Moving!

I've been writing this blog with two main target audiences in mind. One group I've been writing to is the patient that might benefit from more information on nutrition, lifestyle and health. The other group is the acupuncturist or health care practitioner who might benefit from summaries of studies I'm reading or things I find in the research, which may apply to their practices, or they might just find interesting.

I've split these up now. For patients trying to keep track of new articles on various health concerns I've started doing those over at my Healing Jones blog. As of this post, I just finished a recipe for bone broth that I think my patients will really benefit from. I would encourage my patients and lay readers to keep track of postings there and post questions or comments on those articles as this is a great venue to discuss these topics.

For practitioners looking for juicy research developments those will continue here at Modern Herbal. For my next article I'm gathering research on how the variations in the microbiota may influence the absorption of different herbs in our pharmacopeia. I'm pretty excited about that, and there is some pretty neat stuff out there.

How to Prevent Alzheimer's Disease with Bottled Water

Alzheimer's disease is a slow, tragically insidious, soul wrenching disease. It grinds out a gradual destruction of neurons by causing neural atrophy, and gumming up the wiring with amyloid plaques and neurofibrillary tangles. It doesn't just result in a slow death, it also washes out a person's personality and independence. Who they are ceases to be before their physical shell does, and that is traumatizing to witness. We can't say that we've got a full understanding of everything that is happening. What we can say that it is a multi-factorial disease. Like most diseases of modernization (autism, diabetes, auto-immune disease, cancer) there are a lot of causative factors in Alzheimer's disease.

Our current understanding puts a lot of emphasis on a few key factors: insulin function in the brain, vascular damage, and neurotoxicity from environmental toxins. Aluminum has come up in research over the years, and while there is nothing approaching a consensus on this factor, it remains a significant area of ongoing research. Aluminum, like any mineral, is important but not by itself. Our understanding of minerals, and indeed all nutrients, has evolved. Our current understanding of minerals (not yet embraced by all) is that minerals act in coordination with each other, and no mineral can be understood in any valuable way without the context of other minerals and nutrients it occurs with.

One mineral that has gained a lot of popularity for its importance in chronic disease is magnesium. Most of the people who read this blog know that most people eating the Standard American Diet (SAD) are deficient in magnesium, and that supplementing it is important for their health and can improve various conditions from insomnia to heart disease and high blood pressure. But there are a lot of other minerals that are being ignored and the intake of them can be just as important. One that is less talked about is silica. Silica is an important mineral to discuss, and as you will see it bears heavily on the development and prevention of Alzheimer's disease.

Silica is one of the 3 most abundant elements on the planet (along with aluminum and oxygen), but isn't much talked about. On the surface there doesn't seem to be much to talk about. When we examine the presence of silica in our bodies not a whole lot shows up. We see it present in connective tissue and bones mainly, where it contributes to the matrix lending those structures their strength and resiliency. But, when it comes to interacting with our biology from an enzymatic stand-point, it is basically inert. Magnesium plugs in as a key player in all sorts of enzymatic processes in our bodies. Unlike magnesium, there don't seem to be any enzymes that use or rely on silica to function.

It does, however, perform one very, very important job in the body. Remember that aluminum and silica are 2 of the 3 most common elements on our planet, and as such our biology is built around these elements existing in a particular ratio in the food and drink we take in. Our body, in its incredible, brilliant complexity, has evolved a process using silica to chelate excess aluminum out of our bodies. Silica in a meal with aluminum will also prevent it from being absorbed in the first place. In the proper, naturally occurring ratio it does a pretty good job of doing that. When our intake of micronutrients is generally low, as it is with current agricultural techniques, we don't get nearly enough silica. Yet aluminum is ubiquitous. It comes from our cookware, it's in storage containers, and it's used in drinking water treatment plants so it's in city water. Basically, we get way too much aluminum, and without the silica to counter it, our bodies accumulate excess aluminum. That's not a good thing.

Getting that excess aluminum out of the body is important, because aluminum has been found to be neurotoxic. The plaques formed in Alzheimer's disease contain aluminum. Most of the studies on Alzheimer's find that people with higher aluminum exposure are more likely to develop Alzheimer's. (For instance: http://www.sciencedirect.com/science/article/pii/S0361923001004592).  And all of the studies looking at the effect of aluminum on brain function find it to be neurotoxic.

Studies also demonstrate that patients who consume more silica (due to increased amounts in their food and water) tend to have lower levels of dementia and Alzheimer's disease. (Here are two examples: http://ajcn.nutrition.org/content/81/4/897.short, and http://aje.oxfordjournals.org/content/169/4/489.short.)

This is a great example of evolutionary biology setting us up to function best in a particular environment. Our job then is to fix our exposure to come more in line with the biology we have developed. The trick is, how to get that silica? Unfortunately, in the majority of food sources silica is not well absorbed. We don't get a lot out of the fibrous vegetables that contain the most (celery, chard, kale). Silica also comes in barley, oats and other grains, in which it can be much better absorbed. It will be concentrated in the outer layers of the grain so whole grains are the best source. Its presence in grains in turn means that it will be present in beer, the highest content is found in IPA, (Indian Pale Ales, cheers). Without knowing the aluminum content of those foods you won't really know the amount of silica you are absorbing (remember that silica is bound to aluminum in food, preventing your absorption of either). While it's great to not absorb that aluminum, the silica isn't helping to clear excess aluminum from your body if it is just going through the intestines, so the trick is to get it from sources free of aluminum.

A great option is drinking water from a region where the water is naturally high in silica. This is the case with water coming from areas with a significant amount of volcanic rock. One safe and easy source is the "Fiji" brand of mineral water. They list the silica right there on the side of the bottle, 92 mg/L (more than twice the daily intake of the subjects in the study below). This is an effective and safe way to obtain a measurable increase in your silica intake on a regular basis. This pilot study (http://www.ncbi.nlm.nih.gov/pubmed/22976072) found that silica rich mineral water resulted in reduced body burden of aluminum (measured by a steady reduction in urinary excretion of aluminum). This study also found that the cognitive function was measurably improved in 20% of the dementia patients in this study with the only intervention being regularly consuming 1 liter of water containing 35 mg of silica daily for 12 weeks.

Given this information it should follow that the rate of Alzheimer's Disease should be very low in Fiji, and in fact it is. In a 192 country ranking Fiji rates right near the bottom at 190th out of 192. The United States, for comparison, is number 3.

The participants in this study used 35 mg of silica per day in drinking water. One half liter of Fiji mineral water is enough to maintain that dosage, which amounts to less than a dollar per day. It's also a therapeutic option that has no significant down side. If it works (which the science certainly indicates it should), then great. If it doesn't work, you paid a little extra for water, but still probably improved your health by staying better hydrated.

There is obviously another significant argument to make here about whether or not you can justify shipping water bottles made in China to a remote island to be filled with a jungle damaging industry in an otherwise pristine area, then shipped further across the ocean to briefly support our cognitive function before becoming just another empty plastic bottle in the recycling or the landfill. I'm going to gracefully decline involvement in that argument and leave that decision up to you. If you can't bring yourself to do it, and I don't blame you, you can always just supplement with silica instead.

