Saturday, June 25, 2011

Blog #41 On Book Tour with the Nutrition Detective

I am in the middle of a fifteen-city book tour for, “What’s Eating Your Child?” While every city has a different flavor, the problems parents are facing are the same everywhere. In Denver, one news anchor at a local television station talked to me off camera all of sixty seconds. Yet in that small amount of time he volunteered that one of his children suffered terribly from constipation. Glancing at the monitor I knew he would be gone in seconds so I quickly guessed, “I bet she is a heavy consumer of dairy products”.

He stopped short and then replied, “now that you mention it, she loves cheese and yogurt.”

“Unless you want to keep giving her Miralax, you might want to reduce or eliminate the dairy products for awhile,” I speculated further. He looked at me like I was some sort of mind reader but I was simply making assumptions based on the most common scenario. The fact that this information is so surprising is unfortunate.

Everywhere I go parents need help and are living with difficult situations that perhaps nutrition could ameliorate. More than one mother has burst into tears relating her story. Hopefully, the book will help some.

To follow along the book tour check out these links to two of the television appearances:


Fox Health Talk:

Wednesday, June 15, 2011

Blog #40 The Finding Real Food Road Show

I have officially left on the book tour for, “What’s Eating Your Child?” and have already learned a lot of new things about myself. The first shocking revelation is that I like being on TV. The whole TV interview idea had me so shaken that I started wondering if I was developing an anxiety disorder but it turns out there is nothing to worry about. It is just like speaking except with a bigger audience. You can still be an introvert and there are an army of stylists to make your hair look perfect.

What I did not like learning is that I have food snob tendencies. When there is not high quality food around I do not like it one bit and most people in this country have limited access to what I consider decent food. No big news here but one does not appreciate the importance of access to healthy food until it is not easy to get. I am ridiculously lucky that if I am willing to drive up to 25 minutes I have my pick of 6 different places carrying a variety of organic, high quality food. While I usually frequent the place five minutes away, I think nothing about driving 25 minutes to get organic grapes or 15 minutes in the other direction to get the best wild salmon because I can.

Contrast that to the suburb I was stuck in recently when my plane got cancelled. All the hotels close to the airport were already booked, so a $70 cab ride later I alighted in any-town, USA off a busy highway. The hotel offered a continental breakfast consisting of cereal, milk, orange juice and grey bananas. I asked the receptionist if there was any place to get a full breakfast. (I did not want to say, “Is there any place to get real food?” and offend their hospitality.)

The only choice was a diner a mile away. I grabbed a grey banana and started walking. On the way I passed 4 gas stations, a health club, a strip bar, two office buildings, two car repair businesses, and a non-descript strip mall (not related to the strip bar). The food choices were McDonald’s, Subway and Dunkin’ Donuts. Finally, the diner appeared and it was closed.

Now I was starving. There was a BeKind and Odwalla Superfood bar in my suitcase but I had eaten one of each for dinner. Better another bar than McDonald’s I decided and then remembered that Dunkin’ Donuts advertised egg sandwiches. What they actually have is preformed egg patties that they put in a roll just like the other fast food establishments. The place was busy and this is what most people think of as eggs. Not the blue organic ones I eat at home with a chard smoothie chaser.

I could eat the veggie egg white omelet, I thought but then realized that “veggie” was likely a cute euphemism for “vegetable like” as “shake” in fast food lingo really means fake milk-like syrup drink. Next to the menu board was a prominent sign warning consumers to notify the chef if they had a food allergy. Chef was still another euphemism for bored teenager throwing patties (or pucks as my friend Kathy calls them) into a microwave.

Bravely, I placed my order. The girl behind the counter looked at me blankly. “Omelet? What egg white omelet?” After several rounds of negotiation she asked me to just give her a number from the menu. When my number whatever arrived, I scraped off the suspicious cheesy coating, threw away the bread and ate the egg puck with vegetable-like specks. Protein is protein after all.

On the one hand, I could say I am out of touch with most people’s food reality but at the same time, how did most people come to accept this as food? Just last blog I was commenting about the dead feel of the beautiful food at McMillan and Jones but sitting at the Dunkin’ Donuts I would have traded my watch for some of that dead stuff.

Thursday, June 9, 2011

Blog #39 What Einstein Knew About Nutrition

I have been preparing to leave for book tour and so have been somewhat behind in the blogging department. My next few blogs will be about the wonderful world of book touring. This last pre-tour blog is about quantum physics. Since I do not know that much about quantum physics, it will not be overly lengthy. I have always been a fan, however and listen with rapt attention when experts explain why the process of observation changes the outcome of experiments or how atoms are not made up of particles but little bundles of energy.

Once I heard a doctor explain the theory of how physicists could project substance through space like Captain Kirk being beamed up to the starship Enterprise on an old Star Trek episode. He was explaining the military potential for using this technology and I was horrified/fascinated through the entire hour. Unfortunately, I did not understand a single word of the “how” this could be possible. I got that the little bundles of energy formerly known as protons and electrons do not travel in orbits but jump around. Somehow if you blast them with the right kind of energy you can displace them and they show up somewhere else. The details are fuzzy but the important take away is that everything (mind, body and spirit) has an energy configuration. We are just starting to understand what that means and what we can do with it.

Don’t feel bad if this seems mind boggling as apparently even Einstein theorized the quantum physics model but could not prove it mathematically. Despite not understanding the exact details of how Einsteinium physics operates, I ran into a nutrition application recently.

My husband and I offered to take some friends who live in the next state, to dinner. They been through a difficult time and we wanted to be supportive, so we asked them to pick a place they liked. They chose a high end chain I will call McMillan & Jones. The food at this restaurant is famous for being fresh and flavorful.

The company was excellent, the food was indeed fresh and they enjoyed it immensely. My husband and I both had fish dishes and a salad. The fish was flakey and everyone else seemed to like the food. I, on the other hand, chewed my fish and thought it indeed tasty but I did not like it. There was nothing wrong with it but it seemed to lack energy. The meal was beautiful but the food felt dead. (Of course, the fish was dead but that is not what I mean.) If someone told me the chef hated his job and was known for throwing cleavers, I would swear that emotion somehow leaked into the food.

The whole idea was preposterous. The place was packed and everyone else seemed to think the food was superb. Nonetheless, half way through my meal, I pushed the rest of the food aside and could not eat another bite. Truth be told, this is the third meal I have had at the third location of this chain and the experience was the same every time. The experience made me think about the hard to define energetic properties of food.

We know that how a food is grown can change its nutritional value but can the mood or state of mind of the person preparing the food change its ability to nourish? Further, can food mostly grown and processed by machines lack a critical non-nutrient component necessary for health?

From a quantum physics perspective one would have to say , “yes”. If a scientist observing an experiment can affect the outcome just by virtue of watching, then a cook thinking, “I hate people,” while chopping the onions should be able to affect the outcome of the soup. The question is to what extent and how would one notice?

Most people come in contact with many food preparers and handlers in the course of a day so it would be tough to pinpoint long term effect from any one source. But, what if the main food preparer is your spouse and they do not like you or like cooking for you? Would months or years of meals from an emotionally toxic kitchen whittle away at your health?

Studies have shown that toxic relationships are bad for your health but nobody has looked at how that effect is transferred. Could bitterness and resentment experienced by a food preparer alter an otherwise healthy meal so it is not as good for the consumers? I wonder if there would be a way to measure this.

I asked my husband, who is a tax attorney and not a woo woo kind of guy, what he thought about the food at McMillan & Jones. “It was good,” he said neutrally. I countered that I thought it tasted dead. He paused for a few seconds and then replied, “it was somewhat dead now that you mention it.”

Next, I asked him to compare the food to that of a local, inexpensive Italian restaurant near our house. It is a family run operation that pours the same homemade tomato sauce on 90% of its dishes. The fish is clearly not as fresh as McMillan & Jones and the salads are not worth ordering yet we find ourselves there fairly regularly.

“No comparison,” he responded immediately. “The Italian place is better.” This makes no logical or even taste sense yet I bet Einstein would prefer the Italian place, too. It is something to consider next time you eat a perfectly good looking meal that just does not do anything for you.

Monday, June 6, 2011

Me and CNN

On Thursday, June 9th, I am being interviewed live on the CNN national morning show, "American Morning". The interview will be on sometime between 6 and 9 AM eastern standard time. It is one of the early stops on my 17 city book tour which started here at home, today in Alexandria, Virginia. You can follow the book signings at: There will also be local TV appearances in most of the cities. I will let you know how it goes.

