To take or not to take supplements?

That is one of question in health tabloids a la mode these days.  And as always, it is not that simple. Nothing is obvious when it comes to general health, except for that too much and too little is always bad.  But that is true about everything, anyway.

               We ridicule people who present claims and statements that are not backed by scientific evidence. But behind that scientific evidence the evidence is frequently really weak.  Some medicines that are recommended for common diseases like osteoporosis and high cholesterol require a large amount of people to be treated to benefit only one or two, like 1 person out of 100 benefits from using treatment for osteoporosis or 1 out of 30-40 for preventing heart disease.  That one person is the lucky one but the others just get the side effects or take a pill for no good reason.  The reason for this is that we don’t exactly know, who will benefit,  and we treat them all with all of our good intentions.

               Same is for supplements. The science is weak and frequently flip-flops, making not only public but, also, doctors crazy.  Beta-carotene, vitamins E, folic acid, niacin were good for you five years ago, but now, “no more”. Just last week I recommended to the patient to take magnesium, she got home and called me right back after she saw that magnesium might cause I can't remember what, to which I recommended to her not to go with my recommendation. Internet is the greatest source of confusion.  I tried to look up what was wrong with magnesium and still couldn't find but I'm sure something was there.  Another "doesn't make any sense" example that I see pretty much every day is that the sickest middle age people I have in my practice eat only organic foods and take all the "recommended" supplements. I'm pretty sure that there is no correlation between the two, but the obvious message is - the supplements and organic foods do not bring their health back.

               There are three major factors that impact our health:  genetics, age and environment. Until we know our genetics, and as long as we remember our age, we have impact only on our environment.   But when the equation has three variables: one somewhat unknown, the other one relatively stable but impossible to change, we can full around only with our eating, drinking, activities and exercise. What about supplements?  Eat healthy, exercise and take vitamin D, not too much and not too little: 1000 u of D3 will do it for most people.

Sugar Addiction and Beyond

I’m going to give you compelling evidence that there is practically not a lot of difference between sugar and heroin:

- Both come from nature and are derived from plants; heroin from the opium poppy, sugar from sugar beets or sugar cane.

- Both undergo excessive chemical manipulation to get to its final product. 90% of nutrients, water, fiber and protein are removed from sugar beets and sugar cane to turn it into sugar. Heroin is derived from the opium poppy, but to turn it into morphine it has to go through extensive chemical modification.

- Both cause addiction: for heroin about 14 million people and sugar about 1.5 billion worldwide.

- Both cause dependence, craving and withdrawals.

- Both coincide with depression or emotional distress.

- Both cause death: heroin about 600 people per year in the USA, sugar about 300,000.

- Both are used in medicine for medicinal purposes. Morphine is derived from opium and used to alleviate pain. Sugar is used in intravenous fluids for a variety of conditions.

When imaging studies are done in addicts to heroin or sugar, they light up the same locations in the brain, an area called the orbitofrontal cortex: the part of the brain located behind the eyes and among other things is responsible for decision-making.

The key similarity of the two addictions lies in the behavior of the addicts: despite clear knowledge that the use of those substances comes with unpleasant and somewhat deadly consequences, people continue to use those. This also true about alcohol, smoking and gambling, but only gambling acts through exactly the same circuits as sugar and heroin. There is a perceived difference between those two. We can live without heroin but we need sugar for our bodily functions. False! We don’t need sugar per se; we need glucose that we can get from all sorts of foods without any chemical manipulations. Fruits, vegetables, grains and legumes contain plenty of sugar that we can use for thinking, breathing, exercising, and all the other important functions. Honey, molasses, and maple syrup in small amounts will do the job of bringing the sweet taste. What about organic or brown sugar? No different. Just like salt, sugar should be used as a spice and not as an ingredient. So, if heroin of course should not be used at all, sugar can be used as a spice and, as far as I’m concerned, should be sold in spice containers.

I’m certainly not the first person with revelations about sugar addiction. In 1975, William Duffy, released his book “Sugar Blues” which has sold more than 1.5 million copies. There are other books revealing the sugar addiction. Around the time that Duffy’s book became popular, the US changed its “sweetheart” from sugar to high fructose corn syrup. We didn’t abandon sugar, but we just slightly backed off that to the creative genius of the manufacturers. If in 1980, the average person ate 39 pounds of fructose and 84 pounds of sugar (total of 123 lb.), in 2004 the average person consumed 83 pounds of fructose and 66 pounds of sucrose (total of 149 lb). Speaking of ubiquitous – high fructose corn syrup penetrated into 90% of supermarket produce. Is it a mystery why we have an epidemic of obesity? Duh! In the interest of brevity, I suggest two quick solutions:

- Get most of your food from Farmer’s market.

