Homemade Sauerkraut

Basic Sauerkraut Recipe

Sauerkraut is an amazing two ingredient health elixir. Applying a bit of patience to a mixture of shredded cabbage and salt results in a lactobacillus rich condiment.

Ingredients:

• 1 medium head organic cabbage, cleaned, quartered and thinly sliced

• 1-1 1/2 Tablespoon salt per quart of shredded cabbage (I prefer sea salt.)

Directions:

1. In a large bowl combine the cabbage and salt. Thoroughly mix the ingredients with clean hands until the cabbage has softened and started to release some liquid.

2. Transfer the mixture to a clean 1 quart mason jar. (I like to use a wide mouth jar.) Pack the mixture into the jar using a spatula, clean hands or a muddler. Tamp the mixture firmly until the liquid released from the cabbage completely covers the mixture.

3. Apply a weight to the top of the cabbage mixture to keep the cabbage submerged in the brine. A smaller glass jar filled with water (like a 1 cup mason jar), a food safe plastic bag filled with water or a small dish work well.

4. Cover the jar with a clean dish towel and set it in a dark, cool corner of your kitchen. Check the sauerkraut every few days. If you see scum forming in the jar, remove it and wash the weight before replacing it.

5. Allow the sauerkraut to ferment between 4-14 days. A longer fermentation time will result in a more "sour" finished product. Taste the mixture periodically. When the mixture has reached the desired tartness, remove the weight, screw a lid on the jar and place the sauerkraut in the refrigerator. Enjoy a forkful daily as a gut supportive treat.

Once you have mastered this simple technique, experiment with adding veggies, herbs or spices to the mixture for additional flavor varieties.

Try some of the other easy ferments:
NATURAL FOODS FOR GUT HEALTH
PRESERVED LEMONS
HOMEMADE COCONUT YOGURT
SHOULD YOU BE TAKING A PROBIOTIC?

A Primer on the Thyroid and signs it may not be healthy

Learn more at Thyroid.org

The thyroid is a butterfly-shaped gland located in the front of the neck. This small gland produces hormones that regulate the body's metabolic rate including controlling heart, muscle and digestive function, brain development, and bone maintenance. The thyroid is like a thermostat for our metabolic system. It has an influence on nearly every function and organ in the body to some degree, meaning that if the thyroid is not functioning well, it could have a ripple effect to create many health concerns. 

February 2013 Clinical Pediatrics 52(4)

To understand the thyroid, it is helpful to understand its connection to the pituitary gland in the brain. The pituitary gland releases thyroid-stimulating hormone (TSH). TSH in turn, stimulates the thyroid gland to make T3 (triiodothyronine) and T4 (thyroxine) thyroid hormones. The majority of hormone produce by the thyroid is the inactive hormone T4. When it hits the bloodstream, it is converted to T3, the active form of the hormone. There is a feedback loop between the thyroid hormones and the brain. When there is enough hormone in the blood the TSH stops getting released. This interaction between the pituitary, T3, T4, TSH, and thyroid is going on constantly to keep hormone levels in balance. T4 and T3 are the thyroid hormones that have an influence on nearly every cell of the body. 

The key to understanding the thyroid’s role in maintaining optimal health is understanding that it’s function is greatly affected by its environment. Diet, stress, inflammation, and pollution can all drastically change the thyroid’s function. To optimize hormone levels these outside factors must also be optimized which luckily can ultimately be beneficial for your overall health.

What causes thyroid problems?

Thyroid disorders are very common. According to the America Thyroid Association, 12% of the US population will develop a thyroid condition during their lifetime with women being five to eight times more likely to suffer than men. One in eight women will develop a thyroid problem. 

Institute for Functional Medicine (IFM.org)

The cause of thyroid disorders is often multifactorial. Triggers for dysfunction can include the following:

• Autoimmune disease- The most common causes of low and high thyroid function are autoimmune thyroid conditions like Hashimoto’s or Grave’s thyroiditis.

• Nutrient deficiencies like vitamin D, iron, zinc, selenium, or high or low levels of iodine

• High stress levels- Thyroid function can be down-regulated during stressful conditions. Cortisol, a stress hormone, can suppress the release of TSH by the pituitary gland, which then means the thyroid won’t get told to produce hormones.

• High fluoride exposure

• Gluten intolerance

• Chronic Infections like Epstein-Barr virus and Yersinia enterocolitica

• Radiation or surgery affecting the thyroid gland

• Family history of thyroid conditions
  

Symptoms of a Thyroid disorder

Because the thyroid can affect so many organs and systems in your body, the range of symptoms caused by a thyroid problem can be widespread. 

Symptoms of Under-active Thyroid
(Hypothyroid):

• Fatigue

• Increased sensitivity to cold

• Constipation

• Dry skin

• Weight gain

• Puffy face

• Hoarseness

• Muscle weakness

• Elevated blood cholesterol level

• Muscle aches, tenderness and stiffness

• Pain, stiffness or swelling in your joints

• Heavier than normal or irregular menstrual periods

• Thinning hair

• Slowed heart rate

• Depression

• Impaired memory

• Enlarged thyroid gland (goiter)

Symptoms of Over-active Thyroid
(Hyperthyroid):

• Unintentional weight loss

• Rapid heartbeat (tachycardia) — commonly more than 100 beats a minute

• Irregular heartbeat (arrhythmia)

• Pounding of your heart (palpitations)

• Increased appetite

• Nervousness, anxiety and irritability

• Tremor

• Sweating

• Changes in menstrual patterns

• Increased sensitivity to heat

• Frequent bowel movements

• An enlarged thyroid gland (goiter)

• Fatigue, muscle weakness

• Difficulty sleeping

• Skin thinning

• Fine, brittle hair

What to do if you suspect a thyroid problem

Thyroid disorders can be diagnosis with routine blood work. Talk to your health care provider about the symptoms you may be experiencing. At Relish Health, a thyroid evaluation includes checking TSH, free T4, free T3, and thyroid antibodies in order to understand how your thyroid functions on multiple levels. Thyroid ultrasounds are sometimes needed to check thyroid anatomy.

Getting a proper diagnosis is the first step in healing your thyroid and reducing unwanted symptoms. Relish Health is here to help.

Peach Agrodolce Sauce

Peach Agrodolce Sauce

One of my favorite restaurants in town serves a delicious sweet and tart cherry agrodolce sauce with salmon. There is something about pairing sweet fruit with a hint of vinegar, plump raisins and crunchy savory almonds that I can’t resist. Ever since tasting this dish I’ve been recreating it at home with whatever fruit is in season. My friends, this is the best version yet.

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Peach Agrodolce with Pan-seared Salmon

“Agrodolce” is a traditional sweet and sour sauce in Italian cuisine. It is easy to prepare yet makes a dramatic and elegant statement. The recipe captures the flavor of the fruit to make a savory accompaniment to a variety of dishes including fish like salmon or trout, poultry, pork or even roasted veggies like squash or cauliflower.