Tuesday, May 31, 2011

Response to Jackie's Question about Allergy Testing- Blog #34

There are allergies and sensitivities. If you are having a classic allergic reaction (such as hives or swelling), traditional allergy scratch testing or a blood RAST or ImmunoCal test usually works well. Sensitivities and reactions are trickier because the reaction can evolve from a large number of possible causes. Each test looks for a different reaction. For example, there is a specific test for lactose intolerance but it finds no other types of reactions. The best general screening test that I sometimes use is an IgG test from MetaMetrix. It has the least number of false positives and looks for non-allergic reactions to 30 foods. It must be ordered by a practitioner.

Thursday, May 26, 2011

Blog #38 Looking for Piracetam

Recently, my oldest daughter graduated from college (wahoo) and we decided to take a trip to celebrate. I have always wanted to go to Spain and she was willing to go anywhere that had Wi-Fi service so off we went to Barcelona. Barcelona turns out to be a wonderful place to visit and I highly recommend it if this was a travel log. Nor is this a culinary treatise so I will not go on about the intricacies of rabbit stew (not a fan) or chickpeas with black sausage (absolutely delicious). Instead, it is about how even though I left the country, the nutrition detective tagged along.

At first I did not notice her as I experienced the wonders of drinking chocolate and becoming entranced by any architecture designed by Gaudi. Eusebi Gaudi is Barcelona's most famous architect and his presence in the city is impossible to miss. He designed the Sagrada Familia Cathedral using nature as his inspiration. The inside of the cathedral has a forest motif and the outside spires are shaped like stacks of fruit. So, there is something vaguely nutritious about it. There are honeycombs, spirals, plant and animal designs all piled together in an over the top mishmash. You either love or hate the result.

Detectives have curious natures (that is, they experience curiosity, they are not necessarily odd) and as I wondered around, I could not help but notice that in busy areas there are pharmacies on practically every block. You cannot fail to notice them because they have either flashing green or red crosses. And unlike our super pharmacies that carry everything from mops to narcotics, these pharmacies are very small. They have the equivalent of one CVS aisle's worth of items on display and over the counter medicines, like ibuprofen, are all behind the counter. One pharmacy might carry feminine hygiene products and the next not. Maybe that is why they need so many. They must have some type of community pharmacy group where they all agree on who can carry what. Hector's pharmacy gets the face cream but one on 10th and Cambria gets the deodorant.

I could not figure the system out so if we needed something, we just went from one to the next until we ran into it, which never took long. Then I started wondering about locating piracetam. Piracetam is a substance developed in Belgium in the 70's that is the best cognitive enhancer I know. It improves the motor planning and speed of thinking. Nobody knows exactly how it works but taking it with choline enhances its effect. There have been many variants developed since the 70’s but piracetam has a long history of use and so I think it is the most predictable. Piracetam can be found in the US, but the source tends to be China, so I tell people Nootropil (a Spanish brand) from Europe is a more reliable product. And here I was in Spain!

So one morning I walked into a tiny pharmacy three streets behind our apartment and requested in my best high school Spanish a box of Nootropil. They speak a Catalan version of Spanish in Barcelona so nobody ever seemed to understand anything I said. Either that or my Spanish is dreadful which was my daughter's explanation. The clerk looked at me blankly. After repeating several versions of my request she handed me a slip of paper and instructed me to write down the name. "Ahhhhh," she responded with understanding after reading the name. That was easy, I thought until she started shaking her head and waving her hands. I needed to try the pharmacy next door or three doors down that carried piracetam and hair spray.

Armed with my paper I made faster progress until finally at the third pharmacy, I hit pay dirt. There for a measly 3.5 Euros (less than $6), I was able to purchase a box of Nootropil in my choice of potencies (800 or 1,200 mg). When I asked in my cringe inducing Spanish if a prescription was needed, the pharmacist appeared puzzled that I asked. I had asked because piracetam inexplicably sometimes seems to require a prescription and other times does not. I have a client in Ireland who needed a prescription while one from Italy, did not. You can order it from England without a prescription but I think you need one if you are actually in England.

To further thicken the plot, getting piracetam in Spain was no harder than tracking down a nail clipper and about the same cost while getting piracetam in the US can take weeks and costs many times more. It made me realize again how little medicine is about what works and how much it is about health care politics and just how things are done in a particular place at a particular time.

Last year, I saw a child who had severe, global developmental delays. Dmitri had been getting occupational, speech and physical therapies but was making very slow progress. After creating a good nutritional base for learning, I asked his mom if she had ever thought about trying piracetam. In these complicated cases, piracetam can speed up progress by building neuroconnections across the corpus callosum to help with processing. I pointed her to some resources and information about it so she could consult with her doctor.

Several weeks later she reported her doctor advised her against using piracetam. It cannot be that good, the specialist had said, or he would know about it. He could not assure her it was safe and there was no evidence (according to the expert), that it worked. What was his alternate suggestion? There wasn’t one. She would have to learn to live with his disabilities. Dmitri’s mom was discouraged but listened to her doctor. Dmitri progressed very slowly until the summer. His mom decided to take Dmitri home to Poland and spend time with her family.

While there she made an appointment with a neurologist her family liked and asked him about piracetam. He told her Dmitri should have been put on piracetam a long time ago. Of course, it was safe and if she were there, he would have been put on it a long time ago. She started it right away and Dmitri’s speed of progress increased.

So either piracetam only works in Europe or if someone tells you they have never heard of something, you should not trust their opinion on it. The US doctor did not realize how much of what he thought he knew was colored by limited medical cultural experiences. Maybe he should travel more.

Wednesday, May 11, 2011

#35 Nutrition Fatigue and Cholesterol

Lipitor, a cholesterol lowering statin drug, is the best selling medication of all time. One year 9 billion dollar’s worth was sold in the US alone. Now it is more like 7 billion per year (source: Los Angeles Times May 4, 2011) because a bunch of copy cat drugs were rolled out to hone in on such financial largesse. (Crestor, Zetia and Zocor to mention the brand names of 3 of the 6 other statins.) The point is, there is a lot of money involved in anything having to do with statins.

All the statin drugs lower cholesterol but in slightly different ways. The key to their success is buying into the theory that lowering cholesterol reduces heart disease.
Recently my friend, Basil sent me an e-mail, “There is a small but growing school of thought that rejects the high cholesterol-heart disease hypothesis. High cholesterol may not cause CVD (cardiovascular disease),” he wrote. “They were talking about it on that silly Dr. Oz show. You should write about that.”

Okay. I will though I will disclose that my temporarily crippled assistant, Tania, has been spending a lot of time recently deepening her relationship with Dr. Oz and she describes him more as “almost cute”.

An interesting study completed in 2006 on two popular statins, Vytorin (Simvastatin) and Zetia (Ezetimibe) changed the conversation about cholesterol lowering. Both drugs successfully lowered cholesterol however, the study (sponsored by the drugs’ manufacturers Merck and Schering-Plough) found the medications did not prevent heart attacks or other life-threatening events. There was actually no benefit from taking them. (See: The New York Times, Jan 14, 2008, “Drug has no benefit in trial, makers say”.) This four year long, multicenter trial of Simvastatin and Ezetimibe in Aortic Stenosis (SEAS), found the rate of congestive heart failure, stroke and cancer actually went UP when people took these two drugs together though in people who already had symptomatic aortic stenosis, ischemic events decreased (“Intensive Lipid Lowering with Simvastatin and Ezetimibe in Aortic Stenosis,” A.B. Rossebo, et al, NEJM, 2008, 359.)

Dr. Terje R. Pedersen, chairman of the SEAS trial summarized the findings by calling the drug combination “safe and well tolerated”. ( Yeah, but they do not do help prevent disease and may, in point of fact, increase one’s chance of having a stroke or heart attack. Nobody will be surprised to hear that the study was misplaced for a couple of years. There is an ongoing investigation on how that could have happened. Do not expect results any time before hell freezes over.

Confusion and debate commenced and nothing changed. Both drugs still enjoy robust sales because the important point the manufacturers want doctors to remember is that the drugs lower cholesterol. Which brings us to Basil’s point. Maybe high cholesterol levels are not the risk factor for heart disease that they are believed to be.

