Microbiome – Caring for the community inside of us

You are not alone. I am not talking about your connections with your family and community or  alien attacks. I am talking about in your own body. Within our own flesh we have a community of interdependent organisms that are working in concert to help maintain our health and functioning.biotics The name given to this community is the microbiome (micro – small, biome – community of organisms) and it is increasingly becoming a source of interest in the scientific and popular media. This week I would like to talk about the microbiome. There is a lot of speculation about the potential importance of the microbiome in affecting everything from allergies and eczema to arthritis and weight loss. While these concepts are only beginning to be understood, it is clear that the microbiome and caring for it does have important implications for our health. Read on to find out what you can do to keep the community inside of you functioning its best.

So what is the microbiome? (Do you mean I have bugs inside of me?) Do you know anyone who has ever gotten bitten (accidentally I hope) by a person or perhaps an animal? You may have heard people say, humans or cats have ‘dirty mouths’ — assuming they were not referring to their language, they were referring to the idea that our mouths are full of bacteria. These bites are usually treated with antibiotics to prevent infection. In addition to our mouths, we know that our intestines are also home to billions of bacteria and some fungal species. There are also many bacteria that live on our skin. You may have heard of MRSA, a type of bacteria that can be found on skin and that can potentially cause serious skin and other infections. So, yes we do have bacteria in many areas of our body. However, bacteria is not necessarily a bad thing. We are increasingly learning that there can be many potentially good aspects of certain bacteria. They can help us digest certain food components that we might not otherwise be able to digest. Some bacteria may help regulate our hormones  and may influence our metabolism (the process of turning food into energy).

Why should I care about the microbiome? Scientists are only beginning to understand the importance of the microbiome. They are doing this through a variety of experiments and observations in both animals and humans.  Some of these interesting observations have included finding that gut bacteria can manufacture and secrete chemicals that can affect our appetite and digestion. It has been observed that mice who are completely lacking in gut bacteria will tend to gain more weight. Babies who are breast fed versus formula fed tend to have a different mix of gut bacteria. Some of these differences in gut bacteria continue even after infants are weaned and may play a role in the increased rates of allergy and asthma seen in formula-fed infants. Different people in different parts of the world tend to have very different types of bacteria in their gut.  In general, western people tend to have a less diverse mix of bacteria. It is thought that this may be due to higher levels of exposures to antibiotics.

Having a healthy gut bacterial community can be an important part of increasing our resistance to certain infections. Antibiotics are essential in some instances to treat infections.  However, they do not discriminate between ‘good’ and ‘bad’ bacteria and as a side effect of treatment they can cause a significant decrease in the number of ‘healthy’ gut bacteria.  When our gut is populated with healthy bacteria it may be more difficult for bad infections to take hold. One infection that is sometimes seen after receiving antibiotics is called Clostridium Difficile (C. Diff for short). Individuals who get C. Diff can have diarrhea (sometimes bloody), abdominal pain and fevers. This used to be an infection that was mostly seen in sick hospitalized patients. Now we are seeing it more and more in the community. These C. Diff infections are also becoming more difficult treat, often requiring repeated courses of antibiotics. Which in turn can lead to more destruction of healthy gut bacteria and make individuals more likely to contract future infections. You may have heard in the news about fecal (stool) transplants. While this may seem surprising (and kind of gross), these transplants are being used in some places to treat these C. Diff infections. These fecal transplants work by providing the sick person with a dose of healthy gut bacteria. They are showing promise as a potential cure for treatment resistant C. Diff infections.

How can having healthy gut affect my health? Our gut is important.  If it is not in good shape we do not feel good. Our gut health is impacted by the food we eat (or do not eat), by the medications we take, by the way we spend our time and by the thoughts that occupy our mind.  People are increasingly being plagued by digestive issues. Everyday in my office I see people (often young) with gut concerns – reflux, gastritis, bloating, constipation, abdominal pain. We have medications to treat reflux, to treat constipation etc. But, these just address the symptoms. They do not get at the root cause.  The root cause often has many factors and the bacteria we are keeping in our gut may have an important role to play.

How can I protect and strengthen my microbiome? So, while our understanding of the microbiome is limited, there are some things you can do to support a strong and healthy gut community:

  1. Avoid unnecessary antibiotics – Antibiotics are powerful medicines and have an important role to play in treating bacterial infections. However, they can do damage if they are prescribed unnecessarily. For instance, antibiotics are not effective against viruses like the common cold and older children do not necessarily need antibiotics for most ear infections (which are often caused by cold viruses and not bacteria). Antibiotics can damage our healthy gut bacteria. Discuss with your healthcare provider the necessity of antibiotic treatment when it is recommended. Consider taking a probiotic supplement as soon as antibiotics are prescribed.  (Probiotics are tablets or powders that contain doses of healthy gut bacteria. There is good evidence that these decrease the likelihood of getting a C. Diff infection).

  2. Breastfeed your infant if you can (every bit helps) – There are a lot of benefits to breastfeeding. Breast milk helps to establish a healthy mix of gut bacteria that may ‘set your child up for life’ and decrease the likelihood of developing childhood allergies and asthma and may make them less likely to be overweight or obese in later life. Maximum health benefits of breastfeeding have been seen with breastfeeding at least 6 months, but every bit that you can do is a potential benefit. If health or other issues prevent you from breastfeeding, you can still support the health of your children by making sure that they have a healthy and varied diet when they start solid food.