Author: Erica Leazenby, MD
Time: 20 minutes
Serves: 4

Ingredients:

• 2 Tablespoons extra virgin olive oil plus more for the salmon

• 1/4 cup shallot, diced small

• 1 bay leaf

• 1/4 cup golden raisins

• 2 large peaches, pealed diced into 1 cm cubes (or 1-10 oz bag of frozen peaches)

• 1/4 cup slivered almonds, toasted

• 1/2 cup no-sugar added, apple juice

• 2 Tablespoons apple cider vinegar

• Pinch salt and pepper

• Pinch red pepper flakes

• 4 5-ounce wild-caught salmon filet

Pan Seared Salmon

Peach Agrodolce Sauce

Directions:

For the salmon:

1. Preheat the oven to 350 degrees (or 325 if using convection heat).

2. Preheat a cast iron skillet or similar oven-safe pan to medium-high heat. If the pan is not well seasoned add 1 tablespoon of olive or avocado oil to the pan.

3. Season the salmon with salt, pepper and a thin coating of olive oil.

4. Place the salmon skin side up in the skillet. Sear the salmon for 3-4 minutes until the salmon flesh is golden brown and crips. Flip the salmon to skin side down. Place the skillet in the oven and finish baking the salmon until it flakes apart easily or is approximately 120 degrees. Cook the salmon for a total of approximately 10 minutes per inch thickness.

For the peach agrodolce:

1. Preheat a skillet to low-medium heat. Add 2 tablespoons of olive oil, the shallots and the bay leaf to the pan. Sautéed the shallots until they start to soften, about 3-5 minutes.

2. Add the remaining ingredients to the skillet. Simmer the ingredients until the peaches are soft and the pan sauce starts to slightly thicken, approximately 3-5 minutes.

3. Season to taste. Serve the sauce as a base for the salmon.

SEASONAL AGRODOLCE SAUCE (with apples, plums or cherries)

Enjoying Bitter Greens: Promote Digestion and Gain Nutrients

Red Belgian Endive

As Americans we are sugar-addicted and bitter-phobic, but many cultures embrace bitter flavors. Europeans have a tradition of “digestive” bitters and the ideal Chinese meal always includes a bitter food on the plate. We humans have taste receptors for five flavors: sweet, salty, sour, bitter and the elusive umami.

These flavors are important and have played a role in our evolutionary development. For example, sweet flavors signify sugars and sources of easy calories. On the other hand, bitter flavors have likely helped us avoid eating toxic substances. Over time we developed tolerance to these flavors, which has allowed us to eat nutritious plants that have bitter-flavors and now they are easily found in your grocery store. The chemical compounds in these plants that are responsible for the bitter flavors have demonstrated beneficial properties, including stimulating appetite, promoting digestive enzyme production necessary for optimal nutrient absorption as well as promoting gastrointestinal motility. Many people already use bitters for this purpose in the form of a morning cup of coffee. In fact, the three most recognized bitters in the American diet include coffee, chocolate and beer.

Kale, Swiss Chard and Arugula

Americans often ignore these wonderfully nutritious bitter greens. They are packed with vitamins A, C, K and minerals like calcium, potassium and magnesium yet low in calories. They are also great sources of folate and fiber.  Adding bitter greens to your diet can be simple. Arugula, endive, broccoli rabe, swiss chard, dandelion greens, escarole, frisée, kale, mizuna, mustard greens, beet greens, radicchio, and watercress can all be found seasonally in the produce section of most local groceries. The tender bitter greens can be incorporated into your salad. For the sturdier greens, consider lightly sautéing in a small amount of olive oil with a sprinkle of salt to tame the bitter flavor and make the greens more digestible.

To introduce your palate to these flavors, try the following recipe.

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Bitter Greens Salad

Of all the flavors that grace our plate, the bitter flavor is potentially the most fascinating. There is strong tradition around the world to use bitter flavors to help aid digestion, cleanse the body and build vitality. One of the best ways to introduce bitterness to your plate is to incorporate the bitter taste of nutrient dense greens into your salad. Chicory, dandelion, arugula, radicchio, endive or watercress are wonderfully complex tasting greens that are easily found in groceries and farmers’ markets. Slowly increase their proportion to sweeter tasting lettuces in your salad to build up your tolerance.

Author: Erica Leazenby, MD
Serves: 4-6
Time: 10-15 minutes

Ingredients:

2 tablespoons apple cider vinegar
1 teaspoon Dijon mustard
1 teaspoon honey or maple syrup
2 tablespoons olive oil
1/8 teaspoon salt
pepper to taste
6 cups mixed greens like romaine lettuce, endive, radicchio, watercress
Optional add-ins: a thinly sliced apple, fennel or radish

Directions:

1. Combine vinegar, mustard, honey in a small bowl. Add oils and whisk until well blended. Season vinaigrette to taste with salt and pepper.

2. Combine greens and any additional toppings in a large bowl and drizzle with dressing. Toss to coat. Serve immediately.

Notes:
Tart, yet sweet apples, like pink ladies or gala apples work well in this recipe. When possible use raw, unpasteurized apple cider vinegar like Braggs brand. 

Body Composition Analysis with Relish Health

Promoting good health and longevity is the goal of Relish Health, and research has shown that body composition is one of the best indicators to measure how well you are doing. Your weight is made up of muscle, fat, and water. Excess fat in relation to lean body mass, even if you are an “ideal weight,” can greatly increase your risks to cardiovascular disease, diabetes, and more. Instead of tracking how heavy you are, Relish Health uses body composition analysis to detect health risks and allow for earlier intervention and prevention of illness. Understanding your body composition allows your health plan to be tailored to your needs, often focusing on losing body fat and gaining muscle while retaining the proper amount of body water in specific areas of your body. Body composition analysis is the key to tracking and maintaining effective muscle mass and strategic weight loss. 

Relish Health uses an InBody570 bioelectrical impedance analysis (BIA) machine to complete body composition analysis in the office. BIA is a non-invasive, safe measurement of fluid and body mass that can be a critical assessment tool for your current state of health. By standing and holding onto electrodes, the machine determines the resistance to the flow of the current through the body. In about 45 seconds, the InBody machine provides very accurate measurements of your:

• Intracellular Water (ICW): Increases in ICW indicate improved nutrition status and improved overall health

• Extracellular Water (ECW): Increases in ECW indicates toxicity, inflammation, acidity, infection, and/or mineral imbalance.

• Fat Mass: Excess levels of visceral fat are associated with all major degenerative diseases. Additionally, fat stores toxins, converts healthy hormones to toxic hormones and triggers insulin resistance.

• Lean Body Mass (LBM): Optimum levels are associated with healthy aging, vitality, and better resilience against stressors.

Periodic BIA measurements allows Relish Health to track your progress as you improve your health. Improving your BIA measurement, or maintaining a healthy BIA measurement, can help keep your body function properly for healthy aging. Your BIA results can help guide Relish Health in creating a personalized dietary plan, including nutritional supplements when appropriate, and exercise to help you maintain optimal health and wellbeing for a lifetime.

Herbed Vinaigrette Potato Salad

Potatoes sometimes get a bad wrap due to their high carb content. In truth when they are prepared well (e.g. not french fries) they are a great source of antioxidants and gut-supporting, prebiotic resistant starch. Resistant starch, like it sounds, resists human digestion in our gut. This starch acts like soluble fiber which can improve insulin sensitivity, lower blood sugar levels, promote a healthy gut microbiome and help control appetite. The trick to making resistant starch from potatoes is to allow your cooked potatoes to cool. The cooling process allows the digestible starch to convert to resistant starch by retrogradation.

