shows that frequent consumption of sugar perpetuates inflammation, weight gain, fatty liver disease and increases our risk of diabetes, heart disease, dental cavities and even Alzheimer’s disease.  

How much sugar is OK?

There are many public health organizations that weigh in on this issue. The America Heart Association, the CDC and the US Department of Health and Human Services among others, recommend no more than 36 grams of added sugar for men per day and no more that 24 grams for women and children over 2 years of age. For reference, one teaspoon of sugar equals 4 grams. It is easy to meet and exceed these recommendations, especially when that grande pumpkin spice latte at Starbucks clocks in at 50 grams per indulgence!

There is definitely a place for sugar in our lives but keeping sugar to a minimum in our everyday lives is a good idea. Reducing added sugar consumption can help minimize the risks of lifestyle related causes of death like obesity, heart disease and diabetes. 

How do you reduce your sugar intake?

Making diet changes is no small task; and there is not necessarily one right way to do it. Below is a list of suggestions that can help you minimize added sugar in your diet. 

1.     Learn the many names of sugar so you can identify it when reading labels. The food industry has become very clever in disguising sugar. Familiarize yourself with the list below.

• Agave Nectar

• Barbados Sugar

• Barley Malt

• Beet Sugar

• Brown Sugar

• Cane Crystals

• Cane Juice Crystals

• Cane Juice

• Caramel

• Carob Syrup or Sugar

• Coconut Nectar/Sugar

• Concentrated Fruit Juice

• Confectioner's Sugar

• Corn Syrup Solids

• Corn Sweetener

• Crystalline Fructose

• Dextrin

• Diastatic Malt

• Diatase

• Evaporated Cane Juice

• Florida Crystals

• Fruit Concentrate

• Glucose Solids

• Golden Sugar/Syrup

• Granulated Sugar

• Grape Sugar

• Grape Juice Concentrate

• High-Fructose Corn Syrup (HFCS)

• Honey

• Icing/Invert Sugar

• Lactose (added)

• Malt Syrup

• Maple Syrup

• Molasses

• Muscovado

• Nectresse

• Palm Sugar

• Refiner's Syrup

• Rice Syrup/Malt

• Sorghum Syrup

• Sugar/Raw Sugar

• Table Sugar

• Treacle

• Turbinado Sugar

• "-ol" sugars: erythritol, ethyl maltol, mannitol, sorbitol

• "-ose" sugars: dextrose, D-mannose, fructose, galactose, glucose, maltose, sucrose

2.     Gradually cut back on sweetened foods. Strategies like replacing sugar sweetened beverages with unsweetened tea or sparkling water, opting for fruit as a dessert or reaching for a square of dark chocolate instead of a Snickers can help move the needle when addressing our sugar consumption. Over time, our palates adapt and we may no longer appreciate the super-sweet products we once loved. 

3.     Or, eliminate sugars cold turkey. This method works well for some. Opting for a 7-10 days sugar elimination diet resets the palate and can dramatically reduce sugar cravings that keep us perpetually reaching for the candy jar. Be prepared: for some people days 3-5 of this challenge feel the toughest. Hang in there.

4.     Eat protein at breakfast. A meal that includes protein, fat and fiber helps to balance your blood sugar and keep you fueled and focused during your day. When you are satiated, you are less like to eat the donut in the break room that may prime your sweet tooth for a day’s worth of binging. 

5.     Drink more water and green tea. Staying hydrated during the day means we are less likely to confuse signals of thirst for hunger. If water is too boring, try drinking your favorite tea. Green tea in particular is full of antioxidants and contains EGCG which is a natural blood sugar balancer.

6.     Get your gut checked. If you have difficulty overcoming your sugar cravings, it may not be a failure of will power. Our gut is home to trillions of organisms that are metabolically active. Pathogenic bacteria and yeast may be contributing to your cravings. Luckily, there are testing and treatment options available to address the problem organisms. 

Schedule an appointment with Relish Health to develop a personalized plan to reduce sugar.

Interested in guilt-free homemade candies? Check out these recipes:

Salted Date Caramel Turtles
Dark Chocolate Brain Bark
Chocolate Almond Butter Cups
Raw Chocolate Cherry Truffles
Check out these other sweet tooth solutions. 