  3. Wash your hands (but take it easy with the antibacterial soap).  Antibacterial soaps and hand sanitizers have not been shown to be any more effective than washing your hands well with regular soap and water. In addition, while the evidence is not consistent, some previous studies have shown that widespread use of antibacterial soaps may increase the potential for antibiotic resistance.

  4. MOST IMPORTANT – eat a diet rich in whole foods.  Yes, you knew it would have to be here somewhere. The best way to support our gut and the microbes is to feed them what they need. Whole, unprocessed foods, lots and lots of fresh vegetables, some fruits and natural grains (i.e.brown rice, barley, quinoa etc) are essential. We have all heard that we need fiber. It is not just because it keeps you regular, it is also because the fiber supplies some very important nutrients to our gut bacteria who feed on the fibrous materials in these whole foods. These bacteria then benefit us by maintaining our gut health and making us more capable of defending ourselves against disease.

So remember: We are never alone!  We are part of a community inside and out.  Let’s continue working to maintain and increase the health and function of our communities inside and out.

The information contained herein should not be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a healthcare provider if you suspect you are ill.

Update – Be(a)ware of the antibiotics in meat

The Environmental Working Group (EWG)  has recently released a report called Eat Smart – A meat eater’s guide to climate change and health.  In this report they detail the findings of their recent studies which show high rates of antibiotic-resistant bacteria in some meat (as highappy cowh as 81% of ground turkey!).  Why does this matter? These antibiotic resistant bacteria in meat may have the potential to lead to dangerous antibiotic resistant infections in humans.  Shockingly, the majority of antibiotics that are used in this country are used for livestock not human consumption.  Often, these antibiotics are being used to increase the rapid growth of livestock and not to treat infections.  There are many health and environmental reasons why it may be to our advantage to decrease the consumption of meat.   Your can read my previous post about Meat Consumption and Health here.  You can also read the EWGs report here and also be sure to check out the EWG supermarket guide to avoid superbugs to help you avoid exposure to these superbugs and help you decipher what different labels like humanely raised, antibiotic free, cage free etc. really mean.

Is eating meat bad for your health?

Question:

Is eating meat bad for your health?

Answer:

Meat can provide many essential nutrients in our diet. It is a rich source of iron and of protein that is the building block for muscle and manmanshoppingy of the chemical processes in our body.  However, it is not the only source for protein. Non-meat sources of protein include dairy products, eggs, nuts and beans. It is possible to get enough protein in your diet without eating meat and many people chose to adopt a meat-free lifestyle for religious, health or ethical reasons. There are so many recommendations these days about how we should be eating. Some of these recommendations are often in direct conflict to one another. One area where many diets differ is on their recommendations about eating meat – some recommend eating a lot of meat while others recommend limiting or cutting meat out of one’s diet completely. What is best? Read on.

Meat is a broad term. There are many types of meat. ‘Red’ meats such as beef, pork and lamb tend to be higher in saturated fat, a form of fat that is thought to increase the risk of cardiovascular disease. ‘White’ meats are more lean forms of meat such as chicken, turkey and fish are generally lower in saturated fat (especially if you do not eat this skin). Processed meats (they can be red or white) refer to meat products that have things added to them like salt, chemical preservatives, flavorings and sweeteners. Processed meats include things like sausages, bacon, luncheon meats or cold cuts, hot dogs, and ham.

So, should you be eating meat? As with many health questions, there are some things that are known and some things that are less clear. But, here is what we do know.

People who eat less meat tend to live longer. Communities where people eat small amounts to no meat have been shown to have some of the longest life expectancies. For instance, here in the United States, the community with the longest life expectancy is a group of Seventh Day Adventists living in Southern California. Is this because they are vegetarian? Or is it because they and many others who follow a vegetarian lifestyle in general tend to be more health conscious (e.g., smoke less, drink less alcohol) and in the case of religious communities, often have more strong social and community connections which have been shown to be a big contributor to life expectancy? It is not clear. We can benefit from their example by lessening the meat in our diet and making sure that we are paying attention to the other important aspects of our health.

If you are going to eat meat, avoid processed meats. Eating a diet high in processed meats will kill you faster. Yes, you read right. I am not usually this blunt. But, after reviewing the evidence (and there is a lot that has come out recently) it is clear, people who eat more processed meat tend to die sooner, especially from cardiovascular diseases and cancers. The high salt content and preservatives in processed meats are thought to contribute to these problems. So, let’s review, what are examples of processed meats: ham, bacon, sausages, cold cuts, pepperoni, anything where you pick up the package and see a list of ingredients. What can you eat instead? Bake a chicken at the beginning of the week and cut it up to use on sandwiches. Instead of sausage, ham or bacon for breakfast, consider a meatless option or find an unprocessed meat option for breakfast like some chopped up chicken from last night’s dinner cooked with some veggies and eggs.

If you eat meat, eat less of it. Many of us who eat meat, eat a lot more than we need. Our body cannot store the extra protein that is in meat. It will either get broken down and eliminated as waste or be converted and stored as fat. In addition, eating too much meat can be hard on your kidneys. Most adults unless they are extremely active only require somewhere between 40-70 grams of protein per day. If you are like me, I have no idea what that means. So, for example, a 1/2 chicken breast contains approximately 30 grams of protein or almost 1/2 of the average daily requirement. Just think how much extra protein you are getting if you have bacon for breakfast, a couple of pieces of chicken for lunch and pot roast for dinner. This is a lot more than your body needs or can use.