- Read the labels: Buy only foods with few ingredients, preferably without sugar, high fructose corn syrup in it (also don’t forget partially hydrogenated oil and artificial colorings). If sugar is listed, make sure it is toward the end of the ingredient list.

- Dr. Mariam Manoukian

   

Everyday Cranberry and Pear Relish

I am not usually a huge fan of cranberry sauce.  The obligatory sickly sweet red goo that accompanies turkey on Thanksgiving has never been my fave.  However, given the task of bringing cranberry sauce to our potluck holiday dinner, I decided to experiment with recipes.  Looking through the internet and magazines, I found two versions that piqued my interest. This version was given a thumbs-up by my family and, most importantly, by our hosts Jennifer and Brad.  Cranberries, pears, and citrus fruits are fall and winter seasonal foods which is a bonus when shopping for local produce this time of year.  I modified the sugar asked for on the cranberry bag by half because the pears provide perfect sweetness.  Try this on roast pork and chicken instead of just turkey.

Three pears allow for minimal sugar required to sweeten the berries.

serves 10-12                     prep time: about 30 minutes

3 pears, peeled and coarsely chopped

1 bag cranberries, rinsed

1/2 cup sugar

1/3 cup dried cherries

Squeeze of lemon, optional

Into the pot they all go.

Place all ingredients in a saucepan and bring to a slow boil.  Stir regularly with a wooden spoon.  As pears soften and cranberries "pop", squish them down.  After about 15-20 minutes, you should have a fairly smooth mix.  Turn off the heat and use a potato masher to further reduce any lumps.  Cool and serve.

This is almost fully cooked.  A little more time, then a mashing,
and the sauce/relish is ready.  A surprise occured when all the kids
at the table gobbled it up.  Cool!

When I calculated calories (fitday.com) I came out with about 780 calories for the whole batch which includes about 25 g. fiber, and a measly 1 g of fat.  Divide by 10 or more, and you get about 80 calories, 3 g fiber, and 20 g carbs per serving.  Don't forget the value of cranberries for urinary tract health and antioxidant properties.  Cheers!

-Kim Fielding

Watermelon Radish Salad

Vivid colors make your salads come alive. 

I first saw watermelon radishes at my nephew's wedding.  The thin slices adorned a side salad and had everyone talking about the unusual yet familiar coloring.  They have a mild peppery flavor.

serves:  6                           prep time:  15 minutes

6 ounces mixed lettuces, rinsed and dried
2 watermelon radishes, thinly sliced
2 scallions, sliced
1 ounce feta cheese, crumbled
1/4 cup toasted pumpkin seeds or pepitas

Vinaigrette
1/3 cup light olive oil or canola oil
3 tablespoons white wine or rice vinegar
Salt and pepper to taste

Add the salad ingredients to a large bowl.  Mix together the vinaigrette and add enough dressing to moisten the salad.  Arrange the salad onto plates and serve.  About 175 calories per serving.

- Kim Fielding

Toxic Cleanse Drink



Fresh picked from the garden except the ginger and pears.
This drink requires a juicer or a vita-mix type of processor.

Green drinks seem to be the rave among those who wish to cleanse themselves of impurities within their bodies.  After trying a 21-day green clean, I felt better than I have in years.  My skin cleared up, joints weren't as achy, I slept better, and my normally dry skin was smooth.

The ingredients are variable but the ones I like best are in my garden.  However, green is the word here with regard to what goes into the drink.  This is an adaptation of a recipe I found in the Crazy Sexy Life cookbook and website.  If you don't have pears, use apples. 

This recipe makes about 1 quart.

6 dino (Lacinto) kale leaves
4-6 Romaine leaves
4 celery stalks
2 pears, peeled if not organic
2 cucumbers, peeled if not organic
1 large or 2 small broccoli stems
1 piece of ginger, peeled

Process all in a juicer.

I sip this all morning.  If hunger presents itself, a handful of walnuts helps.  Once noon hits, you can add in whole foods (such as steamed brown rice with vegetables) and save the rest of your drink for tomorrow.  The entire recipe contains around 400 calories and offers one-third your RDA for potassium, lots of B vitamins and minerals, and over 100% of your vitamin A and C needs.

- Kim Fielding

Pear and Kohlrabi Salad

A pear, kohlrabi, and walnuts.