Losing Sleep? Four Causes and Solutions for Insomnia

There is more and more research showing the importance of sleep and its impact on our health. Yet, insomnia is a common problem. In fact, as high as 30-45% of the adult population suffers from it. After we drift off each night, our brain remains in an active and dynamic state. The glymphatic system continues to be hard at work cleaning house, eliminating waste and distributing compounds such as glucose, lipids, amino acids, and neurotransmitters. Also, a complex hormonal dance occurs as part of our natural circadian rhythm which regulates memory function, appetite and metabolism, focus, and many other aspects of our health. These hormone levels are directly related to how we feel on any given day, and the lack of sleep can further complicate many other health issues and recovery.

For example, we have all felt the irritably, mood changes, poor concentration and digestion changes that can come after a rough night of sleep. String together multiple nights of poor sleep and we can have more significant health problems like obesity, diabetes, weakened immune systems, and even decreased longevity. . 

The good news is that resetting your sleep is possible. Below is listed four common triggers for insomnia and ways to address it.

1. Low blood sugar related insomnia

   • Problem: If you are waking up in the middle of the night I encourage you to examine what you had for dinner. Dinners that are predominately carbs or followed by sugar in the form of dessert or alcohol can leave us on an insulin-blood sugar roller coaster. If our meals are not adequately balanced there is a risk that our blood sugar dips down too low at night. This can trigger you to wake up. 

   • Solution: Eat a balanced dinner. Take a look at your plate. Ideally half of your plate is covered in fiber rich veggies that help slow glucose absorption from your digestive tract. Aim to include 15-20 grams of protein and a source of good fat like avocado, olive oil or nuts and seeds that help maintain steady glucose levels.

2. High cortisol related insomnia

   • Problem: Cortisol is our stress hormone. It has a natural circadian rhythm that helps us maintain energy over the course of our day. Stress, either psychologic from life events, or physiologic from illness, pain or deficiencies, can trigger our normal cortisol rhythms to be disrupted causing broken and disturbed sleep.

   • Solution: Restoring our natural cortisol level can be challenging until we know the root cause of the disturbance.

     • For emotional stress the role of stress-coping skills cannot be overemphasized. Strategies like meditation, deep breathing exercises, counseling, gratitude journals, regular exercise and appropriately addressing relationship or job concerns are helpful. 

     • For physiologic stress it is best to work with a health care provider that can help uncover and address concerns like nutritional deficiencies, blood-sugar imbalances or chronic pain. 

3. Sex hormone related insomnia

   • Problem: Many peri- and post-menopausal women can testify that sleep changes as our hormones change. Hormones that are unbalanced can trigger a change in sleep quality.

   • Solution: Addressing stress and optimizing digestive health go a long way toward supporting our hormones, but sometimes we still need additional help. If sleep disruption occurs during a particular part of your menstrual cycle or develops in peri-menopause, then I recommend formal hormone testing. The information gathered can help direct targeted treatment. 

4. Melatonin related insomnia

   • Problem: Melatonin is one of the hormones that help regulate our sleep. Low levels of melatonin can be caused by exposure to blue light at bedtime or can occur when we have an imbalance in our serotonin levels. Serotonin is a neurotransmitter that is intimately tied to our mood and is a precursor to melatonin. Much of our serotonin is made in our gut and is a common chemical targeted by antidepressant medications. 

   • Solution: Minimizing our exposure to blue light a few hours before bedtime supports our natural melatonin secretion. We can do this by turning off computers, TVs and phones or wearing blue-light blocking glasses. Optimizing our digestive system, the site of much of our serotonin production is also indirectly helpful for our sleep. Talk to a health professional if you struggle with depression. You may need additional support for neurotransmitters. Some people benefit from direct melatonin supplementation, which is available over the counter in pharmacies.

If you think you are suffering from one or more of these issues and would like to discuss a customized plan for improving your sleep, make an appointment with Relish Health today.