There is more to worry about with meat than just meat. The potential health issues of eating meat go beyond the fat and calories and excess protein.  Recently, there has been a lot in the news about the antibiotics that are used in large quantities in the large scale meat production operations that supply most of the meat in the United States. Many of these antibiotics are used to help increase the size of the farm animals so that they can grow bigger quicker. This allows meat to be sold for cheaper prices, which can make it more affordable, but also contributes to many of us eating more of it than we need. There is growing concern that these antibiotics that are used for animals may still be present in cooked meat and get into our bodies and lead infections that antibiotics can no longer cure. This could become a serious health concern. Eating less meat and trying (if and when possible) to eat meat that is raised humanely without added antibiotics can help protect your health and that of your family and community.

So, what is the answer? We know that many vegetarians live longer than heavy meat eaters, but the reasons for this may have to do not only with their diet but with other lifestyle choices. If you eat meat, try to follow other healthy lifestyle recommendations including regular exercise, not smoking and trying to create and maintain a community of individuals who you can rely on for support. In addition, if you eat meat, consider eating less of it. Vegetables, grains and beans should make up most of what we eat. Finally, avoid processed meats as much as possible. They have well documented health risks.

Just to be clear, I am not advocating that everyone become a vegetarian. I eat meat and I find I function better with a bit of concentrated protein. I know other people who say they feel better not eating meat. However, I continue to work to decrease the overall amount of meat my family and I eat for the many of the reasons we have discussed. With this information and your personal experience find a balanced, sustainable eating plan that works for you and helps support your individual, your family and community’s health.

I want to hear from you!  To respond to this article, request topics for future articles and for additional resources, leave a comment, visit Function Well Medicine on Facebook or tweet @DrNicoleWinbush.  You can also send an email to functionwellmedicine@gmail.com

How to Tame Your Sweet Tooth

Many of us (including myself) have regular cravings for sweet foods.  In limited quantities, sweets may be something that are a manageable and sustainable part of our daily food intake. However, because these foods can be so habit forming and are so widely available many of us find ourselves eating more of these foods then we would like.  There are many potentially negative health effects of eating a diet that contains moderate to high levels of processed sugars.  Most of us are familiar with concerns about excess calories and weight gain.  However, there is increasing evidence, that sugar (and other processed sweeteners) can have negative impacts on our mood and may play a role in increased depression.  Sweeteners may also affect the balance of chemicals idonutbiten our brain and impair our memory and may be a contributor to chronic joint pain and arthritis.  So, if you have ever gotten the sense that your sweet tooth is getting out of hand, I provide the following strategies for you to try.

Respect the craving. Your body is trying to tell you something. Our body is a beautiful interconnected system that is constantly working to maintain our balance and health. When our body feels it needs something, there are many ways it will work to signal our mind of its needs. By really tuning in and listening we can decode these messages and provide our body and mind what they most need to function their best. A craving for sweets may signal general hunger or low blood sugar. Perhaps your craving for sweet snack is just your mind’s way of telling you that it is bored and that eating a snack might give it ‘something to do’, perhaps you are sad or lonely. So, the next time a craving comes up, just take one minute and ask yourself the following question: “Why do I want to eat this right now?” and wait for the answer. If you are hungry, there are better choices you can make that would satisfy your hunger in a way that won’t leave you craving another candy bar in a couple of hours (e.g. nuts, an apple, a banana). If you are bored or sad, can you call a friend or get out of the house and go for a walk?

Make sure that you have lots of ‘good sweets’ in your diet. There are many foods that are naturally sweet and can go a long way to satisfy our sweet craving and also provide us with a wealth of vitamins and minerals that will allow our body and mind to function their best. Really great options to get natural sweets in your diet include: sweet potatoes and yams, squash, carrots, parsnips and beets and natural whole grains (like brown rice, barley etc).

Maybe you need is a little more bitterness and watch the salt. The concept of balancing the flavors in our diet is something that is very common in traditional diets from around the world. Most traditional diets incorporate a balance of flavors throughout the day (foods that are sweet, bitter, sour etc). However, our western diet is often lacking in these other balancing flavors and can lead to a state of imbalance where our body craves more and more of the sweet flavor. In addition, eating a diet that is high in salt can also increase one’s craving for sweets. Bitter flavor does not mean bad tasting. One way in which many African-Americans used to get more of the bitter flavor in their diet was more regular consumption of bitter greens like mustard and collard. Lettuces, celery and salads and vinegar can all provide more bitter flavor.

Limit your choices to better ones. One of the ways that we can set ourselves up for success is to plan ahead and limit our choices. If you know that you are prone to late night cravings for ice cream, don’t buy it. If it is in the house it will be difficult not to eat it. Provide yourself with a better choice (for instance Greek yogurt and fruit). When the late night craving strikes, scoop out some yogurt and stir in some fruit. If you put it in the blender for a few seconds and then the freezer, you will have a healthier substitute for ice cream, the next time a craving arises.

Be kind to yourself. If you eat something you had not intended to, don’t beat yourself up. Generally reflect on: “Why did I eat that? Is there something that I can do differently next time?” and move on. That bad choice is in the past, at every point during our day and during our lives we can recommit ourselves to doing our best and making the best possible choice for our health at that moment.