PS: Here's the cheapest option I found for Fiji water:
FIJI Natural Artesian Water, 50.7 -Fl. Oz Bottles (Pack of 12)

And here's a great book about Alzheimer's by my aunt, and about my grandmother:
Elsie at Ebb Tide: Emerging from the Undertow of Alzheimer's

FAHF-2 Chinese herbal formula for peanut allergies

Never has such a small, modest legume been so feared as the peanut for the allergic person. It's notorious for creating significant anaphylaxis reaction in those susceptible.

Food allergies such as this one are caused by an excessive immune response mediated by IgE. Symptoms typically appear within several minutes and can include abdominal pain, diarrhea, vomiting or an anaphylaxis reaction involving throat swelling and rash.

Treatments that have been explored include extended courses of injecting minute amounts of peanut protein, or administering small amounts of peanut protein orally to desensitize the immune system. These approaches have been met with overwhelming indifference. In the case of the injected proteins, a subject was killed instantly by a miscalculated dose that put an end to that investigation. In the case of oral desensitization, it's a long and slow process, but has made its way into regular clinical application For many it's too time consuming or too expensive. It requires going into the doctor weekly for more than 40 weeks. 

Our understanding of how these allergies occur within a Chinese Medical paradigm would be an interesting discussion. But, an article in the Journal of Allergy and Clinical Immunology might help answer that question for me.  

Some serious rockstars (Srivastava, Dr. Li and friends) at Mount Sanai School of Medicine have tested an herbal formula that was able to entirely eliminate the anaphylaxis reaction in mice with peanut allergies. The formula, called "Food Allergy Herbal Formula" (FAHF for short), and it's successor FAHF-2 are modified versions of Wu Mei San. The initial formulation included xi xin and fu zi, FAHF-2 did not, but was still effective. Other researchers in other facilities took this and ran with it, and there have been and are several studies all over examining this effect and trying to understand it. (here's the study: http://www.ncbi.nlm.nih.gov/pubmed/15637565 not sure if there is a full text version out there, but if someone finds one could you post a link to it in the comments? I have the full text version so I'll try to summarize all the important details :) 

There are actually a lot of really interesting things to learn from these papers. Not the least of which being that they could get rid of a food allergy! But also, how exactly did they get mice to be allergic to peanuts in the first place? And what does that tell us about the allergic process in general? Not only that, but in the study we are examining they also did some tinkering with the murine immune system prior to the study, depleting the CD4 T cells in some mice and the CD8 T cells in other mice, and neutralizing the interferon gamma in a third set. This makes it possible to identify which aspects of the immune function the herbal formula acted through.

So I know it's the first thing you want to know, so I'll tell you now here are the ingredients, it's a modified Wu Mei San:

Prunus Mume

Zanthoxylum schinifolium

Angelica sinensis

Zingiber officinalis

Cinnamomum cassiae

Phellodendrom chinense

Coptis chinensis

Panax ginseng

and Ganoderma lucidum

and the Chinese:

Wu Mei

Cang Er Zi

Dang Gui

Sheng Jiang

Gui Zhi

Huang Bai

Huang Lian

Ren Shen

and Ling Zhi.

Here are the juicy tidbits:

First an immune hypersensitivity to peanuts was established. The specifics about how that happened is interesting. Here's a previous study that looked at how this is done: http://www.ncbi.nlm.nih.gov/pubmed/21762973. The authors found that in order for an antigen to result in an allergic response it needed to be administered with an adjuvant (read "toxic ingredient") to completely freak out the immune system. In the absence of a wickedly toxic tag-along these antigens could not create an allergic reaction. In these mice they mixed cholera toxin with pureed peanuts and fed it to the mice over a 5 week period. When they fed these mice plain old peanuts at week 14 they had increased histamine response, lower temperature, and peanut specific IgE and IgG indicating indeed they now had a peanut allergy. (did we need more reasons to avoid toxins in children and breastfeeding mothers, anyway?)

They administered 64 mg of the herbal mixture twice daily for 7 weeks (from week 8 through week 15). The ratio of each herb in the final formula isn't available in this paper, but is published in "phytotherapy research." I've requested a full text from the author...fingers crossed. I'll let you know if I find out. 

So in the FAHF-2 treated mice the peanut allergy was completely abolished for 40 weeks and even at up to 90 weeks they had only a very mild reaction. The sham group had significant reaction to the peanut challenge at every testing (done 7 times over 50 weeks) with "near fatal reactions." (In fact one mouse did die from the peanut allergy challenge at week 40. Our hats go off to him in gratitude as he joins a long list of mice suffering for the sake of our health going all the way back to the tortured specimens of Hans Selye.) 

The discussion section suggested the benefits are a result of a relative increase in the TH1 division of the immune system (demonstrated by the attenuation of the FAHF-2 effect with neutralization of interferon gamma, and with the depletion of CD8 cells.)

There is currently a human trial going on using FAHF-2 in peanut allergies with promising preliminary results. The ability to rebalance an imbalanced Th1/Th2 immune system is a significant accomplishment with far reaching implications. It is also a useful piece of information as we consider which herbal formulas fit our patient's presentations. It is disturbing that this information isn't spreading quickly across our professional circles. A repurposing of our medicine with this sort of clinically validity is big news for us, and we should be the first to know, not the last. It's an exciting and valuable opportunity to gain a more nuanced understanding of how our herbs influence the immune system in general. It also has repercussions in how we approach clinical problem solving. It echos teachings from Heiner Fruehauf that urge us to reframe our idea of parasite, or Gu patterns as encompassing a wider range of conditions involving systemic immune dysfunction and chronic illness. 

For more information on Gu syndrome look at Heiner's stuff here: 

http://www.prodseminars.net/product/gu-syndrome-unique-strategies-treatment-chronic-fatigue-syndrome-fibromyalgia-lyme-disease-p

and here: http://www.classicalchinesemedicine.org/wp-content/uploads/2010/04/fruehauf_guinterview.pdf

For a great blog on food allergies and the experience of a human subject in the FAHF-2 human trial:

http://foodallergybitch.blogspot.com/

And here's a link to the an article by Jake Fratkin on Dr. Li's work on allergic conditions including this formula:

http://www.acupuncturetoday.com/archives2005/dec/12fratkin.html

Gu Sui Bu, Mender of Shattered Bones

Glad to be back writing blog articles again.  I've been busy getting a new practice running and all the necessary hoop jumping done.  But I'm back, and my new working situation will allow me a lot more time to dig through studies and write this blog.

This is an entry for the herbalists, any patients out there, and the general public may want to tune out, because this is gonna be rich with biology mumbo jumbo and herbalist jargon.