The quiet truth is that the big difference between Zetia and the other statin drugs is that Zetia lacks anti-inflammation properties. All it does is lower blood cholesterol levels. Most of the other statins have mild anti-inflammatory properties. Mounting evidence suggests that high inflammation not high cholesterol may be what is increasing heart attack risk. It just happens that inflammation goes down as a secondary side effect of the cholesterol lowering process.

When you think about it, lowering inflammation as the mode of action makes much more sense than lowering cholesterol. For one thing, if lowering cholesterol is so important, why have heart attack rates barely dropped even though practically everyone you know over 50 takes a statin drug? Heart attacks and heart disease statistics have changed little since the massive and pervasive use of cholesterol lowering therapies.

The cover story for the May 2011 Harvard Heart Letter announced, “Gloomy forecast on heart disease”. The article goes on to say the American Heart Association predicts heart disease will increase 17% and heart failure and stroke will go up by 25% each over the next 20 years. They recommend avoiding tobacco, exercising, maintaining an ideal weight, managing stress and eating better. These are all life style choices that lower inflammation. Only one (healthy eating) might lower cholesterol.

Of course, lowering inflammation requires lots of work on your part while taking a statin drug only gives your wallet a work-out. I predict you will not hear much about the doubts surrounding the effectiveness of statin drugs until October. Actually, you do not need a Nostradamus level of psychic ability to predict that sometime this fall there will suddenly be many reports on how researchers now know it was not the cholesterol lowering properties of Lipitor that helped the heart but its mild anti-inflammatory properties. (We actually already know this.)

Why will this hot news story break in the fall? Because Lipitor goes off patent in November and the 7 billion dollar a year cash cow is about to become hamburger. Generic drug manufacturers will be able to crank out the thing at a tenth of the cost. Seniors on restricted incomes will finally be able to save lots of money on medication but what’s this? They no longer need their statins?

That’s right. I can see the headlines now, “New anti-inflammatory drug slashes heart attack rates.” I think they should call it, Inflamator.

Sunday, May 1, 2011

#34 Nutrition Fatigue

“There was an article in the paper that women who take calcium are more likely to get heart attacks,” my loyal assistant, Tania reported to me one morning. “Should I stop taking my calcium?” she asks ominously.

“E Tu, Tania, E Tu?” I lament dramatically.

“As usual, I have no idea what you are talking about,” she snapped, uncharacteristically irritable.

I hate to say it but Tania has been a tad bit cranky lately. Her mood seemed to shift slightly last month after a freak accident and subsequent major surgery to insert a foot long titanium rod into her leg. The only good thing that seemed to come out of this horrible ordeal is that after years of failed badgering on my part, she finally started taking her supplements regularly. Now it seemed even this small benefit was in danger of being lost under the constant onslaught of negative media reports on supplements.

There is a condition called, compassion fatigue that happens to people when they are so overwhelmed by hearing horrible stories of suffering that they just cannot feel anymore. A general numbness descends. The news media has managed to create this in most of us regarding every major disaster in the last few decades with relentless, non-stop reporting of every tragic, pain ridden moment.

A similar condition happens with “health” reports regarding nutrition which I call nutrition fatigue. Much of the information is negative. Some of the more recent sound bites (insert ten exclamation points to mimic intensity of reporting) claim fish oil does not lower cholesterol, choline causes heart disease, calcium does not protect the bones and melatonin causes precocious puberty, scratch that, now it delays puberty.

No wonder everyone is confused, scared or discouraged because nothing works and the world is going to pot anyway. The solution is to take a deep breath, check into the situation more thoroughly by reading the actual research and think it through. Who has time for all that? Exactly.

I do take the time to do this because people tend to stop taking their supplements in response to these irresponsible reports and I get a lot of panic laced questions. There are so many reported health news disaster stories to pick from but let’s start with calcium because I have already gotten several questions about the study Tania mentioned. Calcium use to be an uncomplicated nutrient until sound bite reporting got to it.

You may recall the beginning of the made-up calcium debate. It involved the huge Women’s Health Initiative study published in the New England Journal of Medicine a number of years ago. The initial headlines screamed that taking calcium does not help bones!!!!!! The comprehensive study had over 36,000 women in it and the ones taking calcium did not have any less fractures than the other group, the reports trilled. Women all over the country viewed their calcium supplements with suspicion. My phone started ringing.

Upon careful review of the study, it turned out that half the women in the calcium supplement group did not actual take their calcium. They were naughty. Unfortunately, there were so many naughty women that removing their data from the study would have invalidated it, so the researcher left the non-compliant ladies in. Garbage science. The study really proved that if you do not take your supplements, they do not work. No big news item there.

In this case as the study was scrutinized, new amended reports started to surface. One from ABC News asked the question, “Does calcium help bones?” Then it answered that in a big study (the same one), women who took calcium had significantly less breaks but they had to take calcium for a long time. So, it was not a quick fix and by the way, maybe it increases kidney stone risk. I guess just saying, “yeah, it does”, would have been boring because everyone already knew that anyway.

The study Tania heard about was a new unexciting study about bone health published in the British Medical Journal. To spice it up, the results were reported with the byline, “Calcium builds bones but may weaken the heart. “ However, there was insufficient evidence in the study to prove or refute an association between taking calcium and heart disease. The researchers were not even looking for a calcium and heart disease link but after the study was done were picking through the data to see what else they could put together to report.

People taking calcium before the study started had no increase in cardiovascular incidents but in the group given calcium for their study there might have been slightly more heart incidents but the association was murky because of many other variables. No problem. Maybe someone else had found an association they could apply, after the fact, to their study. They looked through the literature for other studies to boost the possibility and start a debate.

Researchers from the Women’s Health Initiative (WHI) study weighed in that they did not find any increased cardiovascular risk in the 36,000 women in their study. The new investigators had to be looking very hard to come up with this vague association, one WHI researcher pointed out. (Of course, it is hard to say if one can trust the WHI based on what their researchers initially reported about their study.) There may be science here somewhere but it sounds more like a reality TV script for The Real Biology PhDs of Cambridge. This kind of “I wonder if”,” chitchat should be limited to conversation between researchers over a few beers on a Friday afternoon and not reported as science news.

The result of this sensationalized reporting is some people worried about heart disease, stopped taking their calcium. A larger number of people already forgot the details of the latest report but are building a sense that nutrition is confusing or there is always something wrong with supplements. While annoying and destructive, the results are mild compared to what happens when the financial stakes go up. Then the marketing people get involved and start spinning the results to be sure you take away what they want you to believe which can be very distant from the real findings.

To be continued….

Saturday, April 23, 2011

A Visit to Barnes & Noble

"What's Eating Your Child? was not officially scheduled to come out until June but my friend Lynn reported it was at Barnes & Nobel's already so I had to go take a picture.

Monday, April 18, 2011

Blog #33 The Case of the Passing Wind

Forty three year old Carrie sat down and frowned with concentration. “How can I help?” I asked.

“I am a little uncomfortable talking about this,” she hedged looking down at her lap.

“Take your time and start with what you are comfortable with,” I suggested.

Slowly, her story unfolded. Her health was excellent, in general and she did her best to “stay away from doctors”. Her main strategies for avoiding the medical profession were to eat well, exercise and generally take care of herself.

“I am pretty boring,” she confessed. “I don’t drink or smoke. Not even coffee.”

“Sounds good,” I said encouragingly.

Carrie fidgeted but continued her story. She was not one of those people who liked to complain about the little physical quirks of life, she explained. Her mother-in-law talked about her bowels like she was reporting on the weather, which Carrie thought was disgusting. Where she grew up, this was considered uncouth.

Now Carrie found herself in the embarrassing situation of having developed a sudden problem with her bowels. “Maybe I have no patience for the bowel report because mine have always been perfect,” she says with self-depreciation.

She had not changed her diet or habits but for the last month or so she had developed horrific flatulence. “I could burn a hole in the upholstery,” she laughed nervously, her face turning red.

I laughed with her and agreed that would be cause for concern then asked some questions.

Had she been traveling?
Yes, but only a short business trip. She took these several times a year.

Had she been sick? No.

Any history of bowel issues? None. Her bowels had always been reliable.

Had her bowel movements changed, too? Absolutely. They were now more frequent, mostly loose and “clear the room” stinky. Before they were well formed and regular.

I looked at her diet and was happily surprised to find lots of fresh fruits and vegetables. “As much organic as I can get,” she insisted. She avoided dairy products because they did not agree with her. There was little processed food and her weight was good.

