PROBIOTICS: “Bacteria for life”

The word “PROBIOTIC” is derived from both Latin and Greek, meaning “bacteria for life”.

Probiotics are the healthy bacteria that live in our gut, also known as the microbiome.  These bacteria feast on the foods and fiber that we eat (known as prebiotics), and help maintain out gut integrity, our gut health, and have MANY many other benefits.

There is evidence now that the microbiome of our gut may be a determinant of many diseases, and health, as well as inflammation, obesity, and cancer.

The normal human body has > 100 Trillion bacteria in its intestines.  These bacteria modulate our immune system, both the one in our bloodstream, and the one in our guts.

Did you know that our guts have an immune system?  Did you know that our guts impact our health as much as they do?

Our guts are the gateway between the outside world and our bloodstream.  The gut is where food is broken down into its component pieces, and absorbed into our bodies.  Where the micronutrients, vitamins, minerals, and other factors that we ingest become one with our body.

Our guts regulate our health in so many ways, and now there is evidence that our guts may determine our body weight, our stress response, and even how likely we are to get certain diseases.

This is why so many functional foods are being developed that contain probiotics!

You’ve seen the commercials, and the front-of-package labels stating “good for gut health,” or “promotes healthy gut functioning.”

While many of these products may be an overstatement, or are laden with sugar, fat, and other nutrients that are less beneficial; it is true, that the right strains, the right amounts, and the proper diet can go a long way to keeping us trim and healthy.

During the past year or two, a story came out that transplanting feces from a thin rat, to a fat rat, made the fat rat thinner.  Conversely, transplanting the feces from a fat rat, to a thin rat, made the thin rat fatter.

There have been numerous other peer-review articles also out in the past few years to demonstrate the importance of healthy guts and the microbes that live inside of it.  In fact, there are now human fecal-transplantations being done for inflammatory bowel diseases (IBD) or to heal patients from the bacteria c.diff.  And, while it sounds absolutely “disgusting,” these treatments dramatically improve the health of these patients.

So, what can we do to help our body’s microbiome?  Our probiotic status?  Our GI health?  Our intestinal microflora?

We can take probiotics.

Sure, you can buy designer probiotics, or the yogurt-like probiotic beverages.  But, I think one of the best things we can do is try to get them from a natural source, or get ones that are naturally found in our body.

Lactobacillus GG (lactobacillus rhamnosus) is the best probiotic studied.  So, if you buy a probiotic supplement, make sure it has Lactobacillus in it.

Breastmilk has a number of probiotics on it naturally, so in many ways, buying a probiotic that has the same strains as breastmilk might not be a bad way to go.  I buy “Flora Baby” for my son and take it myself.  But, this brand also makes dozens of other probiotics with similar strains at more potent doses.

Other ways of helping your gut are to eat highly-fermented foods such as kim-chee, kefir, or similar non-dairy sources.  Or, again, taking a probiotic pill or powder.

The other way of stimulating and helping the probiotics are to eat foods that are high in prebiotics; non-digestible fibers that the probiotics can feast on.  Good sources of prebiotics include “less-ripe” bananas, onions, asparagus, beans, almost any “roughage” food.

So…to keep your gut and regular health in tip-top shape, or to improve your current status, it might be a good idea to look into taking probiotics, and eating more fiber.  BUT…make sure to drink sufficient water!!

 

Food, Fitness, and Pregnancy

So, you’re pregnant, or thinking about becoming pregnant.

I’m sure you are asking yourself some questions…other than the obvious…AM I READY?!  What did I do?!

How much weight should you gain?  What can you or should you eat? Can you exercise?

As a dietitian and a recently pregnant, but no longer mom, I can answer those questions.

1.  How much weight should I gain?

According to the American College of Obestetricians and Gynecologists, (ACOG), women should gain weight.  However, the amount of weight you “should” gain depends on your starting/pre-pregnancy weight and BMI.  (see below).

Prepregnancy Weight
Category
Body Mass Index* Recommended
Range of
Total Weight (lb)
Recommended Rates
of Weight Gain in the
Second and Third
Trimesters (lb)
(Mean Range [lb/wk])
Underweight Less than 18.5 28–40 1 (1–1.3)
Normal Weight 18.5–24.9 25–35 1 (0.8–1)
Overweight 25–29.9 15–25 0.6 (0.5–0.7)
Obese (includes all classes) 30 and greater 11–20 0.5 (0.4–0.6)

 

Note how weight gain recommendations are only listed for the 2nd and 3rd trimesters.  This is because you do not need to gain any weight in the first trimester.  There is no need.  Most of the baby’s linear and weight gains occurs in the second and third trimester.  The first trimester is mostly about laying down the foundation.