Try this Herbed Vinaigrette recipe for a healthy dose of prebiotic fiber. 

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Herbed Vinegrette Potato Salad

Author: Erica Leazenby, MD
Time: 20 minutes
Serves: 4

Ingredients:

• 1.5 Pounds small red potatoes

• 1/4 Cup extra virgin olive oil

• 2 Tablespoon red wine vinegar

• 1.5 Tablespoon seedy mustard

• 1/4 Cup diced celery (about 2 stalks)

• 2-3 Tablespoons diced shallot

• 1/2 Cup chopped parsley (about 1/2 bunch)

• 2 Tablespoons chopped tarragon or dill

• Salt and pepper to taste

Directions:

1. Bring a pot or water to a boil. Add a generous amount of salt. Boil the potatoes until they are fork tender but still able to hold their shape.

2. While the potatoes are boiling, add the oil, vinegar and mustard to a mixing bowl. Whisk the mixture together until it is well emulsified. Add the celery, shallot and herbs to the mixture.

3. Cut the warm potatoes into bite size pieces and add to the herb vinaigrette. Stir well to coat each potato in the vinaigrette. Season with salt and pepper to taste. Serve chilled.

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Looking for other great picnic recipes? Give these a try:
NUTS FOR KALE SALAD
SHAVED BRUSSELS SPROUTS SALAD WITH ALMONDS AND CITRUS VINAIGRETTE
BEET AND LENTIL HERB SALAD
MODERN EDAMAME SUCCOTASH

Modern Edamame Succotash

Succotash is a classic culinary dish often made with lima beans and sweet corn. While I enjoy the traditional dish, I’ve given this recipe a model twist by incorporating shelled edamame in place of the lima beans and creamy ripe avocado instead of the traditional butter or lard. The result is a nutrient-dense, flavor-packed salad that is perfect for your summer picnic.

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Edemame Succotash

Author: Erica Leazenby, MD
Servings: 4-6 (makes approximately 6 cups)
Time: 15 minutes

Ingredients:

2 cups frozen wukimame (AKA shelled edamame)
2 cups frozen organic sweet corn 
1 cups grape tomatoes, halved
1 diced red or orange bell pepper
1 ripe avocado, diced
4 scallions, thinly sliced, white and green portions
1/4 cups roasted sunflower or pumpkin seeds
3 Tablespoons olive oil
3 Tablespoons rice wine or champagne vinegar
Salt and pepper to taste
1-2 handfuls of parsley for garnish

Directions:

1. Bring a pot of water to boil. Salt generously. Boil the wukimame for five minutes. During the last minute, add the frozen sweet corn. Drain well and rinse with cold water.

2. In a medium bowl, combine the cool wukimame and corn with the remaining ingredients. Stir well.  

3. Serve chilled.  The salad is best if made several hours in advance.

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Looking for other great picnic recipes? Give these a try:
NUTS FOR KALE SALAD
SHAVED BRUSSELS SPROUTS SALAD WITH ALMONDS AND CITRUS VINAIGRETTE
BEET AND LENTIL HERB SALAD
HERBED VINAIGRETTE POTATO SALAD

Grilled Tuna with Marinated Artichokes

This is summer grilling at it’s finest. Fresh tuna is a rare and special treat at my house. It is one of my all-time favorite meals. I’ve been making this dish for the last 20 years. Even non-fish eaters seem to enjoy this recipe.

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Grilled Tuna Kabobs with Marinated Artichokes

Serves 4
Time: 10 minutes

Ingredients:

1.5 tsp Dijon mustard
2 tsp lemon juice
¼ cup light flavored olive oil
1 small clove garlic, minced
¼ tsp red pepper flakes
Pinch of salt and pepper
1 lbs fresh tuna cut into 1-inch cubes
8 marinated artichoke quarters, drained from their can or jar
4 skewers soaked in water for several minutes

Directions:

1. In a medium size bowl, whisk the mustard, oil, lemon juice, garlic, pepper flakes and salt/pepper until a thick paste develops.

2. Add the fish to the bowl and coat generously in the mixture.

3. Place the fish and artichokes on the skewers in an alternating pattern.

4. Grill the fish about 1 minute per side. The goal is a nice sear on the outside with a pink center of the cube.

I garnish with parsley and serve these skewers with rice and a light salad.
Recipe adapted from a Martha Stewart magazine circa 2002.

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

Functional medicine approach to healing autoimmune disease

An autoimmune disease is a condition in which the body’s immune system mistakenly attacks the healthy cells of the body rather than a germ like a bacteria or virus. The type of autoimmune disease is named based on the organ(s) being targeted by the body. Some autoimmune diseases target only one organ. For example, Hashimoto’s thyroiditis involved damage of the thyroid. Other autoimmune diseases, like systemic lupus erythematosus (SLE), affect the whole body.

Addressing the autoimmune process

Autoimmune disease represents an inappropriate immune response. The solution to reaching symptom control and disease remission is supporting the immune system to behave more normally. In conventional medicine, powerful immune modulating drugs are often prescribed. In functional medicine, there is a focus on restoring balance in the body by addressing lifestyle, diet, gut health and nutritional deficiencies among other factors. Conventional and functional approaches are not mutually exclusive and can be used together. The ultimate goal is to lower chronic inflammation that triggers symptoms flare-ups and disease progression.

It all starts in the gut

About 70 percent1 of the body’s immune system is located in the lining of the gut and is influenced by the health of the gut microbial community2. The immune system here plays a vital role in keeping the body healthy by providing a fine balance between the elimination of invading pathogens and tolerance to healthy self-tissue. Alterations to the gut lining and gut microbial community can cause immune imbalance, leading to autoimmune disorders.

Supporting intestinal health is essential for a healthy immune system and is the ideal place to start a healing journey. The health of the body’s microbiome and gut lining are directly influenced by things like metal health/stress management, diet and sleep3 quality.

Use diet to heal autoimmune disease

Healing the gut with nutrition requires an individualized treatment plan based on what is happening in the gut. A detailed assessment of symptoms combined with specialized testing can provide direction for treatment that may involve correcting microbiome imbalances, parasitic infections or overgrowth patterns. 

Nutrition tips to reduce inflammation and help manage autoimmune symptoms

1. Identify your trigger foods. 

When the gut lining is unhealthy, people may develop sensitivities to foods. These foods can then perpetuate chronic inflammation.  Food trigger will vary person to person and will be different depending on the autoimmune disorder involved. There are certain foods that are common triggers for inflammation and are best avoided with autoimmune disease, such as grains, gluten, dairy, refined and added sugars, alcohol and coffee for a period of time. Once symptoms are improved, these foods are reintroducing slowly back into the diet in a systematic way. 

2. Try an autoimmune paleo diet (AIP).

If avoiding top pro-inflammatory foods listed above does not provide relief, then moving to an advanced paleo diet approach may be helpful. An Autoimmune Paleo Diet (AIP) further restricts foods that may be inflammatory including removing all grains, dairy, gluten, legumes, nuts, seeds, nightshade produce, processed foods, and vegetable oils, as well as sugar and sweeteners from your diet to identify foods that may trigger a flare-up. Not everyone needs a diet this restrictive to find relief and healing, but an AIP intervention can be very powerful for healing. An AIP diet can be very restrictive and is not meant for long-term use. The elimination phase of the diet lasts 30 days and is followed by a structured reintroduction phase. 