Gas is the product of fermentation. The bowels have plenty of partially digested food slug to ferment and the bacteria to do the job. If there are enough of the right kind of good bacteria, there is clean processing and minimum bad gas production. But, if the wrong bacteria and/or excessive yeast get to the food they form all types of gas. One species of bad bacteria, for example, thrives on sulfur and produces methane gas. High levels of methane gas produced by people (and more famously, cows) are thought to be a contributing factor to global climate change. So, reducing personal emissions is another way to go “green”.

Clearly, Carrie had picked up or for other reasons was growing too many unhelpful bacteria. The questions were, which one and why were they growing so well? The most accurate way to measure what is growing in the gut is to have a good lab culture the stool. The test I like also looks at other factors such as digestive enzyme activity and has a marker for general gut immune function. This costs about $200.

After hearing my explanation Carrie was quiet for a minute. “My husband is about to change jobs,” she started hesitantly. “Is there any cheaper way to deal with this?”

I told her we could try to overrun the bad bacteria with good bacteria and then to be sure, we could give her some gut immune support. If the problem was a simple imbalance in an otherwise healthy system a few ecological shifts should make her right as rain. But if she was not better in 2 weeks, we could run the stool test. “That would be great,” she enthused.

The plan was laid out. She would take probiotics (good bacteria) twice per day. I recommended a brand containing 20 billion bugs per capsule that required refrigeration. Then I suggested a gut immune support supplement called Probioplex (2 twice per day).

“The gas may get a little worse for a few days, due to ‘die off’,” I explained. As the bad bacteria “die off” they release toxins which can smell bad and be absorbed into the blood. “But, if it is a simple problem, the system should settle down within a week. If not give me a buzz.”

“Either that or I will have to invest in an industrial grade air purifier and carry it with me everywhere,” Carrie quipped.

Carrie agreed to leave me a message in two weeks. She would report that all was well or request I send her a stool test kit. Two weeks passed and I was going through my e-mails when I saw her name. I clicked on.

“Furniture upholstery is safe and my husband loves you,” it read.

I guess the plan worked.

Friday, April 8, 2011

Blog #32 The Other War on Drugs

I think we might be losing the other war on drugs. More and more kids are being diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and put on stimulants to tolerate an increasing crazy education system and I have become less and less effective at talking parents out of it.

“It is normal for little boys to explore the world through motion,” I will insist.

“But the psychologist said his self esteem will suffer if I don’t help him with medicine,” the parents will counter.

Calling this situation the other war on drugs is not strictly accurate as it is more of a siege with growing numbers of parents ignoring their instincts and succumbing to the pressure to medicate.

The problem is that nutrition, cognitive and other approaches to support brain function work over a long time while stimulants or ‘speed’ work right away. Work how? That is not entirely clear, but stimulants do increase the speed of brain waves and distractibility is linked to excessive slow wave activity.

The brain has different types of electrical wave activity depending on what you are doing. When you are sleeping, for example, there is mostly slow delta wave activity. Concentrate on a calculus problem and there is more alpha activity. Theta waves are associated with semi-conscious, dreamy states such as when you first wake up. They are the next level of activity above delta sleep waves.

Drugs like cocaine and stimulates “speed” up wave activity shifting theta waves to an alpha or beta level. How can kids who are hyperactive have more dreamy waves? One theory is that they have to keep moving to compensate and concentrate. Here is the sticky point- all children have mostly theta wave activity until they are 6 or 7. This dreamy, unfocused state is normal developmentally. So when Molly or Erin or Stacey are pulling their hair out trying to decide if their 5, 6 or 7 year olds should take stimulant medicine because the school is saying their children might have ADHD, I know something is wrong with this picture.

No single human being should be asked to teach a class of twenty seven 6 year olds. It is not possible to do this successfully unless you drug into submission a big hunk of them. They developmentally are not ready to focus.

And it gets even kookier. One of the main diagnostic criteria for ADHD is the ability to concentrate on things that are not interesting to you. The part of the brain thought to be responsible for this function is the prefrontal cortex. Prefrontal cortex (PFC) dysfunction is blamed for ADHD symptoms but the PFC is the last part of the brain to develop. It is not fully operational until age 18 to 22. (Earlier for girls but on the later side for boys.)

The PFC gives you perspective and allows you to do the hard things. A well functioning PFC allows you to wait your turn when you would rather not and recognize the last time you ate two donuts for breakfast you felt lousy all day so you better not do that again. Heck, it is why adults can do their taxes even though they are extremely boring.

It is not suppose to be working very well at age nine or fourteen. Part of the cause of teenage impulse control problems is that their immature PFC does not allow them to truly calculate the results of their actions ahead of time. Kids are not supposed to be little adults.

But who has time to respect or wait for development? We need kids to behave in overcrowded, movement restrictive classrooms now. And the studies show this is exactly what stimulants can do for us.

Most parents think giving their children stimulates will help with academic success and improve self esteem but what they really do is work as a classroom management tool. The few studies done looking at long term use of stimulates found they do not improve standardized test scores but they help kids sit better, at least temporarily. Over many months any perceived changes appear to level off.

Teachers cannot be blamed because they are trying to help kids in a system that does not respect learning differences or even child development. Parents are told that if only their child could concentrate, they would learn. I contend that if only they could learn, they would concentrate. Unfortunately, the education system is broken and we are not going to medicate it into health. But, don’t take my word for it. Before making any decisions, check out this spectacular video by Sir Ken Robinson:
His explanation is spot on and his accent makes everything sound better.

Tuesday, April 5, 2011

It's Coming!!!!!!

My book is printed and sitting in the warehouse ready to ship! Wahoo. I am so excited.
Here it is:

It can be preordered at a discount from Amazon or Barnes & Noble.

Monday, March 21, 2011

Blog #31 The Flu Cometh

Recently, I was congratulating myself on not getting sick for 3 or 4 years. Yes, nutrition and lifestyle really works, I told myself smugly. So when clients brought their sick children to my office, I did not think much about it. Half the people I have run into over the last month had one contagious illness or another. Many had the flu, despite the fact that they had gotten a flu shot. Funny how 40% of Americans get the flu shot, yet the number of people getting the flu does not seem to go down.

This was a particularly tough year for those who “believe” in the flu shot as the one offered did not actually contain the virus responsible for this year’s stomach flu. Personally, I would sooner believe in the Easter Bunny- there is more supporting evidence plus the chance of getting chocolate. But, it is just this type of bold, maybe even obnoxious statement that may make people wonder if I would reconsider my position if I actually got the flu.

Someone asked me a related question at a recent workshop. “What if you had immune deficiency, wouldn’t you get the shot then?” she wanted to know. Viewed logically, having immune deficiency does not make an ineffective shot work better, it only makes the recipient more desperate and willing to consider unproven technology. An understandable case of fear overriding logic.

I responded that I would be even less likely to get the shot because it can contain aluminum and mercury, both of which are immune suppressants. Plus, there are several viruses in the shot which elicit an immune response. Why use up immune resources mounting a response to viruses you are not going to run into that year anyway? Easy words to say when one is healthy. What a scary minefield life is when you pick up everything.

A few busy weeks passed. I took several trips involving cancelled planes, broken down trains and taxicabs with an inch of water on the floor. I was once again feeling thankful for handling it all when I woke up one day feeling extremely tired and crabby. Such is life, I told myself. Though I am fairly even tempered, everyone gets cranky and being tired makes sense given my schedule, so no big deal. As the day wore on and I found myself muttering and cursing over very minor issues, like a stuck drawer, I started to get suspicious.

There is a messenger molecule in the body called IL10. It is in a class of compounds called cytokines. Cytokines deliver all sorts of messages that modulate immune function and IL10’s message makes people feel tired and depressed. It is basically a shut down message telling your body to slow down and rest because the immune system is trying to fight off something. In other words, man the hatches, a storm is acomin’.

By early afternoon, I started thinking that I hated my life and work and need to find something else to do. While anyone can have a similar passing thought, the ferocity of my discontent finally registered. I am getting sick, I realized. As soon as I recognized the early signs provided by IL10 and probably a number of other cytokines, I took action. My acute prevention cocktail is 20,000IUs of vitamin D3, 1000mg of vitamin C, a probiotics, 30mg of zinc, 2 My Community (Host Defense) and 2 Transfer Factor Plus (4 Life). This group of nutrients has warded off any number of illnesses but the key is catching the virus before it has invaded the system too far.