Note, these are recommendations.  Not certainties.  It is OK to gain a little less than the recommendations if the baby is growing well; but, that is a discussion for you and your obstetrician.  In almost no instance; however, is it better to gain “more” than the recommended amount, unless you are pregnant with multiples.

The phrase “eating for two” also, is a myth.  In the second and third trimesters, you only need to add 300 calories/day to your diet.  The equivalent of a snack.  You do not need to eat double your normal intake.

2. What should I eat?

The first trimester, for some women, is known as the survival trimester. This was especially the case for me. In this trimester, you eat what you can, when you can.  It can be very hard.  It is usually the trimester for nausea and vomiting; unless you are me (in which case you’re nauseated the WHOLE pregnancy).

In general however, it is best to eat a plant-based whole-foods diet.  Eat as naturally and as close to nature a possible.  Organic when possible, home-cooked, low in salt, and fresh, fresh, fresh.  Limiting salt is very important for blood pressure control and to prevent too much water retention.

Sushi is considered to be OK, even raw sushi, as long as it is prepared in a safe and sanitary restaurant.

The only real no-no’s are raw/unpasteurized cheeses, raw/unpasteurized dairy products, and certain deli meats (if not properly re-heated).  Basic food-safety is a must.  It’s important to clean cutting boards properly, clean fruits and vegetables properly, to not cross-contaminate, and to make sure all foods are cooked to the proper temperature or cooled quickly.  For more food-safety tips see:

http://www.foodsafety.gov/keep/index.html

If you do have severe nausea, like I did, vitamin B6 can be very useful as a supplement in addition to ginger (though ginger did not work for me).  Another medication to discuss with your doctor is: Doxylamine Succinate.  (It can be found in unisom).

Doxylamine succinate + B6 were very important in helping me keep food in.

But, of course, every patient is different, and every circumstance is different.  So, before starting any medications, discuss with your doctor.

3. Can I exercise?

Yes, Yes, Yes!!!  (with permission from your doctor).  Exercise is SO healthful for you and your baby.  It helps keep weight-gain within the recommended limits.  It helps with the birthing process, it helps to keep you strong.  It helps with lung capacity because the further along you get in your pregnancy, the more difficult it can be to breathe.

Exercise can help with cravings, helps with endorphins, and overall, makes you feel stronger and better about yourself while you’re pregnant.

The ACOG recommends that if you are already exercising, you continue to exercise at a pace that is comfortable.  If it does not feel good, stop!

If you are not currently exercising, you can begin while pregnant, doing simple and easy exercises, including prenatal yoga, swimming, and gentle walking.  Again, it is always best to get the OB’s OK, and also to make sure that if you are taking any classes, swimming, yoga, or otherwise, that your instructor is certified to address pregnancy issues.

With that in mind…I wish you a healthy, happy, easy, and nausea-free pregnancy.

Supplements: Do we need them?

I am asked all the time by patients, should I take a multivitamin?  Do I need a supplement?

While the science has fluctuated on these questions for years, the most recent and sound findings seem to indicate that the answer is no.

If we eat a well-balanced diet; primarily plant-based, full of color, and with a wide-range of foods, then we absolutely can get our full complement of vitamins and minerals from our diet.

With a few exceptions:

  1. Vitamin D:  If you are like I am, you wear sunscreen, or walk in the shade, or you live above the 37th parallel.  In this case, you either need to eat/drink foods that are fortified/enriched with vitamin D, or you may need to take a vitamin D3 supplement.  The best way to find out is ask your doctor to check your vit.D,25-OH level at your next visit.
  2. vitamin B12.  If you are vegan and do not eat foods fortified/supplemented with B12, you may need to take that as a supplement as well.  However, nowadays, there are a lot of foods enriched with B12, and our bodies do intrinsically make it as well (though that decreases with age).
  3. probiotics.  We’d all like to think our guts are super healthy and able to keep their own health.  But it does not hurt to take a probiotic supplement daily, preferably one with Lactobacillus rhamnosus, (unless immunocompromised – then seek medical opinion).