3. Focus on eating a variety of healthy foods.

A common mistake people make when trying to follow an anti-inflammatory diet for autoimmune diseases is restricting the list of foods they eat and eating those same foods over and over again. Focusing eating a variety of foods from the exhaustive list of vegetables, fruits, proteins, etc. that are included in the diet provides healing nutrients like phytonutrients, antioxidants and omega-3’s for healing. Adding a variety of fruits and vegetables into your diet can also help prevent intolerances and ensure you’re getting a spectrum of vitamins and minerals. 

4. Address nutrient deficiencies.

Nutritional insufficiencies and deficiencies are common in the US. In people with autoimmune disorders vitamins A and D, omega-3 fatty acids and minerals like zinc and magnesium are especially important for healing. Addressing gut health to optimize nutrient absorption and eating a nutrient dense diet are imperative steps toward healing. Filling up on vitamin A-rich foods, like beef liver and wild Alaskan fermented cod liver oil, and vitamin D-rich foods, such as sardines and salmon can be helpful. For foods that are excellent sources of zinc, go for oysters, beef, crab, turkey, and chicken. And those that are high in magnesium, check out mackerel, spinach, Swiss chard, and avocado. In some cases, adding strategic supplementation to address deficiencies is important. If you have an autoimmune disease, talk to your doctor about regularly checking your levels of these key nutrients. 

Addressing autoimmunity requires a personalized approach. Talk with Relish Health to begin your healing journey.

BOOST YOUR IMMUNITY WITH FUNCTIONAL MEDICINE
TESTING, TESTING... WHICH ONES MIGHT BE RIGHT FOR YOU?

References:

1.     Vighi G, Marcucci F, Sensi L, Di Cara G, Frati F. Allergy and the gastrointestinal system. Clin Exp Immunol. 2008;153 Suppl 1(Suppl 1):3-6. doi:10.1111/j.1365-2249.2008.03713.x

2.     Wu HJ, Wu E. The role of gut microbiota in immune homeostasis and autoimmunity. Gut Microbes. 2012;3(1):4-14. doi:10.4161/gmic.19320

3.     Smith RP, Easson C, Lyle SM, et al. Gut microbiome diversity is associated with sleep physiology in humans. PLoS One. 2019;14(10):e0222394. Published 2019 Oct 7. doi:10.1371/journal.pone.0222394

A primer on gluten-free flours

Vanilla Almond Flour Cake with Raspberries

There are a variety of reasons to minimize wheat flour in your diet including celiac disease, non-celiac gluten sensitivity or the need to find lower glycemic alternatives for metabolic health. You can avoid gluten while still celebrating life with the occasional treat. Below are some of my favorite flours in my gluten-free kitchen:

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Almond Flour

Almond flour is made from ground blanched (peeled) almonds. It is high in fat, protein and calcium and is a good option when following a low-carbohydrate diets. Almond flour has a mild nutty flavor and is dense in texture. It is great for cookies. It does not rise well so cakes made with the flour are often dense. I recommend sifting before using and storing it in the freezer or a cool dry place. Almond meal is typically made from raw unpeeled almonds. Compared to almond meal, almond flour has a finer texture and lighter color.
Note: Other nut flours, like hazelnut or chestnut flours, cannot be subbed for one another due to differing fat content.
Recipes: Chocolate cake, Vanilla cake

Almond and Arrowroot Rose Cardamom Cookies

Arrowroot Flour

Arrowroot flour is ground from the root of a tropical Indonesian plant. It is mild tasting and can add crispness to cookies. It can also be used interchangeably with cornstarch as a thickener or to give a glossy finish to sauces. It is a good dredging agent. Arrowroot tubers are rich in fiber and the flour may be a good source of prebiotic fiber. It is best mixed with other flours as a blend when baking. 
Recipes: Savory Pie crust

Buckwheat Flour

Despite it’s name, the buckwheat plant has nothing to do with wheat. It is gluten-free and grain-free and has more protein, dietary fiber, and B vitamins than an equal weight of oat or whole wheat flour. Buckwheat flour has an earthy, slightly bitter flavor that is excellent in soba noodles, crepes and hearty sweet or savory treats like biscuits or scones. Beware, excessive mixing or beating may result in a tough texture of your baked good. As a general rule, keep buckwheat flour to about 25% or less of the overall flour mixture.
Recipes: Buckwheat crepes

Chickpea Flour

Chickpea flour is a pale, yellow flour made from ground chickpeas. It is high in protein, fiber, calcium, iron, folate and B vitamins. It is often used in dough, dumplings and noodles or as a thickener for sauces. It can also be used as batter for fried foods. It can impart a mild bean-like flavor to baked goods, so it is best to combine with other flours or use it with strongly flavored batters such as spice and/or chocolate flavors. Socca is a delicious, traditional French pancake from Provence made from chickpea flour.
Recipes: Socca

Almond Flour Doughnuts

Coconut Flour

Coconut flour is made from fresh coconut meat that is dried, de-fatted and ground into flour. It has a similar protein profile as wheat flour. Because it is high in fiber and low in carbohydrates it is an excellent option for low carbohydrate baking. Coconut flour has had the oil removed from the ground coconut flesh making it light in texture but requiring strong binders to hold the baked good together. It has a strong coconut flavor. Store in the freezer or refrigerator. 
Recipes: Almond and coconut flour scones

Corn Flour

Corn flour is made from finely milled kernels of corn. The entire kernel is used to make this product. Corn flour can give lighter texture to baked products and is often used in gluten free pasta.

Oat Flour

Oat flour is made from ground whole or rolled oats. It is easily made with a highspeed blender. It is slightly sweet in flavor and high in protein. It is useful for building structure in a baked good like cookies or crusts. It is heavy in texture and does not work well in cakes meant to be light and spongy. 
Recipes: Banana Bread

Carrot Cake with Almond Flour

Potato Starch

Potato starch is made from steamed potatoes that have been dried and ground. This starch is a dietary source of iron. It is bland in flavor and can lump up easily. It imparts a chewy, fluffy texture to baked goods and is often used in mixes. It is a good thickener and stores well.

Rice Flour, Brown

Brown rice flour is made from finely ground whole grain rice containing bran and germ. It is high in fiber, vitamins, and minerals. Its texture can be gritty and crumbly and the items prepared with it can dry out easily. It is best combined with other flours. It has a short shelf life. Store in the refrigerator or freezer. 

Rice Flour, Sweet

Sweet rice flour is good for sauces. It is an excellent thickening and binding agent. It makes things chewy. Sweet rice flour is ground from glutinous, waxy rice, containing more starch than brown and white rice flours. 

Rice Flour, White

White rice flour is neutral in flavor with a sandy texture and long shelf life. It is best combined with other flours as it tends to be grainy.

Red Velvet (Beet) Almond and Cassava Flour Waffles

Tapioca Starch/Flour

Tapioca flour is also known as cassava, yucca, or manioc flour. Tapioca starch and flour are the same product. It is milled from the dried starch of the cassava root. Cassava flour incorporates the whole root, whereas tapioca flour is made up of only the starchy part of the plant. Tapioca starch thickens when heated with water and is often used to give body to puddings and sauces. Beware, too much tapioca starch can make a baked product sticky or tough. (Using as a 1/3 portion of a flour mixture typically works well.) While it is a great binder, it is inadequate for creating the texture needed for cake.
Recipes: Red velvet waffles, Cassava flour tortillas

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There are actually many more varieties of flour than what I have listed above. Typically, multiple flours are combined to create a blend that behaves close to all-purpose wheat-based flour.