The herb gu sui bu, some may recall, has the action of speeding the mending of broken bones. It translates to literally "bone medicine mender." Interesting stuff.  Every once in a while I'll tell a patient something that is apparently completely ludicrous.  Like, "this root can really speed the healing of your bones."  Or better yet, "did you know that there is a type of cockroach used in chinese medicine that can help to knit fractures and tears back together?"  The incredulous stares have qi and blood dispersing functions on their own.  I'm often forced to go find a study in order to create any real belief that this stuff has a foundation in reality.  Well, I dug up one such study regarding Gu Sui Bu, because I was trying to get a recent fracture patient to use it.  The study was fascinating so I thought I'd pass on what I learned.

"The Effect of Gu-Sui-Bu (Drynaria fortunei J. Sm) on bone cell activities." Biomaterials Journal 2002.

Previous efforts to identify the mechanism by which Gu Sui Bu might increase bone mineralization have demonstrated actions, but were insufficient to fully explain the benefits.  The authors of this study utilized bone cultures that included osteoblasts and osteoclasts, and used an alcohol extraction of gu sui bu, and did find multiple mechanisms.

When I hear about an herb increasing bone density I think that perhaps there is some impact on calcitonin and/or parathyroid hormone synthesis, metabolism, or signaling.  Perhaps this was the target of previous studies, and explains why they didn't find any effect. If you look into the traditional use of this herb, however, you would save yourself the time, because in addition to increasing bone mineralization when taken internally, Gu Sui Bu is also used to harden the teeth used topically.  (non-toxic alternative to fluoride?)  This action would be absent if Gu Sui Bu's actions were mediated through hormonal activity.

The authors of this study found that adding gu sui bu extraction to a bone culture indeed did yield increased mineralization.  They measured the effect of gu sui bu on a number of things: osteoblast concentration, mixed bone cell concentration, alkaline phosphatase (dephosphorylates) (ALP), acid phosphatase (phosphorylates) (ACP), and Prostaglandin E2 (mediates osteoclast binding and bone reabsorption)(PGE2).  They also measured the Osetonectin and Osteopontin mRNA in the cultures. These are two extracellular matrix proteins that are involved in the spreading of osteoclasts through bone tissue, and the mineralization of new bone.

Previous studies had found that Gu Sui Bu have anti-oxidant activities for osteoblasts specifically.  This study also found that Gu Sui Bu affected the cell numbers in a culture, ALP and ACP, and PGE2 as well as the expression of osteonectin and osteopontin.

They found that initially, many markers indicated slower bone formation when gu sui bu was added.  ALP decreased, as did cell concentration.  However by day 3 the effects had reversed considerably, and by day 7 the gu sui bu cultures were indicating significant increased bone formation over the control.

ALP increased, as did ACP in the cultures.  The formation of osteopontin decreased, and with the increased presence of ACP in the matrix, the osteopontin that did present was dephosphorylated faster.  When dephosphorylated, osteopontin's action of assisting the adhesion of osteoclasts is decreased, and bone breakdown slows.  The PGE2 present in the gu sui bu culture also increased significantly (over 25 times that of the control).  PGE2 among other things, inhibits the formation of osteoclasts into multi-nucleated super osteoclasts that break down bone rapidly, further slowing breakdown.

So, interestingly, most of the actions Gu Sui Bu has on improving bone mineralization are due to restricting the actions of osteoclasts, rather than enhancing the actions of osteoblasts. The effects are contrary initially, but pronounced after a week, so administration should continue for several weeks at least. While topical application is appropriate for teeth, the jury is still out whether or not it can be applied to the skin over a fracture and have beneficial actions. (although the pain relieving actions are fantastic!)

The Synergy of Chinese Herbs

Herbal prescription in Chinese Medicine follows advanced and sophisticated dosage and combining protocols. For example an herb may have a specific action like raising prolapsed organs (for instance the herb sheng ma), however that action may only come out when that herb is prescribed with other herbs with similar actions. An herb might treat a particular symptom, but when prescribed with a guiding herb is capable of treating a related but different symptom in a different part of the body. In short, herbal medicine combining, or Dui Yao is not a additive, cumulative science, but a complicated science of synergy and complex interaction.

(entirely off topic, here's a really great video for any adrenalin junkies out there, if you haven't seen this nut, you should.)

Anyway, this is a pretty fascinating topic. We have a sense of how these things operate from a Chinese Medical Paradigm. Within our strange and interesting Chinese Medicine brains, acupuncturists really get these relationships, they make sense and are intuitive, because we have taken the time to build the rules and thought processes for how this world operates. Within the framework of western sciences these relationships are much more difficult to identify. In truth, like a lot of what happens in Chinese Medicine, western science just hasn't caught up yet. But there are some promising approaches developing out there, and I found one particularly interesting study.

"Synergistic therapeutic actions of herbal ingredients and their mechanisms from molecular interaction and network perspectives." (sorry no full text, but I'll try to give you all the juicy details.)

What this paper sought to do, was to elucidate the mechanisms by which herbs interact. (one example of this is Jiao Tai Wan. Huang lian and rou gui interact synergistically to improve symptoms of xin shen bu jiao (noninteraction of heart and kidney)). Chinese Medicine is rife with these sorts of combinations: nu zhen zi and han lian cao; gan cao, sheng jiang and da zao; sheng ma and huang qi; huang lian, huang bai, and huang qin; ma huang and gui zhi; bao shao and gan cao...and so on. We identify each of these combinations as embodying powers beyond the contributions of each individual herb. In some cases entirely new functions are created that are not found, even in lesser power, in the constituent ingredients.

Often one herb alters the ADME (absorption, distribution, metabolism and excretion) of the other. This is suspected to be the case in Jiao Tai Wan, and particularly with regard to absorption. As this study shows, the specific ratio of huang lian to rou gui enhances the absorption of huang lian across the intestinal membrane, thereby increasing the activity of huang lian without increasing its dose.

Constituents also act as teams to influence change in the body. This sounds oddly reminiscent of our understanding of how to build a formula with chief, deputy, assistant, and envoy.

a. Anti-Counteractive: reduce a network's counteractive activities against a constituent's effect. 

b. Complementary: actions positively regulate a target or negatively regulate a competing target. 

c. Facilitating: secondary actions of one constituent in enhancing the activity level of another. 

d. Potentiative modulation: affecting things like cell transports, permeability, delaying or reducing first pass excretion, or metabolism, all of which enhance the activity of the first constituent. 

 The paper gave some examples of studies that have been done into single herb synergism (multiple constituents in one herb act together to have effects larger than the effects of the individual constituents added together), as well as synergism from multiple ingredients.

Berberis:  Plants of this family contain the two key ingredients berberine and 5' methyoyhydnocarpin (5 MHC). What's interesting about these two ingredients is that while berberine has pretty good antibacterial actions, it is much more potent when in the presence of 5 MHC. In order to see why think about a bacteria. Bacterial cell walls have special little pumps on them that work to pump out synthetic and natural antibacterial agents, and keep them from killing the bacteria. These pumps are called multi drug resistant pumps. 5MHC inhibits the activity of these pumps allowing berberine to accumulate inside the bacteria and result in much more effective treatment. I'm not sure whether our big berberine herbs (huang lian, and huang bai) contain 5MHC. A quick glance at Chen didn't answer that question. If anybody out there knows let me know. (here's a link to the full text of this interaction.)