I hope you find some of these strategies helpful.   If you do let me know.  Are there other strategies that you have used to successfully break the holds of a sugar habit or some other craving or addiction? I would love to hear from you.
The information contained herein should not be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a healthcare provider if you suspect you are ill.

5 Ways to Keep Your Memory Strong

Many of us are concerned as we get older that our memory ‘is just not what it used to be’.  Some age related change in memory can be normal. As we get older, it is more likely that we will notice some loss in our short-term memory – our ability to readily recall information that was recently learned. We may find ourselves forgetting the name of the person we were just introduced to or not remembering where we put our keys. Long-term memory – the ability to recall events that are many years past is not as affected by aging. Dementia is a term used to describe a serious form of memory loss that goes forgetbeyond what is normally seen with aging. Alzheimer’s disease is the leading cause of dementia in the U.S. While the exact cause of Alzheimer’s disease is not clear, research has some clues to perhaps lower our chances of developing this devastating condition and ways that we can improve and sustain a healthy memory. Here are some strategies to keep your memory strong.

How is your mood?  Is stress an issue?  Memory issues may be a sign of depression, especially in older adults. When we are feeling down and depressed we may process information more slowly and not remember new information as well. The same is true when we are very stressed. When we have many worries, it is hard to concentrate on one thing and learn new information. Despite what we may think, we can only think about one thing at a time. If our mind is overcome with worries, anxiety or sadness, it will be difficult to maintain mental focus. If depression or stress are issues for you (or a loved one), seek out assistance.  There are many strategies to assist you in getting help with these issues and getting back to functioning your best.

Strengthen your body to strengthen your mind. When we exercise, a complex array of physical and chemical changes occur in our body. Our blood flow increases which may help us to think more clearly. As we age, it is normal to see some shrinking in the size of our brain and it is thought that some of the age-related declines in memory are a result of this shrinking. However, a study has shown that regular exercise such as walking is associated with less brain shrinkage. Exercise is also a potent stress-reducer and has been shown to improve mood. In fact, previous studies have shown that 30 minutes of exercise three times a week can be as effective as an anti-depressant pill for some people with depression.

Eat your colors and spice it up. When our cells become damaged, they do not function normally and it is thought that this cell damage may be a common pathway for many disease and aging processes including Alzheimer’s, Diabetes and Arthritis.  Antioxidants are strong chemical compounds that are thought to protect against cell damage. Natural antioxidants are abundant in many fresh and whole foods especially berries, and some beans (see here for a listing of high antioxidant foods). Also, some spices and green tea are high in antioxidants. So try to get your ‘dose’ of anti-oxidants by including these rich antioxidant foods in your diet. While it is possible to buy anti-oxidant vitamins and in supplements, so far, these non-food antioxidant sources have not been proven by science to be helpful. Eating antioxidant foods is the better (and cheaper) bet.

Diabetes and high blood pressure – prevent them or control them.  Diabetes and high blood sugars have been associated with an increased risk of developing Alzheimer’s disease  and memory problems in general. If you already have diabetes, it is important to know that people with well controlled diabetes have less decline in memory than those whose diabetes is not well controlled. So work on controlling your disease to the best of your ability. High blood pressure also can also be associated with memory problems.  Some people with a long-standing history of high blood pressure will get small strokes (often unrecognized) and these can lead to memory problems. This is called multi-infarct dementia. Maintaining good blood pressure control with lifestyle changes and medications (if needed) is a way to decrease your chances of developing this condition.

Keep Learning and Maintain Connections. Learning new skills and information is a way to keep our brains strong and youthful. This does not mean that you have to go back to school. Perhaps you have always wanted to learn to draw or how to knit or speak Swahili. When we are learning new skills our brain is active and creating new connections. We can also create and maintain connections with people — family members, friends, members of our community.  Sharing our skills and experiences keeps us engaged and excited about our life and its myriad possibilities.  Remember, strong life, strong body, stronger memory.

The information contained herein should not be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a healthcare provider if you suspect you are ill.

The health benefits of spices

Spices can be a great way to improve the taste of food and increase food’s health benefits.  spicesFlavors provided by spices can decrease the use of salt and fat in dishes without compromising taste.  Spices can also be a rich source of nutrients and trace minerals that we may be missing in other areas of our diet. Many spices are thought to have properties that can improve health and function in a wide variety of ways. While all of these effects may not have been proven in rigorously conducted scientific studies, they do have the wisdom of hundreds (if not thousands) of years of traditional use. The food we eat and the spices we add really can be some of our best medicine. With some basic knowledge you can start utilizing the benefits of a little added spice today. Let’s get started.

What are spices?
Spices and herbs are terms that are often used interchangeably. Herbs commonly refer to the leaves of plants.  Spices usually come from other parts of plants or trees (e.g roots, stems and seeds) that can be harvested and often dried for use in cooking, teas and traditional medicines. Examples of common herbs include: oregano, parsley, rosemary and thyme.  Some commonly used spices are: ginger, cinnamon and cayenne. They can be dried and then bottled. This is the form that many of us are familiar with from our spice cabinet.  However, some spices can also be purchased (or in some cases grown) and used fresh.  When used fresh, they often have more powerful flavor and may be more likely to retain more of their health promoting properties.