Here is a recipe from my culinary alma mater, The Natural Gourmet Institute:

All purpose Gluten-free flour blend:

• 2 cups white rice flour

• 2/3 cup potato starch

• 1/3 cup tapioca starch

Treat this blend like it is all-purpose flour. Store it in an air-tight container.

Join a Relish Health Virtual Cooking Class to learn more about gluten and dairy free cooking and baking.

Need a source for these flours? Try Thrive Market.

Try some of these recipes:

DUTCH BABY PANCAKE
PREBIOTIC-RICH POTATO LEEK TART (GRAIN-FREE)
TOASTED MARZIPAN
TIPS TO MAKE YOUR HOLIDAY COOKIES MORE HEALTHY

(This blog post is not sponsored by any manufacturer. However, at no cost to you, Relish Health may receive a commission on purchases made through an Amazon link.)

Equipment from my kitchen to yours

I receive many questions about the equipment I use in the classes I teach. Below are links to the products I love and use regularly.

Gnocchi Class

Gnocchi board

Sheet pans

Silicone freezer storage

General kitchen supplies

Baking Supplies

Specialty Pantry Items

(This blog post is not sponsored by any manufacturer. However, at no cost to you, Relish Health may receive a commission on purchases made through an Amazon link.)

How to Eat for Mental Clarity

Many doctors do not recognize the term “brain fog.” It is not technically a medical diagnosis, but it is a common complaint I hear in the office. Although tough to describe, people will often complain of forgetfulness, slow thinking, difficulty focusing, words-finding, or clouded thoughts. They may call it “mommy brain” or “frequent senior moments” and have valid worries about Alzheimer’s disease. Short, transient bouts of “fog” related to a missed night of sleep or a physically taxing day may be normal, but when these symptoms are chronic, they are warning signs of brain inflammation and compromised health.  

Addressing the root cause of these symptoms is important to restoring normal brain function. Addressing brain fog takes a comprehensive approach. Optimizing sleep, managing stress, balancing hormones, reducing sedating medications and controlling other illnesses like diabetes are all important. Diet is also an important tool to leverage. We can use our food choices to nourish our brain with important vitamins and minerals and turn on or off inflammation. 

Here’s what you need to know:

• Eat to nourish your brain. The health of our brain hinges in large part on what we eat. We need to consume several vitamins, minerals, fats, and antioxidants to feel our best. The only way to authentically do this is with real food. This means eating a balance of vegetables, well-sourced proteins, starchy tubers (translation: sweet potatoes, beets, carrots, plantains), fermented foods, nuts and seeds, fruit and plenty of healthy fats such as olive oil, avocado, and fatty fish (like salmon). What’s not on the plate is what most Americans are eating— sugar, refined carbs (i.e., bread, crackers, pasta, cookies, even seemingly healthy vegan baked goods and gluten-free replacement foods) and inflammatory oils, such as canola oil and fried foods.

• Avoid foods that make you feel sad, foggy or tired. When we talk about eating real food, we often overlook the flip side, which is avoiding the foods that contribute to feeling poorly. This includes anything that takes our mood for a roller-coaster ride like sugar, alcohol, and caffeine and anything that inflames us like gluten, industrially processed vegetable oils, all processed foods, and dairy for some people.

  As a society we prefer to add things to our diet or routine to improve our health. It may be easier to take a supplement or add a colorful superfood to the grocery list than to remove something from our diet—particularly when that something is tasty and cheap (and potentially addictive). While not popular, there is tremendous health gains to be had when we remove foods that are inflammatory or empty calories. For people struggling with brain fog I recommend completing an elimination diet for 30 days. Avoiding gluten, dairy, sugar and processed foods can give the gut and brain a reset and help you know if these foods are problematic. 

• Try time-restricted eating (also called intermittent fasting). Our brains are like hybrid cars. We can run on two fuel sources, glucose and ketones. When we are regularly eating, glucose is the primary fuel used by cells, including neurons. Fasting is defined by not consuming food for a long enough period of time to deplete the liver’s store of glucose. This prompts the liver to produce ketones which are essentially small pieces of fats that cells can use as an energy source. This metabolic switch— going from using glucose to using ketones as an energy source— happens after about 10 to 14 hours of not consuming food, depending on how active you are. In lab animals and we believe humans, fasting stimulates the production of a protein in nerve cells called brain-derived neurotrophic factor, or BDNF. This protein plays critical roles in learning, memory, and the generation of new nerve cells. BDNF also makes neurons more resistant to stress and is overall beneficial to the brain. 

Need help getting started and adapting these strategies to your personal situation. Relish Health is here to help.

Bibb Lettuce with Spring Onion Champagne Vinaigrette

The spring-like colors in this salad are dazzling. Vegetables of every shade offer their own unique phytonutrient benefits to our health. The brilliant contrast of the pale, buttery green leaves and the bright flavor of pink radishes engages all our senses. The nuts and seeds add minerals to make for a nutrient feast for the eyes and the body.

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Bibb Lettuce with Spring Onion Champagne Vinaigrette

Author: Erica Leazenby, MD
Servings: 4
Time: 30 minutes

Salad Ingredients:

1-2 heads Bibb lettuce depending on size
1 Watermelon radish sliced in thin half-moons
¼ cup shelled pistachios
Black sesame seeds for garnish

Vinaigrette Ingredients:

2 green onions, white and light green portion
3 Tbsp olive oil 
1 Tbsp Champagne vinegar
1 tsp Dijon mustard
1 tsp honey
Pinch of Salt 
Pepper to taste

Directions:  

1. Heat a skillet or grill pan over medium high heat. When the pan is hot drizzle a small amount of olive oil in the pan and add the green onions. Sauté the onions until they start to soften and develop sear marks.  Once the onions are soft removed them from the heat and allow them to cool.

2. In a blender, combine the sautéed onions, vinegar, mustard and honey. Start the blender and slowly drizzle in the olive oil until the mixture is smooth and well emulsified. 

3. Just before serving, toss the lettuce, radish, pistachios and dressings to combine. Garnish with black sesame seeds and serve immediately. 

Check out these other delicious salads:

SHAVED BRUSSELS SPROUTS SALAD WITH ALMONDS AND CITRUS VINAIGRETTE
SHAVED FENNEL SALAD WITH ARUGULA AND ORANGE
NUT AND FRUIT KALE SALAD
BEET AND LENTIL HERB SALAD

Shaved Fennel Salad with Arugula and Orange

Fennel is a bright, crispy bulb-like vegetable with a faint flavor of licorice and is slightly sweet. It is well-loved in Mediterranean cooking and is a lovely addition to salads. The orange in the recipe nicely complements the peppery greens and the licorice flavor of the fennel.