Onions and Garlic: Ancient food pairing. Goes together like acupuncture and flutes, especially in the presence of rich or fatty foods. Conveniently enough when together onions and garlic act in a synergistic manner to inhibit the peroxidation of lipids. You heard me right, go big on the onions and garlic to keep those newly absorbed triglycerides and free fatty acids from turning into little artery cloggers. This one is pretty tangled and complicated...what they found is that they could feed someone 100 grams of butter (sounds like a dare I responded to as a teenager), and onions and garlic limited the increase in serum cholesterol and plasma fibrinogen, and increased fibrinogen activity and clotting time.    Onions contain quercitin, myricetin, and kaempferol all of which inhibit various enzymes involved in splitting fats (lipoxygenase 5, 16, and phospholipase A2). Garlic contains sulfurous substances (diallyl disulfide, diallyl disulfide, allicin, alliin, ajoene, N-acetyl cysteine, S-allyl cysteine, S-ethyl cysteine, S-methyl cysteine, S-propyl cysteine) all of which inhibit the mechanisms that the body uses to upregulate those now-downregulated lipase enzymes, allowing the onions to have a stronger effect than they would otherwise. This is an example of an anti-counteractive effect.

Gou Teng and Tian Ma: These two herbs are found in the formula Tian Ma Gou Teng Yin, used for wind due to rising liver yang. This study looked at these two herbs and their actions on decreasing convulsions. Gou teng contains Hirsuteine, which decreases the incidence of seizures by blocking nicotinic receptor ion channel complexes. Tian Ma contains vanilline which inhibits acetylcholinesterase and butyrlcholinesterase, which results in decreased seizures caused by acetylcholine. But unfortunately this decreases acetylcholine degradation, which increases the activity of nicotinic acetylcholine receptor, which would lead to more seizures, if it wasn't for the actions of Gou Teng and that Hirsuteine, blocking nicotinic receptor channels. An example of what the study called an "anti-negatie effect."

Ren Shen and Zhi Gan Cao: The formula ban xia xie xin tang, among others, utilizes this combination. This combination was investigated in ulcerative colitis.  The authors used the entire formula, as well as individual isolates and those isolates in combination. The combination of ginsenoside saponins (GS) and glycyrrhizin (GZ) was effective beyond the effect of both used alone. GS is effective in decreasing the activation of defective Th1 response, while GZ is effective in suppressing defective Th2 response. Together they cover both divisions of aberrant immune response, resulting in benefit beyond either alone. I wasn't aware before reading this paper that this division existed in between these two herbs. That makes these two herbs a handy herb pair that I am likely to employ in my auto-immune formulas in the future, as long as the pattern fits.

It's nice to have western science backing us up for a change, but I'm not convinced of the power of these sorts of methods to really offer a whole lot to our understanding of Dui Yao at the moment. I for one will continue to trust the time honored classics in my herb pairing over the pages of "Bioinformatics and Drug Design." I think that most herbalists out there feel the same way. Studies can provide us with the nitty gritty molecular interaction details about why what we've been doing for thousands of years works so well, but at this point the main things they are likely to add are improvements on delivery methods and small tweaks on use. But the real gems are still to be found in the pages of the Shang Han Lun, Jin Gui and, for me the Pi Wei Lun. It doesn't mean that the information about absorption, distribution, metabolism and excretion isn't important. We are likely to need to know more and more of this in order to stay current in this field. Now excuse me while I go get some onions and garlic chopped for dinner.

Choosing Effective Supplements

The subject of supplements comes up a lot with my patients and the brand you choose has a lot to do with whether or not it is going to work for you. There are some not great companies out there selling substandard product. Here's all the information you need to navigate this area of health. In this blog post we cover:

-How to distinguish quality products from inferior products.

-How to ensure safety in dosage and use.

-A few strategies you can use to maximize benefits.

-Some general recommendations

First: How to distinguish quality from inferior products:

In 1994 the FDA passed the DSHEA (Dietary Supplement Health and Education Act. It laid the responsibility for the products safety on the shoulders of the manufactures, and left as well the responsibility of screening and testing on the companies as well. As long as no one is watching, many companies would just as well not do the testing, or put out inferior products knowing there would be no repercussions for it. From he FDA website: 

“the dietary supplement or dietary ingredient manufacturer is responsible for ensuring that a dietary supplement or ingredient is safe before it is marketed. FDA is responsible for taking action against any unsafe dietary supplement product after it reaches the market. Generally, manufacturers do not need to register their products with FDA nor get FDA approval before producing or selling dietary supplements.”

This means that it is up to use to police these supplements. There are a lot of ways that manufacturers can create inferior products. The first thing to understand is that there are a lot of possible ingredients in a supplement besides just the ingredient you are looking for. Let’s say your taking milk thistle for liver health. Well, there may be much more than just milk thistle in your supplement. Here’s a picture of the typical anatomy of a supplement:

As you can see there is much more going on here than just the main ingredient. In a lot of cases these other ingredients may be causing serious harm in your future, while you think you are taking care of your health. Here’s a look at some of the most dangerous additives to supplements:

Parabens: Common preservative material, have estrogen like activity in the body affecting both men and women:

-Methyparaben

-Ethylparaben

-Polyparaben

-Butylparaben

Pthalates: Used as a plasticizer. Estrogen like material that will stimulate our receptors. Resulting in infertility, sexual dysfunction, and increase risk of cancer.

-Benzylbutylpthalate

-Di2ethylhexylpthalate 

-Diisodecylpthalate

Notice that “paraben” or “pthalate” is only at the end of the ingredient name, without knowing this, you might well pass right over the ingredient name as you scan through.

Titanium Dioxide is another interesting additive. In it’s natural form it is pretty benign. But much of the titanium dioxide is in the form of superfine particles, or nanoparticles. These have been found to cause some pretty significant health issues. Here’s Christopher Chang from the May, 2010 issue of the “Journal of Autoimmunity.”

“Nanomedicine has already opened up a new avenue of research in cancer therapy, drug delivery, and immune regulation. While the benefits of this new science to human civilization are seemingly immeasurable, it is also important to appreciate that these particles can also lead to harmful effects on human health.”

-and again:

“Increased mutation frequency has also been described in cultured human lymphoblastoid cells exposed to ultrafine TiO2 particles. TiO2 nanoparticles have been shown to be cytotoxic in mouse fibroblast cells...”

And a paper out of the UCLA research laboratories found that titanium dioxide damages cells and the genetic level.