Viruses cannot replicate themselves so they take over your cells and use them as incubators. They are little pieces of DNA or RNA (depending on the virus) and they inject themselves into the nucleus of a cell. Now their DNA or RNA is telling the cell what to do, not yours. Just like the movie, “Alien” but at a teeny tiny cellular level.

Once a virus has taken over a cell, the cell stops being useful to you and does nothing but churn out viruses. The immune system’s job is to identify rogue cells, destroy and discard them. The cold or flu symptoms are the result of the immune system coming in to clean up and heave ho the dead cells. (Think runny nose or diarrhea.) If enough cells have been infected, the symptoms are pretty ugly. The virus is trying to stay ahead of the immune system by infecting as many cells as fast as it can while the immune system is targeting and blowing up viral replicating factories as fast as IT can. The battle is on. No wonder you feel terrible.

The reason a cure for the common cold is evasive is that the cold itself partially reflects necessary clean up. The immune system has identified the interloper and is in the process of tossing it out. At that point you can only reduce the severity and length of the symptoms. By strengthening the immune system response, the viruses can tossed out before they invade more cells and cause more of a mess. The big opportunity is prevention. Was I too late?

By late afternoon, I was desperate for a nap but still had 2 more clients to see. Finally, the work day ended. I stood up feeling a little dizzy and crankier than ever. My stomach cramped and rumbled. It was not happy. I suspected I was fighting the stomach flu which appears to be this year’s flu. After an uncomfortable interlude in the bathroom, I was sure. I felt off but not terrible yet. Time to rethink immune support.

The best strategy for fighting stomach bugs is good bugs. I had three different probiotics in the refrigerator and took an aggressive 200 billion bugs. This was two capsules as I had VSL3 on hand ( Before bed I took another probiotics and 2 more Transfer Factor.

The next few days I felt a little wobbly and tired. But all and all, I would say nutrition helps.

Here are my flu statistics:

Number of hours feeling crabby and depressed 36
Number of nights of restless sleep 1
Days feeling shaky and tired 2
Extra trips to the bathroom 3
Weight lost Half pound (It's back)
Percent of regular vitamins taken during flu period 50%
Extra Vitamin D3 (taken as a single dose) 20,000 IUs
Number of good bugs taken per day for 3 days 200 billion
Amount of Transfer Factor taken per day for 3 days 4
Amount of My Community taken per day for 3 days 4
Diet changes Bananas In Green Juice Out
Missed days of work 0
Cost of avoiding possible neurological and immune damage by skipping the flu shot Priceless

Sunday, March 13, 2011

Blog #30 The Trouble with Traveling

Having a detective mindset means having an inquisitive nature and asking a lot of questions. “Why should I care if the IRS clarifies the sub part F regulations?” I asked my husband the tax attorney recently. Or, “why does it cost $1,400 to join a sorority?” this to my daughter, the college sophomore.

So, it is not surprising that when I was at the airport this week-end on my way to teach a course in New York, I found myself asking, why, oh why, oh why? I watched with utter perplexity as a line of people allowed themselves to be lead into a milliwave machine and radiated.

According to Dr. Russell Blaylock, a physician and writer, TSA naked body scanners can cause sperm mutations and increase the risk of breast cancer. The Pilot’s Association has reportedly sent a letter to its members urging them to opt out of the Advanced Imaging Technology (AIT). Other sources report that the ionizing radiation by the machines concentrate on the skin increasing the risk of skin cancer.

This all sounds ominous to me and I figure I should at least wait for some good long term safety data before getting ready for my milliwave close up. So, I was dismayed to watch one person after another dutifully and passively walk in to the mystery machine and get zapped. Not a single person opted out.

I was bracing for a body cavity search or whatever other indignity I was going to be subject to for opting out when I noticed there were two lanes and you could just avoid the X-ray machine. So, I did.

Why are people not objecting? The acceptance by so many of the invasive and unsafe is distressing to me. Ask questions. Object when things don’t make sense. Get patted down but do not add to your chances of getting cancer which are already 1 in 3 over a lifetime.

Depressed by this full scale display of submissiveness, I trudged to my gate. On the way, I saw a man drinking a tall beer at one of the many generic bars. The scene would not have been notable except for the fact that it was 11:00 in the morning. Yes, traveling has gotten to the point that a beer with breakfast is about what you need to get through a typical airport experience.

I realized I was hungry and went searching for food. The places I can most reliably depend on finding edible food at airports is Cibo and Starbucks. Cibo has small salads, mini chicken Cesear chicken wraps, tiny hummus containers, veggies with dip and Be Kind bars. They have reasonable portions. Most of the other places that have single salads that could feed a family of four or lunchmeat sandwiches. What can I say? Lunchmeat is gross. Sadly, this terminal did not have a Cibo, which meant looking for a Starbucks.

Of the chains usually represented at the airport, I have been surprised to find myself sometimes looking for Starbucks, even though I do not drink coffee. This morning, I stood in a long line to order their very tasty oatmeal. I threw away the brown sugar packet but added the nuts and dried fruit. It was made with water and was delicious.

I walked back to my gate and enjoyed every bite. But, I still needed something. Maybe a beer.

Wednesday, March 2, 2011

Blog #29 Secrets of People Who Never Get Sick: The Bonus Material

After writing a book there is a big hunk of empty time while waiting for it to be printed and released. That time for me is happening right now. The down time should be welcomed because of the exhaustive push of deadlines along with my regular work schedule. But, of course, I am too excited to be sitting around waiting so I had to come up with a productive way to fill the time.

My kids are all in college so I can only call and annoy them so much. I took a few baths, trimmed back the liriope (a fast spreading ornamental grass used in landscaping) and sold stuff of my husbands that he almost never uses on Ebay. That took a week and I still have four months left until the June 6th release.

My publisher (Workman) puts out some interesting books and while I had read some before signing with them, I had not had a chance to read any since. I decided to look at books that were in the same health genre as mine. The title, “Secrets of People Who Never Get Sick,” by Gene Stone caught my attention immediately. At least half of the people I have talked to over the last few weeks have been sick so I decided to see what he had to say on the subject.

Most of the hardly-ever-get-sick people I know do what you would expect, they exercise, think bright and happy thoughts, eat a diet full of whole foods (some vegans, others animal eaters) and take a handful of supplements everyday. Stone chose to reveal the secrets of 25 people who concentrated on one main area to maintain their health and avoided those with complex regimens.

I am not going to be a book spoiler though if you are the health conscious type you can probably guess ½ of them. (That could be a fun game to play at your next party if charades is not going well.) Reading it made me think about my own personal keep healthy tricks. Consequently, I am adding my very own bonus secret: mushrooms.

Naturopaths and herbalists have long recommended certain mushrooms for immune enhancement but the exact reason they worked was not discovered until recently. Dr. Ikekawa, arguably the father of mushroom science, discovered that the cancer rates of families of Enoki mushroom growers had remarkably low cancer rates compared to the rest of the population. The cancer rate in the men from mushroom growing families was 1/3 (or 2/3rds less) than other men in the same area. Women had ½ the predicted cancer incidence. If there was a drug that could claim this near miraculous cancer reducing capability, it would be the best selling medicine in the country. Ikekawa isolated the chemical responsible for the immune protecting properties of this little fungi and the science mushroomed from there.

We now know different mushrooms have different immune enhancing compounds. Some prevent cancer, others fight tumors, still others increase first line defense against illness or decrease inflammation. There are species that produce antibiotic compounds and one even helps nerve regeneration. This last one is called Lion’s Mane and it is a white mushroom that grows on trees and logs.

In Blog # 18- What to do to prevent the flu, I mention three great immune enhancers. One, Immpower (American BioSciences) is extracted from specially cultivated mushrooms and has been studied in cancer and AIDS treatment as a natural killer cell enhancer. Natural killer cells are part of the immune system that respond first when an illness threatens. I have used this product for years and it is very effective as a first line defense against colds and flus. I take two twice per day for a few days if I feel run down or am being exposed to a particularly high amount of germs in a stressful environment such as traveling. Whenever I fly, inevitably I am sitting right next to someone who is copiously sneezing and snorting. Then I think about the one cubic feet of air being filtered for the 280 people on the plane and I take out a bottle of mushroom extract and pop a few for peace of mind.