Fasting for Weight Control and Longevity

Fasting is a trendy topic in the wellness community but fasting is certainly nothing new. It has been a regular part of human society and culture for millennia. Historically, periods of feasting and fasting were associated with the natural rhythm of seasons, and alternated between times of plenty and times of scarcity. Additionally, many world religions have long recognized the importance of fasting for mental and physical purification and many people still incorporate regular periods of fasting today. Yet despite its deep root in human evolution and culture, many of us may associate fasting with deprivation and declining health. This is far from the truth; human culture has thrived for millennia with this ancient practice. 

There are many benefits of adopting a lifestyle with periods of fasting. The power of fasting lies not in the mere reduction of calories, but the beneficial hormonal and biochemical changes that occur. Fasting has effects on many hormones including insulin, cortisol and hunger hormone, ghrelin. For years, epidemiological study of centenarians and groups that voluntarily eat less have strongly suggests that people could extend their average lifespan and live healthier. Unfortunately, despite the benefits, cutting calories indefinitely is challenging. Fasting offers a practical solution. There are several fasting strategies that are analogous to daily caloric restriction, such as time restricted feeding (often called intermittent fasting), alternate-day fasting or periodic prolonged fasting.

The list of fasting benefits is extensive:

• Evidence shows that fasting may improve our cholesterol levels and reduce our risk of cardiovascular disease.

• Fasting improves the way we metabolize glucose and how well our cells respond to insulin. This offers protection against obesity. 

• Fasting can improve our cognitive function and may improve mood.

• Fasting significantly improves inflammatory markers in the blood and may reduce autoimmune diseases.

• Fasting can activate stem cell-based rejuvenation.

• Studies suggest that careful use of fasting can reverse type 2 diabetes.  

• Fasting can promote weight loss and decrease body fat, especially the visceral fat near our organs that is particularly risky to our health. 

• Some fasting regimens and time-restricted eating patterns can improve circadian rhythms that are important for body weight regulation, hormone balance, coordination and sleep. 

• Because over consumption of food is stressful for the body and brain, fasting from 12-40 hours can benefit overall health and even slow the aging process.

Fasting is powerful! It turns out that not only is what we eat important but also when we eat it. Excited to get started?

There are a number of fasting regimens and there really is no one best way to fast. Popular fasting strategies include:

• Time-restricted eating means that a person eats all of their meals and snacks within a particular window of time each day. This timeframe can vary according to the person's preference. Typically, the eating window in time-restricted programs ranges from 6–12 hours a day.

• Alternate day fasting is just as it sounds. You fast every other day. Calories are not restricted on the non-fasting days. The most common version of this diet actually involves a "modified" fasting where you can eat a limited number of calories on fasting days.

• Prolonged fasting protocols vary widely, but typically involve fasts lasting longer than 24 hours occurring at intervals between several times a week to several times a year. 

Where to start? It may be easier than you think. 

At Relish Health I recommend that most people begin fasting by doing a 12-hour fast overnight. For example, if you eat dinner around 7pm you would then aim to eat breakfast around 7am. This process gives the body a 12-hour window of fasting that may allow some of the benefits listed above. 

If a 12-hour fast goes well, you can try increasing the period to 16 hours. You can do this daily, or if you’re just getting started, I recommend 2-3 days per week. More intensive or prolonged fasting may be needed for people with specific goals like weight loss or diabetes reversal. I encourage you to talk to a professional familiar with fasting before attempting prolonged fasts. Schedule an appointment with Relish Health to discuss a plan customized to you. 

For some people, just one night of fasting yields benefits like increased focus and metabolism, while others need a few weeks of 12-hour fasting windows to see results. Regardless of how long it takes, nearly all report waking up feeling physically lighter and mentally sharper.

A word of caution: while fasting has proven to be safe, there are select groups of individuals that should not fast. These include pregnant and nursing mothers, underweight individuals or people with a history of eating disorders. In each of these cases, fasting may lead to undernourishment during a time of high nutrient need or may lead to emotional or restrictive eating. 

Life is meant to be celebrated. Feasting with friends and family is an important part of a happy and fulfilled life. Adding periods of fasting to your routine can give a deeper understanding of the feast and celebrations while honoring your health. Balance your feasting with periods of fasting to maintain a healthy rhythm of life.