 

Now that I have cleared that air, a few myths to debunk:

  1.  Taking a multivitamin is perfectly safe:  Well, if you eat a lot of packaged foods that are supplemented/fortified/enriched with vitamins (ie. Total cereal, other cereals, frozen foods, energy drinks), then taking a multivitamin on top of that might set you up for fat-soluble vitamin excess/toxicity.  The fat-soluble vitamins are A,D,E,K, and they are stored in your fat cells.  Thus, taking too much (that do not naturally reside in the food you eat) can be bad.
  2. I don’t drink milk, therefore I need to take Calcium:  Again, this is  not true.  Many foods we eat naturally have calcium in them.  Leafy greens in particular are extremely high in calcium!  Moreover, a recent study came out indicating that calcium supplementation in high-doses, can actually be detrimental to our heart health.  See study I was interviewed about:
  3. https://www.yahoo.com/health/you-should-obsess-about-bone-health-while-youre-223037928.html

 

So, that’s pretty much it!

Eat your fruits, your veggies, your grains, your nuts, legumes, and seeds, take your probiotics, eat your fibers, eat as close to natural as possible, and add in your other favorite foods and you should be getting plenty of vitamins and minerals!

Think of all the money you will still have in your wallet!

Infant and Toddler Nutrition

There is evidence now that we develop physically, mentally, socially, more in the first 5 years of life, than we do over the rest of our lives.  The first 2 years of life are the most critical for cognitive development however.

Much of this development is dependent on proper social interactions with caregivers as well as on proper and healthy nutrition.

Proper nutrition is more than just ensuring an adequate intake of protein and calories.  Proper nutrition is also related to WHAT we intake, the micronutrient content, the “small stuff!”

Obviously, the best nutrition for the first 6 months of life is mother’s milk.  Breast milk.  It is sterile, the proper temperature, has the appropriate amount of water, calories, carbohydrates, fat (and types of fats for brain development), protein (casein:whey ratio), micronutrients (with exception of vitamin D – needs supplementation), immune-mediation factors, lactoferrins, oligosaccharides, and probiotics.

Whoa!  What a lot of stuff!

The next best thing, obviously, is formula.  Organic is probably better than non-organic.  However, there are alternative types of formula available too if you choose not to go with cow’s-milk based formula.

There is now also goat’s-milk based formula; a suitable alternative which may in fact be closer to human milk in terms of protein-ratios, fat-types and other molecules such as lactoferrins and oligosaccharides; all very healthy for your child.

In fact, cow’s milk formula is often made with skimmed milk, and has whey protein and vegetable fats added to it while goat’s milk formulas often may not need the extra whey, and are only partially supplemented with vegetable oils.

Other viable alternatives may include soy formula.  Or for infants with special conditions, specialty formulas.

First foods can include home-made purees.  Avocado, green beans, asparagus, and other vegetables.  I always recommend to go with veggies first; because ALL BABIES and PEOPLE (for that matter) tend to love their fruits more than their vegetables.

When your baby has turned into a toddler, I suggest giving him or her bite-size (finger-sized) pieces of whatever you are eating.  No need to make special foods for your little one.  He should learn to like the foods you like.

Infants and toddlers have this amazing ability to moderate their own appetites.  So, if your child refuses to eat what you put in front of her one night, it might not be that she does not like the food, it could just be that she is not hungry.

Our pediatrician has even said, “If he doesn’t eat what you eat, put him to bed without eating.”

Look, your baby will eat when he is hungry.  Trust me.

One day she will eat everything on her plate, even it was something she refused to eat the day before because she is hungry.  The next day he might eat NOTHING you put in front of him, even if it was his favorite food the night before!

Through my trials and tribulations with my own son, I have learned that he will eat ONLY. WHEN. HE. WANTS. TO.  or when he is hungry.

Making a special food for your child, which he may not eat anyway after the fact, or giving her something unhealthy just so that she will eat, adapts your child’s taste buds to less healthy fare.

Your child will not starve in 1 day if he/she does not eat a meal.  But, you may be teaching unhealthy eating habits if night-after-night you tantalize your child’s taste buds with foods other than what you are eating.

As an expert in the field of nutrition, and a mom…I’ve learned that this works.

For more in-depth information, please refer to my e-book:  The Perfect Baby Diet; available on Kindle.

http://www.amazon.com/Perfect-Baby-Diet-breastfeeding-dietitian-approved-ebook/dp/B012Y5OEI2/ref=sr_1_1?ie=UTF8&qid=1447441181&sr=8-1&keywords=perfect+baby+diet

The Healthy “Alternative”

The Healthy “Alternative.”  What do I mean by that?