Artificial colors are another issue. Many studies have shown that artificial colors contribute to, or exacerbate the symptoms of autism, ADHD, and other behavioral disorders. The artificial colorings are usually found as either “lakes” or “dyes” the difference is that the lakes are the fat soluble forms of coloring and the dyes are those used for water soluble applications. Fat soluble toxins are more damaging than water soluble toxins, because they detoxify from our bodies differently and likely will be present for longer in our tissues that water soluble. If you have to chose between a product containing “lakes” and another containing “dyes,” I’d recommend the dyes. But there are many natural ingredients that can be used for color, including caramel, beet juice, and beta carotene, so in truth there is no need for any artificial dyes or colorings in our supplements.

Magnesium Stearate: is an excipient that is often added to supplements for a few reasons. First it provides bulking so that it can fill out a supplement to a larger size if that is something that makes taking the supplement more convenient. Second it is added to help lubricate the machines. As the tablets or powder moves through the processing and manufacture machinery it is likely to cause binding, slowing, or may stick to the machines. Magnesium stearate is a fatty acid (stearic acid) bound to magnesium and as a result it’s presence in supplements results in less physical friction in processing. In and of itself it is already present in our diet. However its presence does decrease the speed at which supplements break down, and if it is used in excess in supplements then it can decrease our absorption of the ingredients. My recommendation would be to consider it a necessary evil in some brands, and to not necessarily exclude a product by virtue of seeing magnesium stearate on the ingredients, but rather to look for where it appears on the ingredients. It should be a minor player. In unethical and poor quality manufacturing it may make up 50% or more of the weight of the product. It should appear near the end of the additional or inactive ingredients list. Here's some more information on this.

Allergens: are often present in supplements. Due to the relative freedom that supplement companies enjoy, the presence of things like corn, soy, and wheat may not be clearly stated on products containing them. If you have an issue with any of these, or other items I would recommend that you seek products that clearly state they do not contain these ingredients. You can also call the company and have them send you confirmation that these ingredients are safely absent (in writing or email), not just verbal confirmation. Some things to look for include:

Zein: a corn derived protein coating.

Gluten: even if it doesn’t say on the ingredients assume it’s there, unless it states that it is free of it.

Maltodextrin: a corn derived starch

Whey, Casein, and Lactose: dairy derived ingredients

Soy Lecithin: soy lecithin is typically extracted from soybean oil, rather than from the bean itself and is rarely allergenic, however it still can be in people who are especially sensitive. 

Dosage and Use

Supplements and herbs are capable of interacting with medications and their use should ideally be evaluated by an herbalist, naturopath or your acupuncturist. If you are on any of the following medications you are especially at risk for interactions. 

Serotonin modifying medications such as Zoloft, Prozac, Celexa, Lexapro, etc.

Highy protein bound drugs: Warfarin, Phenytoin, Carbamazepine, Valproic Acid, Valium.

Digoxin

Some supplements, such as PGX and Huang Lian Su may be used specifically to decrease absorption, and will interact with your absorption of many medications. Magnesium can interfere considerably with the amount of thyroid medication absorbed. There are a number of contraindicated herbal combinations in traditional chinese medicine because the actions cancel one another out. Such combinations include seaweed and licorice and ginseng and radish. This is another reason that it is best to consult with a trained herbalist or naturopath when selecting supplements. 

In general it is best to avoid supplements with long lists of ingredients. In that case there is often too little of each ingredient to have a significant benefit for your condition. If you have any adverse effects, you won’t know which ingredient you need to eliminate. 

If a little bit of a supplement is good, more is not necessarily better. There is often an ideal therapeutic dose, below which you won’t get results and above which you either won’t get results, or you’ll get adverse reactions. Vitamin C is a good example of this. Above a certain dosage the Vitamin C is no longer absorbed and will result in diarrhea instead. Another concern is that when you take in a supplement your body requires particular metabolic pathways in order to convert that supplement to a usable form for you, or as it works in your body you need to metabolize the byproducts of it’s actions. Above a certain dosage your body can’t keep up with the byproducts. Toxins buildup and instead of helping you, your supplement is slowly poisoning you. Stick to your dosage recommendations. 

Make sure you supplements have been independently analyzed by a third party. Any supplement company worth spending your money on will have their products independently analyzed by a third party. Because the FDA doesn’t do this, many companies realized the need to prove to their customers that their brands actually contain what they say they do. In order to do that they pay another company to come in and do quality analysis on their supplements. They ensure purity, potency, shelf stability, the lack of any contaminants, and the proper dissolubility of the products. Usually this will appear on the supplement. There are a few logos you can look for on your products to ensure that they are independently analyzed: 

USP stands for United States Pharmacopeia. It is a non-profit group that analyzes products and those that pass are able carry their logo on the product:

There are quite a few other companies as well, and just because a product you are looking at doesn’t carry the USP logo doesn’t mean it isn’t quality assured. You often need to call the company and request a copy of their certificate for the product you are getting. 

Maximize your benefit:

Water soluble vitamins get cleared out of the body faster, to maintain idea levels these need to be dosed multiple times per day. Examples include Vitamin C, B vitamins, and Choline.

Fat soluble supplements should bring more caution when it comes to pollutants and contaminants. Make sure that these especially are coming from reputable sources. Examples include: fish oil, flaxseed, CoQ10, Vitamin D, A, E, and K.

Minerals such as magnesium, iron, calcium and zinc are best absorbed with a small amount of an acidic material such as orange or tomato juice (this is especially true in the elderly who often have insufficient stomach acid production).

Phytates are naturally occurring molecules that plants use to store phosphorus. When these are consumed they bind to minerals in our diets, especially iron and zinc, but also magnesium and calcium and pull them out of solution (chelate) so that we cannot absorb them. Beans, tofu, grains, and nuts are some the largest sources of phytates in our diets. Taking mineral supplements with meals containing these molecules will significantly decrease the absorption of these minerals. (Also remember that a lot of grains and flours are enriched with these types of minerals, however they do us little practical good nutritionally because we can’t absorb them bound to phytates.)

Synthetic vs Natural: Vitamins are complex molecules and as such they possess the quality of "chirality". This means that they can exist in two mirror images configurations. When you look into the mirror you see yourself not identical to how people see you, but reversed, the same is true of chiral molecules. They can exist in what’s called a D or an L configuration. Identifying which is which involves shining light through a tube of the molecule and seeing which way it rotates the light. (I know, pretty far out huh?). When these molecules are being used by our bodies they are being plugged into enzymes and receptors. That means it matters which configuration they are in. In order to visualize this think about your two hands. They are chiral, in that they are mirror images of one another, that cannot be superimposed on one another. They look identical otherwise, but when you go to shake someone’s hand, if you have your right hand full and you go to shake their hand with your left hand, it doesn’t really match up and you have an awkward handshake, the right hands, or left hands however fit together nicely. Such is the case with the enzymes and receptors in your body. They are used to seeing molecules come in with a particular configuration, all of life has pretty much agreed that all amino acids are used in their L configuration and all sugars are used in their D configuration. When biological process create these molecules they are in their correct orientation. When the ingredients in your supplement come from natural sources they work well with the body. When they are synthesized in a laboratory they are made in equal parts D and L (in fact a good way to spot a synthetic supplement is to look at the ingredients and look for ingredients preceded by DL, such as DL alpha tocopherol). The part we can’t use needs to be excreted from the body, requiring biological energy that could be better used on making sure you are healthy and thriving. 