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Shaved Fennel Salad with Arugula and Orange

Author: Erica Leazenby, MD
Servings: 4
Time: 5-10 minutes

Ingredients:

4-6 handfuls arugula
1⁄2 fennel bulb, core removed, sliced thin
1 orange, zested then peel cut away and sliced into rounds
1-2 Tablespoon olive oil
1 Tablespoon mild vinegar like Champagne vinegar
Pinch of sea salt
1-2 grinds of fresh pepper
1-2 Tablespoons chopped walnuts (optional)

Directions:

1. Arrange the arugula, fennel and oranges in a salad bowl. Drizzle with orange zest, oil and vinegar, and sprinkle sparingly with salt and pepper. Toss just before serving and garnish with a few of the feathery fennel frons.

Nutrients per serving: Calories 58; Fat 4g; Carbohydrates 6.5g; Fiber 2g; Sugar 3g; Protein 1g

Sleep- An Important Vital Sign

Research shows that we spend up to one-third of our lives sleeping. Sleep is a basic human need, much like food and water, and is crucial to our overall health and well-being. A lack of sleep or poor-quality sleep is known to have a significant negative impact on our health in the short-term and long-term, impacting our attention span, memory recall and learning. Sleep is involved with many physiologic systems. Studies suggest that longer term effects of poor sleep or inadequate sleep are associated with significant health problems; such as obesity, diabetes, inflammation, cardiovascular disease, poor mental health, weakened immune systems and even some cancers. Of course, quality sleep is an important component of functional medicine and crucial to ensure good overall health and quality of life.

Quality of sleep verses quantity of Restorative Sleep

Good quality and restorative sleep is essential for day-to-day functioning and alertness. Studies suggest that sleep quality rather than quantity has a greater impact on well-being and daytime functioning.

World Sleep Society tips for healthier sleep:

1. Establish a regular bedtime and waking time.

2. If you are in the habit of taking siestas, do not exceed 45 minutes of daytime sleep.

3. Avoid excessive alcohol ingestion 4 hours before bedtime, and do not smoke.

4. Avoid caffeine 6 hours before bedtime. This includes coffee, tea and many sodas, as well as chocolate.

5. Avoid heavy, spicy, or sugary foods 4 hours before bedtime. A light snack before bed is acceptable.

6. Exercise regularly, but not right before bed.

7. Use comfortable, inviting bedding.

8. Find a comfortable sleep temperature setting and keep the room well ventilated.

9. Block out all distracting noise and eliminate as much light as possible.

10. Reserve your bed for sleep and sex, avoiding its use for work or general recreation.

Sleep disorders: A Modern global epidemic

Approximately 35% of people do not feel they get enough sleep, impacting both their physical and mental health. Most sleep disorders are preventable or treatable, yet less than one-third of sufferers seek professional help. Better understanding of sleep conditions and more research into the area will help reduce the burden of sleep disorders on society.

Three elements of good quality sleep are:

• Duration: The length of sleep should be sufficient for the person to be rested and alert the following day.

• Continuity: Sleep periods should be seamless without fragmentation.

• Depth: Sleep should be deep enough to be restorative.

Types of sleep disorders:

Insomnia

Insomnia is a sleep disorder in which you have trouble falling and/or staying asleep. The condition can be short-term (acute) or can last a long time (chronic). It may also come and go. Insomnia affects between 30-45% of the adult population. Lack of sleep or poor quality sleep also leaves us more vulnerable to accidents. People who suffer insomnia are seven times more likely to become involved in an accident causing death or serious injury than good sleepers. Studies have shown that people with insomnia suffer from more symptoms of anxiety and depression than people without insomnia.

Sleep Breathing Problems

Breathing regularly during sleep is critical to maintain well-being and health. Persistent interruption of the breathing function during sleep is called sleep apnea. People who have obstructive sleep apnea stop breathing repeatedly during sleep because of a blockage of the upper airway. The collapse of the airway may be due to factors such as a large tongue, extra tissue or decreased muscle tone holding the airway open. Each breathing pause can last from 10 seconds to more than a minute and is accompanied by a drop in oxygen associated with each event. The events may occur 5 to 50 times or more each hour. This puts a strain on the heart and can lead to a number of serious health conditions.

This is a common disorder that affects an estimated 22% of adult men and 17% of adult women. Sleep apnea causes daytime sleepiness and fatigue, and may lead to conditions such as hypertension, ischemic heart disease, stroke, and diabetes. Directly or indirectly, disrupted sleep can have a negative effect on family life and relationships by affecting a person’s mood and the way in which they are able to perform daily activities and interact socially.

Sleep apnea is diagnosed with polysomnography (sleep study) that can be completed at home or in a sleep laboratory. There is proof that successful correction of sleep apnea can lower blood pressure, reduce the risk of heart attacks and stroke and improve excessive daytime sleepiness. Treatment options include non-invasive positive airway ventilation (continuous positive airway pressure, or CPAP), oral devices for mild disease or surgery to remove excessive tissues in the upper airway for more severe disease.  

Movement disorders

Restless Legs Syndrome is a common disorder and occurs between 3-10% of the population. Restless legs syndrome (RLS) is a condition that causes an uncontrollable urge to move your legs, usually because of an uncomfortable sensation. It typically happens in the evening or nighttime hours when you're sitting or lying down. Moving eases the unpleasant feeling temporarily.

Functional medicine can help

Improving sleep quality requires a holistic approach to healing that is well-suited to functional medicine. The root cause of sleep disorders can be behavioral, environmental, emotional distress, unhealthy beliefs about sleep, substance use (medicines, caffeine, nicotine, and/or alcohol) or health conditions (obstructive sleep apnea, heart disease, asthma, lung disease, heart burn, hypothyroidism, diabetes, menopause, etc.).  If you have concerns about your sleep or would like to improve it, schedule an appointment with Relish Health today.

THE 10 COMMANDMENTS OF SLEEP HYGIENE
LOSING SLEEP? FOUR CAUSES AND SOLUTIONS FOR INSOMNIA
IMPROVE YOUR SLEEP, IMPROVE YOUR HEALTH
RAW CHOCOLATE CHERRY PISTACHIO TRUFFLES

References:

• World Sleep Society; World Sleep Day Toolkit. Access 3/14/2021. https://worldsleepday.org/toolkit

• U.S. Dept. of Health & Human Services, NIH, 2009

• Franklin KA, Lindberg E. Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea. J Thorac Dis. 2015;7(8):1311-1322. doi:10.3978/j.issn.2072-1439.2015.06.11

Reverse Cognitive Decline With The Bredesen Protocol

Alzheimer’s disease affects more than 5 million Americans of all ages and it is estimated that 1 in 10 people age 65 and older have the disease. Alzheimer’s disease is more common in advanced age, however this chronic disease epidemic is not a normal part of aging. Genetics play a role in the disease, but the majority of risk for the illness relates to modifiable lifestyle factors in our daily control. While there are no current cures for it, new research is giving us hope for decreasing the risk, slowing its progression and even reversing decline using functional medicine.  

What is The Bredesen Protocol™? 

The Bredesen protocol was created by a team of scientist led by Dr. Dale Bredesen, MD, Professor of Neurology at UCLA. Research suggests Alzheimer’s disease is not a single condition, but is a response to inflammation, suboptimal levels of nutrients, and toxic exposures that are influenced by at least 36 metabolic factors. The factors include micronutrients, hormone levels, and sleep, etc. Dr. Bredesen’s research suggests that abnormalities in these metabolic factors can trigger “downsizing” in the brain.