Last year, I discovered Paul Stamets and his company Host Defense. Stamets is a mushroom nerd. There is probably a more technical term for his avocation like fungologist. All I know is if you ever read anything he has written it makes you want to go out and eat mushrooms by the handfuls. After reading one of his treatises last week, I ran out and bought a half pound of shitake mushrooms to sauté. He talks about mushrooms like they are the most luminous and magical plants in the world.

His classic mushroom mixture product for general immune enhancement is called My Community. Host Defense has a line of mushrooms but My Community is the place to start for beginners. If you are having a hard winter, immune-wise, consider taking two per day. If you are having an awful winter, double that dose. If you are still having trouble, you might have to take a deeper look at your sleep, eating and exercise habits and brush up on those happy thoughts.

Friday, February 18, 2011

Blog #28 What the Dog Ate

“I am so disappointed in Best Foods,” my daughter Isabel fumed throwing down her gloves on the kitchen table.

“How so?” I asked neutrally.

“Their brand of dog food contains animal BY PRODUCTS as its first ingredient. Can you believe it?” she ranted. “Do you know how bad animal by-products are?” she continued. I did. Animal by-products can range from 4-D meat (animals that are dead, dying, diseased or disabled) to road kill to just about anything associated with any type of animal. (Try not to think too carefully about that last one.)

“How can they call themselves Best Foods and sell such crappy dog food?” she asked rhetorically. (Full disclosure statement: Best Foods is a pseudonym because I still want to be able to shop there despite its lamentable dog food.)

“They probably have not taken on dog food yet, honey, “ I soothed. “They may still be dealing with the ruckus from labeling untested food from China ‘organic’.”
Though a smarty pants remark designed to lighten her mood, it may not be far from the truth. Creating a healthy dog food is not only a commitment; it is a whole specialty onto itself. Interestingly, some of the issues about doggy eating are the same as they are for people.

The most important concern is that dogs are increasingly suffering from the same chronic illnesses as people. Could this be related to their diets having some of the same pitfalls as people's diets? Dogs, like people, do best eating a balanced diet of fresh meat, whole vegetables, fruits and grains. For dogs, the heaviest emphasis should be on meat as this is the basis of their natural diet while people arguably should concentrate on vegetables, fruits and grains.

Some of us (I am guilty here) actually make their dogs a diet of whole foods. My dogs eat better than most of the people I know and it requires extra work. My efforts in this regard are a source of laughter and conversation in my neighborhood. A conversation that usually starts with, “What in the world are you making for those dogs?” Yes, steaming up vegetables may seem a little over the top but I had three dogs with touchy stomachs and skin problems so I had to figure out what they could eat, just like I did for the people in my practice. When I took them all off chicken, all of their stomach and skin conditions completely cleared up. Just like removing food irritants can help people symptoms.

Isabel watched this growing up so when she got her own dog she expected to be making her food. But, unlike some children who outgrow a total absorption with animals, she did not. Through college she worked at pet stores ending up at a serious holistic establishment that does not sell any dog food that contains animal by-products, soy or corn. Now she educates me on dog nutrition. Last year, she told me the grains had to go and I should stick to vegetables, fruits and meat. One of our dogs had a bad breathe problem and it made sense to me that getting rid of grains might help as getting rid of gluten sometimes helps people with sour stomachs.

“What else do you tell people?” I asked her, curious.

“Many dogs are overweight,” she explained, “because they eat bagged kibble that contains grains. The best way for them to lose weight is to get off of dry food and starch and eat meat, fruit and vegetables.” Just like people!

Most dogs eat dry dog food out of a bag that contains low quality meat by-products, grains and sweeteners. The sweeteners are added to entice the dogs to eat food that is mainly cheap starch vs. more healthy animal protein. That sounds familiar. This is exactly what fast food restaurants like McDonald's and Taco Bell have been accused of doing with meat entrees. Allegedly Taco Bell taco “beef” filling and McDonald Chicken nuggets contain far less than 50% meat. Instead cheap starch fillers, taste enhancing chemicals and sweeteners are used to entice people to choose an inferior food. (See: concerning the lawsuit against Taco Bell for low meat content in their “beef” taco filling or Michael Pollan’s excellent discussion on McNuggets in The Omnivore’s Dilemma.)

The first veterinarian I ever saw informed me he had extra training in dog nutrition because he knew I was a nutritionist and this would be impress me. He then went on to say that the most balanced way to feed a dog was to use only prepared, expertly fortified dry dog food. “Very funny,” I said thinking he was making a joke at my expense. “And you should only feed your kids fortified dry cereal,” I cracked. He was not joking and I never went back. I had to assume his nutrition “education” was provided courtesy of the Fido Dog Chow company.

“What do you tell people who say their vets only recommend prescription diet food that they sell?” I asked Isabel knowing this situation had to come up frequently.

“Most of those prescription kibbles are the same old junky dog food at premium prices,” she opines. “ but you have to be very careful. People think their vets are experts on dog feeding when they mostly know what the dog food companies want them to know. I try to explain without being offensive that most veterinarians are not properly trained in nutrition and that they have to be informed consumers.”

Just like people.

For more information on how to choose a healthy dog food, see, “Choices, Choices: On what criteria do you base your dog’s food selection?” The Whole Dog Journal, Feb. 2011. (

Thursday, February 10, 2011

#27 The Clues in the Conversation

“No, that is not right,” Rudy said in response to my third attempt to ascertain his reason for coming to see me.

I am in trouble now I thought glancing at the clock. Twenty minutes had passed and I still had not even pinpointed the problem. What I did have was fifty pages of medical reports and test results with symptoms and complaints that Rudy insisted were not accurate.

“How can I help?” I had asked directly fifteen minutes before. Leaning across my desk he passionately described a number of vague aches and pains that appeared to come and go. I listened intently and finally at one point repeated back to him word for word his latest description starting with, “So you are concerned about……”

“No, no,” Rudy shook his head rigorously. He was not concerned about that symptom. In addition, he was upset that his doctor, who had ordered many of the tests whose results were piled up in front of me, did not seem to understand him.

As easy as it is to criticize doctors given the present state of the health care system, I could find not a single fault with the thorough way his physician had analyzed the situation. If Rudy had not been understood, it was not from lack of trying on his doctor’s part. I empathized with the maligned internist.

I had been trying to listen so hard that my eyes were watering and I still was not getting it. Talking with Rudy was not improving my understanding so I reviewed in my mind what I did know. Rudy was prosperous and productive. This I knew because I recognized his name and Daisy, the woman who referred him to me called him “a business genius”. His medical records indicated he was in his early forties and his lean and toned physique were a testament to many hours at the gym. According to the extensive test and procedure results in front of me, there was nothing notably wrong with him.

Could he just be anxious? I wondered. I hated going down this road as so many patients are dismissed as anxious when practitioners cannot figure out what is really wrong. I flipped through the paperwork again and spied his diet diary. It was a mass of scribbles squished chaotically on to the page. I had seen papers written by 3rd graders that were neater. Then, I remembered a conversation I had with my attention-to-details assistant, Tania. She had mentioned that she was having a tough time scheduling Rudy because he was hard to reach by phone and did not use e-mail. I remember wondering how such a successful business owner could function without e-mail and as I was recalling that conversation I suddenly an idea occurred to me.

Rudy was still talking and leaning against the front of my desk when I looked up and interrupted him. “Ah ha, I’ve got it,” I said pulling his papers together and talking with more authority and confidence than I felt.

He looked at me wearily. After all, I was not impressing him up to this point with my stellar detective skills.

“You obviously would like to feel better,” I stated without waiting for agreement. “And I have identified three things that you are going to have to do that will help.” I glanced up to gauge his reaction. He took a breathe, stopped talking and slumped back into the chair. We were in agreement at last. Coming up with three healthy interventions for an overly busy person was not going to be difficult.

Rudy was a fit 40 some year old guy who was experiencing some of the annoying symptoms of middle age. He needed to make a few life style adjustments to optimize his energy. He was not 23 any more but he still had some long standing bad habits that he could get away with then but were not working so well now. This is what I think he had come for but in my view, this was not the most pressing problem. The more interesting issue was what appeared to be a significant learning disability in an otherwise wildly successful person. I wondered how much of his life had been spent covering up or compensating for his learning quirks.