Ginger

Ginger is a root used in food preparation throughout the world and available in powdered form and fresh in most grocery stores. Ginger has a strong spicy flavor that is even more powerful when used in its fresh form. It has documented benefits in aiding in digestion and is often used as a tea to help control nausea. It has a warming quality that makes it a very good addition to winter soups, stews and vegetable dishes. Ways to use ginger: some fresh root chopped up and boiled in water makes a great tea (and helps digestion), pieces of fresh minced root added to stewed meat recipes, carrots, mashed sweet potatoes or squash dishes.

Garlic

Garlic is the strongly flavored bulb of a plant that is closely related to the onion. Garlic has traditionally been used to to help fight off infections and to increase circulation. Modern health claims have suggested that garlic may lower cholesterol, prevent infections like the common cold and help lower blood sugar. Research in these areas has not been able to clearly prove these claims.  Noentheless, garlic when added to dishes provides a strong flavor, and can be especially helpful in aiding in the digestion of hearty meat dishes. Ways to use garlic: fresh garlic chopped or minced and added liberally to meat dishes and sauteed vegetables and mashed potatoes. When cooking, saute the garlic and onions first to soften their flavor before adding other foods.

Cayenne

Cayenne is a powder and is made from dried chili peppers. Just a little can provide quite a bit of heat.  Skin creams made of capsaicin (one of the chemical ingredients in cayenne peppers that provide the heat) have been used for years to treat joint pain. Cayenne increases blood flow (think about the rising sensation of heat you get when eating spicy food).  There is substantial evidence that this increase in blood flow to the stomach caused by eating  foods containing capsaicin may actually  protect against stomach ulcers. In addition, cayenne can be a great treatment for nasal congestion (think how much  your nose runs when eating spicy food). It is a very rich source of Vitamin A and Vitamin C and antioxidants that if used consistently may play a role in supporting immune health. Ways to use cayenne: in hot lemon tea with a small bit of cayenne to clear nasal congestion, added to eggs or beans or anywhere else you need a bit of spice.

Turmeric

Turmeric is a brightly colored orange powder that is made from the dried root of a plant that is related to ginger. It is commonly used in South Asian and Middle Eastern cooking.  Even if these cuisines are not to your taste, most of us will have encountered turmeric as the yellow/orange spice that gives mustard its bright color. Turmeric and one of its chemical components curcurmin has been associated with a long line of potential health benefits.  Studies have demonstrated that curcurmin may improve inflammatory conditions as varied as arthritis, psoriasis, and inflammatory bowel disease. Populations of people that eat a lot of turmeric also have very low rates of Alzheimer’s disease and scientists think that turmeric may play a role in this. It is reasonable to think that adding turmeric liberally to foods may support health by decreasing inflammation. Turmeric is widely available in grocery stores.  Uses for turmeric: add to chicken and rice dishes to give a beautiful yellow color (adding some cinnamon or curry powder can balance out the flavor).  Turmeric tea can also be a way to get a concentrated dose of turmeric.

A few notes about using spices

As with most food products, quality and freshness matters. Spices often sit on supermarket shelves and in our spice cabinets for years before being used. Over time, they can lose their flavor and their potent health effects.  The ideal shelf life for whole herbs (e.g. peppercorns, cinnamon sticks) is usually 2 years. For ground spices the ideal shelf life is 6 months. So use some spice and use it often. I hope you found this information helpful and I would love to hear from you. What ways have tried using spices to add flavor to food and enhance your health?

The information contained herein should not be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a healthcare provider if you suspect you are ill.

Sweet Tea – not so sweet for your health

When discussing food choices, one of the first questions I often ask is “What do you drink?”.  One of the more common answers that I have been getting lately sweetteais that people are drinking a lot of ‘tea’.  Often the tea that is being referred to is a sweetened (or sometimes sugar-free) bottled beverage. Many people will often drink several cups or bottles of ‘tea’ per day.  Often, they tell me that they are drinking tea because they see it as a healthier alternative to soda.  This week we talk about tea, and some of the beverages out there that pass for tea and provide some information about what is known about tea and its health benefits.

What is tea?
Tea refers to a beverage made from the dried leaves of a plant (camelia sinensis) that is native to Asia. It is the major beverage of many people around the world. There are several types of tea (e.g. green, black, white, oolong) these are made by different methods of drying and preparing the tea leaves. In the US, green and black tea are the most common types. There are also herbal teas that are not made from tea leaves and often contain a mixture of dry herbs.

What is not tea?
Many people are now drinking bottled tea beverages and have been given the impression through marketing and packaging that these drinks represent a healthful alternative to soda. They are not. Many of these (sweetened tea beverages) are little more than sugar water. They contain small amounts of tea and lots of added sweeteners.  One 20 oz bottle of sweetened tea often contains more than 200 calories. If you drink an average of one bottle of tea daily, that is 20 pounds of calories a year just from tea.  These beverages retain little to none of the health benefits of brewed tea. They provide excess calories that are likely to contribute to weight gain and increase your risk of developing diabetes and other chronic health conditions. Sugar free bottled teas may have few to no calories but artificial sweeteners may actually encourage your body to eat more due to their overly sweet flavor which has been shown to stimulate your appetite.