When you go through the line at a restaurant and coke or pepsi come with your meal, but water is considered the healthy “alternative.”

When you stand in front of the elevator at work, or home, and the stairs are considered the healthy “alternative.”

When you order that vegetable omelette, and it comes with white potatoes, yet, fruit is the healthy “alternative.”

Why is that we have to request a healthy “alternative?”  Why does health have to be the alternative?  

Shouldn’t health be the default?  Always?

I believe in changing the paradigm.  Make the healthy “alternative” into the healthy “default.”

I believe that when you order those whole-grain pancakes, they should automatically come with fruit on the side, or grilled tofu, or other good-for-you fare.  I believe that when you buy that sandwich at lunch, the default side should be a pear, pomegranate seeds, or a small bag of almonds.  The beverage should be water, or unsweetened iced tea, or other unsweetened beverage.

I know why healthy is the “alternative” option.

It (obviously) has to do with the bottom line, the bottom dollar, the dinero.  It is cheaper to give patrons white flour, white potato, or sugar, than it is to give fresh fruit, salad, or other “health-food.”

And…

We eat it up!  Even with calorie labels on the menus, we still eat the default sides.  Despite their detrimental-health properties.

We need to vote with our dollars.  We need to encourage restaurants, malls, hospitals, other business to change their defaults.  We need to make health, the default.

I’m not taking away your freedom to choose.  By all means, choose to have your fries and your coke.  But, choose it.  It’s not fair for me to always have to request the healthy item.  Why not put the burden on those who want the less healthy choice?

Would there be an uproar?  Probably.  Though, I suppose it would depend on the market.

Perhaps a little experiment is in order?!

I’m sure that I offer the unpopular choice.  But, for the sake of our health, our children’s health, our community’s health, isn’t it time to be healthy and make it so the unhealthy choice is a choice?

Food/beverage, and movement for thought.

Feel free to pose nutrition food-for-thought questions!

Sustainable Eating…why should I care??

I know you have heard it before.  “Eat Green,” “Eat in a sustainable manner,” “avoid all meat,” “It’s good for the planet,” and so on.

While every one of those statements is true, it’s important to understand why.

My entire dissertation research was on food security and climate change.  And, while I will not stand on my soapbox in this post about the evils of industrialized countries and how much pollution we emit, I will discuss the closer-to-home issues of water use.

I live in California.  We are in a SEVERE DROUGHT, several years in the making.  Rains have been dismal, snow-pack has been even worse.  While there is flooding in the East and South, that water does not sink into the ground and replenish aquifers or ground water, instead it runs off the land and brings soil with it.

Here, the lack of precipitation has led to an annual sinking of the land in the Central Valley, the breadbasket of our country, where a large share of the food we eat is produced.  The lack of precipitation also puts us at risk for another “Dust Bowl.”  (Read:  Barren land, dusty, really not fun…)

This sinking is a result of farms digging into the ground and draining the aquifers, which take millenia to refill, of water to grow the food, feed the flocks, and otherwise feed our never-ending need for meat, almonds, and other water-intensive foods.

This weblink below, offers information on water-use for a variety of foods.

http://waterfootprint.org/en/resources/interactive-tools/product-gallery/

Over 80% of our water-use in the United States is for growing food; so, changing our eating habits, may in fact, have a dramatic impact on our future food security.

Now, my entire dissertation research was about climate change and food security.  Here is a link where if you are interested, can you review my research:

http://escholarship.org/uc/item/5bn1j3vv

But, just to offer a few items:

  • Bananas require 90 gallons of water per pound
  • 1 glass of wine ~4-5 ounces requires 25 gallons of water
  • Sugar requires 202 gallons per pound
  • Sheep meat requires ~1200 gallons per pound (to grow the food it eats)
  • Almonds require ~1 gallon PER ALMOND!!!
  • milk requires ~1020 gallons of water per each gallon of milk
  • while not food, 1 pound of leather requires ~2,000 gallons of water
  • 1 egg requires ~50 gallons of water
  • chocolate requires ~2,000 gallons per pound.
  • finally, not to bore you, chicken requires ~491 gallons per pound.
  • and the list goes on, and on, and on…

So, why is this important?

The more almonds, meat, and other super water-intensive foods we eat, (including apparently chocolate), the higher our water foot print.  Similarly, the more of these foods we eat (especially meat), the more methane is created and spewed into our atmosphere, in fact, animals create as much carbon as all the driving around the globe in 1 year.