Here’s your take away: make sure your supplements are:

-All independently quality assured.

-Sourced from natural means rather than synthetic.

-Not interacting with your medications.

-Not chalk full of additives, binders, flavorings, and colorings.

-Taken in a way to maximize the benefits and minimize the harms.

My list of recommended supplements. Unless you are totally dialed in when it comes to diet, I think these are things you should be on to maintain optimal health. These are links to these supplements available from manufactures I trust and use for my own patients.

-Magnesium
Pure Encapsulations Magnesium - Citrate - 180 capsules
-Cod Liver Oil

Green Pastures - Blue Ice Fermented COD Liver Oil, Unflavored, 120 capsules
-Probiotics

Jarrow Formulas Jarro-dophilus EPS, 120 Capsules
-Vitamin D3

Metagenics, D3 5000, 120 Softgels

Thanks for reading!

Nutrition Seminar

Okay everybody. Let’s talk nutrition. 

It’s a bit scary though, this subject is rife with conflict. It is crazy. I would much rather bring up abortion or evolution with a random stranger at the grocery store than dare talk about the garbage in their shopping carts. I suppose that’s mainly because the views that I hold aren’t exactly the status quo yet. But they are gaining ground out there and people are definitely coming around. 

So what do I think is healthy nutrition? Not so fast. First, lets look a little closer at the conventional wisdom out there. 

What do we know about nutrition? What’s healthy to eat and what’s not healthy? Well those are huge questions. Questions that drive entire industries, including but not limited to food companies. The agriculture industry, the pharmaceutical industry and plenty of other folks out there are interested in what we eat and are watching carefully the changing whims of the people so they can be ready to make a profit. Well, we better make sure all the things we’ve heard are correct. 

Let’s start by looking at some common nutrition wisdom and analyzing it carefully. I’m gonna start big. Go big or go home right? Well, I am home, but I’ll go big anyway. We’re going to start by looking at what may be the single biggest nutrition myth perpetuated today:

Saturated fat causes heart attacks and obesity. Fat makes you fat, and clogs your arteries. That’s actually pretty straight forward thinking. It seems like common sense. Fat on your plate jiggles, fat on your body jiggles, there you go. Artherosclerotic plaques in your arteries look like grease, piece of cake...literally.

Fat is one of three macronutrient classes. Macronutrients make up the fuel sources for our bodies. The different macronutrient types are: fat, protein, and carbohydrates. The idea that the health woes of our society are all the result of a single macronutrient class is an attractive idea. First, it provides a simple understanding of a complex subject. It’s tempting to over simplify and over generalize. Our brains seek to find order within complex systems, and as a result we come to incorrect conclusions. If history is any guide the only truly safe bet we can make about any of the conclusions science has reached is that it’s more complicated than we think. We would love to think that fat is the problem and if we can find a way to eat zero fat, we’d experience zero heart attacks.

Well, unfortunately it’s a little more complicated than that. This is the starting point that got Ancel Keys looking at fat intake as the cause of heart disease way back in the 1940s. He was so convinced that this was the case that he made it his single minded purpose to show that this was true. He collected data on fat intake and graphed it against the number of heart disease related deaths in various countries and his graph indeed did demonstrate a correlation between the intake of fat and the number of deaths from heart disease. This is a result we call a “correlation.” It shows that one variable correlates with another variable. It is important to point out that “correlation is not causation.” Which is a common issue among people on both sides of any nutrition argument. Anytime we look at data on nutrition we typically are looking at epidemiological data. That is we look at populations of people, measure two variables present and try to see if they seem related. To understand why this is an imperfect approach lets look at a few other correlations. 

Here’s Ancel Keys’ original graph showing the relationship between saturated fat and heart related deaths:

Just to demonstrate how sometimes a correlation may not represent a causation, here’s another graph, based on the most recent data on heart related deaths:

In my graph I looked at the current number of heart related deaths per country graphed against the number of mcdonalds in that country. You can see clearly that as the number of McDondald’s restaurants increases the number of deaths from heart attacks decrease. All we need to do is build more McDonald’s and we’ll see our rates of heart attacks drop to zero. Case in point: Correlation does not equal causation. 

Is it that the presence of McDonald’s represents an indicator of a separate variable that wasn’t measured. Perhaps the more affluent countries have more disposable income and have attracted more McDonalds restaurants? They also, because of their increased wealth, have better access to medical services and better emergency care of heart attacks, which results in fewer deaths in those populations. The relationship we see in these correlation studies might not be due to the variable they measured but due to a second variable reflected in the first. Because we are looking at heart attack deaths and not the total number of heart attacks, those countries with better medical care available would have a misleadingly lower number than comparable populations with better medical care. Hence the dangers of relying on epidemiological, or observational data when assessing health factors. 

Another way to look at this is to see if there are cultures out there that eat a diet high in fat and remain relatively disease free. Well, as you probably guessed, there are such cultures. The first two that come to mind are the Maasai tribe from Tanzania and the Inuit from the icy north. Both eat a large amount of their calories, more than 60%, from fat. Yet both cultures have low rates of heart disease and chronic disease, and general outstanding health that basically make the rest of us slobs look like Gary Busey. It is important to note that these cultures are also eating traditional ethnic foods, prepared in traditional ways, entirely devoid of processed and refined ingredients and additives.

So maybe fat isn’t the evil death monger we have been led to believe it is. So then the real culprit must be the carbohydrates, right? Well, next we look to the Kitavans, a tribe in the pacific islands that, despite their very high carbohydrate intake, continue to demonstrate less heart disease rates, and better markers of cardiovascular health than ours in the western, more affluent cultures. The Kitavans get roughly 65% of their calories from carbohydrates. The sources include yams, potatoes, fruit, honey, taro and cassava. They also consume pork and fish, but not nearly as much protein as many other cultures with higher rates of heart attacks and strokes. 

So if it isn’t the fat, and it isn’t the carbohydrates, then maybe it’s the protein. Turns out there isn’t a culture that I know of that represents an excessive consumption of protein. Mainly because protein is not separated from fat and carbohydrates in most natural food items. But we do have data looking at relative protein intake and rate of heart attack deaths between countries. Germany eats about 20% less protein than Portugal does, yet has roughly twice the rate of heart attack deaths. If you look carefully at the total protein intake between countries and compare that to the rates of heart attack related deaths there isn’t a correlation.

The conclusion we can draw from this information is that there is no case for condemning any one macronutrient category. A better understanding would be that diet and health are linked through complex relationships that include as many variables as there exist in our diet choices, and every decision we make in terms of our diet has ramifications of varying degree in our health. It’s a little less satisfying, but hey, welcome to health and nutrition. Any system that's been around millions and millions and millions of years (like our metabolisms, digestive systems, and enzyme processes) will have worked in some complicated machinery that responds to pretty subtle gradations in our environments. 