What are the health benefits of tea?
Brewed tea contains chemical compounds called anti-oxidants and are especially rich in one form of anti-oxidant called catechins.  These catechins are highest in green tea but are also present in black tea and to a lesser extent in decaffeinated tea.  Bottled tea beverages contain almost none of these anti-oxidants. Catechins are thought to promote beneficial health effects by helping the blood vessels in the body to function better. When people drink green tea, their blood vessels have been observed to dilate more, aiding in blood flow.  This may explain some of the observed health associations with regular tea consumption. For instance,  drinking 3 cups of black tea daily has been shown to have modest effects on lowering blood pressure. Studies have also suggested potential benefits of regular green tea consumption on lowering stroke and heart disease risk. However, the results are not consistent or fully proven.   Green tea (and more specifically chemical extracts from green tea) has been reported to aid in weight loss, weight loss maintenance and cancer prevention.  However, studies have also not consistently shown this.

Should you start drinking tea?
If you currently are not a regular brewed tea drinker, you could consider adding a cup or two of brewed tea to your diet everyday.  It should be noted that tea (unless decaf) contains caffeine. Caffeine is a stimulant and can help people feel more alert and focused, especially in the morning.  However, if you drink too much or are very sensitive to caffeine, it can make you feel anxious or jittery or if taken late in the day it can sometimes impair sleep.  If you are a sweet tea drinker, consider switching to fresh brewed tea.  It is cheaper and has some potential health benefits.  If you need to add a little sweetener, consider adding a small amount of honey or sugar. This will still have many fewer calories than the bottled variety.  You can also add some milk to your tea, however, be aware that this may reduce the benefits of tea on blood vessel function.

Evaluate how you hydrate
Our body needs fluids to function properly. When I am asked by patients, ‘What should I drink?’, my first answer is always water.  However, as we have discussed brewed tea can also can be a healthful addition and can provide some variety in terms of taste.

The information contained herein should not be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a healthcare provider if you suspect you are ill.

Fibroids: What can you do?

Fibroids are non-cancerous growths that start in the muscle tissue of the uterus.  They are very common and present in about one-third of all women between the ages of 40-60. These rates can be 2-3 times higher in Black women, where fibroids are often seen at even younger ages. While fibroids often do not cause any problems, depending on their location they can cause several issues including constipation, pelvic pain, and heavy and prolblack-woman-smilingonged vaginal bleeding (that when severe can cause anemia). So, while these growths do not cause cancer their effects can be potentially serious. This week we discuss fibroids, what is known about their causes and what you can do to try to prevent or limit their growth.

Fibroids: risk factors and the hormone connection
It is known that women who have a family history of fibroids, are overweight or who have never given birth have an increased risk of developing fibroids. High blood pressure has also been associated with fibroids. We cannot change our family history or lose a lot of weight overnight. However, there is growing evidence to suggest that there are things that you can do to that may decrease fibroid growth. The added benefit is that these lifestyle changes will also help support your overall health. Hormone levels (especially estrogen) stimulate fibroid growth. When a woman who has fibroids reaches menopause, her fibroids will generally shrink.  Fibroid growth is driven by an imbalance in hormones. Estrogen and progesterone are two main female reproductive hormones, but if they are out of balance this can cause problems. Here are some strategies that will aid in restoring or supporting hormone balance.

Be aware and knowledgeable of what we put in and on our body
Eating a diet high in processed carbohydrates, like chips, crackers, bread, etc. has been associated with increased fibroid growth in African-American women. Part of this may be due to the fact that these foods can increase blood sugar which leads to the release of inflammatory and growth factors in our blood. These factors can stimulate estrogen production. On the positive side, eating a diet higher in vegetables and fruits can lower inflammation, moderate blood sugar and is associated with fewer fibroids.

The role of dairy products in fibroid growth is unclear. One study has shown that African-American women who report consuming more dairy products have a decreased risk of developing fibroids.  However, there are hormones that can be given to cows to increase their milk production that increase the hormone levels present in finished milk. To gain the nutritional benefits of dairy products but limit one’s exposure to these added hormones choose organic dairy products whenever possible.

In addition to type of food we eat, we need to pay attention to how it is made and the packaging it comes in. Some of the chemicals that are used to produce plastics have been shown to potentially have estrogen-like effects in the body. Ways to decrease your exposure to these environmental hormones include: avoid heating and reheating foods in plastic containers (use glass, ceramic, metal etc.) or if you must use them ensure that they are labeled microwave and dishwasher safe. Ditch your plastic water bottles or get one that is  BPA-free or made of metal (BPA is a chemical used to manufacture many plastic bottles canned food liners). Decrease your intake of canned foods (most cans are lined with BPA).

It’s not just about food, recent studies have suggested an association between the use of hair relaxers and fibroids. This does not mean that relaxers cause fibroids, more studies are needed. However, these studies do suggest a relationship that is worth knowing about as we are making personal health and beauty decisions. In addition, as a community we need to pressure the companies whose products we buy to do continued research to ensure the safety of these products.

Other lifestyle issues
Normal vitamin D levels are important for the normal growth of cells and low vitamin D levels are also associated with increased inflammation in the body. Early studies have shown that Vitamin D can limit the growth of fibroid cells in test tubes. So, make sure that you are getting your vitamin D. As we have previously discussed with other health issues, stress management is important. Increased stress levels can drive inflammation which can contribute to hormone imbalances, so seek or ways and support to get a handle on stress.