However, that is a different article.

So, why should we care?

While it is probably raining SOMEWHERE around the globe at every moment of every day, the HUGE majority of the globe’s water is unusable, for drinking or for growing food.

The oceans make up the vast majority of water (salty unpalatable, unsafe water), somewhere around 99% of all the world’s water.  The other 1% of pure potable water is primarily tied up in (melting) glaciers around the world, either in the arctic, antarctic, or greenland ice-sheets, or in undergound aquifers that are being sucked dry as we speak.  All the other drinkable, farmable, usable water, found in streams, rivers, and lakes, makes up probably less than 1/4 of 1% of the world’s water.

Thus, what we eat, can make a difference in the world’s water.  It is significantly more efficient to eat a plant-based diet, than it is to eat a characteristically typical American/Western diet.

This is crucial because, when we run out of usable water, and we are quickly doing that, we will be limited, and possibly even unable to grow sufficient (if any) food to feed ourselves.

Yes, this is a climate issue, this is a social justice issue, and this is a food-security issue.

If we westerners continue on the path we are going, not only will we continue our cycle of chronic disease (diabetes, obesity, cardiovascular disease), but we will also hasten our risk of food-insecurity; seemingly opposing issues, and yet, not really.

I encourage you to eat much less meat, and if you do eat meat, eat sustainably-grown meat, meat that is pasture fed, meat that is humanely treated, because these usually go hand-in-hand.  Pasture-fed meat typically require less water and typically create less methane.  If you do eat fish, make sure they not over-fished or that are line-pole caught.  You can get more information at Monterey Bay Aquarium: http://www.seafoodwatch.org/

If we all reduced our consumption of high-water foods, we would do “good” by our water resources, and our planet in general.  So, please consider how you eat…so that our next generation, my son, your kids, and grandkids, can live on a survivable, sustainable, livable planet.

And remember…for more information on how to feed those children and grandchildren, see my E-Book on amazon!

“The Perfect Baby Diet”

http://www.amazon.com/Perfect-Baby-Diet-breastfeeding-dietitian-approved-ebook/dp/B012Y5OEI2/ref=sr_1_1?ie=UTF8&qid=1446849567&sr=8-1&keywords=perfect+baby+diet

Front of package “Health claims.” Do they mean anything…

Frosted Cheerios reads:  “Clinically proven to help reduce cholesterol.”

Cocoa Via reads: “Promotes a healthy heart.”

Oroweat reads:  “Heart Healthy” on many if not all of its bread products.

What does all of this mean?

Frankly, NOTHING.  These are all structure/function claims, meaning they do not need to be backed in hard, rigorous science, if any science truly at all.

Many of these claims can be and are misleading.  They make you believe that what you are about to eat is healthy and good for you, and will “cure” you or “prevent” some ailment or disease.

Yet, you would either need to eat such high volume of the product that the calorie intake would far supersede the health benefit, or it really has no “significant” effect whatsoever.

Consuming 1 portion of any of these food items might have the ability to reduce cholesterol by 1-2 points.  That’s not saying much.  But, eating 4-5 portions, yes, that might reduce cholesterol by a “significant” 5 or more points, but I wouldn’t bet your money on it.

Moreover, the amount of sugar and calories you would be consuming would be detrimental.  Eating 5 portions of frosted cheerios, for example, would cost you at least 600 calories.  But you would only be eating at best, 3-4 cups of cereal.  I’m sure with the amount of sugar, insulin response, and blood glucose response, you would probably be hungry again fairly quickly.

Same with the bread.  Eating 5 slices, ~500 calories, might give you a reduction in cholesterol, but the extra calories you would be consuming would likely increase your weight, and therefore eliminate the benefit.

Food companies do this for many reasons.

  1. The first is to sell their product.  If you believe it is good for you, you are likely to consume more.  The “Halo” effect of food.  This is a real phenomenon.  When people think their food is healthier (ie. organic), they tend to eat significantly more of it.  That green juice must be good for me…even though it has 350 calories in the bottle.
  2. The government says that they can.  Structure/function claims need minimal scientific backing.
  3. It sells more product.
  4. It sells more product.
  5. It sells more product.

So, it not only pads their bottom line, but it pads your bottom.

My advice.  Don’t look at the “claims.”  Look at the ingredients, look at the nutrition-facts label, and buy foods with ingredients you can recognize, understand, and have the fewest number…