Pears are in season this time of year and the varieties available will delight your palate.  Delicious in salads and desserts, and by themselves, pears have more than 5 grams of fiber and less than 100 calories.  A medium pear makes a great afternoon snack that will hold you until dinner time.

Kohlrabi is somewhat alien-looking with the many shoots coming out of it.  A cultivar of cabbage, one cup of kohlrabi offers almost 5 grams of fiber and about 35 calories.  It has a very mild broccoli-like flavor and can be consumed raw or cooked.

The two are paired with walnuts and a light vinaigrette to create a fresh side salad for chicken or pork.  I originally saw a similar recipe on Our Big Earth website.  Nutritional calculations thanks to Fitday.com.

serves: 2                             prep time: 15 minutes

1 pear, cut into matchsticks
1 kohlrabi, peeled and cut into matchsticks
1/4 cup toasted walnut pieces

Vinaigrette:
1 tablespoon honey
1 tablespoon olive oil
juice of 1/2 lemon
salt and pepper to taste

Place the prepared pear, kohlrabi, and walnuts in a bowl.  Whisk together the dressing ingredients and adjust seasoning.  Mix into the salad and serve.

One half of the recipe provides 250 calories, 6 g fiber, 3.6 g protein.

- Kim Fielding

Yogurt

I like yogurt.  No, I'm practically in love with yogurt. Yummy!

How is that possible that someone doesn't like yogurt?  It has a smooth, silky, shiny softness that you can cut through even with an unarmed teaspoon. It has those millions, or billions, or trillions of  bacteria, but, what is the difference in those numbers, anyway.  Bacteria that populate your gut and turn the rocky intestines into a beautiful resort for your gut neurotransmitters.

Yogurt is the new superfood and as always its modest health benefits have turned into a myth/panacea in the hands of the eternally creative food industry.  As a result, the refrigerated sections of dairy produce in supermarkets are overflowing with new brands of yogurt of every possible flavor and additive in it, from acai berry to granola, from pomegranate to vanilla and honey.  And here we go again, Great-Grandma would be shocked if she had seen the variety compared to the homemade yogurt that she used to make in an unlabeled jar.  She poured the hot milk and dipped her finger in to check the temperature, added the starter, and snuggled it into an old worn out towel. Lots of plastic and colorful labels and cute names took over the old grandma skill. 

Is yogurt another vitamin or supplement that appears on the scene with fanfare to bring lots of controversy and eventually claims of pure fiction or even harm, just like vitamin E, carotene and etc? Maybe. But most likely not. 

Bifidobacterium  and Lactobacillus are the friendly bacteria in our gut and for many years have been shown not only to aid digestion but to also to protect humans against the all-killing effects of antibiotics.  Recent  studies also shown a positive effect of yogurt against H. pylori infection. Bacteria in the yogurt also possibly strengthens our immunity.  Your bones certainly will benefit from the calcium in the yogurt.  

When buying yogurt make sure it has active culture, lacks artificial sweeteners, colors, and high fructose corn syrup.  Take the plain yogurt and add some berries, or tangerine slices, nuts and maybe a tablespoon of granola.  If you crave something sweeter add a teaspoon of honey.   

-  Dr. Mariam Manoukian

Cool Salmon for a Hot Day



This dinner is very low in calories with a side roll and fruit salad.  We
like this when the weather is hot and don't feel that hungry.  Start
 by poaching your salmon filet earlier in the day and keep it chilled in the refrigerator.

Yesterday boasted 100+ degree weather here in the Bay Area.  My family needed a supper that wouldn't heat up the kitchen and was cool to eat.

A shredded vegetable salad tossed with lime vinaigrette and topped with poached salmon seemed like a good idea.  The salmon was cooked early in the day and kept chilled.  Served with fresh fruit and a whole grain roll, this was super simple and refreshing.

Serves:  1 

Place a 3 or 4 ounce salmon filet in a medium-sized skillet and add enough water to cover.  Simmer for about 7 minutes or until cooked through.  Don't overcook if you can help it or it may dry out.

The vegetable salad was comprised of what was in the refrigerator.  Using a vegetable peeler, I shredded a small peeled cucumber and a carrot and added it to a bowl.  A thinly sliced whole baby Bok choy was next.  Finally a handful of chopped parsley.   This was tossed with 1/2 of a large lime squeezed, a tablespoon or so of canola oil, and sea salt and pepper to taste.  Extra lime was sliced and served with the salmon.