Dr. Bredesen and his team developed a new personalized therapeutic approach to treating this devastating condition by addressing the underlying causes of the suboptimal metabolic factors. The protocol is not a cure, but participants in the program have shown cognitive stabilization and improved cognition documented using both subjective and objective measures. 

The program begins with a “Cognoscopy™,” a term coined by Dr. Bredesen, describing a thorough review of blood work, genetic tests, and metal status assessments. A formal document called a “ReCODE Report™” is generated from the gathered information. It evaluates the risk factors that can cause neurodegenerative diseases like Alzheimer’s, allowing the physician and participant to chart a personalized course to prevent or reverse cognitive decline. 

The “Cognoscopy™” address the following areas of health:

1. Inflammatory causes of cognitive decline, such as:

   • Imbalances in fatty acids

   • Sugar-damaged proteins

   • Prolonged exposure to infectious pathogens

   • Having the ApoE4 allele (Alzheimer’s gene)

   • Other stressors that cause chronic inflammation

2. Atrophic causes of cognitive decline, such as:

   • Hormonal imbalances

   • Insulin resistance, pre-diabetes or diabetes

   • Nutrient deficiencies

3. Toxic causes of cognitive decline, such as prolonged exposure to:

   • Heavy metals (mercury or copper)

   • Biotoxins

   • Pesticides

   • Organic pollutants, such as mold

Information from the “Cognoscopy™” is used to develop a highly specific treatment plan for each Bredesen protocol participant. Treatment plans often include:

• Specific nutrition regimens and diets with a focus on a plant-based, ketogenic diet

• Exercise programs encouraging aerobic and strength training

• Brain training to enhance the brain’s neuroplasticity

• Sleep regimens, which includes obtaining seven to eight hours per night and testing for obstructive sleep apnea if approprate

• Hormone replacement therapy if necessary

• Meditation and other stress-relief programs or treatments

• Health coaching to optimize your personalized program

• Specific medications, if needed

Who is a good candidate for the protocol?

The Bredesen Protocol™ is a rigorous program that requires many significant lifestyle changes. It takes tremendous dedication. People who strictly adhere to the recommended diet, supplementation routine and lifestyle changes find the most success. 

Ideal candidates include:

• People diagnosed with early dementia or mild to moderate Alzheimer’s disease

• People who have concerns about their own memory or cognition

• People with a family history of dementia or Alzheimer’s disease wishing to prevent the illness before symptoms develop

• People with the ApoE4 genetic variant

Note:  Someone under nursing care is unlikely to benefit. In the majority of these cases, the person may be either too far advanced in cognitive decline or unable to properly implement the broad range of diet and lifestyle interventions required by the protocol.

How long is the protocol?

Maintaining cognitive function gains is dependent upon lifelong maintenance of the lifestyle modifications prescribed by the program.  

How to Learn more about the Program?

• Learn more by reading The End of Alzheimers or The End of Alzheimer’s Program: The First Protocol to Enhance Cognition and Reverse Decline at Any Age.

• To request more information about the ReCODE™ Protocol, please call (317)975-1011 or Contact Dr. Leazenby online. Dr. Leazenby is a qualified Bredesen Protocol™ provider.

The Bredesen Protocol™ by Apollo Health

THE POWER OF FUNCTIONAL MEDICINE VERIFIED

Copyright 2013, 2014, 2015, 2016, 2017, 2018 Bredesen Algorithm™, Bredesen Protocol™​

Copyright 2015, 2016, 2017, 2018 MPI Cognition™, ReCODE Protocol™, ReCODE Report™, Cognoscopy™

Lifestyle Support for Seasonal Affective Disorder

While the pandemic has many of us feeling stressed and isolated, many of us are also confronting the long gray days of winter which may also be taking a toll on our mood. If you struggle with a low mood every winter, these strategies may make this winter a bit brighter. 

What is Seasonal Affective Disorder (SAD)?

Seasonal affective disorder (SAD) is a mood disorder with depressive symptoms that occurs at specific times of year and fully resolves at other times of year. Most SAD occurs in the fall and winter. The cause of SAD is not fully understood, but theories implicate a shift in the circadian rhythm and alterations in serotonin in the brain as potential triggers. If you struggle with SAD, know that you are not alone. SAD affects 0.5% to 2.4% of the population at some point during their lifetime. Additionally, ten to 20% of people struggling with major depression will have a seasonal pattern consistent with SAD. 

What are the risk factors for SAD?

Evidence for risk factors is limited, but some data suggests that family history, being female, younger adulthood, and living at a more northern latitude may increase your risk.

What are the symptoms of SAD?

SAD is a subtype of major depressive disorder. Symptoms include fatigue, loss of interest or pleasure in activities, mood swings, sadness, hopelessness, and social withdrawal among others. Recent studies suggest that SAD may have additional symptoms, including excessive sleepiness, increased appetite especially carbohydrate craving, and weight gain.

How can SAD be treated?

I recommend starting with a proper diagnosis. Before starting treatment, I recommend talking with Relish Health or your trusted healthcare provider about your symptoms. Ruling out underlying physical conditions such as anemia, vitamin deficiencies, hormone imbalances or other medical conditions is important for addressing the root cause of your mood. 

Natural ways to improve SAD include:

Light box for seasonal affective disorder

1. Light Therapy, also called phototherapy, is a well-documented way to improve SAD. The therapy involves sitting a few feet from a special “light box” that exposures you to bright light within the first hour of waking each day. The recommended intensity of light is 2,500-10,000 lux. The time in front of the lamp will depend on the manufacture’s specification and your response to the light. Light boxes are about 20 times brighter than ordinary indoor light. They filter out the potentially damaging UV light, making them a safe treatment for most people. However, people with certain eye diseases or people taking certain medications that increase sensitivity to sunlight may need to use alternative treatments or use light therapy under medical supervision. Light therapy mimics natural outdoor light and appears to cause a change in brain chemicals linked to mood. Light therapy is one of the first line treatments for fall-onset SAD. It generally starts working in a few days to a few weeks. 

2. Psychotherapy, also called talk therapy or cognitive behavior therapy, is another option to treat SAD. A trained metal health professional can help you identify and change negative thoughts and behaviors that may be making you feel worse. Optimizing stress management and learning healthy ways to cope with SAD can do wonders for your mood and long-term mental health. 

3. Optimize vitamin D. Because many people with SAD often have vitamin D deficiency, nutritional supplements of vitamin D may help improve their symptoms. However, studies testing whether vitamin D is effective in SAD treatment have produced mixed findings, with some results indicating that it is as effective as light therapy but others detecting no effect.

4. Eat an anti-inflammatory diet. A nourished brain is a resilient brain. We need to consume several vitamins, minerals, fats, and antioxidants to feel our best, and the only way to authentically do that is with real food. Eat a balance of vegetables, well-sourced fish and poultry, starchy tubers (potatoes, sweet potatoes), fermented foods (sauerkraut, yogurt), nuts, seeds, fruits, and plenty of healthy fats such as olive oil, avocado, coconut oil, and fatty fish like salmon or sardines. If you think you are suffering from SAD, then avoid sugar, refined carbs (i.e., bread, crackers, pasta, cookies), and inflammatory oils, such as canola oil and see if this makes any difference in your mood.

5. Keep moving. Commit to doing something quick, free, easy, convenient, and pleasant for a least a few minutes most days of the week. Exercise is like medicine. Even small amounts can deliver antidepressant benefits. I assure you doing something—no matter how small—is so much better than nothing.