I don't want to suggest that macronutrients don't matter. Once we get a patient pretty dialed in on their nutrient intake and make sure they are actually eating real food at most meals, we turn back to macronutrients. A higher carb intake can enhance thyroid signaling, decrease cortisol levels, and help with weight gain, while a higher fat and protein diet can support weight loss. We might change the macronutrients eaten at different meals to maximize the metabolic process and help maintain energy levels through the day. Neither do I suggest that the Inuit could pack up their harpoons and sleds and ship off to stay with the Kitavans and not have a hard time on a drastically different macronutrient intake. In other words macronutrients are more of an individual question for you and not a smoking gun for the population at large. 

The next part in our seminar was where I shut the heck up about the macronutrients and finally got to some information that people might be able to actually use. We got talking about vitamins, minerals and micronutrients instead. In other words the rest of what's in our food that supports our life, besides just the macronutrients: fat, protein, and carbohydrate.

Vitamins were originally "discovered" in 1912. They were difficult to identify at first so they were named with just letters (C, A, E etc.) Until we were able to identify the actual chemical structure of each (Ascorbic acid, Carotene, and Tocopherol, respectively). Vitamins are "essential" for us meaning that our bodies don't make them sufficiently to support our functions. Minerals are also essential.

A lot of us say, "I get all my vitamins and minerals cause I take a vitamin." Unfortunately there are a lot of reasons why this approach is insufficient. It's much better to get your vitamins from food if you can. In order to illustrate this concept we talked about a few examples at the class. The first was folic acid (typically found in vitamins and "enriched" food) vs Folate (the natural form found in food from natural sources.) Folic acid and folate are not active in our bodies until they are converted to tetrahydrofolate. In the case of Folate this happens as it crosses the intestinal mucosa. In the case of folic acid from a vitamin, folic acid is absorbed, goes to the liver and is converted there by an enzyme called dihydrofolate reductase. In the meantime all this unconverted folic acid is swimming around in your body contributing to big C. Yep cancer. Increased rates of colon cancer correlate with increased intake of folic acid. That is until these people switch to folate and the cancer rates return to normal. The issue is this: Folic Acid is not found in natural food sources. Our bodies didn't get exposed to it till 1945 when they synthesized this in a laboratory. The dihydrofolate reductase enzyme has other things to stay busy with rather than fixing our vitamins so they don't kill us. The good news? Some vitamins made by companies with integrity do put folate rather than folic acid in their pills even though it's more expensive. We'll cover this issue a bit more in the upcoming class on choosing effective supplements. 

Another example of this issue we covered is Vitamin E. Looking at populations who consumed more vitamin E and also had lower rates of prostate cancer, researchers came to the reasonable conclusion that perhaps supplementing vitamin E would protect men against prostate cancer. They set out to study this by setting up a 12 year study. Instead of seeing the cancer rates decrease, they needed to stop their study early because it became obvious that the treatment group was developing more cases of prostate cancer than the control group. The problem with this study is that the type of Vitamin E used was the typical synthetic form found in most supplements (which is typically extracted from petroleum material). Vitamin E is the molecule Tocopherol. There are multiple forms of this molecule and the different forms are denoted with different greek letter prefixes. Alpha tocopherol is the type most commonly used in vitamins and in supplements. The type most prevalent in our diet is gamma tocopherol. Most alternative practitioners use mixed tocopherols, or vitamin E supplements high in gamma tocopherol when treating patients. Again the food source of this vitamin seems to prevent Prostate cancer, while the synthetic form seems to result in increased prostate cancer. 

So bottom line? Much better to get your vitamins and minerals from your food rather than from a multivitamin or a handfull of pills. There are of course exceptions where the food sources may be inadequate for specific people, that what our next seminar will cover. 

How do you ensure that the food that you are eating is higher in nutrients? Well you get real food coming from real sources. The one thing that was the same between the cultures we looked at was that they were eating a traditional diet, entirely devoid of processed and refined foods and ingredients. The food they were eating was high in nutrients. It was coming from natural and wild sources, or it was cultivated using traditional ethnic techniques rather than conventional industrial approaches. Their food was coming from an ecosystem. The food item they harvested was a link in a complex chain.  It supported and received support from a rich web of other organisms. This all results in more nutrients in the food they were eating. These nutrient include vitamins, minerals, phytonutrients, and even living organisms like bacteria. 

It isn't possible for us to get all of our foods from a natural environment. We've got jobs and families, and don't really have the time to be traipsing around picking mushrooms and hunting game. What we can do is choose to buy our foods from those farmers and ranchers that maintain a more natural environment for the food they're growing. Here's a diagram I found that illustrates this concept:

Notice that every waste product from one area in the farm sustains another area in the farm. The waste from the corn harvest is composted back into the soil, the manure from the livestock goes to supplying the nutrients for the growth of the grass and vegetables, the scraps could go to the chickens. In this case there is also an aquaculture, where a fish pond helps to recycle nutrients into food and support the rest of the farm. This is closer to a natural ecosystem, with each step relying on other steps adjacent. This ends up increasing the nutrients in the food obtained from this system because the nutrients are maintained in the system, recycled from step to step. The same magnesium, zinc, copper, and boron are incorporating in one organism then another, then another, and the food in turn obtained from this type of farming provides more of these same nutrients. In conventional farming practices the fertilizer is not recycled material from the farm, but industrial fertilizers that provide Nitrogen, Phosphorus, and Potassium, but not much else. (Think macronutrients for plants without any additional vitamins or minerals). As a result the plants pull the vitamins and minerals they need out of the soil to grow. The vitamins and minerals get shipped off in the crop yield and as a result the soil gets quickly depleted of these minerals and vitamins, meaning the crops get depleted of these vitamins and minerals. We end up getting the same looking vegetables, but with radically different nutritional benefits. Here's an illustration of how the above flow chart would look for more of an industrial, or Big Agriculture operation:

As you can see the trace minerals are depleted from the operation, The population eating this frankenfood ends up, to quote Maoshing Ni and Cathy McNease "overfed, but undernourished." Meaning, although they are getting more calories than they need, they aren't getting sufficient nutrition.

So the moral to this story is look for food grown in a traditional style ecosystem. Unfortunately, buying organic isn't necessarily enough. I know of amazing farmers that put out unbelievably nutritious food, but aren't considered "organic" (Polyface Farm comes to mind). As well as organic operations that operate much like the flow chart above, depleting their soil and bringing in organic, but no less stripped industrial style fertilizers. I get my eggs from a local farm, Abundantly Green. The chickens dig through the compost and are pastured, meaning they forage in the fields for bugs. The chicken's highly nitrogenous waste fertilizes the grass that in turn feeds the cows, and so on. That is a natural style ecosystem. Understanding that about their farm is more important to me than knowing if they are organic or not (which they happen to be). The eggs I get from their farm are rich, with amazingly bright colored yolks that turn my omeletes an incredible bright orange. The organic eggs I get from the store on the other hand, have pale, flat yolks, bland flavor and fragile shells. The difference is that the chickens at Abundantly Green live a life and eat a diet more in line with their evolution and result in better quality eggs. My recommendation would be t go find a local farm and get to know them. If the people that provide your food won't let you walk through their operation, that's a bad sign. See the chickens, ask questions, feel the grass. Get to know your food from its source, and health benefits will be dramatic.