Mediterranean Diet For Everyone

Summer Peach and Tomato Salad with Basil

There are so many different specialty diets these days: Keto, Paleo, Vegan, FODMAP, and the list goes on. I've prescribed all of these diets to patients for different reasons over the years, as everyone has individual needs at times. After 20 years of medical practice, including 3 years focused on food and nutrition, I have come to the conclusion that there is no one perfect diet. That being said, I love to teach and preach about the Mediterranean diet because it is as close to a "one size fits-all" plan that works.

While you can Google a list of specific foods and guidelines for the Mediterranean diet, it doesn't really work that way. Rather, it is really a formula for eating well rather than a specific cuisine. The basic tenants of the eating pattern are simple: focus on eating whole (unprocessed) food that is rich in fruits and veggies, whole grains, nuts, legumes, spices, and extra virgin olive oil. Do this while keeping poultry, fish, dairy, red meat and wine to modest amounts. No matter your dietary allegience, it is hard to argue against a diet that advocates for eating real food. 

The research behind this formula is extensive. Thousands of studies representing millions of lives consistently shows that eating like this helps maintain weight, keeps cholesterol in check and blood sugar and blood pressure low. Also, the risk of cancer, depression and Alzheimer's disease is also lower. All these benefits are gained simply by paying attention to what goes in your mouth. 

Whether you consider yourself a vegan, a paleo die-hard or follower of a specialty diet, applying a Mediterranean diet philosophy to your approach can benefit your health.

Keep the following in mind*:

1. Eat lots of vegetables. There are so many choices! From a simple plate of sliced fresh tomatoes drizzled with olive oil and flaky sea salt, to garlicky greens, fragrant soups and stews, healthy pizzas, or oven-roasted medleys. Vegetables are vitally important to the fresh tastes and health benefits of the Mediterranean diet.

2. Change the way you think about meat. If you eat meat, just do it in smaller amounts. For example, add small strips of sirloin to a vegetable sauté, or garnish a dish of lentils with diced prosciutto. As a main course, have smaller portions (3-4 ounces) of chicken or pastured meat. Think of meat as an accompaniment instead of the center of the plate.

3. Consider eating seafood twice a week. Fish such as salmon, trout and mackeral are rich in heart-healthy omega-3 fatty acids. When you crave more variety add anchovies, sardines and herring. Shellfish including mussels, oysters, and clams have similar benefits for brain and heart health.

4. Cook a vegetarian meal one night per week. Build these meals around beans, whole grains, and vegetables, and heighten the flavors with fragrant herbs and spices. When one night feels comfortable, try two nights per week.

5. Use good fats. Include sources of healthy fats in your daily meals, especially extra-virgin olive oil, nuts, seeds, olives, and avocados.

6. Switch to whole grains. Whole grains are naturally rich in many important nutrients: they are fuller and the nuttier taste and extra fiber keep you satisfied for hours.

7. For dessert, eat fresh fruit. Choose from a wide range of delicious fresh fruits — from fresh figs and oranges to pomegranates, grapes and apples. Instead of daily ice cream or cookies, save sweets for a special treat or celebration.

8. Enjoy wine (optional). Alcohol, in moderation, has been associated with a reduced risk of heart disease in some research studies. For men, 1 to 2 glasses (5 ounces) of red wine at meals may be acceptable. Women should be advised to have just 1 glass of wine no more than four times a week due to the recognized association between breast cancer and increased alcohol consumption. Try low sugar, organic wines.

Use the recipes below as inspiration to get started. 

Roasted Olives with Orange and Rosemary

Mediterranean Lentil Salad

Looking for a place to find low sugar, organic wine. Check out Dry Farm Wines. 

*https://oldwayspt.org/traditional-diets/mediterranean-diet

Improve Your Sleep, Improve Your Health

Sleep is vital to the maintenance and healing of your body each day; and the lack of sleep is linked to a variety of serious health problems, including heart attack, stroke, type-2 diabetes, hormone balance, obesity and even wrinkles. While the amount of necessary sleep differs from person to person, most people need between 7-9 hours each night.

At Relish Health we discuss many lifestyle solutions that can improve your night’s rest, including dietary and nutritional choices listed below. Your body is unique and will respond to different foods and activities depending on a variety of factors. See me to develop a customized plan for improving your sleep and your overall health.