Treatment Options and Supporting your health
For women whose fibroids continue to grow, there are various treatment options both surgical and nonsurgical. If fibroids are small and causing mild to moderate symptoms, it makes sense to try non-surgical treatment options. If these measures fail, surgery is often considered.  Surgical procedures include procedures to attempt to just remove the individual fibroids (myomectomy) and complete removal of the uterus (hysterectomy). If you are needing treatment for your fibroids, make sure you know your options.  Studies have shown that African-American women have high rates of hysterectomy and that some of this may be due to not always having good information regarding alternatives to surgery. Hysterectomy is a surgical procedure and may be an appropriate choice for many women if other options have failed but make sure that you know about the alternatives before deciding on this.

If you have already had a hysterectomy or other procedure for fibroids, it is never too late to make changes for your health. It should be noted that the same hormone imbalances that can drive fibroid growth can present as wide range of health conditions that affect both men and women: premenstrual syndrome, polycystic ovary disease, obesity, blood sugar problems and mood symptoms. Any of these lifestyle changes discussed will still have benefits to your overall health.

The information contained herein should not be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a healthcare provider if you suspect you are ill.

Part 3 Prediabetes – What can I do about It?

This is the final article in a continuing series about prediabetes.  In the first article we discussed the diagnosis of prediabetes and how to know if you are at risk.  Last week we discussed some common myths about prediabetes and in this final article we provide a list of 7 things you can do to reduce or reverse some of the metabolic changes associated with prediabetes.  pre_diabetes_condition_lusvi

  1. Don’t drink your calories.  This may be a change that you have already made. If so, keep it up.  But if not, let’s take a look at the numbers. A typical bottle of soda or sweetened tea contains 180 – 220 calories. This does not seem like much, but over the course of the year, just drinking an average of 1 bottle per day translates into an additional twenty pounds of excess calories.  Have you stopped the soda and tea and started drinking juice instead? The calorie count in juice and soda is about the same.  You are best eating whole fruits or vegetables. The calories are fewer and you will get the benefits of more fiber and nutrients.  Sugar free beverages can be an short term change, but there is evidence to suggest that these drinks may actually increase your appetite for more sweet and calorie-rich foods. What should you drink? Water – our bodies are made up of over 60% water. Unsweetened herbal and green tea are also good choices. If you have developed a taste for sweet beverages, it can take some time to break this habit. Ease your transition by adding water to juice and gradually increasing the proportion of water over time. Your taste buds adapt to dietary changes in a matter of weeks.
  2. Learn about the Mediterranean Diet.  There is no one perfect way of eating. However, there are certain foods that have been shown to be beneficial to controlling blood sugar and to help in weight loss and good weight maintenance. One pattern of eating that has shown benefit is called the Mediterranean diet. In brief, this is a way of eating in which you eat lots of vegetables, moderate amounts of whole grains, nuts and seeds. Meat in this diet most often comes in the form of poultry or fish and is only a couple of times per week. Olive oil is the main oil used in food preparation. If you are interested in learning more about the Mediterranean Diet and adaptations using foods that are more specific to different cultures including the African-American culture, resources can be found here.
  3. Don’t skip meals. Skipping meals is too common in our society. However, if you are wanting to moderate your blood sugar, wanting to lose weight or both, consistency is key. Skipping meals is very stressful to the body. We have already discussed how increased stress hormones can increase blood sugar. In addition, if you frequently skips meals, your body thinks you are in a semi-starvation state that makes it harder to lose weight. Many people tell me that they do not feel like eating much in the morning. If so, start with a room temperature or warm beverage like a glass of tea or water.  This can prepare the stomach for a small meal in the morning. In time, one’s digestion will become accustomed to a morning meal.
  4. Add more veggies. You really cannot eat too many brightly colored and green vegetables.  People with higher vegetable intake have been observed to have lower chances of developing diabetes. Also, choose a variety of vegetables. People who eat a wide range of different veggies have also been shown to have lower rates of diabetes over time. Think about experimenting and trying a new vegetable each time you are at the store.
  5. Gain muscle and lose fat. If you are working to lose weight, do not starve yourself to do it. Make sure that you are getting sufficient calories and protein to provide energy during the day. You want to lose fat not muscle.  If you need assistance developing a balanced eating plan, see your healthcare provider for assistance. Also, make sure that regular physical activity is part of any weight loss plan.  This will allow you to maintain and build muscle while losing weight.
  6. Get a handle on stress. Stress levels affect our blood sugar. Find practices like consistent exercise, relaxation breathing or prayer that allow you to manage life stressors. If you are overwhelmed, please seek out assistance.  You can read my previous articles about stress here and here.
  7. Do what you can to limit exposure to pesticides. Higher levels of pesticides in the blood have been found to be associated with increased diabetes risk regardless of weight. Eating organic vegetables and fruits can lessen your exposure to pesticides. However, it may not possible for many of us to buy organic food due to increased cost and poor availability in some places.  If this is the case, make choices that are less harmful. There are foods that are known to be highest in pesticide levels, and these levels persist even after foods are washed and peeled.  You can find a list of the “dirty dozen” (fruits and vegetables that are on average have the highest pesticide levels) here. If possible, buy these foods organic or consider using alternatives from the “clean 15” list (available at the same link above)  that are lower in pesticides. Always wash fruits and vegetables thoroughly (even if organic).  If buying organic food is not possible, remember that the benefits of eating fresh vegetables and fruits still outweighs the risks of pesticide exposure.