I was having trouble communicating with him because he could not prioritize or organize his thinking. This is why when I repeated exactly what he said he did not agree with himself. It is also why he had thousands of dollars worth of tests looking for the cause of symptoms he claimed he really did not have. The thoughts he said out loud were not necessarily the most relevant ones. His communication was a jumble of important and insignificant information all mixed together. He needed help sorting his chaotic thoughts and a plan with a clear structure.

If organizing his thoughts was this difficult, no wonder he avoided e-mail. Writing must be a nightmare for him. Yet, there were significant areas of his life around his business where he was organized and brilliant. I would bet good money that getting through high school had been pure hell. Luckily, a horrible high school experience is not necessarily a harbinger of future failure because learning differences do not have to be crippling. If a person plays to their strengths and works with or hires people to handle their weak areas, they can succeed spectacularly as Rudy had.

But heavy compensation exacts a toll, especially when people do not understand the nature of their learning differences. Every activity that requires skills in their weak area will be more stressful. They may feel overwhelmed more easily and can get frequently frustrated. To avoid failure some procrastinate while others bully those around them to divert attention from themselves, depending on their nature. The behaviors that result from poor compensation could fill a psychology textbook. I have seen people unwittingly destroy marriages and relationships, lose jobs, fall into depression, suffer from chronic anxiety and become violent.

Rudy had an intense personality and I could not help but wonder how much of that was due to the stress of working around cognitive obstacles. Did he realize how tiring it could be to communicate with him in some areas? Was it equally exhausting for him? I wondered what he knew and how open he would be to discussing his cognitive quirks Exploring and perhaps coming up with some strategies to improve some of the ways his brain worked was how I wanted to help but decided he might not see that as help.

I decided I would have to build some trust and a connection before broaching this potentially touchy subject. And my analysis could be dead wrong leaving him to wonder about what kind of learning disability I had. Consequently, I decided to address what he wanted first and then see if there is an opening next time. Assuming that is, there is a next time.

Tuesday, February 1, 2011

#26 The Case of the Dirty Dishes

I reached for a clean glass to hold my freshly pureed green sludge and there it was. Trailing along the lip were the unmistakable remnants of yesterday’s drink.

“EEEEow,” I squeaked.

“Stinkbug?” my husband called out from the other room.

Like many households in our area we had a mild stinkbug infestation. Occasionally one would fall on our heads from the ceiling or show up unexpectedly looking gross. Hilarity or screaming would ensue depending on the situation.

“No,” I called back. “Just dirty dishes. I think something is wrong with the dishwasher.”

He agreed that he was seeing too much of yesterday’s food on the silverware and suggested calling Mr. Kenny. Mr. Kenny is our personal version of the Maytag repairman that was a TV icon about a decade ago. He is pleasant, efficient and reliable. We love him.

The next day the dishwasher was dismantled with various parts strewn on the kitchen floor. Mr. Kenny looked up and commented conversationally, “that’s what I thought.” There on the floor of the machine was either a million dollars worth of cocaine or all the soap crystals I had poured into the noisy contraption over the last 6 weeks. Mr. Kenny was going with the soap crystal theory.

“A few weeks ago new Maryland EPA regulations regarding the composition of dishwasher detergent took effect, “ he explained.

I stared at him blankly.

“The manufacturers are not allowed to use phosphates any more and that is the chemical that allows the soap to dissolve and get your dishes clean,” he clarified.
It is also the chemical, I thought to myself, responsible for the death of untold numbers of innocent fish.

High levels of phosphates from domestic and municipal wastewater end up in local streams, lakes and rivers. Phosphorus is a growth enhancing nutrient for plants. A little is good but too much and you are looking at Little Shop of Horrors, the water version. As the phosphorus levels go up and up, the algae grow to cancerous proportions literally sucking the streams and rivers dry. Some regulators have recognized the utter destruction of lakes as a bad thing and sixteen states, apparently including Maryland where I live, have enacted laws restricting or removing phosphates from dish washing detergent.

Mr. Kenny informed me that the dishwasher manufactures recommended Cascade Complete with the addition of a water softening product called Lemi Fresh. He admitted the soap manufacturers had not perfected the new formulations yet and they did not work very well. I hate it when choices are reduced down to clean dishes or destroying the environment. As the dishes were getting increasingly dirtier, I had tried Cascade among several other products and was unimpressed. Now I was feeling guilty for inadvertently contributing to massive fish kill all these years when I was not paying attention to which dish washing detergent I was using.

I try to be as ecological conscious as possible by buying organically raised food in part to reduce pesticide run off that also ruins waterways. Except for dish washing detergent, most of the cleaning products in my house are practically edible. For laundry, I stopped using detergent altogether and bought Super Washer Balls ( They are plastic balls filled with ionically charged beads that clean your clothes without soap. I have no idea why messing with ionic particles gets clothes clean but my friend, Bill highly recommended them. I even wash and reuse plastic bags, much to the horror of my husband and children. Yet I never thought twice about the dishwasher. It was a dishwashing detergent blind spot.

I wondered if my clever virtual assistant, Tania, was having similar problems.

“Nope,” she insisted. “I don’t like my dishwasher so the last time I bought detergent was 1996. It was full of phosphates then, so I am good. Do you want me to send it to you?” Some people are ordering dishwashing detergent from non-phosphate restricting states to get around the dirty dish situation.

“And destroy rivers!” I countered. “Absolutely, not. I just have to figure out what will work that is environmentally friendly.” claimed 7th Generation detergent worked best while another site suggested adding a cup of vinegar to the wash cycle. I cannot figure out how or where to add vinegar so it doesn’t just rinse down the drain. There is not a “Vinegar” dispenser on my model. Besides that could get expensive. Seventh Generation has only ever made phosphate free detergent and so that is what I am using now.

“It is even cheaper and more environmentally friendly if you just wash your dishes by hand, like me,” Tania observed smugly. As much as I hate to admit it, she might have a point though I might end up using more water than my dishwasher. I can’t help but think of Kermit the Frog when he lamented, “It is hard to be green”.

Monday, January 24, 2011

Index to the First 25 Blogs:

# 1 Nausea 911 – The case of the woman who woke up nauseous

# 2 A Bear by any other name - Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep

# 3 PANDAS continued

#4 Looking for Mr. Rightcheese - Cheese substitutes for the dairy free

#5 Me and The GI Guy – The case of the sick apartment

#6 The Secret Life of A Nutritionist

#7 Two Salads to Go: Hold the Receipts – Hidden toxins

#8 And You Thought Your Teenager Was Tough

#9 Me and The GI Guy continued (Blog #5 Follow-up)

#10 I Want To Thank Jim Carrey - The story of how I got to write a book

#11 The Subtle Bouquet of Pear Juice - How to write a food endorsement

#12 How To Have a Difficult Conversation

#13 Vitamin M- The relationship between movement and learning

#14 Coming to a Store Near You- New products from the health food expo

#15 One Afternoon at the Conference- What you need to know about infections

#16 Vitamin M Continued

#17 The Most Hysterical Time of the Year- Getting geared up for the flu

#18 What to Do to Prevent the Flu

#19 Topsy Turnips- Getting ready for Thanksgiving

#20 Toddler Crack- Preventing picky eating in your toddler

#21 Men with Rashes- The case of the man with complex rashes

#22 An Afternoon at a Different Conference- Take aways from the American Academy of AntiAging Medicine Conference

#23 Men with Rashes Continued

#24 What You Got from Grandma that Wasn’t in the Will- What you need to know about epigenetics

#25 The Real Reason Some People Can’t Lose Weight- Epigenetics continued

Saturday, January 15, 2011

Epigenetics Discussion

In response to the thoughtful comments by the authors of the DNA article quoted in blog #23. Your points remind me of the Mark Twain quote about how the problem is not what we think we know but what we think we know that just ain’t so. I loved your article but still hold on to some hope that epigenetics will change our narrow understanding/definition of genetics. Perhaps the non-DNA regulatory material will be more reveal some of the answers. The clinical effects are certainly there and we have to come up with some way to deal with them. With a lack of useful research the clinician, as usual is left having to make it up.

Blog 25- The Real Reason Some People Cannot Lose Weight (Blog 23 continued)

Danika was of a young woman of African American descent who had been adopted by a Caucasian couple shortly after birth. She was a happy, bright child who was healthy overall except when it came to eating. "We are concerned about her appetite," her mother reported obviously uncomfortable. "We don't want to make a big deal out of it, but we are worried she might be getting rather too large," she tentatively concluded. She was going for tact but Danika was having none of it.