Maintain a steady blood sugar level. Eating a balanced diet that is rich in fruits, vegetables, “good” fats and lean proteins and avoids added sugar is important for maintaining steady blood sugar levels. Erratic levels can lead to elevated stress hormones that disrupt the sleep process. When eating a bedtime snack be sure to pair carbohydrates with a source of fat or protein to help promote steady absorption of the nutrients. For example, pair almond butter with your banana to make a balanced snack.

Enjoy alcohol wisely. Although alcohol can cause drowsiness, it delays the brain from entering the REM sleep cycle, which is restorative to its function. Consuming alcohol within 3 hours of bedtime may cause you to wake up still feeling tired despite having spent an adequate amount of time in bed. Having a drink at dinner is unlikely to disturb your sleep, but consider switching to tea for a night cap. Herbal teas that are known to promote relaxation include chamomile, holy basil or lemon balm.

Minimize caffeine consumption. Caffeine is a powerful stimulant. It has a 6-hour half-life, which means you still have 50% of your morning caffeine in your body at lunch and still 25% at dinner time. Anything you drink after noon will still be near 50% strength at bedtime.

Consume foods that promote melatonin production. Melatonin is a hormone produced in the pineal gland of the brain. It helps regulate our sleep-wake cycle as well as helps orchestrate other hormonal functions. Certain foods have been associated with boosting the body’s ability to produce this important hormone and minimize the need for supplementation. Consider adding these foods to your evening meal: pineapple, cherries, bananas, oranges, oats, sweet corn, and rice.

Consume foods rich in vitamins and minerals. Key nutrients including magnesium, zinc, vitamin D and B vitamins support relaxations, healing and neurotransmitter manufacturing. Nutrients dense foods include dark leafy greens, nuts, seeds, fish, beans, whole grains, avocados, yogurt, bananas, dried fruit and dark chocolate.

Sweet Tooth Solutions

Are Valentine’s Day treats threatening your New Year’s resolutions for eating better? It happens to the best of us. But sugar is our health nemesis triggering increased blood sugar, inflammation and altering our immunity. Even with dessert, we can learn to love the foods that love us back. Unfortunately, refined sugars and flours don’t love us at all. However, it’s a lot easier than you think to make better after-dinner choices. Here are a few of my favorites:

1.     Pineapple and Papaya Fruit Salad

Pineapple contains bromelain and papaya contains papain; both are proteolytic enzymes meaning they help breakdown proteins and can help with digestion. As a whole we want to decrease our consumption of refined sugars. Eating fruit for dessert help us satisfy our sweet tooth, increase our fiber consumption, and in this case may give us a little boost with our digestion. See recipe below.

2.     Dark chocolate

Yep, I just gave permission to indulge in chocolate. Dark chocolate that is as least 70% or higher cocoa is rich in anti-oxidants such as polyphenols and has been associated with heart-health. Dark chocolate is often dairy free and has less sugar that its cousin, milk chocolate. Enjoy an ounce or two after a meal. Remember to take time to consume it mindfully, savoring its flavor.

3.     Peppermint tea

Like an after-dinner mint, a cup of herbal peppermint tea is a satisfying finish to a delicious meal. Peppermint has been long been attributed with many benefits like relaxation and improved indigestion, but may be just the ticket to satisfy that sweet tooth.

Try this simple fruit salad recipe to help you think outside the pastry and ice cream box for your after-dinner treats.

Tropical Pineapple and Papaya Salad

Both fresh pineapple and papaya contain active enzymes that help breakdown proteins. Rich in fiber and anti-oxidants, try eating this salad as a sweet finish to your meal.

Author: Erica Leazenby, MD

Serves: appx. 6 1-cup portions

Time: 10 minutes

Ingredients:

1 small pineapple, cut into bite-size cubes

1 small papaya, cut into bite-size cubes

1 cup blueberries

Coconut whipped cream (optional)

2 tablespoons Toasted coconut (optional)

Mint leaves (optional)

Directions:

Combine pineapple, papaya and blueberries in a medium bowl. Divide the salad into small serving bowls and garnish with coconut whipped cream, mint and toasted coconut as desired.

For additional sweet tooth taming stratagies read here:

Prepare Yourself for Sugar Season

Tips To Make Your Holiday Cookies More Healthy