6. Medicate or supplement wisely. Because SAD, like other types of depression, is associated with disturbances in serotonin activity, antidepressant medications or targeted supplements have their place in treatment regimens. I always recommend starting with good nourishment and self-care but talk to your healthcare provider or Relish Health if additional support is needed.  

Learn more:

LIFESTYLE TIPS TO EASE YOUR ANXIETY
USE YOUR FORK TO IMPROVE YOUR FEELINGS
GOOD MOOD FOOD

References:

1. Galima SV, Vogel SR, Kowalski AW. Seasonal Affective Disorder: Common Questions and Answers. Am Fam Physician. 2020 Dec 1;102(11):668-672. PMID: 33252911.

2. Campbell PD, Miller AM, Woesner ME. Bright Light Therapy: Seasonal Affective Disorder and Beyond. Einstein J Biol Med. 2017;32:E13-E25.

3. MayoClinic.org. Seasonal affective disorder (SAD), Last accessed 2/10/2021.

4. The National Institute of Mental Health. Seasonal Affective Disorder. NIH Publication No. 20-MH-8138. Last accesses 2/10/21.

(This blog post is not sponsored by any manufacturer. However, at no expense to you, Relish Health may receive a commission on purchases made through an Amazon link.)

6 side dishes for lower blood pressure and improved cardiovascular health

This February marks the 57th annual American Heart Month. This long tradition helps educate people about cardiovascular disease and promotes longer, healthier lives. Despite this wonderful tradition and progress, heart disease remains the single largest health threat to Americans. This month I invite you to learn more about this amazing organ system and then give it some extra TLC with common ingredients from your kitchen.

What is the endothelium?

From a big picture perspective, our cardiovascular system is composed of our heart and a complex system of vessels. At a microscopic level, these vessels are lined with a thin layer of specialized tissues called endothelial cells. This cell layer acts as the interface between the blood and underlying vascular tissue. Endothelial cells respond to moment-to-moment changes in blood flow and blood pressure. They produce factors like nitric oxide that help the vessel wall vasodilate for increased blood flow. Healthy endothelial function and blood flow are associated with improved vascular health, improved wound healing, healthy inflammation balance and better sport and lifestyle performance. Taking care of our heart includes supporting this delicate and vital tissue.

Nitric oxide (NO), an essential ingredient for healthy endothelium

Nature Reviews Drug Discovery

Nitric oxide (NO) is a molecule that’s produced naturally by your body in the endothelium. Its function is to signal the inner muscles of the blood vessels to relax. This relaxation, or vasodilation, allows blood, nutrients and oxygen to travel to every part of your body and helps control our blood pressure. Nitric oxide levels in the body can be compromised by nutritional deficiencies, smoking, elevated blood sugar, a sedentary lifestyle and advancing age among other factors. Nitric oxide production is dependent on a sufficient supply of nutrients including the amino acid arginine and key micronutrients like folate, vitamin C, and magnesium from the diet. Switching up your diet is one of the best and most effective ways to naturally boost levels of this important molecule.

6 side dishes to Boost Nitric Oxide Levels

Beets and greens in particular are rich in dietary nitrates, which your body can convert to nitric oxide. Several studies have shown that beet consumption can improve nitric oxide levels and blood pressure control. Greens like spinach, arugula, kale, and cabbage are also packed with nitrates which are converted to nitric oxide in the body. Greens come with the added benefit of folate and antioxidants. These are some favorite side dishes at my dinner table:

Herbed Beet and Lentil Salad

Kale Salad with Berries and Nuts

Roasted Carrots with Watercress

Arugula (rocket), Fennel and Citrus salad

Shaved Brussel Sprout Salad

Sautéed Spinach with Pinenuts and Raisins

Aging Clinical and Experimental Research (2021)

HOW TO ROAST VEGGIES LIKE A PRO

MEDITERRANEAN DIET FOR EVERYONE

HOW TO PREPARE LENTILS AND BEETS

Beet and Lentil Herb Salad

This dish is hearty enough for a winter meal, but it is actually inspired by summer picnics. So you really can enjoy it any season. Lentils are low in calories, rich in iron and folate and an excellent source of vegetarian protein. They are packed with health-promoting polyphenols and fiber that may reduce risk of heart disease and support a healthy gut microbiome.

If you are unaccustomed to eating beans regularly, lentils are an ideal bean variety to introduce to your body. Lentils are among the easier bean varieties to digest among others such as: black-eyed peas, adzuki, anasazi, lentils and mung beans. Slowly increase them in your diet and let your body get acclimated to the increased fiber.

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Beet and Lentil Herb Salad

Author: Erica Leazenby, MD 
Makes: Approximately 4 cups
Time: 15 minutes (if lentils and beets are prepared)

Ingredients:

3 small prepared beets, diced in 1 cm cubes, about 1 cup (see notes below for beets preparation options)
2 cups cooked lentils (see notes below for lentil preparation options)
3 Tablespoons olive oil
2 Tablespoon lemon juice
½ chopped herbs (like a blend of parsley, basil, mint and/or thyme)
2 Tablespoon diced shallot
½ cup walnuts, raw or toasted
3 cups arugula (3 handfuls)
Salt and pepper to taste

Directions:

1. Place all ingredients in a large mixing bowl. Toss and season to taste. 

2. Serve with crusty (GF) bread or on a bed of additional greens. 

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Notes on Preparing Beets and Lentils:

If you are short on time, you can find high quality organic cooked beets and lentils at your grocery store, which makes this salad very easy to put together. If you have additional time, I recommend the following methods for preparing them yourself.

Beets 3 Ways:

1.     Instapot- Fill your instapot with approximately 1 inch of water. Place the washed, unpeeled beets in the instapot that has been fitted with a rack. Pressure cook the beets for 15 minutes for small beets or 30 minutes for large beets. Allow the beets to cool before peeling under running water. 

2.     Boil your beets- Submerge your clean, unpeeled beets in a pot filled with cold water. Bring to a low boil then allow to simmer for 20-40 minutes or until fork tender. Allow the beets to cool then peel.

3.     Roast your beets- Pre-heat your oven to 400 degrees. Coat your clean, unpeeled beets with avocado oil or other high smoke point oil. Place on a baking sheet and roast in the oven for 30-50 minutes or until fork tender. Time will vary considerably based on size of the beet.  Roasting intensifies the sweetness of beets.

Lentils 2 Ways: 

Cooking time may vary depending on the type and size of lentils used. This recipe is based on traditional brown lentils commonly found at the grocery. 

1 cup dried lentils = approximately 4 cups cooked

1.     Instapot- Rinse your lentils and inspect them for small rocks or impurities. Place the lentils in your instapot with enough water to cover them by 1.5 inches. Add a smashed garlic clove, bay leaf and 2-3 sprigs fresh thyme (1/2 tsp dried) for additional flavor. Cook on high pressure for 7 minutes. 

2.     Stove top- Prep the lentils as above. Simmer on the stove top with the aromatics for approximately 18-20 minutes or until the lentils are soft but still holding their shape. Drain and use as needed.

*Cooked lentils freeze well. I like to make a big batch and freeze in smaller portions for later use. 

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HOW TO ROAST VEGGIES LIKE A PRO

ROASTED BEET CHIPS

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