Calories for 3 ounces of poached salmon, the shredded salad, a cup of chopped fruit (watermelon, canary melon, and pineapple), and a whole grain roll comes to about 440.  Vitamin C and B12 requirements are met for the day and a quarter of your potassium needs are met.  This meal is also high in selenium which is good for your eyes, as well as Vitamin A. 

Experiment with veggies you like and are in season, add a little protein, and voila(!) you have the start of a healthy meal.  Have fun!

- Kim Fielding

Chicken with Bok Choy and Cucumber over Rice



Refreshing and filling chicken with vegetables and citrusy soy sauce.

Hot summer nights mean that I don't always want to cook or even think about turning on an oven. I want to prepare and eat something cool and refreshing yet filling for the three sons. This recipe was designed last year for the Alpha Plan and continues to be a hit. Adapted from a recipe found in Bon Appetit (May 2008), the original called for snow peas, but I swapped in fresh broccoli florets instead which worked fine. This evening, the mix was served over brown rice, but noodles are good too.

Prepare the chicken, veggies, and rice or noodles in advance and place in the refrigerator until everyone is ready to sit down to the table and eat.  Add the dressing just before serving or the chicken will get mushy.

serves:  4                    prep time:  30 minutes

2 skinless boneless chicken breast halves
3 cilantro sprigs plus 3 tablespoons chopped cilantro
2 green onions, chopped
1 crown of broccoli, cut into small florets
1 baby bok choy, thinly sliced crosswise
½ English cucumber, quartered lengthwise, then thinly sliced crosswise
2 tablespoons ponzu sauce or soy sauce
2 tablespoons seasoned rice vinegar
2 tablespoons vegetable oil
2 teaspoons minced peeled fresh ginger
Brown rice, rice noodles, or pasta, cooked

Poach the chicken breast by bringing a medium skillet filled with salted water to simmer. Add the chicken breast, 3 cilantro sprigs and half of the chopped green onion.  Cook until chicken is no longer pink inside about 7-10 minutes depending on the size of the breasts. Transfer chicken to a platter to cool.  In the same water, cook the broccoli until crisp tender, about 1 minute.

Drain and cool the broccoli, discarding the green onion and cilantro sprigs. Coarsely shred the chicken. Mix chicken, chopped cilantro, the other half of the chopped green onion, broccoli, bok choy, and cucumber in a bowl and set aside in the refrigerator until ready to serve.

Whisk together ponzu, vinegar, oil and ginger in a bowl. Add dressing to the chicken mix and toss to coat. Season to taste with salt and pepper.  Serve over rice or noodles.

Place one cup of steamed brown rice or noodles on a plate and top with a quarter of the chicken vegetable mixture.  Serve watermelon slices on the side.  This entire meal offers under 400 calories, almost 7 g fiber, lots of vitamins C, several B vitamins, selenium, phosphorous, and manganese.

*Ponzu Sauce is basically a citrus enhanced soy sauce. You can squeeze one teaspoon each orange and lemon juice into ½ cup soy sauce. It can be refrigerated for a week or more.

- Kim Fielding

Crispy Panko Chicken

Chicken thighs are moist and flavorful with this preparation.

Chicken thighs were on sale this week so I took advantage of the opportunity to make an inexpensive and easy to prepare main course.  Juicy on the inside and crispy on the outside, the pepper infused oil adds just a hint of spicy heat to the coating.

serves: 12                    prep time:  15 minutes
                                  cook time:  40 minutes

Preheat the oven to 400 degrees.

12 boneless skinless chicken thighs
1/3 cup canola or olive oil
1/4 teaspoon cayenne pepper
2 cups of panko (Japanese style bread crumbs)
1/2 teaspoon salt
1/4 teaspoon pepper

Place the oil and cayenne pepper in a heat-proof dish and warm to meld the flavor of the pepper into the oil (microwave 15-20 seconds).  In a pie pan, add the bread crumbs, salt, and pepper, and mix thoroughly.  Using your hands, moisten them with a teaspoon or so of oil and rub it all over a chicken piece.  Place the lightly oiled chicken thigh into the seasoned panko and turn so that both sides are covered with the crumbs.  Repeat this for all of the chicken pieces and place on a shallow baking sheet. 

Bake chicken until well browned and cooked through, 30-40 minutes.  Allow the chicken to stand, uncovered, 5 to 10 minutes to let crisp.

Each piece of panko crispy chicken has approximately 240 calories.  Delicious served with steamed veggies, a large green salad, and brown rice.

- Kim Fielding