"I'm huge," she stated matter of factly.

I generally appreciate when people are blunt because it saves a lot of time and trouble figuring out how to approach a situation. So I liked Danika immediately. She was a big girl heightwise, too, making her look more like a fourteen year old. I would have to remind myself not to expect behavior beyond her actual years especially because she was so articulate.

"Don't say that about yourself," her mother protested, cutting her off and fidgeting in her seat. I stopped for a second and took in the situation. Here sat two thin Caucasian parents raising a non-thin child of African decent. They were trying so hard not to let any cultural preconceived notions prejudice them that they were practically sweating from the stress of not being judgmental. This could get dicey.

"What do you think is going on?" I inquired.

"I try to eat healthy," she explained, "but I am hungry a lot."

Looking at her food diary it was clear she had a good appetite but was not eating the quantity of food I would have expected given her size. Her thyroid had been checked and she was in otherwise perfect health. She was partial to pasta and bread so I suggested a gluten free diet for 6 weeks to see if that helped her feel less hungry. If a reaction to a food is causing excessive hunger, that food usually contains gluten or sugar. It is almost impossible to help someone lose weight if they feel hungry all the time so I thought it was a good place to start. Danika groaned. Her parents groaned but the deal was struck. Six weeks: no gluten.

What does this all have to do with genetics? I could pretend I am trying to build up some suspense, but in truth, it is just complicated so the answer will take a little while. The six weeks passed and Danika’s parents checked in. They were pleased to report her appetite had calmed down and she was eating less. Nonetheless, they were very unhappy because despite her food reduction she had gained of three pounds. It was that old medical joke where the doctor announces the treatment was successful but the patient died.

The laws of physics states this is not possible. In my profession, this phenomenon has only one accepted explanation: the client is fibbing. Nobody wants to blame the client because of course, they do not mean to fib but if there is weight gain, there must be a cookie somewhere nobody is copping to. But after much poking around and having run into this situation before, I concluded Danika was not eating in secret but is likely suffering the results of unfavorable epigenetics.

Recall that epigenetics is how the genes change in response to the environment. When big adaptations occur during pregnancy, the child’s gene expression changes and that child passes that adjustment on to their child and so on for many generations. What may have been useful and adaptive given your grandmother’s environment when she was pregnant, may not be so useful for you now. One of the strongest epigenetic trends has been high rates of obesity in the offspring of pregnant women suffering from starvation. This tendency has been documented to continue through four generations.

Danika’s birth mother’s history was murky. In adoption where the health history is not clear, there is a good chance it involves poverty or other social issues where food is not plentiful or eating is restricted (to hide weight gain, for example). I have also noticed through the years that Africian American women can have a particularly hard time losing weight even on severely restricted diets. I ran into this situation so many times that I developed a theory about it.

From an epigenetic perspective, the best body type for surviving in Africa would be one that conserves calories well. The growing conditions are harsh in many areas and there can be long periods of drought when food is scarce. While in the womb, the smart, adaptive baby would naturally shift its metabolism so it could survive on very little food. And as long as the person lived in Africa, all would be well. But transplant that same metabolism here where most people can get all the food they want, drought or no drought and that same baby will put on weight.

A full figured woman once consulted with me because she had been on a 1,200 calorie diet and had not lost an ounce. She was understandably very discouraged. She insisted that calorie restriction never helped her lose weight and wanted some new ideas. We tried a low carbohydrate version of the low calorie diet with no success. On the plus side, she was an amazingly vibrant woman. She was strong and healthy and probably could survive well on a few turnips a week but her epigenetics was not geared for a plentiful food environment. I could not bring myself to reduce her calories further so I asked her to make a difficult decision. I explained epigenetics. Then I told her she would either have to accept the fact that she needed very little food compared to others to maintain weight or she would have to accept herself as a bigger woman. She chose the later.

I often wonder if this is the situation Oprah faces. Even with a trainer, a chef and 42 personal assistants, does she have an epigenetic situation where she can only lose weight eating ridiculously few calories? It is hard to live in this country on a severely calorie restricted diet and it would make sense that she would hang in there for awhile but periodically eat an extra cracker and gain 3 pounds. That sounds like an exaggeration but the small amount of food people with this epigenetic profile can eat is no joke.

Danika was another strong individual who needed very little food to maintain weight. In fact, when she reduced her calories by going on a gluten free diet, her body immediately interpreted this as starvation. Applying epigenetic theory, Danika’s body was highly adaptive for dealing with starvation and so it went immediately into conservation mode. She was not going to need much food to maintain weight. A tough reality at any age but I thought it might be a good thing for her and her parents to know.

“So, what are we suppose to do?” her mother asked.

“Well, here is the situation…….” I started.

Sunday, January 2, 2011

Blog #24 What You Got from Grandma that Wasn't in the Will

There has been a lot of talk in the medical media lately about genetics. After reading and listening to a number of interesting pieces there seems to be two main points….

1. Genes are not nearly as important/predictive as we have been told
2. Genes are significant in more subtle and profound ways then previously thought.

Media messages are nothing if not abundantly clear.

According to one article (The Great DNA Data Deficit: Are genes for disease a mirage? By Jonathan Latham and Allison Wilson in The Bioscience Resource Project, Dec. 8, 2010), knowing the make-up of your genes helps you predict your chances of getting an illness at about the same accuracy rate as reading an insurance company chart with population statistics of getting a disease and finding your demographic. Forty year old, normal weight black female who does not smoke? You can look up your group on a disease risk chart and find your chances of getting dementia and save yourself the trouble of cracking your personal genetic code.

Francis Collins, renowned geneticist and the head of US National Institutes of Health (NIH) encourages everyone to have their genetic disease susceptibility tested anyway. He had his own mapped and it was such a profound experience that he wrote a book. His most significant personal discovery was that instead of the average risk of developing diabetes given that he was a white male (23%), he had a 29% chance of getting the disease. Otherwise his likelihood of getting cancer, heart disease and dementia was like everyone else. The book must be very short.

Consequently, the gene mapping industry is in trouble. Most people who have done disease risk gene testing discover the same shocking fact: they are average. The exception is those with rare genetic disorders like cystic fibrosis. Of course these individuals by definition are “rare”. With consistently underwhelming findings, the monetary returns that were supposed to be generated from personalized gene mapping technology are looking bleak. At the moment, it looks like you would be better off investing in soap futures or uranium mining.

Genes are not as important and predictive as we have been told because one of the unexpected results of the human genome project was the discovery that DNA is not the most important part of the chromosome. DNA represents half of what is in the chromosome and the only material scientists were interested in until they realized how inert DNA is. Every cell has all the DNA needed for making everything in the body. In addition, there is enormous similarity between the DNA of human and all other animals. We have many fewer genes than scientists expected to explain human diversity let alone the bigger variation between people and fruit flies. DNA turns out to be mostly generic blueprint material. In other words, most of the DNA we carry looks like everyone else’s including monkeys and I don’t mean your brother-in-law.

What regulates and individualizes the DNA? The other half of the material that scientists thought was not important. Yes. It turns out that regulation is where all the action is and few scientists realized this until all the DNA was mapped and turned out to be stunningly generic. (For more on this topic see Dr. Bruce Lipton’s, The Biology of Belief.)

Which leads to point two about the ways genes may be more important than we thought. The DNA might be similar but the controlling proteins and regulation is wildly diverse. Regulation can be affected by your environment, stress, thoughts and your diet. The results are profound and can be so long lasting that what your grandmother or great grandmother ate or experienced while she was pregnant might be effecting how you are expressing your genes today. There is even emerging evidence that your grandfather’s health at the time of conception (try not to think about that part) could shift your disease risk today. This emerging field is called epigenetics and it is mind blogging.

Imagine the implications of this study. Scientists took some male rats and made them fat by feeding them a high fat diet similar to what we Americans eat today. The fat rats, who had symptoms of type 2 diabetes, were bred with non-overweight females. The pups did not become overweight (because of how they were fed) but a lot of them developed type 2 diabetes anyway! Ditto for the next generation.

We already know that pregnant women on starvation diets (due to famine or war) have children and grandchildren with much higher rates of obesity. The fetus makes decisions about gene expression in utero based on the kind of world it thinks it is coming in to. This early gene regulation has life long (and after) ramifications.

So, what practical application can this information have? The results of epigenetics walked into my office in the form of eleven year old, Danika. To be continued…….