Next we covered some super foods that I think everybody should make bigger parts of their diets. Some specific foods that I would recommend are:

Greens:
Kale, chard, collards, mustard greens, beet greens, etc. These are highly nutritious additions to a diet. They are high in Magnesium, iron, calcium, vitamin K, and fiber. Magnesium is deficient in the majority of the american population and deserves some serious attention. In addition the brassica family (kale, chard, brussel sprouts, broccoli, cauliflower, etc) has actions that speed up both phase I and phase II conjugation in the liver. This results in faster detoxification of environmental toxins, more tight regulation of hormone levels, and decreased long term oxidative damage from toxin build up. (read slower aging). The fact that they provide a good source of vitamin K is important as well. Vitamin K is involved in the clotting cascade as well as being a key factor in the proper utilization fo calcium. In the absence of sufficient Vitamin K and Vitamin D calcium can lay down in the arterial walls leading to increases arthersclerosis and cardiovascular risk.

Pastured Foods:
This refers to allowing animals that in nature would forage for their own food to follow their natural inclinations and eat their natural diet. Think cows out grazing in the grass, their natural food, being outdoors with space to move and eating their natural diet. The alternative is feedlot operations where the cows are kept in small enclosures without any growing grass anywhere nearby. The only topography provided comes from the piling up mounds of their manure. The food is trucked in and poured into troughs, and by the way comes from food sources that cows have never eaten in the history of the cow (such as corn, chicken parts, and ground bones.) Pastured food is more expensive but is well worth the price. Grass fed is another term that usually can be used interchangeably. Pastured is not the same as organic; pastured animals may or may not be organic, but are likely much better for you than animals raised in a feedlot setting under organic conditions. You can get pastured beef, chickens, eggs, milk, cheese, butter, and pork.

Raw Dairy:
Milk is not a terrible food. Even though dairy is a relatively recent introduction into our historical diet, genetic studies into different populations have established that some ethnicities are well adapted to consume dairy without any adverse effects. This is a personal question. If you have decided that you work well with dairy, and that your ethnic background makes you well suited to consume dairy (those from the northern european regions tend to have the highest incidence of persisting lactase production after infancy, and are best suited to continue consuming dairy into adulthood.) It is best to consume raw dairy. This preserves some important nutrients, by avoiding the pasteurization process. There was a landmark study called the "Gabriella study" which found that consuming raw dairy greatly decreased the incidence of asthma in youth. Part of the reason that raw dairy maintains healthy immune regulation is that it provides active probiotic cultures in the form of mainly Lactobacillus strains. It also provides a richer source of various vitamins and nutrients than does pasteurized milk. In fact raw, whole fat milk contains every known fat soluble vitamin. Check out the farm supplying your milk and make sure that you trust them and they take the process seriously.

Local Foods:
Eating local means choosing foods that have been grown in the local soil, shipped a minimum distance and in turn tend to be eaten soon after harvesting. This maintains the maximum nutrients in the food you choose. If you are eating foods that have been grown in Chile, shipped to florida, trucked across the country, kept on a palate in the refrigerated warehouse of a grocery store supplier for a few days and finally put on the shelf, you are missing out on significant nutrition. These fruits were picked before ripening, meaning that all the vitamins haven't had a chance to form. The fruits and vegetables have lost considerable amounts of vitamins through the shipping process. The fruits and vegetables have been bred to last on the shelf, often at the cost of nutrition and flavor. Also, when you eat local you are supporting the local economy, providing jobs for your kids, and for the neighbors kids, putting more money into the local government coffers and supporting the people you see at the bank and at the local chamber of commerce. It's a great thing to do for your health, your friends and the community.

Seasonal Foods:
There is a concept in Chinese Medicine, that each food represents a particular energetic state. Any biological system is also in an energetic state. By choosing the right foods at the right times you can bring any imbalances in your system back into balance. The foods that are available at different times of year, tend to align very well with the energetic landscapes we have in our bodies at any given time. Take for instance the fruits and vegetables of the summer: bright fruits, juicy, sweet. These are all of a cooling energetic nature. When the weather is warm this aligns well with your internal environment. When the weather cools off the fruits aren't growing anymore and we see more gourds, squash, and tubers coming out. These foods are heartier and align better with the cooling months of fall. In winter we traditionally eat more stews and stocks, broths, and meats. Just by eating the foods that are available and fresh at a given time of year you end up automatically staying in balance with the seasons and giving yur body just the type of foods it needs at that time of year.

Healthy Fats:
Fat has been chased enough by the lynch mob. Fats are not unhealthy foods. The source of fats you choose can make them either good for you or bad for you. The important thing is where they come from. Some healthy sources are: coconut oil-contains lauric acid a natural anti-inflammatory, consists of mainly medium chain triglycerdes, which absorb quickly and actually contribute to weight loss. Fish Oil-balances omega 3 and omega 6 ratios to decrease inflammation, lower cholesterol, improves cardiovascular health. Pastured fats-butter, grass fed beef, and pastured pork.

Proline and Glycine rich broths:
Proline and glycine are two amino acids responsible for the formation of collagen formation. These amino acids are also involved in the formation of the intestinal membrane. They are typically deficient in our diets as we don't consume a large amount of the types of tissues that are rich in these amino acids (cartilage, connective tissue, and epithelial tissues). In order to remedy this a great step you can take is making a glycine and proline rich broth from the large joint bones of cow and pigs. It's easy to throw a few in a crock pot and cook it slowly over several days. The benefits on your health after a few weeks of consumption will be obvious, including healthier skin, decreased joint pain, better digestion, improved mood (often), and healthier hair.

Bacterial Support:

Our food supply is overly hygienic. Pasteurized milk, antibiotics in our meat and dairy, and processed food all lead to a less robust bacterial presence in our colons. Our colony of bacteria (termed our microbiota) constitutes a lotal of over 10 times more cells than we have human cells in our bodies. It contributes immune regulation, assistance in breaking down and digesting different food items, as well as absorption of minerals and vitamins. In short, it's important. 

Ideal foods: Jerusalem artichokes, onions, garlic, green bananas, cultured foods (sauerkraut, kimchee).

The big picture here is summed up by a short phrase: "eat close to the ground".

The common trend here is the more steps your food takes before getting onto your plate the worse for you. As a result we have food-like substances that our grandmothers would never recognize as food. Processing, storage, transport, manufacturing, or unnatural cultivation methods all represent food that is further from the ground when you eat it, and typically less nutritious. Minimize steps between harvest and plate in order to reap maximum benefit from your food. 

Thanks for everyone who made it to our class. If you had questions that didn't get answered feel free to add those to the comment section below.