This concludes the series on prediabetes.  Remember, your biology is not your destiny.  You have within your power the ability to make choices and take actions, that will improve your health, the health of your family and your community.  You can start today!

The information contained herein should not be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a healthcare provider if you suspect you are ill.

Prediabetes – Get rid of the myths and get the facts

This week’s article is part of a multi-part series on prediabetes.  In the first article I discussed prediabetes and provided information regarding how it is diagnosed and how you could figure out your risk.  This week I will address several misconceptions regarding prediabetes.  The final article will provide some more individual and community strategies for addressing this health issue.  Image

Myth 1 – Diabetes runs in my family, I can’t do anything about it.  Fact, lifestyle can trump genetics.  It works both ways.  People who have no significant family history of diabetes can develop diabetes if they follow a plan of eating and inactivity that increases their risk.  Similarly, people with a strong family history of diabetes who are committed to remaining active and maintaining a healthy weight, greatly decrease their chances of developing diabetes.  Conditions we blame solely on our genes are often related to the fact that we grow up in family systems and cultures that have ways of eating and being that may increase the risk of disease.  It is important to know one’s family history and take it seriously.   However, it is not your destiny.  The food that we feed our body is information that helps determine how our genes express themselves.  There is much in our genes which we have the power to influence for good or ill. If you have already developed prediabetes (or even diabetes), significant and sustained lifestyle changes may improve your condition. However, the further down the line you get, the more difficult these reversals can become.  So when possible, start early and start with prevention. Prevention is especially important for our youth who are facing epidemic levels of overweight, obesity and prediabetes.  We have to help them by modeling and developing healthy habits regarding eating and activity.

Myth 2 – It is just prediabetes.  Once I am diagnosed with diabetes I will make changes, because that is when the real risks start.
Fact, it is now clear that people who have blood sugars in the prediabetes range already experience an increased risk of many dangerous health conditions such as  heart disease and stroke.  Some research suggests that Alzheimer’s disease may be related (at least in part) to disturbances in the way that the brain uses glucose and that people with diabetes (and prediabetes) are at increased risk for developing Alzheimer’s disease.  Prediabetes IS a serious condition and can increase your risk for other health problems. Improving your blood sugars can reduce your risk factors for developing these conditions.

Myth 3 – I know I need to lose weight.  I will just get the bypass surgery and that will take care of it.
Fact, weight loss surgery is increasingly common and in people who are severely overweight, this may represent an appropriate option to help achieve significant weight loss.  Nonetheless, surgery should not be looked at as a miracle cure.  Some studies have suggested that this surgery may decrease the chances of developing diabetes or even reverse diabetes in some people.  However, a more recent study shows that when people who already have diabetes get bypass surgery,  the majority of them will either remain diabetic or (if their diabetes resolves after surgery) be re-diagnosed with diabetes within five years of surgery.

Gastric bypass (and other types of weight loss) surgeries are still relatively recent interventions and we are only beginning to appreciate some the long term health problems from changing the body this way.  As this surgery becomes more popular, I am also increasingly concerned that our health system is often willing to pay for an expensive and potentially risky surgery but there are very limited resources and support available for people to receive intensive lifestyle and nutritional support that might prevent the need for surgery.   It is also important to realize that even in folks who go on to have surgery, they will have to make significant changes to the types and amounts of foods that they eat for their surgery to be successful.  So, no matter how you look at it, finding ways to maintain healthy lifestyle patterns regarding eating and activity are essential for your good health.

Myth 4 – I know I need to eat better, but it costs too much.
Fact, we can pay for our health now or pay for illness later.   Changing the way that we eat can be a big undertaking.   It is not something one can do all at once or that one can do in isolation.  To create an environment where all people have access to healthy affordable foods takes individual and community-wide efforts.  But, here are a few ways to get started:
1.  There are many healthful and affordable additions to one’s diet that do not cost a lot of money:  add as many vegetables as you can to your diet.  Frozen are often more affordable than fresh especially in the winter.  Try to avoid canned vegetables as they provide less overall nutrition and are often high in salt.
2.  Plan ahead.  Plan your meals (at least dinner) for the week and shop to have items on hand that you need to prepare your meals.  Any meal you cook at home, is going to generally be more healthful than a meal eaten on the go at a fast-food restaurant.   Consider preparing meals ahead or in a crock pot to save time.
3.  It is not all about the meat.  There is mounting evidence that eating a diet that has too much meat (especially red and processed meats) can be detrimental to our health.  There are many other excellent non-meat sources of protein.  Consider incorporating more of these into main meals.  For instance, consider beans and eggs.  When you use meat, a little can go a long way and tough cuts (which are often more affordable) can be made deliciously tender when added to soups or stews.
4.  One person cannot do it alone.  For all the efforts that we make as individuals to support our health, we can multiply the power of these efforts with community action.  Find creative ways to support healthy food cultures in our community: create a supper club where friends bring and share healthy foods and recipes, have a neighborhood soup potluck, create a committee at your church that works on community food issues, make requests of the stores where you shop to carry specific items.  Finally, make sure that your elected officials know the value that you place on having access to healthy food in our community and vote for people that share this interest.

I hope these suggestions have been helpful.  I would love to hear from you.  What are your thoughts about how we can reverse the epidemic of prediabetes in our community?

The information contained herein should not be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a healthcare provider if you suspect you are ill.